American Sentinel N522PE Special Topics – Life-Span Assessments, Ethics & Legal Issues Final Project

American Sentinel N522PE Special Topics – Life-Span Assessments, Ethics & Legal Issues Final Project American Sentinel N522PE Special Topics – Life-Span Assessments, Ethics & Legal Issues Final Project Discussion 7 Caring for persons across the life span and from very diverse cultural backgrounds can present challenges in nursing practice. As you studied the ethical and legal issues related to advanced physical assessment what insights have you gained to advance your clinical reasoning? Describe knowledge gained or re-affirmed through a de-identified clinical story. American Sentinel N522PE Special Topics – Life-Span Assessments, Ethics & Legal Issues Final Project Remember to respond to at least two of your peers. Please refer to the Course Syllabus for Discussion Participation Guidelines & Grading Criteria. Permalink: https://nursingpaperessays.com/ american-sentine…es-final-project / ? Example Discussion 7 Approach and Responses I believe one of the areas to understand with the advanced physical assessment that the legal and ethical implications that increase as one progresses. An example would be that as a nurse once you have an assessment of a patient and find something that is abnormal on a minor or critical level, there are nursing procedures you are going to complete to ensure the safety of the patient and one of these is the notification of the primary provider. As the primary provider, once you have completed an assessment you are legally and ethically bound to proceed with a treatment plan that includes collaboration with the patient. Your use of your advanced assessment skills is to be able to interpret the clinical information that is obtained, assimilate an appropriate diagnosis, and proceed to manage this patient on a clinical level that can include testing, immediate medical intervention, or referrals for additional consultation (Zambas et al., 2016). When the provider is assessing a patient, it is also required that the provider include the patient in the plan for further testing and treatments. One situation that I was involved in occurred with a patient in a long-term care setting. She was 87 years old, a smoker for greater than 60 years who of course had COPD in addition to other comorbidities. She had started complaining of severe back pain and wanted pain medications to treat it. Her physician sent her to the hospital for testing because he suspected she had cancer, based on her clinical presentation. He never informed her of what he was testing for and she thought it was to decide how to treat her back pain. When she returned to the facility, we received confirmation that she had stage 3 lung cancer. The physician then stated to me, you have a good relationship with Ms. XXXX, your going to have to tell her she has cancer and there are no treatment options, I don’t want to be the one to tell her. I was beyond floored. He never asked this patient if she wanted to have anything done to find out if she had cancer, she only wanted medication for her back. He completed this knowing that due to age and multiple conditions that she would not be a candidate for any type of management other than palliative which could have been done without knowing her diagnosis. This woman was content with her current place in life, she loved that we jokingly nickname her the queen because we all would get her special items from the store, take her outside to smoke, and etc. She was oriented x3 and competent, there was no way I could not inform her of the diagnosis once we knew it. This woman spent the last two months of her life depressed, crying, and making statements that she never wanted to know she had cancer. She expressed continued feelings of guilt over continuing to smoke each day when she knew she was ill. By not communicating with this patient and having knowledge of what her preferences were in managing her care he was responsible for significantly impacting her end of life quality. American Sentinel N522PE Special Topics – Life-Span Assessments, Ethics & Legal Issues Final Project References: Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., & Soriano, R. P. (2016). Bates guide to physical examination and history taking (Thirteenth, North American ed.). Wolters Kluwer,. Zambas, S., Smythe, E., & Koziol-Mclain, J. (2016). The consequences of using advanced physical assessment skills in medical and surgical nursing: A hermeneutic pragmatic study. International Journal of Qualitative Studies on Health and Well-being, 11. https://doi.org/10.3402/qhw.v11.32090 596 words Permalink In reply to Darcy Paisley Re: Discussion 7 – American Sentinel N522PE Special Topics – Life-Span Assessments, Ethics & Legal Issues Final Project by Kristy Schumacher – Wednesday, November 4, 2020, 2:26 PM Darcy, Thank you for sharing that story and I’m sorry you had to be involved in that. How heartbreaking for her and everyone that knew her. It is almost scary to see how oftentimes physicians “forget” or just bypass these “small details” and then to save face they put the pressure on someone else to take the fall. It does, however, speak to how well many new nurses are being trained on ethics and legal concerns regarding their scope of practice and rights and responsibilities now-a-days. The physicians may not recall learning it, or maybe never did actually learn it, but we’re here to be the patient’s advocate and speak up for them so I’m grateful we’re being taught these “small details”. Bickley (2017) has a perfect example of this scenario in chapter 3, Interviewing and the Health History, page 85 under respectful communication it says to build a mutual respect with your patients by asking, “What did you hope to get from this visit?”. I think this may have helped avoid the predicament or else been the avenue needed to understand the patient’s desires. Great work – we’re almost done with another course! Kristy References Bickley, L. S. (2017). Bate’s guide to physical examination and history taking (12th ed.). Philadelphia, PA: Wolters Kluwer Health | Lippincott Williams & Wilkins. 215 words Permalink Show parent In reply to Darcy Paisley Re: Discussion 7 – American Sentinel N522PE Special Topics – Life-Span Assessments, Ethics & Legal Issues Final Project by Dona Clarin – Thursday, November 5, 2020, 3:32 PM Well done. Be sure to know the recommended exams and health promotion activities for patient’s at different times of life. 20 words Final Project Final Project The Final Project (6-8 page paper) synthesizes the previous weeks’ study of advanced physical assessment by conducting a comprehensive assessment in ShadowHealth. The final project synthesis is focused upon designing evidence-based, culturally competent nursing interventions through the development of an individualized health plan. Assessment of competency is based on the Comprehensive Patient Interview, Physical Examination and Individualized Plan of Care incorporating Healthy People 2020 and evidence-based interventions and patient-centered goals. You will use one comprehensive digital clinical experience health history and physical assessment for this assignment: Comprehensive Assessment. Please submit your summary documentation in MS Word. Use the submission parameters and rubric below to guide you in completion of this written assignment. The use of Headers in your paper is strongly encouraged. Submission Parameters: For this written assignment, please use the following guidelines and criteria. Also, please refer to the rubric for point allocation and assignment expectations. The expected length of the paper is approximately 6-8 pages, which does not include the cover page and reference page(s). Introduction (including purpose statement) Subjective Findings Synthesis Objective Findings Synthesis Plan of Care Apply one nursing theory in planning care for this patient Incorporate Healthy People 2020 Objectives into the plan of care prioritized to meet the health needs of the patient Document evidence to support clinical reasoning for selected evidence-based plan of care Plan of care is individualized to findings, life-span stage of development with culturally specific considerations, and patient-centered. Conclusion References (use primary and/or reliable electronic sources) In regards to APA format, please use the following as a guide: Include a cover page and running head (this is not part of the 6-8 pages limit) Include transitions in your paper (i.e. headings or subheadings) Use in-text references throughout the paper Use double space, 12 point Times New Roman font Apply appropriate spelling, grammar, and organization Include a reference list (this is not part of the 6-8 pages limit) Attempt to use primary sources only. That said, you may cite reliable electronic sources (i.e. NCSBN, AANP) The Final Project documentation is due in Week Seven. Please see the Final Project below to help you complete the assignment. Final Project Rubric – American Sentinel N522PE Special Topics – Life-Span Assessments, Ethics & Legal Issues Final Project Competency 20 18 16 0 Earned/ Possible Points The history, assessment and key findings are synthesized Documentation clearly shows student has completed a comprehensive assessment with a written synthesis of key findings. Documentation supports the student has completed the comprehensive assessment with key findings. American Sentinel N522PE Special Topics – Life-Span Assessments, Ethics & Legal Issues Final Project Documentation supports the student has completed the assessment without documentation of key findings. Documentation supports the student attempted to complete the comprehensive assessment without identification of key findings. The comprehensive health history is briefly documented and lacks depth and specificity. /20 20 18 16 0 Documented Prioritized Physical Examination Findings Documentation clearly shows student has completed the physical examination with findings prioritized. Documentation supports the student has completed the physical examination with findings. Documentation supports student completed some of the physical examination. Documentation is accurate but lacks depth. No evidence that the student is applying read concepts of advanced focused physical assessment. Documentation lacks depth and may lack coherence for understandability. /20 20 18 16 0 Documented Evidence to Support Clinical Reasoning with External Course Resources Discourse clearly shows the student has studied the topic and has given thought in developing the final plan of care with one nursing theory applied and integration of Healthy People 2020. Discourse supports the student has studied the topic and has given thought in developing the final plan of care. Lacks integration of either one applied nursing theory or integration of Healthy People 2020. Discourse supports student studied some of the topic, however, lacks detail and depth in developing the final plan of care. Lacks integration of either one applied nursing theory or integration of Healthy People 2020. No evidence that that student has read or studied the topic. Discourse lacks depth. May be presented in a rambling manner. Content is inaccurate &/or is unclear. No use of one applied nursing theory or integration of Healthy People 2020. /20 20 18 16 0 Individualized and Prioritized Plan of Care is Based Upon Clinical Findings Accurately presents an individualized plan of care based upon clinical findings. Presents an individualized plan of care based upon clinical findings. Some minor omissions are noted. Presents a plan of care that is not individualized based upon the clinical findings. A plan of care is not presented or the plan of care presented lacks demonstration of competency or is irrelevant to the clinical findings. /20 5 4 3 0 Developmentally and Culturally Specific Accurately documents a development-ally and culturally specific assessment and plan of care for the selected patient. Documents a development-ally and culturally specific assessment and plan of care. Presents a development-ally and culturally specific assessment or plan of care and one or both are not based upon the selected patient. A development-ally and culturally specific assessment and plan of care are not presented or based upon the selected patient’s findings. /5 5 4 3 0 Demonstration of Compliance with Ethical and Legal Standards of Professional Nursing Practice Compliance with the ethical and legal standards of professional nursing practice is explicitly stated in the documentation of the comprehensive physical assessment. Compliance with the ethical and legal standards of professional nursing practice is stated in the documentation. Compliance with the ethical and legal standards of professional nursing practice is briefly implied in the documentation of the comprehensive physical assessment or inaccuracies are evidenced in the written assessment. Compliance with the ethical and legal standards of professional nursing practice is not included in the documentation of the physical assessment. /5 10 9 8 0 Grammar, Spelling, and Punctuation APA Format APA Format, grammar, punctuation and spelling is accurate with errors. APA Format, grammar, punctuation and spelling is accurate with less than two types of errors. APA Format, grammar, punctuation and spelling is accurate with five or fewer types of errors. APA Format, grammar, punctuation and spelling is accurate with more than five types of errors. American Sentinel N522PE Special Topics – Life-Span Assessments, Ethics & Legal Issues Final Project /10 COMMENTS: TOTAL: /100 Competency 20 18 16 0 Earned/ Possible Points The history, assessment and key findings are synthesized Documentation clearly shows student has completed a comprehensive assessment with a written synthesis of key findings. Documentation supports the student has completed the comprehensive assessment with key findings. Documentation supports the student has completed the assessment without documentation of key findings. Documentation supports the student attempted to complete the comprehensive assessment without identification of key findings. The comprehensive health history is briefly documented and lacks depth and specificity. American Sentinel N522PE Special Topics – Life-Span Assessments, Ethics & Legal Issues Final Project /20 20 18 16 0 Documented Prioritized Physical Examination Findings Documentation clearly shows student has completed the physical examination with findings prioritized. Documentation supports the student has completed the physical examination with findings. Documentation supports student completed some of the physical examination. Documentation is accurate but lacks depth. No evidence that the student is applying read concepts of advanced focused physical assessment. Documentation lacks depth and may lack coherence for understandability. /20 20 18 16 0 Documented Evidence to Support Clinical Reasoning with External Course Resources Discourse clearly shows the student has studied the topic and has given thought in developing the final plan of care with one nursing theory applied and integration of Healthy People 2020. Discourse supports the student has studied the topic and has given thought in developing the final plan of care. Lacks integration of either one applied nursing theory or integration of Healthy People 2020. Discourse supports student studied some of the topic, however, lacks detail and depth in developing the final plan of care. Lacks integration of either one applied nursing theory or integration of Healthy People 2020. No evidence that that student has read or studied the topic. Discourse lacks depth. May be presented in a rambling manner. Content is inaccurate &/or is unclear. No use of one applied nursing theory or integration of Healthy People 2020. American Sentinel N522PE Special Topics – Life-Span Assessments, Ethics & Legal Issues Final Project /20 20 18 16 0 Individualized and Prioritized Plan of Care is Based Upon Clinical Findings Accurately presents an individualized plan of care based upon clinical findings. Presents an individualized plan of care based upon clinical findings. Some minor omissions are noted. Presents a plan of care that is not individualized based upon the clinical findings. A plan of care is not presented or the plan of care presented lacks demonstration of competency or is irrelevant to the clinical findings. /20 5 4 3 0 Developmentally and Culturally Specific Accurately documents a development-ally and culturally specific assessment and plan of care for the selected patient. Documents a development-ally and culturally specific assessment and plan of care. Presents a development-ally and culturally specific assessment or plan of care and one or both are not based upon the selected patient. A development-ally and culturally specific assessment and plan of care are not presented or based upon the selected patient’s findings. /5 5 4 3 0 Demonstration of Compliance with Ethical and Legal Standards of Professional Nursing Practice Compliance with the ethical and legal standards of professional nursing practice is explicitly stated in the documentation of the comprehensive physical assessment. Compliance with the ethical and legal standards of professional nursing practice is stated in the documentation. Compliance with the ethical and legal standards of professional nursing practice is briefly implied in the documentation of the comprehensive physical assessment or inaccuracies are evidenced in the written assessment. Compliance with the ethical and legal standards of professional nursing practice is not included in the documentation of the physical assessment. /5 10 9 8 0 Grammar, Spelling, and Punctuation APA Format APA Format, grammar, punctuation and spelling is accurate with errors. APA Format, grammar, punctuation and spelling is accurate with less than two types of errors. APA Format, grammar, punctuation and spelling is accurate with five or fewer types of errors. APA Format, grammar, punctuation and spelling is accurate with more than five types of errors. /10 COMMENTS: TOTAL: /100 American Sentinel N522PE Special Topics – Life-Span Assessments, Ethics & Legal Issues Final Project Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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