After discussion with your preceptor, name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account for developing the evidence-based change proposal. Explain how your proposal will directly and indirectly impact each of the aspects.
Now that you have completed a series of assignments that have led you into the active project planning and development stage for your project, briefly describe your proposed solution to address the problem, issue, suggestion, initiative, or educational need and how it has changed since you first envisioned it. What led to your current perspective and direction?

In this module’s introduction, the following assertation is made: “Therefore, nurses in all settings need to strive to learn about existing or emerging mid-range theories, or seek to develop and describe theories that will explain phenomena they observe in practice?” APA, 150 words or more, two or more references.
Given the demands, we all face in our practices, how can we tangibly “seek to develop and describe theories that will explain phenomena they observe in practice?”

Ethical/Legal Discussion of Abuse
Child and elder abuse are disturbing, unfathomable issues due to the helpless nature of the victims; however, many people are affected daily by maltreatment. Healthcare providers often discover this abuse by assessment rather than self-disclosure. It can also be an issue family members bring up to a healthcare provider. Abuse can occur in many forms such as neglect, emotional, stealing their belongings, or sexual abuse. It is vital for health professionals to recognize maltreatment and know how to handle the situation properly for the sake of the patient’s safety. This post will cover four resources covering ethical and legal aspects of child and adult abuse and how they concern psychiatric mental health practitioners in their field.
Elder Abuse Ethics
Saghafi et al. (2019) studied the ethical dilemmas healthcare professionals face while trying to manage elder abuse. The ethical concerns they discuss cover the difficulties care team members face when the abused elder chooses to stay in an abusive situation, the legality of telling other team members secretive patient information for help with how to properly intervene, and the issue of how nurses should intervene for patients with neurocognitive disorders. They also discuss federal law mandating elder abuse reporting and the importance of protecting the autonomy of elders without forcing what another person believes is best for them. This can overlap when it comes to what the healthcare provider believes is best for a patient but it is not what the patient wants.  Saghafi et al. (2019) pointed out the importance of clinical guidelines to help support care teams with making these ethical decisions.
Child Abuse Ethics
Glover and Justis (2015) discussed how many people believe taking care of child abuse when discovered is easy and should be taken care of immediately without realizing how many ethical dilemmas can make child abuse issues difficult to resolve. When people think of sexual or physical abuse, it seems understandable to know and report such abuse. However, when the abuse comes in the form of obese children, underweight children, verbal, or end of life care decisions, the ethics of what is right and wrong can become more difficult (Glover & Justis, 2015). Decisions that are difficult for all parties involved, including the health care provider that would be mandated to report it. Glover and Justis (2015) stated health care providers sometimes might find themselves having to intervene with parents and discuss decisions if not found to be in the child’s best interest, with a threshold of not reporting as mandated as long as their decisions do not cause harm.
Legal Considerations for the Elderly
Hess (2011) provided multiple types of elder abuse to assist health care providers to recognize what is legally mandated to be reported. Besides the more obvious physical or sexual abuse, she discusses psychological abuse that can present as being upset, withdrawn, agitated, or unusual behaviors such as biting, and also financial abuse, neglect, or abandonment. She provides the three R’s in detecting and reporting abuse of recognize, respond, and report. Health care teams should legally follow their reporting procedures for documentation, reporting abuse if needed, and following up to ensure patient safety. Hess (2011) points out a law in place to protect the elderly like the Older Americans Act of 1965. She also provides web sites like (http://www.apsnetwork.org/Abuse/index.htm that provide resources for reporting and http://www.ncea.aoa.gov/NCEAroot/Main_Site/Find_Help/State_Resources.aspx for numbers to call.
Legal Considerations for the Children
Fishe and Moffat (2016) discussed the Child Abuse Prevention and Treatment Act
(CAPTA) of 1974 that causes the Department of Human Services (DHS) to collect data and monitor the effectiveness of each state’s practices. By law, there are certain people required to report any type of child abuse. Fishe and Moffat (2016) provided those who are mandated to report child abuse which includes any medical or mental health professional and should be done quickly in most states (Fishe & Moffat, 2016). If abuse is discovered after a patient turns 18 or a while after the abuse happens, then the occurrences should still be reported (Fishe & Moffat, 2016). Another action required of healthcare professionals is collecting evidence by documenting findings, taking photos of evidence, and presenting lab results if ordered (Fishe & Moffat, 2016).
Personal Practice
Considering all medical or mental health professionals are mandated to report witnessed or suspected child or adult abuse, this directly affects my personal practice by providing an understanding of what, when, and who the information needs to be reported to. I was not aware that if patients report abuse from years ago, that I am mandated to report it so that changes my personal practice as well. According to Fishe and Moffat (2016), the state of Arkansas requires abuse to be reported immediately. Although it can be difficult to report suspected abuse, not knowing if more harm is being done than good, I would much rather live with that on my conscious than not reporting and having a terrible outcome for a patient.
References
Fishe, J. N., & Moffat, I. F. L. (2016). Child Abuse and the Law. Clinical Pediatric Emergency Medicine, 17(4), 302–311. https://doi.org/10.1016/j.cpem.2016.09.003
Glover, J., & Justis, L. (2015) Ethics and the Identification and Response to Child Abuse and Neglect. General Law. https://lawexplores.com/ethics-and-the-identification-and-response-to-child-abuse-and-neglect/
Hess, S. (2011). The Role of Health Care Providers in Recognizing and Reporting Elder Abuse: [1]. Journal of Gerontological Nursing, 37(11), 28–37. http://dx.doi.org/10.3928/00989134-20111012-50
Saghafi, A., Bahramnezhad, F., Poormollamirza, A., Dadgari, A., & Navab, E. (2019). Examining the ethical challenges in managing elder abuse: a systematic review. Journal of medical ethics and history of medicine, 12, 7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6642445/

1) Minimum  3 pages and 3 slides  (No word count per page)- Follow the 3 x 3 rule: minimum three paragraphs per page
You must strictly comply with the number of paragraphs requested per page.
Part 1: minimum  2 pages
Part 2: minimum  1 page and 3 slides
Submit 1 document per part
2)¨******APA norms
All paragraphs must be narrative and cited in the text- each paragraph
Bulleted responses are not accepted
Don’t write in the first person
Don’t copy and paste the questions.
Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph
Submit 1 document per part
3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks)
********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks)
4) Minimum 5 references (APA format) per part not older than 5 years  (Journals, books) (No websites)
All references must be consistent with the topic-purpose-focus of the parts. Different references are not allowed.
5) Identify your answer with the numbers, according to the question. Start your answer on the same line, not the next
Example:
Q 1. Nursing is XXXXX
Q 2. Health is XXXX
6) You must name the files according to the part you are answering:
Example:
Part 1.doc
Part 2.doc
__________________________________________________________________________________
Part 1: Pathophysiology
Topic Osteoporosis
J.S., a 72-year-old woman of Asian descent, has just transferred to your practice. She had a hysterectomy 8 years ago and has not been on hormone replacement therapy. She is 5 ft 2 inches tall and weighs 102 lb. She has had a sedentary lifestyle (she was a secretary and retired 2 years ago). She drinks four glasses of wine a day. Her mother died at age 62 from complications of a hip fracture. J.S.’s sister was just diagnosed with metastatic breast cancer. You prescribe a DEXA scan, and the T-score is −2.6 SD.
Diagnosis: Osteoporosis
1. Explain 3 specific goals of therapy for J.S.
2. What drug therapy would you prescribe? include
a. Dosage
b. Time
b. Why?
3. What are the parameters for monitoring the success of the therapy?
4. Discuss 2 specific aspects of patient education based on the prescribed therapy.
5. Explain two adverse reactions for the selected drug that would cause you to change therapy.
6. What OTC or alternative medicines might be appropriate for this patient?
7. What dietary and lifestyle changes might you recommend?
8. Describe one drug–drug  and one drug–food interactions for the selected drug
Part 2: Global Heath alliance
1 page
Investigate about:  Global Heath alliance
1. what are its key partner coalitions
a. Describe them briefly
2. Do their partnerships influence policies at the local, state, or national level?
a. Explain why
b. Describe their key obstacles
3) Describe the spending allocations (consult the Center for Responsible Politics ( 1 paragraph) www.opensecrets.org************ MANDATORY).
3 slides
In a PPT summarize the information of each point. It is not allowed to paste the same information or include images. All the information on the slides must complement the work written in word.
1. Key partner coalitions (1 slide)
2. Do their partnerships influence policies at the local, state, or national level? (1 slide)
b. Describe their key obstacles
3) Describe the spending allocations (consult the Center for Responsible Politics ( 1 slide) www.opensecrets.org************ MANDATORY).

Morbid obesity is also known as class three obesity. This is a chronic condition where a person has a BMI of more than 40 and experiences obesity-related health conditions such as diabetes heart conditions, which typically cut short life. Briana is a 12-year old girl who is morbidly obese. Briana’s mother has no option but to change her typical meal preparations to a healthier one to correct Briana’s health and life expectancy. She should limit the intake of sweetened beverages, baked potatoes, fast foods, refined grains such as white bread, and intake of stake. Briana’s mother should begin adapting the preparation of vegetables that are low in caloric content, whole grains, whole fruits. All these contain fiber, reducing cholesterol levels (Amayiri et al.,2017).
Briana should also be cautious and self-disciplined in her eating behavior. She should consider several eating strategies at her level. Eating mindfully will enable her to make healthier food choices. Her mother should ensure that she prepared food at home and prevent her from eating restaurant meals. She should always consume small but frequent meals and a healthy breakfast.