Based      on the laws in your state, would the      client be eligible for involuntary commitment? Explain why or why not.

/in /by

PMHNPs may find themselves working in a wide variety of settings—each having their own unique challenges and inherent legal issues. For instance, what do you do in your state of practice when you are providing a therapy/treatment session and a client reports active suicidal ideation? What do you do if you are covering inpatient psychiatric consults and are called to see a patient in the ICU who overdosed on prescription medication requiring intubation? What do you do if you are a PMHNP on an inpatient unit and a client who admitted themselves on a voluntary basis suddenly states that they have decided to sign themselves out of the hospital so that they can go home to kill themselves? These are just some of the legal questions that PMHNPs must know the answers to specific to their state of licensure/practice.

In this Assignment, you investigate your state’s laws concerning voluntary and involuntary commitment. You also analyze a case to determine if the client is eligible for involuntary commitment.

Scenario for Week 7 Case:

You are a PMHNP working in a large intercity hospital. You receive a call from the answering service informing you that a “stat” consult has been ordered by one of the hospitalists in the ICU. Upon arriving in the ICU, you learn that your consult is a 14 year old male who overdosed on approximately 50 Benadryl (diphenhydramine hydrochloride) tablets in an apparent suicide attempt. At the scene, a suicide note was found indicating that he wanted to die because his girlfriend’s parents felt that their daughter was too young to be “dating.” The client stated in the suicide note that he could not “live without her” and decided to take his own life. Although he has been medically stabilized and admitted to the ICU, he has been refusing to talk with the doctors or nurses. The hospital staff was finally able to get in touch with the clients parents (using contact information retrieved from the 14 year old’s cell phone). Unbeknown to the hospital staff, the parents are divorced, and both showed up at the hospital at approximately the same time, each offering their own perspectives on what ought to be done. The client’s father is demanding that the client be hospitalized because of the suicide, but his mother points out that he does not have “physical custody” of the child. The client’s mother demands that the client be discharged to home with her stating that her son’s actions were nothing more than a “stunt” and “an attempt at manipulating the situation that he didn’t like.” The client’s mother then becomes “nasty” and informs you that she works as a member of the clerical staff for the state board of nursing, and if you fail to discharge her child “right now” she will make you “sorry.” How would you proceed?

Learning Objectives

Students will:

  • Evaluate      clients for voluntary commitment
  • Evaluate      clients for involuntary commitment based on state laws
  • Recommend      actions for supporting parents of clients not eligible for involuntary      commitment
  • Recommend      actions for treating clients not eligible for involuntary commitment

To Prepare for this Practicum:

  • Review      the Learning Resources concerning voluntary and involuntary commitment.
  • Read      the Week 7 Scenario in your Learning      Resources.
  • Research      your state’s laws concerning      voluntary and involuntary commitment.

The Assignment (2–3 pages):

  • Based      on the scenario, would you recommend      that the client be voluntarily committed? Why or why not?
  • Based      on the laws in your state, would the      client be eligible for involuntary commitment? Explain why or why not.
  • Did      understanding the state laws confirm or challenge your initial recommendation regarding involuntarily committing      the client? Explain.
  • If the      client were not eligible for involuntary commitment, explain what actions you may be able to take to support the      parents for or against voluntary commitment.
  • If the      client were not eligible for involuntary commitment, explain what initial actions you may be able to take to begin treating the client.

Describe plan for data analysis of study variables (descriptive and inferential statistical tests).

/in /by

The final project for NSG6101 consists of the development of a novel research proposal specific to your role specialization. The project must include an intervention appropriate to nursing practice and consistent with your MSN role option. An alternative to the above includes the selection of a specialty organization to focus research proposals based on the priorities of that organization. Examples of these organizations could include (but are not limited to): Sigma Theta Tau International, American Nurses’ Foundation, Oncology Nursing Society, Association of Nurses in AIDS Care, American Psychiatric Nursing Association, American Association of Critical Care Nurses, National Association of Pediatric Nurse Associates and Practitioners, National League For Nursing, etc.

Throughout this course you have been developing various sections of the research proposal. This week you will assemble the final proposal (addressing faculty feedback). This paper is to be developed in APA format/style using the required template and not to exceed 8-10 pages (excluding title page/references/appendices).

Criteria:
Introduction

  • Background and Significance of Problem
  • Statement of the Problem and Purpose of the Study

Literature Review

  • Summary of the Evidence for the Proposed Study

Research Question, Hypothesis, and Variables with Operational Definitions

Theoretical Framework

  • Overview and Guiding Propositions(s) Described in Theory
  • Application of Theory to Your Study’s/Project’s Focus

Methodology

  • Sample/Setting: Number and criteria for inclusion and description of place in which data will be collected.
  • Sampling Strategy
  • Research Design: Type (e.g., Quasi-Experimental), description, and rationale for selection. 
  • Extraneous Variables (and plan for how controlled).
  • Instruments: Description, validity, and reliability estimates, which have been performed (on a pre-established measure). Include plans for testing validity and reliability of generating your own instrument(s).
  • Description of the Intervention
  • Data Collection Procedures
  • Data Analysis Plans
    • Describe plan for data analysis for demographic variables (descriptive statistical tests).
    • Describe plan for data analysis of study variables (descriptive and inferential statistical tests).

Ethical Issues

  • Describe ethical considerations and your plan to protect human rights.

Limitation of Proposed Study
Implications for Practice
References
Appendices

  • Informed Consent Letter
    • Procedure section is clear, described in detail, specific, and all inclusive. Written in lay language (as documented by reading level score). Includes risks and benefits relevant to study. Address assent (if applicable).

What strategies would you use to inform stakeholders and persuade them of the importance of your identified clinical practice issue?

/in /by

A key aspect of the policy process is agenda setting. How do topics get on that agenda? Agenda setting requires the support of stakeholders to move the issue forward. In this week’s media presentation, Dr. Kathleen White outlines the policy process and discusses how to move issues into the policy arena through agenda setting. The ultimate goal is to gain the attention of leadership whether at the organizational, local, state, national, or international level.

To prepare:

  • Review      this week’s media presentation, focusing on the insights shared by Dr.      White and Dr. Stanley on agenda setting and identification of      stakeholders.
  • Brainstorm      clinical practice issues that you believe are worthy of being on your      organization’s systematic agenda.
  • Who      are the stakeholders who would be interested in this clinical practice      issue?

By tomorrow 03/14/2018 3pm, write a minimum of 550 words in APA format with at least 3 scholarly references from the list of required readings below. Include the level one headings as numbered below”

Post a cohesive response that addresses the following:

1) In the first line of your posting, identify the clinical practice issue you would like to see on your organization’s systematic agenda.

2) What strategies would you use to inform stakeholders and persuade them of the importance of your identified clinical practice issue?

Required Readings

Hyder, A., Syed, S., Puvanachandra, P., Bloom, G., Sundaram, S., Mahmood, S., … Peters, D. (2010). Stakeholder analysis for health research: case studies from low- and middle-income countries. Public Health, 124(3), 159–166.

This study demonstrates how the engagement of stakeholders in research and policy making can assist in the successful implementation of policy proposals. The authors propose that by engaging stakeholders, researchers and policy makers are provided with multiple perspectives on proposed policies, which can lead to greater success with policy adoption and implementation.

Lavis, J. N., Permanand, G., Oxman, A. D., Lewin, S., & Fretheim, A. (2009). SUPPORT Tools for evidence-informed health Policymaking (STP) 13: Preparing and using policy briefs to support evidence-informed policymaking. Health Research Policy & Systems, 71–79. doi: 10.1186/1478-4505-7-S1-S13

The purpose of a policy brief is to communicate an issue clearly and definitively to policy makers. The authors of this article propose an outline for policy briefs and also stress the importance of using research when creating a policy brief.

Lowery, B. (2009). Obesity, bariatric nursing, and the policy process: The connecting points for patient advocacy. Bariatric Nursing & Surgical Patient Care, 4(2), 133–138.

This article provides an example of nurse involvement in policy making by examining a bariatric nursing issue. The author stresses that nurses, in their patient-advocacy role, have a responsibility to be involved in the health care policy process.

Moore, K. (2006). How can basic research on children and families be useful for the policy process? Merrill-Palmer Quarterly, 52(2), 365–375.

Institute of Medicine. (2010). The future of nursing: Leading change, advancing health: Report recommendations. Retrieved from http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2010/The-Future-of-Nursing/Future%20of%20Nursing%202010%20Recommendations.pdf

Introduced in Week 2, this IOM report highlights four key recommendations in its proposal for the future directions of the nursing profession. These recommendations focus on nursing practice, education and training, partnerships with other healthcare professionals, and workforce planning and policymaking.

National Center for Policy Analysis (2010). Ideas changing the world: Free-market health care policy. Retrieved from http://www.ncpa.org/healthcare/

The NCPA is a nonprofit, nonpartisan organization that promotes private sector solutions to public policy issues.

Slack, B. (2011). The policy process. Retrieved from http://people.hofstra.edu/geotrans/eng/methods/ch9c2en.html 

The author presents a policy-making framework and provides details on the four steps of that process: problem definition, policy objectives and options, policy implementation, and policy evaluation and maintenance.

Required Media

Laureate Education, Inc. (Executive Producer). (2011). Healthcare policy and advocacy: Agenda setting and the policy process. Baltimore: Author. 

Note: The approximate length of this media piece is 17 minutes.

Dr. Kathleen White and Dr. Joan Stanley share their insights into agenda setting and how issues are moved forward into the policy process.

Optional Resources

Barnes, M., Hanson, C., Novilla, L., Meacham, A., McIntyre, E., & Erickson, B. (2008). Analysis of media agenda setting during and after Hurricane Katrina: Implications for emergency preparedness, disaster response, and disaster policy. American Journal of Public Health, 98(4), 604–610.

Jennings, C. (2002). The power of the policy brief. Policy, Politics & Nursing Practice, 3(3), 261–263. doi: 10.1177/152715440200300310

Neumann, P. J., Palmer, J. A., Daniels, N., Quigley, K., Gold, M. R., & Chao, S. (2008). A strategic plan for integrating cost-effectiveness analysis into the US health care system. American Journal of Managed Care, 14(4), 185-188.

Plan, Policy, Procedure Relationship Diagram. (n.d.). Retrieved from http://www.informationsecurityintel.com/docs/Fig.%204.3.pdf

Read the the case study “Economic Impact of States Declining Medicaid Expansion”  page 305 of the Milstead text.

/in /by

With coinciding concerns about health care costs and the imperative to improve quality of care, health care providers and others face difficult decisions in the effort to achieve an appropriate balance. Such decisions often are addressed in the policy arena. How do policymakers evaluate which health care services should be financed through government programs? How do ethics-related questions and other considerations play into this evaluation process? Is it possible to contain costs and provide accessible, high-quality care to all, or is the tension between cost and care inherent in the U.S. health care delivery system? These questions are central to health care financing decisions in the United States.

For this Discussion, you will focus on the policy decision-making process that determines what types of care are covered by public and private insurers and the ethical aspects of such financial decisions.

To prepare:

  • Read the the case study “Economic Impact of States Declining Medicaid Expansion”  page 305 of the Milstead text.
  • Review the information in the Washington Post article “Review of Prostate Cancer Drugs Provenge Renews Medical Cost-Benefit Debate” in the Learning Resources.
  • Consider how policy decisions currently are made about what will and will not be paid for and what changes, if any, could improve the process.
  • Reflect on how the Washington Post example illustrates the tension between cost and care.

Post your analysis and assessment of the ethical and economic challenges related to policy decisions such as those presented in the Washington Post article. How does this type of situation contribute to the tension between cost and care? Substantiate your response with at least two outside resources.

Washington Post article:

http://www.washingtonpost.com/wp-dyn/content/article/2010/11/07/AR2010110705205.html