I. NURSING PRACTICE DIMENSION

PRACTICE--Designed and Implemented the Basic Quality Care Blood Pressure Teaching Plan (BPTP). This project is not demonstrating a mere demo leadership. It shows the characteristic leadership at service where the systematic and structured project is designed for the nurses as being their leader.

Issue/Problem: The delayed diagnosis of hypertension puts the patients health at risk of cardiovascular diseases.

Action: I have designed the BPTP to educate the nurses so that the outcome of the treatment improves. It was first introduced during the Nurse Education Council Committee Member meeting and was implemented at the Perry Point Primary Care Clinic/Urgent Care/Wellness Center, and every 3rd New Hire Orientation day.

Population: Nurses and Hypertension Patients.

Outcome(s): This project has been prosperous in enhancing the awareness about the measurement of the blood pressure, perceiving the symptoms early with each session.

Sustainability: This project has already been employed in the Perry Point Primary Care Unit/Urgent Care/Wellness Center and every third New Hire Orientation day. It is further going to be implemented during the nurses week American Nurses Association for CEUs Journaling as it is already published with the copyrights.

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ETHICS-- I have served in, not only recognizing the ethical issues surrounding me but also putting valuable effort into resolving it, showcasing my leadership potentials in taking appropriate action in the face of ethical dilemmas. This has made me keenly involved in anticipating an ethical issue.

Issue/Problem: Ethical dilemma of dual prescribing the Opioids, which was initially prescribed by a Non-VA.

Action: I went through his files, reviewed his charts, and contacted the NP from mental health to inform her of the patients activity. I also made a state note as it is not by the state law to dual prescribe and communicated with the patient politely about it. I have incorporated the COPA (Competency, Outcomes, and Performance Assessment) model within my project of BPTP, which promotes quality care and competence for patient safety. I have been awarded a Certificate of Integrity (2015) and Certificate of Advocacy (2016).

Population: Patients with sensitive drug prescriptions that require adequate inquiry.

Outcome(s): The patient understood and complied with the medical team.

Sustainability: Ethical measures keep the organizations integrity intact, also showcasing my priorities and abilities towards resolving ethical issues.

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RESOURCEUTILIZATION:I have not only utilized the resources but have managed, evaluated and taken actions to enhance the overall health outcome for my project, BTPT as managing and evaluating leads to effective utilization and proper implementation.

Issue/Problem: Lack of proper utilization of resources.

Action: BPTP incorporated evidence-based literature and graded using Melnyks (2016) hierarchy of evidence decision-making matrix. The guidelines of high blood pressure from the American College of Cardiology and the American Heart Association were added for synthesizing evidence of the best practices to the educational plan. A review team was set to evaluate the BPTP consisting of a nursing manager, a PCP, and an MSA using questionnaires, pretests, and a posttest was taken to measure the changes. Through this, I have created an educational teaching guide in collaboration with nursing, medicine, and AHA.

Population: Health care providers.

Outcome: Providing an in-service, post-in service audits reflects an increase in compliance rate from 40% to 80 % for accurately measuring blood pressure that is possible with effective utilization of resources in the educational endeavor of BPTP. There have been vast differences seen in the pretests and posttests scores, which shows that the project is effectively implemented. So, the operations and plans were evaluated, which assisted in letting us know about how well the resources are being utilized.

Sustainability: The resource utilization is sustainable as evidence-based literature is incorporated using the best practices of the past to the educational plan, enhancing the learning experience as well...…my BPTP Project in which I have taken several measures to ensure the improvement within the quality of care outcome. This includes developing a PI project for the BPTP that will lead towards changes in practice and utilized VAHMSC, also teaching the new nurses on and off-campus at the VA to increase their efficiency in measuring the BP and reducing errors in diagnosing.

Population: Hospitalized COPD Patients and Hypertension patients.

Outcome(s): Keeping a logbook about the patient and his weekly interactions has helped enhance the patients adherence to medications and treatment.

Sustainability: The nursing care program improves compliance with the medical team of the patients, assisting in their recovery.

RESEARCH it is essential to identify the problem and rectify it using several types of research, also making sure that it is well-implemented within the facility and the area of requirement. I have done several kinds of research for problems persisted within Healthcare and directed my expertise towards them by manifesting my leadership capabilities.

Issue/problem: Lack of Screening and patients not returning their FITKITS.

Action: I have researched on Colon Rectal Cancer and presented the work to my colleagues to make them aware of the importance of screening our veterans. I have a brown folder for my health tech that I print out every day a list from VSSC of patients who have not to return their FIT KITs. Our Protocol is to call them, send them a reminder of important letters, and last schedule nursing visits. The last being a visit with me because they need some educating on the importance of this test.

Population: Colon Rectal Cancer patients and healthcare providers.

Outcome: The patients and Healthcare have realized the importance of screening.

Sustainability: Keeping the lists and checks and follow-ups keep it more comfortable to go through the procedures and maintain knowledge about the patients, which can potentially improve the overall performance.