Original Work, No Plagiarism, Cite and Reference

Joanna, a psychiatrist, has a busy clinical practice. She is widely recognized as a leader in reducing the number of psychotic episodes that patients with schizophrenia experience. Her treatment modalities are largely informed by her research. She has performed numerous clinical trial studies combining various antipsychotic and other medications to achieve longer intervals without episodes. She has cultivated a trusting relationship with her patients as many have seen her for more than five years as she has provide hope and relief to a great number of them.

Joanna is enrolling participants into a randomized placebo-controlled study with a promising new drug to treat schizophrenia. Although two other psychiatrists in her practice are referring patients to the study, she also decides to offer the protocol to patients in her practice that meet the inclusion criteria.

As part of the consent process, she explains to patients that there is a 50-50 chance whether they are placed in the group receiving the investigational drug or in the group that receives the placebo (sugar pill). She tells them that those who are given placebos will not be offered standard-of-care medicine so that important drug-placebo differences can be identified. Joanna also tells them that rational decision-making does not seem to be affected during short periods of medication-free intervals, according to the most recent research. She does acknowledge that studies have had mixed results about the increased risk of suicidality, however.

One of Joanna’s patients, a potential participant named Duncan, asks how long the study is supposed to last. Joanna knows that Duncan has failed other attempts of reducing the length and severity of his schizophrenic episodes. She also believes that he may be a good candidate for the study—as long as he’s not in the placebo group.  There’s no guarantee that he’ll receive the treatment, or do well on it. If he doesn’t enroll, then his clinical care will go on uninterrupted. If he does enroll, this new experimental drug may be his best shot at receiving an effective treatment so that he can lead a more normal life.

Joanna asks if Duncan is interested. Duncan responds, “Whatever you think is best. You’re the doc.”

Questions:

1. How many different kinds of conflicts of interest does Joanna have?

2. How concerned should she be that her patient(s) might not grasp the risks of participating in a drug trial?

3. In your own words, what is a therapeutic misconception?

4. What do you think motivates patients like Duncan to respond “Whatever you think is best”?

5. Should clinical researchers be allowed to enroll their own patients in a study?

The Assignment (Evidence-Based Project)

Part 3A: Critical Appraisal of Research

Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.

Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.

Part 3B: Critical Appraisal of Research

Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.

To Prepare:

· Review the concepts of technology application as presented in the Resources.

· Reflect on how emerging technologies such as artificial intelligence may help fortify nursing informatics as a specialty by leading to increased impact on patient outcomes or patient care efficiencies.

The Assignment: (4-5 pages not including the title and reference page)

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

· Describe the project you propose.

· Identify the stakeholders impacted by this project.

· Explain the patient outcome(s) or patient-care efficiencies this project is aimed at improving and explain how this improvement would occur. Be specific and provide examples.

· Identify the technologies required to implement this project and explain why.

· Identify the project team (by roles) and explain how you would incorporate the nurse informaticist in the project team.

· Use APA format and include a title page and reference page.

· Use the Safe Assign Drafts to check your match percentage before submitting your work.

BY DAY 7 OF WEEK 4

Submit your completed Project Proposal.

Change in an Organization

This chapter involves change and the response to change in an  organization. If you feel uncomfortable already you probably are in the  majority. Let’s read the scenario below and try to understand why change  is so difficult. 

Scenario: Imagine the days before COVID when we were  all in a classroom. Do you remember back then? Well, think about where  you decided to sit in a classroom. Did you find that you usually chose  the same seat in most of the classrooms that you were in? If not, then  what usually made you choose the seat that you decided to sit in? Now if  you were to sit in a seat in the first class, how likely were you to  sit in the same seat after that? Have I made a point? So change is hard,  and we all have gone through some kind of change, small or large, in  our lives at school, at our workplace, and at home.

Instructions:

1. Read the information above and then answer the following questions: 
   1. Describe what the circumstances were at your workplace when you had to change something
   2. How did you adjust to the change?
   3. Were there colleagues that could not adjust to the change?
   4. Why do you think, in terms of change theory, that there were colleagues that could not adjust?
2. Your should be: 
   • One (1) page

Part I

The Advance Health Care Directive  

Locate a copy of an advanced directive (AD) that complies with the laws of the state in which you work. The organization in which you work should have a copy of an advance directive that is given to patients. If not, download your state’s Advance Directives here http://www.caringinfo.org/i4a/pages/index.cfm?pageid=3289.Links to an external site.

 Part I: 

1. Identify where you obtained the AD and explain its compliance with state law.
2. Conduct research (1-2 sources) to learn more about the AD in your state and explain how it works.    
3. Discuss how easy or difficult it was to complete the AD. Your comments should be specific and both objective and subjective. For example, when you state your personal feelings, you must relate them to the literature (textbook and research) that discusses this process and the difficulties that many people face when completing an advance directive. 

(Cite/ reference any sources you use to explore these questions, including your texts.) 

Part II

Physician Orders for Life-Sustaining Treatment (POLST) Form 

1. What is a Physician Orders for Life-Sustaining Treatment (POLST) formLinks to an external site.?
2. When should this form be completed?
3. Who can complete the form?
4. Who needs to sign the form to make it a legal document?

(Cite/reference any sources you use to explore these questions, including your texts.) 

Part III

Tie the two first sections together by writing a summary and conclusion. 

This section should address:

1. the differences between an Advance Health Care Directive and the POLST,

2. the RN’s important role in assuring the patient’s right to autonomy in choosing the healthcareinterventions the patient does or does not want.

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