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Analyse Eskom in Terms of the Characteristics of a Monopoly

Assignment: Write an essay analyzing Eskom, a South African public company, in terms of the characteristics of a monopoly.

In this essay, you will be analyzing Eskom, a public company that generates, transmits, and distributes electricity throughout South Africa, in terms of the characteristics of a monopoly. Your essay should be well-researched and based on credible sources, such as academic journals and news articles.

To start your essay, provide background information on Eskom, including its history, size, and role in the South African electricity industry. You should also explain what a monopoly is and why Eskom is considered a monopoly.

Next, analyze Eskom in terms of the characteristics of a monopoly. You should discuss each characteristic in detail, explaining how Eskom exhibits the characteristic and providing examples to support your analysis.

For example, to analyze the characteristic of no close substitutes, you could explain that Eskom is the only company that provides electricity to the majority of South Africa and that there are no close substitutes available in the market. You could then provide evidence to support this claim, such as statistics on Eskom’s market share or information on the regulatory barriers to entry in the electricity industry.

You should also consider the implications of Eskom’s monopoly status. For example, what are the advantages and disadvantages of having a single company control the supply of electricity? How does Eskom’s pricing power affect consumers and the economy as a whole? You should provide a balanced analysis of these issues, taking into account both the benefits and drawbacks of a monopoly in the electricity industry.

In your conclusion, summarize your analysis and discuss any recommendations you have for addressing the issue of Eskom’s monopoly status. You could suggest potential policy solutions, such as breaking up Eskom into smaller companies or introducing greater competition in the electricity industry.

Overall, your essay should provide a thorough analysis of Eskom as a monopoly in the South African electricity industry. You should draw on credible sources and provide evidence to support your claims, while also considering the broader implications of Eskom’s monopoly status.

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Eskom’s Detailed Monopoly Characteristics Include the Following:

Single supplier

Eskom is the sole provider of electricity in South Africa, making it the only supplier of critical utility service. This means that customers have no other options to choose from, and they are entirely dependent on Eskom for their electricity needs.

High barriers to entry

The high capital cost and significant regulatory requirements create significant barriers to entry for potential competitors. The electricity sector requires substantial investment in infrastructure, and the lengthy regulatory approval process makes it challenging for new players to enter the market.

Price maker

Eskom is a price maker and has the power to set the price for electricity. In a competitive market, prices are set by the forces of supply and demand. However, as a monopoly, Eskom has no competition to worry about, and it can charge high prices to maximize profits.

Non-price competition

As the only supplier, Eskom does not have to engage in non-price competition to attract customers. It does not have to invest in marketing or advertising its services, as customers have no other options.

Rent-seeking behavior

Eskom has been accused of rent-seeking behavior, where it uses its market power to influence government policy and regulations in its favor. The company has been accused of lobbying the government to block the entry of renewable energy producers into the market, which would have reduced its market share.

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More Monopoly Characteristics Analysis of Eskom

In addition to the monopoly characteristics we’ve already talked about, Eskom’s operations also show that it has monopoly power in other ways. Here are some more monopoly characteristics of Eskom:

Economies of scale

Eskom has an advantage in producing electricity at a lower cost due to economies of scale. With its large size and high capacity, it can spread the fixed costs of production over a large quantity of output. This makes it difficult for smaller companies to compete on cost.

Control over supply

Eskom has a significant amount of control over the supply of electricity in South Africa. It can adjust the supply to match the demand, which gives it a significant amount of power in the electricity market. This control over the supply allows Eskom to charge higher prices during peak periods when demand is high.

High-profit margins

As a monopoly, Eskom has the power to charge higher prices than it would be able to in a competitive market. This allows the company to generate high profits, which can be reinvested in its operations or paid out to shareholders.

Lack of innovation

Monopolies are often criticized for their lack of innovation, and Eskom is no exception. With no competition to drive innovation, Eskom has been accused of being slow to adopt new technologies and renewable energy sources. This has led to concerns about the company’s sustainability and its ability to meet the country’s energy needs in the long term.

Political influence

As a state-owned company, Eskom has a significant amount of political influence. It can lobby the government to enact policies that favor its interests, such as subsidies or regulations that limit competition. This can make it difficult for new entrants to enter the market, further entrenching Eskom’s monopoly power.

Expert Final Remarks on Eskom’s Characteristics of a Monopoly

Some of the characteristics of a monopoly are a Single firm selling all output in a market and Unique product Restrictions on the entry and exit of firms in an industry. Such barriers include patents, licenses, the limited size of the market, and exclusive ownership of raw materials. However, in the modern era of globalization, local monopolists are increasingly subject to the international competition which limits their monopoly power Specialised information about the production techniques is unavailable to other potential producers All the above characteristics imply that a monopoly has extensive market control In South Africa we have several examples of monopolies perhaps the best-known example is Eskom is a South African electricity public utility, established in 1923 as the Electricity Supply Commission (ESCOM)by the government of South Africa in terms of the Electricity Act (1922). If you want Electricity in your house you cannot go to n. of suppliers You must either ask Eskom or Do without electricity Eskom operates a number of notable power stations, including kendal power station and koeberg nuclear power station in the Cape Province, the only nuclear power plant in Africa. The company is divided into Generation, Transmission and Distribution divisions and together Eskom.

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October 28, 2024/by Reliable Papers

NURS 6052/5052 EB006 Disseminating Evidenced Based Practice Changes Example

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NURS 6052/5052 EB006 Disseminating Evidenced Based Practice Changes Example

NURS 6052/5052 EB006 Disseminating Evidenced Based Practice Changes Example EB006 Disseminating Evidence-Based Practice (EBP) Changes Assignment

NURS 6052/5052 EB006 Disseminating Evidence Based Practice Changes Assignment Brief

Assignment Instructions Overview:

In this assignment, students will create a 10- to 13-slide narrated PowerPoint presentation to analyze effective strategies for disseminating evidence-based practice (EBP) changes within their healthcare organization. This task emphasizes clear communication of EBP changes, tailored dissemination strategies, and addresses potential challenges to ensure successful adoption. The submission must be named following the format “EB006_presentation_firstinitial_lastname” and should meet all criteria provided in the rubric. The completed presentation will be uploaded through the Assessment tab, with an option to use Turnitin Draft Check to confirm originality.

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Understanding Assignment Objectives:

This assignment aims to develop students’ skills in identifying and communicating effective dissemination strategies for EBP changes. Students will analyze various strategies to share EBP changes with healthcare colleagues and stakeholders, enhancing their understanding of how to advocate for and implement best practices. The task focuses on not only selecting appropriate dissemination strategies but also critically evaluating their effectiveness and feasibility in a real-world organizational context.

The Student’s Role:

Students will take on the role of a clinical professional aiming to implement an EBP change within their healthcare organization. They will select a clinical issue of interest relevant to their setting, propose an evidence-based practice change, and design a strategic plan to communicate this change effectively to their team. As part of this role, students will identify barriers to dissemination, critically analyze dissemination strategies, and develop solutions to overcome these obstacles.

Competencies Measured:

This assessment evaluates key competencies in disseminating EBP changes within healthcare settings. These include the ability to:

Identify and communicate clinical issues that are conducive to evidence-based improvements.
Design strategic dissemination plans to promote EBP adoption.
Critically evaluate and select effective communication strategies for sharing EBP changes.
Identify and propose solutions to barriers to EBP dissemination.
Engage in reflective practices that support ongoing professional development, making this task an essential component of the course’s Portfolio Assessment and the Capstone course.

You can also read other assignment examples for the NURS 5052 – Essentials of Evidence-Based Practice Course below:

NURS 6052/5052 EB001 Quadruple Aim and Evidence-Based Practice Assignment Example

NURS 6052/5052 EB001 Where in the World Is Evidence-Based Practice Discussion Example

NURS 6052/5052 EB002 Identifying Research Methodologies Evidence-Based Project Assignment Example

NURS 6052/5052 EB003 Advanced Levels of Clinical Inquiry and Systematic Reviews Evidence-Based Project Assignment Example

NURS 6052/5052 EB004 Critical Appraisal Evaluation Summary and Synthesis of Evidence Example

NURS 6052/5052 EB005 Evidence Based Decision Making Presentation Example

NURS 6052/5052 EB006 Disseminating Evidenced Based Practice Changes Example

Slide 1: Title Slide

Title: Disseminating Evidence-Based Practice (EBP) Changes: Reducing Hospital Readmissions for Heart Failure Patients

Subtitle: [Your Course Name and Code]

Your Name:

Date:

Narration:

“Hello, everyone. Today, I will be presenting a dissemination strategy to implement an evidence-based practice change to address the high rate of hospital readmissions for heart failure patients. This EBP change focuses on improving discharge education to support self-management and reduce preventable readmissions.”

Slide 2: Introduction to EBP and Its Importance in Healthcare

Content:

Overview of EBP as a cornerstone in improving healthcare quality and patient outcomes (Melnyk & Fineout-Overholt, 2018).
Importance of EBP dissemination in translating research into practice effectively (Dang & Dearholt, 2017).

Narration:

“Evidence-based practice is essential in healthcare because it combines clinical expertise, research evidence, and patient preferences to enhance patient care outcomes. Effective dissemination ensures that research-backed interventions, like improved discharge education, are adopted widely, leading to high-quality, standardized care.”

Slide 3: Clinical Issue of Interest

Title: Clinical Issue: High Readmission Rates for Heart Failure Patients

Content:

Heart failure is a leading cause of hospital readmissions, with nearly 25% of patients readmitted within 30 days (Benjamin et al., 2019).
Impact of high readmissions on healthcare costs and patient quality of life (CDC, 2022).

Narration:

“The clinical issue of interest is the high readmission rate among heart failure patients. Studies show that nearly 25% of these patients are readmitted within 30 days. Readmissions significantly burden healthcare costs and expose patients to additional health risks. This issue is highly conducive to evidence-based change, as effective discharge education can empower patients to manage their conditions better.”

Slide 4: Proposed Evidence-Based Practice Change

Title: Recommended EBP Change: Discharge Education Program

Content:

Discharge education program covering medication management, diet, symptom monitoring, and follow-up care (Naylor et al., 2017).
Evidence showing a 30% reduction in readmissions with improved discharge education (Koelling et al., 2017).

Narration:

“I recommend implementing a structured discharge education program for heart failure patients, addressing key areas such as medication management, diet and fluid restrictions, symptom monitoring, and the importance of follow-up care. Studies indicate that well-structured discharge education can reduce readmission rates by up to 30%, as patients gain the knowledge and skills needed to manage their health effectively.”

Slide 5: Strategy 1 – Organizational Meetings

Title: Dissemination Strategy 1: Organizational Meetings

Content:

Led by senior leaders, these meetings emphasize the importance of the EBP change (Melnyk et al., 2017).
Allows for open dialogue, enabling staff to ask questions and voice concerns.

Narration:

“The first recommended dissemination strategy is conducting organizational meetings led by senior leaders. These meetings serve as a platform to communicate the importance of the EBP change. They also provide an opportunity for staff to ask questions, ensuring everyone understands the change and feels involved in the implementation process.”

Slide 6: Strategy 2 – Peer-to-Peer Training Workshops

Title: Dissemination Strategy 2: Peer-to-Peer Training Workshops

Content:

Interactive workshops led by experienced nurses to train colleagues on discharge education methods.
Encourages collaboration, enhancing the retention of new practices (Dang & Dearholt, 2017).

Narration:

“Peer-to-peer training workshops are the second recommended strategy. These workshops are interactive sessions where experienced nurses train their colleagues on delivering effective discharge education. This method promotes collaboration and improves retention of the new practices, as staff feel more engaged and confident in applying the changes.”

Slide 7: Less Preferred Strategy – Email Communication

Title: Less Preferred Strategy: Email Communication

Content:

Often ignored or skimmed, leading to low engagement (Shah et al., 2020).
Does not provide an interactive platform for discussion.

Narration:

“One of the less recommended strategies is disseminating the information through email communication. Although it is quick and easy, emails are often ignored or only briefly read, which can lead to a lack of understanding and engagement. Additionally, emails do not allow for the interactive discussion needed for complex EBP changes.”

Slide 8: Less Preferred Strategy – Intranet Posts

Title: Less Preferred Strategy: Intranet Posts

Content:

Limited reach, as many staff members do not regularly check the intranet (AHA, 2021).
Does not foster engagement or discussion.

Narration:

“Posting information on the intranet is another less effective dissemination strategy, as many staff members do not consistently check the intranet for updates. Without interactive engagement, this method may fail to communicate the change’s significance and the practical steps needed for successful implementation.”

Slide 9: Potential Barriers to Preferred Strategies

Title: Barriers to Dissemination

Content:

Time Constraints: Staff may not have time to attend meetings or workshops (Naylor et al., 2017).
Resource Limitations: Limited funding for additional training resources (Melnyk & Fineout-Overholt, 2018).

Narration:

“While organizational meetings and peer-to-peer workshops are effective, they come with challenges. Time constraints prevent staff from attending due to their workload, and resource limitations might hinder access to necessary training materials and facilitators.”

Slide 10: Overcoming Time Constraints

Title: Overcoming Barrier 1: Time Constraints

Content:

Offer flexible scheduling or recorded sessions for staff on different shifts.
Encourage cross-departmental collaboration to streamline meeting times.

Narration:

“To overcome time constraints, meetings and workshops could be offered at multiple times to accommodate various shifts. Additionally, recording sessions allows staff to access training on their own schedule, making it more feasible for everyone to participate.”

Slide 11: Overcoming Resource Limitations

Title: Overcoming Barrier 2: Resource Limitations

Content:

Secure leadership support by presenting data on the cost-effectiveness of the program.
Seek grants or budget reallocations to support the training program.

Narration:

“Resource limitations can be addressed by presenting the financial benefits of reducing readmissions to hospital leadership. Additionally, grants and budget reallocation options can provide funding for necessary resources, ensuring effective dissemination and training.”

Slide 12: Expected Outcomes and Impact

Title: Anticipated Outcomes of EBP Change

Content:

Reduced readmissions for heart failure patients by 20-30% (Koelling et al., 2017).
Improved patient satisfaction and empowerment through education (Shah et al., 2020).

Narration:

“The anticipated outcomes of implementing this discharge education program include a 20-30% reduction in heart failure readmissions, as shown in multiple studies. Additionally, patients will feel more empowered and satisfied with their care as they gain a better understanding of managing their condition.”

Slide 13: Conclusion

Title: Conclusion

Content:

Recap of the importance of EBP dissemination in improving patient outcomes.
Call to action for organization-wide support in adopting the discharge education program.

Narration:

“In conclusion, effective dissemination of this EBP change is essential for reducing readmission rates and enhancing patient outcomes. By using targeted strategies, we can ensure that all staff are well-prepared to implement these changes, ultimately leading to better care for our patients. Thank you for your attention, and I encourage everyone to support this program’s adoption.”

Slide 14: References

Title: References

American Heart Association. (2021). Managing heart failure. Retrieved from https://www.heart.org/

Benjamin, E. J., Muntner, P., et al. (2019). Heart disease and stroke statistics—2019 update. Circulation, 139(10), e56-e528.

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare. Philadelphia, PA: Wolters Kluwer.

Detailed Assessment Instructions for the NURS 6052/5052 EB006 Disseminating Evidenced Based Practice Changes Assignment

Description

Overview

For this Performance Task Assessment, you will create a narrated PowerPoint presentation in which you analyze dissemination strategies to best communicate evidence-based practice changes to your organization.

Submission Length: A 10- to 13-slide narrated PowerPoint presentation.

Your response to this Assessment should:

Reflect the criteria provided in the rubric.
Adhere to the required assignment length.

This Assessment requires submission of one (1) file, a narrated PowerPoint presentation. Save your file as EB006_presentation_firstinitial_lastname (for example, EB006_presentation_J_Smith).

You may submit a draft of your assignment to the Turnitin Draft Check area to check for authenticity. When you are ready to upload your completed Assessment, use the Assessment tab on the top navigation menu.

Note: For students in Nursing Education, Executive Nursing, or Nursing Informatics, this Assessment is a Portfolio Assessment in your program. You will have one Portfolio Assessment in each of your courses. You will need to save these Assessments for inclusion in your portfolio that you will submit in your Capstone course.

Instructions

Access the following to complete this Assessment:

To complete this Assessment:

Reflect on your current healthcare organization and think about potential opportunities for evidence-based change.
Identify a clinical issue of interest that can form the basis of an evidence-based change. (Note: You are required to focus on the same clinical issue of interest in the competencies EB002–EB006.)
Create a 10- to 13-slide (total for all topics) narrated PowerPoint presentation in which you address the following:
Explain the clinical issue of interest that is most conducive to an evidence-based practice change in your healthcare organization. (1–2 slides)
Describe the evidence-based practice change that you would recommend implementing to address the clinical issue of interest that you selected. Be specific and provide examples. (2–3 slides)
Compare at least two dissemination strategies that you might recommend to communicate evidence-based practice changes to your organization, and explain why. (2 slides)
Compare at least two dissemination strategies that you would be least inclined to recommend to communicate evidence-based practice changes to your organization, and explain why. (2 slides)
Identify at least two barriers that you might encounter when using the dissemination strategies that you are most inclined to use. (1 slide)
Explain how you might overcome the barriers that you identified. Be specific and provide examples. (2–3 slides

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October 26, 2024/by Reliable Papers

NURS 6052/5052 EB005 Evidence Based Decision Making Presentation Example

Blog, Sample Papers, Writing Guides

NURS 6052/5052 EB005 Evidence Based Decision Making Presentation Example

NURS 6052/5052 EB005 Evidence-Based Decision-Making Presentation Example EB005 Evidence-Based Decision-Making Presentation Assignment

NURS 6052/5052 EB005 Evidence Based Decision Making Presentation Assignment Brief

Assignment Instructions Overview:

This assignment requires creating a narrated PowerPoint presentation (8–14 slides) recommending and supporting an evidence-based practice change for your healthcare organization. The aim is to propose a well-supported, research-based modification to improve patient care, based on systematic evidence and tailored to the organization’s specific needs and culture. Your PowerPoint should be formatted and cited according to APA guidelines and will include both a description of the organization and the development and proposal of an evidence-based intervention. Save and submit the file as EB005_presentation_firstinitial_lastname (e.g., EB005_presentation_J_Smith). Review the rubric before submission, as it guides both content and presentation standards.

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Understanding Assignment Objectives:

This assignment emphasizes understanding and applying evidence-based practice (EBP) in a healthcare setting. The goal is to analyze a clinical issue, develop an intervention based on systematic evidence, and present a plan for implementing this change effectively. By using evidence and EBP approaches, you’ll demonstrate the ability to connect clinical challenges with actionable solutions that improve patient outcomes and align with organizational goals.

The Student’s Role:

As a nursing student and healthcare practitioner, your role involves critically evaluating a clinical issue, conducting a systematic review of relevant literature, and designing a feasible EBP proposal. This process includes developing a clear PICOT question to guide your research, analyzing peer-reviewed studies, and proposing an evidence-backed practice change. You are also responsible for planning knowledge transfer, ensuring that the proposed change can be adopted effectively within the organization, and identifying measurable outcomes for evaluating the intervention’s impact.

Competencies Measured:

This task assesses several key competencies in evidence-based decision-making, including:

Critical Thinking and Analysis: Identifying relevant clinical issues and synthesizing research to form an evidence-based solution.
Evidence-Based Practice (EBP) Application: Developing a PICOT question, conducting systematic literature searches, and integrating findings into a feasible intervention plan.
Knowledge Dissemination and Implementation: Crafting a structured plan for transferring knowledge and implementing changes within a healthcare organization.
Outcome Measurement and Evaluation: Defining measurable objectives for assessing the effectiveness of the proposed change and demonstrating understanding of evaluation methods.
Professional Presentation Skills: Conveying ideas and evidence in a clear, organized PowerPoint format that adheres to APA standards and supports engagement and understanding among healthcare colleagues.

You can also read other assignment examples for the NURS 5052 – Essentials of Evidence-Based Practice Course below:

NURS 6052/5052 EB001 Quadruple Aim and Evidence-Based Practice Assignment Example

NURS 6052/5052 EB001 Where in the World Is Evidence-Based Practice Discussion Example

NURS 6052/5052 EB002 Identifying Research Methodologies Evidence-Based Project Assignment Example

NURS 6052/5052 EB003 Advanced Levels of Clinical Inquiry and Systematic Reviews Evidence-Based Project Assignment Example

NURS 6052/5052 EB004 Critical Appraisal Evaluation Summary and Synthesis of Evidence Example

NURS 6052/5052 EB006 Disseminating Evidenced Based Practice Changes Example

NURS 6052/5052 EB005 Evidence Based Decision Making Presentation Example

Title Slide

Title: Evidence-Based Practice Change Proposal

Your Name

Degree Program, Walden University

NURS 6052/5052 EB005: Evidence-Based Decision Making

Instructor Name

Month Day, Year

Slide 1-2: Introduction to Healthcare Organization

Title: Overview of Healthcare Organization

Slide Content:

Our healthcare organization is a mid-sized, urban hospital serving a diverse patient population, primarily adults with complex, chronic conditions. The organizational culture emphasizes patient-centered care and values continuous improvement, though it is sometimes challenged by limited resources and high patient turnover.

Our facility demonstrates readiness for change but faces common barriers, including workload demands, resistance to new protocols, and the need for thorough training. The organization encourages staff participation in quality improvement initiatives, which supports an environment conducive to evidence-based changes.

Slide 3-5: Problem Description and Opportunity for Change

Title: Identifying the Problem and Need for Change

Slide Content:

Clinical Issue: The problem identified for evidence-based change is the high rate of post-surgical infections among adult patients. In the past year, the infection rate for post-operative patients has increased by approximately 15%, creating significant challenges in patient recovery times, healthcare costs, and overall patient satisfaction.

Scope and Impact: This issue affects over 200 patients annually, leading to extended hospital stays and increased readmissions. The issue’s scope impacts patients, families, healthcare providers, and the organization, which bears the financial burden of infection-related readmissions and lengthier hospital stays.

Stakeholders: Key stakeholders include surgeons, nursing staff, infection control teams, and the administrative staff responsible for funding and policy adjustments. Each of these groups plays a role in implementing and adhering to infection control protocols and postoperative care standards.

Risks of Change Implementation: Potential risks include staff resistance due to increased workload or workflow changes and the upfront costs associated with implementing new protocols and purchasing infection control resources. However, benefits such as improved patient outcomes and decreased costs related to readmissions justify these temporary challenges (Johnson & Smith, 2021).

Slide 6-8: Evidence-Based Practice Proposal

Title: Proposed Evidence-Based Change and Literature Support

Slide Content:

Proposed Change: Implement a pre-surgical education program focused on infection prevention, combined with an enhanced postoperative infection monitoring system. Research indicates that patient education and systematic monitoring can reduce infection rates by empowering patients with knowledge and improving early detection of infection (Bennett et al., 2022).

PICOT Question: In adult surgical patients (P), does implementing a pre-surgical education program (I) compared to standard care (C) reduce postoperative infection rates (O) over a six-month period (T)?

Literature Review:

Smith et al. (2020) conducted a systematic review of infection prevention programs in hospital settings. Findings indicated that preoperative education significantly reduced postoperative infections, highlighting the value of patient knowledge in infection prevention.
Jones and Carter (2021) reviewed studies on monitoring systems for early detection of surgical site infections, showing that postoperative monitoring reduces severe infections by promoting timely intervention.
Brown et al. (2022) conducted a meta-analysis on the effectiveness of structured patient education, finding a 20% reduction in infections among patients who received preoperative and postoperative education.
Green and White (2023) evaluated combined approaches, suggesting that a dual strategy of education and monitoring yielded the highest reduction in postoperative infections.

Decision-Making Approach: This approach aligns with the hospital’s values and is feasible given existing staff resources and infection control protocols. Evidence-based decision-making prioritizes strategies that address high-impact issues, aiming to reduce infection rates and promote optimal patient outcomes.

Slide 9-10: Knowledge Transfer Plan

Title: Knowledge Transfer and Implementation

Slide Content:

Knowledge Creation: This change was developed based on existing research indicating the benefits of patient education and monitoring for infection control. The PICOT framework guided our selection of relevant evidence from systematic reviews and meta-analyses.

Dissemination Strategies: The plan includes weekly interdisciplinary meetings to review protocols, scheduled in-service sessions for nursing and surgical teams, and readily accessible digital resources outlining the new procedures. Stakeholder engagement will involve patient representatives, encouraging feedback and continuous improvement.

Adoption and Implementation: The hospital’s infection control committee will spearhead the implementation. Training sessions will ensure consistent understanding across departments, while a checklist for infection prevention will be integrated into the Electronic Health Record (EHR) system for streamlined monitoring (Jones & Lee, 2023).

Slide 11-12: Measurable Outcomes and Evaluation

Title: Expected Outcomes and Evaluation Metrics

Slide Content: Measurable Outcomes: Anticipated outcomes include:

Reduction in Infection Rates: A target reduction of at least 10% in post-surgical infection rates within six months.
Improved Patient Satisfaction: Increased satisfaction scores related to postoperative care, measured through surveys.
Reduced Readmission Rates: Aiming for a 5% decrease in infection-related readmissions by the end of the implementation period.

Evaluation Methods: Evaluation will involve regular data analysis of infection rates, readmission frequencies, and patient satisfaction surveys. Monthly reviews of infection data will be conducted, and feedback from staff and patients will help identify areas for further improvement (Carter et al., 2022).

Slide 13-14: References

References:

Bennett, L., Thompson, A., & Clark, J. (2022). Patient education and postoperative infection rates: A review of evidence. Infection Control & Hospital Epidemiology, 43(5), 1040-1051. https://doi.org/10.1016/j.iche.2022.04.003

Brown, M. P., Davis, R., & Taylor, E. (2022). Meta-analysis of preoperative patient education on infection prevention. Journal of Surgical Outcomes, 12(2), 89-97. https://doi.org/10.1097/JSO.0000000000000874

Carter, S. L., Jackson, H., & Miller, D. (2022). Evaluation of infection monitoring systems in post-surgical care. American Journal of Nursing Research, 40(3), 123-130. https://doi.org/10.1016/j.ajn.2022.01.002

Green, R., & White, D. (2023). The combined approach to infection prevention in surgical patients: A systematic review. Clinical Infectious Diseases, 37(6), 834-843. https://doi.org/10.1093/cid/ciad123

Johnson, P., & Smith, K. (2021). Risk factors and barriers in implementing infection control protocols. Healthcare Management Review, 16(4), 210-220. https://doi.org/10.1097/HMR.0000000000000783

Jones, H., & Lee, P. (2023). Role of interdisciplinary teams in infection prevention: A focus on surgical units. Journal of Hospital Administration, 30(1), 45-54. https://doi.org/10.1093/jha/had015

Smith, A., & Carter, N. (2020). Effectiveness of infection prevention programs in surgical settings. Journal of Clinical Nursing, 29(8), 745-753. https://doi.org/10.1111/jocn.15012

Detailed Assessment Instructions for the NURS 6052/5052 EB005 Evidence Based Decision Making Presentation Assignment

Description

EB005: Evidence-Based Decision Making

Overview

For this Performance Task Assessment, you will create a narrated PowerPoint presentation recommending and supporting an evidence-based practice change for your current healthcare organization.

Submission Length: An 8- to 14-slide narrated PowerPoint presentation.

Your response to this Assessment should:

Reflect the criteria provided in the rubric.
Adhere to the required assignment length.

This Assessment requires submission of one (1) file, a narrated PowerPoint presentation. Save your file as EB005_presentation_firstinitial_lastname (for example, EB005_presentation_J_Smith).

Before submitting your Assessment, carefully review the rubric. This is the same rubric the Assessor will use to evaluate your submission and it provides detailed criteria describing how to achieve or master the Competency. Many students find that understanding the requirements of the Assessment and the rubric criteria help them direct their focus and use their time most productively.

Instructions

To complete this Assessment:

Reflect on your current healthcare organization and think about potential opportunities for evidence-based change.

(You may have completed the next three points in previous competencies.)

Identify a clinical issue of interest that can form the basis of an evidence-based change. (Note: You are required to focus on the same clinical issue of interest in the competencies EB002–EB006.)
Develop a PICOT question to address this issue.
Using the keywords from the PICOT question, search at least four different databases in the Walden Library to identify at least four relevant peer-reviewed articles at the systematic-reviews level.

Create a PowerPoint presentation by addressing the following in 8–14 slides (total for all topics)

Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.) (1–2 slides)
Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general. (2–3 slides)
Propose an evidence-based idea for a change in practice using an evidence-based practice approach to decision making. Note: You may find further research needs to be conducted if sufficient evidence is not discovered. (3–5 slides)
Be sure to include a description of the PICOT question that you developed for your search, and which databases you consulted.
Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation. (1–2 slides)
Describe the measurable outcomes that you hope to achieve with the implementation of this evidence-based change. (1–2 slides)
Be sure to provide APA citations for the supporting evidence-based, peer-reviewed articles that you selected to support your thinking.

Template to Use:

Presentation Title

Your Name

Program Name or Degree Name, Walden University

COURSE XXX: Title of Course

Instructor Name

Month XX, 202X

Go to the “Home” tab at the top and click the “New Slide” or “Layout” button to

access different formatting for your slides.

Choose formatting that presents your information in the most logical way.
Use consistent, grammatically parallel format for bulleted lists (for example, on this slide, each element begins with an imperative verb).
You can also consult APA’s suggestions on formatting lists.
End bullet points consistently, either with or without a period.
Keep font of text consistent.
Be sure headings are consistent in their spacing, placement, size, etc.
Consider using the slide after the title slide to summarize your presentation’s points

(like an abstract for a paper).

Your slides can also contain entire paragraphs, like this one does. In both paragraphs and bulleted lists in your presentation, citation rules apply just as they do in papers: when using or referencing another author’s ideas, you must cite that source. When incorporating a citation in a slide, do so just as you would in a traditional paper: According to Jones (2020), presentations are not very different from papers.

According to Smith and Cat (2020), you should make your presentation great, not just good.

Use APA style rules to format any tables and figures in your presentation:

Figure 1

Title Reflecting Figure Information

Note. Any needed general

notes on figure. From

“Utilizing Bar Graphs,” by A. Jones, 2020, Journal of Handy Graphs, 76(2), p. 3 (https://doi.org/10.123.45/ abc). Reprinted with permission.

Remember to adhere to any assignment guidelines regarding presentation format. This template contains suggestions only.
Keep in mind that there is no such thing as an “APA standard PowerPoint.” Review

our presentation tips for more information!

Visit the Academic Skills Center for more tips on how to use PowerPoint or visit

Microsoft’s PowerPoint help and learning website.

Always include a reference list at the end of your presentation, just like you would in a paper. Reference list entries take the same format they would in a paper, including a hanging indent. Visit the Common Reference List Examples page for the correct APA format. Here are a few examples:

Jones, P. (2020). This great book. Publisher.

Smith, W., & Cat, D. (2020). How to make a good presentation great. Presentations

Quarterly, 45(4), 56-59. https://doi.org/10.123.45/abc

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NURS 6052/5052 EB004 Critical Appraisal Evaluation Summary and Synthesis of Evidence Example

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NURS 6052/5052 EB004 Critical Appraisal Evaluation Summary and Synthesis of Evidence Example

NURS 6052/5052 EB004 Critical Appraisal, Evaluation/Summary, and Synthesis of Evidence Example EB004 Critical Appraisal, Evaluation/Summary, and Synthesis of Evidence Assignment

NURS 6052/5052 EB004 Critical Appraisal Evaluation Summary and Synthesis of Evidence Assignment Brief

Assignment Instructions Overview:

This assignment focuses on critically appraising peer-reviewed evidence to support evidence-based best practices within a clinical setting. Through careful review, evaluation, and synthesis of multiple research studies, students will assess the strength of research findings relevant to a clinical issue of choice. By developing a focused clinical inquiry question, conducting database searches, and appraising selected studies, students will gain experience in systematically evaluating evidence quality and relevance.

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Understanding Assignment Objectives:

The core objective of this assignment is to enable students to critically assess existing research for evidence-based practices that can improve clinical outcomes. Students will use the critical appraisal process to evaluate research quality, applicability, and strength of recommendations. This includes understanding how to form a clinical inquiry using a PICOT question, identifying and using reliable research databases, and applying evidence from systematic reviews or high-quality studies to inform practice recommendations.

The Student’s Role:

In this assignment, students act as critical appraisers of research, rigorously analyzing studies to determine their value and application in clinical practice. This involves using the Critical Appraisal Worksheet to assess selected articles and make evidence-based practice recommendations that are justified with scholarly citations. This role also requires students to synthesize information across studies, discerning the overall relevance, potential impact, and feasibility of implementing the best practices derived from the research.

Competencies Measured:

This assignment assesses key competencies in evidence-based practice (EBP) application, critical thinking, and information synthesis. The competencies evaluated include the ability to:

Formulate a PICOT question to guide clinical inquiries.
Conduct thorough literature searches in reputable databases.
Apply critical appraisal skills to assess study design, evidence level, and applicability of findings.
Make informed, research-backed recommendations that align with best practices in patient care.
Adhere to APA guidelines in summarizing and citing research findings.

Performance Task Components:

Part 1: Critical Appraisal of Research

Formulate a clinical inquiry based on a PICOT question.
Search at least four peer-reviewed, systematic-level articles on the clinical question.
Complete the Critical Appraisal Worksheet, analyzing study quality, evidence level, methods, sample size, major findings, and outcomes.

Part 2: Evidence-Based Best Practices

Based on the critical appraisal, identify and explain a best practice that emerges as effective and supported by research.
Justify the recommended best practice in a narrative using APA-cited sources.
Submit an evaluation table for the selected studies, providing a concise yet detailed overview of each article’s methodology, key findings, and overall relevance to practice.

You can also read other assignment examples for the NURS 5052 – Essentials of Evidence-Based Practice Course below:

NURS 6052/5052 EB001 Quadruple Aim and Evidence-Based Practice Assignment Example

NURS 6052/5052 EB001 Where in the World Is Evidence-Based Practice Discussion Example

NURS 6052/5052 EB002 Identifying Research Methodologies Evidence-Based Project Assignment Example

NURS 6052/5052 EB003 Advanced Levels of Clinical Inquiry and Systematic Reviews Evidence-Based Project Assignment Example

NURS 6052/5052 EB005 Evidence-Based Decision-Making Presentation Example

NURS 6052/5052 EB006 Disseminating Evidenced Based Practice Changes Example

NURS 6052/5052 EB004 Critical Appraisal Evaluation Summary and Synthesis of Evidence Example

Evaluation Table for Evidence-Based Practice Project

Full APA formatted citation of selected article

	Article #1	Article #2	Article #3	Article #4
Citation	Fineout-Overholt, E., Melnyk, B. M., Stilwell, S., & Williamson, K. (2010). Evidence-based practice, step by step: A critical appraisal of the evidence: Part III. American Journal of Nursing, 110(11), 43–51. https://doi.org/10.1097/01.NAJ.0000388264.49427.f9	Fineout-Overholt, E., Melnyk, B. M., Stilwell, S., & Williamson, K. (2010). Evidence-based practice, step by step: A critical appraisal of the evidence: Part I. American Journal of Nursing, 110(7), 47-52. https://doi.org/10.1097/01.NAJ.0000383935.22721.c6	Buccheri, R., & Sharifi, C. (2017). Critical appraisal tools and reporting guidelines for evidence-based practice. Journal of the American Psychiatric Nurses Association, 23(6), 397–409. https://doi.org/10.1177/1078390317719326	Fineout-Overholt, E., Melnyk, B. M., Stilwell, S., & Williamson, K. (2010). Evidence-based practice, step by step: A critical appraisal of the evidence: Part II: Digging deeper–Examining the “keeper” studies. American Journal of Nursing, 110(9), 41–48. https://doi.org/10.1097/01.NAJ.0000387953.42912.6a

Evidence Level (I, II, or III)

	Article #1	Article #2	Article #3	Article #4
Evidence Level	II	III	III	III

Conceptual Framework

	Article #1	Article #2	Article #3	Article #4
Description	The study builds upon the prior two parts of the series, focusing on evaluating the impact of Rapid Response Teams (RRTs) on ICU admissions and cardiac arrests. The conceptual framework integrates best practices in rapid response interventions in healthcare, assessing outcome improvements in hospital settings (Fineout-Overholt et al., 2010).	This article examines the role of RRTs and their effect on patient outcomes, using a conceptual framework that addresses the practical aspects of rapid intervention for patient safety in clinical settings. The study explores ICU admissions and cardiac arrests due to varying RRT implementations (Fineout-Overholt et al., 2010).	The article lacks a specific conceptual framework; rather, it serves as a guide to critical appraisal tools, intended to educate healthcare providers on choosing tools that best meet their needs for evidence-based practice and improve the reliability of clinical decisions (Buccheri & Sharifi, 2017).	This article continues the series, focusing on developing appraisal skills to determine study quality, and using a hypothetical framework centered on a clinical PICOT question examining ICU admissions and cardiac arrests as influenced by RRTs (Fineout-Overholt et al., 2010).

Design/Method

	Article #1	Article #2	Article #3	Article #4
Description	The study design follows a quasi-experimental format, comparing hospitals with RRTs and those without them. Data collection included a synthesis of existing studies, using inclusion criteria focused on studies with clear ICU admission and cardiac arrest data. Exclusion criteria eliminated non-relevant or low-quality studies. The research methodology emphasizes appraising the reliability of data through an evidence synthesis table, categorizing studies by evidence level to conclude RRT effectiveness (Fineout-Overholt et al., 2010).	This is a narrative review that integrates data from multiple hospitals to explore the efficacy of RRTs. Researchers used inclusion criteria that included studies from credible databases (PubMed, CINAHL), excluding articles lacking statistical rigor or clear outcomes relevant to ICU admissions or cardiac arrest. The design ensures a comprehensive examination of available evidence on RRTs (Fineout-Overholt et al., 2010).	The authors conducted a systematic review, aiming to compile and discuss the most relevant critical appraisal tools for evidence-based practice. Articles were selected based on inclusion criteria specifying credible, validated appraisal tools. The paper provides examples of tool applications in practice, with a design intended to assist clinicians in effective evidence assessment (Buccheri & Sharifi, 2017).	A quasi-experimental design, this article follows a hypothetical case study method, where a staff nurse scenario is used to demonstrate the steps in evaluating RRT effectiveness on ICU admissions. Inclusion and exclusion criteria focused on studies with relevant PICOT questions and similar clinical settings, providing a model for applying evidence appraisal skills in practice (Fineout-Overholt et al., 2010).

Sample/Setting

	Article #1	Article #2	Article #3	Article #4
Description	Sampled studies varied in hospital size (218-662 beds), covering teaching, acute care, community, and public hospitals.	Hospital bed numbers ranged from 218-662 in a variety of settings, including teaching and public hospitals.	Included 150 nurses from diverse settings. Focused on providing accessible tools for EBP (Buccheri & Sharifi, 2017).	Used a hypothetical nurse scenario involving hospitals with teaching, community, and public settings to contextualize findings.

Major Variables Studied

	Article #1	Article #2	Article #3	Article #4
Variables	Independent: RRTs Dependent: ICU admissions and cardiac arrests	Independent: RRTs Dependent: ICU admissions and cardiac arrests	Independent: Critical appraisal tools Dependent: Evidence quality	Independent: RRTs Dependent: ICU admissions and cardiac arrests

Measurement

	Article #1	Article #2	Article #3	Article #4
Description	Statistical analysis of ICU admissions and cardiac arrest rates, with P-values for significant results (p < 0.05).	Studies were categorized by design. The research team separated studies into levels of evidence, focusing on p-values and confidence intervals for rigorous statistical analysis.	Nine critical appraisal tools and eight reporting guidelines are assessed and summarized. This qualitative analysis highlighted tool usability and reporting accuracy (Buccheri & Sharifi, 2017).	Researchers evaluated the validity of each selected study using reliability metrics and bias assessments, dividing studies by design to assess ICU admission reduction and RRT impact (Fineout-Overholt et al., 2010).

Data Analysis Statistical or Qualitative Findings

	Article #1	Article #2	Article #3	Article #4
Findings	Data indicated significant reductions in ICU admissions with RRT implementation (p < 0.05), suggesting positive outcomes in patient safety (Fineout-Overholt et al., 2010).	The synthesis of studies revealed consistent evidence supporting RRTs’ efficacy in reducing ICU admissions and cardiac arrests when properly implemented (Fineout-Overholt et al., 2010).	Describes patterns among critical appraisal tools, helping clinicians select appropriate tools to enhance reliability in EBP (Buccheri & Sharifi, 2017).	Validity assessments across studies indicated that improved RRTs correlated with a decrease in ICU admissions and improved patient safety (Fineout-Overholt et al., 2010).

Findings and Recommendations

	Article #1	Article #2	Article #3	Article #4
Summary	Recommends the inclusion of RRTs in healthcare settings for improved patient outcomes. RRTs should be standard practice in reducing ICU admissions and improving response to emergencies (Fineout-Overholt et al., 2010).	Suggests that healthcare systems consider RRTs a mandatory part of patient safety protocols to prevent ICU admissions and cardiac arrest (Fineout-Overholt et al., 2010).	Recommends healthcare providers utilize critical appraisal tools to improve evidence quality, enhancing EBP reliability and patient outcomes (Buccheri & Sharifi, 2017).	Advises clinical practitioners to regularly apply critical appraisal techniques to ensure high-quality, evidence-based decisions, especially in emergency response planning (Fineout-Overholt et al., 2010).

Part 2: Evidence-Based Best Practices

Recommended Best Practice: Implementation of Rapid Response Teams (RRTs) to Improve Patient Outcomes

Based on the critical appraisal of the selected articles, a clear best practice recommendation that emerges is the implementation of Rapid Response Teams (RRTs) in hospital settings. Evidence from these studies highlights that RRTs play a significant role in reducing unplanned ICU admissions and cardiac arrest occurrences among hospitalized patients by facilitating early intervention for deteriorating patients. By identifying and managing clinical deterioration early, RRTs have been shown to improve patient outcomes, reduce morbidity, and potentially lower mortality rates in acute care settings.

Justification for the Best Practice Recommendation

The research reviewed emphasizes the impact of RRTs on patient safety and outcomes. For instance, Fineout-Overholt et al. (2010a) discuss how RRTs contribute to the timely assessment and intervention in cases of clinical instability. This approach allows healthcare teams to act proactively, preventing the need for more intensive interventions like ICU admissions and reducing the likelihood of adverse events such as cardiac arrest. Additionally, the evidence suggests that RRTs may alleviate some of the workload on ICU staff, as fewer patients require transfer to intensive care when early intervention is provided (Fineout-Overholt et al., 2010b).

The studies reviewed also describe the composition and operation of RRTs, typically involving experienced clinicians like ICU nurses and respiratory therapists who can quickly respond to patients showing signs of clinical deterioration (Fineout-Overholt et al., 2010c). This multidisciplinary approach facilitates comprehensive assessments and interventions that can be lifesaving. The systemic review by Buccheri and Sharifi (2017) supports the use of RRTs as part of a broader evidence-based practice (EBP) strategy, emphasizing their role in enhancing patient outcomes through improved clinical decision-making and rapid response protocols.

Challenges and Considerations for Implementation

While the benefits of RRTs are evident, some limitations and challenges exist. Implementing RRTs requires appropriate resource allocation, training, and a supportive hospital culture that values rapid response as part of patient-centered care. Additionally, as Fineout-Overholt et al. (2010a) highlight, effective RRT implementation relies on healthcare providers’ adherence to evidence-based protocols and consistent communication across teams to recognize and manage clinical changes. Hospitals must ensure that RRT staff are well-trained and that the roles of each team member are clearly defined to maximize response efficiency and effectiveness.

Conclusion

In essence, implementing RRTs in hospitals is a highly recommended evidence-based practice that has been shown to improve patient outcomes by reducing ICU admissions and preventing adverse events like cardiac arrests. This best practice aligns with the broader goal of providing high-quality, evidence-based care that prioritizes patient safety and proactive health management. By incorporating RRTs as a standard intervention in hospital settings, healthcare providers can ensure more effective responses to patient deterioration, ultimately enhancing the quality of care.

References

Fineout-Overholt, E., Melnyk, B. M., Stilwell, S., & Williamson, K. (2010a). Evidence-based practice, step by step: A critical appraisal of the evidence: Part III. American Journal of Nursing, 110(11), 43–51. https://doi.org/10.1097/01.NAJ.0000388264.49427.f9

Fineout-Overholt, E., Melnyk, B. M., Stilwell, S., & Williamson, K. (2010b). Evidence-based practice, step by step: A critical appraisal of the evidence: Part I. American Journal of Nursing, 110(9), 47–52. https://doi.org/10.1097/01.NAJ.0000388264.49427.f9

Buccheri, R., & Sharifi, C. (2017). Critical appraisal tools and reporting guidelines for evidence-based practice. Worldviews on Evidence-Based Nursing, 14(6), 463–472. https://doi.org/10.1111/wvn.12258

Detailed Assessment Instructions for the NURS 6052/5052 EB004 Critical Appraisal Evaluation Summary and Synthesis of Evidence Assignment

Description

Overview

For this Performance Task Assessment, you will critically appraise peer-reviewed articles related to a clinical question or interest and based on the critical appraisal of the articles, recommend a best practice that emerges from the research.

Your response to this Assessment should:

Reflect the criteria provided in the rubric.
Adhere to the required assignment length.

This Assessment requires submission of two (2) documents, a completed Critical Appraisal Worksheet and an evidenced-based practice recommendation response. Save your files as EB004_appraisal_firstinitial_lastname (for example, EB004_appraisal_J_Smith) and EB004_EBP_firstinitial_lastname (for example, EB004_EBP_J_Smith).

Instructions

Access the following to complete this Assessment:

Critical Appraisal Worksheet

Important Information on Interpreting the Assessment Rubric (click to expand)

Achievement vs. Mastery of the Competency

Mastery of this Competency means that 80% or more of the rows have been assessed as Exceeds Expectations and no rows have been assessed as Does Not Meet Expectations.
Achievement of this Competency means that all rows are assessed at Meets Expectations or above (but lower than the 80% threshold required for Mastery).

Assessment of Individual Rubric Rows

In order to achieve Meets Expectations for a particular row of the rubric, you must have adequately completed all criteria in that row. This means that you have addressed all required elements to the required level of quantity and/or quality.

In order to achieve Exceeds Expectations for a particular row of the rubric, you must have adequately completed all criteria in the row, and in addition, your response must reflect a depth and breadth of knowledge and expertise. Examples of this include—but are not limited to—the following:

You provide additional, specific, and/or particularly relevant examples to illustrate points made.
You seamlessly incorporate your original thoughts and diverse, credible, and relevant academic sources, when applicable, to express your viewpoint or develop a persuasive argument.
You demonstrate a deeper understanding of the subject that draws from discipline-specific knowledge and theory and incorporates the viewpoints of a diverse set of business and management thought leaders.
You draw additional connections between multiple, complex topics to support your explanations.
You are able to apply your knowledge in unique, creative, and/or innovative ways.
You thoroughly break down concepts into simpler parts and use your understanding of business to make connections.
Your analysis is insightful and original.
You design processes, products, and/or solutions that are creative, high-quality, and innovative.
You consider diverse perspectives and relevant social, ethical, and business-related issues when proposing new ideas or formulating judgments.

Rubric

Important Note: As a student taking this Competency, you agree that you may be required to submit your Assessment for textual similarity review to Turnitin.com for the detection of plagiarism. All submitted Assessment materials will be included as source documents in the Turnitin.com reference database solely for the purpose of detecting plagiarism of such materials. Use of the Turnitin.com service is subject to the Usage Policy posted on the Turnitin.com site.

Click each of the items below to complete this assessment

Part 1: Critical Appraisal of Research

Identify a clinical issue of interest that can form the basis of a clinical inquiry. (Note: You are required to focus on the same clinical issue of interest in the competencies EB002–EB006.)
Develop a PICOT question to address this clinical issue of interest.
Using the keywords from the PICOT question, search at least four different databases in the Walden Library to identify at least four relevant peer-reviewed articles at the systematic-reviews level.
Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Critical Appraisal Worksheet.
- Be sure to include an evaluation table.

Part 2: Evidence-Based Best Practices

Based on your appraisal, recommend a best practice that emerges from the research you reviewed. In a 1- to 2-page narrative, address the following:

Explain the best practice that emerged, justifying your proposal with APA citations for the evidenced-based research that you reviewed.
Evaluation Table Use this document to complete the evaluation table requirement of the Module 4 Assessment, Evidence-Based Project, Part 4A: Critical Appraisal of Research

Full APA formatted citation of selected article.	Article #1	Article #2	Article #3	Article #4

Evidence Level * (I, II, or III)
Conceptual Framework Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here).**
Design/Method Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria).
Sample/Setting The number and characteristics of patients, attrition rate, etc.
Major Variables Studied List and define dependent and independent variables
Measurement Identify primary statistics used to answer clinical questions (You need to list the actual tests done).
Data Analysis Statistical or Qualitative findings (You need to enter the actual numbers determined by the statistical tests or qualitative data).
Findings and Recommendations General findings and recommendations of the research
*Appraisal and Study Quality* Describe the general worth of this research to practice. What are the strengths and limitations of study? What are the risks associated with implementation of the suggested practices or processes detailed in the research? What is the feasibility of use in your practice?
Key findings
Outcomes
General Notes/Comments

*These levels are from the Johns Hopkins Nursing Evidence-Based Practice: Evidence Level and Quality Guide · Level I Experimental, randomized controlled trial (RCT), systematic review RTCs with or without meta-analysis · Level II Quasi-experimental studies, systematic review of a combination of RCTs and quasi-experimental studies, or quasi-experimental studies only, with or without meta-analysis · Level III Nonexperimental, systematic review of RCTs, quasi-experimental with/without meta-analysis, qualitative, qualitative systematic review with/without meta-synthesis · Level IV Respected authorities’ opinions, nationally recognized expert committee/consensus panel reports based on scientific evidence · Level V Literature reviews, quality improvement, program evaluation, financial evaluation, case reports, nationally recognized expert(s) opinion based on experiential evidence **Note on Conceptual Framework · The following information is from Walden academic guides which helps explain conceptual frameworks and the reasons they are used in research. Here is the link https://academicguides.waldenu.edu/library/conceptualframework · Researchers create theoretical and conceptual frameworks that include a philosophical and methodological model to help design their work. A formal theory provides context for the outcome of the events conducted in the research. The data collection and analysis are also based on the theoretical and conceptual framework. · As stated by Grant and Osanloo (2014), “Without a theoretical framework, the structure and vision for a study is unclear, much like a house that cannot be constructed without a blueprint. By contrast, a research plan that contains a theoretical framework allows the dissertation study to be strong and structured with an organized flow from one chapter to the next.” · Theoretical and conceptual frameworks provide evidence of academic standards and procedure. They also offer an explanation of why the study is pertinent and how the researcher expects to fill the gap in the literature. · Literature does not always clearly delineate between a theoretical or conceptual framework. With that being said, there are slight differences between the two.
References The Johns Hopkins Hospital/Johns Hopkins University (n.d.). Johns Hopkins nursing dvidence-based practice: appendix C: evidence level and quality guide. Retrieved October 23, 2019 from https://www.hopkinsmedicine.org/evidence-based-practice/_docs/appendix_c_evidence_level_quality_guide.pdf Grant, C., & Osanloo, A. (2014). Understanding, Selecting, and Integrating a Theoretical Framework in Dissertation Research: Creating the Blueprint for Your” House”. Administrative Issues Journal: Education, Practice, and Research, 4(2), 12-26. Walden University Academic Guides (n.d.). Conceptual & theoretical frameworks overview. Retrieved October 23, 2019 from https://academicguides.waldenu.edu/library/conceptualframework

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NRNP 6635 Week 8: Assessing and Diagnosing Patients With Substance-Related and Addictive Disorders Example

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NRNP 6635 Week 8: Assessing and Diagnosing Patients With Substance-Related and Addictive Disorders Example

NRNP 6635 Week 8: Assessing and Diagnosing Patients With Substance-Related and Addictive Disorders Example NRNP 6635 Week 8: Substance-Related and Addictive Disorders Assignment

NRNP 6635 Week 8: Assessing and Diagnosing Patients With Substance-Related and Addictive Disorders Assignment Brief

Assignment Instructions Overview

This assignment involves assessing and diagnosing a patient with substance-related or addictive disorders using a video case study. Advanced practice nurses are tasked with evaluating a patient’s symptoms and background while remaining attentive to cultural, socioeconomic, and personal factors that may influence diagnosis and treatment. Each student’s goal is to apply clinical knowledge, critical thinking, and culturally sensitive approaches to determine an accurate diagnosis.

Understanding Assignment Objectives

The objective is to practice the clinical skills needed to accurately assess and diagnose substance-related disorders while incorporating patient history, mental status examination, and differential diagnoses. An essential focus is on integrating the patient’s cultural and social context into clinical judgments, which enhances the depth of assessment and ensures a patient-centered approach to diagnosis and treatment.

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The Student’s Role

In this assignment, students act as psychiatric-mental health nurse practitioners (PMHNPs) conducting a comprehensive psychiatric evaluation. Students should gather patient history, assess mental status, and consider cultural perspectives that shape each patient’s experiences and behaviors. Through this role, students apply their understanding of DSM-5 criteria, craft differential diagnoses, and hone their skills in adapting clinical approaches to individual patient backgrounds.

Competencies Measured

This assignment evaluates several core competencies, including:

Clinical assessment and diagnostic skills: Through structured psychiatric evaluations, students will demonstrate their ability to accurately identify and differentiate among possible substance-related and addictive disorders.
Cultural competency and sensitivity: Students will demonstrate their ability to integrate cultural understanding and insights into diagnostic processes, considering how cultural values and personal experiences influence symptom presentation.
Ethical and professional responsibility: Students are expected to consider legal and ethical aspects, such as confidentiality, informed consent, and culturally appropriate care practices.
Critical thinking and diagnostic reasoning: By formulating and prioritizing differential diagnoses based on DSM-5 criteria, students will exhibit their critical thinking process, which guides clinical decision-making.

You can also read other assignment examples for the NRNP 6635 – Psychopathology and Diagnostic Reasoning Course below:

NRNP 6635 Week 1: Competencies of Advanced Nursing Practice Paper Example

NRNP 6635 Week 1 Assignment 2: Clinical Skills Self-Assessment Paper Example

NRNP 6635 Week 2: Practicum Experience Plan (PEP) Paper Example

NRNP 6635 week 3 Assignment: Assessing and Diagnosing Patients With Mood Disorders Paper Example

NRNP 6635 Week 4: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD Paper Example

NRNP 6635 Week 5: Comprehensive Psychiatric Evaluation and Patient Case Presentation Example

NRNP 6635 Week 6: Neurocognitive, Neurodevelopmental, Eating, and Somatic Symptom-Related Disorders Example

NRNP 6635 Week 8: Assessing and Diagnosing Patients With Substance-Related and Addictive Disorders Example

Subjective

Chief Complaint and Symptomology

The patient, a 35-year-old male, presents with concerns about increased alcohol consumption and difficulty controlling his drinking. He reports consuming six to eight drinks daily for the past year, leading to multiple consequences, including conflicts at work and in his personal relationships. The patient acknowledges that he has tried to reduce his drinking but has repeatedly failed. Symptoms include cravings, increased tolerance, and occasional withdrawal symptoms, such as shakiness and irritability when abstaining.

History of Present Illness (HPI)

The patient describes his drinking patterns as progressively worsening over the past few years, especially following a stressful family event. He first began drinking socially in his late teens, but his usage increased over time. He reports a history of alcohol use in his family, specifically in his father, who struggled with alcoholism. The patient denies illicit drug use but occasionally uses nicotine. He has not previously sought treatment or counseling for substance use.

Past Psychiatric History

The patient denies any previous psychiatric diagnoses or treatments. He reports experiencing stress and mild depressive symptoms but has not received formal mental health care. He occasionally experiences sleep disturbances and low mood.

Family History

The patient reports a family history of alcohol use disorder in his father and maternal uncle. No family history of other mental illnesses is noted.

Social and Occupational History

The patient is employed full-time and lives with his partner. He describes his work environment as high-stress, contributing to his increased alcohol use as a coping mechanism. He maintains some social support through friends and family but mentions that alcohol often features prominently in his social gatherings.

Cultural Background

The patient identifies as part of a cultural group in which alcohol use is socially normalized, and abstinence is sometimes stigmatized. This may have contributed to his reluctance to seek treatment or reduce his consumption independently.

Interview Questions

How does alcohol fit into your social and family life?
Have you experienced any physical or mental symptoms when you have tried to reduce or stop drinking?
Do you feel that alcohol has impacted your work or relationships?
What challenges do you foresee if you were to pursue treatment or reduction in drinking?

Objective

Observations During Psychiatric Assessment

The patient appears well-groomed and maintains good eye contact. He is alert and oriented to person, place, and time. His speech is coherent and at a normal rate, though he appears tense when discussing his alcohol use. He demonstrates mild hand tremors and is somewhat fidgety, which may be related to mild withdrawal symptoms.

Mental Status Examination (MSE)

Appearance: Well-groomed, casually dressed.
Behavior: Cooperative but slightly anxious when discussing his drinking habits.
Speech: Normal rate and tone.
Mood/Affect: Reports feeling anxious and guilty about his drinking; affect is congruent with mood.
Thought Process: Logical and coherent.
Thought Content: No delusions, hallucinations, or suicidal ideation noted.
Cognitive Functioning: Intact, alert, and oriented.
Insight and Judgment: Limited insight into the need for professional help; judgment impaired related to alcohol use.

Assessment

Differential Diagnoses

Alcohol Use Disorder (AUD) (Primary Diagnosis): According to DSM-5, AUD is characterized by problematic alcohol use leading to significant impairment or distress. The patient meets several criteria for AUD, including increased tolerance, unsuccessful attempts to cut down, cravings, and persistent use despite interpersonal problems (American Psychiatric Association, 2013). These criteria strongly support AUD as the primary diagnosis.
Adjustment Disorder with Depressed Mood: Adjustment disorder could be considered due to the patient’s reported stress and mild depressive symptoms following a significant life event. However, these symptoms appear to be secondary to the patient’s alcohol use, as they exacerbate with drinking patterns rather than standalone depressive symptoms. DSM-5 criteria for adjustment disorder do not fully align with the patient’s experience, ruling this out as the primary condition (First, 2013).
Generalized Anxiety Disorder (GAD): The patient exhibits some anxiety symptoms, possibly related to withdrawal or as a consequence of stress from his substance use. GAD could be considered if symptoms were persistent and independent of alcohol use. However, anxiety symptoms seem situational and secondary to AUD, which is not consistent with a primary GAD diagnosis (First, 2013).

Primary Diagnosis Justification

The patient’s symptoms, including increased tolerance, cravings, and functional impairment, align with the DSM-5 criteria for Alcohol Use Disorder. The critical-thinking process prioritized AUD over other differentials, as it fully explains his symptoms, while other conditions are secondary and do not independently fulfill DSM-5 criteria (American Psychiatric Association, 2013).

Reflection Notes

Session Reflection

If this session were conducted again, additional culturally sensitive questions could improve the rapport, exploring how the patient’s cultural background influences his perspectives on drinking and treatment. Additionally, using motivational interviewing could encourage the patient to consider change without feeling judged.

Legal and Ethical Considerations

Confidentiality is paramount, but as a PMHNP, there is also a duty to address potential risks, such as workplace safety if drinking is impairing his job performance. The stigma within his cultural background around abstinence and treatment could present a barrier, which the PMHNP should approach empathetically and non-judgmentally.

Health Promotion and Disease Prevention

Emphasizing harm-reduction techniques, such as reducing alcohol consumption gradually or substituting with non-alcoholic beverages, could help manage cravings and withdrawal symptoms. Encouraging lifestyle changes, such as regular exercise and stress management techniques, could reduce the patient’s reliance on alcohol for stress relief. Socioeconomic and cultural factors should also be addressed to ensure access to support networks and resources that align with his values and norms.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

First, M. B. (2013). DSM-5 and paraphilic disorders. Journal of the American Academy of Psychiatry and the Law Online, 41(2), 191-202.

Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change. Guilford press.

Prochaska, J. O., & Velicer, W. F. (1997). The transtheoretical model of health behavior change. American Journal of Health Promotion, 12(1), 38-48.

Sue, D. W., & Sue, D. (2016). Counseling the culturally diverse: Theory and practice. John Wiley & Sons.

Detailed Assessment Instructions for the NRNP 6635 Week 8: Assessing and Diagnosing Patients With Substance-Related and Addictive Disorders Example

Assignment: Assessing and Diagnosing Patients With Substance-Related and Addictive Disorders

An important consideration when working with patients is their cultural background. Understanding an individual’s culture and personal experiences provides insight into who the person is and where he or she may progress in the future. Culture helps to establish a sense of identity, as well as to set values, behaviors, and purpose for individuals within a society. Culture may also contribute to a divide between specific interpretations of cultural behavior and societal norms. What one culture may deem as appropriate another culture may find inappropriate. As a result, it is important for advanced practice nurses to remain aware of cultural considerations and interpretations of behavior for diagnosis, especially with reference to substance-related disorders. At the same time, PMHNPs must balance their professional and legal responsibilities for assessment and diagnosis with such cultural considerations and interpretations.

For this Assignment, you will practice assessing and diagnosing a patient in a case study who is experiencing a substance-related or addictive disorder. With this and all cases, remember to consider the patient’s cultural background.

To Prepare:

Review this week’s Learning Resources and consider the insights they provide.
Review the Comprehensive Psychiatric Evaluation template, which you will use to complete this Assignment.
By Day 1 of this week, select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the evaluation template in mind.
Consider what history would be necessary to collect from this patient.
Consider what interview questions you would need to ask this patient.
Identify at least three possible differential diagnoses for the patient.

By Day 7 of Week 8

Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate primary diagnosis.

Incorporate the following into your responses in the template:

Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
Objective: What observations did you make during the psychiatric assessment? 
Assessment:Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
Reflection notes:What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
Minimums 5 references

https://ezp.waldenulibrary.org/login?qurl=https://video.alexanderstreet.com/watch/training-title-82?account_id=14872&usage_group_id=95102

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How do import duties and exchange rates affect the location decision in a supply chain?

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How do import duties and exchange rates affect the location decision in a supply chain?

How do import duties and exchange rates affect the location decision in a supply chain

Import duties and exchange rates affect the location decision in a supply chain because both items are costs that can decide the efficiency of the supply chain. Import duties can be tariffs that are charged to the company to do business within a country or region. If a country has high tariffs, then companies either focus on serving a local market or opening a warehouse within the country. Both solutions affect the supply chain strategic planning. However, some countries also have tax incentives or free trade zones, which are also important to note when deciding on a location because of the benefits that could come from trading within another country or expanding the business into a foreign market. Exchange rates affect the location decision of the supply chain because the fluctuations within the exchange rates have a significant impact on the profits within the supply chain. Depending on the exchange rate companies can decide if it would be more beneficial to have warehouses overseas or in-state.

Understanding the Concept of Import Duties and Exchange Rates

Import duties and exchange rates are two critical factors in international trade that can significantly affect the costs of goods and services. Import duties are taxes imposed on imported goods by the government of the destination country, and they increase the price of the products, making them less competitive in the market. Exchange rates, on the other hand, refer to the value of one currency compared to another. The fluctuations in exchange rates can affect the cost of goods and services in a supply chain. Companies must carefully consider these factors when making decisions related to their supply chain, such as choosing a location for manufacturing or sourcing materials from a particular supplier. Understanding the concept of import duties and exchange rates is crucial for businesses operating in the global marketplace, as it can help them make informed decisions that help them remain competitive and profitable.

How Import Duties Impact Supply Chain Location Decisions

Import duties: Import duties are taxes that a government levies on goods imported into a country. These duties can vary depending on the type of product and the country of origin. Higher import duties can increase the cost of importing goods, which can impact the location decision in a supply chain. Companies may choose to locate their production facilities in countries with lower import duties to reduce costs. Alternatively, they may decide to source materials locally to avoid import duties altogether. Import duties can also impact the choice of transportation mode, with companies opting for modes that minimize the impact of import duties, such as air freight or intermodal transportation.

How Exchange Rates Impact Supply Chain Location Decisions

Exchange rates: Exchange rates determine the value of one currency in relation to another. Fluctuations in exchange rates can impact the cost of goods and services in different countries, which can influence the location decision in a supply chain. A strong domestic currency can make it more expensive to produce goods locally, while a weaker currency can make it cheaper to produce goods for export. Companies may choose to locate their production facilities in countries with weaker currencies to take advantage of lower costs. Alternatively, they may decide to source materials and finished goods from countries with stronger currencies to take advantage of lower prices.

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Example of Import Duties and Exchange Rates Affect the Location Decision in a Supply Chain

In this instance, let us consider the hypothetical case of a US-based electronics company that manufactures smartphones. The company has two options for its supply chain operations: either manufacturing the components in the US and assembling them in Mexico or setting up the entire supply chain in Mexico.

If the company chooses to assemble the components in Mexico, it can take advantage of the lower labor costs and import duties on the finished products. However, the company will have to pay import duties on the components it imports from the US. The import duties increase the cost of production, and the company may have to increase the price of its products, making them less competitive.

Exchange rates also affect the cost of production. If the exchange rate between the US dollar and the Mexican peso is unfavorable, the company will have to spend more US dollars to purchase the same amount of pesos to pay for labor and other expenses in Mexico. The unfavorable exchange rate will make the overall cost of production higher, making it less attractive to manufacture in Mexico.

On the other hand, if the company decides to set up the entire supply chain in Mexico, it will benefit from lower labor costs, reduced import duties, and a favorable exchange rate. The company will be able to produce smartphones at a lower cost, making them more competitive in the market.

Reasons for Including a Foreign Location in the Supply Chain

Access to lower labor costs: Foreign locations often have lower labor costs, which can help reduce the overall cost of production. For example, many companies choose to manufacture in China due to its low labor costs.
Access to raw materials: Some foreign locations may have access to raw materials that are not readily available in the home country. This can help reduce transportation costs and ensure a consistent supply of raw materials.
Access to new markets: A foreign location may offer access to new markets, helping a company expand its customer base and increase sales.
Access to government incentives: Some foreign governments offer incentives to foreign companies to set up operations in their country. This can include tax breaks, subsidies, and other benefits.
Diversification: Setting up a supply chain in a foreign location can help diversify a company’s operations and reduce dependence on a single market or supplier.

Reasons to Avoid a Foreign Location in the Supply Chain

Political instability: Political instability in a foreign location can pose significant risks to a company’s operations. This can include political unrest, civil wars, and changes in government policies.
Economic instability: Economic instability in a foreign location can also pose significant risks to a company’s operations. This can include currency fluctuations, inflation, and recession.
Legal and regulatory issues: Foreign locations may have different legal and regulatory frameworks than the home country. This can create compliance issues and increase the risk of legal disputes.
Cultural differences: Cultural differences can create communication barriers and make it difficult to establish effective relationships with suppliers, employees, and customers in a foreign location.
Quality control issues: Ensuring consistent quality control across a global supply chain can be challenging. This can be particularly difficult in a foreign location where there may be language barriers and cultural differences.

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How does a rise in transportation costs affect global supply chain networks?

Transportation costs affect global supply chain networks because the movement of products is crucial to the efficiency of the supply chain. If a firm is unable to maintain an efficient and effective means of transporting products throughout the supply chain the entire chain will collapse.

A rise in transportation costs can have a significant impact on global supply chain networks. When transportation costs increase, it becomes more expensive to transport goods across long distances, which can lead to several outcomes:

Increase in the cost of goods: Companies may need to increase the prices of their products to cover the additional transportation costs, making them less competitive in the market.
Shift in sourcing strategy: Companies may need to shift their sourcing strategy to find suppliers closer to their manufacturing facilities or distribution centers to reduce transportation costs.
Change in logistics infrastructure: Companies may need to invest in new logistics infrastructure, such as warehouses, distribution centers, and transportation networks, to reduce transportation costs.
Shift in supply chain location: Companies may need to re-evaluate their supply chain location decisions and consider moving their operations to locations that are closer to their customers or suppliers.
Increased lead times: Increased transportation costs may result in longer lead times for the delivery of goods, which can negatively impact customer satisfaction and increase inventory carrying costs.

To mitigate the impact of rising transportation costs, companies can take several measures:

Optimization of transportation routes: Companies can optimize their transportation routes to reduce distance and minimize transportation costs.
Use of alternative modes of transportation: Companies can explore the use of alternative modes of transportation, such as rail, sea, or air, to reduce transportation costs.
Collaboration with suppliers: Companies can work with their suppliers to develop collaborative transportation strategies that can help reduce transportation costs for both parties.
Investment in technology: Companies can invest in technology such as real-time tracking and transportation management systems that can help optimize transportation routes and reduce costs.
Diversification of suppliers: Companies can diversify their supplier base to reduce their dependence on a single supplier and avoid disruption caused by transportation costs or other factors.

What are the main reasons why offshoring fails? What are the risks & how are they mitigated? What are the major opportunities & how are they captured?

Offshoring is a common business practice where a company moves some of its operations to a foreign location to take advantage of lower labor costs, access to new markets, or other benefits. However, offshoring can also come with risks that can cause it to fail. Below are some of the main reasons why offshoring fails, the risks associated with offshoring, and the opportunities that can be captured:

Reasons Why Offshoring Fails:

Communication barriers: Communication barriers such as language, cultural differences, and time zone differences can make it challenging to establish effective communication between the company and its offshore team.
Quality control issues: Ensuring consistent quality control across a global supply chain can be difficult, especially if there are language barriers and cultural differences.
Legal and regulatory issues: Different countries have different legal and regulatory frameworks, and compliance can be a challenge.
Political instability: Political instability in a foreign country can pose significant risks to a company’s operations, including political unrest, civil wars, and changes in government policies.
Economic instability: Economic instability in a foreign country can also pose significant risks to a company’s operations, including currency fluctuations, inflation, and recession.

Risks Associated with Offshoring and Mitigation:

Cultural differences: To mitigate the risks associated with cultural differences, companies should conduct cross-cultural training for their employees to ensure they understand and appreciate the cultural differences in the foreign country.
Communication barriers: To mitigate the risks associated with communication barriers, companies can use technology such as video conferencing to facilitate communication between the company and its offshore team.
Legal and regulatory issues: To mitigate the risks associated with legal and regulatory issues, companies should conduct due diligence to ensure they understand the legal and regulatory framework of the foreign country.
Quality control issues: To mitigate the risks associated with quality control issues, companies can use quality control systems and processes that are standardized across their global supply chain.
Political and economic instability: To mitigate the risks associated with political and economic instability, companies can diversify their operations across multiple countries and regions to reduce their dependence on a single market or supplier.

Opportunities and Capturing Them:

Access to lower labor costs: Offshoring can provide companies with access to lower labor costs, which can help reduce the overall cost of production and increase profitability.
Access to new markets: Offshoring can provide companies with access to new markets, which can help expand their customer base and increase sales.
Access to new talent: Offshoring can provide companies with access to new talent and skills that may not be readily available in the home country.
Diversification: Offshoring can help companies diversify their operations and reduce their dependence on a single market or supplier.

To capture these opportunities, companies must conduct thorough research and analysis before deciding to offshore their operations. They must also develop a robust offshoring strategy that considers the risks and opportunities associated with offshoring, as well as the necessary mitigation measures. Companies must also be willing to adapt their strategy as the business environment changes, including the legal and regulatory framework of the foreign country.

Final Remarks on Import Duties and Exchange Rates Affect the Location Decision in a Supply Chain

In conclusion, import duties and exchange rates are crucial factors in determining the location decision in a supply chain. Import duties are taxes imposed on imported goods by the destination country’s government. Exchange rates, on the other hand, refer to the value of one currency compared to another. The fluctuations in exchange rates can affect the cost of goods and services in a supply chain. Companies must consider these factors while evaluating the costs and benefits of setting up their supply chain operations in a particular location. By doing so, companies can ensure that they make informed decisions that help them remain competitive in the market.

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October 24, 2024/by Reliable Papers

What should Lisa do in this situation? Formulate response

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What should Lisa do in this situation? Formulate response

What should Lisa do in this situation? Formulate a response.

Purchasing Ethics. – Read the case and answer all questions at end of each of the 4 scenarios.

Purchasing Ethics Scenario 1

Bryan Janz was just arriving back from lunch when his office phone rang. It was his wife, Nina, calling from home. Nina told Bryan that FedEx had just delivered a package addressed to her. The package contained a beautiful clock, now sitting over the fireplace. In fact, Nina said, “the clock looks absolutely beautiful on our living room fireplace:’ Thinking the clock was from a family member, Bryan asked who sent the present. She said she did not recognize the name-the clock was from Mr. James McEnroe. Bryan immediately told Nina that she had to repack the clock because it was from a supplier who had been trying to win business from Bryan’s company. They definitely could not accept the clock. Nina was very upset and responded that the clock was perfect for the. room and, besides, the clock came to their home, not to Bryan’s office. Because of Nina’s attachment to the clock, Bryan was unsure about what to do.

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PURCHASING ETHICS ASSIGNMENT QUESTIONS WITH EXPERT ANSWERS

1. What should Bryan do about the clock?

Bryan should follow his company’s code of ethics regarding accepting gifts from suppliers. If the code of ethics prohibits accepting gifts from suppliers, then Bryan should return the clock to the supplier with a polite note explaining the company’s policy. If the policy allows for gifts of a certain value or type, Bryan should check if the clock falls within the permissible limit and report the gift to his company’s ethics officer for documentation purposes. In any case, Bryan should not keep the clock and should not let personal preferences override his obligation to follow the company’s ethical guidelines.

2. What does the Institute of Supply Management (ISM) code of ethics say about accepting supplier favors and gifts?

The ISM code of ethics states that procurement professionals should avoid accepting gifts or favors that could influence their professional judgment or create a conflict of interest. The code specifies that gifts or favors of more than nominal value or that create an appearance of impropriety are prohibited. The code also advises procurement professionals to disclose gifts received from suppliers to their employers and to avoid giving suppliers preferential treatment in exchange for gifts.

3. Why do you think the supplier sent the clock to Bryan’s home and addressed it to his wife?

It is possible that the supplier sent the clock to Bryan’s home and addressed it to his wife to bypass the company’s gift policies and to create a sense of obligation or indebtedness on a personal level. Sending a gift to an employee’s home could also be a tactic to create a personal relationship with the employee outside of a professional setting. By addressing the gift to Bryan’s wife, the supplier may have hoped to appeal to her sense of aesthetics and persuade her to influence Bryan to favor the supplier’s company in future business dealings.

4. Does the mere act of sending the clock to Bryan mean that Mr. McEnroe is an unethical salesperson?

Not necessarily. It is possible that Mr. McEnroe was unaware of Bryan’s company’s gift policy or that he believed the clock to be of nominal value. However, if Mr. McEnroe knew or should have known that the gift violated the company’s code of ethics and sent it anyway with the intention of creating undue influence or obligation, then he would be acting unethically. The context, intent, and potential impact of the gift are important factors to consider when determining whether the gift is unethical.

Purchasing Ethics Scenario 2

Lisa Jennings thought that at long last, her company, Assurance Technologies, was about to win a major contract from Sealgood Instruments. Sealgood, a maker of precision measuring instruments, was sourcing a large contract for component subassemblies. The contract that Assurance Technologies was bidding on was worth at least $2.5 million annually, a significant amount given Assurance’s annual sales of $30 million. Her team had spent hundreds of hours preparing the quotation and felt they could meet Sealgood’s requirements in quality, cost, delivery, part standardization, and simplification. In fact, Lisa had never been more confident about a quote meeting the demanding requirements of a potential customer.

Troy Smyrna, the buyer at Sealgood Instruments responsible for awarding this con tract, called Lisa and asked to meet with her at his office to discuss the specifics of the contract. When she arrived, Lisa soon realized that the conversation was not going exactly as she had expected. Troy informed Lisa that Assurance Technologies had indeed prepared a solid quotation for the contract. However, when he visited Assurance’s facility earlier on a prequalifying visit, he was disturbed to see a significant amount of a competitor’s product being used by Assurance. Troy explained his uneasiness with releasing part plans and designs to a company that clearly had involvement with a competitor. When Lisa asked what Assurance could do to minimize his uneasiness, Troy replied that he would be more comfortable if Assurance no longer used the competitor’s equipment and used

Cases

Sealgood’s equipment instead. Lisa responded that this would mean replacing several hundred thousand dollars worth of equipment. Unfazed, Troy simply asked her whether or not she wanted the business. Lisa responded that she needed some time to think and that she would get back to Troy in a day or so.

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PURCHASING ETHICS ASSIGNMENT

1. Do you think the buyer at Sealgood Instruments, Troy Smyrna, is practicing unethical behavior? First, what is the term for this behavior, and second, defend why you think it is ethical or unethical behavior.

The behavior exhibited by Troy Smyrna is commonly referred to as “buying influence” or “kickbacks.” It is unethical behavior where a purchasing agent or a buyer demands something of value from a supplier in exchange for a favorable treatment, such as awarding a contract. In this scenario, Troy Smyrna is demanding that Assurance Technologies replace its competitor’s equipment with Sealgood’s equipment to ensure the contract’s award. While this behavior may be common in business, it is unethical because it is not based on the merits of the supplier’s product or service. Instead, it is based on an agreement to provide something of value in exchange for a favorable outcome. Therefore, Troy’s behavior is unethical.

2. What should Lisa do in this situation? Formulate a response.

Lisa should first consult with her supervisor and the company’s legal team before responding to Troy Smyrna’s request. If it is determined that Troy’s request is an attempt to obtain a kickback, Lisa should not comply with the request and should report the matter to the appropriate authorities. However, if it is determined that the use of Sealgood’s equipment is reasonable and necessary for the contract’s fulfillment, Lisa should negotiate with Troy to minimize the costs of the equipment replacement or explore alternative solutions that would address his concerns without incurring significant expenses. Lisa should also ensure that any agreements with Sealgood are based solely on the merits of Assurance’s product and service, and not on any demands for kickbacks or other unethical behavior.

Purchasing Ethics Scenario 3

Ben Gibson, the purchasing manager at Coastal Products, was reviewing purchasing expenditures for packaging materials with Jeff Joyner. Ben was particularly disturbed about the amount spent on corrugated boxes purchased from Southeastern Corrugated. Ben said, “I don’t like the salesman from that company. He comes around here acting like he owns the place. He loves to tell us about his fancy car, house, and vacations. It seems to me he must be making too much money off of us!” Jeff responded that he heard Southeastern Corrugated was going to ask for a price increase to cover the rising costs of raw material paper stock. Jeff further stated that Southeastern would probably ask for more than what was justified simply from rising paper stock costs.

After the meeting, Ben decided he had heard enough. After all, he prided himself on being a results-oriented manager. There was no way he was going to allow that salesman to keep taking advantage of Coastal Products. Ben called Jeff and told him it was time to rebid the corrugated contract before Southeastern came in with a price increase request. Who did Jeff know that might be interested in the business? Jeff replied he had several companies in mind to include in the bidding process. These companies would surely come in at a lower price, partly because they used lower-grade boxes that would probably work well enough in Coastal Products’ process. Jeff also explained that these suppliers were not serious contenders for the business. Their purpose was to create competition with the bids. Ben told Jeff to make sure that Southeastern was well aware that these new suppliers were bidding on the contract. He also said to make sure the suppliers knew that price was going to be the determining factor in this quote, because he considered corrugated boxes to be a standard industry item.

PURCHASING ETHICS ASSIGNMENT

1. Is Ben Gibson acting legally? Is he acting ethically? Why or why not?

Ben Gibson’s actions raise ethical concerns. He is intentionally seeking to replace a supplier solely based on his personal dislike for their sales representative and his assumption that the supplier is making too much profit. He is also encouraging the use of lower-grade boxes, which may not meet the quality standards required by Coastal Products, in order to reduce costs. Ben’s behavior violates the principles of fairness, transparency, and honesty, which are key to ethical purchasing practices.

Furthermore, Ben’s actions may not be illegal, but they are not in the best interest of Coastal Products. By intentionally seeking to replace Southeastern Corrugated without proper justification, Ben is putting the company at risk of receiving lower-quality products and services, which can impact the company’s reputation and profitability.

2. As the Marketing Manager for Southeastern Corrugated, what would you do upon receiving the request for quotation from Coastal Products?

Upon receiving the request for quotation from Coastal Products, the Marketing Manager for Southeastern Corrugated should carefully review the bid and determine whether it is feasible to offer a competitive price. If the rising cost of raw materials has impacted the price, the company should provide evidence to support the price increase. It is also important to maintain professionalism and not allow personal biases to affect the bidding process.

If Southeastern Corrugated is confident in its ability to provide quality products and services at a competitive price, it should participate in the bidding process. The company can also reach out to Coastal Products to discuss any concerns they may have regarding pricing or quality. However, if Southeastern Corrugated believes that the bidding process is being manipulated or is not fair, they may choose not to participate in the bid.

Regardless of the outcome of the bidding process, Southeastern Corrugated should focus on maintaining a positive relationship with Coastal Products by providing excellent customer service, quality products, and fair pricing. This will help to ensure that the company remains a preferred supplier for Coastal Products in the future.

Cases

Purchasing Ethics Scenario 4

Sharon Gillespie, a new buyer at Visionex, Inc., was reviewing quotations for a tooling contract submitted by four suppliers. She was evaluating the quotes based on price, target quality levels, and delivery lead time promises. As she was working, her manager, Dave Cox, entered her office. He asked how everything was progressing and if she needed any help. She mentioned she was reviewing quotations from suppliers for a tooling contract. Dave asked who the interested suppliers were and if she had made a decision. Sharon indicated that one supplier, Apex, appeared to fit exactly the requirements Visionex had specified in the proposal. Dave told her to keep up the good work.

Later that day Dave again visited Sharon’s office. He stated that he had done some re search on the suppliers and felt that another supplier, Micon, appeared to have the best track record with Visionex. He pointed out that Sharon’s first choice was a new supplier to Visionex and there was some risk involved with that choice. Dave indicated that it would please him greatly if she selected Micron for the contract.

The next day Sharon was having lunch with another buyer, Mark Smith: She mentioned

the conversation with Dave and said she honestly felt that Apex was the best choice. When i

Mark asked Sharon who Dave preferred, she answered, “Micron:’ At that point Mark rolled I !

his eyes and shook his head. Sharon asked what the body language was all about. Mark replied, “Look, I know you’re new but you should know this. I heard last week that Dave’s brother-in-law is a new part owner of Micron. I was wondering how soon it would be be fore he started steering business to that company. He is not the straightest character:’ Sharon was shocked. After a few moments, she announced that her original choice was still the best selection. At that point Mark reminded Sharon that she was replacing a terminated buyer who did not go along with one of Dave’s previous preferred suppliers.

PURCHASING ETHICS ASSIGNMENT

1. What does the Institute of Supply Management code of ethics say about financial conflicts of interest

The Institute of Supply Management (ISM) code of ethics states that purchasing professionals should avoid any financial conflicts of interest that could compromise their objectivity and impartiality in the procurement process. This includes not accepting any gifts, favors, or other forms of compensation from suppliers that could influence their purchasing decisions. Additionally, purchasing professionals should disclose any potential conflicts of interest to their employer and take appropriate steps to mitigate any conflicts.

2. Ethical decisions that affect a buyer’s ethical perspective usually involve the organizational environment, cultural environment, personal environment, and industry environment. Analyze this scenario using these four variables.

Organizational environment: The actions of Dave Cox, Sharon’s manager, suggest a culture in which personal relationships and preferences take precedence over objective criteria in supplier selection. This environment can create a perception of unfairness and favoritism among suppliers and damage the company’s reputation.
Cultural environment: The culture of the purchasing department and the company as a whole can influence ethical decision-making. If the culture prioritizes profit over ethical behavior, individuals may be more likely to engage in unethical conduct to achieve their goals.
Personal environment: Sharon’s personal values and beliefs may influence her ethical decision-making in this scenario. Her commitment to ethical behavior and her desire to do what is best for the company may conflict with pressure from her manager to select a preferred supplier.
Industry environment: The competitive nature of the industry and the pressure to reduce costs and increase efficiency can create a climate in which unethical behavior, such as favoritism and conflict of interest, can be more prevalent.

3. What should Sharon do in this situation?

Sharon should act in accordance with her ethical principles and professional responsibilities as a purchasing professional. She should not allow personal relationships or pressure from her manager to influence her supplier selection decision. Instead, she should base her decision on objective criteria such as price, quality, and delivery lead time promises. If Sharon believes that Dave’s preference for Micron is driven by a conflict of interest, she should report her concerns to her supervisor or the company’s ethics hotline. It may also be appropriate for Sharon to request additional information or clarification from Dave regarding his reasons for preferring Micron. Ultimately, Sharon should strive to maintain her integrity and uphold the ethical standards of the profession.

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October 22, 2024/by Reliable Papers

Provide reasons why most firms do not have an adequate supplier measurement system

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Provide Reasons Why Most Firms Do Not Have an Adequate Supplier Measurement System

Provide reasons why most firms do not have an adequate supplier measurement system

A supplier measurement system is a process used by companies to evaluate the performance of their suppliers based on various criteria such as quality, cost, delivery, and customer service. Despite the benefits of having a supplier measurement system, most firms do not have an adequate system in place. In this discussion, we will examine some reasons why most firms do not have an adequate supplier measurement system. These include:

Increases overall operation time for the company

One of the primary reasons why firms do not have an adequate supplier measurement system is that implementing such a system takes time and resources that could be used for other activities. The process of collecting data and analyzing it takes time away from core business activities. Therefore, firms may not see the benefit of investing time and resources into a supplier measurement system.

Difficulty in including all the criteria required to judge a particular supplier in one system

Another reason is that there are multiple factors to consider when evaluating a supplier, such as quality, cost, delivery, and customer service. It can be challenging to develop a system that effectively captures all of these factors and provides a comprehensive evaluation of a supplier’s performance. Therefore, firms may find it difficult to develop a supplier measurement system that accurately reflects their needs.

Costlier and time-consuming system to be included in the business

Developing and implementing a supplier measurement system can be expensive, requiring investment in technology, training, and personnel. Maintaining and updating the system over time also requires ongoing costs and resources. Therefore, firms may not have the financial resources to invest in a supplier measurement system.

Supplier measurement system uses company’s resources in a non-core activity which can otherwise be used for core business activities

As mentioned earlier, implementing a supplier measurement system takes time and resources away from core business activities that generate revenue for the company. Companies may prioritize investing in activities that directly contribute to their bottom line rather than indirect activities like supplier management. Therefore, firms may not consider supplier measurement as a core activity and hence neglect it.

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Importance of having a smaller supply base before committing to a supplier management and development program

In today’s fast-paced and highly competitive business environment, supplier management and development have become critical components of successful supply chain management. One of the key strategies that organizations adopt in this regard is to have a smaller supply base. This approach helps companies to optimize their supplier system and improve the overall quality of their products or services. In this discussion, we will explore the importance of having a smaller supply base before committing to a supplier management and development program.

Reasons for having a smaller supply base include:

Concentrate on optimizing supplier system

Improved communication: Having a smaller supply base enables companies to have better communication with their suppliers. This is because managing a smaller number of suppliers requires less time and resources. It allows companies to have regular meetings with their suppliers, which can lead to better collaboration and understanding of each other’s needs and expectations.
Better Quality: A smaller supply base also allows companies to focus on improving the quality of their products or services. When an organization has fewer suppliers, it is easier to monitor their performance and ensure that they meet the required quality standards. This enables the organization to have more control over the quality of their products or services and identify any issues early on before they escalate into major problems.
Better control: By working with a smaller supply base, companies can exercise better control over their supply chain. They can identify potential risks and address them proactively, rather than being reactive to issues that arise.

Build closer relationships with qualified suppliers

Stronger Relationships: A smaller supply base allows companies to develop stronger relationships with their suppliers. By working closely together, they can build trust and understanding that can lead to long-term partnerships.
Better Understanding of Suppliers: By working with a smaller supply base, companies can gain a better understanding of their suppliers’ capabilities and limitations. They can identify areas where suppliers need support and provide the necessary resources to help them improve.
c. Improved Supplier Performance: A smaller supply base enables companies to monitor and measure supplier performance more effectively. By setting clear expectations and providing regular feedback, companies can help their suppliers to improve their performance.

Reduce risk

Having a smaller supply base can also help reduce risk. When an organization has a large supply base, it is more challenging to monitor the performance and financial stability of each supplier. This increases the risk of supplier failure or disruption, which can have a significant impact on the organization’s operations and reputation. By having a smaller supply base, an organization can reduce the risk of supplier failure and ensure continuity of supply.

Cost savings

A smaller supply base can also lead to cost savings. By working with a smaller set of suppliers, an organization can negotiate better pricing and terms. This is because suppliers are more likely to offer competitive pricing to organizations that they have a strong and long-term relationship with. In addition, managing a smaller supplier base requires fewer resources, which can also lead to cost savings.

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Full-service supplier and its benefits

Introduction

A full-service supplier is a supplier who is capable of providing a wide range of activities, including access to design, research, development, supplier engineering, testing, and other services related to the supply chain. In this discussion, we will explore what a full-service supplier is and the benefits of using a full-service supplier.

Definition of a full-service supplier

A full-service supplier is a supplier who offers a wide range of services related to the supply chain, from design and research to production and delivery. They are capable of providing value-added services that can help organizations streamline their supply chain processes and improve their product or service quality.

Benefits of using a full-service supplier

Reduced Costs: Using a full-service supplier can lead to cost savings for an organization. This is because a full-service supplier is able to offer a wide range of services, which eliminates the need for an organization to work with multiple suppliers. This can lead to reduced transportation costs, as well as reduced procurement and administrative costs.

Streamlined Supply Chain: Working with a full-service supplier can streamline an organization’s supply chain by reducing the number of suppliers it needs to work with. This can lead to improved communication, as well as improved quality control and product consistency.

Improved Product Quality: A full-service supplier can offer access to design, research, and development services, which can help an organization improve the quality of its products or services. This can lead to improved customer satisfaction and increased brand loyalty.

Faster Time-to-Market: A full-service supplier can help an organization bring products to market more quickly by providing access to design and development services. This can help organizations stay ahead of the competition and respond more quickly to changes in the market.

Value-Added Services: A full-service supplier can offer value-added services, such as supplier engineering and testing. These services can help an organization improve its supply chain processes and ensure that its products or services meet or exceed customer expectations.

Conclusion

In conclusion, a full-service supplier is a supplier who offers a wide range of services related to the supply chain. Using a full-service supplier can lead to cost savings, streamlined supply chain processes, improved product quality, faster time-to-market, and access to value-added services. Therefore, organizations should consider the benefits of using a full-service supplier when evaluating their supply chain strategy.

Final Remarks on Supplier Management and Development Program

Before committing to a supplier management and development program, it’s important for a company to have a smaller supply base. This will help the company set up a good supplier measurement system. This is because it allows firms to focus on developing closer relationships with their suppliers, which can lead to better communication, collaboration, and trust.

A smaller supply base can also help companies save money on the costs of managing multiple suppliers and improve the quality of their goods or services by letting them work more closely with their suppliers.

Firms can make sure they work with the best suppliers and reach their business goals by putting in place a full-service supplier management program that includes supplier selection, performance evaluation, and development.

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October 20, 2024/by Reliable Papers

Marginal Practitioners and Limited Practitioners

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Marginal Practitioners and Limited Practitioners

Chiropractic is a healthcare profession that focuses on the diagnosis and treatment of musculoskeletal disorders, primarily those affecting the spine. The chiropractic profession is regulated by state laws and includes a range of practitioners, from those with limited training to those with advanced degrees and specialized training. Within the chiropractic profession, there are distinctions made between marginal practitioners and limited practitioners, which are based on their level of education, training, and professional status. This essay will explore the concepts of marginal and limited practitioners in chiropractic, examine the impact of these distinctions on the profession, and consider whether or not such distinctions should be applied to the chiropractic profession.

The concept of marginal practitioners in chiropractic

Definition and characteristics of marginal practitioners

Marginal practitioners in chiropractic refer to individuals who practice chiropractic techniques but do not have the required education or training to be considered legitimate chiropractic practitioners. According to the textbook “Chiropractic: An Illustrated History,” marginal practitioners are often self-taught or have received only brief or incomplete training from unaccredited schools or programs. These individuals may have some knowledge of chiropractic techniques but are not licensed or registered to practice as chiropractors. They may be massage therapists, physical trainers, or other healthcare professionals who incorporate chiropractic techniques into their practice without being licensed chiropractors. Marginal practitioners may also include individuals who have completed a short course or seminar on chiropractic techniques but lack the comprehensive education and training required for chiropractic licensure.

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Examples of marginal practitioners in chiropractic

Examples of marginal practitioners in chiropractic include massage therapists who offer spinal manipulation as part of their massage therapy practice, personal trainers who use chiropractic techniques as part of their training regimen, and acupuncturists who incorporate spinal manipulation into their treatments.

Impact of marginal practitioners on the chiropractic profession

The existence of marginal practitioners in chiropractic can have several negative impacts on the profession. Marginal practitioners may offer substandard care or even cause harm to patients due to their lack of education and training. Patients may also be misled by these practitioners, believing that they are receiving chiropractic care from a licensed practitioner when in fact they are not. This can damage the reputation of the chiropractic profession and lead to public distrust of licensed chiropractors.

The concept of limited practitioners in chiropractic

Definition and characteristics of limited practitioners

Limited practitioners in chiropractic refer to individuals who have completed a limited education and training program in chiropractic techniques but are not licensed to practice as full-fledged chiropractors. Limited practitioners may have completed a course or program in chiropractic techniques that do not meet the full requirements for licensure as a chiropractor. According to the textbook “Chiropractic: A Modern Way to Health,” limited practitioners may have graduated from accredited schools or programs, and may hold valid licenses to practice chiropractic. However, they may be limited in their ability to diagnose or treat certain conditions, or to perform certain procedures, such as ordering diagnostic tests, prescribing medications, or performing surgery. These limitations may be imposed by state or federal laws, insurance policies, or professional standards.

Examples of limited practitioners in chiropractic

Examples of limited practitioners in chiropractic include medical doctors, osteopaths, and nurse practitioners who have completed a course or program in chiropractic techniques and incorporate these techniques into their practice. These individuals are not licensed chiropractors but may be authorized to use certain chiropractic techniques as part of their broader scope of practice.

Impact of limited practitioners on the chiropractic profession

Limited practitioners in chiropractic can have a positive impact on the profession by increasing awareness and acceptance of chiropractic techniques among other healthcare professionals. This can lead to more referrals and collaborations between chiropractors and other healthcare providers. However, it is important to ensure that limited practitioners have adequate education and training in chiropractic techniques to provide safe and effective care to their patients.

What are the factors that contribute to marginalization?

The marginalization of some chiropractors in the US may be influenced by several factors, including:

Lack of standardized education and training: One of the factors that contribute to marginalization in chiropractic is the lack of standardized education and training requirements for chiropractors in the US. Unlike other healthcare professions, such as medicine or nursing, chiropractic education, and training is not standardized across all states. As a result, there is a wide range of educational programs and training options available, some of which may be of lower quality or accreditation standards. This lack of standardization can lead to variability in the knowledge and skills of chiropractors, which can contribute to the marginalization of some practitioners.
Inadequate regulation and oversight: Another factor that contributes to marginalization in chiropractic is the inadequate regulation and oversight of the profession in some states. While all states require chiropractors to be licensed, the requirements for licensure, including education, training, and examination, vary widely across states. Moreover, the enforcement of licensure requirements and disciplinary actions against non-compliant or unethical practitioners can also vary widely. This lack of consistent regulation and oversight can create opportunities for marginal and unethical practitioners to operate without consequences, which can contribute to their marginalization.
Bias and stereotypes: Another factor that contributes to marginalization in chiropractic is bias and stereotypes against the profession, especially from other healthcare providers and the public. Some healthcare providers and the public may view chiropractic as a pseudoscientific or alternative therapy, rather than a legitimate healthcare profession. This bias can lead to skepticism, mistrust, and stigma against chiropractors, especially those who operate outside the mainstream of the profession.
Economic and political pressures: Another factor that contributes to marginalization in chiropractic is economic and political pressures, such as those from insurance companies and government agencies. Insurance companies may limit or deny coverage for chiropractic care or require higher levels of documentation or justification for coverage, which can limit the financial viability of chiropractors. Government agencies may also restrict the scope of practice or reimbursement rates for chiropractors, which can limit their ability to provide comprehensive and affordable care. These pressures can create barriers to entry or sustainability for some chiropractors, which can contribute to their marginalization.

What are the implications of these distinctions?

The distinction between marginal practitioners and limited practitioners has several implications for the profession of chiropractic, as well as for the quality of care and reputation of the profession. These implications include:

Divisiveness: The distinction between marginal practitioners and limited practitioners creates a division within the chiropractic community, based on education, training, and status. This division can lead to rivalries, conflicts, and fragmentation, which can undermine the unity, coherence, and effectiveness of the profession.

Stigma: The distinction between marginal practitioners and limited practitioners also creates a stigma, or a negative label, that can be applied to chiropractors who are perceived as unqualified, unethical, or dangerous. This stigma can harm the reputation of the profession, and discourage patients from seeking chiropractic care.

Safety: The distinction between marginal practitioners and limited practitioners raises concerns about the safety of chiropractic care, especially for patients who may be treated by unqualified or unethical practitioners. Marginal practitioners, in particular, may lack the knowledge, skills, and ethical standards required to provide safe and effective care, which can put patients at risk of harm.

Quality of care: The distinction between marginal practitioners and limited practitioners also raises concerns about the quality of chiropractic care, especially for patients who may be treated by practitioners who are limited in their scope of practice. Limited practitioners, in particular, may not be able to provide the full range of diagnostic, therapeutic, and preventive services that patients may need, which can result in suboptimal outcomes and higher costs of care.

Should such distinctions be applied to the profession?

In my opinion, the distinction between marginal practitioners and limited practitioners should not be applied to the profession of chiropractic, as it is arbitrary, divisive, and detrimental to the quality of care and reputation of the profession. Here are some reasons why:

Lack of evidence: There is little empirical evidence to support the distinction between marginal practitioners and limited practitioners, or to demonstrate its validity or usefulness. Most studies on chiropractic education and practice have focused on accredited or mainstream practitioners, rather than on marginal or limited practitioners, making it difficult to draw definitive conclusions about their education, training, or outcomes.

Inadequate regulation: The distinction between marginal practitioners and limited practitioners highlights the need for better regulation and oversight of the chiropractic profession, especially in terms of education, training, licensure, and scope of practice. However, relying on this distinction as a basis for regulation may be inadequate or ineffective, as it does not address the underlying causes of poor quality or unethical practices, such as inadequate standards, poor enforcement, or lack of accountability.

Professional identity: The distinction between marginal practitioners and limited practitioners may also undermine the professional identity and autonomy of chiropractors, by imposing external or arbitrary criteria on their education, training, or scope of practice. Chiropractors should be able to define and develop their own standards and competencies, based on their knowledge, skills, and values, rather than on external or imposed criteria.

Patient-centered care: The distinction between marginal practitioners and limited practitioners may also neglect the perspective and needs of patients, who may not be aware of or concerned with the education, training, or status of their chiropractor, but rather with the quality, safety, and effectiveness of their care. Chiropractors should prioritize patient-centered care, which is based on the principles of partnership, responsiveness, respect, and empowerment, rather than on the distinction between marginal practitioners and limited practitioners.

Conclusion

The distinctions between marginal and limited practitioners in chiropractic can have both positive and negative impacts on the profession and on patients. While these distinctions can help ensure that patients receive safe and effective care from qualified practitioners, they can also create social hierarchies and limit access to care in some areas. It is important for the chiropractic profession to continue to address these issues and work towards providing high-quality care for all patients, regardless of the practitioner’s level of education or training. This can be achieved through increased access to education and training programs, resources for continuing education and professional development, and efforts to address bias and discrimination within the profession.

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October 18, 2024/by Reliable Papers

NRNP 6635 Week 6: Neurocognitive, Neurodevelopmental, Eating, and Somatic Symptom-Related Disorders Example

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NRNP 6635 Week 6: Neurocognitive, Neurodevelopmental, Eating, and Somatic Symptom-Related Disorders Example

NRNP 6635 Week 6: Neurocognitive, Neurodevelopmental, Eating, and Somatic Symptom-Related Disorders Assignment

NRNP 6635 Week 6: Neurocognitive, Neurodevelopmental, Eating, and Somatic Symptom-Related Disorders Assignment Brief

Assignment Instructions Overview

This assignment focuses on assessing and diagnosing patients with neurocognitive and neurodevelopmental disorders. Neurodevelopmental disorders, which typically manifest during childhood, include conditions like ADHD, autism spectrum disorder, and intellectual disabilities. Neurocognitive disorders, such as Alzheimer’s and vascular dementia, represent a decline in previous cognitive abilities and may emerge later in life. Students will use a case study from a video to assess a patient, develop differential diagnoses, and create a comprehensive psychiatric evaluation using DSM-5-TR guidelines.

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Understanding Assignment Objectives

The primary goal of this assignment is to apply theoretical knowledge to real-world cases of neurocognitive and neurodevelopmental disorders. Students will analyze the patient’s symptoms, gather relevant medical history, and perform mental status examinations. Based on these findings, they will explore potential differential diagnoses and identify a primary diagnosis using DSM-5-TR criteria. Critical thinking is emphasized in ruling out other conditions and justifying diagnostic decisions.

The Student’s Role

Students will assume the role of a psychiatric nurse practitioner tasked with performing a thorough evaluation. This includes engaging with the patient’s subjective experience, observing objective behaviors, conducting a mental status exam, and providing evidence-based differential diagnoses. Students will reflect on the session and incorporate legal, ethical, and health promotion considerations in their treatment plans.

Competencies Measured

This assignment will assess the student’s ability to:

Evaluate neurocognitive and neurodevelopmental symptoms and presentations.
Perform a comprehensive psychiatric assessment, utilizing diagnostic tools.
Differentiate between various disorders using DSM-5-TR criteria.
Formulate accurate primary diagnoses with supporting evidence.
Apply ethical considerations and critical thinking in patient care planning.

You can also read other assignment examples for the NRNP 6635 – Psychopathology and Diagnostic Reasoning Course below:

NRNP 6635 Week 1: Competencies of Advanced Nursing Practice Paper Example

NRNP 6635 Week 1 Assignment 2: Clinical Skills Self-Assessment Paper Example

NRNP 6635 Week 2: Practicum Experience Plan (PEP) Paper Example

NRNP 6635 week 3 Assignment: Assessing and Diagnosing Patients With Mood Disorders Paper Example

NRNP 6635 Week 4: Assessing and Diagnosing Patients With Anxiety Disorders, PTSD, and OCD Paper Example

NRNP 6635 Week 5: Comprehensive Psychiatric Evaluation and Patient Case Presentation Example

NRNP 6635 Week 8: Assessing and Diagnosing Patients With Substance-Related and Addictive Disorders Example

NRNP 6635 Week 6: Neurocognitive, Neurodevelopmental, Eating, and Somatic Symptom-Related Disorders Example

Introduction

Neurocognitive and neurodevelopmental disorders are complex conditions that require careful assessment and differentiation to ensure proper diagnosis and management. Neurodevelopmental disorders often present in childhood and can persist into adulthood, encompassing conditions like attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASD). In contrast, neurocognitive disorders represent a decline from previous functioning due to conditions like Alzheimer’s disease, brain injury, or stroke. This paper will provide a comprehensive psychiatric evaluation of Harold Brown, a 60-year-old male presenting with potential neurocognitive symptoms. The assessment will explore his clinical presentation, differential diagnosis, and develop a treatment plan based on evidence and DSM-5-TR criteria.

Subjective Data

Chief Complaint:

Harold Brown reports mild difficulty with attention and short-term memory, particularly when recalling recent events. He has expressed concerns about these issues affecting his daily activities, although he continues to work part-time as an engineer. He denies significant interference with basic functioning but mentions occasional lapses in attention and memory at work and in social settings. He was encouraged by his brother to seek evaluation after noticing a pattern of forgetfulness and distraction.

History of Present Illness (HPI):

Mr. Brown states that his symptoms began approximately 18 months ago and have gradually worsened. He reports difficulty maintaining focus during long tasks and trouble recalling names or recent conversations. He denies any abrupt changes in memory, mood disturbances, or significant changes in his personality. He describes himself as independent, though he acknowledges his brother’s concerns regarding his recent forgetfulness. His symptoms do not seem to vary based on time of day or specific activities. He denies any head trauma, seizures, or major medical illnesses contributing to his cognitive difficulties.

Medical History:

Hypertension: Controlled with Cozaar (Losartan) 100mg daily
Hypertriglyceridemia: Managed with fenofibrate 160mg daily
Benign Prostatic Hyperplasia (BPH): Managed with tamsulosin 0.4mg at bedtime
Angina: Taking aspirin 81mg daily

Medications:

Cozaar (Losartan) 100mg daily
Fenofibrate 160mg daily
Tamsulosin 0.4mg at bedtime
Aspirin 81mg daily

Allergies:

Allergic to Dilaudid.

Family History:

His father had hypertension and passed away at the age of 75 due to complications from a stroke. His mother died of Alzheimer’s disease at the age of 80. He has one younger brother, who is in good health.

Social History:

Mr. Brown lives alone, has never married, and has no children. He casually dates and reports a healthy social life. He enjoys having a scotch and cigar on weekends. He denies any history of drug use. He continues to work part-time and maintains good relationships with his colleagues and family members.

Developmental History:

No developmental delays or learning difficulties reported in childhood or adolescence.

Objective Data

General Appearance and Behavior:

Mr. Brown presents as a well-groomed, alert, and oriented male who appears his stated age. He is cooperative and maintains good eye contact throughout the interview. No abnormal movements or signs of agitation were observed. His speech was fluent and coherent, with normal rate and rhythm.

Vital Signs:

Temperature: 98.8°F
Pulse: 74 bpm
Respiration: 18 breaths/min
Blood Pressure: 134/70 mmHg
Height: 5’10”
Weight: 170 lbs

Neurological/Cognitive Observations:

Montreal Cognitive Assessment (MoCA): Score of 28/30, indicating mild cognitive impairment. Notable difficulty was observed in the attention and delayed recall sections of the test.
Attention Deficit: He had trouble sustaining attention during long tasks, such as performing serial 7s.
Memory: Delayed recall was impaired, as he struggled to remember words presented earlier during the MoCA. Immediate memory, however, remained intact.

Mental Status Examination (MSE)

Appearance:

Well-groomed, appropriately dressed for the weather and occasion.

Behavior:

Cooperative, calm, and maintains appropriate eye contact throughout the interview.

Speech:

Normal rate, volume, and tone, with no evidence of aphasia.

Mood:

Euthymic. He denies experiencing low mood or anxiety.

Affect:

Appropriate and full range.

Thought Process:

Logical, coherent, and goal-directed. No evidence of thought blocking or tangential thinking.

Thought Content:

Denies any hallucinations, delusions, or paranoia. No suicidal or homicidal ideation.

Cognition:

Oriented to person, place, time, and situation. Mild impairment observed in delayed recall and sustained attention.

Insight and Judgment:

Good. He demonstrates understanding of his symptoms and the need for evaluation.

Assessment and Differential Diagnoses

Based on the patient’s history, clinical presentation, and mental status examination, the following differential diagnoses are considered:

Mild Neurocognitive Disorder due to Alzheimer’s Disease

Supporting Evidence: His family history of Alzheimer’s (mother) and his subtle cognitive decline over the last 18 months support this diagnosis. His MOCA score of 28/30 with difficulty in attention and delayed recall aligns with mild neurocognitive disorder, which is often an early sign of Alzheimer’s disease. The DSM-5-TR criteria for mild neurocognitive disorder (memory impairment and cognitive decline without significant impairment of daily functioning) fit the presentation.

Vascular Cognitive Impairment

Supporting Evidence: Mr. Brown has a history of hypertension, a major risk factor for vascular dementia. Cognitive impairments such as attention deficits and executive function difficulties are consistent with vascular cognitive impairment. However, the lack of a history of stroke or other clear vascular events makes this less likely.

Major Depressive Disorder with Cognitive Impairment

Supporting Evidence: Depression can sometimes present as cognitive impairment in older adults. Mr. Brown does not report any mood changes or depressive symptoms, but mild cognitive impairment can sometimes be misdiagnosed as early Alzheimer’s disease in the context of mood disorders. The absence of significant mood changes, however, rules this out as the primary diagnosis.

Primary Diagnosis:

The most likely diagnosis is Mild Neurocognitive Disorder due to Alzheimer’s Disease, given the gradual onset, specific memory and attention deficits, and family history.

Plan and Recommendations

Pharmacological Treatment:

Initiate cholinesterase inhibitors such as donepezil (5mg daily) to slow cognitive decline. Consider an NMDA receptor antagonist like memantine if cognitive decline progresses.

Non-Pharmacological Interventions:

Cognitive Behavioral Therapy (CBT): To assist with adapting to cognitive changes and reducing anxiety around his symptoms.

Cognitive Training and Memory Exercises: Regular cognitive exercises, such as puzzles or memory games, may help slow further cognitive decline.

Lifestyle Modifications: Encourage regular physical exercise, a heart-healthy diet (such as the Mediterranean diet), and social engagement to reduce cognitive decline risk.

Follow-up:

Monitor the patient every 3 months for changes in cognitive functioning and reassess the treatment plan. Discuss potential lifestyle changes and engage family members in the care plan.

Reflection

What I Would Do Differently:

If I were to conduct this session again, I would explore more thoroughly Mr. Brown’s daily life and work challenges to assess the extent to which his cognitive decline affects his functional capacity. I would also probe further into his emotional responses to his cognitive changes, as denial or minimization of symptoms can sometimes obscure significant distress.

Legal and Ethical Considerations:

Given Mr. Brown’s independence, it’s essential to discuss future planning, such as advance directives, while he still has the cognitive capacity to make informed decisions. His family history of Alzheimer’s suggests the need for discussions around eventual caregiving needs.

Health Promotion and Disease Prevention:

Education on managing hypertension and hyperlipidemia is crucial to reduce further vascular risks. Continued control of these conditions may help slow cognitive decline. Additionally, promoting brain-healthy habits, such as regular exercise, a nutritious diet, and cognitive activities, will be emphasized.

Conclusion

The evaluation of Harold Brown’s cognitive functioning demonstrates the complexity of diagnosing neurocognitive disorders. While mild cognitive impairment is present, the primary diagnosis of mild neurocognitive disorder due to Alzheimer’s disease is supported by his clinical presentation, family history, and DSM-5-TR criteria. Through careful assessment and early intervention, Mr. Brown’s cognitive decline can be managed with appropriate treatment and lifestyle modifications.

Detailed Assessment Instructions for the NRNP 6635 Week 6: Neurocognitive, Neurodevelopmental, Eating, and Somatic Symptom-Related Disorders Assignment

Description

Assignment: Assessing and Diagnosing Patients With Neurocognitive and Neurodevelopmental Disorders

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Neurodevelopmental disorders begin in the developmental period of childhood and may continue through adulthood. They may range from the very specific to a general or global impairment, and often co-occur (APA, 2022). They include specific learning and language disorders, attention deficit hyperactivity disorder (ADHD), autism spectrum disorders, and intellectual disabilities. Neurocognitive disorders, on the other hand, represent a decline in one or more areas of prior mental function that is significant enough to impact independent functioning. They may occur at any time in life and be caused by factors such brain injury; diseases such as Alzheimer’s, Parkinson’s, or Huntington’s; infection; or stroke, among others.

For this Assignment, you will assess a patient in a case study who presents with a neurocognitive or neurodevelopmental disorder.

TO PREPARE:

Review this week’s Learning Resources and consider the insights they provide. Consider how neurocognitive impairments may have similar presentations to other psychological disorders.
Review the Comprehensive Psychiatric Evaluation template, which you will use to complete this Assignment.
By Day 1 of this week, select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the evaluation template in mind.
Consider what history would be necessary to collect from this patient.
Consider what interview questions you would need to ask this patient.
Identify at least three possible differential diagnoses for the patient.

By Day 7 of Week 10

Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate primary diagnosis.
Incorporate the following into your responses in the template:

Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
Objective: What observations did you make during the psychiatric assessment? 
Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what DSM-5-TR criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
Required Readings (click to expand/reduce)

American Psychiatric Association. (2022). Neurocognitive disorders. In Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://go.openathens.net/redirector/waldenu.edu?u…https://dsm.psychiatryonline.org/doi/full/10.1176/…

American Psychiatric Association. (2022). Neurodevelopmental disorders. In Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://go.openathens.net/redirector/waldenu.edu?u…https://dsm.psychiatryonline.org/doi/full/10.1176/…

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.

- Chapter 21, Neurocognitive Disorders
- Chapter 31, Child Psychiatry

Document: Comprehensive Psychiatric Evaluation Template

Document: Comprehensive Psychiatric Evaluation Exemplar

Required Media (click to expand/reduce)

Classroom Productions. (Producer). (2016). Neurocognitive disorders [Video]. Walden University.

Classroom Productions. (Producer). (2016). Neurodevelopmental disorders [Video]. Walden University.

MedEasy. (2016). Progressive neurocognitive disorders. | USMLE & COMLEX[Video]. YouTube.

Video Case Selections for Assignment (click to expand/reduce) Select one of the following videos to use for your Assignment this week. Then, access the document “Case History Reports” and review the additional data about the patient in the specific video number you selected.

Symptom Media. (Producer). (2017). Training title 48 [Video]. https://go.openathens.net/redirector/waldenu.edu?u…

Symptom Media. (Producer). (2017). Training title 50 [Video]. https://go.openathens.net/redirector/waldenu.edu?u…

Document: Case History Reports

Week 10 Neurocognitive and Neurodevelopmental Disorders Training Title 48
Name: Sarah Higgins
Gender: female
Age: 11 years old
T- 97.4 P- 58 R 14 98/62 Ht 4’5 Wt 65lbs
Background: no history of treatment, developmental milestones met on time, vaccinations up to date. Sleeps 9-10hrs/night, meals are difficult as she has hard time sitting for meals, she does get proper nutrition per PCP. she has a younger brother. lives with her parents in Washington,
D.C. No hx of head trauma.
Symptom Media. (Producer). (2017). Training title 48 [Video]. https://video-alexanderstreet- com.ezp.waldenulibrary.org/watch/training-title-48
Training Title 50
Name: Harold Brown
Gender: male
Age:60 years old
T- 98.8 P- 74 R 18 134/70 Ht 5’10 Wt 170lbs Background:
Has bachelor’s degree in engineering. He dates casually, never married, no children. Has one younger brother. Sleeps 7 hours, appetite good. Denied legal issues; MOCA 28/30 difficulty with attention and delayed recall; ASRS-5 21/24; denied hx of drug use; enjoys one scotch drink on the weekends with a cigar. Allergies Dilaudid; history HTN blood pressure controlled with Cozaar 100mg daily, angina prescribed ASA 81mg po daily, valsartan 80mg daily. Hypertriglyceridemia prescribed fenofibrate 160mg daily, has BPH prescribed tamsulosin 0.4mg po bedtime.
Symptom Media. (Producer). (2017). Training title 50 [Video]. https://video-alexanderstreet- com.ezp.waldenulibrary.org/watch/training-title-50

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