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Successful completion of a competency-based insulin pen administration checklist along with successful demonstration of a mock insulin injection would be required before a nurse could administer insulin to a patient using the insulin pen devices. During this training period, all pharmacists and pharmacy technicians would also need to be trained how to use, label, dispense, and store the insulin pens (Davis, Christensen, Nystrom, Foral and Destache, 2008).
Another option would be for hospitals to only use insulin pens that are equipped with a safety needle that provides a passive safety feature that automatically engages after an injection is administered. The safety feature helps to prevent accidental needle sticks and needle reuse and is locked into place throughout needle disposal. The safety needle complies with U.S. Department of Labor Occupational Safety and Health Administration (OSHA) guidelines and appears on OSHA's list of approved safety-engineered sharps devices (Davis, Christensen, Nystrom, Foral and…
Alert issued about use of insulin pens for hospitalized diabetic patient. (2009). Retrieved April
14, 2010, from Consumer Med Safety Web site:
Davis, Estella M., Christensen, Carla M., Nystrom, Kelly K., Foral, Pamela A. And Destache,
Stand/Being a Patient Advocate
Description of the role as a moral agent or advocate for quality and patient safety
The present times are challenging for healthcare workers. Exceptional healthcare system alterations, in the form of financial pressures, regulatory mandates for improving patient safety and care quality, uncertainty of healthcare reforms' direction, technological advances, patient population change and emerging workforce deficiencies, are affecting care in every practice setting. These changes may prove be a challenge to decisions pertaining to resource allocation, and may negatively affect work environment in the health sector (Chiarella & McInnes, 2008).
This paper deals with being a nurse advocate for regulatory agency mandates aimed at improving patient safety and care quality. The nurse advocate's roles here include: presenting to patients the patient rights code of the hospital; handing out the patient rights manual to them; confirming patient understanding regarding who must be approached with concerns or queries;…
Almidei, N. (2010). So you want to make a difference: Advocacy is the key. (16th ed.) Washington DC: OMB Watch.
Chiarella, M., & McInnes, E. (2008).Legality, morality and reality - The role of the nurse in maintaining standards of care. Australian Journal of Advanced Nursing, 26(1), 77 -- 83.
Olson, D.A. (2009). Are great leaders born, or are they made? Frontiers of Health Services Management, 26(2), 27 -- 30.
Page, A. (2004). Keeping patients safe: Transforming the work environment of nurses. Washington, DC: The National Academies Press.
Patient non-compliance with medication is a problem that can have adverse effects on patient outcomes. Non-compliance with medication can occur in the in-patient or out-patient setting. Leigh (2010) estimates as many as 50% of all prescriptions filled—between one and 1.5 billion—per year are not taken correctly (p. 1). Moreover, there are different types of non-compliance, including taking medications incorrectly, taking the wrong dose or at the wrong frequency, or not taking the medications at all. The causes of patient non-compliance with medication can be traced to miscommunication, requiring healthcare leaders to take a more active role in patient advocacy and education. Misunderstandings of how a medication should be taken, what the medication is for, and other issues related to patient education can be directly solved via direct intervention and improved communication. However, some of the causes of patient non-compliance with medication are due to structural issues including the costs of…
De Brincat, M. (2012). Medication adherence: patient education, communication, and behaviour. Journal of the Malta College of Pharmacy Practice 18(2002).
Hoesli, T.M. & Smith, K.M (2011). Effects of religious and personal beliefs on medication regimen design. Orthopedics 34(4): 292-295.
Leigh, E. (2010). Teaching patients about their medications. The Center for Healthcare Communication. Retrieved online: http://www.communicatingwithpatients.com/articles/teaching_about_meds.html
Weiner, S. (2001). I can’t afford that! Journal of General Internal Medicine 16(6): 412-418.
Nurse as Patient Advocate
Persons who choose nursing as a profession do so because they have a deep sense that they want to help others. Most do not do it because of pay incentives. Those who choose nursing for that reason are soon disillusioned by the long hours, physical and mental fatigue that go along with it. People choose nursing because they have a need to help those in need. hen they become nurses however, the role that they play is often defined by a large, bureaucratic system and they sometimes find that they must choose between their sense of doing what is right for the patient and conforming to the rules of the system.
Nurses traditionally served as helpers to the doctors, performing mundane tasks to free the doctor for other things.. Doctors make the decisions and give the orders. Nurses follow the orders that the doctor gives. Sometimes…
Brophy, Mary S. Sheeran (2001). Nurse Advocacy in the neonatal unit: Putting theory into Practice. Journal of Neonatal Nursing. Volume 7 (1). p. 10-12.
Hewitt, Jeanette (2002). A Critical Review of the Arguments Debating the Role of the Nurse Advocate. Journal of Advanced Nursing. Volume 37 (5). March 2002. p. 439-435.
Keffer, M. Jan. (1996). Nurse Advocate: Advocate for Whom? Nursing. Volume 5 (2) April 1996. p. 129-126.
After sixteen years of working as a nurse, I realized more fully the impact my profession and the people in it have on public health, public safety, social norms related to health, and public policy. This MSN program has effectively prepared me for the next stage of my career as a nurse advocate who actively participates in public policy development and public health initiatives. I have been strongly influenced by issues related to nurse advocacy throughout the course of my career. This program has highlighted areas in which nursing practice can be applied to helping members of my community empower themselves with knowledge, with the resources available to them to improve their health choices, and improve quality of life for all members of my community.
When I started the program, I was a nurse. I was an experienced nurse who was confident with my role in the hospital,…
Lewis, Cheek & Hendricks (2001) support developmental advocacy as a framework from which counselors can promote the health and well-being of patients in a dynamic forum. Kiselica & obinson (2001) point out the community outreach programs may be beneficial for clients but also the counseling profession. This notion is supported by other research including that of Myers, Sweeney & White (2002) who suggest that professional associations can create venues for counselors to share knowledge, training and standards, as well as provide advocacy advancement and help the profession remain credible (394).
Though advocacy programs in the past have focused primarily on the needs and abilities of school counselors and educational representatives, counselors must broaden their perspectives so advocacy may now include all branches of the counseling field. This may require additional training and resources, but will help strengthen the credibility and success of the profession. Advocacy efforts will also help raise…
Akos, P. & Galassi, J.P. (2004). "Developmental advocacy: Twenty-first century school counseling." Journal of Counseling and Development, 82(2): 164
Hart, P.J., & Jacobi, M. (1992). From gatekeeper to advocate: Transforming the role of the school counselor. New York: College Entrance Examination Board.
House, R.M., & Martin, P.J. (1998). Advocating for better futures for all students: A new vision for school counselors. Education, 119, 284-291.
Kiselica, M.S., & Robinson, M. (2001). Bringing advocacy counseling to life: The history, issues, and human dramas of social justice work in counseling. Journal of Counseling & Development, 79, 387-397.
Most advocacy groups can help the families of veterans also understand their legal entitlements to support services.
Congressional representatives can occasionally come to the aid of their constituents who are veterans. Lawmakers listening to the concerns of their constituents can bring special cases to the attention of their fellow congressmen and women in Washington to help advocate on behalf of veterans and veterans affairs. Some congressional representatives may be willing to serve on special committees that advocate for veterans affairs in Washington.
Social workers have an obligation to learn about the large-scale organizations that serve the needs of veterans as well as smaller scale community organizations. Even social workers that do not specialize in veterans affairs should become familiar with the unique legal situation of their clients. For example, social workers should familiarize themselves with the specific medical, social, occupational, and psychiatric needs that veterans have, especially the veterans that…
Nurse Patient atios and Quality of Care
This study reviews the broad level of issues that surround the nurse/patient ratio: a critical shortage of trained and experienced nurses; increased political and fiscal demands from all sectors of society; rising costs internally and externally combined with a rising number of under-insured; and the conundrum of nursing ethics and the ability to foster excellence in care and patient advocacy. We note that there remains an issue about hiring more nurses -- where will these nurses come from if the nursing schools do not increase their recruitment efforts and broaden their curriculum. In addition, we note that the large majority of patients and stakeholders primarily want two things when admitted to a healthcare facility: better paid nurses and more highly-trained professionals who are satisfied with their vocation.
Modern nursing is, by necessity, a mixture of complex balance: patient care vs. staffing; procedures…
More Nurses Make the Difference. (February 2012). The Lamp. 69 (1): Retrieved from: http://search.informit.com/au/documentSummary;dn=045435426132502;res=IELHEA
Safe Nurse Staffing: Looking Beyond the Numbers. (2009). Vantage Point, CNA. Retrieved from: https://www.nso.com/pdfs/db/newsletters/Safe_Nurse_Staffing_-_Looking_Beyond_the_Raw_Numbers_20094.pdf?fileName=Safe_Nurse_Staffing_ -_Looking_Beyond_the_Raw_Numbers_2009-pdf&folder=pdfs/db/newsletters
Aiken, L. (2001). The Hospital Nurse Workforce: Problems and Prospects."Draft
For the Council on the Economic Impact of Health System Change. Retrieved from: http://council.brandeis.edu/pubs/hospstruct / Council-Dec-14-2001-Aiken-paper.pdf
" (Bernall, 1992, p. 19)
Though historically this role could have strained the nurses professional relationships with other health care professionals, and especially doctors the modern medical industry has afforded a new way of understanding the role, including an emphasis of such a nursing role in medical school. (Bernall 1992, p. 22)
As this belief has proven to be a long-standing one, it is therefore important to explore a greater understanding of the application of its use in patient care. The particular example of the mentally handicapped / epileptic patient is important as the complicated nature of these possibly debilitating diseases often leaves patients feeling helpless to contribute to their own general health and wellness. In one study the application of a nurse, for the specific role of advocacy was used to study it effects of the patients health and wellness outcomes.
A nurse functioning as patient advocate for 21…
Baribeault J.J. "Clinical advocacy for persons with epilepsy and mental retardation living in community-based programs." Journal of Neuroscience Nursing, Dec 1996 28/6 pp. 359-67.
Bernal E.W. "The nurse as patient advocate." The Hastings Center Report, July-August
1992. 22/4, pp. 18-23.
The Hastings Center Report, July-August 1992 v22 n4 p18(6)
.....nurse assigned to care for this patient, I would strongly advocate on behalf of the patient's autonomy. The clash between patient autonomy and the healthcare system and its representatives like nurses can only be resolved by being honest in this situation. The patient is under a high degree of stress, not only because of his health condition and the fear that brings out in him, but due to other stressful life events including his financial situation. He was also supposed to get married immediately before the bypass surgery was scheduled, and this is bound to add to his level of stress. The primary issue here is providing what the patient needs to keep him safe during the procedure, and if he insists on using his own pump, which he has successfully used for the thirty years he has lived with the disease of diabetes, then he should use his own…
133). This informal power is quite significant when it comes to patient decisions and as such doctors need to appreciate and understand this power nurses wield.
Due to the unique information nurses have about patients, nurses have considerable decision-making responsibilities concerning patients. For this reason, many medical schools have implemented programs, in their curriculum, to teach medical student how important it is to listen to the advice of their nurses. Innovative universities like the University of Kentucky Medical Center actually encouraged their residents to develop a collaborative partnerships with the nurses with which they worked. Paynton (2009) notes that outcomes of patient care improve when collaboration increases and the role of nurses is valued. However, regretfully, this collaboration does not always take place.
Although there is a shift in trends towards more collaboration between doctors and nurses, giving nurses more formal power in advocating for patients, the narratives collected by…
Goodman, B. (Nov 2003). Ms. B and legal competence: Examining the role of nurses in difficult ethico-legal decision-making. Nursing in Critical Care, 8(2). Retrieved April 22, 2009, from CINAHL Plus.
Keatley, V. (2008). Identifying and Articulating the Characteristics of Nursing Agency: BSN Students' Perspective. Self-Care, Dependent-Care & Nursing, 16(2). Retrieved April 22, 2009, from CINAHL Plus.
Lawson, L. (2008). Person-centered forensic nursing. Journal of Forensic Nursing, 4(3). Retrieved April 22, 2009, from CINAHL Plus.
McCarthy, V. & Freeman, L. (Fall-Winter 2008). A multidisciplinary concept analysis of empowerment: Implications for nursing. Journal of Theory Construction & Testing, 12(2). Retrieved April 22, 2009, from CINAHL Plus.
Inter and Intraprofessional Communication
Patient-centered practice is designed to address issues that usually appear as a consequence of nurses having a limited understanding of their role and as a result of patients not being provided with the opportunity to learn more about the attitudes they need to take in order to make the experience less painful for all individuals involved. One of the principal ideas related to this type of thinking is the fact that there is always room for innovation and nurses thus need to be proactive in their line of work. Considering that conventional strategies are likely to be ineffective in certain situations, nurses need to be able to adapt to stressing conditions and to get actively involved in trying to provide patients with the best service possible.
Through concentrating on intraprofessional and interprofessional practices, nurses can contribute to their understanding of their line of work in general…
Norgaard, B. "Communication with patients and colleagues," Retrieved May 29, 2015, from http://www.danmedj.dk/portal/pls/portal/!PORTAL.wwpob_page.show?_docname=8390873.PDF
"Interprofessional Education, Team, Intraprofessional Communication" Committee," Retrieved May 29, 2015, from http://symposium.medicine.dal.ca/documents/Team2ReportIPE_Team_IntraprofessionalCommunication.pdf
Mitigating isks from Dementia
Providing adequate care for an individual suffering from dementia presents many difficulties for nurses. Patients with dementia often have debilitating conditions such as Alzheimer's or similar neurologic diseases which are progressive, thereby making it challenging for them to remember, think lucidly, communicate effectively or complete activities of daily living. Furthermore, dementia can cause rapid variations in mood or even modify personality and behavior. With the tremendous number of elderly in society more and more nurses are required to care for patients with progressive dementias. It is imperative that a diagnosis be reached early in the course of the cognitive impairment and that the patient is closely monitored for coexisting morbidities. Nurses have a central role in assessment and management of individuals with progressive dementia. This essay provides some evidence-based practical strategies for managing the behavioral problems and communication difficulties often encountered in this population.…
Aud, M.A., Oliver, D., Bostick, J. And Schwarz, B. 2011. Effectiveness of Social Model Care Units for Dementia. International Nursing Research Congress 2005.
Care, N.D. 2010. Teaching and Learning. Pulse. Winter Edition.
Fletcher, S. And Zimmerman, S. 2010. Trainee and trainer reactions to a scripted dementia care training program in residential care/assisted living settings and nursing homes. Alzheimer's Care. 11(1): 61-70.
Goodman, C. 2011. The organizational culture of nursing staff providing long-term dementia care is related to quality of care. Evidence-Based Nursing. 47:1274-1282.
Issler is a patient who recently moved with his daughter-in-law who is no longer married to his son. As part of her interest in helping to take care of Mr. Issler, she noticed that he was pale and diaphoretic after a two and a half hour flight. The daughter-in-law took him to an emergency room where he was attended to by a cardiologist and set a follow-up check up for an echo cardiogram next week. Mr. Issler has complained of congestive heart failure and a history of deep vein thrombosis. The cardiologist recommended that he seeks out a primary care provider and check up of his thyroid. As the primary care provider, the patient has also expressed his uncertainties on whether he has hyper of hypo thyroidism though he has been under thyroid medication for several years. In addition to being very pale, he has a large bag of…
Bray, D.L. (n.d.). Thyroid Storm and the AACN Synergy Model. Journal of Nursing. Retrieved from http://rnjournal.com/journal-of-nursing/thryoid-storm-and-the-aacn-synergy-model
Drewes at. al. (2012, October). The Effectiveness of Chronic Care Management for Heart Failure: Meta-Regression Analyses to Explain the Heterogeneity in Outcomes. Health Services Research, 47(5), 1926-1959.
Hardin, S. & Hussey, L. (2003, February). AACN Synergy Model for Patient Care Case Study of a CHF Patient. Critical Care Nurse, 23(1), 73-76. Retrieved from http://ccn.aacnjournals.org/content/23/1/73.full.pdf
Kaplow, R. & Reed, K.D. (2008). The AACN Synergy Model for Patient Care: A Nursing
This is a legislator information sheet on nurse-patient ratios (as adapted from Aikan et al. 2010) for a busy legislator who will only have time to read bullet points:
The ratio of nurse patient is lower in California than in other states with nurses in CA having at least one patient less than nurses have in other states (as for instance in New Jersey and in Pennsylvania as mentioned in Aikman et al. (2010))
California nurses had lower nurse-patient ratio on medical and surgical units when compared to other states. The average amongst CA nurses was 2 patients less than those in other states.
The lower the nurse-patient ration, the lower the level of mortality amongst patients
When nurses' workloads paralleled those of workloads of Californian nurses, the following results occurred:
a. nurses' burnout decreased
b. nurses' job dissatisfaction decreased
c. nurses reported consistently better quality of care…
(Hummelvoll, 1996, p. 13)
The professional relationship that the client has with the nurse is often one of the most fundamental of all the relationships the client has in his or her life. The nurse can act as an advocate between the client and other health care professional as well as an advocate for the client with his or her own family. The holistic needs of the client are often met through this and other relationships, when they are strong, consistent and productive.
A an authentic caring relationship between clients and nurses. This relationship stimulates mutual empowerment and helps the client pass through the conglomerate of not easily accessible helping systems in the United States. The purpose of this reciprocal and chosen partnership is to increase the client's safety and quality of life. Here too, empowerment is a means to better health, with the nurse acting as the client's advocate,…
Hummelvoll, J.K. (1996) "The Nurse-Client Alliance Model." Perspectives in Psychiatric Care. 32/4, pp.12-17.
Vuckovich, P.K. (2000) "The Ethics of Involuntary Procedures." Perspectives in Psychiatric Care. 36 / 4. p.111.
Healthcare for Mentally Impaired Patients
Probing what information is available about the current status of placement or accommodation and level of personal healthcare available to mentally impaired and emotionally disturbed individuals, it is clear that the analysis is as diverse as there are different mental illnesses. While statistics on managed care treatment for people with severe and disabling mental illnesses are sparse, it is evident that the financial responsibility to care for and house these patients is enormous.
According to Dr. David Satcher, the Surgeon General (1999), approximately 20% of the U.S. adult population has a mental illness. He says, "These illnesses include anxiety disorders, mood disorders, anorexia nervosa, and severe cognitive impairment. More serious mental illnesses include ipolar disorder and schizophrenia. Mental illness accounts for 15% of overall burden of disease -- more than malignant cancer and respiratory diseases -- and as far back as 1996 the direct cost…
Boulard, G. (2000, April). Forgotten Patients the Mentally Ill. State Legislatures, 26, 12. Retrieved February 13, 2004, from Questia database, http://www.questia.com .
Callahan, D. (1993, October) Minds and hearts: priorities in mental health services.
The Hastings Center Report.
Fox, M. & Kim, K. (2004, January) Evaluating a Medicaid Home and Community-based Physical Disability Waiver. Family and Community Health. Vol 27: 37.
" (South Australia, p. 8)
This demonstrates the balance which is necessary in protecting the rights of the patient and simultaneously ensuring that physicians have the freedom necessary to perform to the best of their abilities. In a respect, this underscores the nature of the strategies used for the protection of patients' rights. The intention is primarily to provide a basic forum for the constructive interaction of patient and physician with legal recourse serving as a failsafe. So is this implied by the LSCSA, which indicates that the demands of existing Patients' Rights standards are designed to make the physician actively accountable to the patient's interests. Therefore, the LSCSA indicates a strategy for preserving the right to consent, reporting that "although the first step usually should be to speak to the doctor or other health care provider who has treated the patient, if any doubts remain, a patient should not…
Legal Services Commission of South Australia (LSCSA). (2010). Patients' Rights. Law Handbook.sa.gov.au.
South Australia (1995). Consent to Medical Treatment and Palliative Care Act 1995. Legislation Revision and Publication Act 2002.
South Australia1 (2009) Mental Health Act 2009. Legislation Revision and Publication Act 2002.
The modern nurse must then be willing to move beyond a simple catch-all of medical jargon and bureaucracy and become someone who is both supportive and critical of the system. This may seem dichotomous, but in reality is not. The system is designed with beneficence in mind -- to help the patient at all costs. It is thus up to the nurse advocate to ensure that that actually happens (Sheldon, 2009).
Undertake assessments which are sensitive to the needs of the patient- Assessment is one of the key factors in management of clinical medicine. The nurse is often at the forefront of that process simply due to the logistical nature of the situation -- taking vitals, preparing the patient for blood work, etc. However, it is in two particular areas that the nurse can be most effective when assessing the actual needs of the patient; culturally and when questions are…
Edwards, N., et.al. (2003). Aging, Heart Disease, and Its Management. Humana Press.
Lundy, K. And Janes, S. (2003). Essentials of Community-Based Nursing. Sudbury, MA:
Jones and Bartlett.
Miller, C. (2009). Nursing for Wellness in Older Adults. Philadelphia, PA:
Initial Patient Analysis
Discomfort in lower back.
Patient is a 78-year-old woman presented as disheveled, with bug bites throughout her body, and exuding a foul odor. Cognitively, she orients only to her name with a BMI of 30 and a minimal understanding of the English language. She is able to nod "yes" or "no" to questions, but calls the nurse "Mother." She is unsteady on her feet, and has a fine "pill-rolling "tremor in her left hand. He legs are quite cool to the touch, hairless, and toe capillary refill is greater than 2 seconds.
Past Medical History
Unknown, but patient appears to be in distress both physically and psychologically.
Poor, disheveled, may not be receiving adequate care or living in an environment with enough food or warmth. BMI of 30 is technically obese, which also may indicate the patient is not…
Hypoglycemia. (2012). Web MD. Retrieved from: http://symptoms.webmd.com/#./conditionView
Michael, K. And Shaughnessy, M. (2006). Stroke Prevention and Management in Older
Adults. Journal of Cardiovascular Nursing. 21 (55): 521-26.
Mohr, J., et al. (2004). Stroke: Pathopshyciology, Diagnosis and Management. New York: Churchill Livingstone.
Planned change in the eldercare advocacy organization
In the coming years, many countries will experience a dramatic shift in healthcare infrastructure due to an expanding elderly population size. However, the changes may vary across countries depending on many factors such as the kind of social welfare available in each country, the political environment which determine policies, the level of healthcare available and individual expectations in each country. Due to this wide variance, the innovations within this space will also vary greatly. What this means to the healthcare manager is that managing innovations becomes very hard (Shlutz, Andre & Sjovold, 2015 p 42). This also impacts on performance management which is fast gaining popularity in the public sector as a means to improve on accountability. Unfortunately, it has been cumbered by a series of challenges in its implementation; this is in spite of the frameworks developed over the last couple of…
The healthcare industry has widely adopted IT solutions in the development and maintenance of information systems for this sector. These information system applications will go a long way in boosting medical care goals by reducing costs significantly, increasing efficiency in the process and achieving a zero error. With this, client satisfaction will be realized. At the core of this is the electronic medical records (EHR) which is representative of all the health information of an individual that is available in a database and can be shared across healthcare service providers (Rouse, 2016). Also integral to this system are two components; mobile health (mHealth) and telehealth (telemedicine). Though the two are interconnected, they have a slight difference. Telehealth includes home monitoring of health conditions through desktops, laptops and other online material (Terry, 2016), while mobile health is restricted to mobile devices.
Considering the impact of electronic medical records (EHR), it is…
Foster Care and Adoptions
The Bronfenbrenner ecological model proposes that "individual human development occurs within interconnected and embedded ecological systems." (McWhirter, et al., Chapter 1). These are the macrosystem of societal norms, the exosystem of public policy, the microsystems such as family and schools, and the individual characteristics. Defects in one or more of these systems can put a child at risk.
An example of a child at risk is Doughboy, Ice Cube's character in Boyz in the Hood. A teenage black male in an impoverished area of Los Angeles, Doughboy faces a number of risk factors. His environment is characterized by poverty, but also by social norms and gender roles. The social norm in the area is that many young males join gangs, and he is specifically at risk because of the emphasis on aggression as part of one's self-worth among males in that area. Such cultural values among…
Child Welfare Policy.org (2013). State child welfare policy database. Child Welfare.org. Retrieved April 21, 2016 from http://www.childwelfarepolicy.org/tools/assets/files/Florida_Child-Maltreatment-Factsheet_2013.pdf
McWhirter, J., McWhirter, B., McWhirter, E. & McWhirter, R. (2013) At risk youth. Cengage Learning.
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)
The general exception to that rule is that women are likely to see gynecologists/obstetricians. The fact that certain strains of HPV may be linked to stroke makes this connection an even more critical one, since ob/gyns are the doctors most likely to provide HPV screening and treatment. Moreover, women are likely to visit pediatricians for child healthcare. Therefore, the health initiative that should be instituted is that ob/gyns should be involved in stroke symptom screening and education with every patient at every visit. Furthermore, pediatricians should engage in screening and education for parents, because maternal health is a critical component of child health.
The desired sponsor for this advocacy program would be the U.S. Department of Health and Human Services Offices on Women's Health. It could partner with national organizations such as the National Stroke Association, the American Heart Association, the Women's Heart Association, and even Planned Parenthood, since Planned…
National Stroke Association. (2012). Women and stroke. Retrieved from:
U.S. Department of Health and Human Services Office on Women's Health. (2009, January 28).
Stroke fact sheet. Retrieved January 30, 2012 from Women's Health website:
Quality Improvement Project
Diabetes -- Chronic Condition Background
Type 1 and Type 2 Diabetes
isk factors for type 1 diabetes
isk factors for prediabetes and type 2 diabetes
isk factors for gestational diabetes
The ationale for Selection
The Target Population
It has been estimated that in New York there is roughly two million people, or over twelve percent of the population, that have diabetes; furthermore, of this population, over half a million people have the condition but are not aware that they have it (American Diabetes Association, N.d.). It is further estimated that nearly five and a half million people, or over a third of the population, have prediabetes. Diabetes and diabetes-associated cardiovascular diseases have become the leading cause of death in the region accounting for roughly two-thirds of the deaths and the rates of diabetes has lead this trend to be referred to as the…
American Diabetes Association. (N.d.). Health Disparities. Retrieved from American Diabetes Association: http://www.diabetes.org/advocacy/advocacy-priorities/health-disparities.html
American Diabetes Association. (N.d.). New York, New York. Retrieved from American Diabetes Association: http://www.diabetes.org/in-my-community/local-offices/new-york-new-york/
CDC. (2013). Diagnosed Diabetes, Age Adjusted Rate (per 100) Adults - Total 2013. Retrieved from Center for Disease Control: http://gis.cdc.gov/grasp/diabetes/DiabetesAtlas.html
Department of Health. (N.d.). Diabetes. Retrieved from New York State: https://www.health.ny.gov/diseases/conditions/diabetes/
Policy of choice: Patient Safety
The provision of healthcare services is a complex responsibility that the professionals in healthcare risk management must never take lightly. Hospital regulations and accreditation standards make the safety requires complex and inevitable (PSQH, 2014). With formal procedures and policies, it is possible to promote and encourage compliance with regulation and high safety standards in the workplace. These policies also make quality healthcare and patient safety easier to deliver. Well articulate policies will alleviate variability in nursing practice that is likely to lead to compromises in care and eventual harm to the patient. The financial situations that require more attention for patient care may make it difficult to continuously review procedures and policies. Failure to update and develop policy can cause negative consequences for the patients (PSQH, 2014).
Patient safety policy is significant for the fulfillment of several professional requirements including:
· Adherence with the set…
unninghead: UNNING AND WHITEBAOD USAGEOUNDING AND WHITEBOAD USAGEounding and Whiteboard Usage in Postpartum WomenFull Name and Credentials?Name of Degree: Doctorate of Nursing PracticeAcademic University?September 20172017Authors Full NameALL IGHTS ESEVEDAbstractThis paper explores the impact of hourly rounding and the implementation of a whiteboard in postpartum women in regards to the care received and outcomes achieved. Namely, this paper examines the question of whether hourly rounding and the use of a whiteboard in postpartum women increases patient satisfaction and pain management immediately after delivery to 72 hours of postpartum stay, particularly when compared to the absence of both rounding and a whiteboard.Keywords: postpartum, whiteboard, roundingTable of ContentsSection One: Introduction and Overview of the Problem....8Introduction to Problem?8Problem Statement?....8Current Practices?...8Purpose of the DNP Project?...8Project Objectives and Outcomes..9Background/Significance of Problem....9Clinical Question (PICOT)...9Conclusion...10Section Two: eview of Literature11eview of the Literature11Search Table?..12Appraisal of Evidence?12Table of Evidence (Appendix).12Limitations..13Conclusion..13Section Three: Conceptual Foundation.14Conceptual/Theoretical Model...14Constructs?..14Implications for Project?..15Concept Definition and Identification...15Evidence-Based Practice…
References.51Appendices....52Tables....53Figures...54IRB Approval55Permissions....56Letters of Reliance.57Measurement Instrument...58DNP Essentials..59
Employee's Rights to Health and Safety in the Workplace
The objective of this study is to analyze the rights of employees to health and safety in the workplace in regards to the scenario as follows:
DoRight has recently been hired as the President of the "Universal Human Care Hospital," where he oversees all departments with over 5,000 employees and over 20,000 patients at the medical facility. He has been provided with a broad set of duties and oversight of numerous departments, including business development, customer services, human resources, legal, patient advocacy, to name a few. He has managers in each department that he supervises and who work with him to address the needs of the various internal and external stakeholders of the hospital. Dr. DoRight discovers that some patients within the hospital have been dying as a result of a variety of illegal procedures by doctors and nurses, and negligent…
Grush, Rick (nd) Introduction to some basic ethical orientations. Biomedical Ethics Readings. Retrieved from: http://mind.ucsd.edu/syllabi/03-04/1-Summer/readings/biomed-readings.pdf
Mossman, Douglas (2012) Physician Impairment: When Should You Report? Malpractice RX. Retrieved from: http://www.currentpsychiatry.com/pdf/1009/1009CP_Malpractice.pdf
Rabinowitz, Phil (2012) Identifying and Analyzing Stakeholders and Their Interests. Community Toolbox. Retrieved from: http://ctb.ku.edu/en/tablecontents/chapter7_section8_main.aspx
Alpers, Ann (2001) Key Legal Principles for Hospitalists. Retrieved from: http://hospitalmedicine.ucsf.edu/improve/literature/discharge_committee_literature/handoff_communication_and_discharge/key_legal_principles_for_hospitalists_alpers_am_j_med.pdf
Hydration Advocacy Campaign
Health Advocacy Campaign
Part 1 Developing a Health Advocacy Campaign
Health advocacy programs are mostly tailored to specific groups of people that are in need of special attention. While this approach can be useful, simple approaches are sometimes more effective and can address widespread problems more economically and efficiently. The importance and simplicity of water and its role within our health and well being represents an approach of basic health advocacy and may target many in need of such information. Health advocates must look out for their patients and subscribe to the most important issues of the day that may have a deep and profound impact on healing the individual and the healing processes that can evolve in and throughout the community.
The purpose of this health advocacy development plan is to argue that the issue of hydration, for all people, is one of the most significant…
Manz, F., & Wentz, A. (2005). The importance of good hydration for the prevention of chronic diseases. Nutrition reviews, 63(s1), S2-S5.
Schwartz, L. (2002). Is there an advocate in the house? The role of health care professionals in patient advocacy. Journal of medical ethics, 28(1), 37-40.
Shaner-McRae, H., McRae, G., & Jas, V. (2007). Environmentally Safe Health Care Agencies: Nursing's Responsibility, Nightingale's Legacy. OJIN: The Online Journal of Issues in Nursing, 12(2).
Stahl, A., Kroke, A., Bolzenius, K., & Manz, F. (2007). Relation between hydration status in children and their dietary profile -- results from the DONALD study. European journal of clinical nutrition, 61(12), 1386-1392.
One of the complexities of 21st century medicine is the evolution of nursing care theories in combination with a changing need and expectation of the stakeholder population. Nurses must be advocates and communicators, but must balance these along with an overall philosophy of ethics while still remaining mindful of budgets and the need for the medical institution to be profitable. It seems as if these issues comprise a three-part template for nursing: respect for patient value & individuality, education of patients, and cognition and respect for the realities of contemporary medicine. In many ways, too, modern technology has advanced further than societal wisdom, especially when confronting the issue of death. The modern nurse's role is to create a nurse-patient culture that encourages the individual to take responsibility for their healthcare and, in partnership with the nurse, to be involved in their recovery. The modern complexities of…
Basford, L. And O. Slevin. (2003). Theory and Practice of Nursing: An Integrated Approach to Caring Practice. New York: Nelson Thomas.
Beckstead, J. And Beckstead, L. (2004). A multidimensional analysis of the epistemic origins of nursing theories, models and frameworks. International Journal of Nursing Studies. 43
Cohen, J. (1991). Two portraits of caring: a comparison of the artists - Leininger
Policy Process: Evaluation, Analysis and evision
The National Nursing Shortage eform and Patient Advocacy Act was designed to address the public health workforce shortage that is seen, especially where nurses are concerned. It is no secret that nurses are leaving the profession in record numbers, and as they do that it is becoming more and more difficult to replace them with others who want to do the same type of work (Buerhaus & etchin, 2013; Iglehart, 2013). Because of all the nurses retiring, and so many of them experiencing burnout, the gap between the number of needed nurses and those who are available continues to widen (Negron & Cohen, 2013). The issue here is how that Act becomes a policy, so it can provide more help to a public health workforce that is struggling. In order for the Act to become a policy, it must first be evaluated. The Act…
Buerhaus, P.I., & Retchin, S.M. (2013). The dormant National Health Care Workforce Commission needs congressional funding to fulfill its promise. Health Affairs, 32(11), 2021-2024.
Iglehart, J.K. (2013). Expanding the role of advanced nurse practitioners - risks and rewards. New England Journal of Medicine, 368(20), 1935-1941.
Negron, B., & Cohen, E. (2013). Back to the future: A standardized approach to delivering effective nursing care. Nurse Leader, 11(2), 52-56.
S.739 (2014). Congress.gov. Retrieved from https://beta.congress.gov/bill/113th-congress/senate-bill/739
Nursing and the E
The Emergency oom is often one of the most visible parts of healthcare for political debate. It is also one of the most difficult environments for a modern nurse. It is interesting that one of the founders of modern nursing had emergency experience prior to developing her overall theories. Nightingale also looked at negatives and positives that are the conditions, which could help make people recover and reach their actual potential, as also noted by Maslow hierarchy of needs. She did not look or speak directly of the disease per se, but rather, looked at air, clean water, environment, and sanitation. She published her book in1860 with the title a "Notes on Nursing: What it Is and What it Is Not," connecting human beings and quality of human life, and comparing the stagnant sewage she saw in Scutari, as well as in London. She…
Americans at Risk. (March 2009). Families USA. Retrieved from:
Patient Perceptions in the Emergency Department: Physicians, Physician Assistants,
Nurse Practitioners. (30 August 2010). Retrieved from: http://idiopathicmedicine.wordpress.com/2010/08/30/patient-perceptions-in-the-emergency-department-physicians-physician-assistants-nurse-practitioners/
Is there a limit to one's professional obligation to the patient? Is that the same as advocacy?
Advocacy can be construed as a professional obligation to the patient, especially when advocacy is framed as an ethical obligation. There are therefore few limits to a nurse's ethical responsibilities to the patients, even though some situations may seem morally ambiguous. Many nursing researchers promote the concept of patient advocacy as "an ethic of practice," one that is an immutable part of the professional responsibilities of the nurse. (Gaylord & Grace, 1995, p. 11).
Are the characteristics of caring relevant to 2010?
The characteristics of caring are more relevant in 2011 than they were in 2010 or have ever been before, in part because of increasing patient diversity. Knowledge of the different concepts of health, healing, illness, and the role of the doctor helps make nurses more accountable to patient needs. Viewing…
Beyea, S.C. (2005). Patient advocacy: nurses keeping patients safe. AORN Journal. On FindArticles. Retrieved online: http://findarticles.com/p/articles/mi_m0FSL/is_5_81/ai_n13793213/
Gaylord, N. & Grace, P. (1995). Nursing advocacy: An ethic of practice. Nursing Ethics 2(1): 11-18.
Hanks, R.G. (2008). The lived experience of nursing advocacy. Nursing Ethics 15(4): 468-477
Vaartio, H., Leino-Kilpi, H., Salantera, S. And Suominen, T. (2006), Nursing advocacy: how is it defined by patients and nurses, what does it involve and how is it experienced?. Scandinavian Journal of Caring Sciences, 20: 282 -- 292. doi: 10.1111/j.1471-6712.2006.00406.x
Client Autonomy in Community Health & Nurse Safety in Community Practice
Nurses involved in community nursing often face ethical and practical dilemmas, particularly with regard to the issue of patient autonomy. Community practice differs for nursing in more formal settings in that there are many complex variables that can intervene in nursing care.
they are made more complex because of the influence of the setting (isolation from nursing colleagues, role ambiguity, the shift in control, family dynamics, and the increased need to collaborate). Even something as simple as access to patients in the community cannot be assumed in the same way it can be in acute care.
(Ethical Awareness for Community Care Nurses)
Examples of this complexity are cases where access is refused by the client, even when the client is in need of urgent assistance. This presents an acute problem on an ethical level for the community nurse. As…
Aulisio M. The Home Setting: Posing Ethical Challenges to Clients and Caregivers. Retrieved may 16, 2005 fropm Community Ethics. Web site:
Ellis. J. ( 2003) The Client's Right to Know Their Nurse and Question Care vs. The Nurse's Right to be Protected from Harm. Retrieved May 15, 2005 from RNABC. Web site: http://www.rnabc.bc.ca/registrants/nursing_practice/articles/Client_Right_to_Know.htm
Ethical Awareness for Community. Retrieved 15 May 2005 from Care Nurses. Volume 3, Issue 11 - January 2001 web site: http://www.phen.ab.ca/materials/intouch/vol3/intouch3-11.html
The nursing career differs from the medical field in that nursing is solely focused on the care and advocacy of the patient. Nurses are the intermediaries between doctor-patient relationships; they are the bridges that enable patients to understand the situation regarding healthcare and healthcare practices. Nurses depend on the human responses and the human condition in order to better care for the patients. They are responsible for further interactions with patients as well as their families and communities (American Nurses Association). This is the broad scope that the American Nurses Association basically defines the nursing career (American Nurses Association). Nurses not only assist physicians and doctors when it comes to certain diagnoses and treatments, they also are taught to genuinely care for the patients that transcend the medicine.
Nurses have the ability to fill a myriad of fields, one of which includes being a caregiver or the one responsible…
American Nurses Association. Nursing: Scope and Standards of Practice, p. 7. 2004.
American Nurses Association. Nursing's Social Policy Statement. Second Ed, p. 6. 2003.
Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2010-11 Edition, Registered Nurses. Web. Retrieved on May 28, 2011. .
Glicksman, Allen, Joan Klein and Irene Warner Maron. Caregiver Nursing Protocol: Integrating Nursing Intervention With Social Work Services. Philadelphia Corporation for Aging. 2005. Web. 28 May 2011. .
The National Association of Clinical Nurse Specialists - The NACNS was founded in 1995, specifically to enhance and promote the unique and high-value contributions that clinical nurses make to the health and well-being of individuals, families, groups, and communities in their particular branch of healthcare. They also have a foundation, scholarship programs, a journal and discussion portal, various levels of conferences, scholarship programs, honors and awards, and the ability for advanced certification. A Clinical Nurse Specialist is a licensed N who has graduate preparation (MA or PhD) in nursing specifically as a Clinical Nurse Specialist. This field of healthcare goes beyond the duties of an LPN or N, or even charge nurse, and deals with either advanced levels of clinical specialization, or broader, community and national health concerns. The field requires a rather significant academic bent, and the association is designed to support and enhance that paradigm focus (CNS -…
About ENA. (2010, January). Retrieved October 2010, from Emergency Nurses Association: http://www.ena.org/about/Pages/Default.aspx
About the ACNM. (2010, February). Retrieved from American College of Nurse-Midwives: http://www.midwife.org/members.cfm
CNS - Who We Are and What We Do. (2010, January). Retrieved October 2010, from National Association of Clinical Nurse Specialists: http://www.nacns.org/AboutNACNS/MissionStatement/tabid/57/Default.aspx
Kozier, B., Erb, G. & Blais, K. (1997), Professional nursing practice (3rd edition),
Ethics to Practice: Analysis of 'end of life' decision making
The foregoing discussion is an incursion into nursing ethics. Implication(s) to 'omission' of information as a customary practice within our healthcare institution is reviewed in relation to best practices pertaining to 'informed consent,' and hospital policy is not definitive. Directed at the evolution of ethical decision making, the general query to the study focuses on the parameters of informed consent where individual practice is concerned.
In the nation of Canada where I am a nurse the number of situations where patient informed consent decisions might be subject to our national code of nursing ethics is many. e face critical ethical dilemmas every day, as emergency procedures and critical care interventions are standard practice. Complexity in decision making is furthered in the conduct and approaches made by international colleagues on contract in our institution by way of exchange.
The primacy of…
Bullough, B. ed. The Law and the expanding nursing role. New York, NY: Appleton-Century-Crofts, 1980.
Callahan, Joan, ed. Ethical Issues in Profesional Life. Oxford: Oxford University Press, 1988.
Canadian Medical Protection Association (CMPA), 2010. Web.
Finlay and Fernandez. Failure to report and provide commentary on research ethics board approval and informed consent in medical journals is discussed Journal of Medical Ethics, 34.10 (2008), 761-764. doi:10.1136/jme.2007.023325.
Health Care -- Impact Evaluation and Accountability
Accountability to stakeholders should be an integral aspect of any health-related government program. This is achieved by systematic and objective assessment of how a program's effectiveness, evaluation normally involves measuring and documenting a program's effectiveness; calculating a program's outcomes; documenting a program's execution and cost effectiveness; strengthening a program's impact. In the case of health-related government programs, the stakeholders to whom accountability is owed typically are those served by the program, those conducting the program, and those who will use evaluation findings to make decisions about the program. The importance of evaluations for accountability is underscored by the resources provided by state and federal governments for ongoing evaluations to ensure ongoing accountability to all stakeholders. Evaluation for the purpose of accountability can assist stakeholders and specifically those in charge of the programs in a number of ways, all of which in program continuation,…
Chatterji, M. (2008, Jan/Feb). Synthesizing evidence from impact evaluations in education to inform action. Retrieved on December 2, 2012 from search.proquest.com Web site: http://search.proquest.com/docview/216902584/13AC6E704D753569CAD/1?accountid=28844
MacDonald, G., Starr, G., Schooley, M., Yee, S.L., Klimowski, K., & Turner, K. (2001, November). Introduction to program evaluation for comprehensive tobacco control programs. Retrieved on December 2, 2012 from www.cdc.gov Web site: http://www.cdc.gov/tobacco/tobacco_control_programs/surveillance_evaluation/evaluation_manual/pdfs/evaluation.pdf
Main State Legislature. (2009, January 2). OPEGA Home. Retrieved on December 2, 2012 from www.main.gov Web site: http://www.maine.gov/legis/opega/index.htm
National Center for Chronic Disease Prevention and Health Promotion. (2011, November 10). Program Evaluation - DASH - Resources/HealthyYouth. Retrieved on December 2, 2012 from www.cdc.gov Web site: http://www.cdc.gov/HealthyYouth/evaluation/resources.htm
Nurses during Emergency
During the tackling of disasters, teams from varied fields, experiences expertise and education come together; these group present broad spectrums of capabilities and qualification; essential for assistance in situations of public health emergency. This article looks at the regulations, ethical practice, limitations and guidelines for regulating of nursing practices in cases of public health emergencies (Couig, Johnson & ick, 2011). The regulations in the legal authority of action by nurses are done through education, licensure, and discipline which define the scope of practice for nurses practicing during health emergencies. Limitations to preparedness in the nursing practice brought about by burnout, depression, self-esteem, personal accomplishment, and emotional exhaustion and depersonalization problems. The environment in, which nurses practice, determines their preparedness in tackling of emergencies. Promoting the emotional well-being of nurses then becomes a beneficial aspect for the carrying out of nursing practice. It is important to provide nurses…
Couig, M., Johnson, K.A., & Rick, S. (2011). Nursing Scope of Practice Issues in Public Health
Emergencies. Journal Of Nursing Regulation, 2(3), 13.
EDDINS, E.E., JIE, H., & HUAPING, L. (2011). Baccalaureate Nursing Education in CHINA:
Issues and Challenges. Nursing Education Perspectives, 32(1), 30-33.
Boston Children's Hospital
This goal of this case is to demonstrate the importance of a community health nursing, or public health nursing strategy. The concepts addressed in the case study include forming strategic partnerships or alliances with related health care institutions, universities, and insurers. Concepts also include the ways non-profit organizations function and how strategic alliances are especially important to maintain. Also, the case study addresses the concept of community health nursing in general. Students should understand this case focuses on the multifaceted roles of the health care organization in the community. Students should also acknowledge the complex interaction between various external forces like economic constraint, legislation, and policy and the functioning of the organization. Students should also understand the complex interaction between internal forces like human resources management and cost accounting on the functioning of the organization. Students should recognize the key success factors for a non-profit health care…
Boston Children's Hospital Website: http://www.childrenshospital.org/
"The Health Care Law and You." Retrieved online: http://www.healthcare.gov/law/
US News and World Report (2013). U.S. News Best Children's Hospitals 2012-13
Speaking Truth Concept
Discuss the concept of speaking truth to power. Are you better prepared to advocate for patients, nurses and nursing after taking this class?
During a time when there is a nationwide shortage of nurses (Glazer, 2009), identifying opportunities to improve their working conditions and status has assumed new importance and relevance and the concept of speaking truth to power can help achieve this outcome. According to Greear (2015), the concept of "speaking truth to power" was coined by the Quakers during the 1950s and has come to mean "taking a stand and mobilizing society around change" (para. 2). An important point made by Greear (2015) is that mere humans are only capable of knowing some of the truth at any given point in their lives but it is essential to act on what truth is known by taking action to effect meaningful change where it is needed.…
Glazer, G. (2009, January). Legislative: The nursing shortage: A public health issue for all. Online Journal of Issues in Nursing, 14(1), 37.
Greear, J. (2015, December 2). Speaking truth to power. The Huffington Post. Retrieved from http://www.huffingtonpost.com/jade-greear/speaking-truth-to-power_2_b_8824094.html .
Paynton, S. T. (2009, January). The informal power of nurses for promoting patient care. Online Journal of Issues in Nursing, 14(1), 21.
Healthcare -- Administration and Legal
Many vectors -- science, research funding, social acceptance or rejection -- influence how and whether medical technology is eventually adopted into medical praxis (Hogle, et al., 2012). Undergirding the choices and changes is a shared body of ethical standards and law, the establishment of which is often not consensual or efficacious. Any emerging technology can encounter unanticipated social resistance and ethical concerns that can change the course of how medical science research progresses (Hogle, et al., 2012). Medical technology often poses questions about access to expensive innovations and considerations about race, gender, and social justice that are inseparable from the socio-economic levels of patients (Hogle, et al., 2012). In contemporary society, there are the inevitable considerations about patent issues, clinical practice, and the commercialization of medical innovations (Hogle, et al., 2012). The recent court decision finding in favor of Myriad Genetics, Inc. provides a good…
Cho, M. (2010, November 1). Patently unpatentable: implications of the Myriad court decision on genetic diagnostics. Trends in Biotechnology, 28(11), 548-551. Retrieved http://www.cell.com/trends/biotechnology//retrieve / pii/S0167779910001411?_returnURL= http://linkinghub.elsevier.com/retrieve/pii/S0167779910001411?showall=true
Hogle, L., Tobin, S., Gaba, D. And Yock, P. (2012). Web-Based Research Integrity Training for Biomedical Engineers and Medical Device Researchers (Public Health Service). Stanford Center for Biomedical Ethics. Palo Alto, CA: Stanford School of Medicine. Retreived http://bioethics.stanford.edu/research / programs/science_and_society.html
Morrison, E. (2011). Ethics in health administration: A practical approach for decision makers. (2nd ed.). Sudbury, MA: Jones and Bartlett.
Stempel, J., Steenhuysen, J., Wallace, J., Grebler, D. And Orr, B. (2012, August 16). Myriad wins gene patent ruling from U.S. appeals court. Thomson Reuters. Retrieved http://www.reuters.com/assets/
Nightingale met a friend Richard Monckton Miles in 1842. Then in 1844, Nightingale asked Dr. Howe if she could do a charitable job in a hospital like the catholic nuns, and refused her marriage to her cousin, Henry Nicholson. By 1845, Nightingale started training herself in the nearby Salisbury Hospital, but her parents were not happy about it, seeing nursing as an inappropriate job for a well to do woman like their daughter. In the next year, Nightingale began teaching herself from the government blue books. In the meantime, Monckton Miles wanted to marry her, but soon she travelled to Rome, Italy with friends to avoid him. Britain unlimited, 2009). Finally, after she attended the Herbert's Charmouth convalescent home, her knowledge was recognized. In 1849, after refusing finally to Miles proposal, she decided to go to Egypt while accompanying her friends, the Bracebridges. They then travelled through Europe, and ended…
(Source: Cody, 2006, p. 259).
Differences Between Nightingale's Theory and Emancipatory Knowing -- When Nightingale thought about the benefits of a well-ventilated room, she was not basing her view on previous knowledge. Emancipatory progress is now evident in the way world healthcare approaches a patient's room -- typically well-ventilated and clean (Beck, 2005, pg. 140). Nightingale was born in an era were by women has very little voice most of the work done by women were in-house work so most of Nightingale's major innovation was providing place for women to work with and for women (Selanders, 2005, pg., 83). Today with Emancipatory knowledge we see a more educated workforce of both men and women in nursing. Although in the late 19th century there were still arguments regarding Nightingale's visions, today's theorists use her broad-based knowledge as a best -- practice template for modern conceptions (Attewell, 2005).
The Legacy of Nightingale Part 1 -- Nursing Ethics -- Most modern ethical theorist are based on traditions dating back as far as Ancient Greece. However, medical, and in particular nursing, ethics are clearly a post-Nightingale logical evolution (never a conclusion). The philosophical combination of advocacy and ethics, while still remaining true to the realities of budgets and the need for a medical institution to
Obesity is a global epidemic affecting almost all population cohorts. Rates of obesity are rising worldwide. According to the World Health Organization (WHO, 2013), the obesity epidemic “is not restricted to industrialized societies,” with millions of obesity-related cases burgeoning in developing countries (p. 1). With billions of cases worldwide, obesity has therefore been described as the “major health hazard of the 21st century,” (Zhang, Liu, Yao, et al., 2014, p. 5153). Given the global nature of the disease, clinical guidelines have become increasingly standardized, but it is still necessary to tailor interventions to specific populations to create age appropriate, culturally appropriate, and gender appropriate treatment interventions. After a brief discussion of obesity pathophysiology, this paper will evaluate standard practices at local, state, national, and international levels. Access to care and treatment options also determine disease outcomes. Therefore, this paper will also address…
he Neuman Model is appropriate for senior care.
Studies necessary with other models.
Penrod, et.al.; Reframing Person Centered Care for Persons with Dementia
Research and heory for Nursing Practice
Lit. Review, discussion
Research shows individual personhood approach has positive effects on care.
Biomedical and psychological models must be merged for persons with dementia.
Further study using different integration modeling.
Rajapaksa and Rothstein; Factors hat Influence the Decisions of Men and Women Nurses to Leave Nursing.
Qualitative, some quantitative analysis
For men, compensation largest barrier to remaining in nursing; for women dissatisfaction with career goals
Barriers to entry in profession for men and still social stigma
It is possible for hospitals and care centers to develop program to retain more nurses
Needs more demographic and psychographic variation.
Gillespie and Peterson; Helping Novice Nurses Make Effective Clinical Decisions
Their Experiences With a Refugee Population." Journal of Nursing Education.
Watson, J. (2008). "Social Justice and Human Caring." Creative Nursing. 14 (2): 54+.
"Studies of the relationship between managed care penetration in the health care market and expenditures for Medicare fee-for-service enrollees have demonstrated the existence of these types of spill over effects" (Bundorf et al., 2004).
Managed care organizations generate these types of spillover effects by increasing competition in the health care market, altering the arrangement of the health care delivery system, and altering physician practice patterns. Studies have found that higher levels of managed care infiltration are linked with lower rates of hospital cost inflation and lower physician fees are consistent with competitive effects. "Other studies demonstrate the impact of managed care on delivery system structure including hospital capacity, hospital admission patterns, the size and composition of the physician workforce and the adoption and use of medical equipment and technologies. More recent evidence has linked market-level managed care activity to the process, but not the outcomes of care" (Bundorf et al.,…
Altman, D.E. And L. Levin. (2005). The Sad History of Health Care Cost Containment as
Told by One Client. Health Affairs, 24(1).
Bodenheimer, T. (2005). High and rising health care costs. part 1: Seeking an explanation.
Annals of Internal Medicine, 142(10), 847-54.
Reducing Turnover in New Graduate Residence Program
Introduction- The process of recruiting and training, particularly in high-impact fields like healthcare, has become increasingly complex and expensive. Turnover is the rate at which an organization gains or loses employees. High turnover means that more employees are leaving more rapidly, which can be harmful to productivity and finances. Real costs of hiring including recruitment time, opportunity costs, and investment in both the new employee and the staff in Human Resources. Indirect costs include training, loss of production, reduction of performance levels, overtime due to inexperience, etc. In fact, this issue is so important that in for-profit organizations, the cost of employee turnover is estimated to be about 150% of the total payroll and benefit package (Rothwell, 2012). One needs to also understand the high costs of post-employment; drug-screening, physical exams, orientation, learning curve, coaching from others, etc. Staff time is difficult to…
Nurses' job satisfaction well below average. (2012, March 5). Retrieved from Medical Express: http://medicalxpress.com/news/2012-03-nurses-job-satisfaction-average.html
The Real Costs of High Turnover. (2012, October). HRNNewsdaily. Retrieved from:
Agency for Healthcare Research and Quality. (2013, January). Researcha dn Data. Retrieved from U.S. Department of Health and Human Services: http://www.ahrq.gov/
Sunrise Clinical System Version 6.1
The Emergency Room: Hybrid System
Meetings and Collaborative Care Councils
orkflow of the EMR
The KBC ( Knowledge Bas Charting) 3.4 Upgrade 6
The Role of the Nurse Informaticist
Comprehensive Analysis of my Clinical Experience
After completing 100 hours of practicum in informatics, the following will show the time at the site with my preceptor. The practicum took place at Franklin Hospital - North Shore Long Island. North Shore-LIJ which is an award-winning health system that consist of world-class tertiary hospitals, a nationally well-known children's hospital, a notorious mental facility and an assortment of community hospitals, in addition to a range of wellness and health programs. North Shore-LIJ Health System consist of 16 award-winning hospitals and approximately 400 physician practice locations all through New York, as well as Long Island, Manhattan, Queens and Staten Island. North Shore-LIJ Proudly serving an area of seven…
North Shore-LIJ Health System. (2014, April 29). Retrieved from North Shore LLJ: http://www.northshorelij.com/hospitals/services-and-programs/bariatric-surgery
Russell, C.L. (2010). A clinical nurse specialist -- led intervention to enhance medication adherence using the plan-do-check-act cycle for continuous self-improvement. Clinical Nurse Specialist, 24(2), 69-75. doi:10.1097/NUR.0b013e3181cf554d
Seidl, K. L. And Newhouse, R.P. (2012). The Intersection of evidence-based practice with 5 quality improvement methodologies. JONA, 42(6), 299-304. doi: 10.1097/NNA.0b013e31824ccdc9
Smith, K., Tremblay, M.L., Richer, M.C., and Lanctot, S. (2010). Exploring nurses perceptions of organizational factors of collaborative relationships. The Health Care Manager, 29(3), 271-278. Doi:10.1097/HCM.0b013e3181e9351a
The caregiver role includes those activities that assist the client physically, mentally, and emotionally, while still preserving the client's dignity. In order for one to be an effective caregiver, the patient must be treated in a holistic manner. Proper communication and advocacy is another role that the modern caregiver assumes when providing quality care (Carroll).
It is in the role of patient advocacy and cost-cutting that most nursing leaders are directly involved with hospital policy. Technology has increased the ease and ability for adequate communication -- there are more translators, access to databases, etc. within the field, and certainly there is more information about healthcare available for the layperson. However, the manner in which modern medicine works -- the reality that it is the nurse as opposed to the doctor who tends to follow the patient throughout their care, lends greater credibility to the use of the modern nurse as…
Carroll, T. (2005). Leadership Skills and Attributes of Women and Nurse Executives -Challenges for the 21st Century. Nursing Administration Quarterly, 29(2), 146-54.
Gershenson, Moravick, Sellman and Somerville. (n.d.). Expert to Novice: A Nuse Leader's Evolution. Nursing Management, 49-52.
Kouzes and Posner. (1994). An extension of the leadership practices inventory management systema dn individual contributors. Educational and Psychological Measurement, 54(4), 959-66.
Vesterinen, Isola and Paasivvra. (2009). Leadship Styles of Finnish Nurse Managers and Factors Influencing it. Journal of Nursing Management, 17(2), 503-9.
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…
" (Allen 2008) This means that nursing educators are also a key stakeholder.
Other stakeholders include healthcare facility administrators, corporate trustees and public office holders, who will often have entangled or competing interests relating to the profitability of operations and the political expediency of policy orientation. This will also be true of the various professional advocacy groups, nursing associations and lobby groups that will vie for influence in the discussion on any legislation relating to the nursing shortage.
A primary policy objective is to endorse any legislation that would aggressively enforce better recruitment of nursing students, better training of existing nurses, improvements in working conditions for nurses and mandated nurse-to-patient ratios. These objectives are underscored by evidence of the opportunities to save lives facilitated by mandated ratios. According to the text by Health Services Research (HSR) (2010), "key findings of the study reportedly include that 10-13% 'fewer surgical…
Allan, L. (2008). The nursing shortage continues as faculty shortage grows. Nursing Economics, 26(1), 35-40.
Berkowitz, B. (2012). The Policy Process. .
Cullen, E.; Ranji, U. & Salganicoff, A. (2010). Addressing the Nursing Shortage. Kaiseredu.org.
GovTrack. (2010). S. 1031: National Nursing Shortage Reform and Patient Advocacy Act. govTrack.us.
legislators on health care issues and nursing, specifically?
To make healthcare inexpensive through tackling the fast increasing cost of healthcare
Patients ought to have a better access to information about the cost and quality of services offered so that they can make cost-effective and informed decisions about their healthcare. Healthcare providers should make available costs publicly available, particularly for the most sought after procedures. Medicaid, Medicare and other kinds of data should be provided to other independent entities that have the expertise to give superior quality assessments than the Centers for Medicaid and Medicare Services.
Several reforms are needed in healthcare to help bring down the costs. These include: enabling more pooling schemes and the sale of insurance across state borders; both of these measures will help bring down the cost of premiums. Moreover, making the tax field level for both individual and employer markets would assist people to buy…
Email provided by Catherine White: -- .
(n.d.). Texas Nurses Association. Advocacy: Top Issues - Texas Nurses Association. Retrieved May 20, 2015, from http://www.texasnurses.org/?page=TopIssues
Willmann, J.H. (2013). Nursing Legislative Agenda for Texas 83rd Legislative Session. Nursing Voice.
Hinson, K. (2015, April 28). Texas Nurses Association. TNA Opposes Legislation Lessening Whistleblower Protections - Texas Nurses Association. Retrieved May 21, 2015, from http://www.texasnurses.org/news/228914/TNA-Opposes-Legislation-Lessening-Whistleblower-Protections.htm
roles available to nurse administrators.
Include at least one nurse administrator role in a health care agency.
Complete each cell of this grid with concise descriptions. Bulleted words and phrases are preferred to complete sentences.
Cite a minimum of 4 peer-reviewed resources, and include a reference page formatted according to APA guidelines.
Healthcare IT (HIT)
Legal Nurse Consultant
Two related responsibilities
Medical navigational assistance
Home health assistance
Electronic coding and billing systems
Electronic medical records (EMR)
- Networks for digital imaging such as PACS
- Making sure health care services are being used appropriately.
- Ensuring high quality care is administered as economically as possible.
-- Case management (utilization review plus discharge)
Analyze complex medical information
2 - Render informed opinions to attorneys in medical-legal matters
Identify the practice environment where this role may be applied
Clinics: Accompany a patient to appointments
Identification of Stakeholders
Identification of Stakeholders
Stakeholders are defined as those groups of people or individuals who have the potential to exert influence on an organization. They are the individuals or groups that help businesses and organizations to be successful.
Stakeholders have certain expectations from the company in a very similar manner as an organization needs support from the stakeholders and hence the assessment of the degree to which these expectations are managed to be satisfied by the organization in a balanced fashion is a value that indicates the current and future performance of the organization.
There are two essential groups of stakeholders in relation to any company -- internal and external. The stakeholders who normally are not in the pay role of an organization and who are not directly associated with the company are termed as external stakeholders. One the other hand the people directly…
Kloppenborg, T. (2012). Contemporary project management. Mason, Ohio: South-Western Cengage Learning.
Marks, L., Cave, S. And Hunter, D. (2010). Public health governance: views of key stakeholders. Public Health, 124(1), pp.55-59.
cultural diversity issues and its impact on nursing professionals' practice. It assesses a client hailing from a different culture, and employs information derived from the assessment determining and reflecting on health practices and beliefs of the client's culture. Lastly, nurses' role in the care of patients hailing from diverse backgrounds care is analyzed, and a conclusion is drawn.
Client Interview Data
Client's health beliefs in relation to cultural diversity
The client comes from a family-focused background, in which she plays the role of chief household organizer and attends to her family and their needs. She believes one ought to lead a life of a good and virtuous individual, and support one's family, particularly in times of need. In her opinion, sickness must be tended to, for preserving life. She believes in healthcare professionals and services they offer, for leading a healthy life. She is comfortable having healthcare professionals take care…
American Nurses Association. (1998). Discrimination and Racism in Health Care. Silver Spring, MD: American Nurses Association.
Anderson, L. (2012, October 10). Cultural Competence in the Nursing Practice. Retrieved from Nurse Together: http://www.nursetogether.com/cultural-competence-nursing-practice
Coe, S. (2013, January 15). Cultural Competency in the Nursing Profession. Retrieved from Nurse Together: http://www.nursetogether.com/cultural-competency-nursing-profession
Graue, M., Dunning, T., Hausken, M. F., & Rokne, B. (2013). Challenges in managing elderly people with diabetes in primary care settings in Norway. Scand J Prim Health Care, 31(4), 241-247.
Health Care Communication
Background- Within the modern nursing paradigm, there must be a clear link between a health outcome and the process that helps ensure those outcomes. Typically, outcomes are classified in terms of preventability, impact, severity and an overall holistic view of the client's safety issues. Positive behaviors that impact individuals either rescue or protect patients from potential or actual events. This is also part of the issue with modern communication and dissemination of information to patients, stakeholders, and the community (Burns and Grove, 2005).
At the heart of 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…
Alligood, et.al. (2002). Nursing Theorists and their Work. Philadelphia: Mosby.
Burns, N. And Grove, S. (2004). The Practice of Nursing Research. St. Louis:
D'Antonio, P., et al., eds., (2007). Nurses Work: Issues Across Time and Place. New York:
he study was unable to determine -- did not really attempt to determine, it must be said -- what caused physicians to tend to write down trade names for drugs rather than generic varieties. hus, there was little new information present for me in this article. Having picked up and filled several prescriptions myself, I have grown used to asking the pharmacist rather than the physician for a generic prescription. I understand and appreciate the importance of backing up this anecdotal evidence with a scientific study, but the actual findings of the study, though well proven, are of little revelatory value.
I would like to ask the author first how she came to think of conducting this study, and second what her purpose was in conducting it and presenting her findings. She remains as objective as is ever truly possible, especially in using surveys to gather data -- albeit the…
The time period covered by the actual study was very narrow; the data used was collected by the author in a survey distributed to patients and their physicians. Thus, the study covers only an unspecified time period shortly before the publication of the study, likely a time period during 1997. The author does rely on data from previous years in her introduction, however, citing changes in the prescription rates of generic and trade name drugs during the 1980s and into the 1990s. In general, the author found that despite the sudden emergence and popularity of generic drugs in 1984, prescription rates as of 1989 reflected a very limited use by physicians of specifying generic prescriptions for their patients. Despite the fact that seventy-percent of the drugs prescribed in 1989 had generic versions as well as trade name drugs available (making them so-called "multisource" drugs), only thirty-percent of prescriptions specified generic drugs despite significant cost benefits to patients.
The study attempted to determine the cause of this apparent preference for trade name drugs. In brief, its findings suggested that patient conditions, temperaments, and other patient-related variables were of negligible and inconsistent effect on the prescription of generic drugs, but that physicians were of immense importance in making the determination between generic and trade name prescriptions. The study was unable to determine -- did not really attempt to determine, it must be said -- what caused physicians to tend to write down trade names for drugs rather than generic varieties. Thus, there was little new information present for me in this article. Having picked up and filled several prescriptions myself, I have grown used to asking the pharmacist rather than the physician for a generic prescription. I understand and appreciate the importance of backing up this anecdotal evidence with a scientific study, but the actual findings of the study, though well proven, are of little revelatory value.
I would like to ask the author first how she came to think of conducting this study, and second what her purpose was in conducting it and presenting her findings. She remains as objective as is ever truly possible, especially in using surveys to gather data -- albeit the data was quantitative -- but I am curious as to what applications she sees for her research. She does suggest further research to determine what it is that makes physicians make the choices in generic vs. trade name prescription that they tend to make, but even here refrains from suggesting how this knowledge could be applied. Patient advocacy would be an ethical use of this knowledge, but I can easily see an ethical danger being presented for physicians and pharmaceutical companies coming out of this knowledge as well. I would also suggest that the author look at pharmaceutical marketing techniques, especially direct communications with physicians, in an attempt to find deeper causes of trade name prescription preference.
The caregiver role includes those activities that assist the client physically, mentally, and emotionally, while still preserving the client's dignity. In order for a nurse to be an effective caregiver, the patient must be treated in a holistic manner. Patient advocacy is another role that the modern nurse assumes when providing quality care. Advocacy is the active support of an important cause, supporting others, or speaking on behalf of those who cannot speak for themselves (Kozier, Erb and Blais, 1997).
For the Ns to be more satisfied then, we need a new paradigm or process that is more inclusive, more active between management and staff, and provides more lines of open communication between the groups. Taking into account that the Ns job is hectic, hospital schedules are always frenzied, and there always seems to be a shortage of people, it will take considerable commitment and effort from management to sort…
Memorial Herman - About Us. (2010, January). Retrieved October 2010, from Memorial Herman Hospital: http://www.memorialhermann.org/
Allen and Wilburn. (2002). Linking Customer and Employee Satisfaction. Milwaukee, WI: American Society for Quality Press.
Bowen, B. (2000). Recognizing and Rewarding Employees. New York: McGraw-Hill.
Corrigan, Greiner and Erickson. (2003). Fostering Rapid Advances in Health Care: Learning From System Demonstrations. Washington, DC: National Academies Press.
" (AAF, nd)
The Health Maintenance Organization further should "…negotiate with both public and private payers for adequate reimbursement or direct payment to cover the expenses of interpreter services so that they can establish services without burdening physicians…" and the private industry should be "…engaged by medical organizations, including the AAF, and patient advocacy groups to consider innovative ways to provide interpreter services to both employees and the medically underserved." (AAF, nd)
One example of the community healthcare organization is the CCO model is reported as a community cancer screening center model and is stated to be an effective mechanism for facilitating the linkage of investigators and their institutions with the clinical trials network. It is reported that the minority-based CCO was approved initially by the NCI, Division of Cancer revention Board of Scientific Counselors in January 1989. The implementation began in the fall of 1990 and the program was…
Principles for Improving Cultural Proficiency and Care to Minority and Medically-Underserved Communities (Position Paper) (2008) AAFP -- American Academy of Family Physicians http://www.aafp.org/online/en/home/policy/policies/p/princcultuproficcare.html
Volpp, Kevin G.M. (2004) The Effect of Increases in HMO Penetration and Changes in Payer Mix on In-Hospital Mortality and Treatment Patterns for Acute Myocardial Infarction" The American Journal of Managed Care. 30 June 2004. Issue 10 Number 7 Part 2. Onlineavaialble at: http://www.ajmc.com/issue/managed-care/2004/2004-07-vol10-n7Pt2/Jul04-1816p505-512
Darby, Roland B. (2008) Managed Care: Sacruificing Your Health Care for Insurance Industry Profits: Questions You must ask before joning an HMO. Online available at: http://www.rolanddarby.com/br_managedhealth.html