Review and compare competencies from the ANA Competency Model and AOEN Nurse Manager Competencies.

(Please the attachment below for the ANA Competency Model and AOEN Nurse Manager Competencies).

Please provide general comments on how you would progress in your nursing career to achieve the competencies as a nurse manager and/or nurse leader.

APA format with in-text citation use attachment provided for references and citation.

 Social boundaries are what I encounter on daily basis in my current practice. Working in a community heavily populated with minorities of poor socioeconomic status, low educational level, and language barriers, I am frequently faced with patients experiencing social boundaries. These boundaries oftentimes result in poor quality care or access to care for these patients. These patients present for surgery with a multitude of poorly managed health problems which include, hypertension, diabetes, end-stage renal disease, coronary artery disease, congestive heart disease, obstructive sleep apnea, chronic obstructive pulmonary disease, morbid obesity, hyperlipidemia, and so on. These co-morbidities constitute a high anesthetic risk for these patients which continually leads to cancellation of their surgical procedures, postponement of their cases, prolonged hospital stay, or post-operative complications. The frequent commonality among these patients is non-compliant with their care. They are often labeled as “non-compliant” in their charts.

However, as I interact with some of these patients, I’ve noticed that their medication non-compliance is multifactorial. For most patients, it’s the unaffordability of their medications, some are confused about the medication instructions due to poor education or language barriers and for some, they experience adverse drug reactions (ADRs) and stop taking the medications. According to Wood and Lightfoot (2018), 25% of patients who were non-compliant with their medications before surgery were confused about the medication instructions.  Song et al., (2020) cite ADRs alone as a global clinical problem leading to increased morbidity and mortality. While medication costs and affordability were the most commonly mentioned barriers to medication adherence (Heidari et al., 2019). Poor compliance is very common among hypertensive patients constituting a worldwide problem (Ahmad & Shaheen, 2020).

As a leader, I must be an advocate for my patients. I’ve been able to advocate care for my patients by relating some of these concerns to my interprofessional teams. These include our leadership team, social workers, primary care physicians, and pharmacy. On the nursing level, we assess every patient for health literacy upon admission. We achieve this by communicating clearly, in simple and plain English. As we share information or instructions with patients or caregivers, we ask that they repeat to us their understanding of what was said and ask clarifying questions as necessary. Medical jargon is avoided as much as possible while communicating with patients. A video-assisted language line is provided to assist with communication for non-English speaking patients and social workers are involved with the care of patients with medication affordability concerns. The pharmacy helps find alternatives for medications with adverse effects or high costs.

To leverage resources to overcome these boundaries, we heavily advocate for family involvement in patients’ care and request that our non-English speaking patients come for their procedures with an English-speaking relative, and with their consent, instructions are given in the presence of caretaker in both their native language and English using a language line. Patients and or caretakers are asked to repeat instructions as given both pre-and postoperatively. A language line is provided in almost all languages and used on every non-English speaking patient. Reasons for non-compliance are addressed with resources provided as necessary and social worker consult is made on every patient having financial difficulties accessing medications or treatments. The facility has provided free walk trails for the members of the community. Patients and families are encouraged to use the trails.

References

Ahmad, I., & Shaheen, A. (2020). Status of medication compliance among patients with hypertension: A global challenge. Pakistan Heart Journal, 53(4), 210-212. https://doi.org/10.47144/ph.v53i4.1846

Heidari, P., Cross, W., Weller, C., Nazarinia, M., & Crawford, K. (2019). Medication adherence and cost‐related medication non‐adherence in patients with rheumatoid arthritis: A cross‐sectional study. International Journal of Rheumatic Diseases, 22(4), 555-566. https://doi.org/10.1111/1756-185X.13549

Song, Y., Zhang, W., Zhang, S., Wang, T., Jiang, Z., Meng, C., . . . Sun, Y. (2020). Factors influencing administration, recognition, and compliance of medicine among community residents from Jilin province, china: A questionnaire study. BioMed Research International, 1-13. https//doi.org/10.1155/2020/8730212

Wood, D., & Lightfoot, N. (2018). An audit of regular medication compliance prior to presentation for elective surgery. The New Zealand Medical Journal, 131(1480), 75-80.  https://chamberlainuniversity.idm.oclc.org/login?url=https://search-ebscohost-com.chamberlainuniversity.idm.oclc.org/login.aspx?direct=true&db=mdc&AN=30116068&site=eds-live&scope=site

I NEED A COMMENT FOR THIS DISCUSSION BOARD WITH AT LEAST 2 PARAGRAPHS AND USE AT LEAST 3 SOURCES NO LATER THAN 5 YEARS.

1 postsRe: Topic 3 DQ 2

The primary level of health care promotion involves the prevention of injuries or diseases before they even occur. It is done by preventing the exposure to harm that may lead to injuries, diseases, or unsafe behaviors that may cause injuries or increase the disease resistance. The secondary level involves the reduction of the impact of an injury or disease that has occurred already. It is achieved through detecting and treating the injury or disease with the aim to regain the original health status.

The tertiary level aims at softening the impact of an illness or disease that is ongoing and has a lasting effect. It is achieved through assisting patients to manage their complex health issues and injuries. The above levels of health promotion determine the educational needs of a patient. For instance, at the primary level that is involved in the prevention of the disease, the patients are educated on various measures that they are required to take to prevent themselves from diseases. At the secondary level, the patient is educated on how to mitigate the effect of a certain health condition. At the secondary level, the patients are instructed on the practices that they should engage on softening the effect of a certain disease. And at the tertiary, “the focus is for the patient to be able to achieve some semi balance of normalcy and acclimate back in their lives and society depending on their complications, and some may need extensive rehabilitation,” (gcu, 2018) .

Respond to the above student’s post posting the discussion using 200-300 APA format with a reference.

There are 4 parts to the assignment. Please place all four assignments into one paper. The different parts should be clearly marked so your professor knows which question you are addressing.

1. Rewrite the following essays. Correct all errors in capitalization, spelling, and punctuation. Divide the passage into appropriate paragraphs.

• Essay #1:

When my husband Joe had cancer surgery five years ago, each of his family members responded just as I knew they would. John, his father, decided to organize the family’s calls. Because, of course, everything would run so much more smoothly. Thus Jane, Matt, and Jim received detailed sheets of instructions in the mail. Telling them which days to telephone r.j. smith hospital to talk to Joe and what presents to send. Jane, enraged, promptly threw a tantrum. Calling Matt and me to complain about her father’s overbearing behavior. “I,” she yelled, “am a Psychiatrist who knows how to handle these situations, i am not still a child.” Matt also responded predictably. By avoiding the situation. He threw himself into his work. Normally a late sleeper, Matt took to leaving at 5:00 a.m., driving on the deserted expressway and arriving at work before six a.m. In addition, he didn’t return until 11:00 p.m. When he would fall into bed so exhausted that he couldn’t worry about Joe. Jim, too, responded predictably. He fumed inside for weeks, ignored John’s instructions, and sent cartons of books to Joe. So that he would never be bored. The books were funny. Because Jim had read Norman Cousins’ book about the healing power of laughter. Within a few months, Joe recovered from the surgery-in spite of his family

• • Essay #2:

Treatment of atrial septal defect depends upon the size and symptoms and therefore is individualized an atrial septal defect of less than 3mm usually closes spontaneously (The Merck Manual, 2006). When the defect is between 3mm and 8mm it closes spontaneously in eighty percent of cases by the age of eighteen months, however, atrial septal defects located in the anteroinferior aspect of the septum (ostium primum) or in the posterior aspect of the septum near the superior vena cava or inferior vena cava (sinus venosus) don’t close spontaneously. If the defect is very small does not close spontaneously and the patient is asymptomatic. The treatment may be simply too monitor via an annual echocardiogram. Of course their is a risk of patients’ becoming symptomatic.

Moderate-sized atrial septal defects or larger or patients’ who are symptomatic require closure of the shunt this is usually done between the ages of 2 and 6 years. A catheter-delivered closure device, such as Amplatzer Septal Occluder or Cardio-Seal device. May be used for closure of atrial septal defects less than 13mm in size, except than primum or sinus venosus defects. If the defect is greater than thirteen milimeters or located near important structures. Surgical repair becomes necessary. If the atrial septal defect is repaired during childhood there mortality rates approach 0 and the patient’s life expectancy approaches that of the general population prior to surgical repair, patients may need to be treated with diuretics; digoxin; ACE inhibitor; or beta blockers to prevent congestive heart failure (Moser & Riegel, 2007). Following surgical repair patience will receive aspirin to prevent clots, and be monitored closely for dysrhythmias and pulmonary hypertension. Oxygen and nitric oxide therapy have proven to be beneficial in treating postoperative pulmonary hypertension. Also patients who have primum atrial septal defect will need endocarditis prophylaxis.

1. Guided writing exercise:
   • Think about a recent experience you have had that required you to use critical thinking skills. Set a timer for five minutes. Write about your experience. Do not worry about grammar, punctuation, or spelling. Just write, but stop at five minutes. Now go back and write your experience with correct grammar, punctuation, and spelling. Submit both written pieces. Add a concluding paragraph that answers the follows questions: How was the formal writing experience different from the timed writing experience? What did you do differently? Was there any difference in the time it took you? How did you ensure your spelling, grammar, and punctuation were correct?
2. Describe when the following words would be used in a scholarly essay (define each word). Then, use those that are appropriate to a scholarly essay in a sentence.
   • Their, there, they’re
   • Affect, effect
   • Its, it’s
   • your, you’re
   • then, than
   • accept, except
3. Describe the use of apostrophes in writing in general. When should apostrophes be used in formal writing? When should apostrophes be avoided in formal writing?

Note: There is no Synthesis Paper assignment due this week.

Assignment Expectations

Length: N/A

Structure: Place all 4 parts in one document

References: N/A

• Select an adult patient that you examined during the last 4 weeks who presented with a disorder other than the disorder present in your Week 3 Case Presentation.
• Create a Focused SOAP Note on this patient using the template  provided in the Learning Resources. There is also a completed Focused  SOAP Note Exemplar provided to serve as a guide to assignment  expectations.

• Present the full complex case study. Include chief complaint;  history of present illness; any pertinent past psychiatric, substance  use, medical, social, family history; most recent mental status exam;  current psychiatric diagnosis including differentials that were ruled  out; and plan for treatment and management.
• Report normal diagnostic results as the name of the test and  “normal” (rather than specific value). Abnormal results should be  reported as a specific value.
• Be succinct in your presentation, and do not exceed 8 minutes.  Specifically address the following for the patient, using your SOAP note  as a guide:
• 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 patient mental status examination  results. What were your differential diagnoses? Provide a minimum of  three possible diagnoses and why you chose them. List them from highest  priority to lowest priority. What was your primary diagnosis, and  why? Describe how your primary diagnosis aligns with DSM-5 diagnostic criteria and supported by the patient’s symptoms.
• Plan: What was your plan for psychotherapy? What was your  plan for treatment and management, including alternative therapies?  Include pharmacologic and nonpharmacologic treatments, alternative  therapies, and follow-up parameters, as well as a rationale for this  treatment and management plan. Be sure to include at least one health  promotion activity and one patient education strategy.
• Reflection notes: What would you do differently with this  patient if you could conduct the session over? If you are able to follow  up with your patient, explain whether these interventions were  successful and why or why not. If you were not able to conduct a follow  up, discuss what your next intervention would be.

 Discuss key stakeholders that you believe critical to developing a state initiative to address suicide.

Instructions:

Use an APA 7 style and a minimum of 200 words. Provide support from a minimum of at least three (2) scholarly sources. The scholarly source needs to be: 1) evidence-based, 2) scholarly in nature, 3) Sources should be no more than five years old (published within the last 5 years), and 4) an in-text citation. citations and references are included when information is summarized/synthesized and/or direct quotes are used, in which APA style standards apply.

• Textbooks are not considered scholarly sources. 

• Wikipedia, Wikis, .com website or blogs should not be used.

Focused SOAP Note and Patient Case Presentation

Psychiatric notes are a way to reflect on your practicum experiences and connect them to the didactic learning you gain from your NRNP courses. Focused SOAP 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 during the last three weeks, using the Focused SOAP 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. Also review the Kaltura Media Uploader resource in the left-hand navigation of the classroom for help creating your self-recorded Kaltura video.
• Select a patient of any age (either a child or an adult) that you examined during the last 3 weeks.
• Create a Focused SOAP Note on this patient using the template provided in the Learning Resources. There is also a completed Focused SOAP Note Exemplar provided to serve as a guide to assignment expectations. Please Note:
  • All SOAP notes must be signed, and each page must be initialed by your Preceptor. Note: Electronic signatures are not accepted.
  • When you submit your note, you should include the complete focused SOAP note as a Word document and PDF/images of each page that is initialed and signed by your Preceptor.
  • You must submit your SOAP note using SafeAssign. Note: If both files are not received by the due date, faculty will deduct points per the Walden Grading Policy.
• Then, based on your SOAP note of this patient, develop a video case study presentation. Take time to practice your presentation before you record.
• Include at least five scholarly resources to support your assessment, diagnosis, and treatment planning.
• 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 with a lab coat 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. Include chief complaint; history of present illness; any pertinent past psychiatric, substance use, medical, social, family history; most recent mental status exam; current psychiatric diagnosis including differentials that were ruled out; and plan for treatment and management.
• Report normal diagnostic results as the name of the test and “normal” (rather than specific value). Abnormal results should be reported as a specific value.
• Be succinct in your presentation, and do not exceed 8 minutes. Specifically address the following for the patient, using your SOAP note as a guide:
  • 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 their mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses and why you chose them. List them from highest priority to lowest priority. What was your primary diagnosis and why? Describe how your primary diagnosis aligns with DSM-5 diagnostic criteria and supported by the patient’s symptoms.
  • Plan: What was your plan for psychotherapy? What was your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan. Also be sure to include at least one health promotion activity and one patient education strategy.
  • Reflection notes: What would you do differently with this patient if you could conduct the session again? If you are able to follow up with your patient, explain whether these interventions were successful and why or why not. If you were not able to conduct a follow up, discuss what your next intervention would be.

Response to 2 Peers

1. Consider peer responses.  Are they similar or different than yours?

2. How often should you check in with others regarding moral distress in your work environment?

Write me for additional information. Do not compare the two peers responses. These are two DIFFERENT responses, not a compare and contrast. 200 words minimum for each and at least one recent reference for each.