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Special Considerations for Patient Populations

Utilize the case study assigned to you by faculty for a patient population for special consideration during prescribing practices. You will consider the specific patient and determine the appropriate medication to prescribe, based on the patient specifics and medication attributes in various case studies. You will construct a 4 pgs.

    ACOG recommendations or standpoint about Birth-Doulas pwerpint

    I have uploaded the assignment instructions and the article that will serve as the topic of the assignment. Please read all instructions and the article. Also, do the extra slide with ACOG recommendations or standpoint about Birth-Doulas.

    Assignment Objectives

    1. Demonstrate communication, professionalism, and collaboration skills 

    · Submit the powerpoint to the drop box prior to the start of the session 

    · Arrive on time with a working microphone and camera

    · Meet from a quiet location with a stable internet connection

    · Present your information live, succinctly, and clearly

    · Actively engage in discussion of your peers' projects without distraction

    2. Develop an understanding of the ACNM core documents and their application to practice

    · Select one ACNM position statement or issue brief

    · Briefly describe the selected statement

    · Discuss how three of the  ACNM Code of Ethics apply to the position statement or issue brief you selected

    · Describe which three of the  Hallmarks of Midwifery the position statement or issue brief illustrates 

    · Reflect on how this will guide your practice as a nurse-midwife

    3. Appreciate the value of collegial networks and collaborative learning.

     

    You signed up for this session in week 1 of the course. Please check your calendar for the date and time you signed up for. Your faculty will provide joining information. 

    Each student will choose a position statement from the list of  ACNM Position Statements, Clinical Bulletins, or Issue Briefs  (links located in Module 4). You'll apply ethical principles and the Hallmarks of Midwifery to your chosen statement and consider how this statement will affect future practice. Each student will present their slides in 3-5 minutes, with a few minutes for discussion after each presentation. 

    Step by Step Instructions.

    1. Choose an ACNM position statement, Clinical Issue, or Issue Brief that addresses a topic that you are interested in.

    2. Create your slides:

    · Plan to briefly share the key points of the statement with your group. They should be familiar with your statement so you do not have to read it to them. Please do not use this time to provide a lengthy lecture about this topic. If the position statement is long, then bullet the salient points. Only share what you must to describe the position statement's stance. (One slide)

    · Identify 3 of the ACNM code of ethics that are relevant to your chosen statement. (One slide)

    · Identify 3 of the Hallmarks of Midwifery (Hallmarks are found in the ACNM Core Competencies document) that the statement utilizes or illustrates. (One slide)

    · Finish with a reflection on how you foresee the statement and the associated ethical implications/hallmarks or midwifery that may guide your practice (One slide)

    · Follow these best practices for your presentation, including image attribution: https://library.frontier.edu/ld.php?content_id=57245504Links to an external site.

    · Include a reference slide at the end using APA 7th edition. 

    · Practice your presentation–it should take 3-5 minutes to present. 

    3. Read the position statements chosen by the other participants in your group so you are prepared to discuss.

    4. Submit your slides to the dropbox before your presentation begins–this assignment is due on the day of your presentation, NOT on the canvas due date!

    5. Arrive at the correct session on time and presentation ready with headphones/earbuds available and in an environment conducive to participation. 

    6. Present your slides to the group & help facilitate a group discussion on your topic. 

     

     

    Optional– Accessing ACOG position statements

     If anyone is interested in exploring and comparing an ACOG position statement, committee opinion, or practice bulletin on the same topic. They may access the ACOG document as follows.

     

    1. Go to the ACOG website-www.acog.org

    2. Go to "My ACOG" in the upper left corner

    3. Login with username:  [email protected] .

                         password: TeddyBear!

    If you choose to include the ACOG statement in your ethical discussion then feel free to add one additional ppt. slide to highlight the key points made by ACOG.

    Rubric

    Ethical Principles

    Ethical Principles

    Criteria

    Ratings

    Pts

    This criterion is linked to a Learning OutcomeEthical and Hallmarks of Midwifery Content

    10 ptsProficientThe presentation includes an overview of the chosen statement. The presentation clearly identifies 3 ethical principles and/or codes of ethics that reflect pertinent ethical implications raised within the position statement. Presentation clearly identifies and explains how 3 Hallmark of Midwifery are illustrated by the statement.

    7 ptsApprenticeThe presentation is not clear or does not include an overview of the chosen statement and/or the presentation identifies 1-2 ethical principles and/or codes of ethics that reflect pertinent ethical implications raised within the position statement. Presentation identifies and explains how 1-2 Hallmarks of Midwifery are illustrated by the chosen statement.

    4 ptsNoviceThe presentation does include an overview of the chosen statement. The presentation does not clearly identify, explain, or include the Hallmarks of Midwifery and/or pertinent ethical principles/code of ethics.

    0 ptsNo MarksNo ethical or Hallmark of Midwifery content addressed. (0 pts.)

    10 pts

    This criterion is linked to a Learning OutcomePresentation

    5 ptsProficientPresentation is well delivered and reflect thoughtful consideration of the required readings and other course content. PPT. slides use bullets and graphs in an attractive manner. Slides include citations and a Reference slide. (Max 5pts)

    3 ptsApprenticePresentation is well delivered and reflect consideration of require readings but is given in generalities. Some slides are wordy with few graphics. No citations and/or no references are included. (Max 3pts)

    1 ptsNovicePresentation is vague and poorly delivered. All slides are wordy with no graphics. No citations and no references are included. (1pts)

    5 pts

    This criterion is linked to a Learning OutcomeParticipation

    5 ptsProficientActively engage in your peers' presentations without becoming distracted. Participate in the discussion by making several substantive contributions.

    3 ptsApprenticeEngage in peers' presentations with few distractions. Some participation in discussion with few substantive comments.

    1 ptsNoviceStudent is distracted during the presentation, does not make any substantive contributions to the discussion (1pts)

    5 pts

    This criterion is linked to a Learning OutcomeProfessionalism

    5 ptsProficientStudent arrives on time to the correct session with a working microphone and camera. Student joins the session from a quiet, professional location.

    3 ptsApprenticeStudent arrives late, to the wrong session, creates a disruption, or joins from an environment that is not conducive to respectful participation.

    1 ptsNoviceStudent arrives more than 5 minutes late, microphone and/or camera are not working, or joins from a loud or chaotic environment.

    5 pts

    ,

    8403 Colesville Road, Suite 1230, Silver Spring, MD 20910-6374 • ph. 240.485.1800 • fax: 240.485.1818 • www.midwife.org | 1

    POSITION STATEMENT

    Birth Doulas

    Doulas are trained to provide physical, emotional, and informational support to a laboring person

    and their support people. Their work on the maternity care team is known to improve birth

    outcomes and increase satisfaction with the birth experience.1 Birth doulas are an integral part of

    the maternity care team, promoting physiologic birth,2 attending to the nonclinical needs of the

    laboring person, and enhancing communication and relationships among the client and their

    midwife, physician, and nurse.

    The continuous labor support provided by birth doulas is consistent with the hallmarks of

    midwifery: incorporation of scientific evidence into clinical practice; promotion of patient- and

    family-centered care; recognition of the therapeutic value of human presence; collaboration with

    members of the interprofessional health care team; and advocacy for informed choice, shared

    decision-making, and the right to self-determination.3 Federal, state, local, and institutional

    policies that promote continuous labor support will yield optimal birth outcomes for mothers and

    babies and result in substantial cost savings overall.4,5

    The American College of Nurse-Midwives (ACNM) affirms the following:

    • The skill, training, and expertise provided by doulas make them a valuable part of the

    health care team, working collaboratively to facilitate a safe, satisfying, and client-

    centered labor and birth experience.

    • Decades of research clearly demonstrate that continuous labor support contributes to

    improved outcomes, such as lower cesarean rates, lower rates of epidural anesthesia

    use, and higher rates of breastfeeding initiation, without risk of harm.2,6

    • Given that states now recognize investments in doula care as an integral part of

    maternity care reform, ensuring adequate remuneration and investment in all

    evidence-based maternity care will advance sustainable efforts to improve maternal

    and infant health outcomes.7

    • By providing culturally congruent, client-centered care and advocacy, community-

    based doulas may give support that will help protect parents from the effects of

    racism and racial bias in health care settings.8

    Background on the Benefits of Continuous Labor Support

    Physical, emotional, and informational support is essential to ensuring the best perinatal

    outcomes. The physical support provided by a birth doula can include guiding position changes

    during labor, ensuring adequate energy and hydration for the client, and relieving the client’s

    discomfort and pain by offering comfort measures. Physical support can also include massage

    and help with ambulating or getting in and out of the bathroom or tub. This type of support not

    only increases a laboring person’s sense of well-being, confidence, and comfort, but it also may

    shorten the duration of labor.9 Emotional support is essential because labor and birth are intense

    8403 Colesville Road, Suite 1230, Silver Spring, MD 20910-6374 • ph. 240.485.1800 • fax: 240.485.1818 • www.midwife.org | 2

    life experiences, often occurring in an unfamiliar health care setting. The relationship among a

    doula and the birthing person, their support persons, and the provider can enhance the birthing

    person’s confidence and trust in themselves and the birth process and increase pride and

    satisfaction in labor and birth. Making positive memories of the birth experience can create a

    strong foundation for the future challenges of parenting. Informational support expands and

    explains what the other perinatal care providers may be offering, provides reassurance about the

    normal course of labor and birth, and allows access to evidence-based information about options

    in labor and birth for the laboring person and their support person.10 Trained birth doulas can

    assist maternity care providers in explaining health care jargon, terminology, and routine

    processes to the people they serve in culturally congruent ways. Informed and shared decision-

    making is enhanced when a doula is part of the maternity care team.

    In addition to their work during birth, doulas provide support to birthing people before and after

    birth. Prenatally, doulas meet one on one to aid with readiness for labor as well as provide

    education about how to cope. Postnatally, doulas often support the family by cooking, cleaning,

    and caring for other children. This allows the parent(s) to focus on bonding with and feeding the

    baby. Many doulas are also certified breastfeeding counselors and can work to improve the

    breastfeeding/chestfeeding experience.

    ACNM supports the collaborative role doulas play in the care of pregnant and birthing people

    and recognizes the importance of their skill set as a positive addition to the health care team.

    References

    1. Bohren MA, Hofmeyr G, Sakala C, Fukuzawa RK, Cuthbert A. Continuous support for

    women during childbirth. Cochrane Database Syst Rev. 2017;7(7):CD003766.

    doi:10.1002/14651858.CD003766.pub6

    2. Zielinski RE, Brody MG, Low LK. The value of the maternity care team in the promotion

    of physiologic birth. J Obstet Gynecol Neonatal Nurs. 2016;45(2):276-284.

    doi:10.1016/j.jogn.2015.12.009

    3. American College of Nurse-Midwives. ACNM core competencies of basic midwifery

    practice. Published March 20, 2020. Accessed April 5, 2021.

    https://www.midwife.org/acnm/files/acnmlibrarydata/uploadfilename/000000000050/AC

    NMCoreCompetenciesMar2020_final.pdf

    4. Kozhimannil KB, Hardeman RR, Alarid-Escudero F, Vogelsang CA, Blauer-Peterson C,

    Howell EA. Modeling the cost-effectiveness of doula care associated with reductions in

    preterm birth and cesarean delivery. Birth. 2016;43(1):20-27. doi:10.1111/birt.12218

    5. Greiner KS, Hersh AR, Hersh SR, et al. The cost-effectiveness of professional doula care

    for a woman's first two births: a decision analysis model. J Midwifery Womens Health.

    2019;64(4):410-420. doi:10.1111/jmwh.12972

    6. Thurston LAF, Abrams D, Dreher A, Ostrowski SR, Wright JC. Improving birth and

    breastfeeding outcomes among low-resource women in Alabama by including doulas in

    the interprofessional birth care team. J Interprof Educ Pract. 2019;17:100278.

    doi:10.1016/j.xjep.2019.100278

    8403 Colesville Road, Suite 1230, Silver Spring, MD 20910-6374 • ph. 240.485.1800 • fax: 240.485.1818 • www.midwife.org | 3

    7. Mehra R, Cunningham SD, Lewis JB, Thomas JL, Ickovics JR. Recommendations for the

    pilot expansion of Medicaid coverage for doulas in New York State. Am J Public Health.

    2019;109:217-219. doi:10.2105/AJPH.2018.304797

    8. Ogunwole SM, Bennett WL, Williams AN, Bower KM. Community-based doulas and

    COVID-19: addressing structural and institutional barriers to maternal health equity.

    Perspect Sex Reprod Health. 2020;52(4):199-204. doi:10.1363/psrh.12169

    9. Lawrence A, Lewis L, Hofmeyr GJ, Styles C. Maternal positions and mobility during

    first stage labour. Cochrane Database Syst Rev. 2013;(8):CD003934.

    doi:10.1002/14651858.CD003934.pub3

    10. American College of Nurse-Midwives. Appropriate use of technology in childbirth.

    Published April 2001. Updated May 2014. Accessed January 17, 2021.

    https://www.midwife.org/acnm/files/ACNMLibraryData/UPLOADFILENAME/0000000

    00054/Appropriate-Use-of-Technology-in-Childbirth-May-2014.pdf

    Note. The terms midwifery and midwives as used throughout this document refer to the education

    and practice of certified nurse-midwives (CNMs) and certified midwives (CMs) who have been

    certified by the American Midwifery Certification Board (AMCB).

    Original Source: Division of Advocacy and Government Affairs

    Approved by the ACNM Board of Directors: 2022

    Organizational Issues and Solutions

     TOPIC: IT DEPARTMENT IN COLLEGE OR UNIVERSITY

    Overview

    Leaders address issues and propose solutions. As a leader, you'll need to stay on top of events that may facilitate or hinder productivity. You must create and implement solutions to address these issues.

    You will continue to use the approved organization you selected in the Week 2 and 3 Assignments. Describe its organizational issue and identify how it hinders organizational efficiency. This assignment exposes you to complex modern organizational challenges. The solutions you devise should reflect your learning and research of organizational and individual influences in the workplace.

    Instructions

    The new CEO has selected your consulting firm to provide an analysis of the organization's efficiency.

    Write a 2–3 page, double-spaced paper in which you present to the CEO your findings during your research steps. You must propose strategic solutions in your paper that include the following:

    1. Describe the organization and the organizational issue that adversely affected productivity you propose to review and resolve.
      • Use the description and feedback from the instructor in the Week 3 Assignment.
    2. Analyze the organization's culture and how it has contributed to the identified issue.
      • Hint: Review the mission and vision statement as well as the corporate website for information.
    3. Describe how the current corporate culture facilitated the development of the current issue.
    4. Identify the organization's areas of weakness as they relate to the issue.
      • To help identify the areas of weakness, apply your research on organizational behavior approaches to aspects of corporate culture—such as diversity, teamwork, and motivational strategies.
    5. Develop recommendations for management that include the organizational practice modifications you would use to solve identified weaknesses and issues.
    6. References and citations:
      • Provide at least two quality resources such as the course textbook, a company website, business websites (CNBC, Bloomberg, and the like), resources from the Strayer Library, and/or outside sources. Note: Wikipedia and Web-based blogs do not qualify as credible resources.
      • You can find in-depth and quality company information using the Nexis Uni database through the Strayer University Online Library.
      • In-text citations are required when paraphrasing or quoting another source.

    Confidentiality: Since you will be addressing real issues in real organizations in your assignments, it is important to respect confidentiality. Feel free to use an alias for any company or individuals you might mention in your assignments. Remember that all discussions about these organizations should only occur within this course and not be shared with people outside the course.

      Mental Health Counselors

      Program evaluation is important in the work that we do as Mental Health Counselors.  We need to know if the program that we are running is producing client/agency/community etc. outcomes as expected.  Discuss how a needs assessment can be utilized in program assessment and provide examples of when a needs assessment could be conducted at an agency or private practice.  When and how would you utilize a formative assessment to inform your decision making and advocacy efforts?  When and how would you utilize a summative assessment to inform your decision-making and advocacy efforts?

        DLRL Week 10 Final Project

        Throughout the course, you have been developing various components of your literature review. In this Final Project, you will pull everything together into a coherent structure. This is not an exercise in copying and pasting but in ensuring you present a smooth, well-developed process and argument.Compile the following into one Word document, making sure to incorporate any feedback you may have received from your Instructor.

        1. Title page
        2. Social Problem Description: Based on the literature you have reviewed in Weeks 4–8, write a description of the social problem that you have been investigating.
        3. Gap in the Literature: Describe the gap in the literature that you have identified in a concise statement.
        4. Research Problem
        5. Purpose Statement
        6. Appendices
          1. Appendix A: Annotated Bibliography Your annotated bibliography must contain all 10 articles identified in Weeks 4–8 and revised, as necessary.
          2. Appendix B: Literature Review Outline The outline of your literature review must be based on themes you identified in Week 9.
          3. Appendix C: Overview of Relevant Theories Your overview of relevant theories must identify theories referred to in the literature and provide a 1-page description of one potential theory you identified for your study.

                     7. References for any articles you cited (outside of the annotated bibliography)Your Final Project must adhere to APA Style guidelines. Refer to the Assignment area for page length requirements of each Final Project section.
          To prepare:

        • Throughout the course, you have been developing various components of your literature review. In this Final Project, you will pull everything together into a coherent structure. This is not an exercise in copying and pasting but in ensuring you present a clear, well-developed outline of your developing literature review. Be sure to review any of the resources that will help you in completing the Assignment.
        • Review the Final Project Requirements (PDF) document in the Learning Resources to understand the requirements of the project. This Assignment will be evaluated according to all criteria in the Final Project Rubric on the course's Final Project page. The rubric should be reviewed before developing your Final Project paper.
        • Use the graduate course APA Course Paper Template (APA 7), accessed from the Week 10 Learning Resources, to complete your Final Project.

        Assignment: 9- to 12-page paper, not including title page or references page(s)Compile the following into one Word document, making sure to incorporate any feedback you may have received from your Instructor:

        • Title page Include the information identified on the graduate course APA Course Paper Template, accessed from the Week 10 Learning Resources.   
        • Social Problem Description (1–2 paragraphs) Based on the literature you have reviewed in Weeks 4–8, write a description of the social problem that you have been investigating.   
        • Gap in the Literature (1 sentence) Describe the gap in the literature that you have identified in this way: “While previous research has studied…, there is a lack of knowledge about (or little or no research about)….   
        • Research Problem (1 paragraph) State the research problem.   
        • Purpose Statement (1 paragraph) Create a draft purpose statement.   
        • Appendices Each appendix should be a separate section using the following headings. (Note: Be sure to apply feedback received to your revision of these documents.)   
          • Appendix A: Annotated Bibliography (3–4 pages) Your annotated bibliography must contain all 10 articles identified in Weeks 6 and 8 and revised, as necessary.   
          • Appendix B: Literature Review Outline (3–4 pages) The outline of your literature review must be based on themes you identified in Weeks 9 and 10 and revised, as necessary.   
          • Appendix C: Overview of Relevant Theories (1–2 pages) Your overview of relevant theories must identify theories referred to in the literature you reviewed during Weeks 9 and 10. Also, provide a 1-page description of one potential theory you identified for your study.   
        • References Include articles you cited outside of the annotated bibliography.

        Note: You will have studied many of the concepts here in other course and may already be familiar with the Prospectus Form. You will be able to bring your enhanced knowledge from this course to the ongoing development of a feasible research study. Be sure that your Final Project adheres to APA Style guidelines. 

          Two Student Responses (300-400 Words)

          Respond to at least two of your colleagues’ posts (on different days). In each case, expand on your colleague’s posting by offering a new perspective or insight or offering additional (new) supporting information for consideration.

          Note: Your responses to colleagues should be substantial (250 words minimum), supported with scholarly evidence from your research and/or the Learning Resources, and properly cited using APA style. Your responses should enrich the initial post by supporting and/or adding a fresh viewpoint and be constructive, enhancing the learning experience for all students. 

            DLRL Week 10 Discussion

            To prepare:

            • Review the revisions to previous assignments, annotated bibliography, etc. What strategies have you used to address these challenges? Review previous resources on the components that you are finding challenging.

            Post your response to the following:

            • What challenges are you experiencing as you work on your outline?
            • What strategies have you used to address these challenges?

            Note: Your posts should be substantial (500 words minimum), supported with scholarly evidence from your research and/or the Learning Resources, and properly cited using APA style. 

              AQR&A Week 9 Workshop

              As Patton so rightly said, “[Y]ou don’t want to wait until you’ve collected your data to figure out your analysis approach” (2015, pp. 527). You had some hands-on experience with this in RSCH 8310, in which you practiced hand-coding using two or more strategies described in Saldaña’s (2016) book.

              Therefore, you focus here on the strategic aspects of planning your analysis. There are many ways to approach building your analysis plan.

              • Reconnect with your approach: Revisit methodological books and articles and published research that uses the approach you proposed. Use these as guidelines for deciding where and how to start the analysis process.
              • Connect your approach to your sample: Revisit why you chose the participants you did. What does your approach require in terms of information-rich cases for analysis? Were you considering intensity sampling to saturate a phenomenon? Diversity sampling to examine common experiences across diverse demographic or geographic criteria? Your analysis strategy must align with your approach and sampling purpose.

              Be willing to be wrong: The phenomenological technique of epoche (also known as bracketing) is a helpful way to make visible all of your pre-existing notions and plans of what you hope to find by making a transcript or written document prior to beginning the data analysis. Compare this document against your analyses to make sure you are discovering new insights, unpredicted findings, and discrepancies; proving that “you were right” is not the purpose of your study.

              In this Workshop, you will describe your analysis plan.

              Post responses to the following:

              • Restate your research question, your chosen approach, and your sampling plan.
              • Identify the key elements of data analysis that are consistent with your chosen approach to propose your analysis plan. Be sure to cite sources specific to your approach as well as your textbooks.
              • Choose one coding method and code both interviews. Indicate the codes in the text of the transcript or summary. You can use Excel or Word. Attach this document to your post.
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