Assessing The Practicum Problem Assignment Paper

Working with patients during their treatment and therapy sessions is an integral part of practicum work. This is facilitated by the therapeutic bond that is created when one first meets the patient. In this particular case of problem assessment, I have identified a group of patients battling drug addiction including alcohol addiction and opioid addiction that I intend to work with. Drug addiction is a major problem in the community that surrounds the healthcare facility in which the practicum is taking place. What I hope to learn in this interaction is their fears, reasons for getting addicted, and their future hopes. My rationale for choosing this particular group is that it has a good number of clients that I had seen myself, sometimes with the preceptor. Ideas will be presented in a tow-way communication format, transformational leadership and collaboration will reign, and potential barriers such as lack of trust will be combatted by fidelity. The purpose of this paper is to present a way of exercising leadership, collaboration, communication, change management, and policy considerations with a group of patients. Assessing The Practicum Problem Assignment Paper

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A Population Health Problem Relevant to Personal and Professional Practice

Alcohol addiction is a major problem that has been identified in the community concerned. Most of the patients in the chosen group have alcohol use disorder or AUD (APA, 2022; Boland et al., 2021). Males still drink greater quantities of alcohol than females do, and they also sustain and contribute to more alcohol-related injuries and fatalities. Nevertheless, the differences are closing. Differences in alcohol consumption have shrunk among young people and emerging adults, mainly because men’s alcohol usage has decreased more than women’s. Alcohol use among adults is rising for women but not for males. Adult instances of alcohol-related ER visits, hospitalizations, and fatalities have all grown over the previous 20 years.

The increases in these outcomes have been greater for women, which is consistent with the evolving patterns of alcohol consumption (White, 2020). Additionally, according to recent studies, women are more vulnerable than men to alcohol-related liver inflammation, cardiovascular disease, memory loss, hangovers, and several malignancies. There is a need for prevention measures that target rising alcohol intake and specific health hazards for women. Assessing The Practicum Problem Assignment Paper

Opioid addiction is the other drug addiction problem in this community. The opioid epidemic in the United States is thought to have been caused by widespread opioid addiction (Zhao et al., 2019). It has mostly been caused by the requirement that doctors write prescriptions for controlled or scheduled drugs for individuals who need pain relief. However, due to the addictive properties of these controlled substances, patients may discover that they require more of these prescriptions even before the time for a refill. The patients turn to illegal means of obtaining addictive opioid medicines from illicit sources such as cocaine and heroin, because they are unable to obtain a legal refill from their clinician (Duncan et al., 2019; Gleber et al., 2020). Addiction that becomes out of control has negative consequences, including acute poisoning or even death.

The situation that will be the focus of this exercise will be individuals who are receiving therapy primarily for severe alcohol dependence but also for an addiction to opiates. In terms of lack of compliance, these patients are particularly those who have struggled to follow the regimen of alcohol anti-addiction medications like disulfiram (Antabuse), naltrexone (Vivitrol), or acamprosate (Campral), among others (Akbar et al., 2018; Stahl, 2020). They have been admitted for this reason so they may be carefully watched as they take the prescribed medicine. Assessing The Practicum Problem Assignment Paper

In addition, they are receiving cognitive behavioral treatment, commonly known as CBT, as psychotherapy at the same time (Wheeler, 2020). The gender and socioeconomic position of those alcohol addicts who are severely impacted will be the specific data to be gathered and used in this scenario. White (2020) asserts that there is a sizable gender difference in alcohol addiction, particularly in the United States. It would be desirable to have precise information on these gender discrepancies at the local facility level for this reason.

Analysis of Evidence from Peer-Reviewed Literature and Professional Sources that Describes and Guides Nursing Actions

To combat the above menace of drug addiction and especially opioid addiction, there is enough evidence-based data showing that prescription of non-opioid analgesics is a viable option for curbing addiction. Both pharmacotherapeutic and non-pharmacotherapeutic treatments have been identified as alternative or complementary therapies that are evidence-based and effective. In addition to NSAIDs like ibuprofen that are non-addictive, they additionally encompass alternative therapies including yoga, acupuncture, chiropractic treatment, and physical therapy (Duncan et al., 2019; Gleber et al., 2020; Zhao et al., 2019). Nursing actions backed by EBP therefore include education on the acceptance of non-opioid analgesics, as well as on the dangers of opioid addiction that include death from overdose.            The amount of information that can be learned from the addiction data is vast. For example, it will be possible to learn more about the socio-demographic elements that are at the basis of alcohol and drug addiction. It will also aid in illuminating the socioeconomic elements influencing gender roles and drug and alcohol abuse. Since they are in charge of the clinical decision support (CDS) system, the electronic health record (EHR) system, and the healthcare data warehouse, the nurse informaticist will play a crucial role in supporting data mining (McGonigle & Mastrian, 2021). The nurses will be able to extrapolate facts and draw conclusions from the knowledge acquired from the data in order to create new knowledge (EBP). For instance, the underlying social determinants of health including socioeconomic position and their role in the gender gap in alcohol addiction might be inferred. Assessing The Practicum Problem Assignment Paper

Therapy

            The Diagnostic and Statistical Manual of Mental Disorders-Text Revision, also known as the DSM-5-TR, has a diagnostic category for addictive disorders called substance use disorders, or SUDs (APA, 2022). The main characteristic of SUDs is the presence of cognitive or other signs that demonstrate the patient continues to use the substance despite the fact that doing so causes them issues (APA, 2022; Boland et al., 2021). One of the most successful evidence-based treatment techniques for various addiction diseases is psychotherapy. For example, group psychotherapy has been demonstrated to have the highest success rates in treating alcohol addiction.

The psychotherapeutic approach for drug addiction that has the most evidentiary backing is cognitive behavioral therapy (CBT), in a cognitive therapy addiction group or CTAG (Ezhumalai et al., 2018). Evidence also shows that group therapy for addiction is the most effective and cost-effective too (David et al., 2018; Olmstead et al., 2019; Wendt & Gone, 2018). This is partly because within group therapy, there are therapeutic factors that are in operation, as suggested by Irvin Yalom. These include catharsis, altruism, universality, group cohesiveness, interpersonal learning, imitative behavior, and instillation of hope amongst others (Hauber et al., 2019). These curative factors can only operate in a group setting. Assessing The Practicum Problem Assignment Paper

In order to help patients learn how to cope without the drug of abuse, CBT, an addiction therapy method, modifies both thoughts and actions (Wheeler, 2020). In addition, it includes extensive psychoeducation, where group members are encouraged to understand that their addiction to the substance is merely a result of their pessimistic thoughts. For instance, they can assert that they risk going insane if they abstain from using the addictive chemical.    The CBT method is used because addictive behaviors, such as abusing alcohol or drugs, can be linked to signals, triggers, or activating stimuli. The group members would be able to successfully adopt a different style of thinking and healthy behavior if they become conscious of these signs in each of their circumstances (Wheeler, 2020). Normal activating cues come from within, but they can also come from outside. Internal triggers include physiological sensations like tension or emotions like anxiety or depression. Therefore, the addiction is the outcome of an effort to make up for unpleasant sentiments. Environmental triggers like specific locations, people, or objects are examples of external cues.

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Motivational enhancement therapy, or MET, is a different treatment option for addiction in a group environment (Wendt & Gone, 2018). This involves evaluating the patient to find patterns of problematic behavior and drug usage. This evaluation could last up to eight hours, and then there could be another three to four sessions. Therefore, the first session is set aside for the assessment, and the subsequent ones are intended to aid the patient in discovering the motivation to change. Assessing The Practicum Problem Assignment Paper

Together with the client, goals are created, and they then create a strategy for achieving them, which may include quitting the behavior that led to the addiction. This is also a good choice because it is based on evidence and has been shown in the literature to be efficient and effective (Wendt & Gone, 2018). The same research suggests that combining any of these (CBT or MET) with 12-step organizations like Alcoholics Anonymous (AA) is significantly more successful.

How State Board of Nursing Standards and/ or Organizational or Governmental Policies Affect the Population Problem of Drug Use

The state boards of nursing all have professional standards of practice that nurses are expected to abide by. These include exercising professionalism at all times, treating every patient with respect and cultural sensitivity, respecting the patient’s wishes (autonomy), and avoiding doing harm to the patient. Governmental policies in this case come in the form of regulations by the Drug Enforcement Administration or DEA. These include the requirement that each prescriber of scheduled medications possess a unique DEA number for accountability. Organizational policy may include the requirement to prescribe non-opioid analgesics and reserve opioids only for terminally ill cancer patients. Assessing The Practicum Problem Assignment Paper

Leadership Strategies to Improve Outcomes, Patient-Centered Care, and Patient Experience Related to the Problem of Drug Use

The leadership strategy that will be adopted is transformational leadership style. This one motivates, empowers, and inspires the other staff to perform to the best of their abilities. The result will be very good outcomes such as a 100% rate of habit cessation. Even though it will be group therapy, patient-centered care will still be fostered through allowing every group member to speak and exercise catharsis.

Conclusion

Drug and substance addiction is the problem identified in the practicum location among the surrounding community members. The chosen patients are a group of drug and alcohol addicted individuals who have not been compliant with medications as well as therapy. They are inpatients now because of the need for close monitoring for compliance and uninterrupted therapy with CBT. Assessing The Practicum Problem Assignment Paper