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The questions on legal liability issues were minimal as the field of legal issues is new in nursing. The questions addressed a theoretical part regarding the legal liability issues. They were no need of clarification since the questionnaires were easy and self -- administrative. Although the researcher was there for assistance but telephonically.
1.7. Data analysis
In this chapter, the analysis is discussed in detail. Data was collected by means of questionnaires that were distributed in the critical care units of a private hospital group over five weeks. The questionnaires were completed and returned to the researcher. Of the two hundred questionnaires distributed, 171 were received back. This represents a response of 85%, which in view of the discussion can be rated as very good.
1.8. Layout of the study
The paper is divided into five chapters. Chapter one in generally on the general orientation of the paper while chapter…
1. ACEP Policy Statements. Procedural Sedation in the Emergency Department (2004) and Delivery of Agents for Procedural Sedation and Analgesia by Emergency Nurses (2005).
2. ACEP Clinical Policy: Procedural Sedation and Analgesia in the Emergency Department. Ann Emerg Med. (2005) Feb; 45(2):177-196.
3. ACEP Clinical Policy: Evidence-Based Approach to Pharmacologic Agents Used in Pediatric Sedation and
4. Analgesia in the Emergency Department. Ann Emerg Med. 2004 Oct; 44(4):342-377.
Director of Critical Care
Mr./Ms. X, Chief Nursing Officer
Adventist Midwest Health System
120 North Oak Street, Hinsdale, IL 60521
E: DIECTO OF NUSING III, Critical Care, Full Time (Job Number: 118447)
Dear Mr. / Ms. X:
My annexed resume is submitted for the position of "Director of Nursing III, Critical Care, Full Time, Job Number 118447." While the resume details my extensive qualifications, I appreciate this opportunity to speak pointedly about my exceptional capabilities for this position. Excellent patient care is the hallmark of my 20-year Nursing career and with or without the title of "Director," I have readily led, collaborated or followed as needed in my unflinching commitment to that ideal. As a result, in addition to the customary minimal qualifications, I possess a depth and breadth of outstanding skills that make me an exemplary candidate and I welcome 24-hour accountability to achieve system-wide excellence.
I am specifically…
Resources, Finance, Information Technology and Communications to advance programs and capably manage hospital units and resources.
I am eager to discuss my qualifications at your convenience. Meanwhile, please do not hesitate to contact me for any further information/documentation that will aid in your decision about my enhancement of Critical Care as Director of Nursing III.
Mark E. Ingold
The final question (g) of having adequate resource availability in terms of familial and financial aid I was unable to assess. I was curious if the medications she would have to take would be a burden in terms of costs, administration, or confusion with her many other treatment.
Personal reflection about visit to the CSICU
Although I was a bit frustrated I was not able to get to know Ms. X better, I thrived in the very intense and fast-paced environment. I was constantly aware of the need to closely monitor the patient, because I knew there could be and was likely to be constant change in terms of the patient's medical condition as she was still very critical and highly unstable, when she first came in from the operating room. It was very personally empowering to me to know that I had such a positive impact upon a patient's…
The AACN Synergy Model for Patient Care." (2005). AACN: American Association of Critical Care Nurses Website. Last updated Jul 2005. Retrieved on 13 Feb 2007 at http://www.aacn.org/certcorp/certcorp.nsf/vwdoc/SynModel?opendocument
Sundt, Thoraf. (2000). "Mitral Valve Replacement." STS Patient Information. Retrieved 13 Feb 2007 at http://www.sts.org/doc/4101#2
The conglomeration of BCs and platelets held together by the fibrin forms the clot. After the injury to the damaged artery heals, the clot is no longer needed. The body will then destroy the clot by breaking down the fibrin fiber network that binds the blood products together. This action is performed by a chemical called tissue plasminogen activator (TPA), which is secreted by the endothelial cells within normal blood vessels. To be strictly correct, the TPA itself does not break down the clot but instead initiates a cascade in which plasminogen is activated and becomes plasmin, with then acts on the fibrin breaking fibrin down into fibrin degradation products. The fibrin fibers are cleaved, and the clot is destroyed. All thrombolytic agents facilitate the conversion of plasminogen to plasmin and are therefore known as plasminogen activators
Indications for thrombolysis are ST-elevation in two or more contiguous leads on ECG…
American College of Cardiology Guidelines: The management of patients with Acute Myocardial Infarction: A report of the American College of Cardiology and the American Heart Association Task Force on Practice Guidelines, 2000, Bethesda, MD
Birkhead, J. (1999) Trends in the Provision of thrombolytic treatment between 1993 and 1997, Heart, 82:438-442
Boutros F, Redelmeire D. (2000) Effects of trauma on the care of patients who have chest pain in the emergency department. Journal of Trauma 48:649-663
Brownwald, H. ed. Harrison's Textbook of Internal Medicine, 15th edition 2003
Orem's Theory And Critical Care
Background- The 21st century nursing profession has a greater exposure to new technologies, methods, and techniques than any other in the past. In fact, "the use of clinical judgment in the provision of care to enable people to improve, maintain, or recover health, to cope with health problems, and to achieve the best possible quality of life, whatever their disease or disability, until death" is one of the definitions of modern nursing (oyal College of Nursing, 2003). While this is certainly the case, it is also important not to lose touch of the holistic approach -- that of advocating and caring for the patient based on their individual needs. One approach that can help the nurse manage patient care and advocacy is the theory of "Self-Care Deficit," based on the book Nursing: Concepts of Practice (Orem, 2001).
Orem found the medical care system Post-World War…
Dorothea Orem's Self-Care Theory. (2010). Current Nursing. Retrieved from:
Alligood, M. And A. Tomey. (2005). Nursing Theory: Utilization & Application. Maryland Heights, MO: Mosby.
Beretta, R. (2011). Assessment: The Foundations of Good Practice. Retrieved from: http://asheehan.brinkster.net/nursing/downloads/articles/Nursing%20Practice%20and%20Health%20care%20 -- %20Assessment.pdf
users of your curriculum? Medical Providers are the primary target user group of the Fundamentals of Critical Care curriculum.
What are their needs? Medical Providers need to continue applying relevant research to critical care practice. Ongoing support and continuing education are essential for effective, reliable, and evidence-based quality of care. Medical Providers need to make "sound and rapid clinical judgments" while under pressure and also need to "recognize and deal with the ethical issues inherent" in a critical care environment (WHO European Strategy for Continuing Education for Nurses and Midwives, 2003). Therefore, primary needs include measurably improving quality of care based on patient outcomes, and improving perceived quality of care measured by both staff and patient self-reports.
How will evaluation results be used? Global rating forms, self-assessment forms, essays on the respondent's experience, written or computer-interactive tests, oral examinations, questionnaires, individual interviews, group interviews or discussions, direct observation, and performance…
"50 CATS by Angelo and Cross," (n.d.). Retrieved online: http://vcsa.ucsd.edu/_files/assessment/resources/50_cats.pdf
Lipsett, P.A. & Kern, D.E. (n.d.). Step 6: Evaluation and feedback.
WHO European Strategy for Continuing Education for Nurses and Midwives (2003). Retrieved online: http://www.euro.who.int/__data/assets/pdf_file/0017/102266/e81552.pdf
Leadership Development Plan
As Moneke (2014) notes, the CCN certification "is a mark of excellence and a distinguishing accomplishment" (p. 77). It represents the knowledge that one, as a nurse, has and professionally uses to provide optimal level care to patients. Giving patients both the reassurance and confidence they require when receiving critical treatment and ensuring that I myself am qualified to give them the best care they can get is a top priority of mine,. Thus, my SMAT goal topic is to become a Critical Care egistered Nurse by obtaining my CCN certification.
My goal is to become CCN certified and be in a position to provide optimal quality person-centered care to patients.
I aim to achieve this goal first by obtaining the appropriate study materials for taking the exam and utilizing them to strengthen my understanding of the core assessments; I will study, practice and…
Conger, Jay A. (1989). Leadership: The art of empowering others. Academy of Management Executive, 3 (1) 17- 25.
Davis, L., Taylor, H., Reyes, H. (2014). Lifelong learning in nursing: A Deplhi study.
Nurse Education Today, 34(3): 441-445.
Kent, K. (2014). Adult CCRN Certification Review. NY: Springer Publishing.
ealth Care Theory
The Modeling and Role Modeling Theory was developed by elen Erickson, Evelyn M. Tomlin, and Mary Anne P. Swain. It was first published in 1983 in their book Modeling and Role Modeling: A Theory and Paradigm for Nursing. This theory is very pertinent in regards to the changing dynamic of healthcare currently underway. New health care laws and regulations have created a more diverse and unique set of individuals with access to healthcare. Many of these individuals, were previously uninsured, or had very limited coverage. Due primarily to new regulation, many of these individuals can now access health care. The theory enables nurses to care for and nurture each patient with an awareness of and respect for the individual patient's uniqueness. This concept is critical as individual patients, more than anytime in history, will now have unique attributes that need attention. This exemplifies theory-based clinical practice that…
How did the happenings of the nursing profession impact the origin of this theory?
The nursing professional plays an integral role in a globalized society. This is particular true in developed nations such as America and Japan. The nursing profession has undergone fundamental change reflecting the changing dynamics within the industry. For one, with emphasis on America, consumers are becoming older and living longer. The baby boomer population in particular has seen dramatic change in regards to the transition from work to retirement. The nursing profession therefore has needed to change in order to accommodate the changing needs of society with particular emphasis on the baby boomer population. As these demographic ages, they will typically become more prone to sickness or other forms of detrimental illnesses. As such, the importance of nursing in the coming years will be even more profound. Theories therefore have been impacted due to the changing occurrences within the profession (Janie, 2010).
Legislation in particular has had a profound impact on the overall nursing profession. First, due to the Affordable Care Act of 2010, the nursing profession is undergoing a fundamental shift in regards to the patient experience. As noted in the above theory. Patients will now demand a more unique experience, catering to their specific needs. A "one-size-fits-all," approach will no longer are tolerated by consumers. This will be particular true of minority patients who now have health care but who possesses differing needs. These needs have occurred primarily due to hereditary characteristics rather than behavioral characteristics. For instance, African-Americans are more prone to sickle cell anemia. However, the African-American population historically has had the highest numbers of uninsured individuals. As such, the U.S. health care system is now shifting the focus from acute and specialty care to that of primary care which requires a shift in business operations. Also, due primarily to that aging of the baby boomer generation mentioned above, the need for primary care overall is shifting to one that required individualized care. The last 10 years in particular has seen an increasing influx of retiring baby boomers that subsequently need care. A positive impact on the ACA legislation is that more
The decade-old system that specifies least standards for staffing in nursing homes need to be restructured, the report says. The U.S. Department of Health and Human Services must call for nursing homes to have at least one N within the facility during all times. Based on the departments' 2001 report to Congress on minimum staff-to-patient ratios for nursing homes, the HHS should mention the staffing levels that increased with the number of patients. Central and state report cards on nursing homes should give information on levels of nursing staff, and measuring of staffing levels should be developed for hospital report cards. The healthcare facilities should avoid using nurses from temporary agencies to fill the vacancy. (Substantial Changes equired in Nurses Work Environment to Protect Patients from Health Care Errors)
Working for long hours on the part of the nurse's makes them fatigue since it decreases their energy and reduces their…
ANA Commends IOM Report Outlining Critical Role of Nursing Work Environment in Patient Safety" (November 5, 2003) Retrieved at http://www.nursingworld.org/pressrel/2003/pr1105.htm . Accessed on 11 February 2005
Hallmarks of the Professional Nursing Practice Environment" (January, 2002) AACN White Paper. Retrieved at http://www.aacn.nche.edu/Publications/positions/hallmarks.htm . Accessed on 11 February 2005
Statement of the American Nurses Association for the Institute of Medicine's Committee on Work Environment for Nurses and Patient Safety" (September 24, 2002) Retrieved at http://www.nursingworld.org/pressrel/2002/iom924.htm . Accessed on 11 February 2005
Substantial Changes Required in Nurses Work Environment
Furthermore, one of the pillars of collaborative care that will need to be firmly established is the fostering of clear dialogue and a means for strong communication within the care management planning. For instance, there needs to be a clear decision and communication of all tests ordered and when the test results will be available. One of the most important aspects of this collaborative care will be the nursing interventions which can have significant impact on the patient's health and stabilization (Allen, 2010). In fact, strategic nursing care can even minimize readmission rates of Margaret and other patients with comparable conditions (Chen et al., 2012).
Prioritize the Nursing Care Needs of Margaret
The prioritization of nursing interventions is essential, and the way in which a nurse determines this priority is going to be something unique and distinct. "Trials reviewed demonstrated a beneficial impact of nursing interventions for secondary prevention in…
Adler, H.M. (n.d.). Toward a biopsychosocial understanding of the patient -- physician relationship: An emerging dialogue. (2007). J Gen Intern Med,22(2), 280 -- 285.
Afilala, J. (n.d.). Frailty in patients with cardiovascular disease: Why, when, and how to measure. (2011). Curr Cardiovasc Risk Rep, 5(5), 467 -- 472.
Allen, J.K. (2010). Randomized trials of nursing interventions for secondary prevention in patients with coronary artery disease and heart failure: Systematic review.
Journal of Cardiovascular Nursing,25(3), 207-220.
Issler is a patient who recently moved with his daughter-in-law who is no longer married to his son. As part of her interest in helping to take care of Mr. Issler, she noticed that he was pale and diaphoretic after a two and a half hour flight. The daughter-in-law took him to an emergency room where he was attended to by a cardiologist and set a follow-up check up for an echo cardiogram next week. Mr. Issler has complained of congestive heart failure and a history of deep vein thrombosis. The cardiologist recommended that he seeks out a primary care provider and check up of his thyroid. As the primary care provider, the patient has also expressed his uncertainties on whether he has hyper of hypo thyroidism though he has been under thyroid medication for several years. In addition to being very pale, he has a large bag of…
Bray, D.L. (n.d.). Thyroid Storm and the AACN Synergy Model. Journal of Nursing. Retrieved from http://rnjournal.com/journal-of-nursing/thryoid-storm-and-the-aacn-synergy-model
Drewes at. al. (2012, October). The Effectiveness of Chronic Care Management for Heart Failure: Meta-Regression Analyses to Explain the Heterogeneity in Outcomes. Health Services Research, 47(5), 1926-1959.
Hardin, S. & Hussey, L. (2003, February). AACN Synergy Model for Patient Care Case Study of a CHF Patient. Critical Care Nurse, 23(1), 73-76. Retrieved from http://ccn.aacnjournals.org/content/23/1/73.full.pdf
Kaplow, R. & Reed, K.D. (2008). The AACN Synergy Model for Patient Care: A Nursing
Evolution of Health Care Information Systems Physician's Office Operation
Filling in the hole of health care information technology will endorse safe, capable, patient-centered, and patient care that is fruitful in a timely way. In this essay, the theme is to look into two modern health
care organizations and then compare and contrast many characteristics that will involve the kind of evidence systems are using at the moment, investigate the transmission of information 20 years ago and how the substitute of data today. Furthermore, this essay will cover two major events and technology developments that have inclined present Health Care Informational Services practices.
Compare and Contrast Doctor's Workplace Operation
These day's doctor's office operation is familiarizing to the health care reform that was sanctioned in 2010 by the Obama organization. During sometime in October of 2013, the exchanges in health insurance was available on the market for customers on order to…
Burke, D., Wang, B., & Wan T.T.H. & Diana, M. (2009). Exploring Hospitals' Adoptionof IT. Journal of Medical Systems, 21(9), 349 -- 355.
Callen, J., & Braithwaite, J. & . (2008). Cultures in Hospitals and TheirInfluence on Attitudes to, and Satisfaction with, the Use of Clinical InformationSystems. Social Science and Medicine, 65(4), 635-639.
Finchman, R., & Kohli, R. & . (2011). Editorial Overview -- The role of IS inHealthcare. Information Systems Research, 22(3), 419-428.
Caring for ody and Soul
Critiquing Research Report
Modern nursing practice has focused more and more on treating the whole person, through four domains (Chan, 2009). These are physical, mental, social, and spiritual. Of the four, the spiritual domain is the most neglected. A retrospective study recently found that nurses with religious beliefs are more likely to extend spiritual care. The greater their spiritual perceptions, the more frequently they include a spiritual dimension to their care of patients (Chan). However, not many nurses are able to extend care in this domain.
Jean Watson's Theory of caring is applied as theoretical framework. Her concept sees caring as a process of transpersonal caring. It is something exceeding the self and recognizing the relationship as "mutual and reciprocal (Goliath, 2008)." It is in this environment that the nurse connects with the patient under his specific circumstances. Watson uses 10 carative factors in applying…
Chan, MF. (2009). Factors affecting nursing staff in practicing spiritual care. Vol 19
Journal of Clinical Nursing: Blackwell Publishing Ltd.
Deal, B. (2010). A pilot study of nurses' experience of giving spiritual care. Vol 15 # 4
The Qualitative Report: Nova Southeastern University. Retrieved on May 18, 2011
Critical Thinking Case Study: Let it Pour - My First Assignment as Executive Assistant
Key Problems and Issues
The first of the problems are coming from the origin of the hospital as it is an organization with a lot of spiritual heritage and values. These have to be retained even while providing all the required services and satisfaction for the patients. The second problem that the hospital is facing is due to the difficulties that exist in the operations of any hospital, and those difficulties exist irrespective of the mission or the origin of the hospital. One of the problems from this origin is the headlines and extensive coverage given by the media to medical errors that hospitals are committing. These are mentioned and reflect on all hospitals whether they are a party to such errors or not. Another problem arises from the differences within the issues of living up…
Baldwin, Fred. "Emergency Room Drama: Be Prepared Before a Crisis Happens" Retrieved
from http://www.icepts.com/pennmed/25-147.htm Accessed on 23 June, 2005
Colliver, Victoria. (12 April, 2005) "St. Luke's could face merger California Pacific may join forces with S.F. hospital known for treating poor" San Francisco Chronicle. Retrieved from http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2005/04/12/BUG63C6H4T1.DTL& ; type=business Accessed on 23 June, 2005
Evans BJ; Kiellerup FD; Stanley RO; Burrows GD; Sweet B. "A communication skills program for increasing patient's satisfaction with general practice consultations" Br Journal of Medical Psychology. 1987; December: 60 (Pt 4):373-378. Retrieved from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve& ; db=PubMed& list_uids=3426975& dopt=Abstract Accessed on 23 June, 2005
The question then becomes do these nurses become worried about the long hours that they may have to work and the quality of care that the patients are getting, or do they sit back and remind the world that they knew this was going to happen, because pay has traditionally been low for nurses and this is why more people are choosing other fields of study when looking for career (Taft, 2001).
Perhaps many nurses will not choose either of these options. Many may choose to continue doing the job that they've been doing for years, for the pay that they have come to expect. Those that choose this option will likely be more concerned with care of the patient then they will with the money that they receive from their job, or how many hours they have to put in for that paycheck. Their primary concern will always remain…
Beu, Burke. 2002. Nursing Issues. The Association of Perioperative Registered Nurses. Retrieved at http://www.aorn.org/journal/2002/novhpi.htm
Cheskin Life Sciences Perspectives: The emerging healthcare consumer. 2001. Cheskin. http://www.cheskin.com/life .
Grace, Helen, & Gloria Smith. Women in Health Leadership Roles: The Challenges of Change. 2002. Center for Research on Women and Gender, the University of Illinois at Chicago.
Green, David. French health service is best. 2001. Guardian Unlimited. http://www.societyguardian.co.uk/health/comment/0,7894,440883,00.html .
Critical Thinking Case Study
Faith Community Hospital is a not-for-profit health care services organization that is currently facing a situation, which may compel it to resort to stringent cost cutting measures just to break even, and that too providing the average reimbursement rate does not change. Financial problems, however, are just one of the several problems that Faith Community Hospital must resolve in order for the organization to maintain and further build its reputation as a quality health care services provider. In brief, some of the other critical issues that the hospital needs to address are the conflict between the organization's spiritual heritage and values and the ethics of the medical profession; non-compliance with government, managed care, and insurance regulations; and non-adherence to hospital operational policies. Indeed, it is evident from the preceding list of issues that Faith Community Hospital has an organizational management problem on its hands, which needs…
The other problem is regarding third party reimbursements and state regulators which have had a significant effect on hospitals during the last ten years. Another factor that is brought out by the study is that during both 1983 and 1986 there were important variations in the inpatient reimbursement system that helped in improving the operating and final margins of hospitals. At the same time there are the health insurance companies who provide a large portion of the funds to hospitals are continually on the look out for reducing payment amounts. There are methods through which this is done and one of that is changing from inpatient settings to ambulatory surgery. Another set of problems come from settlements with labor unions. As an example a major portion of the health care providers were affected due to the settlement with Local 1199. This settlement also created similar effects in other…
Brennan, Phil. (April 12, 2002) "Church Crises Threaten Charities, Schools, Hospitals"
Retrieved from http://www.newsmax.com/archives/articles/2002/4/11/212641.shtml Accessed on 27 June, 2005
"Challenge of being chief of the hospitals" Retrieved from http://www.thisisworcester.co.uk/worcestershire/worcester/news/WEN_NEWS_FEATURES_COUNTY9.html Accessed on 27 June, 2005
Donoghue, Richard J. (December, 1990) "Evaluation of hospitals as entities able to continue as going concerns" The CPA Journal. Retrieved from http://www.nysscpa.org/cpajournal/old/09691991.htm Accessed on 27 June, 2005
I also assumed that the nurse I was observing would likely support the doctor and try to talk the patient into changing her mind. My assumptions were incorrect. Later I took the time to reflect upon my reaction to the situation.
After thinking through the entire situation, it is my belief that she did make the right choice, she no longer wished to live a life tied to a machine, wheeled about in a chair and unable to enjoy even the smallest of pleasures. As a nurse, my approach would be to comfort the patient, understanding and giving support to the family and friends who are attempting to support the patient. The patient is experiencing enough trauma, and should be fully supported in making whatever decision is best for that particular individual.
Other nurses might disagree. One study determined that even though 80% of newly graduated nurses have developed a…
Drennan, J.; (2010) Critical thinking as an outcome of a Master's degree in nursing programme, Journal of Advanced Nursing, Vol. 66, Issue 2, pp. 422 -- 431
Wangensteen, S.; Johannson, I.S.; Bjorkstrom, M.E.; Nordstrom, G.; (2010) Critical thinking dispositions among newly graduated nurses, Journal of Advanced Nursing, Vol. 66, Issue 10, pp. 2170-2181
elf-regulation and analysis are interpersonal skills used by the nurse to convey potentially upsetting news, or to analyze the nurse's own behavior and professionalism in his or her nursing duties.
Critical thinking in nursing is further delineated by the UNM College of Nursing (2005). As seen above, this aspect of the profession is not only essential in terms of the patient-nurse relationship, but also in terms of the intrapersonal relationship of the nurse with him- or herself. The self-regulation and morality developed by means of critical thinking in the profession helps the nurse to make the often difficult decisions required on a daily basis. It also provides the nurse with the ability to serve as a liberating force for patients and their families, as the nurse helps them to face medical dilemmas.
Facione, Peter A. (2004). "Critical thinking: What it is and why it counts." California Academic Press. http://www.insightassessment.com/pdf_files/what&why2004.pdf…
Facione, Peter A. (2004). "Critical thinking: What it is and why it counts." California Academic Press. http://www.insightassessment.com/pdf_files/what&why2004.pdf
UNM College of Nursing. (2005, Sept. 16-17). "What is critical thinking? http://hsc.unm.edu/consg/conct/whatis.shtml
Critical Thinking & Generational Teams
In the course of caring for patients, nurses deal with life threatening situations every day. This constitutes the necessity to develop critical thinking skills in order to know what to do, when to do it, and how it needs to be done to ensure safety and sensibility in patient care. Critical thinking skills develop over time with experience, developing deeper knowledge, and developing higher levels of judgment in the course of care (Alfaro-LeFevre, Apr 2000).
Critical thinking skills involve checking accuracy and reliability of information, recognizing inconsistencies, and identifying patterns of missing information. In the course of busy times, natural tendencies cause people to react without thinking. These patterns are dangerous in patient care. It is important to realize that critical thinking takes time to develop and implement. It requires knowledge, skills, practice, caution, and judgment and is best away from the patient…
Alfaro-LeFevre, R. (Apr 2000). Critical thinking: Usually not rapid fire. AACN News, 2(12).
Halfer, D.S.-L. (2013). Bridging the generational gaps. Retrieved from Nurse.com: http://ce.nurse.com/RetailCourseView.aspx?CourseNum=ce478&page=1&IsA=1
Critical Thinking Styles and Forces of Influence
Any choice or decision that a manager makes influences the organization's performance. It is one of an employee's job responsibilities to make decisions that are in favor of the organization. If the decision taken serves any personal interest of one person or a few people then it is bound to prove harmful for the organization. Therefore such decisions can bring devastating results for the entire company. However it cannot be ignored that any decision made by an employee is influenced by a number of factors since decisions are not made in a vacuum. These factors include the different thinking patterns that are employed by a person in making a choice and the various forces of influences that act upon him and determine the choice he is going to make.
Critical Thinking Patterns
One of the most important factor that determines the choice or…
McAulay, Laurie, Russell, Graeme and Sims, Julian. How Do Financial Directors Make Decisions? Management Accounting (British), (1997): Vol. 75.
McCall, Morgan, Jr. And Robert E. Kaplan. Whatever it Takes. The Realities of Decision Making. Prentice Hall 1990.
Waldersee, Robert and Sheather, Simon. The Effects Of Strategy Type On Strategy Implementation Actions. Human Relations, (1996): Vol. 49, No. 1.
In fact Congress should pass a bill that gives that prescription drug benefit to Medicare patients.
QUESTION NINE: In the United States, healthcare is so expensive that over 45 million people are without health insurance. It is a broken system, leaving out many people, especially children. Recently the executive branch vetoed a bill that would have provided health insurance to millions of middle and low-income children, indicating a lack of government concern for the well being of the population. Bush said it was too expensive, yet it's not too expensive to continue spending billions on an unpopular war in Iraq. Meanwhile, for the past 45 years, Canada has had a "government-funded, national healthcare system..." based on these five principles, according to www.medhunters.com.One, it is universally available to permanent residents; two, it is comprehensive; three, it is available regardless of income; four, it is "portable within and outside" Canada; and five,…
American Association of Colleges of Nursing. (2007). Fact Sheet: Nursing Shortages.
Retrieved Feb. 7, 2008, at http://www.aacn.nche.edu/media/factsheets/nursingshortage.htm .
Duke, Elizabeth. (2004). Report to Congress. The Critical Care Workforce: A Study of the Supply and Demand for Critical Care Physicians. U.S. Department of Health & Human
Services / Health Resources & Services Administration. Retrieved Feb. 6, 2008, at http://bhpr.hrsa.gov/healthworkforce/reports/criticalcare/cc1.htm.
nurses deliver evidence-Based care?
Define main ideas within the title supported from the literature
Nurse instructors confront many hurdles in the present healthcare environment. Educational methods, philosophies, and the content of curricula is required to reviewed to cater to the requirements of the professional nurses who would practice in the coming millennium. (Kessenich; Guyatt; DiCenso, 25) Evidence-based practice or EBP has currently emerged to be a remarkable attribute in nursing literature along with a key impetus in restructuring nursing practice. (Elizabeth; Pyle, 64) Evidence-Based Nursing or EBN is the strategy by which the nurses formulate clinical conclusions applying the best available research evidence, their clinical skill and patient prioritization. (Evidence-Based Nursing: University of Minnesota) It could be narrated as the meticulous, unequivocal and judicious application of the current best evidences in formulating decisions about the care of individual patients. When clinicians formulate health care conclusions for a population or group…
Asking Clinical Questions: Introduction. Retrieved from http://www.poems.msu.edu/InfoMastery/Questions/Questions.htm Accessed on 18 June, 2005
Beyers, Marjorie. About Evidence-Based Nursing Practice. Nursing Management. October, 1999. Vol: 11; No: 1; pp: 103-105
Code of professional Conduct. Retrieved from http://www.nmc-uk.org/nmc/main/publications/reqForPre-regNursing.pdf Accessed on 17 June, 2005
Cronenwett, L. Research, Practice and Policy: Issues in Evidence-Based Care. Journal of Issues in Nursing. February 19, 2002. Vol: 7; No.2; pp: 57-61
.. If one of the goals of the healthcare system is to promote health and prevent illness and injury, it may be logical to start with those who work in the system." (Yassi, Ostry, Spiegel, and Walsh, 2002, p.1)
Presently the healthcare environment is characterized by nurse shortages of 25% of the entire nursing force. It is held that the working conditions along with job stress negatively impact the nursing force and its turnover rate. Injuries are also reported by nursing staff. It is likely that the nursing shortage is the number one challenge in today's healthcare provision. The negative work environment negatively impacts the nursing professional and their decision to either leave or to potentially fail altogether to enter the profession.
Naturally when there is a shortage of any type of professional worker some area suffers their absence and when this concept is applied in the field of healthcare…
Institute of Medicine. Performance Measurement: Accelerating Improvement. Washington DC: National Academy Press; 2006.
Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington DC: National Academy Press; 2001.
Lewis Patricia S. And Latney, Cynthia (2003) Achieve Best Practice With an Evidence-Based Approach. Critical Care Nurse. Vol. 23. No. 6 December 2003. Online available at: http://ccn.aacnjournals.org/cgi/reprint/23/6/67.pdf
Rundall, K. (2002) Evidence-Based Management in Healthcare: Lessons from Clinical Practice. Academy for Health Services Research and Health Policy. Meeting. Abstr Acad Health Serv Res Health Policy Meet. 2002; 19: 20. Manchester Centre for Healthcare Management, Manchester Business School University of Manchester, Devonshire House, University Precinct Centre, Oxford Road,, Manchester,
However...generally a vast difference exists between what healthcare providers understand and what laypersons are able to comprehend. This immeasurability of knowledge was evident in the participants' narratives and was exacerbated by the conveying of "false hope" or "false optimism" to patients and patients' family members.
Seconding Robichaux's argument is ackstrand's (2006) findings that hospital-based EOL programs are not the "ideal" form of healthcare that elderly patients should receive, according to a survey of nurses. For the nurses, "no patient should face death alone," which ultimately happens when patients are confined in a hospital facility receiving palliative care. Comparing ICU EOL care against the hospice and nursing home care programs, 'dying with dignity' is remote in this kind of program, since "[t]he ICU is no place to die. It would be nice to have a comfortable, quiet, spacious room for those who are dying. Let everyone in and let the rest…
Anderson, R. (2003). "Nursing home quality, chain affiliation, profit status, and performance." Journal of Real Estate Research, Vol. 25, Issue 1.
Backstrand, R. (2006). "Providing a "good death": critical care nurses' suggestions for improving end-of-life care." American Journal of Critical Care, Vol. 15, Issue 1.
Elliot, D. (2006). "Determining the financial impact of hospice." Healthcare Financial Management, Vol. 60, Issue 7.
Imhof, S. (2005). "What do we owe the dying? Strategies to strengthen end-of-life care." Journal of Healthcare Management, Vol. 50, Issue 3.
Universal healthcare is the only saving formula for this nation, which is doomed in a health care crisis of unprecedented proportions. There is a urgent need to transform healthcare from its present state of commercialism towards the humanitarian approach which guarantees 'healthcare for all' independent of their social or financial circumstances. A shared and collective responsibility of healthcare management is the only viable formula for America. It is high time we learn from Canada, UK and other European nations and restructure the current broken state of our healthcare. The successful passing of the USNHC act (H.R. 676) is the only way for America to wake up from its healthcare nightmare. Will the powerful insurance industry hold its ground yet again and resist this awakening leaving all the citizens doomed? This is an important question for all the citizens of our country.
1) Science Daily, 'American Values lamed for U.S.…
1) Science Daily, 'American Values Blamed for U.S. Healthcare Crisis',
Accessed May 11, 2009, Available at, http://www.sciencedaily.com/releases/2008/12/081204160558.htm
2) Laura K. Altom, BS, MSIII and Larry R. Churchill, PhD, Ann Geddes Stahlman
'Pay, Pride, and Public Purpose: Why America's Doctors Should Support
S. healthcare structure do not include the unobserved disparities. This may sound very rudimentary, even silly to point out, but in by understanding that the numbers are actually worse than they appear, and that the rising costs of healthcare services re associated with both what we see and can't see, it is easier to understand how costs rise so quickly.
It is also a sobering fact that what we cannot observe is still out there, existing beyond the scope of the government and social programs designed to help people overcome obstacles to access to healthcare and health insurance. The ethnic group that is most unobserved within the bounds of many of the studies and statistics related to the disparities in the U.S. healthcare industry is non-Mexican Latinos (Bustamante, et. al., 2009). This group represents a major portion of the U.S. population that currently lacks access to healthcare. In understanding this…
Bodenheimer, T., Chen, E., and Bennett, H.D. (2009). "Reorganizing Care:
Confronting The Growing Burden Of Chronic Disease: Can The U.S. Health Care Workforce Do The Job?" Health Affairs. Vol. 28, No. 1. Pp. 164-174.
Braveman, P.A., Cubbin, C., Egerter, S., Williams, D.R., and Pamuk, E. (2010).
"Socioeconomic Disparities in Health in the United States: What the Patterns Tell Us." American Journal of Public Health. Vol. 100, No. 1. Pp. 186-196.
Leadership and Management in Healthcare
Models of management and leadership in health care contexts
As when it comes to modern company structures, management and leadership play a main function in health care as well, specifically focusing on reform motions, kinds of services offered, quality of services and capital use. As we specified earlier, there is no universal dish for effective management and leadership, contextual aspects like political system and socio-economic elements play a substantial part in the results.
In basic terms, a health care system has to complete 2 standard things (adjusted from Dorros, 2006):
Enhance the wellness condition of the population (according to specific requirements and targets);
Provide services in the most reliable method possible in order to achieve the first objective.
Furthermore despite the condition of the economy and nation, when attempting to reform health care systems, governments have to ask themselves 3 standard concerns: Who spends for…
Collins, J.C. (2001). Good to Great. New York, NY: HarperCollins: 17 -- 40.
Collins, J.C. And Porras, J.I. (1997). Built to Last. New York, NY: HarperCollins; 173 -- 174.
Contino, D.S. (2001). Budget training: it's overdue. Nurs Manage; 32:16 -- 17.
Contino, D.S. (2004). Leadership Competencies: Knowledge, Skills, and Aptitudes Nurses Need to Lead Organizations Effectively. Critical Care Nurse; 24: 52-64.
Ethical Analysis of Healthcare Rationing
The topic of health care rationing has been the subject of debate in the U.S. The last few years as government expenditures on health care have far exceeded budgeted levels. Central to the concern is the ethical issue over whether it is better if fewer Americans profit with a greater amount of health resource allocation or if the majority benefit to a lesser degree for an equity in health care benefits. In the essay, "We've Got To Ration Health Care," (author unknown) the position is taken that America would fare better to follow the course of health care action seen in other western countries, where it is considered better to ration medical procedures to the extent that a system provides "the highest possible level of basic health care that can be delivered to all the people." With the growing concern over health care rationing, and…
Cook, D & M. Giacomini. 1999. "The Sound of Silence: Rationing Resources for Critically Ill
Patients." Critical Care. 3: R1-R3.
Devettere, RJ. 1993, Feb. "Clinical Ethics and Happiness." Journal of Medical Philosophy.
Devettere, RJ. 2000. Practical Decision Making in Health Care Ethics: Cases and Concepts, 2nd ed. Washington, DC: Georgetown University Press.
Trust and transparency with the public. Given the leadership position that Methodist Healthcare has it is imperative that it cultivate trust as a core part of its branding strategy with the public segments and audiences it serves.
Financial management and cost controls in place and integrated new IT system and architecture. This is a major critical success factor for Methodist Healthcare to aggressively pursue as it moves to create a more unified approach to financial management across its many medical specialty areas.
Strategic Objectives of Methodist Healthcare
The following are the strategic objectives of Methodist Healthcare. For each of these objectives a strategy for each objective's accomplishment is provided below:
To clearly differentiate Methodist Healthcare in the market
Strategies for accomplishing this objective:
While this first objective is very broad, Methodist Healthcare needs to define who they are different for. Uncovering the unmet needs of physicians is a first step,…
We can compare the healthcare workplace to what is seen by a person when he/she looks through a kaleidoscope: since there are numerous different patterns that appear as the moments pass by. The shortage of nurses which has been publicized widely and the high turnover rates amongst the nurses are some of the unwanted patterns which have occurred. The dependence of healthcare institutions on the nurse-managers for the retention and recruitment of nurses is steadily increasing (Contino, 2004).
There are a number of routes through which the critical care nurses have become the leaders. Most of these routes don't have any educational or managerial training as a part of the process. There is a need for effective strategies for the care leaders who provide critical care in order to inspire the staff and manage the departmental operations in an effective manner to get positive results. One of the strategies…
Adams, J., Erickson, J., Jones, D., & Paulo, L. (2009). An evidence-based structure for transformative nurse executive practice, Nursing Administration Quarterly, 33(4), 280-87
Advisory Board Web site. (2004). Available at: http://www.advisory.com .
Ales, B.J. (1995). Mastering the art of delegation. Nurs Manage. August; 26: 32A, 32E.
American Organization of Nurse Executives (2005). AONE Nurse Executive Competencies. Nurse Leader, 3(1), 15-22.
Personal Healthcare Technology
Sunrise Hospital and Medical Center and the Sunrise Children's Hospital
The Sunrise Hospital and Medical Center, which includes the Sunrise Children's Hospital, is an approximately 55-year-old facility located in Southern Nevada; it serves the greater Las Vegas area and the surrounding communities. The Sunrise Health and Medical Center is proud of its quality initiatives to ensure patient safety and comfort, including direct approaches to pharmaceutical safety such as safe medication dosing via smart pump technology, and bar coding on medications. As well, the Sunrise Health and Medical Center does not discriminate with respect to HIV / AIDS or in any manner related to employment, program participation, admission and/or treatment.
Sunrise has been rated as the most popular area hospital for 15 years in patient surveys. As well, Sunrise Health and Medical Center has developed community outreach programs for health education in a variety of areas, often based…
Appari, A., & Johnson, M.E. (2010). Information security and privacy in healthcare: Current state of research. International Journal of Internet and Enterprise Management, 6 (4), 279-314. Retrieved from http://www.ists.dartmouth.edu/library/501.pdf
Ayanian, J.Z., & Weissman, J.S. (2002). Teaching hospitals and quality of care: A review of the literature. The Milbank Quaterly, 80(3), 569-593. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690120/pdf/milq0080-0569.pdf
Baker, J.J., & Baker R.W. (2000). Health care finance: Basic tools for nonfinancial managers. Gaithersburg, MD: Aspen
Byington, R., Keene, R., Masini, D. (2006). The impact of federal and state funding levels on strategic decisions and how those decisions affect patient care. The Internet Journal of Healthcare Administration. (4)2. Retrieved from https://ispub.com/IJHCA/4/2/5827
Evidence-Based Protocol Implementation
Influencing Multiple Systems Through Evidence-Based Change as advance practice nurse, work informed factors direct reach, influence extends context labor. Likewise, propose a nurse leader influenced multiple systems, turn, impact groups.
Nurses are encouraged to utilize and incorporate in their daily practice evident-based practice. The Evidence-based practice (EBP) is considered to be a scientific standard that determines and guides on the best clinical measure (LoBiondo-Wood and Haber). EBP has grown in its relevance to clinical decision making and support to the nursing profession since it facilitates efficiency in provision of care and quick recovery to patients. Successful implementation of EBP calls for monitoring of existing practices, documentation of relevant procedures and evaluation of possible change practices in clinical and nursing care (LoBiondo-Wood and Haber).
Possible adjustments needful for patient's care protocol
Immediate care for patients coming from SICU is critical to their recovery from the procedure they undergo.…
Grossman, S., C. Bautista, and L. Sullivan. "Using Evidence-Based Practice to Develop a Protocol for Postoperative Surgical Intensive Care Unit Patients." Dimensions Of Critical Care Nursing 21.5 (2002): 206-14. Print.
LoBiondo-Wood, G., and J. Haber. Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice. St. Louis: Mosby Elsevier, 2006. Print.
Melnyk, B., and E. Fineout-Overholt. Evidence-Based Practice in Nursing and Healthcare. Philadelphia: Lippincott, Williams and Wilkins 2005. Print.
Schmidt, N.A., and J.M. Brown. Evidence-Based Practice for Nurses: Appraisal and Application of Research. (Eds.) United States: Laureate Education, Inc. custom ed., 2012. Print.
Spiritual Care Practices
Mitchell, Andrea. (2011), Focusing on mind, body, and spirit while caring for patients and their families. Critical Care Nurse, (31), 69-70.
How did the transport nurse manage the patient's physical needs?
What is so extraordinary about the story of the transport nurse, as related in Mitchell (2011) is the degree to which the nurse, even while dealing with the emotionally-fraught situation of a critically ill patient going to view the body of his dead wife, was able to be mindful of Mr. L's physical needs. For the journey, the patient Mr. L was initially switched to a travel ventilator. However, when he did not tolerate this, the nurse suggested a manual resuscitation bag instead, although the travel ventilator was still brought along during the transport. The transport nurse carefully monitored the patient throughout the visitation. During the ceremony at the chapel where his wife's body was present,…
It brought continuity to the process of dying, and a way to deal with critical issues in a way everyone could understand. it's holistic because it takes the process of dying, coordinates the patient's care, and brings resolution to things often left unstated. It allows the patient to have a degree of control. And it evaporates some of the high-tech coldness that can come between caregivers and patients."
The most significant area of spirituality and palliative care still unaddressed by researchers seem to be those identified by Cohen and Koenig: "the religious and spiritual needs of people of different religions, the positive and negative effects of religion and spirituality in palliative and end-of-life care, and the contributions that religious and spiritual institutions as well as health care professionals can make to such endeavors" (Cohen and Koenig
Currently, there is a widely held belief that spirituality is a valuable part…
Bogin, Rabbi S. (2000) Spiritual issues of palliative care. Nursing Homes, December. Retrieved 13 March 2005 from www.findarticles.com.
Burnside, G. (1998) New paths in end-of-life care. Health Progress, May/Jun. Retrieved 13 March 2005 from www.findarticles.com.
Cohen, a.B. And H.G. Koenig. (2002) Spirituality in palliative care. Geriatric Times 3(6). Retrieved 13 March 2005 from www.findarticles.com.
Cole, B.V. (2001) Nursing care at the end of life. Perspectives in Psychiatric Care 37(3). Retrieved 13 March 2005 from www.questia.com.
, 2008, p. 66). One of the most viable means of correcting this issue is to employ a series of strategic incentives to dissuade trained instructors from retiring and to get others to engage in this occupation.
The usage of incentives can be a powerful means of compelling more individuals to engage in the teaching nursing subjects. Naturally, the more qualified instructors there are to teach in this profession, the more readily qualified individuals can be produced to handle the projected nursing shortage that will be exacerbated by the 2014 completion of the Patient Protection and Affordable Care Act in full. However, it is quite possible that incentives can also be used to assist in the preparation and utilization of more copious supplies of physicians as well. At present, physicians have a substantial reduction in the amount and quality of incentives to enter the healthcare industry. Due to certain components…
Connolly, M.A., Keller, V., Siela, D., Twibell, K.R. (2008). "The shortage of nurses and nursing faculty: what critical care nurses can do." AACN Advanced Critical Care. 19 (1): 66-67.
Garson Jr., a. (2000). "The U.S. healthcare system 2010: problems, principles and potential solutions." Circulation. Retrieved from http://circ.ahajournals.org/search?fulltext=the+U.S.+Healthcare+System+2010%3A+Problems%2C+Principles%2C+and+Potential+Solutions&submit=yes&x=0&y=0
Matthews, M., Litow. (2013). "ObamaCare's Health-Insurance Sticker Shock." The Wall Street Journal. Retrieved from http://online.wsj.com/article/SB10001424127887323936804578227890968100984.html
Defined as the philosophical study of right and wrong action, Ethics is a predominant subject of concern in nursing (Michael Dahnke, 2006). Being presented with various situations, the ethical and cultural problems are a serious concern faced by the nursing and healthcare staff which needs to be catered to day in and out. There is no time tested methodology that can be applied here, since the every patient is different, with a different background history, therefore the ethical and cultural implications of each decision would also vary.
Importance of Ethical Theory to Nursing
Defining what is right and wrong is a very subjective approach and even that can change from scenario to scenario. Therefore it is important to have some form of umbrella under which the functioning of nurses takes place. It is under this rationale that the importance of ethical theory emerges in front of us.
DuAnne Foster Edwards, R.M. (1999, Feburary). The Synergy Model: Linking Patient Needs to Nurse Competencies. Retrieved September 30th, 2011, from American Association of Critical Care Nurses: http://www.aacn.org:88/wd/certifications/content/synpract2.pcms?pid=1&menu=
Green, D.B. (2001, July). Medical Ethics. Retrieved September 30th, 2011, from Priory.com: http://priory.com/ethics.htm
Michael Dahnke, H.D. (2006). Defining Ethics and Applying the Theories. In P.M. Vicki D. Lachman, Applied Ethics in Nursing (p. 3). New York: Springer.
Samar Noureddine RN, M. (2001). Development of the ethical dimension in nursing theory. International Journal of Nursing Practice, 2-7.
Healthcare Financing and Organization
Healthcare is a field that is constantly evolving. This is because of fundamental changes in their financing and organization. The result is that the entire operation is shifting. To fully understand what is occurring requires focusing on why this is a key component for the nurse -manager. This will be accomplished by looking at the way healthcare is organized, the roles and the scope of contemporary practicum. Together, these elements will highlight the shifts and the long-term implications on the field of nursing.
Describe how health care is organized and financed, including the implications of business principles, such as patient and system cost factors.
Healthcare is organized based upon the type of entity that is established. There are three different models that are used to include: for profit, nonprofit and governmental. For profit organizations are focusing on meeting the needs of patients, reducing costs and increasing…
Lowe, N. (2015). Nursing, Nurses and Ethics. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 44 (3), 339 -- 340.
Orgeas, M. (2010). Selected Medical Errors. American Journal of Critical Care Medicine, 181 (2), 134-142.
In the U.S healthcare environment, the clinical practice guidelines are the effective healthcare protocol to enhance patient’s safety as well as achieving evidence-based practice. The clinical guidelines provide recommendations to the best available practice to assist clinicians and other healthcare professionals to deliver best and quality care. More importantly, the clinical practice guidelines are designed to optimize patients’ care using the systematic assessment and evidence based review to assess pros and cons of the alternative care options. The guidelines serve as the strongest resources to assist the healthcare professionals to make clinical decisions as well as incorporating evidence gained through practice and scientific investigations into patient practice. Healthcare organizations develop the guidelines in form and policies, which are endorsed across the organization to create a platform that employees will follow and holding employees accountable to achieve a standard of care.
Clabsi Hospital is one of the best healthcare organizations…
Family Centered Care
Family-centered care is a significant part of the nursing profession, and this is becoming more important as healthcare changes and evolves. Nurses are charged with being compassionate in their duties and treating everyone as being valuable no matter what kinds of conditions they have or where they come from (The Guide, 2010). It is the first Provision of the Code of Ethics for nurses, with sub-issues that address human dignity, relationships with patients, the nature of the health problems, the right to self-determination, and relationships with colleagues and others. These courtesies, however, should also extend to the families of those patients, as caring for the family as a whole can make the process easier and more cohesive. This paper will address family-centered care in the context of the Code of Ethics Provision One and the sub-issues that are contained in it.
Provision One and Family-Centered Care
Bailey, J.J., Sabbagh, M., Loiselle, C.G., Boileau, J., & McVey, L. (2010). Supporting families in the ICU: A descriptive correlational study of informational support, anxiety, and satisfaction with care. Intensive and Critical Care Nursing, 26: 114-122.
Mitchell, M.L. & Chaboyer, W. (2010). Family Centred care -- A way to connect patients, families and nurses in critical care: A qualitative study using telephone interviews. Intensive and Critical Care Nursing, 26: 154-160.
The Guide to the Code of Ethics for Nurses: Interpretation and Application (2010). Code of Ethics for Nurses with Interpretive Statements. Nursing World.
The Lebanese and the overall middle easterners are known to be strict to their cultural beliefs and practices. Such beliefs and practices dictate every aspect of their lives and how they interact with other people from other cultures across the world as well as other aspects of life that are widely applicable in the contemporary world. This culture has a great impact on the structure and nature of health care that is appreciated among the Lebanese and other middle easterners (Shiloh, 2007). It is imperative to understand their cultural perception on care presentation, accommodation, and repatterning to offer a more effective healthcare under this cultural setting.
The Lebanese have a unique perception on culture care presentation. The cultural practices in Lebanon emphasize the importance of both nuclear and extended families. Moreover, the family members rely heavily on each other. During illnesses, the family members offer the primary care and support…
Interdisciplinary Care Providers
CABG or coronary artery bypass graft surgery is advised for individuals suffering from CHD (coronary heart disease), for alleviating symptoms, prolonging lifespan, and improving QOL (quality of life) (Bayoumi, 2015). Improvements in mechanical ventilation-supported cardiac operation patient management continues to be a major focus area for better optimizing clinical results. The FTE (fast-track extubation) theory applied in case of cardiac operation patients is growing in popularity, in a bid to offer more economical and superior-quality healthcare. A large number of research works have established that prompt extubation (i.e., between 6 and 8 hours after surgery) may be a safe step, whilst decreasing admission and resource use expenses (Cheng, Karski & Peniston, 1996). In spite of the aforementioned advantages, prompt extubation is not consistently performed, underscoring the need to adopt a protocolized strategy for decreasing setbacks and variations and linked to weaning mechanical ventilation. Time-guided extubation protocols’ benefits have been…
Pfizer, 'NEW FRAGMIN INDICATION FIGHTS SECOND LEADING CAUSE of DEATH in CANCER PATIENTS, CANCER-ASSOCIATED THROMOSIS', retrieved feb 29th 2008, from, http://www.pfizer.ca/english/newsroom/press%20releases/default.asp?s=1&releaseID=160
Huget P, van Dam P,
Vermeulen P. (2002), 'Plasma fibrin D-dimer levels correlate with tumor volume, progression rate and survival in patients with metastatic reast Cancer', ritish Journal of Cancer, http://www.ncbi.nlm.nih.gov/pubmed/11875705
John a Heit, (Sep 2005), "Cancer and Venous Thromboembolism: Scope of the Problem', Cancer Control, Vol! 2, Supplement 1.
Diana M. eck, (Oct 2006), 'Venous Thromboembolism: Prophylaxis: Implications for Medical Surgical Nurses,"
MEDSURG Nursing -- October 2006 -- Vol. 15/No. 5, Available online at, http://www.medsurgnursing.net/ceonline/2008/article10282288.pdf
Race, Tara Kay SN, RN, CCRN; Collier, Paul E. MD, (July-Sep 2007), 'The Hidden Risk of Deep Vein Thrombosis -- the Need for Risk Factor Assessment: Case Reviews.', Critical Care Nursing Quarterly, 30(3):245-254
Susan egelman MD, 'Venous Thromboembolism',…
MF Scully (2005), 'Clinical Guide Cancer and Thrombosis', retrieved Feb 28th 2008, at http://www.tigc.org/pdf/cancervte05.pdf
Alexander G. Turpie, (2002) 'ABC of Antithrombotic Therapy', British Medical Journal, available at http://www.bmj.com/cgi/content/full/325/7369/887
Pfizer, 'NEW FRAGMIN INDICATION FIGHTS SECOND LEADING CAUSE of DEATH in CANCER PATIENTS, CANCER-ASSOCIATED THROMBOSIS', retrieved feb 29th 2008, from, http://www.pfizer.ca/english/newsroom/press%20releases/default.asp?s=1&releaseID=160
In reaction, diabetes research looks into pharmacological options and changes in lifestyle to contain the trend. Recent findings point to the need for healthcare professionals to empower diabetes sufferers to take recourse in self-management as the best option at the moment (Kumar).
The purposefulness of a plan and its implementation in assisting a client with diabetes helped fill in her self-care deficit (Kumar 2007). The interpersonal relationship between a nurse and her client minimizes the stress experienced by the latter and her family. This enables the client or patient and her family to act more responsibly in health matters. An assessment and plan of care may use Orem's client-related concepts -- of self-care, self-care agency, therapeutic self-care demand and self-care deficit --, the concepts of nursing agency and nursing system and the basic conditioning factors. Integrating these concepts into other theories on health promotion and family systems may guide effective…
Aldridge, V. (2005). Self-monitoring of blood, glucose invaluable in managing diabetes. 3 pages. Journal of Diabetes Nursing: SB Communications. Retrieved on October 24, 2008 at http://findarticles.com/p/articles/mi_mOMDR/is_10_9/ai_n27865119?tag=content;col1
Aliha, J.M., et al. (2006). Relation between self-care behavior and self-care needs in patients with heart failure.2 pages. Southern African Journal of Critical Care: South African Medical Association. Retrieved on October 24, 2008 at http://findarticles.com/p/article/mi_6870/is_1_23/ai_n28450856?tag=content;col1
Bruce, E., et al. (2008). Dorothea Orem's theory of self-care. 38 pages. SlideShare, Inc. Retrieved on October 24, 2008 at http://www.slideshare.net/jben501/dorothea-orem-theory
Cook, a., et al. (2006). Self-care needs of caregivers dealing with stroke. 9 pages.
Nursing Health Care Informatics
"…At the beginning of the 21st century, nursing informatics has become a part of our professional activities…[and has] advanced the field of nursing by bridging the gap from nursing as an art to nursing as a science…" (Saba, 2001, 177).
Nursing Health Care informatics relate to and address technology and other cutting edge issues of great interest in the healthcare field. According to the AMIA, Nursing Informatics is the "…science and practice (that) integrates nursing, its information and knowledge, with management of information and communication technologies to promote the health of people, families, and communities worldwide." New and relevant knowledge presented in the genre of informatics helps to empower nurses and other healthcare practitioners to deliver the most effective patient-center care possible. This paper presents several informatics in the belief that applying healthcare technologies and practices that are genuinely progressive and helpful to today's nurse is…
AMIA (2009) Working Group Nursing Informatics. Retrieved March 9, 2014, from http://www.amia.org .
An, J.Y., Hayman, L.L., Panniers, T., and Carty, B. (2007). Theory Development in Nursing
And Healthcare Informatics. A Model explaining and Predicting Information and Communication Technology Acceptance by Healthcare Consumers. Advances in Nursing Science, 30(3), E37-E49.
Cipriano, P.F. (2011). The Future of Nursing and Health IT. Nursing Economics, 29(5).
Theory guides practice. This is true of many things, but is especially true of nursing. While many processes, actions, and rules are involved in becoming a great nurse, understanding and applying theory must be the most important aspect. Nursing theory allows for one to examine concepts and then attempt practical application of these concepts when theories are tested. Evidence-based practice for example, is the wonderful lovechild of theory and application in that when theories are constructed, they are then tested, and if they work, are applied to standard practice via modification. This essay aims to provide a deeper synthesis of nursing theory by examining two important nursing theories: Orem's Self-care Theory and Watsons Nursing Theory. Additionally, one will see how nursing theory has evolved since its beginnings.
Background on Nursing Theory
Many say nursing is as old as humankind. If there was someone sick, there was someone willing to…
Kenyan Healthcare Assessment
Across the globe, manmade and natural calamities are on the rise, occurring almost every single day and having destructive effects on individual people, households and entire communities. People's lifestyles and quality of life are undermined by both minor and major catastrophes. The African continent has long struggled with internal conflicts that have had destructive impacts, threatening its inhabitants' survival. Extensive casualties have resulted from these occurrences. It is an undisputed fact that war and conflict interferes with communities' social, religious, economic and educational dimensions. This section attempts to understand disaster-related emergency preparedness and healthcare scenario in the epublic of Kenya.
Just like a majority of other African nations, Kenya has encountered manmade and natural catastrophes that have led to huge losses of life. One good example would be the 2007-08 post-election clashes. The nation witnessed largely politically-initiated inter-community fights that had immense, large-scale consequences. Hence, its healthcare…
Aragon Penoyer, D. (2010).Nurse staffing and patient outcomes in critical care: A concise review. Critical Care Medicine, 38(7), 1521-1528. doi:10.1097/ccm.0b013e3181e47888
Wafulapaul. (2014). Study: Staffing of medics is skewed. Read more at: https://www.standardmedia.co.ke/health/article/2000138842/study-staffing-of-medics-is-skewed . Standard Digital [nairobi].
F. The uninsured are increasingly using the ED for their non-emergency needs.
III. The effects of emergency room overcrowding can be deadly.
A. Boarding patients, or keeping already treated or stabilized patients in the ED, prevents patients from receiving the inpatient care they need.
B. Long wait times and inefficient service can mean loss of life
IV. Possible solutions demand health care system overhaul.
A. More efficient hospital registration would streamline emergency room procedures.
B. Standing orders would allow nurses and EMTs to proceed on critical care without doctors.
C. Special fast-track and sub-waiting areas would alleviate hallway overcrowding.
D. Re-budgeting will allocate more funds to emergency admissions.
E. Reducing non-urgent visits via universal healthcare initiative would reduce unnecessary use of the emergency room.
F. Increasing hospital capacity for acute inpatient needs would replace boarding.
G. Hospitals can add support staff during critical hours.
The delivery health care system takes into account the assimilation of physicians, healthcare facilities, together with other medical services with plan to facilitate the provision of the total continuum of medical care for its consumers. In a whole incorporated system, the three fundamental components including physicians, medical facilities and the membership to health plans are counterpoised in terms of equating medical resources with the necessities of patients and purchasers (Coddington, Moore, and Fischer., 1994). One of the key concerns in the present delivery of healthcare is cost. Increasing costs of healthcare has been a major worry in the past number of years, making the United States to have one of the most expensive systems of healthcare. The main objective of this paper is to analyze the different costs linked to healthcare delivery system, and delineate the manner in which these costs impact different populations and how it also affects…
The American healthcare system is in a crisis situation, with exorbitant spending unbalanced by “poor health outcomes, including shorter life expectancy and greater prevalence of chronic conditions” versus high income countries with universal healthcare systems (Squires & Anderson, 2015, p. 1). The Affordable Care Act was an attempt, albeit an incomplete one, to reform the way healthcare is structured and financed. Universal health care is a concept that has gained some traction in the United States, but its thorough implementation is hindered by values, norms, and fears. Overall, the pros of universal healthcare undoubtedly outweigh the cons. The pros of universal healthcare include reductions in wasteful spending, the promotion of social justice and health equity, and the improvement of overall health outcomes in the United States.
The United States already has some limited forms of universal healthcare, addressing the needs of specific patient populations. For example, the American…
739, p=0.009, e?=0.727). This study clearly highlighted that sleep shortage and work fatigue poses a threat to patient safety and that nurse self-care is warranted.[Dorrian et.al, (2006)]
Nurse Support Services
An earlier Australian study by Moore KA (2001) which observed 201 nurses working in three different hospitals had concluded that organizational restructuring policies and the consequent work overload was a high stressor for nurses and this was made worse by the poor communication style (top -- down approach instead of consultative style) that only contributed more to nurse burnout. [Moore KA, (2001)]. Given the high levels of occupational stress and burnout among nurses, it is important that nurse self-care interventions are prioritized. A recent literature review on the subject of work stress and coping methods among Australian nurses revealed that 'work load ', 'role conflict' and 'expression of aggression' were the three main stressors. The literature study also revealed 'seeking…
1) Linda H. Aiken, 'Image of Nursing Global Trends', retrieved Sep 4th 2010, from, http://www.fpnl.co.za/downloads/Presentations/Presentations/Prof%20Linda%20Aiken%20-%20Image%20of%20Nursing%20-%20Global%20Trends.pdf
2) Jillian Dorrian, Nicole Lamond & Cameron Van del Heuvel et.al (Oct 2006), 'A Pilot study of the Safety Implications of Australian Nurses' Sleep and Working Hours', Chronobiology International, Vol 23, Issue 6, pg 1149-1163
3) Lim J, BOGOSSIAN F. & AHERN K. (2010), ' Stress and coping in Australian nurses: a systematic review. International Nursing Review 57, 22-31
4) Moore KA, (2001), 'Hospital restructuring: impact on nurses mediated by social
Extracorporeal Membrane Oxygenation is a procedure that allows for the oxygenation of a patient through the use of an external machine. Oxygen is required in order to keep a body healthy and alive. The definition of oxygenation is the amount of oxygen in the bloodstream of a patient. If the oxygen level drops below 90% a condition called hypoxemia occurs. Hypoxemia can be very serious and if not addressed within a short period of time can be fatal. Hypoxemia is diagnosed through cyanosis (the skin turning blue). Patients being treated with the EMCO procedure are usually longer-term patients (3-10 days) as compared to the short-term patients who receive a standard cadriopulmonary bypass which is a support that usually only lasts for a number of hours (not days).
According to odriguez-Cruz et al. The purpose of the ECMO is "to allow time for intrinsic recovery of the lungs and…
Adhikari, N.K.; Burns, K.E.; Friedrich, J.O.; Granton, J.O.; Cook, D.J.; Meade, M.O.; (2007). Effect of nitric oxide on oxygenation and mortality in acute lung injury: systemic review and meta analysis, BMJ; Vol. 334, pp. 779.
Bastin, A.J. & Firmin, R.; (2011) Extracorporeal membrane oxygenation for severe acute respiratory for failure in adults: NICE guideance, Heart, Vol. 97, Issue 20, pp. 1701-1703
Berryman, S.; (2010) Extracorporeal membrane oxygenation in a Scottish intensive care unit, Nursing in Critical Care, Vol. 15, Issue 5, pp 262 -- 268
Brower, R.G. & Krishnan, J.A.; (2000) High frequency ventilation for acute lung injury or acute respiratory distress syndrome, Chest; Vol. 118, pp. 795 -- 807.
There are however existing organizations such as the Healthcare Communications Association which was also formed in 2001, however, this organization was formed primarily for pharmaceutical companies and practitioners. The 'Coalition for Healthcare Communication" organization when searched with keywords 'skilled nursing staff' returned a 'sorry no pages found with your keyword' indicating a gap in the communication network for skilled nursing staff in the communication network for health care issues under debate and analysis. The work of Thornby (2006) entitled: "eginning the Journey to Skilled Communication" states that often skilled nursing staff were found to be avoiding communication with physicians who were known to be aggressive or abrasive instead of becoming competent in skilled communication. It is additionally noted in Thornby (2006) that skills development is needed among today's skilled nursing staff in order to enable competent skilled communication among skilled nursing staff and other practitioners and physicians.
SUMMARY & CONCLUSION…
Thornby, Denise (2006) Beginning the Journey to Skilled Communication. Advanced Critical Care. Vol. 17, No. 3, 2006 AACN. Online available at http://www.aacn.org/WD/HWE/Docs/AACN17_3_266-271_HWE.pdf
Coalition for Healthcare Communication (2009) Current Issues. Online available at http://www.cohealthcom.org/content/current.htm
Sorry no pages found matching your keywords' (2009) Coalition for Healthcare Communication. Online available at http://cohealthcom.org/cgi-bin/search.cgi
Healthcare Communications Association (2009) Online available at http://www.hca-uk.org/Join-the-HCA
eligion and health have long been linked, and continue to be so in most cultures around the world. In fact, both mental and physical health problems were once believed to have supernatural or spiritual origins, a belief which persists until this day in spite of empirical evidence showcasing the biological and chemical causes of illnesses (Koenig, 2000). egardless of whether or not religion is a worthwhile social institution, religion, spirituality, and practices like prayer remain central to the lives of most people. eligion can be inextricably linked with personal and cultural identity, and can greatly inform both medical decisions and health practices including lifestyle choices. There is also a notable link between religiosity and a number of health outcomes including morbidity and mortality rates, proven in empirical studies. The literature tends to support a strong connection between prayer and stress relief in particular, as prayer and religion are widely believed…
Bearon, L.B. & Koenig, H.G. (1990). Religious cognitions and use of prayer in health and illness. The Gerontologist 30(2): 249-253.
Davis, L.I. & Owens, C. (2013). The impact of religion on health practices. American Association of Colleges of Pharmacy. Retrieved online: http://www.aacp.org/governance/SIGS/hdcc/Documents/Webinar%20Materials/Impact%20of%20Religion%20Webinar.pdf
Koenig, H.G. (2000). Religion and medicine I. International Journal of Psychiatry in Medicine 30(4): 385-398.
Koenig, H., King, D. & Carson, V.B. (2012). Handbook of Religion and Health. Oxford University Press.
Many patients epoted they pefe childen not visit so they could potect o shield childen fom the cisis associated with the ICU envionment.
The eseaches also identified citical illness as an impotant souce of disuption and stess fo family membes, and suggested that an open and moe flexible policy be adopted egadless. The eseaches suggest futhe studies ae necessay to detemine collaboative ways nusing staff and caegives could wok with families and patients to ceate a less stessful envionment fo childen's visitations. The study does point out nuses lack of time and ole secuity often contibute to poo attitudes about childen visiting adult patients. Positive inteventions howeve may be adopted to help impove elationships and the expeience childen have in the ICU envionment. This in tun may pomote moe holistic cae.
Aticle 4 - "The meaning of caing to nuses: an investigation into the natue of caing wok in an…
references of patients in the intensive care unit and in complex care medical unit." American Journal of Critical Care, 13(3): 194.
Wilkin, K., & Slevin, E. (2003- Jan). "The meaning of caring to nurses: an investigation into the nature of caring work in an intensive care unit." Issues in Clinical Nursing
Wilkstrom, A.C. & Larsson, U.S. (2003 - May). "Technology - an actor in the ICU: a study in workplace research tradition." Issues in Nursing.
ethics regarding organ donation by brain-damaged people. The writer explores how a brain-damaged person is defined, and whether or not the donation of organs from that person is ethical. There were 15 sources used to complete this paper.
The field of medicine has advanced mankind to arenas never before thought possible. Today doctors can take entire organ systems out of one person and place them in another and the recipient can live for many years with transplanted organs. Hearts, lungs, kidneys, livers, eyes and many combinations of them are just a few of the organs that are transplanted worldwide today. As the medical community continues to advance age and quality of life the need for more organs has reached the critical stage. One of the most argued and passionate debates in the medical community today is whether or not it is ethical to remove organs in the case of a…
BROOKER Michelle, The gift of life after death., The Press (Canterbury, New Zealand), 08-10-2002, pp 3.
CAROL ANN CAMPBELL, Staff Writer, TV SHOW ANGERS ORGAN DONOR GROUPS., The Record (Bergen County, NJ), 11-13-1996, pp a09.
Author not available, [Thoughts of The Times] An Explanation of Brain Death., The Korea Times (Seoul, S. Korea), 02-09-2000.
Author not available, Pre-transplant brain-death test done on man in his 20s., Kyodo World News Service, 06-13-1999.
Research Proposal for Catheter Associated Urinary Tract Infections
Catheter Associated Urinary Tract Infections (CAUTI) affects timely reimbursement and prolongs patient stays in the healthcare facility. Many hospitals strive for ways to reduce CAUTIs and take specific medical measures to aid patients in recovery from the same and avoid recurrence of the cases of CAUTIs. These deliberate measures ensure so they can have better patient outcomes and improve patient care. This also improves the reimbursement received from insurance providers.
The research seeks to investigate the effect of frequent CAUTI education, among the in-hospital patients with indwelling urinary catheter, conducted over six months.
Background and Significance of the Problem
It is common medical knowledge that urinary catheters have the potential to cause urinary tract infections, known as catheter-associated urinary tract infections (CAUTIs). Indwelling catheters are a part of many plans of care, specifically for emergent and critical care patients within…
While most hospitals seem to be well-run and most situations and scenarios are planned for in advance when it comes to what nurses should be doing, should not be doing and why, this is not always the case. Just one example of this would be situations where palliative care is probably or definitely called for in a given situation but there is not a defined or clear protocol as to when the palliative path should be started and what criteria should be used. Indeed, patients that are facing such a situation are typically terminal or they at least cannot be treated for what is ailing them. An easy example to point to would be a cancer patient whose disease is beyond what medicine can do for them. When there is an absence of leadership when it comes to palliative care protocols, it falls to nurses to collaborate, work…
Engel, J., & Prentice, D. (2013). The ethics of inter-professional collaboration. Nursing Ethics,
20(4), 426-435. http://dx.doi.org/10.1177/0969733012468466
Ewashen, C., McInnis-Perry, G., & Murphy, N. (2013). Inter-professional collaboration-in-practice: The contested place of ethics. Nursing Ethics, 20(3), 325-335.
personal philosophy of leadership. Address what role you feel a health care leader should play, what leadership theory they should follow, and why leaders should follow that theory.
My personal philosophy of leadership is that leaders need to remain strong and focused, decisive and relatively uninfluenced by their own or others' emotions. In healthcare, it is particularly important to apply evidence-based practice and rational thought to decisions, rather than rely on charismatic leaders to become figureheads in an organization or healthcare team. Increasingly, healthcare leaders rely on collaborative work environments where leadership philosophies that are collaborative and democratic prove most successful (Chriem, et al., 2013). Collaborative work environments occasionally rely on having a formal leader, but increasingly we are encountering shared power situations in which there is no one clear leader and in which each person's contributions are recognized as equal. This is true in some, but not all, healthcare…
Chriem, S., et al. (2013). Leadership as boundary work in healthcare teams. Leadership 9(2): 201-228.
Rus, V. (1980). Positive and negative power. Organization Studies 1(1): 3-19.
Zheng, X. et al. (2016). Curvilinear relationships between role clarity and supervisor satisfaction. Journal of Managerial Psychology 31(1): 110-126.
Disaster Management Plan
Emergency Needs Assessment
There are many tough decisions that hospital facilities have to make in the event of a disaster and preparation is one of the critical success factors in such a situation that can make a world of difference. For example, the delivery of critical care in the emergency department is critically important to identify the nature of critically injured patients and decide whom to attend to first and who needs medical attention at the earliest. Furthermore, in the event of a category 3 hurricane, such as Hurricane Victoria, such a disaster can greatly exacerbate the limitations of a hospital to provide the needed neurological intensive care services. This analysis will provide an overview of the steps that can be taken in the event of a major public emergency and the role that needs assessment and service rationing play in such an event.
Gilboy, N. (2012). Emergency severity index. Rockville, MD: Agency for Healthcare Research and Quality.
Michigan University. (N.d.). Vulnerability Assessment. Retrieved March 24, 2014, from http://www.michigan.gov/documents/7pub207_60741_7.pdf
Papastavrou, E. (2013). The ethical complexities of nursing care rationing. Health Science Journal, 346-348.
Schubert, M., Glass, S., Clarke, L., Aiken, B., & Sloan, D. (2008). Rationing of nursing care and its relationship to patient outcomes: the Swiss extension of the International Hospital Outcomes Study . International Journal for Quality in Health Care, 227-237.