Safety

Safety

[Name of the Writer]

[Name of the Institution]

Safety

Fall and injury prevention is a challenging issue across hospitals in the US. In the US inadvertent falls are very common and are a major cause of severe injuries. Especially at the age of 65 and above people get injured because of the falls. Almost 41 out of 100,000 people die because of the falls. Falls and medical errors are consistent with each other. In hospitals falls happen due to technical errors, for example, placing a call light from the reach of the patient, or providing an aggressive physical therapy to the patients when even their balance has not been established (Koo et al., 2009). Another cause of falls is due to an error in the commission that is defined as the error caused by the consequences of any action taken. For instance the occurrence of falls during electroconvulsive therapy. All these medical errors cause severe discomfort which will damage the hospital's reputation.

Problem statement

In Miami hospital according to the statistics, there is a total of 10 falls per month out of 200 patients in which 6 are because of medical errors. It is a huge concern for the hospital executive authorities as this damages hospital reputation. Also, patient dissatisfaction results in major fines hospitals have to pay. So the hospital decided to use PDCA in order to reduce the falls.

PDCA

PDCA stands for plan, do check and apply the approach. This approach is used by many organizations to solve the problems they are facing and improving their standards (Johnson, 2002).

Fig: 1 PDCA cycle (https://www.google.com/search?q=pdca&source=lnms&tbm=isch&sa=X&ved=0ahUKEwjfnfGU8LbjAhXdQxUIHWhrBfkQ_AUIECgB&biw=1440&bih=789#imgrc=JC-Suca4EGthRM:)

Methodology

A stepwise scheme to decrease patients falls in the Miami hospital is proposed by using PDCA. These kinds of projects require extensive provision from the administration of the hospital. The methodology to determine the causes of falls and reducing them respectively is presented. First of all the data is collected from the hospital administration about the number of falls per month. Then the reasons for the falls are enquired. After getting complete data a plan is developed which will further be implemented to see whether it worked or not.

Step 1: Gather a quality improvement team:

Falls depends upon different factors and no specific provider solely is able to create a lasting impact on harms caused by falls. In order to reduce falls, it is important to create a quality improvement team. This team consists of an active member of both physicians and nurses that will report all their findings to the team leader. The QI team should be of at least five members. It is necessary to engage the hospital’s patient safety and quality department as they will assess the reports from the team. There is a need for high-level connectivity between the team members to ensure positive results.

Step 2: Analyzing risk factors and circumstances for falls:

It is important to examine the problem carefully by thoroughly studying the data from the database of fall incident reporting maintained by the hospital. This information will help in determining the factors involved in the falling of patients. These include circumstances involved in the fall like toilets, beds, chairs and time of the day or night. Additionally, the demographics of patients that experienced falls like their age and gender, etc.

Step 3: Selecting a pilot site:

The initial stage of the project is always critical. It is necessary that the priority of hospital leadership is patient safety and fall reduction. The first step is to select a pilot site where all the new changes and will be done. The key determinant in the project is frontline hospital staff as without their cooperation the project won’t work.

Step 4: Determining points of leverage for intervention:

With the help of frontline clinicians, the QI team can easily decide whether elements of the project will apply to all the patients or should base on individuals risk factors. Additionally, the team should look for the incongruity between the existing practice and specific evidence-based interventions that are specifically followed at healthcare institutions.

Step 5: Evaluating each element of intervention:

It is very important to evaluate multiple factors of interventions to assess the individual elements of the project. If there is any failure in the improvements it means that the elements of interventions are not applied and practiced correctly. In order to circulate intervention with the help of pilot site, it is required to document staff education and competence. This evaluation can be considered as measuring the performance of the process measures taken.

Step 6: Investigate the impact of changes:

The impact of the interventions on the rate of falls should be examined carefully. Failure to show any improvements in fall rates depends upon the staff incompetence or the data collected for assessing the situation is correct or not. If there is still a deficiency in the proposed solution then it is important to design a new approach.

Step 7: Reviewing and expanding the project:

If a project is successful in the pilot site then it should be expanded and can be slightly modified as well. It is important to consider that an intervention that is successful in one department might not show the same results in another. It is, therefore, necessary to expand slowly to meet the requirement of every department.

Step 9: Manage new baseline:

The QI team should not assume that this new intervention will always work. It is important to monitor the change regularly in order to maintain balance.

References

Koo, J., Kim, S., Kim, H., Kim, Y. H., & Yoon, E. S. (2009). A systematic approach towards accident analysis and prevention. Korean journal of chemical engineering, 26(6), 1476-1483.

Johnson, C. N. (2002). The benefits of PDCA. Quality Progress, 35(5), 120.

Sampling Methodologies

Data collection tools

[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.]

Data collection tools

Data Collection Tools or Instruments

Description of Data Collection Tools or Instruments

Questionnaire Method

One of the most effective tools is the questionnaire method for data collection. This is an arrangement of questions on a paper having suitable space available for the participants to answer. This tool is more effective when researcher need to collect data for small research, very specific and accurate answers required for research for a large population-based study ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1c26jpucse","properties":{"formattedCitation":"{\\rtf (\\uc0\\u8220{}Methods Map: Purposive sampling: SAGE Research Methods,\\uc0\\u8221{} n.d.)}","plainCitation":"(“Methods Map: Purposive sampling: SAGE Research Methods,” n.d.)"},"citationItems":[{"id":162,"uris":["http://zotero.org/users/local/ONknjWue/items/UGHV9ICP"],"uri":["http://zotero.org/users/local/ONknjWue/items/UGHV9ICP"],"itemData":{"id":162,"type":"webpage","title":"Methods Map: Purposive sampling: SAGE Research Methods","URL":"https://methods.sagepub.com/methods-map/purposive-sampling","accessed":{"date-parts":[["2019",10,5]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“Methods Map: Purposive sampling: SAGE Research Methods,” n.d.).

Interviews

This tool is used to collect data for the researches in which the researcher wants to have direct interaction with the participants. Interviews can also be done using telephones, video calls, or conference calls. Interviews may be in the form of structured, semi-structured, or unstructured based on formal, semi-formal, or informal type questions ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ad297iab94","properties":{"formattedCitation":"(Lefever, Dal, & Matthiasdottir, 2007)","plainCitation":"(Lefever, Dal, & Matthiasdottir, 2007)"},"citationItems":[{"id":166,"uris":["http://zotero.org/users/local/ONknjWue/items/3BPMD7UM"],"uri":["http://zotero.org/users/local/ONknjWue/items/3BPMD7UM"],"itemData":{"id":166,"type":"article-journal","title":"Online data collection in academic research: advantages and limitations","container-title":"British Journal of Educational Technology","page":"574-582","volume":"38","issue":"4","author":[{"family":"Lefever","given":"Samuel"},{"family":"Dal","given":"Michael"},{"family":"Matthiasdottir","given":"Asrun"}],"issued":{"date-parts":[["2007"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Lefever, Dal, & Matthiasdottir, 2007). This is the best tool for a better understanding of the interviewee.

Focus Group

A way of data collection by utilizing 10-18 members to engage in a discussion ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"amemg0c78d","properties":{"formattedCitation":"(Bretschneider, Cirilli, Jones, Lynch, & Wilson, 2017)","plainCitation":"(Bretschneider, Cirilli, Jones, Lynch, & Wilson, 2017)"},"citationItems":[{"id":164,"uris":["http://zotero.org/users/local/ONknjWue/items/2M6BCED8"],"uri":["http://zotero.org/users/local/ONknjWue/items/2M6BCED8"],"itemData":{"id":164,"type":"book","title":"Document review as a qualitative research data collection method for teacher research","publisher":"SAGE Publications Ltd","ISBN":"1-4739-5743-5","author":[{"family":"Bretschneider","given":"Pamela J."},{"family":"Cirilli","given":"Stefanie"},{"family":"Jones","given":"Tracey"},{"family":"Lynch","given":"Shannon"},{"family":"Wilson","given":"Natalie Ann"}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Bretschneider, Cirilli, Jones, Lynch, & Wilson, 2017). Participants can discuss with one another, and it stimulates a discussion on a specific topic with the help of a facilitator. This is a well-organized way of data collection, and various questions would be answered.

Observation Method

This is a tool used in research studies and is more effective in the collection of data related to everyday life. Participants would be observed for their behaviors. It includes viewing and recording the performance of persons or individuals, or the actions that happen in a specific (Draugalis, Coons, & Plaza, 2008). This is a good tool for the collection of data for the behavior’s researchers want to observe.

Document Analysis

From the literature review, document review, and diaries, to collect data is another important data collection tool ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"aeppggjsd","properties":{"formattedCitation":"(Draugalis, Coons, & Plaza, 2008)","plainCitation":"(Draugalis, Coons, & Plaza, 2008)"},"citationItems":[{"id":165,"uris":["http://zotero.org/users/local/ONknjWue/items/QWPYGG54"],"uri":["http://zotero.org/users/local/ONknjWue/items/QWPYGG54"],"itemData":{"id":165,"type":"article-journal","title":"Best practices for survey research reports: a synopsis for authors and reviewers","container-title":"American journal of pharmaceutical education","page":"11","volume":"72","issue":"1","author":[{"family":"Draugalis","given":"JoLaine Reierson"},{"family":"Coons","given":"Stephen Joel"},{"family":"Plaza","given":"Cecilia M."}],"issued":{"date-parts":[["2008"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Draugalis, Coons, & Plaza, 2008). This tool is best suitable for the researches that need a large amount of views and information for the research. Reliable sources and public researches are usually available to collect data for the research of interest ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a23u7j7qliv","properties":{"formattedCitation":"(Bretschneider et al., 2017)","plainCitation":"(Bretschneider et al., 2017)"},"citationItems":[{"id":164,"uris":["http://zotero.org/users/local/ONknjWue/items/2M6BCED8"],"uri":["http://zotero.org/users/local/ONknjWue/items/2M6BCED8"],"itemData":{"id":164,"type":"book","title":"Document review as a qualitative research data collection method for teacher research","publisher":"SAGE Publications Ltd","ISBN":"1-4739-5743-5","author":[{"family":"Bretschneider","given":"Pamela J."},{"family":"Cirilli","given":"Stefanie"},{"family":"Jones","given":"Tracey"},{"family":"Lynch","given":"Shannon"},{"family":"Wilson","given":"Natalie Ann"}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Bretschneider et al., 2017).

References

ADDIN ZOTERO_BIBL {"custom":[]} CSL_BIBLIOGRAPHY Bretschneider, P. J., Cirilli, S., Jones, T., Lynch, S., & Wilson, N. A. (2017). Document review as a qualitative research data collection method for teacher research. SAGE Publications Ltd.

Draugalis, J. R., Coons, S. J., & Plaza, C. M. (2008). Best practices for survey research reports: a synopsis for authors and reviewers. American Journal of Pharmaceutical Education, 72(1), 11.

Lefever, S., Dal, M., & Matthiasdottir, A. (2007). Online data collection in academic research: advantages and limitations. British Journal of Educational Technology, 38(4), 574–582.

Methods Map: Purposive sampling: SAGE Research Methods. (n.d.). Retrieved October 5, 2019, from https://methods.sagepub.com/methods-map/purposive-sampling

SAT Task 1

SAT Task 1

[Name of the Writer]

[Name of the Institution]

SAT Task 1

Discuss how the application of nursing-quality indicators could assist the nurses in this case in identifying issues that may interfere with patient care.

Ans. The case explained in the scenario is about Mr J who is 72 years old retired person and is diagnosed with mild dementia. The sensitive indicators of nursing includes hospital-acquired pressure ulcers, restrained use and satisfaction level of the family with overall health care facilities and nursing. These indicators encompass the care given to the patients and how it is given, procedures, policies, staffing, experience and education. These indicators also help to measure the overall satisfaction level of patients. It can lead to adverse outcomes when these indicators are not identified and understood properly. Unescessary use of restrains and development of pressure ulcer are formed due to the lack of understanding these indicators. Analyzing the justification of the patients can be observed from the situation when the patient did not receive the kosher meal and his daughter filed a complained with a physician.

There was a risk factor involved was the use of restrains when the patient developed ulcers. The causes were staff immobility in the hospital. The nurse did not have a clear understanding of the pressure ulcers when the patient was lying flat on his back. There was clearly a lack of knowledge when the nurse was repositioning him in bed and assessing his skin. If she had proper knowledge of the case then such an event would have been handled before. (Rokstad, et al, 2015)

The bed alarm or sitter could have been used instead of restraints Or allowing him to move independently in bed which would have controlled the development of pressure ulcers. But the facility did not consider other other option and used restraints as an alternative. The daughter of the patient wasn’t satisfied with the services provided by the hospital because restraints have caused more injury. Corrective actions should be taken by the hospital management in this case to solve the problem. The hospital or health care industry should maintain the knowledge level of the staff to prevent such cases.

Analyze how hospital data of specific nursing-quality indicators (such as the incidence of pressure ulcers and prevalence of restraints) could advance quality patient care throughout the hospital.

Ans. These hospitals measure certain problem patients face such as pressure ulcers or falls and nurses play the primary role in addressing these issues. The national database of quality indicators is the database of nursing on the national level that provides annual and quarterly reports of outcomes, process and structure (Montalvo, 2007). This data helps to improve the quality of care in the health care industry. These reports are used to evaluate the nursing unit of the health care industry. If there is an increased number of occurrences then the hospital management should make interventions to reduce the number. When the intervention is made by the management of the hospital then it would make them able to know the outcome of interventions by analysing the collected data. When interventions to reduce the occurrence of pressure or falls it would make new policies for the hospital which would improve the quality of health care services.

Another sensitive indicator of nursing is to analyse the satisfaction level of the patients. As Mr Family was not satisfied from the services of the hospitals. The patient was served with a kosher meal instead of cutlet. His family wasn't even aware of the occurrence but when the nurse was questioned by his daughter and she realized that they aren’t sensitive enough to take proper care of his father. The hospital in that scenario has already experienced several complaints and was noticed by the administrator and the physician. These occurrences needed intervention because it would have lost the member patients from the Jewish community. The nurse, in this case, should offer a heart-life apology to the patient family to keep their trust and that of the patient. They should provide an assurance to the families about preventing these issues from reoccurring. If there is an electronic way of record keeping of application it would make them able to understand the needs of the patient and complete the process correctly without any errors.

Analyze the specific system resources, referrals, or colleagues that you, as the nursing shift supervisor, could use to resolve an ethical issue in this scenario.

Ans. In the health care industry, the nurses can serve the leading position by learning the skills of leading, managing and following. From the patient care to the development of policy requires the more active involvement of those nurses. Nurses should learn the skills of emotional intelligence as well to deliver high-quality health care services to the patients. Leading and managing require proper education and understanding of the health care system which should also be the priority for the policymaker. (Pozgar, 2019). In the scenario, there was the ethical issue which needs to be addressed by the supervisors from the nursing section of the night shift. The first case occurs when pressure ulcers were developed and the certified Nursing assistant failed to appropriately address that. A team should have been made to conduct an educational program to the staff for handling the problem of pressure ulcers. And the physician who ordered the restraints should have been contacted for appropriate use in necessary conditions. The wound care team can collect the data of subsequent development of pressure ulcers and use of restraints. The staff made the mistake of serving the wrong diet food to a patient in the scenario, As the diet included a kosher meal and the patient had a serving of Pork meal. In that case, the physician would have been contacted for more information about complaints. To handle the situation well the nursing staff could have contacted the administrator of the hospital instead of contacting a kitchen supervisor.

The daughter of the patient was not informed about the dietary mistake made by the worker I the dietary section. And she was inadvertently informed by one of the worker in the dietary section in the next day. The valuable resources in the hospital are the ethical team which can be consulted in this scenario to educate the staff and teach them how to address these problems.

References

Montalvo, I. (2007). The national database of nursing quality indicators (NDNQI®). OJIN: The Online Journal of Issues in Nursing, 12(3), 112-214.

Pozgar, G. D. (2019). Legal and ethical issues for health professionals. Jones & Bartlett Publishers.

SAT Task 3

Organizational Systems and Quality Leadership

Task 3, SAT1-0517/1217

Lissangela Rivera

Western Governors University

Healthcare Financing

This template is intended to be used for task 3 for SAT1-0517/1217.

Please follow the task instructions and rubric in the course of study in responding to these prompts.

A1. Country to Compare

The healthcare systems of many developed countries today are faced with similar challenges yet have developed and adopted different strategies and policies to address them, in which some are more successful than the other in terms of relative performance for a particular aspect of healthcare. In this paper, some differences between the healthcare systems of the U.S. and the UK will be discussed in terms of their quality, access, and other factors governing their overall efficiency in providing care to their respective populations.

A1. Access

In the United States, access to healthcare is complex and fragmented. A range of insurance coverage options, private and public, are offered with varying coverage to citizens, children, the retired or the unemployed. The Affordable Care Act was passed in 2010 to address some of these inefficiencies and aimed to provide affordable and high quality health care options to individuals, employers and the government. Individual states and the U.S. federal government jointly finance the Medicaid program that offers medical coverage to qualified lower income families, pregnant women, children and the disabled. The CHIP Program was developed for children and their families that are not covered by Medicaid. Those who are not covered by insurance, such as the unemployed or senior citizens are offered plans through an insurance marketplace system. Those who are above the age of 65 or are retired are eligible for the Medicare program, whereas the unemployed can buy coverage from the marketplace CITATION Mar99 \l 1033 (Baribault & Cloyd, 1999).

In contrast, the healthcare system is run by the UK government through taxation. The ‘National Health Service’ (NHS) is a universal and free healthcare system that provides coverage for individual citizens as well as the retired, the unemployed, or children. Healthcare services are delivered free of cost by the NHS, while offering senior or retired people the same access as any other individual. Public hospitals, local health programs and clinics deliver healthcare to both the unemployed and the uninsured CITATION Pat15 \l 1033 (Kimuyu, 2015). Moreover, different health care institutions are situated in urban as well as country areas, while the income of an individual does not generally determine the type of healthcare access or coverage they are provided.

A2A. Coverage of Medications

Most healthcare plans within the U.S. healthcare system cover medication, although the extent of coverage can vary among states and the type of coverage. Some private insurance plans cover prescription drugs though shared costs in the form of annual deductibles and co-payments. In the Medicare plan, prescription medication is covered if individuals have registered themselves for an additional plan, whereas medication is covered entirely by the Medicaid plan, without incurring shared costs. In the UK, the NHS provides certificates and vouchers that individuals can use to obtain medication. Prescriptions can be purchased through annual, monthly or single vouchers, which however, depends on the prescriptions required per month. Different health and social care services provide coverage for unemployed citizens which includes prescription medication costs CITATION Jes18 \l 1033 (Glenza, 2018). Nevertheless, the overall system in the U.S. is more expensive for an average citizen compared to the British NHS, since it depends heavily upon the type of insurance coverage they have, which ultimately determines how much they are required to pay.

A2B. Referral to See a Specialist

Some forms of insurance coverage in the U.S. health care system require referrals while some do not. Although, there is no restriction with regards to choosing a specialists’ or a physician’s services in the free-for-service insurance program, however any referrals to specialists needs a prior referral by the primary care provide, in certain plans. Similarly, in the UK, a referral to see a specialist requires the approval of a general practice physician. Moreover, because the number of available specialists can be limited, therefore it can take longer for a patient to be able to see a specialist, especially in the case of an elective or a non-emergent procedure.

A2C. Coverage for Preexisting Conditions

Pre-existing medical conditions are generally not covered by the NHS in the UK, unless a certain time-period has lapsed. The application process is easier and quicker since it does not require any medical questionnaire to be filled, and additionally, providers are encouraged for lower premiums by the systemCITATION Ass17 \l 1033 (Assistant Secretary for Public Affairs, 2017). In the U.S. the different plans offered in the insurance marketplace generally include coverage for pre-existing conditions, regardless of whether the condition occurred before the coverage plan was initiated. The client cannot be rejected by the insurer and the rates cannot be increased exclusively on grounds of pre-existing health conditions post-enrollment. Medicaid, CHIP, and other plans all follow the same direction. However, if the individual changes his or her insurance plan, then treatment may be declined on account of the precondition clause.

A3. Finance Implications for Healthcare Delivery

The different systems governing healthcare in the U.S. and the UK have contrasting financial implications. For instance, the 15% of the U.S. economy’s GDP is spent on healthcare but according to many, it does not achieve a good value for money. Comparatively, the NHS is regarded to be a generally improved system in terms of the number of care providers, facilities and services available. One factor behind the higher cost of healthcare in the U.S. is to reimburse private health insurance and drug companies with profits, and thus healthcare providers are usually more willing to carry out expensive treatments. In contrast, UK’s healthcare system encourages doctors to select a more cost-effective solution in order to fulfill budgetary requirements. Although, the U.S. healthcare system is expensive, as a result of the premiums collected by insurance companies, healthcare providers are able to recommend better and more costly treatments in spite of higher expense. Moreover, doctors and nurses are also compensated better. There are generally no waiting lists to commence treatment. Nevertheless, the coverage depends highly on one’s individual circumstances and the phase of life an individual is in. For the uninsured, paying healthcare bill through cash can be highly expensive, and more elderly citizens are worried in the U.S. about healthcare in comparison to the UK CITATION Rob03 \l 1033 (Blendon, Schoen, DesRoches, Osborn, & Zapert, 2003). The UK’s healthcare system has its own drawbacks, such as cost-benefit analysis of treatments and often long waiting lists for specialized treatment, however, it offers British citizens a greater value for money by providing equitable and a more comprehensive coverage, with a healthcare expense of only 6% of the economy’s GDP. Nevertheless, inefficiencies exist within the system since a competitive market with a profit incentive does not exist. Both systems have been developed with a different framework in mind, owing to their country’s individual circumstances and criteria which leads to contrasting approaches to achieve quality of care.

References

BIBLIOGRAPHY Assistant Secretary for Public Affairs. (2017, January 31). Pre-Existing Conditions. Retrieved February 9, 2019, from Health Care Services UK Government: https://www.hhs.gov/healthcare/about-the-aca/pre-existing-conditions/index.html

Baribault, M., & Cloyd, C. (1999, July 26). Health Care Systems: Three International Comparisons. Retrieved February 9, 2019, from Stanford: Ethics of Development in a Global Environment (EDGE): https://web.stanford.edu/class/e297c/poverty_prejudice/soc_sec/health.htm

Blendon, R. J., Schoen, C., DesRoches, C., Osborn, R., & Zapert, K. (2003, June). Common Concerns Amid Diverse Systems: Health Care Experiences In Five Countries. Health Affairs, 22(3), pp. 106-121. Retrieved from https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.22.3.106

Glenza, J. (2018, March 13). Sky-high prices of everything make US healthcare the world's most expensive. Retrieved Febraury 9, 2019, from The Guardian: https://www.theguardian.com/us-news/2018/mar/13/us-healthcare-costs-causes-drug-prices-salaries

Kimuyu, P. (2015). In search of the perfect health system (1st ed.). London: Macmillan Education Palgrave.

Scenario About Critical Decision Making

A scenario about Critical Decision Making

[Name of the Writer]

[Name of the Institution]

A scenario about Critical Decision Making

Consequences of Failure to Report

When it comes to Critical Decision Making in healthcare and nursing, there are certain things that should always be kept in mind. For starters, the decision made should always be in light of the Hospital or Clinic's policies and vision. It is evident that every healthcare organization prioritizes it's patient's health and safety. Mike the lab technician's scenario is very clear. He has been coming late for quite some time and has been warned by his supervisor that another late will lead to termination.

Mike is the sole provider for his newborn and wife, and he cannot afford to lose the job. In light of the scenario, Mike is late again even though he left 20 minutes earlier from his house (Kon, Davidson, Morrison, Danis, & White, 2016). He gets caught up in the traffic because of an accident on his way to the hospital. When Mike reaches the hospital on the last minute he is faced by an ethical dilemma. He notices a spill on the floor on his way to his department. Upon looking at the spill he contemplates that whether he should report it or let the concerned department deal with it. He is amid a tough situation since he has already been given a warning by his supervisor about the termination. If Mike stays back and reports the spill, chances are that he will not be able to reach on time. However, Mike takes the hard decision of ignoring the spill and prioritizing his family.

By looking at the case it is obvious that either reporting or avoiding to report both have negative consequences for Mike. If he makes the decision of reporting the spill there is a high possibility that he will be late again, but if he does not report the spill there is indeed a chance of someone slipping and hurting themselves. However, Mike’s failure of not reporting the spill leads to a patient falling and getting hurt. The patient ends up getting badly hurt and might even have a broken hip. Now Mike is facing a dilemma in which he has to make a confession that he failed to report the spill which led to the patient getting injured, this can lead to direct termination.

The fact that Mike failed to report the spill has led to a negative impact on the facility. His ignorance has led to a patient falling, which is quite costly in terms of both the hospital resources and time (Kon, Davidson, Morrison, Danis, & White, 2016). Other than that, there is a negative impact on the patient as he/she got injured. The injuries have resulted in extended hospital stay, decreased the independence of the patient and further has raised depression and created a fear of falling.

Impact of Failure to Report

Mike’s failure of reporting ended up causing an overall negative impact. He initially thought that the decision will only be impacting him but it affected every facet involved. By not reporting the incident the safety of a patient was compromised. It is a priority to keep a patient safe since a patient injury or fall can have an impact on both the sufferer as well as the healthcare facility. Apart from the negative impact on the patient, the healthcare facility will be facing an issue in regards to finances as well. It is obvious that if an almost recovered inpatient faces an injury due to the facility’s fault, it will be liable to nurse back the patient back to health on its own expense (Stiegler, & Gaba, 2015). A prediction of the CDC further makes the picture clearer. They have forecasted that the whole cost of injuries caused by falling will rise up to 67.7 billion by the year 2020. This fact puts fall injuries in the list of 20 most costly medical conditions.

Adding to the negative financial impact that a patient fall or injury can bring to a healthcare facility, there are legal issues that can surface as well. The patient might sue the healthcare facility for its carelessness. If the patient decides to sue the healthcare facility it will further lead in the usage of resources and various expenses. Further, legal actions do not go unannounced or unnoticed. If an individual takes legal action against a healthcare facility it will also bring about negative publicity with it, which will further bring a decrease in the facility's satisfaction scores and ratings. Once a facility gets bad publicity that too of a legal nature, the effects stick for quite some time (Stiegler & Gaba, 2015). Word of mouth further damages the reputation of the clinic and it takes years to build the patient trust and restore the image of the facility. Additionally, the working staff will also be impacted by the patient's fall. They will be burdened with the extra workload, since the nurses will have to do added assessments and monitoring, added occupational and physical therapy, added radiology tests, added ortho consults and finally added case management.

The Role of the Manager

The event that has been described by the scenario serves as an opportunity and example for the leaders to further guide their staff so such mishaps can be avoided. Being Mike's manager the first thing that will be done is to use the management and evidence-based leadership to help motivate the workers. It is a fact that employees who are more involved harvest better outcomes. The employees can only get more involved if they are satisfied and productive. Before the manager takes a decision it is necessary he/she reflects on Mike's scenario thoroughly (Reichenpfader, Carlfjord & Nilsen, 2015).

After getting a clearer picture of the stance, the manager also needs to gain knowledge in regards to Mike’s job description, inclusive of salary and schedule, evaluations and the previous staff that he has worked with. This step is necessary as it will help the manager figure out if there are any environmental factors that are causing job dissatisfaction for Mike and making him appear late for work every day. It is essential that the manager also takes rounds and have a session with the staff to make sure that everything is in check. When taking these sessions the manager should try to have one on one session with all staff members. In these sessions, the managers should discuss both professional as well as the personal life of the worker, asking them about their family and life. This will give the manager an insight into the staff member's life and help them see what triggers the employees to work.

In Mike’s case, he has a newborn baby. This can be a significant factor that he is not getting a full night's sleep and is unable to wake up early on time for his shift. The manager should give some penalty to Mike so he does not fail to report again, but his job should stay secure (Reichenpfader, Carlfjord & Nilsen, 2015). His shift timing can be changed so he can raise his child as well as provide for his small family. It is a small yet effective step. The punishment will help show other employees carelessness will not be ignored but if there are certain personal factors they will be catered to.

Conclusion

The scenario mentioned above is indeed a reality and are recurring in the world of healthcare. Managers or leaders are responsible to make sure that all the workers working under them are satisfied so they are able to give there 100% to the patients. The implementation of management and evidence-based leadership helps ensure that there is a connection between the employee and the leader, further, it helps harvest sustainability in the workplace.

References

Kon, A. A., Davidson, J. E., Morrison, W., Danis, M., & White, D. B. (2016). Shared decision making in intensive care units: an American College of Critical Care Medicine and American Thoracic Society policy statement. Critical care medicine, 44(1), 188.

Stiegler, M. P., & Gaba, D. M. (2015). Decision-making and cognitive strategies.

Reichenpfader, U., Carlfjord, S., & Nilsen, P. (2015). Leadership in evidence-based practice: a systematic review. Leadership in Health Services, 28(4), 298-316.

SCHOLARLY ARTICLE

Scholarly Article

[Writer]

[Institution]

Scholarly Article

Decision making for nurses in their evidence-based practice (EBP) is a very essential thing in health delivery systems. This practice can be made more effective in introducing patient preferences in it. Healthcare delivery in EBP means when a sound balance is kept between the scientific data and individual preferences of the patients. The main purpose of the study is to find out how good nurses maintain effective relationships with their patients considering patient preferences. It also suggests how this knowledge helps them in making decisions to provide quality care. This study is based on qualitative design, data collection, and analysis along with participant observation based in the Netherlands ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"U5W4Exsj","properties":{"formattedCitation":"(Den Hertog & Niessen, 2019)","plainCitation":"(Den Hertog & Niessen, 2019)","noteIndex":0},"citationItems":[{"id":229,"uris":["http://zotero.org/users/local/OnfrXiA2/items/UN5V83YY"],"uri":["http://zotero.org/users/local/OnfrXiA2/items/UN5V83YY"],"itemData":{"id":229,"type":"article-journal","title":"The role of patient preferences in nursing decision‐making in evidence based practice: excellent nurses’ communication tools","container-title":"Journal of advanced nursing","author":[{"family":"Den Hertog","given":"Ria"},{"family":"Niessen","given":"Theo"}],"issued":{"date-parts":[["2019"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Den Hertog & Niessen, 2019).

Findings of this study suggested that the individual preferences are imperative in maintaining careful coordination among nursing care and patient norms and preferences. Nurses need to remain in contact with their patients regularly. Three types of communication tools were found out that nurses use to attend to their patients. First is making a click with the patient, in which they make a connection with them within few minutes by physical contact on their hands or legs to show affection, a little humor or any kind gesture. This click helps the patients to open up with their nurses and make communication easier. The second strategy is monitoring the behavior of the patients and the response of the nurses. Nurses use their intuitions and sense the patient's feelings towards any treatment. The last tool is asking emphatic questions from the patients about their feelings and assessment of the situation. It helps nurses to inspire the patients and make them anticipate the progress ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"edqQPVWC","properties":{"formattedCitation":"(Al Danaf et al., 2018)","plainCitation":"(Al Danaf et al., 2018)","noteIndex":0},"citationItems":[{"id":230,"uris":["http://zotero.org/users/local/OnfrXiA2/items/H7QS9QX9"],"uri":["http://zotero.org/users/local/OnfrXiA2/items/H7QS9QX9"],"itemData":{"id":230,"type":"article-journal","title":"Surfacing and addressing hospitalized patients’ needs: Proactive nurse rounding as a tool","container-title":"Journal of nursing management","page":"540-547","volume":"26","issue":"5","author":[{"family":"Al Danaf","given":"Jad"},{"family":"Chang","given":"Bickey H."},{"family":"Shaear","given":"Mohammad"},{"family":"Johnson","given":"Kristine M."},{"family":"Miller","given":"Sandra"},{"family":"Nester","given":"Lynda"},{"family":"Williams","given":"Amy W."},{"family":"Aboumatar","given":"Hanan J."}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Al Danaf et al., 2018). Another interesting finding is that nurses take out time from their busy schedules to interact with their patients.

This study can prove to be significantly useful in improving health delivery in evidence-based practice. It is important to understand the value of the patient-nurse relationship and how it can affect the quality of care. The methods mentioned in this study used by nurses to interact with their patients should be implemented more often. I believe considering the patient preferences and maintaining open interaction with them can boost confidence in them and make the care process efficient. More studies like this should be conducted to validate the findings.

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Al Danaf, J., Chang, B. H., Shaear, M., Johnson, K. M., Miller, S., Nester, L., … Aboumatar, H. J. (2018). Surfacing and addressing hospitalized patients’ needs: Proactive nurse rounding as a tool. Journal of Nursing Management, 26(5), 540–547.

Den Hertog, R., & Niessen, T. (2019). The role of patient preferences in nursing decision‐making in evidence based practice: Excellent nurses’ communication tools. Journal of Advanced Nursing.

Scholarship And Nursing Practice

Title page

Scholarship and Nursing practice

Day 3 week 6

I have selected the article CITATION Rob171 \l 1033 (Kok & Reynolds, 2017) pertaining to my practice area of depression. The topic is of particular interest to me because I want to become professional healthcare provider. The article highlights the interventions for preventing depression in the primary care. I am also interested in the topic because stress is one of the critical health problem faced by older people in the current world settings. It is thus important to identify methods that a professional nurse can adopt for preventing depression among patients.

I retrieved the article from Walden University database. I did not find any such difficulty in finding the article. I entered the keywords ‘depression and nursing. A list of 25 articles were opened. Then I chose the most relevant ones that were suitable for the topic. This allowed me to choose the 5 most relevant articles that identifies nursing role in preventing depression and interventions for providing them adequate care CITATION Mar153 \l 1033 (Bruce, 2015).

The database will be useful for the colleagues because it is credible and provide adequate information on depression. Young healthcare providers who are aiming to specialize in mental health issues would gain meaningful information. This will provide information about the challenges that a healthcare professional face in treating depressed patients CITATION ELL06 \l 1033 (Kathleen, 2006).

I would recommend this database to the other healthcare professionals who are working in at hospitals and clinics. This is because they would be able to learn about the interventions and ways of treating depression in patients CITATION Hil92 \l 1033 (Peplau, 1992). The database provides credible information that will enhance their knowledge and allow them to adopt adequate measures for maximizing care and welfare. I would also recommend this database to the professionals so they could manage to commit fewer errors CITATION Alb11 \l 1033 (Ranheim, Kärner, & Berterö, 2011).

References

Bruce, M. L. (2015). CARING FOR DEPRESSION IN OLDER HOME HEALTH PATIENTS . J Psychosoc Nurs Ment Health Serv , 53 (11), 25–30.

Kathleen, E. L. (2006). Depression Care for the Elderly: Reducing Barriers to Evidence Based Practice . Home Health Care Serv Q , 25 (1), 115–148.

Kok, R. M., & Reynolds, C. F. (2017). Management of Depression in Older Adults . JAMA , 317 (20), 2114-2122.

Peplau, H. E. (1992). Interpersonal Relations: A Theoretical Framework for Application in Nursing Practice. Sage Journals, Vol 5, Iss 1 .

Ranheim, A. E., Kärner, A., & Berterö, C. (2011). Eliciting reflections on caring theory in elderly caring practice . Int J Qual Stud Health Well-being , 6 (3).

SCHOLARSHIP AND NURSING PRACTICE

Title page

Nursing practice and scholarship

Week 4 | Part 4: Research Analysis

I have identified one topic of interest for further study. I have researched and identified one peer-reviewed research article focused on this topic and have analyzed this article. The results of these efforts are shared below

Step 1: Research Analysis

Complete the table below

Topic of Interest:

Improving patient care

Research Article: Include full citation in APA format, as well as link or search details (such as DOI)

Babiker, A., Husseini, M. E., Nemri, A. A., Frayh, A. A., Juryyan, N. A., Faki, M. O., et al. (2014). Health care professional development: Working as a team to improve patient care. Sudan J Paediatr, 14 (2), 9–16. DOI: PMC4949805.

Professional Practice Use:

One or more professional practice uses of the theories/concepts presented in the article

The article stresses on the concepts of team-based health care stating that the professionals must be able to work in collaboration with the patient. The concept of teamwork depicts that high quality care can be attained through effective team. The article highlights the collaborative care model that is crucial for enhancing health of the patients.

Research Analysis Matrix

Add more rows if necessary

Strengths of the Research

Limitations of the Research

Relevancy to Topic of Interest

Notes

Provides adequate evidence about the effectiveness of team-based work (Babiker et al., 2014).

Limited sample size is considered for the study.

Team-based work and collaborative model leads to improved patient care.

Professional care provides must learn to work in team and collaborative environment.

Qualitative methods are used that include direct experience of patients (Entwhistle et al., 2010).

Limited sample size that targets small population only.

Collaborative care is linked to the topic of improved patient care.

Nurses must learn the significance of collaborative care.

The article used credible sources for explaining the significance of nursing informatics. Empirical evidence is used for supporting findings (McGonicle et al., 2014).

Possibilities of implicit bias.

Nursing informatics have positive impact on healthcare outcomes as it eliminates chances of errors.

Informatics can be used by nurses to improve their competency.

Use of qualitative data provides real-time experiences (Meekeer, 2002).

Limited sample size that targets small population only.

Patient-centered care leads to improved quality of care.

Patient-centered care engage patients.

Qualitative methods. Use of evidentiary sources (Wachter, 2010).

Limited sample size.

Collaborative environment is effective positive healthcare outcomes.

Collaborative care is suggested as improved care model.

Step 2: Summary of Analysis

My approach to identify and analyze peer-reviewed research was to find sources that provides information on the methods for attaining enhanced healthcare. The keywords used for finding appropriate articles include ‘team-based nursing practice’, ‘enhanced patient care’, ‘collaborative care’. I used Google scholar for finding credible sources.

The resource that I intend to use in future is (Babiker et al., 2014) because it stresses on the need for team-based work. It also stresses on the values and ethics including honesty, humility, creativity, curiosity and discipline. The value of honesty is required for transmitting the accurate information and taking action that is in the best interest of the patient. Honesty improves the commitment of professional nurses. Creativity allow patients to tackle problem more conveniently. The concept of effective communication states that it leads to better health outcomes.

References

Babiker, A., Husseini, M. E., Nemri, A. A., Frayh, A. A., Juryyan, N. A., Faki, M. O., et al. (2014). Health care professional development: Working as a team to improve patient care. Sudan J Paediatr, 14 (2), 9–16. DOI: PMC4949805.

Entwistle, V. A., Carter, S. M., Cribb, A., & McCaffery, K. (2010). Supporting Patient Autonomy: The Importance of Clinician-patient Relationships. J Gen Intern Med, 25 (7), 741–745.

McGonigle, D., Hunter, K., Sipes, C., & Hebda, T. (2014). Why Nurses Need to Understand Nursing Informatics. AORN Journal, 19.

Meeker, W. Q. 2002. “Reliability: The Other Dimension of Quality.” ASQ Statistics Division Newsletter 21 (2): 4–10.

Wachter, R. 2010. “Patient Safety at Ten: Unmistakable Progress, Troubling Gaps.” Health Affairs 29 (1): 165–73.

Scholarship And Nursing Practice

Scholarship And Nursing Practice

[Name of the Writer]

[Name of the Institution]

Scholarship And Nursing Practice

The videos that my classmate watched have given them a comprehensive understanding of the principles of writing scholarly and professional articles. It has been learned that there is a considerable amount of difference between professional and scholarly writing. While professional writing is based on diversified experience, scholarly writing focus on incorporating facts and figures that are evidence-based (Lillis & Curry, 2006). Furthermore, professional writing ranges from writing emails to letters to diversified articles (William, 2019). On the other hand, scholarly writing is purely based on evidence (Lillis & Curry, 2006). Additionally, scholarly work is free from biases because academic audience demands evidence, not opinion or biases (Lillis & Curry, 2006).

While searching for a scholarly work on diabetes on the Walden Library, my classmate was redirected to Google Scholar. Google scholar is a database that is host to millions of scholarly works published around the world (Schmetzke, 2001). My classmate found the user interface of Google Scholar to be interactive as well as friendly. However, what my classmate has concluded is that Walden library is friendlier to use than Google Scholar.

The article that had been selected by my classmate focuses on Type 2 diabetes. There are two cases faced in Type 2 diabetes. Either the pancreas does not produce sufficient insulin or the body develops immunity against the insulin (Black, Markides & Ray, 2003). There can be multiple reasons for Type 2 diabetes. However, excessive weight and lack of healthy activities are the biggest factors (Black, Markides & Ray, 2003). According to the report published in May 2019 by the Center for Disease Control and Prevention, there are more than 30 million Americans afflicted from diabetes (Jillien & Kevin, 2008). Various studies have proven that prediabetics is a precursor to Type2 diabetes. Additionally, controlling prediabetics has been found to only delay the Type 2 diabetes (Jillien & Kevin, 2008). Making significant changes in personal life and medications have proved to delay Type2 diabetes. Lastly, the Behavioral Risk Factor Surveillance System carried out a study which found that there is a strong relationship between low income and demographics with Type2 diabetes.

References

Black, S. A., Markides, K. S., & Ray, L. A. (2003). Depression predicts increased incidence of adverse health outcomes in older Mexican Americans with type 2 diabetes. Diabetes care, 26(10), 2822-2828.

Jillien, L., & Kevin, F.. (2008). Effects of intensive glucose lowering in type 2 diabetes. New England journal of medicine, 358(24), 2545-2559.

Lillis, T., & Curry, M. J. (2006). Professional academic writing by multilingual scholars: Interactions with literacy brokers in the production of English-medium texts. Written communication, 23(1), 3-35.

Schmetzke, A. (2001). Web accessibility at university libraries and library schools. Library hi tech, 19(1), 35-49.

William, A. (2019).Academic and Professional Writing. Essayacademia.com. Retrieved 10 July 2019, from https://essayacademia.com/academic-and-professional-writing.php

Scholarship Essay

Scholarship Essay

[Name of the Writer]

[Name of the Institution]

Scholarship Essay

My interest in nursing sparked when I was in my early childhood visiting my grandfather who was admitted in a hospital. My grandfather was fighting with cancer as I watched him struggling for his life. We went to the hospital every day in the morning and leave in the evening. Several nurses were dedicated to looking after him the whole day. The nurses even stayed with him when we were not there. The nurses showed care, compassion, and empathy for my grandfather. This attitude at the display from the nursing staff proved an impetus to my interest in nursing. For this reason alone, I opted for a professional degree in healthcare and nursing. I aim to become a full time registered professional nurse once I complete my degree. I aim to look after the patients with the same compassion and empathy with which my grandfather was treated in his last days. Currently, despite holding to a job, I am faced with some financial difficulties due to which I might not be able to conclude my degree successfully. However, receiving a scholarship would assist me financially and enable me to complete my education. The scholarship would help me with attaining my long term goal of becoming a full-time nurse. My long term goal is aimed to become a specialized nurse and help patients in the hardest battles of their lives (Kooken & Hopkins, 2016). So far in my degree, I have been a shining student. Apart from winning numerous extracurricular distinctions, I have maintained the highest grades in my class throughout the degree. This scholarship would be a source of motivation to further pursue my education with more passion. Certainly, the skills and experiences gained throughout the degree would assist me in the effective provision of healthcare services to the patients in need.

References

Kooken, W. C., & Hopkins, A. F. (2016). Creating a Collaborative Academic Culture for Successful Scholarship in Nursing Faculty.

School Work

School Work

[Name of the Writer]

[Name of the Institution]

School Work

Introduction

The nursing improving care for healthy system elders which is pronounced as “nitch” is a program based on the helping hospitals and organizations of healthcare to improve the services for senior citizens. There is an evidence based practices that include the management and prevention of urinary incontinence, adverse medication events, pressure ulcers falls and delirium. Through the practical steps and evidence based works nurses have the opportunity to improve their practice and advance the system of health care delivery. A plan of action is essential for the APRN practice and it is based on certain principles as for how the health care practioners will move for intervention of older age adults. To meet the standard of practice there is a professional development plan which is a confidential document and it will maintain the competence to satisfy patients.

Discussion

There would be search for law to recognize the practice, its viability and acceptance from the concerned organization. The laws of states are governing the practices vary and these act according to the rules followed by certain area. After carefully reviewing the Nurse Practice Act along with the advisory letters and related documents, they will move for reasonable steps to deal with the patient. Through the massive information and knowledge one can effectively move from novice to expert (Montgomery et al., 2016). Declining medical workforce and the increased demand for the adaption of roles by each nurse will enhance services and works of medication. Importance of professional identity is again important because it defines the roles and actions taken by the concerned professional. A patient can be deal under the group of nurses for learning and obtaining diverse experience from each other. There would not be any societal level of influence as it will negatively affect the person under treatment.

Before starting and intervening the person, nurses can educate their client about the coming plan of action and how they will treat the patient. It is because of the fact that the curiosity of patient will be reduce and he or she will satisfied accordingly ((Montgomery et al., 2016). The needs and goals of the patient will be satisfied according to the demands or the ones that are describe in their responsibilities. There will be a time frame for the treatment and it will also follow the assessment of person to know that how the intervention process is going on. The specific, measurable, attainable, and attainable and the realistic nature of objectives can be achieved through a progressive plan which must be followed by nurses in an accurate way. There would be review of the cases that are tackled by the nurses previous to their action for current patient.

The in-service education and the training for the nurses would be highly beneficial and it designed a line of action for them to tackle the patient accordingly. Further the use of instruments should be good enough to intervene a person in a professional way. Nurses or the hospitals should not have need of borrowing the instruments from other sources. It would be a discrimination or unfair practice that a hospital has no tools or devices. The improved understanding of the principles for using the tools would be beneficial. The staff must try to deal the patient separately to satisfy them at optimum level (Willson et al., 2017). Some individual have the concern that why APRN practice is important and considerable in dealing the patients. Various reasons are mentioned by the authors and medical professionals who have increased experience reflect that these measures are taken due to shortage of staff and physicians.

Nurses can fill the gap in absence of professionals. There is no substitute found for constant monitoring and managing the patient in a proper way. In general it happens that senior medical staff does not care much about the patient safety and well-being. There should be someone who could replace the duty (Willson et al., 2017). Certain emergency cases also contribute for the members who are working in the primary and related staff in dealing with the patient effectively. Same is the case in the plan where nurses will have optimized communication and it will be improved through the constant relationship with senior medical professionals like physicians and doctor. Further the process of recruitment and hiring new nurses or other staff will be evaluated during the interview. If someone have any issue regarding the placement of duty, jobs and description of responsibility it will be catered accordingly. Such facility will enhanced the trust of working with the particular health care center and hospital.

For the satisfaction of patients it is very important to address the grievances of nurses for fair distribution of work load and efficient services. There are some nurses who have to face the problems of unemployment and join the service on the strict policy of organization. Now the candidate has to face certain hardships how she can be able to serve the older adults in an adequate manner (Willson et al., 2017). Forcing the staff would not provide significant result for favoring the patient rather it is the facilities and reduction in difficulties. Maximum level of encouragement and positive dissemination of information can be shared with staff during the interview. After the appointment at the position of APRN expert, there will be certain barriers that could hinder the services and positions of the person at respective stage.

Administration personnel or the staff allocated with the APRN always create troubles for distribution of services in an appropriate manner. First of all there would be proper explanation of responsibilities for those who are appointed against their concerned positions. What is need is that everyone should perform his/her works in line with organization strategy and plan of action for optimum level of patient satisfaction. It is not possible for a single APRN to work and ensure all that is required by the customers. The complex nature of health care system should be change because nurses cannot have the power to approach every element that is based for reducing the challenges (Wheeler & Schumann, 2018). One of the major challenge is the lack of proper training and education where medical staff could have the ability to understand issues and problems being faced by the patient. Certain admitting privileges after the admission of patient hinder the service and coordination of APRN to meet the criteria of merit. Everyone should be treated in accordance with the ethical codes and principles that are designed to act accordingly. There should be career advancement opportunities for a nurse to serve effectively.

Conclusion

Concluding the discussion the program for “nitch” is the best tool to address issues and challenges confronted by the patient. The plan of action is based on evidence based practices that include the management and prevention of urinary incontinence, adverse medication events, pressure ulcers falls and delirium. Through the practical steps and evidence based works nurses have the opportunity to improve their practice and advance the system of health care delivery in a professional manner. The plan will not only be beneficial for the people of United States but it will also ensure the culture of advance action for the early recovery of ill-health person. A number of examples reflect that we must be careful about the health of close relative because there is no fast-track system which could work during emergency conditions of patients.

References

Montgomery, K. A., & Byrne, S. K. (2016). How Doctoral-Level Advanced Practice Roles Differ from Master’s-Level Advanced Practice Nursing Roles. DNP Role Development for Doctoral Advanced Nursing Practice, 113.

Wheeler, K. J., & Schumann, L. L. (2018). GLOBAL HEALTH: DYNAMIC ROLES FOR THE APRN/ADVANCED PRACTICE NURSE. Advanced Practice Nursing Roles: Core Concepts for Professional Development, 81.

Willson, P., Lee, S. K., & Poole, M. (2017). Advance Practice Registered Nurses'(APRNs') Clinical Practice Strategies to Deter Antibiotic Overuse.

Scin 4

Initial discussion post

Submitted by

Affiliation

Date

Discussion post

Inflammation is a powerful protective process through which our immune system works. In trauma, special pattern recognition receptors with inflammatory cytokines stimulate the production of immune cells, which, in turn, lead to a number of physiological processes - such as dilation of blood vessels, increasing their permeability, accumulation of leukocytes and plasma at the site of injury, increasing the number of pain receptors.

Modern pathophysiology and general pathology state: "Inflammation is a typical phase-developing pathological process formed in the process of evolution and arising in response to local tissue damage." Currently , inflammatory processes are studied at the cellular and molecular level, which requires a “clarification of the relationship” between inflammation and immunity - two forms of protection of the body against any foreign agent that has penetrated it

(Deretic & Klionsky, 2018).

Inflammation includes a number of well-known external signs and microstructural changes. The former include edema, pain, hyperemia, local or systemic rise in temperature, dynamic changes in the structure and function of the damaged organ. The second group includes an exudative-vascular reaction, migration of leukocytes to the inflammation center with the formation of cell infiltrates, and at the final stage fibroblasts and other cells involved in the process of post-inflammatory repair or sclerosis of damaged tissues.

The duration and severity of individual phases of the inflammatory process depends on the nature of the damage and related conditions, including the development of immunodeficiency. Despite the universality of the underlying mechanisms of inflammation in each case, the process is unique in its manifestations (Simbirtsev, 2012). The individual features of inflammation depend on its localization in various organs, the nature of the etiological factor, the phenotypic and genetic properties of the invading microorganism, the ratio of the duration and severity of individual phases and the particular mechanisms underlying it. Inflammation is not always good like last year my grandfather who is having asthma had an inflammatory cytokine that lead to an autoimmune reaction to the respiratory mucosa.

References

Deretic, V., & Klionsky, D. J. (2018). Autophagy and inflammation: a special review issue.

Simbirtsev, A. S. (2012). Cytokines as a new system, regulating body defense reactions.

Cytokines and Inflammation, 1, 9-16.

Scjolarship And Nursing Practice

Scholarship and Nursing Practice

[Name of the Writer]

[Name of the Institution]

Scholarship and Nursing Practice

With so much research publishing every day, it is highly important to find a credible source for searching something of interest which may be a topic, a paper, an article or a chapter or full book. Walden Library is one of the credible sources that I have ever come across. The most convenient aspect of the library is it is easily accessible through the students’ portal. Beyond that, the user interface is highly user-friendly and interactive. One can easily and comfortably understand the way to search articles, databases, journals, thesis, papers, and even books or topics (Carroll, & Ginanni, 2007). In addition, it has integrated Twitter which keeps the users updated about new developments and updates. It (Walden Library) has also kept users informed about the upcoming webinar for students to further enhance and increase their knowledge.

Geeti used Ebsco database for searching topic of her interest which was titled “Entrust-able Professional Activities in Nurse Practitioner Education” and she found the scholarly conveniently with facing no huge difficulties while searching and getting the article from the database, instead she got full access to the article (Carroll, & Ginanni, 2007), but it is an undeniable fact that many students (a large number of students) are not familiar with the Ebsco database and the way it works. As well as most of the students (who are not familiar with the database) face huge difficulties while searching or accessing the topic or article of their interest (Research Guides, 2019).

So, based on my research and experience, I would like Geeti to use Google Scholar for searching topics or work of her interest (Giglia, 2011). It has been recommended because Google Scholar is the most famous resource which provides most relevant results if you type only a single word or few related words while you would not be required to type the entire or full topic or title (Heather, 2010). Additionally, it facilitates the users to search completely based on their needs as well as it includes articles of even all fields (Enago, 2014).

References

Carroll, J., & Ginanni, K. (2007). EBSCO Publishing. Serials Review, 33(2), 145-148.

Enago, L. (2014). Why Researchers Should Use Google Scholar? Enago Academy. Retrieved 9 July 2019, from https://www.enago.com/academy/why-a-researcher-should-use-google-scholar/

Giglia, E. (2011). Academic social networks: it’s time to change the way we do research. European journal of physical and rehabilitation medicine, 47(2), 345-349.

Heather, V. (2010). Google Scholar: A Credible Database. The Clever Researcher. Retrieved 9 July 2019, from https://beryliveylibrary.wordpress.com/2010/10/21/google-scholar/

Research Guides (2019). Getting Better Results with Google Scholar: Google Scholar Advanced Searching. Uark.libguides.com. Retrieved 9 July 2019, from https://uark.libguides.com/c.php?g=78885&p=511524

Secnerio Based Clinical Leadership And Patient Care Essay

Scenario Based Clinical Leadership and Patient Care Essay

[Writer]

[Institution]

Scenario Based Clinical Leadership and Patient Care Essay

Introduction

The health care industry is transforming vigorously based on the requirements of better care services and patient safety and principles. Effective leadership is the basic necessity for achieving anticipated standards of patient safety in a health care system. Within a health care work force system, nursing leaders are required to motivate the followers to utilize their maximum potential. Leadership can be defined as the ability individuals to lead and influence others into following them towards the accomplishment of desired objectives. Strong leadership skills can ensure patient safety in a health care facility. But it is very important to understand the concept of patient safety. Patient safety culture is the outcome of some individuals’ behaviour patterns, capabilities, perceptions and commitment that determine the proficiency of health delivery and safety management. The fundamental responsibility of nursing leaders is to understand the nature and implications of components of patient safety in a health care setup.

Leadership in patient safety culture

Leadership in a health care organization has the competency to acknowledge that environment in such a setting is high-risk. Nursing leaders adjust their tasks so that they can make the health care work force competent enough to use the economic and anthropological resources to guarantee patient safety. Patient care revolves around the patients and their families and they also serve as a liaison between organization and societies. Leaders engage in designing strategies and framework that monitor the safety process and their consequences. Literature has stated that the most efficient facilitators of patient safety culture are administrative leaders (Hillege, 2014). It is suggested that the safety culture should start from the highest levels in the health care work force and then pass on to all the levels.

The health care systems work with the goals of utilizing their effective leadership for ensuring the finest global care delivery. It has now become a global urgency and different organizations and inter-professional work in collaborations to provide the effective care to the patients. In a system, where medical practitioners, researchers and policy makers all work in closed efforts for the promotion of safety culture, it cannot be achieved without nursing leaderships. A number of leadership styles are adopted for enhancing the care quality and safety in health care organizations. The well-known styles namely transcriptional, transformational and laissez-faire are used. But researchers have suggested that for achieving the superlative outcomes within an organization, transformational style is most efficient (Curtis, de Vries, & Sheerin, 2011).

Leaders that follows transformational style are preemptive and have strong influential powers over their followers in convincing them to struggle hard to achieve better results of performance. Such leaders earn high admirations and seek superiority among others. They instill inspiration and acknowledge workers for their achievements. They are optimistic about future and expressive about the aims and objectives their teams have to achieve. This style is associated with increased satisfaction of the job, staff wellbeing, less stress at the workplace and less staff turnover.

The transcriptional style of leadership involves social exchange of inflicting the authority and motivating the followers. During emergency situations, autocratic leadership proves to be the best option as leaders take decisions entirely based on their own intuitions and without asking the subordinates’ opinions. This social exchange of ideas may occur by two different methods; active management by exception or contingent rewards. Active management by exception method is used as a counteractive action style. Leaders who follow this style look into the queries when instantaneous act is necessary but this method does not guarantee the long term commitment. Leaders who adopt contingent reward strategy are unable to motivate employees in engaging and committing to the organization as there is lack of inspiration but its response is still better than active management by exception strategy. When a task is accomplished successfully, rewards are given to the employees in the form of bonuses, incentives and appreciations. But in the case of failure in achievement of the assigned task, punishments are inflicted in the form of salary deduction and in some severe cases termination may occur. Before the implementation of transformational style of leadership, transcriptional style was used in health care organizations as the most effective leadership style.

The laissez-faire style of leadership is considered as the direct opposite of transformational style of leadership. It is mainly regarded by inactive management by exception. Leaders who adopt a passive strategy in work force anticipate until the issues become quite serious before intervening. This method is followed by leaders who have to deal with a large amount of direct queries or whose employment entails them to be absent from work. This type of leadership style is professed as less effective in contrast to other styles (Merrill, 2015). In this type of leadership methodology, the employees make decisions based on their own conscience without the direction of the leaders. In the absence of leaders where patient safety is the utmost priority, nurses, consultants, researchers, educators and other employees think through together and formulate an efficient strategy (Marquis & Huston, 2015).

Nursing leaders follow a well-defined scheme to certify the patient safety in any health care related situation. In the efforts of achieving resourceful safety culture, health care work force should have three main core competencies; information related to medicine administration and medicine error, safety measurements for staff nurses and competent nursing leadership. Role of nurse leaders cannot be compromised in care management and medicine delivery while following all safety principles. The choice of leadership style is also a critical step in maintaining a profound patient safety culture.

The transcriptional and transformational styles of leadership are mainly performance based. As the focus of global health care communities is promptly on the acquisition of higher levels of safety modules, nursing staff has to face tough challenges. It is the need of the day for care giving organizations to have more flexible and adaptive styles of leadership. Authoritative leaderships are only concerned with the achievement of task and so is not much suitable for the guaranteed satisfactory results (Jurek & Scime, 2013). Laissez-faire style does not provide means for learning of advanced procedures and new methods of drug administration. But the transcriptional and transformational methods are quite dynamic and strongly believe in accomplishment of organization’s objectives through unparalleled commitment. It is very important that the leadership is very effective and responsive as staff satisfaction should be made mandatory. Studies have suggested that nurses who are contented with their leadership and the mode of authority, show more commitment towards their work and aspire high levels of professionalism. In order to attain an effective leadership, a mutual understanding among nursing scholars, educators, and managers is very essential. It also has a positive impact on patient’s response towards the health care.

Though the health care systems work with utmost commitment for the provision of patient safety but still there are hurdles in the pursuit of attaining error free safety. The main problem in such situations is the lack of proper accountability and pellucidity in the honest reporting of errors in medical practice. The hallmarks of a reliable care organizations are that possible and adverse errors be reported immediately and the safe solution be sorted out (Moller, 2013). But admitting the flaws during practice can create a serious dilemma as public has expectations with health care organizations. Coming forward and disclosing the mistakes exposes the offenders to criticism and accountability. It may also result in inciting serious disciplinary actions by the managers, regulatory authorities and legal system. Feared from these consequences, the offenders refrain from exposing themselves especially when there is no harm to patient safety. Examples like these lead to the failure of accountability system in medical community and it leaves the next patients prone to similar kind of negligence. In medical culture there should be some flexibility to understand and accept that most of the mistakes might occur because of multiple human and accidental errors instead of deliberate acts of negligence. In such capacities, nursing leaders need to play an important role for the promotion of ethical and a reliable work environment where nurses and care delivery staff feel confident in reporting such events and morally responsible.

Conclusion

Strong nursing leadership attributes and the quality of patient safety are directly proportional. Leaders need not only to have management and authoritative roles but in order to ensure the competency of their organizations, they need to understand the safe medicine practices and safety protocols. An effective leadership is essential for health care staff and patients’ satisfaction to the quality of services provided. The method of leadership matters a lot in critical decision making and achieving health safety goals. Transcriptional and transformational styles of leadership have proved to be more competent as they instill elements of motivation and commitment among their followers. Health care organizations have their own specific organizational culture as per the characteristics such as behaviour, beliefs and moral values. These attributes vary among all the individuals working in the organization. But through efficient leadership, accountability and excellence can be achieved for implementing patient safety improvement strategies.

References

Cuitis, E.A., de Vries, J., &Sheerin, F. K. (2011). Developing leadership in nursing: Exploring core factors. British Journal of Nursing 20(5), 306-309.

Hillege, S. (2014). Safety. In J, Dempsey, S. Hillege& R. Hill (Eds.).Fundermentals of nursing and midwifery: A person-centred approach to care (2nd Australian and New Zealand ed., pp. 664-683). Sydney, Australia: Lippincott William & Wilkins.

Jurek, S. &Scime, A. (2013). Achieving Democratic Leadership: A Data-Mined Prescription. Social Science Quarterly, 95(1), 97-110.http://dx.doi.org/10.1111/ssqu.12035.

Marquis, B. L., & Huston. C. J. (2015). Classical views of leadership and management. In Leadership roles and management functions in nursing: Theory and application (8th ed., pp. 33-48). Philadelphia, PA: Wolters Kluwer Health

Merrill, K. (2015). Leadership Style and Patient Safety. JONA: The Journal Of Nursing Administration, 45(6), 319-324. http://dx.doi.org/10.1097/nna.0000000000000207.

Moller, J. (2013).Leadership, Accountability, and Patient Safety.Journal Of Obstetric, Gynecologic& Neonatal Nursing, 42(5), 506-507.http://dx.doi.org/10.1111/1552-6909.12241

Self Evaluate Your Own Assessment

Self-Evaluate Your Own Assessment

[Author]

[Institution]

Author Note

Self-Evaluate Your Own Assessment

Introduction / Futurist Concept Identification

The subject of the assessment, i.e. “Healthcare and Cybersecurity” has been very well introduced, in my opinion. It not only details the issue at hand and the consequences that can occur as a result of a security breach, especially on a personal level for individuals at a healthcare facility, but the future possibilities that such a breach would entail, given the sensitivity of the issue. This introduction part is adequately described and leaves enough room for the body of the assessment so that the issue can be addressed in detail.

Body / Concept Analysis

The body of the assessment progresses in a systematic manner, which makes it easier to comprehend the issue at hand. However, while the body gives examples as to the prevalence of the subject and why it can give rise to grave consequences, most of the data presented are theoretical in nature. The issue could have been better addressed if some statistical data was incorporated into the text to understand the gravity of the situation.

The future implications of the topic of assessment are based in reality and have the potential to be extremely detrimental at best. The concept is not only fully explained, with the various nuances and the intricacies on the subject detailed. Examples have also been stated to show just how much of an impact the possible occurrence of such an event can hold. A breach of cybersecurity is a very real threat to the healthcare system, with the implication ranging from extortion, and the use of personal medical health information for things such as the illegal organ trade.

Paper Organization / Content

The language used in the paper is consistent, with the use of proper grammar and vocabulary. The paper follows APA style citations and referencing format and it has been consistently followed throughout the text of the passage. The transitions between paragraphs are smooth, although some areas can definitely use connecting verbs to make the flow of the narrative even smoother.

4 ) Conclusion / Further research

Unlike most conclusions for an assessment, the conclusion is just as strong as the introduction and works well to tie up loose ends. It goes into vivid details regarding the implication of the issue being discussed and its possible negative impacts, along with examples. Such a placement is favorable and works well.

Servant Leadership

Servant Leadership

Kris

[Institutional Affiliation(s)]

Author Note

Servant Leadership

The idea of a helping others so that they reciprocate in turn is a time-tested idea. Robert Greenleaf, however, used the idea to build a leadership model that came to be known as ‘Servant Leadership’; a model that redefined the idea of serving and leading others (Greenleaf Center, 2016). In servant leadership, leaders are expected to lead their followers carrying an inner desire to serve them, providing them with appropriate support to help them attain shared objectives. In this model, leaders simply become an agent and a messenger who represents their people. The model essentially relies on transferring authority and power over to the people instead of concentrating it into the hands of a single leader.

To become a servant leader requires that one demonstrates empathy, awareness, persuasion, listening, and most importantly, a people-centric approach. Additionally, the servant leader focusses on stewardship, conceptualization, and community building. Moreover, Greenleaf explains that a servant-leader focusses on the little beginnings at first and is not afraid of taking risks. Since they are not motivated by the acquisition of power, they can happily assume themselves to be a leader second and a servant first CITATION SLI18 \l 1033 (SLI, 2018). Consequently, a strong inclination develops within servant leaders into empathizing with people’s needs and ensuring that they are met.

There are a number of reasons why more organizations, institutions and groups have begun to embrace this model. Firstly, it helps business leaders keep their employees motivated, since the focus shifts towards the growth and welfare of every stakeholder in the organization. This occurs when the employees perceive their leader to be pursuing every opportunity in creating a difference in their lives, which in turn positively impacts their behavior.

Furthermore, servant leadership is able to enhance intra-organizational relationships and creates more servant leaders leading to the propagation of positive practices in supporting and caring for everyone. This, in turn, leads to greater job satisfaction as the model generates more team cohesion, trust, shared goals and enhanced teamwork in achieving organizational objectives CITATION Vic141 \l 1033 (Trastek, Hamilton, & Emily E. Niles, 2014). A better environment is fostered in which communication within the team is encouraged, which leads to greater efficiency and consequently reduced costs.

References

BIBLIOGRAPHY Greenleaf Center. (2016). What is Servant Leadership? Retrieved February 3, 2019, from Centre for Servant Leaership: https://www.greenleaf.org/what-is-servant-leadership/

SLI. (2018). Why Servant Leadership. Retrieved January 3, 2019, from Servant Leaership Institute: https://www.servantleadershipinstitute.com/what-is-servant-leadership-1/

Trastek, V. F., Hamilton, N. W., & Emily E. Niles. (2014). Leadership Models in Health Care—A Case for Servant Leadership. Mayo Cinic Proceedings, 89(3), 374-381.

Serving Vulnerable Populations

Serving Vulnerable Populations

[Author’s name]

[Institute’s name]

Serving Vulnerable Populations

           It is one major task for the assigned nurse to develop a comprehensive plan of opportunities for JK to ensure the proper acquisition of the healthcare community services for her. Consideration of different integrated aspects eventually helps to obtain and sustain the proper access to appropriate foods for JK by considering her health condition.

Appropriate and Realistic Estimated Budget

           Availability of healthy food is one major concern for the diabetic patient who lives in the food desert. Undoubtedly, JK has to face a huge amount of expenses to ensure the consideration of healthy lifestyle according to her health concerns. Travel cost and time costs are major indicators or aspects linked with the approach of developing an appropriate and realistic estimated budget. $75 to $120 is the estimated budget for the week that needs to apply when it comes to the application of realistic budgeting domain.

Shopping Locations

           Accessing proper shopping locations is no easy task for JK as she has to travel miles to get a grocery store. The approach of food desert locator map can be used to determine the nearest shopping location for JK. Attainment of healthy food for JK every week will not be an easy task for her that can never be achieved without the proper mechanism of transportation.

Transportation Means, Routes, and Timing

           Assuring availability of proper transportation for JK is one complex phenomenon because she is not able to drive. The viable option of bus scoring can be considered to attain better forms of transportation (Gundlach, Resch, & Omri, 2013). The routes of public transportation can be an option for weekly shopping from grocery stores.

Support Services

           Consideration of the food empowerment project is necessary to step to guarantee the availability of proper support services for the patient who is suffering from the issues of hypertension and type-II diabetes. 

Comparison of JK’s Community to County Census Data

           The approach of critical comparison reveals that food security and healthy food availability is a difficult task in the case of JK’s community as compared to people living in San Bernardino county. 

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Gundlach, L., Resch, B., & Omri, M. (2013). Food Deserts: Evaluating Grocery Stores and Bus Accessibility using GIS in Madison, Wisconsin.