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