please reply to each DQ with 150-200 words each. thank you :)Christina DQ 1 Three regulatory bodies or industry regulations that specify certification, licensure requirements, or scope of practice for nurse educator would be the Boards of Nursing (BONs), National Council of State Boards of Nursing (NCSBN), and the American Association of Colleges of Nursing (AACN). The Board of Nursing influences the way educators teach because it formats and upholds licensing criteria “including board-approved courses of nursing education” (DeNisco & Barker, 2016). The goal of the state board of nursing is to protect the public by making sure its applicants are fully qualified to perform the nursing scope of practice. As an educator it is important to known and teach the scope of practice, and be familiar with the nurse practice act, so that future nurses are prepared and safe in the field. The Arizona board of nursing does this by “the regulation of the practice of nursing and the approval of nursing education programs” (AZBN, 2018). National Council of State Boards of Nursing (NCSBN) is important because it is where one can go for nursing regulatory knowledge. It is a resource that can be used in the classroom because it is important to be up to date on regulatory knowledge. The NCSBN is anonymous and allows people to come together to discuss issues of importance “affecting public health, safety and welfare, including the development of nursing licensure examinations” (NCSBN, 2021). In 1995, the APRN certification program requirements for Accrediting Agencies and Criteria were developed by the NCSBN (DeNisco & Barker, 2016). The NCSBN APRN Advisory Committee alongside the APRN Consensus Work Group worked together to create the APRN Consensus Model. The consensus model consists of four APRN roles; certified registered nurse anesthetist, certified nurse–midwife, clinical nurse specialist, and certified nurse practitioner, with recommendations and criteria for educational programs so that APRN will qualify to sit for national certification (DeNisco & Barker, 2016). The American Association of Colleges of Nursing has written guidelines focused on “establishing quality standards in nursing education’ (AACN, 2021). This is important as an educator because what the students are taught in the class needs to be held to the highest quality standards for quality care in the field. In 2000, the Advanced Practice Task Force was facilitated by The NCSBN and the AACN to create the American Nurses Credentialing Center (ANCC), credentialing research. (DeNisco & Barker, 2016). All these agencies are important to APRN education as they not only protect the public, but they protect nurses as well by making sure education is standardized with quality education that meets board standards for the profession.ReferencesAmerican Association of Colleges of Nursing (AACN). (2021). Retrieved April 01, 2021, from https://www.aacnnursing.org/About-AACNArizona State Board of Nursing (AZBN). (2018). Retrieved April 01, 2021, from https://www.azbn.gov/board/about-the-organizationDeNisco, S. M., & Barker, A. M. (2016). Advanced Practice Nursing: Essential Knowledge for the Profession (3rd Edition). Retrieved April 01, 2021, from https://www.gcumedia.com/digital-resources/jones-a…National Council of State Boards of Nursing (NCSBN). (2021). Retrieved April 01, 2021, from https://www.ncsbn.org/index.htmRosemarie DQ 1Advanced Practice Registered Nurses (APRNs) profession is one of the many professions which embrace several industry regulations. Several regulatory bodies are involved in the certification, licensure, and scope of practice for this specialty. Three of these regulatory bodies are; American Nurses Credentialing Center (ANCC), the American Association of Critical Nurse (AACN), and the American Academy of Nurse Practitioners Certification Board (AANPCB). Each of these regulatory bodies plays different roles and has unique influences on APRNs’ educational requirements and experience.The ANCC body essentially has three functions. The first one is to provide certification to nurses who have met the academic requirement. It, therefore, influences the educational requirement of APRNs by ensuring that all these professionals have the right academic qualifications (Rantz et al., 2017). The second role is to accredit all organizations that offer continued training to nurses. This ensures that APRNs are encouraged to gain experience as well as keep growing their knowledge base. The third role is to recognize hospitals and other settings based on their excellence in nursing. This plays in influencing the experience of nurses by ensuring that they are excellence-driven.The AANPCB primarily provided valid programs that evaluate nurses who wish to advance in their profession through the certification program. This body has a major influence on the educational requirement and experience of nurses. It is a key determinant in how convenient a nurse can advance in their professional studies to become an APRN. The AACN body is tasked with creating effective healthcare systems driven by the needs of the patients and their families, in which acute and critical nurses make the key decisions. This has a major influence on the experience of the ARRNs because it puts the nurses at the center of decision-making.ReferencesRantz, M. J., Birtley, N. M., Flesner, M., Crecelius, C., & Murray, C. (2017). Call to action: APRNs in US nursing homes to improve care and reduce costs. Nursing Outlook, 65(6), 689-696.Advanced Practice Nursing: Essential Knowledge for the Profession.https://www.gcumedia.com/digital-resources/jones-and-bartlett/2016/advanced-practice-nursing_essential-knowledge-for-the-profession_3e.phpChristine DQ 2 Two different advanced registered nurse roles regarding ethical guidelines are a nurse educator and family nurse practitioner. Both roles have ethical guidelines that build on their registered nursing license, the nursing code of ethics. I do not believe there is a difference in ethical guidelines that governs these roles. As nurses we learn to care for the weak and be the voice for the venerable and becoming APRN, that does not change. The code of ethics for nursing has the general understanding that the nursing profession as a “whole and the individual nurse will use the code as the foundation for ethical analysis, decision making, and professional behavior” (Weberg, Mangold, Porter-O’Grady , & Malloch, 2019). The ANA code of ethics with interpretive statements does not differentiate based on nursing roles, i.e., the nurse educator or the FNP as it laid down as the framework for the whole profession. However, there are different responsibilities within the two roles. The nurse educator focuses on education vs the FNP practices in the clinical environment. One situation where the two position might respond differently is when it comes to contraceptive. The nurse educator may have a belief one way or another contraceptive but they at the end of the day, the choice is up to the patient. Whereas the if the FNP does not believe in contraceptive, according to the ANA code of ethics, provision 5, it allows the APRN to care for the needs for oneself and personal beliefs allowing the FNP “to refuse treatment or recuse themselves from participating in care based on philosophical or religious objection” (DeNisco & Barker, 2016). All APRN should practice in the best interest of their patients. Regardless of situation either may face, the code of ethics states that “it is always expected that the professional nurse will explore these issues and work to resolve ethical challenges in a way that best addresses the standards of the profession and the needs of those it serves”, as it always comes back to quality of care. (Weberg, Mangold, Porter-O’Grady , & Malloch, 2019).References:DeNisco, S. M., & Barker, A. M. (2016). Advanced Practice Nursing: Essential Knowledge for the Profession (3rd Edition). Retrieved April 01, 2021, from https://www.gcumedia.com/digital-resources/jones-and-bartlett/2016/advanced-practice-nursing_essential-knowledge-for-the-profession_3e.phpWeberg, D., Mangold, K., Porter-O’Grady, T., & Malloch, K. (2019). Leadership in nursing practice: Changing the landscape of healthcare (3rd Edition). Retrieved April 01, 2021, from https://www.gcumedia.com/digital-resources/jones-a…

Unit 5: Discussion-The Suicide Epidemic
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Introduction
We have already reviewed materials on the changing brain development of teens and young adults, and know there is evidence for a delay in many of the brain areas in charge of executive functioning. Does this play a role in the increase in suicides we have seen in young adults attending college? Please read the below article and view the video regarding the issues many college campuses have seen recently:
Students in Crisis: Mental Health and Suicide on College Campuses (Links to an external site.)
Directions
After viewing the above materials, respond to the following:

What are your general thoughts on the epidemic? 
Why is early adulthood such a crucial time for development?
Why might the current generation be different from past generations?
What role might developmental psychologists play in attempting to correct this problem?
In addition to the suggestions provided by the experts, how might a parent begin preventing this from occurring to their child, and when should prevention begin?

Post 1
What are your general thoughts on the epidemic?
My thoughts on this epidemic is that mental health is not talked enough in higher institutions and that students are just suppose to brush it off. And to me a lot of has to do from transitioning from having your family around all the time and having friends who you known for years around. Then your off at a new school with not knowing a lot of people and your family being miles away so students feel more isolated and lonely. Not only that but on top of that you have this pressure to excel in school and spend a lot of time studying. It is way different then high school classes where say you would get A’s & B’s but now your in college and are receiving C’s & D’s. For me my first year of collage was incredible difficult I felt alone not having family around and not being around friends that I grew up with in high school. Not only that but my grades suffered I felt like no matter how much I studied I could never achieve the grades I wanted.
Why is early adulthood such a crucial time for development?
With early adulthood according to Kraynok, et al., (2017) “people become more independent from families of origin but have not taken many roles that we see as being part of adulthood”. Not only that but we start to rely more on our friends and really figuring out who we are and who we want to be as well as what we want to do with our lives. With Ericksons theory “young adults must develop the ability to establish close, committed relationships with peers and the ability to tolerate the threat of fusion and loss of identity that intense intimacy raises” (Kraynok, M.C., Seifert, K.L., Hoffnung, R.J. & Hoffnung, M., (2017).
Why might the current generation be different from past generations?
There is so many differences in todays generation then there is with past generations because with this generation we are surrounded with technology and social media and have to know how to use it for jobs as well as college classes. Not only that but we are pressured to go to college because we are told without it there is no way for us to really get a career or we will get stuck in a dead end job. According to U. S Department of Education. (2021) “Between 1992 and 2012, the average amount owed by a typical student loan borrower who graduated with a bachelor’s degree more than doubled to a total of nearly $27,000”. What this means is we are spending more in school which is making it harder to go to school and honestly puts a lot of pressure on college students to excel in there classes due to how much they cost. Another difference is this generation is not pressured to quickly marry and have children in our early adulthood where as past generations you would marry at such a young age.
What role might developmental psychologists play in attempting to correct this problem?
Developmental psychologists role would be to conduct studies to find out what methods are going to be the best option for college students. According to Cuijpers, P., Cristea (2015) “It is well-established that individual, group, and guided self-help treatments are effective in the treatment of depression”. So in other words if more mental health treatments were offered and college students were informed that these types of treatments were available to them there could be a significant decrease of depression in college students. Further more Cuijpers, P., Cristea (2015) goes on to say “Such efforts could have important societal effects, as college students represent the future leaders of society and their success is critical for societal human capital development”.
In addition to the suggestions provided by the experts, how might a parent begin preventing this from occurring to their child, and when should prevention begin?
I don’t think there is really any guarantee to prevent it from happening to there child but what I suggest for parents is talking to there child about the options for them when they do feel depressed which include therapy as well as letting them know that you are there to talk to them without judgement. Just knowing that there parent is there for them could make a big difference and just being educated about early indicators that might go un detected.
Reference
Cuijpers, P., Cristea, I. A., Ebert, D. D., Koot, H. M., Auerbach, R. P., Bruffaerts, R., & Kessler, R. C. (2015, December 18). PSYCHOLOGICAL TREATMENT OF DEPRESSION IN COLLEGE STUDENTS: A METAANALYSIS. Depression and anxiety. https://pubmed.ncbi.nlm.nih.gov/26682536/ (Links to an external site.).
Kraynok, M.C., Seifert, K.L., Hoffnung, R.J. & Hoffnung, M., .(2017). Lifespan Development. (3rd Ed.). USA: Academic Media Solutions.
U. S Department of Education. (2021). College Affordability and Completion: Ensuring a Pathway to Opportunity. College Affordability and Completion: Ensuring a Pathway to Opportunity | U.S. Department of Education. https://www.ed.gov/college

Post 2
It is imperative to understand that there is no typical suicide victim, nothing is normal and should be accepted as such. Yes, there may be subtle clues and hints but honestly there is no one detail or thing that you can point to and say, “This child or that child is contemplating suicide.” Suicide is a complicated phenomenon, and there are numerous red flags that a child or adolescent may exhibit. Children and adolescents are thinking of suicide are often fascinated with death, dying, and suicide. I’ll never be one to place blame on anyone for any situation, but parents need to be heavily involved with their children bottom line, YOU ARE NOT THEIR FRIEND!!! Teenagers who are considering suicide may give away their belongings, particularly those that they hold dear to them. They may become increasingly withdrawn, apathetic, depressed, angry, and/or resentful. Children and teens who are thinking about death and suicide may show drastic changes in their school performance and appearance. Many teens who attempt or die by suicide have a mental health condition. “As a result, they have trouble coping with the stress of being a teen, such as dealing with rejection, failure, breakups, school difficulties and family turmoil”, (Teen Suicide: What Parents Need to Know, 2021). Perhaps your child once loved to get manicures and wear make-up, or play sports and hang out, but they have been disinterested in these activities lately. It is important for children and teens who are depressed and/or suicidal to have at least one adult in their lives with whom they have a close relationship. There may be many factors over which you have limited control, but there are also steps those parents and educator can take to ensure kids do not slip through the cracks. Talk to them and have a heart-to-heart way before you think your losing control of them or they are slipping, that may require you to put your phone down. As a parent you have a duty to your children, who were not asked to be born, to set them up for success and have a huge impact on them for the rest of their lives long after we are gone, and they are parents of their own children.
Ref:
Teen suicide: What parents need to know. (2021, May 18). Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/tween-and-teen-health/in-depth/teen-suicide/art-20044308?reDate=07072021

60 words each for each peer review.Peer 1 LauraIn describing what is meant by social awkwardness, it helps to define social competence. Accordingly, social competence is the ability to process and participate in social interactions in an appropriate, effective way. Social competence continues to develop through consecutive, positive interactions with peers, teachers, coworkers, and family members (Juntunen & Schwartz, 2016). Likewise, the impact of social competence effects social, emotional, and cognitive development across the lifespan, and it establishes a positive trajectory for healthy relationships, interactions, and value-based outcomes as an adult (Juntunen & Schwartz, 2016). Conversely, social awkwardness comes from unexpectedly and unintentionally behaving in a manner that violates culturally accepted rules of social conduct. This can cause emotional challenges and interpersonal conflicts in every aspect of development (Moscovitch et al., 2012). As such, developing social competence is a central, preventive intervention that should begin in early childhood. Social adeptness directly influences foundational relationships, academia, and the overall quality of life. Accordingly, improving developmental pathways and healthy relational functioning in early childhood can significantly lower risk factors for mental illness and substance misuse (Juntunen & Schwartz, 2016). Further, social competency influences the success of academic achievement and technical competency. Often, the primary setting for social and emotional learning is in school. Studies report that in educational institutions that have constructive, classroom management, developmentally appropriate discipline practices, and positive, reciprocal relationships between peers and teachers, positively contribute to the school climate and promote greater, academic success. In this climate, students are actively engaged in learning, can safely practice social and emotional competencies, and develop healthy relational skills (Juntunen & Schwartz, 2016). Similarly, programs that foster positive interactions between adults and peers lead to opportunities to equip children with technical skills and leadership prospects. As such, there are a few ways schools can promote social competency. Several social and emotional learning (SEL) programs are available that can be successfully implemented in schools. The SEL programs focus on teaching kids of all ages to understand and manage their emotions, improve problem-solving skills, and increase communication proficiencies, strengthen empathy, and promote assertiveness. Programs such as 4Rs, PATHS, The Incredible Years, RULER, CASEL, and Work-based learning have proven successful in developing healthy, effective interpersonal relationships and academic success (Juntunen & Schwartz, 2016). These programs are effective because they incorporate a variety of cultures, socioeconomic conditions, and include parent engagement. Research states that interventions that incorporate multifaceted training and support are the most successful (Juntunen & Schwartz, 2016).References:Juntunen, C.L. & Schwartz, J.P. (Eds). (2016). Counseling across the lifespan (2nd ed.). SAGE Publications, Inc. https://viewer.gcu.edu/V6W8wFMoscovitch, D. A., Rodebaugh, T. L., & Hesch, B. D. (2012). How awkward! Social anxiety and the perceived consequences of social blunders. Behavior Research and Therapy, 50(2), 142–149. https://doi-org.lopes.idm.oclc.org/10.1016/j.brat.2011.11.002Peer 2 Elizabeth“Socially Awkward” means a person doesn’t have social skills to understand social cues, read body language, they aren’t able to change their behavior when the environment and/or the people change, they might react inappropriate to a situation, and have a hard time communicating their feelings with others. Developing social competence is a HUGE form of prevention. Teaching social skills at a young age helps people understand the world around them and how to be a part of it. We are social beings. Everything we do is within a social context. We do things to make ourselves comfortable and to make others feel comfortable too. Relationships are vital to our survival. It is extremely important to teach social skills so that people can have a mentally healthy life.Thinking of social competency and connecting it to academic standards, let’s think about a reading standard. When a student is reading a story and are expected to make an inference and prediction, they are supposed to be able to decide how a character is feeling, wanting, will do, how the story will end and more. To be able to answer those questions they need to have social skills. Academics are tied to social connection, group listening, and conversational skills and kids will be expected to use those skills throughout an academic day (Winner,2015). Social skills help students interpret and respond to academic lessons that require them to consider others’ thoughts, feelings, intentions, beliefs, motives, plans, etc. These skills are the foundation learning needed for Common Core Standards. It’s a process and as students become familiar with or recognize these concepts, changes happen. This helps students internalize these ideas and become socially and academically smarter. The ability to comprehend and explain information, spoken or written, rests on our social knowledge (Winner, 2015).There are many ways schools can promote healthy and effective relationships in students. It comes from teachers and staff modeling the behavior themselves, having a student of the month character theme, posters in the hall, anti-bullying lessons, social emotional curriculum lessons starting at kindergarten, afterschool programs, full time counselor, book clubs, leadership team, and acknowledging national holidays to promote inclusion and love.References:Winner, M. G. (2015, January 20). Socialthinking – Free Articles & Strategies. Socialthinking.Com. https://www.socialthinking.com/Articles?name=socia…Peer 3 JamalWhen I think of the term socially awkward, due to the nature of my current occupation, I automatically Think of Autism and the characteristics that make this diagnosis up. On a lighter note, socially awkward in my opinion is described as behaviors and characteristics of an individual or group of individuals who do not meet societal norms such as having numerous friends, keeping to themselves or overly displaying themselves, and even dressing a certain way. Socially awkward is one of those terms that is going to vey from environment to environment. What may be socially awkward in one situation in a particular environment may not be in another. Not only does developing social competence help individuals learn what behaviors are realized as inappropriate and/or socially awkward, it also acts as a method of prevention.Developing social competence acts as a method of prevention because it makes the individual knowledgeable of the behaviors that are accepted within the society we live in today. Imagine if an individual was not socially competent. I could strongly guess that the individual would face a hard time growing up and unfortunately faced with situations that lead to mental health issues such as bullying and unhealthy relationships. I believe that social competency should be connected to academic achievement and technical competency in school programs because school is a place where you go to learn with hundreds of other adolescents your age that are going through some of the same developmental stages. I believe that school is a place that tests the social competence of children. With that it is very hard for a child to achieve academically if they are having troubles with thriving socially.In order for schools to promote social competence to develop healthy and effective relationships in their students, schools could and do implement extracurricular activities such as sports, arts, and clubs. These programs are usually coached or sponsored by adults who guide the individuals in developing healthy and meaningful relationships. I know from experience of being involved with football all four years of high school, learning the actual sport was just the half of it. It was the building of relationships and dealing with adversity that made me into a better athlete and eventually a better individual within society.

Wellness, Coordinated Care, Caregiver Support, Acute Care Management] Describe how best to identify specific gaps and fill them in any of the following areas: Wellness, Coordinated Care, Caregiver Support, or Acute Care Management?.
Answer this question:
Acute Care Management, Readmissions, and Transitional Care
Readmissions are a costly reminder of our failure to provide adequate Acute Care Management. “Nearly one in five Medicare patients discharged from the hospital returns within 30 days and roughly 75 percent of those readmissions are considered preventable.” (Hodach, 2016) The problem arises not necessarily from a failure of the acute care team, but a failure in the ability of the system to manage patients from the primary care office, to the admission, then home, and back to the PCP.  Hodach, et, al, go on to say “In a broader sense, it can be attributed to systemic failures that begin in the hospital and continue in the fragmented healthcare settings that patients move through after discharge.” (Hodach, 2016) I would argue that it starts in the primary care setting and not in the hospital.
The identification of the gaps is not difficult. Most insurers have portals that can be accessed to identify “frequent flyer” readmits. Also, many hospital systems have Case Management teams that use tools to identify high risk patients. Our hospital, for example, uses a modified version of the Better Outcomes for Older Adults model.  (Earl, 2020) Many hospitals can also utilize their own EHRs, population health software, or Hospital Association data to develop these registries.
Filling this gap is where things get a little more tricky.  I believe that a strong transitional care team is absolutely imperative to achieving the goal of decreased readmissions. Our organization was able to decrease readmissions simply by incorporating the BOOST model and giving more attention to the patients that were identified with it, but when I took on this role, I wanted to take that further.
Our approach has been to utilize Lean management concepts (as detailed in the Hodach book) to approach the problem. Because transitions of care involve many areas of the in and outpatient world, our first meeting consisted of myself as administrative representative and “owner” of the A3 (what we call a lean process because of the size of paper you use to draw the process), hospitalist, floor nurses, case management, home health, in and out patient pharmacy, physical therapy, and population health.  We have had several meetings over the course of the year and eventually had to have several smaller A3s to work out process problems before coming back to the table.
We are nearing the end of the A3 – COVID has thrown a wrench in a lot of the planning – and have already implemented many of the processes. We hired a transitional care LPN who goes to morning huddle with nursing and case management every morning. She works with case management to identify the needs of the patients identified with BOOST to help coordinate follow up and transitional care. We also hired a home visit NP who attends and meets the highest risk patients in the hospital, then does a home visit. High risk patients get referred to our transitional care program and receive a phone call at 24 and 48 hours and a home visit within a week.  Moderate risk patients receive a phone call at 48 hours.  Low risk patients are touched only by the transitional care nurse, not case management, and are assessed to make sure that nothing was missed. We have developed three ring binders with colorful inserts containing information on the disease reason for admission as well as other contributing diseases, medications, and follow up appointments. We have also started utilizing our meds to beds program and are having the pharmacists look at new rx for potential cost issues. If these arise, they are looking at our 340 B program and having the transitional care nurse discuss options with the patient.
We drew our model from several sources, but the one I relied most heavily on was The Science of Successful Care Transition Management by the Healthcare Intelligence Network. (Healthcare Intelligence Network, 2017) We have not got all of the pieces in place at this time, but we hope to see a decrase in readmissions as well as increased patient satisfaction once it’s rolling. A big barrier has been COVID and nursing shortages. Our population health nurses have been pulled to more “critical” staffing. Also, meetings were on hold for a good part of last year.  All in all, though, I think this is a good step toward better population health and decreased readmissions. I hope to move farther with this in the future by addressing some of the “chronic ambulatory care sensitive conditions” and hire more team members to monitor and administer in home care. (Longman, 2015)
Works Cited
Earl, T. P. (2020). Making Healthcare Safer III: A Critical Alalysis of Existing and Emergent Patient Safety Practices. Rockville: Agency for Healthcare research and Quality (US).
Healthcare Intelligence Network. (2017). The Science of Successful Care Transition Management: Leveraging Home Visits to Improve Readmissions and ROI. Sea Girt: The Healthcare Intelligence Network.
Hodach, R. M. (2016). Provider-Led Population Health Management. (M. Karen Ezekiel Handmaker, Ed.) Indianapolis, IN, USA: John Wiley & Sons, Inc.
Longman, J. M. (2015). Admissions for chronic ambulatory care sensitive conditions – a useful measure of potentially preventable admission? BMC Health Services Research. Sydney, Australia.
Respond to this comment
Wellness: Gaps in Breast Cancer Screening
Yearly mammograms starting at age 40 have been shown, in randomized control trials and real-world screening data, to reduce mortality from breast cancer by 40%. However, recommendations for getting a mammogram differ between organizations.  For instance, the American College of Radiology, Society for Breast Imaging, National Comprehensive Cancer Network, and many others recommend annual mammograms at age 40. By contrast, the United States Preventive Services Task Force recommends biennial mammograms from ages 50 to 74. Many insurance plans base their coverage on USPSTF’s recommendations. These various policies make it confusing for women and providers and may contribute to gaps in care. Furthermore, the USPSTF’s recommendations are based on data from mostly white women. Black women have higher mortality rates from breast cancer compared to White women are more at risk for BRACA1 and BRACA2 mutations, and for triple negative cancers. Because Black women have a higher risk, they would benefit from earlier and annual mammograms. Low socioeconomic status can also compound disparity because of lack or access to care and no insurance.
A program in Chicago called Equal Hope helps women receive breast care at no cost. Their evidence based system to reduce disparities has the following steps:
1. Landscape Analysis-map out where people get their care, and find the gaps
2. Develop a Quality Scorecard-analyze what is highest quality of care to get best outcomes at lowest side effects. Use an easy to understand scorecard so providers and facilities see how they can improve.
3. Create a Big Tent-enroll providers and facilities to provide quality data-everybody in and nobody out
4. Assess How the Healthcare System Works in Real Life-What are the touch points, what are the barriers, and what helps patients get what they need
5. Listen and Learn From Patients
6. Design Evidenced Based Interventions
By determining which neighborhoods had the most need, pinpointing quality improvement issues within facilities (radiologist training, followup to imaging), public campaigns to communicate the need and provide free breast care for uninsured patients, and patient navigation were all implemented to decrease Chicago’s disparity. In fact they claim Chicago is now #1 in reducing breast cancer deaths among African Americans.
References:
Monticcilo, D. (2020) Current guidelines and gaps in breast cancer screening. Journal of American College of Radiology. https://doi.org/10.1016/j.jacr.2020.05.002 (Links to an external site.)
Equalhope.org
Improving Access and Quality of Breast Health Services in Chicago.https://equalhope.org/wp-content/uploads/2019/05/s…

Purpose
The purpose of this assignment is to provide the student an opportunity to reflect on selected RN-BSN competencies acquired through the NUR4516 course.  
Course Outcomes
This assignment provides documentation of student ability to meet the following course outcomes: 

The student will identify the different types of crisis and their impact on the patient safety and health (AACN Essentials, QSEN: safety, teamwork and collaboration, quality improvement, informatics and patient centered care). 
The student will be able to approach and safely manage patient/families in crisis.

Points
This assignment is worth a total of 100 points (10%).
Due Date
Submit your completed assignment under the Assignment tab by Monday 11:59 p.m. EST of Week 8  as directed.
Requirements
1.The Course Reflection is worth 100 points (10%) and will be graded on quality of self-assessment, use of citations, use of Standard English grammar, sentence structure, and overall organization based on the required components as summarized in the directions and grading criteria/rubric.
2.Follow the directions and grading criteria closely. Any questions about your essay may be posted under the Q & A forum under the Discussions tab. 
3.The length of the reflection is to be within three to six pages excluding title page and reference pages.
4.APA format is required with both a title page and reference page. Use the required components of the review as Level 1 headers (upper and lower case, centered): 
Note: Introduction – Write an introduction but do not use “Introduction” as a heading in accordance with the rules put forth in the Publication manual of the American Psychological Association (2010, p. 63).
a.Course Reflection 
b.Conclusion
Preparing Your Reflection
The BSN Essentials (AACN, 2008) outline a number of healthcare policy and advocacy competencies for the BSN-prepared nurse. Reflect on the NUR4516 course readings, discussion threads, and applications you have completed across this course and write a reflective essay regarding the extent to which you feel you are now prepared to:

“Integrate theories and concepts from liberal education into nursing practice.
Synthesize theories and concepts from liberal education to build an understanding of the human experience. 
Use skills of inquiry, analysis, and information literacy to address practice issues.
Use written, verbal, non­verbal, and emerging technology methods to communicate effectively.
Apply knowledge of social and cultural factors to the care of diverse populations.
Engage in ethical reasoning and actions to provide leadership in promoting advocacy, collaboration, and social justice as a socially responsible citizen.
Integrate the knowledge and methods of a variety of disciplines to inform decision making.
Demonstrate tolerance for the ambiguity and unpredictability of the world and its effect on the healthcare system.
Value the ideal of lifelong learning to support excellence in nursing practice.” (p. 12).

Reference:
American Association of Colleges of Nursing [AACN]. (2008). The essentials of baccalaureate education for professional nursing practice. Washington, DC: Author.
Directions and Grading Criteria
Category
Points
%
Description
(Introduction – see note under requirement #4 above)
8
8
Introduces the purpose of the reflection and addresses BSN Essentials (AACN, 2008) pertinent to healthcare policy and advocacy.
You Decide Reflection
80
80
Include a self-assessment regarding learning that you believe represents your skills, knowledge, and integrative abilities to meet the pertinent BSN Essential and sub-competencies (AACN, 2008) as a result of active learning throughout this course. Be sure to use examples from selected readings, threaded discussions, and/or applications to support your assertions to address each of the following sub-competencies:

“Integrate theories and concepts from liberal education into nursing practice.
Synthesize theories and concepts from liberal education to build an understanding of the human experience. 
Use skills of inquiry, analysis, and information literacy to address practice issues.
Use written, verbal, non­verbal, and emerging technology methods to communicate effectively.
Apply knowledge of social and cultural factors to the care of diverse populations.
Engage in ethical reasoning and actions to provide leadership in promoting advocacy, collaboration, and social justice as a socially responsible citizen.
Integrate the knowledge and methods of a variety of disciplines to inform decision making.
Demonstrate tolerance for the ambiguity and unpredictability of the world and its effect on the healthcare system.
Value the ideal of lifelong learning to support excellence in nursing practice.” (p. 12).

Conclusion
4
4
An effective conclusion identifies the main ideas and major conclusions from the body of your essay. Minor details are left out. Summarize the benefits of the pertinent BSN Essential and sub-competencies (AACN, 2008) pertaining to scholarship for evidence-based practice.
Clarity of writing
6
6
Use of standard English grammar and sentence structure. No spelling errors or typographical errors. Organized around the required components using appropriate headers. Writing should demonstrate original thought without an over-reliance on the works of others.
APA format
2
2
All information taken from another source, even if summarized, must be appropriately cited in the manuscript and listed in the references using APA (6thed.) format:
1.Document setup
2.Title and reference pages
3.Citations in the text and references.
Total:
100
100
A quality essay will meet or exceed all of the above requirements.
Grading Rubric
Assignment Criteria 
Meets Criteria
Partially Meets Criteria
Does Not Meet Criteria
(Introduction – see note under requirement #4 above)
(8 pts)
Short introduction of selected BSN sub-competencies (AACN, 2008) pertinent to scholarship for evidence-based practice. Rationale is well presented, and purpose fully developed. 
7 – 8 points
Basic understanding and/or limited use of original explanation and/or inappropriate emphasis on an area.
5 – 6 points
Little or very general introduction of selected BSN sub-competencies (AACN, 2008). Little to no original explanation; inappropriate emphasis on an area.
0 – 4 points
You Decide Reflection
(80 pts)
Excellent self-assessment of skills, knowledge, and integrative abilities pertinent to healthcare policy and advocacy. Reflection on pertinent BSN sub-competencies (AACN, 2008) supported with examples.
70 – 80 points
Basic self-assessment of skills, knowledge, and integrative abilities pertinent to healthcare policy and advocacy. Reflection on pertinent BSN sub-competencies (AACN, 2008) not supported with examples.
59 – 69 points
Little or very general self-assessment of skills, knowledge, and integrative abilities pertinent to healthcare policy and advocacy. Little or no reflection on pertinent BSN sub-competencies (AACN, 2008) or reflection not supported with examples.
0 – 58 points
Conclusion
(4 pts)
Excellent understanding of pertinent BSN sub- competencies (AACN, 2008). Conclusions are well evidenced and fully developed.
3 – 4 points
Basic understanding and/or limited use of original explanation and/or inappropriate emphasis on an area.
2 points
Little understanding of pertinent BSN sub-competencies (AACN, 2008). Little to no original explanation; inappropriate emphasis on an area.
0 – 1 point
Clarity of writing
(6 pts)
Excellent use of standard English showing original thought with minimal reliance on the works of others. No spelling or grammar errors. Well organized with proper flow of meaning. 
5 – 6 points
Some evidence of own expression and competent use of language. No more than three spelling or grammar errors. Well organized thoughts and concepts.
3 – 4 points
Language needs development or there is an over-reliance on the works of others. Four or more spelling and/or grammar errors. Poorly organized thoughts and concepts.
0 – 2 points
APA format
(2 pts)
APA format correct with no more than 1-2 minor errors. 
2 points
3-5 errors in APA format and/or 1-2 citations are missing.
1 point
APA formatting contains multiple errors and/or several citations are missing.
0 points
Total Points Possible =  100  points