Complex Regional Pain Disorder White Male With Hip Pain

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Decision Point One
Savella  12.5 mg once daily on day 1; followed by 12.5 mg BID on day 2 and 3;  followed by 25 mg BID on days 4-7; followed by 50 mg BID thereafter
RESULTS OF DECISION POINT ONE

  • Client returns to clinic in four weeks
  • Client comes into the office to without crutches but is limping a  bit. The client states that the pain is “more manageable since I started  taking that drug. I have been able to get around more on my own. The  pain is bad in the morning though and gets better throughout the day”.  On a pain scale of 1-10; the client states that his pain is currently a  4. When asked what pain level would be tolerable on a daily basis, the  client states, “I would rather have no pain but don’t think that is  possible. I could live with a pain level of 3.”. When questioned  further, the PMHNP asks what makes the pain on a scale of 1-10 different  when comparing a level of 9 to his current level of 4?”. The client  states that since using this drug, I can get to a point on most days  where I do not need the crutches. ” The client is also asked what would  need to happen to get his pain from a current level of 4 to an  acceptable level of 3. He states, “If I could get to the point everyday  where I do not need the crutches for most of my day, I would be happy.”
  •  Client states that he has noticed that he frequently (over the  past 2 weeks) gets bouts of sweating for no apparent reason. He also  states that his sleep has “not been so good as of lately.” He does  complain of nausea today
  •  Client’s blood pressure and pulse are recorded as 147/92 and 110  respectively. He also admits to experiencing butterflies in his chest.   The client denies suicidal/homicidal ideation and is still future  oriented

Decision Point Two
 Continue with current medication but lower dose to 25 mg twice a day  
RESULTS OF DECISION POINT TWO

  • Client returns to clinic in four weeks
  • Client comes to office today with use  of crutches. He states that his current pain is a 7 out of 10. “I do not  feel as good as I did last month.”
  • Client states that he is sleeping at night but woken frequently from pain down his right leg and into his foot
  • Client’s blood pressure and heart rate recorded today are 124/85 and 87 respectively. He denies any heart palpitations today
  • Client denies suicidal/homicidal ideation but he is discouraged about the recent slip in his pain management and looks sad

Decision Point Three
 Change Savella to 25 mg orally in the MORNING and 50 mg orally at BEDTIME 

Guidance to Student
The client has a complex neuropathic  pain syndrome that may never respond to pain medication. Once that is  understood, the next task is to explain to the client that pain level  expectations need to realistic in nature and understand that he will  always have some level of pain on a daily basis. The key is to manage it  in a manner that allows him to continue his activities of daily living  with as little discomfort as possible. Next, it is important to explain  that medications are never the final answer but a part of a complex  regimen that includes physical therapy, possible chiropractic care, heat  and massage therapy, and medications. Savella is a SNRI that also  possesses NMDA antagonist activity which helps in producing analgesia at  the site of nerve endings. It is specifically marketed for fibromyalgia  and has a place in therapy for this gentleman. Tramadol is never a good  option along with other opioid type analgesics. Agonists at the Mu  receptors does not provide adequate pain control in these types of  neuropathic pain syndromes and therefore is never a good idea. It also  has addictive properties which can lead to secondary drug abuse.  Reductions in Savella can help control side effects but at a cost of  uncontrolled pain. It is always a good idea to start with dose  reductions during parts of the day that pain is most under control. The  addition of Celexa with Savella needs to be done cautiously. Both  medications inhibit the reuptake of serotonin and can, therefore, lead  to serotonin toxicity or serotonin syndrome.

Community Resources

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Research a selected local, national, or global nonprofit organization or government agency to determine how it contributes to public health and safety improvements, promotes equal opportunity, and improves the quality of life within the community. Submit your findings in a 3-5 page report.
As you begin to prepare this assessment, it would be an excellent choice to complete the Nonprofit Organizations and Community Health activity. Complete this activity to gain insight into promoting equal opportunity and improving the quality of life in a community. The information gained from completing this activity will help you succeed with the assessment.

Professional Context

Many organizations work to better local and global communities’ quality of life and promote health and safety in times of crisis. As public health and safety advocates, nurses must be cognizant of how such organizations help certain populations. As change agents, nurses must be aware of factors that impact the organization and the services that it offers. Familiarity with these organizations enables the nurse to offer assistance as a volunteer and source of referral.
This assessment provides an opportunity for you gain insight into the mission, vision, and operations of a community services organization of interest.

Demonstration of Proficiency

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

  • Competency 1: Analyze health risks and health care needs among distinct populations.
    • Explain how an organization’s work impacts the health and/or safety needs of a local community.
  • Competency 2: Propose health promotion strategies to improve the health of populations.
    • Explain how an organization’s mission and vision enable it to contribute to public health and safety improvements.
  • Competency 3: Evaluate health policies, based on their ability to achieve desired outcomes.
    • Assess the impact of funding sources, policy, and legislation on an organization’s provision of services.
  • Competency 4: Integrate principles of social justice in community health interventions.
    • Evaluate an organization’s ability to promote equal opportunity and improve the quality of life within a community.
  • Competency 5: Apply professional, scholarly communication strategies to lead health promotion and improve population health.
    • Write clearly and concisely in a logically coherent and appropriate form and style.

Note: Complete the assessments in this course in the order in which they are presented.

Preparation

Assume you are interested in expanding your role as a nurse and are considering working in an area where you can help to promote equal opportunity and improve the quality of life within the local or global community. You are aware of the work of several nonprofit organizations and government agencies whose work contributes to this effort in some way. You have particular interest in one of these organizations but would like to know more about how it contributes to public health and safety improvements. In addition, you would like to report the results of your research in a scholarly paper that you could submit for publication.
As you begin to prepare this assessment, it would be an excellent choice to complete the Nonprofit Organizations and Community Health activity. Complete this activity to gain insight into promoting equal opportunity and improving the quality of life in a community. The information gained from completing this activity will help you succeed with the assessment.
Then, choose the organization or agency you are most interested in researching:

Note: Remember that you can submit all, or a portion of, your draft research paper to Smarthinking Tutoring for feedback, before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.

Instructions

Research your chosen organization and submit a report of your findings.

Document Format and Length

Format your paper using APA style.

  • Use the APA Style Paper Template. An APA Style Paper Tutorial is also provided to help you in writing and formatting your paper. Be sure to include:
    • A title page and references page. An abstract is not required.
    • A running head on all pages.
    • Appropriate section headings.
  • Your paper should comprise 3–5 pages of content plus title and references pages.
Supporting Evidence

Cite at least three credible sources from peer-reviewed journals or professional industry publications that support your research findings.

Graded Requirements

The research requirements, outlined below, correspond to the grading criteria in the assessment scoring guide, so be sure to address each point.

  • Explain how the organization’s mission and vision enable it to contribute to public health and safety improvements.
    • Include examples of ways a local and/or global initiative supports organizational mission and vision and promotes public health and safety.
  • Evaluate an organization’s ability to promote equal opportunity and improve the quality of life in the community.
    • Consider the effects of social, cultural, economic, and physical barriers.
  • Assess the impact of funding sources, policy, and legislation on the organization’s provision of services.
    • Consider the potential implications of funding decisions, policy, and legislation for individuals, families, and aggregates within the community.
  • Explain how an organization’s work impacts the health and/or safety needs of a local community.
    • Consider how nurses might become involved with the organization.
  • Write clearly and concisely in a logically coherent and appropriate form and style.
    • Write with a specific purpose and audience in mind.
    • Adhere to scholarly and disciplinary writing standards and APA formatting requirements.

Additional Requirements

Before submitting your paper, proofread it to minimize errors that could distract readers and make it difficult for them to focus on your research findings.
Grading Rubric:
1.  Explain how an organization’s mission and vision enable it to contribute to public health and safety improvements.
Passing Grade:  Explains how an organization’s mission and vision enable it to contribute to public health and safety improvements. Draws well-reasoned, logical conclusions about the organization’s work and provides a specific, relevant example of how a local and/or global initiative supports the organization’s mission and vision and promotes public health and safety.
2.  Evaluate an organization’s ability to promote equal opportunity and improve the quality of life in a community.
Passing Grade:  Evaluates an organization’s ability to promote equal opportunity and improve the quality of life in a community, with regard to the effects of social, cultural, economic, and physical barriers and their implications for the organization and community.
3.  Assess the impact of funding sources, policy, and legislation on an organization’s service delivery.
Passing Grade:  Assesses the impact of funding sources, policy, and legislation on an organization’s service delivery. Provides clear insight into the potential implications of funding decisions, policy, and legislation for community members.
4.  Explain how an organization’s work impacts the health and/or safety needs of a local community.
Passing Grade:  Explain how an organization’s work impacts the health and/or safety needs of a local community, and offers creative or insightful ideas about how nurses might become involved with the organization.
5.  Write clearly and concisely in a logically coherent and appropriate form and style.
Passing Grade:  Writes clearly and concisely in a logically coherent and appropriate form and style. Main points, ideas, arguments, or propositions are well-developed and engaging. Adheres to all applicable disciplinary and scholarly writing standards.

PDSA – Plan-Do-Study-Act or Plan-Do-Check-Act model

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As the CNO of my current healthcare organization having to restructure a top heavy nursing department with the intention of reducing financial loss, we must evaluate the best way to restructure the department without inadvertently losing employees in the process, as well as flattening the line to reduce additional cost. As a leader we must evaluate and assess all three decision-making models and integrate the problem at hand in each scenario.
Overall, the PDSA makes the most sense in a scenario as sensitive to the possibility of resistance to change such as healthcare organizational changes. The PDSA Model also known as the Plan-Do-Study-Act or Plan-Do-Check-Act model is a methodology tool used as a part of the Institute for Healthcare improvements’ Model for Improvement. The PDSA tool is ultimately utilized to improve quality of care, in return improving healthcare safety disparities, patient adverse events, and producing a timely, effective, patient-centered solution to disparities, in this case nursing staffing shortages in healthcare organizations (Polit & Beck, 2017). The cycle consists of four steps, the first step is “plan”, planning a change in this case such as implementing to reduce leadership roles. Second step to the PDSA cycle is “do”, healthcare organization carries out the plan on a small scale or pilot program. In this scenario, the shift in personnel/staff  will be implemented on medical surgical units only where based from previous studies, the med-surg units are often times short staffed and hold lowest job satisfaction scores (Donnelly & Kirk, 2015). The third step is “study”, data and review analysis take priority, in this phase where researchers, administrators and leadership identify outcomes and lessons learned. The final step is “act”, essential step to facilitating effective change by gathering learned information, data and disseminating to associates to implement effective change.

Essay About Nursing Education

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The topic is nursing education. It’s a essay paper of 2-3 pages. The article 1 and 2 provided in pdf is peer reviewed journal  for the insight of the paper

Essay About Nursing Education

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The topic is nursing education. It’s a essay paper of 2-3 pages. The article 1 and 2 provided in pdf is peer reviewed journal  for the insight of the paper

Research paper – How nurses should deal with patients with malaria without contracting the disease

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How nurses should deal with patients with malaria without contracting the disease

Research paper – How nurses should deal with patients with malaria without contracting the disease

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How nurses should deal with patients with malaria without contracting the disease

Essentials Of Nursing Research

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Assignment:
Evidence-Based Practice Model and Change Model
Create a PowerPoint presentation that addresses each of the following points/questions. Be sure to completely answer all the questions for each bullet point. Use clear headings that allow your professor to know which bullet you are addressing on the slides in your presentation. Support your content with at least three (3) sources using APA citations throughout your presentation. Make sure to cite the sources using the APA writing style for the presentation. Include a slide for your references at the end. Follow best practices for PowerPoint presentations related to text size, color, images, effects, wordiness, and multimedia enhancements. Review the rubric criteria for this assignment.
Part 1: Choose and explain one Evidence Based Practice Model from Chapter 13 of the textbook (Melnyk and Fineout-Overholt, 2015). Then, related to your research topic from Mod 1, describe in detail how you would utilize the model to implement an evidence-based practice change in your personal clinical practice environment. Models to choose from include: Stetler Model of EBP, Iowa Model of EBP, A Model for EBP Change, ARCC Model, PARIHS, Clinical Scholar Model, John Hopkins Nursing EBP, ACE Star Model of Knowledge Transformation
Part 2: Choose one Change Model/Theory from Chapter 14 of the textbook (Melnyk and Fineout-Overholt, 2015). Then, related to your research topic from Mod 1, describe in detail how you would utilize the model/theory to implement an evidence-based practice change in your personal clinical practice environment. Models/theories to choose from include: Change Curve, Kotter and Cohen’s, Roger’s Theory of Diffusion of Innovations, The Transtheoretical Module of Health Behavioral Change

  • Title Slide (1 slide)
  • Objective Slide (1 slide)
  • Choose and explain one Evidence Based Practice Model from Chapter 13 of the textbook (Melnyk and Fineout-Overholt, 2015). (1-2 slides)
  • Related to your research topic from Mod 1, describe in detail how you would utilize the model to implement an evidence-based practice change in your personal clinical practice environment (2-3 slides)
  • Choose one Change Model/Theory from Chapter 14 of the textbook (Melnyk and Fineout-Overholt, 2015). (1-2 slides)
  • Related to your research topic from Mod 1, describe in detail how you would utilize the model/theory to implement an evidence-based practice change in your personal clinical practice environment. (2-3 slides)
  • References (1 slide)

Assignment Expectations:
Length: 9-13 slides
Structure: Include a title slide, objective slide, content slides, reference slide in APA format. Title/Objective/Reference slides do not count towards the minimum slide count for this assignment.
References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of three (3) scholarly sources are required for this assignment.

Discussion – Using Cannabis As A Therapeutic Tool For Epilepsy

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Hi, this is my research method, that was redone but the professor said that it was done incorrectly and this it is still meta-analysis which I’m guessing know she does not want
Here are something that I’ve added this time that can help you formulate the Research Method
Click http://expertjournals.com/how-to-write-a-research-methodology-for-your-academic-article/ link to open resource.
and I also uploaded something as well
Here’s an example of a student’s research method, the professor said it well done:

Re: Using Cannabis As A Therapeutic Tool For Epilepsy

The data was collected using a meta-analysis methodology. The researcher summarized the results of several studies to come up with their report. The information was collected from several scientific studies and journals, synthesized and compiled. Preference was given to studies that used randomized trial method. Different studies were assessed with the main focus being on those that did experiments (lasting a month or more) and recorded results before the study and compared them with the results after the study. For this study, the case study approach was used in which the researcher collected data from past researchers and did an analysis of the secondary data. The researcher was keen to focus only on qualitative and quantitative data that was collected first hand from experiments and observations.
A meta-analysis method was preferred because it was both cost and time effective and provided deep insights on the topic of choice. During the collection of the data, a two-step approach was taken. First, the researcher identified credible sources of information relating to the topic from journals by filtering data using key words. The main key words of choice consisted of a combination of terms; “Epilepsy cure with cannabis” and “therapeutically cure of epilepsy with CBD.” After collecting studies that fitted into the key terms, the researcher then checked the year of publication with only recent studies qualifying (5 years). By reading the abstracts, relevant articles were chosen to be used as data for the study. The second approach entailed deriving data from the chosen sources, synthesizing and analyzing them to create new data. Particular emphasis was on the effects of CBD in the therapeutic cure of epilepsy by comparing the quantities and duration of CBD administration to the symptoms and effects in the patients after approximately two weeks.
Discussion Forum: Research Methods
1. Formulate the Research Methods of your selected topic. Based on the chosen methods, please ensure that your incorporate all appropriate elements.
2. Post your Research Methods.
3. Then, read the posts submitted by two other classmates and provide meaningful feedback for improvement.
This is mine :
Case Study: This is a qualitative research method that facilitates a close assessment of the data within a particular context. A researcher selects few individuals to be the study’s subject (Wilson, 2016). Further, this method helps the researcher to study and investigate opioid education for the youth as a contemporary real-life phenomenon. This exploration and investigation are done through an in-depth contextual analysis of a restricted events’ number relating to the subject of the study.
Phenomenology Method: This qualitative research method enables a researcher to emphasize and focus on studying individual youth’s lived experiences within the world of drugs. It will be easier to study the structure of different types of youth’s experiences ranging from emotion, perception, and imagination regarding the use of opioids. The method builds a complex account of semi-permanent awareness, spatial awareness, and awareness of a person’s experience (Qutoshi, 2018). A researcher can also describe the nature of experience just as he finds it in his experience. Thus, the method is based on a description of the lives of youths who abuse opioids as a surviving mechanism. An interpretation of the type of experience that links or closely connect with relevant features of the context in the study plays a crucial role in the research.
Tools
Under the case study method, a researcher can use documentation review as a tool for increasing validity (Wilson, 2016). Documents and data get analyzed to establish sensitive information regarding the subject of the study.
Within the phenomenology method, depth interviews are used as a tool where the respondents are less, and the research focuses on a particular issue or situation.
References
Qutoshi, S. B. (2018). Phenomenology: A philosophy and method of inquiry. Journal of Education and Educational Development, 5(1), 215-222.
Wilson, V. (2016). Research Methods: Design, Methods, Case Study… oh my!. Evidence Based Library and Information Practice, 11(1 (S)), 39-40.
What the professor said: You have again incorrectly formulated it. Your method is meta-analysis! Check the in-class practice and replicate that on your study.

Discussion – Using Cannabis As A Therapeutic Tool For Epilepsy

/0 Comments/in /by
Hi, this is my research method, that was redone but the professor said that it was done incorrectly and this it is still meta-analysis which I’m guessing know she does not want
Here are something that I’ve added this time that can help you formulate the Research Method
Click http://expertjournals.com/how-to-write-a-research-methodology-for-your-academic-article/ link to open resource.
and I also uploaded something as well
Here’s an example of a student’s research method, the professor said it well done:

Re: Using Cannabis As A Therapeutic Tool For Epilepsy

The data was collected using a meta-analysis methodology. The researcher summarized the results of several studies to come up with their report. The information was collected from several scientific studies and journals, synthesized and compiled. Preference was given to studies that used randomized trial method. Different studies were assessed with the main focus being on those that did experiments (lasting a month or more) and recorded results before the study and compared them with the results after the study. For this study, the case study approach was used in which the researcher collected data from past researchers and did an analysis of the secondary data. The researcher was keen to focus only on qualitative and quantitative data that was collected first hand from experiments and observations.
A meta-analysis method was preferred because it was both cost and time effective and provided deep insights on the topic of choice. During the collection of the data, a two-step approach was taken. First, the researcher identified credible sources of information relating to the topic from journals by filtering data using key words. The main key words of choice consisted of a combination of terms; “Epilepsy cure with cannabis” and “therapeutically cure of epilepsy with CBD.” After collecting studies that fitted into the key terms, the researcher then checked the year of publication with only recent studies qualifying (5 years). By reading the abstracts, relevant articles were chosen to be used as data for the study. The second approach entailed deriving data from the chosen sources, synthesizing and analyzing them to create new data. Particular emphasis was on the effects of CBD in the therapeutic cure of epilepsy by comparing the quantities and duration of CBD administration to the symptoms and effects in the patients after approximately two weeks.
Discussion Forum: Research Methods
1. Formulate the Research Methods of your selected topic. Based on the chosen methods, please ensure that your incorporate all appropriate elements.
2. Post your Research Methods.
3. Then, read the posts submitted by two other classmates and provide meaningful feedback for improvement.
This is mine :
Case Study: This is a qualitative research method that facilitates a close assessment of the data within a particular context. A researcher selects few individuals to be the study’s subject (Wilson, 2016). Further, this method helps the researcher to study and investigate opioid education for the youth as a contemporary real-life phenomenon. This exploration and investigation are done through an in-depth contextual analysis of a restricted events’ number relating to the subject of the study.
Phenomenology Method: This qualitative research method enables a researcher to emphasize and focus on studying individual youth’s lived experiences within the world of drugs. It will be easier to study the structure of different types of youth’s experiences ranging from emotion, perception, and imagination regarding the use of opioids. The method builds a complex account of semi-permanent awareness, spatial awareness, and awareness of a person’s experience (Qutoshi, 2018). A researcher can also describe the nature of experience just as he finds it in his experience. Thus, the method is based on a description of the lives of youths who abuse opioids as a surviving mechanism. An interpretation of the type of experience that links or closely connect with relevant features of the context in the study plays a crucial role in the research.
Tools
Under the case study method, a researcher can use documentation review as a tool for increasing validity (Wilson, 2016). Documents and data get analyzed to establish sensitive information regarding the subject of the study.
Within the phenomenology method, depth interviews are used as a tool where the respondents are less, and the research focuses on a particular issue or situation.
References
Qutoshi, S. B. (2018). Phenomenology: A philosophy and method of inquiry. Journal of Education and Educational Development, 5(1), 215-222.
Wilson, V. (2016). Research Methods: Design, Methods, Case Study… oh my!. Evidence Based Library and Information Practice, 11(1 (S)), 39-40.
What the professor said: You have again incorrectly formulated it. Your method is meta-analysis! Check the in-class practice and replicate that on your study.