Evidence of Achievement: 

• Translates research and other forms of knowledge to improve practice processes and outcomes.

• Develops new practice approaches based on the integration of research, theory, and practice knowledge.

1. I applied evidence-based guidelines when treating an uncomplicated UTI for an 18 year old female patient.  During her visit, she complained of the hallmark symptoms of frequency, urgency, and dysuria.  Prior to choosing a treatment, I consulted with UpToDate's literature on urinary tract infections.  Based on her symptomatology and lack of red flag signs, I chose Nitrofurantoin (Macrobid) 100 mg PO BID for 5 days, which is a recommended first line treatment for uncomplicated cystitis in females (Gupta, 2025).

2. I used evidence-based resources from the CDC to choose a treatment for a chlamydial infection in an 18 year old female who presented with dysuria and inconsistent condom use.  After confirming chlamydia via nucleic acid amplification testing, I referenced the CDC's most recent treatment guidelines to decide the proper treatment plan.  Based on her risk for noncompliance due to age and difficulty swallowing pills, I decided to treat her with a single dose of Azithromycin 1g PO for her chlamydia (Centers for Disease Control and Prevention, 2021).

Evidence of Achievement:

• Self-reflection of leadership style and identification of personal merits.

• Inter-professional leadership and collaboration

• Demonstrates leadership that uses critical and reflective thinking.

1. I saw an 18 year old female for a PPD evaluation and she was positive on her two-step exam.  The student did not have insurance and she was positive at 12mm.  As she was underinsured, I provided her with resources to the TB clinic so she could get assistance with obtaining a QuantiFERON GOLD test or chest x-ray prior to being cleared for clinical.

https://dhss.delaware.gov/dph/chs/chstb/ 

2. I  conducted a sick visit for a 15-year-old female complaining of toothache.  Upon assessment, I saw that the area looked inflamed and needed attention from a dentist.  The girl was upset because her family was uninsured and she previously told her parent that her mouth was hurting.  I researched cost-effective healthcare resources and gave her information to the West Side Health clinic so they can evaluate her dental pain.

https://www.westsidehealth.org/services/support-programs/ 

Evidence of Achievement:

• Clinical decision-making based on evidence and shared decision-making

• Functions as a licensed independent practitioner 

• Provides patient-centered care recognizing cultural diversity and the patient or designee as a full partner in decision-making.

1. A completed an entire sick visit for a 14-year-old child who came in with acute headache and nausea.  I derived her history and found that she suffers from chronic migraines and recently ran out of her abortive therapy for these headaches.  After reviewing her chart for allergies as well as UpToDate for the migraine treatment protocol, I ordered a dose of Zofran and Ibuprofen for her symptoms. I then instructed the patient to follow up with her PCP to re-order her medication (Schwedt & Garza, 2025).

2. I responded to a student emergency and assisted the school nurses with rapidly assessing a child who was having a seizure-like episode.  During this time, I completed a brief neurologic and cardiopulmonary exam to check for reflexes and perfusion, obtained vital signs, and positioned her appropriately in case she vomited to prevent aspiration.  The child was stabilized and transferred to the nearest ED once the paramedics arrived.  

Evidence of Achievement:

• Inter-professional collaborative relationships

• Evaluates the impact of healthcare delivery systems on patients, providers, stakeholders, and the environment

1. I conducted a visit for functional abdominal pain in a 14-year-old child who had previously never presented to the wellness center.  Upon exam, he was very quiet, had a flat affect, and did not maintain eye contact with me.  During my assessment, I gave him a moment to complete the GAD-7.  Her score was 14 so I referred her to mental health counseling with the in-office LCSW (Sapra et al., 2020).

2. I was completing a routine physical for a 16-year-old male who was wanting to try out for the wrestling team.  Due to him being at risk for rapid weight changes to make weight, I proactively referred him to the in-office registered dietician for counseling on health weight management strategies (Carl et al., 2021).

Evidence of Achievement:

• Uses best available evidence to continuously improve clincial practice 

• Evaluates relationships among access, cost, quality, and safety, and their influence on healthcare

1. I was completing a contraceptive appointment for a 17-year-old male who was at risk for STIs due to having a high volume of sexual partners.  I was able to connect with the patient and provide anticipatory guidance and sexual counseling from UpToDate.  Initially, the child was not interested in obtaining baseline STI labs but I convinced him to get his blood drawn and provide a urine.  When his results returned, I found that he was positive for Chlamydia and was able to treat him with the proper pharmacotherapy, a course of Doxycycline (Rietmeijer, 2025).  Additionally, I provided him with condoms to prevent pregnancy and further STI contraction.

2. I conducted a vaccination visit for a 15 year old child who was overdue for his yearly influenza vaccination.  I reviewed the refrigerator temperature logs and expiration dates for the vaccine of choice before reconciling his vaccines using the DelVax portal within the electronic medical record.