Assessment Tool and Environment

Practicum Critique

Nursing Checklist Assessment Tool -- by Ivy Amoranto

Did They Include?

Pros and Cons: No -- not explicitly.

Feasibility of the project: No -- not explicitly

Viability of Implementation in Another Environment: No

Grading

Pros and cons: No explicit pros and cons present

Feasibility of the project: No explicit feasibility items mentioned

Viability of implementation in another environment: Not explicity covered but the totality of the data reflects an assessment tool and a covering thereof that is rather solid.

Three Questions: 1) Will you revisit and revise the tool as needed if it becomes apparent that something is missing, not needed or perhaps worded/displayed wrongly? 2) Do you think any single assessment tool can be properly exhaustive without being too verbose, wordy or long. 3) Are you concerned that some of the symptoms to check off are up to the subjectivity or objectivity of the patient that is being seen and/or whether the patient is unconscious and thus unable to answer health questions?

Three Discussion Points: 1) When it comes to "increasing revenues," there is perhaps a bit of an ethics problem when it comes to any sort of medical facility that focuses the least bit of effort on profits more so than quality of care, customer service, visiting with the families. 2) Discuss the idea of the government taking a harder line when it comes to profit-based care homes and other medical facilities and whether that might make a sometimes messy situation even worse. 3) Discuss the proper balance between staffing levels and a lack of efficiency when it comes to long-term care homes and the like.

Critique Two -- Fall Prevention -- by Heather King

Did They Include?

Pros and Cons: No explicit section but mentioned in passing throughout the report

Feasibility of the project: Yes...it is covered what interventions are workable and which ones are not.

Viability of Implementation in Another Environment: Yes...falls in different environments are covered.

Assignment Files: Yes

Grading

Pros and cons: There is the admission that there is a give and take when it comes to fall prevention. However, there seems to be a disconnect in that there is multiple mentions of "reducing" falls but no mention of ending them entirely, at least by the author herself. This would be because there is no surefire way to stop all falls short of having a person in each room (not feasible) or strapping people into their beds (not feasible or legal/ethical)

Feasibility of the project: Very feasible...presuming that it is admitted and understood that some falls are not preventable irrespective of the interventions employed or not employed.

Viability of implementation in another environment: Fall risks and interventions to reduce the same are obviously going to be present in many medical environments. However, it is clear that long-term care and any care for elderly or dementia-ridden patients, just to use two example, are going to be a bigger issue than any lucid adult that has his/her wits about them and/or stays in the bed as instructed by the medical staff.

Three Questions: 1) Do bed alarms cause more problems than they solve? 2) What is an acceptable fall rate per 100 patient (the answer cannot be zero...as that is not possible). 3) What interventions are more effective than others when it comes to preventing falls?

Three Discussion Points: 1) Discuss the idea that there are just some falls that cannot be prevented given that nurses cannot be in all rooms all of the time and people cannot be restrained or limited to their beds (even if they are not of sound mind due to dementia or similar disorders) 2) Discuss the interventions that would do the best for patients overall such as keeping dementia and frail patients closer to the nursing station as opposed to patients that are of lesser risk. 3) Discuss whether the broader nursing community should move to a "greenhouse" concept where rooms and such are in a circle or square orientation rather than along a series of long hallways.

Critique Three -- Optimizing Admission Process -- by Theresa Altman

Did They Include?

Pros and Cons: Yes

Feasibility of the project: Yes

Viability of Implementation in Another Environment: yes

Assignment Files: Yes

Grading

Pros and cons: The table that shows the methods/sources used for the literature review and how they all are good or bad depending on the situation is a good compare and contrast. It would seem a weakness to some to use only exterior/secondary sources but those are often the best sources of data s they are more commonly done in a scientific way. This article balances the fact that this is true and contrasts this with the idea that there are pros and cons to each type of scholarly source.

Feasibility of the project: There is absolutely merit to this project as striking a proper balance between efficacy and efficiency in a high-speed medical environment is absolutely an issue that can and should be covered.

Viability of implementation in another environment: Extremely high -- the admissions process is important to very important across the medical and nursing paradigms