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Introduction

As a baccalaureate-prepared nurse, your participation and leadership in interdisciplinary teams will be vital to the health outcomes for your patients and organization. One way to approach designing an improvement project is to use the Plan-Do-Study-Act (PDSA) cycle. The Institute for Healthcare Improvement describes it thus:

The Plan-Do-Study-Act (PDSA) cycle is shorthand for testing a change in the real work setting—by planning it, trying it, observing the results, and acting on what is learned. This is the scientific method adapted for action-oriented learning…Essentially, the PDSA cycle helps you test out change ideas on a smaller scale before evaluating the results and making adjustments before potentially launching into a somewhat larger scale project (n.d.).

You might also recognize that the PDSA cycle resembles the nursing process. The benefit of gaining experience with this model of project design is that it provides nurses with an opportunity to ideate and lead improvements. For this assessment, you will not be implementing all of the PDSA cycle. Instead, you are being asked to interview a health care professional of your choice to determine what kind of interdisciplinary problem he or she is experiencing or has experienced in the workplace. This interview, in Assessment 2, will inform the research that you will conduct to propose a plan for interdisciplinary collaboration in Assessment 3.

It would be an excellent choice to complete the PDSA Cycle activity prior to developing the report. The activity consists of four questions that create the opportunity to check your understanding of best practices related to each stage of the PDSA cycle. The information gained from completing this formative will promote your success with the Interview and Interdisciplinary Issue Identification report. This will take just a few minutes of your time and is not graded.

Reference

Institute for Healthcare Improvement. (n.d.). 
How to improve. http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx

Demonstration of Proficiency

· Competency 2: Explain how interdisciplinary collaboration can be used to achieve desired patient and systems outcomes.

· Summarize an interview focused on past or current issues at a health care organization.

· Describe collaboration approaches from the literature that could be relevant in establishing or improving an interdisciplinary team to address an organizational issue.

· Competency 3: Describe ways to incorporate evidence-based practice within an interdisciplinary team.

· Identify an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate.

· Competency 4: Explain how change management theories and leadership strategies can enable interdisciplinary teams to achieve specific organizational goals.

· Describe change theories and a leadership strategy that could help develop an interdisciplinary solution to an organizational issue.

· Competency 5: Apply professional, scholarly, evidence-based communication strategies to impact patient, interdisciplinary team, and systems outcomes.

· Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.

· Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.

Professional Context

This assessment will introduce the Plan-Do-Study-Act (PDSA) Model to create change in an organization. By interviewing a colleague of your choice, you will begin gathering information about an interprofessional collaboration problem that your colleague is experiencing or has experienced. You will identify a change theory and leadership strategies to help solve this problem.

Scenario

This assessment is the first of three related assessments in which you will gather interview information (Assessment 2); design a proposal for interdisciplinary problem-solving, (Assessment 3); and report on how an interdisciplinary improvement plan could be implemented in a place of practice (Assessment 4). At the end of the course, your interviewee will have a proposal plan based on the PDSA cycle that he or she could present to stakeholders to address an interdisciplinary problem in the workplace.

For this assessment, you will need to interview a health care professional such as a fellow learner, nursing colleague, administrator, business partner, or another appropriate person who could provide you with sufficient information regarding an organizational problem that he or she is experiencing or has experienced, or an area where they are seeking improvements. Consult the 
Interview Guide [DOCX]
 Download Interview Guide [DOCX]for an outline of how to prepare and the types of information you will need to complete this project successfully.

Remember: this is just the first in a series of three assessments.

Instructions

For this assessment, you will report on the information that you collected in your interview, analyzing the interview data and identifying a past or current issue that would benefit from an interdisciplinary approach. This could be an issue that has not been addressed by an interdisciplinary approach or one that could benefit from improvements related to the interdisciplinary approach currently being used. You will discuss the interview strategy that you used to collect information. Your interview strategy should be supported by citations from the literature. Additionally, you will start laying the foundation for your Interdisciplinary Plan Proposal (Assessment 3) by researching potential change theories, leadership strategies, and collaboration approaches that could be relevant to issue you have identified. Please be certain to review the scoring guide to confirm specific required elements of this assessment. Note that there are differences between basic, proficient and distinguished scores.

When submitting your plan, use the 
Interview and Issue Identification Template [DOCX], 
 Download Interview and Issue Identification Template [DOCX],which will help you to stay organized and concise. As you complete the template, make sure you use APA format for in-text citations for the evidence and best practices that are informing your plan, as well as for the reference list at the end.

Additionally, be sure to address the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.

· Summarize an interview focused on past or current issues at a health care organization.

· Identify an issue from an interview for which an evidence-based interdisciplinary approach would be appropriate.

· Describe potential change theories and leadership strategies that could inform an interdisciplinary solution to an organizational issue.

· Describe collaboration approaches from the literature that could facilitate establishing or improving an interdisciplinary team to address an organizational issue.

· Communicate with writing that is clear, logically organized, and professional, with correct grammar and spelling, and using current APA style.

Additional Requirements

·
Length of submission: Use the provided template. Most submissions will be 2–4 pages in length. Be sure to include a reference page at the end of the plan.

·
Number of references: Cite a minimum of 3 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than 5 years old.

·
APA formatting: Make sure that in-text citations and reference list follow current APA style.

Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final Capstone course.

Please Reply to the following 2 Discussion posts:

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Please see the attachment for instructions

AURP

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Total points possible: 100 points

Preparing the assignment
1. Research the literature and obtain two to three resources for current,
evidence-based information related to Tapinarof
2. Develop a teaching brochure and one page paper following these guidelines.

a. Brochure for nurses- Focus on nurses for literacy level
• Key/Relevant Drug Information (30 points/30%)

o Drug Class
o Mechanism of Action
o Drug Administration and Dosage
o Drug Interactions
o Lab effects/interference

• Patient Education Considerations (35 points/35%)
o Nursing Management
o Patient Education Considerations (special considerations)- provide examples
specific to client age needs- geriatric, pediatric and pregnant client
o Patient Assessment
o Side Effects/Adverse Effects/Toxicities
o Special considerations- provide examples specific to client age needs-
geriatric, pediatric, and pregnant clients
o Visual Effects/Creativity (10 points/10%)
o Developed per the required standard
o Appropriate for the intended audience (focus on nurses for literacy level)
o Graphics enhance the purpose of the brochure
o Brochure is visually appealing

b. One Page Paper (15 points/15%)
• Describes intended use of brochure (focus on nurses for literacy level)
• Includes:

o Name
o Date
o Class
o Reference page

• Describe how brochure information would be revised if intended brochure
audience had a low health literacy level.

c. APA Format (5 points/5%)
• Includes no more than 3 unique errors with APA format (current ed.)
• At least two (2) scholarly, primary sources from the last 5 years, excluding the
textbook, are provided

d. Writing and Mechanics (5 points/5%)

• Clearly written
• Includes no more than three unique errors of grammar
• Includes no more than three unique errors in writing mechanics
• Paper is one page, excluding references and title page

Nursing Research Assignment

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Research Assignment

Blog

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 blog on evidence-based practice in the healthcare organization where you practice. (psychiatry)Drawing on your understanding of EBP and your firsthand observations within your organization, include the following content in your blog: 

Informatics in healthcare

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IM3001A Module 3 Pre-Assessment (PDF)

Module Pre-Assessments are your opportunity to practice applying module content before final submission of your Competency Assessment. For your final Competency Assessment, you will address scenarios related to the importance of nursing informatics in healthcare.

For your Module 3 Pre-Assessment, respond to the following prompts. These prompts match those in your final Assessment. Be sure to support your responses with evidence from scholarly literature.

Prompts:

Scenario:

A patient approaches you after her consultation with her physician. Her physician had reviewed her electronic health record with her during the consultation. The patient realized that some of the information in her EHR was incorrect. The patient asks you to make changes to this information. Is this possible? Why or why not? Write a 1-page response that includes the following:

  • Describe what you would tell the patient in this scenario regarding making changes to her electronic health record (EHR).
  • Explain your reasons for responding to the patient in the way you describe.
  • Be sure to reference any legal requirements related to EHRs.

Nursing assignment 5 psycho

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Goal: Develop a PowerPoint presentation on a personality disorder.

Content Requirements:

  • Students will be randomly selected to participate in groups of three.
  • Create a case study of a patient based on your assigned group topic.  
  • The presentation must provide information:
    • Introduce a fictitious patient with a disease or disorder based on your assigned group topic.  Must specifically address the disease as it relates to one of the following populations:  infants, toddlers, school-aged children, adolescents, adults, or the elderly.
    • Definition of the disease or disorder
    • Epidemiology of the disease or disorder
      • Incidence
      • Prevalence
    • Pathogenesis
      • Pathophysiology of the disease/disorder to the cellular level.
      • Including genetics/genomics, neurotransmitters, and neurobiology of this specific disorder.
    • Clinical features of the disease or disorder
      • History of the patient’s problems
      • Physical findings
      • Psychiatric findings (Using DSM5-TR diagnosis only.)
    • Recommendations
      • Treatment recommendations according to the US clinical guidelines. 
      • Patient education for management and anticipatory guidance.
      •  Non-pharmaceutical, cultural, and spiritual considerations must be addressed.

Format Requirements: 

Submission Requirements

  • Complete and submit the PowerPoint by 11:59 PM ET Sunday
  • Late work policies, expectations regarding proper citations, acceptable means of responding to peer feedback, and other expectations are graded at the discretion of the instructor.
  • You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.

200 word case

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  DUE 9/15   7PM EST

  1. assignment criteria listed above.

Please use, at minimum three scholarly references, and your paper should be 300-words, excluding title and reference pages.

week 3 discussions

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Week 3 Discussion Forum

  • Why  is your research needed, and how will it affect social change or change  within your organization? Discuss the key people involved and how your  research will affect them.

Wk3soap668B

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Week 3: Problem-Focused SOAP Note

Criteria Ratings Pts

This criterion is linked to a
Learning Outcomes
(Subjective)

2.5 pts

Accomplished

Symptom analysis is well organized, with C/C,

OLD CART, pertinent negatives, and pertinent

positives. All data needed to support the

diagnosis & differential are present. Is

complete, concise, and relevant with no

extraneous data.

2.5 pts

This criterion is linked to a
Learning Outcome
(Objective)

2.5 pts

Accomplished

Complete, concise, well organized, well

written, and includes pertinent positive and

pertinent negative physical findings. Organized

by body system in list format. No extraneous

data.

2.5 pts

This criterion is linked to a
Learning Outcome A
(Assessment)

2.5 pts

Accomplished

Diagnosis and differential dx are correct,

include ICD code, and are supported by

subjective and objective data.

2.5 pts

This criterion is linked to a
Learning Outcome (Plan)

2.5 pts

Accomplished

The plan is organized, complete and supported

with 2 evidence-based references. Addresses

each diagnosis and is individualized to the

specific patient and includes medication

teaching and all 5 components: (Dx plan, Tx

plan, patient education, referral/follow-up,

health maintenance).

2.5 pts

Total Points: 10

Use the template that I gave you before. The first page needs blank for cover sheet.

Diagnoses is R300; Dysuria. Needs ICD 10 codes for differential dx,

CPT codes for labs and procedures such as UA, Urine culture and sensitivity, physical

examination etc Do not paste and copy all (it needs paraphrasing). Research a lot for

patient education, pertinent positive and pertinent negative, non-pharmacologic

treatment etc. APA 7 format. I can give you five days to complete it.

Patient initial: J. V.

Patient DOB: 1963 Sex: F

SUBJECTIVE:

Chief Complaint:

History Of Present Illness:

-Patient is seen today for flank pain and dysuria

Medical History:

COVID pos 5/7/22

anemia

UTI, pyelonephritis s/p hospitalization w/sepsis

Mx kidney stones

Varicose Veis

Scoliosis

Surgical History:

Lithotripsy 2020

Gynecological History:

G5P5A0

denies h/o abnormal pap or mammo

Family History:

M: dementia, lupus, hypothyroid

F: varicose veins

Social History:

-single

-lives with children

-works as food service worker HMH

-denies tobacco

-denies ETOH

-denies recreational drugs

Smoking Status: Never Smoked

Allergies:

Macrobid; ; Dizziness

Morphine; ;

Current Medications:

Currently not taking medications

Review of System:

Constitutional: #fatigue#

Patients deny weight change, fever, chills, weakness, sleep changes, appetite changes.

Head: Patient denies headache.

Neck: Patient denies abnormal masses, neck stiffness.

Eyes: Patient denies vision loss, blurring, discharge, excessive tearing, dryness.

Ears: Patient denies hearing loss, tinnitus, vertigo, discharge, pain

Nose: Patient denies rhinorrhea, stuffiness, sneezing, itching.

Mouth: Patient denies ulcers, bleeding gums, taste problems.

Throat: Patient denies throat pain, difficulty swallowing,

Cardiovascular: Patient denies chest pain, chest pressure, palpitations, DOE,

orthopnea.

Respiratory: Patient denies shortness of breath, cough, increased sputum, hemoptysis.

Gastrointestinal: Patient denies nausea, vomiting, heartburn, dysphagia, diarrhea,

constipation, melena, abdominal pain, jaundice, hemorrhoids.

Genitourinary: #R flank pain, dysuria, increased frequency#

Patient denies abnormal urgency, hesitancy, incontinence, hematuria, nocturia, stones.

Musculoskeletal: Patient denies arthralgias, joint stiffness, myalgias, muscle weakness,

instability and abnormal range of motion

Integumentary (Skin and/or Breast): Patient denies rash, changes in hair, changes in

nail, pruritus

Neurological: Patient denies headache, syncope, seizures, vertigo, ataxia, diplopia,

tremor, numbness, tingling.

Psychiatric: #insomnia#

Patient denies depression, mood abnormalities, anxiety, memory loss, appetite

changes

Endocrine: Patient denies sensitivity to cold or heat, polyuria, polydipsia.

Hematologic/Lymphatic: Patient denies bleeding, bruising, lymphadenopathy.

GYN: Patient denies abnormal bleeding, changes in menstrual cycle, hot flashes.

OBJECTIVE:

Vital Signs:

Height: 64.50 in

Weight: 139.40 lbs

BMI: 23.56

Blood Pressure: 135/78 mmHg

Temperature: 98.60 F

Pulse: 86 beats/min

Physical Exam:

Constitutional:

WD, WN, Alert, Oriented X3 in NAD. Affect appropriate. Gait normal.

Eye: PERRLA, EOMI, nl conjunctiva

Ear: No pinnea/tragal tenderness. Drums are visualized, no wax in canals

Nose: N1 mucosa. N1 Nasal septal walls and turbinates.

Mouth: N1 bucal mucosa, no lesions noted.

Throat: Clear, no erythema or exudates.

Neck: supple, no masses. No thyromegaly. Trachea is midline. N1 carotid auscultation.

No JVD

Cardiovascular: RRR, N1 S1 and S2, No cardiac murmurs, rubs or gallops.

Lungs: ctab, no wheezes, rhonchi or crackles

Chest/Breasts: 4/12/22: #L breast 3 o clock lumpiness, ttp#

Gastrointestinal (Abdomen): soft, nt, nd, bs(+). No palpable masses.

Genitourinary: #R flank CVAT#

Lymphatic: -No LAN noted

Musculoskeletal: #ttp over medial aspect of L knee with preserved ROM with small

healed 1 x1 cm scar from abrasion#

strength symmetrical and wnl. No muscle weakness or stiffness. No joint effusion

Skin: #callus noted between 4th and 5th metatarsal on L foot#

Normal color and texture.

Extremities: #varicose veins R greater than L#

Warm, no clubbing, cyanosis or edema. N1 DP/PT pulses bilaterally

Neurological/Psychiatric: CN I-XII intact, neurosensory wnl, strength (5/5), (2+) DTR

UE/LE bilaterally

-Judgment and insight intact

Imaging: 9/21/22 arterial u/s neg

ASSESSMENT:

Diagnosis:

ICD-10 Codes:

1)M545; Low back pain

2)R300; Dysuria

3)R946; THYROID ABNORMAL RESULT

4)D649; Anemia, unspecified

5)R5383; Fatigue

PLAN:

Procedures:

1) 99215; Comprehensive

2) 99401; 15 min

3) 99000; Handling of specimen from doctor to lab

4) 81002; Urinalysis/Dip

Orders:

1) 5463; UA complete (lab order)

2) 395; UCX (lab order)

Medications:

Augmentin 500-125 MG Oral Tablet; Take 1 tablet orally every 12 hours; Qty: 14;

Refills: 0

Care Plan:

.

***recurrent UTI, h/o pyelo and sepsis- last UCx 4/12/22 showed 100K E coli resistant to

cipro and levaquin. Pt reports 2 day h/o R flank pain, dysuria, frequency and fatigue.

Tried Macrobid in the past which caused severe dizziness.

-UA 12/23/22 pos for leukocytes

-send out Ucx 12/23/22

-Rx Augmentin 500/125mg bid x7 days, r/b d/w pt

-ER precautions over holiday weekend

-referred to uro given recurrent UTI and high-risk history

***abnormal TSH- noted on labs 4/19/22. TSH 0.266 unsure if ever discuss

-reordered TSH 12/23/22

**fatigue- h/o anemia. pt reports hgb dropped to 9 once, donates blood occasionally. per

pt took iron in the past. no overt bleeding 4/19/22 cbc and irons normal. Pt requesting

again to check

-ordered iron panel, ferritin 12/23/22 per pt request

***elevated B12- 4/19/22 B12 level over 1500

-discuss nv, but will need to stop any supplementation

***L knee pain- fell and landed on L knee. worsen with prolonged standing. Reports she

had same pain on R knee and had steriod injection, which resolved it. On PEX, ttp over

medial aspect of L knee with preserved ROM with small healed 1 x1 cm scar.

-on 8/8/22 spoke to pt regrading her L knee x ray. MRI is recommended given that she

sustained a trauma to her knee and has radiologic findings of possible soft tissue injury.

She is in significant pain, takes Ibuprofen, reports difficulty with ambulation. Pt states

that she tried to make appt with ortho and radiology, but no slots were available anytime

soon.

-Needs MRI. Can either order or she can see ortho and do it with them. I was able to

arrange an appt for her to see Dr Panosyan tomorrow at 1:30.

***varicose veins, bil leg pain- to b/l LEX, R greater than L, chronic. c/o occasional

aching. prolonged standing and walking at work. 9/21/22 arterial duplex neg

-Ordered venous u/s 8/3/22

-referred to vein specialist 4/12/22 and 8/3/23

Plan Notes Continued: .

***Tinea cruris bilaterally – noted on PEX on 10/26/22

-Rx ketoconazole 2% cream top bid x 2wks, r/b, d/w pt

***Callus- Pt reports painful, itchy lesion in between 4th and 5th metatarsal. Works long

hours on her feet. Pt reports she has new shoes and tried OTC counter products with

no relief. Admits to trying her son's salicylic acid acne med on lesion. On PEX, small,

hardened callus is noted.

-Referred to podiatry on 10/26/22

***insomnia- chronic. has failed melatonin and hydroxyzine 50 mg. also took Ambien

5mg prn in past

-cont w/caution

Patient Instructions: .

-Pt has been instructed to take medications as prescribed

-Pt received education on compliance with medications and recommendations

-Pt received counseling regarding Medication Side Effects

-Pt received counseling on following a well-balanced healthy diet with veg, fruit and

fiber.

-Pt was instructed to do CV exercise at least 3-4 times every week for 30 minutes.

-Pt received counseling regarding stress management

PHCM: .

58 yo F:

-annual PEX: done 4/12/22–next due 4/12/23

-annual labs: done 4/19/22 unsure if ever discussed

-cervical CA screening: referred to gyn 4/12/22

-breast CA screening: dx mammo L breast u/s ordered 4/12/22

-colon CA screening: referred to GI 4/12/22

-skin CA screening: referred to derm 4/12/22

Immunizations:

-influenza: fall 2021

-tetanus: unsure, rec 4/12/22

-shingrix: rec 4/12/22

-COVID: Pfizer 5/2021, 6/2021, booster 3/2022

  • Week 3: Problem-Focused SOAP Note