Home Health week 2 peer response

respond to peers thoughtfully, add value to the discussion, and apply ideas, insights, or concepts from scholarly sources, such as: journal articles, assigned readings, textbook material, lectures, course materials, or authoritative websites. For specific details and criteria, refer to the discussion rubric in the Menu (⋮) or in the Course Overview Weekly Discussion Guidelines. 

1st peer response

McKenzie Ledbetter

The Health Belief Model (HBM) was developed by Hochbaum, Rosenstock, and Kegels, psychologists working in the US Public Health Services. HBM is based on perceived susceptibility, severity, benefits, and barriers. This Model can be used to predict health behaviors, for example, the intention to vaccinate or comply with medical interventions. I chose this model because it is important to know if your patients will engage with healthy behavior or not. If it is the latter, you can implement education and resources to help them make healthy choices.

During the COVID pandemic, misinformation had an enormous impact on people following precaution guidelines. Many people ignored recommendations due to their lack of accurate information. The HBM can raise awareness of the relationship between health, information, and the digital landscapes the public interacts with (Houlden et al., 2021).

I believe this model can address my topics because there are a lot of people who have been misinformed about healthy behaviors regarding mental health and childbirth. This model can help screen for those individuals and once identified, education and resources can be offered to encourage better heath decisions.

 

Houlden, S., Hodson, J., Veletsianos, G., Reid, D., & Thompson-Wagner, C. (2021). The health belief model: How public health can address the misinformation crisis beyond COVID-19. 
Public health in practice (Oxford, England), 
2, 100151. https://doi.org/10.1016/j.puhip.2021.100151

2nd peer response

Megan Brown

· I chose the Transtheoretical/Stages of Change Model. This model helps describe a patient's motivation and readiness to change a health-related behavior they may want to improve. It is described in a five-step process and evaluates the patient's behavioral change, the process of the changes, decision-making, and self-efficacy. Here are the five stages of this model: 

      1. Precontemplation: the patient is unaware of their need to change and most likely is unwilling to change. 

      2. Contemplation: this is when the patient begins to develop a desire to change and get better. 

      3. Preparation: personal plans begin of how to change. 

      4. Action: when the patient incorporates the new behavior into their life and/or routine. 

      5. Maintenance: the patient is consistent in changing and demonstrating that change, usually for six months or more. 

· I chose this model because I feel it gives the patient ways to improve and get better in a clear and precise way. It gives the patient their own choice to get better, which I feel is an excellent way to get a patient to change unhealthy behaviors. The patient needs to have that desire to change and get better first. It demonstrates more of an understanding of the actual cognitive and behavioral changes the patient will experience and go through. “Movement through these stages does not always occur in a linear manner, but may also be cyclical as many individuals must make several attempts at behavior change before their goals are realized” (Marcus & Simkin, 1994). It gives the patient time to work through each stage, even if it may not happen the first time, but it helps them feel more fulfilled. 

· This model can be used to address the Healthy People topic and objective I have chosen because, a lot of the time, the patient is unaware they need to change or unwilling to change. They don't know what steps they need to take to get better. Once given the education on how to get better, they need to desire to get better. This model can show the patient that they are getting better and gives them something to look at. It can also show healthcare professionals how the patient is improving and where they are at. 

 

Reference: 

Marcus , B. H., & Simkin, L. R. (1994, November 26). 
The transtheoretical model: Applications to exercise behavior. National Library of Medicine. https://pubmed.ncbi.nlm.nih.gov/7837962

Previous class

PRAC 6665/6675 Clinical Skills 

Self-Assessment Form

Desired Clinical Skills for Students to Achieve	Confident (Can complete independently)	Mostly confident (Can complete with supervision)	Beginning (Have performed with supervision or needs supervision to feel confident)	New (Have never performed or does not apply)
Comprehensive psychiatric evaluation skills in:
Recognizing clinical signs and symptoms of psychiatric illness across the lifespan		X
Differentiating between pathophysiological and psychopathological conditions		X
Performing and interpreting a comprehensive and/or interval history and physical examination (including laboratory and diagnostic studies)		X
Performing and interpreting a mental status examination		X
Performing and interpreting a psychosocial assessment and family psychiatric history		X
Performing and interpreting a functional assessment (activities of daily living, occupational, social, leisure, educational).		X
Diagnostic reasoning skill in:
Developing and prioritizing a differential diagnoses list		X
Formulating diagnoses according to DSM 5-TR based on assessment data		X
Differentiating between normal/abnormal age-related physiological and psychological symptoms/changes		X
Pharmacotherapeutic skills in:
Selecting appropriate evidence based clinical practice guidelines for medication plan (e.g., risk/benefit, patient preference, developmental considerations, financial, the process of informed consent, symptom management)		X
Evaluating patient response and modify plan as necessary		X
Documenting (e.g., adverse reaction, the patient response, changes to the plan of care)		X
Psychotherapeutic Treatment Planning:
Recognizes concepts of therapeutic modalities across the lifespan		X
Selecting appropriate evidence based clinical practice guidelines for psychotherapeutic plan (e.g., risk/benefit, patient preference, developmental considerations, financial, the process of informed consent, symptom management, modality appropriate for situation)		X
Applies age-appropriate psychotherapeutic counseling techniques with individuals and/or any caregivers		X
Develop an age-appropriate individualized plan of care		X
Provide psychoeducation to individuals and/or any caregivers		X
Promote health and disease prevention techniques		X
Self-assessment skill:
Develop SMART goals for practicum experiences		X
Evaluating outcomes of practicum goals and modify plan as necessary		X
Documenting and reflecting on learning experiences		X
Professional skills:
Maintains professional boundaries and therapeutic relationship with clients and staff	X
Collaborate with multi-disciplinary teams to improve clinical practice in mental health settings	X
Identifies ethical and legal dilemmas with possible resolutions	X
Demonstrates non-judgmental practice approach and empathy	X
Practices within scope of practice	X
Selecting and implementing appropriate screening instrument(s), interpreting results, and making recommendations and referrals:
Demonstrates selecting the correct screening instrument appropriate for the clinical situation		X
Implements the screening instrument efficiently and effectively with the clients		X
Interprets results for screening instruments accurately		X
Develops an appropriate plan of care based upon screening instruments response		X
Identifies the need to refer to another specialty provider when applicable		X
Accurately documents recommendations for psychiatric consultations when applicable		X

Summary of strengths:

With my previous clinical rotations, the guidance of my preceptor and my classes, today I can say that my knowledge has advanced, and I can apply it as a professional to patients and their families. I feel very safe working with other professionals, working as a team and applying and identifying ethical and legal dilemmas. I have observed the progress in issues of psychiatric evaluation, in pharmacology, in psychotherapies that in these next clinical rotation and classes I must continue advancing to achieve my complete confidence.

Opportunities for growth:

Despite my confidence in my knowledge of psychiatric evaluations and pharmacotherapeutics, practice may help me diagnose patients and create treatment strategies. I may also require more competence in selecting evidence-based clinical practice guidelines when designing psychotherapy treatments. I can enhance my screening instrument implementation and data interpretation to make recommendations and referrals. This self-assessment gave me goals and objectives to help me learn these skills.

Now, write three to four (3–4) possible goals and objectives for this practicum experience. Ensure that they follow the SMART Strategy, as described in the Learning Resources.

1. Goal: Confidant in psychiatric evaluation a. Objective: To recognize more confidently in children and adolescents the signs and symptoms in psychiatric evaluations. b. Objective: To recognize more confidently in adults and older adults the signs and symptoms in psychiatric evaluations. c. Objective: To be most confident (independent) At the end of my clinical rotation with the recognition of signs and symptoms. 2. Goal: Improve the development and prioritization of the list of differential diagnoses. a. Objective: To review the diagnostic criteria of the DSM and the list of differential diagnoses during my clinical rotation. b. Objective: Create a differential diagnosis list and discuss with my preceptor. c. Objective: To be more confident in the formulation of the diagnosis based on DSM -TR and to discuss it with my preceptor. 3. Goal: To choose evidence-based clinical practice recommendations for a medication strategy. a. Objective: To systematically evaluate the pharmaceutical classes and the literature on side effects. b. Objective: Evaluate and choose evidence-based medication strategies for children and adolescents. c. Objective: Evaluate and choose evidence-based medication strategies for adults and older adults.

Signature: Nasihely Echemendia Lozano

Date:05/29/2023

Course/Section: PRAC-6665F

see attachment 

Make a follow-up of a student's weekly discussion and respond with your opinion regarding to her post

——You don't have to post this in APA format necessarily, it's just giving feedback to the student .

Alayna Polter

Hello Professor and class, 

Ethical guidelines ensure patients are safe from harm. Having someone prescribe a medication who is not properly educated on the possible side effects, directions, doses, drug interactions and many other implications is considered unethical. A huge component of prescribing ethically includes examining the patients’ needs for the current situation in which they are seeking medical help for which was not done in this case study (Duquesne University, 2020). There is also a legal implication due to providers having the responsibility to make informed medical decisions before prescribing medications due to potential side effects, drug interactions etc. If the doctor prescribes the wrong medication, inappropriate dosages, or misinforms about the possible side effects they could be held liable (Harris, 2020). This will clearly affect everyone including the practice. Practicing without a license will presume this care was negligent. If this individual was injured this could justify punitive damages. If this was ruled in favor of, compensation for the harm would be involved as well as additional penalties for “deceiving the victim” (Suszek, 2023). This would cost the practice in fines as well as diminish their reputation. A medical director is in charge of running the facility, implementing regulations, budgets and many other things. This problem will quickly become their problem when trying to sort out this situation. As for the medical assistant, I am going to discuss the punishment where I live because it can vary depending on state. In Florida this medical assistant is practicing without a license and as a first-time offense this would usually be a first-degree misdemeanor. The penalties for this can include up to one year in jail and up to $1,000 in fines (The Law Place, n.d.).

I clearly do not think this medical assistant was trying to be malicious by her actions. However, she is probably not aware of the implications behind these actions and needs to be educated about what can happen if she does not follow her scope of practice. Therefore, to ensure this does not happen again, everyone needs to be educated about their roles. This is not just directed to medical assistants, but others could be informed how to best utilize them in their practice. It was stated in the case study that this was a busy primary care practice, and management should work to improve the stressful conditions for these workers. They have a lot of different roles and should have the efficient help to get their tasks done but understand exactly what they can and cannot do (Family Medicine, 2022). I also believe something in the computer system would have to be changed. It should not be that easy for someone without the proper education to put in a prescription. I think everyone needs a pin number or password to put in medications for patients.

A leadership quality I would apply is setting ethical standards. Healthcare lacking ethics can have extremely harmful effects on patients lives. Leaders that have built a reputation around integrity can set ethical standards for their team members and influence them to do the same. Another positive change would be having accountability. We all will make mistakes and being accountable for your actions will be favorable for your team. Lastly, applying mentorship is very important, in this circumstance there were many nurse practitioners, and providers that would all be very good leaders. Mentors are able to assess and support others to acquire the necessary skills to exceed in their role (DeVry University, 2022).

 

References

Aprn’s role in Ethical Prescribing: Duquesne University. Duquesne University School of Nursing. (2020, May 20). 

https://onlinenursing.duq.edu/blog/aprns-role-responsibility-ethical-prescribing/Links to an external site.

13 key traits for leadership in Healthcare. devry.edu. (2022, February 23). https://www.devry.edu/blog/key-traits-for-leadership-in-healthcare.html#:~:text=Leading%20with%20a%20positive%20attitude,difficulties%20more%20effectively%20and%20productively.

Family Medicine researchers identify most effective practices of medical assistants in the primary care setting, as well as barriers: Family medicine: Michigan medicine. Family Medicine. (2022, June 16). https://medicine.umich.edu/dept/family-medicine/news/archive/202206/family-medicine-researchers-identify-most-effective-practices-medical-assistants-primary-care

Harris, J. R. (2020, April 8). 
Who is liable for errors involving drug prescriptions?. Harris Lowry Manton LLP. 

https://www.hlmlawfirm.com/blog/who-is-liable-for-errors-involving-drug-prescriptions/Links to an external site.

Suszek, A. (2023, August 8). 
Practicing medicine without a license: Criminal & Civil Liability. www.alllaw.com. https://www.alllaw.com/articles/nolo/medical-malpractice/practicing-without-license-criminal-civil-liability.html#:~:text=Laws%20vary%20by%20state%2C%20but,in%20addition%20to%20prison%20sentences.

What are the penalties for practicing without a license in Florida?. What are the penalties for practicing without a license in Florida? – The Law Place. (n.d.). https://www.thelawplace.com/faqs/what-are-the-penalties-for-practicing-without-a-license-in-florida/#:~:text=Fines%20and%20Imprisonment,5%20years%20in%20state%20prison.

 

NR326 Mental Health Nursing

RUA: Scholarly Article Review Guidelines

Purpose

The student will review, summarize, and critique a scholarly article related to a mental health topic.

Course outcomes: This assignment enables the student to meet the following course outcomes.

(CO 4) Utilize critical thinking skills in clinical decision-making and implementation of the nursing process for psychiatric/mental health clients. (PO 4)

(CO 5) Utilize available resources to meet self-identified goals for personal, professional, and educational development appropriate to the mental health setting. (PO 5)

(CO 7) Examine moral, ethical, legal, and professional standards and principles as a basis for clinical decision-making. (PO 6)

(CO 9) Utilize research findings as a basis for the development of a group leadership experience. (PO 8)

Due date: Your faculty member will inform you when this assignment is due. The Late Assignment Policy applies to this assignment.

Total points possible: 100 points

Preparing the assignment

1) Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions.

a. Select a scholarly nursing or research article, published within the last five years, related to mental health nursing. The content of the article must relate to evidence-based practice.

· You may need to evaluate several articles to find one that is appropriate.

b. Ensure that no other member of your clinical group chooses the same article, then submit your choice for faculty approval.

c. The submitted assignment should be 2-3 pages in length, excluding the title and reference pages.

2) Include the following sections (detailed criteria listed below and in the Grading Rubric must match exactly).

a. Introduction (10 points/10%)

· Establishes purpose of the paper

· Captures attention of the reader

b. Article Summary (30 points/30%)

· Statistics to support significance of the topic to mental health care

· Key points of the article

· Key evidence presented

· Examples of how the evidence can be incorporated into your nursing practice

c. Article Critique (30 points/30%)

· Present strengths of the article

· Present weaknesses of the article

· Discuss if you would/would not recommend this article to a colleague

d. Conclusion (15 points/15%)

· Provides analysis or synthesis of information within the body of the text

· Supported by ides presented in the body of the paper

· Is clearly written

e. Article Selection and Approval (5 points/5%)

· Current (published in last 5 years)

· Relevant to mental health care

· Not used by another student within the clinical group

· Submitted and approved as directed by instructor

f. APA format and Writing Mechanics (10 points/10%)

NR326 Mental Health Nursing

RUA: Scholarly Article Review Guidelines

NR326 Mental Health Nursing

RUA: Scholarly Article Review Guidelines

NR326_RUA_Scholarly_Article_Review_V4b_FINAL_MAY21 2

· Correct use of standard English grammar and sentence structure

· No spelling or typographical errors

· Document includes title and reference pages

· Citations in the text and reference page

For writing assistance (APA, formatting, or grammar) visit the
APA Citation and Writing page in the online library.

Please note that your instructor may provide you with additional assessments in any form to determine that you fully understand the concepts learned in the review module.

Grading Rubric Criteria are met when the student’s application of knowledge demonstrates achievement of the outcomes for this assignment.

Assignment Section and Required Criteria (Points possible/% of total points available)	Highest Level of Performance	High Level of Performance	Satisfactory Level of Performance	Unsatisfactory Level of Performance	Section not present in paper
Introduction (10 points/10%)	10 points	8 points	0 points
Required criteria 1. Establishes purpose of the paper 2. Captures attention of the reader	Includes 2 requirements for section.	Includes 1 requirement for section.	No requirements for this section presented.
Article Summary (30 points/30%)	30 points	25 points	24 points	11 points	0 points
Required criteria 1. Statistics to support significance of the topic to mental health care 2. Key points of the article 3. Key evidence presented 4. Examples of how the evidence can be incorporated into your nursing practice	Includes 4 requirements for section.	Includes 3 requirements for section.	Includes 2 requirements for section.	Includes 1 requirement for section.	No requirements for this section presented.
Article Critique (30 points/30%)	30 points	25 points	11 points	0 points
Required criteria 1. Present strengths of the article 2. Present weaknesses of the article 3. Discuss if you would/would not recommend this article to a colleague	Includes 3 requirements for section.	Includes 2 requirements for section.	Includes 1 requirement for section.	No requirements for this section presented.
Conclusion (15 points/15%)	15 points	11 points	6 points	0 points
1. Provides analysis or synthesis of information within the body of the text 2. Supported by ides presented in the body of the paper 3. Is clearly written	Includes 3 requirements for section.	Includes 2 requirements for section.	Includes 1 requirement for section.	No requirements for this section presented.
Article Selection and Approval (5 points/5%)	5 points	4 points	3 points	2 points	0 points
1. Current (published in last 5 years) 2. Relevant to mental health care	Includes 4	Includes 3	Includes 2	Includes 1	No requirements for

NR326 Mental Health Nursing

RUA: Scholarly Article Review Guidelines

NR326_RUA_Scholarly_Article_Review_V4b_FINAL_MAY21 4

3. Not used by another student within the clinical group 4. Submitted and approved as directed by instructor	requirements for section.	requirements for section.	requirements for section.	requirement for section.	this section presented.
APA Format and Writing Mechanics (10 points/10%)	10 points	8 points	7 points	4 points	0 points
1. Correct use of standard English grammar and sentence structure 2. No spelling or typographical errors 3. Document includes title and reference pages 4. Citations in the text and reference page	Includes 4 requirements for section.	Includes 3 requirements for section.	Includes 2 requirements for section.	Includes 1 requirement for section.	No requirements for this section presented.
Total Points Possible = 100 points

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