This document outlines the rubric for evaluating a student's submission of a focused SOAP note case study assignment. It provides detailed criteria and point values for assessing students' documentation of the patient's subjective history, objective diagnostic results, assessment including a mental status exam and differential diagnoses, and treatment plan. The highest scores are for responses that thoroughly, accurately, and critically describe all required elements of the SOAP note based on the case study provided. References to current evidence and adherence to APA style are also evaluated. The rubric aims to guide students in including all essential information needed for a psychiatric evaluation note.
Harassment and Retaliation in the Workplace
HR Training Presentation
z
z
What Every Employee
Needs to Know
Part 1: Harassment and Retaliation in the Workplace
z
Part 1 of your PowerPoint Presentation should consist of 5-10 slides.
2
Harassment and Retaliation in the Workplace
Definitions & Examples
z
Describe harassment and retaliation in the workplace by defining both terms and providing workplace examples of each.
3
Harassment and Retaliation in the Workplace
FAQs: Questions & Answers
z
Provide at least 5 possible questions an employee might ask about harassment and retaliation in the workplace and your responses to those questions.
4
Harassment and Retaliation in the Workplace
Recommended Resources
z
Identify at least 5 quality recommended resources you would like every employee to have. Be sure to annotate each one with a brief summary of the resource and your rationale for your recommendation.
5
Making It Real!
Part 2: Harassment and Retaliation in the Workplace
z
Part 2 of your PowerPoint Presentation should consist of 6-10 slides.
6
Harassment and Retaliation in the Workplace
Summarizing and Analyzing a Real Situation
z
Provide a summary of a situation from your work experience, or reported abuse from a legitimate news report, demonstrating harassment in the workplace, whether retaliation was involved, and if so, in what ways.
7
Harassment and Retaliation in the Workplace
Anticipating and Avoiding Retaliatory Actions
z
If you were the HR professional involved, what retaliatory actions might you anticipate, and how might these be avoided?
8
Harassment and Retaliation in the Workplace
What HR Professionals Need to Know
About the Law
z
Explain what you would need to know about the law in order to handle the situation appropriately and effectively as an HR professional.
9
Harassment and Retaliation in the Workplace
Taking Steps for Prevention
z
Identify next steps that you would recommend to prevent this situation from happening again.
10
Resources
Part 3: Harassment and Retaliation in the Workplace
z
List your resources for this PowerPoint Presentation on the next slide.
11
RESOURCES
z
Your final slide should list in APA format the References that support the content provided.
12
Rubric Detail
Select Grid View or List View to change the rubric's layout.
Content
Name: NRNP_6675_Week5_Assignment_Rubric
Grid ViewList View
Excellent
90%–100%
Good
80%–89%
Fair
70%–79%
Poor
0%–69%
Create documentation in the Focused SOAP Note Template about your assigned patient.
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
Points:
...
DirectionsRefer to your potential dissertation topic from your AlyciaGold776
Directions:
Refer to your potential dissertation topic from your submission of "Dissertation Development" in RES-820. For this assignment, you must use a qualitative methodology.
Review your submission of "Quantitative Analysis and Argumentation" in Topic 4 of this course and any feedback from your instructor on that assignment. Update the following as needed, and transfer the updated information to the presentation template "RES-831 Qualitative Study Defense" attached to this assignment:
1. Potential Research Topic
1. Background to the Problem
1. Problem Space
1. Theoretical Foundation
1. Initial Literature Review
Continuing in the presentation template "RES-831 Qualitative Study Defense," complete the template slides to prepare a presentation to describe and defend your choices of the following as a qualitative study:
1. Problem Statement
1. Research Questions and Phenomena
1. Study Methodology
1. Study Feasibility
Your choices must be defended with relevant current research
Rewatch the same Patient Interview. This time, you will focus on writing the diagnosis and differential discussion. The discussion should include the following sections:
· A summary of findings
· Psychodynamic formulation
· Primary diagnosis with ICD code
· Prognosis
· Plan including medications, labs, therapy, patient education, follow up, non-pharmacological treatments
An example is outlined on page 24 of Kaplan & Sadock’s Synopsis of Psychiatry textbook.
Rubric
Psychiatric Report: Impression: Diagnosis/Differentials
Psychiatric Report: Impression: Diagnosis/Differentials
Criteria
Ratings
Pts
This criterion is linked to a Learning OutcomeAssessment & Diagnoses
15 pts
Proficient
Identifies the most appropriate primary diagnosis and ICD code for the patient presented in the scenario. Identifies all additional psychiatric and medical diagnoses presented in the scenario.
11.25 pts
Acceptable
The primary diagnosis and ICD code identified is similar to the most appropriate diagnosis. At least one additional psychiatric and medical diagnosis presented in the scenario was identified.
7.5 pts
Needs Improvement
The primary diagnosis and ICD code identified is vague or not similar to the most appropriate diagnosis. The additional psychiatric and medical diagnosis presented in the scenario was not correct.
3.75 pts
Unsatisfactory
The primary diagnosis and ICD code identified is not correct for the patient presented in the scenario. No additional psychiatric or medical diagnoses presented in the scenario were identified.
0 pts
Missing
No primary diagnoses, ICD code, secondary, or medical diagnoses were given.
15 pts
This criterion is linked to a Learning OutcomeDifferential Diagnoses
15 pts
Proficient
Identifies at least 2 appropriate differential diagnoses for the patient presented in the scenario.
11.25 pts
Acceptable
Identifies at least 1 appropriate differential diagnosis for the patient presented in the scenario.
7.5 pts
Needs Improvement
Identifies at least 1 differe ...
Bipolar TherapyClient of Korean DescentAncestryDecisionChantellPantoja184
Bipolar Therapy
Client of Korean Descent/Ancestry
Decision Point One
B Begin Risperdal 1 mg orally BIDegin Risperdal 1 mg orally BID
RESULTS OF DECISION POINT ONE
Client returns to clinic in four weeks
Client is accompanied today by her mother who must help the client into your office, the client looks very sedated and lethargic
Client's mother explains that “she has been like this since about a week after the last office visit”
Decision Point Two
RESULTS OF DECISION POINT TWO
Discontinue Risperdal and start Lithium sustained release 300 mg orally BID
Client returns to clinic in four weeks
Client no longer lethargic after the end of the first week
Client has a slight decrease in her Young Mania Rating Scale (from 22 to 19)
Client reports that her sleep is again decreasing, but that overall, she is happy
Decision Point Three
Make no changes at this time & reevaluate in 4 weeks
Guidance to Student
Recall that the client is of Korean descent and is positive for CYP2D6*10 allele. As a result, she may be demonstrating slower clearance of Risperdal from her system, resulting in higher than normal levels of Risperdal in the blood, resulting in sedation. The client responded well to the discontinuation of Risperdal and after about a week of drug cessation, she was no longer lethargic/sedate. However, in the following 3 weeks, she had experienced increased symptoms, although a slight improvement in YMSR score was noted. You could make no changes at this time and allow the lithium to remain at its current dose for an additional 4 weeks and reassess. Conversely, you can increase the lithium to 450 mg orally BID and then reassess in 4. The additional milligrams may hasten mood stabilization. Risperdal 0.5 mg orally BID may be appropriate if the clients’ symptoms are worsening, however, you would need to have the client return to the office sooner than 4 weeks for an interim visit to assess effects of drug and presence of somnolence/lethargy.
Rubric Detail
Select Grid View or List View to change the rubric's layout.
Content
Name: NURS_6630_Week5_Assignment_Rubric
Grid ViewList View
Excellent
Point range: 90–100
Good
Point range: 80–89
Fair
Point range: 70–79
Poor
Point range: 0–69
Introduction to the case (1 page)
Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.
Points:
Points Range:
9 (9%) - 10 (10%)
The response accurately, clearly, and fully summarizes in detail the case for the Assignment.
The response accurately and clearly explains in detail the specific patient factors that impact decision making when prescribing medication for this patient.
Feedback:
Points:
Points Range:
8 (8%) - 8 (8%) ...
Decision Point OneBegin Zoloft 50 mg orally dailyBegin Zoloft LinaCovington707
Decision Point One
Begin Zoloft 50 mg orally dailyBegin Zoloft 50 mg orally daily
RESULTS OF DECISION POINT ONE
· Client returns to clinic in four weeks
· Client informs you that he has no tightness in chest, or shortness of breath
· Client states that he noticed decreased worries about work over the past 4 or 5 days
· HAM-A score has decreased to 18 (partial response)
Decision Point Two
Increase dose to 75 mg orally daily
RESULTS OF DECISION POINT TWO
· Client returns to clinic in four weeks
· Client reports an even further reduction in his symptoms
· HAM-A score has now decreased to 10. At this point- continue current dose (61% reduction in symptoms)
Decision Point Three
Maintain current dose
Guidance to Student
At this point, it may be appropriate to continue client at the current dose. It is clear that the client is having a good response (as evidenced by greater than a 50% reduction in symptoms) and the client is currently not experiencing any side effects, the current dose can be maintained for 12 weeks to evaluate full effect of drug. Increasing drug at this point may yield a further decrease in symptoms, but may also increase the risk of side effects. This is a decision that you should discuss with the client. Nothing in the client’s case tells us that we should consider adding an augmentation agent at this point as the client is demonstrating response to the drug. Avoid polypharmacy unless symptoms cannot be managed by a single drug.
Generalized Anxiety Disorder
Middle-Aged White Male With Anxiety
Anxiety
BACKGROUND INFORMATION
The client is a 46-year-old white male who works as a welder at a local steel fabrication factory. He presents today after being referred by his PCP after a trip to the emergency room in which he felt he was having a heart attack. He stated that he felt chest tightness, shortness of breath, and feeling of impending doom. He does have some mild hypertension (which is treated with low sodium diet) and is about 15 lbs. overweight. He had his tonsils removed when he was 8 years old, but his medical history since that time has been unremarkable. Myocardial infarction was ruled out in the ER and his EKG was normal. Remainder of physical exam was WNL.
He admits that he still has problems with tightness in the chest and episodes of shortness of breath- he now terms these “anxiety attacks.” He will also report occasional feelings of impending doom, and the need to “run” or “escape” from wherever he is at.
In your office, he confesses to occasional use of ETOH to combat worries about work. He admits to consuming about 3-4 beers/night. Although he is single, he is attempting to care for aging parents in his home. He reports that the management at his place of employment is harsh, and he fears for his job. You administer the HAM-A, which yields a score of 26.
Client has never been on any type of psychotropic medication.
MENTAL STATUS EXAM
The client is alert, oriented to person, place, time, and ev ...
APA Title page, running head, page numbers, reference sheet. Use L.docxjustine1simpson78276
APA Title page, running head, page numbers, reference sheet. Use Level 1 and 2 headings to make identifying the components of the paper easier. – 5 points after grade calculated from rubric.
TO be successful in the clinical setting do the following:
You need a APA cover sheet, running head and reference page for anything you turn in (Journal, SOAP note, Time Log).
Do Not change the template.
Do use the template located in the Doc Sharing. This is the explanation of the template…this is not the template.
READ every line of this document please.
You must site 2 journal articles in addition to Epocrates/Medscape and text book failure to do so is -10 points outside of the rubric.
All grades are final. No revisions. Do not ask for revisions of SOAP grades.
Nurse Practitioner SOAP Notes
Purpose: To explain what each section of the SOAP note should include. Remember that Nurse Practitioners treat patients in a holistic manner and your SOAP note should reflect that premise. DO NOT INCLUDE IN NOTE
Subjective data value @ 15 points
SUBJECTIVE DATA: What the patient tells you but organized by you in logical fashion
Chief Complaint (CC): One to three words explaining why patient came to clinic value 1 point
History of Present Illness (HPI): Paint a picture of what is wrong with the patient. You need to start EVERY HPI with age, race, gender. (Example: 34-year-old AA male) Must include the 7 attributes of each principal symptom: value 7 points hint: OLD CART
Write your paragraph in the order of old cart & chart as well if missing paragraph -3.5 if missing list -3.5
Onset
Location
Duration
Characteristics
Aggravating Factors
Relieving Factors
Treatments/Therapies
Each of these are valued at 0.5 points (maximum 4 points)
Medications: list each one by name with dosage and frequency
Allergies: include specific reactions to medications, foods, insects, environmental
Past Medical History (PMH): Illnesses, hospitalizations, risky sexual behaviors. Include childhood illnesses
Past Surgical History (PSH): Dates, indications and types of operations
OB/GYN History: (if applicable) Obstetric history, menstrual history, methods of contraception and sexual function
Personal/Social History: Tobacco use, Alcohol use, Drug use. Patient’s interests, ADL’s IADL’s if applicable. Exercise, eating habits. Pediatrics: school status, parental smoking hx, birth history etc
Immunizations: Last Tdp, Flu, pneumonia, etc. Pediatrics- (per pediatric schedule for age)
Family History: Parents, Grandparents, siblings, children
Review of Systems: Go Head to toe. Cover each system that covers the Chief Complaint, History of Present Illness and History (this includes the systems that address any previous diagnoses). YOU DO NOT NEED TO DO THEM ALL UNLESS YOU ARE DOING a TOTAL H&P. Remember, this is what the patient tells you. Delete the system if not addressing. DO NOT put wnl or no complaints be specific. Value 3 points
General: any recent weight changes, weakness, fatigue,.
Harassment and Retaliation in the Workplace
HR Training Presentation
z
z
What Every Employee
Needs to Know
Part 1: Harassment and Retaliation in the Workplace
z
Part 1 of your PowerPoint Presentation should consist of 5-10 slides.
2
Harassment and Retaliation in the Workplace
Definitions & Examples
z
Describe harassment and retaliation in the workplace by defining both terms and providing workplace examples of each.
3
Harassment and Retaliation in the Workplace
FAQs: Questions & Answers
z
Provide at least 5 possible questions an employee might ask about harassment and retaliation in the workplace and your responses to those questions.
4
Harassment and Retaliation in the Workplace
Recommended Resources
z
Identify at least 5 quality recommended resources you would like every employee to have. Be sure to annotate each one with a brief summary of the resource and your rationale for your recommendation.
5
Making It Real!
Part 2: Harassment and Retaliation in the Workplace
z
Part 2 of your PowerPoint Presentation should consist of 6-10 slides.
6
Harassment and Retaliation in the Workplace
Summarizing and Analyzing a Real Situation
z
Provide a summary of a situation from your work experience, or reported abuse from a legitimate news report, demonstrating harassment in the workplace, whether retaliation was involved, and if so, in what ways.
7
Harassment and Retaliation in the Workplace
Anticipating and Avoiding Retaliatory Actions
z
If you were the HR professional involved, what retaliatory actions might you anticipate, and how might these be avoided?
8
Harassment and Retaliation in the Workplace
What HR Professionals Need to Know
About the Law
z
Explain what you would need to know about the law in order to handle the situation appropriately and effectively as an HR professional.
9
Harassment and Retaliation in the Workplace
Taking Steps for Prevention
z
Identify next steps that you would recommend to prevent this situation from happening again.
10
Resources
Part 3: Harassment and Retaliation in the Workplace
z
List your resources for this PowerPoint Presentation on the next slide.
11
RESOURCES
z
Your final slide should list in APA format the References that support the content provided.
12
Rubric Detail
Select Grid View or List View to change the rubric's layout.
Content
Name: NRNP_6675_Week5_Assignment_Rubric
Grid ViewList View
Excellent
90%–100%
Good
80%–89%
Fair
70%–79%
Poor
0%–69%
Create documentation in the Focused SOAP Note Template about your assigned patient.
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
Points:
...
DirectionsRefer to your potential dissertation topic from your AlyciaGold776
Directions:
Refer to your potential dissertation topic from your submission of "Dissertation Development" in RES-820. For this assignment, you must use a qualitative methodology.
Review your submission of "Quantitative Analysis and Argumentation" in Topic 4 of this course and any feedback from your instructor on that assignment. Update the following as needed, and transfer the updated information to the presentation template "RES-831 Qualitative Study Defense" attached to this assignment:
1. Potential Research Topic
1. Background to the Problem
1. Problem Space
1. Theoretical Foundation
1. Initial Literature Review
Continuing in the presentation template "RES-831 Qualitative Study Defense," complete the template slides to prepare a presentation to describe and defend your choices of the following as a qualitative study:
1. Problem Statement
1. Research Questions and Phenomena
1. Study Methodology
1. Study Feasibility
Your choices must be defended with relevant current research
Rewatch the same Patient Interview. This time, you will focus on writing the diagnosis and differential discussion. The discussion should include the following sections:
· A summary of findings
· Psychodynamic formulation
· Primary diagnosis with ICD code
· Prognosis
· Plan including medications, labs, therapy, patient education, follow up, non-pharmacological treatments
An example is outlined on page 24 of Kaplan & Sadock’s Synopsis of Psychiatry textbook.
Rubric
Psychiatric Report: Impression: Diagnosis/Differentials
Psychiatric Report: Impression: Diagnosis/Differentials
Criteria
Ratings
Pts
This criterion is linked to a Learning OutcomeAssessment & Diagnoses
15 pts
Proficient
Identifies the most appropriate primary diagnosis and ICD code for the patient presented in the scenario. Identifies all additional psychiatric and medical diagnoses presented in the scenario.
11.25 pts
Acceptable
The primary diagnosis and ICD code identified is similar to the most appropriate diagnosis. At least one additional psychiatric and medical diagnosis presented in the scenario was identified.
7.5 pts
Needs Improvement
The primary diagnosis and ICD code identified is vague or not similar to the most appropriate diagnosis. The additional psychiatric and medical diagnosis presented in the scenario was not correct.
3.75 pts
Unsatisfactory
The primary diagnosis and ICD code identified is not correct for the patient presented in the scenario. No additional psychiatric or medical diagnoses presented in the scenario were identified.
0 pts
Missing
No primary diagnoses, ICD code, secondary, or medical diagnoses were given.
15 pts
This criterion is linked to a Learning OutcomeDifferential Diagnoses
15 pts
Proficient
Identifies at least 2 appropriate differential diagnoses for the patient presented in the scenario.
11.25 pts
Acceptable
Identifies at least 1 appropriate differential diagnosis for the patient presented in the scenario.
7.5 pts
Needs Improvement
Identifies at least 1 differe ...
Bipolar TherapyClient of Korean DescentAncestryDecisionChantellPantoja184
Bipolar Therapy
Client of Korean Descent/Ancestry
Decision Point One
B Begin Risperdal 1 mg orally BIDegin Risperdal 1 mg orally BID
RESULTS OF DECISION POINT ONE
Client returns to clinic in four weeks
Client is accompanied today by her mother who must help the client into your office, the client looks very sedated and lethargic
Client's mother explains that “she has been like this since about a week after the last office visit”
Decision Point Two
RESULTS OF DECISION POINT TWO
Discontinue Risperdal and start Lithium sustained release 300 mg orally BID
Client returns to clinic in four weeks
Client no longer lethargic after the end of the first week
Client has a slight decrease in her Young Mania Rating Scale (from 22 to 19)
Client reports that her sleep is again decreasing, but that overall, she is happy
Decision Point Three
Make no changes at this time & reevaluate in 4 weeks
Guidance to Student
Recall that the client is of Korean descent and is positive for CYP2D6*10 allele. As a result, she may be demonstrating slower clearance of Risperdal from her system, resulting in higher than normal levels of Risperdal in the blood, resulting in sedation. The client responded well to the discontinuation of Risperdal and after about a week of drug cessation, she was no longer lethargic/sedate. However, in the following 3 weeks, she had experienced increased symptoms, although a slight improvement in YMSR score was noted. You could make no changes at this time and allow the lithium to remain at its current dose for an additional 4 weeks and reassess. Conversely, you can increase the lithium to 450 mg orally BID and then reassess in 4. The additional milligrams may hasten mood stabilization. Risperdal 0.5 mg orally BID may be appropriate if the clients’ symptoms are worsening, however, you would need to have the client return to the office sooner than 4 weeks for an interim visit to assess effects of drug and presence of somnolence/lethargy.
Rubric Detail
Select Grid View or List View to change the rubric's layout.
Content
Name: NURS_6630_Week5_Assignment_Rubric
Grid ViewList View
Excellent
Point range: 90–100
Good
Point range: 80–89
Fair
Point range: 70–79
Poor
Point range: 0–69
Introduction to the case (1 page)
Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.
Points:
Points Range:
9 (9%) - 10 (10%)
The response accurately, clearly, and fully summarizes in detail the case for the Assignment.
The response accurately and clearly explains in detail the specific patient factors that impact decision making when prescribing medication for this patient.
Feedback:
Points:
Points Range:
8 (8%) - 8 (8%) ...
Decision Point OneBegin Zoloft 50 mg orally dailyBegin Zoloft LinaCovington707
Decision Point One
Begin Zoloft 50 mg orally dailyBegin Zoloft 50 mg orally daily
RESULTS OF DECISION POINT ONE
· Client returns to clinic in four weeks
· Client informs you that he has no tightness in chest, or shortness of breath
· Client states that he noticed decreased worries about work over the past 4 or 5 days
· HAM-A score has decreased to 18 (partial response)
Decision Point Two
Increase dose to 75 mg orally daily
RESULTS OF DECISION POINT TWO
· Client returns to clinic in four weeks
· Client reports an even further reduction in his symptoms
· HAM-A score has now decreased to 10. At this point- continue current dose (61% reduction in symptoms)
Decision Point Three
Maintain current dose
Guidance to Student
At this point, it may be appropriate to continue client at the current dose. It is clear that the client is having a good response (as evidenced by greater than a 50% reduction in symptoms) and the client is currently not experiencing any side effects, the current dose can be maintained for 12 weeks to evaluate full effect of drug. Increasing drug at this point may yield a further decrease in symptoms, but may also increase the risk of side effects. This is a decision that you should discuss with the client. Nothing in the client’s case tells us that we should consider adding an augmentation agent at this point as the client is demonstrating response to the drug. Avoid polypharmacy unless symptoms cannot be managed by a single drug.
Generalized Anxiety Disorder
Middle-Aged White Male With Anxiety
Anxiety
BACKGROUND INFORMATION
The client is a 46-year-old white male who works as a welder at a local steel fabrication factory. He presents today after being referred by his PCP after a trip to the emergency room in which he felt he was having a heart attack. He stated that he felt chest tightness, shortness of breath, and feeling of impending doom. He does have some mild hypertension (which is treated with low sodium diet) and is about 15 lbs. overweight. He had his tonsils removed when he was 8 years old, but his medical history since that time has been unremarkable. Myocardial infarction was ruled out in the ER and his EKG was normal. Remainder of physical exam was WNL.
He admits that he still has problems with tightness in the chest and episodes of shortness of breath- he now terms these “anxiety attacks.” He will also report occasional feelings of impending doom, and the need to “run” or “escape” from wherever he is at.
In your office, he confesses to occasional use of ETOH to combat worries about work. He admits to consuming about 3-4 beers/night. Although he is single, he is attempting to care for aging parents in his home. He reports that the management at his place of employment is harsh, and he fears for his job. You administer the HAM-A, which yields a score of 26.
Client has never been on any type of psychotropic medication.
MENTAL STATUS EXAM
The client is alert, oriented to person, place, time, and ev ...
APA Title page, running head, page numbers, reference sheet. Use L.docxjustine1simpson78276
APA Title page, running head, page numbers, reference sheet. Use Level 1 and 2 headings to make identifying the components of the paper easier. – 5 points after grade calculated from rubric.
TO be successful in the clinical setting do the following:
You need a APA cover sheet, running head and reference page for anything you turn in (Journal, SOAP note, Time Log).
Do Not change the template.
Do use the template located in the Doc Sharing. This is the explanation of the template…this is not the template.
READ every line of this document please.
You must site 2 journal articles in addition to Epocrates/Medscape and text book failure to do so is -10 points outside of the rubric.
All grades are final. No revisions. Do not ask for revisions of SOAP grades.
Nurse Practitioner SOAP Notes
Purpose: To explain what each section of the SOAP note should include. Remember that Nurse Practitioners treat patients in a holistic manner and your SOAP note should reflect that premise. DO NOT INCLUDE IN NOTE
Subjective data value @ 15 points
SUBJECTIVE DATA: What the patient tells you but organized by you in logical fashion
Chief Complaint (CC): One to three words explaining why patient came to clinic value 1 point
History of Present Illness (HPI): Paint a picture of what is wrong with the patient. You need to start EVERY HPI with age, race, gender. (Example: 34-year-old AA male) Must include the 7 attributes of each principal symptom: value 7 points hint: OLD CART
Write your paragraph in the order of old cart & chart as well if missing paragraph -3.5 if missing list -3.5
Onset
Location
Duration
Characteristics
Aggravating Factors
Relieving Factors
Treatments/Therapies
Each of these are valued at 0.5 points (maximum 4 points)
Medications: list each one by name with dosage and frequency
Allergies: include specific reactions to medications, foods, insects, environmental
Past Medical History (PMH): Illnesses, hospitalizations, risky sexual behaviors. Include childhood illnesses
Past Surgical History (PSH): Dates, indications and types of operations
OB/GYN History: (if applicable) Obstetric history, menstrual history, methods of contraception and sexual function
Personal/Social History: Tobacco use, Alcohol use, Drug use. Patient’s interests, ADL’s IADL’s if applicable. Exercise, eating habits. Pediatrics: school status, parental smoking hx, birth history etc
Immunizations: Last Tdp, Flu, pneumonia, etc. Pediatrics- (per pediatric schedule for age)
Family History: Parents, Grandparents, siblings, children
Review of Systems: Go Head to toe. Cover each system that covers the Chief Complaint, History of Present Illness and History (this includes the systems that address any previous diagnoses). YOU DO NOT NEED TO DO THEM ALL UNLESS YOU ARE DOING a TOTAL H&P. Remember, this is what the patient tells you. Delete the system if not addressing. DO NOT put wnl or no complaints be specific. Value 3 points
General: any recent weight changes, weakness, fatigue,.
Assignment 1 Lab Assignment Assessing the Abdomen Please note th.docxfelicitytaft14745
Assignment 1: Lab Assignment: Assessing the Abdomen
Please note this assignment is due week 6. Please refer to your resource list as well as your grading rubrics and study guide for week 6. In this Lab Assignment, you will analyze an Episodic note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients as well as which physical exams and diagnostic tests should be conducted. You will also formulate a differential diagnosis with several possible conditions. Please use your Resource list and grading rubric as a guide. Please reach out to me if you have any questions regarding this assignment
ABDOMINAL ASSESSMENT
Subjective:
CC: “My stomach hurts, I have diarrhea and nothing seems to help.”
HPI: JR, 47 yo WM, complains of having generalized abdominal pain that started 3 days ago. He has not taken any medications because he did not know what to take. He states the pain is a 5/10 today but has been as much as 9/10 when it first started. He has been able to eat, with some nausea afterwards.
PMH: HTN, Diabetes, hx of GI bleed 4 years ago
Medications: Lisinopril 10mg, Amlodipine 5 mg, Metformin 1000mg, Lantus 10 units qhs
Allergies: NKDA
FH: No hx of colon cancer, Father hx DMT2, HTN, Mother hx HTN, Hyperlipidemia, GERD
Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)
Objective:
VS: Temp 99.8; BP 160/86; RR 16; P 92; HT 5’10”; WT 248lbs
Heart: RRR, no murmurs
Lungs: CTA, chest wall symmetrical
Skin: Intact without lesions, no urticaria
Abd: soft, hyperactive bowel sounds, pos pain in the LLQ
Diagnostics: None
Assessment:
Left lower quadrant pain
Gastroenteritis
PLAN:
This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.
To Prepare
Review the Episodic note case study your instructor provides you for this week’s Assignment. Please see the “Course Announcements” section of the classroom for your Episodic note case study.
With regard to the Episodic note case study provided:
Review this week’s Learning Resources, and consider the insights they provide about the case study.
Consider what history would be necessary to collect from the patient in the case study.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
Identify
at least five
possible conditions that may be considered in a differential diagnosis for the patient.
The Assignment
Analyze the subjective portion of the note. List additional information that should be included in the documentation.
Analyze the objective portion of the note. List additional information that should be included in the documentation.
Is the assessment supported by the subjective and objective information? Why or why not?
What diagnostic tests would be appropriate for this case, and how would the results.
CASE STUDYFemale, 15, separation anxiety disorder, Depression.docxbartholomeocoombs
CASE STUDY:
Female, 15, separation anxiety disorder, Depression
The patient is a fifteen-year-old female teenager who presents to the clinic with her mother for her first assessment. Patient is being referral to the clinic by the school counselor due to low grades and poor school assistance. During the session, both the patient and the mother are neatly dressed. Her mother seems to be worried about her daughter. The patient said, "I worry a lot about my family members. I fear that one day my parents will be abducted or fatally injured. The worries and fears make me have difficulties concentrating on personal well-being and my studies in school." The mental assessment shows that the patient is depressed, and she refuses to leave the proximity of her mother. Her mother says that her daughter has been experiencing depression or anxiety attacks. The physical assessment shows that the patient has been experiencing physical aches and pains. She maintains good eye contact. Her mood is a little anxious. The symptoms conclude that the patient has separation anxiety disorder because the symptoms have progressed for the past six months. Treatments include antidepressants, group therapy, family therapy, dialectical behavioral therapy, and cognitive-behavioral therapy. A follow-up is to be done in two weeks.
Assignment 2: 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
· 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.
· 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 o.
Sills MR. Medication Adherence PROM Measures and Self Efficacy. Slides for teleconference to facilitate discussion of Cardiovascular PRO Measure Selection by SAFTINet Stakeholders. 21 May 2012.
This webinar slide-set illustrates the stepwise process of engaging Scalable Architecture for Federated Translational Inquiries Network (SAFTINet) practice stakeholders in
selecting and adapting a measure of patient-reported medication adherence.
For more information on SAFTINet, please see http://www.ucdenver.edu/academics/colleges/medicalschool/programs/outcomes/COHO/saftinet/Pages/default.aspx
SOAP NOTEAcute abdominal pain- appendicitis The goal of thi.docxpbilly1
SOAP NOTE
Acute abdominal pain- appendicitis
The goal of this assignment is to practice writing a SOAP Note for a sick or episodic visit related to the focus system(s) reviewed in the previous week’s learning materials. Review the SOAP Note Rubric. Use a case from the previous week’s discussion or patient from your video submission or clinical practicum experience (adding content as needed to represent abnormal findings). Submit your own note. Do not submit documentation from the patient’s record.
RUBRIC
SOAP Note Rubric
[SOAP Note Rubric] – 100 PointsCriteriaExemplary
Exceeds ExpectationsAdvanced
Meets ExpectationsIntermediate
Needs ImprovementNovice
InadequateTotal Points
Subjective – 25%
Information about the patient (3 points)
Name (initials only); age, and gender
Source of information; note relationship to patient, if relevant
Reliability of information
Chief Complaint (1 point)
History of Presenting Illness (8 points)
Location
Quality
Quantity or severity
Timing (onset, duration, frequency)
Setting in which it occurs
Factors that aggravate or relieve the symptoms
Associated manifestations
Review of Focus System(s) (5 points)
Medications/Allergies (3 points)
History (5 points)
Past Medical History
Past Surgical History
Family History
Social History
Health Maintenance Practices
Patient described in appropriate detail
Concise and clear chief complaint as described by patient
HPI includes all components with appropriate detail
Comprehensive review of focus system(s) includes pertinent negatives
Name, dose, route, and frequency of prescribed and over-the-counter medications noted, including compliance;
Allergies to medications and reaction noted
Comprehensive health history is appropriate to reason for visit and includes pertinent negatives
25 points
Patient described in appropriate detail
Concise and clear chief complaint as described by patient
HPI missing minor detail
Comprehensive review of focus system(s)
Name, dose, route, and frequency of prescribed and over-the-counter medications noted, including compliance; Allergies to medications and reaction noted
Comprehensive health history is appropriate to reason for visit
22 points
1 detail missed in patient description
Chief complaint as described by patient, may not be concise or clear
HPI missing 1 component or significant detail
Review of focus system missing 1-2 components
Medication history missing 1-2 components
Health history not appropriate for reason for visit or missing 1-2 components
19 points
>2 details missed in patient description
Chief complaint not identified, concise, or clear
HPI missing >2 components and significant detail
Review of focus system(s) missing >3 components
Medication history missing >3 components
Health history missing >3 components
17 points25
Objective – 30%
Physical exam includes appropriate areas for Chief Complaint, History of Presenting Illness, and Rev.
SOAP NOTE- GASTRITISThe goal of this assignment is to practi.docxpbilly1
SOAP NOTE- GASTRITIS
The goal of this assignment is to practice writing a SOAP Note for a sick or episodic visit related to the focus system(s) reviewed in the previous week’s learning materials.--GASTRITIS . Review the SOAP Note Rubric. Use a case from the previous week’s discussion or patient from your video submission or clinical practicum experience (adding content as needed to represent abnormal findings). Submit your own note. Do not submit documentation from the patient’s record.
RUBRIC
SOAP Note Rubric
[SOAP Note Rubric] – 100 PointsCriteriaExemplary
Exceeds ExpectationsAdvanced
Meets ExpectationsIntermediate
Needs ImprovementNovice
InadequateTotal Points
Subjective – 25%
Information about the patient (3 points)
Name (initials only); age, and gender
Source of information; note relationship to patient, if relevant
Reliability of information
Chief Complaint (1 point)
History of Presenting Illness (8 points)
Location
Quality
Quantity or severity
Timing (onset, duration, frequency)
Setting in which it occurs
Factors that aggravate or relieve the symptoms
Associated manifestations
Review of Focus System(s) (5 points)
Medications/Allergies (3 points)
History (5 points)
Past Medical History
Past Surgical History
Family History
Social History
Health Maintenance Practices
Patient described in appropriate detail
Concise and clear chief complaint as described by patient
HPI includes all components with appropriate detail
Comprehensive review of focus system(s) includes pertinent negatives
Name, dose, route, and frequency of prescribed and over-the-counter medications noted, including compliance;
Allergies to medications and reaction noted
Comprehensive health history is appropriate to reason for visit and includes pertinent negatives
25 points
Patient described in appropriate detail
Concise and clear chief complaint as described by patient
HPI missing minor detail
Comprehensive review of focus system(s)
Name, dose, route, and frequency of prescribed and over-the-counter medications noted, including compliance; Allergies to medications and reaction noted
Comprehensive health history is appropriate to reason for visit
22 points
1 detail missed in patient description
Chief complaint as described by patient, may not be concise or clear
HPI missing 1 component or significant detail
Review of focus system missing 1-2 components
Medication history missing 1-2 components
Health history not appropriate for reason for visit or missing 1-2 components
19 points
>2 details missed in patient description
Chief complaint not identified, concise, or clear
HPI missing >2 components and significant detail
Review of focus system(s) missing >3 components
Medication history missing >3 components
Health history missing >3 components
17 points25
Objective – 30%
Physical exam includes appropriate areas for Chief Complaint, History of Presenting Illness, and Review of Systems.
FO613 Signature Assignment Rubric Area Minimal Adequate ShainaBoling829
FO613 Signature Assignment Rubric
Area Minimal Adequate Good Exceptional Points
Symptom
Identification,
Observation, and
Impact
Student did not detect and described
two positive and two negative
symptoms of psychosis in the client,
or did not mention the client’s
presentation in the video, or
minimally discussed the impact of his
symptoms on his interactions with
others.
0-8 pts
Student detected and described two
positive and two negative symptoms
of psychosis in the client, mentioned
the client’s presentation in the video,
and discussed the impact of his
symptoms on his interactions with
others.
9-11 pts
Student detected and described at
least two positive and at least two
negative symptoms of psychosis in
the client, appraised the client’s
presentation in the video, and
analyzed the impact of his symptoms
on his interactions with others.
12-14 pts
Student detected and described
multiple positive and multiple
negative symptoms of psychosis in
the client, astutely appraised the
client’s presentation in the video, and
accurately analyzed the impact of his
symptoms on his interactions with
others.
16-18 pts
18
Differential
Diagnoses
Student either did not generate any
alternate diagnoses or did not
distinguish their alternate diagnosis
from the actual diagnosis.
0-5 pts
Student generated at least one
alternate diagnosis but minimally
stated their diagnostic rationale for it.
6-8 pts
Student generated alternate
diagnoses and delineated their
diagnostic rationale for them.
9-10 pts
Student generated multiple alternate
diagnoses, provided their diagnostic
rationale, and contrasted their
alternate diagnoses from the actual
diagnosis.
11-12 pts
12
Therapeutic
Modality
Student did not select a therapeutic
modality or their selected modality is
not suitable to treat psychotic
disorders.
0-5 pts
Student selected and applied a
therapeutic modality to treat the
psychosis in this case but the
modality may not have been optimal
for treating psychotic disorders.
6-8 pts
Student selected and applied an
appropriate therapeutic modality to
effectively treat the psychosis in this
case.
9-10 pts
Student selected and applied an
appropriate therapeutic modality to
effectively treat the psychosis in this
case and discussed the client’s
anticipated response to it.
11-12 pts
12
Professional
Collaboration
Student’s plan for collaboration with
other professionals on this case was
either absent or did not involve
relevant professionals.
0-5 pts
Student created a plan for
collaboration with at least one other
professional on this case.
6-8 pts
Student created an effective plan for
interdisciplinary collaboration with
other relevant professionals on this
case.
9-10 pts
Student created an effective plan for
interdisciplinary collaboration with
multiple other rel ...
Course Number and NameCourse NURS 210L-ABNURSING CARE PLAN .docxmarilucorr
Course Number and Name
Course: NURS 210L-AB
NURSING CARE PLAN RUBRIC
NURS 101L, NURS 210L-AB, NURS 317L
STUDENT NAME: COURSE: DATE:
PATIENT INITIALS: ___________ PATIENT DISEASE/DISORDER:
Criteria
4
Exceeds Expectations
3
Meets Expectations
2
Approaching Expectations
1-0
Does Not Meet Expectations
Score
History of PresentIllness
HPI explained in detail with accurate and in-depth understanding of chief complaint and supported by evidence based citations.
HPI explained in some detail with moderate understanding of chief complaint or no support from evidence based citations.
HPI explained in limited detail with marginal understanding of chief complaint and no support from evidence based citations.
HPI details limited with poor understanding of chief complaint and no evidence based citations to support.
X2
Physical Assessment, & Diagnostic tests/ procedures
Identifies 5-6 key assessments parameters relevant to medical diagnoses with relevant diagnostic procedures supported by evidence based citations.
Identifies 3-4 key assessments parameters relevant to medical diagnosis with relevant diagnostic procedures supported by evidence based citations.
Identifies 1-2 key assessments parameters relevant to medical diagnosis, relevant diagnostic procedures and vaguely supported by evidence based citations.
Identifies assessments parameters not relevant to medical diagnoses, relevant diagnostic procedures or not supported by evidence based citations.
X2
Past Medical &
Surgical History, Pathophysiology
Past medical/surgical history detailed with full explanation of Pathophysiology for each diagnosis & accurate details with specific detail related to the client’s history and symptoms and supported by evidence based citations.
Past medical/surgical history given with partial explanation of identified preexisting medical diagnoses & explanation accurate with some detail related to the client’s history and symptoms. supported by evidence based citations.
Past medical/surgical history given with minimal explanation of identified preexisting medical diagnoses & few details related to the client’s history and symptoms or not supported by evidence based citations.
No past medical/surgical history given without explanation; no pre-existing medical diagnosis identified or explanations inaccurate and not related to the client’s history and symptoms without evidence.
X2
Erikson’s
Developmental Stages
Identifies and defines correct stage with examples of meeting/not meeting tasks supported by evidence based citations.
Identifies and defines correct stage with examples of meeting/not meeting tasks supported by evidence based citations.
Identifies correct stage without adequate definition or example of meeting/not meeting tasks without evidence based citations.
Identifies incorrect stage without definition or inappropriate examples given, not supported by evidence based citations.
X2
Socioeconomic/ Psychosocial Assessment
Describes socioec.
The goal of this assignment is to practice writing a SOAP Note for a.docxrtodd194
The goal of this assignment is to practice writing a SOAP Note for a sick or episodic visit related to the focus system(s) reviewed in the previous week’s learning materials- APPENDICITIS. Review the SOAP Note Rubric. Use a case from the previous week’s discussion or patient from your video submission or clinical practicum experience (adding content as needed to represent abnormal findings). Submit your own note. Do not submit documentation from the patient’s record.
RUBRIC:
SOAP Note Rubric
[SOAP Note Rubric] – 100 PointsCriteriaExemplary
Exceeds ExpectationsAdvanced
Meets ExpectationsIntermediate
Needs ImprovementNovice
InadequateTotal Points
Subjective – 25%
Information about the patient (3 points)
Name (initials only); age, and gender
Source of information; note relationship to patient, if relevant
Reliability of information
Chief Complaint (1 point)
History of Presenting Illness (8 points)
Location
Quality
Quantity or severity
Timing (onset, duration, frequency)
Setting in which it occurs
Factors that aggravate or relieve the symptoms
Associated manifestations
Review of Focus System(s) (5 points)
Medications/Allergies (3 points)
History (5 points)
Past Medical History
Past Surgical History
Family History
Social History
Health Maintenance Practices
Patient described in appropriate detail
Concise and clear chief complaint as described by patient
HPI includes all components with appropriate detail
Comprehensive review of focus system(s) includes pertinent negatives
Name, dose, route, and frequency of prescribed and over-the-counter medications noted, including compliance;
Allergies to medications and reaction noted
Comprehensive health history is appropriate to reason for visit and includes pertinent negatives
25 points
Patient described in appropriate detail
Concise and clear chief complaint as described by patient
HPI missing minor detail
Comprehensive review of focus system(s)
Name, dose, route, and frequency of prescribed and over-the-counter medications noted, including compliance; Allergies to medications and reaction noted
Comprehensive health history is appropriate to reason for visit
22 points
1 detail missed in patient description
Chief complaint as described by patient, may not be concise or clear
HPI missing 1 component or significant detail
Review of focus system missing 1-2 components
Medication history missing 1-2 components
Health history not appropriate for reason for visit or missing 1-2 components
19 points
>2 details missed in patient description
Chief complaint not identified, concise, or clear
HPI missing >2 components and significant detail
Review of focus system(s) missing >3 components
Medication history missing >3 components
Health history missing >3 components
17 points25
Objective – 30%
Physical exam includes appropriate areas for Chief Complaint, History of Presenting Illness, and Review of Systems (20 points)
Approp.
The goal of this assignment is to practice writing a SOAP Note for acarmanl5wisc
The goal of this assignment is to practice writing a SOAP Note for a sick or episodic visit related to the focus system(s) reviewed in the previous week’s learning materials- CARPAL TUNNEL SYNDROME . Review the SOAP Note Rubric. Use a case from the previous week’s discussion or patient from your video submission or clinical practicum experience (adding content as needed to represent abnormal findings).
RUBRIC:
SOAP Note Rubric
[SOAP Note Rubric] – 100
Subjective – 25%
Information about the patient (3 points)
Name (initials only); age, and gender
Source of information; note relationship to patient, if relevant
Reliability of information
Chief Complaint (1 point)
History of Presenting Illness (8 points)
Location
Quality
Quantity or severity
Timing (onset, duration, frequency)
Setting in which it occurs
Factors that aggravate or relieve the symptoms
Associated manifestations
Review of Focus System(s) (5 points)
Medications/Allergies (3 points)
History (5 points)
Past Medical History
Past Surgical History
Family History
Social History
Health Maintenance Practices
Patient described in appropriate detail
Concise and clear chief complaint as described by patient
HPI includes all components with appropriate detail
Comprehensive review of focus system(s) includes pertinent negatives
Name, dose, route, and frequency of prescribed and over-the-counter medications noted, including compliance;
Allergies to medications and reaction noted
Comprehensive health history is appropriate to reason for visit and includes pertinent negatives
25 points
Patient described in appropriate detail
Concise and clear chief complaint as described by patient
HPI missing minor detail
Comprehensive review of focus system(s)
Name, dose, route, and frequency of prescribed and over-the-counter medications noted, including compliance; Allergies to medications and reaction noted
Comprehensive health history is appropriate to reason for visit
22 points
1 detail missed in patient description
Chief complaint as described by patient, may not be concise or clear
HPI missing 1 component or significant detail
Review of focus system missing 1-2 components
Medication history missing 1-2 components
Health history not appropriate for reason for visit or missing 1-2 components
19 points
>2 details missed in patient description
Chief complaint not identified, concise, or clear
HPI missing >2 components and significant detail
Review of focus system(s) missing >3 components
Medication history missing >3 components
Health history missing >3 components
17 points25
Objective – 30%
Physical exam includes appropriate areas for Chief Complaint, History of Presenting Illness, and Review of Systems (20 points)
Appropriate techniques of examination used to identify pertinent findings (10 points)Appropriate areas and systems included in physical assessment
Comprehensive techniques of observation, palpation, percu ...
THE NEED FOR EVIDENCE-BASED PRACTICE
STEPS OF EVIDENCE-BASED PRACTICE
PICOT FORMAT IN EBP
RATING SYSTEM FOR THE HIERARCHY OF EVIDENCE: QUANTITATIVE QUESTIONS
ELEMENTS OF EVIDENCE-BASED ARTICLES
INTEGRATE THE EVIDENCE
EVALUATE THE OUTCOMES OF THE PRACTICE DECISION OR CHANGE
COMMUNICATE THE OUTCOMES OF THE EVIDENCE-BASED PRACTICE DECISION
SUSTAIN KNOWLEDGE USE
NURSING RESEARCH
TRANSLATION RESEARCH
5 PHASES OF TRANSLATION RESEARCH
OUTCOMES RESEARCH
SCIENTIFIC METHOD
CHARACTERISTICS OF SCIENTIFIC RESEARCH
NURSING AND THE SCIENTIFIC APPROACH
TYPES OF RESEARCH
TYPES OF RESEARCH APPROACH
RESEARCH PROCESS
RIGHTS OF HUMAN SUBJECT
COMPARISON OF STEPS OF THE NURSING PROCESS WITH THE RESEARCH PROCESS
Performance Improvement
Performance Improvement Programs
EXAMPLES OF PERFORMANCE IMPROVEMENT MODELS
THE RELATIONSHIP BETWEEN EBP, RESEARCH, AND PERFORMANCE IMPROVEMENT
SIMILARITIES AND DIFFERENCES AMONG EVIDENCE-BASED PRACTICE, RESEARCH, AND PERFORMANCE IMPROVEMENT
KEY ELEMENTS
11/14/22, 8:09 PM Clinical Judgment Plan
https://canvas.westcoastuniversity.edu/courses/23793/assignments/578656 2/9
Criteria Ratings Pts
4 pts
8 pts
4 pts
Assessment & History of
Present Illness
Recognizing cues focused
on observation
4 pts
Proficient
HPI explains in
detail with
accurate and in-
depth
understanding of
chief complaint
and supported by
evidence-based
citations.
3.04 pts
Acceptable
HPI explains in
some detail with
moderate
understanding
of chief
complaint or no
support from
evidence-based
citations.
2.4 pts
Needs
Improvement
HPI explains in
limited detail
with insufficient
understanding of
chief complaint
or support from
evidence-based
citations.
0 pts
Unsatisfactory
HPI details
limited with
poor
understanding
of chief
complaint and
no evidence-
based citations
to support.
Recognizing assessment
parameters
Clinical thinking and
assessment cues
8 pts
Proficient
Identifies the 4
imperative
assessment
cues and or
medical
diagnoses
supported by
evidence-
based
citations.
6.08 pts
Acceptable
Identifies 2
imperative
assessment
cues and or
medical
diagnosis
supported by
evidence-
based
citations.
4.8 pts
Needs
Improvement
Identifies 1
imperative
assessment
cues and or
medical
diagnosis,
vaguely
supported by
evidence-based
citation.
0 pts
Unsatisfactory
Unable to identify
any imperative
assessments
parameters relevant
to medical
diagnosis and
without supported
evidence-based
citation.
Interpreting diagnostic
criteria & diagnostic tests
and procedures
Clinical reasoning and
analysis of cues
4 pts
Proficient
Clearly and
accurately
describes the
client’s
diagnostic
criteria which
clearly supports
the chief
complaints and
presenting
signs/symptoms.
3.04 pts
Acceptable
Adequately
describes the
client’s
diagnostic
criteria which
adequately
supports the
identified chief
complaint and
presenting
signs/symptoms
2.4 pts
Needs
Improvement
Vaguely
describes the
client’s
diagnostic
criteria which
vaguely
supports the
identified chief
complaint and
presenting
signs/symptoms.
0 pts
Unsatisfactory
Lack
description of
the client’s
diagnostic
criteria that
does not
support the
identified chief
complaint and
presenting
signs/symptoms
11/14/22, 8:09 PM Clinical Judgment Plan
https://canvas.westcoastuniversity.edu/courses/23793/assignments/578656 3/9
Criteria Ratings Pts
8 pts
8 pts
Past medical & surgical
history, pathophysiology
Clinical judgment and
recognizing cues
8 pts
Proficient
Past
medical/surgical
history detailed
with full
explanation of
pathophysiology
for admitting
diagnosis and for
each diagnosis &
accurate detail
with specific
detail related to
the client’s
history and
symptoms and
supported by
evidence-based
citations.
6.08 pts
Acceptable
Past
medical/surgical
history given
with partial
explanation of
identified
admitting
diagnosis and
preexisting
medical
diagnoses,
intermittent
details related to
the client’s
history and
symptoms, or
not completely
supported by
evidence-based
citations.
.
JW House FundraiserJourney Through the Enchanted Forest Ga.docxpauline234567
JW House Fundraiser
Journey Through the Enchanted Forest Gala
Silent Auction
Table Decor
Specialized cocktails for Event
Three Screens will be Placed for Optimum Viewing by all Attendees
New House Announcement
Happy 30th Birthday, JW!
Auction
Isle down Center Allows Fundraising Auctioneer to Engage Audience
Balloon
Drop
S’mores Sponsored by Largest Corporate Donor
Finish the Evening with Dancing & Beverages
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1. INTRODUCTION. Begin by stating what you will discuss and explain why is important.
2. CRITICAL SUMMARY. Summarize the relevant views and the arguments that you believe are important.
Usually in a critical discussion it is not sufficient to merely summarize the author’s view. Your attention should be
focused on the author's development of the view--that is, on his arguments, in the broadest sense of the word.
3. CARE IN CITATIONS. Make sure you accurately state the position of the author and always include page
references for each quotation or attribution to her/him if applicable.
4. CRITICAL EVALUATION FROM A CHRISTIAN PERSPECTIVE. At least half of your paper must be devoted
to a critical evaluation of the views of the author you are discussing from the perspective of the Christian thesis that
a Christian call in business may prop-up the role of the markets.
5. CONSIDER POSSIBLE RESPONSES TO YOUR OBJECTIONS. Whenever you offer an objection to an
author's position, explicitly consider whether the author has said anythin.
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Assignment 1 Lab Assignment Assessing the Abdomen Please note th.docxfelicitytaft14745
Assignment 1: Lab Assignment: Assessing the Abdomen
Please note this assignment is due week 6. Please refer to your resource list as well as your grading rubrics and study guide for week 6. In this Lab Assignment, you will analyze an Episodic note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients as well as which physical exams and diagnostic tests should be conducted. You will also formulate a differential diagnosis with several possible conditions. Please use your Resource list and grading rubric as a guide. Please reach out to me if you have any questions regarding this assignment
ABDOMINAL ASSESSMENT
Subjective:
CC: “My stomach hurts, I have diarrhea and nothing seems to help.”
HPI: JR, 47 yo WM, complains of having generalized abdominal pain that started 3 days ago. He has not taken any medications because he did not know what to take. He states the pain is a 5/10 today but has been as much as 9/10 when it first started. He has been able to eat, with some nausea afterwards.
PMH: HTN, Diabetes, hx of GI bleed 4 years ago
Medications: Lisinopril 10mg, Amlodipine 5 mg, Metformin 1000mg, Lantus 10 units qhs
Allergies: NKDA
FH: No hx of colon cancer, Father hx DMT2, HTN, Mother hx HTN, Hyperlipidemia, GERD
Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)
Objective:
VS: Temp 99.8; BP 160/86; RR 16; P 92; HT 5’10”; WT 248lbs
Heart: RRR, no murmurs
Lungs: CTA, chest wall symmetrical
Skin: Intact without lesions, no urticaria
Abd: soft, hyperactive bowel sounds, pos pain in the LLQ
Diagnostics: None
Assessment:
Left lower quadrant pain
Gastroenteritis
PLAN:
This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.
To Prepare
Review the Episodic note case study your instructor provides you for this week’s Assignment. Please see the “Course Announcements” section of the classroom for your Episodic note case study.
With regard to the Episodic note case study provided:
Review this week’s Learning Resources, and consider the insights they provide about the case study.
Consider what history would be necessary to collect from the patient in the case study.
Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
Identify
at least five
possible conditions that may be considered in a differential diagnosis for the patient.
The Assignment
Analyze the subjective portion of the note. List additional information that should be included in the documentation.
Analyze the objective portion of the note. List additional information that should be included in the documentation.
Is the assessment supported by the subjective and objective information? Why or why not?
What diagnostic tests would be appropriate for this case, and how would the results.
CASE STUDYFemale, 15, separation anxiety disorder, Depression.docxbartholomeocoombs
CASE STUDY:
Female, 15, separation anxiety disorder, Depression
The patient is a fifteen-year-old female teenager who presents to the clinic with her mother for her first assessment. Patient is being referral to the clinic by the school counselor due to low grades and poor school assistance. During the session, both the patient and the mother are neatly dressed. Her mother seems to be worried about her daughter. The patient said, "I worry a lot about my family members. I fear that one day my parents will be abducted or fatally injured. The worries and fears make me have difficulties concentrating on personal well-being and my studies in school." The mental assessment shows that the patient is depressed, and she refuses to leave the proximity of her mother. Her mother says that her daughter has been experiencing depression or anxiety attacks. The physical assessment shows that the patient has been experiencing physical aches and pains. She maintains good eye contact. Her mood is a little anxious. The symptoms conclude that the patient has separation anxiety disorder because the symptoms have progressed for the past six months. Treatments include antidepressants, group therapy, family therapy, dialectical behavioral therapy, and cognitive-behavioral therapy. A follow-up is to be done in two weeks.
Assignment 2: 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
· 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.
· 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 o.
Sills MR. Medication Adherence PROM Measures and Self Efficacy. Slides for teleconference to facilitate discussion of Cardiovascular PRO Measure Selection by SAFTINet Stakeholders. 21 May 2012.
This webinar slide-set illustrates the stepwise process of engaging Scalable Architecture for Federated Translational Inquiries Network (SAFTINet) practice stakeholders in
selecting and adapting a measure of patient-reported medication adherence.
For more information on SAFTINet, please see http://www.ucdenver.edu/academics/colleges/medicalschool/programs/outcomes/COHO/saftinet/Pages/default.aspx
SOAP NOTEAcute abdominal pain- appendicitis The goal of thi.docxpbilly1
SOAP NOTE
Acute abdominal pain- appendicitis
The goal of this assignment is to practice writing a SOAP Note for a sick or episodic visit related to the focus system(s) reviewed in the previous week’s learning materials. Review the SOAP Note Rubric. Use a case from the previous week’s discussion or patient from your video submission or clinical practicum experience (adding content as needed to represent abnormal findings). Submit your own note. Do not submit documentation from the patient’s record.
RUBRIC
SOAP Note Rubric
[SOAP Note Rubric] – 100 PointsCriteriaExemplary
Exceeds ExpectationsAdvanced
Meets ExpectationsIntermediate
Needs ImprovementNovice
InadequateTotal Points
Subjective – 25%
Information about the patient (3 points)
Name (initials only); age, and gender
Source of information; note relationship to patient, if relevant
Reliability of information
Chief Complaint (1 point)
History of Presenting Illness (8 points)
Location
Quality
Quantity or severity
Timing (onset, duration, frequency)
Setting in which it occurs
Factors that aggravate or relieve the symptoms
Associated manifestations
Review of Focus System(s) (5 points)
Medications/Allergies (3 points)
History (5 points)
Past Medical History
Past Surgical History
Family History
Social History
Health Maintenance Practices
Patient described in appropriate detail
Concise and clear chief complaint as described by patient
HPI includes all components with appropriate detail
Comprehensive review of focus system(s) includes pertinent negatives
Name, dose, route, and frequency of prescribed and over-the-counter medications noted, including compliance;
Allergies to medications and reaction noted
Comprehensive health history is appropriate to reason for visit and includes pertinent negatives
25 points
Patient described in appropriate detail
Concise and clear chief complaint as described by patient
HPI missing minor detail
Comprehensive review of focus system(s)
Name, dose, route, and frequency of prescribed and over-the-counter medications noted, including compliance; Allergies to medications and reaction noted
Comprehensive health history is appropriate to reason for visit
22 points
1 detail missed in patient description
Chief complaint as described by patient, may not be concise or clear
HPI missing 1 component or significant detail
Review of focus system missing 1-2 components
Medication history missing 1-2 components
Health history not appropriate for reason for visit or missing 1-2 components
19 points
>2 details missed in patient description
Chief complaint not identified, concise, or clear
HPI missing >2 components and significant detail
Review of focus system(s) missing >3 components
Medication history missing >3 components
Health history missing >3 components
17 points25
Objective – 30%
Physical exam includes appropriate areas for Chief Complaint, History of Presenting Illness, and Rev.
SOAP NOTE- GASTRITISThe goal of this assignment is to practi.docxpbilly1
SOAP NOTE- GASTRITIS
The goal of this assignment is to practice writing a SOAP Note for a sick or episodic visit related to the focus system(s) reviewed in the previous week’s learning materials.--GASTRITIS . Review the SOAP Note Rubric. Use a case from the previous week’s discussion or patient from your video submission or clinical practicum experience (adding content as needed to represent abnormal findings). Submit your own note. Do not submit documentation from the patient’s record.
RUBRIC
SOAP Note Rubric
[SOAP Note Rubric] – 100 PointsCriteriaExemplary
Exceeds ExpectationsAdvanced
Meets ExpectationsIntermediate
Needs ImprovementNovice
InadequateTotal Points
Subjective – 25%
Information about the patient (3 points)
Name (initials only); age, and gender
Source of information; note relationship to patient, if relevant
Reliability of information
Chief Complaint (1 point)
History of Presenting Illness (8 points)
Location
Quality
Quantity or severity
Timing (onset, duration, frequency)
Setting in which it occurs
Factors that aggravate or relieve the symptoms
Associated manifestations
Review of Focus System(s) (5 points)
Medications/Allergies (3 points)
History (5 points)
Past Medical History
Past Surgical History
Family History
Social History
Health Maintenance Practices
Patient described in appropriate detail
Concise and clear chief complaint as described by patient
HPI includes all components with appropriate detail
Comprehensive review of focus system(s) includes pertinent negatives
Name, dose, route, and frequency of prescribed and over-the-counter medications noted, including compliance;
Allergies to medications and reaction noted
Comprehensive health history is appropriate to reason for visit and includes pertinent negatives
25 points
Patient described in appropriate detail
Concise and clear chief complaint as described by patient
HPI missing minor detail
Comprehensive review of focus system(s)
Name, dose, route, and frequency of prescribed and over-the-counter medications noted, including compliance; Allergies to medications and reaction noted
Comprehensive health history is appropriate to reason for visit
22 points
1 detail missed in patient description
Chief complaint as described by patient, may not be concise or clear
HPI missing 1 component or significant detail
Review of focus system missing 1-2 components
Medication history missing 1-2 components
Health history not appropriate for reason for visit or missing 1-2 components
19 points
>2 details missed in patient description
Chief complaint not identified, concise, or clear
HPI missing >2 components and significant detail
Review of focus system(s) missing >3 components
Medication history missing >3 components
Health history missing >3 components
17 points25
Objective – 30%
Physical exam includes appropriate areas for Chief Complaint, History of Presenting Illness, and Review of Systems.
FO613 Signature Assignment Rubric Area Minimal Adequate ShainaBoling829
FO613 Signature Assignment Rubric
Area Minimal Adequate Good Exceptional Points
Symptom
Identification,
Observation, and
Impact
Student did not detect and described
two positive and two negative
symptoms of psychosis in the client,
or did not mention the client’s
presentation in the video, or
minimally discussed the impact of his
symptoms on his interactions with
others.
0-8 pts
Student detected and described two
positive and two negative symptoms
of psychosis in the client, mentioned
the client’s presentation in the video,
and discussed the impact of his
symptoms on his interactions with
others.
9-11 pts
Student detected and described at
least two positive and at least two
negative symptoms of psychosis in
the client, appraised the client’s
presentation in the video, and
analyzed the impact of his symptoms
on his interactions with others.
12-14 pts
Student detected and described
multiple positive and multiple
negative symptoms of psychosis in
the client, astutely appraised the
client’s presentation in the video, and
accurately analyzed the impact of his
symptoms on his interactions with
others.
16-18 pts
18
Differential
Diagnoses
Student either did not generate any
alternate diagnoses or did not
distinguish their alternate diagnosis
from the actual diagnosis.
0-5 pts
Student generated at least one
alternate diagnosis but minimally
stated their diagnostic rationale for it.
6-8 pts
Student generated alternate
diagnoses and delineated their
diagnostic rationale for them.
9-10 pts
Student generated multiple alternate
diagnoses, provided their diagnostic
rationale, and contrasted their
alternate diagnoses from the actual
diagnosis.
11-12 pts
12
Therapeutic
Modality
Student did not select a therapeutic
modality or their selected modality is
not suitable to treat psychotic
disorders.
0-5 pts
Student selected and applied a
therapeutic modality to treat the
psychosis in this case but the
modality may not have been optimal
for treating psychotic disorders.
6-8 pts
Student selected and applied an
appropriate therapeutic modality to
effectively treat the psychosis in this
case.
9-10 pts
Student selected and applied an
appropriate therapeutic modality to
effectively treat the psychosis in this
case and discussed the client’s
anticipated response to it.
11-12 pts
12
Professional
Collaboration
Student’s plan for collaboration with
other professionals on this case was
either absent or did not involve
relevant professionals.
0-5 pts
Student created a plan for
collaboration with at least one other
professional on this case.
6-8 pts
Student created an effective plan for
interdisciplinary collaboration with
other relevant professionals on this
case.
9-10 pts
Student created an effective plan for
interdisciplinary collaboration with
multiple other rel ...
Course Number and NameCourse NURS 210L-ABNURSING CARE PLAN .docxmarilucorr
Course Number and Name
Course: NURS 210L-AB
NURSING CARE PLAN RUBRIC
NURS 101L, NURS 210L-AB, NURS 317L
STUDENT NAME: COURSE: DATE:
PATIENT INITIALS: ___________ PATIENT DISEASE/DISORDER:
Criteria
4
Exceeds Expectations
3
Meets Expectations
2
Approaching Expectations
1-0
Does Not Meet Expectations
Score
History of PresentIllness
HPI explained in detail with accurate and in-depth understanding of chief complaint and supported by evidence based citations.
HPI explained in some detail with moderate understanding of chief complaint or no support from evidence based citations.
HPI explained in limited detail with marginal understanding of chief complaint and no support from evidence based citations.
HPI details limited with poor understanding of chief complaint and no evidence based citations to support.
X2
Physical Assessment, & Diagnostic tests/ procedures
Identifies 5-6 key assessments parameters relevant to medical diagnoses with relevant diagnostic procedures supported by evidence based citations.
Identifies 3-4 key assessments parameters relevant to medical diagnosis with relevant diagnostic procedures supported by evidence based citations.
Identifies 1-2 key assessments parameters relevant to medical diagnosis, relevant diagnostic procedures and vaguely supported by evidence based citations.
Identifies assessments parameters not relevant to medical diagnoses, relevant diagnostic procedures or not supported by evidence based citations.
X2
Past Medical &
Surgical History, Pathophysiology
Past medical/surgical history detailed with full explanation of Pathophysiology for each diagnosis & accurate details with specific detail related to the client’s history and symptoms and supported by evidence based citations.
Past medical/surgical history given with partial explanation of identified preexisting medical diagnoses & explanation accurate with some detail related to the client’s history and symptoms. supported by evidence based citations.
Past medical/surgical history given with minimal explanation of identified preexisting medical diagnoses & few details related to the client’s history and symptoms or not supported by evidence based citations.
No past medical/surgical history given without explanation; no pre-existing medical diagnosis identified or explanations inaccurate and not related to the client’s history and symptoms without evidence.
X2
Erikson’s
Developmental Stages
Identifies and defines correct stage with examples of meeting/not meeting tasks supported by evidence based citations.
Identifies and defines correct stage with examples of meeting/not meeting tasks supported by evidence based citations.
Identifies correct stage without adequate definition or example of meeting/not meeting tasks without evidence based citations.
Identifies incorrect stage without definition or inappropriate examples given, not supported by evidence based citations.
X2
Socioeconomic/ Psychosocial Assessment
Describes socioec.
The goal of this assignment is to practice writing a SOAP Note for a.docxrtodd194
The goal of this assignment is to practice writing a SOAP Note for a sick or episodic visit related to the focus system(s) reviewed in the previous week’s learning materials- APPENDICITIS. Review the SOAP Note Rubric. Use a case from the previous week’s discussion or patient from your video submission or clinical practicum experience (adding content as needed to represent abnormal findings). Submit your own note. Do not submit documentation from the patient’s record.
RUBRIC:
SOAP Note Rubric
[SOAP Note Rubric] – 100 PointsCriteriaExemplary
Exceeds ExpectationsAdvanced
Meets ExpectationsIntermediate
Needs ImprovementNovice
InadequateTotal Points
Subjective – 25%
Information about the patient (3 points)
Name (initials only); age, and gender
Source of information; note relationship to patient, if relevant
Reliability of information
Chief Complaint (1 point)
History of Presenting Illness (8 points)
Location
Quality
Quantity or severity
Timing (onset, duration, frequency)
Setting in which it occurs
Factors that aggravate or relieve the symptoms
Associated manifestations
Review of Focus System(s) (5 points)
Medications/Allergies (3 points)
History (5 points)
Past Medical History
Past Surgical History
Family History
Social History
Health Maintenance Practices
Patient described in appropriate detail
Concise and clear chief complaint as described by patient
HPI includes all components with appropriate detail
Comprehensive review of focus system(s) includes pertinent negatives
Name, dose, route, and frequency of prescribed and over-the-counter medications noted, including compliance;
Allergies to medications and reaction noted
Comprehensive health history is appropriate to reason for visit and includes pertinent negatives
25 points
Patient described in appropriate detail
Concise and clear chief complaint as described by patient
HPI missing minor detail
Comprehensive review of focus system(s)
Name, dose, route, and frequency of prescribed and over-the-counter medications noted, including compliance; Allergies to medications and reaction noted
Comprehensive health history is appropriate to reason for visit
22 points
1 detail missed in patient description
Chief complaint as described by patient, may not be concise or clear
HPI missing 1 component or significant detail
Review of focus system missing 1-2 components
Medication history missing 1-2 components
Health history not appropriate for reason for visit or missing 1-2 components
19 points
>2 details missed in patient description
Chief complaint not identified, concise, or clear
HPI missing >2 components and significant detail
Review of focus system(s) missing >3 components
Medication history missing >3 components
Health history missing >3 components
17 points25
Objective – 30%
Physical exam includes appropriate areas for Chief Complaint, History of Presenting Illness, and Review of Systems (20 points)
Approp.
The goal of this assignment is to practice writing a SOAP Note for acarmanl5wisc
The goal of this assignment is to practice writing a SOAP Note for a sick or episodic visit related to the focus system(s) reviewed in the previous week’s learning materials- CARPAL TUNNEL SYNDROME . Review the SOAP Note Rubric. Use a case from the previous week’s discussion or patient from your video submission or clinical practicum experience (adding content as needed to represent abnormal findings).
RUBRIC:
SOAP Note Rubric
[SOAP Note Rubric] – 100
Subjective – 25%
Information about the patient (3 points)
Name (initials only); age, and gender
Source of information; note relationship to patient, if relevant
Reliability of information
Chief Complaint (1 point)
History of Presenting Illness (8 points)
Location
Quality
Quantity or severity
Timing (onset, duration, frequency)
Setting in which it occurs
Factors that aggravate or relieve the symptoms
Associated manifestations
Review of Focus System(s) (5 points)
Medications/Allergies (3 points)
History (5 points)
Past Medical History
Past Surgical History
Family History
Social History
Health Maintenance Practices
Patient described in appropriate detail
Concise and clear chief complaint as described by patient
HPI includes all components with appropriate detail
Comprehensive review of focus system(s) includes pertinent negatives
Name, dose, route, and frequency of prescribed and over-the-counter medications noted, including compliance;
Allergies to medications and reaction noted
Comprehensive health history is appropriate to reason for visit and includes pertinent negatives
25 points
Patient described in appropriate detail
Concise and clear chief complaint as described by patient
HPI missing minor detail
Comprehensive review of focus system(s)
Name, dose, route, and frequency of prescribed and over-the-counter medications noted, including compliance; Allergies to medications and reaction noted
Comprehensive health history is appropriate to reason for visit
22 points
1 detail missed in patient description
Chief complaint as described by patient, may not be concise or clear
HPI missing 1 component or significant detail
Review of focus system missing 1-2 components
Medication history missing 1-2 components
Health history not appropriate for reason for visit or missing 1-2 components
19 points
>2 details missed in patient description
Chief complaint not identified, concise, or clear
HPI missing >2 components and significant detail
Review of focus system(s) missing >3 components
Medication history missing >3 components
Health history missing >3 components
17 points25
Objective – 30%
Physical exam includes appropriate areas for Chief Complaint, History of Presenting Illness, and Review of Systems (20 points)
Appropriate techniques of examination used to identify pertinent findings (10 points)Appropriate areas and systems included in physical assessment
Comprehensive techniques of observation, palpation, percu ...
THE NEED FOR EVIDENCE-BASED PRACTICE
STEPS OF EVIDENCE-BASED PRACTICE
PICOT FORMAT IN EBP
RATING SYSTEM FOR THE HIERARCHY OF EVIDENCE: QUANTITATIVE QUESTIONS
ELEMENTS OF EVIDENCE-BASED ARTICLES
INTEGRATE THE EVIDENCE
EVALUATE THE OUTCOMES OF THE PRACTICE DECISION OR CHANGE
COMMUNICATE THE OUTCOMES OF THE EVIDENCE-BASED PRACTICE DECISION
SUSTAIN KNOWLEDGE USE
NURSING RESEARCH
TRANSLATION RESEARCH
5 PHASES OF TRANSLATION RESEARCH
OUTCOMES RESEARCH
SCIENTIFIC METHOD
CHARACTERISTICS OF SCIENTIFIC RESEARCH
NURSING AND THE SCIENTIFIC APPROACH
TYPES OF RESEARCH
TYPES OF RESEARCH APPROACH
RESEARCH PROCESS
RIGHTS OF HUMAN SUBJECT
COMPARISON OF STEPS OF THE NURSING PROCESS WITH THE RESEARCH PROCESS
Performance Improvement
Performance Improvement Programs
EXAMPLES OF PERFORMANCE IMPROVEMENT MODELS
THE RELATIONSHIP BETWEEN EBP, RESEARCH, AND PERFORMANCE IMPROVEMENT
SIMILARITIES AND DIFFERENCES AMONG EVIDENCE-BASED PRACTICE, RESEARCH, AND PERFORMANCE IMPROVEMENT
KEY ELEMENTS
11/14/22, 8:09 PM Clinical Judgment Plan
https://canvas.westcoastuniversity.edu/courses/23793/assignments/578656 2/9
Criteria Ratings Pts
4 pts
8 pts
4 pts
Assessment & History of
Present Illness
Recognizing cues focused
on observation
4 pts
Proficient
HPI explains in
detail with
accurate and in-
depth
understanding of
chief complaint
and supported by
evidence-based
citations.
3.04 pts
Acceptable
HPI explains in
some detail with
moderate
understanding
of chief
complaint or no
support from
evidence-based
citations.
2.4 pts
Needs
Improvement
HPI explains in
limited detail
with insufficient
understanding of
chief complaint
or support from
evidence-based
citations.
0 pts
Unsatisfactory
HPI details
limited with
poor
understanding
of chief
complaint and
no evidence-
based citations
to support.
Recognizing assessment
parameters
Clinical thinking and
assessment cues
8 pts
Proficient
Identifies the 4
imperative
assessment
cues and or
medical
diagnoses
supported by
evidence-
based
citations.
6.08 pts
Acceptable
Identifies 2
imperative
assessment
cues and or
medical
diagnosis
supported by
evidence-
based
citations.
4.8 pts
Needs
Improvement
Identifies 1
imperative
assessment
cues and or
medical
diagnosis,
vaguely
supported by
evidence-based
citation.
0 pts
Unsatisfactory
Unable to identify
any imperative
assessments
parameters relevant
to medical
diagnosis and
without supported
evidence-based
citation.
Interpreting diagnostic
criteria & diagnostic tests
and procedures
Clinical reasoning and
analysis of cues
4 pts
Proficient
Clearly and
accurately
describes the
client’s
diagnostic
criteria which
clearly supports
the chief
complaints and
presenting
signs/symptoms.
3.04 pts
Acceptable
Adequately
describes the
client’s
diagnostic
criteria which
adequately
supports the
identified chief
complaint and
presenting
signs/symptoms
2.4 pts
Needs
Improvement
Vaguely
describes the
client’s
diagnostic
criteria which
vaguely
supports the
identified chief
complaint and
presenting
signs/symptoms.
0 pts
Unsatisfactory
Lack
description of
the client’s
diagnostic
criteria that
does not
support the
identified chief
complaint and
presenting
signs/symptoms
11/14/22, 8:09 PM Clinical Judgment Plan
https://canvas.westcoastuniversity.edu/courses/23793/assignments/578656 3/9
Criteria Ratings Pts
8 pts
8 pts
Past medical & surgical
history, pathophysiology
Clinical judgment and
recognizing cues
8 pts
Proficient
Past
medical/surgical
history detailed
with full
explanation of
pathophysiology
for admitting
diagnosis and for
each diagnosis &
accurate detail
with specific
detail related to
the client’s
history and
symptoms and
supported by
evidence-based
citations.
6.08 pts
Acceptable
Past
medical/surgical
history given
with partial
explanation of
identified
admitting
diagnosis and
preexisting
medical
diagnoses,
intermittent
details related to
the client’s
history and
symptoms, or
not completely
supported by
evidence-based
citations.
.
JW House FundraiserJourney Through the Enchanted Forest Ga.docxpauline234567
JW House Fundraiser
Journey Through the Enchanted Forest Gala
Silent Auction
Table Decor
Specialized cocktails for Event
Three Screens will be Placed for Optimum Viewing by all Attendees
New House Announcement
Happy 30th Birthday, JW!
Auction
Isle down Center Allows Fundraising Auctioneer to Engage Audience
Balloon
Drop
S’mores Sponsored by Largest Corporate Donor
Finish the Evening with Dancing & Beverages
Image Sources
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http://pngimg.com/uploads/question_mark/question_mark_PNG126.png
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1. INTRODUCTION. Begin by stating what you will discuss and explain why is important.
2. CRITICAL SUMMARY. Summarize the relevant views and the arguments that you believe are important.
Usually in a critical discussion it is not sufficient to merely summarize the author’s view. Your attention should be
focused on the author's development of the view--that is, on his arguments, in the broadest sense of the word.
3. CARE IN CITATIONS. Make sure you accurately state the position of the author and always include page
references for each quotation or attribution to her/him if applicable.
4. CRITICAL EVALUATION FROM A CHRISTIAN PERSPECTIVE. At least half of your paper must be devoted
to a critical evaluation of the views of the author you are discussing from the perspective of the Christian thesis that
a Christian call in business may prop-up the role of the markets.
5. CONSIDER POSSIBLE RESPONSES TO YOUR OBJECTIONS. Whenever you offer an objection to an
author's position, explicitly consider whether the author has said anythin.
JP Morgan Chase The Balance Between Serving Customers and Maxim.docxpauline234567
JP Morgan Chase: The Balance Between Serving Customers and Maximizing Shareholder Wealth
Penelope Bender
William Woods University
BUS 585: Integrated Studies in Business Administration
Dr. Leathers
Abstract
This paper investigates why JP Morgan Chase and other financial institutions struggle to balance client interests over maximizing wealth.
It is an exploratory study done through literature review.
Often financial institutions, like JP Morgan, put profits ahead of the interests of those they serve.
The paper contributes to better understanding of corporate culture.
This paper investigates why JP Morgan Chase and other financial institutions struggle to balance client interests over maximizing shareholder wealth. This exploratory study is done through a literature review to answer why financial institutions, specifically JP Morgan, often put profits ahead of those they serve. The study will provide evidence of the complex nature of balancing client interests over maximizing shareholder and individual wealth and the need for tighter internal and external oversight. This paper contributes to a better understanding of why corporate culture encourages profit over stakeholders’ interests.
2
Research Question
Why does JP Morgan Chase and other financial institutions struggle to balance client interests over maximizing shareholder wealth?
Employees of JP Morgan Chase and other large banks work in their best interests to increase wealth and succeed by meeting management goals. However, because of the complex nature of large banks, an individual(s), unethical behavior can go unchecked.
3
Problem Statement
JP Morgan Chase competes globally and faces competition from other large banks in the US and abroad.
JP Morgan Chase is part of a complex system of regulation, self-interests, and wealth creation.
The interests of shareholders and investors is sometimes overshadowed by agents working in their own best interests.
Financial markets are a complex web of interests, and because of opportunities for individual profits, regulating individual’s actions without stricter regulations and internal oversight is impossible.
The study is not meant to be a moral or ethical analysis but merely why the complex relationship exists and will continue to exist in capitalist society. This paper contributes to a better understanding of why capitalism or financialism’s (Clarke, 2014) fundamentals encourage wealth creation. Financial markets are a complex web of interests, and because of opportunities for individual profits, regulating individual’s actions without stricter regulations and internal oversight is impossible.
4
Literature Review
The literature review showed a connection between self-interests, regulators, competition, and risk, which all lead to a complex system of conflicting agendas.
5
How Self-Interests Influence Behavior
Ross (1973) explains that all employment relationships are agency relationships and moral hazards are generally .
Interpret a Current Policy of Three CountriesInstructionsAs .docxpauline234567
Interpret a Current Policy of Three Countries
Instructions
As a scholar in public administration, you are asked to present options based on three different countries' information for the next congressional meeting in your state. Be sure to include the following information:
• Perform a SWOT analysis of each immigration system presenting the strengths, weaknesses, opportunities, and threats of each system. You are required to evaluate the United States' system but may choose two other countries besides Costa Rica and Ghana as these were already covered in your weekly resources. Topics such as ethics, history, actors, budgeting can be incorporated into your SWOT analysis.
• Facilitate an immigration benefit analysis for each system to determine the best fit for your state (be sure to identify your state to provide context for your presentation).
• Prepare a plan for the implementation of your chosen immigration program.
Compare how the immigration system is treated in three countries (the U.S. and two other countries).
Length: 12 to 15 pages, not including title and reference pages
References: Include a minimum of seven scholarly references.
The completed assignment should address all the assignment requirements, exhibit evidence of concept knowledge, and demonstrate thoughtful consideration of the content presented in the course. The writing should integrate scholarly resources, reflect academic expectations, and current APA standards.
Respond to
two or more of your colleagues’ posts in one or more of the following ways:
(100 words each Colleague)
· Ask a question about or provide an additional suggestion for the risks that your colleague’s organization might face if it engaged in the capital investment project.
· Provide an additional perspective on the level of risk associated with the project your colleague identified for their selected organization or on how willing/capable the organization might be in taking on and managing the risks your colleague identified.
· Offer an insight you gained from your colleague’s summary of the trade-offs between risks and returns and/or their recommendation for their selected organization to move or not move forward with the project.
Return to this Discussion in a few days to read the responses to your initial posting. Note what you have learned or any insights you have gained as a result of the comments your colleagues made.
1st Colleague to respond to:
The risks associated with a capital investment project for medical equipment for healthcare organizations such as hospitals, as discussed in Week 7, are listed below.
· An inadequate system of budget management caused by unethical conduct.
· The lack of a clearly defined internal process management framework
· Insufficient communication channels within the organization.
The information provided by the managerial accountant assists in making crucial business decisions. Thus, if such information is fabricat.
INTRODUCTIONWhen you think of surveillance, you may picture tw.docxpauline234567
INTRODUCTION
When you think of surveillance, you may picture two police officers camped out in an unmarked car, watching the comings and goings at a suspect’s apartment building. Or you may imagine an investigator trailing a car on the highway or tapping a suspect’s phone to listen in on potentially incriminating conversations. Surveillance is all these activities, but in the 21st century, it is also much more.
Consider video surveillance of local businesses, streets, and highways; cell phone data; and the reams and reams of digital information gathered on everyday activities—from social media and computer use to credit card transactions.
This week, you analyze concerns related to this new era of surveillance, such as privacy and legal requirements.
LEARNING OBJECTIVES
Students will:
Analyze issues related to privacy and surveillance
Describe surveillance
Differentiate between legal and illegal surveillance
Analyze legal requirements for conducting surveillance
PRIVACY VERSUS PUBLIC SAFETY
The average citizen today may feel as though they are constantly being watched and their actions recorded. And perhaps rightly so. After all, social media sites market personalized products based on how you use the Internet, cell phones pinpoint your location, and fitness trackers transmit your health and fitness activities to the cloud. This sense of being “spied on,” however, does not negate the important use of surveillance techniques in solving and preventing crime.
For this Discussion, you analyze how to balance two sometimes opposing sides in surveillance work: the expectation of privacy and the goal of public safety.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
YOU WILL FIND THE READING FOR THIS ASSIGNMENT IN THE ATTACHED READING MATERIALS PLEASE GO THERE AND READ BEFORE TRYING TO COMPLETE THIS ASSIGNMENT SO YOU WILL UNDERSTAND WHAT IS NEEDED TO COMPLETE THE WORK….
Post a response to the following:
When conducting surveillance, explain how to balance an expectation of citizen privacy with legitimate investigative procedure that has public safety as its goal.
Explain whether citizens should differentiate between government intrusion and private companies who use citizens’ online data to surveil their movements and activity.
.
Interviews and Eyewitness Identifications AP PhotoMat.docxpauline234567
Interviews and
Eyewitness
Identifications
AP Photo/Matthew Apgar
OBJECTIVES
After reading this chapter you will be able to:
• Identify the evidence collected
by investigators in the BP
gas station robbery and
discuss its role in the
identification and apprehension
of the perpetrator.
• Discuss the advantages and
disadvantages of using facial
identification software and
forensic sketches to create
composite pictures of
suspects.
• Identify and discuss the
rationale of the recommended
lineup procedures.
• Discuss the research that
has been conducted on the
accuracy of hypnotically elicited
testimony. • Identify the difference between
primary and secondary
witnesses and give an example
of each.
• Discuss the value of eyewitness
identifications in establishing
proof. • Compare and contrast the
cognitive interviewing approach
with standard police interviews.
• Identify and discuss the
methods of eyewitness
identifications.
• Identify the three phases of
human memory and discuss
how factors at each phase
may affect the retrieval of
information from witnesses.
• Discuss the contributions
of cognitive interviewing in
enhancing memory recall.
From the CASE FILE
BP Gas Station Robbery
The introduction to this chapter consists of a police
report (edited for length) of the investigation of an
armed robbery of a British Petroleum (BP) gas station
that occurred on August 22, 2011, in Germantown,
Wisconsin (a suburb of Milwaukee). The report serves
as an example of a criminal investigation case report
and also highlights issues discussed in this chapter,
such as the value of eyewitness identification. Issues
discussed in other chapters, including the important
role of patrol officers in investigations, crime scene
photographs, investigation of robbery and auto theft,
and the value of DNA, are also present in this report.
Incident Report Number: 11-014277,
Report of Officer Toni Olson
On Monday, August 22, 2011, I, Officer Olson, was
assigned to investigate and respond to a robbery, which
had just occurred at the County Line BP, located at 21962
County Line Road. Officers were advised that the c I erk at
the BP gas station had called the non-emergency number
reporting that a younger wh ite male came into the store and
hit him over the head with an unknown object before taking
money out of his cash drawer and leaving in a red SUV or
truck, northbound on Bell Road. A possible registration
of 583RIB was given out for the suspect vehicle. I, along
with Lt. Huesemann, Officer Brian Ball, and Officer Daniel
Moschea of the Germantown Police Department responded.
Upon arriving on scene, officers were advised that witnesses
reported the suspect veh icle leaving the scene of the
robbery northbound on Bell Road into a subdivision. The
witnesses also stated that they had not seen the suspect
vehicle leave the subdivision, which only has two ways to get
in and.
Interview Presentation: Questions
To prepare:
· Identify an interview subject with a different cultural background than you.
· Ask your interview subject the questions below. Be sure to record the interview and/or take good notes.
During the interview, ask the individual the following interview questions:
· Have you ever lived or visited outside of the United States? If so, where? Describe the experience.
· What do you identify as your culture?
· What are the most important values and beliefs of your family and community?
· What are the important events, traditions, celebrations, and practices in your family or community?
· How does your family or community define gender roles?
· How do you identify your:
· Race
· Ethnicity
· National origin
· Color
· Sex
· Sexual orientation
· Gender identity or expression
· Age
· Marital status
· Political belief
· Religion
· Immigration status
· Disability status
· How well do you fit within your family or community based on these other identities you hold?
· How do you think others outside your community view your culture?
· Have you experienced prejudice or discrimination? Please describe.
Social Media and Ethical Considerations
Walden’s MSW Social Media Policy
A student’s presence on and use of social media reflects on the MSW program and the social
work profession; therefore, behavior on social media will be held to the same professional
standards and student code of conduct expectations. Social Work professionals, including
students, are expected to adhere to the NASW Code of Ethics related to virtual communications.
Students should use social work values and principles, as well as specific agency policy, to guide
their social media interactions.
Students need to consider the ethical consequences of their own social media use, as well as use
of social media in practice. Be aware of and follow agency policies regarding the use of social
media. Before using social media communication tools on behalf of a field agency, students
must seek agency approval of any messages or posts.
Walden MSW students are expected to adhere to the ethical standards outlined in the NASW
Code of Ethics. Common ethical issues that social workers need to understand and manage when
utilizing social media include, but are not limited to, privacy and confidentiality (Section 1.07),
conflicts of interest and dual relationships (Section 1.06), and informed consent (Section 1.03).
There is significant risk of unintentionally sharing protected information when using social
media. Be cautious when posting information about an agency. Never post confidential or
private information about clients or colleagues, even using pseudonyms.
Students need to remain aware of professional boundaries even when participating in social
media in their personal time. Managing “friend” requests and maintaining privacy settings is
critical regardless of whether a student uses social me.
INT 220 Business Brief Template Course Project.docxpauline234567
INT 220 Business Brief Template
Course Project
Section One: Drivers for Global Entry
Going global would afford the company many benefits including increased sales and revenues. Japan is a developed market and thus the purchasing power of the consumers is high, which implies that many consumers will be able to purchase our products. Expanding to Japan will enable increased profits that can be reinvested in research and development of new technology and innovation that will create a competitive advantage for both domestic and international market. In addition, entering the foreign market will help the business to tap into new market segment. According to International Data Corporation (IDC), Apple was the largest smartphone brand in 2020 in Japan with a 47.3 percent market share (Sudarshan, 2021). The data shows that Japan would be an ideal market for quality phone cell cases due to high purchase of smartphones. Therefore, the company will benefit from increased sales and profits.
Section Two: Market Profile
Cultural Profile
CategoryUnited StatesJapan
Commonly Spoken Languages
English
Japanese
Commonly Practiced Religions
Christianity
Shinto
Power Distance Index (PDI)
40
54
Individualism Versus Collectivism (IDV)
91
46
Masculinity Versus Femininity (MAS)
95
62
Uncertainty Avoidance Index (UAI)
92
46
Long-Term Orientation Versus Short-Term Normative Orientation (LTO)
88
26
Indulgence Versus Restraint (IVR)
42
68
Political and Economic Profile
CategoryUnited StatesJapan
Political System
Representative democracy
Constitutional monarchy
Current Leaders
Joseph Biden president
Fumio Kishida prime minister
Economic Classification
Developed
Developed
Economic Blocs Impacting Trade
World trade organization
World trade organization
Gross Domestic Product
23 trillion USD
4.9 trillion USD
Purchasing Power Parity
22,996.08
100.412
Gross Domestic Product Per Capita
69,287.54 USD
39,285.16 USD
Human Development Index
Very high 0.921
0.919
Human Poverty Index
$26,246 for a family of four
Poverty headcount ratio at $5.50 a day
In terms of economic development, both countries have developed economy, thus making them ideal for business. Consumers have high purchasing power which means that they are able to purchase new products. US has a higher GPD compared to Japan, however, this can be attributed to the size and population of U.S. compared to that of Japan. Furthermore, both countries are members of World Trade Organization, which means that their trade operations with other nations are regulated and subject to WTO regulations. The culture in Japan is hugely different then the culture in America. Americans are self-motivated while the Japanese culture embraces more of a group mentality and looks for approval from their superiors before making big decision. Both cultures work long hours and take very little breaks. For the most part Japanese culture is more formal in the work place then in the U.S.
Section Three: Market Consideratio.
Instructor Name Point Value 30Student NameCATEGORY .docxpauline234567
Instructor Name: Point Value: 30
Student Name:
CATEGORY Excellent (12–11 points) Good (10–9 points) Fair (8–7 points) Poor (6–1 points) Did Not Complete (0 points) # of points
Content Quality
40% of total Discussion
grade
Student participated in the
Discussion about the presented
topic with detailed, relevant,
supported initial posts and
responses. Student enhanced
points with examples and
questions that helped further
discussion. Discussion is well
organized, uses scholarly tone,
follows APA style, uses original
writing and proper paraphrasing,
contains very few or no writing
and/or spelling errors, and is fully
consistent with graduate-level
writing style. Discussion contains
multiple, appropriate and
exemplary sources
expected/required for the
assignment.
Student participated in the
Discussion about the presented
topic with detailed, relevant,
supported initial posts and
responses. Discussion is mostly
consistent with graduate level
writing style. Discussion may have
some small or infrequent
organization, scholarly tone, or
APA style issues, and/or may
contain a few writing and spelling
errors, and/or somewhat less than
the expected number of or type of
sources.
Student participated in the
Discussion about the presented
topic with adequate content but
the content lacked either detail,
relevancy, or support. Discussion
is somewhat below graduate level
writing style, with multiple smaller
or a few major problems.
Discussion may be lacking in
organization, scholarly tone, APA
style, and/or contain many writing
and/or spelling errors, or shows
moderate reliance on quoting vs.
original writing and paraphrasing.
Discussion may contain inferior
resources (number or quality).
Content of student's post and
responses was not clear, relevant,
or supported. Discussion is well
below graduate level writing style
expectations for organization,
scholarly tone, APA style, and
writing, or relies excessively on
quoting. Discussion may contain
few or no quality resources.
Student did not submit a post or
response.
CATEGORY Excellent (12–11 points) Good (10–9 points) Fair (8–7 points) Poor (6–1 points) Did Not Complete (0 points) # of points
Engagement
40% of total Discussion
grade
Student participated actively as
evidenced by strong reflective
thought in both the initial post and
in responses to classmates' posts.
Student response participation
exceeded the stated minimum
requirements.
Student participated actively as
evidenced by strong reflective
thought in both the initial post and
in responses to classmates'
posts.Student responses
contributed to classmates'
experience.
Student participated somewhat
actively as evidenced by posts
and responses that were adequate
but lacking strong reflective
thought.
Student did not participate actively
as evidenced by little reflective
thought in i.
InstructionsThere are two high-level types of distribution cha.docxpauline234567
Instructions
There are two high-level types of distribution channels, direct and indirect. In the direct distribution channel, goods are moved directly from the Producer to the Consumer. In the indirect distribution channel, the producer will meet consumer demand through third -party wholesalers and/or retailers. Direct channels produce short supply chains, indirect channels produce long chains.
Research and report on two large producers, Costco and Apple, and describe in detail which distribution approach each company uses -- direct, indirect, or mixed – for at least two products in each company.
Your APA paper should be at least 1,000 words in length.
.
InstructionsNOTE If you have already reviewed this presentation.docxpauline234567
Instructions
NOTE: If you have already reviewed this presentation in a different class please enter class number and instructor’s name in the submission text box below.
____________________________________________________________________
If you have not reviewed this presentation in a previous class, please proceed.
Please review the curated presentations below. These presentations will prepare you for writing deliverables that meet the expectations of this course. We want you to be successful in all your courses so please refer back to this tool often. This presentation is located in the library and the Student Center. To view an presentation, please click on the button below. Be sure to review all five presentations for this week!
Presentation Four: The Research Process & Choosing a Topic
Presentation Five: Types of Sources
Presentation Six: Search Strategies & Techniques
Presentation Seven: Evaluating Information
Presentation Eight: Ready to Shine!
When you have finished reviewing all five presentations, please copy and paste the following statement into the submission box below:
STATEMENT: I HAVE REVIEWED WEEK TWO INFORMATIONAL PRESENTATION. I UNDERSTAND THIS PRESENTATION IS ALSO LOCATED IN THE LIBRARY AND STUDENT CENTER FOR FUTURE REFERENCE.
.
InstructionsRead two of your colleagues’ postings from the Di.docxpauline234567
Instructions:
Read two of your colleagues’ postings from the Discussion question.
Respond with a comment that asks for clarification, provides support for, or contributes additional information to two of your colleagues.
Timia Brown (
She/Her)
In healthcare, whether long-term or acute care, interdisciplinary communication is necessary to provide patient-centered care. The two scenarios provided both effective and ineffective communication.
Scenario 1
Assuming the leader for the interdisciplinary rounds was the case manager, she introduced the nursing student, who was not paying attention. The case manager did not present other team members, so the student was left guessing. The pharmacist and the physical therapist were laughing and talking during the discussion. There was no engagement; the MD was on her phone, and everyone was preoccupied. Each team member individually knew the patient and his shortcomings, yet there was no preparation for the actual engagement with each other. Each team member projected issues onto the next member, using terms such as "somebody" or "someone" needed to do this. There was no responsibility for care. The team spoke unprofessionally to each other, using words like "yep" and "umm." In the end, the case manager assigned responsibility; however, the disciplines accepted the responsibility grudgingly. The team's disrespect for each other was portrayed to the student, who was disengaged throughout the meeting. The patient was not ready to be discharged from the sound of this scenario. The patient's pain was not controlled, nor was his anxiety; no equipment had been ordered for discharge. The patient's safety was not a priority in this meeting, which could lead to readmission or fall risk at home.
In scenario two, the team all appeared happy to be there, with smiling faces and excellent eye contact. The leader engaged the nursing student immediately by having the team introduce themself. The team was much more prepared and engaged. Each member respected the other's role in providing care and a safe, patient-centered discharge. The team took responsibility for what was needed from each of them now and at the time of release. The communication was more two-way communication. They did a recap of what was discussed, and everyone willingly took part in making sure the patient went home safely and confidently.
Effective communication between interdisciplinary teams must be present to provide the care needed for each patient. It starts with respecting each other's role in the patient's care and remembering the patient is the priority. The
Journal of Communication in Healthcare stated the leading cause of all sentinel events from 1995 to 2004 was ineffective communication. (2019, Altabba) Therefore effective communication could decrease the number of incidents, and lead to proper care.
References
Altabbaa G, Kaba A, Beran TN. Moving from structure.
InstructionsRespond to your colleagues. Respond with a comment .docxpauline234567
Instructions:
Respond to your colleagues. Respond with a comment that asks for clarification, supports, or contributes additional information to two or more of your colleagues.
Reynaldo Guerra
As influencers in our society, that bring about social change in healthcare as all those we contact, the type of agent I would align with is a Purposeful Participant. Where "School or work are the primary motivations for involvement in positive social change." (
What kind of social change agent are you? n.d.) are what defines greatly the type of agent I am. Due to my desire to expand my education and grow, I have been allowed to not just see but know that I can contribute to various aspects of healthcare. At the hospital I currently am employed, many principles are introduced to us and help us with making a difference for our patients as all professionals alike by the way we interact and the relationship we create with everyone. Even if driven by these two motivators, they have opened my eyes and expanded my limitations in the change we can bring about.
This eye-opening experience has changed my perspective on how I can make a social change with all those around me. I now feel that a cascade effect comes from my changes as little as it might seem, it gets passed down and impact larger changes in the long run. How I speak with my patients and show the advocate I am for them in addressing their healthcare issues with importance, to the trust and relationship I have created with the primary care providers, goes to show these small social changes can in the end bring a great change for all. This has shown me that social change has a larger purpose in the end and even as small of a change we bring about, if we all come together and do the same, the results would be even more significant than what we perceived as a small change in the beginning. From our professional interactions with one another to our desire to help and better our care with all patients alike, these changes have a great purpose and impact on our future as everyone else.
Apart from that, social change has influenced my education by motivating me to seek ways to make a difference in a community project presented by my university. It has ignited a flame in me, so to speak, and piqued my interest in seeing what my university has to offer in making a social change. Whether this is by being part of projects, joining a committee, or being part of future alumni programs to help others. Also, being able to refine my nursing practice in our community as in the hospital has been a change for me. This, in turn, will be put forth in the interactions and relationships I create with my patients, colleagues, peers, and others I come in contact with, hopefully, bringing a social change in the end. This is what the principles of social change will bring about for me.
References
Walden University. (n.d.).
What kind of social change agent are you? Lin.
Instructions
Procurement Outsourcing (PO) Strategies:
PO strategies at the highest level involve either materials or traditional business processes such as HR, IT, Finance, Accounting, Travel/Entertainment services, Marketing/Print/Advertising, or Customer Relationship Management (CRM). Your task here is to choose a public business organization and report on what direct materials are being outsourced. Direct materials are categorized as strategic (high-impact), bottleneck items (low-profit impact and high-supply risk), leverage items (high-profit items and low-supply risk), or non-critical (low-profit impact and low-supply risk). Describe the outsource process in detail, who provided the outsourced services, and what direct materials were involved.
You are to prepare a PowerPoint presentation, with a minimum of twelve (12) slides, to include inline citations, a cover slide, and a slide of references. Your citations and references should be APA-compliant.
Level of writing: Exemplary
.
InstructionsPart Four of Applied Final Project,Playing with Ge.docxpauline234567
Instructions
Part Four of Applied Final Project,Playing with Gender: Understanding Our Gendered Selves:
"Understanding My Playing-with-Gender Act" (20% of course grade; due end of Week 7) Five (5) pages (1200-1500 words)
All parts of this project should be formatted in APA style (follow for both essay and citation styles):https://libguides.umgc.edu/c.php?g=1003870
Purpose: Act Analysis
In this part of the assignment, you will perform, describe, and analyze your act. After you perform your act, compose a 5-page (1200-1500 words) task specifying your experiences. The first section (one-third to one-half of your paper) should describe your act and your responses to it, and the second section should analyze your act in terms of the scholarship on gender:
Section One (minimum 500 words):
1. Describe your act:
2. What did you do?
3. Where did you do it?
4. How did you prepare for it?
5. What responses did you get while performing your act?
6. How did you feel while performing your act?
7. What would you do differently if you had to perform this same act again? Would you perform the act in the same location and at same time? Would you change your appearance during the act? Would you do anything else differently?
8. Please refer directly to the required reading on Participant Observation (Mack et al., 2005) in this section of the paper (Mack et al., 2005) (
PLEASE see attached for document):
Mack et al. (2005). "Module Two: Participant Observation," from
Qualitative Research Methods: A Data Collector's Field Guide, Family Health International. Read Module 2, pages 13-27. Retrieved from
https://www.fhi360.org/sites/default/files/media/documents/Qualitative%20Research%20Methods%20-%20A%20Data%20Collector's%20Field%20Guide.pdf
Section Two: (minimum 700 words):
(Please see attached for document listing the sources)
Referring directly to at least three academic sources for support (these may be pulled from the sources you identified and discussed in your Annotated Bibliography for Part 3
and/or the readings for this class), consider the potential impact of your act. Here are some questions to consider (you do not have to answer all of these questions; they are provided to help you to think about ways your act may have impact on society):
· Can you explain the range of reactions to your act? Did those reactions reflect any of the sociological scholarship found in the course readings or in your research? Did any of the reactions challenge that research?
· How do you think class, race, age, and sexuality came into play during the conception and performance of the act?
· Was performing this act an act of feminism? Why? and, if so, what type(s) of feminism?
· Was your act an act of activism? That is, could it help to create social change? If so, how?
Please see attached for Project 1, 2 & 3 for information and assistance.
Qualitative
Research
Methods:
A DATA CO L L E.
InstructionsClients come to MFTs because they want to change, .docxpauline234567
Instructions
Clients come to MFTs because they want to change, whether the change is in cognitions, structure, insight, or something else. Therefore, it is important for you to understanding why, when, and how people change. This week, you will continue the exploration of core concepts related to systems theory and its application to MFT field concepts. You will review several concepts associated with change including homeostasis, first-order change, second-order change, continuous change, and discontinuous change.
Complete the provided worksheet template located in this week’s resources. Note: You will use the worksheet you complete this week as part of your work in Week 4.
For each item, be sure to address the following:
· Record a direct quotation that defines the concept or describes the assumption.
· Paraphrase the definition or description by explaining the information in your own words. As you are paraphrasing, keep in mind that concepts often involve several interrelated ideas. When you are paraphrasing, be sure to not oversimplify the concept.
· Provide an original example (not one you read about in the course resources) of the concept or assumption.
· Explain how your example reflects the definition. Refer to your paraphrased definition in order to compare the example to the concept.
Should you have questions or need clarification on any items, please contact your professor to discuss it.
Length: 1-2 pages (completed template). Additional resources/reference page is not required.
Your cheat sheet should demonstrate thoughtful consideration of the ideas and concepts presented in the course by providing new thoughts and insights relating directly to this topic. Be sure to adhere to Northcentral University's Academic Integrity Policy.
Upload your document, and then click the
Submit to Dropbox button.
Building Blocks to Conceptualizing Family: A Family System’s Perspective Valerie Q. Glass, PhD, LMFT
Background of Systemic Thinking
Systemic thinking, for some, means trying on a new and unique lens when considering “presenting problems” that arise in therapeutic settings. Most mental and emotional health backgrounds study individual cognitive and emotional processes, systemic thinking means a shift in looking at one person to looking at a whole system. Keeney (1983) calls this change in professional theory an epistemological shift. Epistemology, most basically, is the way one understands what is in front of them, and the root with which decisions are made. Helping fields all develop from different epistemologies. Psychiatry views medicine and biology as their epistemological construct of how or why people act the way they do. Much of the epistemological focus of social work fields embraces the necessity or connecting to resources and social support as a catalyst for change. Psychology explores the make-up of the individual’s mind and develops steps for change. Family systems, and.
INST560, Internet of Things (IoT)UNIVERSITY OF NORTH AMERICA.docxpauline234567
INST560, Internet of Things (IoT)
UNIVERSITY OF NORTH AMERICA
Lecture 3: Fall 2022
Professor Aliakbar Jalali
[email protected]
1
Internet of Things Enabling Technologies
/59
UoNA-ST560-FALL-2022, Internet of Things (IoT)
Overview
Introduction
Evolution of the Technology
Some significant statistics
IoT Technology
Risks of IoT Technologies
Use Cases of IoT Technology!
What are IoT Enabling Technology
Conclusion
References
2
/59
UoNA-ST560-FALL-2022, Internet of Things (IoT)
Introduction
Because of technological changes taking place in the world, IoT is gradually taking over all the fields, and the future of the IoT applications are increasing day by day.
Technological advances are fueling the growth of IoT.
Technology improved communications and network, new sensors of various kinds; cheaper, denser, more reliable, and power efficient storage both in the cloud and locally are converging to enable new types of IoT based products that were not possible a few years ago.
IoT technology will further develop to make our day-to-day operations much easier and more remotely controlled in the days to come.
3
/59
UoNA-ST560-FALL-2022, Internet of Things (IoT)
Introduction
Businesses need to constantly explore IoT applications within their domain to stay ahead in competitiveness and implementation.
The competition will primarily define in the coming decade as how companies take advantage of innovative technology.
However, it is the dominant technology that determines the future of many businesses attached to the future of the internet of things (IoT).
4
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UoNA-ST560-FALL-2022, Internet of Things (IoT)
Introduction
The emerging trends in IoT are majorly driven by technologies like artificial intelligence, blockchain, 5G and edge computing.
We need to know more in detail about the elements that make up broad spectrum of technologies, we know as the Internet of Things.
Technological advances lies in the business value of IoT applications like smart wearables, smart homes and buildings, smart cities, autonomous cars, smart factories, location trackers, wireless sensors and much more.
5
/59
UoNA-ST560-FALL-2022, Internet of Things (IoT)
Introduction: Technology is changing the world!
Technology is changing the world.
It is changing the way we communicate, shop, learn, travel, play and of course the way we work.
http://www.telegraph.co.uk/technology/2017/05/06/internet-things-could-really-change-way-live/
6
/59
UoNA-ST560-FALL-2022, Internet of Things (IoT)
6
Introduction: Technology is changing the world!
7
Global gigabit subscriptions are expected to jump to 50 million in 2022, more than doubling from 24 million at the end of 2020, according to a new report from analyst firm Omdia.
High Speed Internet!
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UoNA-ST560-FALL-2022, Internet of Things (IoT)
Introduction: Social Media is Changing societies!
8
Are you on social media a lot? When is the last time you checked Twitter, Facebook, or Instagram? Last n.
Insert Prename, Surname of all studentsWinter Term 202223Theo.docxpauline234567
Insert Prename, Surname of all students
Winter Term 2022/23
Theory Factsheet: Insert name of theory
Level of analysis
Insert levels of analysis, e.g., organisation, individual, social
Dependent construct(s)
Please insert the dependent construct(s) of the theory
Independent construct(s)
Please insert the independent construct(s) of the theory
Short description of the theory
Please describe the theory in full sentences.
Cause-Effect Model
Please insert a visual diagram of the cause-effect relationships or factor model of the theory (if available).
Applications of the theory
Please describe for which purposes / in which fields the theory has been applied.
Which relevance does the theory have for digitalization in organizations?
Criticism
Describe alternative views, potential critique, and open discussion on the theory.
References
Insert sources and references used in this factsheet in APA 7th style.
Students will write a 2-3 pages essay analyzing one of the topics addressed during the semester under the section of Contemporary Issues: Human Rights. The student will be free to choose any of the topics discussed during class as well as his/her opinion about it.
1. Choose a topic (death penalty, assisted suicide, abortion, death by euthanasia, bioethics… etc.)
2. First page: description of the problem (is is here Fl, or national or worlwide, statistics, etc)
Second page: YOUR ETHICAL POSITION ABOUT IT (why is this an ethical issue, where your argument os coming from, etc)
3. REFERENCES (could be ppt, movie, article, web, book)
The writing will be evaluated for clarity and proper handling of terms, phrases, and concepts addressed up to this date. APA or MLA style will be required
https://owl.english.purdue.edu/owl/section/2/10/.
Reading listWinter semester 2022/23
Version 24.09.2022
Reading
Package
No.
Theories Papers
Information Systems Foundational Theories
Structuration Theory Orlikowski, W.J. (1992). The Duality of Technology: Rethinking the Concept of Technology in Organizations. Organization Science, 3 (3), 398-
427.
Structuration Theory Orlikowski, W.J. and Robey, D. (1991). Information Technology and the Structuring of Organizations. Information Systems Research, 2 (2),
143-169.
Structuration Theory Walsham, G. and Han, C.K. (1991) Structuration theory and information systems research. Journal of Applied Systems Analysis 17: 77-85.
Institutional Theory Barley, S.R and Tolbert, P.S. (1997). Institutionalization and structuration: studying the links between action and institution. Organization
Studies 18 (1): 93-118.
Institutional Theory Orlikowski, W. J., & Barley, S. R. (2001). Technology and institutions: What can research on information technology and research on
organizations learn from each other? MIS Quarterly, 25(2), 145.
Design Science Hevner, A. R., March, S. T., Park, J., & Ram, S. (2004). Design science in information systems research. MIS Quarterly, 28 (1), 75.
Informative SpeechCourse COM103 Public SpeakingCriteria.docxpauline234567
Informative Speech
Course: COM103 Public Speaking
Criteria Level 4 Level 3 Level 2 Level 1 Criterion Score
Introduction / 10
Material / 8
Transitions / 10
10 points
Introduction
contained a
strong
attention
getter,
introduction of
the topic,
credibility
statement, and
previewed the
speech.
7 points
Introduction
contained 3 of
the following:
a strong
attention
getter,
introduction of
the topic,
credibility
statement, and
previewed the
speech.
4 points
Introduction
contained 2 of
the following:
a strong
attention
getter,
introduction of
the topic,
credibility
statement, and
previewed the
speech.
0 points
Introduction
contained 1 of
the following:
a strong
attention
getter,
introduction of
the topic,
credibility
statement, and
previewed the
speech.
8 points
Material was
clear AND
well organized
5.6 points
Material was
either clear
OR well
organized
3.2 points
NA
0 points
Material was
neither clear
and well
organized
10 points
Transitions
were clear and
used after the
intro, between
each main idea
and before the
conclusion
7 points
Transitions
were clear, but
were not used
in all areas:
after the intro,
between each
main idea and
before the
conclusion
4 points
Transitions
used after the
intro, between
each main idea
and before the
conclusion,
but were not
effective
0 points
Transitions
were not used.
Rubric Assessment - COM103 Public Speaking - National University https://nationalu.brightspace.com/d2l/lms/competencies/rubric/rubrics_a...
1 of 4 12/6/22, 5:38 PM
Criteria Level 4 Level 3 Level 2 Level 1 Criterion Score
Conclusion / 8
Time limit / 8
Preparation
outline
uploaded
/ 8
8 points
The
conclusion
contained a
strong closing
AND the
speaker
signaled the
end of the
speech
5.6 points
The
conclusion
contained a
strong closing
OR the
speaker
signaled the
end of the
speech
3.2 points
The speaker
needs
improvement
signalling the
end of the
speech and a
stronger
closing.
0 points
The
conclusion
neither
contained a
strong closing
and the
speaker did
not signal the
end of the
speech
8 points
The length of
the speech
was between
5 and 6
minutes
5.6 points
NA
3.2 points
The length of
the speech
was shorter
than 5 minutes
or longer than
6 minutes
0 points
NA
8 points
The
preparation
outline was
uploaded with
the speech
5.6 points
The
preparation
outline was
uploaded after
delivering the
speech
3.2 points
The
preparation
outline was
not in a
preparation
outline format
0 points
The
preparation
outline was
not uploaded.
Rubric Assessment - COM103 Public Speaking - National University https://nationalu.brightspace.com/d2l/lms/competencies/rubric/rubrics_a...
2 of 4 12/6/22, 5:38 PM
Criteria Level 4 Level 3 Level 2 Level 1 Criterion Score
Eye Contact / 10
Delivery / 10
Non verbals / 10
Overall
preparation
/ 8
10 points
The speaker
had strong eye
contac.
We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
1. NRNP_6665_Week4_Assignment_Rubric
NRNP_6665_Week4_Assignment_Rubric
Criteria
Ratings
Pts
This criterion is linked to a Learning OutcomeCreate
documentation in the Focused SOAP Note Template about the
patient in the case study. 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
15 to >13.0 pts
Excellent
The response throughly and accurately describes the patient's
subjective complaint, history of present illness, past psychiatric
history, medication trials and current medications,
psychotherapy or previous psychiatric diagnosis, pertinent
histories, allergies, and review of all systems that would inform
a differential diagnosis.
13 to >11.0 pts
Good
The response accurately describes the patient's subjective
complaint, history of present illness, past psychiatric history,
medication trials and current medications, psychotherapy or
previous psychiatric diagnosis, pertinent histories, allergies,
and review of all systems that would inform a differential
diagnosis.
11 to >10.0 pts
Fair
The response describes the patient's subjective complaint,
history of present illness, past psychiatric history, medication
trials and current medications, psychotherapy or previous
2. psychiatric diagnosis, pertinent histories, allergies, and review
of all systems that would inform a differential diagnosis but is
somewhat vague or contains minor innacuracies.
10 to >0 pts
Poor
The response provides an incomplete or inaccurate description
of the patient's subjective complaint, history of present illness,
past psychiatric history, medication trials and current
medications, psychotherapy or previous psychiatric diagnosis,
pertinent histories, allergies, and review of all systems that
would inform a differential diagnosis. Or the subjective
documentation is missing.
15 pts
This criterion is linked to a Learning OutcomeIn the Objective
section, provide:• Review of Systems (ROS) documentation and
relate if pertinent to the chief complaint, HPI, and history•
Diagnostic results, including any labs, imaging, or other
assessments needed to develop the differential diagnoses
15 to >13.0 pts
Excellent
The response thoroughly and accurately documents the patient's
ROS for pertinent systems. Diagnostic tests and their results are
thoroughly and accurately documented.
13 to >11.0 pts
Good
The response accurately documents the patient's ROS for
pertinent systems. Diagnostic tests and their results are
accurately documented.
11 to >10.0 pts
Fair
Documentation of the patient's ROS is somewhat vague or
contains minor innacuracies. Diagnostic tests and their results
are documented but contain minor inaccuracies.
10 to >0 pts
Poor
3. The response provides incomplete or inaccurate documentation
of the patient's ROS. Systems may have been unnecessarily
reviewed. Or the objective documentation is missing.
15 pts
This criterion is linked to a Learning OutcomeIn 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.
20 to >17.0 pts
Excellent
The response thoroughly and accurately documents the results
of the mental status exam. Response lists at least three
distinctly different and detailed possible disorders in order of
priority for a differential diagnosis of the patient in the assigned
case study, and it provides a thorough, accurate, and detailed
justification for each of the disorders selected.
17 to >15.0 pts
Good
The response accurately documents the results of the mental
status exam. Response lists at least three distinctly different and
detailed possible disorders in order of priority for a differential
diagnosis of the patient in the assigned case study, and it
provides an accurate justification for each of the disorders
selected.
15 to >13.0 pts
Fair
The response documents the results of the mental status exam
with some vagueness or innacuracy. Response lists at least three
different possible disorders for a differential diagnosis of the
4. patient and provides a justification for each, but may contain
some vagueness or innacuracy.
13 to >0 pts
Poor
The response provides an incomplete or inaccurate description
of the results of the mental status exam and explanation of the
differential diagnoses. Or the assessment documentation is
missing.
20 pts
This criterion is linked to a Learning OutcomeIn the Plan
section, provide:• Your plan for psychotherapy• 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. • Incorporate
one health promotion activity and one patient education
strategy.
25 to >22.0 pts
Excellent
The response provides an evidence-based, detailed, and
appropriate plan for psychotherapy for the patient. The response
provides an evidence-based, detailed, and appropriate plan for
treatment and management, including pharmacologic and
nonpharmacologic treatments, alternative therapies, and follow-
up parameters. A strong rationale for the plan is provided that
demonstrates critical thinking and content understanding. ... The
response includes at least one evidence-based health promotion
activity and one evidence-based patient education strategy.
22 to >19.0 pts
Good
The response provides an evidence-based and appropriate plan
for psychotherapy for the patient. The response provides an
evidence-based and appropriate plan for treatment and
management, including pharmacologic and nonpharmacologic
treatments, alternative therapies, and follow-up parameters. An
5. adequate rationale for the plan is provided. ... The response
includes at least one health promotion activity and one patient
education strategy.
19 to >17.0 pts
Fair
The response provides a somewhat vague or inaccurate plan for
psychotherapy for the patient. The response provides a
somewhat vague or inaccurate plan for treatment and
management, including pharmacologic and nonpharmacologic
treatments, alternative therapies, and follow-up parameters. The
rationale for the plan is weak or general. ... The response
includes one health promotion activity and one patient
education strategy, but it may contain some vagueness or
innacuracy.
17 to >0 pts
Poor
The response provides an incomplete or inaccurate plan for
psychotherapy for the patient. The response provides an
incomplete or inaccurate plan for treatment and management,
including pharmacologic and nonpharmacologic treatments,
alternative therapies, and follow-up parameters. The rationale
for the plan is inaccurate or missing. ... The health promotion
and patient education strategies are incomplete or missing.
25 pts
This criterion is linked to a Learning Outcome• 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!), social
determinates of health, health promotion, and disease
prevention that takes into consideration patient factors (such as
age, ethnic group, etc.), PMH, and other risk factors (e.g.,
socioeconomic, cultural background, etc.).
5 to >4.0 pts
Excellent
6. Reflections are thorough, thoughtful, and demonstrate critical
thinking.
4 to >3.5 pts
Good
Reflections demonstrate critical thinking.
3.5 to >3.0 pts
Fair
Reflections are somewhat general or do not demonstrate critical
thinking.
3 to >0 pts
Poor
Reflections are incomplete, inaccurate, or missing.
5 pts
This criterion is linked to a Learning OutcomeProvide 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).
10 to >8.0 pts
Excellent
The response provides at least three current, evidence-based
resources from the literature to support the assessment and
diagnosis of the patient in the assigned case study. The
resources reflect the latest clinical guidelines and provide
strong justification for decision making.
8 to >7.0 pts
Good
The response provides at least three current, evidence-based
resources from the literature that appropriately support the
assessment and diagnosis of the patient in the assigned case
study.
7 to >6.0 pts
Fair
Three evidence-based resources are provided to support the
assessment and diagnosis of the patient in the assigned case
7. study, but they may only provide vague or weak justification.
6 to >0 pts
Poor
Two or fewer resources are provided to support the assessment
and diagnosis decisions. The resources may not be current or
evidence based.
10 pts
This criterion is linked to a Learning OutcomeWritten
Expression and Formatting - The paper follows correct APA
format for parenthetical/in-text citations and reference list.
5 to >4.0 pts
Excellent
Uses correct APA format with no errors
4 to >3.5 pts
Good
Contains a few (one or two) APA format errors
3.5 to >3.0 pts
Fair
Contains several (three or four) APA format errors
3 to >0 pts
Poor
Contains many (five or more) APA format errors
5 pts
This criterion is linked to a Learning OutcomeWritten
Expression and Formatting - English Writing Standards: Correct
grammar, mechanics, and punctuation
5 to >4.0 pts
Excellent
Uses correct grammar, spelling, and punctuation with no errors
4 to >3.5 pts
Good
Contains a few (one or two) grammar, spelling, and punctuation
errors
3.5 to >3.0 pts
8. Fair
Contains several (three or four) grammar, spelling, and
punctuation errors
3 to >0 pts
Poor
Contains many (five or more) grammar, spelling, and
punctuation errors that interfere with the reader’s understanding
5 pts
Total Points: 100
NRNP/PRAC 6665 & 6675 Focused SOAP Psychiatric
Evaluation Exemplar
INSTRUCTIONS ON HOW TO USE EXEMPLAR AND
TEMPLATE—READ CAREFULLY
If you are struggling with the format or remembering what to
include, follow the
Focused SOAP Note Evaluation Template
AND the Rubric
as your guide. It is also helpful to review the rubric in
detail in order not to lose points unnecessarily because you
missed something required. After reviewing full details of the
rubric, you can use it as a guide.
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
9. · Allergies
· ROS
Read rating descriptions to see the grading standards!
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.
Read rating descriptions to see the grading standards!
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-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.
·
Read rating descriptions to see the grading standards!
Reflect on this case. Include: 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!), social determinates of health, 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.).
10. (The FOCUSED SOAP psychiatric evaluation is typically the
follow-up visit patient note. You will practice writing
this type of note in this course. You will be focusing more on
the symptoms from your differential diagnosis from the
comprehensive psychiatric evaluation narrowing to your
diagnostic impression. You will write up what symptoms are
present and what symptoms are not present from illnesses to
demonstrate you have indeed assessed for illnesses which could
be impacting your patient. For example, anxiety symptoms,
depressive symptoms, bipolar symptoms, psychosis symptoms,
substance use, etc.)
EXEMPLAR BEGINS HERE
Subjective:
CC (chief complaint): A
brief statement identifying why the patient is here. This
statement is verbatim of the patient’s own words about why
presenting for assessment. For a patient with dementia or other
cognitive deficits, this statement can be obtained from a family
member.
HPI: Begin this section with patient’s initials, age, race, gender,
purpose of evaluation, current medication and referral reason.
For example:
N.M. is a 34-year-old Asian male presents for medication
management follow up for anxiety. He was initiated sertraline
last appt which he finds was effective for two weeks then
symptoms began to return.
Or
P.H., a 16-year-old Hispanic female, presents for follow up to
discuss previous psychiatric evaluation for concentration
difficulty. She is not currently prescribed psychotropic
medications as we deferred until further testing and screening
was conducted.
11. Then, this section continues with the symptom analysis for your
note. Thorough documentation in this section is essential for
patient care, coding, and billing analysis.
Paint a picture of what is wrong with the patient. First what is
bringing the patient to your follow up evaluation? Document
symptom onset, duration, frequency, severity, and impact. What
has worsened or improved since last appointment? What
stressors are they facing? Your description here will guide your
differential diagnoses into your diagnostic impression. You are
seeking symptoms that may align with many
DSM-5 diagnoses, narrowing to what aligns with
diagnostic criteria for mental health and substance use
disorders.
Substance Use History: This section contains any history or
current use of caffeine, nicotine, illicit substance (including
marijuana), and alcohol. Include the daily amount of use and
last known use. Include type of use such as inhales, snorts, IV,
etc. Include any histories of withdrawal complications from
tremors, Delirium Tremens, or seizures.
Current Medications: Include dosage, frequency, length of time
used, and reason for use. Also include OTC or homeopathic
products.
Allergies:
Include medication, food, and environmental allergies
separately. Provide a description of what the allergy is (e.g.,
angioedema, anaphylaxis). This will help determine a true
reaction vs. intolerance.
Reproductive Hx:
Menstrual history (date of LMP), Pregnant (yes or no),
Nursing/lactating (yes or no), contraceptive use (method used),
types of intercourse: oral, anal, vaginal, other, any sexual
concerns
12. ROS: Cover all body systems that may help you include or rule
out a differential diagnosis. Please note: THIS IS DIFFERENT
from a physical examination!
You should list each system as follows:
General:Head:
EENT: etc. You should list these in bullet format and
document the systems in order from head to toe.
Example of Complete ROS:
GENERAL: No weight loss, fever, chills, weakness, or fatigue.
HEENT: Eyes: No visual loss, blurred vision, double vision, or
yellow sclerae. Ears, Nose, Throat: No hearing loss, sneezing,
congestion, runny nose, or sore throat.
SKIN: No rash or itching.
CARDIOVASCULAR: No chest pain, chest pressure, or chest
discomfort. No palpitations or edema.
RESPIRATORY: No shortness of breath, cough, or sputum.
GASTROINTESTINAL: No anorexia, nausea, vomiting, or
diarrhea. No abdominal pain or blood.
GENITOURINARY: Burning on urination, urgency, hesitancy,
odor, odd color
NEUROLOGICAL: No headache, dizziness, syncope, paralysis,
ataxia, numbness, or tingling in the extremities. No change in
bowel or bladder control.
MUSCULOSKELETAL: No muscle, back pain, joint pain, or
stiffness.
HEMATOLOGIC: No anemia, bleeding, or bruising.
LYMPHATICS: No enlarged nodes. No history of splenectomy.
ENDOCRINOLOGIC: No reports of sweating, cold, or heat
intolerance. No polyuria or polydipsia.
Objective:
Diagnostic results: Include any labs, X-rays, or other
diagnostics that are needed to develop the differential diagnoses
13. (support with evidenced and guidelines).
Assessment:
Mental Status Examination: For the purposes of your courses,
this section must be presented in paragraph form and not use of
a checklist! This section you will describe the patient’s
appearance, attitude, behavior, mood and affect, speech, thought
processes, thought content, perceptions (hallucinations,
pseudohallucinations, illusions, etc.)., cognition, insight,
judgment, and SI/HI. See an example below. You will modify to
include the specifics for your patient on the above elements—
DO NOT just copy the example. You may use a preceptor’s way
of organizing the information if the MSE is in paragraph form.
He is an 8-year-old African American male who looks his stated
age. He is cooperative with examiner. He is neatly groomed and
clean, dressed appropriately. There is no evidence of any
abnormal motor activity. His speech is clear, coherent, normal
in volume and tone. His thought process is goal directed and
logical. There is no evidence of looseness of association or
flight of ideas. His mood is euthymic, and his affect appropriate
to his mood. He was smiling at times in an appropriate manner.
He denies any auditory or visual hallucinations. There is no
evidence of any delusional thinking. He denies any current
suicidal or homicidal ideation. Cognitively, he is alert and
oriented. His recent and remote memory is intact. His
concentration is good. His insight is good.
Diagnostic Impression:
You must begin to narrow your differential diagnosis to
your diagnostic impression. You must explain how and why
(your rationale) you ruled out any of your differential
diagnoses. You must explain how and why (your rationale) you
concluded to your diagnostic impression. You will use
supporting evidence from the literature to support your
rationale. Include pertinent positives and pertinent negatives for
the specific patient case.
14. Also included in this section is the reflection. Reflect on this
case and discuss whether or not you agree with your preceptor’s
assessment and diagnostic impression of the patient and why or
why not. What did you learn from this case? What would you do
differently?
Also include in your reflection a discussion related to
legal/ethical considerations (
demonstrating critical thinking beyond confidentiality
and consent for treatment!), social determinates of health,
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.).
Case Formulation and Treatment Plan
Includes documentation of diagnostic studies that will be
obtained, referrals to other health care providers, therapeutic
interventions including psychotherapy and/or
psychopharmacology, education, disposition of the patient, and
any planned follow-up visits. Each diagnosis or condition
documented in the assessment should be addressed in the plan.
The details of the plan should follow an orderly manner.
*See an example below. You will modify to your
practice so there may be information excluded/included. If you
are completing this for a practicum, what does your preceptor
document?
Risks and benefits of medications are discussed including non-
treatment. Potential side effects of medications discussed (be
detailed in what side effects discussed). Informed client not to
stop medication abruptly without discussing with providers.
Instructed to call and report any adverse reactions. Discussed
risk of medication with pregnancy/fetus, encouraged birth
control, discussed if does become pregnant to inform provider
as soon as possible. Discussed how some medications might
15. decreased birth control pill, would need back up method
(exclude for males).
Discussed risks of mixing medications with OTC drugs, herbal,
alcohol/illegal drugs. Instructed to avoid this practice.
Encouraged abstinence. Discussed how drugs/alcohol affect
mental health, physical health, sleep architecture.
Initiation of (list out any medication and why prescribed, any
therapy services or referrals to specialist):
Client was encouraged to continue with case management and/or
therapy services (if not provided by you)
Client has emergency numbers: Emergency Services 911, the
Client's Crisis Line
1-800-_______. Client instructed to go to nearest ER or
call 911 if they become actively suicidal and/or homicidal.
(only if you or preceptor provided them)
Reviewed hospital records/therapist records for collaborative
information; Reviewed PMP report (only if actually completed)
Time allowed for questions and answers provided. Provided
supportive listening. Client appeared to understand discussion.
Client is amenable with this plan and agrees to follow treatment
regimen as discussed. (this relates to informed consent; you will
need to assess their understanding and agreement)
Follow up with PCP as needed and/or for:
Labs ordered and/or reviewed (write out what diagnostic test
ordered, rationale for ordering, and if discussed fasting/non
fasting or other patient education)
19. Develop a Focused SOAP Note, including your differential
diagnosis and critical-thinking process to formulate a primary
diagnosis. Incorporate the following into your responses in the
template:
·
Subjective: What details did the patient provide
regarding their chief complaint and symptomatology 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 to lowest priority.
Compare the
DSM-5-TR 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.
·
Plan: What is your plan for psychotherapy? What is
your plan for treatment and management, including alternative
therapies? Include pharmacologic and nonpharmacologic
20. treatments, alternative therapies, and follow-up parameters as
well as a rationale for this treatment and management plan. Also
incorporate one health promotion activity and one patient
education strategy.
·
Reflection notes: 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!), social determinates of health, health
promotion, and disease prevention that takes into consideration
patient factors (such as age, ethnic group, etc.), PMH, and other
risk factors (e.g., socioeconomic, cultural background, etc.).
[MUSIC PLAYING] DR. MOORE: Hi. Good afternoon. My
name is Dr. Moore. Am I understanding you're here
for a mental health assessment today? PETUNIA PARK: That's
right. DR. MOORE: OK. So to make sure I have the right
patient and the right chart, can you tell me your name
and your date of birth? PETUNIA PARK: Yes. I'm Petunia Park.
My birthday is July 1, 1995. DR. MOORE: And can you tell
me what today's date is? PETUNIA PARK: So
it's December 1. DR. MOORE: Do you know the year?
PETUNIA PARK: 2020. DR. MOORE: And what day
of the week is this? PETUNIA PARK: It's Tuesday.
[CHUCKLING] DR. MOORE: And do you
know where we are today? PETUNIA PARK: Yes I am here
in the beautiful, sunny office at the clinic. DR. MOORE: OK,
great. Thank you. So can you tell me a little bit
about why you're here today? What brings you here today?
PETUNIA PARK: Yes. So I have a history of taking
medications and then stopping them. I don't think I need them. I
really feel like the
21. medication squashes who I am. DR. MOORE: OK, OK. So I'm
going to be able
to help you with that. But to begin, I'm going
to ask you some questions about your family. I'm going to ask
you some
history-type questions. I'm going to ask
you some symptoms that you might be having. And all of these
questions are going to help me work with you
on a treatment plan, OK? So I would like to
begin with, when was the first time that you
ever had any mental health or substance use
treatment in your life? PETUNIA PARK: OK. Well, when I was
a teenager,
my mom put me in the hospital after I went four or five
days without sleeping. I think I may have been
hearing things at that time. [CHUCKLES] I think they
started me on some medication, but I'm not sure. DR. MOORE:
Oh, OK so
you were hospitalized. How many times have you been
hospitalized for mental health? PETUNIA PARK: Oh, I've been
hospitalized about four times. The last time was
this past spring. No detox or residential
rehabs, though. DR. MOORE: OK, good. Were any of these
hospitalizations due to any suicide gestures? PETUNIA PARK:
One was in 2017. I overdosed on
Benadryl, but I've not had those thoughts since then. DR.
MOORE: Well, I'm very glad
to hear that you've not had any of those thoughts since then.
And I'm glad that you turned
out OK from that overdose. I'm glad that you're here today. Can
you tell me a
little bit about what you've been diagnosed with
during your past treatments? PETUNIA PARK: Well,
I think depression, and anxiety, had some
even say maybe bipolar. DR. MOORE: OK, and
what medications have you been tried on
22. before for those illnesses? And if you can remember,
what was your reactions to those medications? PETUNIA
PARK: Oh, let's see. Oh, I took Zoloft, and that
made me feel really high. [CHUCKLES] I couldn't sleep. My
mind was racing, and
then I took risperidone. That made me gain
a bunch of weight. Seroquel gave me weight, too. I took
Klonopin, and that
seems to slow me down some. I really can't
remember the others. I think the one I just
stopped taking was helping. It started with an L, I think. I don't
really
remember the name, but it squashed
me in creativity. DR. MOORE: OK, well,
we're going to try to help you find some
medication that doesn't make you feel squashed or have any of
those negative side effects today. But in order to do that, I
need some more information. And the next questions I'm going
to ask you are about substances you may have used. And I want
you to know that you
don't get in trouble in here if you've used some
of these substances. It really just helps
me to make sure that what's in your
system that could be impacting your neurochemistry. And when
we do talk
about medications, so I don't give you something
that would negatively interact with something
you may be using, OK? So do you-- PETUNIA PARK: OK. DR.
MOORE: --use any nicotine? PETUNIA PARK: Yes. I smoke
about a pack
a day, and I'm not going to quit for you, either. [CHUCKLES]
Oh. DR. MOORE: That's OK, that's OK. And what about
alcohol? When was your last
drink of alcohol? PETUNIA PARK: When I
was 19 because alcohol and me do not work
well together. [CHUCKLES] DR. MOORE: OK, and what
23. about any marijuana? When was your last
use of any marijuana? PETUNIA PARK: Oh no. I tried that once
and
got really paranoid. DR. MOORE: OK. What about any last
use of cocaine? PETUNIA PARK: Never. DR. MOORE: Last
use of any
stimulants or methamphetamines? PETUNIA PARK: Never. DR.
MOORE: What about
any huffing or inhalants? PETUNIA PARK: Never. DR.
MOORE: OK, have
you used anything like Klonopin or Xanax, any
of those sedative medications? PETUNIA PARK: Never. DR.
MOORE: All right, good. What about any hallucinogenics
like LSD, or PCP, or mushrooms? PETUNIA PARK: No, never.
DR. MOORE: Wonderful. OK, what about any use of pain
pills or opiate medications? Anything prescribed
or anything you've obtained from the street? PETUNIA PARK:
No, never. DR. MOORE: Good. And anything synthetic like
Spice, or ecstasy, Bath Salts, Mollies, anything like that?
PETUNIA PARK: Never. DR. MOORE: Oh, wonderful. Well,
I'm glad to hear that. You know those things
aren't good for your brain. So I encourage you to continue
to stay away from those things. Have you ever had any
blackouts or seizures from drugs or alcohol? Or seen things that
you
weren't sure were there? PETUNIA PARK: Never. DR.
MOORE: Good. What about any legal
issues or any DUIs? PETUNIA PARK: Never. DR. MOORE:
OK. Good, good. All right, so I'm just
going to ask a little bit about your family right now. Any blood
relatives have any
mental health or substance abuse issues? PETUNIA PARK:
Yeah, well,
well, why would you ask that? It's not your business. DR.
MOORE: Right. I could see where you
might find that wouldn't be any my business. But really,
24. sometimes these
issues can be genetic. They're alarm behaviors. So my
understanding
of your family helps me to understand you. PETUNIA PARK:
Huh. Well, my mother
was seen as crazy. I think they said she
had bipolar or something. And my father went
to prison for drugs. And well, we haven't heard,
or seen, or heard from him in 8 or 10 years. My brother, while I
think
he's a little schizo, but he hasn't ever
went to the doctor. Nobody else with anything. DR. MOORE:
OK. So that sounds like
it must be tough growing up not
seeing your father and having some of those
issues in your family. But any family, blood
relatives commit suicide? PETUNIA PARK: Well, my mom
tried, but nobody really did it, you know? DR. MOORE: OK.
Have you ever done anything
like that, or anything like cut on yourself, burn yourself?
PETUNIA PARK: I already told
you, I tried to kill myself. Why ask me that again? No, I'm not
going to kill
myself or anyone else, and I don't cut myself. DR. MOORE:
OK. Well, I'm glad to hear that. And I want you to know
that I am here for you, and we most certainly
will make sure you have a crisis like number
at the end of this session if you do have those
thoughts in the future. So I'm glad to
hear that you don't have those thoughts today. OK. What type of
medical
issues do you have? PETUNIA PARK: Oh, hoo. Let's see. I have
a thyroid issue that
I take some medicine for, that hypothyroidism. And I take a
birth control
pill for polycystic ovaries. DR. MOORE: OK, when
25. was your last menses? PETUNIA PARK: Oh, well I have
a regular one each month. So let's see. It was last month
sometime. DR. MOORE: OK, so any
chance that you're pregnant? PETUNIA PARK:
[LAUGHS] Lordy, no. I may have a lot of sex
around, but I'm safe. DR. MOORE: Hm. You "have a lot of sex
around." Can you maybe tell
me what that means? PETUNIA PARK: Well, it's
exciting and thrilling to find new people to explore sex with. It
helps me keep my
moods high, high, high. [CHUCKLES] DR. MOORE: OK, so
that makes
you feel really high and kind of what, OK? PETUNIA PARK:
Oh yeah. DR. MOORE: So who raised you? PETUNIA PARK:
My mom and
my older brother, mainly. DR. MOORE: And who
do you live with now? PETUNIA PARK: Well, I
live with my boyfriend. And sometimes, stay with my
mom when he gets mad at me for sleeping around some. DR.
MOORE: So that's
created some issues in your relationship, I see. OK. Are you
single, married,
widowed, or divorced? PETUNIA PARK: I've
never been married. DR. MOORE: OK. Do you have any
children? PETUNIA PARK: No. DR. MOORE: All right. Are
you working? PETUNIA PARK: Yes, I work part
time at my aunt's bookstore. She's more tolerant of
the days I don't come in from feeling too depressed. DR.
MOORE: OK, so I hear some,
maybe, feelings of depressed. OK. What is your level of
education? PETUNIA PARK: Oh,
I'm in vo-tech school right now for cosmetology. I'm going to
do makeup
for movie stars. [CHUCKLES] DR. MOORE: Oh, that
sounds really wonderful. OK, so but what about now? What do
you do for fun now? PETUNIA PARK: Well, I am
26. writing my life story, and it's going to be published. I also paint
like Picasso. I'm going to sell those
paintings to movie stars, too. DR. MOORE: Well,
that's wonderful. Maybe someday you can show
me your paintings as well. OK, have you ever been arrested
or convicted for anything? PETUNIA PARK: No. The police did
pick me up and
take me to the hospital once. I didn't have much
sleep that week. And they said I was dancing
around in my nightgown in a field with my guitar. I really don't
remember
much of that, though. I think maybe my mom made
up that story against me because she wanted me to go
back to my boyfriend's house. DR. MOORE: OK, so that was
one of your hospitalizations that we talked about earlier. OK,
what about any history of
trauma with childhood or adult? Any kind of physical,
sexual, emotional abuse? PETUNIA PARK: Well, my
dad was pretty hard on us when he was around. But he didn't
really
touch us or anything. More just yelled at us a lot. DR. MOORE:
OK. All right, so I've
gathered some history here. Now, I want to get
into more of some of the symptoms that brought
you in to see me today. So you mentioned before that
sometimes your depression keeps you from working
at your aunt's bookstore. Can you tell me
a little bit more about what that
looks like for you? PETUNIA PARK: Well, about
four or five times a year, I have these times when I just
don't want to get out of bed. I have no energy, no
motivation to do anything. I just can't feel any
interest in my creativity. I feel like I'm not worth
anything because I feel that creativity slipping away. So this is
usually
happening after I've been up for five
27. days working hard on my works with my writing,
painting, and music. Everyone says I'm
depressed, but I'm not sure. It could be that I'm just
exhausted from working so hard. DR. MOORE: OK, so I hear
you
talking about these creativity episodes right before you crash.
Per se, this depression. Tell me a little bit more
about those episodes. What do those look like for you?
PETUNIA PARK: Oh,
I love those times. Those are the reasons
I don't always take my medication because
I feel like I'm squashed. I have lots of energy
to do a lot of things. I can go four or five days
with very little sleep. I get lots of things
done, but my friends tell me I talk too much
and appear scattered. [SIGHS] They're just jealous
of all the accomplishments I'm getting done. These are the times
I
look to explore my mind and body with feeling good
through sex with other people. DR. MOORE: OK, how long do
those episodes last typically when you have them? PETUNIA
PARK: About a week. DR. MOORE: About a week. OK. So I
want to ask a little bit
more about some other symptoms that maybe we
haven't talked about. Do you feel like you worry
a lot or have any kind of anxiety and panic symptoms?
PETUNIA PARK: No, no no. I'm not a worry. DR. MOORE:
OK, do
you do anything that you feel like you have to
do repetitively over and over? And if you can't do them, you
feel like the end of the world is coming? Something like maybe
count on threes or wash your hands 20 times? Anything like
that? PETUNIA PARK: [LAUGHS] No, no. I don't have OCD, if
that's what you're asking. DR. MOORE: OK, what about
hearing or seeing things you're not sure
others see or hear? Anything like that? PETUNIA PARK: Not
28. right now. It's been a couple of
months since that happened. Sometimes when I'm
not sleeping good, I hear voices telling me how
great and wonderfully talented I am. DR. MOORE: OK. So, but
no voices right now? PETUNIA PARK: No. DR. MOORE: OK,
good. What about your appetite? How's your appetite?
PETUNIA PARK: Well, when
I'm really creative, I'm too busy to eat. And when I'm
crashing and resting, I eat everything in sight. DR. MOORE:
OK, so
what about your sleep? On average, how much time
do you think you sleep in a whole 24-hour period? And do you
have any bad dreams? PETUNIA PARK: No bad dreams. Most
of the time, I get
about five or six hours. When I'm creative,
I'm lucky to get three hours and a whole week. Ugh. And when
I'm crashed, I sleep
about 12 or 16 hours a day. DR. MOORE: OK, wonderful. So
this is great. I have a lot of
information from you that I think we will be able to
come up with a treatment plan and maybe find some
medication that's going to help you feel better
without you feeling so squashed and having negative
side effects, but really help you be able
to function through the day. [MUSIC PLAYING]