Nursing

Exercise Content

1.

Principio del formulario

According to you, what are the challenges associated with nursing? Include a summary of your research and how it correlates to the subject you are studying. Identify these challenges and explain their importance in healthcare.

 Guidelines: 

· APA Format 

· MUST utilize credible data sources such as CINAHL, MEDLINE, Embase, ClinicalKey, The Cochrane Library. Library resources can be accessed from the Library page at the FNU.edu website. FNU Librarians are available to assist each student with retrieving the required scholarly content.

· Research paper must be 500 – 650 words. 

· 3 or more scholarly sources must be utilized

· Sources must be within the last 5 years 

· Must have a minimum of 3 Sources 

· All article sources must be cited by including them in reference sheet (separate).

Final del formulario


NEED help

Based on course readings, resources, and discussions, create your own theory based on your specific practice area. For example, Liken’s Theory of Nurse/Patient Connectedness for Individuals with a Diagnosis of Depression. 

Be sure to include definitions and descriptions of at least two key concepts that make up your theory. Describe the relationships between these concepts. For example “connectedness” and “depression.” 

What role does research play in the development and use of your theory in practice? 

Give a case example of how your concepts and theories would be used in a specific client situation in practice. What are the barriers to using your theory in practice? 

NUR 445 – Week 3 Discussion: Researching and Recommending Evidence-Based Research Resources

tep 1 Read the case scenario.
You are part of an interprofessional team working on an evidence-based project to look at falls in patients with dementia in the long-term care setting. The team was brought together in response to a noted increase in the incidence of falls in residents with dementia over the past three months. One of the recent changes before the increase in falls was a mandate to no longer use physical restraints on residents. Several staff members feel that the use of restraints is a must, and they do not have time to use the restraint alternatives that have been suggested. They also feel they do not have enough time to continuously check on residents. This has caused major issues of concern and has compromised the quality and safety of the residents.

When the team meets together, one of the first items discussed is the clinical question. The team uses the PICO question format to develop the following question:

In patients with a diagnosis of dementia in the long-term care setting (P), how does the use of a comprehensive falls assessment prevention plan that includes restraint alternatives (I) compare with the use of a fall prevention protocol that includes the use of restraints (C) affect the number of falls that occur (O)?

Step 2 Post to the discussion forum.
In your initial response, address the following questions:

  1. Determine the best resources to use when conducting a search on the topic. Consider these questions: What databases would be most appropriate? Where would you locate clinical practice guidelines that could be used in the EBP process for this issue?
  2. Conduct a search using the resources you identified in Step 2a. What key search terms did you use? What filters did you use?
  3. From your search, identify at least three articles that you would consider using in an EBP project such as the one described in the case scenario. If possible, suggest resources that meet the highest level (Level I) of evidence. Why would these sources be most appropriate in determining best practices and supporting clinical decision-making for this issue?

DB

Respond to this discussion using two scholarly references  APA format

 Nursing staffing shortages are among the most significant national stressors within the United States healthcare system. Specifically, the nursing shortage has increased dramatically following the COVID-19 outbreak due to a rise in demand for healthcare services. Nurses enhance patient care quality, safety, efficiency, and timeliness to achieve desired health outcomes (Bakhamis et al., 2019). Additionally, nurses transform healthcare organizations through leadership roles (Broome & Marshall, 2021). Therefore, the nursing shortage affects the US healthcare system adversely.

            The shortage of nurses has impacted our healthcare organization negatively. Nurses’ workload has increased substantially in the healthcare organization to meet the high demand for healthcare services. Studies show that healthcare outcomes in medical facilities significantly depend on nurses’ workload (Norful et al., 2018). Therefore, nurses’ job performance, productivity, and ability to provide high-quality and safe patient care have been compromised, resulting in adverse health outcomes. The social determinant with the most significant effect on the nursing shortage is the decrease in nursing graduates in the United States. A lower number of nurse graduates is a significant challenge facing the United States healthcare system (Chan et al., 2021). As a result, it is challenging to meet the high demand for nurses nationwide. 

            The management has introduced various measures to address the nursing shortage in the healthcare organization. First, the organization hires contract nurses to meet the high nurse demand. Additionally, nurses are hired depending on the demand for healthcare services. For instance, more critical care nurses are hired to meet the increased demand for healthcare services in the emergency department during the COVID-19 pandemic. These measures resolve nursing in the healthcare organization, improving the quality and safety of patient care.

                                                                                                                            References

Bakhamis, L., Paul, D.P., Smith, H., & Coustasse, A. (2019). Still an Epidemic: The Burnout Syndrome in Hospital Registered Nurses. Healthcare Management; 38(1):3-10

Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). New York, NY: Springer.

Chan, G. K., Bitton, J. R., Allgeyer, R. L., Elliott, D., Hudson, L. R., & Burwell, P. M. (2021). The impact of COVID-19 on the nursing workforce: a national overview. Online Journal of Issues in Nursing26(2), 1–17.

Norful, A. A., de Jacq, K., Carlino, R., & Poghosyan, L. (2018). Nurse practitioner–physician comanagement: A theoretical model to alleviate primary care strain. Annals of Family Medicine, 16(3), 250–256.

Capstone

· After completion of the quiz, complete a 1-2 pg APA formatted paper with a reflection on the quiz and plan, moving forward, to maintain areas of strength and improve areas of weakness.

W3R see attachment

Make a follow-up of a student's weekly discussion and respond with your opinion regarding to her post

——You don't have to post this in APA format necessarily, it's just giving feedback to the student .



Jacqueline Kenney

Good Evening Professor,

 

              I work in one of the largest hospital systems in Atlanta. The facility I work for has the bed capacity for 686 patients. The hospital specializes in cardiovascular procedures (the implantation of the LVAD) and transplantation of liver, and kidneys. The hospital attracts people from across the country. People coming from literally every state, and sometimes from out of the country.

            The area where I see the EHR impeding patient care, and again this might be in part, due to end-user negligence, are providers not utilizing the information and data contained within the patient's EHR frequently enough.  We run off a system called EPIC (EHR). I have come to realize most hospitals in the state of Georgia, and other states use EPIC as well.  Embedded within the EPIC system is a hyperlink called Care Everywhere. The Care Everywhere tab allows all providers on the EPIC system to see notes, documentation, tests results, frequency of visits, and more. This data covers every hospital, clinical, urgent care, and office visit the patient has encountered so as long as the facility is on the EPIC system. I believe the shear amount of medical information becomes overwhelming and time consuming to comb through, especially for medical providers who are already seeing numerous patients at the bedside and in specialty offices. 

          Despite medical documentation being readily available to providers across the healthcare spectrum, there seems to be little time for a busy Cardiologist to review necessary documentation from the patient's Pulmonary doctor, or the notes placed from Endocrinology. Often a patient comes for a visit due to CAD, but the patient is also a diabetic with uncontrolled elevated blood glucose. We know one disease process feeds the other, but in spite of the EHR containing valuable patient data, providers are still missing imperative clinical information required to treat the patients holistically. 

          The one department which I see consistently using chart review to coordinate care with patients, providers, and families are RN Case Managers within the hospital setting.  RN Case Managers, and Care Coordinators are responsible for knowing what is missing in the patient continuum of care. The RNCM interfaces with the providers, and assists in providing education to both medical MDs and patients regarding critical clinical information which will advance the clinical process and bring better patient outcomes. McBride & Tietze (2018) discussed unintended harm, or consequences suffered by patients with the implementation of the EHR. One such consequence has to do with physicians required to research, and review copious amounts of previous documentation, as well as being required to spend greater amounts of time entering documentation.  Such time consuming tasks often create information, and important patient data not being read, or documented in an effort to save time, and so providers can physically see more patients. 

 

Resources

                FAAN, S.M.P.R. C., & FAAN, M.T.P.R. F. (2018). 
Nursing Informatics for the Advanced Practice Nurse (2nd ed.). Springer Publishing LLC. 

https://ambassadored.vitalsource.com/books/9780826140555Links to an external site.

           Williams, M. D., Asiedu, G. B., Finnie, D., Neely, C., Egginton, J., Finney Rutten, L. J., & Jacobson, R. M. (2019). Sustainable care coordination: a qualitative study of primary care provider, administrator, and insurer perspectives. 
BMC health services research
19(1), 92. https://doi.org/10.1186/s12913-019-3916

 Reply

Module 03 Case Study

due 10-15-23 @ 10 am

Journal Entry

  • Refer to the “Population-Focused Nurse Practitioner Competencies” found in the Week 1 Learning Resources, and consider the quality measures or indicators advanced nursing practice nurses must possess in your specialty of interest.
  • Refer to your Clinical Skills Self-Assessment Form you submitted in Week 1, and consider your strengths and opportunities for improvement.

Learning From Experiences

  • Revisit the goals and objectives from your Practicum Experience Plan. Explain the degree to which you achieved each during the practicum experience.
  • Reflect on the three (3) most challenging patients you encountered during the practicum experience. What was most challenging about each?
  • What did you learn from this experience?
  • What resources were available?
  • What evidence-based practice did you use for the patients?
  • What would you do differently?
  • How are you managing patient flow and volume?
  • How can you apply your growing skillset to be a social change agent within your community?

Replies 5600L

 Replies these works with 200 each ones  Please include scholarly reference.  

1.The far-reaching consequences can be the results of unethical behaviors both in a nursing master’s program and in the nursing practice. This applies both to the involved individuals and the healthcare system as a whole. This discussion aims at comparing and examining the consequences of unethical behavior with one example for each case (setting).

Unethical Behavior in a Nursing Master’s Program

Example: Plagiarism in a Nursing Research Assignment

Consequences

Impact on Future Nursing Practice: In a Master’s program, if unethical behavior goes undetected, it can lead to long-lasting consequences on the future practice of a nurse. There is an expectation of nurses to provide evidence-based care and uphold high ethical standards. Amal et al. (2022), state that in case a nurse has not learned how important it is to observe ethical conduct during their education, they may jeopardize the safety of patients because of ethical violations in their clinical practice.

Loss of Profession and Trust: Trust among faculty members and peers is eroded by ethical lapses like plagiarism (Amal et al., 2022). In the field of nursing where nurses collaborate closely with colleagues, trust is paramount. This is because they depend on accurate information to make providence of effective and safe patient care. Professional relationships may be impacted by loss of trust in an educational setting, hindering the networking opportunities.

Academic Consequences: According to Amal et al. (2022), in any educational setting, plagiarism is a severe ethical breach, including nursing Master’s programs. The integrity of a student’s education is undermined when the student engages in plagiarism. Academic penalties like failing assignments or expulsion from the program can be the results of plagiarism in many institutions. The academic reputation of a student can be damaged as well as the progress.

Unethical Behavior in Nursing Practice

Example: Medication Theft by a Registered Nurse

Consequences

Ethical and Legal Repercussions: Severe legal consequences can be the results of engaging in unethical behavior in nursing practice, like theft. According to Ahtisham et al. (2020), the nurses who are found guilty of such actions can face civil lawsuits, loss of their nursing license, and face criminal charges. The difficulty in finding future employment in the healthcare field can be the lasting professional and personal consequences that these legal and ethical repercussions can have (Ahtisham et al., 2020).

Patient Safety: Medication theft, which is an unethical behavior in nursing practice, can endanger patient safety in a direct manner. Medication errors, delayed treatment, and incorrect dosages can be the results when a nurse steals medications meant for patients (Ahtisham et al., 2020). These errors can lead to patient harm, including worsening conditions, adverse reactions, or even death.

Damage to the Nursing Profession: The entire nursing profession of a nurse is negatively reflected by unethical behavior. The reputation of the profession as a whole can be tarnished alongside loss of trust in nurses by patients and their families. The end result of this can be reduced willingness by people to follow medical advice or seek healthcare services, which has societal implications that are broader for public health – Ahtisham et al. (2020).

Conclusion

In summary, serious consequences can be the results of unethical behavior in both nursing practice and nursing Master’s programs. In the educational setting, it can damage future professional success and hinder academic progress. In the clinical setting, it directly impacts the overall reputation of the nursing profession, legal standing, and patient safety. Therefore, for the well-being of both students and patients, it is essential to address and prevent unethical behavior since ethical conduct and integrity are fundamental to nursing.

2. Ethics is an essential element of nursing education. In most cases, ethical standards in nursing ensure that nursing faculties are guided by provided clinical and accreditation standards and regulations to guarantee quality education for nursing students in line with nursing practice competency. In practice, nurses also rely on ethical guidelines to make difficult decisions and decide on dilemmas.

In the nursing Master’s program, one unethical behavior can be the falsification of research data. Falsification of research data refers to the action of making up false data to be used in a student’s research project (Bassey & Owan, 2019). In most cases, student’s research projects are based on real research scenarios and can be used in nursing practice. This implies that the research should be conducted with utmost honesty using real data from real clinical scenarios. However, when such data is fake, the integrity and results of the project are undermined. This creates room for inaccurate results, which also undermines the credibility of the master’s program. Also, suppose the project is published, its application in the health sector can be quite detrimental to public health and to the research community’s goal of safe care for all. Thus, it is crucial for nursing programs to keenly monitor students to engage them in a practical manner whereby they can see the essence of conducting credible research and not using falsified data.

In nursing practice, one unethical behavior can be a situation where nurses’ personal beliefs interfere with their ability to care for their patients (Kwame & Petrucka, 2021). Although nurses can decline to take part in the care of patients when their religious beliefs are conflicted, they cannot refuse to care for such patients from discrimination. For example, when presented with patients who abuse drugs or alcohol, some nurses can feel morally upset, but this should not be the grounds for declining to care for such patients. In most cases, nurses who feel affected may object to such care. However, they can always make arrangements with their supervisors and coworkers to ensure such patients receive the care they need. The most significant consequence of this is that the patients may not receive the necessary care, and this may compromise their ability to recover from the illness. In other cases, the conflict of beliefs may also compromise patient education, whereby the nurse will provide inadequate information regarding personal care and the recovery process for the patient, thus ensuring misinformation on the patient’s side.

In conclusion, ethics is essential in nursing programs and practice since it provides guidelines and standards of practice to ensure patient care is effective. However, without regard to ethical standards, the care of patients may be gravely compromised. Nursing programs should monitor students to ensure they follow acceptable standards as this will provide room for better clinical practice.