Assigment .Apa seven . All instructions attached.
butterflyl
5 days ago
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files (4)APA_7_Professional_Paper_Template_June_20203.docx
Outline2.docx
APA7professional-annotated-compressed.pdf
- DecisionMakingProcessPaperDue.docx
APA_7_Professional_Paper_Template_June_20203.docx
TITLE OF YOUR PAPER 1
Title of Your Paper
Your Name
Gateway Technical College
Abstract
The abstract is a brief summary of your paper and generally around 250 words. Consult your course syllabus or your instructor for specific details.
Title of Your Paper
The main text of your paper begins here. Consult with your assignment details in regard to section headings and other requirements.
References
Enter your reference citations in alphabetical order by author or title. Include hanging indents where the first line is flush to the left margin and the second and additional lines are indented by a half-inch.
Outline2.docx
2
Population Health and Emerging Healthcare Systems: Psychiatric ED Boarding and Divert Decisions
Erika Brito
Florida National University
Decision Making
Dr. Nora Hernandez-Pupo
September 18, 2026
Population Health and Emerging Healthcare Systems: Psychiatric ED Boarding and Divert Decisions
I. Introduction
1. Background: Psychiatric ED boarding, the de facto stage of care that occurs when a decision is made to admit a patient but no bed is available, is a stage of care that is influenced by decreasing bed capacity (Rojas-Velasquez, 2026; Lindenfeld et al., 2025).
2. Statement of the Problem: Long psychiatric ED boarding creates problems with patient safety, placement, and timely access to appropriate psychiatric care, necessitating a coordinated framework to guide divert decisions (Hoffmann et al., 2025; Schulte et al., 2026).
3. Thesis Statement: Coordination of Tanner's Clinical Judgment Model, shared decision-making, and transformational leadership can be used to guide placement and divert decisions and support equitable outcomes.
II. Body
First Topic: Scope and Significance of Psychiatric ED Boarding
Point A: Causes and Extent of the Problem
1. The number of psychiatric beds in short-term acute care hospitals (STACs) decreased nationally between 2011 and 2023, while the number of total inpatient psychiatric beds was relatively stable (Lindenfeld et al., 2025).
2. Approximately one in three pediatric mental-health ED visits resulting in admission or transfer involved boarding for more than 12 hours (Hoffmann et al., 2025).
Point B: Impact Across Levels of Nursing Practice
1. Boarding surfaces structural gaps that bedside staff, managers, and APNs must navigate together (Rojas-Velasquez, 2026).
2. Boarded youth and guardians report higher levels of stress and disturbed sleep (Hong et al., 2025).
Second Topic: Decision-Making Models Relevant to the Problem
Point A: Bedside and Advanced Practice Models
1. Tanner's Clinical Judgment Model uses noticing, interpreting, responding, and reflecting to structure nursing clinical judgment during changing patient conditions (Connor et al., 2022; Haanes, 2026).
2. Shared decision-making involves integrating patient preferences, autonomy, and communication into mental health care, where clinically appropriate (Hormazábal-Salgado et al., 2024).
Point B: Leadership-Level Model
1. Transformational Leadership is associated with increased RN-perceived quality of care, with varying degrees of association (Alanazi et al., 2023).
Third Topic: Application, Comparison, and Funding Implications
Point A: Comparative Application Across Levels
1. The bedside nurse would use Tanner's model to re-evaluate suicide risk, behavior, symptoms, safety concerns, and changes in condition during boarding.
2. Shared decision making, where clinically appropriate, would be used to include patient preferences and individualized clinical considerations in disposition planning.
3. The nurse manager would use transformational leadership to create standardized boarding and diversion protocols, escalation criteria, communication pathways, and staff education.
Point B: Benefits, Limitations, and Funding Source
1. Reducing prolonged boarding may mitigate risks of prolonged waiting, such as functional decline and restraint, but more research is required to assess the effectiveness of specific interventions (Schulte et al., 2026).
2. Any framework should consider documented differences in psychiatric ED boarding rates for children and adolescents.
3. SAMHSA's Community Mental Health Services Block Grant provides a potential funding source for crisis-service initiatives, with a 5% set-aside for crisis services of at least $219 million from FY2021 to FY2024 (U.S. Government Accountability Office, 2025)..
III. Conclusion
Point A
1. Psychiatric ED boarding is an ongoing cross-level problem in both the pediatric and older adult populations, which is linked to a reduction in bed capacity and a lack of diversion options.
2. Targeted funding and comparison and prioritization of the three models can offer a structured approach to enhance placement decisions, patient safety and coordination between levels of nursing practice.
References
Alanazi, N. H., Alshamlani, Y., & Baker, O. G. (2023). The association between nurse managers' transformational leadership and quality of patient care: A systematic review. International Nursing Review, 70(2), 175–184. PubMed. https://doi.org/10.1111/inr.12819
Connor, J., Flenady, T., Massey, D., & Dwyer, T. (2022). Clinical judgement in nursing: An evolutionary concept analysis. Journal of Clinical Nursing, 32(13–14), 3328–3340. Wiley Online Library. https://doi.org/10.1111/jocn.16469
Haanes, G. G. (2026). Extending Tanner’s framework: The digital clinical judgment model for nursing education. BMC Nursing, 25(1), 546. PubMed Central. https://doi.org/10.1186/s12912-026-04703-y
Hoffmann, J. A., Foster, A. A., Gable, C. J., Carlin, K. E., Pergjika, A., Burkhart, K., Schultz, T. R., Mullins, S., Edemba, D., & Saidinejad, M. (2025). Pediatric Mental Health Boarding in US emergency departments, 2018-2022. Journal of the American College of Emergency Physicians Open, 6(4), 100180. PubMed. https://doi.org/10.1016/j.acepjo.2025.100180
Hong, V., Harness, J., Cranford, J., Cervantes, V., Czyz, E., Bailey, J., Burke, N., Malas, N., & Rogers, A. (2025). The impact of psychiatric boarding in the emergency department: A mixed-methods study. Hosp Pediatr, 15(6), 491–500. https://doi.org/10.1542/hpeds.2024-008065
Hormazábal-Salgado, R., Whitehead, D., Osman, A. D, & Hills, D. (2024). Person-centred decision-making in mental health: A scoping review. Issues in Mental Health Nursing, 45(3), 294–310. PubMed. https://doi.org/10.1080/01612840.2023.2288181
Lindenfeld, Z., Cantor, J. H., McCullough, C. M., Bather, J. R., & McBain, R. K. (2025). Inpatient psychiatric bed capacity within CMS-certified U.S hospitals, 2011–2023: A cross-sectional study. PLOS Medicine, 22(7), e1004682. https://doi.org/10.1371/journal.pmed.1004682
Rojas-Velasquez, D. (2026). The wait for “geripsych”: Prolonged boarding of older adults awaiting inpatient psychiatry. Journal of Hospital Medicine, 21(8), 943–945. PubMed Central. https://doi.org/10.1002/jhm.70326
Schulte, V. P., Guasch, C., Landerholm, A., & Rojas-Velasquez, D. (2026). Emergency department boarding for psychiatric hospitalization in older adults: Placement challenges and associated risks. The Western Journal of Emergency Medicine, 27(3), 572–578. PubMed. https://doi.org/10.5811/westjem.61704
U.S. Government Accountability Office. (2025). U.S. GAO - behavioral health: Federal activities to support crisis response services. Behavioral Health: Federal Activities to Support Crisis Response Services. https://www.gao.gov/products/gao-25-107586
APA7professional-annotated-compressed.pdf
https://apastyle.org
Hi, APA Styler!
Thank you for using the APA Style annotated sample professional paper for guidance when wri�ng your paper or assignment.
This sample paper PDF contains annota�ons that draw aten�on to key APA Style content and forma�ng such as the �tle page, headings, in-text cita�ons, references, and more. Relevant sec�ons of the seventh edi�on of the Publication Manual are also provided for your reference.
You can find this sample paper and many other resources in the seventh edi�ons of the Publication Manual and Concise Guide to APA Style.
Please use discount code STYLEPAPER15 for 15% off APA Style print products with free shipping in the United States.
Happy wri�ng!
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50 • PAPER ELEMENTS AND FORMAT
Sample Papers
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Sample Professional Paper
abstract, 2.9; section labels, 2.28
keywords, 2.10
professional title page, 2.3
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Sample Professional Paper (continued)
Level 2 heading in the introduction, 2.27, Table 2.3, Figure 2.4
narrative citation, 8.11; paraphrasing, 8.23
parenthetical citation of a work with one author, 8.17
parenthetical citation for works with the same author and same date, 8.19
parenthetical citation of multiple works, 8.12
Level 2 heading in the introduction, 2.27, Table 2.3, Figure 2.4
title, 2.4, Table 2.1
running head, 2.8
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Sample Professional Paper (continued)
parenthetical citation of multiple works, 8.12
Level 2 heading in the introduction, 2.27,
Table 2.3, Figure 2.4
narrative citation used to paraphrase methods from two studies, 8.23
long paraphrase, 8.24
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Sample Professional Paper (continued)
Level 2 heading, 2.27, Table 2.3, Figure 2.5
Level 1 heading after the introduction, 2.27, Table 2.3, Figure 2.5
Level 2 heading, 2.27, Table 2.3, Figure 2.5
italics used for anchors of a scale, 6.22
statistics presented in text, 6.43
Level 2 heading, 2.27, Table 2.3, Figure 2.5
en dash used in a numerical range, 6.6
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54 • PAPER ELEMENTS AND FORMAT
Sample Professional Paper (continued)
Level 1 heading, 2.27, Table 2.3, Figure 2.5
statistics presented in text, 6.43
Level 2 heading, 2.27, Table 2.3, Figure 2.5
table called out in text, 7.5; table numbers, 7.10
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Sample Professional Paper (continued)
footnote callout, 2.13
referring to a previous footnote, 2.13
footnote in page footer, 2.13
Level 2 heading, 2.27, Table 2.3, Figure 2.5
figure called out in text, 7.5; figure numbers, 7.24
Level 1 heading, 2.27, Table 2.3, Figure 2.5
parenthetical citation of multiple papers by the same author, 8.12
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56 • PAPER ELEMENTS AND FORMAT
Sample Professional Paper (continued)
percent symbol repeated in a range,
6.44
parenthetical citation of multiple works, 8.12
parenthetical citation of a work with two
authors, 8.17
Level 3 heading, 2.27, Table 2.3, Figure 2.5
Level 2 heading, 2.27, Table 2.3, Figure 2.5
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Sample Professional Paper (continued)
Level 3 heading, 2.27, Table 2.3, Figure 2.5
parenthetical citation of two works, 8.12
“see also” citation, 8.12
parenthetical citation of a work with one author, 8.17
Level 2 heading, 2.27, Table 2.3, Figure 2.5
quotation marks used to indicate an ironic
comment, 6.7
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58 • PAPER ELEMENTS AND FORMAT
Sample Professional Paper (continued)
journal article reference without a DOI, 10.1
journal article reference, 10.1
reference list, 2.12, Chapter 9; section labels, 2.28
letters used after the year for multiple works with the same author and year, 9.47
book reference, 10.2
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Sample Professional Paper (continued)
journal article reference with missing
issue number, 9.26
title ending with a question mark, 9.19
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Sample Professional Paper (continued)
table number, 7.10
figure number, 7.24
table title, 7.11
figure title, 7.25
table note, 7.14
figure note, 7.28
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