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The data gathered is subjected to statistical analysis using statistical methods of linear regression and chi square testing.
The main purpose of the study was to confirm the hypothesis that consultation with CNS or RN in a drug-monitoring clinic has a significant positive impact on the well being of patients with rheumatoid arthritis. The study involved a single blinded randomized controlled trial over a period of three years. Subjects were chosen from the rheumatology out patient setting in a district general hospital with a drug monitoring service. A total of 71 subjects who were starting out on anti-rheumatic therapy were randomly assigned to either the interventional or the control group. While the interventional group was supervised by the CNS to assess patient needs (using Pendelton's framework) alongside drug safety evaluation, the control group was seen by an outpatient staff nurse purely for drug safety concerns. oth the groups were assessed…
Teri Britt Pipe; Kay E. Wellik; Vicki L. Buchda; Carol M. Hansen; Dana R. Martyn, 2005, "Implementing Evidence-Based Nursing Practice," Urol Nurs. 25(5): 365-370, Available at, http://www.medscape.com/viewarticle/514532
Ryan, S, Hassell, a.B, Lewis, M, & Farrell, a. (2006). Impact of a Rheumatology Expert Nurse on the well-being of patients attending a drug monitoring clinic. Journal of Advanced Nursing, 53(3), 277 -286.
Considine, J. & Botti, M. (2004) Who, when and where? Identification of patients at risk of an in-hospital adverse event: Implications for nursing practice. International Journal of Nursing Practice. 10: pp. 21-31
This is one of the most common forms of research and, for some research questions is clearly a strong design (Ethics in Critical Care Nursing Research, 2005).
The research that was done in this article would be considered a non-experimental type. There were two types of observation that were conducted. The first type was that of focus groups and the second being the file audit, both of which are observational in nature. In this case this was the most appropriate type of research design to use. Since they were simply trying to see what was actually going on in this area and how that was affecting patients the only real way to tot this was by observation. From this article a nursing care issue that can be raised is that of how palliative care nurses manage family involvement with end of life issues. Are there any standard procedures that are…
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.
This wrong doing is in violation of the ethical obligation of nurses to advocate on behalf patients in order to ensure their well-being. If a patient is injured due to this kind of mistreatment, the hospital is liable, and the nurse may receive discipline, possibly suspension. However, the plaintiff (the patient) may also choose to file a law suit against the individual nurse as well (Giordano, 2003).
Another example would be if a surgical nurse noticed during routine charting procedures that a patient about to go into surgery on their left knee was supposed be receiving their surgery on their right knee. To avoid medical error and a subsequent malpractice suit, the nurse could verify with other nurses and the surgeon that the patient would be receiving the appropriate surgery.
Giordano, K. (2003). Examining nursing malpractice: a defense attorney's perspective - legal counsel. Critical…
Giordano, K. (2003). Examining nursing malpractice: a defense attorney's perspective - legal counsel. Critical Care Nurse, 23(2), 104-07.
, 2010). It is perfectly conceivable that this nurse leader would welcome more collaborative or shared leadership responsibilities, particularly since the setting for empirical clinical research on this very issue was, in fact, an ICU (osengren, Bondas, Nordholm, et al., 2010).
Finally, it appears from this interview subject's input into this project that she is a competent and effective nursing leader, largely by virtue of her description of her supervisory and administrative style and inclination. However, her input lacked any substantial data on the basis of which a reviewer could evaluate her effectiveness as a clinical leader more specifically. Those particular skill sets may occur in combination but they undoubtedly also occur individually within different leaders (Stanley & Sherratt, 2010). A review of historical literature (such as in connection with Florence Nightingale) clearly demonstrates that good nursing leaders may or may not necessarily also be equally good clinical leaders (Stanley…
Armstrong, P.W. "A time for transformative leadership in academic health sciences."
Clinical & Investigative Medicine, 30(3); 2007: E127-132.
Davidson, S.J. "Complex responsive processes: a new lens for leadership in twenty-first-
century health care." Nursing Forum, 45(2); 2010: 108-117.
Either style may be beneficial in some situations but detrimental to organizational objectives (i.e. patient health and welfare) in others. A typical example of an appropriate use of authoritarian leadership would be in a working group consisting of individuals who have varying degrees of expertise and professional experience, particularly if they also have little experience working together as a group. On the other hand, the democratic style might be more appropriate in working groups consisting of very similarly skilled individuals with similar degrees of experience, especially where they have also worked together extensively and have demonstrated good self-management, decision-making, and collaboration within the group.
Leadership vs. Management
The principal difference between leadership and management is that leadership pertains more to people whereas management pertains more to operations (Marquis & Huston, 2008). Generally, organizational leadership involves improving the organization by addressing motivational issues and other factors that contribute to the morale…
Marquis, B.L. And Huston, C.J. (2008). Leadership Roles and Management Functions in Nursing: Theory and Application. (6th ed.). Philadelphia: Lippincott, Williams, & Wilkins.
Medley, F. And LaRochelle, D.R. "Transformational leadership and job satisfaction."
Nursing Management, Vol. 26, No. 9; (1995). Retrieved January 9, 2011 from:
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
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.
pressure? How respo
There was a time when I was under extreme duress to get to work on time. Although I can look back on the situation fondly now and apply the lessons learned, back then it could have had serious negative ramifications for my career. I had recently moved and was beginning a new nursing position. I was supposed to fly in on the Friday before I started the following Monday, but I missed the flight and had to catch the next one. By the time I arrived, I barely had a chance to get a full night's rest in my own bed, let alone plot the route from my new residence to my job. I remember feeling so pressured as I drove around the downtown streets which all looked alike since I had just moved. At the time, the last thing I wanted to do was start a…
Healthcare Practices in Nursing Today
Over the last 50 years, health care systems all over the world have experienced rapid and significant changes. Some of these changes have been the result of innovative developments in medical science and technology that have greatly benefited patients, prolonging and saving the lives of millions. Some of these changes, however, have had the unfortunate result of limiting patient access to prescribed treatment and diminishing the overall quality of care.
Significant challenges are being faced in health care as systems restructure and reinvent themselves in a difficult and often painful effort to make more efficient use of their available resources (ICN, 2001). Since health care is such a labor-intensive industry, the stresses on these systems inexorably trickle down to affect those employed by the system. Nurses, who are the most highly trained caregivers who have ongoing, regular patient contact, stand at the very heart of…
Abramson, S. (1980). Adverse Occurrences in Intensive Care Units. Journal of the American Medical Association 244 (14): 1582-1584.
Ahmadi, M. (1989). Traditional vs. Nontraditional Work Schedules. Industrial Management 31(2), 20-23.
Bennett, M. & Hylton, J. (1990). Modular Nursing: Partners in Professional Practice. Nursing Management 21(3), 20-24.
Beauchamp, T.L. & Childress, J.F. (1994). Principles of Biomedical Ethics, 4th ed. New York: Oxford University Press.
After spending a semester in the Newborn Intensive Care Unit (NICU) as a student nurse in training, I can report that I have learned a great deal about the vital issues and practices that are involved in the intensive care unit for newborns, and about the duties and responsibilities of a nurse in that area of healthcare. Part of my training involved treating wounds and the therapeutic communication that is involved in wound care; also, I became well familiarized with the family centric care that is part and parcel of the NICU.
Family Centered Care at the NICU
hat can be more important for a family that has just been on the emotional roller coaster of giving birth prematurely to a new member of the family than being made to feel welcomed and to be treated with a great deal of professionalism and respect? There are a number…
Auckland District Health Board (2010). Car seats for babies / Information for parents. Retrieved May 2, 2013, from http://www.abhd.govt.nz.
Auckland District Health Board (2010). Establishing and Maintaining Breast Milk Supply /
Information for parents. Retrieved May 2, 2013, from http://www.abhd.govt.nz.
Aukland District Health Board (2010). Meconium and Newborn Babies / Information for Parents. Retrieved May 2, 2013, from http://www.abhd.govt.nz.
Personal Nursing Philosophy
My Nursing Autobiography
I have dreamt of being a nurse all my life. My mother and older cousins tell me stories of how I loved to line up my dolls and animals, place bandages over them to nurse their 'injuries' and stick branches in their armpits to have a feel of their temperature. Well, I believe these stories because to this day, these are the very things that keep my life going; I derive so much satisfaction from just being able to help people when they are in no position to help themselves. I took an elective nursing course in high school, where I was supposed to report at the local facility at least once every week to assist in the administration of basic care to patients. This marked the beginning of my career in nursing, and since then, I have logged almost 15 years of experience…
Reed, P. (2012). A Treatise on Nursing Knowledge Development for the 21st Century: Beyond Postmodernism. In P. Reed & N. Shearer (Eds.), Perspectives of Nursing Theory (6th ed.) (pp. 37-46). Burlington, MA: Jones & Bartlett.
Reed, P. & Lawrence, L. (2008). A Paradigm for the Production of Practice-Based Knowledge. Journal of Nursing Management, 16(4), 422-432
Volker, D.L. & Limerick, M. (2007). What Constitutes a Dignified Death? The Voice of Oncology Advanced Practice Nurses. Clin Nurse Spec., 21(5), 241-247
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.
The Politics of Nurse Jackie
Kathleen McHugh's 2012 article entitled "Nurse Jackie and the Politics of Care" offers an analytical discussion on the portrayal of nurses and the nursing profession in popular culture. The discursive assessment of nursing as seen in mass media centers less on the content of the media itself than on the sociological implications of common portrayals in relation to such critical issues as prescribed gender roles and the dynamics of care. The discussion here provides a deconstruction of the McHugh article, identifying its perspective, its primary arguments and the approach taken to delivering said argument. Specifically, the discussion will focus on the ways that the complex portrayal of the title character in the television series Nurse Jackie casts distinction in a way that the author considers positive to the public image of the profession.
McHugh composes this article for members of the nursing profession…
McHugh, K. (2012). Nurse Jackie and the Politics of Care. Nursing Outlook, 60, 12-18.
Mendes, IA, Trevizan, MA, Noqueira, MS, Mayashida, M. (2000) Humanistic Approach to Nursing Communication: The Case of hospitalized Adolescent Female.
Rev ras Enferm (2000) Jan-Mar, 53(1):7-13.
Williams, Carol A. & Gossett, Monette T. (2001) Nursing Communication: Advocacy for the Patient or Physician" Clinical Nursing Research Vol. 10 No. 3 332-340 (2001) Online available at http://cnr.sagepub.com/cgi/content/abstract/10/3/332.
Colon-Emeric, Cathleen (2006) Patterns of Medical and Nursing Staff Communication in Nursing Homes: Implications and Insights From Complexity Science. Qualitative Health Research Vol. 16 NO. 2, 1713-188 (2006)
Vaartio, H. et al. (2006)Nursing Advocacy: How is it Defined by Patients and Nurses, What does it Involve and How is it Experienced? Scand J. Caring Sci 2006 S. ept;20(3):282-92.
Tfouni, LV; de Carvalho, EC; Scochi, CG (1991) Discourse, institution, power: an analysis of the nurse patient interaction 0 Rev Gaucha Enferm 1991 Jan;12(1):20-5.
Jarrett, N. And Payne, S. (1995) A Selective Review of the Literature…
Mendes, IA, Trevizan, MA, Noqueira, MS, Mayashida, M. (2000) Humanistic Approach to Nursing Communication: The Case of hospitalized Adolescent Female.
Rev Bras Enferm (2000) Jan-Mar, 53(1):7-13.
Williams, Carol A. & Gossett, Monette T. (2001) Nursing Communication: Advocacy for the Patient or Physician" Clinical Nursing Research Vol. 10 No. 3 332-340 (2001) Online available at http://cnr.sagepub.com/cgi/content/abstract/10/3/332 .
Colon-Emeric, Cathleen (2006) Patterns of Medical and Nursing Staff Communication in Nursing Homes: Implications and Insights From Complexity Science. Qualitative Health Research Vol. 16 NO. 2, 1713-188 (2006)
In the emergency room, this distinction can have a determinant impact on the ability of the staff to preserve life and diminish pain and suffering.
The introduction of a bioethical perspective into this dialogue invokes a question as to the primacy of an interest in pursuing to the utmost the well-being of the patient. This speaks to one of the core values associating the principles of the ANA with the treatment outcomes desired in patiences. An examination of the ANA's Code of Ethics reveals that a theoretical basis exists to contend a direct correlation between the nurse's self-interest and that which is best for any given patient. There exists an essential obligation for such healthcare practitioners to "examine the conflicts arising between their own personal and professional values, the values and interests of others who are responsible for patient care and health care decisions, as well as those of the…
American Nurse's Association (ANA). (2004). The Nurses Code of Ethics. The Center for Ethics and Human Rights. Online at .
The American Organization of Nurse Executives (AONE). (2009). AONE Resource Center. www.aone.org.
Dimaria, R.A. & Ostrow, L. (2004). West Virginia University School of Nursing Makes the Move to Web-Based Learning. Technological Horizons in Education Journal, 31.
Emergency Nurses Association (ENA). (2008). Vision/Mission Statements and Code of Ethics. www.ena.org.
Communication between nurses is an important instrument for professionals to deliver safe, quality healthcare as a team. Therefore, provision of quality healthcare in hospitals, depends entirely on the capability of the health practitioners to communicate efficiently between each other. However, little healthcare education addresses inter-professional communication, and this may account for the major medical errors. In addition, communication is significant given the interdependence of professionals and the important role they play towards providing quality patient care. Various factors constitute effective and ineffective communication (Manjlovich, Antonakos and onis, 2010). espect is a factor that may facilitate effective communication while negligence is a factor that may facilitate ineffective communication.
The operating room is a crucial facility in the hospital setting. Many of the errors that arise in the operating room result from failed communication between the nurses, healthcare team and the patient. In addition, there are factors that may bring…
Manajlovich, M., Antonakos, L.C., & Ronis, L.D. (2009). Intensive Care Units,
Communication Between Nurses and Physicians, and Patient Outcomes. American Association of Critical-Care Nurses, 18(1), 21-30
Marshall, S., Harrison, J., & Flangan, B. (2009). The Teaching of Structured Tool
Improves the Clarity and Content of Inter-professional Clinical Communication. Quality and Safety in Health Care, 18(2), 137-140.
The death of a child is significant and in this case avoidable and a plaintiff has the right to seek compensatory damages as is allowed by law.
Case Study 1 Part B
At the end of the night shift, Nurse Brown took a verbal handover and then noticed the observation chart had not been filled in. To assist her friend, Nurse Harvey, whom she knew had a busy night, filled in the observation chart and fluid balance chart for the hours from 0200-0600 hrs.
Overcome by the events of the last 24 hrs, Nurse Harvey and Nurse Brown go to the local tavern for a few drinks before Nurse Harvey goes on duty. They discussed Mr. Spencer and his son. John, a friend of Mr. Spencer, overheard the conversation and joined them. He was also upset by the events of the day and was most keen to discuss the accident…
Hall, J. (1960). General Principles of Criminal Law (2nd ed.). Indianapolis: Bobbs-Merrill.
Markesinis, B.S., & Deakin, S.F. (1999). Tort Law (4th ed.). Oxford: Clarendon Press.
ANCI Competency Standards for the Enrolled Nurse at http://www.anmc.org.au/docs/Publications/Competency%20standards%20EN.pdf
Scope of Nursing Practice Decision Making Framework, 2006 at http://www.nursingboardtas.org.au/nbtonline.nsf/attachment/SoPDMFFinal/$File/Scope%20of%20Nursing%20Practice%20Decision%20Making%20Framework.pdf
It is critical that NHAs are first qualified nurses, as their ability to relate to other nurses is essential to the organizational success of the nursing home ("Nursing home administrator jobs," 2011). Career paths for an NHA are rooted with education background and nursing experience. Although experience is necessary for being a successful NHA, a career path at minimum requires clinical licensing (Decker, & Castle, 2009).
The NHA is the management body over the facility, and their positions are in high demand. In the U.S. In 2008, approximately 17,000 nursing home administrators were responsible for the oversight of care for 1 million elderly adults and 1.3 million employees (Leister, 2009). Overseeing a large nursing staff, as well as vulnerable residents, are the daily demands of the NHA. The future of NHA field is concerning to researchers and professionals, as the number of licensed NHAs is on the decline. In Maryland,…
Decker, F, and Castle, N. (2009). The relationship of education level to the job tenure of nursing home administrators and directors of nursing. Health Care Management, 34(2), 152-160.
Leister, D. (2009). The vanishing nursing home administrator: stress and intent to leave.
Informally published manuscript, Capella University, Minneapolis, MI. Retrieved from http://gradworks.umi.com/3359575.pdf
Nursing home administrator jobs. (2011). Retrieved from http://www.nursinghomesjobs.org/nursing-home-administrator-jobs/
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
Fatigue and Compassion as Functions of Ethical Nursing
The American Nursing Association's Scope and Standards of Practice are designed to provide a blueprint for preempting and addressing the various challenges, pitfalls and procedurals norms of the profession. These help to draw a professional, ethical and practical connection that offers a basic outline for that which is expected of the registered nurse. Indeed, it is of critical benefit to the nursing professional and to the patient community that there exist some clearly elaborated set of ethical standards that pertains directly to sometimes difficult to identify challenges such as bedside manner and fatigue. The American Nursing Association (ANA) provides just such standards, and these function to significantly aid in the decision-making, workplace culture and treatment processes undertaken by nurse professionals.
Ethical orientation is an important feature of a nursing team, particularly as it impacts the morale of nurses and the treatment…
AIPPG. (2010). Betty Neuman's System Model. Nursing Theories.
American Nursing Association (ANA). (2004). Nursing: Scope and Standards of Practice. Nursingbooks.
hile the article Educational Studies in Mathematics highlights the discrepancy between book and experiential learning in mathematics, the article "Interprofessional perspectives on teamwork in health care" highlights the difficulties experienced by nurses working on management teams in hospitals, and allowing their disciplines' framework of knowledge to be accepted as equal to their physician-colleagues. "There is a discrepancy between nursing's and medicine's views and expectations of 'interdisciplinary team'" (Temkin-Greener 2000, p. 641). hile medicine sees nurses in a subordinate role, in a team context, the profession of nursing sees its contribution as unique. Nursing leaders have fought to define nurses as nurses, not mere 'physician-extenders.' But when surveyed, physicians on 'interdisciplinary teams' in healthcare settings with a stress upon equality showed a lack of enthusiasm about the 'team' concept and the unique contribution of nursing. The physician's responses suggested that the viewed "teamwork as a nursing concept, beneficial primarily to nursing…
Noss, Richard & Stefano Pozzi, Celia Hoyles. (1999, October). Touching epistemologies:
Meanings of average and variation in nursing practice. Educational Studies in Mathematics. 40(1), 25-51
Temkin-Greener, Helena (1983, Autumn). Interprofessional perspectives on teamwork in health care: A case study. The Milbank Memorial Fund Quarterly. Health and Society. 61(4),
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
Nurse Case Manager:
Case management in the nursing field is basically described as the functions and activities carried out by the nurse case manager within a specific care setting. In some cases, these functions and activities are usually performed by a self-governing practitioner, especially in private case management practices and community nursing facilities (Cohen & Cesta, 2005, p.278). Generally case management responsibilities are provided by the nurse case manager in acute care, primary care, home care, and managed care organizations. Nonetheless, these activities may be offered to particular patient populations and communities like the elderly. Some of the most case management activities include patient identification and intake, problem identification and assessment, patient outreach, development and implementation of plan of care, and coordination of care.
oles and Functions of Nurse Case Manager:
In acute care organizations, the roles and functions of the nurse case manager includes coordinating the care provided to…
Blancett, S.S. & Flarey, D.L. (2006). Case studies in nursing case management: health care delivery in a world of managed care. Gaithersburg, MD: Aspen Publishers, Inc.
Cohen, E.L. & Cesta, T.G. (2005). Nursing case management: from essentials to advanced practice applications (4th ed.). St. Louis, MO: Elsevier Health Sciences.
Meadows, P. (2009, January). Community Health Nursing. American Journal of Nursing,
109(19). Retrieved from http://journals.lww.com/ajnonline/fulltext/2009/01001/community_health_nursing.5.aspx
Batcheller, J.A. (2011). On-boarding and enculturation of new chief nursing officers.
Journal of Nursing Administration, 41(5), 235-239.
This article examines the on-boarding process for new chief nursing officers by examining the onboarding process for 6 new chief nursing officers. The examination is aimed at determining what type of support leaders new to an executive role requires and how to on-board leaders who are experienced, but who are new to a particular organization. The possible implications of this research is that if the on-boarding process is insufficient, then it may contribute to high turnover rates and the short length of chief nursing officer positions.
Carlson, C.L. & Plonczynski, D. (2008). Has the BARRIER cale changed nursing practice? An integrative review. Journal of Advanced Nursing, 63(4), 322-333.
This article examines whether the BARRIER cale, which identifies nurses' barriers to using evidence-based practice, contributed to an increase in the use of…
Storch, J., Rodney, P., Pauly, B., & Fulton, T.R., Stevenson, L., Newton, L., & Makaroff,
K. (2009). Enhancing ethical climates in nursing work environments. Retrieved September 27, 2014 from Canadian Nurse website: http://www.canadian-nurse.com/en/articles/issues/2009/march-2009/enhancing-ethical-climates-in-nursing-work-environments
The article examines the outcomes of the Leadership for Ethical Policy and Practice, which was a three-year participatory action research survey aimed at nurses, managers, and other team members. The respondents found that nurse leader support was a critical component when enacting ethical leadership initiatives. They also found that an ethical leadership model resulted in higher levels of job-related satisfaction at all levels of the healthcare management team.
It has been shown through research to be critical that the organization make the provision of support for the nursing staff in terms of their education and provisioning career support as well through making time and financial allocations to provide the necessary support system in which the nursing staff may advance their education and hence their career. (Cook, Horz & Mildon, 2006; paraphrased citing the work of: Robinson, (2001 and Hinshaw (2002) Additionally falling within these provisions of support are time and financial allocations for "research, special projects and publications (Kramer & Schmalenberg, 1988; as cited by Cook, Horz, & Mildon, 2006) the research fact sheet includes the necessity for organizations to "Support a 'bias toward action' (Kramer & Schmalenberg, 1988; as cited by Cook, Horz, & Mildon, 2006); and to "Enhance nurse-staffing rations (Hinshaw, 2002; as cited by Cook, Horz, & Mildon, 2006) and lastly to provide encouragement among…
Cook, a. Hiroz, J. And Mildson, B. (2006) Strategies and Outcomes Associated Magnet Hospitals Fact Sheet II of II - Nursing Health Services Research Unit 2006 September Online available at http://18.104.22.168/search?q=cache:wmmvrr7kMqUJ : www.nhsru.com/factsheets/Magnet%2520factsheet%2520Part%2520II%2520of%2 520II%2520-%2520Strategies.FINAL.pdf+Nursing+Leadership:+Healthcare +organizational+analysis&hl=en&gl=us&ct=clnk&cd=79.
Quality First: Core Values and Concepts for Quality Leadership (2006) American Health Care Association - Provider Guidelines. Online available at http://www.ahca.org/quality/qf_corevalues.htm .
Alexander, Jeffrey; Bloom, Joan; and Nichols, Beverly (1991) Nursing Turnover and Hospital Efficiency: An Organizational Level Analysis (1991) Institute of Industrial Relations University of California Berkley
Nursing Leaderships Role: 'Key' Factors in Organizational Analysis
The budgeting process at CHOMP is varied and requires that nursing managers and department heads keep a close eye on the daily activities of staff. It is described as a structured process that begins with planning meetings in August with the financial services department. The department director and the Vice President sign off on the budget in December, and then all budgets are reviewed by the President's Advisory Committee which includes the CEO and the Vice Presidents.
Department directors also have to sign off on their budget in November or December. Budgeting decisions are made by each nursing department. The budget is generally two to three million dollars, including wage and non-wage budgets. The budget is flexible. Nurses need to stay between 95-105% for productivity with an aim of 100%. The budget is averaged so on days when full time employees exceed the hours budgeted based on patient numbers they…
About Us." (2005). Available:
Schmaedick, G.L. (1993). "Cost-effectiveness in the nonprofit sector: Methods and examples from leading organizations." Westport, CT: Quorum Books.
Ward Jr., W.J. (1994). "Health care budgeting and financial management for non- financial managers." Westport, CT: Auburn House.
Resources needed include manpower and positional aids mentioned previously in this report. Evaluation of the effectiveness of the change would be accomplished through data collection related to the frequency of pressure ulcer occurrence in patients and nurse compliance in the four hours supine positional rotation of patients. Questionnaires will also be administered to nursing staff in order to gain insight as to their attitudes, behaviors and perceived barriers to pressure ulcer prevention.
Phase V: Transplantation and Application
This study concludes that positional rotations of every four hours has been shown to be the most effective prevention of pressure ulcer formation in older patients in elderly care homes and further that that attitudes, behaviors and perceptions of barriers in the view of staff nurses predicts the effectiveness of the implementation of such a prevention program for pressure ulcer care. (Moore and Price, 2006)
Exact Nature of Practice Implications
____ Change the…
Moore, Z. And Price, P. (2004) Nurses' Attitudes, Behaviors, and Perceived Barriers Towards Pressure Ulcer Prevention Journal of Clinical Nursing 13, 2004.
Vanderwee, K.; Grypdonck, D.; Bacquer, De and Defloor, T. (2006) Effectiveness of Turning with Unequal Time Intervals on the Incidence of Pressure Ulcer lesions. JAN Original Research 10 July 2006.
Nursing: Utilization Review
Many recommend use of minimally invasive techniques including SEPS to treat and address problems related to chronic venous insufficiency (Kalra & Glovisczki, 2002). Multiple studies confirm the safety and efficacy of SEPS when used early, especially resulting from its low complication rates compared with other procedures including the formerly popular Linton procedures (Kalra & Gloiscki, 2002; Lee, et al. 2003; Tenbrook, et al., 2004; Bianchi, et al. 2003).
More randomized clinical trials are necessary however to answer additional questions related to the efficacy of new procedures including SEPS, though this procedures remains important for patients with advanced CVI secondary to PVI or with patients who do not demonstrate other complications including DVT (Kalra & Gloiscki, 2002; Bianchi, et al. 2003).
Wagner-Cox (2005) also notes that it is important for nurses to be considerate, knowledgeable and compassionate toward patients with acute and chronic illnesses, especially when caring for…
Baranoski, S. & Thimsen, K. (2003, Aug). "Oasis Skin and Wound Integumentary
Assessment Items: Applying the WOCN Guidance Document." Home Healthcare Nurse, 21(8): Supplement 3-13.
Baron, H.C., Wayne, M.G., Santiago, C.A. & Grossi, R. (2004, Sep-Oct). Vasc
Endovascular Surg. 38(5): 439-42.
cute care facilities try to maintain low costs and employ quality nurses. Within this statement is a double standard. How can we have quality nurses and cut costs at the same time? This is where the skill mix comes into play. In the skill mix, there are Registered Nurses (RNs), Licensed Practical Nurses (LPNs), and unlicensed staff. If the lesser skilled staff free RNs they can be better able to perform their nursing duties and assessments. If acute care facilities can agree on an appropriate number of each type of staff member within the facility, they might be better able to accomplish safe patient outcomes while keeping costs down.
Determining nurse-to-patient ratios is a complex issue where one solution is not sufficient to cover all circumstances. The merican Nurses ssociation assembled a panel of nursing and health professionals to research appropriate staffing levels. The panel developed the following Matrix for…
Aiken and colleagues have been pioneers in studying nurse patient ratios and their relationship to patient outcomes.
Aiken, Sochalski, and Lake (1997) demonstrated that nursing presence, whether measured as RN ratios or as RN hours relative to other nursing personnel hours, is significantly correlated to mortality. When studying patient outcomes in specialized AIDS units,
Aiken, Sloan, Lake, Sochalski, and Weber (1999) found that at 30 days post admission, mortality rates were 60% lower in magnet hospitals, and 40% lower in dedicated AIDS units than in conventional scattered bed units. The researchers concluded that higher nurse patient ratios were a major factor in these lower
Nursing Culture: Overcoming Barriers to Change
Introduction and Theoretical Framework
This program of study continues personal research and professional practice in the field of nursing within the area of public and private health systems. In an era characterized by increasing calls for more efficient approaches to healthcare delivery and accountability on the part of healthcare providers, there is a growing need for identifying opportunities to overcome organizational barriers to change that facilitate the implementation and sustainment of evidence-based practices over time. In order to accomplish this challenging enterprise, the nature of existing organizational barriers must be better understood, an issue that directly relates to the problem to be considered by the study proposed herein and which is discussed further below.
Statement of the Problem
According to Mannion, Davies and Marshall et al. (2005), the results of much of the research to date have identified a relationship between nursing culture and…
Banyard, V.L., & Miller, K.E. (1998). The powerful potential of qualitative research for community psychology. American Journal of Community Psychology, 26(4), 485.
Burton, S., & Steane, P. (2004). Surviving your thesis. New York: Routledge.
Dennis, C., & Harris, L. (2002). Marketing the e-business. London: Routledge.
Department of Health. (2000). The NHS plan: A plan for investment, a plan for reform. London:
Besides facing stress, and having easy access to medications, critical care and emergency nurses may use recreational drugs more often because they are more likely to have a sensation-seeking personality trait (www.nurseweek.com/news/98-5/25e.html)."
Getting treatment for chemical dependency will help the nurse get back to his or her daily life, however the nurse will have to address concerns and/or consequences related to the addiction. He or she faces a "multitude of traumatic experiences both potential and real, such as arrest, license suspension/revocation; negative publicity; reactions of family, friends and co-workers; fines; board and legal hearings; inability to secure work other than nursing; physical illness; and possible lack of health insurance. In the treatment setting, issues such as these add complexity to the nurse's recovery (Anderson)."
There are other complications which must be addressed during treatment of the impaired nurses. These issues include being considered a role model by everyone,…
Anderson, Jenny Lynn. "Treatment considerations for the addicted nurse." Behavioral Health
Management. (1994): 01 September.
(Substance abuse in nurses varies by specialty. (accessed 15 November, 2004).
Third, lack of attention to evidence-based practice can lead to inconsistent delivery of care services.
Evidence-based practice relates to almost every aspect of health care at every stage of a client's relationship with the institution. For example, evidence-based practice informs the types of questions asked during the diagnostic procedures and might even impact the diagnosis itself (Bennett & Bennett, 2000). Evidence-based practice impacts the methods by which infections are prevented (Cantrell, 2009). Evidence-based practices impact the extent to which nurses are empowered to make sound, safe, and effective decisions (Scott & Pollock 2008). Evidence-based practice has the potential to transform the structure of a health care organization like MMH. This is because evidence-based practice changes the hierarchical structure in the organization due to the increased responsibility of nurses for conducting their own research. Alternatively, evidence-based practice can be an extension of organizational change. Health care organizations reducing the hierarchical nature…
Artinian, B.M., West, K.S., & Conger, M.M. (2011). The Artinian Intersystem Model. New York: Springer.
Bennett, S. & Bennett, J. (2000). The process of evidence-based practice in occupational therapy: Informing clinical decisions. Australian Occupational Therapy Journal (2000), 47, 171-180.
Burns, N. & Grove, S.K. (2009). The Practice of Nursing Research. St. Louis, MO: Saunders.
Cantrell, S. (2009). Performing under pressure: Caring for decubitus ulcers. Healthcare Purchasing News. Aug 2009.
Drug dosing is often based overall on the "volume of distribution for the loading dose and on the clearance for maintenance, with volume of distribution being increased if drug is distributed among lean and fat tissues (Casati & Putzu, 2005).
Coe, Saleh, Samuel & Edwards (2004) report that multiple problems related to anesthesia and obesity exist. The level of obesity defined by MBI has a significant impact on the type of anesthesia most patients choose (Coe, et. al, 2004). ecent studies have focused on encouraging patients to lose a certain amount of weight prior to surgical intervention to make anesthesia delivery a more viable and safe option (Coe, et. al, 2004). Unfortunately most patients undergoing bariatric surgery have utilized all other resources thus must risk any potential contraindications associated with anesthetic delivery in order to lose weight.
Obesity is a complicated and rapidly advancing disease affecting millions of people…
Bostwick, G.J. & Melcher, J. (1998). "The obese client: Myths, fats, assessment and intervention." Health and Social Work, 23(3): 195.
Cabay, C., Dreyer, M.G. & Pellegrinelli, N. (2001 - May). "Leptin directly induces the secretion of interleukin-1 receptor antagonist in human monocytes." Journal Clinical Endocrinology Metabolism 86: 783-91.
Casati, A. & Putzu, M. (2005 - mar). "Anesthesia in the obese patient: Pharmacokinetic considerations." J. Clin Anesth. 17(2): 134-45.
Coe, A.J., Saleh, T., Samuel, T., Edwards, R. (2004 - Jun). "The management of patients with morbid obesity in the anaesthetic assessment clinic." Anaesthesia, 59(6): 570-3.
Certainly, in my interview with a professional nurse educator, I would gain further reinforcement for the findings outlined above. Specifically, the subject of my interview would state unequivocally that the difficulty of being a nurse educator is today greater than it has ever been. I spoke at length with the Unit Nurse Educator in a local university hospital ward and learned a great deal about the specific daily challenges that come with the role.
First, she explained that one of the biggest challenges she faces every day concerns how best to channel and utilize the labor at her disposal. She explained that "our hospital, like a lot of other hospitals in the region, has been effected by a nursing shortage. Many of the people that work here must work long, hard hours, which has an effect on morale and on turnover. Because of this, one of the biggest…
Kramer, M., Schmalenberg, C., Maguire, P., Brewer, B., Burke, R., Chmielewski, L., Meeks-Sjostrom, D. (2009). Walk the talk: Promoting control of nursing practice and a patient-centered culture. Critical Care Nurse, 29(3), 77-93.
Motacki, K., & Burke, K. (2011). Nursing delegation and management of patient care. St. Louis, MO: Mosby Elsevier.
Parker, V., Giles, M., & Higgins, I. (2009). Challenges confronting clinicians in acute care. Journal of Nursing Management, 17(6), 667-78.
Theoretical Foundations of Nursing:
Nursing can be described as a science and practice that enlarges adaptive capabilities and improves the transformation of an individual and the environment. This profession focuses on promoting health, improving the quality of life, and facilitating dying with dignity. The nursing profession has certain theoretical foundations that govern the nurses in promoting adaptation for individuals and groups. These theoretical foundations include theories, theory integration, reflection, research and practice, and assimilation.
Grand Nursing Theory:
There are several grand nursing theories that were developed by various theorists including the Science of Unitary Human Beings by Martha ogers, Sister Callista oy's Adaptation Model, and Systems Model by Betty Neuman. Sister Callista oy's Adaptation Model is based on the consideration of the human being as an open system. She argues that the system reacts to environmental stimuli via cognator and regulator coping techniques for individuals. On the other hand, the…
American Sentinel (2012). 5 Steps for Nurses to Stay Updated with Health Care Changes.
Retrieved September 4, 2013, from http://www.nursetogether.com/5-steps-for-nurses-to-stay-updated-with-health-care-changes
Andershed, B. & Olsson, K. (2009). Review of Research Related to Kristen Swanson's Middle-range Theory of Caring. Scandinavian Journal of Caring Sciences, 23, 598-610.
"Application of Theory in Nursing Process." (2012, January 28). Nursing Theories: A
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,…
Public Health Nurse Interview
When it comes to community education and health care, nurses are essential. They provide important services, but they also provide a lot of ongoing support and education. Those are all important aspects of what they do, and can significantly alter and affect a community based on how they are handled. There are three roles that nurses play in a community when it comes to the prevention of health care problems: primary, secondary, and tertiary. Those will be discussed here, along with an interview conducted with Sarah Winters, a nurse who has been working in community education for 35 years. By combining the educational information of various sources with the personal information that can only be provided by interviewing a person in the field, a better understanding of the role and value of the community health nurse can be seen. That provides insight to communities who are…
D'Antonio, P. (2010). American nursing: A history of knowledge, authority, and the meaning of work . NY: JHUP.
Fairman, J. & Lynaugh, J.E. (2000). Critical care nursing: A history. NY: Jones & Bartlett Learning.
Fitzpatrick, J.J. & Kazer, M. (eds.). (2011). Encyclopedia of nursing research (3rd. ed.). NY: Springer Publishing Company.
Longe, J. (ed.). (2013). Gale encyclopedia of nursing and allied Hhealth (6 vol.). NY: Gale Group.
The American Association of Colleges of Nursing (AACN) and the Council on Graduate Education for Administration in Nursing (AACN, 1996; Dienemann & Aroian, 1995) operationally define the professional nurse as one who has been prepared with a minimum of a baccalaureate or higher degree in nursing. (Feldman & Greenberg, 2005, p. 219)
These were necessary requirement in the 90's. Now in an ever increasing age of need for more highly educated professional, the Clinical Nurse Leader armed with a Master's degree or better, is more adapted to handle a wide range of situations and create a fulcrum from which to balance all the staff in a given unit.
Clinical Nurse Leader
Kennedy, M.S.. (2004) Introducing the Clinical Nurse Leader. American Journal of Nursing, 104 (10), 22.
This article is a report regarding the decisions calling for a new role for nurses. The American Association of Colleges of Nursing…
Dalton, B., & Wright, L. (1999). Using Community Input for the Curriculum Review Process. Journal of Social Work Education, 35(2), 275.
Feldman, H.R. & Greenberg, M.J. (Eds.). (2005). Educating Nurses for Leadership. New York: Springer.
Kennedy, M.S.. (2004) Introducing the Clinical Nurse Leader. American Journal of Nursing, 104 (10), 22.
Knorr, R.S., Condon, S.K., Dwyer, F.M., & Hoffman, D.F. (2004). Tracking Pediatric Asthma: The Massachusetts Experience Using School Health Records. Environmental Health Perspectives, 112(14), 1424-1439.
" (Morris & Woodcock, 2004)
V. Murakami et al. (2003)
In the work entitled: "Deep Venous Thrombosis Prophylaxis in Trauma: Improved Compliance With a Novel Miniaturized Pneumatic Compression Device" the authors state that: "Intermittent pneumatic compression (IPC) devices prevent lower-extremity deep venous thrombosis (LEDVT) when used properly, but compliance remains an issue." (Murakami et al., 2003) the study conducted by Murakami et al. (2003) is stated to be a."..prospective trial in which trauma patients (mean age, 46 years; revised trauma score, 11.7) were randomized to DVT prophylaxis with a standard calf-length sequential IPC device (SCD group) or a miniaturized sequential device (continuous enhanced-circulation therapy [CECT] group). Compliance rates for all subjects were averaged in each location: emergency department, operating room, intensive care unit, and nursing ward." (Murakami et al., 2004) the study results state that: "Total compliance rate in the CECT group was significantly higher than in the SCD group…
Kehl-Preutt, Wendy (2006) Deep Vein Thrombosis in Hospitalized Patients: A Review of Evidence-based Guidelines for Prevention. Dimensions of Critical Care Nursing March/April 2006. Vol. 25 No.2. Online available at http://www.nursingcenter.com/prodev/cearticleprint.asp?CE_ID=636024 .
Chang, David et al. (2002) Compliance with sequential compression device prophylaxis in at-risk trauma patients: a prospective analysis. Am Surg. 2002 May;68:470-3 Online available at http://lib.bioinfo.pl/auid:1350109.
Practice Alert: Deep Vein Thrombosis Prevention" (2006 American Association of Critical-Care Nurses Journal " Vol. 23 No. 1 January 2006.
Morris, Rhys J. & Woodcock, John P. (2004) Evidence-Based Compression: Prevention of Stasis and Deep Vein Thrombosis. Ann. Surg. 2004 February 239(2): 162-171.
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
.. 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,
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.
Refinement of a Nursing Concern into an Evidence-based Practice Proposal Using the Research Process
Research is mainly used to generate new knowledge or for the validation of existing knowledge based on a theory. Evidenced-based practice (EBP) is the translation of evidence and applying the evidence to clinical decision-making. Most of the evidence used in EBP stems from research. However, EBP will go beyond the use of research and it will include clinical expertise together with patient preference and values. EBP will make use of the evidence developed or knowledge discovered using research to determine the best evidence that can be used or implemented in clinical practice. Research and EBP go hand in hand in that while one will generate new knowledge, the other will make practical use of the knowledge and make use of the knowledge by implementing it into clinical practice. EBP is supported by research since any…
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…
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.
The progressive care unit (PCU) is a practice setting in which the researcher’s health care team is often failing to meet quality care objectives according to patient reporting on the hospital consumer assessment of healthcare providers and systems (HCAHPS). Opportunities for growth in quality care based on the HCAHPS of the PCU include topic areas related to patient inclusion as well as communication skills of the members of the healthcare team. Patient perception of quality is that the healthcare team in the PCU is unable to explain the care process in a way that the patient and family members feel comfortable with or that allows them to understand the care that is being provided to them. The researcher has first-hand experience with this challenge in the PCU and has heard first-hand from patients there that the care seems disjointed, that continuity is lacking, and how problematic it is for…
Master of Science in Nursing (MSN) - RN to MSN - Family Nurse Practitioner
I wish to pursue a Master of Science in Nursing (MSN). The program is specifically designed for RNs such as myself to obtain an MSN in this field. I consider this the next step in my journey to my ultimate goal of nursing a doctor of nursing practice.
I have been working as an RN since 2007. I will receive my BS in nursing from Holy Names University in August of 2015. I am proud to say that I have a straight A average and have received the distinction of being placed on the president's list because I have maintained a 3.8-4.0 G.P.A every semester.
For all of my classes, I completed numerous research papers on a variety of nursing topics, spanning from technical subjects regarding nursing care to nursing…
Exercising Leadership as a Charge Nurse
At some point in their careers, many people are called upon to be leaders at some level. A personal example of this eventuality was my promotion to charge nurse in a hospital setting where I was required to exercise leadership in ways that improved health care, including a reduction in the noise levels of my ward to promote a restful and comfortable environment for inpatients. This paper describes this leadership experience, including the rationale in support of this intervention, a description of what actions were taken in response. In addition, an analysis of the barriers that were encountered during the implementation and administration of the noise level reduction intervention is followed by a discussion concerning what actions could have been taken to make the intervention more effective. Finally, a summary of the research and important findings concerning this leadership experience are presented in the…
Freedman, N. S., Kotzer, N., & Schwab, R. J. (1999). Patient perception of sleep quality and etiology of sleep disruption in the intensive care unit. American Journal of Respiratory and Critical Care Medicine, 159, 1155-1162.
Hultman, T., Coakley, A. B., Annese, C. D. & Bouvier, S. (2012, July 1). Exploring the sleep experience of hospitalized adult patients. Creative Nursing, 18(3), 135-141.
Patel, M., Chipman, J., Carlin, B., & Shade, D. (2008). Sleep in the intensive care unit setting. Critical Care Nursing Quarterly, 31, 309-318.
Wenham, T. & Pittard, A. (2009). Intensive care unit environment. Continuing Education in Anaesthesia, Critical Care & Pain, 9(6), 178-183.
This is a 12 lead ECG taken for Mr. Long at the Emergency Department. He presented with a two hour history of chest pain radiating to his left arm. The ECG is suggestive of an antero-septal Myocardial infarction. Further scrutiny of the ECG displays a normal sinus rhythm, with a rate of 75 bpm that is regularly regular. There is no axis deviation with a P interval of 200 ms and normal qrs complexes. Leads I and aVL also show a q wave which may be suggestive of an old high lateral wall MI. Leads I, V1, V2, V3 and aVL show ST segment elevation of greater than 2 mm and ST segment depression in leads II and III. Mr. Long is suffering from a fully evolved ST-segment elevation myocardial infarction.
A correlation can be made with the area of myocardium involved and the vessel involved. The antero-septal…
B, Deborah, Diercks. (2010). Mission Lifeline: Developing a STEMI regonal care. American Heart Association. -. Print.
Jois, P. (2011). Nstemi and stemi: therapeutic updates 2011. The Practical Journal for Emergency Physicians, 32(1), 1-7.
Katzung, B., & Masters, S. (2011). Katzung's pharmacology. (9 ed.). United States of America: Mc-Graw Hill.
Kumar, V., & Robbins, (2007). Basic pathology. (8 ed.). London: Saunders Company.
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.
Caring in Nursing
Over time, nursing and caring have largely been regarded synonymous. With that in mind, it is important to note that quite a number of caring theories have been developed based on caring as a central concept. Some of these theories include the Cultural Care theory by Leininger as well as the Human Caring theory by Jean Watson whose development took place in 1970's. In this text, I will concern myself with caring as a concept in nursing. In so doing, I shall come up with a detailed evaluation of the nature of the practice theory gap most particularly in Bahrain as far as nursing is concerned.
Caring in Nursing: A Definition
To begin with, it is important to note that caring behaviors in the context of nursing can be taken to be those approaches as well as practices that are evidenced by nurses as they seek to…
Barker, A.M. (2009). Advanced Practice Nursing: Essential Knowledge for the Profession. Jones and Bartlett Learning
Callara, L.E. (2008). Nursing Education Challenges in the 21st Century. Nova Publishers
Chitty, K.K. (2005). Professional Nursing: Concepts and Challenges. Elsevier Health Sciences
Cody, W.K. (2006). Philosophical and Theoretical Perspectives for Advanced Nursing Practice. Jones & Bartlett Learning
In the previous section, Estabrooks raised the question of the ability of the EP framework to provide the "best evidence" in nursing practice and the danger of excluding nurses in decision-making tasks as a result of EP prevalence and dominance.
Rolfe, while he analyzed the empirical foundations of EP, also looked at it from a practical perspective, or how EP is applied in the current practice of nursing. Identifying the problem of EP as the question of its "technical rationality," Rolfe uncovered an important issue that best describes also Estabrooks' contentions in her article: the "theory-practice" gap in nursing practice.
In thoroughly discussing this phenomenon in nursing, Rolfe illustrated how theory-practice gap occurs in the practice scenario (39):
First, that nurses rarely read research reports; second, that when they do read them, they rarely understand them; and third, even when they do read and understand research reports, they are reluctant…
Avis, M. (Oct 2006). "Evidence for practice, epistemology, and critical reflection." Nursing Philosophy, Vol. 7, Issue 4.
Estabrooks, C. (1998). "Will evidence-based nursing practice make practice perfect?" Canadian Journal of Nursing Research, Vol. 30, No. 1.
McCormack, B. (2006). "Evidence-based practice and the potential for transformation." Journal of Research in Nursing, Vol. 11, No. 2.
Rolfe, G. (Jan 2006). "Nursing praxis and the science of the unique." Nursing Science, Vol. 19, No. 1.
Define the Problem
Today, there is a serious problem within the nursing field. There is a huge shortage of nurses in general, but an even greater shortage of nurses with higher levels of education. This ultimately means there are less capable nursing staff that can take on specialty and leadership roles. Unfortunately, "without a more educated nursing workforce, the nation's health will be further at risk" (Tri-Council of Nursing, 2010). Without greater numbers of RNs with advanced degrees, there is only so much the available nursing population can contribute within the field of healthcare. It is clear that "nurses with advanced education are needed in large numbers to serve as teachers, scientists, primary care givers, specialists, and leaders throughout the healthcare delivery system" (Tri-Council of Nursing, 2010). Currently, there is a huge shortage of more advanced nursing specialists and practitioners. s the nation's healthcare demands continue to grow and…
A survey of the existing research that provides statistics to show how alarming the problem is becoming, but also to provide foundation for the most potentially successful solutions. The projected numbers of needed advanced nursing specialists, as well as the goals for future benchmarks, all need to be documented within the context of this research in order to show how dire the problem is and create a foundation for potential solutions. The research was carefully surveyed and thus, data was collected through comprehensive means. The ideal target / benchmark uncovered in this search was that 80% of nursing staff should hold baccalaureate degrees (Pecci, 2013). This research also helps focus in on the most lucrative proposed solutions as a way to promote them within actual practice. It needs to uncover solid alternatives that can help increase the number of advanced practice nurses in this country in a practical and feasible manner. Essentially, the data collection is a survey of prior research, and can be done independently. This means I will personally scour the published resources from academic and scholarly sources, as well as from professional nursing organizations.
A number of alarming statistics were uncovered in this comprehensive search of the research. If the situation continues as it is today, by 2025, there will be a shortage of 260,000 nurses in this country (American Nurses Association, 2010). Only about 50% of RNs working today have a baccalaureate degree, with only 13.2% holding a master degree or higher (American Nurses Association, 2010). Even more alarming, the enrollment growth of entry-level baccalaureate nursing programs from 2008 to 2009 was only 3.5%
However, women also receive labor support even when its starts at a later stage in labor, in settings with companions of their choice, and settings with routine epidural. The supportive care provided to women during labor and birth through the one-to-one nursing includes various processes like provision of physical comfort and information and emotional support. The other processes include assisting women to communicate to caregivers and engaging members of their family as desired by the woman.
As an important part of one-to-one nursing during stages of labor and delivery, continuous support during childbirth enhances the normal labor processes while lessening the use of obstetric interventions. Therefore, this kind of support is an exceptional element of maternity care that provides well-established incentives and has no identified disadvantages.
Enhancement of Spontaneous Vaginal Birth:
Since continuous one-to-one nursing support during childbirth enables women to avoid analgesia or anesthesia and cesarean surgery, it's vital…
Barrett, S.J. & Stark, M.A. (2010). Factors Associated With Labor Support Behaviors of Nurses.
Journal of Perinatal Education, 19(1), 12-18. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2820357/
"Chapter 5 -- Care During Labour and Birth." (n.d.). Family-Centered Maternity and Newborn
Care: National Guidelines. Retrieved from Public Health Agency of Canada website: http://www.phac-aspc.gc.ca/hp-ps/dca-dea/publications/fcm-smp/fcmc-smpf-05-eng.php#careduring
Two practice concepts specific to nursing:
Culturally-informed care for the 'person' and 'environment'
Two practice concepts specific to nursing:
Culturally-informed care for the 'person' and 'environment'
As a clinical nurse specialist (CNS), an advanced practice nurse "whose care focuses on a specific patient population," the concept of multicultural care is integral to my daily practice (CNS, 2011, career overview). "A CNS can specialize in certain types of diseases (such as diabetes or cardiovascular disease), can work in many different medical environments (such as operating room, emergency room or critical care), and can focus on a variety of procedures (such as surgical or clinical)" (CNS, 2011, career overview). egardless of the specialty of the CNS the care he or she dispenses must be culturally appropriate and take into consideration the patient's daily environment. A CNS must often be even more conscious of the social implications of nursing care than nurses…
Clinical nurse specialist (CNS). (2011). Career overview. Retrieved March 5, 2011 at http://www.allnursingschools.com/nursing-careers/clinical-nurse-specialist/cns
Diabetes and women's health. (2011). Centers for Disease control (CDC).
Retrieved March 5, 2011 at http://www.cdc.gov/diabetes/pubs/women/index.htm
Nursing theories: An overview. (2011, March 1). Current Nursing. Retrieved March 5, 2011 at http://www.currentnursing.com/nursing_theory/nursing_theories_overview.html
Health Information Technology has significant impacts on nursing policy and practice including the role of these professionals in patient education. Actually, the Information Technology development process in healthcare is based on the nurses' ability to understand the community and provide distinctive insights about patient education among other factors (Effken & Abbott, 2009). Since nurses are important elements of the healthcare system, they are critical in ensuring that the confidence of patients in the health providers is maintained even as technology mediates interactions.
The main impact of the emergence of Health Information Technology on the role of a nurse in patient education is that technology mediates interactions between patients and their care providers. As a result, nurses are required to ensure that the role technology plays in mediating these interactions does not affect the insights provided in the process or the delivery of improved patient care. Moreover, through Health Information Technology,…
Adams, K., Greiner, a.C. & Corrigan, J.M. (2012). Chapter 5 -- Patient Self-Management
Support. Retrieved from the National Academies Press website: http://www.nap.edu/openbook.php?record_id=11085&page=57
Bastable, S.B. (2008). Nurse as educator: principles of teaching and learning for nursing practice (3rd ed.). Sudbury, MA: Jones and Bartlett Publishers.
Effken, J.A. & Abbott, P. (2009, August). Health it-enabled Care for Underserved Rural
I believe that my education and my professional experience in management genres, in healthcare -- including working as a nursing assistant and in homecare environments -- and in business have prepared me well for a career in nursing. After reviewing my qualifications and my skill set -- revealing that I have a history of competent, dependable involvement in worthy vocations -- and the extent of my career interests, I believe it will be clear that I am well positioned for a career as a practical nurse.
Reasons that justify my Goal of becoming a Practical Nurse
First of all, I am very familiar with a number of pivotal aspects of medicine and healthcare and have worked extensively in the industry. I have an Associate Degree in Respiratory Therapy (1992) from the California College of Health Sciences through St. Joseph's Hospital in Minot, North Dakota. As a respiratory therapist at…
Senior nursing staff ought to aid peers in their career development through helping them practically employ theoretical knowledge and promoting testing of novel skills within an encouraging, safe work climate. This illustrates a combination of leadership and developmental tasks, that together lead to the creation of proficient practitioners via practice-grounded learning. These nursing personnel ought to employ a supportive approach to leadership, incorporating mentorship, guidance and tutoring as their key values. Substantial support on the part of nursing supervisors is known to decrease emotional fatigue and buffer adverse impacts of their work environment. Thus, it would prove especially advantageous if supervisors offer junior employees emotional backing and provide proper performance-related feedback for improving their self-confidence (Seitovirta, 2017).
I personally feel that leaders ought to believe in and respect human dignity. Their leadership approach ought to integrate empathetic listening, encouragement, attentiveness, motivation, and preserving a rewarding organizational culture. It implies…