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Nursing homes and facilities that are somewhat less restrictive are needed and necessary in some situations so as to allow for the proper level of care and supervision. However, the isolation and removal from the outside world that people experience as a result of being in a nursing home can be oppressive and hurtful. There are often times where temporary jaunts outside of the nursing home or fun activities within the same can allow for relief from monotony and so forth. However, advanced medical conditions like Alzheimer's, infectious diseases and bacterial/hygiene issues can all aggravate the isolation just mentioned as there have to be more restrictions on freedom and activity.
Nursing Home Isolation
Other than the obvious concerns about medical care, quality of life and so forth, perhaps one of the most saddening things about seniors being in nursing homes is the isolation and "border" that is created by the…
Works Cited -- Annotated
Carstensen, Laura L., and William J. Fremouw. "The Influence Of Anxiety And Mental Status
On Social Isolation Among The Elderly In Nursing Homes." Behavioral Residential
Treatment 3.1 (1988): 63-80. Psychology and Behavioral Sciences Collection. Web. 29
Care for a Family Member
hen a family is searching for the best possible healthcare environment for an older person in the family, that family really has three choices. They can place the elderly person in a nursing home, or have a home care agency come into the home and provide services, or the family can turn to a long-term care solution. This paper reviews the positives, negatives, and other aspects of all three solutions. Using peer-reviewed sources, this paper looks at specific areas of interest in the three potential solutions for a family.
Nursing Homes - Suicide
According to the Centers for Medicare and Medicaid Services, more than 40% of Americans will need some care in a nursing facility (which is also seen as a "long-term" service) in their lifetime (Mullin, 2013). Moreover, the cost for a private room (on average in the United States) in a nursing home…
Andre, B., Sjovold, E., Rannestad, T., and Ringdal, G.I. (2014). The impact of work culture
On quality of care in nursing homes -- a review study. Scandinavian Journal of Caring
Science, Vol.28, 449-457.
Mezuk, B., Lohman, M., Leslie, M., and Powell, V. (2015). Suicide Risk in Nursing Homes
The Nursing Home Community: A Critical Ethnography
A nursing home is a community of care ideally designed to provide seniors with a safe and supportive environment in which to receive around-the-clock evidence-based healthcare and ancillary services. Nursing homes are also complex environments, with the residents comprising one distinct social cohort and staff another, with evident hierarchies and roles within the organization. An ethnographic approach to the nursing home community lends insight into the relationships between various parties and stakeholders in the community. Furthermore, the ethnographic methods permit unique qualitative, phenomenological insights into the lived experiences of both staff and residents. Through the window of ethnographic research, it may be possible to recommend changes to nursing home care delivery and improve client perceptions, experiences, and outcomes. Critical analysis of nursing home ethnographic research reveals several primary insights into the structure and culture of the community. Although diverse, the nursing home community…
Diamond, Timothy. “Social policy and everyday life in nursing homes: A critical ethnography.” Social Science & Medicine, Vol. 23, No. 12, 1986, pp. 1287–1295. doi:10.1016/0277-9536(86)90291-1
Harnett, Tove. “Seeking exemptions from nursing home routines: Residents\\\\' everyday influence attempts and institutional order.” Journal of Aging Studies, Vol. 24, No. 4, Dec 2010, pp. 292-301.
Henderson, J. Neil and Vesperi, Maria D. The Culture of Long Term Care. Greenwood Publishing Group, 1995.
Shared Governance in Nursing Homes
The concept of shared governance in nursing is not a new one, but rather has been recognized since the 1970s as a key indicator of excellence in the nursing practice and specific departments and institutions (Cherry & Jacob 2005, pp. 276-8). In a study of nursing home facilities in particular, it was determined that nursing leadership style had a great deal to do with levels of staff turnover, suggesting that shared governance ad other more open and empathetic leadership styles are conducive to more effective nursing and more satisfactory nursing practice (Donoghue & Castle 2009). There are a number of other factors that influence nursing practice, including patient loads, specific areas or specializations of practice, and a host of economic and social factors. Leadership style, however, is one of the most easily changed factors with a large degree of influence on the practice and profession…
Burger, S., Kantor, B., Mezey, M., Mitty, E., Kluger, M…. & Rader, J. (2009). Nurses Involvement in Nursing Home Culture Change: Overcoming Barriers, Advancing Opportunities. Pioneer Network. Accessed 20 February 2011. https://pioneer-network.org/Data/Documents/CultureChanegNursesIssuePaper.pdf
Cherry, B. & Jacobs, S. (2005). Contemporary Nursing. St. Louis: Elsevier.
Donoghue, C. & Castle, N. (2009). Leadership Styles of Nursing Home Administrators and Their Association With Staff Turnover. The Gerontologist 49(1): 21-7.
Havens, D. & Aiken, L. (1999). Shaping Systems to Promote Desired Outcomes: The Magnet Hospital Model. Journal of Nursing Administration 29(2): 14-20.
Falls in Nursing Homes, Are They Preventable
Preventing falls in nursing homes
Falls are quite common in the homes of the elderly with around one hand a half falls for each nursing-home bed-years. Although most falls are not fatal, 10% to 20% lead to admissions in hospitals and fractures. It is, therefore, important that care providers in these homes cut down the falls and the rate of fall-related dangers. Interventions have succeeded in reducing these falls in community- residence for aged patients, but efficiency in reducing them in nursing homes is not evident. Various studies investigate the effectiveness of diverse programs to reduce falls within nursing homes. Examples of the intervention programs comprise of environmental evaluation, assessment and alteration of the assistive device, changes in medication, evaluation, and training of gait, staff education, exercise programs, use of hip protector, and the evaluation of blood pressure. esearch shows that the intervention…
Berry, S. D., Lee, Y., Cai, S., & Dore, D. D. (2013). Nonbenzodiazepine sleep medication use and hip fractures in nursing home residents. JAMA internal medicine, 173(9), 754-761.
Centers for Disease Control and Prevention. (2015). Falls in Nursing Homes. Retrieved from http://www.cdc.gov/homeandrecreationalsafety/falls/nursing.html
Gillespie, L. D., Robertson, M. C., Gillespie, W. J., Sherrington, C., Gates, S., Clemson, L. M., & Lamb, S. E. (2012). Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev, 9(11).
Quigley, P., Bulat, T., Kurtzman, E., Olney, R., Powell-Cope, G., & Rubenstein, L. (2010). Fall prevention and injury protection for nursing home residents. Journal of the American Medical Directors Association, 11(4), 284-293.
Fall Prevention Project
The target audience for this fall prevention plan consists of Ns and LPNs who work at nursing home facilities, or otherwise work with the elderly. There is a strong body of evidence that shows that fall-related injuries to the elderly are associated with negative health outcomes that go beyond the immediate injury. The elderly are more at risk of falling than other patients are, and nursing homes are not always properly equipped, designed to prevent falls. Further, the staff at nursing homes do not always have the best possible training with respect to fall prevention. Nursing homes experience 1.5 falls per bed per year, and there are a number of precipitating causes (ubenstein, Josephson & obbins, 1994).
The main causes of falls in nursing homes are gait and balance disorders, weakness, dizziness, environmental hazards, confusion, visual impairment and postural hypotension (ubenstein, Josephson & obbins, 1994). Most of…
Palmer, B. (2004). Overcoming resistance to change. Quality Progress. April 2004, 35-39.
Rubenstein, L, Josephson, K. & Robbins, A. (1994). Falls in the nursing home. Annals of Internal Medicine. Vol. 121 (1994) 442-451.
Tinetti, M. & Williams, C. (1997). Falls, injuries due to falls, and the risk of admission to a nursing home. New England Journal of Medicine. Vol. 337 (18) 1279-1284.
Zimmer, J., Watson, N. & Treat, A. (1984). Behavioral problems among patients in skilled nursing facilities. AJPH. Vol. 74 (10) 1118-1121
Before the plan was put into place data was collected so that the changes could be measurably recorded (osher, 2006).
In addition, before the plan began Phase I, the nursing home staff was retrained and agreement and enthusiasm for the plan was attained.
The culture change program was as success. Several residents were recorded as developing new energy and drive for life when allowed to pursue previous interests. One resident, who had dementia approached a newly obtained bird and talked to it for 15 minutes. She had raised birds during her adult life before entering the center and she was still able to advise others on how to care for and feed pet birds. Another resident who was blind and hearing impaired came alive with excitement when she was provided bunnies to pet and care for each day (osher, 2006).
Another study gauged at recording nurse response to patients with…
____(2006) Common Problems of Hospitalized Older Adults. Journal of Gerontological Nursing
Kovach, Christine, RN; Kebler Sheryl RN; Simpson, Michelle, MS (2006) Behaviors of Nursing Home Residents With Dementia, Examining Nurse Responses. Journal of Gerontological Nursing
Rosher, RB, Robnison, RB (2006) Barriers to Culture Change Journal of Geontological Nursing
Improving Healthcare Delivery in Nursing Homes: Focus on Broken Bones
The objective of this study is to focus on health care management issues, problems, and policies in a current organization and specifically that of a nursing home with a focus on broken bones.
Identification of Problem
Osteoporosis and fracture related to osteoporosis "are primary health concerns and sources of significant death and disability around the world." (Clinton, 2011) In 2006, it is stated that hip fractures along "cost Americans in excess of $20 billion." (Clinton, 2011) This is a huge problem since one in four patients with a hip fracture die "within one year of having the fracture." (Clinton, 2011) Osteoporosis is a bone disease that is stated to "decrease bone density" and to increase the "risk of fractures." (Clinton, 2011) These types of fractures are termed 'fragility fracture' and this occur with "minimal trauma and typically would not happen…
Clinton, Jeremiah (2011) Osteoporosis is a Major Health Concern for Seniors. Ravalli Republic. 21 June 2011. Retrieved from: http://ravallirepublic.com/lifestyles/health-med-fit/article_05bd7530-9c78-11e0-a619-001cc4c03286.html?print=1
Rubenstein, LZ and Josephson, KR (2006) Falls and Their Prevention in Elderly People: What Does the Evidence Show? Med Clin N. Am 90 (2006). Retrieved from: http://www.nchh.org/Portals/0/Contents/Article0786.pdf
Kutner, NG, et al. (1992) Measuring the Quality of Life of the Elderly in Health Promotion Intervention Clinical Trials. Public Health Reports. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1403694/pdf/pubhealthrep00071-0044.pdf
Masud, T. And Morris, RO (2001) Epidemiology of Falls. Age and Aging 2001; 30-S4. Retrieved from: http://ageing.oxfordjournals.org/content/30/suppl_4/3.full.pdf
baby boomers grow older, America is faced with a growing need to provide for them in long-term care situations, such as Nursing Homes. However, at the same time, we are faced with a growing difficulty finding and retaining a workforce to care for them. People are attracted to the health care industry that have a genuine heart-felt desire to care for people. They receive their education and enter the industry with enthusiasm. However, for many, it does not take long until the realities of the working conditions set in and the employee finds themselves burnt-out and they leave.
The causes of employee burnout are many. Caring for disabled and frail patients is physically and mentally demanding. Employees involved directly in the care of patients often have few advancement opportunities. In addition, direct care employees are often the lowest paid employees in the field of long-term health care (Turner, 2002). With…
Banaszak-Holl J, Hines MA. (1996) "Factors associated with nursing home staff turnover." Gerontologist. 36(4):512-517.
Brown, L. (2002) "High Turnover Rate May Undermine HIV/Hemophilia Care."
Center for the Advancement of Health. Brown University. URL: http://www.cfah.org/hbns/newsrelease/turnover2-12-02.cfm Accessed June 5, 2004.
Crown WH, Ahlburg DA, MacAdam M. (1995) "The demographic and employment characteristics of home care aides: A comparison with nursing home aides, hospital aides, and other workers." Gerontologist 35(2):162-170.
Epidemiological Study on Falls
This is a matched cohort study of 754 volunteer elders who live together in a community in New Haven, Connecticut in determining damaging effects of injurious falls among the disabled ones (Gill et al., 2013). It sought to discover the connection between hip fractures and the damaging effects. Of this total number of participants, 122 were hospitalized patients for injurious falls, 59 of whom were hip-fractured and 63 were injured for other causes. They were compared or matched with 241 patients who were hospitalized for other causes not related to falls. Their mean age was 85.7 and they were evaluated every month for disability. They were admitted in nursing homes from 1998 to 2010 for injuries caused by hip fractures and other causes. It was found that their disability substantially increased in the first 6 months of hospitalization as compared to those who were hospitalized for…
Retrieved on April 8, 2015 from https://www.clinicalkey-com.proxygw.wrlc.og/#!/content/book/3-s2.0=B978145573733800013
- more on causal inferences. Clinical Key. Chapter 15, Epidemiology: Elsevier, Inc.
Retrieved on April 8, 2015 from https://www.clinicalkey-com.proxygw.wrlc.og/#!/content/book/3-s2.0=B978145573733800013
Identify High isk Patients
Ask nursing staff to list conditions and characteristics of patients at high risk for a fall. These include patients with mobility and balance issues due to illnesses such as Parkinson's as well as patients suffering from dementia. Also, patients with conditions that make their bones likely to be brittle such as osteoporosis should also be flagged as high risk.
Ask staff to list medications which may impede mobility, cognitive functioning, or increase the risk of osteoporosis.
Physically audit the area for areas likely to cause falls
While staff are not involved in the planning of the facility itself, they should be aware of the features that have been added to the facility to reduce the risk of falls. These may include railings near beds, hallways, and bathrooms. esidents who are capable of understanding should likewise be taken on a tour of the facility to…
Preventing falls among older adults. (2013). CDC. Retrieved from:
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/
eport on Conditions at Brighton and Sussex University Hospitals NHS Trust
The following report is based on extensive observation of the conditions for patients living at the Brighton and Sussex University Hospitals NHS Trust. While some patients received moderate care, overall, the quality of care in this facility was appalling. All patients -- all people -- deserve to be treated with dignity, and this was far from the case. The conditions were especially distressing given that in general they could be fixed or at least ameliorated relatively easily. Not all of the ills of old age or disability can be remedied, of course. Pain and fear will be present even with the best possible care. Given that this is true, all possible efforts must be made to reduce fear, anxiety, and pain to the greatest degree possible.
The facts that this report is based on were documented by…
Grant, P. (2010). Ethical lessons from the 'undercover nurse': implications for practice and leadership. Medical Ethics 36: 469-472.
Margaret Haywood's diary. Retrieved from http://news.bbc.co.uk/2/hi/programmes/panorama/4701651.stm .
Online bulletin. Retrieved from http://www.southerneditorial.co.uk/bulletin/july05/breaknews.htm.
Reasons for the substantive hearing of the Conduct and Competence. Retrieved from http://www.nursingtimes.net/Journals/1/Files/2009/4/17/haywood_NMCruling.pdf
Clearly, since the focus of these articles are based on an institutional economics point-of-view of healthcare quality, a limitation of the study is that it does not take into consideration other variables that might influence the efficiency of nursing homes in providing quality healthcare. Among these unaccounted variables are the politics behind healthcare, specifically federal laws and policies related to the provision of healthcare. Apart from policies and laws, another variables unaccounted for in this study is a thorough look or analysis of the relational dynamics between patients and nurses, as well as other healthcare practitioners and professionals. This variable is vital in understanding the concept of quality healthcare because it provides an in-depth look at the 'experiential" dimension or perspective healthcare -- that is, healthcare quality as assessed by patients and healthcare professionals/practitioners.
In terms of socio-demographic characteristics, the literature collated regarding nursing home care does not…
Nursing Home esident Agitation: Predictors and Interventions
To critically review selected articles investigating and discussing predictors of nursing home resident agitation, and recommended interventions.
Burgio et al., (2007, p. 642) provides a working definition of nursing home resident agitation "… as verbal, vocal, and motor activities that are repetitive, outside of social standards, and considered inappropriate by staff." Agitation can often involve physical and/or verbal aggression, which can increase the risk of harm to residents and staff, disrupt activities, divert precious resources, and lead to staff burnout and high turnover.
Critical literature review.
Medical literature databases were searched using the keywords 'agitation, nursing home, and demetia' and a limited number of articles published within the last 10 years were selected for review.
Inclusion Criteria. Articles investigating and/or reviewing the etiology of agitation in geriatric nursing home residents suffering from dementia were selected, as were articles recommending interventions.
Exclusion Criteria. Only…
The two cohort studies reviewed here used computer assisted behavioral observation systems (CABOS) to identify predictors of agitation in geriatric nursing home residents suffering from dementia. One study monitored 78 nursing home residents (Burgio, Park, Hardin, and Sun, 2007, mean age = 82.2) and the other 123 (Vance, Burgio, Roth, Stevens, Fairchild, and Yurick, 2003, mean age = 82.3), but neither study used a normal control population. The experimental strategy involved assessing various physical and mental criteria periodically to determine if they predicted agitation behaviors within this population. Both studies found a statistically significant correlation between cognitive functioning and agitation (p < 0.01). Burgio et al., (2007) was unable to find a significant correlation between agitation and gender, age, and daily activities, but the earlier study (Vance et al., 2003) reported significant, but weak correlations between agitation and gender (r = 0.21), visual impairment (r = -0.21), and hearing impairment (r = 0.42). The inverse relationship between visual impairment was attributed to residents being unable to notice staff walking by, which can otherwise trigger outbursts. Only in the latter study was retrospective nursing staff reports able to predict agitation behavior based on assessments of cognitive functioning, suggesting variability in the ability of nursing home staff to correctly assess resident cognitive status. The authors of both studies recommend the use of CABOS-like systems of measurement to determine activity levels for future studies, because staff reports aren't a reliable predictor of agitation behavior.
For more than 60 years it has been recognized that agitation worsens in Alzheimer's patients in late afternoon and early evening, a phenomenon accordingly termed Sundowning Syndrome (reviewed by Bachman & Rabins, 2006). Volicer et al. (2001) used body temperature to track circadian rhythms in inpatient Alzheimer patients with a mean age of 71 and suffering from different levels of dementia. It was discovered that individuals within the
..significantly below the maximum of $3,000 per day" (and more like $300 to $350).
And fourth, in about 22% of the cases where nursing homes were in serious violation of regulations - and causing harm to their patients - "there was no record" of sanctions at all.
Conclusion: Given the widespread problem reviewed here in this paper, it seems reasonable that the federal government (with oversight by the Congress) should implement the recommendations of the GAO. One, there should be new legislation requiring the CMS administrator to "collect civil money penalties more expeditiously"; two, the policy of punishing nursing home violators needs to be greatly strengthened and enforced; three, the oversight of nursing homes that are frequently in violation of regulations should be expanded; and four, enforcement "data systems" need to be improved, so Congress and CMS administrators have up-to-date information on which nursing homes have received sanctions, how much…
Baisden, Harry. "Senate Panel Proves Nursing Home Failures." AHA News 36.36 (2000): p. 7.
Government Accountability Office. "Report to the Ranking Minority Member, Committee on Finance, U.S. Senate: Nursing Homes: Efforts to Strengthen Federal Enforcement Have Not
Deterred Some Homes from Repeatedly Harming Residents." Retrieved September 2, 2007, at http://www.gao.gov/cgi-bin/getrpt-GAO-07-241 .
Lee, Christopher. "Arizona Veterans' Services Director Quits Amid Scandal." The Washington
Nursing Home Facilities: A Solution for Long-Term Care
Nursing home facilities offer a unique setting for long-term care of elderly persons. Serving as places of residence where the elderly person can obtain assistance with daily living and with medical needs, the nursing home acts exactly as its name suggests—as a home wherein nursing care is provided on a daily basis. This paper will describe the setting of the nursing home, where it falls on the long-term care continuum, how family and friends can play a supportive role, what the role of public relations is in the nursing home, and how oversight of the nursing home is provided by government or other organizational agencies.
Long-Term Care Continuum
The nursing home typically falls at the end of the long-term care continuum spectrum. This spectrum can include four stages: 1) aging in place, which consists of self-care, home support, and adult…
The pathways scheme aims to offer opportunities for every grade of practitioner. This is part of a national process that anticipates quality improvement as a continuously evolving process.
Achieving fair and equal access to professional development for nurses and healthcare providers in the private sector has been difficult in the past. Education has sometimes been viewed as expensive and time-consuming, with staff release for learning difficult to achieve especially acute staff shortages are a definable obstacle already to effective treatment provision. However, it is vital to the principle of performance improvement and the pursuit of standardizing quality outcomes that healthcare provision be based on the active pursuit of staff excellence. This is to be seen as a far more desirable approach to personnel orientation than the imposition of sanctions for poor performance. Central to this is the need for improvement of the local facility's knowledge economy. To this extent, knowledge…
Burgess, M.M. (2003). What difference does public consultation make to ethics? Electronic Working Papers Series. W. Maurice Young Centre for Applied Ethics, University of British Columbia.
Cho, I. & Park, H. (2003). Development and evaluation of a terminology-based electronic nursing record system. Journal of Biomedical Informatics, 36(4), 304-312.
Cooymans, M.P.M. And Hintzen, E.F.M. (2000) Winst en Waarden. Deventer and Den Bosch: Samson.
DoH. (2004) Quality Standards. The Department of Health.
Depending on the patient's condition, the aide may also change the dressings on the patient's wounds, give a massage to the patient or an alcohol rub, or assist with the patient's braces and artificial limbs. "Experienced home health aides also may assist with medical equipment such as ventilators, which help patients breathe" ("Nursing, Psychiatric, and Home Health Aides," U.S. Department of Labor Bureau of Labor Statistics, 2007).
The aide may also make a simple meal for the patient, keeping within the patient's prescribed diet that is still (hopefully) palatable to the patient. An aide will have a good sense of the patient's likes and dislikes. If the patient needs groceries and can be left unattended, the aide may go and do the patient's shopping. The aide may also purchase other basic necessities and medications, if the patient desires, or even do simple errands like post a letter.
During the visit,…
Getting the most out of home health care." Yale University. 2007.
17 Feb 2007] http://www.ynhh.org/choice/home_health.html
LEO: Writing a Process Essay." The Write Place. 2007. [17 Feb 2007] http://leo.stcloudstate.edu/acadwrite/process.html
Nursing, Psychiatric, and Home Health Aides." U.S. Department of Labor
Social Construction of Aging in Nursing Homes
Aging is socially constructed. Using the perspective of symbolic-interactionism, it is possible to show the precise processes whereby the social construction of aging takes place inside specific institutional contexts, like the American nursing home. The American nursing home offers insight into the culturally constrained concept of aging, for attitudes towards aging bodies and aging as a philosophical concept are informed by cultural milieu, worldview, and value construction. Biological aging is not social aging. The positive aging movement and the harmonious aging movement offer counterpoints to traditionally antagonistic and negative views of aging. Especially as the population of the United States and other industrialized nations shifts towards the older end of the age spectrum, it becomes important to reconsider the biological, psychological, and social processes and functions of aging.
The nursing home offers the opportunity to examine aging from a multidisciplinary perspective, while using…
Bengtson, V.L. & Deliema, M. (2016). Theories of aging and social gerontology. In Gerontology: Changes, Challenges, and Solutions. ABC-CLIO.
Featherstone, M. & Hepworth, M. (1995). Images of positive aging. In Images of Aging. Taylor & Francis.
Gergen, K.J. & Gergen, M.M. (2000). The new aging. Social Structures and Aging. New York: Springer. Retrieved online: http://www.swarthmore.edu/sites/default/files/assets/documents/kenneth-gergen/The_New_Aging.pdf
Katz, S. (2005). Cultural Aging. Canadian Journal of Sociology Online, Jan-Feb 2006. Retrieved online: http://www.cjsonline.ca/pdf/culturalaging.pdf
4. Identify effective approaches to bridging the cross-cultural gap that may prevent families from using nursing home facilities when they are in the elders' best interests.
The following strategies will be used to help achieve the above-stated goals:
1. Develop expertise in writing grant applications.
2. Identify nongovernmental organizations that provide funding for these types of social programs.
3. Formulate a community education program to inform the people of Liberia of the need for long-term care facilities for the elderly when immediate family members are unable or unavailable to do so.
4. Develop a training regimen that can be used to help employees become familiar with the day-to-day care needs of the elderly and what part they will play in the process.
Given the current reluctance of the international community to make substantive investments in Liberia, the short-term tactics used to achieve the above-stated goals would require an…
Bray, M. (2009). The Mabel Bray Foundation. [Online]. Available: http://womeninactionfor progress.com/.
Liberia. (2009). U.S. government: CIA world factbook. [Online]. Available: https://www.cia.
Takahashi, K. (2008). Liberia: The impact of civil war. The Chicago Tribune. [Online].
Treatment of Heart Failure in Nursing Home Residents
Heart failure (HF) symptoms may occur because of systemic and pulmonary congestion, structural defects arising on account of HF, structural defects leading to HF, or from treatment complications. At first, studies addressing the issue of heart failure focused on HF patients and decreased left ventricular contraction. As a result, therapies were tested within this patient cluster. This patient cluster's agreed description is HF with LVSD (left ventricular systolic dysfunction) (NCGC, 2010).
In order to treat chronic HF, non-pharmacological as well as pharmacological therapy ought to be utilized for patients. While this condition is quite frequently witnessed among patients living in nursing homes, whether the suggestions put forward in the pharmacological therapy guidelines are implemented within this cluster of patients is unclear (Daamen, et al., 2016).
Owing to the lack of awareness of the precise prevalence of chronic HF, this phenomenon is…
Barents, M., Horst, V., Voors, A., Hillege, J., & Jongste, M. (2008). Prevalence and misdiagnosis of chronic heart failure in nursing home residents: the role of B-type natriuretic peptides. Neth Heart J., 123 -- 128.
Davidson PM, Cockburn J, Newton PJ, et al. (2010). Can a heart failure-specific cardiac rehabilitation program decrease hospitalizations and improve outcomes in high-risk patients? Eur J. Cardiovasc Prev Rehabil. 2010;17:393 -- 402
Dinkelaker S. (1999) Can A Nurse-Managed Medication Discharge Planning and Follow-Up Program Affect Readmission Rates of Patients with a Diagnosis of congestive Heart Failure?
Daamen, M., Hamers, J., Gorgels, A., Tan, F., Schols, J., & Rocca, H. (2016). Treatment of heart failure in nursing home residents. J Geriatr Cardiol., 44 -- 50.
Field, Marilyn Jane & Cassel, Christine K. (1997). Approaching Death: Improving Care at the End of the Life. National Academic Press.
This work emphasizes the necessity to improve end of life care as a way to help ease fears about death and reduce anxiety which would create a more negative death experience within the nursing home. Additionally, this work shows the negative impact of over treating symptoms that are relating to oncoming death which cause patients unnecessary stress and pain in their last few days.
anson, Laura C. (2003). Improving Nursing ome Care of the Dying: A Training Manual for Nursing ome Staff. Springer Publishing Company.
This handbook for physicians emphasizes taking a multi-disciplinary approach to caring for the dying, which also encourages nursing home staff to learn from the lessons seen in hospice care. This includes taking a strategy of main management, rather than resuscitation in order to provide…
Hall, Sue; Longhurst, Susan; & Higginson, Irene. (2009). Living and dying with dignity: a qualitative study of the views of older people in nursing homes. Age and Aging. 38(4):411-416.
This study works within the established fact that most older people who reside in nursing homes will eventually die there. Thus, it examines an empirically-based model of dignity, defined through psychotherapy as a way to help increase the individual perceived levels of dignity within individuals in a nursing home setting. Results shows that issues attacking individual dignity is not necessarily related to the perception of death, but more towards illness-related concerns and the decline of their social role when dealing with various illnesses.
Henderson, Lori. (2009). Variables affecting death anxiety. Le Moyne College. Retrieved
This can be done in three basic ways:
Change dietary patterns -- it is easier to eat high-sugar, high-fat, and high-carb foods because they are everywhere. This is particularly true for individuals on a fixed income. However, adding more fresh fruit and vegetables to the diet, eliminating sodas and empty calorie drinks, and ensuring 8-glasses of water consumed daily, and reducing fast food and snacks goes a long way to maintaining optimum weight.
Change activity patterns -- Older adults sometimes do not want to exercise or move a great deal. At the very least, walk for 30 minutes daily; and if weather is an issue, consider a treadmill or a walking club at a local mall. Join a club and consider water aerobics.
Change social patterns -- Sometimes, older adults feel isolated. It takes effort to join groups, particularly after the death of a spouse. However, studies show activities like…
Obesity Related Statistics in America. (2008, June). Retrieved from Get America Fit: http://www.getamericafit.org/statistics-obesity-in-america.html
Boseman, J., & Victor, L. (2004). Aging Americans and Diabetes: A Public Health and Clinical Resopnse. Geriatrics, 59(4), 14-17.
Ellison, J. And S. Verma. (2003). Depression in Later Life: A Multidisciplinary
Psychiatric Approach. Marcel Dekker.
opportunity to work at a nursing home, offering my support during physical, occupational, and speech therapy sessions. These sessions offered insight into diverse types of therapy. I worked with a range of different health care workers and specialists, lending insight into how each member of the health care team coordinates their efforts and communicates with each other as well as with patients and family. One of the types of therapy sessions that I supported at the nursing home was therapy with animals. We brought in several animals to assist with therapy, including dogs, cats, and exotic creatures. Therapy Dogs International (n.d.) provided the animals and sometimes the trainer.
The seniors responded well to these therapy sessions, and I intend to support such programs in the future by perhaps providing fund raising for organizations that offer animal therapy. I am also interested more in music and art therapy after performing and…
Brown, J.G. (1999). Physical and occupational therapy in nursing homes. Retrieved online: http://oig.hhs.gov/oei/reports/oei-09-97-00122.pdf
Therapy Dogs International (n.d.). Retrieved online: http://www.tdi-dog.org/OurPrograms.aspx?Page=Nursing+Homes
Falls in the Nursing Home
There has been an increase in falls in the nursing home. A number of things can cause residents to fall (Patient falls: How to prevent them). Illnesses, such as dementia among others, can cause residents to be confused. Confusion with residents requires continual monitoring in keeping the resident safe. Muscle weakness and instability cause falls when residents are confused, or when the resident insists on doing things themselves and maintaining their own independence in spite of the weakness or instability issues. Medications can also cause confusion. Sedatives and anti-anxiety medications are a particular concern in causing confusion. Medications can also cause drowsiness that can cause falls if patients are not put to bed when the medications are given.
Environmental factors also play a role in falls. Wet floors, poor lighting, incorrect bed height, improperly fitted shoes, unmaintained wheel chairs, or items…
Falls in Nursing Homes. (n.d.). Retrieved from Centers for Disease Control and Prevention: http://www.cdc.gov/HomeandRecreationSafety/Falls/nursing.html
Patient falls: How to prevent them. (n.d.). Retrieved from patient Safety Partnership: http://www.patientsafetypartnership.org/Patient_Falls.html
The main focus of this essay is going to concern the nurse-patient relationship idea, and why it is important. This was chosen because the researcher desired to achieve a better accepting of how a helpful nurse-patient relationship can be advanced and even from different theorists who have discovered this idea. In this essay, the researcher sets out to demonstrate what they have learnt regarding the nurse-patient relation concept and how this connection can utilized in the clinical practice setting. T The nurse patient connection, according to a study done by Press Gamey Associates Inc., creates the quality of the care experience and generates an influential influence on patient gratification. Nurses will a lot of their time with patients. Patients see nurses' relations with people among the care team and make their own conclusions about the hospital founded on what they are observing. Furthermore, nurses' approaches toward their vocation,…
Berdes, C. & . (2001). Race relations and caregiving relationships: A qualitative examination of perspectives from residents and nurses aides in three nursing homes. Research on Aging, 23(1), 109-126.
Biering, P. (2002). Caring for the involuntarily hospitalized adolescent: The issue of power in the nurse-patient relationship. Journal of Child and Adolescent Psychiatric Nursing, 16(2), 65-74.
Heijkenskjold, K.B. (2010). The patients dignity from the nurses perspective. Nursing Ethics, 6(3), 313-24.
LaSala, C.A.-B. (2007). The role of the clinical nurse specialist in promoting evidence-based practice and effecting positive patient outcomes. The Journal of Continuing Education in Nursing, 38(6), 262-70.
The author quotes Gary Zukav as emphasizing that if a nurse perceives herself as powerless and her image as negative, the idea can sink to the subconscious level and realize itself. She will be drawn to those who will reinforce the idea. Practitioner Pauline Robitaille's stresses impact each nurse has on others. Her influence on people she comes in contact at the peri-operative setting cannot be overstated. She found the published feedbacks of registered nurses in nursing journals as very positive while others were very negative. Those who gave positive feedbacks described the efforts of preceptors to teach and support them. Thus the intended learning flowed smoothly. However, other nurses reported the negative, punitive and critical behavior of their preceptors. The nurses described the difficulty of working with these preceptors. Hence, the nurses did not benefit from their experience with the preceptors.
Ulmer emphasizes that those in the profession must…
Gonzales, L. (2005). A mission for the center for nursing advocacy. 3 pages. Nevada RN Foundation: Nevada Nurses Association
Nursing BC (2002). How to create community media coverage for nursing. 2 pages. Registered Nurses Association of British Columbia: ProQuest Information and Learning Company
Ulmer, B.C. (2000). The image of nursing. 4 pages. AORN Journal: Association of Operating Room Nurses, Inc.
Willging, P (2005). it's time to take the politics out of nursing home quality. 5 pages. Nursing Homes: Medquest Communications, LLC
Nursing profession is among the oldest in history. Currently, there is much debate that surrounds the profession because of the need for more trained nurses. In recent years the nursing shortage has become a major problem for the medical profession and has resulted in poor patient care and slower patient recover. The purpose of this discussion is to provide an in depth examination of the nursing profession. We will discuss the current state of the nursing profession, including the causes for the shortage and the solution. We will also explore the status of the nursing profession in Australia. Let us begin our discussion by providing a comprehensive definition of what is means to be a nurse.
Definition of a nurse
According to the American Heritage Dictionary, a nurse is defined as " a person trained to care for the sick or disabled under the supervision of a physician." (American Heritage…
American Heritage Dictionary. (1982) Second Edition.
Bashford, A. (1997). Starch on the collar and sweat on the brow: self sacrifice and the status of work for nurses. Journal of Australian Studies, (52), 67+. Retrieved August 24, 2003, from Questia database, http://www.questia.com .
It is thus possible for the institution to retain nurses by strengthening the interpersonal leadership and management skills that lead to empowerment within the healthcare environment. This is especially supported by studies that found that despite the fact that a nurses' pay is important, it is not as critical in enhancing retention as a positive work place or an empowered environment that promotes teamwork and encourages ongoing learning, trust, and respect. (Chan, 2001).
It must always be remembered that nursing retention is the result of a combination of factors. There is no easy solution, and managers and leaders need to choose the combination of approaches that will be effective in their specific organization, since there is no one range or combination of strategies that will fit all.
Buerhaus, P., Staiger, D.O. & Auerbach, D.I. (2003) Is the Current Shortage of Hospital Nurses Ending? Health Affairs 22: 191-198.
Buerhaus, P., Staiger, D.O. & Auerbach, D.I. (2003) Is the Current Shortage of Hospital Nurses Ending? Health Affairs 22: 191-198.
Chan, C.C.A. (2001). Implications of organizational learning for nursing managers from the cultural, interpersonal and systems thinking perspectives. Nursing Inquiry, 8(3), 196-199.
Faulkner, J., & Laschinger, H. (2008). The effects of structural and psychological empowerment on perceived respect in acute care nurses. Journal of Nursing Management. 16(2): 214-221.
Kanter, R.M. (1979). Power failure in management circuits. Harvard Business Review, 65-75.
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)
Perhaps a nurse must also be given a say in the way in which the entire healthcare system is being run today, especially since it is a nurse who is the closest to the patient, and who is completely responsible for the daily care of the patient, and it is a nurse who would put the patient on the road to recovery. A nurse would then be allowed and be given a chance to make use of her education, her leadership training, her skills in mass communication and her management skills in order to further the interest of the patient. The International Council of Nurses in Geneva, Switzerland has summarized the various duties of nurses today, as they increasingly take part in important decision making processes, as follows: 'strategic planning, budgeting, efficient resource planning and utilization, and the planning, management and evaluation of programs and services'. (Akinci, 2007) it can…
Akinci, Ugur. (2007, Jun) "More nurses in decision making roles, prospects and challenges" Retrieved 16 November, 2007 at http://www.nurse-recruiter.com/articles/misc/more_nurses_in_decision_making_roles.html
Allen, Davina. (2001) "The changing shape of nursing practice"
Beaulieu, Elise M. (2002) "A guide for nursing home social workers." Springer
Concept Synthesis on Personal Nursing Philosophy
My interest in nursing peaked at an early age when I attended Clara Barton High School for health professions in Brooklyn NY and graduated in 1991. I first worked as a nurse's aide and home health aide for about two years and found this position to be quite rewarding. I subsequently moved to North Carolina where I took the CNA course in 1995 and began working as a CNA at various nursing homes and hospitals in the regional area. My experience as a CNA certainly helped me in my journey and provided the foundation for the later developments in my career.
Later I moved to Las Vegas in 1997 where I got married in 1998. After forming this union I went back to school for my BSN in 2002 while working as a CNA. I finished my BSN from Nevada…
Andrews, H., & Roy, C. (1991). The Adaptive Model. Norwalk: Appleton and Lange.
Denler, H., Wolters, C., & Benzon, M. (2013). Social Cognitive Theory. Retrieved from Education: http://www.education.com/reference/article/social-cognitive-theory/
Farlex. (2011). The Medical Dictionary. Retrieved from Farlex: http://medical-dictionary.thefreedictionary.com/adaptation+model
Nursing Theory. (2011). Sister Callista Roy. Retrieved from Nursing Theory: http://nursing-theory.org/nursing-theorists/Sister-Callista-Roy.php
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
Nursing and Issue of Falls
Falls are responsible for considerable morbidity, immobility, and mortality among older persons, especially those living in nursing homes. Falls can occur in a home, community, long-term rehabilitation, or acute care Setting (Laurence Z.. et.al, 1994). The risk of falls can be related mostly to mobility status, exposure to hazardous environments and risk-taking behaviors such as climbing ladders for seniors living in the community setting. Factors for a fall in hospitalized adults are greatly influenced by acute illness that often has a marked, albeit temporary, impact on physical and cognitive function compounded by care provided in unfamiliar surroundings in the long-term care setting, the risk factors for falls are influenced by impaired cognition, wandering or impulsive behavior, use of psychotropic medications, incontinence and urgency, lack of Exercise, unsafe environments, and low staffing levels. Patient falls are serious problems
In acute care hospitals and are used as…
Anuradha Thirumalai, (1998). Nursing Compliance with Standard Fall Prevention
Protocol Among Acute Care Hospital Nurses. Retrieved September 26, 2012 from http://digitalscholarship.unlv.edu/cgi/viewcontent.cgi?article=1191&context=thesesdissertations&sei-redir=1&referer=http%3A%2F%2Fwww.google.co.ke%2Furl%3Fsa%3Dt%26rct%3Dj%26q%3Dnursing%2520compliance%2520with%2520standard%2520fall%2520preventionprotocol%2520among%2520acute%2520care%2520hospital%2520nurses%26source%3Dweb%26cd%3D1%26ved%3D0CCAQFjAA%26url%3Dhttp%253A%252F%252Fdigitalscholarship.unlv.edu%252Fcgi%252Fviewcontent.cgi%253Farticle%253D1191%2526context%253Dthesesdissertations%26ei%3Dg-NiUPW8CuLB0QW_r4DgAw%26usg%3DAFQjCNE6__5zNu8vjRxc-jIFBXbBfKVIng#search=%22nursing%20compliance%20standard%20fall%20preventionprotocol%20among%20acute%20care%20hospital%20nurses%22
Dykes, P.C., Carroll, D.L., Hurley, A.C., Benoit, A., & Middleton, B. (2009). Why do patients in acute care hospitals fall? Can falls be prevented? Journal of Nursing Administration, 39(6), 299-304. doi:10.1097/NNA.0b013e3181a7788a
Laurence Z. Rubenstein, Karen R. Josephson & Alan S. Robbins, (1994). Falls in the Nursing
Nursing Case Study
Managing a possible Case of Gastroenteritis: A Nursing Case Study
The effective delivery of optimal nursing care requires a comprehensive treatment plan that addresses both the patient's symptoms and the security of the immediate environment. This report presents a case study of appropriate evidence-based nursing practices in treating an elderly female patient presenting with abdominal discomfort in a residential care setting.
The client presents with new onset faecal incontinence, diarrhoea and increasing abdominal discomfort and cramps. These symptoms suggest a possible gastrointestinal disturbance (Crisp & Taylor, 2009) and present a number of possible diagnoses. While the client's nursing care plan indicates that she is normally continent, her confidential disclosure to the nurse suggests that her symptoms may be more prolonged. Another relevant client characteristic is her advanced age of 85 years.
The client's proximity to the dirty utility room in the aged care facility and the report…
1. Crisp J, Taylor C. (2010). Potter & Perry's fundaments of nursing (3rd ed.). Chatswood, N.S.W.: Elsevier, Australia.
2. Kirk MD, Hall GV, Veitch MGK, Becker N. (2010). Assessing the ?incidence of gastroenteritis among elderly people living in long-term care facilities. Journal of Hospital Infection, 76, 12.
3. Australian Government: Department of Health and Ageing. (2007). Retrieved from- http://www.health.gov.au/internet/main/publishing.nsf/content/icg-guidelinesindex.htm .
4. Andrew E, Simor MVD. (2010). Diagnosis, Management, and Prevention of Clostridium difficile Infection in Long-Term Care Facilities: A Review. The-Americans Geriatric Societ, 58(8), 1557-1593.
egistered nurses are both qualified, educated, and certified to provide a high quality of various care services that an individual may need in a home setting or elsewhere. Hence, providing these practitioners with the power to certify and provide home care is a solution to an overwhelming problem that has plagued the health care environment in recent years. Nursing practitioners, as a result of the nature of their work, are closely connected to the needs of individual patients. This means that they, more than many other health care providers and institutions, are able to assess the needs of individuals, their households, and the level of care they require. This places them in a position to accurately determine the need and/or of such individuals to obtain long-term home care and when such home care becomes unviable. As such, registered nurses who serve individuals in the home setting are able to maintain…
AARP Public Policy Institute. (2013). FAQs. Retrieved from: http://assets.aarp.org/rgcenter/ppi/ltc/ltss_faq.pdf
Brassard, A. (2011). Removing Barriers to Advanced Practice Registered Nurse Care: Home Health and Hospice Services. AARP Public Policy Institute. Retrieved from: http://www.aarp.org/content/dam/aarp/research/public_policy_institute/health/removing-barriers-advanced-practice-registered-nurse-home-health-hospice-insight-july-2012-AARP-ppi-health.pdf
Doty, P. (2000, June). Cost-Effectiveness of Home and Community-Based Long-Term Care Services. U.S. Department of health and Human Services. Retrieved from: http://aspe.hhs.gov/daltcp/reports/2000/costeff.htm
Lynch, M., Estes, C., and Hernandez, M. (2007, June). Long-Term Care Policy Option Proposal: Consumer Controlled Chronic, Home, and Community Care for he Elderly and Disabled. Georgetown University Long-Term Care Financing Project: Working Paper No. 4. Retrieved from: http://ltc.georgetown.edu/forum/4lynch061107.pdf
Getting old is not very fun when considering the opinions of the elderly. This is true because many hard and difficult decisions must be made in terms of health and health care. Two options immediately arise when one is not able to take care of themselves and seek the assistance of others. The first option is home health care and the other is nursing home health care. The purpose of this essay is to examine, weigh and discuss these two options. This essay will then conclude on when it is best to choose nursing home care and when it is not wise or advisable to do such a thing.
Home Health Care
What exactly is home health care and what does it entail? Home health care helps seniors live independently for as long as possible, given the limits of their medical condition. It covers a wide range of…
Berger, Joseph, (2012). A Shift From Nursing Homes to Managed Care at Home. The New York Times, 23 Feb 2012. Web. http://www.nytimes.com/2012/02/24/nyregion/managed-care - keeps-the-frail-out-of-nursing-homes.html?pagewanted=all&_r=0
Bojorquez, Manuel, (2013). Eleven states get failing grades for nursing home care. CBS News, 9 Aug 2013. Web . http://www.cbsnews.com/8301-18563_162-57597944/eleven-states - get-failing-grades-for-nursing-home-care/
Friedland, R. (2009). Home Care vs. Nursing Home Care. Care, 25 Nov 2009. Retrieved from http://www.care.com/senior-care-home-care-versus-nursing-home-care-p1017- q14698.html
Klauber, M. (2001). The 1987 Nursing Home Reform Act. Public Policy Institute, Feb 2001. Retrieved from http://www.aarp.org/home-garden/livable-communities/info - 2001/the_1987_nursing_home_reform_act.html
I can see the quest narrative being used in the Diving Bell and the Butterfly movie. Bauby suffered from a very rare condition that is not only not well-known but less understood. In stead of feeling sorry for himself because of the situation in which he ended up, he took the negative thing that happened to him and turned it into something good. He made up his mind that he was going to go on with his life as best that he could. He had already had plans to right a book before he became ill and choose to go ahead with that project. He told his story in order to help himself understand what had happened to him as well as to tell his story to the rest of the world so that they could better understand it as well.
In the movie Away from Her, I can see…
Away from Her. Dir. Sarah Polley. Lions Gate Entertainment, 2006. Film.
Frank, Arthur W. (1997). The Wounded Storyteller: Body, Illness, and Ethics. Chicago: University of Chicago Press
The Diving Bell and the Butterfly. Dir. Julian Schnabel. Miramax Films, 2007. Film.
Simply put, it is impossible to regulate motivation and concern on the part of caregivers. On the other hand, there are various ways that at least some of the external manifestations of lack of concern for patient welfare can be better identified and addressed than they seem to be at many facilities. Failure to adhere to fundamental protocols, such as those pertaining to antisepsis have been proven time and again to contribute directly to the unacceptably high rate of nosocomial infections in clinical environments (eid, 2009). Generally, those types of protocols, such as compliance with hand-washing requirements and glove changing are some of the first signs that a health care worker is not highly motivated to provide the best possible care to patients (Hamric, Spross, & Hanson, 2009). That problem is one that government regulators have sought to resolve, at least indirectly, by shifting the financial burden of several types…
Hamric, a.B., Spross, J.A., and Hanson, C.M. (2009). Advanced Practice Nursing: An
Integrative Approach. St. Louis, MO: Saunders.
Reid, T. (2009). The Healing of America: A Global Quest for Better, Cheaper, and Fairer
Healthcare. New York, NY: Penguin.
The majority of communities in Alaska are separated by vast distances and the distance from many communities to the nearest medical facility is equivalent to the distance from New York to Chicago (Indian Health Service Alaska Area Services, 2011).
A study funded by AOA examined issues affecting access to home- and community-based long-term-care services among AI/ANS. Study results indicated that home healthcare was one of the most frequently needed services among AI/ANS. Further, 88% of the services sometimes, rarely, or never met the need, and 36% of services were rarely to never available (Jervis, Jackson & Manson, 2002). Only twelve tribally operated nursing homes exist in the U.S., and these rely predominantly on funding from Medicaid and tribal subsidies. Many tribes would like to have nursing homes but are blocked by state certificate-of-need requirements, Medicaid licensing requirements, and lack of commercial financing. The lack of alternate medical resources, whether private…
Alaska Area Indian Health Service. (2011). Indian Health Service. Retrieved from http://www.
Goins, R.T. & Spencer, S.M. (2005). Public health issues among older American Indians and Alaska natives. Generations, 29(2), 30-33.
Indian Health Service Alaska area services. (2011). Indian Health Service. Retrieved from http://www.ihs.gov/FacilitiesServices/areaOffices/alaska/dpehs/documents/area.pdf .
The prescriptions include wisdom, honesty, and courage, as well as human dignity, integrity, respect, health, and independence.
Part 3: Formulate possible evidence-based practices and an action plan that could work towards achieving improvement outcomes.
Provide insight into the diagnostic processes (e.g., root cause analysis) used to determine the primary causes of the problem. Consider both qualitative (cause-effect diagram, barrier analysis), and quantitative (theory testing or drill down analysis) methods.
Analyze the cost-effectiveness of your initiative and how your initiative mitigates risk and improves health care outcomes.
Countless interventions have been used for fall prevention amongst the elderly population. These include risk-assessment and management programs, I.e. Designed to screen those who are most at risk and to design interventions that will reduce their risk of falling; exercise programs slanted dot enhancing flexibility, endurance, and strength; education programs (including one-to -one counseling on methods to prevent falls); environmental modification in homes or…
ANA Nursing-Sensitive Indicators. http://www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/PatientSafetyQuality/Research-Measurement/the-National-Database/Nursing-Sensitive-Indicators_1
Butts, JB Ethics in professional Nursing Practice
Broe, K et al. (2007) a Higher Dose of Vitamin D Reduces the Risk of Falls in Nursing
Of course, as Medicare beneficiaries increase because of the number of baby boomers, the Medicare program may adjust. However, current hospice figures demonstrate that only about twenty percent of all elderly individuals that die are enrolled in hospice programs.
Implementation and Monitoring
The needs of this new program will require thorough training and once implemented, precise monitoring. "When you approach a problem in the way your work group functions, you're implementing an organizational change. By taking a critical look at your process, and using some theories from organizational design, you can fix the problem -- and change your organization to make quality more likely." (Derby, 1999) The training will be a key because of the potential requirements associated with the Hospice program that may require completely new skill sets for the majority of our staff. The fact is that many of our nurses may not have acquired the necessary skills…
Derby, Esther. (2002). Modeling Organizational Change. Retrieved on February 12, 2005, at http://www.estherderby.com/writings/modeling.htm
Hospice Benefits and Utilization in the Large Employer Market. Ed. Beth Jackson, Teresa Gibson, Joline Staeheli. March 2000. U.S. Department of Health and Human Services. Retrieved on February 12, 2005, from http://aspe.os.dhhs.gov/daltcp/Reports/empmkt.htm.
Rubenfeld, M. Gaie, & Scheffer, B.K. (1995). Critical Thinking In Nursing. Philadelphia: JB Lippencott.
Social Security Administration. (1993) "Social security programs in the United States." Social Security Bulletin 12/22/1993.
Others include delays in data accessibility, albeit shorter delays and the continued need for source data verification (Donovan, 2007).
Other obstacles have occurred in the developing of mobile healthcare applications. These have included mobile device limitations, wireless networking problems, infrastructure constraints, security concerns, and user distrust (Keng and Shen, 2006).
A third problem that has been encountered is that of a lack of education on not only the importance of the information technology but also training on how to use the specific pieces of equipment. The tools that are provided to people are only as good as the training that is provided on how to use them. The tools may be able to do wonderful things, but if those that are using them do not know how to get the best use out of them they will in the end be less efficient.
According to an Institute of…
Al-Assaf, Al F., Bumpus, Lisa J., Carter, Dana, and Dixon, Stephen B. (2003). Preventing Errors
in Healthcare: A Call for Action. Hospital Topics. 81(3), 5-12.
Brommeyer, Mark. (2005). e-nursing and e-patients. Nursing Management -- UK. 11(9), 12-13.
Damberg, Cheryl L., Ridgely, M. Susan, Shaw, Rebecca, Meili, Robin C., Sorbero, Melony E.,
Nurse Practice Act or OC 4723, permits the OBN to create and enforce regulations and rules for practical nurses, registered nurses, certified nurse-midwives, dialysis technicians, certified registered nurse anethetists, certified nurse practitioners, and also community health works fall under the Act as of 2003. The board members made up of nurses and one consumer adminsters and enforces all provisions under NPA. The licensing and certification requirements of nurses in Ohio are as follows: first in order to get an APN certificate and work in Ohio as a nurse, one must have completed successfully a graduate degree in a nursing specialty, or anything related; Then one must take a national certification examm either in a specialty area within one of four general APN roles or as a generalist according to the Ohio Board of Nursing; Thirdly, one must apply for a certificate of authority or COA. This allows one to practice…
AANP,. (2014). Prescriptive Privilege. Retrieved 14 October 2014, from http://www.aanp.org/images/documents/publications/prescriptiveprivilege.pdf Accessed July 24, 2013
Ohiopa.com,. (2014). OAPA | LICENSURE AND PRESCRIPTIVE AUTHORITY. Retrieved 16 October 2014, from http://www.ohiopa.com/aws/OAPA/pt/sp/stayinglegal
OSU,. (2014). Ohio State's Wexner Medical Center, Ohio Valley Health Services Sign Affiliation Agreement. Retrieved 22 October 2014, from http://medicalcenter.osu.edu/mediaroom/releases/Pages/OVMC-hospital-affiliation-agreement.aspx
It is related that "This patterns of delayed referral does more than deprive individuals of palliative care-it jeopardizes hospice programs themselves. To be financially viable, hospice programs, which receive per diem reimbursements, must be able to balance out the high initial costs of services to new patients with the lower costs of maintaining stabilized patients." (Open Society Institute - Project on Death in America, 2007) Finally, it is related that "high quality end-of-life care depends upon an integrated network of in-hospital, out-patient, home and nursing home services." (Open Society Institute - Project on Death in America, 2007) Issues requiring research which present barriers to the provision of comprehensive quality palliative care include the issues as follows: (1) How does the six-month eligibility requirement affect patient access to end-of-life care?; (2) What is the impact of delayed referrals on hospice services?; (3) Are there cost incentives within HMOs to rush patients…
Thomas, Keri Dr. (2003) Caring for the Dying at Home: Companions on the Journey. Chapter Five Excerpts. Online available at http://www.goldstandardsframework.nhs.uk/content/guides_and_presentations/Evidence_base.doc
Cramer, LD et al. (2003) Nurse's Attitudes and Practice Related to Hospice Care. J Nurs Scholarsh. 2003;35:249-255
Wright, K. (2002) Caring for the Terminally Ill: The District Nurse's Perspective. Br J. Nurs. 2002;11:1180-1185
Palliative Care (2007) Nursing Matters - Fact Sheet. Online available at http://www.icn.ch/matters_palliative.htm
nursing care for as long as I can remember, as a member of a family who commits its life to creating and serving people in it business, nursing care facilities. I understand the inner workings of the business, including the importance of documentation and patient care as well as cost benefits issues, sometimes not understood by all staff. With this experience I have developed a clear understanding of the overall needs of both patients and an evolving health care industry, something I hope to continue to be a part of in the long-term.
How have you been involved in the health care profession in either volunteer or paid capacity?
My experience in health care has been associated with experience working as a volunteer for my family in several residential nursing facilities they are the owners and operators of. In fact most of my volunteer work has been associated with health…
Evolving Practice of Nursing and Patient Care Delivery Models
How the Practice of Nursing is Expected to Grow and Change: The Future of Nursing has a few healthcare delivery challenges unique to it, but there are several such issues that commonly occur in other nations, as well. Population aging is one issue that generates demand for increased healthcare services. A growing number of individuals, from all age groups, suffer from chronic illnesses; about 50% of U.S. citizens have been diagnosed with arthritis, diabetes, cardiovascular diseases, mental disorders, and hypertension (Reinhard & Hassmiller, n.d.).
A 2009 report by the AARP (American Association of Retired Persons) pertaining to chronic problems notes that patients and caregivers have firsthand experience of the absence of patient care-related coordination amongst healthcare workers, typically leading to needless repeat hospitalizations, repeat procedures and examinations, and arduous hospital-to-home moves. An acute dearth of professionals (such as nurses) is being…
ANA. (2011). ADVANCED PRACTICE NURSING: A NEW AGE IN HEALTH CARE. American Nurses Association, 1-7. Retrieved from: http://www.nursingworld.org/FunctionalMenuCategories/MediaResources/MediaBackgrounders/APRN-A-New-Age-in-Health-Care.pdf
Reinhard, S., & Hassmiller, S. (n.d.). The Future of Nursing: Transforming Health Care. AARP Internation: The Journal. Retrieved from: http://journal.aarpinternational.org/a/b/2012/02/The-Future-of-Nursing-Transforming-Health-Care
Ridge, R. (2011). Future of Nursing special: Practicing to potential. Nursing Management, 32- 37. Retrieved from: http://www.nursingcenter.com/journalarticle?Article_ID=1176058
Wilson, A., Whitaker, N., & Whitford, D. (2012). Rising to the Challenge of Health Care Reform with Entrepreneurial and Intrapreneurial Nursing Initiatives. The Online Journal of Issues in Nursing. Retrieved from: http://nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-17-2012/No2-May-2012/Rising-to-the-Challenge-of-Reform.html
Leisure World Business Plan
Startup living-assistance firm Leisure World is seeking to enter into the long-term care market as a provider of in-home caregivers. The company will seek to market itself as an alternative to the nursing home, and will use daytime television advertising as its primary mode to reaching a target of families with aging loved ones. Expenses for the organization will include insurance and certification costs, material resources, labor and advertising. Management will proceed from a top-down approach.
Description of the business
Leisure World is an alternative to nursing and long-term care facilities. For many families, the decision to find assistance for care with aging loves ones can be an extremely difficult one, both financially and emotionally. Relegating a family member to a nursing home can be both heartbreaking for the family and psychologically devastating to a loved one who must now endure the end stages of life…
One of the most important ethical issues in nursing is how to approach end-of-life care. Nurses have a duty to provide compassionate care in ways that respects the individual’s autonomy and dignity. As patients live longer due to advancements in medical care, nurses are increasingly being faced with care options that extend life, versus options that do not extend life but which promote quality of life through a greater acceptance of death. A related issue is physician-assisted suicide. When physician-assisted suicide is legal, nurses may have this option presented to them by patients, creating ethical dilemmas. This paper will examine multiple sides of the end-of-life issue, showing that while there is no easy or “right” solution, individual cases should highlight the means by which nurses can always ascribe to their professional duties and the ethical standards of the profession.
Point of View: Quality of Life Over Quantity
The author of this report has been asked to create and frame a plan that involves the recruitment, selecting, onboarding and retraining of ten nurses over the next ninety days. The questions and steps that will be answered to in this report will include the steps that will be taken and in what order, the methods that will be used to recruit the nurses, a discussion of how the nursing candidates will be selected, how an efficient onboarding process will be a boon to the company in terms of retention and other metrics as well as overall retention strategies that could and should be used in general and with the new nursing staff in particular. While the overall recruitment and retention process is not all that difficult to understand, it is extremely important that it be created, perfected and upheld so that the continuity of nursing operations at…
Grau, L., Chandler, B., Burton, B., & Kolditz, D. (1991). Institutional Loyalty and Job Satisfaction among Nurse Aides in Nursing Homes. Journal of Aging & Health, 3(1), 47-65. http://dx.doi.org/10.1177/089826439100300103
HR.com. (2016). Negligent Hiring - The Human Resources Social Network. HR.com. Retrieved 28 February 2016, from http://www.hr.com/SITEFORUM?&t=/Default/gateway&i=1116423256281&application=story&active=no&ParentID=1119278077613&StoryID=1119654449890&xref=https%3A//www.google.com/
Wirkus, M. (2016). What are Hiring Managers Looking for in New Nurse Graduates? - NurseZone. Nursezone.com. Retrieved 28 February 2016, from http://www.nursezone.com/recent-graduates/recent-graduates-featured-articles/What-are-Hiring-Managers-Looking-for-in-New-Nurse-Graduates_20152.aspx
Throughout my life, I have exemplified core Christian values like faith and temperance. Christian role models have helped me to shape a character and identity that is conducive to a life of selfless service, which I view the nursing profession to be. I want nothing more than to participate in a Christian nursing community, with the goals of making the world a better place one patient, and one community, at a time. Effective nurse education will allow me to develop my skills in all areas of nursing: from leadership to bedside practice. The Mark and Huldah Buntain School of Nursing is unique in that it offers a perfect fusion of Christian values with cross-cultural awareness, and correspondingly, cultural sensitivity.
I have always valued my spiritual health every bit as much as my physical and psychological health. This is why I gravitated towards the Mark and Huldah Buntain School…
("Summary of the LPN Declaratory Ruling, 2003)
The selected tasks and shared responsibilities of the licensed practical nurse define such nurses as responsible for being adequately prepared for the nursing responsibilities they assume because they have obtained the validation of completion of an approved preparatory program and have evidence of the successful completion of a nursing licensing examination. A registered nurse, however, as the title conveys, must be registered as a specific health care professional, within a professional organization, rather than merely possess evidence of having a license, and has passed the necessary coursework to obtain his or her master's in the nursing profession. The LPN's validation documents state that he or she has reached the achievement of mastering all theoretical and nursing skill competencies required of an entry level practical nurse in caring for individuals in any age group. It states that the licensed practical nurse has the sufficient…
Carter, Melodie R. (Jun 2004) "ABCs of Staffing Decisions." Journal of Nursing Management. Retrived 2 Sept 2005 at http://www.findarticles.com/p/articles/mi_qa3619/is_200406/ai_n9425719
Nurse Practice Act. (2004) Retrived 2 Sept 2005 at http://www.arsbn.org/pdfs/practice_act/2004/nursepracticeact_2004.pdf
Summary of the LPN Declaratory Ruling." (Feb 2003) Connecticut Nursing Journal. Retrived 2 Sept 2005 at http://www.findarticles.com/p/articles/mi_qa3902/is_200212/ai_n9305171
Nursing Theorist: Sr. oy Adaptation Model
The oy Adaptation model for Nursing had its beginning when Sister Callista oy happened to get admitted in the Masters Program of pediatric nursing in the University of California, Los Angeles, in the year 1964. At that time, Sr. Callista was familiar with the idea of 'adaptation' in nursing, and it must be mentioned that Sr. Callista's adviser at that time was Dorothy E. Johnson, who believed firmly in the need to define nursing as a means of focusing the development of knowledge, for the practice of nursing. When Sr. Callista oy started working with children in the pediatric ward of the hospital, she was quite impressed with the basic resiliency of the small children who had been admitted into the wards for treatment. This was why when the first seminar in pediatric nursing was called for; Sr. Callista oy proposed that the basic…
"Callista Roy's Adaptation Model" Retrieved From
http://www.geocities.com/ninquiry2002/callistaroy Accessed 28 October, 2005
'Case Study" Retrieved From
http://www.geocities.com/ninquiry2002/casestudy.html Accessed 28 October, 2005
Nursing - Discharge planning
Discharge Planning in Nursing
Mr. Trosack's Case
The three main health issues include movement hindrance where by Mr. Trosack will move with the help of a walker. Mr. Trosack diabetic condition is main health issue. Mr. Trosack is depressed and lonely and requires a special care and assistance. Mr. Trosack lives in a crowded apartment located at a second floor in a 3-storey building. The building does not have an elevator and thus Mr. Trosack has to use the stairs to reach to his apartment. The house has furniture and personal valuables and thus making it hard for him to use his walker once inside the room. e takes the garbage by himself since he lives alone because his wife died two years ago. e fears climbing up the stairs because of pain that emanate from the strain. is family works for 60 hours a week…
Hip fracture is a main health issue that happens in the United States. This study uses the baseline (1993) and data collected in 2006 in order to evaluate the aftermath of hip placement discharge. Patient discharge depends on the status code from the Medicare inpatient claim. They categorize discharge status depending on the condition of the patient. Mr. Trosack would fall for nursing facility because he would not get the required professional assistance from his family. In this study, most of the hip fracture patients went to a nursing facility.
An evaluation in this study reveals that at the time of placement, the patients had gone home for 90 days, and 180 days for patients discharged at a nursing facility. The evaluation of the care of hip placement patients needs consideration when choosing a discharge placement for them. Mr. Trosack, in addition to the surgery, is diagnosed with diabetes, hypertension, and obesity. The family, despite knowing all this, does not provide or hire a medical officer for a regular check up on him.
In order for Mr. Trosack to get well, it is crucial to refer him to a nursing facility. In this study, the home and rehabilitation discharge seems to decline while many people opt for the nursing placement, which increased. In these nursing facilities, patients are not likely to report any health issue compared to those placed at their homes. In addition, these nursing facilities offer functional needs to patients and may reduce hip fractures in elderly people.
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…
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Nurse etention Capacity
Standards & Analysis on Nurse etention
The demand for nursing staff in the United States has significantly increased and according to the Center for American Nurses, employment in these positions have increased to an amazing 83% which is now at the highest it has been since 1980, and considering that this role is the biggest job in healthcare offering over 2.6 million jobs, the problem in hospitals, healthcare facilities, and in home care is the lack of nurses (Bureau of Labor Statistics, 2011). Furthermore, there are many reasons as to why experts and the healthcare facilities are unable to hire enough people to fulfill the positions within their establishments, and most research has determined that the main reasons there is such a shortage in nursing jobs is because of the poor management and leadership within the nursing work environment, the increased amount of responsibility and work load…
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Chart Your Course International (2011). Nursing shortage. Retrieved from http://www.highretention.com/nursing_research.html
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Nursing Administration -- Controlling
The FOCUS model requires the nursing administrator to find out what the main problem is, obtain information about this problem, communicate effectively with the nurses and patient, understand the needs of the nurses and the patient, and finally summarize these findings for the patient and nurses Dlugacz, 2009.
In this scenario, the process to be improved is responsiveness and willingness of the nurses to help the patient's situation.
Using the FOCUS model, the nursing leader should identify and clearly define the problem. To do this, they must recognize the role of the patient and the nurses in the situation and prioritize the potential improvements in the process Kreitner, 2008.
They also need to draft this problem statement in a clear way. The problem statement for this scenario is that the nurses feel inadequate in responding to the situation where the patient needs…
Dlugacz, Y.D. (2009). Value-Based Health Care: Linking Finance and Quality. New York: Wiley.
Kleespies, P.M., & Association, A.P. (2009). Behavioral Emergencies: An Evidence-Based Resource for Evaluating and Managing Risk of Suicide, Violence, and Victimization. Washington, D.C., DC: American Psychological Association.
Kreitner, R. (2008). Management. Mason, OH: Houghton Mifflin Company.
Zun, L.S., Chepenik, L.G., & Mallory, M.N.S. (2013). Behavioral Emergencies for the Emergency Physician. Cambridge, United Kingdom: Cambridge University Press.
" (1) What does the phrase "concept inventing" mean to you?
2) Does the process of concept inventing add clarity to a unique lived experience that aides in individualizing patient care? - or - Does the process of concept inventing add unnecessary jargon to the profession of nursing which creates barriers in collaboration with other disciplines? (3) State your stance on this issue and create a logical argument to defend your thoughts.
C. (1). "Concept inventing" can be thought of as a way to analyze situations in such a way as to contemplate their meaning to create understanding. Using both the aspects of science, including logic, rationality, and empirical analysis, and art, including intuition, emotion, integrity, honor, and compassion, nurses can process information in such a way as to create a complete conceptual picture of both the abstract aspects and concrete facts of a situation. In doing so, nurses can…
Chen, K.M. (2000, January.) The focus of the discipline of nursing: Caring in the holistic human health experience. Nursing (Graduate Research), 2(1). Retrieved Dec 3, 2006 from Graduate Research. Website: http://www.graduateresearch.com/kueimin2.htm.
Nagai-Jacobson, M.G., & Burkhardt, M.A. (1996). Viewing persons as stories: A perspective for holistic care. Alternative Therapies, 2(4), 54-58.
Rogers, M.E. (1990). Nursing: Science of unitary, irreducible, human beings: In E.A.M. Barrett (Ed.), Rogers' Science-Based Nursing. New York, NY: National League for Nursing.
Wainwright, P. (1999). The art of nursing. International Journal of Nursing Studies, 36, 379-385.
Autonomy in the nursing profession states the importance of the client's role in making decisions that reflect advocacy for the client (Wade, 1999, p.310). Ultimately, this includes taking care of the patient physically as well as mentally and emotionally, developing a relationship with the patient that is beneficial to his care and actively advocating for the patient's rights and care. This type of autonomy, it is important to note, is not the same as individual or work autonomy, yet it must be considered that empowerment in nursing autonomy will inevitably lead to better professional and personal autonomy and should also lead to increased job satisfaction (Wade, 1999, p.310).
Typical definitions of autonomy would include the idea of complete independence for the person making the decisions. However, in the case of the nursing profession, the client's needs and desires must be heavily weighed and, in fact, become central…
Wade, G.H. (1999). Professional nurse autonomy: Concept analysis and application to nursing education. Journal of Advanced Nursing, 30(2), 310-8.
Gaylord, N. & Grace, P. (1995). Nursing advocacy: An ethic of practice. Nursing Ethics, 2(1),
White, L. (2004). Foundations of nursing: Second edition. Clifton Park, NY: Delmar Learning.