Research Paper

Research Paper

[Name of the Writer]

[Name of the Institution]

Research Paper

COPD is basically an incurable and also progressive disease which is basically characterized by the slow progressive and also irreversible airflow obstruction. This disease is basically considered to be a disease of the middle and old age and also it produces disabling symptoms and signs which effect every single aspect of life. COPD is basically an umbrella term which is used to describe progressive lung’s diseases including bronchitis and also non-reversible asthma. Further this disease is characterized by progressive breathlessness. The impact of COPD is quite severe not only on the society but on the individuals also. It has been noted that as compared to angina there are double number of general physicians are present and the cost that is involved in this particular condition is much higher than any other health condition. Although the treatment for COPD is not yet available there are only some medications and also practices in order to reduce the severity of this condition but no general treatments are yet available for treating this particular health condition CITATION Rac06 \l 1033 (Booker, 2006). But having said that there are some precautionary measures which should be taken by the COPD patients in order to feel better and live a normal life and some of the health advices are listed below in this paper CITATION Rac06 \l 1033 (Booker, 2006).

1: Quit Smoking

It is a known fact that COPD occurs most frequently in those patients who have smoking problem where quit smoking can be the only way in such patients to reduce the progression of the disease. Although it is true that the lost function of the lungs cannot be recovered but it is also true that by cutting down on the smoking it can reduce the decline rate of the lungs function to that of a nonsmoker. Quit smoking is never too late and all the health professional must encourage their patient in order to quit smoking and feel better. There are certain strategies which must be adopted by the healthcare professionals, nicotine replacement therapy or bupropion along with an active and helpful support can help in maximizing the chances of success of quitting cigarette smoking. Although smoking is said to modify the natural history of COPD but there are many patients for whom quitting smoking is challenging. So while treating these patients they must be encouraged that it is never too late to end smoking and every effort must be made by the healthcare professional in order to encourage such patients. For the patients with COPD quitting smoking can be linked with a slight short term increase in FEV which is evaluated to last for a year or more. It has been proved via various studies that for people who actually want to quit smoking a verbal appreciation or written instruction can be quite useful. It is effective in about 3% of the patients CITATION Per071 \l 1033 (Perry, 2007).

2: Managing the Problem of Breathlessness

Breathlessness is a common symptom of COPD and it sometimes makes the patient quite freaked out and frustrated. This is quite integral to the overall progression of the disease and there are many people who try to control this particular symptoms by effectively changing their life style. There are majority of people who mostly ignore the early symptoms of COPD like early coughing and wheezing and also breathlessness thinking that these might be the symptoms of aging or in some cases due to lack of physical health. Therefore, most of these patients only get help when the symptoms get serious and it cannot be ignored any further. For most of the patients’ breathlessness can be quite scary as it not only make the exercise intolerance worse but at the same time the patient can suffer from social isolation. With the passage of time the health of the patient gets even more serious and they further experience breathlessness while at rest as well as during the activity CITATION Rac06 \l 1033 (Booker, 2006).

Their lifestyle gets even more complicated due to the severity of this condition. Due to the fear of breathlessness patients become afraid of doing any physical activity therefore cardiovascular function and also skeletal muscle mass decline with the passage of time. Lack of fitness leads towards fatigue and also loss of functional independence. Therefore, in case of such patients, they must be referred to the evaluation of suitability for pulmonary rehab which is considered to be a gold standard for patient who have COPD problem. It provides training and also therapy along with the disease’s prevention education. Through various studies it is confirmed that this particular rehabilitation method has improved the exercise tolerance, reduced breathlessness problems and also the bed-day usage reduced to a greater extent. If this facility is not available, then it is important to encourage the patients to do exercise within their comfort zone. Breathlessness used by most of the healthcare providers in order to determine any type of exertion and a scale is further used to assess this. For most of the patients the intensity of the exercise will not be interrupted by breathlessness until the patient experiences some exertions CITATION Rac06 \l 1033 (Booker, 2006).

The healthcare providers can also advice the patients to do short intervals of exercise with some rest in between and as a result the patients can be able to do high intensities of exercise later. They can also be advised to walk regularly to the point where he/she will become breathless and over a period of few weeks the patient should be advice to steadily increase the pace of the exercise. It is shown in studies that by exercising on daily basis the overall sensations of breathlessness can be improved thus producing an improvement in the functional capacity and also the health status. It is the responsibility of the healthcare providers to ensure the patients that breathlessness is not hazardous and it is just unpleasant If in one session they receive advice on how to manage their breathlessness problem it must be reinforced during the follow up sessions (Perry, 2007).

3: Exercise:

Exercise is one of the most effective strategy to manage breathlessness and also in the management of COPD as a whole. Therefore, it is better for the COPD patients to maintain a better and increase levels of activity. They should be asked about doing certain physical activities which cause the breathlessness sensations and they should be encouraged to do it again. If for example the patients become breathless they should be advised to do it multiple times. For COPD patients the exercise is a healthy activity that can help them to manage their health condition and it should include simple regimens that must associate with other daily life activities like climbing stairs, walking and cycling. Also the relatives of the patients must allow them to do their things for themselves even if by doing they become breathless. It can help them to maintain their physical activity and also their self-esteem (Booker, 2006).

4: Nutrition:

For the COPD patient maintains a healthy diet is a mandatory thing and they should be advised to maintain a healthy diet in order to successfully cope with their overall health condition. Although for most of the people it is quite shocking that what we eat in a day mostly likely affects our breathing. In order to perform all the functions of the body, our body uses the food that we eat so if a person has consumed the right amount of nutrients it means that he/she can breathe easier. It is also important to note that a single food cannot provide all the important nutrients there must be a variety of foods in order to fulfill the nutritional requirements of the body. Hence, for the COPD patients it is very important to come up with a diet plan along with the healthcare professional. To do that it is important to arrange a meeting with a registered dietician nutritionist to get a direction on what to eat. By asking your doctor it is possible to find out a nutritionist who also has a speculation in COPD CITATION Rac06 \l 1033 (Booker, 2006).

It might be surprising for some people to know that breathing requires a lot of energy and for patients who also have COPD this requirement is much higher as compared to the normal humans. In case of COPD patients the muscles that are used in breathing may require 10 times more calories than a person who has no COPD. Therefore, good nutrition is important in the overall process of breathing but it also helps to resist various infections. Chest infection is the major cause of hospitalization in case of COPD patients so it is important to reduce the overall risk of COPD by following a healthy diet plan. The nutritional requirements of people are different according to their health conditions so it is very important to figure out other’s health related issues. For example, if a person is overweight and has a problem of COPD then the lungs and the heart has to work extra harder making the process of breathing even more difficult, additionally the extra weight of the individual might demand more oxygen. Therefore, it is important for such individuals to limit daily calories along with exercising. In contrast for underweight people, they might feel weak and also tired which ultimately increases the chances of an infection. Hence, in such people it is very important to consume enough calories to produce energy in order to stay away from any possible infection. Moreover, it is very important for such patients to monitor their weight once in a week and if it is recommended from the doctor then monitor it twice a day ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"LP3Nh4eZ","properties":{"formattedCitation":"(\\uc0\\u8220{}Diet and Nutrition for Energy with COPD,\\uc0\\u8221{} n.d.)","plainCitation":"(“Diet and Nutrition for Energy with COPD,” n.d.)","noteIndex":0},"citationItems":[{"id":1530,"uris":["http://zotero.org/users/local/4C6u8dIT/items/PVQ2E82T"],"uri":["http://zotero.org/users/local/4C6u8dIT/items/PVQ2E82T"],"itemData":{"id":1530,"type":"webpage","title":"Diet and Nutrition for Energy with COPD","container-title":"Cleveland Clinic","abstract":"Learn how diet and nutrition are important for managing COPD from the Cleveland Clinic, including the affect on your energy and metabolism.","URL":"https://my.clevelandclinic.org/health/articles/9451-nutritional-guidelines-for-people-with-copd","language":"en","accessed":{"date-parts":[["2019",4,16]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“Diet and Nutrition for Energy with COPD,” n.d.).

Drinking a lot of water also helps in the management of COPD, it is recommendable to consume 5 to 8 glasses of water each day and it should be make sure that the fluid is non-caffeinated the patients must be advised to consume more water and green tea so that not only their body will stay hydrated but at the same time they will be able to strengthen their immune system. However, doctor’s advice is necessary in every case because people who have heart problems may need to limit their liquid consumption. High fiber food like vegetables, fruits, dried peas and also beans are useful for COPD patients. As fiber is an indigestible part of the plant body so it helps to move the food in the digestive tract as a result the blood sugar is maintained and also the cholesterol level in the body is reduced ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"4Ve73eSK","properties":{"formattedCitation":"(\\uc0\\u8220{}Nutrition and COPD,\\uc0\\u8221{} n.d.)","plainCitation":"(“Nutrition and COPD,” n.d.)","noteIndex":0},"citationItems":[{"id":1499,"uris":["http://zotero.org/users/local/4C6u8dIT/items/TY9GPGS6"],"uri":["http://zotero.org/users/local/4C6u8dIT/items/TY9GPGS6"],"itemData":{"id":1499,"type":"webpage","title":"Nutrition and COPD","container-title":"American Lung Association","abstract":"Your body uses food as fuel for all of its activities. The right mix of nutrients in your diet can help you breathe easier.","URL":"https://www.lung.org/lung-health-and-diseases/lung-disease-lookup/copd/living-with-copd/nutrition.html","language":"en","accessed":{"date-parts":[["2019",4,13]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“Nutrition and COPD,” n.d.).

Nutritional Guidelines:

Choosing the right nutritional guidelines is very crucial for COPD patients, choosing complex carbohydrate is beneficial for such patients and if the patient is underweight eating whole-grain carbohydrates and also fresh fruits is quite helpful and if the person is overweight then eating fresh fruits and vegetables can help the patients not only in reducing weight but also coping with the disease. Additionally, the patient needs to limit the use of simple carbohydrates like candies and sugar along with soft drinks. The COPD patients must choose mono and poly unsaturated fats which do not have cholesterol. Such fats often belong to the plant sources and they are liquid at room temperature like canola and corn oils. There are certain foods like butter, fats and skin from the meat and also fried foods these are the saturated foods which can have harmful effects on the overall health of the individual so the consumption of such food must be limited by the person in order to reduce the complexities of this particular disease ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"4Ve73eSK","properties":{"formattedCitation":"(\\uc0\\u8220{}Nutrition and COPD,\\uc0\\u8221{} n.d.)","plainCitation":"(“Nutrition and COPD,” n.d.)","noteIndex":0},"citationItems":[{"id":1499,"uris":["http://zotero.org/users/local/4C6u8dIT/items/TY9GPGS6"],"uri":["http://zotero.org/users/local/4C6u8dIT/items/TY9GPGS6"],"itemData":{"id":1499,"type":"webpage","title":"Nutrition and COPD","container-title":"American Lung Association","abstract":"Your body uses food as fuel for all of its activities. The right mix of nutrients in your diet can help you breathe easier.","URL":"https://www.lung.org/lung-health-and-diseases/lung-disease-lookup/copd/living-with-copd/nutrition.html","language":"en","accessed":{"date-parts":[["2019",4,13]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“Nutrition and COPD,” n.d.).

5: Exacerbations:

Exacerbations in case of COPD can be disturbing experience for the patients, it has been noted that the effect of exacerbations can last longer even for a period of four months. If the exacerbations are quite frequent then they not only increase the progression of the disease but at the same time it can impact the quality of life of the individual. Therefore, the patent must be advice on how to avoid exacerbations and how to manage them in case these occur. It is important to mention that all the patients of COPD must be vaccinated against influenza and also pneumococcal pneumonia. Common colds are causes of exacerbations of COPD and mostly there are difficult to avoid, therefore the patients must be advised to tell their friends and family not to visit them quite often if they are having cold. To increase the immunity of these patients it is important to take care of the nutrition and also enough heating. The patient should be told not to go out when it is cold or when the air quality is not good. The patient should be advised practically without being too restrictive or harsh. In order to remain socially active, the patient must be able to live normally (Perry, 2007).

Conclusion:

Although at present time there is not proper treatment for COPD and the available treatments are used to reduce the progression of disease. Therefore, the role of practiced nurses is very crucial and important for the COPD patients because they know better that when sand how to seek help in case of an emergency. By effectively identifying the signs of deterioration it is possible to seek for early medical help which can further be helpful in avoiding the need of hospitalizations. If the total number of diagnosis of COPD patients will increase, then there will also be a rise to the need of advice and information. Hence, practice nurses can be vital in this case with patients who not only struggle with the disease but also suffer on daily basis.

References

BIBLIOGRAPHY

BIBLIOGRAPHY Booker, R. (2006). COPD - advice for life. The Journal for Nurses in General Practice; Philadelphia , 10.

Diet and Nutrition for Energy with COPD. (n.d.). Retrieved April 16, 2019, from Cleveland Clinic website: https://my.clevelandclinic.org/health/articles/9451-nutritional-guidelines-for-people-with-copd

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Nutrition and COPD. (n.d.). Retrieved April 13, 2019, from American Lung Association website: https://www.lung.org/lung-health-and-diseases/lung-disease-lookup/copd/living-with-copd/nutrition.html

Perry, M. (2007). Non-pharmacological advice for patients with. The Journal for Nurses in General Practice; Philadelphia, 5.

Research Paper, The Effects Of Mental Health Literacy On Suicidal Behavior In Adolescents.

Research Paper

[Name of the Writer]

[Name of the Institution]

Introduction

Emotional well-being and prosperity of the youth all around the globe has become a developing worry as of late because of an expansion in the frequency of suicide and psychological wellness issues. There are many issues that the present society is battling, for example, despondency, anxiety and depression, substance misuse i.e. drug abuse, and a lessening in the normal period of the beginning, with half of all psychological and mental wellbeing and its issue starting from 14 years old. The numbers have been increasing slowly as an Australian mission for Youth survey found out that mental disorders in adolescents have increased from 18 percent in 2012 to 22.8 percent in 2016. Research demonstrates that people who have elevated levels of psychological wellness proficiency take part in help-chasing for emotional well-being issues more in contrast with those with low emotional well-being education. It is along these lines imperative to guarantee that youngsters can distinguish indications of mental trouble and recognize appropriate provisions and assets when essential. Fundamental research has distinguished sexual orientation contrasts in seeking help and recognizable proof of problems related to mental health. This examination is meant to research the connection between psychological well-being education, seeking help and achieving goals and prosperity in senior secondary school students.

Discussion

The issue with mental health education has been around for a long time and it has been increasing ever since. Many types of research have indicated that the world population has a very low mental health literacy and many times people ignore issues related to their mental and psychological health1. The 2007 National Survey of Mental Health and Wellbeing (NSMHW) indicated that youngsters aged between 16–24 years, just 32% looked for proficient assistance for fighting depression, 49% seek help for emotional disorders and 11% for substance maltreatment in the past year. As showed in the latest Youth Mental Health Report (2012–2016), youngsters with a plausible genuine psychological and mental disorder have reliably announced that they would go to companions, guardians or the web for help, rather than proficient administrations. Schools and colleges also provide counseling services to the students but only 16 percent of the students reported to have ever accessed this service. Humiliation, the dread of the judgment, the inclination for independence, disgrace, and poor passionate fitness and MHL are a portion of the variables that have been distinguished as hindrances from seeking help. Absence of comprehension of what emotional well-being issues can prompt whenever left untreated is likewise likely. These issues need to be voiced at all levels. The absence of comprehension of emotional well-being and prosperity in this populace has been reported in various examinations.

Research states that just 8% of the members (13–14 years) believed psychological wellness to be a piece of general wellbeing and prosperity, 97% of members saw being beneficial to mean being physically strong, including eating admirably and working out. Psychological and mental wellness literacy, characterized as information and convictions about mental issue that guide their acknowledgment, the organization or counteractive action, incorporates six qualities that incorporate the capacity to perceive emotional well-being issue, recognize chance variables, realize how to look for and acquire psychological and mental wellbeing data, information on anticipation, distinguish the best medications and assets accessible, just as how to get to this assistance2. Rising exploration in the advancement of child Mental Health Literacy scales has distinguished five key subjects in considering children's psychological wellbeing information: having a diagram of dysfunctional behavior, lessening disgrace, building flexibility, providing help and assistance, and considering risk factors.

Perceiving a psychological wellness issue is the initial step to looking for help from an expert. The inability to perceive the signs and side effects of an emotional wellness issue is probably going to postpone help-chasing, bringing about poor results. Low degrees of Mental Health Literacy has been connected to high paces of suicides and unexpected weakness results in males and females both, and poor assistance offering reactions to peers experiencing psychological conditions.

The Relationship Between Mental Health Literacy and Help-Seeking

People settle on contemplated choices to participate in practices by assessing the data accessible to them. In this way, it very well may be accepted that by improving Mental Health Literacy, by tending to convictions and frames of mind, and giving precise data about psychological and mental health-related issues and suitable assets accessible, we might have the option to impact youngsters' dispositions and ability to take part in seeking help conduct for emotional well-being concerns.

In accordance with a survey adolescent’s acknowledgment rates of anxiety and insanity, announcing that practically 50 percent of the members identified discouragement effectively, while just a quarter recognized psychosis accurately. More members ranging between the ages 12–17 years were additionally altogether more averse to recognize both discouragement and psychosis contrasted with the more matured gathering, 18–24 years. Having little or absence of life experience and presentation was recommended as a potential explanation behind the discoveries3. In a similar report, clinicians and therapists were regularly prescribed by members for those with mental disorders, while GPs were selected for the downturn vignettes. The scientists feature the need to additionally assess youngsters' information as to other psychological wellness issues, for example, social fear, posttraumatic trauma and related issue and resources for the assistance they can have. Likewise, Morgan and Jorm in 2007 indicated that about 40 percent of teenagers perceived Beyondblue as an association giving psychological wellness administrations to youth.

Most examinations concur that suicide is firmly connected to mental issues. About 90% of individuals who end it all have experienced at any rate one mental issue. Mental issues are found to contribute somewhere in the range of 47 and 74% of suicide hazards. Full of the feeling issue is the turmoil most of the time found in this unique situation. Measures for desolation were found in 50 to 65 percent of suicide cases, more frequently among females than males. Drug misuse, and all the more explicitly liquor abuse, is additionally unequivocally connected with suicide hazards, particularly in more established young people and guys. Among 30 to 40 percent of individuals who kick the bucket by suicide had character issues, for example, fringe or introverted character issue4.

Suicide is regularly the reason for death in youngsters with dietary problems, specifically anorexia nervosa, just as in individuals suffering from schizophrenia, even though with schizophrenia all things considered records for not many of all adolescent suicides. At long last, affiliations have additionally been found among suicide and nervousness issues, yet it is hard to evaluate the impact of temperament and substance misuse and other issues that are likewise regularly present in these cases. As a rule, the comorbidity of mental issues significantly builds suicide chance. Particularly significant here is the high commonness of comorbidity among full of feeling and substance misuse issues.

Previous Suicide Attempts

Numerous investigations locate a solid connection between past suicide endeavors, or a background marked by self-damage, and suicide. Around 25 to 33 percent of all instances of such incidents were preceded by a previous suicide endeavor, a marvel that was more pervasive among young men than young ladies. Research has indicated that young men with a past suicide endeavor have a 30-overlay increment in suicide chance contrasted with young men who have not endeavored suicide. Young ladies with past suicide endeavors have a triple increment in suicide chance. In planned investigations, it was discovered that 1 to 6 percent of individuals endeavoring suicide bite the dust by suicide in the principal year. The danger of suicide is seen as related essentially to oneself incurring go about all things considered, and less to the level of the self-destructive aim of that demonstration.

Personality Characteristics

Suicide is related to emotions. Even though we realize that self-destructive thoughts and actions can take weeks, months or even years, the deadly progress from suicidal thoughts and suicide endeavors to a real finished suicide happens all of a sudden, out of the blue and rashly, particularly among young people5. Troubles in dealing with the different, frequently solid and blended feelings and state of mind vacillations going with the encounter with new and regularly changing difficulties in various spaces is another hazard factor for youth suicide, likely incompletely affected by bio-neurological components. It was found that youngsters who have committed or attempted suicide were additionally found to have had more unfortunate critical thinking abilities than their companions. Their conduct was described by a somewhat inactive frame of mind, hanging tight for another person to take care of the issue for them, for basic issues just as for progressively complex relational issues.

A few scientists demonstrate imperfections of memory in this specific situation, with barely any itemized recollections of successful arrangements previously. Others connect it to the inflexible reasoning procedure regularly found in these youngsters. Along these lines of reasoning, likewise called "polarity thinking," individuals experience occasions and express their encounters as thoroughly "dark" or "white," absolutely great or awful, with little space for subtlety and degree. This additionally represents their mental self-view. This failure in critical thinking and mind-set guideline frequently causes weakness, low self-viability, and confidence, however, it can likewise prompt annoyance and forceful conduct, passionate emergency and self-destructive emergency, particularly in the mix with stickler characters

Family Factors

One of the most significant wellsprings of help with referring to the numerous difficulties of youth is the family setting wherein youngsters live or have grown up. A few hazard factors concerning family structure and procedures have been connected to suicide conduct in various examinations. It is assessed that in half of youth suicide cases, family factors are included. One significant factor is a past filled with the mental issue among direct relatives themselves, particularly misery and substance misuse. It is not certain whether these disarranges straightforwardly impact the self-destructive conduct of the youngster, or rather do so in a roundabout way, through mental issue evoked in the kid because of this family setting. Analysts likewise found an increased nearness of self-destructive conduct among relatives of youngsters who have ended it all by committing suicide.

There has been a great deal of discourse about the systems behind this discovery6. There may unquestionably be a sort of impersonation conduct in the newborn, yet the study of adoption has announced a more noteworthy concordance of self-destructive conduct with natural family members than assenting family members, which directs more to a hereditary clarification. Besides, violence at home frequently is by all accounts found in the history of youthful suicide cases, not just explicitly against the kid, however more as a method for managing issues between relatives. Parental separation accordingly is just pitifully connected with the suicide of the kids in question, and this affiliation is presumably bewildered by the pragmatic, budgetary and financial ramifications of living in a solitary parent family or social foundation factors identified with the separation.

Availability of Means

Individuals pondering or harvesting suicidal thoughts are generally critical about the thought of choice. The change from self-destructive thoughts and feelings to genuine suicide regularly happens rashly as a response to intense psychosocial stressors, particularly among youngsters. Accessibility of methods for committing suicide can be significant for that progress at that time and that particular circumstance, and the technique picked may likewise decide the lethality of the activity7. Now and again it is even connected to national examples found in suicide techniques. In accordance with this, kids typically end it all by hanging, bouncing from a high spot or running into traffic, and harming with physician endorsed drugs they have set aside.

Conclusion

Suicide among youth establishes a significant public psychological wellness issue. Youngsters and particularly youths are essentially a powerless gathering for emotional wellness issues. While suicide is generally uncommon in youngsters, its commonness grows fundamentally all through youthfulness. What’s more, despite the fact that adolescent suicide rates are marginally diminishing inside the European district, regardless it positions as a main source of death among the youth and teenagers worldwide and, all things considered, it is answerable for a generous number of unexpected losses and a colossal measure of inconsequential misery and cultural misfortune. Every suicide is the consequence of a mind-boggling dynamic and extraordinary transaction between various contributing elements, and individual endeavors to foresee and counteract suicide will, in general, come up short. Then again, our insight into chance elements is expanding considerably. The mental issue, past suicide endeavors, explicit character qualities, hereditary stacking and family forms in blend with activating psychosocial stressors, presentation to moving models and accessibility of methods for ending it all are key hazard factors in youth suicide. To raise effective endeavors to address youth suicide, later on, the further unwinding of the perplexing suicide process must be joined by continued and considerable endeavors in experimentally supporting and (re)evaluating progressing and new counteractive action system plans, and this is to a great extent a matter of arrangement needs and responsibility.

End Notes

Das JK, Salam RA, Lassi ZS, et al. Interventions for Adolescent Mental Health: An Overview of Systematic Reviews. Journal of Adolescent Health. 2016.

Methodology of Young Minds Matter: The second Australian Child and Adolescent Survey of Mental Health and Wellbeing - Jennifer Hafekost, David Lawrence, Katrina Boterhoven de Haan, Sarah E Johnson, Suzy Saw, William J Buckingham, Michael G Sawyer, John Ainley, Stephen R Zubrick, 2016.

Salam RA, Das JK, Lassi ZS, Bhutta ZA. Adolescent Health Interventions: Conclusions, Evidence Gaps, and Research Priorities. Journal of Adolescent Health. 2016.

1. Hom MA, Stanley IH, Joiner TE. Evaluating factors and interventions that influence help-seeking and mental health service utilization among suicidal individuals: A review of the literature. Clinical Psychology Review. 2015.

The SOS Suicide Prevention Program: Further Evidence of Efficacy and Effectiveness | SpringerLink. https://link.springer.com/article/10.1007/s11121-015-0594-3. Accessed November 25, 2019.

1. Li D, Yang R, Wan Y, Tao F, Fang J, Zhang S. Interaction of Health Literacy and Problematic Mobile Phone Use and Their Impact on Non-Suicidal Self-Injury among Chinese Adolescents. International Journal of Environmental Research and Public Health. 2019;16(13):2366. doi:10.3390/ijerph16132366

Loganathan S. Targeting adolescents for mental health literacy via NIMHANS life skill education model. Indian J Psychiatry. 2012;54(3):292. doi:10.4103/0019-5545.102449

Research Process And Methods

Research Process and Methods

[Writer]

[Institution]

Research Process and Methods

Part 1

Steps in the Research Process

Explain the steps in the research process.

1. Literature review and generating a research question

First step in a research process is searching for the literature related to the general idea of the research. It helps in identifying the already published work, methods and theories and finding a direction to proceed. After identifying and analyzing the right literature, next thing is generating a research question; how, what theories, methods, what is known, strengths and weaknesses and existing gaps. The most common criterion are FINER and PICOT.

2. Research aims and hypothesis

Next step is to define the aim of the study that what are the expectations from this research and what will be its implications in the particular field. The research questions should lead to develop a hypothesis and drive the research data collection and practical approach. The hypotheses testing helps make an inference related to the population involved in the study.

3. Implementing the research methodology

After careful analysis and defining the suitable research methodology, it is important to implement it in the studies as prescribed. Samples and site should be selected on the basis of population of interest. After securing their consent and enrolling the subjects, research procedure should be implemented. The nature of the study, qualitative or quantitative, shapes the methodology.

4. Analyzing data and generating findings

When the data is collected, organized and stored, analyzing it is the next big step. Data management is a very crucial stage before the application of analysis techniques. These methods are also dependent on the type of the research methods. After the interpretation of the results by using statistical or computing methods, generating the findings of the study into a comprehensible set of conclusions is the most important step.

5. Dissemination of the research findings

Last step in the research process is compiling all the steps and findings in the form of research papers, presentations or posters. The dissemination process is about sharing the work with scientific community and making it open to opinions and criticism. The research can also be shared with non-scientific community including the populations on which the study was conducted for creating awareness ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"HsQBKqRm","properties":{"formattedCitation":"(Taylor & Kielhofner, 2017)","plainCitation":"(Taylor & Kielhofner, 2017)","noteIndex":0},"citationItems":[{"id":87,"uris":["http://zotero.org/users/local/9Hfkg8Y0/items/VBU7XFQV"],"uri":["http://zotero.org/users/local/9Hfkg8Y0/items/VBU7XFQV"],"itemData":{"id":87,"type":"chapter","title":"Chapter 9: Steps in Research Process and Characteristics of Sound Research","container-title":"Kielhofner's Research in Occupational Therapy: Methods of Inquiry for Enhancing Practice","publisher":"F.A. Davis","source":"Google Books","ISBN":"978-0-8036-4216-4","note":"Google-Books-ID: BkvoDQAAQBAJ","language":"en","author":[{"family":"Taylor","given":"Renee R."},{"family":"Kielhofner","given":"Gary"}],"issued":{"date-parts":[["2017",1,5]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Taylor & Kielhofner, 2017).

Part 2

Difference between research question and hypotheses.

Research questions are used in a study to identify the variables, participants and problem that is needed to be addressed. It states the purpose of the study and is used when there is no specific hypothesis or anticipation of desired results. Research hypothesis is very specific and researchers have a predetermined approximation of the results based on theories and literature ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"GD4HwWFd","properties":{"formattedCitation":"(Connelly, 2015)","plainCitation":"(Connelly, 2015)","noteIndex":0},"citationItems":[{"id":83,"uris":["http://zotero.org/users/local/9Hfkg8Y0/items/ABXHKIF4"],"uri":["http://zotero.org/users/local/9Hfkg8Y0/items/ABXHKIF4"],"itemData":{"id":83,"type":"article-journal","title":"Research questions and hypotheses","container-title":"Medsurg Nursing","page":"435-436","volume":"24","issue":"6","author":[{"family":"Connelly","given":"Lynne M."}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Connelly, 2015).

Part 3

Qualitative Research

Quantitative Research

1. ObservationIt is a systematic process in which data is collected on the basis of observations of a particular phenomenon. It is mainly used when that topic is not well-studied before or lacks enough literature. It is a flexible and dynamic method but is time-taking and may include human error or bias.

1. Surveys

Surveys allow the researchers to collect the data directly from the participants involved in the study. Surveys are designed systematically in a particular order that reflects their participant’s opinions, behavior and their perception over a defined topic. Surveys mainly represent the results on the behalf of a large population.

2. Field Research

It provides researchers the opportunity of having depth perception about a particular event or participants. It allows to understand the behavior of people towards certain stimuli. But the results of such research cannot be generalized to larger cohorts. Documenting the observations can be challenging as the real results show up after a long field research.

2. Correlational Study

It is an exploratory method that is used to determine the relationship among two or multiple variables. It provides the knowledge about the strength and direction of particular type of relationship. The data collected from this study can be quantifies using correlational coefficient. But this method only explains the relation and not the causation.

3. Case Studies

Case studies are primarily used in the investigation of complex cases including multiple variables under inquiry. Such studies provide advancements to the information collected on field. This method is adopted in applied sciences mainly in social sciences, health, gender studies and education. It offers innovative and challenging circumstances to theoretical conventions.

3. Simulation

Simulation is a technical research method based on computers replicating all kinds of processes in the word. It creates models that represent the patterns of real world systems on a software. It can also be used for creating theories, hypotheses, observations and future predictions. It is usually applied in complex practical problems that could not be modeled by mathematical equations ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"FlPwbNsI","properties":{"formattedCitation":"(Queir\\uc0\\u243{}s, Faria, & Almeida, 2017)","plainCitation":"(Queirós, Faria, & Almeida, 2017)","noteIndex":0},"citationItems":[{"id":86,"uris":["http://zotero.org/users/local/9Hfkg8Y0/items/B8H3MIVU"],"uri":["http://zotero.org/users/local/9Hfkg8Y0/items/B8H3MIVU"],"itemData":{"id":86,"type":"article-journal","title":"Strengths and limitations of qualitative and quantitative research methods","container-title":"European Journal of Education Studies","author":[{"family":"Queirós","given":"André"},{"family":"Faria","given":"Daniel"},{"family":"Almeida","given":"Fernando"}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Queirós, Faria, & Almeida, 2017).

Difference between qualitative and quantitative research methodologies

Qualitative methodologies are used when the researchers have to find out the reason and manner of a specific phenomenon in order to formulate a theory. These include a cohort, individual questioning, participation or observations. Quantitative research methodologies are used to quantify the behaviors, attitudes and defined variables. These methods include surveys, polls, longitudinal and systematic observations ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"sw9xGLhr","properties":{"formattedCitation":"(Fetters, Curry, & Creswell, 2013)","plainCitation":"(Fetters, Curry, & Creswell, 2013)","noteIndex":0},"citationItems":[{"id":84,"uris":["http://zotero.org/users/local/9Hfkg8Y0/items/ZC2QCWXP"],"uri":["http://zotero.org/users/local/9Hfkg8Y0/items/ZC2QCWXP"],"itemData":{"id":84,"type":"article-journal","title":"Achieving integration in mixed methods designs—principles and practices","container-title":"Health services research","page":"2134-2156","volume":"48","issue":"6pt2","author":[{"family":"Fetters","given":"Michael D."},{"family":"Curry","given":"Leslie A."},{"family":"Creswell","given":"John W."}],"issued":{"date-parts":[["2013"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Fetters, Curry, & Creswell, 2013).

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Connelly, L. M. (2015). Research questions and hypotheses. Medsurg Nursing, 24(6), 435–436.

Fetters, M. D., Curry, L. A., & Creswell, J. W. (2013). Achieving integration in mixed methods designs—Principles and practices. Health Services Research, 48(6pt2), 2134–2156.

Queirós, A., Faria, D., & Almeida, F. (2017). Strengths and limitations of qualitative and quantitative research methods. European Journal of Education Studies.

Taylor, R. R., & Kielhofner, G. (2017). Chapter 9: Steps in Research Process and Characteristics of Sound Research. In Kielhofner’s Research in Occupational Therapy: Methods of Inquiry for Enhancing Practice. F.A. Davis.

Research Question

Research question

[Authors Name]

Research question

What is the perception of nurses regarding the effectiveness of clinical handover in patient safety?

Study design

It will be a descriptive qualitative study that will be carried out to gain an insight about perception and understanding of nurses’ towards bedside clinical handover. The justification to why qualitative research will be chosen as this design emphasizes on verifiability, flexibility, transparency and trust ADDIN EN.CITE <EndNote><Cite><Author>Glesne</Author><Year>2016</Year><RecNum>96</RecNum><DisplayText>(Glesne, 2016)</DisplayText><record><rec-number>96</rec-number><foreign-keys><key app="EN" db-id="2s2s0zrapsf0pbe5efuvv20f9rszvx0sd2fe" timestamp="1568632592">96</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Glesne, Corrine</author></authors></contributors><titles><title>Becoming qualitative researchers: An introduction</title></titles><dates><year>2016</year></dates><publisher>ERIC</publisher><isbn>0133859398</isbn><urls></urls></record></Cite></EndNote>(Glesne, 2016). This method will be suitable here as it will develop detail insight into the perception of nurses towards the effectiveness of clinical handover in patient safety. Focus group discussion will be carried out for this study. In a focus group discussion individuals are asked about their belief, perceptions and attitude towards a particular idea or phenomenon. Focus group discussions are among the instruments that are most commonly utilized by the researchers ADDIN EN.CITE <EndNote><Cite><Author>Carey</Author><Year>2016</Year><RecNum>97</RecNum><DisplayText>(Carey &amp; Asbury, 2016)</DisplayText><record><rec-number>97</rec-number><foreign-keys><key app="EN" db-id="2s2s0zrapsf0pbe5efuvv20f9rszvx0sd2fe" timestamp="1568632643">97</key></foreign-keys><ref-type name="Book">6</ref-type><contributors><authors><author>Carey, Martha Ann</author><author>Asbury, Jo-Ellen</author></authors></contributors><titles><title>Focus group research</title></titles><dates><year>2016</year></dates><publisher>Routledge</publisher><isbn>1315428369</isbn><urls></urls></record></Cite></EndNote>(Carey & Asbury, 2016). In this study focus group discussion will be chosen to get a deep understanding of the perception of nurses towards the bedside clinical handover in patient safety. This will also help to explore the areas which are not touched in the previous studies.

Rationale

Handover is accountability and transfer of professional responsibility for few or all aspects of patient care, group of patients or any other person such as family, professional group and legal guardian on a permanent and temporary basis ADDIN EN.CITE <EndNote><Cite><Author>Anderson</Author><Year>2015</Year><RecNum>98</RecNum><DisplayText>(Anderson, Malone, Shanahan, &amp; Manning, 2015)</DisplayText><record><rec-number>98</rec-number><foreign-keys><key app="EN" db-id="2s2s0zrapsf0pbe5efuvv20f9rszvx0sd2fe" timestamp="1568632687">98</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Anderson, Judith</author><author>Malone, Linda</author><author>Shanahan, Kerry</author><author>Manning, Jennifer</author></authors></contributors><titles><title>Nursing bedside clinical handover–an integrated review of issues and tools</title><secondary-title>Journal of Clinical Nursing</secondary-title></titles><periodical><full-title>Journal of clinical nursing</full-title></periodical><pages>662-671</pages><volume>24</volume><number>5-6</number><dates><year>2015</year></dates><isbn>0962-1067</isbn><urls></urls></record></Cite></EndNote>(Anderson, Malone, Shanahan, & Manning, 2015). Few studies have been conducted that have explored the perception of nurses regarding the effectiveness of bedside handover in patient safety. Handover is a common practice in a health care setting and many problems such as medication error and treatment delay can occur due to poor communication ADDIN EN.CITE <EndNote><Cite><Author>Herceg</Author><Year>2015</Year><RecNum>95</RecNum><DisplayText>(Herceg, 2015)</DisplayText><record><rec-number>95</rec-number><foreign-keys><key app="EN" db-id="2s2s0zrapsf0pbe5efuvv20f9rszvx0sd2fe" timestamp="1568632177">95</key></foreign-keys><ref-type name="Journal Article">17</ref-type><contributors><authors><author>Herceg, Nina</author></authors></contributors><titles><title>Improving Bedside Shift-to-shift Nursing Report Process</title></titles><dates><year>2015</year></dates><urls></urls></record></Cite></EndNote>(Herceg, 2015). Therefore there is a need to conduct an in-depth study to gain an insight into the nurse's perception of bedside clinical handover in the patient safety. This will help to improve the bedside clinical handover process in future and will lead to the patient safety.

References

ADDIN EN.REFLIST Anderson, J., Malone, L., Shanahan, K., & Manning, J. (2015). Nursing bedside clinical handover an integrated review of issues and tools. Journal of clinical nursing, 24(5-6), 662-671.

Carey, M. A., & Asbury, J.-E. (2016). Focus group research: Routledge.

Glesne, C. (2016). Becoming qualitative researchers: An introduction: ERIC.

Herceg, N. (2015). Improving Bedside Shift-to-shift Nursing Report Process.

Research Question And Literature Review

Research Question and Literature Review

[Author Name(s), First M. Last, Omit Titles and Degrees]

[Institutional Affiliation(s)]

Problem

Double-checking is a typical method intended to improve patient safety and security. It is almost perceived in all areas and units inside the healthcare facilities. It is significant to double-check the medication before administering it to the patients predominantly in the emergency departments ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a20siv3jpg7","properties":{"formattedCitation":"(Chua, Lee, Peralta, & Lim, 2019)","plainCitation":"(Chua, Lee, Peralta, & Lim, 2019)"},"citationItems":[{"id":311,"uris":["http://zotero.org/users/local/p8kwKNoG/items/GF6ULSYA"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/GF6ULSYA"],"itemData":{"id":311,"type":"article-journal","title":"Medication Safety: A Need to Relook at Double-Checking Medicines?","container-title":"Asia-Pacific Journal of Oncology Nursing","page":"246","volume":"6","issue":"3","author":[{"family":"Chua","given":"Gek Phin"},{"family":"Lee","given":"Kim Hua"},{"family":"Peralta","given":"Gemma Diente"},{"family":"Lim","given":"John Heng Chi"}],"issued":{"date-parts":[["2019"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Chua, Lee, Peralta, & Lim, 2019). Incapacitating the barriers need administrations to review medicine procedure strategies and involve nurses more in medicine security research and in planning medical guidelines for their practice ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a19172f2mol","properties":{"formattedCitation":"(dos Santos, Ulbrich, Woloszyn, & Vieira, 2018)","plainCitation":"(dos Santos, Ulbrich, Woloszyn, & Vieira, 2018)"},"citationItems":[{"id":324,"uris":["http://zotero.org/users/local/p8kwKNoG/items/9Z7BC29J"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/9Z7BC29J"],"itemData":{"id":324,"type":"article-journal","title":"DDC-outlier: preventing medication errors using unsupervised learning","container-title":"IEEE journal of biomedical and health informatics","page":"874-881","volume":"23","issue":"2","author":[{"family":"Santos","given":"Henrique DP","non-dropping-particle":"dos"},{"family":"Ulbrich","given":"Ana Helena DPS"},{"family":"Woloszyn","given":"Vinícius"},{"family":"Vieira","given":"Renata"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (dos Santos, Ulbrich, Woloszyn, & Vieira, 2018). However, the significance of the double-check policies and any errors exposed during the double-check procedure must also be castoff for learning, education, awareness and organization development would be addressed in the research.

Review of Literature

Double examination of medicine administration in hospices is normally standard exercise, predominantly for high-risk medications. However, its efficacy in decreasing medication administration errors (MAEs) and enhancing patient consequences rests unclear (Koyama et al., 2019). A systematic review using five databases PubMed, CINAHIL, Ovid@Journals, was conducted to evaluate the evidence of the efficacy of double-checking to decrease MAEs ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"aki3i4c0m1","properties":{"formattedCitation":"(Koyama, Maddox, Li, Bucknall, & Westbrook, 2019)","plainCitation":"(Koyama, Maddox, Li, Bucknall, & Westbrook, 2019)"},"citationItems":[{"id":301,"uris":["http://zotero.org/users/local/p8kwKNoG/items/GTZXHYZE"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/GTZXHYZE"],"itemData":{"id":301,"type":"article-journal","title":"Effectiveness of double checking to reduce medication administration errors: a systematic review","container-title":"BMJ Quality &amp; Safety","page":"bmjqs-2019-009552","abstract":"Background Double checking medication administration in hospitals is often standard practice, particularly for high-risk drugs, yet its effectiveness in reducing medication administration errors (MAEs) and improving patient outcomes remains unclear. We conducted a systematic review of studies evaluating evidence of the effectiveness of double checking to reduce MAEs.Methods Five databases (PubMed, Embase, CINAHL, Ovid@Journals, OpenGrey) were searched for studies evaluating the use and effectiveness of double checking on reducing medication administration errors in a hospital setting. Included studies were required to report any of three outcome measures: an effect estimate such as a risk ratio or risk difference representing the association between double checking and MAEs, or between double checking and patient harm; or a rate representing adherence to the hospital’s double checking policy.Results Thirteen studies were identified, including 10 studies using an observational study design, two randomised controlled trials and one randomised trial in a simulated setting. Studies included both paediatric and adult inpatient populations and varied considerably in quality. Among three good quality studies, only one showed a significant association between double checking and a reduction in MAEs, another showed no association, and the third study reported only adherence rates. No studies investigated changes in medication-related harm associated with double checking. Reported double checking adherence rates ranged from 52% to 97% of administrations. Only three studies reported if and how independent and primed double checking were differentiated.Conclusion There is insufficient evidence that double versus single checking of medication administration is associated with lower rates of MAEs or reduced harm. Most comparative studies fail to define or investigate the level of adherence to independent double checking, further limiting conclusions regarding effectiveness in error prevention. Higher-quality studies are needed to determine if, and in what context (eg, drug type, setting), double checking produces sufficient benefits in patient safety to warrant the considerable resources required.CRD42018103436.","DOI":"10.1136/bmjqs-2019-009552","journalAbbreviation":"BMJ Qual Saf","author":[{"family":"Koyama","given":"Alain K"},{"family":"Maddox","given":"Claire-Sophie Sheridan"},{"family":"Li","given":"Ling"},{"family":"Bucknall","given":"Tracey"},{"family":"Westbrook","given":"Johanna I"}],"issued":{"date-parts":[["2019",8,7]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Koyama, Maddox, Li, Bucknall, & Westbrook, 2019). The research has evaluated the problems associated with the risk difference represented by the connection of double-checking and MAEs, the association of double-checking and patient harm and a percentage adherence to the hospital's twofold checking procedure ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a2635gkbplr","properties":{"formattedCitation":"(Koyama et al., 2019)","plainCitation":"(Koyama et al., 2019)"},"citationItems":[{"id":301,"uris":["http://zotero.org/users/local/p8kwKNoG/items/GTZXHYZE"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/GTZXHYZE"],"itemData":{"id":301,"type":"article-journal","title":"Effectiveness of double checking to reduce medication administration errors: a systematic review","container-title":"BMJ Quality &amp; Safety","page":"bmjqs-2019-009552","abstract":"Background Double checking medication administration in hospitals is often standard practice, particularly for high-risk drugs, yet its effectiveness in reducing medication administration errors (MAEs) and improving patient outcomes remains unclear. We conducted a systematic review of studies evaluating evidence of the effectiveness of double checking to reduce MAEs.Methods Five databases (PubMed, Embase, CINAHL, Ovid@Journals, OpenGrey) were searched for studies evaluating the use and effectiveness of double checking on reducing medication administration errors in a hospital setting. Included studies were required to report any of three outcome measures: an effect estimate such as a risk ratio or risk difference representing the association between double checking and MAEs, or between double checking and patient harm; or a rate representing adherence to the hospital’s double checking policy.Results Thirteen studies were identified, including 10 studies using an observational study design, two randomised controlled trials and one randomised trial in a simulated setting. Studies included both paediatric and adult inpatient populations and varied considerably in quality. Among three good quality studies, only one showed a significant association between double checking and a reduction in MAEs, another showed no association, and the third study reported only adherence rates. No studies investigated changes in medication-related harm associated with double checking. Reported double checking adherence rates ranged from 52% to 97% of administrations. Only three studies reported if and how independent and primed double checking were differentiated.Conclusion There is insufficient evidence that double versus single checking of medication administration is associated with lower rates of MAEs or reduced harm. Most comparative studies fail to define or investigate the level of adherence to independent double checking, further limiting conclusions regarding effectiveness in error prevention. Higher-quality studies are needed to determine if, and in what context (eg, drug type, setting), double checking produces sufficient benefits in patient safety to warrant the considerable resources required.CRD42018103436.","DOI":"10.1136/bmjqs-2019-009552","journalAbbreviation":"BMJ Qual Saf","author":[{"family":"Koyama","given":"Alain K"},{"family":"Maddox","given":"Claire-Sophie Sheridan"},{"family":"Li","given":"Ling"},{"family":"Bucknall","given":"Tracey"},{"family":"Westbrook","given":"Johanna I"}],"issued":{"date-parts":[["2019",8,7]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Koyama et al., 2019). Thirteen studies were observed, including ten observational studies, one randomized control trial and last was a randomized trial (Koyama et al., 2019). Out of these studies it has been observed that one of three represented a significantly positive association of double-checking of administration of medicines with a reduced number of medication administration errors (Koyama et al., 2019). The study has shown an insignificant effect of double-checking in the reduction of medically administered errors overall (Koyama et al., 2019). Higher-quality reviews are required to conclude if, and in what setting, double-checking yields adequate remunerations in patient well-being to permit the substantial resources required.

Another study delivered suggestion that single checking arrangement is a feasible way to plummeting medication mistakes and also deliberate the additional benefit of staff gratification. Pledging quality and security contains the necessity to encounter the status quo grounded on exposed evidence ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1bscmb32hv","properties":{"formattedCitation":"(Chua, Lee, Peralta, & Lim, 2019)","plainCitation":"(Chua, Lee, Peralta, & Lim, 2019)"},"citationItems":[{"id":311,"uris":["http://zotero.org/users/local/p8kwKNoG/items/GF6ULSYA"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/GF6ULSYA"],"itemData":{"id":311,"type":"article-journal","title":"Medication Safety: A Need to Relook at Double-Checking Medicines?","container-title":"Asia-Pacific Journal of Oncology Nursing","page":"246","volume":"6","issue":"3","author":[{"family":"Chua","given":"Gek Phin"},{"family":"Lee","given":"Kim Hua"},{"family":"Peralta","given":"Gemma Diente"},{"family":"Lim","given":"John Heng Chi"}],"issued":{"date-parts":[["2019"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Chua, Lee, Peralta, & Lim, 2019). This study was conducted by Chua and the colleagues in 2019 to present an organized assessment procedure that delivers indication that the single-checking (SC) organization is not only a practical decision in decreasing medication mistakes but likewise has the additional improvement in the management. The study was performed via a survey and study survey comprised of 12 questions with a 5-point Likert rule. It has resulted in the number of medication errors essentially reduced (P < 0.001; a two-sample test of proportions). The nurses and the staff responded positively when introduced with changes regarding double checking process in the hospitals (Chua et al., 2019). The single checking procedures resulted in better delivery of quality care to the patients, staff self-satisfaction, and minimum time for waiting for patients and utilization of the available resources effectively (Chua et al., 2019). The study has suggested that single checking is a practical decision, and discerning double-checking may be merely for those RNs who are unacquainted with the procedure or medicines ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a2npijgqgnn","properties":{"formattedCitation":"(Chua et al., 2019)","plainCitation":"(Chua et al., 2019)"},"citationItems":[{"id":311,"uris":["http://zotero.org/users/local/p8kwKNoG/items/GF6ULSYA"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/GF6ULSYA"],"itemData":{"id":311,"type":"article-journal","title":"Medication Safety: A Need to Relook at Double-Checking Medicines?","container-title":"Asia-Pacific Journal of Oncology Nursing","page":"246","volume":"6","issue":"3","author":[{"family":"Chua","given":"Gek Phin"},{"family":"Lee","given":"Kim Hua"},{"family":"Peralta","given":"Gemma Diente"},{"family":"Lim","given":"John Heng Chi"}],"issued":{"date-parts":[["2019"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Chua et al., 2019). The double examination must only be functional deliberately to circumstances that utmost warrant their consumption.

To evaluate the exercise of diverse double-checking measures in chemotherapy administration and to discover nurses' understandings, for instance, how frequently they essentially discover errors by a certain process. There are a lot of studies that have suggested a negative influence of double-checking before administering medication; however, few studies have shown a significant decline in the administration of medication errors. This cross-sectional survey was conducted by the researchers for universal assessments concerning double-checking, the incidence of disruptions through and produced by check, or what is observed as its vital feature was evaluated. It was essential to observe the oncology unit double-checking procedures to observe the types of procedures applied in it. It was a cross-sectional study in which 274 nurses were the participants ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1m68spvbgk","properties":{"formattedCitation":"(Schwappach, Pfeiffer, & Taxis, 2016)","plainCitation":"(Schwappach, Pfeiffer, & Taxis, 2016)"},"citationItems":[{"id":308,"uris":["http://zotero.org/users/local/p8kwKNoG/items/TLFJZB3Z"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/TLFJZB3Z"],"itemData":{"id":308,"type":"article-journal","title":"Medication double-checking procedures in clinical practice: a cross-sectional survey of oncology nurses' experiences","container-title":"BMJ open","page":"e011394","volume":"6","issue":"6","source":"PubMed","abstract":"BACKGROUND: Double-checking is widely recommended as an essential method to prevent medication errors. However, prior research has shown that the concept of double-checking is not clearly defined, and that little is known about actual practice in oncology, for example, what kind of checking procedures are applied.\nOBJECTIVE: To study the practice of different double-checking procedures in chemotherapy administration and to explore nurses' experiences, for example, how often they actually find errors using a certain procedure. General evaluations regarding double-checking, for example, frequency of interruptions during and caused by a check, or what is regarded as its essential feature was assessed.\nMETHODS: In a cross-sectional survey, qualified nurses working in oncology departments of 3 hospitals were asked to rate 5 different scenarios of double-checking procedures regarding dimensions such as frequency of use in practice and appropriateness to prevent medication errors; they were also asked general questions about double-checking.\nRESULTS: Overall, 274 nurses (70% response rate) participated in the survey. The procedure of jointly double-checking (read-read back) was most commonly used (69% of respondents) and rated as very appropriate to prevent medication errors. Jointly checking medication was seen as the essential characteristic of double-checking-more frequently than 'carrying out checks independently' (54% vs 24%). Most nurses (78%) found the frequency of double-checking in their department appropriate. Being interrupted in one's own current activity for supporting a double-check was reported to occur frequently. Regression analysis revealed a strong preference towards checks that are currently implemented at the responders' workplace.\nCONCLUSIONS: Double-checking is well regarded by oncology nurses as a procedure to help prevent errors, with jointly checking being used most frequently. Our results show that the notion of independent checking needs to be transferred more actively into clinical practice. The high frequency of reported interruptions during and caused by double-checks is of concern.","DOI":"10.1136/bmjopen-2016-011394","ISSN":"2044-6055","note":"PMID: 27297014\nPMCID: PMC4916573","shortTitle":"Medication double-checking procedures in clinical practice","journalAbbreviation":"BMJ Open","language":"eng","author":[{"family":"Schwappach","given":"D. L. B."},{"family":"Pfeiffer","given":"Yvonne"},{"family":"Taxis","given":"Katja"}],"issued":{"date-parts":[["2016"]],"season":"13"}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Schwappach, Pfeiffer, & Taxis, 2016). The research was conducted utilizing the survey method and read back was most frequently rated to avoid medication mistakes. The survey evaluated that the nurses practising the double-checking procedures found it 78% appropriate process to effectively reduce the administration medication errors. Double-checking process was interrupted and it was the most frequently observed answer. It has been concluded that the double-checking was the most observed characteristics of oncology nurses and jointly observed was also most often observed among these nurses ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"kkI2BLx1","properties":{"formattedCitation":"(Schwappach et al., 2016)","plainCitation":"(Schwappach et al., 2016)"},"citationItems":[{"id":308,"uris":["http://zotero.org/users/local/p8kwKNoG/items/TLFJZB3Z"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/TLFJZB3Z"],"itemData":{"id":308,"type":"article-journal","title":"Medication double-checking procedures in clinical practice: a cross-sectional survey of oncology nurses' experiences","container-title":"BMJ open","page":"e011394","volume":"6","issue":"6","source":"PubMed","abstract":"BACKGROUND: Double-checking is widely recommended as an essential method to prevent medication errors. However, prior research has shown that the concept of double-checking is not clearly defined, and that little is known about actual practice in oncology, for example, what kind of checking procedures are applied.\nOBJECTIVE: To study the practice of different double-checking procedures in chemotherapy administration and to explore nurses' experiences, for example, how often they actually find errors using a certain procedure. General evaluations regarding double-checking, for example, frequency of interruptions during and caused by a check, or what is regarded as its essential feature was assessed.\nMETHODS: In a cross-sectional survey, qualified nurses working in oncology departments of 3 hospitals were asked to rate 5 different scenarios of double-checking procedures regarding dimensions such as frequency of use in practice and appropriateness to prevent medication errors; they were also asked general questions about double-checking.\nRESULTS: Overall, 274 nurses (70% response rate) participated in the survey. The procedure of jointly double-checking (read-read back) was most commonly used (69% of respondents) and rated as very appropriate to prevent medication errors. Jointly checking medication was seen as the essential characteristic of double-checking-more frequently than 'carrying out checks independently' (54% vs 24%). Most nurses (78%) found the frequency of double-checking in their department appropriate. Being interrupted in one's own current activity for supporting a double-check was reported to occur frequently. Regression analysis revealed a strong preference towards checks that are currently implemented at the responders' workplace.\nCONCLUSIONS: Double-checking is well regarded by oncology nurses as a procedure to help prevent errors, with jointly checking being used most frequently. Our results show that the notion of independent checking needs to be transferred more actively into clinical practice. The high frequency of reported interruptions during and caused by double-checks is of concern.","DOI":"10.1136/bmjopen-2016-011394","ISSN":"2044-6055","note":"PMID: 27297014\nPMCID: PMC4916573","shortTitle":"Medication double-checking procedures in clinical practice","journalAbbreviation":"BMJ Open","language":"eng","author":[{"family":"Schwappach","given":"D. L. B."},{"family":"Pfeiffer","given":"Yvonne"},{"family":"Taxis","given":"Katja"}],"issued":{"date-parts":[["2016"]],"season":"13"}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Schwappach et al., 2016). The most subsequently observed answer that the double-checking was interjected is a measure of concern that entails further research to be appraised.

Checking medicines before their administration by nurses is a fundamental anticipatory action for medication mistakes (Athanasakis, 2019). The research was conducted by Athanasakis and the colleagues to get evidence of the reviews concerning the method of checking medications before administration in the year 2019 ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1aq4t68kh3","properties":{"formattedCitation":"(Athanasakis, 2019)","plainCitation":"(Athanasakis, 2019)"},"citationItems":[{"id":310,"uris":["http://zotero.org/users/local/p8kwKNoG/items/WL3UAEXH"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/WL3UAEXH"],"itemData":{"id":310,"type":"article-journal","title":"A meta‐synthesis of how registered nurses make sense of their lived experiences of medication errors","container-title":"Journal of clinical nursing","author":[{"family":"Athanasakis","given":"Efstratios"}],"issued":{"date-parts":[["2019"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Athanasakis, 2019). In everyday clinical practice, because nurses accomplish medication checking in the routine medical practice. They practice it on their own (Single) or through another nurse (double) and are accountable for whatever they direct to the patients; the examination is openly connected to nursing. A literature examination was commenced from PubMed, Science-Direct, and British nursing index and Cinahil databases by particular keywords for appropriate articles available in English from January 1990 to March 2015. Twenty main study reviews and three assessments were incorporated for this study. The reviews taken were in support of the argument that states single checking, and double-checking before administering medication errors can significantly reduce the number of errors in hospitals. Single checking is being adapted in a few hospitals and has observed a decrease in medication errors. Various studies have also suggested that double-check can significantly decline the rate of administration of medication errors. It is very crucial for the nurses to single check and has double-checked, particularly when administering medication to the patients of critical care units and highly critical care units. However, the scarcity and ambiguous status of the data available has limited the review to generalize the results universally. This review has identified a research gap between limited data and research which has strongly recommended that there is a need for further research to evaluate the exact areas where and how these checking procedures are helpful.

There was a disparity among pediatric nurses' observance to double-checking stages through medication management. The greatest recurrent kind of administration mistakes or aberration commencing policy intricate the drug being delivered to the mothers to direct to the youngster while the healthcare provider was not present ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a2ebfv79kul","properties":{"formattedCitation":"(Alsulami, Choonara, & Conroy, 2014)","plainCitation":"(Alsulami, Choonara, & Conroy, 2014)"},"citationItems":[{"id":304,"uris":["http://zotero.org/users/local/p8kwKNoG/items/AX73MSMH"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/AX73MSMH"],"itemData":{"id":304,"type":"article-journal","title":"Paediatric nurses' adherence to the double-checking process during medication administration in a children's hospital: an observational study","container-title":"Journal of Advanced Nursing","page":"1404-1413","volume":"70","issue":"6","source":"PubMed","abstract":"AIM: To evaluate how closely double-checking policies are followed by nurses in paediatric areas and also to identify the types, frequency and rates of medication administration errors that occur despite the double-checking process.\nBACKGROUND: Double-checking by two nurses is an intervention used in many UK hospitals to prevent or reduce medication administration errors. There is, however, insufficient evidence to either support or refute the practice of double-checking in terms of medication error risk reduction.\nDESIGN: Prospective observational study.\nMETHODS: This was a prospective observational study of paediatric nurses' adherence to the double-checking process for medication administration from April-July 2012.\nRESULTS: Drug dose administration events (n = 2000) were observed. Independent drug dose calculation, rate of administering intravenous bolus drugs and labelling of flush syringes were the steps with lowest adherence rates. Drug dose calculation was only double-checked independently in 591 (30%) drug administrations. There was a statistically significant difference in nurses' adherence rate to the double-checking steps between weekdays and weekends in nine of the 15 evaluated steps. Medication administration errors (n = 191) or deviations from policy were observed, at a rate of 9·6% of drug administrations. These included 64 drug doses, which were left for parents to administer without nurse observation.\nCONCLUSION: There was variation between paediatric nurses' adherence to double-checking steps during medication administration. The most frequent type of administration errors or deviation from policy involved the medicine being given to the parents to administer to the child when the nurse was not present.","DOI":"10.1111/jan.12303","ISSN":"1365-2648","note":"PMID: 24224731","shortTitle":"Paediatric nurses' adherence to the double-checking process during medication administration in a children's hospital","journalAbbreviation":"J Adv Nurs","language":"eng","author":[{"family":"Alsulami","given":"Zayed"},{"family":"Choonara","given":"Imti"},{"family":"Conroy","given":"Sharon"}],"issued":{"date-parts":[["2014",6]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Alsulami, Choonara, & Conroy, 2014). The greatest number of errors were reported in the surveys which was related to the medication administration by parents. It was prospective observational research in which the drug doses, administration of drugs, double-checking policies and drug administration in the pediatric unit ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a15fgbkm5f6","properties":{"formattedCitation":"(Rosenfeld et al., 2018)","plainCitation":"(Rosenfeld et al., 2018)"},"citationItems":[{"id":322,"uris":["http://zotero.org/users/local/p8kwKNoG/items/SDI85X3F"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/SDI85X3F"],"itemData":{"id":322,"type":"article-journal","title":"Interdisciplinary medication decision making by pharmacists in pediatric hospital settings: An ethnographic study","container-title":"Research in Social and Administrative Pharmacy","page":"269-278","volume":"14","issue":"3","author":[{"family":"Rosenfeld","given":"Ellie"},{"family":"Kinney","given":"Sharon"},{"family":"Weiner","given":"Carlye"},{"family":"Newall","given":"Fiona"},{"family":"Williams","given":"Allison"},{"family":"Cranswick","given":"Noel"},{"family":"Wong","given":"Ian"},{"family":"Borrott","given":"Narelle"},{"family":"Manias","given":"Elizabeth"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Rosenfeld et al., 2018). The pediatric nurses usually observe single checking and double-checking in case of critical care practice during their services delivered to the children; however, the parents often fail to administer medicine as per prescribed dose ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a2c47ughugf","properties":{"formattedCitation":"(Alsulami et al., 2014)","plainCitation":"(Alsulami et al., 2014)"},"citationItems":[{"id":304,"uris":["http://zotero.org/users/local/p8kwKNoG/items/AX73MSMH"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/AX73MSMH"],"itemData":{"id":304,"type":"article-journal","title":"Paediatric nurses' adherence to the double-checking process during medication administration in a children's hospital: an observational study","container-title":"Journal of Advanced Nursing","page":"1404-1413","volume":"70","issue":"6","source":"PubMed","abstract":"AIM: To evaluate how closely double-checking policies are followed by nurses in paediatric areas and also to identify the types, frequency and rates of medication administration errors that occur despite the double-checking process.\nBACKGROUND: Double-checking by two nurses is an intervention used in many UK hospitals to prevent or reduce medication administration errors. There is, however, insufficient evidence to either support or refute the practice of double-checking in terms of medication error risk reduction.\nDESIGN: Prospective observational study.\nMETHODS: This was a prospective observational study of paediatric nurses' adherence to the double-checking process for medication administration from April-July 2012.\nRESULTS: Drug dose administration events (n = 2000) were observed. Independent drug dose calculation, rate of administering intravenous bolus drugs and labelling of flush syringes were the steps with lowest adherence rates. Drug dose calculation was only double-checked independently in 591 (30%) drug administrations. There was a statistically significant difference in nurses' adherence rate to the double-checking steps between weekdays and weekends in nine of the 15 evaluated steps. Medication administration errors (n = 191) or deviations from policy were observed, at a rate of 9·6% of drug administrations. These included 64 drug doses, which were left for parents to administer without nurse observation.\nCONCLUSION: There was variation between paediatric nurses' adherence to double-checking steps during medication administration. The most frequent type of administration errors or deviation from policy involved the medicine being given to the parents to administer to the child when the nurse was not present.","DOI":"10.1111/jan.12303","ISSN":"1365-2648","note":"PMID: 24224731","shortTitle":"Paediatric nurses' adherence to the double-checking process during medication administration in a children's hospital","journalAbbreviation":"J Adv Nurs","language":"eng","author":[{"family":"Alsulami","given":"Zayed"},{"family":"Choonara","given":"Imti"},{"family":"Conroy","given":"Sharon"}],"issued":{"date-parts":[["2014",6]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Alsulami et al., 2014). There were 64 medicines left for the parents to administer to their children and at that time, nurses were not present ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"2ZB6wV95","properties":{"formattedCitation":"(Alsulami et al., 2014)","plainCitation":"(Alsulami et al., 2014)"},"citationItems":[{"id":304,"uris":["http://zotero.org/users/local/p8kwKNoG/items/AX73MSMH"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/AX73MSMH"],"itemData":{"id":304,"type":"article-journal","title":"Paediatric nurses' adherence to the double-checking process during medication administration in a children's hospital: an observational study","container-title":"Journal of Advanced Nursing","page":"1404-1413","volume":"70","issue":"6","source":"PubMed","abstract":"AIM: To evaluate how closely double-checking policies are followed by nurses in paediatric areas and also to identify the types, frequency and rates of medication administration errors that occur despite the double-checking process.\nBACKGROUND: Double-checking by two nurses is an intervention used in many UK hospitals to prevent or reduce medication administration errors. There is, however, insufficient evidence to either support or refute the practice of double-checking in terms of medication error risk reduction.\nDESIGN: Prospective observational study.\nMETHODS: This was a prospective observational study of paediatric nurses' adherence to the double-checking process for medication administration from April-July 2012.\nRESULTS: Drug dose administration events (n = 2000) were observed. Independent drug dose calculation, rate of administering intravenous bolus drugs and labelling of flush syringes were the steps with lowest adherence rates. Drug dose calculation was only double-checked independently in 591 (30%) drug administrations. There was a statistically significant difference in nurses' adherence rate to the double-checking steps between weekdays and weekends in nine of the 15 evaluated steps. Medication administration errors (n = 191) or deviations from policy were observed, at a rate of 9·6% of drug administrations. These included 64 drug doses, which were left for parents to administer without nurse observation.\nCONCLUSION: There was variation between paediatric nurses' adherence to double-checking steps during medication administration. The most frequent type of administration errors or deviation from policy involved the medicine being given to the parents to administer to the child when the nurse was not present.","DOI":"10.1111/jan.12303","ISSN":"1365-2648","note":"PMID: 24224731","shortTitle":"Paediatric nurses' adherence to the double-checking process during medication administration in a children's hospital","journalAbbreviation":"J Adv Nurs","language":"eng","author":[{"family":"Alsulami","given":"Zayed"},{"family":"Choonara","given":"Imti"},{"family":"Conroy","given":"Sharon"}],"issued":{"date-parts":[["2014",6]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Alsulami et al., 2014). Drug prescription calculation was merely twofold verified autonomously in 591 (30%) medication administrations ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"QugYg71i","properties":{"formattedCitation":"(Alsulami et al., 2014)","plainCitation":"(Alsulami et al., 2014)"},"citationItems":[{"id":304,"uris":["http://zotero.org/users/local/p8kwKNoG/items/AX73MSMH"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/AX73MSMH"],"itemData":{"id":304,"type":"article-journal","title":"Paediatric nurses' adherence to the double-checking process during medication administration in a children's hospital: an observational study","container-title":"Journal of Advanced Nursing","page":"1404-1413","volume":"70","issue":"6","source":"PubMed","abstract":"AIM: To evaluate how closely double-checking policies are followed by nurses in paediatric areas and also to identify the types, frequency and rates of medication administration errors that occur despite the double-checking process.\nBACKGROUND: Double-checking by two nurses is an intervention used in many UK hospitals to prevent or reduce medication administration errors. There is, however, insufficient evidence to either support or refute the practice of double-checking in terms of medication error risk reduction.\nDESIGN: Prospective observational study.\nMETHODS: This was a prospective observational study of paediatric nurses' adherence to the double-checking process for medication administration from April-July 2012.\nRESULTS: Drug dose administration events (n = 2000) were observed. Independent drug dose calculation, rate of administering intravenous bolus drugs and labelling of flush syringes were the steps with lowest adherence rates. Drug dose calculation was only double-checked independently in 591 (30%) drug administrations. There was a statistically significant difference in nurses' adherence rate to the double-checking steps between weekdays and weekends in nine of the 15 evaluated steps. Medication administration errors (n = 191) or deviations from policy were observed, at a rate of 9·6% of drug administrations. These included 64 drug doses, which were left for parents to administer without nurse observation.\nCONCLUSION: There was variation between paediatric nurses' adherence to double-checking steps during medication administration. The most frequent type of administration errors or deviation from policy involved the medicine being given to the parents to administer to the child when the nurse was not present.","DOI":"10.1111/jan.12303","ISSN":"1365-2648","note":"PMID: 24224731","shortTitle":"Paediatric nurses' adherence to the double-checking process during medication administration in a children's hospital","journalAbbreviation":"J Adv Nurs","language":"eng","author":[{"family":"Alsulami","given":"Zayed"},{"family":"Choonara","given":"Imti"},{"family":"Conroy","given":"Sharon"}],"issued":{"date-parts":[["2014",6]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Alsulami et al., 2014). The study was conducted by the Alsulami and the colleagues in the year 2014, and the purpose of the research was to decline the rate of medication administration errors.

Oncology department has been observed with clear and specific strategies to maintain double-checking before administering medicines to the patients ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1h0finjjk4","properties":{"formattedCitation":"(Rosenfeld et al., 2018)","plainCitation":"(Rosenfeld et al., 2018)"},"citationItems":[{"id":322,"uris":["http://zotero.org/users/local/p8kwKNoG/items/SDI85X3F"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/SDI85X3F"],"itemData":{"id":322,"type":"article-journal","title":"Interdisciplinary medication decision making by pharmacists in pediatric hospital settings: An ethnographic study","container-title":"Research in Social and Administrative Pharmacy","page":"269-278","volume":"14","issue":"3","author":[{"family":"Rosenfeld","given":"Ellie"},{"family":"Kinney","given":"Sharon"},{"family":"Weiner","given":"Carlye"},{"family":"Newall","given":"Fiona"},{"family":"Williams","given":"Allison"},{"family":"Cranswick","given":"Noel"},{"family":"Wong","given":"Ian"},{"family":"Borrott","given":"Narelle"},{"family":"Manias","given":"Elizabeth"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Rosenfeld et al., 2018). Nurses have been observed to follow the rules and policies while administering medication according to the hospital facility. Nurses observed with satisfying behaviour and efficiency was improved while administering medicine with a double-check. This study was conducted in the oncology department in the year 2018. The research has shown an enhanced self-medication administration in the department of oncology. Double-checking medicines is an extensively castoff policy to improve safe medication management in oncology; however, there is diminutive evidence to favour its efficacy. The increased usage of double-checking may be clarified by optimistic approaches to checking between nurses (Leahy et al., 2018). This was a survey conducted in three Swiss hospitals with a survey questionnaire (Fu et al., 2018). The survey included 41 objects with 6 areas ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1mlkl9p1kv","properties":{"formattedCitation":"(Schwappach, Taxis, & Pfeiffer, 2018)","plainCitation":"(Schwappach, Taxis, & Pfeiffer, 2018)"},"citationItems":[{"id":306,"uris":["http://zotero.org/users/local/p8kwKNoG/items/XCBNT8VR"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/XCBNT8VR"],"itemData":{"id":306,"type":"article-journal","title":"Oncology nurses' beliefs and attitudes towards the double-check of chemotherapy medications: a cross-sectional survey study","container-title":"BMC health services research","page":"123","volume":"18","issue":"1","source":"PubMed","abstract":"BACKGROUND: Double-checking medications is a widely used strategy to enhance safe medication administration in oncology, but there is little evidence to support its effectiveness. The proliferated use of double-checking may be explained by positive attitudes towards checking among nurses. This study investigated oncology nurses' beliefs towards double-checking medication, its relation to beliefs about safety and the influence of nurses' level of experience and proximity to clinical care.\nMETHODS: This was a survey of all oncology nurses in three Swiss hospitals. The questionnaire contained 41 items on 6 domains. Responses were recorded using a 7-point Likert scale. Multiple regression analysis was used to identify factors linked to strong beliefs in the effectiveness of double-checking.\nRESULTS: Overall, 274 (70%) out of 389 nurses responded (91% female, mean age 37 (standard deviation = 10)). Nurses reported very strong beliefs in the effectiveness and utility of double-checking. They were also confident about their own performance in double-checking. Nurses widely believed that double checking produced safety (e.g., 86% believed errors of individuals could be intercepted with double-checks). In contrast, some limitations of double-checking were also recognized, e.g., 33% of nurses reported that double checking caused frequent interruptions and 28% reported that double-checking was done superficially in their unit. Regression analysis revealed that beliefs in effectiveness of double-checking were mainly associated with beliefs in safety production (p < 0.001). Nurses with experience in barcode scanning held less strong beliefs in effectiveness of double-checking (p = 0.006). In contrast to our expectations, there were no differences in beliefs between any professional sub-groups.\nCONCLUSION: The widespread and strong believe in the effectiveness of double-checking is linked to beliefs about safety production and co-exists with acknowledgement of the major disadvantages of double-checking by humans. These results are important factors to consider when any existing procedures are adapted or new checking procedures are implemented.","DOI":"10.1186/s12913-018-2937-9","ISSN":"1472-6963","note":"PMID: 29454347\nPMCID: PMC5816392","shortTitle":"Oncology nurses' beliefs and attitudes towards the double-check of chemotherapy medications","journalAbbreviation":"BMC Health Serv Res","language":"eng","author":[{"family":"Schwappach","given":"D. L. B."},{"family":"Taxis","given":"Katja"},{"family":"Pfeiffer","given":"Yvonne"}],"issued":{"date-parts":[["2018"]],"season":"17"}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Schwappach, Taxis, & Pfeiffer, 2018). Every question was documented with 7 points Likert rule. The results were depicted via regression analysis that has positively responded with 86% rate ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"cZYkedPg","properties":{"formattedCitation":"(Schwappach et al., 2018)","plainCitation":"(Schwappach et al., 2018)"},"citationItems":[{"id":306,"uris":["http://zotero.org/users/local/p8kwKNoG/items/XCBNT8VR"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/XCBNT8VR"],"itemData":{"id":306,"type":"article-journal","title":"Oncology nurses' beliefs and attitudes towards the double-check of chemotherapy medications: a cross-sectional survey study","container-title":"BMC health services research","page":"123","volume":"18","issue":"1","source":"PubMed","abstract":"BACKGROUND: Double-checking medications is a widely used strategy to enhance safe medication administration in oncology, but there is little evidence to support its effectiveness. The proliferated use of double-checking may be explained by positive attitudes towards checking among nurses. This study investigated oncology nurses' beliefs towards double-checking medication, its relation to beliefs about safety and the influence of nurses' level of experience and proximity to clinical care.\nMETHODS: This was a survey of all oncology nurses in three Swiss hospitals. The questionnaire contained 41 items on 6 domains. Responses were recorded using a 7-point Likert scale. Multiple regression analysis was used to identify factors linked to strong beliefs in the effectiveness of double-checking.\nRESULTS: Overall, 274 (70%) out of 389 nurses responded (91% female, mean age 37 (standard deviation = 10)). Nurses reported very strong beliefs in the effectiveness and utility of double-checking. They were also confident about their own performance in double-checking. Nurses widely believed that double checking produced safety (e.g., 86% believed errors of individuals could be intercepted with double-checks). In contrast, some limitations of double-checking were also recognized, e.g., 33% of nurses reported that double checking caused frequent interruptions and 28% reported that double-checking was done superficially in their unit. Regression analysis revealed that beliefs in effectiveness of double-checking were mainly associated with beliefs in safety production (p < 0.001). Nurses with experience in barcode scanning held less strong beliefs in effectiveness of double-checking (p = 0.006). In contrast to our expectations, there were no differences in beliefs between any professional sub-groups.\nCONCLUSION: The widespread and strong believe in the effectiveness of double-checking is linked to beliefs about safety production and co-exists with acknowledgement of the major disadvantages of double-checking by humans. These results are important factors to consider when any existing procedures are adapted or new checking procedures are implemented.","DOI":"10.1186/s12913-018-2937-9","ISSN":"1472-6963","note":"PMID: 29454347\nPMCID: PMC5816392","shortTitle":"Oncology nurses' beliefs and attitudes towards the double-check of chemotherapy medications","journalAbbreviation":"BMC Health Serv Res","language":"eng","author":[{"family":"Schwappach","given":"D. L. B."},{"family":"Taxis","given":"Katja"},{"family":"Pfeiffer","given":"Yvonne"}],"issued":{"date-parts":[["2018"]],"season":"17"}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Schwappach et al., 2018). They have suggested that the reduction is possible in administering medication if there is a double check policy ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a2khllkb5bo","properties":{"formattedCitation":"(Schwappach et al., 2018)","plainCitation":"(Schwappach et al., 2018)"},"citationItems":[{"id":306,"uris":["http://zotero.org/users/local/p8kwKNoG/items/XCBNT8VR"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/XCBNT8VR"],"itemData":{"id":306,"type":"article-journal","title":"Oncology nurses' beliefs and attitudes towards the double-check of chemotherapy medications: a cross-sectional survey study","container-title":"BMC health services research","page":"123","volume":"18","issue":"1","source":"PubMed","abstract":"BACKGROUND: Double-checking medications is a widely used strategy to enhance safe medication administration in oncology, but there is little evidence to support its effectiveness. The proliferated use of double-checking may be explained by positive attitudes towards checking among nurses. This study investigated oncology nurses' beliefs towards double-checking medication, its relation to beliefs about safety and the influence of nurses' level of experience and proximity to clinical care.\nMETHODS: This was a survey of all oncology nurses in three Swiss hospitals. The questionnaire contained 41 items on 6 domains. Responses were recorded using a 7-point Likert scale. Multiple regression analysis was used to identify factors linked to strong beliefs in the effectiveness of double-checking.\nRESULTS: Overall, 274 (70%) out of 389 nurses responded (91% female, mean age 37 (standard deviation = 10)). Nurses reported very strong beliefs in the effectiveness and utility of double-checking. They were also confident about their own performance in double-checking. Nurses widely believed that double checking produced safety (e.g., 86% believed errors of individuals could be intercepted with double-checks). In contrast, some limitations of double-checking were also recognized, e.g., 33% of nurses reported that double checking caused frequent interruptions and 28% reported that double-checking was done superficially in their unit. Regression analysis revealed that beliefs in effectiveness of double-checking were mainly associated with beliefs in safety production (p < 0.001). Nurses with experience in barcode scanning held less strong beliefs in effectiveness of double-checking (p = 0.006). In contrast to our expectations, there were no differences in beliefs between any professional sub-groups.\nCONCLUSION: The widespread and strong believe in the effectiveness of double-checking is linked to beliefs about safety production and co-exists with acknowledgement of the major disadvantages of double-checking by humans. These results are important factors to consider when any existing procedures are adapted or new checking procedures are implemented.","DOI":"10.1186/s12913-018-2937-9","ISSN":"1472-6963","note":"PMID: 29454347\nPMCID: PMC5816392","shortTitle":"Oncology nurses' beliefs and attitudes towards the double-check of chemotherapy medications","journalAbbreviation":"BMC Health Serv Res","language":"eng","author":[{"family":"Schwappach","given":"D. L. B."},{"family":"Taxis","given":"Katja"},{"family":"Pfeiffer","given":"Yvonne"}],"issued":{"date-parts":[["2018"]],"season":"17"}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Schwappach et al., 2018). However, 33% have suggested that there were errors and interruptions while double-checking before administering medicines ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"8khQ87Xw","properties":{"formattedCitation":"(Schwappach et al., 2018)","plainCitation":"(Schwappach et al., 2018)"},"citationItems":[{"id":306,"uris":["http://zotero.org/users/local/p8kwKNoG/items/XCBNT8VR"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/XCBNT8VR"],"itemData":{"id":306,"type":"article-journal","title":"Oncology nurses' beliefs and attitudes towards the double-check of chemotherapy medications: a cross-sectional survey study","container-title":"BMC health services research","page":"123","volume":"18","issue":"1","source":"PubMed","abstract":"BACKGROUND: Double-checking medications is a widely used strategy to enhance safe medication administration in oncology, but there is little evidence to support its effectiveness. The proliferated use of double-checking may be explained by positive attitudes towards checking among nurses. This study investigated oncology nurses' beliefs towards double-checking medication, its relation to beliefs about safety and the influence of nurses' level of experience and proximity to clinical care.\nMETHODS: This was a survey of all oncology nurses in three Swiss hospitals. The questionnaire contained 41 items on 6 domains. Responses were recorded using a 7-point Likert scale. Multiple regression analysis was used to identify factors linked to strong beliefs in the effectiveness of double-checking.\nRESULTS: Overall, 274 (70%) out of 389 nurses responded (91% female, mean age 37 (standard deviation = 10)). Nurses reported very strong beliefs in the effectiveness and utility of double-checking. They were also confident about their own performance in double-checking. Nurses widely believed that double checking produced safety (e.g., 86% believed errors of individuals could be intercepted with double-checks). In contrast, some limitations of double-checking were also recognized, e.g., 33% of nurses reported that double checking caused frequent interruptions and 28% reported that double-checking was done superficially in their unit. Regression analysis revealed that beliefs in effectiveness of double-checking were mainly associated with beliefs in safety production (p < 0.001). Nurses with experience in barcode scanning held less strong beliefs in effectiveness of double-checking (p = 0.006). In contrast to our expectations, there were no differences in beliefs between any professional sub-groups.\nCONCLUSION: The widespread and strong believe in the effectiveness of double-checking is linked to beliefs about safety production and co-exists with acknowledgement of the major disadvantages of double-checking by humans. These results are important factors to consider when any existing procedures are adapted or new checking procedures are implemented.","DOI":"10.1186/s12913-018-2937-9","ISSN":"1472-6963","note":"PMID: 29454347\nPMCID: PMC5816392","shortTitle":"Oncology nurses' beliefs and attitudes towards the double-check of chemotherapy medications","journalAbbreviation":"BMC Health Serv Res","language":"eng","author":[{"family":"Schwappach","given":"D. L. B."},{"family":"Taxis","given":"Katja"},{"family":"Pfeiffer","given":"Yvonne"}],"issued":{"date-parts":[["2018"]],"season":"17"}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Schwappach et al., 2018). Double-check policy is directly linked with staff satisfaction; the safety of the patient and disadvantages have been reduced to a greater extent as compared to a single check.

How well the existing literature addressed the problem? Barriers and Challenges

The available researches and the studies have substantial information that has focused the scientists recognizing the problem and the barriers to overcome the issue. With workload problems impending deeply over physicians, autonomous twofold checks should merely be castoff for very discerning high-risk tasks or high-alert medicines (not all) that most permit their use ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a8au75bbpe","properties":{"formattedCitation":"(Heneka, Shaw, Rowett, Lapkin, & Phillips, 2018)","plainCitation":"(Heneka, Shaw, Rowett, Lapkin, & Phillips, 2018)"},"citationItems":[{"id":328,"uris":["http://zotero.org/users/local/p8kwKNoG/items/R4GQQTRG"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/R4GQQTRG"],"itemData":{"id":328,"type":"article-journal","title":"Exploring factors contributing to medication errors with opioids in Australian specialist palliative care inpatient services: A multi-incident analysis","container-title":"Journal of palliative medicine","page":"825-835","volume":"21","issue":"6","author":[{"family":"Heneka","given":"Nicole"},{"family":"Shaw","given":"Tim"},{"family":"Rowett","given":"Debra"},{"family":"Lapkin","given":"Samuel"},{"family":"Phillips","given":"Jane L."}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Heneka, Shaw, Rowett, Lapkin, & Phillips, 2018). Double-check is a process that consumes time, and in a healthcare facility, there is a workload that consumes a lot of time of the healthcare provider ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ap63mmsr3l","properties":{"formattedCitation":"(Litman, 2018)","plainCitation":"(Litman, 2018)"},"citationItems":[{"id":323,"uris":["http://zotero.org/users/local/p8kwKNoG/items/6453XQE7"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/6453XQE7"],"itemData":{"id":323,"type":"article-journal","title":"How to prevent medication errors in the operating room? Take away the human factor","container-title":"British journal of anaesthesia","page":"438-440","volume":"120","issue":"3","author":[{"family":"Litman","given":"R. S."}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Litman, 2018). Deficiency of time to transmit out the examination procedure correctly was a robust, recurrent subject in studies of unsuccessful double checks and workforce confrontation to this policy ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a2oqs11ffks","properties":{"formattedCitation":"{\\rtf (Foged, N\\uc0\\u248{}rholm, Andersen, & Petersen, 2018)}","plainCitation":"(Foged, Nørholm, Andersen, & Petersen, 2018)"},"citationItems":[{"id":325,"uris":["http://zotero.org/users/local/p8kwKNoG/items/GHPH3YZ9"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/GHPH3YZ9"],"itemData":{"id":325,"type":"article-journal","title":"Nurses’ perspectives on how an e‐message system supports cross‐sectoral communication in relation to medication administration: A qualitative study","container-title":"Journal of clinical nursing","page":"795-806","volume":"27","issue":"3-4","author":[{"family":"Foged","given":"Signe"},{"family":"Nørholm","given":"Vibeke"},{"family":"Andersen","given":"Ove"},{"family":"Petersen","given":"Helle Vendel"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Foged, Nørholm, Andersen, & Petersen, 2018). It has been observed in various studies that staff is reluctant to adopt the new and additional duties assigned to them. It includes the double-check of medication before administration to the patients. Nurses have shown a positive attitude towards the double-check, however, have suggested that it took 20 minutes to double-check medication before administering and lack of information technology usage is also influencing the delays and wrong administration of medication ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a235nh0vjon","properties":{"formattedCitation":"(Hu, Chiu, & Wu, 2018)","plainCitation":"(Hu, Chiu, & Wu, 2018)"},"citationItems":[{"id":331,"uris":["http://zotero.org/users/local/p8kwKNoG/items/3GX89UDH"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/3GX89UDH"],"itemData":{"id":331,"type":"article-journal","title":"Threats of Medication Process in Outpatients: Qualitative Study With Physicians, Nurses, and Pharmacists","author":[{"family":"Hu","given":"Sophia H."},{"family":"Chiu","given":"Yi-Chun"},{"family":"Wu","given":"Lei-Lan"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Hu, Chiu, & Wu, 2018). Studies have suggested that it is more profound in outcomes to double-check medication, but the time-consuming activities are usually not practical in healthcare facilities.

Four major areas have been identified in the medication practices such as understanding of the medication errors including how and what kind of errors usually happen in the healthcare facilities ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1tc4dsudad","properties":{"formattedCitation":"(Alomari, Wilson, Solman, Bajorek, & Tinsley, 2018)","plainCitation":"(Alomari, Wilson, Solman, Bajorek, & Tinsley, 2018)"},"citationItems":[{"id":313,"uris":["http://zotero.org/users/local/p8kwKNoG/items/UTDP5UZW"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/UTDP5UZW"],"itemData":{"id":313,"type":"article-journal","title":"Pediatric nurses’ perceptions of medication safety and medication error: a mixed methods study","container-title":"Comprehensive child and adolescent nursing","page":"94-110","volume":"41","issue":"2","author":[{"family":"Alomari","given":"Albara"},{"family":"Wilson","given":"Val"},{"family":"Solman","given":"Annette"},{"family":"Bajorek","given":"Beata"},{"family":"Tinsley","given":"Patricia"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Alomari, Wilson, Solman, Bajorek, & Tinsley, 2018). The second important factor identified was the busy schedule of the staff and healthcare providers (Alomari, Wilson, Solman, Bajorek, & Tinsley, 2018). This includes the duty routine, self-administration, single check, double-check and time consumption in administering and delivering the services ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a243g3kscuh","properties":{"formattedCitation":"{\\rtf (Rishoej, Almarsd\\uc0\\u243{}ttir, Thybo Christesen, Hallas, & Juel Kjeldsen, 2018)}","plainCitation":"(Rishoej, Almarsdóttir, Thybo Christesen, Hallas, & Juel Kjeldsen, 2018)"},"citationItems":[{"id":327,"uris":["http://zotero.org/users/local/p8kwKNoG/items/LD6PI7IT"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/LD6PI7IT"],"itemData":{"id":327,"type":"article-journal","title":"Identifying and assessing potential harm of medication errors and potentially unsafe medication practices in paediatric hospital settings: a field study","container-title":"Therapeutic advances in drug safety","page":"509-522","volume":"9","issue":"9","author":[{"family":"Rishoej","given":"Rikke Mie"},{"family":"Almarsdóttir","given":"Anna Birna"},{"family":"Thybo Christesen","given":"Henrik"},{"family":"Hallas","given":"Jesper"},{"family":"Juel Kjeldsen","given":"Lene"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Rishoej, Almarsdóttir, Thybo Christesen, Hallas, & Juel Kjeldsen, 2018). The third profound factor that also hindered the way of double-check policy is the physical environment such as the environment of the healthcare facility, healthcare rooms, poor atmosphere, non-cooperation from the staff, and the patient-centred areas including the interruptions from parents and patient relations ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"as10lp77vm","properties":{"formattedCitation":"(Alomari et al., 2018)","plainCitation":"(Alomari et al., 2018)"},"citationItems":[{"id":313,"uris":["http://zotero.org/users/local/p8kwKNoG/items/UTDP5UZW"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/UTDP5UZW"],"itemData":{"id":313,"type":"article-journal","title":"Pediatric nurses’ perceptions of medication safety and medication error: a mixed methods study","container-title":"Comprehensive child and adolescent nursing","page":"94-110","volume":"41","issue":"2","author":[{"family":"Alomari","given":"Albara"},{"family":"Wilson","given":"Val"},{"family":"Solman","given":"Annette"},{"family":"Bajorek","given":"Beata"},{"family":"Tinsley","given":"Patricia"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Alomari et al., 2018). Fourth important factor identified was the compliance with the policy related to the medications and practices ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a13f3m1l5e0","properties":{"formattedCitation":"(Schutijser et al., 2018)","plainCitation":"(Schutijser et al., 2018)"},"citationItems":[{"id":319,"uris":["http://zotero.org/users/local/p8kwKNoG/items/VVMUMEXC"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/VVMUMEXC"],"itemData":{"id":319,"type":"article-journal","title":"Nurse compliance with a protocol for safe injectable medication administration: comparison of two multicentre observational studies","container-title":"BMJ open","page":"e019648","volume":"8","issue":"1","author":[{"family":"Schutijser","given":"Bernadette"},{"family":"Klopotowska","given":"Joanna Ewa"},{"family":"Jongerden","given":"Irene"},{"family":"Spreeuwenberg","given":"Peter"},{"family":"Wagner","given":"Cordula"},{"family":"Bruijne","given":"Martine","non-dropping-particle":"de"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Schutijser et al., 2018). Family involvement in understanding medication drug usage and its adverse effects are also associated with the wrong administration of medicines ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"at1auva3t5","properties":{"formattedCitation":"(El-Saifi, Moyle, & Jones, 2019)","plainCitation":"(El-Saifi, Moyle, & Jones, 2019)"},"citationItems":[{"id":332,"uris":["http://zotero.org/users/local/p8kwKNoG/items/RMIMCDEY"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/RMIMCDEY"],"itemData":{"id":332,"type":"article-journal","title":"Family caregivers’ perspectives on medication adherence challenges in older people with dementia: a qualitative study","container-title":"Aging & mental health","page":"1333-1339","volume":"23","issue":"10","author":[{"family":"El-Saifi","given":"Najwan"},{"family":"Moyle","given":"Wendy"},{"family":"Jones","given":"Cindy"}],"issued":{"date-parts":[["2019"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (El-Saifi, Moyle, & Jones, 2019). It involves the complete details of the administration of the medications, the guidelines related to the medicines, preparation training and the administering rules of the healthcare facilities ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a25t7m29l8i","properties":{"formattedCitation":"(Chua et al., 2019)","plainCitation":"(Chua et al., 2019)"},"citationItems":[{"id":311,"uris":["http://zotero.org/users/local/p8kwKNoG/items/GF6ULSYA"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/GF6ULSYA"],"itemData":{"id":311,"type":"article-journal","title":"Medication Safety: A Need to Relook at Double-Checking Medicines?","container-title":"Asia-Pacific Journal of Oncology Nursing","page":"246","volume":"6","issue":"3","author":[{"family":"Chua","given":"Gek Phin"},{"family":"Lee","given":"Kim Hua"},{"family":"Peralta","given":"Gemma Diente"},{"family":"Lim","given":"John Heng Chi"}],"issued":{"date-parts":[["2019"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Chua et al., 2019).

Unfavourable conditions of the healthcare facilities and the time-consuming policies have a significant influence on double-checking policies of administering medication to the patients ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"av2oi2d741","properties":{"formattedCitation":"(Keers et al., 2018)","plainCitation":"(Keers et al., 2018)"},"citationItems":[{"id":326,"uris":["http://zotero.org/users/local/p8kwKNoG/items/IV8SP6UI"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/IV8SP6UI"],"itemData":{"id":326,"type":"article-journal","title":"What causes medication administration errors in a mental health hospital? A qualitative study with nursing staff","container-title":"PloS one","page":"e0206233","volume":"13","issue":"10","author":[{"family":"Keers","given":"Richard N."},{"family":"Plácido","given":"Madalena"},{"family":"Bennett","given":"Karen"},{"family":"Clayton","given":"Kristen"},{"family":"Brown","given":"Petra"},{"family":"Ashcroft","given":"Darren M."}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Keers et al., 2018). Assignments and load, recurrent disruptions to the procedure, underprivileged physical setting scheme particularly in radiation departments, absence of preparation space, and unfeasible medicine rules are recognized as barriers to nontoxic medication practice (Christensen, Nause‐Osthoff, Waldman, Spratt, & Hearn, 2019).

References

ADDIN ZOTERO_BIBL {"custom":[]} CSL_BIBLIOGRAPHY Alomari, A., Wilson, V., Solman, A., Bajorek, B., & Tinsley, P. (2018). Pediatric nurses' perceptions of medication safety and medication error: a mixed-methods study. Comprehensive Child and Adolescent Nursing, 41(2), 94–110.

Alsulami, Z., Choonara, I., & Conroy, S. (2014). Paediatric nurses’ adherence to the double-checking process during medication administration in a children’s hospital: an observational study. Journal of Advanced Nursing, 70(6), 1404–1413. https://doi.org/10.1111/jan.12303

Athanasakis, E. (2019). A meta‐synthesis of how registered nurses make sense of their lived experiences of medication errors. Journal of Clinical Nursing.

Chua, G. P., Lee, K. H., Peralta, G. D., & Lim, J. H. C. (2019). Medication Safety: A Need to Relook at Double-Checking Medicines? Asia-Pacific Journal of Oncology Nursing, 6(3), 246.

dos Santos, H. D., Ulbrich, A. H. D., Woloszyn, V., & Vieira, R. (2018). DDC-outlier: preventing medication errors using unsupervised learning. IEEE Journal of Biomedical and Health Informatics, 23(2), 874–881.

El-Saifi, N., Moyle, W., & Jones, C. (2019). Family caregivers’ perspectives on medication adherence challenges in older people with dementia: a qualitative study. Aging & Mental Health, 23(10), 1333–1339.

Foged, S., Nørholm, V., Andersen, O., & Petersen, H. V. (2018). Nurses’ perspectives on how an e‐message system supports cross‐sectoral communication in relation to medication administration: A qualitative study. Journal of Clinical Nursing, 27(3–4), 795–806.

Fu, Y., Han, H. H., Zhang, J., He, X. P., Feringa, B. L., & Tian, H. (2018). Photocontrolled Fluorescence “Double-Check” Bioimaging Enabled by a Glycoprobe–Protein Hybrid. Journal of the American Chemical Society, 140(28), 8671-8674.

Heneka, N., Shaw, T., Rowett, D., Lapkin, S., & Phillips, J. L. (2018). Exploring factors contributing to medication errors with opioids in Australian specialist palliative care inpatient services: A multi-incident analysis. Journal of Palliative Medicine, 21(6), 825–835.

Hu, S. H., Chiu, Y.-C., & Wu, L.-L. (2018). Threats of Medication Process in Outpatients: Qualitative Study With Physicians, Nurses, and Pharmacists.

Keers, R. N., Plácido, M., Bennett, K., Clayton, K., Brown, P., & Ashcroft, D. M. (2018). What causes medication administration errors in a mental health hospital? A qualitative study with nursing staff. PloS One, 13(10), e0206233.

Koyama, A. K., Maddox, C.-S. S., Li, L., Bucknall, T., & Westbrook, J. I. (2019). Effectiveness of double checking to reduce medication administration errors: a systematic review. BMJ Quality &amp; Safety, bmjqs-2019-009552. https://doi.org/10.1136/bmjqs-2019-009552

Leahy, I. C., Lavoie, M., Zurakowski, D., Baier, A. W., & Brustowicz, R. M. (2018). Medication errors in a pediatric anesthesia setting: Incidence, etiologies, and error reduction strategies. Journal of clinical anesthesia, 49, 107-111.

Litman, R. S. (2018). How to prevent medication errors in the operating room? Take away the human factor. British Journal of Anaesthesia, 120(3), 438–440.

Rishoej, R. M., Almarsdóttir, A. B., Thybo Christesen, H., Hallas, J., & Juel Kjeldsen, L. (2018). Identifying and assessing potential harm of medication errors and potentially unsafe medication practices in paediatric hospital settings: a field study. Therapeutic Advances in Drug Safety, 9(9), 509–522.

Rosenfeld, E., Kinney, S., Weiner, C., Newall, F., Williams, A., Cranswick, N., … Manias, E. (2018). Interdisciplinary medication decision making by pharmacists in pediatric hospital settings: An ethnographic study. Research in Social and Administrative Pharmacy, 14(3), 269–278.

Schutijser, B., Klopotowska, J. E., Jongerden, I., Spreeuwenberg, P., Wagner, C., & de Bruijne, M. (2018). Nurse compliance with a protocol for safe injectable medication administration: comparison of two multicentre observational studies. BMJ Open, 8(1), e019648.

Schwappach, D. L. B., Pfeiffer, Y., & Taxis, K. (2016). Medication double-checking procedures in clinical practice: a cross-sectional survey of oncology nurses’ experiences. BMJ Open, 6(6), e011394. https://doi.org/10.1136/bmjopen-2016-011394

Schwappach, D. L. B., Taxis, K., & Pfeiffer, Y. (2018). Oncology nurses’ beliefs and attitudes towards the double-check of chemotherapy medications: a cross-sectional survey study. BMC Health Services Research, 18(1), 123. https://doi.org/10.1186/s12913-018-2937-9

Treiber, L. A., & Jones, J. H. (2018). After the Medication Error: Recent Nursing Graduates' Reflections on Adequacy of Education. Journal of Nursing Education, 57(5), 275-280.

Research Topic On The Communication Barriers In Class

INFECTION CONTROL AND FLU VACCINE

Author’s name

Class name

Professor

School name

City and state

Date

INFECTION CONTROL AND FLU VACCINE

SUMMARY

This paper is aimed at exploring the effectiveness of flu vaccines in infection control with reference to students’ perspectives. A brief rationale behind selecting this subject matter will be defined under the background section followed by the description of research hypothesis and research objectives. In order to settle the arguments concerning hypothesis on the logical and rational grounds, two peer reviewed literature pieces would be identified and embraced deliberate contemplated discussion. Further, two methods of data collection would be identified based on their favorableness with respect to time and economical resources. The result section will attempt to document the findings attained from the prospective data collection tools followed by their detailed explanation in the conclusion section. Practical implication and suggestions would encapsulate the practical relevancy of the research findings and potential suggestions to overcome methodological shortcomings. The reflection section, in the end, will attempt to wrap my personal perspectives and feelings regarding whole research activity and its valuable findings. In a nutshell, this paper will provide the reader with the profound understanding about the subject matter based on the preexisting literature and freshly executed research activity.

BACKGROUND

Flu is termed as highly contagious respiratory illness characterized by cough, sore, throat, headache, fatigue, muscle aches, runny nose and shivering. Influenza virus is the most exclusive cause behind flu symptoms. It is said to be highly contagious because tiny droplets of the fluid act as active mediums to spread this disease through coughing, talking or sneezing. After landing on the mouth or nose of the nearby individuals, viruses contained in these droplets are absorbed into the blood stream and interfere with the structural and functional working of the various body organs. As soon as the virus arrives into the body, our lymphocytes—an integral part of immune system— recognize these entities as the antigens and start developing prospective antibodies to engulf them. This process is natural however in the individuals with compromised immune system; vaccines are required to develop antibodies within the body for the influenza virus to combat them soon after their arrival. Hence, vaccine acts as the first line intervention to prevent and treat flu. Based on the effectiveness of vaccines, I chose this topic to undertake thorough contemplation though systematic research. The basic rationale behind conducting this research is to contribute to the existing acceptability of vaccines in treating and preventing flu and improving the nursing interventions in this regard.

RESEARCH HYPOTHESIS

There is a significant negative relationship between acquisition of flu and utilization of vaccines

RESEARCH OBJECTIVES

To enable students to increase their knowledge about vaccinations

To contribute to the preexisting literature concerning effectiveness of vaccines

To encourage the utilization of influenza vaccines in the class

To obtain hands- on knowledge about the effectiveness of flu vaccines

EVIDENCE—LITERATURE SUPPORT

In order to support the hypothesis through preexisting literature, following studies were identified and selected from the Pub MED website. Their brief summary will be presented below which will highlight the significance and effectiveness of vaccines as the first line prevention and treatment option for flu.

Pub MED https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6160951/

This article attempted to define the effectiveness of influenza vaccination in three classes of the subjects; healthy adults, newborns and pregnant women. It was a systematic review that included various cross- sectional correlational and experimental studies from various databases i.e., Cochrane Central Register of Controlled Trials, MEDLINE, the WHO International Clinical Trials Registry Platform and EMBASE. After analyzing the available data, it was found that individuals who received inactivated influenza vaccine after birth experienced less influenza symptoms, Influenza- like symptoms, hospitalization and severe symptoms as compared to the individuals with no vaccine just after vaccination and later life stages. Another finding indicated that side effects of influenza vaccines were considerably higher in newborns and pregnant women as compared to the general population encapsulating the mild intensity of fever whereas no evidence was found concerning nausea and vomiting. However, the protective effects of vaccines were also measured greater in pregnant women and newborn as compared to the general population; no correlation was found between severe side effects and influenza vaccines. In a nutshell, effectiveness of vaccines dominated their side effects to a considerable degree.

Pub MED https://www.ncbi.nlm.nih.gov/pubmed/24034492

This article was aimed at guiding the healthcare workers over preventive strategies regarding influenza virus because it is highly contagious in nature and spreads readily to the individuals that they come in direct contact with. Healthcare workers spend most of their time with patients hence they have the potential to act as a vector of influenza from one patient to others. This study summarized the systematic reviews regarding the effectiveness of influenza vaccines in providing the direct protection to at risk- individuals mainly suffering from respiratory complications. In order to attain the appropriate literature through a predefined strategy, numerous sources of grey literature and databases were searched resulting in the selection of 20 relevant articles. The desirable entities were extracted from the pool based on the specified inclusion criteria. Validated tools were used to identify the risks associated with research methodology and results were summarized qualitatively. After analyzing the data, it was found that influenza vaccines are very likely to offer protection against respiratory complications particularly in flu and its associated symptoms. Hence, this study also provided a sound basis to my research hypothesis and validated the efficacy of vaccines in controlling and treating flu symptoms successfully—a type of respiratory illness.

TWO METHODS OF DATA COLLECTION WITH THEIR RATIONALE

In the social and medical sciences, the primary tool of data extraction is human being himself. Although human beings threaten the validity of research findings through their subjectivity and individual differences yet they also contribute to the creation of significant and valuable knowledge within the prospective fields. All the data collection tools revolve around the appropriateness of the type of population considered for research measures and the nature of relationship between variables being measured. In my research, data will be collected from students for exploring their perspective regarding the effectiveness of vaccines to treat flu symptoms. For that matter, interviews and surveys are the best methods for collecting desired data from the population.

Surveys are mainly used for quantitative research—they quantify the responses into numbers which makes the systematic analysis easy and accurate. Open and close ended questionnaires are the best tools of data collection that encapsulate the items measuring desired phenomenon. A close ended questionnaire might have dichotomous or polychotomous format with their prospective values of reliability and validity. Surveys are less time and resource consuming because we can obtain larger data from numerous individuals at the same time without manipulating conditions in laboratory.

The second tool of data collection is interview. Interview questions might also be close and open ended aimed at exploring the phenomenon profoundly and allowing the researcher to obtain in- depth information along with the verbal and non- verbal cues coming from the subjects regarding problem issue. Interviews are also highly economical in nature however they are highly effort and time consuming. An average interview may last for 30-40 minutes ranging from 2-3 sessions for each individual. A calm and distraction- free environment is also a prerequisite for conducting interview successfully. Therefore, it requires substantial efforts but gives profound access to data.

PROCEDURE

Items were first designed for exploring student’s views regarding the effectiveness of vaccines in controlling flu symptoms. Total of 5 items will be designed for collecting data through interview and questionnaires. For the survey, out of five, two items will be worded negatively for eliminating the response bias; they will be fed into data analysis software after reverse scoring. Reliability and validity of the items will be tested through pilot study on the sample of 10. After designing the survey instrument, an informed consent will be attached with it and data will be collected from 20 students. On the other hand, 2 students will be selected for interview purpose and after developing rapport, data will be obtained. Data collection through survey will take place at classroom and will be completed in 10 minutes approximately whereas interviews will be conducted in free classes and will take 30 minutes to complete. After obtaining the data from both the tools, it will be analyzed using different approaches.

RESULTS

Data obtained from survey will be analyzed using two different tools; Statistical Package for Social Science (SPSS) version 21 and thematic analysis for the data obtained from questionnaires and interviews respectively. In the SPSS, data would be fed and bi-variate correlation command will be run. Results will indicate strong negative correlation between utilization of vaccines and instances of getting the flu symptoms. On the other hand, thematic analysis of the interview data would give off two themes; logical views about vaccines and their observable effectiveness.

CONCLUSION

A strong negative correlation between utilization of vaccines and instances of getting the flu symptoms indicates that when vaccine use becomes high, the instances of getting flu symptoms would be declined. In other words, students’ perspective suggests that vaccines must be used as the first line treatment for flu symptoms. On the other hand, thematic analysis would propound following results; logical views about vaccines and their observable effectiveness. Overall, students hold positive views about vaccine use; depicted through above mentioned themes. Logical views encapsulate the mechanism of action of vaccines that they learned in the academic course; these views helped them realizing the effectiveness of vaccines in the most logical manner. Further, observable effectiveness includes their personal and others’ experience that they found favorable; subjects benefited from these vaccines.

PRACTICAL IMPLICATIONS

Based on the proven effectiveness of vaccines, findings have the potential to be applied in the clinical setting for mitigating flu symptoms on the part of nurses and patients. Nurses can vaccinate themselves for influenza virus so that they could protect themselves from transmitting viruses to the patients. It can be used for infected patients who do not produce enough antibodies as well.

SUGGESTIONS & RECOMMENDATIONS

The attainment of perfection in terms of results particularly in the behavioral and medical sciences is something next to impossible. This happens for many reasons; methodological troubles and subjective biasness. Methodological complications may include means of sample selection, number of subjects (sample size), selection criteria, validity and reliability of instrument, items being over representative or under representative of the subject matter and language of the items. Subjective biasness includes innate predispositions or environmental influences responsible for perceiving situations, optimism and pessimism of subjects, mental state, halo effect, conformity, the attainment of social desirability, subjective approach of researcher to interpret the results and lack of researching skills. These factors may threaten the validity and generalization of results gravely. However, some of these methodological complications can be corrected; for example, random sampling technique might be used to eliminate selection biasness because it gives equal chance of selection to all the members of population. Furthermore, increasing the sample size might eliminate another methodological complication. These factors can be addressed to eliminate limitations and to make the findings more applicable.

REFLECTION

I somewhere heard; the best lessons of life come from live experiences. This phrase strikingly illuminated my mind when I thought about reflecting upon this activity. Undoubtedly, we learn better from experiencing situations at our own; although I added two widely- acknowledged literature articles yet they did not make me learn about the effectiveness of vaccines as good as my personal indulgence did. I learned about exploring things scientifically, thinking and acting like a researcher and contemplating the phenomenon of interest holistically. I learned that situations and events are interrelated and affect each other and only researchers pay this much attention to the trivial happenings. I felt good about it because I created and contributed something to the world of knowledge. In a nutshell, this activity enabled me to find the question, devise hypothesis and explore the most scientific ways to test my hypothesis. I can say that I explored the research validity about the effectiveness of vaccines in controlling the flu symptoms scientifically.

References

Dolan G. P. Harris R. C. Clarkson, M. et. al. 2013. Vaccination of healthcare workers to protect patients at increased risk of acute respiratory disease: summary of a systematic review. Influenza Other Respir Viruses. 7(2): pp.93-6. doi: 10.1111/irv.12087.

Demicheli V., Jefferson T., Ferroni E. 2018. Vaccines for preventing influenza in healthy adults. Cochrane Database Syst Rev. 1(2):CD001269. doi: 10.1002/14651858.CD001269.pub6.

Resopnse To Peer

PLS PUT EACH RESPONSE BELOW EACH STUDENTS WORK. I SENT YOU 4 STUDENTS WORK. FOR THIS ASSIGNMENT YOU HAVE TO READ EACH STUDENT WORK AND RESPONSE TO WHAT THEY ARE SAYING. 75 WORDS

Student 1 idis

BEATRICE AJONG

In health care, cultural competency is critical because even such as health and illnesses mean different things for some people until they are used in the context of their culture (Freshman, 2018). In the practice situation presented in the case, the nurses and health practitioners never really considered the role of the child's Chinese culture to the parents as well as the child. They pushed the parents to the corner, making them place the child in medical foster care where she significantly improved from the Proteus syndrome she was suffering from. The primary medical team even went ahead to request a palliative care consultation without considering the cultural aspects of the child's condition. The remarkable recovery that the child went through when she was eventually discharged to the parental home which was interwoven with strong cultural ties clearly showed how essential culture was in her recovery. The healthcare professionals should have, therefore sought to combine both medical and cultural aspects in providing medical care to the child. This way, they would have yielded better health outcomes since the cultural side was glaringly lacking from the child's care (Andrews & Boyle, 2016).

MY RESPONSE

Dear Beatrice, after reading your post I must say that you did an amazing job in explaining cultural competency in the context of health care. I agree with you that it is a major issue in the health care system that most health care professionals treat their patients without considering their cultural values. As in your post you mentioned Chinese culture, I agree with you that in Chinese culture taking care of a sick person is considered very noble. So when a Chinese child who was discharged to parental home showed remarkable recovery. Thus it is necessary to combine both medical and cultural aspects while providing care to a patient.  

Student 2 idis

NATHANIEL K

As we have previously discussed in other weekly entries it and how evidenced based research has shown, incorporating the patient's cultural beliefs and practices as well as cultural norms aids in their overall outcomes (Wellbery, 2006).  As in the case discussed in chapter six though, we see that it is not always the case that our patient's are able to have their cultural beliefs, norms, and wishes respected in such a way that their quality of care is also not impacted directly and negatively.  It was relinquishing care of their child that the Chinese family mentioned was then able to make a full recovery due to be in a more optimal healing environment. Due to the family's circumstances, in my opinion, they made the best decision possible for their child and the evidence speaks for itself because, "the child began to thrive, smile, make eye contact with her family, and even walk as few feet" (Andrews & Boyle, 2016)

MY RESPONSE

Dear Nathaniel, after reading your discussion post I was able to know about the importance of culture while treating a patient. I also agree with you that most times our cultures and beliefs are not respected by health care professionals. This impacts the patient negatively. Typically, family support plays a huge role in the recovery of a patient. Specifically, discussing Chinese child I also agree that his parents took the best decision by taking him home rather than letting their child stay in the hospital.

Student 3

CHINONSO O

When thinking about older patients who are chronically ill, there are different factors that come to mind. You must assess the situation. The patient is a 82 year old, who just got discharged and is chronically ill. The patient lives by themselves in a city. When i think about these certain factors, certain questions arise.  What is their certain illness? Who takes care of them at home? Does their living situation, assist their needs? Are they able to get around in the city?  For resources, i would need to look  into a home health nurse who be able to assist them. We need to find what he can do and what he can't such as his adl's. Can he cook? Can he ambulate around his apartment? A questionnaire must be done about his need and limitation. We must investigate first before we can decide what the patients needs. " Self-management is considered as an essential component of chronic care by primary care professionals. People with a chronic disease, such as diabetes, chronic obstructive pulmonary disease (COPD) or a cardiovascular condition, have to make day-to-day decisions to manage their own disease. Self-management requires an active role of the patient in managing one’s symptoms, treatment, physical and psychosocial consequences and lifestyle changes" (Huygens et al. , 2016).  From my understanding it just depends which type of chronic illness it is and how it is affecting them. The only way to know what resources is needed is by assessing what the needs and limitations are. Just knowing that the patient is 82, chronically ill and living alone  is not enough information. It gives you a glimpse but there are still other questions to be askedStudent 4 idis

MY RESPONSE

Dear Chinonso, after reading your post I must say that you did an amazing job in explaining the benefits of self-management. Due to the increase in average life expectancy, the number of older citizens has increased. Many of the older people are living with chronic illness. I agree with you that it is necessary to promote self-awareness among people so that in case of emergency they can give themselves first aid that can be lifesaving.

ASHLEY EN

An eighty-two-year-old man could suffer from a chronic disease like asthma which could be considered a burden to the family. The room under occupation should have proper ventilation and clean all the time. Cleanliness would help prevent dust and dumbness that would encourage or bring moisture to the air. The nurse is expected to assess the environment and get rid of environmental elements like flowers that would cause an allergy that may worsen the asthma situation (Wagner et al., 2002).  

The nurse has a duty of checking the clothes of the eighty-two-year-old man to ensure the warmth of the patient. Deodorants and perfumes present that may contribute to worsening of the allergies should be done away with. The nurse should also put into consideration the climate and weather conditions of the area to create a care plan for the patient. Taking into account the medication prescription will help the nurse to know if extra activities will help in the recovering process of the patient. Additional events are necessary to keep the patient lively (Wagner et al., 2002). 

The nurse is expected to know the feeding habit of the patient to schedule a proper care plan. The type of food that would generate energy on the patient's body, yet the meal fed is a balanced diet. The nurse should be keen on the number of the patient's visitors and response to the patient's ailment.  If the visits are causing the patient to strain, then such activity should be limited for the patient's welfare.

MY RESPONSE

Dear Ashley, after reading your post I learned a lot regarding the role of nurses in treating a patient who has a chronic illness. I agree with you that any perfume or dust can worsen the symptoms of a patient who has COPD. So it is the responsibility of the nurse to ensure that the patient’s from is clean and has no fragrance. I also think that nurses must consider environmental factors such as climate change as well so that they can provide effective care to their patients.

Respond To Discussion

Title

[Author Name(s), First M. Last, Omit Titles and Degrees]

[Institutional Affiliation(s)]

Author Note

[Include any grant/funding information and a complete correspondence address.]

Discussion

It is true that the US healthcare system has some deficiencies and shortages but I believe that it is not reasonable to declare the whole system as dysfunctional. The healthcare system in the United States is the most expensive as compared to other developed nations and most of the people have a hard time paying for their healthcare expenses but it is sensible to have an eye on the factors that contribute to the high cost of medical care in the US. The US healthcare system is a hybrid one, having so single regulation and no universal healthcare coverage. There are many drivers of the high cost of health; the first factor is that the US healthcare system is privately owned. and it is not regulated by one single agency and little integration between the services and the health care service provider, which makes it multifarious, and offer fewer benefits to the inexpensive healthcare options (“Important Aspects and Characteristics of the US Healthcare System | National Institute of Health Policy,” n.d.).

In addition, it is highly focused on the state of the art technology; US hospitals are equipped with the best equipment and procedures that push the cost of healthcare up. There is a high legal risk involved in healthcare in the US, to avoid these malpractices of lawsuits the US healthcare institutes makes the healthcare procedures prolonged to ensure that all the requirements are fulfilled. However, in 2010, the Affordable Care Act changed a few things, benefited, and solved some of the healthcare insurance issues. If more states expand their Medicaid plans under the Affordable Care Act, more people would be able to obtain Medicaid.

Reference

ADDIN ZOTERO_BIBL {"custom":[]} CSL_BIBLIOGRAPHY Important Aspects and Characteristics of the US Healthcare System | National Institute of Health Policy. (n.d.). Retrieved from https://www.nihp.org/important-aspects-and-characteristics-of-the-us-healthcare-system/

Response Paper

Food Security

[Author Name(s), First M. Last, Omit Titles and Degrees]

[Institutional Affiliation(s)]

Author Note

[Include any grant/funding information and a complete correspondence address.]

Food Security

With the time passage, our priorities have changed from natural food including healthy and organic food to fast food and the fast-processed food products available in the market. These food products are available in the market for cheaper prices and are available excessively which people consume daily.

The food security is the availability of and access to food products in the market. Individuals are considered as food secure when they have access to food, and they do not starve for food and that food is sufficient, nutritious, and safe for the consumers. Over the past years, the food production and eating patterns have been changed; the vegetables are replaced by the burgers and the organic juices are replaced by the cold drinks. These patterns of eating have changed to non-organic food products and these products can be easily accessed in the market. The producers and the industrial sectors have evolved and made an impact on the decision-making ability of people to choose nutritious food and drinks.

The food products which we consume are unhealthy and they are not nutritious the fast foods available in the market have caused death because of their unhealthy supplies of products like burgers which had E. coli. Realizing, after watching the movie, it can be said that food that we eat is harmful to us and our body mechanism but still people like me would choose these food products because of lack of time and the higher prices for organic food in the market. We have to understand the food chain and food production because the meat which we consume has been processed but unhealthy processing. The meat sometimes is infected by bacteria and viruses, but we are not changing our priorities, however, the government has started an initiative to highlight food processing and food regulations. The safe can be introduced in the market if the government bans all the inappropriate technologies and means of food productions.

Response Plan For Three Intervention Scenarios

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Response Plan for Three Intervention Scenarios

Your Name (First and Last)

Institution or School name

Response Plan for Three Intervention Scenarios

Emergency scenarios and medical related issues are discussed every single day in our lives. These emergencies can be of different capacities and can be related to anything. The scenarios are different and medical units are trained to handle any kind of task or emergency at hand whether they are nurses, doctors or team workers.

Introduction

Analyze the ideas and information that is gathered and give a main view point about the topic being discussed and how it matters in our daily life routine.

Thesis Statement

Emergencies can be of any kind medical staff is required at every spot to deal with emergencies and at school, skilled nurses play a vital role to look into emergencies that students might face (Winland-Brown et al., 2015). Some students might require special attention and might suffer from various diseases. In these circumstances, nurses or medical staff provide all the basic facility to deal with these emergencies.

Change Theory

How the nurse will identify the situation and how the situation will be handled after planning out the proper treatment for the student

Strategies and rationale

For scenarios that are related to emergencies, the leadership I think suits best if the situational leadership. I will match this leadership with the situation at hand and make the leadership work and provide positive results.

Expected Outcome

Using the leadership style, the results will be positive. How my leadership will affect the situation and how it will make things easy for the whole medical staff and how the students will feel about it

Professional Standards

How students react to the professionalism showed by the nurse will depict the skills and understanding of the scenario that the nurse comprehended.

Emergency Unit Scenario

Introduction

How hospitals work and what staff is generally doing at the hospital How emergencies are declared and who are responsible for the work.

Thesis statement

At hospitals, the medical staff is completely busy working and collaborating with each other to tackle the trickiest of the situation. The main thing is communication and leadership and how the senior level management is working with the lower grass root level workers (Burke, 2017). Emergencies are very common at the hospitals and great deal of experience can be gathered.

Change theory

The gathering of information by looking the scenarios that is present at hand, how the nurses and doctors will respond to that emergency and how the results will come out to be

Strategies and rationale

Servant leadership will be suitable as all the directions and decision will be given to each and every worker. In this case all the nurses. This will make team work in a dire situation easy.

Expected Outcome

With the leadership selected, the outcome can come in both ways but what I will strive for is a positive feedback from the selected leadership.

Professional Standards The training of the nurse will allow the readers to critically assess her capability.

Office Emergency Scenario

Introduction

Provide the work environment of a typical office and how an emergency can occur. The scenario meets the required standard and evaluate all the information that is present at hand.

Thesis Statement

Our daily life routine is continuously evolving and rapidly growing (Plummer et al., 2017). Nurse staff

Change Theory

The situation discovered and called upon by an employee and after that what steps were taken by the office workers to report the emergency to the medical unit How the medical unit reached and apprehended the given situation

Strategies and Rationale

Situational leadership is best suited for this emergency scenario.

Expected Outcomes

If the emergency is told on time, then the outcome will come out in my favor.

Professional Standards

The knowledge the nurse will have, make the situation better or worse will depend on the nurses professionalism.

References

Winland-Brown, J., Lachman, V. D., Swanson, E. O. C. (2015). The newcode of ethics for nurses with interpretive statements(2015) practical clinical application, Part I.Medsurg Nursing,24(4), 268-272.

Burke, W. W. (2017).Organization change Theory and practice. Sage Publications.

Plummer, P., DeWolf, M., Bassok, M., Gordon, P. C., Holyoak, K. J. (2017). Reasoning strategies with rational numbers revealed by eye tracking.Attention, Perception, Psychophysics,79(5), 1426-1437.

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2

RESPONSE PLAN FOR THREE INTERVENTION SCENARIOS

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Response To Audrey

Response to Audrey

Felisha Jones

[Institutional Affiliation(s)]

Author Note

Response to Audrey

As part of the healthcare community, I found the National Academy of Medicine (NAM) and the American Association of Colleges of Nursing (AACN) setting new trends in healthcare research. Both organizations you refereed are working great at expanding research in nursing. I think the nursing profession needed such robust organizations that should raise awareness about pressing issues in nursing and healthcare, and as well as fund projects that are aimed at highlighting new findings in medicine and health-related issues. You rightly pointed towards the publications of the National Academy of Medicine (NAM), but I believe that the programs they run about Health and Nursing are equally beneficial as well. I had been through their website many times, and have explored their programs, which I found academically rich, in terms of their content ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"yzvnhKRQ","properties":{"formattedCitation":"(Home n.d.)","plainCitation":"(Home n.d.)","noteIndex":0},"citationItems":[{"id":415,"uris":["http://zotero.org/users/local/8reWiRZH/items/G7FE9SY5"],"uri":["http://zotero.org/users/local/8reWiRZH/items/G7FE9SY5"],"itemData":{"id":415,"type":"webpage","container-title":"National Academy of Medicine","language":"en-US","title":"Home","URL":"https://nam.edu/","accessed":{"date-parts":[["2020",1,18]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Home n.d.). NAM had been working to highlight new trends in incubation services and it is also supporting, young nurses under a program named Emerging Leaders in Health and Medicine Program ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"VP9J78UT","properties":{"formattedCitation":"(Publications n.d.)","plainCitation":"(Publications n.d.)","noteIndex":0},"citationItems":[{"id":417,"uris":["http://zotero.org/users/local/8reWiRZH/items/PKE7R2DF"],"uri":["http://zotero.org/users/local/8reWiRZH/items/PKE7R2DF"],"itemData":{"id":417,"type":"post-weblog","container-title":"National Academy of Medicine","language":"en-US","title":"Publications","URL":"https://nam.edu/publications/","accessed":{"date-parts":[["2020",1,18]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Publications n.d.).

American Association of Colleges of Nursing (AACN) has an academically rich structure as well. The AACN works to incorporate new findings related to healthcare and nursing, which have been introduced in other parts of the world. Among the organizations related to the nursing profession, the AACN is quite different in scope. The faculty development programs of AACN like the Nursing Residency Programs and programs related to quality and safety education in nursing are extremely rich with respect to course content. I just found that between 2010 and 2014, the AACN conducted a faculty development program that was a part of the QSEN initiative at a national level ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"tKage03n","properties":{"formattedCitation":"(About AACN n.d.)","plainCitation":"(About AACN n.d.)","noteIndex":0},"citationItems":[{"id":418,"uris":["http://zotero.org/users/local/8reWiRZH/items/AFHLGND2"],"uri":["http://zotero.org/users/local/8reWiRZH/items/AFHLGND2"],"itemData":{"id":418,"type":"webpage","title":"About AACN","URL":"https://www.aacnnursing.org/about-aacn","accessed":{"date-parts":[["2020",1,18]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (About AACN n.d.). They are also working on establishing weblink based learning mechanisms that will foster distance learning in healthcare. Both these organizations have changed the course of learning new concepts in nursing and health care, which is exceptional.

References:

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY “About AACN.” https://www.aacnnursing.org/about-aacn (January 18, 2020).

“Home.” National Academy of Medicine. https://nam.edu/ (January 18, 2020).

“Publications.” National Academy of Medicine. https://nam.edu/publications/ (January 18, 2020).

Response To Erica

Response to Erica

Felisha Jones

Institutional Affiliation(s)

Author Note

Response to Erica

Response to Erica’s Post

The discussion highlights an important topic that the role of nurses is unique and critical for the healthcare sector. The reflection is correct that nurses who advocate for the better health condition of their patients can potentially also advocate for bringing positive changes in the existing policies. The discussion revealed the reason a nurse should choose to be a lobbyist or an advocate as priority. The nurses spend a lot of time with patients and they understand the required changes better. The nurses closely observe the facilities provided to patients, issues of health care systems and the urgently needed changes. This is the reason the decision and policy makers should concentrate on the reviews, suggestions, and complaints of the nurses. As they experience the issues on a daily basis. It is important to understand that if the nurses don’t raise voices about the issues that they or patient face every day, they will not be able to convey them to authorities or make changes. Only those who have competing interest will be sharing their views ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"i5B8y4tf","properties":{"formattedCitation":"(Oestberg, 2013)","plainCitation":"(Oestberg, 2013)","noteIndex":0},"citationItems":[{"id":"YNKhpGD0/OoBOYiKR","uris":["http://zotero.org/users/local/YgsdZK9k/items/YZUQD7FP"],"uri":["http://zotero.org/users/local/YgsdZK9k/items/YZUQD7FP"],"itemData":{"id":956,"type":"article-journal","abstract":"An abstract is unavailable.","container-title":"Nursing2020 Critical Care","DOI":"10.1097/01.CCN.0000429392.92546.6f","ISSN":"1558-447X","issue":"3","language":"en-US","page":"48","source":"journals.lww.com","title":"Getting involved in policy and politics","volume":"8","author":[{"family":"Oestberg","given":"Fredrik"}],"issued":{"date-parts":[["2013",5]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Oestberg, 2013). Nurse can understand the influencing of policing on the health sector quickly and evaluate the outcome of the policing ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"rg8rm2Kg","properties":{"formattedCitation":"(Arabi et al., 2014)","plainCitation":"(Arabi et al., 2014)","noteIndex":0},"citationItems":[{"id":"YNKhpGD0/vATVU1rB","uris":["http://zotero.org/users/local/YgsdZK9k/items/YJJX6BRB"],"uri":["http://zotero.org/users/local/YgsdZK9k/items/YJJX6BRB"],"itemData":{"id":953,"type":"article-journal","abstract":"Nurses’ influence on health policy protects the quality of care by access to required recourses and opportunities. This is a new and important concept for nursing; however, research studies on policy influence of nurses in health care sector are ...","container-title":"Iranian Journal of Nursing and Midwifery Research","issue":"3","language":"en","note":"PMID: 24949073","page":"315","source":"www.ncbi.nlm.nih.gov","title":"Nurses’ policy influence: A concept analysis","title-short":"Nurses’ policy influence","volume":"19","author":[{"family":"Arabi","given":"Akram"},{"family":"Rafii","given":"Forough"},{"family":"Cheraghi","given":"Mohammad Ali"},{"family":"Ghiyasvandian","given":"Shahrzad"}],"issued":{"date-parts":[["2014",6]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Arabi et al., 2014). Thus, they should come forward as the advocate or lobbyist to raise the concerns. Clearly, the nurses are the most important personnel when it comes to advocating or lobbying for betterment of healthcare sector. Nowadays, there are several nursing organizations that have legislative department. The role of the legislature department is to provide problem analysis as well as guide the nurse about communication for nursing advocacy ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"Ep5lpJMG","properties":{"formattedCitation":"(Abood, 2007)","plainCitation":"(Abood, 2007)","noteIndex":0},"citationItems":[{"id":"YNKhpGD0/5l9abgNS","uris":["http://zotero.org/users/local/YgsdZK9k/items/6M6A9CG8"],"uri":["http://zotero.org/users/local/YgsdZK9k/items/6M6A9CG8"],"itemData":{"id":958,"type":"article-journal","abstract":"Nurses are well aware that today’s health care system is in trouble and in need of change. The experiences of many nurses practicing in the real world of health care are motivating them to take on some form of an advocacy role in order to influence a change in policies, laws, or regulations that govern the larger health care system. This type of advocacy necessitates stepping beyond their own practice setting and into the less familiar world of policy and politics, a world in which many nurses do not feel prepared to operate effectively. Successful policy advocacy depends on having the power, the will, the time, and the energy, along with the political skills needed to ‘play the game’ in the legislative arena. This article describes the role of the nurse as health care policy advocate, identifies the power bases available to nurses as they assume that role, discusses the policy process in the legislative arena, and presents strategies for effective action. A list of selected online resources is included to help readers learn more about shaping and influencing future health policy.","container-title":"The Online Journal of Issues in Nursing","issue":"1","title":"Influencing Health Care in the Legislative Arena","URL":"http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume122007/No1Jan07/tpc32_216091.aspx","volume":"12","author":[{"family":"Abood","given":"Sheila"}],"accessed":{"date-parts":[["2020",1,31]]},"issued":{"date-parts":[["2007"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Abood, 2007). The observation is valid if the nurses do not convey their issue sot authorities and policymakers, it is not possible to bring a change by merely realizing the issues. The nurses are being provided with opportunity to advocate and they should avail it.

Response to Megan’s post

This discussion is based on the role of nurses and NLN as advocates of healthcare system. The nurses have been advocating since the early ages. In the past, there were exceptional examples of nurses who empowered themselves to better the healthcare system. They archived this milestone through forming policy suggestions, varying or vetoing proposals presented by others, and considerably influencing the execution of healthcare policy. From those great examples, today’s nurses are motivated to step up and advocate for the necessary and positive modifications in exiting policies, legislation and regulations which directly or indirectly impact the healthcare system. The advocacy or lobby role requires background knowledge, preparation, and experience; however, it does not require anything apart from anything that nurse gains from daily routine. It is important that nurse and patient care centered policies are formed which help integrate higher standards for healthcare systems. There are many leading nursing organizations which encourage the active participation of nurses when a policy is formed ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"aVlX64UE","properties":{"formattedCitation":"(Institute of Medicine & Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine, 2011)","plainCitation":"(Institute of Medicine & Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine, 2011)","dontUpdate":true,"noteIndex":0},"citationItems":[{"id":"YNKhpGD0/4eagwuXR","uris":["http://zotero.org/users/local/YgsdZK9k/items/A34LHVD5"],"uri":["http://zotero.org/users/local/YgsdZK9k/items/A34LHVD5"],"itemData":{"id":962,"type":"book","abstract":"The Future of Nursing explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned in the Affordable Care Act (ACA) enacted this year. Nurses should be fully engaged with other health professionals and assume leadership roles in redesigning care in the United States. To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates. Furthermore, regulatory and institutional obstacles -- including limits on nurses' scope of practice -- should be removed so that the health system can reap the full benefit of nurses' training, skills, and knowledge in patient care. In this book, the Institute of Medicine makes recommendations for an action-oriented blueprint for the future of nursing.","ISBN":"978-0-309-15823-7","language":"en","note":"Google-Books-ID: LbN9wvTx7CwC","number-of-pages":"700","publisher":"National Academies Press","source":"Google Books","title":"The Future of Nursing: Leading Change, Advancing Health","title-short":"The Future of Nursing","author":[{"family":"Institute of Medicine","given":""},{"family":"Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine","given":""}],"issued":{"date-parts":[["2011",3,8]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Institute of Medicine & Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing at the Institute of Medicine, 2011). Several specialty nursing and state nursing administrations offer policy fellowships and internships ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"fpweH5Ft","properties":{"formattedCitation":"(Hofler, 2006)","plainCitation":"(Hofler, 2006)","noteIndex":0},"citationItems":[{"id":"YNKhpGD0/tkCeK5VA","uris":["http://zotero.org/users/local/YgsdZK9k/items/I99VXHI8"],"uri":["http://zotero.org/users/local/YgsdZK9k/items/I99VXHI8"],"itemData":{"id":960,"type":"article-journal","abstract":"This article describes the experience of a nurse leader engaged in a state Health Policy Fellowship instituted in North Carolina by the North Carolina Center for Nursing (NCCN). This Health Policy Fellowship is designed to provide a focused practicum in major aspects of state-level health policy with emphasis on the role of the nurse leader. The program design includes exposure to experienced mentors with diverse areas of focus to learn from observation and interaction. This article describes the experience of a state Health Policy Fellow and includes discussion of understandings derived from interacting with key state stakeholders in the health policy arena and pearls of wisdom from the policy fellowship experience.","container-title":"Policy, Politics & Nursing Practice","DOI":"10.1177/1527154406290910","ISSN":"1527-1544","issue":"2","journalAbbreviation":"Policy Polit Nurs Pract","language":"eng","note":"PMID: 16864631","page":"110-113","source":"PubMed","title":"Learning from the best: the benefits of a structured health policy fellowship in developing nursing health policy leaders","title-short":"Learning from the best","volume":"7","author":[{"family":"Hofler","given":"Linda D."}],"issued":{"date-parts":[["2006",5]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Hofler, 2006). It is true that National League for Nursing raises awareness and advocates in favor of policies of healthcare sector. NLN has designed a toolkit for nurses, students studying nursing, and educators to them about different levels of authorities and government for policy making.

The healthcare experts and the nurse leaders are of view that the responsibility to point out the healthcare issues lies with the nurses. Any healthcare system is built to facilitate the patients and nurses serve as a pillar for these institutions. They realize and understand the healthcare which is affordable as well as good quality for people from all social classes. Thus, there is a need that all nurses take active leadership roles in policy formation sector of healthcare ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"69jV3BaT","properties":{"formattedCitation":"(Ferguson, 2001)","plainCitation":"(Ferguson, 2001)","noteIndex":0},"citationItems":[{"id":"YNKhpGD0/nzu7qCws","uris":["http://zotero.org/users/local/YgsdZK9k/items/35IQSNP8"],"uri":["http://zotero.org/users/local/YgsdZK9k/items/35IQSNP8"],"itemData":{"id":964,"type":"article-journal","abstract":"Health care delivery systems are evolving and transforming rapidly. Nurses will need new leadership and policy skills to meet the challenge of ensuring patient care safety and quality health care delivery. Nurses bring a unique perspective to health care policy development because of their educational training, professional values and ethics, advocacy skills, and experiential background. Significant progress has occurred over the years toward advancing nursing's presence, role, and influence in the development of health care policy. However, more nurses need to learn how to identify issues strategically; work with decision makers; understand who holds the power in the workplace, communities, state and federal level organizations; and understand who controls the resources for health care services. In health care policy development, nurses are essential in ensuring quality health care that is accessible and affordable for all women and their infants. More nurses need to actively work as leaders in the health policy arena.","container-title":"Journal of obstetric, gynecologic, and neonatal nursing: JOGNN","DOI":"10.1111/j.1552-6909.2001.tb01575.x","ISSN":"0884-2175","issue":"5","journalAbbreviation":"J Obstet Gynecol Neonatal Nurs","language":"eng","note":"PMID: 11572536","page":"546-551","source":"PubMed","title":"An activist looks at nursing's role in health policy development","volume":"30","author":[{"family":"Ferguson","given":"S. L."}],"issued":{"date-parts":[["2001",10]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Ferguson, 2001).

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Abood, S. (2007). Influencing Health Care in the Legislative Arena. The Online Journal of Issues in Nursing, 12(1). http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume122007/No1Jan07/tpc32_216091.aspx

Arabi, A., Rafii, F., Cheraghi, M. A., & Ghiyasvandian, S. (2014). Nurses’ policy influence: A concept analysis. Iranian Journal of Nursing and Midwifery Research, 19(3), 315.

Ferguson, S. L. (2001). An activist looks at nursing’s role in health policy development. Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN, 30(5), 546–551. https://doi.org/10.1111/j.1552-6909.2001.tb01575.x

Hofler, L. D. (2006). Learning from the best: The benefits of a structured health policy fellowship in developing nursing health policy leaders. Policy, Politics & Nursing Practice, 7(2), 110–113. https://doi.org/10.1177/1527154406290910

Institute of Medicine, & Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine. (2011). The Future of Nursing: Leading Change, Advancing Health. National Academies Press.

Oestberg, F. (2013). Getting involved in policy and politics. Nursing2020 Critical Care, 8(3), 48. https://doi.org/10.1097/01.CCN.0000429392.92546.6f

Response To Stevie

Title page

Response

I like the post of Stevie because he has discusses the goals and role of healthcare institutes. I agree that the central goal of hospitals is to offer care to the people by adopting effective healthcare model. However maintaining financial stability is also very important for these institutes. Efficient management of finances and budget is important for running healthcare institute CITATION Joa12 \l 1033 (Pynes & Lombardi, 2012). I agree that integration of business principles assist healthcare institutes in enhancing quality of care. The healthcare providers need to focus on the needs of the patients and respond to the ones with worse conditions more immediately. This can help them in saving their lives by responding on time CITATION Mon13 \l 1033 (Montefiore, 2013). This also requires reducing the wait time spent by the patients in emergency. The principle reflects giving education to the nurses and staff for adopting the right strategies. The first principle is thus focused on training staff for using resources appropriately.

I agree with Stevie that the second principle for improving the healthcare model is managing employees. Building strong and reliable employees is crucial for the success of hospitals. This requires for the institutes to retain experienced and skilled staff. I think hiring the right people for different jobs must be matched according to the skill sets. I agree that the third principle is managing customer expectations CITATION Fra121 \l 1033 (Maurer & Smith, 2012). In the current period healthcare institutes have become more customer-centered due to increased competition in the industry CITATION Joh112 \l 1033 (Westbrook, Rob, Woods, & Parry, 2011). Provision of high quality service is thus crucial for staying in the healthcare industry.

I strongly agree with Stevie that the hospitals and clinics must adopt business principles for attaining competitive advantage. This allows institutes in management of resources, staff and facilities more appropriately. These three are best principles that can be implemented for attaining the model of high quality care.

References

BIBLIOGRAPHY Maurer, F. A., & Smith, C. M. (2012). Community/Public Health Nursing Practice: Health for Families and Populations (Maurer, Community/ Public Health Nursing Practice) 5th Edition . Saunders.

Montefiore. (2013). Anuual Report. Montefiore.

Pynes, J. E., & Lombardi, D. N. (2012). Human Resources Management for Health Care Organizations: A Strategic Approach. Jossey-Bass.

Westbrook, J. I., Rob, M. I., Woods, A., & Parry, D. (2011). Errors in the administration of intravenous medications in hospital and the role of correct procedures and nurse experience. BMJ Qual Sa , 20 (12).

RESPONSE TO TIFFANY

Response to Tiffany

Felisha Jones

[Institutional Affiliation(s)]

Author Note

Response to Tiffany

I have explored the Joint Commission in detail as well, and the National Academy of Medicine (NAM) is also a new organization for me before I have just had the chance to explore it. I see that the Joint Commission is sorting some very important aspects of nursing. As it accredits healthcare organizations, it presents to us (the practitioners) of what aspects we need to consider before enrolling in a nursing-related healthcare institute. I understand its importance from the perspective of a new organization that is developing every day, which essentially requires a guarding body. The Joint Commission is doing that perfectly and its role has become an essential component of the healthcare field in the United States ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"AZLRC4EW","properties":{"formattedCitation":"(Johnston and Villa 2018)","plainCitation":"(Johnston and Villa 2018)","noteIndex":0},"citationItems":[{"id":421,"uris":["http://zotero.org/users/local/8reWiRZH/items/USJZBNAJ"],"uri":["http://zotero.org/users/local/8reWiRZH/items/USJZBNAJ"],"itemData":{"id":421,"type":"article-journal","container-title":"JONA: The Journal of Nursing Administration","issue":"9","page":"422–424","source":"Google Scholar","title":"Shifting Culture: A New CNO Leading to Nursing Excellence","title-short":"Shifting Culture","volume":"48","author":[{"family":"Johnston","given":"Diann"},{"family":"Villa","given":"Julie"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Johnston and Villa 2018). The JC’s research is related to new regulations being developed around the world, however, it accredits our healthcare institutions based on norms and regulations developed here ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"SoZiSclU","properties":{"formattedCitation":"(Leading the Way to Zero | The Joint Commission n.d.)","plainCitation":"(Leading the Way to Zero | The Joint Commission n.d.)","noteIndex":0},"citationItems":[{"id":424,"uris":["http://zotero.org/users/local/8reWiRZH/items/CAHIDT4F"],"uri":["http://zotero.org/users/local/8reWiRZH/items/CAHIDT4F"],"itemData":{"id":424,"type":"webpage","title":"Leading the Way to Zero | The Joint Commission","URL":"https://www.jointcommission.org/en/","accessed":{"date-parts":[["2020",1,18]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Leading the Way to Zero | The Joint Commission n.d.). I believe that there are a few other organizations with as much stature, in the world. Thus, the Joint Commission is an unmatchable institution in its frame of work.

The National Academy of Medicine (NAM), on the other hand, works over policy-related issues concerning healthcare ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"12fMmkhu","properties":{"formattedCitation":"(About the NAM n.d.)","plainCitation":"(About the NAM n.d.)","noteIndex":0},"citationItems":[{"id":423,"uris":["http://zotero.org/users/local/8reWiRZH/items/XB7KVJMV"],"uri":["http://zotero.org/users/local/8reWiRZH/items/XB7KVJMV"],"itemData":{"id":423,"type":"post-weblog","container-title":"National Academy of Medicine","language":"en-US","title":"About the NAM","URL":"https://nam.edu/about-the-nam/","accessed":{"date-parts":[["2020",1,18]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (About the NAM n.d.). You rightly noted its publication and research aspect, but I believe it is thin in choice. The narrow sense, I believe is about its vision which I don’t find that broad. Though, despite such concerns of mine, I believe it has an important role in shaping our healthcare community. It can broaden its scope and incorporate new programs about nursing, as other people have referred in their writings. Nursing, being a much comprehensive phenomenon need continuous research which should be focused over its disciplinary nature. The researches of NAM, so far of what I have gone through, are critical in nature, and is appropriate. I therefore, second your point of biasness. Both these organization’s role is critical and require continuous evolution and being part of this community, I believe we should come forward and make this system more robust.

References:

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY “About the NAM.” National Academy of Medicine. https://nam.edu/about-the-nam/ (January 18, 2020).

Johnston, Diann, and Julie Villa. 2018. “Shifting Culture: A New CNO Leading to Nursing Excellence.” JONA: The Journal of Nursing Administration 48(9): 422–424.

“Leading the Way to Zero | The Joint Commission.” https://www.jointcommission.org/en/ (January 18, 2020).

Review Of Current Healthcare Issues

Title page

Healthcare issues

I agree that stress is one of the common issues faced by nurses in healthcare settings. The institutes must take active role in creating a stress free environment for nurses. Safe patient-to-nurse ratio plays significant role in building a positive relationship between staff and patients that also works to improve their health. I agree that California and Massachusetts are two states where states have made laws for implementing nurse-patient ratios. Most of the states are lacking these rations that could undermine the quality of care. I think that the states must develop these ratios for enhancing the quality of care (Johnson, K. J., & Mutchler, 2014). Patient-to-nurse ratio stresses on setting critical care units that are based on the idea of providing efficient care without any delay. This is also focused on offering care according to the patients need.

In Pennsylvania the hospitals are not maintaining nursing staff rations. These laws focus on 1:1 nurses care which depicts the implementation of the enhanced care more (Maddox, 2000). These changes could play significant role in offering care on time. I agree that the role of nurses will also improve because they would manage to handle patients in traumatic conditions. Federal regulation has stated that the healthcare institutes must have adequate number of registered nurses that will ensure offering appropriate care with accuracy. The number of nurses impacts the quality of care (Naiddo & Wills, 2009). This improve their competency of delivering care at critical time and even when they face high turnover. Right ratio means that every patient will get response on time and nurses can save their lives. In critical care units like emergency the role o patient to nurse rations is more evident. This requires the nurses to possess adequate knowledge and skills.

References

Johnson, K. J., & Mutchler, J. E. (2014). The Emergence of a Positive Gerontology: From Disengagement to Social Involvement . The Gerontologist , 54 (1), 93–100.

L.Maddox, G. (2000). Promoting Health: Intervention Strategies from Social and Behavioral Research. Washington: National Academies Press.

Naidoo, J., & Wills, J. (2009). Foundations for Health Promotion 3rd ed. London: Elsevier.

Sheffield Unitary Authority. (2016). Protecting and Improving Nation's Health. Public Health England.

Sözeri-Varma, G. (2012). Depression in the Elderly: Clinical Features and Risk Factors . Aging Dis , 3 (6), 465–471.

Review Of A Bill

Review of a Bill

Maggie

Review of a Bill

Introduction

The state legislature on the breaks for meals and working hours is ‘Meal and Rest Periods Bill’ also known as ‘SBH 1155’. The bill concerns the overtime and excessive professional services extended by the nursing staff to ensure healthcare. The Bill establishes a prohibition on overtime by healthcare professionals that are imposed by hospitals. The bill allows nurses to refute work that surpasses their standard duty duration. This bill also limits the nursing working hours to eight hours only, it prohibits the on-call professionals from catering to regular healthcare or administrative chores within the hospital or cover shifts for absent staff. This bill also forbids the hospitals from endorsing license sanctions and terminating nursing staff on such grounds. The bill would not forbid the hospitals from imposing such working hours in emergency situations and medical procedures CITATION Sen \l 1033 (Committee).

Background

The Department of Labor and Industries by rule requires rest breaks for the employees. The rest breaks constitute for a good 30 minute between every five hours of work. However, in the healthcare practiced is not followed as such be. The nursing staff works consecutively at the risk of their job security and fatigue without rest or meal breaks, leading to medical errors and diminishing quality of healthcare delivery.

The Bill SBH1155 has been passed within both the houses. There have been committees to associating with the rework of the previous legislation that makes it mandatory for the nurses to work without any meals or rest breaks. The Bill was passed in the Senate to exempt the critical access of the regulations.

Challengesto the Legislation

The bill SBH 1155 did not need much confidence in the passing in the House as well as senate. The Senate passed it with 32 to 16 votes while the House ratified it with a vote of 70-24 votes. Issues stalling the nursing acthave been recognized as being sexist and gendered issues as highlighted by the senator Walsh who suggested that since the profession was female-oriented it lacked standing, the senator compared the issue with the pilots who face the same overtime without complaining about it. Moreover, there are grave concerns and hence the final implementation would be carried out by the end of the year 2020.

The challenges that the issues that reflect upon them are that they are incompatible with the staffing needs required. There are two different versions of the bill both in the house and the senate which makes it difficult, and hence requires it to reconcile before finally passing it into law. There are delays in the execution of bill and regulations. It needs a complete comprehension of the bill that would not leave out any aspect of nursing healthcare and delivery to the patients.

Support and Opposition for the Bill

The senators have proposed the bill I the senate which been opposed by Senator Walsh, the senator suggested that it is a female-oriented profession hence the overtime has become a concerning whereas pilots face same overtime and aren’t shown such support CITATION Bru191 \l 1033 (Lee, 2019).

The hospitals have alsopetitioned the initiatives with the exceptions where procedures would not be possible without the help of experts such as organ transplant, heart procedures, and gynecology. The Washington State hospital has raised concerns on falling short of nursing staff and hence facing the ineffective policy implementation, healthcare delivery and deteriorating quality of overall healthcare. These concerns are anticipated to be observed in hospitals CITATION Kip192 \l 1033 (Hill, 2019).

Nurses Labor standards- we will address the needs of the women to address the healthcare changes and identify the changes that are essential to the protection of health care staff. Have welcomed the initiatives by the senate. Concerns by the burses united have also reflected that the bill may be irrelevant as the hospitals may not always be able to adjust patient to nurse ratio.

Pros and Cons of Key Stakeholder

The pros of the bill will most sufficiently advance the conditions of the nursing practice. It will limit the working hours releasing the tensions of mandatory presence, license issuance, and termination. Overall the bill will aid both the nurses in practice and the patients as the quality of health care will improve.

There are a number of the challenges that would occur as the Meal and Rest periods Bill implemented. The nursing staff is will be short staff according to the hospitals, the patients may not be able to receive the care they are required. The inefficiency and untimely presence of specialist staff will lead to medical errors that will further escalate the matter of dealing with life and death especially in the rural staff where the incident reports within the hospitals are already low in ratio CITATION Kip192 \l 1033 (Hill, 2019). This will also increase the fragility observed in the finances of the healthcare which will increase the costs further.

Practice to Achieve the Highest Scope in Nursing

The bill will comprehensively empower the nursing practice, give them a sense of recognition. The efficiency of their work will effectively increase and lead to a timely finishing of work without delays. Fatigue negatively affects nursing professional practice. This would formally reduce the medical errors which were previously evident. The nurses would professionally cater to the needs of the patients with utmost dedication and honesty.

Assistive Actions by Nurses to Assist the Legislation

The nurses have resourcefully dealt with assisting the passage to encourage the assistance they have successfully mobilized into trade unions and shown unity by encouraging the legislative bill. They have been protesting in case the senate does not pass the bill. The hospitals can help in sufficiently facing lack of present staff however it can be managed by raising incentives for the staff. The consent for the availability is another aspect, hospital staff should manage to shift the mandatory policy to voluntary by raising overtime wages instead to conditioning it with rigid redundancy actions. The nurses can show commitment to profession managing within the resources effective with the help of regenerative policies, that add to the hospital quality assurance and helps in overcoming the issues that arise from eliminating the mandatory meals and rest breaks.

References

BIBLIOGRAPHY Committee, S. (n.d.). SENATE BILL REPORT, SBH 1155. Retrieved from Government of US: http://lawfilesext.leg.wa.gov/biennium/2019-20/Pdf/Bill%20Reports/Senate/1155-S%20SBR%20LBRC%2019.pdf

Damour, L. (2019, january 16). How to Help Tweens and Teens Manage Social Conflict. The New York Times .

Hill, K. (2019, April 3). Washington nurses, hospitals at odds over bill limiting overtime, requiring rest breaks. The Columbian .

Lee, B. Y. (2019, April 29). Why State Senator Walsh Said Nurses 'Play Cards For A Considerable Amount Of The Day'. Forbes .

Review Of Current Healthcare Issues

Title page

Nursing scope

Nurse practitioners have always faced restrictions by the states that impact their practice. It is important for the state to impose restrictions for promoting appropriate care. I agree that nurses cannot fulfill the healthcare standards without these laws. I also agree that nurses must develop competencies for delivering care. Robert Wood Johnson Foundations identified some of the competencies that must be possessed by all nurses. I think that the purpose of Nurse Practitioners Mobilization Act was also to safeguard the interests of the population by imposing laws that make it compulsion for nurses to develop skills.

The laws states that they need to integrate adequate methods for assessing performance of student nurse. The purpose of conducting assessment testing and measurements, as they are crucial tools for evaluating the nursing education. This allow learners to understand how things work in the healthcare settings and they manage to choose the right course of action that is in the best interest of the patients CITATION Placeholder1 \l 1033 (Seyhan & Özbaş, 2018). The evaluation relies on the relationship between the instructor and the students as improved interaction increase the understanding of the instructors regarding students learning.

These laws states that healthcare institutes must focus on building skills through practice and by offering hands-on experience. Students are allowed to work across different aspects that involve continuum of care and real-life situations. The pre-licensure grads also stresses on preparing students to take leadership roles. The courses and the teaching plan cover the areas of health assessment, adult health, mental health, pediatrics, obstetrics, pharmacology, information, research, ethics and policy. it further offer opportunities for allowing students to integrate simulation technology into value-based curriculum. Students also learn to develop critical thinking, reasoning and communication skills.

References

Johnson, K. J., & Mutchler, J. E. (2014). The Emergence of a Positive Gerontology: From Disengagement to Social Involvement . The Gerontologist , 54 (1), 93–100.

L.Maddox, G. (2000). Promoting Health: Intervention Strategies from Social and Behavioral Research. Washington: National Academies Press.

Naidoo, J., & Wills, J. (2009). Foundations for Health Promotion 3rd ed. London: Elsevier.

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