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Journal entry

Journal entry

Goals and objectives

Looking at the goals and objectives from my practicum experience plan, I achieved all my goals and objectives. I was able to independently examine the mental and functional aspects of an individual and link them to the symptoms that they are presenting with. I also used The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), to make accurate psychiatric diagnoses. Furthermore, I was able to choose appropriate treatment plans for different patients with various psychiatric illnesses. A woman came in with complaints of sleep disturbance. I did a mental and functional examination and used the DSM-5 manual to diagnose her with insomnia. I then gave her trazodone 50mg nightly to manage insomnia.

Challenging patients

One of the most challenging patients I encountered was a 54-year-old African-American female. She had multiple comorbidities: systemic lupus erythematosus (SLE), hypertension, hypothyroidism, osteoporosis, and insomnia. Formulating an appropriate therapeutic plan was difficult because I had to ensure that all the medications she was going to receive would not react with each other (Fravel & Ernst, 2021). I also had to ensure that the medication would not negatively influence the other comorbidities. Another challenge was ensuring compliance with medication. The patient was not taking some of the medication prescribed for her because she thought it would extremely lower her blood pressure.

Another challenging patient I encountered was a 59-year-old Caucasian male. He was a challenge because he was new to the office, and he had no medical record from his previous primary care physician. He also had multiple comorbidities. He was suffering from dementia, erectile dysfunction, alcohol withdrawal syndrome, depression, insomnia, stool incontinence, and deep venous thrombosis. The other challenging patient was a 70-year-old Hispanic female. She was a challenge because she presented with multiple comorbidities. She was suffering from chronic pain, gastroesophageal reflux disease, and bilateral limb edema.

Lesson learned

I learned how to thoroughly examine patients with mental conditions, how to make an accurate diagnosis using the DSM-5 manual, and how to formulate individualized treatment plans. I learned how to set professional boundaries with my colleagues and even with my patients. Professional boundaries are important for a healthy working environment (Omori et al., 2019). I also learned how to work with other members of the mental healthcare services team.

Available resources and evidence-based practice

Psychiatric nurses, psychotherapists, art therapists, addiction counselors, psychologists, and psychiatrists were always available during my rotation. They were willing to be sought for consultation whenever they were available. Brochures, pamphlets, and flyers were also available. These were used to educate patients, families, and other healthcare practitioners about mental health conditions. Furthermore, they had information about health promotion and disease prevention techniques (Hall et al., 2021). I diagnosed various conditions only after comparing the patient’s presenting symptoms with the DSM-5 manual diagnostic criteria. I also used clinical research articles from the Walden Library to learn more about mental conditions.

Changes and managing patient flow and volume

One thing I would do differently is to involve the family members more in the management of their sick relatives. Each patient has different needs depending on what they are presenting with (Kovalchuk et al., 2018). It is, therefore, important to allocate enough time to each patient to make sure they are thoroughly assessed. During my practicum, I used to allocate each patient one hour for adequate examination, diagnosis, and individualized treatment formulation.

References

Fravel, M. A., & Ernst, M. (2021). Drug Interactions with Antihypertensives. Current hypertension reports, 23(3), 1-8. https://doi.org/10.1007/s11906-021-01131-y

Hall, B., Kelly, F., Wheeler, A. J., & McMillan, S. S. (2021). Consumer perceptions of community pharmacy‐based promotion of mental health and well‐being. Health Promotion Journal of Australia, 32(1), 26-31. https://doi.org/10.1002/hpja.312

Kovalchuk, S. V., Funkner, A. A., Metsker, O. G., & Yakovlev, A. N. (2018). Simulation of patient flow in multiple healthcare units using process and data mining techniques for model identification. Journal of biomedical informatics, 82, 128-142. https://doi.org/10.1016/j.jbi.2018.05.004

Omori, M., Baker, C., Jayasuriya, J., Savvas, S., Gardner, A., Dow, B., & Scherer, S. (2019). Maintenance of professional boundaries and family involvement in residential aged care. Qualitative Health Research, 29(11), 1611-1622. https://doi.org/10.1177%2F1049732319839363

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Question 


Realizing that an organization’s CMMI level affects an organization’s success on requests for proposals (RFPs), your CIO wants to get the software development processes to CMMI level 3. Your organization has started developing software applications and database systems for their customers. The CIO wants to ensure that the software development and database development processes are being properly managed and audited, and he wants to ensure that the organization begins taking the necessary steps to progress to CMMI level 3. In preparation for your response, review the CMMI information.

Journal entry

Journal entry

Instructions

IT managers will commonly manage software development and systems integration activities. Write a 3–5 page paper in which you:

Describe the software engineering process, the challenges in managing software development activities, and the potential interface issues from the software development perspective.
Analyze the CMMI levels and define a road map that the organization will need to follow to get its software development processes to CMMI level 3. Note: This is important because the CMMI level that an organization achieves impacts their software development reputation.
Explain the auditing tasks that must be performed in order to achieve level 3.
Determine the continuous assurance auditing activities that the organization will need to implement to help achieve CMMI level 3.
Analyze the ITIL service management guidelines and principles.
Examine how ITIL service management practices relate to CMMI levels and continuous service auditing.
Use at least three quality resources. Note: Wikipedia and similar websites do not qualify as quality resources.

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