Nursing Shortage on Patient Outcomes
The objective of this study is to examine the effects of nursing shortage on the outcomes of patients. Towards this end, this study will conduct a review of the literature in this area of inquiry.
There is a severe shortage of nursing in today's healthcare workforce. This impacts the outcomes of patients in terms of their healthcare and their overall health. According to the 'Nursing World' website "Nursing is integral to patient care and is delivered in many and varied settings. The sheer number of nurses and their central role in caregiving are compelling reasons for measuring their contribution to patients' experiences and the outcomes that are attained." (2010, p.1)
According to a report by the American Association of Nurses "n an article published in Health Services esearch in August 2008, Dr. Christopher Friese and colleagues found that nursing education level was significantly…… [Read More]
Nursing -- Measuring Patient Outcomes
Measuring Patient Outcomes
Measuring patient outcomes is crucial to evaluating the quality of healthcare since achieving positive patient outcomes is the most fundamental of all goals of healthcare in general (Hamric, Spross, & Hanson, 2009; Taylor, Lillis, & LeMone, 2008). In principle, patient outcome indicators should include seven objective elements or characteristics, namely: (1) they should be based on precise agreed definitions; (2) they should be sufficiently specific and sensitive to eliminate false positive and false negative findings; (3) they must be valid and reliable; (4) they must discriminate sufficiently for findings to be meaningful; (5) they must relate to clearly identifiable events for the targeted audience; (6) they must allow and promote useful comparisons; and (7) they must be strictly evidence-based (Mainz, 2003). Generally, the quality of healthcare is directly determined by many factors among which the specific roles of healthcare workers are some…… [Read More]
Nursing and Patient Outcomes
Identify one area of nursing research that has improved patient outcomes. State the study and its impact on patient care. How have these findings changed your nursing practice?
As the field of nursing research continues to expand, the potential for improving patient outcomes has increased exponentially, with enhancements to efficiency and methodological innovation combining to provide modern nurses with an array of advantages. One area of nursing research which has proven especially productive focuses on the emerging concept of Magnet hospitals, which are "distinguished by their competent managers, decentralized decision making by direct caregivers, chief nurse executives who were directly involved in top management decisions, flexible nurse scheduling, investment in their employees & #8230; and supporting continuing education of the nursing workforce" (Cheung et al., 2008). These Magnet hospitals tend to thrive even during nursing shortages, and by studying the methods employed by managers of these…… [Read More]
P: Nurses and Nursing.
Nursing leadership and patient outcome
eview of studies and literature that examine the association and relationship between nursing leadership practices and patient outcomes.
O: Evidence suggests relationships between positive relational leadership styles and higher patient satisfaction and lower patient mortality, medication errors, sentinel events, and hospital-acquired infections.
Over three months
Healthcare faces an economic downturn, stressful work environments, upcoming retirements of leaders and projected workforce shortages, implementing strategies to ensure effective leadership and optimal patient outcomes are significant.
The nursing shortage continues to be a serious concern for the healthcare industry as a whole. "According to the Bureau of Labor Statistics' Employment Projections 2012-2022 released in December 2013, egistered Nursing (N) is listed among the top occupations in terms of job growth through 2022. The N workforce is expected to grow from 2.71 million in 2012 to 3.24 million in 2022, an increase of…… [Read More]
The Impact of Nursing Education on Healthcare Quality
The percentage of registered nurses (Ns) with at least a baccalaureate degree was estimated to be 61% in 2013 (osseter, 2014a). While this statistic may indicate that the prevalence of highly educated Ns is considerable, the Institute of Medicine called for an increase in the number of Ns with a bachelor degree in nursing (BSN) to exceed 80% within 10 years. The rationale for this recommendation was that the healthcare system was changing is significant ways and BSN- and graduate degree-prepared Ns will be needed to usher in a new era in healthcare within the United States, one focused on improving patient safety. These statistics and recommendations were cited in a fact sheet released by the American Association of Colleges of Nursing (AACN) and recently updated in 2014 (osseter, 2014a). At the beginning of what can only be considered a…… [Read More]
Ethics in EOL Decisions
Finding Common Ground in EOL Care Decisions
Churchill (2014) presents to readers a case study to highlight some of the ethical and moral issues that will occur during end-of-life (EOL) decisions. The case study is not a factual event, but represents the mean severity and complexity of the EOL struggles experienced by the typical stakeholders. In this example, the treating physician has unsuccessfully tried to convince the adult daughter that her father will never recover from a coma and would benefit the most by palliative care, while the daughter refused to give up on the hope that her father would recover. Churchill (2014) spent time with clinicians and family member to try and understand their perspectives, thereby fulfilling his duties as a clinical ethics consultant. He discovers the patient has a living will and durable power of attorney, which prevented the use life-sustaining interventions in circumstances…… [Read More]
ole of Technology in Patient Education
The patient care is improving in most health facilities because of the interactive technology that supports learning. Inventions and innovation are shaping health care because of new approaches to patients care in the health centers. The technology and research have helped in educating patients regarding the essence of personal care. The nursing practice is improving because of the use of objective experience and research-based evidence to solve complex problems. The evidenced-based research has helped improve decision-making and has brought desirable change in the nursing. esearch in the nursing practice helps in improving patient outcomes. Patient education is important as it helps the patient understand tips for healthy living, self-management, and comprehend their health care needs.
In many hospitals, patient education helps the patient understand processes of treatments and be able to participate in their health management (Cook et al., 2014). Literate patients appreciate the…… [Read More]
Tay-Sachs Teaching Plan
Desired patient outcomes
The patient to understand the genetic nature of Tay-Sachs disease.
Patient to understand the treatment options for Tay-Sachs disease.
Patient to understand the prognosis of Tay-Sachs.
Patient to know about support groups available and appropriate referrals.
Patient to understand information about Tay-Sachs in pregnancy.
Genetic nature of Tay-Sachs
Tay-Sachs is a fatal genetic disorder that is related to storage of genetic lipids in quantities that are harmful leading to the tissues and nerve cells in the brain. The lipid involved is ganglioside GM2. Tay-Sachs is caused by insufficient action of beta-hexosaminidase A enzyme which is a catalyst for the biodegradation of acidic fatty materials, gangliosides. As the brain develops, gangliosides are generated and biodegrade rapidly in the early ages of life. It is extremely rare. However, it leads to death of infants with this disorder at an early age Melillo & Leisman,…… [Read More]
Handoffs are essentially crucial elements that serve various functions including social bonding, team building, and coaching and teaching. In the health care setting, nursing handoffs play an important role with regards to information processing i.e. ensuring that essential information is transferred for patient safety. This implies that nursing handoffs are important in maintaining continuity of care during a patient's stay in a health care facility. Handoffs act as communication links between the various medical personnel or professionals providing patient care. Despite their significance in continuity of care and ensuring patient safety, nursing handoffs have recently been characterized by errors, care omissions, inefficiencies, increased costs, increased hospital stay, preventable re-hospitalizations, and unsuitable treatment (Halm, 2013, p.158). This is primarily because they are carried out in a substandard manner or are variable handoffs. This is major issue that requires examination in order to identify suitable measures for improving nursing handoffs with the…… [Read More]
Reducing Patient Waiting Time for Better Patient Outcomes
Most healthcare institutions start their day with the intention of perfectly managing their time schedules. While the expected outcome is excellent patient outcome many practices often end up bringing in more patients into a schedule that is already overloaded hence requiring more time to attend to the scheduled patients (Capko, 2015). The outcome of the busy schedules is inefficiency, bottlenecks, frustration, and more waiting time for the patients. Patients are forced to spend more time in the exam room or reception area waiting for an opportunity to be attended to (Capko, 2015). For the patient things appear to be moving in slow motion.
In order to overcome the scheduling problems it is important to address the foundation of this patient scheduling problems. It may seem easy but it is more complex than many would think. It takes a lot of…… [Read More]
Patient acuity system provides the nurses and other healthcare practitioners in health cares' information that can guide them in their attention towards the patients. The nurses track information and then weigh them in accordance to the urgency of assessment. The basis that the nurses use is the complexity of the level to which patients are unwell. An example is the determination of whether the patients immediately require ventilation and those who do not need any. The nurses are able to pick on the various patients in the healthcare and then record the data. In a single healthcare, there are many patients with different degrees of illnesses. As a result, they all require varying levels of evaluations from the nurses. It is, therefore, imperative that the nurses spread their attention appropriately to avoid any inconveniences. This system helps the nurses to determine the attention that patients require within a short period.…… [Read More]
Many advocates of the move feel that lower patient to nurse ratio would lead to additional savings because it would reduce nurse turnover rate, lawsuits, complications and length of stay. Nursing unions in the state of California have asked for a PTN ratio of 3 to 1. The health association however agreed on 5 to 1 which sound more reasonable than the originally proposed 10 to 1. (othberg, 2005)
Patient to nurse ratio when it is too high can definitely adversely affect care. And with baby boomers aging and needing healthcare, we know that number of people looking for healthcare will continue to rise in the coming years. However staff shortage continues to pose a serious problem. And unfortunately, the problem doesn't always lie with cost control. While it is true that most of the problems with staff shortage can be attributed to hospitals cutting down their costs and hence…… [Read More]
The author also explains that the data stored in the system can be used to help public health officials identify medical issues facing the community as well as track various trends from the community and public health perspectives.
(How does this article relate to you as doctor?)
As a physician, I recognize that my time will be in very short supply. Therefore, any system or resource capable of saving time and increasing the efficiency of the healthcare services that I provide will be greatly appreciated. Similarly, patient safety, elimination of medical errors, and patient outcome are always paramount concerns for any physician. Therefore, I would welcome the opportunity to use EHR systems to the extent they address those issues positively. Moreover, as a physician, I am always interested in any approach that might be beneficial to human welfare and community and public health issues. According to the article,…… [Read More]
Evidence Based Practice
University of Illinois Evidence Based Medicine Resources: Lessons Learned
From the search resources I learned that in evidence based medicine, patient values comprising of their unique concerns, preferences, and expectations introduced to the clinical encounter ought to be integrated in determining the ideal care for patient. This integration will guarantee that the individual patient’s clinical state, the clinical setting and best patient outcome prevail in ideal decisions on optimal service delivery to the patient (Sackett, Rosenberg, Gray, Haynes, & Richardson, 1996).
The second aspect learned is that in order to integrate Evidence-Based Nursing and clinical care, there is the need for a basic comprehension of the attributes related to the inherent published evidence. Resources in Evidence-Based Practice are categorized in a hierarchy relating to the quality of the research or evidence. In Evidence-Based Practice, decisions making on best care to patient are not just basically guided by…… [Read More]
Patient-centered care is the goal of many healthcare organizations, but the ability of an organization to deliver patient-centered care is influenced by a number of factors both internal and external. Business practices, regulatory requirements, and reimbursement all can impact patient-centered care in any healthcare organization. Promoting patient-centered care requires an organizational culture committed to this paradigm, which also needs to be embedded in the mission and values of the organization.
Executives and administrators create the organizational culture that promotes patient-centered care. All leaders in the organization are responsible for using patient-centered practices and communications styles in their interactions with patients and their families. Furthermore, administrators oversee the policies and procedures that directly impact the culture of care. Analyzing areas of weakness within the organizational structure and culture via established assessments like the Patient-and Family-Centered Care Organizational Self-Assessment Tool, it is possible to create multidisciplinary teams that promote the organization’s…… [Read More]
The author of this report has been asked to answer several questions relating to a survey that was taken and the conclusions or outcomes that can be drawn from the same. Within this report, the current practice setting will be describe as well as the patient- and family-centered nature (or lack thereof) of the organization. The gaps that exist will be described, there will be an analysis of how business practices and regulatory requirements can impact patient- and family-centered care and there will be a strategy created based on all of the above. While all businesses need to make a profit and while not all feedback is helpful or based on the most good for the most people, cutting out the feelings and feedback of families and patients is less than wise and should never be happening.
State of the Practice
The basic state of the practice at…… [Read More]
Patient Centered Medical Homes
In the 1960s, the medical home concept referred to as patient centered medical home was developed.In order to reform the healthcare in the U.S.; the patient centered medical homes are evolving as a centerpiece of efforts (Bates, 2010). Basically, PCMH can be defines as a primary care model that offers coordinated and comprehensive care to the patients in order to improve health outcomes. PCMH is also recognized by the National Committee for Quality Assurance (NCQA). Patient centered medical homes can be portrayed as a team of people working together in form of a community. The purpose is to improve the health as well as healing of the people in that community. In comparison with the primary care, PCMH is more responsive towards the needs of local patients.
PCMH offers a number of benefits including complementary nutrition as well as wellness counseling along with providing prevention education…… [Read More]
Patient, Mr. D., is a 74-year-old male Caucasian, married and retired. Mr. D. complains of dizziness and weakness. Type-2 diabetes was diagnosed in 1994, hypertension in 2002, and arthritis in 2007. Mr. D. is currently taking 20mg Lipitor/daily; 81 mg Aspirin/daily; 333mg Calcium/daily; 5mg zinc/daily, and 500mg Vitamin C/3X day. He denies any drug or herbal use, and uses 650 mg of Tylenol for pain as needed. He has no known food allergies, does not use tobacco or illicit drugs, but has a family history of diabetes and heart disease with both mother and father. His general health acuity is strong (bowels, urinary, etc.), but has occasional slurred speech, weakness in right lower limb, syncope, vertigo, and vision fluctuations. Mr. D. reports that his wife complains he asks the same question repeatedly within a short time period.
Areas for Focused Assessment- The combination of syncope, vertigo, vision, and memory issues…… [Read More]
Patient Centered Medical Homes (PCMH) are often confused as being actual "homes" for patients to be admitted in and given medical treatment and care. PCMH is actually a health care model based on which health care is provided to patients, under the supervision of physicians. The PCMH model of health care provides patients with continuous, comprehensive medical care, in order to increase the chances of achieving the goal of benefitting the patient with as much attention and medical care in order to maximize his/her health outcomes.
Over the years the PCMH model of health care has become widely adopted and preferred. This is because of the philosophy and approach that the model adopts in organizing and delivering the health care initiatives. The PCMH model is based upon delivering medical care and attention to patients with team-based health and medical experts that are focused strongly on the quality and the safety…… [Read More]
I also added, honestly, that the family members who had changed their ways actually felt better on a daily basis, as well as had a better prognosis in terms of their health. This was the true essence, I stated, of "loving life" in my opinion. I tried to make him see what he was going to have to do after his operation as a gain, rather than a loss. He would be regaining control over his health, and would feel younger and better.
I tried to help this patient feel empowered, by going into detail what would happen to him during the operation in layperson's terms. I could see that feeling in control was very important to him, and I tried to facilitate that sense of control. After the operation, I saw the patient again, when he was going to see his grandson who had had some minor surgery on…… [Read More]
To wit, power is a huge influence in any social interaction, and in a study reported by the University of California Press (est, 2008, p. 87), men often interrupt women during conversations because men are generally viewed as the power in any male-female interaction. "Physicians interrupt patients disproportionately" in doctor-patient interactions, est writes, "except when the doctor is a 'lady'; then, "patients interrupt as much or more than physicians, and their interruptions seem to subvert physicians' authority" (est, p. 87). In other words, the stratification of male doctors having the power to interrupt is reversed when a woman is the doctor.
Blumer, Herbert. (1986). Symbolic Interactionism: Perspective and Method. Berkeley:
Breen, Catherine M., Abernethy, Amy P., Abbott, Katherine H., and Tulsky, James a. (2007).
Conflict Associated with Decisions to Limit Life-Sustaining Treatment in Intensive Care
Units. Journal of General Internal Medicine, 16(5), 283-289.
Donovan, Jenny L., and Blake,…… [Read More]
Most of the literature deals with healthcare issues experienced in the United States or Europe. hat small amount of literature there is available on healthcare in Malaysia seldom has anything to do with the clinic(s) in specific. This study could help, in some small measure, to alleviate that problem.
Chowdhury, N., (1999) the Power of Towers, Fortune, Vol. 139, No. 7, pp. 110-112
Kurokawa, I., Takami, M., Cheriex, H., (1999) Futuristic flight plan - the Kuala Lumpur International Airport was designed for the new millennium, Lighting Design + Application, Vol. 29, No. 8, pp. 42-45
Manson, L.A., Baptist, a.J., (2002) Assessing the cost-effectiveness of provider-based status, Healthcare Financial Management, Vol. 56, No. 8, pp. 52-59
Romano, M., (2006) Physicians in pain, Modern Healthcare, Vol. 36, No. 4, p. 40
Shameen, a., (2004) Malaysia: Coining it in Kuala Lumpure - Start-up ECM Libra has capitalized on strong markets, hard…… [Read More]
Patient Education Decrease Anxiety Undergoing Invasive Cardiac Procedures
In this case, one of the main areas of topic is based on the role played by initial patient education on the anxiety of patients undergoing noninvasive cardiovascular surgery. It has been reported that the initial education provided by the nurses to the patient in relation to the noninvasive cardiac surgery helps the patient, as there is a great reduction in stress and level of anxiety in relation to the surgical procedures and the outcomes.
Riegel, B (ed). Journal of Cardiovascular Nursing. Philadelphia, U.S..
The journal is a complete online source for the information needed by the nurses in accordance to the procedures that can be used to reduce anxiety levels in the patients undergoing noninvasive cardiac surgery. These days it is important that the patients be taken into complete confidence by making sure they are aware of the procedures…… [Read More]
Patient-Centered Medical Home
How the Patient-Centered Medical-Home reducing cost and improving quality and safety for patients.
The patient centered medical home is a platform that fills a need in the current healthcare system. The U.S. healthcare system has been plagued for quite some time with a trend of substantially rising healthcare costs as well as another trend of slipping quality standards. These two trends are argued to be a phenomenon that has emerged at least partly from poor planning and ineffective use of resources. One solution to some of these issues can be found in the patient-centered medical home (PCMH) model of primary care. This model has been developed with the coordination of long-term physician-patient relationships in mind. Developing these relationships further can not only reduce costs in unnecessary procedures that are the result of the missed opportunity for preventive care, but also have been shown to improve…… [Read More]
These studies demonstrate that there are several factors associated with patient noncompliance, regardless of the disease being treated. Medication side effects represent only one of these issues. Nurse practitioners could help to resolve many of these issues by being proactive and asking questions about side effects in patients at risk for becoming noncompliant. They may also be able to predict noncompliance in patients that are prescribed medications with known side effects. By informing the patient of the side effects and giving them practical ways to cope with them, the nurse practitioner can play an active role in helping to eliminate patient noncompliance.
Education was found to play an important role in patient noncompliance. The overall educational level of the patient was found to be important. The nurse practitioner can take positive action by being aware of the patient's overall educational background. Extra care must be taken with those of low…… [Read More]
Patient Satisfaction in Quality of Managed Care
Aspect to be compared
Gender and Patient
Satisfaction in Managed Care, etc.
Stakeholder Perceptions of Quality in Managed Care Plans
Two Steps to Enhance Managed Care Quality
Emily eisman, MS
Jacobs Institute of omen's Health
Carolyn M. Clancy, MD
Paul L. Grimaldi, Ph.D.
To determine what the differences are and what variables might affect women patients' perceptions of the quality of managed care
To find out what attributes three different health care stakeholders, physicians, employers and consumers, value most in determining their assessments of the quality of managed care health plans
To explain the ramifications of two developments in managed care: the new application form for MCOs to become Medicare risk contractors, and the National Committee for Quality Assurance plan to begin performance-based accreditation.
Determining what the differences between men's and women's perceptions of the quality of…… [Read More]
PATIENT & HEALTH POFESSIONAL PESPECTIVES
Patient & Professional Perspectives
Quality of care is a massive concern when it comes to healthcare in general. The issue is so multi-dimension and complicated. Even further, there are a lot of ideological bents and perspectives that further shape and form the issue as it exists today. A significant part of the paradigm mentioned above would be the perspectives of both patients and healthcare professionals as it relates to the aforementioned quality of care. Obviously, there are going to be some differences and similarities when talking to any large swath of patients or healthcare providers. The differences could be huge divides in some cases due to what is being expected being too different than what is able to be delivered given the resources or even the perspective or opinion of the healthcare professionals or providers. While there is no simple or neat answer to how…… [Read More]
Treatment to Patients
The main objective of providing treatment to patients is to relieve symptoms along with decreasing the progression of the disease as well as the mortality or morbidity. However, in some cases, this objective is not fully achieved, especially in the case of the patients who are admitted to the ICU with some serious and almost always a terminal stage of the disease. For example, when old patients are admitted in the ICU, their immunity is extremely low and this is the perfect time for the opportunistic infections to make matters worse for these patients. There are many infections that are specifically associated with patients admitted in the hospitals. Pseudomonas Aurigeonosa is a micro-organism that is well documented to cause bacterial pneumonia and bacteremia in the patients who are terminally ill and are receiving treatment in the hospital setting. Since most of the patients in the ICU are…… [Read More]
Demographic Perception Survey of Patients with Atypical CP Who Present to Cardiac Care Doctors and Patient Outcomes
This study intends to examine gender differences in individuals who present to cardiac doctors with chest pain and specifically, atypical chest pain in women. The work of Debra L. Issac (2000) states that over the past ten years "there has been increasing awareness of both the importance of CAD in women and of the significant differences between men and women who have the disease. Potential gender biases, both within the medical community and within the general population of women themselves also have been identified. These gender differences and biases have the potential to influence investigation and management of suspected or confirmed CAD in women, and should be taken into consideration when faced with a woman with potential cardiovascular disease." (p.157)
Issac also states that chest pain in women is "common and often non-ischemic.…… [Read More]
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…… [Read More]
Health Information Technology has significant impacts on nursing policy and practice including the role of these professionals in patient education. Actually, the Information Technology development process in healthcare is based on the nurses' ability to understand the community and provide distinctive insights about patient education among other factors (Effken & Abbott, 2009). Since nurses are important elements of the healthcare system, they are critical in ensuring that the confidence of patients in the health providers is maintained even as technology mediates interactions.
The main impact of the emergence of Health Information Technology on the role of a nurse in patient education is that technology mediates interactions between patients and their care providers. As a result, nurses are required to ensure that the role technology plays in mediating these interactions does not affect the insights provided in the process or the delivery of improved patient care. Moreover, through Health Information Technology,…… [Read More]
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,…… [Read More]
Osteomyelitis in the Diabetic Patient
Management OF OSTEOMYELITIS IN THE DIABETIC PATIENT
Osteomyelitis is an infection of the bone or bone marrow which is typically categorized as acute, subacute or chronic.1 It is characteristically defined according to the basis of the causative organism (pyogenic bacteria or mycobacteria) and the route, duration and physical location of the infection site.2 Infection modes usually take one of three forms: direct bone contamination from an open fracture, puncture wound, bone surgery, total joint replacement, or traumatic injury; extension of a soft tissue infection such as a vascular ulcer; or hematogenous (blood borne) spread from other infected areas of the body such as the tonsils, teeth or the upper respiratory system.2(p807) Bacteria such as Staphylococcus aureus, Pseudomonas, Klebsiella, Salmonella, and Escherichia coli are the most common causative agents of the disease, although viruses, parasites and fungi may also lead to the development of osteomyelitis.3
Patients…… [Read More]
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…… [Read More]
Application: Systems Theory
Healthcare organizations provide nursing services centered on multiple theories. For instance, the Open Systems Theory established in 1978 by Katz and Kahn considers the healthcare organization as social systems divided into interconnected subsystems (Meyer & O’Brien-Pallas, 2010). Meyers and O’Brien-Pallas (2010) provide that these interrelated subsystems include outputs, throughputs, inputs, negative feedbacks and a cycle of events. The primary care hospital environment has various units that handle different cases including the intensive care, intermediate care, medical-surgery, emergency department (ED) etcetera. This paper delves into system theory in the emergency department, identify goals and challenges in this department and establishes an appropriate structural outcome.
Subsystems in Emergency Department
In the emergency department, the inputs include financial resources, supplies, and staffing needed for the unit to be functional. The emergency department is in operation all day and night and needs sufficient nurses and subordinate staff to give a throughput…… [Read More]
ED Patient Boading |
Emegency Depatment Patient Boading
Emegency Depatment (ED) cowding is a nationwide cisis which affects the efficiency and the quality of patient cae (Sox, Bustin, Oav, et al., 2007). A huge contibution to patient ove-cowding is the boading of admitted patients in the ED. An altenative use of time which is lost in the admitting of patients is used to teat patients who ae waiting to be seen; this is seen typical in ove-cowded EDs. The ovecowding of EDs esult in isking patient safety and altenatives to this should be obseved.
Holding admitted patients in EDs always was known to be bad fo patient flow, but thee is a gowing body of eseach showing that it also hams patients. Thee is significant evidence which demonstates that ED cowding due to boading is esponsible fo poo outcomes (Sox, Bustin, Oav, et al., 2007). In many hospitals, it is…… [Read More]
Nursing Unit Turnover on Patient Outcomes in Hospitals
While it might seem intuitive that higher rates of turnover within a unit are problematic, the study by Bae, Mark, & Fried (2010) attempts to show using a quantitative study the extent to which turnover has had a negative impact upon patient care. This study compared the levels of turnover at 268 units from 141 hospitals and assessed its relationship to both patient satisfaction and the nurse's own perceptions of cohesion, relational coordination, and learning. The study is quite distinct in design from qualitative studies which often have an anecdotal approach and emphasize experience vs. data in evaluating policies.
One problem, however, with the use of such a study which emphasizes numbers over narration is the difficulty of quantifying subjective variables like efficacy. In this instance, nurses' own perceptions of what policies were useful were assessed as well as patients' perceptions to…… [Read More]
e. incurable cancer; (2) referral to the Department of Palliative Medicine. The exclusion criteria for the study were: (1) estimated prognosis of less than 1 week; (2) significant cognitive impairment, i.e. unable to provide consent; (3) significant physical impairment, i.e. unable to complete protocol; (4) clinical evidence of dehydration; (5) current/recent (less than 2 weeks) use of antifungal medication. (Davies, railsford and eighton, 2005)
Davies, railsford and eighton (2005) report that the clinical component of the study involved "...completion of a study questionnaire (demographic data and clinical data), completion of the Memorial Symptom Assessment Scale, clinical examination of the oral cavity, measurement of the unstimulated whole salivary flow rate (UWSFR), measurement of the stimulated whole salivary flow rate (SWSFR), and performance of an oral rinse." ( p.698) The study results states that all patients/participants "...had either locally advanced, or metastatic cancer. The prevalence of different cancer diagnoses were: carcinoma breast…… [Read More]
CERNER software is built to allow for an enterprise-wide view of a patient\'s clinical information in order to coordinate patient care and document at which point care was delivered especially in acute patient settings. Using the software providers will have access to the right information and at the right time within the clinical workflows in order to make the best possible decision regarding patient care (Curry, 2010). In acute patient settings, it is vital that a nurse has the right information before they start attending to a patient. This is mainly beneficial to ensure that they understand the patient\'s condition or problem before they can begin to offer care. Using the CERNER software, it is easy for a nurse to access this information and make informed decisions based on the information that has been entered regarding the patient’s condition. In acute care, real-time information is vital to the provision of…… [Read More]
Blueprint for Evaluating Patient Safety Competency in Nursing Students
Ever since the report To Err is Human was published in 2000 by Kohn and colleagues, healthcare stakeholders in Western countries have intensified reform efforts designed to increase patient safety. The report revealed that nearly 100,000 patients were dying annually from medical errors in the 1990s, a statistic that caught the attention of legislators, healthcare policymakers, clinicians, patients, and the general public. Additional research revealed that nurses were considered to be the source of most medical errors and also the best defense against errors, but nurses had little, if any, control over patient care planning (Lachman, 2007). Systems were therefore a major determinant of patient safety.
Patient safety and nursing ethics are also inseparable (Lachman, 2007, p. 401). While avoiding specific recommendations, provision three in the American Nurses Association Code of Ethics states that nursing professionals must protect the safety of…… [Read More]
Pediatric Nurse Practitioner in the Care of Terminally Ill Children
Pediatric nurse practitioners provide a valuable contribution to the care of chronically and terminally ill children. This position is essentially a subtype of advanced practice nurse, whose function is to provide the best possible patient care for ill children. This position functions within a pediatric hospital setting, in which the goal is to provide cost-effective patient care that meets and exceeds the needs of patients and their families. Although the pediatric nurse practitioner may work with children that present with acute or chronic illnesses, there is a critical need for nursing practitioners that are motivated to work with terminally ill children. Terminally ill children and their families present unique needs and situations that require knowledge, expertise, and intervention skills beyond what conventional nurses can offer. This population requires specialized care that can be fulfilled by a trained pediatric nurse practitioner.…… [Read More]
Improved quality of care is one of the major issues that has characterized modern healthcare practices. Ferreri et al. (2016) conducted a study to examine enhanced quality of life and decrease of traditional drugs in homeopathy treatment of allergic patients. The study was carried out in the Centre for Integrated Medicine in Pitigliano, Tuscany. These researchers conducted their study in this healthcare facility because its an innovative hospital that provides homeopathy and acupuncture in combination with conventional clinical care. Therefore, this facility provides integrated medical care for patient treatment, which makes it ideal for examining enhanced quality of life and decrease in conventional drugs. This paper examines the study conducted by these researchers in relation to establishing the reliability of its findings and conclusions as well as the suitability of the research process.
Brief Summary of the Research
Ferreri et al. (2016) conducted a research in which the examined the…… [Read More]
cute care facilities try to maintain low costs and employ quality nurses. Within this statement is a double standard. How can we have quality nurses and cut costs at the same time? This is where the skill mix comes into play. In the skill mix, there are Registered Nurses (RNs), Licensed Practical Nurses (LPNs), and unlicensed staff. If the lesser skilled staff free RNs they can be better able to perform their nursing duties and assessments. If acute care facilities can agree on an appropriate number of each type of staff member within the facility, they might be better able to accomplish safe patient outcomes while keeping costs down.
Determining nurse-to-patient ratios is a complex issue where one solution is not sufficient to cover all circumstances. The merican Nurses ssociation assembled a panel of nursing and health professionals to research appropriate staffing levels. The panel developed the following Matrix for…… [Read More]
Diabetes Foot Care
Qualitative esearch Critique: Diabetes Foot Care
Sue Flood (2009) saw a need to examine the nurse-patient interaction in relation to diabetes foot care outcomes, in part because at least one health care organization (Agency for Healthcare esearch and Quality) has concluded that diabetes care received by patients often do not meet best practice standards. The impact of substandard care includes a 45 to 85% difference in the incidence of foot ulcers and amputations, as reported by the U.S. Centers of Disease Control and Prevention. The author further justified this study based on the ongoing global obesity and diabetes epidemics.
Flood (2009) decided to examine the nurse-patient interactions because this relationship has been shown to have a significant impact on patient outcomes. This represents the primary assumption the author tests in her study. The four components of nurse-patient interactions are: (1) affective support, (2) health information, (3) decisional…… [Read More]
patient satisfaction with the care provided by nursing staff and physicians, as well as how satisfaction can be improved through better communication among physicians and nurses, and with their patients. It will, in particular, deal with a nursing student's own clinical experience with patients and their perception of healthcare provider-patient communication. In addition, the paper will examine the student's project which considered the strategy of updating white boards in patient rooms regularly for better communication.
Ten medical surgical ward patients were interviewed during rounds by a student, who rated patient satisfaction and tried to discover some common theme. While patients expressed satisfaction with how nursing staff delivered care, they felt physicians didn't keep them informed. A number of patients were visited by two or more doctors. However, there was no communication between doctors, leading to issues such as a patient being marked "not ready for surgery" by the cardiologist, owing…… [Read More]
Improving Provider-Patient Communication Among LEP Patients
Elderly Hispanic patients experience numerous challenges when seeking for healthcare services since they are only eloquent in their native language and are classified as Limited English Proficient (LEP) patients. Language barriers contribute to poor provider-patient communication and necessitate the integration of third parties in the care delivery process. This paper whether the use of professional interpreters improves patient-provider communication and results in better health outcomes. Through a study that was carried out a sample of 40 elderly Hispanic diabetic patients at a Wellness Center in Los Angeles, using a professional interpreter improves provider-patient communication. The use of professional interpreters and language concordance is associated with improved provider-patient interactions, enhanced interpersonal care, and better medication adherence within three months.
Keywords: elderly Hispanics, patients, medication adherence, bilingual interpreters, treatment, patient-provider communication, healthcare providers.
Provider-patient communication is an important factor in enhancing patient outcomes in…… [Read More]
This created problems in the care of patients that should have been admitted to other units, as well as for all patients receiving care in the emergency department on an inpatient or an outpatient basis.
In addition, research was undertaken that examined alternatives to simply increasing the efficiency with which ED patients are either treated and released or admitted on an inpatient basis, and it was found that increasing staffing level and other practices were still insufficient. The research all quite clearly suggested that the practice of inpatient boarding in emergency departments was detrimental to patients as well as to medical, nursing, and support staff, and was also not cost effective for hospitals. It was recognized that a huge benefit could be derived from a comprehensive and conclusive survey of the issue, which would lead to clearer recommendations for nursing and medical staff as well as hospital administrators than have…… [Read More]
Assessment 3: Professional Accountability and Patient Safety
Defining the Issue: Violence from Patients towards Nurses:
In this discussion, I concern myself with ‘violence from patients towards nurses.’ It is important to note, from the onset, that violence meted to nurses by patients is one of the least discussed contemporary nursing issues. In the words of Stevenson, Jack, O’Mara and LeGris (2015, p. 32), “registered nurses (RNs), compared to other healthcare providers are at a higher risk of experiencing violence in the workplace that is initiated by patients and families.” In essence, violence from patients towards nurses includes any act of aggression initiated by the patient and (or) their relatives and friends and directed at the nurse. Acts of aggression in this case could include, but they are not limited to, grabbing, scratching, hitting, and in some cases shouting down the nurse in a threating manner. It is important to note…… [Read More]
High Nursing Turnover in a Hospital Affecting Patient Operations
In every healthcare institution, it is the expectation of every patient to receive adequate medical care when he/she visits the health care institution. Often, the hospital management and stakeholders must always ensure that all patients are treated as their health needs require. This will be critical in maintaining and enhancing the reputation of the hospital. However, when the patient is visiting the hospital increases, it will reach an extent that the nurses and other staff working in the hospital are overwhelmed. When the nurses and other staff are overwhelmed, the patients will not receive satisfactory medical care (Bae, Mark, & Fried, 2010). In the end, the hospital's reputation will be severely affected. Since not all the patients will be served as expected, they will opt to visit other near hospitals to seek better services. The hospital will receive stiff competition due…… [Read More]
hourly nurse rounds help to reduce falls, pressure ulcers, call light use and contribute to rise in patient satisfaction base on evidence base practice
The healthcare center is faced with numerous challenges affecting clinical results and client satisfaction (e.g., ulcers, use of call light and falls). The above challenges have brought on the need to develop and institute an appropriate framework to improve patient care delivery by means of better and increased interaction between patients and nurses. Chiefly, the creation of this sort of system necessitates striving for required authorization and assistance from leaders and staff members in the organization. This involves meeting with top management at organization appraisal board meetings, in addition to collaborating with peers concerning existing best practices for handling the issue. Taking into account organizational issues and nursing-related evidence-based practices (EBPs), the best answer to dealing with current issues is hourly nurse rounds. Implementing this recommended…… [Read More]
Safe Environment -- Patient Outcomes
hat are the best practices that nurses and nursing leaders can implement to assure safe working conditions and high quality patient care? This paper delves into those issues using the available literature -- scholarly articles -- as guiding references to reach an understanding of how to assure safe working conditions for nurses and patients.
Required time and staffing for safe and effective patient care
According to author Kathy Malloch, the task of creating safe practices for nursing staff "…continues to be illusive for nurse leaders" (Malloch, 2015). The problem is that discovering the amount of time needed in order for a nurse to provide proper patient care is still a work in progress; measuring that needed time is not in the "mature stage" yet, according to Malloch. As of the publishing of this article in Nursing Economics (2015), there was as yet no "gold standard…… [Read More]
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…… [Read More]
ICU and Delirium
Evidence-Based Project Proposal
Patients that are sixty-five years or older account for an average of more than fifty percent of the visitors to the Intensive Care Unit (ICU) and there are a host of known risk factors that are associated with individuals who are among this demographic and many elderly patients are discharged directly to long-term living facilities due to the fact that they are unable to continue to function independently and maintain daily activities (Tang, Tang, Hu, & Chen, 2016). It is further estimated that approximately one quarter of all of the elderly patients that are admitted to the emergency department display some form of metal impairment related to delirium, dementia, or both, and many hospital departments have made mental assessments for these demographics part of their routine operations (Soryal & al., 2014). Therefore, not only does the prevalence of mental impairments serve as a serious…… [Read More]
Perhaps the most fundamental tenet of my nursing philosophy is the administration of care in an intrinsically empathetic manner which benefits the patient. I unequivocally believe in patient-centered care and that nurses who are able to maintain this component of their practice as their primary goal are able to produce the greatest efficacy in administering to patients. Moreover, with all of the concerns of the contemporary healthcare market, including various facets of financial and technological concern, the shortage of various practitioners, and innovations in precision medicine, it is easy to forget that the most vital component of the health care industry is the patients themselves. Quite simply, patients have the most to gain and lose from the health care system. Therefore, I readily believe that keeping those patients as the center of the care delivered by me and others within my profession is the best way we can…… [Read More]
patients undergoing mechanical ventilation contract Ventilator Associated Pneumonia (VAP). This acute medical condition always results in increased death rates and associated medical costs among patients. This article reviews several literatures that try to enlighten masses on the diagnosis, medical treatments and VAP prevention methods. In addition, this article outlines recommendations medical practitioners can implement in their daily practices to curb VAP and offers an insight on controversies that usually arise during VAP diagnoses, treatment plans and prevention methodologies. This article defines VAP to be the causative agent of approximately 25 to 54% mortality rates among patients undergoing mechanical ventilation in ICUs. Factors responsible for VAP among patients include patients' population in ICUs, hospital stay durations and antimicrobial treatments. Even though antimicrobial medications are confirmed to reduce VAP casualties, further studies should be undertaken such as the ones outlined in the literatures below to help in early identification and treatment of…… [Read More]
Biology -- Patient Scenario
What are the components of physical examination? Describe each component.
Physical examination consists of 5 basic components after obtaining a patient's description of the history of his/her systems. First, the provider observes the patient for physical signs of disease and evaluates such factors as mobility, posture, facial expression, alertness, responsiveness to stimuli and changes in skin color (Jarvis, 2011, pp. 33, 127-9). Secondly, one must take a patient's vital signs, including blood pressure, heart rate, breathing rate and temperature, and compare the patient's results with the reference ranges (Jarvis, 2011, pp. 136-150). Third, one must perform auscultation, using a stethoscope to listen to the patient's lungs, heart and bowel (Jarvis, 2011, p. 118). Fourth, one performs percussion by tapping on the patient's chest and abdomen to listen for sounds indicating normal conditions, fluid, excess air, size of the lungs and size of the affected area (Jarvis,…… [Read More]
Responsibilities of Nurses to Patients
Why is it important
The role of nurses has a direct implication on the patients. For example, nurses observe and provide direct care to the patients. The physicians give orders and thus are the role of the nurses to implement (Aiken et al., 2014). Often, the work of the physicians is not complete without the help of the nurses. The nurses are responsible for changing clothes and giving the medications to patients. Often, the patients are unable to do basic tasks, and therefore the roles of nurses become very important. Nurses keep medical records for the patients and therefore give medications to the patients in time and monitor their progress.
Another important role of the nurse is assessing the response of the patients to medications. Keep the records for the progress of patients is an invaluable practice. The records help the nurses to monitor how…… [Read More]
Another way to put the patient at ease during moments like this is for the nurse to be absolutely certain that she is not showing any signs of being judgmental. If this happens, it could throw the patient off guard and create an uncomfortable situation where the patient no longer feels comfortable being honest with the nurse. Once this happens, the nurse will have an inaccurate patient history and the patient runs the risk of not being treated properly for the underlying symptoms.
In order for the history to be as accurate as possible, the nurse should ask questions regarding several issues that may affect the patient's health. The patient's past medical history is vitally important to the process because it can serve as a guide to what has worked in the past and what treatments are ineffective. The patient's mental health is also important. This will give the nurse…… [Read More]
Structured interviews of the subjects were conducted at the end of each individual set of simulation runs to obtain triangulation data.
Video segments were coded by nursing experts.
Statistical and content analyses of the data were conducted.
All nurses were female. Males may have provided different response. The sample may have been too small; only 10 individuals of each handedness were involved. The sample was extracted from only one environment, the participants were familiar with environment. Replication of various other environments may have provided different response. The repeated measures design may have influenced response second time around.
I found details of structured interview to be too vague. The best accounts of experimental studies are those that reader can replicate. Many of the steps of this study were sufficiently elaborate for repllication, but I found details of interview questions vague and incompletely elaborated upon so that one left with…… [Read More]
Patient’s chief complaint: A man aged 69 comes to the emergency room with a sharp pain to his chest’s left side, lasting between 30 and 40 mins and then subsiding.
History of present illness: The pain has woken him up thrice in the last 7 days. He claims the pain first started roughly six months ago. Initially, however, the pain used to surface only occasionally, commonly while he was doing gardening. The patient’s past medical history reveals a diagnosis of hypertension twenty-five years back.
Precipitating/alleviating factors: The patient has been smoking a half-cigarette pack daily for the last forty-five years.
Family History: The patient has lost two brothers and his dad to heart disease. The patient does not report any other significant illness history in the family.
Social History: His typical pastimes include sharing a drink with pals and gardening.
Review of Systems: From a physical examination of…… [Read More]