[ANSWERED 2023] In this Assignment you will analyze recent presidential healthcare agendas. You also will prepare a fact sheet to communicate the importance of a healthcare issue and the impact on this issue of recent or proposed policy
In this Assignment you will analyze recent presidential healthcare agendas. You also It may seem to you that healthcare has been a national topic of debate among political leaders for as long as you can remember. Healthcare has been a policy item and a topic of debate not only in recent times but as far back as the administration of the second U.S. president, John Adams. In 1798, Adams signed legislation requiring that 20 cents per month of a sailor’s paycheck be set aside for covering their medical bills. This represented the first major piece of U.S. healthcare legislation, and the topic of healthcare has been woven into presidential agendas and political debate ever since. As a healthcare professional, you may be called upon to provide expertise, guidance and/or opinions on healthcare matters as they are debated for inclusion into new policy. You may also be involved in planning new organizational policy and responses to changes in legislation. For all of these reasons you should be prepared to speak to national healthcare issues making the news. In this Assignment you will analyze recent presidential healthcare agendas. You also will prepare a fact sheet to communicate the importance of a healthcare issue and the impact on this issue of recent or proposed policy. To Prepare: Review the agenda priorities of the current/sitting U.S. president and the two previous presidential administrations. Select an issue related to healthcare that was addressed by each of the last three U.S. presidential administrations. Reflect on the focus of their respective agendas, including the allocation of financial resources for addressing the healthcare issue you selected. Consider how you would communicate the importance of a healthcare issue to a legislator/policymaker or a member of their staff for inclusion on an agenda. The Assignment: (1- to 2-page Comparison Grid, 1-Page Analysis, and 1-page Fact Sheet) Part 1: Agenda Comparison Grid Use the Agenda Comparison Grid Template found in the Learning Resources and complete the Part 1: Agenda Comparison Grid based on the current/sitting U.S. president and the two previous presidential administrations and their agendas related to the public health concern you selected. Be sure to address the following: Identify and provide a brief description of the population health concern you selected and the factors that contribute to it. Describe the administrative agenda focus related to the issue you selected. Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue. Explain how each of the presidential administrations approached the issue. Part 2: Agenda Comparison Grid Analysis Using the information you recorded in Part 1: Agenda Comparison Grid on the template, complete the Part 2: Agenda Comparison Grid Analysis portion of the template, by addressing the following: Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected? How do you think your selected healthcare issue might get on the agenda for the current and two previous presidents? How does it stay there? Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected for the current and two previous presidents? Part 3: Fact Sheet or Talking Points Brief Using the information recorded on the template in Parts 1 and 2, develop a 1-page narrative that you could use to communicate with a policymaker/legislator or a member of their staff for this healthcare issue. Be sure to address the following: Summarize why this healthcare issue is important and should be included in the agenda for legislation. Justify the role of the nurse in agenda setting for healthcare issues. Expert Answer and Explanation Agenda Comparison Grid Assignment Part 1: Agenda Comparison Grid Identify the Population Health concern you selected. Opioid Crisis The Population Health concern. According to statistics by the National Institute of Drug Abuse, over 50,000 people died from opioid overdose in 2019. Similarly, the same statistics indicate that close to $80 billion is spent on dealing with issues associated with opioid addiction including, loss of productivity, rehabilitation, involvement with the criminal activities to list a few. Over the years, different presidents established different approaches to tackle opioid issue, with each approach eliciting different reactions. This paper will compare former President Obama and President Trump’s policy stand on the opioid crisis. Administration (President Name) President Barrack Obama President Donald Trump How each of the two presidential administrations approached the issue. During President Obama’s tenure as president, he raised the level of sensitization on how serious the opioid crisis is and the impact on the American community. He made all stakeholders, especially the legislative wing of the government to start recognizing the intensity of the problem. However, it was until the final days of his term that the Congress passed the 21st Century Cures Act, which among other things increased the state funding channeled towards response against the opioid crisis (Barlas, 2017). During President Trump’s tenure, he established opioid crisis as both a security and a health issue. He was quite vocal on recognizing the fact that opioid crisis is a matter of national concern joining gun violence as part of the leading causes death in the US. To help curb the issue, president trump passed into law the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act, also known as the SUPPORT for Patients and Communities Act, which among other things helped to increase the federal funding on evidence-based treatment for opioid use disorder. President Trump also declared the opioid crisis as a national crisis in 2018, making him the first president to do so (The White House, n.d.). Allocations of resources After the implementation of the 21st Century Cures Act, over one billion dollars was allocated by the federal government towards collaborative efforts with states and other agencies in dealing with the opioid crisis (Office of the Press Secretary, 2016). President Trump’s administration in 2018 through congress, passed a budget of $13 billion to be spread across two financial periods. This allocation was meant to
[ANSWERED 2023] Assignment Assessing and Diagnosing Patients With Substance-Related and Addictive Disorders
Assignment Assessing and Diagnosing Patients With Substance–Related and Addictive Disorders An important consideration when working with patients is their cultural background. Understanding an individual’s culture and personal experiences provides insight into who the person is and where he or she may progress in the future. Culture helps to establish a sense of identity, as well as to set values, behaviors, and purpose for individuals within a society. Culture may also contribute to a divide between specific interpretations of cultural behavior and societal norms. What one culture may deem as appropriate another culture may find inappropriate. As a result, it is important for advanced practice nurses to remain aware of cultural considerations and interpretations of behavior for diagnosis, especially with reference to substance-related disorders. At the same time, PMHNPs must balance their professional and legal responsibilities for assessment and diagnosis with such cultural considerations and interpretations. For this Assignment you will practice assessing and diagnosing a patient in a case study who is experiencing a substance-related or addictive disorder. With this and all cases, remember to consider the patient’s cultural background. To Prepare: Review this week’s Learning Resources and consider the insights they provide. Review the Comprehensive Psychiatric Evaluation template, which you will use to complete this Assignment. By Day 1 of this week select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the evaluation template in mind. Consider what history would be necessary to collect from this patient. Consider what interview questions you would need to ask this patient. Identify at least three possible differential diagnoses for the patient. By Day 7 of Week 8 Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate primary diagnosis. Incorporate the following into your responses in the template: Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life? Objective: What observations did you make during the psychiatric assessment? Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what DSM-5-TR criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case. Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.). RUBRIC Create documentation in the Comprehensive Psychiatric Evaluation Template about the patient you selected. In the Subjective section, provide: Chief complaint History of present illness (HPI) Past psychiatric history Medication trials and current medications Psychotherapy or previous psychiatric diagnosis Pertinent substance use, family psychiatric/substance use, social, and medical history Allergies ROS In the Objective section, provide: Physical exam documentation of systems pertinent to the chief complaint, HPI, and history Diagnostic results, including any labs, imaging, or other assessments needed to develop the differential diagnoses. In the Assessment section, provide: Results of the mental status examination, presented in paragraph form. At least three differentials with supporting evidence. List them from top priority to least priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case. Reflect on this case. Discuss what you learned and what you might do differently. Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.). Provide at least three evidence-based, peer-reviewed journal articles or evidenced-based guidelines that relate to this case to support your diagnostics and differential diagnoses. Be sure they are current (no more than 5 years old). Written Expression and Formatting—Paragraph development and organization:Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria. Written Expression and Formatting—English writing standards:Correct grammar, mechanics, and punctuation TRANSCRIPT OF VIDEO FILE: 00:00:00______________________________________________________________________________ 00:00:00 BEGIN TRANSCRIPT: 00:00:00 [sil.] 00:00:20 LISA Well I had to be here in this hospital if that answers your question. 00:00:25 OFF CAMERA Yes, thank you. Can I get you a drink of water or something else to drink? Anything? 00:00:35 LISA A drink isn’t going to convince me, right? You’re going to have to convince me. 00:00:40 OFF CAMERA What is you want me to persuade you to do? 00:00:45 LISA Going to rehab. 00:00:50 OFF CAMERA What worries you about going to rehab? 00:00:55 [sil.] 00:01:00 LISA Everything. 00:01:00 OFF CAMERA Okay. I tell you what let’s go back a little bit and tell me about how you’re feeling today. 00:01:10 LISA Scared. 00:01:15 OFF CAMERA Can you tell me more about that feeling of being scared? 00:01:20 LISA Well, I don’t want to be. I don’t want to be what people say I am because if I say it and I’m not going to say it because I ain’t going to change. I can’t. 00:01:35 OFF CAMERA What do people say you are? 00:01:40 LISA And I’m not.
[ANSWERED 2023] Use the Agenda Comparison Grid Template found in the Learning Resources and complete the Part 1: Agenda Comparison Grid based on the current/sitting U.S.
Use the Agenda Comparison Grid Template found in the Learning Resources and It may seem to you that healthcare has been a national topic of debate among political leaders for as long as you can remember. Healthcare has been a policy item and a topic of debate not only in recent times but as far back as the administration of the second U.S. president, John Adams. In 1798, Adams signed legislation requiring that 20 cents per month of a sailor’s paycheck be set aside for covering their medical bills. This represented the first major piece of U.S. healthcare legislation, and the topic of healthcare has been woven into presidential agendas and political debate ever since. As a healthcare professional, you may be called upon to provide expertise, guidance and/or opinions on healthcare matters as they are debated for inclusion into new policy. You may also be involved in planning new organizational policy and responses to changes in legislation. For all of these reasons you should be prepared to speak to national healthcare issues making the news. In this Assignment, you will analyze recent presidential healthcare agendas. You also will prepare a fact sheet to communicate the importance of a healthcare issue and the impact on this issue of recent or proposed policy. To Prepare: Review the agenda priorities of the current/sitting U.S. president and at least one previous presidential administration. Select an issue related to healthcare that was addressed by two U.S. presidential administrations (current and previous). Consider how you would communicate the importance of a healthcare issue to a legislator/policymaker or a member of their staff for inclusion on an agenda. Use your Week 1 Discussion post to help with this assignment. The Assignment: (1- to 2-page Comparison Grid, 1-Page Analysis, and 1-page narrative) with a title page. This is an APA paper. Use 2-3 course resources and at least 2 outside resources. Part 1: Agenda Comparison Grid Use the Agenda Comparison Grid Template found in the Learning Resources and complete the Part 1: Agenda Comparison Grid based on the current/sitting U.S. president and the previous president, and their agendas related to the population health concern you selected. Be sure to address the following: Identify and provide a brief description of the population health concern you selected. Explain how each of the presidential administrations approached the issue. Identify the allocation of resources that the presidents dedicated to this issue. Part 2: Agenda Comparison Grid Analysis Using the information you recorded in Part 1: Agenda Comparison Grid on the template, complete the Part 2: Agenda Comparison Grid Analysis portion of the template, by addressing the following: Which administrative agency (like HHS, CDC, FDA, OHSA) would most likely be responsible for helping you address the healthcare issue you selected and why is this agency the most helpful for the issue? How do you think your selected healthcare issue might get on the presidential agenda? How does it stay there? An entrepreneur/champion/sponsor helps to move the issue forward. Who would you choose to be the entrepreneur/champion/sponsor (this can be a celebrity, a legislator, an agency director, or others) of the healthcare issue you selected and why would this person be a good entrepreneur/ champion/sponsor? An example is Michael J. Fox is champion for Parkinson’s disease. Part 3: Fact Sheet Using the information recorded on the template in Parts 1 and 2, develop a 1-page fact sheet that you could use to communicate with a policymaker/legislator or a member of their staff for this healthcare issue. Be sure to address the following: Summarize why this healthcare issue is important and should be included in the agenda for legislation. Justify the role of the nurse in agenda setting for healthcare issues. By Day 7 of Week 2 Submit your final version of Part 1: Agenda Comparison Grid, Part 2: Agenda Comparison Grid Analysis, and Part 3: Narrative. Submission and Grading Information To submit your completed Assignment for review and grading, do the following: Please save your Assignment using the naming convention “WK2Assgn+last name+first initial.(extension)” as the name. Click the Week 2 Assignment Rubric to review the Grading Criteria for the Assignment. Click the Week 2 Assignment link. You will also be able to “View Rubric” for grading criteria from this area. Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK2Assgn+last name+first initial.(extension)” and click Open. If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database. Click on the Submit button to complete your submission. Expert Answer and Explanation Agenda Comparison Grid and Fact Sheet or Talking Points Brief Assignment Template for Part 1 and Part 2 Part 1: Agenda Comparison Grid Use this Agenda Comparison Grid to document information about the population health/healthcare issue your selected and the presidential agendas. By completing this grid, you will develop a more in depth understanding of your selected issue and how you might position it politically based on the presidential agendas. You will use the information in the Part 1: Agenda Comparison Grid to complete the remaining Part 2 and Part 3 of your Assignment. Identify the Population Health concern you selected. Mental Health Describe the Population Health concern you selected and the factors that contribute to it. Mental health is an issue affecting most of the citizens in the country. In the contemporary society many people are thought to have mental illnesses. Statistics shows that many people are dealing with depression and this has led to increased suicides and drug use in the country. Through legal action some presidents have been able to address the issue, although it is clear that with the current strain of life brought up by the pandemic the increased cost of living there will be more people needing mental health attention. Administration (President Name) (President Joe Biden) (Bill Clinton) (Jimmy Carter) Describe the administrative agenda focus related to this issue for the current and two previous presidents. He is the current president and his administration has worked on ensuring that
[2023] A 6 year old female child that came to the clinic with accompanied by her mother complaining of cough since 8 weeks ago
A 6 year old female child that came to the clinic with accompanied by her mother Asthma case study instructions ( Essay) A 6 year old female child that came to the clinic with accompanied by her mother complaining of cough since 8 weeks ago. The cough is triggered when she laugh or cry. Her cough get worse when she is exposes to cold air, exercise, and at night. Patient past medical history of mild eczema and chronic nasal congestion. No shortness of breath, wheezing or fever reported. She is currently talking no medications. No known allergies reported. On her examination she is not in acute distress. Positive findings during examination: nasal turbinates little pale and edematous. During lungs auscultation she had end- expiratory wheezing, but no use of accessory muscle of respiration. The child was born in India moved to United Stated when she was 1 year old. Her family recently moved to a new area, since that, she is complaining of worsening nasal congestion. The house has some carpets on the floor. She also has a dog in her house. Patient has a history of mother and cousins diagnosed with asthma. The primary diagnosis is asthma based on her past history, clinical presentation and family history. Introduction Should be a paragraph that provides a brief overview of the case and main diagnosis: 1-Asthma Differential Diagnoses Provide EACH differential diagnosis with the rationale and supporting evidence with the REFERENCE for each one. Also explain why differentials Viral pneumonia and sinusitis) were not the main diagnosis. Asthma: Viral pneumonia: Sinusitis: Diagnostics Identify the lab, radiology, or other tests needed for Asthma with supporting evidence. Treatment Include the initial treatment plan for Asthma. It should include medication names, dosages, and frequencies Education Patient/family education in patient with asthma Follow-Up for athma Appropriate follow up plan. Please include when will patient follow up: 2 weeks, 1month, 3 months. What are some follow up labs or test. Referrals Why are they following up? What outcome do you wish to assess? References Requirement: APA format Intext citation References at least 4 high-level scholarly reference per post within the last 5 years in APA format. EACH differential diagnostic gets 1 reference Plagiarism free. Turnitin receipt. Place your order now for a similar assignment and get fast, cheap and best quality work written by our expert level assignment writers.Use Coupon Code: NEW30 to Get 30% OFF Your First Order How to Help a Child with Difficulty Breathing When a child experiences difficulty breathing, it can be a distressing situation for both the child and their caregivers. The ability to breathe freely is crucial for proper growth, development, and overall well-being. Understanding the importance of helping a child with difficulty breathing is essential to provide immediate assistance, seek appropriate medical attention, and establish long-term strategies for managing respiratory issues effectively. Identifying the Cause Recognizing the signs of difficulty breathing in children is the first step towards providing necessary aid. Symptoms such as rapid or shallow breathing, wheezing, coughing, bluish discoloration of the lips or face, and retractions (visible sinking of the skin between the ribs or at the base of the neck) indicate respiratory distress. Common causes of difficulty breathing in children include asthma, allergies, respiratory infections, foreign body aspiration, and chronic conditions like cystic fibrosis. Immediate Steps to Assist a Child with Difficulty Breathing In a situation where a child is struggling to breathe, it is crucial to remain calm and take immediate action. Ensuring the child’s safety by removing any potential hazards is paramount. If there is an airway obstruction, such as food or a small object, it should be cleared promptly and safely. In cases where the child is not breathing adequately, rescue breathing techniques, such as mouth-to-mouth resuscitation or chest compressions, may be necessary. Activating emergency medical services should be a priority when the child’s condition does not improve or if there is a severe respiratory emergency. Long-term Strategies to Support a Child with Respiratory Issues Seeking medical diagnosis and treatment is vital for managing chronic respiratory conditions. Consulting with a healthcare professional will help determine the underlying cause of the child’s difficulty breathing and develop an appropriate treatment plan. Creating a safe and clean environment by reducing exposure to allergens, dust, and pollutants can significantly improve the child’s respiratory health. Implementing healthy lifestyle habits, such as maintaining a balanced diet, regular exercise, and adequate hydration, also contribute to overall well-being. In some cases, respiratory devices or medications prescribed by a healthcare professional may be necessary to alleviate symptoms and support optimal lung function. Emotional Support for the Child and Family Caring for a child with difficulty breathing can be emotionally challenging for both the child and their family. Communicating with empathy and reassurance is essential to provide emotional support. Encouraging open dialogue and allowing the child to express their emotions freely helps them cope with their condition. Seeking support from healthcare professionals or joining support groups for families facing similar challenges can provide additional guidance, resources, and a sense of community. Preventive Measures to Reduce the Risk of Difficulty Breathing Preventing respiratory issues in children involves proactive measures. Maintaining a clean and allergen-free environment by regularly cleaning surfaces, using air purifiers, and minimizing exposure to smoke or strong odors can reduce respiratory triggers. Promoting healthy habits, such as proper hand hygiene and encouraging regular exercise, supports a strong immune system. Ensuring timely vaccination and immunization helps protect children from respiratory infections. Monitoring and managing any underlying health conditions, such as allergies or asthma, can also minimize the risk of difficulty breathing. Conclusion Helping a child with difficulty breathing requires a multi-faceted approach that encompasses immediate assistance, long-term strategies, emotional support, and preventive measures. By understanding the signs, taking immediate action, seeking medical guidance, and providing a supportive environment, caregivers can effectively assist children with respiratory issues and improve their overall quality of life. FAQs What are the common causes of difficulty breathing in children? Difficulty breathing in children can be caused
[ANSWERED 2023] A Puerto Rican Woman With Comorbid Addiction
A Puerto Rican Woman With Comorbid Addiction A Puerto Rican Woman With Comorbid Addiction. The Assignment: Examine Case Study: A Puerto Rican Woman With Comorbid Addiction. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes. At each decision point stop to complete the following: · Decision #1 o Which decision did you select? o Why did you select this decision? Support your response with evidence and references to the Learning Resources. o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. o Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different? · Decision #2 o Why did you select this decision? Support your response with evidence and references to the Learning Resources. o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. o Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different? · Decision #3 o Why did you select this decision? Support your response with evidence and references to the Learning Resources. o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. o Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different? Note: Support your rationale with a minimum of three academic resources no more than five years old. Co-morbid Addiction (ETOH and Gambling) 53-year-old Puerto Rican Female BACKGROUND Mrs. Maria Perez is a 53 year old Puerto Rican female who presents to your office today due to a rather “embarrassing problem.” SUBJECTIVE Mrs. Perez admits that she has had “problems” with alcohol since her father died in her late teens. She reports that she has struggled with alcohol since her 20’s and has been involved with Alcoholics Anonymous “on and off” for the past 25 years. She states that for the past two years, she has been having more and more difficulty maintaining her sobriety since they opened the new “Rising Sun” casino near her home. Mrs. Perez states that she and a friend went to visit the new casino during their grand opening at which point she was “hooked.” She states that she gets “such a high” when she is gambling. While gambling, she “enjoys a drink or two” to help calm her during high-stakes games. She states that this often gives way to more drinking and more reckless gambling. She also reports that her cigarette smoking has increased over the past two years and she is concerned about the negative effects of the cigarette smoking on her health. She states that she attempts to abstain from drinking but that she gets such a “high” from the act of gambling that she needs a few drinks to “even out.” She also notices that when she drinks, she doesn’t smoke “as much” but enjoys smoking when she is playing at the slot machines. She also reports that she has gained weight from drinking so much- she currently weights 122 lbs., which represents a 7 lb. weight gain from her usual 115 lb. weight. Mrs. Perez is quite concerned today because she has borrowed over $50,000 from her retirement account to pay off her gambling debts. She is very concerned because her husband does not know that she has spent this much money. MENTAL STATUS EXAM The client is a 53 year old Puerto Rican female who is alert, oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. Her speech is clear, coherent, and goal directed. Her eye contact is somewhat avoidant during the clinical interview. As you make eye contact with her, she looks away or looks down. She demonstrates no noteworthy mannerisms, gestures, or tics. Her self-reported mood is “sad.” Affect is appropriate to content of conversation & self-reported mood. She visual or auditory hallucinations, no delusional or paranoid thought processes are readily appreciated. Insight and judgment are grossly intact, however, impulse control is impaired. She is currently denying suicidal or homicidal ideation. Diagnosis: Gambling disorder, alcohol use disorder Decision Point One: Select what the PMHNP should do: Naltrexone (Vivitrol) injection, 380 mg intramuscularly in the gluteal region every 4 weeks RESULTS OF DECISION POINT ONE Client returns to clinic in four weeks Mrs. Perez said that she felt “wonderful” as she has not “touched a drop” to drink since receiving the injection Client reports that she has not been going to the casino, as frequently, but when she does go she “drops a bundle” (meaning, spends a lot of money gambling) Client She is also still smoking, which has her concerned. She is also reporting some problems with anxiety, which also have her concerned Decision Point Two: Select what the PMHNP should do next: Add on Valium(diazepam) 5 mg orally TID/PRN/anxiety RESULTS OF DECISION POINT TWO Client returns to clinic in four weeks Mrs. Perez reports that when she first received the valium, it helped her tremendously. She states “I was like a new person- this is a miracle drug!” However, she reports that she has trouble “waiting” between drug administration times and sometimes takes her valium early Client is asking today for you to increase the valium dose or frequency Decision Point Three: Select what the PMHNP should do next: Continue current dose of Vivitrol, increase Valium to 10 mg orally TID/PRN/anxiety. Refer to counseling for her ongoing gambling issue Guidance to Student Anxiety is a common side effect of Vivitrol. Mrs. Perez reports that she is doing well with this medication, and like other side effects, the anxiety associated with this medication may be transient. The psychiatric mental health nurse practitioner should never
[ANSWERED 2023] Select a patient for whom you conducted psychotherapy during the last 6 weeks. Create a Comprehensive Psychiatric Evaluation Note on this patient using the template provided in the Learning Resources
Select a patient for whom you conducted psychotherapy during the last 6 weeks. Create a Assignment 2: Comprehensive Psychiatric Evaluation Note and Patient Case Presentation Psychiatric notes are a way to reflect on your practicum experiences and connect the experiences to the learning you gain from your weekly Learning Resources. Comprehensive psychiatric evaluation notes, such as the ones required in this practicum course, are often used in clinical settings to document patient care. For this Assignment, you will document information about a patient that you examined at your practicum site, using the Comprehensive Psychiatric Evaluation Note Template provided. You will then use this note to develop and record a case presentation for this patient. To Prepare Review this week’s Learning Resources and consider the insights they provide about impulse-control and conduct disorders. Select a patient for whom you conducted psychotherapy during the last 6 weeks. Create a Comprehensive Psychiatric Evaluation Note on this patient using the template provided in the Learning Resources. There is also a completed template provided as an exemplar and guide. All psychiatric evaluation notes must be signed, and each page must be initialed by your Preceptor. When you submit your note, you should include the complete comprehensive evaluation note as a Word document and pdf/images of each page that is initialed and signed by your Preceptor. You must submit your note using SafeAssign. Please Note: Electronic signatures are not accepted. If both files are not received by the due date, Faculty will deduct points per the Walden Grading Policy. Then, based on your evaluation of this patient, develop a video presentation of the case. Plan your presentation using the Assignment rubric and rehearse what you plan to say. Be sure to review the Kaltura Media Uploader resource in the left-hand navigation of the classroom for help creating your self-recorded Kaltura video. Include at least five scholarly resources to support your assessment and diagnostic reasoning. Ensure that you have the appropriate lighting and equipment to record the presentation. The Assignment Record yourself presenting the complex case study for your clinical patient. In your presentation: Dress professionally and present yourself in a professional manner. Display your photo ID at the start of the video when you introduce yourself. Ensure that you do not include any information that violates the principles of HIPAA (i.e., don’t use the patient’s name or any other identifying information). Present the full complex case study. Be succinct in your presentation, and do not exceed 8 minutes. Include subjective and objective data; assessment from most recent mental status exam; current psychiatric diagnosis including differentials that were ruled out; current psychotherapeutic plan (include one health promotion activity and one patient education strategy you provided); and patient progress toward treatment goals. Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What was the duration and severity of their symptoms? How are their symptoms impacting their functioning in life? Objective: What observations did you make during the psychiatric assessment? Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses in order of highest to lowest priority and explain why you chose them. What was your primary diagnosis and why? Describe how your primary diagnosis aligns with DSM-5 diagnostic criteria and is supported by the patient’s symptoms. Plan: What was your plan for psychotherapy (including one health promotion activity and one patient education strategy)? What was your plan for treatment and management, including alternative therapies? Include nonpharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan. Reflection notes: What would you do differently with this patient if you could conduct the session again? Excellent Good Fair Poor Photo ID display and professional attire 5 (5%) – 5 (5%) Photo ID is displayed. The student is dressed professionally. 0 (0%) – 0 (0%) 0 (0%) – 0 (0%) 0 (0%) – 0 (0%) Photo ID is not displayed. Student must remedy this before grade is posted. The student is not dressed professionally. Time 5 (5%) – 5 (5%) The video does not exceed the 8-minute time limit. 0 (0%) – 0 (0%) 0 (0%) – 0 (0%) 0 (0%) – 3 (3%) The video exceeds the 8-minute time limit. (Note: Information presented after 8 minutes will not be evaluated for grade inclusion.) Discuss Subjective data: • Chief complaint • History of present illness (HPI) • Medications • Psychotherapy or previous psychiatric diagnosis • Pertinent histories and/or ROS 9 (9%) – 10 (10%) The video accurately and concisely presents the patient’s subjective complaint, history of present illness, medications, psychotherapy or previous psychiatric diagnosis, and pertinent histories and/or review of systems that would inform a differential diagnosis. 8 (8%) – 8 (8%) The video accurately presents the patient’s subjective complaint, history of present illness, medications, psychotherapy or previous psychiatric diagnosis, and pertinent histories and/or review of systems that would inform a differential diagnosis. 7 (7%) – 7 (7%) The video presents the patient’s subjective complaint, history of present illness, medications, psychotherapy or previous psychiatric diagnosis, and pertinent histories and/or review of systems that would inform a differential diagnosis, but is somewhat vague or contains minor inaccuracies. 0 (0%) – 6 (6%) The video presents an incomplete, inaccurate, or unnecessarily detailed/verbose description of the patient’s subjective complaint, history of present illness, medications, psychotherapy or previous psychiatric diagnosis, and pertinent histories and/or review of systems that would inform a differential diagnosis. Or subjective documentation is missing. Discuss Objective data: • Physical exam documentation of systems pertinent to the chief complaint, HPI, and history • Diagnostic results, including any labs, imaging, or other assessments needed to develop the differential diagnoses 9 (9%) – 10 (10%) The video accurately and concisely documents the patient’s physical exam for pertinent systems. Pertinent diagnostic tests and their results are documented, as applicable. 8 (8%) – 8 (8%) The response accurately documents the patient’s physical exam for pertinent systems. Diagnostic tests and their results are documented, as applicable. 7 (7%) – 7 (7%) Documentation of the patient’s physical exam is somewhat vague or contains minor inaccuracies. Diagnostic tests and their results are documented but contain inaccuracies. 0 (0%) – 6 (6%) The response provides incomplete, inaccurate, or unnecessarily detailed/verbose
[ANSWERED 2023] Explain multicultural communication and its origins. Compare and contrast culture, ethnicity, and acculturation
Explain multicultural communication and its origins. Compare and contrast culture Write a 650-1300 word response to the following questions: Explain multicultural communication and its origins. Compare and contrast culture, ethnicity, and acculturation. Explain how cultural and religious differences affect the health care professional and the issues that can arise in cross-cultural communications. Discuss family culture and its effect on patient education. List some approaches the health care professional can use to address religious and cultural diversity. List the types of illiteracy. Discuss illiteracy as a disability. Give examples of some myths about illiteracy. Explain how to assess literacy skills and evaluate written material for readability. Identify ways a health care professional may establish effective communication. Suggest ways the health care professional can help a patient remember instructions. This assignment is to be submitted as a Microsoft Word document. Expert Answer and Explanation Culture and Literacy Effective communication in healthcare is essential for providing quality patient care. The intersection of culture and literacy plays a significant role in how healthcare professionals interact with patients. Understanding the impact of culture and literacy on healthcare communication is crucial for delivering patient-centered care and ensuring positive health outcomes. Multicultural Communication Multicultural communication is the practice of effective communication between individuals from different cultural backgrounds. It aims to bridge the gap in understanding, minimize misunderstandings, and promote effective interaction between people of diverse cultural, ethnic, and linguistic backgrounds (Park, 2020). The origins of multicultural communication can be traced back to the growing diversity and globalization of our world, where individuals from various cultures come into contact through work, travel, and migration. This has created a necessity for effective cross-cultural communication, leading to the development of this field. Culture, Ethnicity, And Acculturation Culture refers to the shared values, beliefs, customs, and traditions of a specific group, whereas ethnicity pertains to a person’s identification with a specific racial, national, or social group based on common cultural factors, including language, religion, or history (Dey et al., 2019). Acculturation, on the other hand, refers to the process of adopting the cultural traits or social patterns of a dominant culture, typically due to prolonged contact or assimilation. While culture and ethnicity are primarily about one’s identity, acculturation deals with the adaptation to another culture. Cultural And Religious Differences in Health Care Professional Cultural and religious differences can significantly affect healthcare professionals. They can lead to misunderstandings, misinterpretations, and hinder effective patient-provider communication. Issues that may arise in cross-cultural communications include variations in health beliefs and practices, differing perceptions of illness and wellness, and language barriers that can impede informed consent and shared decision-making (Young & Guo, 2020). To address religious and cultural diversity, healthcare professionals can employ various approaches such as cultural competency training, providing culturally tailored patient education materials, and fostering an environment of respect and sensitivity to patient needs. Family Culture and Its Effect on Patient Education Family culture also plays a critical role in patient education, as familial beliefs and values can influence an individual’s health-related decisions and adherence to treatment plans. Family culture has a significant impact on patient education. Families can play a key role in helping patients understand their condition, manage their treatment, and make informed decisions about their care (Young & Guo, 2020). Family values and beliefs can influence how patients view their health and illness. Family communication patterns can also affect patient education. For example, families that have open and supportive communication may be more likely to encourage patients to ask questions and learn about their condition. Addressing Religious and Cultural Diversity Healthcare professionals should become familiar with the different cultural and religious backgrounds of the patients in their community. This can be done through reading, taking cultural competency training, or talking to patients and their families. It is also important to be respectful of patients’ cultural and religious beliefs. This means being sensitive to patients’ needs and avoiding making assumptions about their beliefs and practices (Young & Guo, 2020). Additionally, healthcare organizations can promote diversity and inclusion within their workforce to better reflect the patient population they serve, further facilitating cross-cultural communication and understanding in healthcare settings. Types Of Illiteracy There are various types of illiteracy with each comprising of unique but correlated differences. Functional illiteracy refers to the inability to read and write at a level that is necessary to function in everyday life. Health illiteracy is the inability to understand and use health information to make informed decisions about one’s health (van Kessel et al., 2022). This includes being able to read and understand prescription labels, medical records, and other health-related materials. Digital illiteracy is the inability to effectively use digital devices and navigate the internet for information and communication. Cultural illiteracy is the lack of knowledge and understanding of one’s own or other cultures, including their history, customs, and traditions. On the other hand, numeracy illiteracy is the inability to understand and work with numbers and mathematical concepts. Illiteracy As a Disability Illiteracy can be considered a disability when it significantly hinders an individual’s ability to participate in essential activities, such as reading prescription labels, understanding medical instructions, and accessing healthcare information (van Kessel et al., 2022). This limitation can lead to adverse health outcomes and reduced quality of life. In some cases, illiteracy may be associated with learning disabilities or cognitive impairments, further emphasizing its role as a disability. Myths About Illiteracy There are several misconceptions about illiteracy that need to be clarified. Firstly, illiteracy is not solely an individual’s fault or a result of their lack of effort; it can be influenced by various factors, including access to education and learning resources. Secondly, equating illiteracy with a lack of intelligence is unfair and inaccurate; many illiterate individuals have other valuable skills and knowledge (van Kessel et al., 2022). Additionally, it is a misconception that illiterate adults cannot learn to read or write. With the right support and resources, many adults can improve their literacy skills. Lastly, illiteracy is a significant issue that affects a substantial
[ANSWERED 2023] Alma Faulkenberger is an 85-year-old female outpatient sitting in the waiting room awaiting an invasive pelvic procedure. The health care professional who
Alma Faulkenberger is an 85-year-old female outpatient sitting in the waiting room Alma Faulkenberger is an 85-year-old female outpatient sitting in the waiting room awaiting an invasive pelvic procedure. The health care professional who will assist in her procedure enters the room and calls “Alma.” There is no reply so the professional retreats to the work area. Fifteen minutes later the professional returns and calls “Alma Frankenberg.” Still no reply, so he leaves again. Another 15 minutes pass and the professional approaches Alma and shouts in her ear, “Are you Alma Frankenberg?” She replies, “No I am not, and I am not deaf either, and when you get my name correct I will answer you.” Using the Topic 1 Resources, develop a plan to help Alma be compliant with the procedure and post-treatment medication. Also, describe the approach you would take to patient education in this case. Expert Answer and Explanation Patient adherence is a crucial aspect that healthcare professionals must prioritize for optimal healthcare delivery (Snider et al., 2020). It’s imperative for healthcare providers to be well-informed about the various factors affecting patient adherence and take prompt actions to address these issues. The case of Alma Faulkenberger highlights the problem of the doctor mispronouncing the patient’s name, which resulted in miscommunication and non-compliance on the patient’s part. To foster compliance in Alma’s case, the doctor should implement a series of strategies aimed at enhancing patient collaboration (Snider et al., 2020). The initial step in the compliance plan involves ensuring that the patient comprehends the core values upheld by the healthcare facility. Explaining to Alma that even healthcare professionals can make pronunciation errors without any ill intentions can help establish a positive rapport. Acknowledging the mistake and inviting Alma to express her preferred name or title can effectively address the communication issue (Snider et al., 2020). The compliance plan for Alma also encompasses collaboration with other medical professionals to gain insights into the patient’s specific needs, preferences, beliefs, and any other factors that could impact the provision of medical care. In addition, the doctor can employ various techniques for patient education, particularly concerning post-treatment medication. Effective communication necessitates a collaborative approach between the doctor and the patient to identify areas of concern and the preferred teaching method (Cortellini et al., 2019). By tailoring the education to meet Alma’s preferences, the doctor can deliver the necessary medical information in a way that resonates with her, thereby reducing non-compliance and ultimately enhancing the quality of care and patient outcomes. References Cortellini, S., Favril, C., De Nutte, M., Teughels, W., & Quirynen, M. (2019). Patient compliance as a risk factor for the outcome of implant treatment. Periodontology 2000, 81(1), 209-225. Snider, S. H., Flume, P. A., Gentilin, S. L., Lesch, W. A., Sampson, R. R., & Sonne, S. C. (2020). Overcoming non-compliance with clinical trial registration and results reporting: One Institution’s approach. Contemporary clinical trials communications, 18, 100557. Alternative Expert Answer and Explanation From time to time, while practicing nursing, one may come across patients who refuse to comply with directives. Elderly patients often display stubbornness and hostility toward anyone. An intrusive intervention is required in one of Alma’s cases. She is at once stern and disobedient. However, she could not have wanted to feel that way (Baryakova et al., 2023). To make her more comfortable with the situation and promote her compliance, it might be wise to urge another medical practitioner to offer her an apology first. When the patient’s name was pronounced, and no one responded, I believe the healthcare worker should have questioned the client concerning her identification and whether she was waiting to be attended. Healthcare providers must inquire about the client if they have pronounced their name rightfully or whether that is how they would prefer to be acknowledged to demonstrate dignity and take cognizant of the actuality that not everyone identifies by their correct legal name. Analyzing the communication approach must be the plan’s primary focus to help Alma comply with all procedures and subsequent treatments and interventions. The initial steps include introducing Alma appropriately and explaining the procedure, potential risks, potential benefits, and appropriate follow-up care therapy (Rothenberg, 2003). The healthcare provider may have demonstrated respect for Alma by using her full name and speaking to her in a way appropriate for her advanced age. It is important to establish eye contact and smile while doing the introduction. Providing her with numerous opportunities to address any concerns is also essential. A caretaker, family member, or additional resource person for the client should be there throughout the process to keep them calm and comforted. Lastly, give her printed information she can consult, such as a surgical plan, directions for discharge, and an outline of her prescriptions. The primary objective of client education is to guarantee that Alma is informed about the process, the planned outcomes, and the prescribed drugs to be needed following the therapy. This can be implemented by offering Alma complete details of the procedure and pharmaceuticals from the vantage point of healthcare providers. To convey the details, they must express themselves plainly, gently, and in simple terms. It would also be valuable to let Alma talk to a healthcare professional concerning her concerns. It is imperative to deliver information to her vocally and in writing so she might employ it later (Atolagbe et al., 2023). The healthcare practitioner may want to incorporate visual aids like pictures or illustrations as well as real-world examples to assist Alma in grasping the process and prescription more thoroughly. Furthermore, it is critical to encourage Alma to go over all the directions and details to be positive that she comprehends. References Atolagbe, E. T., Sivanandy, P., & Ingle, P. V. (2023). Effectiveness of educational intervention in improving medication adherence among patients with diabetes in Klang Valley, Malaysia. Frontiers in Clinical Diabetes and Healthcare, 4, 1132489. https://www.frontiersin.org/articles/10.3389/fcdhc.2023.1132489/full Baryakova, T. H., Pogostin, B. H., Langer, R., & McHugh, K. J. (2023). Overcoming barriers to patient adherence: the case for developing innovative drug delivery systems. Nature Reviews Drug
[ANSWERED 2023] Mrs. Adams a 68-year-old widow who was referred to case management upon discharge from the hospital based on her physician’s recommendation that she is not able to care for herself independently.
Mrs. Adams a 68-year-old widow who was referred to case management upon discharge Mrs. Adams a 68-year-old widow who was referred to case management upon discharge from the hospital based on her physician’s recommendation that she is not able to care for herself independently. Her diagnosis is diabetes, hypertension, and breast cancer. She is 5 days’ post-op from a right sided mastectomy. Mrs. Adams apartment is located in a low income area of the city where crime is prevalent. Upon assessment by the Community Health Nurse, Mrs. Adams apartment was in disorder with minimal airflow or light. Her cloths appeared unchanged and she had no food in the apartment. The small apartment also housed 3 cats and a small dog who Mrs. Adams considers family since the death of her husband 1 year ago. Mrs. Adams complains of pain and draining from her surgical site and a broken air conditioner. Using Nightingales Environmental Theory, what actions would the nurse take upon the first assessment? What are the five essential components of Nightingales Theory? Prioritize an appropriate care plan for Mrs. Adams? Apply Nightingale’s Environmental Theory to an area of your nursing practice, what patient population would benefit from this approach? Support this practice change with at least one evidenced-based article (this means current EBP of 5 years of less for the article.) The assignment should be completed in APA format, as an essay of between 1000 and 1500 words. The paper should include at least 2 outside references and the textbook. The paper should be in APA format with a title page, level headings, and reference page, please see the Shell that I have included in this module. 1st person is not acceptable in APA papers, make sure to keep this is 3rd person. EXPERT ANSWER AND EXPLANATION Case Study The plan of the recovery of a chronic patient involves several interventions, with one of the main ones being the configuration of the environment or setting of the patient to make it friendlier. Florence Nightingale, the founder of modern nursing, also called ‘The Lady with the Lamp’ from her service during the Crimean war had several views about the implication of sanitation to the nursing field (Idrees & Shah, 2017). Applying her environmental theory in the care of Mrs. Adams, a 68-year-old woman with hypertension, cancer of the breast, and diabetes can guide in the development of the best practice from her situation. Actions the Nurse would take upon the First Assessment Using Nightingale’s Environmental Theory Mrs. Adams is referred to case management upon discharge from hospital, but upon assessment of her living conditions, there are numerous elements that show that her current home is not the ideal place of care. Besides living with four animals, three cats and one dog, Mrs. Adam’s apartment shows that there is minimal light flow, limited food, and the clothes are barely changed. Also, the air conditioner is broken, and the place she lives in is a high crime area. The first action that the nurse in charge would take would be the assessment of the possibility of changing the environment, or her chances of moving to a better place. The following are some of the environmental factors that the nurse would consider as pointed out in the environmental theory by Florence Nightingale. Pure Fresh Air The air that the patient breaths should be made as clean as possible. Stuffy environments increase the chances of chilling, which could limit the chances of recovery. Also, to maintain the right concentrations of oxygen required in the body, the patient would have to ensure that the external environment is completely sanitized (AliSher et al. , 2019). Pure Water Pure water serves almost the same purpose as pure fresh air- making sure that the patient’s circulation is not contaminated with too much concentrations of unwanted substances. Impure water that is used for drinking purposes could lead to the absence of the right elements that would help in proper patient hydration (Mughal & Irshad Ali, 2017). In worse case scenarios, this impure water could lead to the addition of undesired elements to the body of the patient. Effective Drainage Effective drainage in the patient environment helps to ensure that their waste material is removed constantly from their residence. Lack of proper waste removal can lead to the build-up of undesired bacteria that could contribute to patient re-infection. Effective drainage can also help the patient feel more mentally comfortable with their environment. Cleanliness Nursing mainly entails preserving cleanliness of both the patient and their environment. According to the environmental theory, clean environments have a large mental implication to ensuring patient wellness (Couto et al., 2020). Cleanliness also prevents chances of re-infection and re-admissions. Light This is the last factor that should be considered in nursing according to the environmental theory. Direct sunlight has numerous health benefits such as helping in bone growth and development. Lighting up the room of a patient can also increase their mental alertness and wellness. Appropriate Plan of Care for Mrs. Adams In the plan of care for Mrs. Adams, the first step would be making suitable environmental adjustments that would contribute to improving her environment. For the patient to achieve a healing state, the introduction of a healthy environment is paramount. Having four pets could be disadvantageous to her given her economic conditions, as she would probably not be able to feed them well. These pets could roam around the streets and bring her a fourth disease, which would be problematic to her health. The plan of care should therefore include elimination of three of the pets to leave her with possibly a male cat. Also, general cleaning of her environment should be made to ensure that the surroundings are clean and safe for her to live in. In the plan of care, the possibility of moving to a new apartment where lighting, security, and clean water is in plenty should be made. Changing the environment could also help her make new friends and hence contribute to
[ANSWERED 2023] In the Hospital Hope scenario, what do you think was the most important factor that led to the change in practice in the SICU?
In the Hospital Hope scenario, what do you think was the most important factor that led A Culture of Patient Safety Read this article: Sammer, C. & James, B. (2011, September 30). Patient safety culture: The nursing unit leader’s role. OJIN: The Online Journal of Issues in Nursing,16(3), Manuscript 3. In the Hospital Hope scenario, what do you think was the most important factor that led to the change in practice in the SICU? If you worked in a facility that needed a practice change, what framework would you use and why? my facility is Acute and long-term rehabilitation Expert Answer and Explanation A Culture of Patient Safety As patient advocates, nurses must ensure that they develop a culture of patient safety when caring for patients in the hospital. Although there have been many improvements done over the years to ensure that the quality of care improves in the hospital setup, there are still an alarming number of avoidable hospital infections and other aspects that compromises patients’ safety in the hospital. Through evidence-based care, several frameworks have been created to improve patients’ experience, reduce their hospital stay and generally improve their health. Some frameworks include building a culture of care and incorporating a patient-centered care system. According to Sammer & James(2011), other factors that can effectively improve patients’ outcomes include leadership, teamwork, and a learning environment. As nurses devote themselves to improved patient care, it is paramount to understand how the factors can affect the wellbeing of patients in their care. Most Important Factor That Led to Change in Practice in SICU Hospital Hope In Hospital Hope, nurses were frustrated that most of their patients suffered from hospital-acquired infections and had a high mortality rate (Sammer & James, 2011). Therefore, they vowed to change their practice mode to improve the patients’ experience. The most important factor that led to change in practice is the change of culture. It was clear that the culture in the hospital was not supportive of patient-centered care, making it necessary for a different framework to be enacted. By identifying that the culture was inappropriate for patient care, the hospital’s leadership was able to ensure that there were positive changes that eventually improved the patients’ outcomes. As a center of patient excellence the hospital leaders felt that they need to research more on the causes of hospital infections and come up with an issue that would reduce their occurrence. Through good leadership, it was clear that the hospital was able to identify several factors affecting patients’ wellness; therefore, to improve the culture, they must be addressed. The leaders were not only ready to accept their responsibility in the current situation but were also focused on positively ensuring their followers as they sought to improve the patient’s experience in the hospital (Braithwaite et al. 2017). By developing this culture, it was clear that the nurses enjoyed their leaders’ support throughout the process, evidenced by their ability to talk about their mistakes and work on finding a solution. The framework of cultural change also incorporates the use of the evidence-based practice. Notably, in contemporary society, medical practitioners are more drawn to evidence-based practice as it involves current tested methods of improved care. The nurse manager researched evidence-based practice and came across a comprehensive Unit-Based Patient Safety Program (CUSP), which was integral in ensuring patients’ safety in the hospital. Following the framework, the nurse manager became more aware of what needs to be done to reduce hospital infections. By focusing on cultural change, the hospital encouraged learning in the hospital. It is clear that after the leaders discovered that some of the nurses had experience and were studying what they were currently affecting them, they could be integral to enhancing the needed change in the system. Therefore, they asked them to make reports on the progress, which increasingly showed what was wrong in the system, giving them a chance to improve on their experience. Moreover, the nursing manager went ahead and challenged some of the nurses to research the current operations of the hospital and how they can be improved, and this offered a wide perspective of care and encouraged learning amongst the nurses. Moreover, it encouraged the nurses’ to participate in decision-making as their opinions were welcome and valid. It is also clear that the culture adopted focused on fostering teamwork in the nursing team. According to Sammer & James (2011), the nurses were able to support each other by enhancing transparency in the department. They were all encouraged to report their performance even though it appeared that it would report negatively on their work. Additionally, they increased their cooperation as they communicated effectively and updated each other well during the end of their shifts. As a result, there was no gap in patient care, which improved the patients’ recovery time (Mannion & Davies, 2018). It is also notable that communication among the nurses greatly improved as the nurses were able to consider the input of both patients and other stakeholders in providing the care needed in the hospital ad encouraging transparency. Through the change of culture, it became possible to improve patients’ outcomes and the quality of work life. Practice Change Framework To Use In My Facility I have been working in an acute and long-term rehabilitation facility, and while the performance has been admirable over the years, I still believe there is much room for improvement. The facility focuses on rehabilitating patients who have suffered from traumatic injuries that have affected their ability to lead a normal life (Santana et al. 2018). Notably, patients are not only physically stressed but also emotionally vulnerable, especially if they suddenly become dependent on others’ help after leading a life of independence. As a result, some might be stubborn and refuse help, delaying their recovery. By changing the current framework, which focuses on excellence, it will be possible to understand further and support patients, improving the care outcome. The best framework to incorporate is the patient-centered framework which focuses on working