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Nursing Informatics on Patient Outcomes

The Impact of Nursing Informatics on Patient Outcomes and Patient Care Efficiencies

How Nursing Informatics Benefits Quality OutcomesTo Prepare:

  • Review the concepts of technology application as presented in the Resources.
  • Reflect on how emerging technologies such as artificial intelligence may help fortify nursing informatics as a specialty by leading to increased impact on patient outcomes or patient care efficiencies.

The Assignment: (4-5 pages)

In a 4- to 5-page project proposal written to the leadership of your healthcare organization, propose a nursing informatics project for your organization that you advocate to improve patient outcomes or patient–care efficiency. Your project proposal should include the following:

  • Describe the project you propose.
  • Identify the stakeholders impacted by this project.
  • Explain the patient outcome(s) or patient–care efficiencies this project is aimed at improving and explain how this improvement would occur. Be specific and provide examples.
  • Identify the technologies required to implement this project and explain why.
  • Identify the project team (by roles) and explain how you would incorporate the nurse informaticist in the project team.

Sample Answer

Introduction

Nursing informatics has a significant role it plays in improving patient outcomes as well as patient care efficiencies. According to McCormick and Saba (2015), specialists in nursing informatics have utilized health information technology to make great contributions in healthcare settings. As health organizations are expanding, they consequentially have to provide quality care and deliver it timely to patients. In the contemporary world, health organizations that are still using traditional approaches methods of management encounter challenges in trying to synchronize functions in various departments in healthcare units (Sewell, 2018). With that in mind, the proposed nursing informatics project to the leadership of the healthcare organization that I offer my services is the implementation of a computerized hospital management system.

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Description of the Proposed Project

Healthcare facilities in rural settings have major challenges in providing quality and efficient care to patients. Mamlaka Healthcare Organization is one of the healthcare care facilities that is trying to beat the odds in meeting the needs of every stakeholder. Major challenges that the organization is currently facing is the inability to keep proper records of patients appropriately, poor maintenance of doctors’ schedule and poor financial management. Therefore, integrating computerized hospital management system in this hospital would facilitate all the management functions in the departments (Olamide et al., 2015). Having a single computerized hospital management system (CHMS) would assist in serving all sections in the hospital thus eliminating the challenges that the hospital is currently facing. This means that the system would synchronize patients’ information through electronic medical records (EMR) which would help health professionals to document and communicate patient information within the departments. In the long run, this would assist in reducing time wastage and save on paper. Still, with the CHMS, this would help in enhancing operational and financial management. In this case, this system comes with accounting software which supports and facilitates functions in billing, inventory control, and policy management. It also provides statistical reports where the administration can use the information to evaluate the necessary and unnecessary expenditure and track occupancy of patients in the hospital. This is in fact quite critical mostly during emergencies where incoming patients have to be admitted once they have received triage assessment. Generally, the implementation of a single CHMS would have a significant impact on enhancing the quality of care and efficient operations in the health organization.

Stakeholders Impacted by this Project

Considering that the computerized hospital management system is an efficient and safe infrastructure for a health organization, implementing this project would impact patients, health professionals, and management. With this system which has a variety of functions, patients would benefit by engaging with different clinicians through the patient portal and getting access to information concerning their personal health (Olamide et al., 2015). Today’s patients are more engaged in knowing the kind of treatment they are getting for their health conditions. Therefore, the portals would help them access all the information they want to know about their health. Also, there are instances where it is difficult for patients to attend scheduled appointments with their physicians due to a number of issues such as movement challenges or financial setbacks. Other times, the lack of adequate doctors in this hospital since it is in rural settings also make it difficult for the patients to get a chance to see their doctor. Therefore, to overcome these challenges, the patient portal would come in handy in by helping such patients regardless of their location to access doctors in the health facility. Further, this system would have an impact on the medical team. For instance, with handheld devices such as pens, note pads, blood pressure meters, and thermometers, nurses would manage to collect accurate information from their patients. The functions of these handheld devices are connected with the CHMS; therefore, this would help in reducing recording errors which arise when nurses input the patients’ information manually. Hence, for outpatient services, quick data collection would reduce the time patients spend in the health facility. Most importantly, the management would also reap positive outcomes such as generating high revenue. On this note, the provision of quick services due to the eased functions would enable the healthcare organization to serve many clients, unlike other facilities that have not integrated technology in their functions.

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Patient Outcome(S) or Patient-Care Efficiencies this Project is Aimed at Improving

With this project, it is evident that patients, health professionals, and the overall health organization will be directly impacted. Generally, this project will improve patient-care efficiencies in the delivery of quality healthcare. In this case, the active involvement of the medical team is required to comprehend how to handle the computerized technologies that come with the CHMS. This is necessary so that when they are delivering healthcare services they do so competently. For instance, in the finance department, the personnel would manage to improve patient-care efficiencies. They would achieve this by ensuring that there are no missing records, duplicate records or delays when preparing bills for the medical services patients receive. The automated functions with the CHMS will improve data management thus help the staff to be at ease when delivering patient care.

The Technology Required to Implement this Project

To achieve improving patient-care efficiency, the technology that will be required is the hospital management software which facilitates performance standards in all areas in the hospital. This software would allow the management of Mamlaka Healthcare Organization to have a single point of control and ensuring that there is better coordination of activities in different departments. This is because the different components in this software provide diagnostic support where the user community comprising of physicians, administrators, nurses, and researchers among others collaborate to improve healthcare.

The Project Team and Their Roles

In this project, the team will be headed by the project manager whose role will be ensuring that there is proper coordination in the implementation of the hospital management software. Further, the head of management in the hospital will ensure that there are enough equipment and finances for the project. The project will also have two clinical analysts who will ensure that networks are well maintained and upgraded regularly. An infrastructure manager will also be needed to identify the limitations and risks within the project plan. Another important team member will be a database specialist who will ensure that the databases in the hospital management software are functioning as required. The project will also incorporate a nurse informaticist. This team member will interpret the results of analytics and identifying how to reduce errors by addressing quality issues in different departments to promote healthcare efficiencies (McCormick, & Saba, 2015). The nurse informaticist will monitor and evaluate the measurable outcomes of care and provide a comprehensive report of the effectiveness of implementing the project in the health organization.

Conclusion

Overall, Mamlaka Healthcare Organization has the opportunity of being an outstanding health facility that puts the safety and quality care of patients at interest. This is evident if only the leadership in this organization takes steps in approving the proposal of implementing CHMS to enhance patient care. The organization will also benefit by increasing its profitability and also gaining a positive reputation against its competitors. Generally, the use of computerized systems will enable the organization to fit in the current universal technological trends where automated functions are making work easier in health organizations.

Reference

McCormick, K., & Saba, V. (2015). Essentials of nursing informatics. McGraw-Hill Education.

Olamide, O., Adedayo, E., & Abiodun, O. (2015). Design and Implementation of Hospital Management System Using Java. IOSR Journal of Mobile Computing & Application, 2(1).

Sewell, J. (2018). Informatics and Nursing. Lippincott Williams & Wilkins.

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Social and Emotional Development Regarding Divorce

Social and Emotional Development Regarding Divorce

How Divorce affects finances? What are your financial rights when going through a divorceTo Prepare:

  • Choose two of the following aspects of social and emotional development:
    • Relationship with and interactions between mother, father, siblings
    • Quality of peer relationships
    • Empathy
    • Expression of emotion
    • Emotion regulation (e.g., impulse control)
    • Romantic relationship formation/success
  • Choose a developmental stage to focus on in this Discussion (e.g., preschool years, middle childhood, adolescence, emerging adulthood). (Note: If you choose emerging adulthood, please make sure you focus on the development of individuals 18–25 whose parents are divorcing.)
  • Consider how divorce has been shown to impact that aspect of development in the short and long term.

By Day 4

Post an analysis of how divorce has been shown to impact the aspect of social and emotional development that you selected, both within the first 2 years after the divorce as well as long term (e.g., into adulthood). Reference at least two peer-reviewed articles beyond this week’s Learning Resources to support the arguments you present in your post.

Model Answer

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Social and Emotional Development Regarding Divorce

Divorce has negative impacts in the adolescence developmental stage. Mainly at this stage, when the dissolution of marriage occurs, the children are profoundly impacted since this is a time they have heightened sensitivity. The transition period, therefore, makes the adolescents vulnerable to any changes that may occur in the family structure or other close relationships. In the first two years, it becomes quite challenging for the parents as well as the adolescents to cope with the new family arrangements of the separated parents. Divorce leads to adverse short-term and long-term effects on the quality of peer relations and the expression of emotions aspects of social and emotional development in the adolescent stage.

The Short-Term Impacts

Once the parents have divorced, a significant short-term effect is that the children become rebellious and resistant to following the rules set at home. This mostly happens as a result of feelings of anger and hatred due to the separation. During the adolescent stage, children are encountered with identity crises since; they try to develop their individuality so that they are independent of their parents. That is why at this stage, the children value the relationships they develop with their peers than with their families. In social development, peer relationships have a significant influence on the individuality of the adolescents (Clarke-Stewart, & Parke, 2014). In this case, the children are not able to control their bitterness which they extend to their peers, and this affects the quality of the friendships.

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Another short-term effect on the aspects of expression of emotions is that the adolescents struggle expressing their feelings concerning the divorce which leads to stress. They develop emotions of guilt, shame, grief, sadness, and even abandonment. Such emotions overwhelm them to a point they are not able to adjust to the situation. This forces them to socially withdraw themselves from their peers, families and the society which is the other short-term effect. Also, children in the adolescent stage are not able to cope and communicate openly when they are exposed to stressful situations. Unfortunately, this contributes to a decline in their academic performance. The academic performance is affected as a result of dropout rates, failing to attend classes and poor concentration in class. For instance, when there are no proper arrangements on who is to take care of the children’s education and overall well-being, the parent that ends up with the children may experience financial challenges. This is a significant stressor that the adolescents are not able to openly communicate about with their already stressed parent (Dunsmore, et al., 2009).

The Long-Term Impacts

The adolescents are not able to maintain good relationships with their peers so; they end up in wrong peer groups where they are introduced to drugs and other substances. In the long run, they become drug addicts, alcoholics, pickpockets, or even thugs. They mostly do so to further infuriate or rebel against their divorced parents. Still, the peers develop premature intimate relationships which lead to teenage pregnancies. The shame from the actions makes the adolescents have low self-esteem which affects their psychological growth. Still, the quality of peer relationships may diminish since the adolescents become insecure which affects their future friendships.

In the case of expression of emotions, since the adolescents cannot communicate openly about their feelings, it increases their stress levels, and this leads to health issues such as mental disorders. This happens because the parents are not usually emotionally and physically present to interact and share problems with their children. Such gaps leave the children vulnerable to mental conditions like depression. Approximately 3-8% of adolescents suffer from depression whereby the rate of depression in the adolescent girls is reported to be high (Meichenbaum, 2010). This is because girls at this stage are more prone to be affected by unhealthy environments because of the hormonal changes in their bodies which increase their sensitivity.

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Conclusion

The above short-term and long-term effects can be prevented if the separated parents are cooperative in ensuring that the adolescents adjust to the new family arrangements. For instance, they should maintain loving relationships with their children as well as prioritizing their needs. Also, they should encourage open communication and ensure that as they co-parent, they should actively listen to their adolescent children. Most importantly, the parents should take time before they involve themselves in other relationships. This enables the children to have an adequate time of adjusting to the separation. Otherwise, new relationships make the parents have divided attention which affects the adjustment process of their children. Also, intervention programs should be considered since the children learn how to manage stress, communicate, regulate their emotions, as well as adjust to the changes.

References

Clarke-Stewart, A., & Parke, R. D. (2014). Social development (2nd ed.). Hoboken, NJ: Wiley.

Dunsmore, J. C., Her, P., Halberstadt, A., & Perez-Rivera, M. B. (2009). Parents’ beliefs about emotions and children’s recognition of parents’ emotions. Journal of Nonverbal Behavior, 33(2), 121–140

Meichenbaum, D. (2010, May). Child and adolescent depression and suicide: Promising hope  and facilitating change. In At the 14th Annual Conference May (Vol. 7).

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Students Will Create a Change Management Plan

Question

8 Steps for an Effective Change Management Process | SmartsheetStudents will create a change management plan that follows project management best practices to allow controlled changes to the project specifically for Schedule, Scope, Budget and Resources. The process should analyze the impact of changes to the project objectives and how changes to the overall project get approved or denied. Students may propose an alternative project of their own design that shows attainment of the corresponding course outcome. The mentor must approve the alternative project.

Model Answer to the Above Question

Introduction

A change management plan is an essential tool for the achievement of project success. This includes the roles and activities to manage and control change during different stages in the projects. Change is at most necessary during the execution and control stages of the project. Change is always defined against the project baseline which requires that a request for change is made and approved or denied by the relevant authorities. Change is very critical to success, and hence only responsible persons can authorize the change. For project success, there should be no change unless it’s evaluated and approved even in very critical conditions. Although the approval urgency can vary from one project to another, every changing aspect needs to be extensively evaluated. A change control board performs the role of approving or declining a change request. To promote consistency, a change request form is necessary, which helps captures all the essential elements of the change needed.

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A project change request can be focused on the various aspects of the project. A change management plan identifies change on the project schedule, scope and budget, and resources. Change takes a critical element of project management, and it’s inevitable in the project. The change management plan focuses on proposing the aspects to consider before considering approving the change for any of the defined project aspect. The discussion also includes the impact that change has on the project objectives.  Since any of the shareholders can request a change, the control teams need to assess its impact on the goal since change can as well be worthless or inconvenient. One consideration is that the shift in project control team includes project management leaders since the proposed project may lack the capacity to dispatch the proposed change successfully and effectively. In a construction, project change can occur at the execution and the control stages affecting the schedule, scope, budget, and resources and would thus need a well-defined control team for evaluation and approval.

Defined Plan for Change

There are two forms of changes that will be expected and upheld in the construction of the apartment and the perimeter wall. The customer will fund some changes while other changes will be based on the project team/ contractors. The design engineers can propose a change in the design especially on the interior design of segments of the building. This change will influence the disbursement of resources and causes changes in the budget. Changing the fittings to more durable type for safety and sustainability issues would mean adding more resources to the project. In this case, a change in the quality will be approved by the control team only if the proposed change influences the overall objective of the project. Customer proposed change will be based on the marketability value, and the influence of the customer has in the project. Some of the customers designed changes such as portioning of the individual stalls will be made at their costs after signing the tenancy contract. However, the team will consider if that change affects the durability of the apartment and if there would be a need to approve the change. The project team can be requested to independently fulfill the required change in the best interests of all stakeholders.

Schedule

This project is expected to run for 11 months to achieve all its objectives. Both structural and operational changes will affect the schedule to extend time assigned for some tasks at the expense of others. There is a need to maintain the project baseline to ensure a reflection of the current status of the project. The change request needs not to cause a significant overlap of tasks in the project plan. According to Harrison, and Lock, (2017) a four stages process can be useful in controlling the changes that would be approved for the schedule. The control team needs to determine the current status of the schedule. The project manager needs then need to influence the factors that could cause the schedule to change. There is a need for evaluation of the change to determine whether it’s a positive or negative change. Assessment of whether the changes have occurred and managing those changes as they occur would be very critical to the change management process. In the evaluation of the change factors analysis of the need for corrective action is necessary. For instance, construction is scheduled for nine months, and changes in the design would extend the assigned time. There is a need for an evaluation to ensure the change is valuable to the project.   

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Scope

The WBS for this project has four levels and will need to be sustained and controlled despite the requests for change. The level of change that the control team needs to evaluate and approve need to satisfy various aspects and objectives defined in the WBS. Effective control of the scope of the project is one essential requirement of project management (Bpayne, & Waytte, n.d.). There are some events if they occur the control team will approve the change to the scope. If there is change on the sponsor’s financial health and they do request for suspension of some tasks such considerations will have to be approved. Other change requests on the scope of the project will be declined especially if they result from increases in the overall costs.  A change management system will be defined one which will ensure that the appropriate level of management authorizes the changes in the scope. The changes to the scope that results from decreasing in the cost will be assessed to ensure that the quality of the house will not be compromised. 

Budget and Resources

All the change requests affect results from a need to increase or decrease the budget or reduce the resources including human resources. This change management plan is flexible to increasing or decreasing the budget by less than 2% but only under specialized approval. The resource allocation is considered to have been made in the best interests of the objectives and hence reducing or increasing the workforce will be avoided. However, in case of a risk team members will be requested to work for extra hours. To control the change in the budget and resources, all the evaluation process will be made by the project manager.

Impact of Changes to the Project Objectives

A poorly managed change control would lead to negative influence in the project objectives. Some of the goals like having classic apartments appealing to the market could be compromised. To the worse, the house may never be completed following insufficient funds. The impact change can have on the project objective determined, is useful in assessing the effectiveness of the quality managers.  The schedule variance and cost variance are the primary aspects of change that will be used to determine the impact of change (Millhollan, 2008). The impact of change on the objectives is different for the various changes. Those changes that are inclined directly to the project scope are more sensitive and may demand closer attention. One approach to controlling change is to ensure an extensive understanding of the objectives of the project. At times the impact of change on the objectives is positive. In as much as the project manager would be committed to fulfilling the results as communicated the client could be unhappy with the results. Change is significant, and when there is an improvement in the quality of the product without escalation of the costs, the change will be adequately achieved.

How Changes to the Overall Project Get Approved or Denied

Approving and denying the change request will be completed by the project change control team. The project management isn’t in a capacity to approve all change requests.  The project management will outline a standard form for making the change request. Any member of the project can make a change request; however, only the change control team will make the final decisions. Once a change request has been made, they will be evaluated to the aspect of the project that they affect such as the scope, schedule, budget or the resources. There is a need to have a clear score factor for the evaluation of the change request to ensure uniformity throughout the project period (Jalagat, 2016). A change process affects various operations, and hence the management will assess the impact against the objectives of the project. Sometimes consultations will be made before any decisions can be made and once approved there is needed to determine how to implement that change.

Conclusion

The discussion is a change management plan focusing on ensuring that the change process is completed within the scope of the needs of the stakeholders. As much as a project manager would fulfill all deliverables as requested by the client, it’s not a guarantee that they will be happy. This means then that change needs to be considered and controlled depending on the prevailing circumstances of the project. Change impacts the objectives either negatively or positively, and those assessments need to be evaluated before approval or denial decisions. To some extents, project managers success depends on their quality of controlling the change.

References

Bpayne, & Waytte, A. (n.d.). Framework for Project Management. Retrieved from             https://opentextbc.ca/projectmanagement/chapter/chapter-4-framework-for-project-management-project-management/

Harrison, F., & Lock, D. (2017). Advanced project management: a structured approach.        Routledge.

Jalagat, R. (2016). The Impact of Change and Change Management in Achieving Corporate Goals and Objectives: Organizational Perspective. International Journal of Science and  Research (IJSR), 5, 1233-1239.

Kerzner, H., & Kerzner, H. R. (2017). Project management: a systems approach to planning, scheduling, and controlling. John Wiley & Sons.

Millhollan, C. (2008). Scope change control: control your projects or your projects will control you! Paper presented at PMI® Global Congress 2008—North America, Denver, CO. Newtown Square, PA: Project Management Institute.

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Treatment of Borderline Personality Disorder

bpd graphic world mental health awareness monthBorderline Personality Disorder is a condition that affects mood instability and makes it difficult for people to form relationships. According to Brüne (2016), unstable relationships, fear of being abandoned, inability to regulate emotions, feelings of depression, and high-risk behaviors are some of the characteristics of the condition. According to APA (2013), people with the disorder have increased chances of committing suicide. Brüne (2016) says that people suffering from the condition have paranoid ideas, and they always have self-injurious behavior. There are several intervention measures that are being used to manage borderline personality disorder. These intervention measures are generalized to all populations, but they can be adapted to work in specific circumstances such as in sexual minorities.

Causes of the disorder

Several factors predispose a person to borderline personality disorder. Genetics is one factor that can contribute a person to suffering from the condition. According to NHS (2019), genes a person inherits from their parents can make them vulnerable to the disorder. Researchers claim that if an identical twin has the disease. The chances are high that the order twin has the condition. However, there is no reliable research that ties genes to borderline personality disorder. Another factor that is likely to cause the disease is brain chemicals. NHS (2019) reports that people suffering from the disorder are believed to be having something wrong with their neurotransmitters, particularly serotonin. When the amount of serotonin produced is altered, it leads to depression and aggression.

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Another factor that is likely to cause the disease is brain chemicals. NHS (2019) reports that people suffering from the disorder are believed to be having something wrong with their neurotransmitters, particularly serotonin. When the amount of serotonin produced is altered, it leads to depression and aggression. Another factor that causes borderline personality disorder is problems with brain development. NHS (2019) reports that brain scans of people with the disease reveal that they have a small amygdala, hippocampus, and orbitofrontal cortex. The development of these parts of the brain is affected by the early upbringing of a child. These sections of the brain are for regulating moods, and therefore underdevelopment of these parts of the brain leads to the inability of an individual to control their tempers. Environmental factors are also responsible for causing the disorder. Some of these environmental factors are molestations as a child, neglect by parents, and growing up in a dysfunctional family. Unresolved childhood issues such as anger and fear lead a child to grow with distress and, therefore, a distorted thinking pattern that makes them vulnerable to the disorder.

Treatment approaches to borderline personality disorder

Psychotherapy

This is one of the conventional methods for treating the disorder. Its application leads to a reduction of the symptoms that a person with the condition exhibits over time. According to Biskin & Paris (2012), several types of psychotherapy exist that are for managing the disorder. Some of the popular psychotherapies used to manage the condition are dialectical behavior and mentalization-based treatment.

Dialectical behavior therapy

According to Biskins & Paris (2012), this psychotherapy was the first to be found useful in managing borderline personality disorder. This treatment combines Eastern philosophy with behavioral therapies in treating a patient. This therapy is divided into individual and group sessions. In these sessions, the participants are taught skills in mindfulness, regulation of emotions, interpersonal effectiveness, and distress tolerance. Dialectical behavior therapy is made to last for a year. The patient can consult with the psychotherapist over the phone. May, Richardi & Barth (2016) claim that this intervention mechanism was developed by Marsha Linehan in the 1990s, and it was for treating women from a borderline personality disorder. The term “dialectical” in the intervention mechanism refers to the use of “acceptance and change necessities for improvement.” This psychotherapy method treats maladaptive behaviors by replacing them with good behaviors. May, Richard & Barth (2016) affirm that the method is effective in treating conditions like mood disorders, posttraumatic stress disorders, and eating disorders.

How the intervention is used

As indicated earlier, dialectical behavior therapy involves two sessions, one of which is the individual session. During this session, an individual meets with the certified therapist on a one-on-one basis. The therapist ensures the training achieves its therapeutic objectives. The role of the therapist in these individual sessions is to motivate the patient in applying the skills taught to contain the disorder. In group therapy, the members offer each other mutual support through sharing of experiences and encouraging one another. In the group-based sessions, there are also trained therapists who lead the process. Psychology Today (n.d) reports that the training sessions last for two hours, and the group usually meets for about six weeks. In these sessions, members are given questions that test what they have learned from the sessions.

Mentalization-based treatment

Mentalization is the ability of an individual to recognize their mental states. It involves knowing your mental state and the ability to think of the impact of your actions on other people. Mentalization-base therapy focuses on enabling a person to recognize their thoughts and think about the outcome of their behavior. In developing this therapy, Bateman and Fonagy believed that people with the condition are unable to acknowledge their mental states because of problems they encountered as children, which affected the growth of their mentalization. In using this therapy, the focus of the therapist is in the present mental state of the patient and not the past. The therapist works towards enabling the patient to recognize their mental states and emotions. While administering this therapy, the therapist does not give advice and opinion on how the patient should behave. Instead, the therapist helps the patient explore their mental states and how to mentalize. Salters-Pedneault (2019) reports that research supports the use of therapy in managing borderline personality disorder. A randomized controlled study conducted by researchers showed that patients suffering from the disease who were exposed to the mentalization-based therapy reported a reduction in self-harm, depression, and anxiety.

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According to Morken, Binder, Arefjord, & Karterud (2019), a study conducted regarding the application of mentalization-based therapy in people with borderline personality disorder reveals that it increases mentalization in patients. Morken, Binder, Arefjord, & Karterud (2019) say that the therapy, just like dialectical behavior therapy, consists of two sessions, namely individual and group therapies. There are specific aspects of mentalizing that the therapy focuses on. According to Morken, Binder, Arefjord & Karterud (2019), there are several domains of mentalization-based therapy which can be used by the therapist. They are mentalization process, relational mentalization, effective mentalizing narrative, and non-mentalizing modes. The mentalization process is concerned with the mentalizing process. Relational mentalization involves focusing on the relationship between the therapist and the patient. The mentalizing effective narrative requires that therapists focus on narratives and should be concerned with the effect while non-mentalizing modes are applicable when the patient is not in mentalizing mode.

Medications

According to Salters-Pedneault (2019), drugs used to manage anxiety and depression have been found to reduce the symptoms of borderline personality disorders. Currently, there are no specific medications for treating borderline personality disorder. The drugs that are presently being used are those that reduce the symptoms of the disease, but they don’t lead to complete healing from the condition. Among some of the medications that are used are those for managing psychological conditions that usually occur with the condition like major depressive disorder. Independently, medications may not be effective in controlling the disorder, and so they are used with other intervention mechanisms such as psychotherapy.

Types of medications used

Antidepressants

Initially, antidepressants were designed for people suffering from a major depressive disorder. Salters-Pedneault (2019) claims that it was also for managing other mental conditions characterized by low mood. The antidepressants that have been approved for use in managing borderline personality disorder are monoamine oxidase inhibitors, selective serotonin reuptake inhibitors, and tricyclic and tetracyclic antidepressants. Salters-Pedneault (2019) reports that studies indicate that antidepressants are effective in managing sadness, anxiety, and low moods. Some of the commonly used antidepressants are Nardil, Prozac, Zoloft, Effexor, and Wellbutrin.

Antipsychotics

Early psychiatrists discovered that the symptoms of the condition were in the border of psychosis and neurosis. This is why they named the disease “borderline” to imply in the border between the two conditions. Early medications for the disease were antipsychotics. Later, it was found that the antipsychotics were effective in treating other disorders that were no-psychotics. Salters-Pedneault (2019) claims that antipsychotics reduce anxiety, anger, impulsiveness, and paranoid thinking. Some commonly used antipsychotics are Haldol, Zyprexa, Clozaril, Seroquel, and Risperdal.

Mood stabilizers

These medications are used to stabilize the moods of individuals. One of the characteristics of borderline personality behavior is the presence of mood swings. Some of the drugs that are used in this category are Lithobid, Depakote, Lamictal, and Tegretol.

Anxiolytics

Usually, people with the disorder experience anxiety. Anxiolytics are drugs that the patients suffering from the condition are given to manage the disease. Salters-Pedneault (2019) says that little research has been done to ascertain whether the drugs are efficient in treating the condition. There also some anxiety drugs that, when used, can worsen the condition of the patient. This, therefore, requires that proper consultations are done before prescribing the drugs. According to Salters-Pedneault (2019), Benzodiazepines are particularly dangerous when individuals who abuse drugs use it since it is addictive. The anxiolytics commonly used to combat the disorder are Ativan, Klonopin, Xanax, Valium, and Buspar.

The application of the treatment methods in treating marginalized people

Rivera-Segarra et al. (2014) claim that stigmatization has been a hindrance for people with mental conditions from seeking care. Among the marginalized populations are sexual minorities such as bisexuals, gays, and lesbians. Plöderl et al. (2017) allege that sexual minorities experience barriers when seeking treatment for mental illnesses since there is a lack of specific treatment for sexual minorities. Plöderl et al. (2017) further claim that sexual minorities are at risk since they have more stressing factors compared to the rest of the population. Apart from the usual stressors that other people have, other stressing factors for them are fear of being discriminated against and internalized homophobia associated with hiding one’s sexual orientation. Medications operate in the same manner for all people irrespective of their sexual orientations, and therefore there are no different medicines for managing BPD in sexual minorities.

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Therapies in treating sexual minorities with BPD

For sexual minorities, invalidation is the biggest issue that affects them. The dialectical behavioral therapy, which, initially, was developed for treating people with suicidal tendencies, has been adapted for the treatment of people across different settings. According to Skerven, Whicker & LeMaire (2019), the majority of the people being diagnosed with BPD identify as gays, lesbians, or bisexuals. Skerven, Whicker & LeMaire (2019) reiterate the findings of Bradford Reich & Zanarini (2008) that sexual minorities accounted for 75% of patients diagnosed with BPD. Research also affirms that sexual minorities are more likely to have suicidal thoughts and self-harm compared to other people (Whicker & Le Maries, 2019). Dialectical behavioral therapy is being used by therapists to reduce stressor and help the patients regain their self-respect so that they can cope with stress. DBT is the best intervention currently available for sexual minorities since other interventions are aimed at reducing the stressors instead of teaching the patient how to cope with the stress. Skerven, Whicker & LeMaire (2019) allude that DBT addresses the environmental stressors and self-esteem, and therefore it is an effective intervention for the Lesbians Gay Bisexual Transgender Queer (LGBTQ) community. Dialectical behavioral therapy is made of four significant components, namely emotional regulation, interpersonal effectiveness, core mindfulness, and distress tolerance. The four modules of DBT are meant for enabling the client to rein on their emotions. Through individual and group therapies, a therapist guides the client into coping with all kinds of stigma and how they can accept their identity.

Conclusion

A borderline personality disorder is a mental condition that makes a patient have suicidal thoughts, and this can lead to unstable relationships. This condition is characterized by mood swings, whereby the moods of an individual keep changing. Several factors exist which predispose a person to the disorder. They are environmental, brain chemicals, and genetics. Environmental factors are those concerned with the upbringing of an individual. If a person is brought up in a dysfunctional home where abuses are the norm, chances are high that they will develop the disorder when they are grown up. On brain chemicals, lack of proper development of the brain leads to an imbalance in chemicals in the brain. This leads to the inability of an individual to effectively balance emotions. Genetics, even though not yet proven, scientifically is believed to lead to the condition. There are several interventions for treating borderline personality disorder. There are therapies, such as dialectical behavioral and mentalization-based therapies. Medications such as antidepressants are also used to manage the condition. These interventions are used to treat BPD across many settings. Among the minorities that the interventions are used in are sexual minorities. There are generally no specific intervention measures for treating sexual minorities suffering from BPD. The existing mechanisms, such as dialectical behavioral therapy, have been adapted to fit their situation. On medicines, there are no unique medicines for managing BPD for sexual minorities since drugs work in the same manner irrespective of individuals’ sexual orientation.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.

Biskin, R., & Paris, J. (2012). Management of borderline personality disorder. Canadian Medical Association Journal, 184(17), 1897-1902. doi: 10.1503/cmaj.112055

Borderline personality disorder – Causes. (2019). Retrieved 13 November 2019, from https://www.nhs.uk/conditions/borderline-personality-disorder/causes/

Brüne, M. (2016). Borderline Personality Disorder. Evolution, Medicine, And Public Health, 2016(1), 52-66. doi: 10.1093/emph/eow002

Dialectical Behavior Therapy | Psychology Today. (2019). Retrieved 13 November 2019, from https://www.psychologytoday.com/intl/therapy-types/dialectical-behavior-therapy

May, J., Richardi, T., & Barth, K. (2016). Dialectical behavior therapy as a treatment for borderline personality disorder. Mental Health Clinician, 6(2), 62-67. doi: 10.9740/mhc.2016.03.62

Morken, K., Binder, P., Arefjord, N., & Karterud, S. (2019). Mentalization-Based Treatment From the Patients’ Perspective – What Ingredients Do They Emphasize?. Frontiers in Psychology, 10. doi: 10.3389/fpsyg.2019.01327

Plöderl, M., Kunrath, S., Cramer, R., Wang, J., Hauer, L., & Fartacek, C. (2017). Sexual orientation differences in treatment expectation, alliance, and outcome among patients at risk for suicide in a public psychiatric hospital. BMC Psychiatry, 17(1). doi: 10.1186/s12888-017-1337-8

Rivera-Segarra, E., Rivera, G., López-Soto, R., Crespo-Ramos, G., & Marqués-Reyes, D. (2014). Stigmatization Experiences among People Living with Borderline Personality Disorder in Puerto Rico. The Qualitative Report, 19(15), 1-18. Retrieved from https://nsuworks.nova.edu/tqr/vol19/iss15/2

Salters-Pedneault, K. (2019). Borderline Personality Disorder Medications Can Treat Symptoms. Retrieved 13 November 2019, from https://www.verywellmind.com/borderline-personality-disorder-medications-425450

Salters-Pedneault, K. (2019). Mentalization-Based Therapy May Help Borderline Personality Disorder. Retrieved 13 November 2019, from https://www.verywellmind.com/mentalization-therapy-for-bpd-425459

Salters-Pedneault, K. (2019). Mentalization-Based Therapy May Help Borderline Personality Disorder. Retrieved 13 November 2019, from https://www.verywellmind.com/mentalization-therapy-for-bpd-425459

Skerven, K., Whicker, D., & LeMaire, K. (2019). Applying dialectical behavior therapy to structural and internalized stigma with LGBTQ+ clients. The Cognitive Behaviour Therapist, 12. doi: 10.1017/s1754470x18000235

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Business Strategy

Business StrategyBusiness Strategy

Currently, the modern business environment is more competitive than ever, and this is because numerous business outfits have emerged to compete for roughly the same market. Therefore, successful companies are those that devise means which give them a competitive edge over their rivals. One such measure entails the adoption of a practical business strategy. The term business strategy is a workable plan that a business entity uses to compete favorably with other organizations, improve financial performance, achieve organizational goals, and attract new customers. An effective strategy is one that plots a clear guideline on actions that people are encouraged (not) to take for the betterment of the company, thus ensuring that no vital aspect of the business is left to chance.

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In this digital era, innovations like the internet have driven companies towards globalization, raising the stakes, and making it imperative for companies to adopt effective strategies. Regarding the analysis of business organizations’ strategies, few are as insightful as Team Wikispeed’s case. This paper proceeds on the thesis that Team Wikispeed’s case is a testament to the fact that companies must incorporate novel ideas into their operations if they are to succeed in the business scene.

Embracing Agile

In the quest to assess Wikispeed’s strategy and performance, it is vital to create the proper context in which this discourse shall occur. No article gives more insight into the intricacies of crafting effective business strategies and embracing creativity than Embracing Agile. In this piece, the authors highlight the revolutionary impact of innovation and place a particular focus on the information technology sector to derive lessons that any business entity can adopt (Rigby et al., 2016). They note that innovative Agile methods have radically altered the IT landscape for the last thirty years in software development, quality improvement, and market speed, as well as enhancing the IT teams’ drive and productivity. Rigby et al. (2016) conceptualize Agile’s methodologies as welcome reprieves from the conventional command-and-control model of management. The approach embodies a whole set of new values and practices that yield immense benefits to people working in the organization. According to the authors, Agile’s proposal has gained widespread acceptance in other business spheres owing to its universally applicable principles.

The authors pinpoint innovation as the fundamental aspect of Agile’s approach (Rigby et al., 2016). According to the authors, this creative approach works for most companies because the business environment is more dynamic than ever, necessitating the formulation of plans to enable business entities to keep up with the rapidly changing market conditions. The biggest challenge, however, is that most executives purport to implement the novel strategy, yet they are reluctant to let go of outdated methods. For instance, many CEOs launch too many programs and set strict deadlines for employees, yet the company would fare much better if only a few projects were prioritized. They also tend to overturn the decisions that teams make by intervening midway and re-introducing concepts that had been ruled out.

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As a remedy to the challenges that entities face in implementing the Agile approach, the authors make six recommendations (Rigby et al., 2016). First, leaders must familiarize themselves with the new method if they are to provide effective leadership. The second facet entails appreciating situations where the strategy would work, and those where attempts at implementing it will constitute wasted effort. The third recommendation is that entities should resist the urge to change everything at once and instead introduce new methodologies progressively. The fourth step for success in a dynamic business environment is to allow for flexibility so that proficient teams can customize processes. At the fifth stage, entities should implement innovative strategies like agile in high-ranking functions within the company in situations where the mundane routine aspects of company operations are static, leading to corporate realignments in their organizations. The last step entails removing all the possible hurdles to the implementation of novel and creative interventions. The researchers discovered that bureaucracy is the main frustrating factor for creativity because innovations are subjected to long approval sequences. To remedy this shortcoming, Rigby et al. (2016) recommend inquisitorial leadership where executives ask questions on the viability of innovations rather than clamping down on innovative ideas using the conventional command-and-control model.

The Wikispeed Approach and its Difference from Traditional Product Development Processes

The case study on Team Wikispeed provides a radically unique perspective on product development approaches (Kupp et al., 2013). Team Wikispeed embraced the Agile model, and from the details provided by its founder Joe Justice, the development process that the team uses is markedly different from conventional practice. Where others use the standard Waterfall model, Wikispeed uses Scrum, which embodies agile principles. In Agile methodologies, the development process allows for iteration, which is the repetition of sequences until one achieves the desired outcome. On the other hand, the Waterfall sequence entails the input of immense efforts and resources into a predetermined path from the beginning and pursuing that plan until it is complete.

Another difference that exists between these two processes pits flexibility against rigidity (Kupp et al., 2013). The agile approach is akin to an inquisitorial process where the parties try different things until the product’s specifications are deemed appropriate. The advantage of this approach is that it allows for alteration of the design in case the product’s requirements, in this case, a car, change. In the Waterfall model, however, the specifications are fixed, and the product design finalized even before the process takes off. As such, there is no space for making changes when circumstances change midway through the process. The inadaptability of the Waterfall method makes production a costly affair, especially where sales dwindle, customer preferences change, or the industry makes discoveries that render previous designs and materials obsolete.

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The line of production’s organization is another distinguishing factor between Team Wikispeed’s production process and other conventional approaches (Kupp et al., 2013). Wikispeed embraces a collaborative structure under Scrum to ensure that responsibility is distributed evenly across the team. The organization around production takes a tri-faceted approach with the product owner, team members, and the scrum master bearing different roles. On the contrary, conventional productions take a command-and-control model where team members are accountable to the manager.

Elements of the Wikispeed Approach Applicable to Traditional manufacturing Firms

A critical factor in the successful implementation of Agile is knowing where it can work and the aspects that can or cannot work in a given scenario (Kupp et al., 2013). Traditional manufacturing firms do not have the opportunity to try out novel ideas like iteration because their fields are not dynamic. However, there are vital lessons that they can borrow from Wikispeed’s approach. A significant transgression that multinationals have been guilty of in reverse engineering is planning on market segments using existing products (Winter & Govindarajan, 2015). Such a strategy manifests in removing existing features and leaving a lower quality product to serve less affluent markets. The main lesson from Team Wikispeed’s case study is the necessity of shifting accountability of the business from the manager to the customer (Kupp et al., 2013). Managers tend to be out of touch with the market, and while they may provide strategic leadership, the basis of manufacturing should satisfy the consumer’s needs.

Another positive practice embraced by Wikispeed is the distribution of responsibility across the entire team and allowing teams that have attained expertise in their fields to improvise where necessary to create practical solutions (Kupp et al., 2013). Traditional manufacturers should remove rigidity where strict adherence to specific processes have no functional impact on products and embrace new ideas.  In trying to come up with new products, executives should conceptualize the problem objectively without having an immediate solution (Winter & Govindarajan, 2015). Taking such an approach will remove the inconveniences caused by managers exercising their executive authority to interfere with the teams.

In conclusion, business strategy is a necessary facet of organizational operation as it determines its success or failure. Team Wikispeed’s approach demonstrates the importance of having a flexible and customer-centered plan. Even where the entities involved are traditional manufacturing companies, there are a few lessons that can be borrowed from Agile to improve efficiency.

References

Kupp, M., Dahlander, L., & Morrow, E. (2013, November 8). Team Wikispeed: Developing Hardware the Software Way. HBR Store. https://store.hbr.org/product/team-wikispeed-developing-hardware-the-software-way/ES1391

Rigby, D. K., Sutherland, J., & Takeuchi, H. (2016, May 1). Embracing Agile. Harvard Business Review, May 2016. https://hbr.org/2016/05/embracing-agile

Winter, A., & Govindarajan, V. (2015, July 1). Engineering Reverse Innovations. Harvard Business Review, July–August 2015. https://hbr.org/2015/07/engineering-reverse-innovations

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