Assignment: NR 452 Week 6 RUA: Evidence-Based Practice Paper

Purpose

The student previously analyzed their performance on the integrated comprehensive assessments and reflected on areas of opportunity and strategies to promote NCLEX-RN success and transition into practice. The student will now apply the priority concept (topic) to evidence-based professional practice upon which nurses have the ability to resolve or have a positive impact. There is a focus on the healthcare disparities of the individual, as well as ethical and legal implications to professional practice. The student will discuss how an interdisciplinary approach promotes quality improvement for the patient and evidence-based professional practice, driving positive outcomes.

Course outcomes: This assignment enables the student to meet the following course outcomes:

CO # 1: Synthesize knowledge from sciences, humanities, and nursing in managing the needs of humans as consumers of healthcare in a patient-centered environment. (PO#1)

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CO # 2: Integrate communication and relationship skills in teamwork and collaboration functioning effectively with health team members and consumers of care. (PO#3)

CO # 3: Utilize information technology to manage knowledge, mitigate error, and support decision making with health team members and consumers of care. (PO# 8)

CO # 4 Integrate critical thinking, clinical reasoning skills, best current evidence, clinical expertise, and patient/family preferences/values in the implementation of the nursing process. (PO# 4)

CO # 5: Explore the impact of professional standards, legislative issues, ethical principles, and values on professional nursing, using data to monitor outcomes and improve quality and safety. (PO# 5, 6)

Due date: Your faculty member will inform you when this assignment is due. The Late Assignment Policy applies to this assignment.

Total points possible: 230 points

Preparing the assignment: Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions.

In this paper the student will provide a detailed description of the relationship between the category from the NCLEX-RN examination blueprint, the priority concept (topic) selected based on assessment performance, and professional practice.

Write a 4-6 page paper (not including the title page or reference page) using APA format
Include the following sections:
1. Introduction- 20 points/8%
Offer a detailed description of the purpose statement for the
Identify the priority concept (topic) from the Individual Student Comprehensive Assessment Trends: Longitudinal Performance Table drawn from one (1) of the four (4) main categories of the NCLEX-RN examination blueprint:
Assurance of a safe and effective care environment
Health promotion and maintenance of health
Preservation of the patient population’s psychosocial integrity
Preservation of the patient population’s physiological integrity
Provide a detailed description of the relationship between the category from the NCLEX-RN examination blueprint and the priority concept (topic).
1. Importance – 20 points/8%
Describe the importance of the priority concept (topic) to professional practice.
Describe the importance of the priority concept (topic) to the health status of a patient population.
Include the potential negative effect(s) to professional practice if the priority concept (topic) is unresolved.
Include the potential negative effect(s) to the patient population if the priority concept (topic) is unresolved.
1. Healthcare Disparities, Inequalities, and Interventions- 70 points/28%
  - Identify patient populations that may be negatively influenced by the priority concept (topic) if unresolved.
  - Identify healthcare resources to support evidence-based professional practice related to the priority concept (topic).
  - Summarize potential priority concept (topic) healthcare disparities and inequalities related to diverse populations.
  - Propose an evidence-based solution for the priority concept (topic) related to healthcare disparities.
  - Identify three (3) evidence-based practice interventions.
  - Prioritize the identified evidence-based practice interventions and provide rationale.
  - Discuss two (2) patient education considerations related to the priority concept (topic).
2. Legal & Ethical Considerations and Intervention Challenges- 40 points/16%
  - Identify at least one (1) ethical and one (1) legal implication for addressing the priority concept (topic) in professional practice.
  - Discuss at least one (1) strategy in prevention of an ethical dilemma related to the priority concept (topic) in professional practice.
  - Discuss at least one (1) strategy in prevention of legal consequences related to the priority concept (topic) in professional practice.
  - Identify one (1) anticipated challenge to the success of preventing the priority concept (topic) in professional practice.
  - Identify one (1) anticipated challenge to the success of resolving the priority concept (topic) in professional practice.
3. Participants and Interdisciplinary Approach – 20 points/8%
  - Identify all the parties who will be involved in the implementation of the priority concept (topic) interventions.
  - Discuss the role of each member in the intervention implementation for the priority concept (topic).
  - Identify a minimum of two (2) members of a discipline outside of nursing.
  - Discuss the benefit of including the identified interdisciplinary members from disciplines outside nursing to promote evidence-based professional practice.
4. Quality Improvement– 20 points/8%
  - Provide at least one (1) benefit in patient outcomes from addressing the priority concept (topic) within the clinical environment.
  - Provide at least one (1) benefit to the nursing profession that will result from addressing this priority concept (topic) in clinical professional practice.
  - Discuss at least one (1) resource utilized to promote improved patient outcomes in the clinical environment.
  - Discuss at least one (1) resource utilized to increase professional nurse knowledge promoting improved clinical professional practice.
5. Conclusion – 20 points/8%
  - Provide a thorough recap of the purpose to promote increased evidence-based professional practice knowledge related to the priority concept (topic) deficiency.
  - Summarize resources identified to support improved evidence-based professional practice related to the priority concept (topic).
  - Include a complete statement describing why addressing the priority concept (topic) matters for patient outcomes and evidence-based professional practice.
6. APA Style and Organization– 20 points/8%
  - References are submitted with paper.
  - Uses current APA format and is free of errors.
  - Grammar and mechanics are free of errors.
  - At least three (3) scholarly, peer reviewed, primary sources from the last 5 years, excluding the textbook, are provided. Each section should have a cited source to support information provided.

For writing assistance (APA, formatting, or grammar) visit the APA Citation and Writing page in the online Chamberlain library.

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Grading Rubric

Criteria are met when the student’s application of knowledge within the paper demonstrates achievement of the outcomes for this assignment.

Assignment Section and Required Criteria (Points possible/% of total points available)	Highest Level of Performance		High Level of Performance	Satisfactory Level of Performance	Unsatisfactory Level of Performance		Section not present in paper
Introduction (20 points/8.7%)	20 points			16 points	8 points	0 points
Required criteria 1. Offer a detailed description of the purpose statement for the paper. 2. Identify the priority concept (topic) from the Individual Student Comprehensive Assessment Trends: Longitudinal Performance Table drawn from one (1) of the four (4) main categories of the NCLEX-RN examination blueprint: a. Assurance of a safe and effective care environment b. Health promotion and maintenance of health c. Preservation of the patient population’s psychosocial integrity d. Preservation of the patient population’s physiological integrity 3. Provide a detailed description of the relationship between the category from the NCLEX-RN examination blueprint and the priority concept (topic).	Includes all 3 requirements for section.			Includes no fewer than 2 requirements for section.	Includes no fewer than 1 requirement for section.	No requirements for this section presented.
Importance (20 points/8.7%)	20 points		18 points	16 points	8 points	0 points
Required criteria 1. Describe the importance of the priority concept (topic) to professional practice 2. Describe the importance of the priority concept (topic) to the health status of a patient population. 3. Include the potential negative effect(s) to professional practice if the priority concept (topic) is unresolved. 4. Include the potential negative effect(s) to the patient population if the priority concept (topic) is unresolved.	Includes all 4 requirements for section.		Includes no fewer than 3 requirements for section.	Includes no fewer than 2 requirements for section.	Includes no fewer than 1 requirement for section.	No requirements for this section presented.
Healthcare Disparities, Inequalities, and Interventions (70 points/30.4%)	70 points		63 points	54 points	21 points	0 points
Required criteria 1. Identify patient populations that may be negatively influenced by the priority concept (topic) if unresolved. 2. Identify healthcare resources to support evidence-based practice related to the priority concept (topic). 3. Summarize potential priority concept (topic) healthcare disparities and inequalities related to diverse populations. 4. Propose an evidence-based solution for the priority concept (topic) related to healthcare disparities. 5. Identify three (3) evidence-based practice interventions. 6. Prioritize the identified evidence-based practice interventions and provide rationale. 7. Discuss two (2) patient education considerations related to the priority concept (topic).	Includes all 7 requirements for section.		Includes no fewer than 5-6 requirements for section.	Includes no fewer than 3-4 requirements for section.	Includes no fewer than 1-2 requirements for section.	No requirements for this section presented.
Legal & Ethical Considerations and Intervention Challenges (40 points/17.4%)	40 points		36 points	31 points	12 points	0 points
Required criteria 1. Identify at least one (1) ethical and one (1) legal implication for addressing the priority concept (topic) in professional practice. 2. Discuss at least one (1) strategy in prevention of an ethical dilemma related to the priority concept (topic) in professional practice. 3. Discuss at least one (1) strategy in prevention of legal consequences related to the priority concept (topic) in professional practice. 4. Identify one (1) anticipated challenge to the success of preventing the priority concept (topic) in professional practice. 5. Identify one (1) anticipated challenge to the success of resolving the priority concept (topic) in professional practice.	Includes all 5 requirements for section.		Includes no fewer than 4 requirements for section.	Includes no fewer than 3 requirements for section.	Includes no fewer than 1-2 requirements for section.	No requirements for this section presented.
Participants and Interdisciplinary Approach (20 points/8.7%)	20 points		18 points	16 points	8 points	0 points
Required criteria 1. Identify all the parties who will be involved in the implementation of the priority concept (topic) interventions. 2. Discuss the role of each member in the intervention implementation for the priority concept (topic). 3. Identify a minimum of two (2) members of a discipline outside of nursing. 4. Discuss the benefit of including the identified interdisciplinary member from disciplines outside nursing to promote evidence-based professional practice.	Includes all 4 requirements for section.		Includes no fewer than 3 requirements for section.	Includes no fewer than 2 requirements for section.	Includes no fewer than 1 requirement for section.	No requirements for this section presented.
Quality Improvement (20 points/8.7%)	20 points		18 points	16 points	8 points		0 points
Required criteria 1. Provide at least one (1) benefit in patient outcomes from addressing the priority concept (topic) within the clinical environment. 2. Provide at least one (1) benefit to the nursing profession that will result from addressing this priority concept (topic) in clinical professional practice. 3. Discuss at least one (1) resource utilized to promote improved patient outcomes in the clinical environment. 4. Discuss at least one (1) resource utilized to increase professional nurse knowledge promoting improved clinical professional practice.	Includes all 4 requirements for section.		Includes no fewer than 3 requirements for section.	Includes no fewer than 2 requirements for section.	Includes no fewer than 1 requirement for section.		No requirements for this section presented.
Conclusion (20 points/8.7%)	20 points			16 points	8 points		0 points
Required criteria 1. Provide a thorough recap of the purpose to promote increased evidence-based professional practice knowledge related to the priority concept (topic) deficiency. 2. Summarize resources identified to support improved evidence-based professional practice related to the priority concept (topic). 3. Include a complete statement describing why addressing the priority concept (topic) matters for patient outcomes and evidence-based professional practice.	Includes all 3 requirements for section.			Includes no fewer than 2 requirements for section.	Includes no fewer than 1 requirement for section.		No requirements for this section presented.
APA Format, Grammar, and Punctuation (20 points/8.7%)	20 points	18 points		16 points	8 points	0 points
Required criteria 1. References are submitted with paper. 2. Uses current APA format and is free of errors. 3. Grammar and mechanics are free of errors. 4. At least three (3) scholarly, peer reviewed, primary sources from the last 5 years, excluding the textbook, are provided. Each section should have a cited source to support information provided.	Includes all 4 requirements for section.	Includes no fewer than 3 requirements for section.		Includes no fewer than 2 requirements for section.	Includes no fewer than 1 requirement for section.	No requirements for this section presented.
Total Points Possible = 230 points

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RUA: Evidence-Based Practice Paper

Preservation of the patient population’s psychosocial integrity is the selected priority topic from the Individual Student Comprehensive Assessment Trend. Psychosocial integrity is a fundamental health need for all individuals. It refers to a state of psychological and sociological homeostasis, which is affected during illness, stress, or crisis. The purpose of this paper is to explain the importance of psychosocial integrity and the related healthcare disparities, ethical and legal considerations, and interdisciplinary approach.

Importance

Psychosocial integrity is significant to professional nursing practice and patients, particularly in the element of behavioral interventions. The nurse is tasked with assessing a patient’s appearance, mood, and psychomotor behavior, identifying and addressing inappropriate and abnormal behavior, and assisting the patient with the self-control of behavior. This helps to promptly identify patients with abnormal behavior and take appropriate nursing interventions, which reduces the mental health burden for nurses (Hancock, 2018). Patients are trained on appropriate behavior control, like stress and relaxation techniques, physical exercise, and maintaining a consistent environment, schedules, and routines. This improves their mental, social, and physical well-being leading to better health outcomes (Hancock, 2018). Failing to resolve psychosocial integrity can raise the burden of mental health disease, increasing the workload for healthcare providers. Besides, it would affect patients due to a high prevalence of mental disorders like anxiety, depression, and substance use disorders (SUDs), which affect their overall health.

Healthcare Disparities, Inequalities, and Interventions

Adolescents can be negatively affected if psychosocial integrity is unresolved. The 21st century has seen a dramatic shift in adolescent risks and behaviors, threatening their mental health and well-being. Adolescents are a vulnerable patient population and are generally prone to mental health issues. Farley (2020) explains that any social and physical circumstances and behaviors can affect adolescents’ health and increase the risk of mental disease and suicide. Adolescents are a vulnerable population to health issues owing to their stage of development, which affects their capacity to make safe decisions and the need to depend on others for support (Wahid et al., 2021). Besides, adolescents often perceive expectations from family and peers are too high, resulting in stress and hopelessness.

Adolescents are also vulnerable to mental health and behavioral disorders because of risk factors that cause stress during adolescence, like pressure to conform to peers, a desire for higher autonomy, exploration of sexual identity, and more access to and use of technology (Wahid et al., 2021). Failure to address psychosocial health in adolescents by providing adequate emotional and economic support results in the adolescents being overwhelmed with feelings of insecurity, helplessness, and stress. This leads to common mental disorders like anxiety and depression, as well as emotional disorders characterized by frustration, irritability, anger, mood changes, unexpected outbursts, and sleep disturbances.

The evidence-based interventions to address the mental health disparity in adolescents will include comprehensive mental health assessment, health education, and the involvement of teachers and school counselors. Healthcare providers must be able to conduct a mental health assessment and identify normal and abnormal variations in development and behaviors in adolescents (Farley, 2020). Adolescents with potential mental illness but without suicidal concerns should be educated on available resources and referred to a mental health provider for further assessment. The only way to identify suicidal thoughts or ideations in adolescents is through assessment. In this case, the nurse should evaluate if the adolescent has a plan and involves the parents to ensure safety (Farley, 2020). Furthermore, the nurse should teach the adolescent’s family the warning signs of a looming suicide attempt like increased alcohol and drug abuse, reckless behavior, changes in sleep patterns, panic attacks, agitation, anxiety, and conveying feelings of hopelessness or worthlessness.

Legal and Ethical Considerations and Intervention Challenges

Ethical implications that can arise when addressing psychosocial integrity surround the issue of autonomy. The provider should respect the patient’s right to decide if they will engage in a particular assessment or intervention and when they want to discontinue (Kurpad, 2018). Legal implications can occur when the confidentiality of patient information is not maintained. Confidentiality is vital in promoting an effective therapeutic alliance. The provider should note that the choice of which family member will be involved in the patient’s care is made by the patient. Nurses can avoid ethical dilemmas related to psychosocial integrity by providing patients with the information they require to give informed consent right from the beginning (Kurpad, 2018). If the patient is incompetent in making decisions, the nurse must give the proxy the same information.

Legal consequences can be avoided by creating the limits of confidentiality prior to initiating assessment or intervention, including the circumstances under which the confidentiality can be broken, to whom, and what degree. This includes cases of risk of harm to self or others and where there is a legal obligation for mandatory reporting (Kurpad, 2018). The social stigma linked to mental illness can hinder the prevention of psychosocial integrity issues, which affects the patient and the family. Thus, individuals may be hesitant to access mental health care and support systems when experiencing stress or suicidal ideations (Coombs et al., 2021). Besides, challenges to success in resolving psychosocial integrity include a lack of social support, which worsens existing mental health issues leading to feelings of helplessness and hopelessness.

Participants and Interdisciplinary Approach

Interventions for addressing psychosocial integrity require an interdisciplinary team approach comprising a mental health nurse, psychiatrist, counselor, and religious leader.

The mental health nurse will provide care and health education for acute and chronic behavioral health issues. The psychiatrist will evaluate patients for impaired cognition, assess for signs and symptoms of acute and chronic mental diseases, develop a treatment plan, and evaluate it (Wahid et al., 2021). Besides, the counselor will guide patients on behavior modification, provide psychotherapy, integrate behavioral management techniques in therapy, and assess patients’ support systems and available resources. The religious leaders will assess and plan interventions to meet patients’ spiritual needs and evaluate if these needs are met. The psychiatrist and religious leader are team members outside the nursing discipline. It is important to include these members since the psychiatrist provides care beyond the nurse’s scope of practice and deals with complex cases (Wahid et al., 2021). The religious leader helps meet the spiritual needs of patients, which would be challenging for nurses.

Quality Improvement

Addressing psychosocial integrity will benefit patients by promoting early recognition and diagnosis of mental illnesses. This will promote prompt treatment of mental diseases, prevent the progression of these diseases, improve mental health outcomes, and reduce suicide rates. The nursing profession will also benefit since improved mental health outcomes will lead to a more healthy population (Hancock, 2018). Consequently, the patient workload and nursing burnout will significantly reduce. Social support groups can help improve patient outcomes since they provide a platform for individuals to socialize and relieve any distress related to loneliness and lack of social support (Coombs et al., 2021). Professional nurse organizations can increase nurse knowledge by providing members with continuing education, role-related competencies, certification opportunities, and educational conferences. Besides, they promote and encourage the application of EBP to its members.

Conclusion

Psychosocial integrity is a state of psychological and sociological homeostasis, an essential health need for all persons. Addressing this concept helps to identify patients with abnormal behavior early and take appropriate nursing interventions, reducing the mental health burden. It also improves individuals’ mental, social, and physical well-being leading to better health outcomes. Adolescents face various risk factors which increase their likelihood of developing mental and behavioral health conditions. Ethical and legal issues related to psychosocial integrity surround the patient’s right to autonomy and confidentiality, which should be upheld to avoid consequences.

References

Coombs, N. C., Meriwether, W. E., Caringi, J., & Newcomer, S. R. (2021). Barriers to healthcare access among U.S. adults with mental health challenges: A population-based study. SSM – population health, 15, 100847. https://doi.org/10.1016/j.ssmph.2021.100847

Farley, H. R. (2020). Assessing mental health in vulnerable adolescents. Nursing2020, 50(10), 48–53. https://doi.org/10.1097/01.NURSE.0000697168.39814.93

Hancock, T. (2018). Mental health promotion must be a priority. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 190(16), E522. https://doi.org/10.1503/cmaj.180464

Kurpad, S. S. (2018). Ethics in psychosocial interventions. Indian journal of psychiatry, 60(Suppl 4), S571–S574. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_26_18

Wahid, S. S., Ottman, K., Hudhud, R., Gautam, K., Fisher, H. L., Kieling, C., Mondelli, V., & Kohrt, B. A. (2021). Identifying risk factors and detection strategies for adolescent depression in diverse global settings: A Delphi consensus study. Journal of affective disorders, 279, 66–74. https://doi.org/10.1016/j.jad.2020.09.098