SOWK 602 Family Analysis

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SOWK 602 Family Analysis

A three-generational genogram and culturagram are built with an explicit structure to examine how a person is influenced by intergenerational values, beliefs, and relationships (McCullough-Chavis & Waites, 2004). Paper is a critical self-awareness exercise that shapes my personal and professional identity within the Yoruba-American family system, influenced by migration, culture, and faith. This analysis will be based on the Family Systems Theory, the DSM-5 Cultural Formulation Interview (CFI), and the models of Waites, Chavis, and Boyd-Franklin to investigate the role of my family system in promoting resilience, stability, and intergenerational continuity (APA, 2013; Boyd-Franklin, 2003; Waites, 2009).

My family history is transnational, starting with my grandmother in Nigeria, then my mother and her siblings, and finally my generation, with my siblings in Baltimore, Maryland. Combining genogram and culturagram reveals a system that possesses a high degree of coherence, a high degree of cultural identity, as well as protective factors based on faith, education, and family cohesion. These factors have played a crucial role in my growth and in the maturation of my profession as a social worker. This assignment will critically reflect on how explicit relationships and implicit cultural expectations have informed my systemic self. The genogram is not only a family map; it is also a diagnostic instrument that illustrates patterns of emotional functioning, stability, and resilience (McCullough-Chavis & Waites, 2004). This process provides me with awareness of how I have built my worldview and how I use it in personal and professional interactions. Such a degree of reflexivity is crucial in ethical social work practice because it enables me to identify potential biases and to be culturally humble and open to clients.

Visual Integration: Genogram and Culturagram
Elijah
Dalopo
Dad
Ay Daddi

 

 

In Nigeria

In Baltimore

Migration (Nigeria to United States)

Church (central support system)

Family unity

Marriage

School

The genogram is a three-generation map that depicts biological connections, emotional dynamics, and relational stability. Nuclear-family marriage is intact across, indicating a high level of relational permanence. On the contrary, extended family members are single, as they are emotionally attached and adaptable to the system as a whole. Emotional relationships are largely supportive, with little evidence of conflict or estrangement, suggesting a cohesive, high-functioning family system.

The culturagram complements this analysis by pointing out the interplay between cultural aspects and family structure. The Yoruba custom and the Christian faith emphasize unity, respect, and commitment, which support the stability evident in the genogram (Boyd-Franklin, 2003). Meanwhile, the differences in the marital status of extended family members demonstrate that cultural expectations do not override individual life directions. Also, the culturagram displays the impact of external systems such as schools, churches, and the workplace. These schools support family values in terms of discipline, achievement, and religion, which shows that a family does not exist in a vacuum. This integration emphasizes the role of studying families as moving systems that are both affected by internal and external arrangements.

Patterns and Processes of Family Systems Theory

The Family Systems Theory offers insight into how my family sustains itself and passes values across generations. These ideas, namely, homeostasis, emotional system of the nuclear family, multigenerational transmission, triangulation, and differentiation of self, can be observed in the given analysis.

Emotional System and Homeostasis of the Nuclear Family

The family with a high ability to maintain homeostasis, which is the tendency of the system to ensure stability and balance. Mutual values, expectations, and regular patterns of relationships maintain such a balance. High emotional support and minimal manifested conflict define the nuclear family emotional system, which produces an organized and predictable environment and minimizes anxiety.

Stable marriages in the nuclear family make the norm of relational permanence stronger, even though members of the extended family are not married. This uniformity cushions against outside pressures, and the young generations can concentrate on their education and career building. Nevertheless, the focus on harmony can make the tensions hidden and prevent open disagreement. Although predictability creates psychological safety and confidence, this effect can also reduce the ability to develop conflict-resolution skills that should be applied in more complex environments.

Multi-generational Process of Transmission

The process of multigenerational transmission is also evidenced by the fact that the beliefs, values, and emotional responses were constantly passed down (McCullough-Chavis & Waites, 2004). One of the major stories, the family is a castle, and faith is the key, was created by my grandmother, and it still includes the further generations. This story encourages strength, group identity, and meaning.

These passed-down beliefs act as family transference, in which the expectations of success, stability, and faith are integrated by the younger individuals in the family (Waites, 2009). Although these expectations are motivating and instil confidence, they can also put pressure to fit in, especially in terms of education and career choices. It is transmitted explicitly and through observation since the stable relationships and firm faith are presented as normative. Nevertheless, strong values may also be a source of inflexibility, and it is hard to fight or modify established standards.

Triangulation and Support Systems

My family triangulation is a facilitating process and not dysfunctional. When people experience stress, they usually depend on a triangle consisting of a person, their parents, and the church (McCullough-Chavis & Waites, 2004). This model dispels the tension and encourages group problem-solving, making it less likely to scapegoat.

The religion of these three triangles strengthens the spiritual identity of the family and offers a culturally significant coping mechanism (Boyd-Franklin, 2003). Nevertheless, collective and spiritual assistance can be a constraint to the possibilities of personal emotional processing. It can also minimize attention to other resources, including mental health care, which makes culturally responsive interventions that do not undermine spiritual coping and increase the support options important.

Differentiation of Self

Differentiation of self is the possibility to preserve belonging to the self and, at the same time, be emotionally attached to the family. There is differentiation in my family, but high conformity expectations tame this. Independence is promoted on issues like education and career, but it is not as lenient in terms of cultural and moral values. This dynamic forms a balance of independence and interdependence and brings about a sense of belonging, making complete individuation more complicated. Family expectations have been frequently internalized as individualized expectations, and it is hard to make a distinction between self-driven and hereditary expectations. This realization is necessary for real self-development. Additionally, differentiation entails a process of balancing family values and developing independent thinking. The balance is particularly relevant in the field of social work practice, where one has to interact with different views, and self-reflection and adaptability are required.

Cultural Analysis: Migration, Identity, and Values.

Migration has been one of the characteristics of my family. The case of the migration between Nigeria and the United States is a demonstration of a proactive seeking of an opportunity, as opposed to a crisis response (Waites, 2009). The status of legal citizenship offers resources of stability, where the family can concentrate on future mobility and assimilation. Nevertheless, this experience can restrict my knowledge about the lives of people with a more precarious migration background. Language is also an essential aspect in the preservation of cultural identity. Yoruba is used at home, and it serves to keep one in touch with heritage, whereas English is used to move around in greater society. This bicultural competence is manifested by bilingualism, which increases flexibility and confidence in different situations.

Family dynamics are additionally developed in terms of core values associated with education, work, and religion. Achievement is considered a shared responsibility, which is a communalist orientation. Christianity provides a focal point to explain experiences and deal with difficulties, which serve to foster the aspect of resilience and optimism (Boyd-Franklin, 2003). Such values make the situation more stable, but they can bring about pressure to achieve high expectations.

Framework on Interview: CFI and Cultural Insight

DSM-5 Cultural Formulation Interview (CFI) is a tool that helps to understand how people and families make sense of their experiences in the cultural context (American Psychiatric Association [APA], 2013). The use of this model in my family shows that culture defines problems, help-seeking, and family roles.

One of the major themes is the propensity to interpret challenges as something of faith. This interpretation places emphasis on the resilience, perseverance, and spiritual meaning to enable the family to hold on to hope in times of adversity. Nevertheless, it is also a viewpoint that can make the use of professional mental health services unnecessary because it encourages individuals to resolve their struggles internally instead of using external assistance.

Help-seeking behaviors also indicate dependence on inner and community-based systems. Primary sources of emotional support and guidance are the family members and the church, which promotes trust and cultural fit (Boyd-Franklin, 2003). On the one hand, this can help in the cohesion, but on the other hand, it can restrict interaction with outside resources. Concerning social work practice, it underscores the need to be respectful of the support systems that are already in place, but promote access to wider interventions.

The hierarchical family structure is another aspect of the CFI where people are placed in positions of authority based on age and experience. This structure fosters order and respect, and can be restrictive to free communication, especially among the younger members. It is critical to appreciate the advantages as well as the shortcomings of such a setup in order to enhance more adaptive interactions.

Developmental Framework Analysis

Developmental models demonstrate the issue of the main strengths and protective aspects in my family system. In the view of Waites (2009), bicultural competence is at the center. This capacity of moving both as a Yoruba and as an American makes one adaptable and confident in any surroundings. This is a strength with high cultural identity coupled with family cohesion that helps to overcome discrimination and fosters resilience. However, it can also be a pressurizing factor to achieve high standards of success.

The multisystem model by Boyd-Franklin (2003) also describes how my family is interconnected. The family is also a part of a larger framework, which encompasses extended family and the church that serves as a significant source of emotional and spiritual support. These overlapping systems are stable and accountable, which means that the people are there when one needs them. Meanwhile, excessive dependence on such systems can suppress autonomy if they are not weighed against autonomy. This balance is a key aspect that needs to be understood in order to facilitate such a connection as well as personal development, especially in social work practice.

Structural Analysis and Critical Race

Despite the stability in my family, the larger picture of systemic inequality should be mentioned. We, as a black family living in the United States, continue to be impacted by systematic differences in education, employment, and available resources (Waites, 2009). Concurrently, being an immigrant and having socioeconomic stability gives relative privilege in contrast with other Black families that have been disadvantaged for generations. This stance is subject to bias in my view, and it is necessary to build consciousness about the existence of systemic oppression and its diverse effects. Social work practice does not only entail individual comprehension of the experience, but it also involves the promotion of change in structure.

Professional Reflection and Self-Awareness

The perception of what would have defined a healthy family system is shaped by my family because of its cohesion and stability. Although such experiences form a powerful basis, they can also lead to biases when one is dealing with clients whose experiences vary widely. The professional self-awareness strategy is to identify these assumptions and be culturally humble (Waites, 2009). It also involves constant thinking and being willing to learn different points of view. Concurrently, my family strengths, including my resilience, faith, and good relationships, can influence my practice positively. Through the combination of these strengths and critical self-awareness, I will approach clients in a way that is responsive and culturally empathetic.

Cultivating professional self-awareness requires continuous reflexivity, especially regarding the role of my position in shaping my thoughts about clients and their experiences. The fact that my family was a steady, religious, and functional family structure may unintentionally influence my perception of how I expect stability and coping behavior, as well as how family roles work. Therefore, I would be obligated to be mindful of the distinctions between my personal values and my professional practice to avoid imposing them on clients. Participation in supervision, lifelong learning, and culturally responsive practices frameworks will be critical for confronting implicit biases and expanding my worldview. The process not only makes me more ethical in practice but also more competent at establishing genuine, respectful, and effective relationships with people from diverse and complex backgrounds.

Conclusion

A three-generational genogram and culturagram integration has given me a clear picture of my Yoruba-American family system and the role that the system has played in shaping my identity and growth. My family is based on the cultural traditions and influenced by migration, which proves its resilience, cohesion, and continuity between generations. This analysis shows the strengths and complexities of my family system through the utilization of the Family Systems Theory, CFI, and developmental frameworks. Above all, it establishes the significance of self-awareness in social work. A self-reflection practice supports the idea that self-knowledge is not a goal but a sustained professional responsibility. My social work practice is likely to intersect with my professional role, which is why I need to continuously assess how my cultural background, family experiences, and personal values align with my social work role. This consciousness will make me flexible, receptive, and attentive to the changing demands of customers. Finally, a combination of personal awareness and theoretical understanding will enhance my ability to advocate, facilitate equity, and contribute to socially just practice across a wide variety of populations.

 

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

Boyd-Franklin, N. (2003). Black families in therapy: Understanding the African American experience (2nd ed.).

McCullough-Chavis, A., & Waites, C. (2004). Genograms with African American Families: Considering Cultural Context. Journal of Family Social Work, 8(2), 1–19. https://doi.org/10.1300/j039v08n02_01

‌Waites, C. (Ed.). (2009). Social Work Practice with African American Families. Routledge. https://doi.org/10.4324/9780203868874

SOWK 602 Family Analysis

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AN_NU 688 Wk 10 IPPD

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AN_NU 688 Wk 10 IPPD

Week 1

Name:

APRN Speciality Foci: Psychiatric-Mental Health Nurse Practitioner (PMHNP)

Where you plan to practice as APRN: Ohio

State’s definition

Advanced practice registered nurse has a current, valid license obtained under chapter 4723 that allows them to exercise advanced practice nursing and is recognized as one of the subsequent: A certified registered nurse anesthetist, a certified nurse practitioner, a clinical nurse specialist, and a certified nurse-midwife (Buppert, 2021).

Title allowed by Ohio

Certified Nurse Practitioner (CNP) OR Advanced Practice Registered Nurse (Buppert, 2021).

Board of nursing hyperlink: https://nursing.ohio.gov/

A summary of how Ohio is meeting the components of the consensus model.

The Nurse Practice Act, found in Chapter 4723 of the Ohio Revised Code, was enacted by the Ohio legislature (“APRN consensus implementation status,” n.d.). The Board is a management body established by Ohio law to control the nursing profession in the state for the public’s safety. Secondly, Ohio Administrative Code (OAC) – Forms the Administrative Rules. The Board implements rules from Chapters 4723-1 through 4723-27 of the Ohio Administrative Code that defines guidelines for licensing and certification, morals of conduct, discipline, and pre-deployment nursing training, all of which are founded on the Nurse Practice Act (“Find your Nurse Practice Act,” n.d.).

Week 5

A review of the nurse practice act and summary of practice for N.P.s in Ohio

In Ohio, the Nurse Practice Act, set out in chapters 4723-01 through to 4723-099, creates regulations for certification and licensure, pre-licensure nursing education, standards of practice, and discipline. The act provides that the N.P.’s scope of practice shall be overseen by the nursing board consisting of thirteen members who are residents of Ohio and citizens of the United States. It authorizes certified or licensed nurse practitioners recognized by the nursing board and nurses who practice in specific settings (Burson et al., 2016). According to the Act, a nurse should be able to perform specified functions, including ordering and interpreting diagnostic procedures, prescribing, dispensing, and administering treatments. It also provides a transition to various nursing practice programs. Further, it does not restrict N.P.s by not demanding that they work with physician oversight.

A review of information related to Ohio’s physician supervision/ collaboration requirement.

Nurse practitioners in Ohio cannot practice alone. According to state law, nurse practitioners must work with physicians. The act provides that R.N.s of all categories must enter into a standard care arrangement with physicians, either in person or electronically. Supervision means nurses are under the direction of the physician (s) to act within the scope of practice per the act’s provisions. In contrast, nurses and physicians collaborate to create a standard care arrangement, which is a written document that guides the planning and evaluation of patient care.

A summary of restrictions of practice and collaborative/ supervisory practice agreements

Ohio’s Nurse Practice Act restricts the practice authority of N.P.s to a limited scope (Joel, 2017). As part of the act, nurses must create a written standard care arrangement with their supervisor to plan and evaluate patients’ health, including prescribing medications, interpreting diagnostic tests, and providing other essential services to the patients. Unlike states, for example, California, Ohio does not restrict advanced practice registered nurses (APRNS) from practicing independently. In other words, nurses are not prohibited from establishing and operating independent private healthcare businesses.

The information can be found at the link: https://codes.ohio.gov/ohio-revised-code/section-4723.01.

Regulatory Agency for N.P. practice

The Ohio Board of Nursing operates as the state’s regulatory body for NPS. It ensures the state has high-quality registered nurses by safeguarding and advocating public health and safety. The Board’s duties include establishing Registered Nurse Education Standards, evaluating licensure and applications, approving Ohio Nursing programs, issuing certificates, issuing and renewing licenses, managing intervention programs, taking disciplinary actions, and operating an online license verification system.

 

Summary of information related to licensing and qualification for APRNS

The Ohio Board of Nursing regulates and issues qualified registered nurses with a certificate of authority in the following APRN roles: Certified Registered Nurse Aesthetic (CRNA), Certified Nurse Specialist (CNS), Clinical Nurse Specialist (CNS), and Certified Nurse-Midwife (CNM). An individual must hold a valid unencumbered Ohio R.N. license to be approved to work (Burson et al., 2016). One can obtain an active R.N. license in Ohio by applying using the Licensure Examination Application packet if one is a graduate of a nursing program approved by the Ohio Nursing Board. Suppose one is a graduate of a nursing program out of the state. In that case, one can apply by submitting a Transcript Authorization Form using the Licensure by Examination Application packet. Individuals who are R.N. licensed in another jurisdiction or state must apply for approval using the Licensure by Endorsement Application packet.

Requirements for ARNP licensure in Ohio

The Ohio Nursing board establishes that one must hold an action Ohio R.N. license and a master’s or doctoral degree with a major in a nursing specialty. The nursing specialty must be approved by the Board that certifies and qualify APRN license and designation for nurses. For CNPs, CNSs, and CNMs, one must prove to complete at least 45 hours of course in advanced pharmacology, whose contents are following section 4723.482(B) (Burson et al., 2016). The advanced pharmacology course has to be completed within the last five years before applying for APRN licensure is made. Also, for CNPs, CNSs, and CNMs, applicants from other jurisdictions must show proof of prescriptive authority and complete a two-hour course in Ohio prescribing law.

APRN licensing requirements in Ohio

  • The individual must be a U.S. citizen (either legally living or legally allowed in the U.S.)
  • A current and valid Ohio R.N. license is required.
  • Completion of the application by answering the questions about compliance.
  • Payment of the applicable fees
  • Passing the due diligence or criminal record check
  • A master’s or doctoral degree with a specialization in an area of nursing practice is required (or a related field that qualifies the applicant for the APRN national certification)
  • The individual must pass the APRN national certification exam and maintain a certificate from a nationally recognized organization recognized by the Ohio Board of Nursing.

Below is the Hyperlink for this information

http://www.ohioaprn.com/l.a.c.e..html

Week 6

Prescriptive Authority Requirement

The Ohio Board of Nursing licenses Advanced Practice Registered Nurses (APRNS) in Ohio. Graduate degrees and national certifications are required for state licensure. Also, experience is required for nurse midwives, clinical nurse specialists, and nurse practitioners who need prescriptive authority (Prescribing Resources, 2022). Further, additional requirements are required for prescriptive authority. For instance, a course in advanced pharmacology is required (http://codes.ohio.gov/orc/4723.482v2). The course must include at least 45 contact hours designed for the nurse’s specialty. It must cover information mandated by state law, such as issues regarding prohibited substance prescriptions and pharmacokinetic principles. Externship is also a requirement (http://codes.ohio.gov/oac/4723-9). For in-state applicants, the usual externship is 1, 500hrs, including at least 500hours spent under direct supervision by a professional supervisor. Out-of-state nurses with prescriptive experience, including controlled substances, are exempted from externship but must complete a two-hour course on the state’s drug legislation and prescribing authority. On the other hand, nurses with prescriptive experience but with no experience in controlled substances are offered reduced externship requirements ((“Find your Nurse Practice Act,” n.d.).

MD supervisory or collaborative regulation of controlled and non-controlled substances:

In Ohio, prescriptive authority for NPs requires physician involvement. The prescription authority for NPs is established through an agreement between the NP and the collaborating physician (O.R.C. 4723.43 (C) and 4723.48 (A)) (Nurse Practitioner Interactive Map, 2022). According to the nursing practice act, NPs can prescribe schedule iii-v controlled substances. (ORC 4723.48). Similarly, the act authorizes NPs to prescribe schedule ii-controlled substances (ORC 4723.481 (C); ORC 3719.06 (A) (2)) (“Find your Nurse Practice Act,” n.d.).

The state of Ohio maintains a drug monitoring program. OARRS is Ohio’s prescription drug monitoring system (PDMP). OARRS is a system for tracking patients’ distribution and personal delivery of regulated prescription medications. It gives health officials current and timely information regarding prescribing and patient behaviors, allowing them to respond quickly and effectively.

Hyperlink for Ohio prescriptive authority: https://codes.ohio.gov/ohio-revised-code/chapter-4723

Federal DEA Requirements

In Ohio, The Ohio Nursing Board keeps track of the number of NPs with certifications to prescribe, but not how many have DEA numbers. In other words, having a DEA number is not mandatory. For a DEA license, applicants must provide state licensing information and social security number and pay the applicable fee. During application, applicants must fill in their background, personal and practice information, state license, business activities, and prescribing schedules and payments.

MD supervisory collaborative regulations related to prescription of a controlled substance:

In Ohio, Schedule II prescriptions, which include the majority of narcotics, are subject to supervision. The state’s act, ORC 4723.481 (C); ORC 3719.06 (A) (2)) indicates NPS authority to prescribe narcotic drugs under a written practice agreement with a physician (Nurse Practitioner Interactive Map, 2022).

Restrictions to Naloxone and Opioids

Naloxone falls under schedule IV of control substances (Buppert, 2020, p.209). In Ohio, the nursing practice Act authorizes NPs to prescribe schedule iii-V controlled substances, among which Naloxone belongs. This regulation is aimed at making Naloxone more accessible to persons who may be at risk of experiencing an opioid-related overdose. According to House Bill 341, prescribers must acquire patient information from Ohio Reporting System before the prescription. The majority of opioids fall under class I to IV. NPs in Ohio have the prescription authority of controlled substances falling under the mentioned schedules. In 2018, the state introduced new regulations for opioid prescriptions (State Medical Board of Ohio, 2022). Before administering an opioid drug, doctors are required by law to raise the patient’s level of consciousness. Non-opioid medications must first be considered and documented by physicians. If an opioid prescription is judged necessary, it should be written in the shortest possible time. If a prescriber suspects opioid abuse, they must undertake a functional pain evaluation, complete and document the patient’s medical history, administer a diagnostic test if necessary, and document the treatment plan in a patient’s medical records, among other requirements (State Medical Board of Ohio, 2022).

DEA hyperlink: https://www.deadiversion.usdoj.gov/ or https://www.dea.gov/who-we-are

References

APRN consensus implementation status. (n.d.). NCSBN. https://www.ncsbn.org/5397.htm/

Buppert, C. (2021). Nurse practitioner’s business practice and legal guide. Jones & Bartlett Learning.

Burson, R., Moran, K. J., & Conrad, D. (2016). Why Hire a Doctor of Nursing Practice–Prepared Nurse? The Value-Added Impact of the Practice Doctorate. Journal of Doctoral Nursing Practice, 9(1), 152–157. https://doi.org/10.1891/2380-9418.9.1.152

Find your Nurse Practice Act. (n.d.). NCSBN. https://www.ncsbn.org/npa.htm/

Joel, L. A. (2017). Advanced practice nursing: Essentials for role development. FA Davis.

Nurse Practitioner Interactive map: https://lmscontent.embanet.com/Media/RC/NU668/NU668-w10-m01/

Ohio Board of Nursing. (2022). Retrieved 31 May 2022, from https://nursing.ohio.gov/wp-content/uploads/2022/02/APRN-Licensure-and-Practice-in-Ohio.January-2022.pdf

Prescribing Resources. (2022). Ohio Board of Nursing. https://nursing.ohio.gov/practice-resources/prescribing-resources/

State Medical Board of Ohio > Overview: Regulations for Chronic and Subacute Opioid Prescriptions. (2022). Retrieved 9 June 2022, from https://med.ohio.gov/Overview-Regulations-for-Chronic-and-Subacute-Opioid-Prescriptions

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AN_NU 688 Wk 10 IPPD

Paper details

State is Ohio
IPPD is attached.
Please write one page or less and include references
Week 10 Assignment 2: State and National Networking
Value: Complete at 100 points/Incomplete at 0 points. This assignment is worth 3% of
the total grade.
Due: Day 3
Grading Category: IPP Document Development
Instructions
Using the IPP document you started in Week 1 and added to in Weeks 5 and 6,
please add the following information:
1. Identify one state and one national professional organization in the area in which
you will reside/ practice that will provide you with professional networking
opportunities.
2. Please identify the organizations, their purpose, membership fees, and the
resources they provide. Professional organizations include Nurse Practitioner
Associations or specialty organizations such as Nurse Practitioners in Women\'s
Health (NPWH). Please summarize this information; do not cut and paste to your
IPPD assignment.
3. Refer to the Nurse Practitioner Association for details on Nurse Practitioner
Association websites.

Please refer to the Grading Rubric for details on how this activity will be graded.
For this assignment to be considered complete, you must identify at least one state and
one national professional organization and address all prompts by Day 3.

NU 646-Family Systems Project

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NU 646-Family Systems Project

Week 12 Assignment 1: Family Systems Project
Value: 100 points
Due: Day 7
Gradebook Category: Assignments
Instructions
The Family Systems Assignment
Review the following resources before beginning the assignment:
 Genograms in Nursing Education and Practice a Sensitive but Very
Effective Technique: A Systematic Review
 Genogram Tip Sheet (Word)
 Explaining Genograms
 Introduction to the Genogram: What is a Genogram? Video
 What is a Genogram? Video Transcript
For this assignment:
 Create a family genogram (three generations), including:
o All the members of your family, identifying significant
alliances among the various members.
o The relationship you had as a child with each person.
o Your relationship with each member now.
 Cite and discuss at least two family systems theories to support the
dynamics of the family genogram.
 Ensure the genogram is neatly diagrammed and labeled.
 See Family Therapy applied to the Case of Stan, Corey 9th ed., p p.
452–455, (7th ed., pp. 435–438) for an explanation of diagrammatic
legends
A. Genogram: Provide a three-generation genogram of your family of origin (
with a copy of your paper), based on McGoldrick et al. (2008) (PDF) guidelines.
ALSO, incorporate aspects of the Cultural Genogram (Hardy & Lasloffy,
1995)(PDF) by color-coding specific ethnic/cultural factors noted in your

family. Cultural aspects can also be provided on a separate genogram, if you
prefer.
B. In a separate document, provide a brief description of significant
relationships and patterns among family members noted on your g enogram.
ALSO, describe some of the connections you have made of patterns noted in
your family of origin (as depicted on your g enogram) and your current
significant relationships and behaviors with others. For example, are there
patterns you observe in your current relationships that are connected to the
background/context presented in your genogram?
C. Given some of the relational patterns, events, stressors, and descriptors
noted in your genogram, please describe any potential “blinders” or “blind
spots” that may get in the way of your practice with clients. In other words, are
there certain issues (healthy or unhealthy, resolved or unresolved, functional
or dysfunctional) that would impact your work with clients in ways that you
need to be aware of?
D. No family is perfect or problem-free. All families struggle with issues,
concerns, and transitions through time. Given what you have presented in
your genogram and how you have described your family, discuss one area of
concern that could be (or could have been) addressed in therapy. How would
a Bowenian Natural Family Systems therapist go about addressing this issue
in therapy? Make use of theoretical principles and interventions consistent
with transgenerational thinking and practice.
E. Now that you have a broader understanding of your family by way of your
genogram and your place within it, do you see yourself doing anything
differently in relation to one or more members in your family? Would you like
to interact differently or change your behavior in any way? What impact might
this change in your behavior have on your family system?
NOTE: It is important to undertake this assignment with a degree of openness
to learning about the subject matter and about yourself as a person in
context. This paper will be graded on your degree of openness to learning
about yourself in relation to your family, the accuracy of course concepts used
in your genogram and paper, writing style, and systemic orientation. The
instructor will be the only one to read your paper, and its contents will be held
in strict confidence.

NU 646-Family Systems Project

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AN-NU 668 wk 15 SWOT analysis

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AN-NU 668 wk 15 SWOT analysis

Problem: Poor Communication Skills in a health institution.

QSEN Competency Knowledge Skill Attitude
patient-centered care A patient-centered approach to effective communication in a health institution recognizes the entire individual, including their personality, life experience, and social structure, to build a shared understanding of the issue, treatment objectives, and impediments to treatment and well-being (Pagani et al., 2019, p. 1).

Identify the primary barriers to patient-centered communication, which are as follows: perceived lack of time, talking about data rather than patient experiences, and an outdated mindset.

 

 Communication is required for patient-centered care, including retrieving the patient’s objective using open-ended inquiries, especially early during patient-nurse interaction (Rau & Lytle, 2020, p. 278). In patient-nurse communication, avoiding interrupting patients as they express themselves is essential (Pagani et al., 2019).  A good nurse should participate in concentrated active listening.

Another important thing in providing patient-centered care communication is understanding patients’ viewpoints of their condition by demonstrating empathy Rau & Lytle, 2020, p. 278).

 

  

The positive attitudes of physicians toward patient-centered communication influence their desire to engage patients in medical choices, implying the need to consider physicians’ opinions to complete patient involvement procedures successfully (Rau & Lytle, 2020, p. 278).

 
Teamwork and Collaboration Most healthcare institutions have talented, intergenerational, culturally diverse, multifunctional group members (Tremblay et al., 2017, p. 6).

Even though each profession has a distinct specialty, they all have a collective objective: the well-being of their patient and a good working atmosphere where they are free with their colleges. A collaborative approach to care delivery is adopted to guarantee that patients are happy during their healthcare interactions (Tremblay et al., 2017, p. 6).

Training lets the whole health team in the health institution be aware of the importance of effective communication as the fundamental notion of cooperation and team cohesiveness.

Identify the barriers to successful communication in a team of health care personnel in the facility.

 

 Nonverbal communication and listening skills are required for effective interaction among healthcare team members, patients, and their loved ones Rau & Lytle, 2020, p. 278).

The members of a healthcare team must appreciate the importance of body language, facial emotions, and eye contact during encounters.

Regarding collaboration in health care, conflict resolution is an important skill to address, which can be seen when working with patients and their families Rau & Lytle, 2020, p. 278). Conflict may emerge anytime, and knowing how to de-escalate and manage conflict is priceless in any healthcare setting.

 

 When healthcare team members listen in an open, non – judgmental environment, they can exhibit their understanding of the words and feelings of individuals they interact with through demonstration of verbal and nonverbal empathy Rau & Lytle, 2020, p. 278).

Individuals at a health care institution may establish trust, responsibility, shared power and governance, and compassion through effective communication, teamwork, and collaboration.
Evidenced Based Practice The utilization of communication techniques such as training and seminars in delivering nursing services that use the most recent research studies to enhance patients’ health, safety, and overall well-being.

 

Examine how an evidence-based practice approach enhances the nursing communication processes (Dhakal & Long, 2017, p. 8).

 Critical Thinking: Evidence-based communication in nursing need the capacity to assess information logically and balance the evidence (Tremblay et al., 2017, p. 6). The skill of Scientific Ethos: Being scientifically conscious means that the nurses are open to inquiries and studies. It includes empirical literature, patient, healthcare professionals, and research evidence (Dhakal & Long, 2017, p. 96).

 

 The evidence-based nursing practice supports improved patient outcomes by encouraging nurses and patients to make decisions together through effective communication in a health facility.

 

Evidence-based Healthcare systems that enhance nurse communication are often more likely to observe advances in other Value-Based Purchasing parameters, such as pain control inpatient, drug communication, and better overall healthcare quality scores. As a result, nurse-patient communication increases patient care quality and safety in a health care institution (Park et al., 2020).

 
Quality Improvement The great news is that approaches have been demonstrated to assist health care providers in improving their patient-centered communication abilities (Tremblay et al., 2017, p. 6). The nurse can implement these practices today to provide more effective patient treatment (Rau & Lytle, 2020, p. 98). Allow patients time to express their feelings.

Consider Body Language When Treating Patients.

Maintain Simple Conversations.

 

 As a nurse, asking open-ended questions and allowing patients to express their feelings is crucial. Don’t disrupt or make assumptions about how patients feel. Allow them to feel valued and heard.

Instead of using Language and facts in your talks, utilize phrases that patients will comprehend (Rau & Lytle, 2020). Keep your negotiations brief and on the subject matter. Remember to provide patients with plenty of time to ask questions. It is critical that patients feel comfortable asking educated inquiries about their health (Rau & Lytle, 2020).

  
Safety

 

 Packed, noisy, and stressful environments can exacerbate patient stress. Close doors, open blinds, and minimize outside noises wherever possible to create a secure and pleasant atmosphere (Tremblay et al., 2017, p. 6).

Religion, ethnicity, Language, age, and norms are all examples of social barriers (Park et al., 2020, p. 2). Understanding the cultural background of each patient can help health practitioners avoid bias and communicate properly.

 

 The introduction of evidence-based Healthcare systems that enhance nurse communication is often more likely to observe advances in other Value-Based Purchasing parameters, such as pain control inpatient, drug communication, and better overall healthcare quality scores. As a result, nurse-patient communication increases patient care quality and safety in a health care institution (Park et al., 2020, p. 8).

 

 The hospital center Commit to being a safety

mentor and role model through maintaining free and open communication channels from bottom to top (Tremblay et al., 2017, p. 6). The primary barriers to patient-centered communication include perceived time constraints, discussing data rather than patient experiences, and an outdated mindset (Tremblay et al., 2017, p. 6).

Nurses in the health facility may make patients feel understood, encourage them to share essential and reliable info, and alleviate their anxieties and concerns about their health through effective communication.
Informatics Learn more about current communication methods as Informatics may be achieved in a health institution using technology and expertise. The use of technology, particularly information technology, has risen in recent decades, which has improved the effective transfer of information from one health practitioner to the next (Tremblay et al., 2017, p. 6)

. Examine the benefits and limitations of electronic health records in facilitating effective communication about healthcare practices and recommendations.

Understand how to use electronic health records to promote successful communication in a health care setting (Dhakal & Long, 2017, p. 235).

 

 Utilizing the EHR’s performance improvement features, such as the use of shared electronic health records, improves information exchange in a health facility (Park et al., 2020, p. 2). I will promote and push the benefits of utilizing a universal EHR to enable care team members to communicate on patient treatment plans (Pagani et al., 2019, p. 1). We are recognizing and applying novel communication concepts in clinical practice (Pagani et al., 2019, p. 1).

Recognize how electronic health records may be utilized to simplify communication methods in a health institution (Park et al., 2020, p. 3). Identify how patients and care team members utilize communication technology differently regarding attitudes and abilities (Pagani et al., 2019, p. 1).

 

References

Dhakal, P., & Long, J. D. (2017). Enhancing EBP Skills of RN-BSN Students Through Academic Mentoring in Independent Study. Worldviews on Evidence-Based Nursing, 14(4), 334–335. https://doi.org/10.1111/wvn.12210

Pagani, S., Crozeta, K., & Crisigiovanni, A. B. R. (2019). Culture of patient safety: evaluation of nurses. Rev Rene, 20, e39782. https://doi.org/10.15253/2175-6783.20192039782

Park, M., Jeong, M., Lee, M., & Cullen, L. (2020). Web-based experiential learning strategies to enhance the evidence-based-practice competence of undergraduate nursing students. Nurse Education Today, 91, 104466. https://doi.org/10.1016/j.nedt.2020.104466

Rau, W., & Lytle, M. (2020). The Role of the School Nurse in Increasing Instructional Time Using Multi-Tiered Systems of Support for Behavior (MTSS-B): A Quality Improvement Project. NASN School Nurse, 35(5), 276–283. https://doi.org/10.1177/1942602×20942492

Tremblay, D., Roberge, D., Touati, N., Maunsell, E., & Berbiche, D. (2017). Effects of interdisciplinary teamwork on the patient-reported experience of cancer care. BMC Health Services Research, 17(1). https://doi.org/10.1186/s12913-017-2166-7

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AN-NU 668 wk 15 SWOT analysis

Paper details

This order will be built from order 5486 and 5488. Please write about one page with
three references.

Week 15 Assignment 1: SWOT Analysis
Value: Complete at 100 points/ Incomplete at 0 points. This assignment is worth 5% of
total grade.
Due: Day 7
Grading Category: Assignments
Instructions
Using the information from the Week 14 Assignment 1: Aligning Clinical Issues to
QSEN competency table that you submitted in Week 14, begin to organize this
information on the SWOT Analysis Table (Word). You can refer to How to do a SWOT
analysis [with examples] as needed. Please incorporate peer and faculty feedback from
Week 14\'s discussion board and assignment.
Submit your completed SWOT analysis table for this assignment. Make sure that there
are at least three references at the end of your table.
Review the following two examples for guidance in your own assignment:
 Example 1 SWOT (PDF)
 Example 2 SWOT (PDF)
Please refer to the Grading Rubric for details on how this activity will be graded.

For this assignment to be considered complete, you must complete the SWOT analysis
table based on your identified problem, taking into account feedback from fellow
classmates and your faculty. You must include at least three references and submit the
assignment no later than Day 7.

Needs Assessment Matrix

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Needs Assessment Matrix- Banner Health Corporation

 

Department Required Functions Department of Employee Needs Jobs or Tasks Current Training
Intensive care and PCU Providing intense care for patients that require higher levels of care than the average patient.

 

Patients who require a higher level of care, surveillance, and monitoring throughout an illness or following surgery are put in the intensive care unit (Becker et al., 2019).

 Suitable tools and equipment and adequately trained personnel ICU-trained nurses  

Cardiac monitoring

 

Implementing resuscitation to save lives

 

Implementing pre and post-operative care

 

Providing care to ventilated and intubated patients

 

Titration, monitoring, and use of sensitive medications

 
Progressive Care Services Taking care of patients who require more specialized care than the average hospital patient but who are not life-threatening enough to require an intensive care unit (Becker et al., 2019). Suitable tools and equipment and adequately trained personnel. RNs with PCU or greater training Thorough knowledge of cardiac diseases and the capacity to read rhythm strips.

 

A certification in adult cardiac life supports Implementing resuscitation to save lives (Becker et al., 2019).

 

Cardiac monitoring

 

Implementing pre and post-operative care

 

Multitasking

 

 

 

 

 

There is a critical shortage of nurses in the current medical field. Banner Health also has experienced this shortage. The critical care units have been most affected. Intensive Care Units (ICU) and Progressive Care Units (PCU) have been established to care for patients who require a greater degree of care than the average hospital patient. The facility has the appropriate monitoring equipment and staff trained to manage and evaluate patients taking sensitive medications (Becker et al., 2019). Medications such as these are crucial for maintaining a patient’s blood pressure, for patients who have suffered from strokes, or those who are intubated and need to be sedated after surgery.

A shortage of staff exists in all critical units in Banner Health Corporation. Because of the specialties of the patients, PCUs and ICUs must receive top priority when it comes to hiring the correct staff to deal with them. With a staffing shortage, hospitals have had to increase patient-to-nursing ratios, which is alarming because the increased ratios are likely to pose a safety threat to staff and patients (Becker et al., 2019). Considering the severity of the care, the patients above require, the nurses in the ICU and PCU should receive adequate training in cardiac monitoring, pre-and post-operative care, and lifesaving resuscitation procedures. If nurses do not monitor medications carefully, they can cause death to patients, and the effects of this increase can be felt significantly.

Referecnce

Becker, C. D., Fusaro, M. V., & Scurlock, C. (2019). Deciphering factors that influence the value of tele-ICU programs. Intensive Care Medicine, 45(7), 1046–1051. https://doi.org/10.1007/s00134-019-05591-4

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Needs Assessment Matrix- Banner Health Corporation

Paper details
Once you have a clear understanding of what your organization needs, it is time to
consider the interview process. This assignment is a continuation of the acquiring,
developing, and leveraging employee process you have already been working on during
this course. The interview process is an important step in hiring the right person for your
organization.
For this assignment, develop an interview strategy you would consider using to interview
and select the right candidate for your organization. You are required to use the job
description you developed in the previous assignment. As you are developing your
interview strategy, think about testing options that would benefit the interview process.
The following must be included in your interview strategy (600 words)
 A detailed description of the time, place, format, interview type, and employees
involved in the actual interview process.
 At least one testing option to be included in the selection process. Explain why
this testing option is best suited for selecting a diverse array of employees.
 A minimum of four situational and four behavirol interview questions you would
use to interview for the job. (Reminder: Use the job description from your
previous assignment.)
Prepare this assignment according to the guidelines found in the APA Style Guide

Please use the attached paperwork to guide this assignment.

Shifting Health Care Priorities in the US

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Shifting Health Care Priorities in the US

Overview of Shifting Health Care Priorities in the US

The United States has undergone significant changes in its approach to healthcare policy and priorities in recent years. In this paper, we will explore these changes and their impact on the healthcare system in the United States. Before the Affordable Care Act (ACA), also known as Obamacare, individuals without health insurance could not receive medical care unless they could afford to pay out-of-pocket. The ACA aimed to provide affordable health insurance coverage for all Americans, regardless of income or pre-existing conditions. However, the Trump administration has made moves to dismantle the ACA, and its future is uncertain (Brown et al., 2019).

Other changes that have taken place under the Trump administration include a shift in funding from public programs to private initiatives. For example, the Trump administration proposed cuts to Medicaid, which provides health coverage for low-income Americans, and Medicare, which provides health coverage for seniors and people with disabilities. People across the country are still feeling the impact of these changes. Millions of Americans have lost or are at risk of losing their health insurance, and millions are struggling to afford medical care. The future of healthcare in the United States is uncertain, and it is unclear how these changes will impact the healthcare system and the American people (Cha & Cohen, 2022).

How do Changes impact People to Health Care Policy?

While healthcare policy changes at the federal level are being debated, it’s important to understand how they impact people. At the state level, various changes have been made to Medicaid, the state and federal program that provides health care to low-income Americans. In some states, people are now required to complete work or job training as a condition of eligibility for Medicaid. This can be difficult for people who cannot work due to illness or disability. In addition, the Trump administration had proposed a rule allowing states to impose work requirements on Medicaid recipients who are not pregnant, elderly, or disabled. This could significantly impact the more than 78 million Americans who rely on Medicaid for health care (Cha & Cohen, 2022).

Examining the Impact of Changes to Health Care Policy at the State and Federal Level

Changes to health care policy in the United States have significantly impacted people across the nation. At both the state and federal levels, health care policy has shifted to prioritize the needs of insurance companies and wealthy Americans over the needs of ordinary citizens. One of the most visible impacts of these changes has been the rise in premiums and deductibles. As healthcare costs have increased, insurance companies have shifted more of the cost burden to their customers. This has resulted in millions of Americans being unable to afford necessary healthcare services. These changes will likely continue to impact people’s access to health care in the years to come. As elections approach, it will be important for voters to consider how candidates’ policies will affect access to affordable health care for all Americans (Brown et al., 2019).

Evaluating the Likelihood of Change to Health Care Policy

There are a few factors to consider when making this prediction. First, we must look at who is making the decisions about health care policy. The executive branch, specifically the President, has a lot of power when setting the healthcare reform agenda. However, they need buy-in from Congress actually to pass any legislation. And as we’ve seen in recent years, getting Congress to agree on anything is no easy feat.

In addition, we need to consider the role of interest groups and lobbying regarding health care policy. Healthcare reform is a complex and sensitive issue that interests various groups, from insurance companies to pharmaceutical companies to hospitals. These groups have a lot of money and influence and often lobby hard to protect their interests. So even if there is the political will to make changes to health care policy, vested interests can make it difficult to get anything done (Cha & Cohen, 2022).

Conclusion

Shifting healthcare priorities in the United States will significantly impact state and national healthcare policy. The people most affected by these policy changes will be those who rely on government assistance to afford health care and those who are chronically ill or have pre-existing conditions. These groups will likely see a decrease in the quality and availability of healthcare services shortly.

References

Brown, A. F., Ma, G. X., Miranda, J., Eng, E., Castille, D., Brockie, T., Jones, P., Airhihenbuwa, C. O., Farhat, T., Zhu, L., & Trinh-Shevrin, C. (2019). Structural Interventions to Reduce and Eliminate Health Disparities. American Journal of Public Health, 109(S1), S72–S78. https://doi.org/10.2105/ajph.2018.304844

Cha, A., & Cohen, R. (2022). “Demographic Variation in Health Insurance Coverage: United States, 2021.” United States Census Bureau. https://doi.org/10.15620/cdc:121555

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Shifting Health Care Priorities in the US

Research and select an issue from one of the following categories that has or may
have an influence on U.S. health care policies:
 Changing social norms at the state level
 Shifting health care priorities in the United States
 Impacts of global health care U.S. policy
 Effects of health care on our environment

Write a 525- to 700-word paper that discusses the impact that issue selected can have
on changing health care policy.
 Describe the issue selected.
 Identify people or groups of people the issue impacts.
 Describe the impact the issue has at the state and federal level.
 Describe how likely it is the issue selected may change health care policy.
Cite at least 2 reputable references. Reputable references include trade or industry
publications, government or agency websites, scholarly works, a textbook, or other
sources of similar quality.

NU 641 Week 6. Case Study

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NU 641 Week 6. Case Study

Diagnosis: Acute Exacerbation of Chronic Bronchitis—Please provide your rationales for each answer with supporting data

  1. Which of the following would suggest the need for antibiotic therapy in A.M.?

History of previous COPD exacerbations, cough, and fever: By analysing this answer, it suggests that the patient has a history of respiratory infections and worsening symptoms which is in line with the Anthony Miller case study. The presence of fever suggests that the patient may have an underlying bacterial infection, therefore the need for antibiotic therapy in A.M. Antibiotic therapy may be indicated for patients with acute exacerbation of chronic bronchitis if they have signs of infection, such as increased purulence of sputum and fever. Acute exacerbation of chronic bronchitis (AECB) is typically caused by an infection, such as a bacterial or viral infection. In cases of AECB, the infection can lead to airway inflammation and blockage, resulting in the common symptoms of COPD like coughing, wheezing, and shortness of breath. Other potential causes of AECB include exposure to irritants and allergens—such as cigarette smoke, ozone, or dust—and pre-existing medical conditions like asthma or a weakened immune system. Of course, any underlying cause should be identified and treated for a successful outcome (Crisafulli et al., 2020).

 

What is a likely pathogen associated with an acute exacerbation of chronic bronchitis in A.M.?

Streptococcus pneumonia (pneumococcus) is a common bacterium that can cause acute exacerbations of chronic bronchitis (AECB). Streptococcus pneumonia is a Gram-positive, aerobic, facultative pathogen that is found in the nasopharynx of healthy individuals. It is also the most common cause of community-acquired pneumonia, which can lead to an acute exacerbation of chronic bronchitis.

The pathogenesis of Streptococcus pneumonia is multifactorial and includes the following factors: adherence to epithelial cells, production of proteases and toxins, and evasion of the innate immune response. These virulence factors allow Streptococcus pneumonia to colonize the respiratory tract and cause disease. Pneumococcal infections can lead to inflammation and narrowing of the airways, which can cause increased coughing and shortness of breath. In some cases, pneumococcal infections can also spread to other parts of the body, such as the lungs, bloodstream, or middle ear, and cause severe infections such as pneumonia, bacteremia, or meningitis. Antibiotic therapy is usually required to treat pneumococcal infections, as it helps to reduce the bacterial load, relieve symptoms, and prevent further exacerbations. Therefore, if a patient with AECB is found to have a pneumococcal infection, they would likely require antibiotic therapy to treat their condition (Jacobs et al., 2019).

  1. What antibiotic would be most appropriate to treat an acute exacerbation of chronic bronchitis in A.M.?

If an acute exacerbation of chronic bronchitis (AECB) is caused by Streptococcus pneumonia, the antibiotic appropriate for its treatment is Amoxicillin-clavulanate: This is a combination of two antibiotics that is effective against a wide range of bacteria, including gram-negative bacteria such as Pseudomonas aeruginosa. There are several reasons why amoxicillin-clavulanate would be the best antibiotic to use for treating an acute exacerbation of chronic bronchitis.

First, this antibiotic has a broad spectrum of activity that allows it to effectively treat a variety of pathogens, including Streptococcus pneumonia. Additionally, amoxicillin-clavulanate is available in both oral and intravenous formulations, making it easy to use in a variety of settings. Most importantly, amoxicillin-clavulanate is known to be highly effective at treating Streptococcus pneumoniae infections. In fact, it has been shown to be up to 98% effective at eradicating this pathogen. For these reasons, amoxicillin-clavulanate is the antibiotic of choice for treating acute exacerbations of chronic bronchitis.

It is generally prescribed in an oral dosage form, taken twice a day at 8-hour intervals. The dosage recommended for adults is 500 mg to 1000 mg every 12 hours, depending on the severity of the infection. It is important to take the medication regularly and complete the full course of treatment even if symptoms improve after a few days. This helps ensure that the infection is fully treated and prevents any recurrence or further complications.

What is the mechanism of action of the medication of choice in question #3? Provide rationale.

Amoxicillin-clavulanate is a combination antibiotic that is used to treat a variety of bacterial infections, including acute exacerbations of chronic bronchitis (AECB) caused by Pseudomonas aeruginosa. Amoxicillin is a penicillin-type antibiotic that works by inhibiting the synthesis of the bacterial cell wall. However, many strains of bacteria, including Pseudomonas aeruginosa, have developed resistance to amoxicillin through the production of beta-lactamases, enzymes that can break down the amoxicillin molecule (Lexicomp, 2017).

Clavulanate, also known as clavulanic acid, is a beta-lactamase inhibitor. When combined with amoxicillin, clavulanate acts to inhibit the action of beta-lactamases produced by the bacteria, thereby preventing the breakdown of the amoxicillin and increasing its effectiveness against resistant strains of bacteria. Therefore, the mechanism of action of amoxicillin-clavulanate in treating AECB caused by Pseudomonas aeruginosa is to inhibit the synthesis of the bacterial cell wall, with clavulanate providing enhanced activity against beta-lactamase-producing bacteria such as Pseudomonas aeruginosa. This allows amoxicillin to effectively target the bacteria and reduce the infection.

It is important to note that the efficacy of amoxicillin-clavulanate against Pseudomonas aeruginosa may still be limited, and treatment with antibiotics that are active against this organism, such as carbapenems or fluoroquinolones, may be more appropriate. Additionally, the use of combination antibiotic therapy may be considered for severe or complicated infections (Li et al., 2019).

  1. What kind of counseling points would you provide for A.M.?

When counseling Anthony Miller who is suffering from acute exacerbation of chronic bronchitis (AECB), several important points should be emphasized to improve overall health and prevent future exacerbations. Medication Compliance: Ensure that Anthony Miller understands the importance of taking his antibiotics as prescribed, even if they start feeling better before the medication is finished. Emphasize that skipping doses or stopping the medication prematurely can allow the bacteria to continue to grow and increase the risk of antibiotic resistance.

Lifestyle Changes: Encourage Anthony Miller to quit any form of smoking and avoid exposure to environmental irritants such as second-hand smoke and air pollution. Provide information on healthy lifestyle habits, such as regular exercise and a balanced diet, to improve lung function and overall health.

Respiratory Hygiene: Advise Anthony Miller to cover their mouth and nose with a tissue when coughing or sneezing, and to wash their hands frequently to prevent the spread of respiratory infections.

Vaccination: Recommend that the patient receive the pneumococcal vaccine to reduce their risk of developing severe pneumococcal infections. Additionally, the flu vaccine may also be recommended to reduce the risk of respiratory infections during the flu season.

Follow-Up Care: Schedule follow-up appointments with the patient’s healthcare provider to monitor their progress and make any necessary adjustments to their treatment plan. Encourage the patient to seek medical attention promptly if their symptoms worsen or if they develop any new symptoms. These counseling points can help improve the patient’s health and prevent future exacerbations of their chronic bronchitis, as well as reduce the risk of complications and improve their overall quality of life.

References

Crisafulli, E., Manco, A., & Torres, A. (2020). How may we improve clinical outcomes for patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease? A narrative review about possible therapeutic and preventive strategies. Expert Review of Respiratory Medicine, 14(5), 493–500. https://doi.org/10.1080/17476348.2020.1732823

Jacobs, D. M., Pandit, U., & Sethi, S. (2019). Acute exacerbations in chronic obstructive pulmonary disease. Current Opinion in Infectious Diseases, 32(2), 143–151. https://doi.org/10.1097/qco.0000000000000533

Lexicomp. (2017). Drug Information Handbook for Advanced Practice Nursing (17 ed.). Wolters Kluwer Clinical Drug Information.

Li, Z., Yuan, X., Yu, L., Wang, B., Gao, F., & Ma, J. (2019). Procalcitonin-guided antibiotic therapy in acute exacerbation of chronic obstructive pulmonary disease. Medicine, 98(32), e16775. https://doi.org/10.1097/md.0000000000016775

Taketamo, C. K. (2017). Pediatric and Neonatal Dosage Handbook (24th ed.). Lexicomp Incorporated.

Woo, T. M., & Robinson, M. V. (2020). Pharmacotherapeutics for Advanced practice Nurse prescribers for Advanced practice Nurse prescribers (5Tth ed.). F.A. Davis Company. Retrieved Feb 6, 2023

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NU 641 Week 6. Case Study

 

Modern DNA Analysis

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Modern DNA Analysis

Modern DNA analysis is a powerful technique that has drastically changed the way criminal justice systems use evidence. It involves extracting cells from biological samples such as blood, saliva, and hair, isolating that cell’s DNA, and then studying it to form a unique profile of an individual. The technique has become widely used in many forensic criminal investigations and can be applied to both current and historical cases.

Technology-based forensic science has had a tremendous impact on the criminal justice system over the last few decades. For example, with the advent of DNA analysis capabilities, investigators are now able to re-evaluate evidence from unsolved cases in an entirely new way. In recent years, DNA analysis has been used to reexamine physical evidence such as hair, blood and tissue samples from cold cases and has yielded countless convictions that wouldn’t have been possible without modern forensic technology (Campbell et al., 2016).

Technology-based forensic science has not only helped in solving crimes and gaining convictions but it is also proving quite useful in exonerating wrongfully accused individuals for whom traditional methods of investigation could not account. This is especially true for cases that involve missing persons or unidentified remains. In many cases, the once mysterious process of assessing fingerprints or analyzing trace evidence is now secondary to sophisticated DNA testing techniques, which have revolutionized the way crime scenes are managed and solved.

In light of the advancements in technology and DNA analysis, cases that have remained unsolved for years can now be reexamined with a new lens. Much of the evidence from historical cases can now be tested with modern DNA analysis, providing invaluable insight that can lead to reevaluation of evidence and possible convictions. For instance, a recent cold case in California was reopened after DNA testing connected the perpetrator to a 1993 murder in Los Angeles. This case had gone cold for 26 years before the sample was tested using modern forensic techniques, which provided an exact match between the perpetrator’s profile and that of the crime scene sample. This is only one example of how technology has transformed criminal justice investigations and enabled prosecutors to get justice in cases they would have been unable to prosecute due to a lack of evidence. This is just one example of how modern science has had an immeasurable impact on criminal justice by allowing us to look at historical cases with 21st century technology. With such sophisticated tools available today, the potential for uncovering truth and bringing closure to families is greater than ever before (Gershaw et al., 2011).

References

Campbell, R., Feeney, H., Pierce, S. J., Sharma, D. B., & Fehler-Cabral, G. (2016). Tested at Last: How DNA Evidence in Untested Rape Kits Can Identify Offenders and Serial Sexual Assaults. Journal of Interpersonal Violence, 33(24), 3792–3814. https://doi.org/10.1177/0886260516639585

Gershaw, C. J., Schweighardt, A. J., Rourke, L. C., & Wallace, M. M. (2011). Forensic utilization of familial searches in DNA databases. Forensic Science International: Genetics, 5(1), 16–20. https://doi.org/10.1016/j.fsigen.2010.07.005

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Modern DNA Analysis

Paper details
Technology is one of the major factors that has reshaped forensic science over the last
few decades. What was once unimaginable has now become common place because of
technology. Nowhere are these dramatic changes more evident than in forensic DNA
analysis capabilities.
Prior to beginning work on this discussion, please review the following:
 The articles:
o Policies and Practices in Cold Cases: An Exploratory Study
o The Impact of DNA Exonerations on the Criminal Justice System
o Cold Cases: Resources for Agencies, Resolution for Families
o The special report Using DNA to Solve Cold Cases
 The videos:
o
o IBIS and a Cold Case (video above)
o Just Wrong: The Aftermath of Wrongful Convictions
o Power of Forensic DNA & Technology in Cold Case Prosecutions – Justice
Journal Episode 1
 The web pages:
o Cold Case Initiative
o Cold Case Investigations and Forensic DNA

Significant advances in forensic science and technology have been made in just the last
50 to 75 years. The two areas most significantly affected by these advances, which have
allowed investigators to re-evaluate old cases with new tools, are cold case
investigations (i.e., usually homicide or sexual assault) and exonerating individuals
wrongfully convicted. The class will be divided into groups to explore these topics
closely.
You are also strongly encouraged to review the recommended sources, which may
further support this discussion forum. You will be assigned to topics by last name to
complete this discussion forum.
You will be assigned as follows if your last name begins with the following letters:

 A through M: Unsolved cold cases
From the perspective of your assigned topic, evaluate modern science’s potential in
reevaluating evidence from historical cases. Provide examples and specific details about
what has changed and the impact it has had on the criminal justice system.
The instructor has the discretion to reassign students to an alternative category to
ensure topics are all covered.
The body of your initial post should be at least 250 words in length. Support your claims
with examples from this week’s required material(s) and/or other scholarly resources
and properly cite any references. Remember science is objective, not a matter of
subjective opinions.?

Anxiety Disorders Case Study

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Anxiety Disorders Case Study

. List specific treatment goals for Ivy.

In the case of Ivy, the young woman has been experiencing anxiety related to her childhood wearisomeness. Her anxiety has reached a point where it has prevented her from engaging in activities she would normally take part in. The most important goal for Ivy is to find an effective way to reduce her anxiety symptoms and restore her confidence (Levy et al., 2021). Cognitive Behavioral Therapy, or CBT, is an effective treatment for anxiety and could help Ivy address negative thought patterns, learn to recognize her triggers, and develop coping skills.

  1. What drug therapy would you prescribe? Why?

Since Ivy is experiencing a significant level of anxiety, drug therapy may also be appropriate to help reduce her symptoms. Selective Serotonin Reuptake Inhibitors (SSRIs) are the most commonly prescribed antidepressants for anxiety disorders; SSRIs help balance serotonin, a neurotransmitter known to affect mood and behavior (Gosmann et al., 2021). The usual starting dosage for SSRIs is low and then titrated up as needed. Ivy should be prescribed an SSRI at an initial dosage of 10-20mg per day, divided into two doses for convenience. This dosage should be re-evaluated every two weeks, and adjust the dosage accordingly. SSRIs can help to reduce symptoms of anxiety and depression, stabilize mood, and improve concentration and focus. However, it is important to note that drug therapy is only effective when combined with other treatments, such as CBT or psychotherapy, which can help to identify the triggers associated with Ivy’s anxiety and ultimately help her to develop better strategies for managing her anxiety.

  1. What are the parameters for monitoring the success of the therapy?

In order to determine the success of an individual’s treatment, it is imperative to observe how the symptoms are progressing throughout the process and determine whether or not the therapy has a positive impact. When it comes to monitoring the success of CBT, it is important to observe patient behavior to assess the therapy’s effects. This can include observing changes in attitude and behavior and the patient’s anxiety levels. Additionally, it is important to track the patient’s progress in managing their anxiety and using healthy coping strategies (Silberman et al., 2021). Ultimately, CBT aims to help the patient gain greater self-regulation and efficacy, so it is important to assess whether this has occurred.

  1. Describe specific patient monitoring based on the prescribed therapy.

When it comes to monitoring the success of drug therapy it is critical to monitor the patient’s symptoms and behaviors to determine if the drug is having a positive effect. Additionally monitoring the patient’s side effects to detect any adverse reactions to the medication and adjust the dosage accordingly is important. Ultimately, drug therapy aims to improve the patient’s symptoms and quality of life, so it is important to assess whether or not this has been achieved (Woo & Robinson, 2019). It is also worth mentioning that monitoring the success of therapy for anxiety disorders is an important part of the treatment process. Observing, the patient’s behavior and symptoms make it possible to determine whether the therapy is having a positive effect or if further adjustments or treatments are needed. Anxiety disorders can be effectively treated with rate monitoring.

  1. One, or two adverse reactions for the selected agent that would cause you to change therapy.

One potential adverse reaction to be aware of in using SSRIs is the increased risk of suicidal thoughts and behaviors. When starting a patient on an SSRI, it is important to closely monitor the patient for any signs or symptoms of suicidal ideation. If a patient is at an increased risk for suicide or exhibits signs or symptoms, it is important to adjust or discontinue the treatment immediately (Zemestani et al., 2021). Another potential adverse reaction to be aware of is sexual dysfunction. Suppose a patient has reported any issues with sexual dysfunction. In that case, it is important to select a different SSRI, as SSRIs have been known to have varying levels of impact on sexual functioning.

  1. What would be the choice for second-line therapy?

If SSRIs are not an appropriate treatment for the patient, a second-line therapy option can be to consider other forms of talking therapy, such as Cognitive Behavioral Therapy (CBT). CBT is a form of psychotherapy focused on helping individuals identify and challenge negative beliefs and behaviors perpetuating their anxiety (Woo & Robinson, 2019). CBT is a useful tool for helping individuals confront their fears and manage their anxiety effectively (Levy et al., 2021). In the case of Ivy, a 23-year-old experiencing anxiety, a suitable prescription of CBT would involve cognitive restructuring. Cognitive restructuring is a technique used to identify and challenge irrational or harmful thoughts while promoting more healthy, realistic thinking. This type of therapy would focus on identifying automatic negative and irrational thinking patterns that lead to anxiety-producing behavior and replace them with more helpful and rational beliefs. Cognitive restructuring would also involve applying problem-solving approaches to address difficult situations.

In addition to cognitive restructuring, relaxation techniques can also be used to help with anxiety. Relaxation techniques can help reduce the physical and cognitive symptoms of anxiety by focusing on deep breathing, muscle relaxation, and distraction techniques. Thus, an appropriate course of CBT for Ivy would involve cognitive restructuring and relaxation techniques to help her manage her anxiety. Overall, it is important to consider a patient’s circumstances when selecting appropriate therapy and consider any potential adverse reactions to the chosen agent. While SSRIs may be one option for treating anxiety disorders, it is important to consider other therapeutic approaches and adjust or discontinue the treatment if necessary.

  1. What dietary and lifestyle changes should be recommended for this patient?

When considering dietary and lifestyle changes for a patient suffering from anxiety, it is important to note that diet and lifestyle can greatly influence overall mental well-being. To this end, the patient should be encouraged to maintain a healthy balance of macronutrients, incorporate fresh fruits and vegetables into their diet, and exercise regularly (Silberman et al., 2021). It is also important to ensure that the patient can practice mindfulness, learning to be aware of the present moment so that they can observe their thoughts and feelings without judgment.

  1. Describe one or two drug–or drug–food interactions for the selected agent.

Regarding drug-drug or drug-food interactions, selecting Selective Serotonin Reuptake Inhibitor (SSRI) medications is important. These can interact with certain foods, such as grapefruit, and certain medications, such as Monoamine oxidase (MAO) inhibitors (Zemestani et al., 2021). Additionally, patients should be aware of the potential for SSRIs to interact with other medications that can increase serotonin levels, such as St John’s wort, as these can lead to serotonin overload and possible side effects. Similarly, alcohol should be avoided, as this can further exacerbate anxiety symptoms.

References

Gosmann, N. P., De Abreu Costa, M., De Barros Jaeger, M., Motta, L. S., Frozi, J., Spanemberg, L., Manfro, G. G., Cuijpers, P., Pine, D. S., & Salum, G. A. (2021). Selective serotonin reuptake inhibitors, and serotonin and norepinephrine reuptake inhibitors for anxiety, obsessive-compulsive, and stress disorders: A 3-level network meta-analysis. PLOS Medicine, 18(6), e1003664. https://doi.org/10.1371/journal.pmed.1003664

Levy, H. C., O’Bryan, E. M., & Tolin, D. F. (2021). A meta-analysis of relapse rates in cognitive-behavioral therapy for anxiety disorders. Journal of Anxiety Disorders, p. 81, 102407. https://doi.org/10.1016/j.janxdis.2021.102407

Silberman, E., Balon, R., Starcevic, V., Shader, R., Cosci, F., Fava, G. A., … & Sonino, N. (2021). Benzodiazepines: it’s time to return to the evidence. The British Journal of Psychiatry, 218(3), 125-127. https://doi.org/10.1192/bjp.2020.164

Woo, T. M., & Robinson, M. V. (2019). Pharmacotherapeutics for Advanced Practice Nurse Prescribers.

Zemestani, M., Beheshti, N., Rezaei, F., Van Der Heiden, C., & Kendall, P. C. (2021). Cognitive Behavior Therapy Targeting Intolerance of Uncertainty Versus Selective Serotonin Reuptake Inhibitor for Generalized Anxiety Disorder: A Randomized Clinical Trial. Behavior Change, 38(4), 250–262. https://doi.org/10.1017/bec.2021.16

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Anxiety Disorders Case Study

 

 

 

JEA’s Buckman Wastewater Treatment Plant

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JEA’s Buckman Wastewater Treatment Plant

JEA’s Buckman Wastewater Treatment Plant is a community resource for safe and efficient water management in Jacksonville, Florida. This facility processes over 300 million gallons of wastewater daily, making it one of Southeast’s largest wastewater treatment plants (“JEA | US EPA,” 2022). Everyone in the community should understand where their water comes from, how it is stored, how frequently it is tested for purity, and what safeguards are in place to prevent tampering with the public water supply. With that in mind, we will look closer at JEA’s Buckman Wastewater Treatment Plant and learn more about these critical facets of our community’s water supply system.

JEA’s Buckman Wastewater Treatment Plant is located on the St. Johns River in Jacksonville, Florida, and serves over 500,000 people in the greater Jacksonville area. It is one of the largest publicly owned facilities in the United States, with a capacity of 80 million gallons daily. The plant processes more than 10 billion gallons of wastewater a year. The plant uses advanced technology to continuously monitor and test incoming water for physical, chemical, and bacteriological characteristics. This ensures that all water sent to customers meets regulatory standards for safety and quality (“JEA | US EPA,” 2022). The community’s water comes from several sources, including surface water (lakes and rivers) and groundwater (aquifers). Surface water from lakes and rivers is treated at the JEA Buckman Wastewater Treatment Plant before being sent to distribution systems. Groundwater is collected from aquifers or wells located within or adjacent to an area where customers receive their supply of drinking water.

The City of Jacksonville stores its water in three large reservoirs in Jacksonville and Clay counties. These facilities are the Blue Cypress, Southfork, and Black Creek Reservoirs, which have a combined capacity of nearly 7 billion gallons. These reservoirs provide a safe source of drinking water and irrigation for residential, industrial, and agricultural areas throughout their service area  (Jessica, 2022 ). The City of Jacksonville also conducts regular tests to ensure that the water quality in their reservoirs meets or exceeds all state and federal standards, as well as other institutions such as the Centers for Disease Control (CDC). Special interest organizations such as the Florida Department of Environmental Protection (FDEP) also perform periodic tests on the city’s water supply to ensure its safety and purity.

The plant filters out unwanted particles at its water intake points to ensure clean water. This guarantees that any elements that could harm our drinking water never enter the system. Once filtered and treated, JEA stores the purified water in reservoirs that can hold up to 20 million gallons of pristine drinking water at any time. The Buckman Wastewater Treatment Plant tests numerous times daily to ensure that all parts meet strict EPA standards  (Jessica, 2022 ). The plant also provides comprehensive lab testing to ensure the drinking water is safe for human consumption. JEA has multiple security protocols to prevent tampering with purified drinking water  (Jessica, 2022 ). This includes physical security, such as surveillance cameras and secure gates; electronic safeguards, such as firewalls; administrative procedures, such as restricting access to sensitive areas; and chemical treatments for any threat from contaminants entering the system.

The City of Jacksonville has also implemented additional safeguards to secure the integrity of its water supply. This includes a three-stage filtration process at each reservoir to remove impurities from natural bodies of water; 24/7 monitoring of its computerized pump stations; regular maintenance checks; yearly boater safety classes; physical inspections by authorized personnel; and secured access points with security cameras throughout each facility  (Jessica, 2022 ). JEA’s Buckman Wastewater Treatment Plant is the largest sewage treatment facility in the region and serves over one million customers in the Jacksonville area. The plant is located in the Ortega neighborhood and was recently renovated to improve its energy efficiency and environmental impact (“Buckman Wastewater Treatment Plant | Open Green Map,” n.d.).

As a public health nurse, I would ask several questions when investigating an outbreak at JEA’s Buckman Wastewater Treatment Plant. Firstly, I would want to know about the number and types of employees, the safety measures that are in place, and the protocols for preventing the spread of infection. Additionally, I would ask about the number and types of visitors, the safety measures that are in place for them, and the protocols for preventing the spread of infection.  In order to avoid a disease outbreak at the facility, several strategies may be employed. First, educational outreach to employees and visitors should be conducted to increase knowledge of disease prevention and the proper use of PPE. Additionally, access points to the facility should be monitored to reduce the overall risk of a disease outbreak. Proper handwashing stations should be located throughout the facility and hand sanitizer should be made available to all visitors. Finally, regular inspections and evaluations of the wastewater treatment facility should be conducted to ensure that all safety protocols are being followed.

As a change agent, I would offer suggestions and collaborate with staff members to ensure that any deficiencies are identified and addressed. I would also provide guidance and resources to keep the facility in compliance with all health regulations. Furthermore, I would use data collection and analysis to make informed decisions for the success of the facility. Finally, I would work with other public health professionals to ensure that the facility is following best practices and make recommendations for future changes.

References

Buckman Wastewater Treatment Plant | Open Green Map. (n.d.). Green Map. https://www.opengreenmap.org/greenmap/jacksonville/buckman-wastewater-treatment-plant-16676

JEA | US EPA. (2022, September 29). US EPA. https://www.epa.gov/sustainability/jea

Jessica, B. (2022, March 31). JEA water treatment facility breaks ground in 80-acre lot in Southsidearea.doi:file:///C:/Users/User/AppData/Local/Temp/MicrosoftEdgeDownloads/6bf8a344-2c8e-4aa0-9030c619ea02ede6/Racism%20without%20Racists%20(4th%20Edition)%20-%20Eduardo%20Bonilla-Silva%20(1).pdf

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JEA’s Buckman Wastewater Treatment Plant

Paper details

  • Now, look at the site you visited through the eyes of the public health nurse (PHN). Imagine you are the PHN and have been asked to investigate an outbreak at this facility.
  • What questions would you ask?
  • What suggestions could you make to avoid a disease outbreak at the facility?
  • What would your role as a change agent be for any deficiencies you find in your on-site inspection?