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DNP-prepared nurse, there is likelihood of encountering several different methods of disseminating the findings and implications of an evidence-based project. The existence of varying methods for presentation of findings and implications of an evident-based project is fueled by the unique benefits of each method. Therefore, the DNP-nurse should be careful when choosing his/her method of presenting findings and implications through thorough analysis and consideration of the unique benefits of each method. It is important for the nurse to conduct such analysis in order to enhance chances of delivering effective presentations. Moreover, the need to choose an effective presentation method by a DNP-prepared nurse is attributed to the fact that these professionals are uniquely qualified to lessen the gap between research and practice (Vincent et al., 2010, p.28).
Generally, there is a wide range of opportunities and methods that can be used by DNP-prepared nurses to disseminate the findings and implications…
Bradley, E., McSherry, W. & McSherry, R. (2010, November 6). Disseminating Research: How
Joint NHS and University Posts Can Support This Process. Retrieved October 24, 2014, from http://www.nursingtimes.net/nursing-practice/specialisms/management/disseminating-research-how-joint-nhs-and-university-posts-can-support-this-process/5021440.article#
DiCenso, A. (2003, December). Research: Evidence-based Nursing Practice: How to Get There
from Here. Nursing Leadership 16(4), 20-26. Retrieved from http://www.longwoods.com/content/16257
The provision of healthcare requires patience, compassion and dedication. In addition to possessing these qualities and desiring to share them with those in the greatest need, I am well-suited for the emotional, practical and educational rigors of a distinctly challenging occupation. Though I am driven by professional ambition, academic achievement and a degree of healthcare experience, I am also inspired by the deeply personal interest in helping others. I believe that the advanced level focus of the Doctor of Nursing Practice (DNP) is particularly suited to the development of the skills and knowledge required to truly qualify as an outlet for such help.
Indeed, the DNP program appears to serve in the achievement of both my short- and long-term goals as an evolving professional. The emphasis on improving practice skills and treatment quality suggest that a DNP program will make me a better provider of healthcare services on a day-to-day…
American Association of Colleges of Nursing (AACN). (2010). The Doctor of Nursing Practice. AACN.NCHE.edu.
Cramp, L. (2005). PhD vs. DNP. All Experts.
Over the course of the practicum, I hope to enhance my knowledge, the first level of Bloom’s Taxonomy of knowledge (1999), of how to communicate with patients from different cultural contexts in a more effective fashion. As noted in the DNP essential regarding the scientific underpinnings of practice, biological, psychological, and social factors must all be integrated into evidence-based analysis. Specific patient groups, according to the scientific literature, may face unique health barriers based upon a host of different factors and the nurse must be aware of these obstacles.
Also over the course of the practicum, I hope to expand upon my application of knowledge to enhance my ability to engage in interprofessional collaboration, another DNP essential. Healthcare is increasingly a team effort. Nurses must be regarded as key players on leadership teams to ensure that patient-centered perspectives are given equal value as other perspectives in medicine. Understanding different professional…
Essential aspects of DNP education. (2017). AACN. Print.
Transtheoretical Stages of Change Model. (2016). Boston University. Retrieved from:
http://sphweb.bumc.bu.edu/otlt/MPH - Modules/SB/BehavioralChangeTheories/BehavioralChangeTheories6.html
Academic and Professional Goals: Doctorate in Nursing Practice
Shortly after beginning my career as a licensed practical nurse I became interested in palliative and hospice care, in addition to advancing my professional career through further academic preparation to become a registered nurse. After earning a two-year associates degree in nursing and obtaining licensure in the State of Florida, I obtained a staff nursing position at Hope Hospice and Community Services in Lee County. While there I earned the trust of my colleagues and supervisors and took on the roles of case manager for Medicare home visits, after hour's triage manager, and charge nurse for a 36-bed inpatient free-standing facility.
The clinical experience I obtained as an RN increased my awareness of persistent unmet care needs within this patient population and how pursuing further academic training could help me address these needs. Accordingly, I completed a four-year nursing degree as preparation…
Immersion Project: Best Practice ecommendations for End-Stage Dementia Care
My immersion project created opportunities to interact with other care professionals, including primary care physicians, nurse practitioners, geriatric specialists, hospice nurses, and hospice administrators. Through these interactions I came to realize that there was a great need for best practice recommendations for end-stage dementia care, among primary care providers and the clinicians staffing long-term care facilities. Writing the literature review helped me realize that best practice recommendations do exist, but are not readily accessible to clinicians who need reliable and accurate tools for estimating life expectancies of terminally ill patients. The best tool available for patients suffering primarily from dementia, based on my research in this field, was the one developed by Mitchell and colleagues (2010a). Despite using the best evidence available for developing this tool, accuracy was modest at best and the authors of this study concluded that the provision…
O'Grady, E.T. (2008). Advanced practice registered nurses: The impact on patient safety and quality. In R.G. Hughes (ed.), Patient Safety and Quality: An Evidence-Based Handbook for Nurses (pp. 2-601-2-620). Rockville, MD: Agency for Healthcare Research and Quality.
Much has been written about the current nursing shortage and its impact upon the healthcare profession as a whole: with too few nurses on call, existing staff members are forced to work longer and later hours. This inevitably contributes to medical errors, burnout, and, ironically enough, poorer retention rates of experienced nurses. The nursing shortage thus can become a self-perpetuating cycle. The more unpleasant the conditions, the fewer and fewer nurses wish to remain in the profession and fewer people want to enter the profession. This state of affairs will only worsen in the future as more baby boomers are likely to retire from nursing. However, the source of the shortage is not simply a lack of willing and able candidates: nursing schools admit that they turn away many potentially qualified candidates year after year. With a shortage of nursing faculty, institutions have no other choice. A lack of…
DNP today a clash of culture, power, politics or none of these?
When first instituted, the DNP (Doctor of Nursing Practice) degree was thought to address a very important deficit within the nursing profession, namely a need for greater preparation of nurses to enter an increasingly complex and technologically sophisticated medical environment while still staying true to the practice-based focus of nursing. Before the DNP, nurses could either effectively remain stalled at the master's level of education or they could pursue a PhD, a research-focused degree. The DNP was designed to 'bridge the gap' between these two degrees for nurses who wished to remain in clinical practice yet gain a greater grounding in evidence-based medicine. Today, "there are many enthusiasts toward the DNP. Seen by some as a symbol of social progressivism…better parity with other practice disciplines such as medicine, audiology, physical therapy, and pharmacy, which all require a doctoral…
Bachmann, H. (2011) SDS reports: The DNP degree. Retrieved from:
Bellini, S. (2012). The Doctor of Nursing Practice for entry into advanced practice: The
controversy continues as 2015 looms. NAINR. 12(1):1-6. http://www.medscape.com/viewarticle/760749_6
DNPs Are Effective Leaders
The Doctorate of Nursing Practice (DNP) prepares leaders for the fast changing health care industry and provides opportunity for candidates to integrate their quotidian practice skills with the knowledge gained in their studies. Every industry is experiencing change, but few sectors are changing as rapidly as medicine and health care. For instance, technology has been disruptive in medicine and healthcare -- as it has everywhere else -- acting as both catalyst and vehicle for telemedicine. And soon medical records for all patients under nearly all conditions and in most contexts will be held electronically as informatics continues to evolve into a practice that fosters improved patient care and the transmission of more complete information.
Critical as the need is for graduates of doctor of nursing practice programs, there is currently a shortage, in large part, because the program is relatively new. The doctorate of nursing practice…
American Association of Colleges of Nursing. (2004). AACN position statement on the practice doctorate in nursing. Retrieved from http://www.aacn.nche.edu/DNP/DNPPositionStatement.htm
Danzey, I.M., Emerson, E.A., Fitzpatrick, J.J., Fann, S.J., Garbutt, S.J., Rafferty, M., Zychowicz, M.E. (2011). The doctor of nursing practice and nursing education: highlights, potential, and promise. Journal of Professional Nursing, 27(5), (September -- October), 311 -- 314. Retrieved from https://www.doctorsofnursingpractice.org/cmsAdmin/uploads/the_DNP_and_nursing_education_highlights_potential_and_promise.pdf
Montgomery, K.L., & Porter-O'Grady, T. (2010). Innovation and learning: Creating the DNP nurse leader. Nurse Leader, 8(4), 44 -- 47. Retrieved from http://www.tpogassociates.com/reference/Innovation_and_Learning.pdf
Carnegie National Nursing Education Study investigated the three dimensions of nursing education and formation apprenticeships (enner et al., 2010). These are the learning of theory and scientific methods, the mastery of skillful practice, and the development of a professional identity and agency. These dimensions must be incorporated and integrated into every professional nurse's identity and actions (enner et al.).
The most important finding of this Study was the lack of education in responding to the demands of their profession among present-day nurses ( -- enner et al., 2010). This deficit or education-practice gap was an issue, which bothered earlier researches. Nurses of the past did not possess the ability to adopt in practice settings and to reflect correctly on what they were taught in school. The current issue has been reversed. The practice-education gap refers to the difficulty of nursing education to cope with fast, research-driven changes and new technologies…
Benner, P. et al. (2010). Educating nurses: a call of radical transformation. Carnegie Foundation
Archive eLibrary: Carnegie Foundation. Retrieved on October 31, 2015 from http://archive.carnegiefoundation.org/elibrary/educating-nurses-highlights
---------- -- -- - (2008). Formation and everyday ethical comportment. Vol. 17, American Journal
of Critical Care: American Association of Critical-Care Nurses. Retrieved on October 31,
shifting research, or can search current literature to glean the why's and wherefores on a wide variety of subjects. In the case of medical research many times the appropriate design includes attempts to discern what exactly are the best methods for gathering evidence-based data that will have an impact on how practices, diagnosis and/or treatments are carried out. In fact, in 2003 the Institute of Medicine provided guidelines that a population-level approach to improving the public's health should be adopted by public health system organizations and that actions taken by those organizations are based on evidence (Committee, 2003).
An ongoing concern for the medical community is the rate of Hospital Acquired Infections (HAI) prevalent in hospitals especially after Foley catheter use. Knoll et al. (2011) determined that Foley catheter (FC) use is a modifiable risk factor for hospital-acquired urinary tract infection, the most common type of nosocomial infection. Findings from…
Committee on Assuring the Health of the Public in the 21st Century (2003) The future of the public's health in the 21st Century, Washington, DC: Institute of Medicine
Knoll, B.M.; Wright, D.; Ellingson, L.; Kraemer, L.; Patire, R.; Kuskowski, M.A. & Johnson, J.R.; (2011) Reductions of inappropriate urinary catheter use at a Veterans Affairs hospital through a multifaceted quality improvement project, Clinical Infectious Diseases, 52(11) p. 1283-1290
Saint, S.; (2000) Clinical and economic consequences of nosocomial catheter related bacteriuria, American Journal of Infections Control, 28, p. 68-75
Speroff, T. & O'Connor, G.T.; (2004) Study designs for PDSA quality improvement research, Quality Managed Health Care, 13(1) p. 17-32
The American Association of Colleges of Nursing (AACN) (2006), highlights the role of the nurse as an advocate for the patient on a level that goes beyond the individual care that the patient receives. DNP Essentials underscores the role of the nurse as a leader with a responsibility to help policymakers make good decisions about healthcare that will have a positive effect on patient outcomes (AACN, 2006). These essentials are reduced to seven basic principles that involve advocacy, education, and serving in an advisory role regarding healthcare policies. The following outlines how I plan to incorporate these seven essentials into my nursing practice.
The Nurse’s Unique Role In Healthcare
The nurse is in a unique position in that they can see the effects of national and community scale policies in the “real world” setting (Abood, 2007). They are in a place to see firsthand the effects of rising healthcare costs,…
eleis, A.I., & Dracup, K. (2005). The case against the DNP: History, timing, substance, and marginalization. The Online Journal of Issues in Nursing, 10(3), 1-8.
Ever since the establishment of nursing as a distinct profession, nurses have worked hard and long to make a case that they are healthcare professionals who have a unique contribution to make to the field of medicine. Nurses are not merely the helpmates of doctors -- they offer their own distinct brand of caritas to patients. One component of the effort in garnering respect for nurses has been the effort to institutionalize nursing theory at an advanced level in academia. To expand the potential for nurses to gain advanced certification, the Doctor of Nursing Practice (DNP) is currently offered at many academic institutions. However, according to eleis & Dracup (2005), nursing is ultimately about performing in the field, and it can be detrimental to…
Meleis, A.I., & Dracup, K. (2005). The case against the DNP: History, timing, substance, and marginalization. The Online Journal of Issues in Nursing, 10(3), 1-8.
Ever since the establishment of nursing as a distinct profession, nurses have worked hard and long to make a case that they are healthcare professionals who have a unique contribution to make to the field of medicine. Nurses are not merely the helpmates of doctors -- they offer their own distinct brand of caritas to patients. One component of the effort in garnering respect for nurses has been the effort to institutionalize nursing theory at an advanced level in academia. To expand the potential for nurses to gain advanced certification, the Doctor of Nursing Practice (DNP) is currently offered at many academic institutions. However, according to Meleis & Dracup (2005), nursing is ultimately about performing in the field, and it can be detrimental to separate nursing theory from nursing practice. In fact, the authors argue that the creation of the DNP actually conspires against the goal for nurses to gain respect within the academy, and feel that the current, doctoral-level degrees as more appropriate venues to do so. There are already a number of advanced degrees that fulfill the goals of enabling nurses to conduct academic research about their profession: Doctor of Nursing Science (DNS or DNSc) degree, the Doctor of Science in Nursing (DSN) degree, the Doctor of Education (EdD) degree, and the Nursing Doctorate (ND). Having a professional degree other than the PhD merely confuses how to evaluate nurses' current credentials. These degrees also strive to marry theory to practice, while the DNP strives to create a division between the two, by focusing on practice.
The authors also feel that there are more important debates within the profession other than the need to generate new degrees, and a candidate should either elect to get a master's degree or advanced to the PhD track, rather than linger in some nebulous 'in-between' zone. The authors are persuasive in their statement that although initially there may not seem to be any harm in getting a degree for a degree's sake, given the finite resources that exist on a university level (and in terms of prospective candidate's time and financial resources), the case for the additional value of the degree must be made to justify its existence. The DNP also seems to suggest, contrary to what is taught by most nursing theorists, that there is a divide between work in the field and work in the academy.
DNP has been a relatively new one for the nursing profession. Today, "there are many enthusiasts toward the DNP. Seen by some as a symbol of social progressivism, the endorsement of doctoral education for advanced practice nursing has many potentially positive outcomes. Among them, better parity with other practice disciplines" (Bellini 2012: 6). However, there have also been many naysayers about the degree. They "strongly argue for the retention of MS-level preparation for APNs based on economic and workforce issues… [they argue that the DNP is] detrimental to society, as the projected number of APNs needed is expected to rise in the years to come, The authors argue that this is unlikely to occur if the DNP-mandate deters potential APN students from pursuing graduate study" (Bellini 2012: 6). This reflects the idea that nursing, however much theory might inform the teaching of nursing, is ultimately always a practical discipline.
Bellini, S. (2014). The doctor of nursing for entry into advanced practice. Medscape.
DNP student gained much from the immersion project, especially from interacting with clinicians specializing in oncology and the cancer patients. The planning, executing, and analyzing the DNP project provided additional experience into clinical research, especially concerning the self-efficacy of patient coping before and after implementing a psychoeducational intervention. While the DNP student expressed concern over failing to reach the goal of 40 patients participating in the study or statistical significance, I imagine that much was gained by the experience as a whole.
Given a p value of 0.607, it seems unlikely that reaching the goal of 40 patients would have made much difference in the statistical outcome. Additionally, this p value does not predict whether a larger sample size would result in a statistically-significant…
Heitzmann, C.A., Merluzzi, T.V., Jean-Pierre, P., Roscoe, J.A., Kirsh, K.L., & Passik, S.D. (2011). Assessing self-efficacy for coping with cancer: Development and psychometric analysis of the brief version of the Cancer Behavior Inventory (CBI-B). Psychooncology, 20(3), 302-12.
Motulsky, H.J. (2014). Common misconceptions about data analysis and statistics. Naunyn-Schmiedeberg's Archives of Pharmacology, 387(11), 1017-23.
Sullivan, G.M., & Feinn, R. (2012). Using effect size -- or why the P. value is not enough. Journal of Graduate Education, 4(3), 279-82.
At times patients cannot care for themselves, and nurses must remedy these self-care deficits (Dorothea Orem's Self-care theory, 2011, Nursing Theories).
Whenever possible, patients should be empowered to act as best as they can to care for themselves. The nurse is viewed as an aid to remedy the self-care deficit in Orem's view. The nurse is not seen as superseding the patient's basic right to autonomy. Although some nurses know this intuitively, when busy or rushed sometimes it can be easy to forget the value of allowing patients to do as much as possible as they can for themselves, even if this is something as simple as eating and drinking or going to the bathroom.
Given the preponderance of lifestyle-related diseases today, Orem's stress upon patient self-knowledge and awareness is essential. Patients will care for themselves when they return home from a healthcare environment in most instances, and they must…
Cody, W.K. (2006). Philosophical and theoretical perspectives. Sudbury, MA: Jones and Bartlett
Dorothea Orem's Self-care theory. (2011, January 11). Nursing Theories.
Retrieved April 6, 2011 at http://currentnursing.com/nursing_theory/self_care_deficit_theory.html
ules & Ways of Knowing
The author of this report is asked to answer several questions as they relate to the current nursing classes that the author is taking. The first question is the role of scholarly during an APN/DNP program. The second question asks the author to discuss the interest the author has in the selected role and degree in question. A sub-section of that question is whether the role in question meets the APN consensus statement, what professional organizations offer certification in the applicable certification role and what the criteria are for any applicable industry exams. Next up will be a selection and explanation of an APN conceptual framework for practice. After that will be an explanation of the ways of knowing and how they influence the author's current practice. What will follow that is an identification and explanation of the author's preferred paradigm. Last will be a…
BCEN. (2014, June 3). Get Certified CEN ®. CEN BCEN. Retrieved June 3,
2014, from http://www.bcencertifications.org/Get-Certified/CEN.aspx
Duke. (2014, June 3). FAQ's. Duke School of Nursing. Retrieved June 3, 2014, from https://nursing.duke.edu/academics/programs/dnp/faqs
MUN. (2014, June 3). Conceptual Model. School of Nursing. Retrieved June 3, 2014,
healthcare as an institution is, of course, the need to care for the sick and the injured. However, in the contemporary model of healthcare, effective communication during a crisis is not only important, but also vital. Communication by healthcare professionals takes the concern and worry out of the situation; offers a quicker resolution, makes better control of information possible, earns the trust of the public and individual families; and keeps the flow of information consistent and accurate, thus averting potential external problems. Based on my current experience in the nursing field, I realize that to advance my professional goals, as well as contribute soundly to the profession, I must expand my educational experience and am therefore seeking entrance into the Doctor of Nursing Practice (DNP) in Psychiatric Mental Health Nursing.
I believe I am well-qualified and motivated to undergo this program. Currently, I am a master's prepared Neonatal Nurse Practitioner…
Making available recovery program treatment besides collaborating with partnership to leverage resources and knowledge is a role that I perform in efforts of helping clients access care. I am also involved in continual community-based quality improvement programs that are designed to support care access and quality.
B. Veteran Centered Care
With respect to centered care, I normally assist with provision of alternatives to inpatient care for mental health linked problems. Additionally, I make CVT available for weekend and evening hours. As a MHICM practitioner, I perform various administrative and clinical functions for clients and my team. Clinical tasks entail stress and crisis management, group therapy, advocacy and treatment planning. I also ensure that patient preferences with respect to appointments and mental health care providers are maintained.
C. Performance Measures
I offer administrative and clinical supervision for my team besides facilitating cohesiveness communication, education programs and systems concerning community-based services. Given…
Committee on the Robert Wood Johnson Foundation initiative on the future of nursing.(2011). The future of nursing: Leading change, advancing health. New York: National Academies Press
Daniels, R., & Nicoll, L.(2011). Contemporary medical-surgical nursing, Volume 1. New York: Cengage Learning.
Sullivan-Marx, E.(2010). Nurse practitioners: The evolution and future of advanced practice. New York: Springer Publishing Company.
Thonicroft, G. (2011). Oxford textbook of community mental health. London: Oxford University Press.
Evidence-Based Project Implementation Issues: Pressure Ulcers
Evidence-based research as opposed to evidence-based practice is defined as "research [that] is generating new knowledge about a phenomenon or validating existing knowledge…Although evidence-based practice may have opinion -- expert opinion, but opinion still -- woven in, research is built in such a way to avoid bias" ("Evidence-based practice and avoiding confusion," 2014). Experiments must have controlled variables to ensure that extraneous data does not influence the result. In the case of my DNP project, the use of two-hour turning and positioning to decrease pressure ulcers in elderly bed-bound patients in nursing homes, one clear issue is the extent to which the patient's poor health could influence outcomes. Nursing home patients can have a variety of issues which could impact the results and both experimental and control groups must be carefully balanced. "More than 100 risk factors of pressure ulcers have been identified in…
Evidence-based practice and avoiding confusion. (2014). Health Leader's Media Council.
Retrieved from: http://www.healthleadersmedia.com/page-1/nrs-245879/EvidenceBased-Practice-and-Nursing-Research-Avoiding-Confusion
Haynes, B & Haines, A. (1998). Barriers and bridges to evidence-based clinical practice. BMJ,
317(7153): 273 -- 276. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1113594/
NEW MODELS FO EVIDENCE-BASED PACTICE a professional goal DNP-prepared nurses produce evidence-based models care develop evidence-based guidelines. As continue develop DNP Project Premise engage EBP Project, aim mind.
As a nurse practitioner who works in a diverse range of settings spanning from hospitals to nursing homes to clinics, evidence-based practice is part of my daily routine. Virtually all of the facilities at which I work prioritize evidence-based practice given that the facilities' scarce resources means that time, energy, and money cannot be wasted on untested treatments or treatments based merely upon 'hunches.' Evidence-based practice is based upon demonstrated benefits from particular approaches to patient care in recent literature. I strive to remain current in my own knowledge of EBP, frequently reviewing nursing journals and articles online as well as the websites of professional associations so I am aware of new treatments, approaches, and evidence of what works…
ACE Health Star Model. (2013). University of Texas Health Center San Antonio. Retrieved:
According to the AACN's report, "Nurse Practitioner Primary Care Competencies in Specialty Areas: Adult, Family, Gerontological, Pediatric, and Women's Health" (2002), "Competencies are the domain or body of knowledge and skills that essentially define a profession or discipline. This domain of competencies guides training programs, provides expectations for employers, and drives the nature of assessment instruments and performance standards for credentialing institutions, certifying agencies, and accrediting organizations" (p. 14).
The core competencies for nurse practitioner graduates are intended to help candidates used what they have already learned and require a graduate-level education in order to attain certification as an APN and the AACN has developed this graduate curriculum as the basis for advanced practice nursing. As described by AACN, advanced practice nursing preparation includes ". . . graduate nursing core content (e.g., research, health policy, ethics, and more) and advanced nursing practice content (e.g., advanced health assessment, advanced physiology and…
Type I diabetes is usually diagnosed in children and young adults and results from the body's failure to produce insulin. Type 1 account for 5% to 10% of all diagnosed cases of diabetes (Centers for Disease Control, National Diabetes Fact Sheet, www.cdc.gov/diabetes/pubs/pdf/ndfs_2003.pdf). The most common form of diabetes is Type II, which accounts for about 90 to 95% of all diagnosed cases of diabetes (Centers for Disease Control, National Diabetes Fact Sheet, www.cdc.gov/diabetes/pubs/pdf/ndfs_2003.pdf). Pre- diabetes is a condition often present prior to the development of Type II diabetes. In pre-diabetes, blood glucose levels are higher than normal, but not high enough to be considered diabetic.
Pre-diabetes does not have to lead to the development of diabetes if a person diagnosed with this condition: Patients who work to control their weight and increase their physical activity can often prevent or delay the onset of diabetes. There are 41 million Americans…
American Diabetics Association. Retrieved 22 March 2010 from http://www.diabetes.org/diabetes-basics/diabetes-statistics/
Centers for Disease Control, National Diabetes Fact Sheet.Retrieved 18 March 2010 from www.cdc.gov/diabetes/pubs/pdf/ndfs_2003.pdf
Practice Issue Evidence-Based Practice (EBP) Project in courses DNP program, asked
The practice issue I have chosen to explore is whether or not q2 hourly turning and positioning actually decreases the incidence of pressure ulcers in the elderly bed bound population in nursing homes. The conception that turning does help to relieve the pressure associated with these types of ulcers has been longstanding. Specifically, there is clinical evidence to indicate the fact that "Unrelieved pressure is a well-known clinical risk factor for ulcer development" (Salcido, 2004, p. 156). As such, the turning of patients at least every two hours has been carried on for quite some time in the nursing population, although there are some salient points of concern that need to be addressed with this issue.
One of the major things that individuals need to be aware of who take on such a practice is the fact that the…
Leeds, L. (2004). Importance of turning q2. www.denvernursingstar.com. Retrieved from http://denvernursingstar.com/specials/newsletter_view.asp?newsid=310&catid=85&active=0&mode=current&count=0
Salcido, R. (2004). Patient turning schedules, why and how often? Advances in Skin & Wound Care: The Journal for Prevention and Healing. 17(4), 156.
Wound, Ostomy & Continence Nurses Society. (2012). Patient turning and repositioning: current methods & challenges, a WOCN perspective. www.sageproducts.com. Retrieved from http://www.sageproducts.com/documents/pdf/education/studies_articles/sacral/WOCN%20White%20Paper_Aug2012.pdf
Family Nurse Practitioner: Promoting Change
Strategies to communicate and educate stakeholders
I am currently employed as family nurse practitioner and am doing my DNP at a clinic under the supervision of a medical doctor. Communicating with patients is an essential component of treatment and care. If patients cannot engage in effective self-care at home, the treatment dispensed by the clinic will be of little value. The nurse must communicate clearly and seriously the full weight of the patient's condition and need for treatment. For example, if a patient is pre-diabetic, the nurse must make the patient understand what this means: that weight loss, diet and exercise modifications may be able to prevent full-blown diabetes from occurring. The fact that diabetes is not a disease that can easily be managed with drug treatments, although many new drugs and forms of glucose monitoring are available, should also be conveyed to the patient:…
Alavi, M. & Tiwana, A. (2002). Knowledge integration in virtual teams. Journal of the American Society of Information Science and Technology. 53(12):1029-1037. Retrieved from:
Bowers B (2011) Managing change by empowering staff. Nursing Times; 107: 32/33.
The student in a Doctorate of Nursing (DNP) program has an obligation to get permission when launching a scholarly research project; and the student also has a responsibility to disseminate that research once it is completed. This paper delves into those aspects of research -- and others -- for the DNP student.
DNP Competencies for Clinical Scholarship - Background
In the Journal of the American Association of Nurse Practitioners (Buchholz, et al., 2013), the authors explain that a nursing student getting an advanced degree must have a "fundamental and strong understanding of research design and interpretation." However, though evidence-based research translation is "essential" to the DNP student, there is no consensus as to the skill levels required to conduct the required research (Buchholz, 473). Given that the Doctor of Nursing is a "new nursing role," and there are still requirements to be worked out, the importance of the DNP…
American Association of Colleges of Nursing. (2015). The Doctor of Nursing Practice:
Current Issues and Clarifying Recommendations / Report from the Task Force on the Implementation of the DNP. Retrieved March 8, 2016, from http://www.aacn.niche.edu.
Buchholz, S.W., Budd, G.M., Courtney, M.R., Neiheisel, M.B., Hammersla, M., and Carlson,
E.D. (2013). Preparing practice scholars: Teaching knowledge application in the Doctor
1. Description of your leadership philosophy
a. Fundamental leadership concept
The main emphasis emerging from the transformational leadership concept is for nursing leaders to produce not just constructive but also valuation challenges for their subordinates and followers for the realization of the established organizational objectives. Based on Damirch, Rahimi, and Seyyedi (2011), the famous James MacGregor Burns created this design when researching governmental leaders; nevertheless, its good effect traversed to other fields and areas. In my situation, the importance given to the transformational leadership idea is related to its development of a higher-performing, dedicated personnel when used in health-care institutions. In medical centers as well as other treatment institutions, transformational leadership could be carried out within any institutional system or department like worker groups, divisions, sectors, as well as at the top leadership (Choi, Goh, Adam, And Tan, 2016). Essentially, this idea improves not just the inspiration but the overall…
DNP degree was recognized by the American Association of Colleges of Nursing as representing the highest level of preparation for clinical nursing practice in 2004 and the first doctor of nursing practice (DNP) program was offered in 2001 by the University of Kentucky (Moore, 2014). In contrast to doctoral of philosophy (Phd) nursing program which is research-oriented, DNP programs are regarded as terminal degrees for teaching (Moore, 2014). Nevertheless, DNPs are also required to perform basic research for a wide range of applications with a view towards improving clinical practice (Moore, 2014).
esearching a topic of interest has become far easier than it was in 1957 when the famous German scientist Wernher von Braun explained that, "Basic research is what I am doing when I don't know what I am doing." Today, doctors of nurse practice (DNP) enjoy a veritable cornucopia of academic, professional and scholarly research resources, but the…
Davis, M. (2015, March). Issues up close: Keeping pace: ANA's revised code of ethics for nursing. American Nurse Today, 10(3), 16-19.
Fayer, L. & Zalud, G. (2011, November-December). Student perceptions of the use of inquiry practices in a biology survey laboratory course. Journal of College Science Teaching, 41(2), 82.
Laabs, C. A. (2012, January/February). Confidence and knowledge: Regarding ethics among advanced practice nurses. Nursing Education Perspectives, 33(1), 10-13.
Moore, K. (2014, January). How DNP and Phd nurses can collaborate to maximize patient care. American Nurse Today, 9(1), 48-50.
Timeline for Professional and Personal Growth
Nurse Practitioner (NP) role is one of the specialties in advanced practice nursing and has experienced an increase in demand because of the shortage of nursing (Hamric, Tracy & Hanson, 2013). The growth of the NP role in the modern advanced practice nursing field is also attributable to the increased demand in primary care services. Given the increased demand of these practitioners, the nursing education field is increasingly encouraging more individuals to enroll for nurse practitioner roles. However, for an individual to become an accomplished nurse practitioner, he/she has to undergo or navigate a complex process to become a full-fledged practicing nurse practitioner (Luckey, 2018). Therefore, the individual needs to have a clear timeline for professional and personal growth as he/she enters the world of advanced practice nurse. This paper provides my timeline for professional and personal growth as a nurse practitioner in today’s…
size is an important step in the sample selection process. In Negarandeh, Bahabadi & Mamaghani's (2014) study, the procedure used to determine the sample size is clearly described. Following a pilot study, using the sample size formula, and based on the population of the hospital in which the trial was carried out, the authors estimated the sample size at 100 participants (50 participants in each group). evealing how the sample size was determined enables readers to ascertain the extent to which the sample selected is representative of the larger population (Thomas, 2009). In quantitative research, a representative sample is important for improving the generalizability of findings (Bryman, 2008). In this case, the sample was quite representative of the study population. The study setting was a 530-bed hospital. The trial was specifically conducted in the medical surgical ward, which had 40 active beds, meaning the findings can readily be generalized to…
Al-Abri, R., & Al-Balushi, A. (2014). Patient satisfaction survey as a tool towards quality improvement. Oman Medical Journal, 29(1), 3-7.
Broeck, J., Cunningham, S., Eeckels, R., & Herbest, K. (2005). Data cleaning: detecting, diagnosing, and editing data abnormalities. PLoS, 2(10), e267.
Bryman, A. (2008). Social research methods. 3rd ed. Buckingham: Open University Press.
Creswell, J. (2014). Research design: qualitative, quantitative, and mixed methods approaches. 4th ed. London: SAGE.
The goal of evidence-based practice (EBP) implementation, according to Purdy and Melwak (2009), is to exploit research findings so ". . . that every patient receives the right care every time" (p. 263). The recommended steps for EBP implementation are (1) develop a well-framed question, (2) find the best evidence, (3) critically evaluate scientific findings, (4) implement, and (5) evaluate efficacy. Step 3 seems to be a critical step, because the quality of research findings may not be sufficient to justify EBP implementation. In other words, there should be another step between 3 and 4 where the doctor of nursing practice (DNP)-prepared nurse decides whether the quality of the evidence is sufficient to justify implementation. These steps, however, help to define the role a DNP-prepared nurse can play in EBP implementation.
Yoder and colleagues (2014) distinguish between research utilization and EBP by limiting the former to…
Purdy, I.B., & Melwak, M.A. (2009). Implementing evidence-based practice: A mantra for clinical change. Journal of Perinatal & Neonatal Nursing, 23(3), 263-9.
Yoder, L.H., Kirkley, D., McFall, D.C., Kirksey, K.M., StalBaum, A.L., & Sellers, D. (2014). Staff nurses' use of research to facilitate evidence-based practice. American Journal of Nursing, 114(9), 26-37.
An increasing number of people trust NPs with their health and choosing them as their preferred healthcare provider. The range of health services NPs provide is amazing and they help their patients make better healthcare and lifestyle decisions. The role NPs play is particularly unique as they provide a wholesome service that includes even educating the clients about their conditions and how to have an excellent life with their conditions (AANP 2014). The number of U.S. NP programs is rising as the number of students seeking enrollment increase. Many more people appreciate being a nursing provider as a noble profession with the increasing demand for primary caregivers all over the country. Most of the applicants who want to be NPs are registered nurses followed by second-degree holders. Selecting the right NP program is not an easy task. The features that influence one's choice like preceptor requirements, curricula and…
AANP. (2014). Planning Your NP Education. Retrieved September 09, 2016, from https://www.aanp.org/education/student-resource-center/planning-your-np-education/1058-i-want-to-become-an-np
Catar, W. (2014, February 23). Why did you become a Nurse Practitioner? Retrieved September 09, 2016, from http://allnurses.com/advanced-practice-nursing/why-did-you-908035.html
DeCapua, M. (n.d.). 5 Reasons to Become a Nurse Practitioner. Retrieved September 09, 2016, from http://www.nursepractitionerschools.com/blog/5-reasons-to-become-an-np
Napolitano, M., & Klein, T. (2012, October 22). So You Want to Be a Nurse Practitioner? Choose the Right Program. Retrieved September 09, 2016, from http://www.medscape.com/viewarticle/772568
University Doctor of Nursing Practice Program?
The Doctor of Nursing Practice is a unique degree in that it prepares nurses with the research skills to work more effectively in clinical settings. Unlike a purely academic degree, it is designed to prepare nurses to become leaders in the field, rather than work primarily in a university. But it still demands a rigorous understanding of evidence-based practice. The DNP reflects the fact that research can be critical in improving the quality of medicine while still ensuring that the research has a practical focus and can be used in a meaningful way to better the lives of patients and providers alike.
The increased complexity of healthcare regulation, the sophistication of medical technology, and the growing diversity of the patient population all reflect the need for leaders in the nursing field to pursue advanced degrees. To have the necessary background to act as an…
Specific: Hone Interpersonal Abilities
Measurable: e a part-time preceptor to novice nurses
Attainable: Engage in one-on-one work with nurses fresh out of university, as this role necessitates explaining all hospital operations clearly, right from updating patient charts to working in collaboration with the organization's workforce, including doctors and other nurses.
Realistic: The above experience helps gear up for the nurse educator's role well before enrolling in an advanced course.
Timely: Attain this goal within a period of 1 year (Williams, 2016)
Specific: Develop Clinical Experience
Measurable: Work independently full-time
Attainable: Obtain comprehensive, practical, clinical experience prior to transitioning to the educator roles. Further, concentrate on emergency medicine, pediatrics, or some other specialized field.
Realistic: Concentrate entirely on patient treatment, prior to teaching distinct criteria
Timely: Attain this goal within a 2-year period (Kelly, 2011)
Goal # 3
Specific: Acquire a Teaching Certificate
Measurable: Earn a general nursing educator…
ANS. (n.d.). About a doctoral degree in nursing. Retrieved from All Nursing Schools: http://www.allnursingschools.com/nursing-careers/dnp/
Kelly, P. (2011). Nursing Leadership & Management. Boston: Cengage Learning.
Kemppainen, V., Tossavainen, K., & Turunen, H. (2012). Nurses' roles in health promotion practice: an integrative review. Health Promot. Int.
Williams, E. (2016). An Example of Short-Term Goals to Becoming a Nurse Educator. Retrieved from Chron: http://work.chron.com/example-short-term-goals-becoming-nurse-educator-24051.html
MS Case Study Nurse Practice
When patients enter hospitals it is oftentimes they become more ill and sicker due to inappropriate care and professional ignorance. This is due mainly to the amount of hubris involved within the medical profession and a tendency to ignore empirical evidence as practiced to success. This approach underlines the most important aspects of healing and the medical profession itself.
The argument for continued improvement in the treatment of patients is best exemplified in the case of MS. His ill health has led to more problems and the approach by the nurse practitioner and her staff is critical to the ultimate survival of this young child who innocently trusted the advice of both his parents or caretakers that the medical staff would be able to treat him with the care and respect that every patient deserves when being encountered during a medical treatment or hospital stay.…
Arnold, M., & Barbul, A. (2006). Nutrition and wound healing. Plastic and reconstructive surgery, 117(7S), 42S-58S.
Bennett, G., Dealey, C., & Posnett, J. (2004). The cost of pressure ulcers in the UK. Age and ageing, 33(3), 230-235.
Campbell, N.C., Murray, E., Darbyshire, J., Emery, J., Farmer, A., Griffiths, F., ... & Kinmonth, A.L. (2007). Designing and evaluating complex interventions to improve health care. BMJ: British Medical Journal, 334(7591), 455.
Corbett, L.Q. (2012). Wound care nursing: professional issues and opportunities. Advances in Wound Care, 1(5), 189-193.
Inward Journey of Leadership
For a majority of individuals, becoming a successful leader constitutes a lifelong endeavor, requiring tremendous amounts of commitment and work. There are few who reach their complete potential as leaders, though this isn't on account of their lack of technical skills. Growing into a first-rate leader entails a lot more than management proficiency or improved strategic thinking. The process deals, most fundamentally, with personal transformation. Every great leader is on an ongoing internal journey of self-growth and self-discovery, with the intent to transform their organization as well as themselves (Souba, 2006).
Famous German poet, ainer ilke, once remarked that only one true journey exists in life, which is, to go inside oneself. However, an increasing proportion of individuals focus on the external; they are only concerned with standing out and looking good. However, concurrently, they face an internal restlessness, an intensifying feeling that they are missing…
Bennis W. (1994). On becoming a leader. New York: Addison-Wesley Publishing Co.
Gardner W, Avolio B. (1998). Charismatic leadership: The role of impression management. Acad Manage Rev; 23:32.
Goffee R, Jones G. (2005). Managing authenticity: The paradox of great leadership. Harvard Business Review. December 2005:86-94.
Harman W. (1998). Global mind change. San Francisco: Berrett Koehler Publishers.
Nursing Practicum: Learning Objectives and Timeline
As a future primary care provider seeking NP board certification, one of my primary areas of focus will be how to enhance my patients' understanding of preventative medicine. This directly relates to DNP Essential VII: of "Clinical Prevention and Population Health for Improving the Nation's Health" (The Essentials, 20016, p.15). The United States has seen a dramatic rise in chronic illnesses rooted in poor lifestyle choices such as diabetes and heart disease. Through my practicum experience, my first learning objective is the ability to more effectively engage with patients and express the need to achieve health-related goals in layperson's terms. I also seek to work with patients to create a plan for healthy living that they view as reasonable and achievable, given that patients are often intimidated by the need for lifestyle changes.
This also related to my Evidence-Based Practice (EBP) Project which specifically…
The essentials of doctoral education for advanced nursing practice. (2006). AACN. Retrieved
High blood pressure educational materials for patients. (2015). CDC. Retrieved from:
Pressure Ulcers in the Elderly
Dr. Judi Kuric
DNP Project Question
Will Every Two Hourly Turning and Positioning Decrease Pressure Ulcers in the Elderly Bed Bound Population in Nursing Home.
Will Every Two Hourly Turning and Positioning Decrease the Pressure Ulcers in the Elderly Bed Bound Population in Nursing Homes.
Pressure ulcers are a common cause of immobility among the elderly, which results in immense pain, suffering, and substantial costs with charges because of increased length of stay in the nursing homes. Prior studies suggest that patients who receive care in accordance to evidence-based guidelines are not at risk of developing pressure ulcers. However, the empirical evidence on the effectiveness of the measures is inadequate. Nevertheless, frequent manual repositioning of patients is a firmly established standard of care for the elderly; although there has been no much evidence on the same, experts suggest that…
One important aspect of nursing home living is that most of the time the people living there are helpless to accomplish many tasks that are part of everyday living. The employees are trained (for the most part) and as one study found it is "important to assess whether nursing staff levels and skills are meeting nursing home resident care needs" (Zhang, Unruh, Wan, 2013, p. 290). For example, incontinence is a significant risk factor for skin breakdown. The moisture changes the chemical balance of the skin, and often without adequate ventilation and care, a route for bacterial infection. In either case, pressure on the wound area, increased bacteria and moisture, all contribute to the lesions becoming rather serious (Gefen, 2008).
Many of the employees are taught to turn the elderly in their beds to relieve pressure, presumably thereby lowering the incidence of pressure ulcers. According to Fossum et al., "pressure ulcers can be prevented if residents at risk are identified early and relevant preventive measures are implemented" (Fossum, et al.,, 2011, p. 2429).
Current research shows that, at least in nursing homes, employees have a cognitive nature concerning pressure ulcers (amongst other things) and the positive results from taking preventive measures. Much of the current literature espouses the fact that nurses are trained to do so, but there is not really a lot of specific information on
life stories in it in forming one's own DNP project.
Diffusion can be described as the procedure through which an innovation is conveyed via particular channels over time amidst members of a social system. An innovation, on the other hand, can be described as a practice, idea, or even object regarded as new by somebody or adoption unit (ogers, et.al). The process of diffusion basically entails both interpersonal communication and mass media channels. In the current world, information technologies like mobile phones and the internet are a representation of remarkable diffusion tools. Think of the following encounter of co-author Singhal in the Philippines.
In May 2006, as Singhal walked down Epifanio de los Santas Avenue (known as "Edsa") in Manila, Philippines, a Filipina associate noticed that "Edsa" was actually the street where cell phones brought down President Estrada's government. Taking in the bewildering look on Singhal's face, she explained that…
Cain, M., & Mittman, R. (2002). California Health Care Foundation -- Health Care That Works for All Californians. Diffusion of Innovation in Healthcare. Retrieved March 10, 2016, from http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/PDF%20D/PDF%20DiffusionofInnovation.pdf
Rogers, E., Singhal, A., & Quinlan, M. (n.d.). Diffusion of Innovations. Retrieved March 10, 2016, from http://126.96.36.199:8088/2155562/Article_for_diffusion_and_innovations.
Thrower, T. (2014, December 7). Linked In. Disruptive Reinvention of Health Information Technology (HIT). Retrieved March 11, 2016, from http://www.linkedin.com/pulse/20141207004502-21163620-disruptive-reinvention-of-health-information-technology-hit
Letter of Intent
hat is your motivation for earning a doctoral degree?
First, I have always been motivated to succeed in every aspect of education and professional training that I have pursued. I have never settled for anything less than excellence in all endeavors I have undertaken -- in particular, education and training. I conduct research with thoroughness and I have fine-tuned my study strategies so I can make the most of my pursuit of pivotal knowledge. To wit, by learning more and through advanced training strategies, I will definitely be of greater assistance to those whose care will be my responsibility -- and my ability to mentor young people that entering the nursing field will also be greatly enhanced.
Hence, a doctorate program will certainly help me fulfill my strong desire to obtain the knowledge I need to pursue my goals in nursing education. I am aware that the…
Nursing Research.(2013). Evidence-Based Nursing. Retrieved March 22, 2016, from http://www.nursingplanet.com .
Stevens, K.R. (2013). The Impact of Evidence-Based Practice in Nursing and the Next Big
Ideas. The Online Journal of Issues in Nursing. 18(2), 1-13.
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.
Another case study, this one by Cole (2011) examines the cultural and community impacts of tourism, both sustainable and unsustainable, on specific cultures in Indonesia. Cole concludes as well that in order to help keep the cultural and community influences and positive attitudes intact, it is important to consider the local community as a major stakeholder in the sustainability of a tourist destination. Cole states in her article, "ourism has the potential to empower communities and the sustainable tourism agenda needs to focus on how to bring this about. As the case study illustrates, understanding tourists and tourism processes is the first stage to empowering the local community to make informed and appropriate decisions about their tourism development. Considerable investments are required in communication and trust building between the actors in tourism. his paper examines how action research, focus groups and the creation of a tourism forum can be concrete,…
These are the questions which are very difficult to answer, but in order to have a maintained tourism system they plays an important role.
Moreover, the use of term "itself" is confusing for a sustainable tourism. Alternative tourism, 'soft' tourism, ecotourism, and 'green' tourism are the types of tourism which can be used with sustainable tourism which is a high class branch of tourism. The story behind tourism in 1919, about 664 million tourists were present, and those who were known as mass tourism were approximately 80%. Development of sustainable tourism is affected by the differences in between mass tourism and sustainable tourism (Berno and Bricker, 2001).
If one can make a difference between 'good' tourism (best known as the alternative forms of tourism) and 'bad' tourism (particularly mass tourism) then sustainable tourism can appear as disruptive force in the society (Swarbrooke, 1999). To confuse ecotourism with sustainable tourism can give a bad result because all sustainable tourism does not take place at natural area and not all types of ecotourism are sustainable. According to Wall (1997), as the mass tourists might not prefer to visit threatened remote areas, their demand may be lesser than that of
Integration Evidence-Based Practice Professional Nursing Practice
The concept of evidence-based practice -- EBP is becoming growingly significant in the sphere of nursing. (Stiffler; Cullen, 2010) Evidence-based practice is not entirely a novel concept; it is the manner in which nurses cater to the norms of care and practice efficiently. (Nysna, 2006) According to Linda Burnes Bolton, DrPH, N, FAAN, vice president and chief nursing officer in the Cedars-Sinai Medical Center in Los Angeles, evidence-based practice -- EBP in reality it is only an alternative mode of viewing the conventional theme of the nurses maintaining their sanctified reliability with society. (Wessling, 2008) David Sackett, MD, a Canadian physician, is regarded the father of evidence-based practice. According to Sackett, "evidence-based practice is the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. . .[by] integrating individual clinical expertise with the best available external…
Adams, Susan; McCarthy, Ann Marie. (2005) "Evidence-Based Practice and School
Nursing" The Journal of School Nursing, vol. 21 no. 5, pp: 258-265.
Ciliska, Donna. (2006) "8. Evidence-based nursing: how far have we come? What's next?"
Evid-Based Nurs, vol. 9, no. 2, pp: 38-40.
Range Nursing Theory
A clinical nurse is generally involved with specialized research; for example, a clinical nurse specializing in oncology would likely be heavily involved in the treatment of patients with cancer, according to Andrea Santiago. That clinical nurse specialist (CNS) working with cancer patients may also create helpful protocols or other strategies to improve the delivery of services in a hospital (Santiago, 2013). This paper delves into the reasons why the CNS can (and will) benefit from the use of the middle range theory.
hat are middle range theories?
Judy Davidson (RN, DNP, CNS) explains that middle range theories are designed to "guide practice" for nurses (including clinical nurse specialists) and are "more focused than grand theories" because they zero in on a "single aspect of practice" and are not as general as grand theories (Davidson, 2010, p. 28). Moreover, because grand theories only offer a framework in terms…
Andershed, Birgitta, and Olsson, Kristina. (2009). Review of research related to Kristin
Swanson's middle-range theory of caring. Scandinavian Journal of Caring Sciences, 23(3),
Davidson, Judy E. (2010). Facilitated Sensemaking: A Strategy and New Middle-Range Theory
Museums in Paris
The Louvre Museum can be categorized as one of the world's largest and most magnificent museums. It also marks a monument and an attractive sightseeing location for tourists from all over the world. Standing near the River Seine and stretching over 60,000 meters square, this museum has its own unique history.
The museum was a transformation from the Louvre Palace, built as a fortress for King Louis XIV. He considered the Palace too small for his needs and then went on to making the Palace of Versailles. He left behind this beautifully structured monument to become the museum of beautiful art. The Louvre Museum was initiated in 1793 with initially just 537 paintings. Many of these were the confiscated church paintings and the others were donations from the prestigious and powerful people of the time. Slowly and gradually, the collection of the museum started increasing under Napoleon…
Danilov, Victor J. Museum careers and training: A professional guide. Greenwood Press, 194.
Dean, David. Museum Exhibition: Theory and Practice. Routledge, 1996.
Friedlander, Max J. Early Netherlands Painting: From Van Eyck to Bruegel. Phaidon Publishers, 1956.
Greenhill, Eileen Hooper. Museum, Media, Message. Routledge, 1995.
Among the most important aspects to the health promotion plan will be the benefits associated with a care manager, who can ensure that all six core elements of CCM are implemented fully. If this is accomplished, there should be a significant reduction in health disparities for patient and caregiver outcomes across generations.
AHQ. (2012). National Healthcare Disparities eport, 2011. No. 12-0006. ockville, MD: Agency for Healthcare esearch and Quality. etrieved 16 Apr. 2014 from http://www.ahrq.gov/research/findings/nhqrdr/nhdr11/nhdr11.pdf.
Braveman, P.A., Kumanyika, S., Fielding, J., Laveist, T., Borrell, L.N., Manderscheid, . et al. (2011). Health disparities and health equity: The issue is justice. American Journal of Public Health, 101(Suppl. 1), S149-55.
Brodaty, H. & Donkin, M. (2009). Family caregivers of people with dementia. Dialogues in Clinical Neuroscience, 11, 217-28.
Castro, A. & uiz, E. (2009). The effects of nurse practitioner cultural competence on Latina patient satisfaction. Journal of the American Academy of Nurse…
AHRQ. (2012). National Healthcare Disparities Report, 2011. No. 12-0006. Rockville, MD: Agency for Healthcare Research and Quality. Retrieved 16 Apr. 2014 from http://www.ahrq.gov/research/findings/nhqrdr/nhdr11/nhdr11.pdf .
Braveman, P.A., Kumanyika, S., Fielding, J., Laveist, T., Borrell, L.N., Manderscheid, R. et al. (2011). Health disparities and health equity: The issue is justice. American Journal of Public Health, 101(Suppl. 1), S149-55.
Brodaty, H. & Donkin, M. (2009). Family caregivers of people with dementia. Dialogues in Clinical Neuroscience, 11, 217-28.
Castro, A. & Ruiz, E. (2009). The effects of nurse practitioner cultural competence on Latina patient satisfaction. Journal of the American Academy of Nurse Practitioners, 21(5), 278-86.
Jonas Veterans Healthcare Program
Recognizing the tremendous commitment and sacrifices our veterans have made to serve our country, the Jonas Center is committed to do our part to support improved healthcare for this population (Jonas Center, N.d.).
The Jonas Center's vision is to foster new partnerships that help improve veterans' healthcare through nursing and we welcome all contributions to support our efforts.
• Program scope
Starting in the fall of 2012, the Jonas Center will support scholarships for 54 nurses to be trained at the doctoral level (PhD and DNP) on veteran-specific healthcare needs, ranging from clinical to policy to administration to education, to help ensure our veterans are receiving the best possible care. Scholar's research projects will be focused on priority veterans' healthcare need (as identified by the hite House and Veterans Administration).
• Program audience
Students, veterans, and the general public.
• Program background…
Jonas Center. (N.d.). History. Retrieved from Jonas Center: http://www.jonascenter.org/who-we-are/history
Jonas Center. (N.d.). Jonas Veterans Healthcare Program. Retrieved from Jonas Center: http://www.jonascenter.org/program-areas/scholars/jonas-veterans-healthcare-program
Ocial Work Practice With Individuals: Engagement Strategies
First I need to get past Mr. Fahza's son in order to get to his father. I need the former's agreement because I need a smooth start. His son agreement would encourage a discussion under the right auspices.
According to The Patient Self-Determination Act (PSDA) of 1990, Mr. Fahza has the right to be informed about his own clinical condition in order to take a decision about continuing with chemotherapy or going to the hospice and die peacefully. This is the strict approach of the western hemisphere.
The religion of Islam believes in death and resurrection of the body and soul, like Christianity. Islam also teaches about how to prepare for death, when aware that death is imminent. Statistics show that a vast majority of the American male population would want to know about the eventuality of dying because of a fatal illness…
Kagawa-Singer, M., & Backhall, L. (2001). "Negotiating cross-cultural issues at end of life." Journal of American Medical Association, 286(3001), 2993-. Available at: http://ethnomed.org/clinical/end-of-life/Table2.pdf retrieved: Oct 7th, 2014
Koenig B.A., Gates-Williams J. (1995) "Understanding cultural difference in caring for dying patients." West J. Med. Sep 1995; 163(3): 244 -- 249. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1303047/?page=4
Coolen Phyllis R., DNP, MN, RN. (2012)Cultural Relevance in End-of-Life Care. EthnoMed. Available at: https://ethnomed.org/clinical/end-of-life/cultural-relevance-in-end-of-life-care
Rizvi, Sayyid Muhammad. What You Should Do Just Before Death. Islam.org. Available at: http://www.al-islam.org/articles/what-you-should-do-just-before-death-sayyid-muhammad-rizvi
Questions to AANP
What is the possibility of a U.S. NP working in Europe?
A number of European States can be classified in the primary nurse practitioner level and others in the advanced nurse practitioner level. Every time nursing positions are open, they are usually filled by locally available and trained NPs or even APNs. Global nursing role is presently not at the level where one can easily shift from one country to another in order to practice.
Is there an accredited NP program in Asia (India)?
In India, only one institute comes to mind, which provides a Masters in Nursing; however, it is not a Nurse Practitioner Program and no other institute exists that offers such programs, at least not to my knowledge.
The benefits to members
Grant opportunities and scholarships, encouraging NPs and the development of the NP profession together with the APN community.
AANP. (2016, January 10). Professional Membership. Retrieved from The American Association of Nurse Practitioners: https://www.aanp.org/membership/professional-membership
Greggs-McQuilkin. (2005). Why join a professional nursing organization? Nursing, 35, 19.
Thomas, A. C., Crabtree, M. K., Delaney, K. R., Mary Anne Dumas, Kleinpell, R., Logsdon, M. C., . . . Nativio, D. G. (2012). Nurse Practitioner Core Competencies . Washington D.C: The National Organization for Nurse Practitioner Faculties.
Leadership: Born vs. Taught Leaders
Born vs. Taught Leaders: Leadership
Experts have given conflicting views in the question of whether leaders are born or made. One faction believes that leaders are born with special qualities that predispose them to occupy positions of authority from an early age. The other, however, believes that leadership capabilities are developed over time through education and training. This text evaluates both arguments and gives a tentative position on the issue.
Are Leaders Born or Taught?
ose Haggerty and Don Berwick give conflicting views on the question of whether people who are not born leaders can actually become good leaders. Berwick is of the opinion that whereas some people are born to be leaders, anyone can lead, as long as they receive the right training and education. In other words, leadership can be taught. Haggerty, on the other hand, believes that leaders are born; as such,…
Berger, W. (2015). Why Curious People are Destined for the C-Suite. Harvard Business Review. Retrieved from https://hbr.org/2015/09/why-curious-people-are-destined-for-the-c-suite
Connelly, M. S., Gilbert, J. A., Zaccaro, S. J., Threlfall, K. V., Marks, M. A., & Mumford, M. D. (2000). Exploring the Relationship of Leadership Skills and Knowledge to Leader Performance. Leadership Quarterly, 11(1), 65-86.
Porter-O'Grady, T. (2001). Profound Change: 21st Century Nursing. Nursing Outlook, 49(4), 182-186.
PWC. (2015). Refining Business Success in a Changing World. PWC. Retrieved from http://www.pwc.com/gx/en/ceo-survey/
obert Wood Johnson Foundation Committee Initiative on the Future of Nursing and the Institute of Medicine
The Institute of Medicine (IOM) has published a guide for the future of nursing in the U.S., the purpose of which is to facilitate nurses, health care providers and community leaders with the tools they need to implement effective changes towards improving the health of their communities. This paper will discuss the key messages of the IOM report, the importance of the report for nursing, and what the state is doing in terms of its Action Coalition to achieve the goals outlined by the report.
The key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health are that nurses should 1) maximize their education and training in their practice by working to implement everything they have learned, 2) pursue further education/training through a program of continuing education that supports progress, and…
Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing,
at the Institute of Medicine. (2011). The Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academies Press.
Davis, L., Taylor, H., Reyes, H. (2014). Lifelong learning in nursing: A Deplhi study.
Nurse Education Today, 34(3): 441-445.
Letter of ntent
This brief document serves as my letter of intent to apply to your prestigious doctoral program. The important and necessary items that will be covered in this document include my motivations for earning a doctoral degree, what envision doing differently when my degree is complete, the topic or topics that have on my mind when it comes to my Direct Practice mprovement project and where plan to do most of my practice hours. While there are a few places that could go for my doctoral program, your university is the one that clearly stands out above the rest.
When it comes to why am getting my doctoral degree, happen to know that many to most people really do not need a doctoral degree to advance within their field or so their job. However, there are certain positions in certain fields that require or at least encourage people…
In conclusion, I wish to thank any reviewers and judges of my stated goals and qualifications for any and all consideration that you give me. I whole-heartedly wish to attend your wonderful college and I look forward to integrating myself into the processes that would be to come. At the same time, I fully understand and realize that my acceptance into the same is by no means guaranteed or assured and I'm humble enough to know that I should not assume I'm going to be brought on. Regardless, I know that my dreams will not be deterred and I just hope that your institution is part of my future. Thanks again for your time.
Faculty development programs are necessary in allowing students better access to competent and prepared instructors/faculty. A suitable online faculty development program should be established with the foremost support of central nursing faculty. Principal nursing faculty should be included in the preparation and assessment facets of the program. Furthermore, they should continue as active contributors throughout the entire process. An appropriately planned online faculty development program should fulfill the varied faculty needs, significant workshop prospects, workload necessities, incorporation of technology, education training and suitable modeling. The aim of this project is to assess and implement a suitable online faculty development program for nurse educators with major emphases on enabling the changeover process from on-ground teaching to the online background.
The medical field uses technology in almost all aspects of day-to-day work activities and must be integrated in an education setting. Nurses in particular must become acclimated to use of technology within…
Boling, E.C., Hough, M., Krinsky, H., Saleem, H., & Stevens, M. (2012). Cutting the distance in distance education: Perspectives on what promotes positive, online learning experiences. The Internet and Higher Education, 15(2), 118 -- 126. Retrieved from http://www.sciencedirect.com/science/article/pii/S109675161100090X
Springer. (2010). A Faculty Development Program for Nurse Educators Learning to Teach Online. TechTrends, 54(6), 20. Retrieved from http://link.springer.com/article/10.1007/s11528-010-0450-z#
Vitale, A.T. (2010). Faculty Development and Mentorship Using Selected Online Asynchronous Teaching Strategies. The Journal of Continuing Education in Nursing, 42(12), 549-556. Doi: 10.3928/00220124-20100802-02
A depression-screening tool would of course be an effective tool for use in the obesity clinic and would be worthwhile to employ even without any external research project being undertaken, but to have no recruitment procedures at all seems to invite the potential for a host of problems in sampling and in other aspects of research. Otherwise, however, a study-based directly on the population you are gathering for is clearly going to be an effective sample.
This leads to another issue -- a question more than a problem -- with the proposed in-clinic sampling. In such a situation, are there appropriate controls necessary to ensure a representative sample? If there are essentially no exclusionary requirements, could less accurate or somehow flawed data get through and cause the results to become skewed, even in some small way? For example, one study shows that many clinics have a fairly high attrition rate,…
Honas, J., Early, J., Frederickson, D., & O'Brien, M. (2003). Predictors of Attrition in a Large Clinic-Based Weight-Loss Program. Obesity Research 11: 888-94.
Paeratakul, S., Lovejoy, J., Ryan, D. & Bray, G. (2002). The relation of gender, race and socioeconomic status to obesity and obesity comorbidities in a sample of U.S. adults. International Journal of Obesity and Related Metabolic Disorders 26(9): 1205-10.
Stress Ulcer Prevention
The subject up for study in this report shall be whether stress ulcers in hospital patients induced by being bedridden can be mitigated or even prevented by turning the patient to a new position at least once every two hours. The amount of research on this subject is not pervasive and voluminous. However, some material about the subject does exist. Thus, a conclusion should be possible regarding whether patient-turning is a solution to prevent stress ulcers from forming in the first place. While it may not truly be a fix-all solution, the practice of turning patients at two hour intervals shows some promised based on evidence-based research and results.
Stress ulcers, otherwise commonly referred to as deep tissue injury (DTI) is a pressing and persistent issue in the medical field. This is especially true when speaking of patients that are bedridden for any significant amount of time…
Behrendt, R., Ghaznavi, A.M., Mahan, M., Craft, S., & Siddiqui, A. (2014).
CONTINUOUS BEDSIDE PRESSURE MAPPING AND RATES OF HOSPITAL-
ASSOCIATED PRESSURE ULCERS IN A MEDICAL INTENSIVE CARE
UNIT. American Journal Of Critical Care, 23(2), 127-133.
Threaded discussion #2
As the individual observes, the N must use critical thinking to guide her care specifically since, as she shows, conflict of duties and unpredictable situations can lead to uncertainty and conflict.
The motion for the importance of critical thinking in nursing initiated in the 1960s where Bruner (1961) argued that self-reflection and independent acquisition of knowledge cause that knowledge to become more readily available when needed. No where is that more important than in the nursing field when reliable knowledge should be at hand when needed. Advantages for nurses to practice critical and reflective thinking are numerous and include the fact that the knowledge becomes more vibrant, immediate, and easily accessible, aside from the aspect that new perspectives can be channeled in nursing and erroneous data discovered, challenged, and replaced.
In a more indirect manner, and helpful to this situation where, as the individual observes, greater teamwork…
Jennings, B.M. & Loan, L.A. (2001). Misconceptions amongst nurses about evidence-based practice. Journal of Nursing Scholarship, 33,121-127
Joel, L. (2009) Advanced Practice nursing: Essentials for role development, Davis, NY
NHS. Quality and Service Improvement Tool. SBAR.
Establishing an NP Led Wellness and Recovery Center for Deinstitutionalized Individuals
Historically, nursing, and medicine professions have been loath to utilize tools commonly linked with mercenary aspects of business, such as market research and decision analysis. In the contemporary health care setting, however, consumers hold numerous options for care providers. The division of the market or market segmentation into different subgroups allows the determination of target markets and the buildup of marketing policies specific to the needs and interests of the selected subgroups. Market analysis allows the identification of policies for nurse practitioners to enhance their practice in a way that centers on the interests and needs of the selected market. While scores of the nurse practitioner's dream of operating their own businesses, those that have set up their own practice understand that it requires a compelling passion for owning a business, and for the profession.
A nurse practitioner is…
Participants filled out a Short-Form McGill Questionnaire, an Arthritis Self-Efficacy Scale, and Fibromyalgia Impact Questionnaire in order to measure their levels of pain over the past few weeks. What the researchers found through statistical analysis was self-management strategies that reduced pain over time were most effective in the group that was exposed to guided imagery techniques. The level of guided imagery therapy was not itself significant, but more of the fact of whether or not it was present in the patient's therapy or not. This helps illustrate the effectiveness of guided imagery in managing long-term chronic pain when there are no fundamental cures present within traditional therapeutic practices. Pain management symptoms improved, but the symptoms overall remained. This shows that guided imagery is not a cure in and of itself, but rather an effective way to reduce and manage the pain that is present in chronic conditions like fibromyalgia.
Ferrell, Betty R., et al. "Pain management for elderly patients with cancer at home." CANCER-PHILADELPHIA- 74 (1994): 2139-2139.
Menzies, V., Taylor, a.G., & Bourguignon, C. (2006). Effects of guided imagery on outcomes of pain, functional status, and self-efficacy in persons diagnosed with fibromyalgia. Journal of Alternative & Complementary Medicine, 12(1), 23-30.
Weydert, J.A., Shapiro, D.E., Acra, S.A., Monheim, C.J., Chambers, a.S., & Ball, T.M. (2006). Evaluation of guided imagery as treatment for recurrent abdominal pain in children: a randomized controlled trial. BMC pediatrics, 6(1), 29.
I also need to know the length of time that I have scheduled to speak since professional research conventions usually allocate 10 minutes to 90 minutes for a presentation. If only a short time, I may be advised to present highlights and to give handouts of my presentation. Visual images also facilitate the learning. I will need to build in time for question and discussions.
With each audience, I should consider their specific interests and structure the speech accordingly. With non-health laypeople, for instance, I can structure it to the challenges of dealing with relations with dementia and the kind of characteristics they should look for in caregivers as well s ways that can give them less stress and give their patients more comfort in dealing with them. I should also present it in a creative way in order to make it more interesting.
When approaching journals (and there are…
Byrne, M. Disseminating and presenting qualitative research findings - Research Corner
However, the study sought to determine if new or additional CBT techniques were effective. The control condition for this study should have been broken up into two different groups: a WLC group and a group that received traditional CBT without new techniques involved. The current study only affirms that CBT is effective in treating PTSD; however, it does not determine if the new additional techniques over the traditional CBT techniques offer any incremental validity in the treatment of PTSD. Therefore, the overall design of the study is flawed. Moreover, we do not know which CBT techniques were beneficial in treatment. Perhaps a mixed design could have assisted in better understanding this.
2. Chemtob, Nakashima, and Carlson (2002) report that up until the current study there was only one controlled treatment study of children with PTSD following a natural disaster. The current study was designed to look at a brief treatment…
New Practice Approaches Through Policy
One of the major current concerns in health care is the rapidly aging nature of the populations in Western societies today. This is, in general, attributed to developments in medical science and better information regarding personal health choices and activities. Despite this, however, it is also true that aging seldom brings with it a glowing sense of health. While many people today age better than ever before in human history, the elderly also tend to suffer from an increasing number of conditions, some of which leave them bed bound. Many of these bed bound residents, in addition to their initial conditions, also suffer related ailments such as pressure ulcers. These create not only great physical discomfort and emotional stress, but also great burdens on the health care system in terms of treating such ulcers. For this reason, it is suggested that policies should be created…
Leonard, R. (2001, Spring). Policy Considerations for Nursing Home Quality Improvement. Harvard Health Policy Review 2(1). Retrieved from: http://www.hcs.harvard.edu/~epihc/currentissue/spring2001/leonard.html
Mackie, S. And Dunnery, P. (2008). Clinical Policy: Pressure Ulcer Prevention and Care for Adults in Hospital. Retrieved from: http://www.nhstayside.scot.nhs.uk/about_nhstay/commitees/08_iaq/27012009/docs_024483.pdf
Niezgoda, J.A. And Mendez-Eastman, S. (2006, Feb.). The Effective Management of Pressure Ulcers. Advances in Skin & Wound Care: The Journal for Prevention and Healing 19(1). Retrieved from: http://www.nursingcenter.com/lnc/JournalArticle?Article_ID=636557&Journal_ID=54015&Issue_ID=636556
Rich, S.E., Margolis, D., Shardell, M., Hawkes, W.G., Miller, R.R., Amr, S., and Baumgarten, M. (2011, Jan.). Frequent manual repositioning and incidence of pressure ulcers among bedbound elderly hip fracture patients. Wound Repair Regen 19(1). Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3059225/