Disorder Analysis Project The purpose/objective of this assignment is the development of a scholarly case study presentation. The student will apply mental health clinical assessment and scholarly literature review to the development of an evidence-based care plan for a client of the student pair’s choosing. Elements of the assignment include: 1. Detailed mental status examination 2. Development of a relevant clinical PICOT question 3.
Completion of a literature review to answer the PICOT question 4. Development of an evidence-based nursing care plan for the specific client described. 5. The case study will be presented as a scholarly presentation to your professional peers supported by a professional level PowerPoint presentation. Assignment Requirements: This assignment builds in stages. • The student pair will choose a client from their clinical setting with a diagnosis of a mood disorder, a psychotic disorder, PTSD, or a co-occurring substance abuse disorder (in addition to any of the prior diagnoses). Other diagnoses may be considered with approval of the instructor. • The first step is the completion of a mental status examination on the chosen client and development of a problem list. • Next the students develop a research question based on the client’s clinical needs, using the most important of your three nursing diagnoses. (The focus of the literature search and the care plan will be to answer this question.) • The students will then complete a literature search for a minimum of five scholarly research and evidence-based practice articles. Each article which will be analyzed using the worksheets provided and turned as a research bundle of the completed worksheets. • The final version of the disorder analysis presentation will be completed according to the detailed rubric below and presented to your clinical group on the last clinical day of the semester. Sources of information: Direct interview of client, personal observation of milieu, consultation with treating staff (psychiatrist and other multidisciplinary clinical team members), other academic psychiatric literature (e.g. psychiatric textbooks), research studies from peer reviewed mental health/nursing journals and evidence based practice articles from peer reviewed nursing journals are required. Secondary sources are not acceptable unless approved by the instructor. Presentation: The presentation should be no more than 20 minutes long, supported by a PowerPoint presentation. Assignment weight/points: Combined pre-writing assignments and final presentation is worth 10 % of course grade. DAP Pre-writing Assignments a. Mental Status Examination (MSE): See rubric for Mental Status Examination. The MSE provides the clinical database for your presentation. Graded by the clinical instructor. b. Research Question: Based on your assessment, develop a question in modified PICOT format. Submit to lecture instructor. Research Question should include: • Client Problem: What is the significant client problem to which evidence-based care will be applied? • Research direction: What area of evidence-based practice do you intend to explore? • Intervention: What do you hope to learn in the literature review to support your care plan interventions? (Specific therapies, medications, education, etc.) • Outcome: What measurable client outcomes do you seek? (Less symptoms, no symptoms, sobriety, medication adherence etc.) • Time: What is the time frame? The time frame should be realistic in the care setting. c. Research Bundle The purpose of the Research Bundle is to gather and critically evaluate reference material related to your PICOT question. Your Halter text is not an acceptable source. Submit to lecture instructor a completed worksheet for each study. Note that there are two forms. One is for research studies. The other is for all other types of scholarly sources. Evaluate four sources, possibly including: A) Theoretical books and/or articles to understand the disorder. B) Research studies (qualitative and/or quantitative) related to the dynamics of the disorder, medication management, and/or clinical management. C) Scholarly nursing research studies, consensus papers, and other scholarly sources regarding evidence-based practices related to the client’s care planning and/or medication needs. Disorder Analysis Paper Research Bundle Worksheets Research Study: (citation in APA format) Why was the study done? (What was the problem under investigation and the purpose (research question) of the study?) How closely does the focus of the study relate to your area of interest? Who was studied? Describe the population included in the study sample. Include the number of participants. What concerns do you have about generalizing from this population to your client? How was the study done? A. Identify the research methodology: 1. Quantitative: e.g. descriptive, correlational, cohort, randomized controlled, quasi-experimental 2. Qualitative: e.g. ethnography, grounded theory, phenomenology 3. Mixed method: a bit of both (e.g. descriptive survey plus phenomenology) B. What was the intervention? Discuss how the study was carried out? What variables were measured and/or compared? How were the variables measured? What was the outcome? Briefly summarize the research results. How you will apply this data to your DAP care plan? Summary of strengths/limitations/relevance of the study and its findings for use in your DAP? Scholarly Review or Theoretical Article: (citation in APA format) Description of source? (Integrative review, systematic review, meta-analysis, Meta-synthesis, Evidence-based clinical practice guideline? See Davies and Logan, p. 31) Significant data/evidence based practices? Strengths/limitations of the data/evidence presented? For example, did the author present sufficient scholarly support for practice implications or other conclusions? Relevance of the clinical/theoretical material presented to your client/ PICOT question? What concerns do you have about generalizing from this information to your client’s care planning needs? How can you use the results? Briefly describe the implications (i.e. how this study can /cannot be applied) to your problem of interest and your DAP care plan. Disorder Analysis Project Presentation The final presentation will be evaluated for thesis, audience, following directions, support, and professional writing style/grammar/usage/spelling, professional presentation, and APA references. Note that this assignment description is quite detailed. The time limit of 20 minutes will be strictly adhered to. Therefore, all information must be summarized and bulleted effectively to achieve a successful presentation. See below for suggested slide layout. Slides should include citations for referenced data and a reference list in APA format. Disorder Analysis Project PowerPoint Presentation Guidelines Slide #1: The title of your project Slide #2: Research question with discussion of the significance of the question. Slide #3: Introduce your client by using the demographic data and Axes I-V on the first page of the Mental Status Examination (MSE) form. Slide #4: Present only the pertinent/positive findings of the MSE. There is no need to mention those sections of the MSE, which reflect no problem. Slide #5: Medication table. The client may be taking many medications but you should focus only on the psychotropic medications and why this particular client is taking them. Cite a minimum of two scholarly references in addition to Halter on this slide. Sample Medication Table Medication Classification Action Dosage and Route Side Effects Rationale for use in this client Aricept (Donepezil hydrochloride) Cholinesterase inhibitor Inhibits the breakdown of endogenously released acetylcholine. 5 mg po every morning Monitor for gastrointestinal bleeding. Mild drowsiness, headache, metallic aftertaste, allergic dermatitis Used for the treatment of mild to moderate dementia of the Alzheimer’s type. This client currently exhibits moderate memory loss. Zyprexa (Olanzapine) Atypical Antipsychotic Blocks serotonin receptors and D2 receptors. 10 mg/day po every
evening Somnolence, agitation, nervousness, insomnia, dizziness, weight gain, constipation, dry mouth, increased appetite, Used for the treatment of psychotic symptoms of dementia. This client exhibits auditory hallucinations and paranoid delusions. Slide #6: The three most important nursing diagnoses for the subject of your presentation and which of these diagnoses led to the formulation of your PICOT question. Briefly discuss rationale for this nursing diagnosis based client problem and literature findings. Slides #7 +: The nursing interventions for the chosen nursing diagnosis for this client and how these interventions are supported by the literature. Based on your research, develop three interventions with rationales that are: a) Client specific b) Behaviorally measurable with timeframes c) Realistic and appropriate to the clinical setting. d) Based on the student’s literature search (with citations). Evaluation: If you were able to implement the intervention, discuss the actual client response. If not implemented, discuss the hoped-for result and how it would be behaviorally evaluated. As in all care plans, evaluation criteria must be client specific, setting specific, measureable, and have a clear timeframe. When a source is cited, please make sure you note it on the slide in APA format just as you would in a paper. There may be research articles, which don’t support your proposed nursing interventions. However, the preponderance of scholarly citations should support the interventions you would use with this client. This section should be heavily referenced, but your Halter textbook is not an acceptable source for this section. Cite a minimum of two primary research studies in your discussion. In addition, scholarly books and theoretical articles from peer-reviewed journals are appropriate. Slide: #? Conclusion: This slide should briefly summarize your presentation and answer your research question. Briefly identify practice implications and needs for further study. Slide: #? References: All sources cited in the presentation are listed at the end of the Power Point presentation in APA format and should be in 20-point font in order for the audience to be able to see them. Use as many slides as needed. DAP Presentation Grading Rubric Category Exemplary Meets Requirements Needs Improvement Score Article Selection Maximum 5 points All articles published in past 5 years unless instructor permission is received. Highly relevant research from scholarly source. Relevance of articles to the topic is apparent in most of the articles. All articles are current within past 5 years unless instructor permission is received. Relevance of articles is not apparent. Some articles older than 2009 without instructor permission. Fewer than 5 articles are included or articles were not all from scholarly sources. Introduction and research question Maximum 5 points Topic and research question for the case study are introduced and defined; significance to the client’s care and direction of the presentation explicit. Topic and research question for the case study are identified and defined. Significance to the client’s care and direction are identified. Topic and purpose is unclear to the reader. Significance to the client’s care is unclear. Client Problem and Assessment 15 points Data are presented in a concise, relevant manner incorporating all pertinent clinical data and clearly identifying significance of key findings. Data are presented in a relevant manner, which identifies the significance of key findings. Significant data is missing or clinical significance is unclear to the reader. Dynamics of the Disorder Maximum 15 points Thoughtful and in-depth synthesis of literature findings related to clinical problem. Organized presentation. Content vocabulary used appropriately and precisely. Topic addressed adequately. Information provides reader with sufficient knowledge of topic. Themes/issues evident. Content vocabulary generally accurate. Topic not addressed adequately. Information provides little knowledge on topic. Lacks organization. Significant errors in content vocabulary. Nursing Management 15 points Problem list is logically prioritized; care plan clearly incorporates evidence-based practices in a client/clinical setting-specific manner. Interventions, outcomes and evaluation are client specific, measurable, relevant and thoroughly evaluated. Problem list is logically prioritized; narrative care plan incorporates evidence based practices manner relevant to the client’s needs and clinical setting. Interventions, outcomes, and evaluation are client specific, measurable, and relevant. Problem list is poorly prioritized. Evidence-based rationale for interventions, outcomes and evaluation criteria are unclear, minimally relevant to the client’s needs and clinical setting and/or not measurable. Analysis and Conclusion Maximum 15 points Clear conclusions and analysis of research question. Insights and inferences appropriate and well supported from the literature reviewed and client assessment. Implications are strongly connected to findings. Conclusions regarding research question are based on findings. Inferences appropriate. Implications are identified and supported by findings. Conclusions not connected to findings. Research question not answered. Inferences inappropriate or general. Implications missing or poorly linked to findings. Grammar & Spelling Max. 5 points No grammar or spelling errors. 1-2 minor errors. 3 or more errors. APA Format, Citations, References, and Formatting 10 points Citations present when needed without errors. All citations and references include all elements of APA formatting, according examples in APA 7.01. Uses Word functions appropriately. Font readable on all slides and in handout format. Slides attractive and professional in appearance. No more than 2 minor errors in including and formatting citations in APA style formatting in all citations and references. Follows examples in APA 7.01. Follows all formatting guidelines; minor problems with Word functions. Font smaller than comfortable to read in some slides. Slides neat and professional in appearance More than two minor errors or one significant error in including and formatting citations and references. Does not follow APA 7.01. Formatting errors; page length incorrect; poor use of Word functions. Font too small to read on slides and handout format. Slide format distracts from presentation. Presentation 15 points Presentations clear, concise and coherent. Student presents information in logical, interesting sequence, demonstrates command of knowledge, is easy to understand (elocution and volume) Presentation clear logically presented. Student presents information in organized manner and answers question appropriately. Presentation does not flow or is without logical organization. Student is unable to provide detailed answers to question. Low volume or poor enunciation interferes with audience understanding of content. Total points (100 possible):
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