Impact of Nursing Leadership on Performance

Impact of Nursing Leadership on Performance Order Instructions: Use the topic area I choose in the last assessment(the last assignment I was ordered here also, I will attach the order number of the last assignment in the order page together with the details of instruction), to prepare a literature review paper.

the literature review should adhere to the following structure and utilize essential readings and information from the learning modules for guidance.

Impact of Nursing Leadership on Performance Sample Answer

Impact of nursing leadership on the performance of nurses

Name

Course code

Institution
Abstract

Creating conducive working environments for nurses will require fundamental changes throughout the nursing units – in the manner personnel get deployed, work is designed and the culture of the healthcare organizations understanding of patient safety. These changes demand a type of leadership that has the capacity of transforming not only the physical environments but also the nurses’ practices and beliefs when delivering care. This paper aims to critically assess the nursing leadership- transformational leadership and the barriers faced in implementing this type of leadership. This paper evaluates the various ways nurse leaders dispense their leadership and its impacts on nurse performance. This paper consists of five major sections; the introduction which will introduce the research topic; method chapter which is a brief methodology of research metrics applied. The literature review chapter will critically evaluate available literature on the impact of transformational leadership on nurse performances. The Discussion chapter shed lights on the evidence based practice, which will be summarized in the conclusion chapter.

Impact of Nursing Leadership on Performance Introduction

Leadership is one great essential component in most aspects of a nurse role. However, this aspect is not considered as essential as other areas of nursing such as the clinical skills. Today’s health care environment is fast changing and uncertain which makes it important for effective nurse leadership skills (Malloy & Penprase, 2010; Giddens & Morton, 2010). Research indicates that competent leaders influence their work environments positively, improve the patient safety and the quality outcomes of the organizations. Therefore, healthcare organizations are advised to continue to develop and support leadership training in order to maintain and to promote its development in practice. When leadership competencies are effectively taught and integrated in nursing practice, it positively impacts the leadership skills as well as their practices (Crosby & Shields, 2010)

Research indicates that nursing practice is bureaucratic. Therefore, it is very important for nurses to be equipped with leadership skills. These skills are enhanced by the leadership styles in their nursing unit. Nurse leaders who follow transformational leadership style have the capacity to identify the needed changes, and have the capacity to integrate change by inspiring the team members and establishing an environment that creates some sense of commitment (Rudisill & Thompson, 2012). Such type of nurse leaders feels more confident and comfortable when interacting with their follower; which is associated with positive outcomes. Therefore, it is important that in the nursing realm, the nurse leaders should apply this type of leadership so as to grow the skills sets necessary for future nurse leaders. However, the impending lack of transformational nurse leaders within the nursing unit and healthcare overall is a proportionately critical concern is yet to receive much attention. In this context, this paper provides insights on the importance of developing leaders in academic and clinical arenas is important for nursing professions, and it mandates critical awareness (Hutchinson & Jackson, 2013).

Impact of Nursing Leadership on Performance Methodology

The research methodology used in this paper is a systematic literature review. To obtain the appropriate research literature for this literature review study, papers were searched from peer-reviewed databases. The peer reviewed articles in this study were those with recent studies. Although finding recent publications was a challenge, the use of the available search engines revealed many nursing leadership studies published recently. The studies provided an effective comprehensive pool of information, which helped in compiling the literature review.

The key words applied during the study search were ‘leadership,’ ‘nursing,’ and ‘practice.’ In most of the paper, these words were used together and in a particular order. The database used included the Ebschost, ProQuest website, and Cochrane. The Google Scholar and Google search engine were very instrumental for this study. The other websites that were used were the Canadian Nurses Association (CAN), American Nurse Today website, the nursing world organization and the American Nurses Association (ANA).

Approximately half of the sources used in this paper were obtained from the Google Scholar. The rest of the papers were from the electronic nursing journals mainly from healthcare facilities that operated within the American healthcare sector. The variation of the sources used was done in order to obtain information from diversified institutions, in order to make the information gathered to be evidence based practice, and to be relevant in similar healthcare settings in the USA and the world (Malloy & Penprase, 2010; Giddens & Morton, 2010).

Impact of Nursing Leadership on Performance Literature review

In healthcare, leadership is defined as “ the process of engaged decision making linked with actions taken in the complex face, uncharted and perilous circumstances in clinical scenario’s that have no standardized solutions” (Curtis, De Vries, & Sheerin, 2011). Creating conducive working environments for nurses will require fundamental changes throughout the nursing units – in the manner personnel get deployed, work is designed and the culture of the healthcare organizations understanding of patient safety. These changes demand a type of leadership that has the capacity of transforming not only the physical environments but also the nurses’ practices and beliefs when delivering care (Kouzes & Posner, 2012).

The characteristics of an effective leader includes being visionary leaders, leaders who are equipped with effective strategies and plan as well as a desire to direct their teams to meet future goals. The leaders should be adequately equipped with problem solving skills in order to effectively develop nurses self esteem and group identification. The leaders should also be dynamic, motivational and passionate to their followers (Malloy & Penprase, 2010; Giddens & Morton, 2010). Transformational leadership styles apply these characteristics to their work, which enables them to win respect and trust of the team members. Evidence based practice indicates that applying these characteristics to their work enables the nurses to be in a position to influence the development of each other, and in ensuring that professional standards and code of ethics are maintained. Transformational leaders are the source of inspiration and role models for nurses (Malloy & Penprase, 2010).

Research work on behavioral work force effectiveness and health services as well as the organizational disasters identify few management practices associated with successful implementation of initiatives of safety (Frazzini & Fink, 2011).. These includes practices such as a) balancing the organization tension that exist between reliability and efficiency, b) creation as well as maintaining trust in the organization, c) active management of change processes, d) integration of employees in decision making that pertains to work design and work flow, and e) use of management knowledge to establish a “ learning organization.” These practices are very essential in maintaining nurses and a patient environment conducive. Evidence based research indicates that to fully secure these five management practices, the transformational leadership are needed (Gillam & Siriwardena, 2013).

The transformational leadership theory was first developed in 1978 by James McGregor Burns. The theory was developed with the aim of addressing the components that lead success in an organization, and identification of strategies that will improve employee’s commitment and enthusiasm in their work place. This style of leadership works by identifying the employee’s values at their work place. According to evidence based studies, the transformational leadership styles works by inspiring the employees to discover their purpose and meaning in relation to their work, which improves employee’s growth and maturity (Malloy & Penprase, 2010).

Research indicates that staffing problems arise due to a poor delegation of skills and poor response by the leaders to address to clinical economic factors and patient demographics, which ultimately affects the organizations goals. The ultimate of any healthcare organization is to influence the quality of care. This is achieved through effective nursing leadership. Transformational leadership helps the leader influence the nurses to gain a better understanding of patient needs and values, which in turn increases patient satisfaction (Malloy & Penprase, 2010; Giddens & Morton, 2010). Research indicates that empowered nurses often are eager to implement evidence based practice because they tend to be highly motivated and well informed. This kind of leadership enables the nurses to be committed to better patient’s outcome by promoting staff ability and competence, which in turn increases nurse expertise. Hospital environment have a significant effect on patient outcomes. Therefore, the nurse leaders should encourage the nurses to seek maximum and minimum standards in order to achieve and maintain high quality benchmarks (Raes et al. 2013).

The central function of leadership is attaining the organization’s collective purpose. Leadership is observed as the essential precursor of attaining safety in most of the industries, which is a critical factor in ensuring the success of most change initiatives and in sustaining the organization competitiveness. A study conducted in the USA on healthcare facility reengineering initiatives for a period of one year (1996-1997), indicated that the type of leadership in any healthcare organization is influenced by the type of leadership, and also determines the organization’s productivity, organizational commitment, job satisfaction and retention (Malloy & Penprase, 2010; Giddens & Morton, 2010).)

Pulitzer Prize- winning study on leadership outlined the essential characteristics of leadership. In his study, James Burns’s distinguished transactional leadership from transformational leadership by stressing that leadership in the organization is based on the relationship between the leader and his followers. In contrast, to exercise of power, effective leadership is one that has the capacity to identify and to respond to the needs and goals of the leader and his/her team members (Nadeem et al. 2013). Therefore, it is effectively exercised by integrating the followers during the decision making which in turn motivates them to work towards achieving their specific goals which represent the motivations, values and organizations expectations. According to Burn, the genius of leadership depends on the manner in which the leaders see his/her follower’s values and motivations, and in satisfying the follower’s values (Paterson, Henderson, & Trivella, 2010).

Transformational leaders are very effective when they generate visions that enables them to gain trust and convince their followers to make the necessary action. This involves listening to the followers concerns in order to deal with objections. However, this type of leadership can be ineffective if it is not properly followed. For instance, there are risks on improper use of influence by the leaders (Spinelli, 2006; George & Lovering, 2013). This is because transformational leaders act as role models to their respective followers. Therefore, if the leaders are involved in unethical behaviors, the entire organization suffers. The other drawbacks associated with transformational type of leadership includes risks of following wrong decisions especially in cases where leaders makes harsh decisions out of emotions. Recent study associated the transformational type of leadership with employee burnout. This is because when the employees are inspired to attain the organization goals, they tend to overwork themselves in order to achieve the organization’s goals. Consequently, they tend to become dissatisfied (Heuston & Wolf, 2011).

Despite the demerits, research indicates that transformational leadership is the most effective type of leadership in the nursing unit. This is because it helps establish organized environment by building a cohesive team and in setting a common goal. However, several barriers of the transformational type of leadership have been established. These include lack of teamwork and change resistance by some of the team members. Some of the followers feeling that the leaders assign the subordinates too much work and tends to become too personal with them. Evidence based practice indicates a positive correlation between job satisfaction and transformational type of leadership (Pieterse & Schippers, 2010)

Work attitudes strongly influence the quality of nurse’s profession lives. Research indicates that job satisfaction and the organization commitment are the variables that determine the nurse work attitudes. Leadership, especially the transformational type of leadership is associated with increased levels of satisfaction. Therefore, use of transformational leadership helps improve the employee’s psychological wellbeing and jobs satisfaction. This is because the higher the support from the nurse leaders and supervisors the higher the levels of job satisfaction, which correlates to increased organizational commitment. This is associated with reduced incidences of general health well being (Cathcart, Greenspan, & Quin, 2010)

Impact of Nursing Leadership on Performance Discussion

Evidently, there is recognition in the healthcare arena of the need of transformational nurse leaders. This is constitutes the Institute of Medicine report, the future of Nursing: Leading change. This report focuses on the importance of nurse leaders in clinical settings. The healthcare system in the world is dynamic and is increasingly becoming complex. The American Nurse Association (ANA) continues to emphasize on the need for nurses to play a proactive role of leadership in their healthcare set up, local and state level (Fennimore & Wolf, 2011). Research indicates that the nature of the country’s healthcare system requires the nurse managers to apply transformational leadership style. This leadership styles is supported by the evidence based practice in that it facilitates the identification of areas that need change, and it guides change by inspiring their team and establishing a sense of commitment. The qualities of the transformational type of nurse leadership allows the nurse managers to become confident and comfortable of their practices, especially when engaging in healthcare developmental policies, the dynamic aspects of healthcare technology and mentorship of young leaders (Sanford, 2011).

Nurse leadership primarily is about making decisions, deligating duties, acting with the utmost integrity and resolving of conflicts. The role involves nurturing the other nurses so that they can understand the patients. These functions are the core elements that are necessary in connecting nurse leadership with effective development of the other members (Fennimore & Wolf, 2011). This is attained by working alongside the nurses and mentoring them as well as coaching them. Every successful nurse leader seeks to develop the team members by facilitating learning opportunities, supervising them and assessing their development (Raes et al. 2013). The terminologies commonly used alongside transformational leader are a teacher, supporter, assessor, coach, supervisor and a role model. In most organization, the commonly used phrase is “just do not tell me, show me.” This implies that the transformational leader should inspire the nurses by showing them how to perform the task. This involves establishing a culture of continual learning empowers and motivates the followers. This kind of leadership and clinical environments is essential to the achievement of best practices (Polit & Beck, 2012).

The main roles of a transformational leaders in healthcare settings includes promoting followers self esteem, encouraging teamwork, staff motivation and empowering of staff in order to achieve a high level of performance. This is achieved by making the nurses/ followers to be involved in designing of procedures and policies of an organization. In this type of leadership, the nurse leader is expected to portray trustworthiness and acts as a role model to the team members. This type of leadership is vital in clinical areas as it promotes a healthy environment for the employees, which is associated with improved job satisfaction, low turnover rates and improved patient safety and satisfaction (Polit & Beck, 2012).

Further research studies indicate that training nurse leaders to apply the transformational style of leadership in clinical settings have a positive impact on the mental health as well as the outcomes of the nurses. Therefore, more studies are needed in order to develop an evidence based educational programs interventions to educate nurse leaders on how to integrate transformational leadership into practice. Although much of the studies have focused on work related stress such as nurse burn out, most of the studies focus on stress management at an individual level. It is hypothesized that the use of transformational leadership in clinical settings enhances an employee’s commitment to the organization’s vision (Smith, 2011). Evidence based practice identifies transformational leadership style as the most appropriate style that leads to the better emotional well being of the nurses. The main implication of this leadership style is that it offers a deeper understanding between the nurse leadership and his or her follower’s emotional well being. On a more practical level, it implies that this type of leadership cam be used to promote conducive working environments and the overall organizational health (Raes et al. 2013).

Impact of Nursing Leadership on Performance Conclusion

The main aim of this study was to establish a better understanding of the impact of transformational nurse leadership on nurse’s performance. The study evaluated the available literature that reveals the relationship of transformational leadership and job satisfaction, job content and the overall organizations commitment as well as the employees well being. The study concludes that the transformational leadership style influences the quality of nurses working life through indirect pathways, which contributes to improved emotional well being and organizational commitment. Therefore, transformational style of leadership is the most appropriate nurse health and professional promotion intervention which should be applied within the healthcare setting.

Impact of Nursing Leadership on Performance References

Crosby, F. & Shields, C. (2010) Preparing the next generation of nurse leaders: An educational needs assessment. The Journal of Continuing Education in Nursing 41(8) 363-368.

Cathcart, E., Greenspan, M., & Quin, M. (2010) The making of a nurse manager: the role of

experiential learning in leadership development. Journal of Nursing Management 18,440 447.

Curtis, E., De Vries, J., & Sheerin, F. (2011) Developing leadership in nursing: exploring core factors. British Journal of Nursing, 20(5), 306–309.

Fennimore, L., & Wolf, G. (2011). Nurse manager leadership development: Leveraging the evidence and system- level support. Journal of Nursing Administration,41(5),204-210. doi: 10.1097/NNA.0b013e3182171aff.

Frazzini, R., & Fink, A. (2011). Transformational mentoring in University of Minnesota co-curricular leadership programs. Retrieved from http://transformationalmentoring.org/wp-content/uploads/2012/09/FINAL-Transformational-Mentoring-Paper-Formatted-1Alex7.pdf.

George, V., & Lovering, S. (2013). Transforming the context of care through shared leadership and partnership: An international CNO perspective. Nursing 69 Administration Quarterly,37 (1), 52-59. doi: 10.1097/NAQ.0b013e3182751732.

Giddens, J. F., & Morton, N. (2010). Report card: An evaluation of a concept-based curriculum. Nursing Education Perspectives, 31(6), 37-377.

Gillam, S., & Siriwardena, A. N. (2013). Frameworks for improvement: clinical audit, the plan–do–study–act cycle and significant event audit. Quality in Primary Care, 21(2), 123-130

Heuston, M. & Wolf, G. (2011). Transformational leadership skills of successful nurse managers. Journal of Nursing Administration, 41(6), 248-251.

Hutchinson, M. & Jackson, D. (2013). Transformational leadership in nursing: towards a more critical interpretation Nursing Inquiry,20(1), 11–22

Kouzes, J. & Posner, B. (2012). The Leadership Challenge. 5th ed. San Francisco, CA: Jossey-Bass.

Malloy, T. & Penprase, B. (2010). Nursing leadership style and psychosocial work environment. Journal of Nursing Management 18, 715-725.

Nadeem, E., Olin, S., Hill, L., Hoagwood, K., & Horwitz, S. (2013). Understanding the components of quality improvement collaboratives: A systematic literature review. The Milbank Quarterly, 91(2),354-394. doi:10.1111/milq.12016.

Paterson, K., Henderson, A., Trivella, A. (2010) Educating for leadership: a program designed to build a responsive healthcare culture. Journal of Nursing Management 18(1). 78–83.

Pieterse, van Knippenberg, Schippers, & Stam. (2010). Transformational and transactional leadership and innovative behavior: The moderating role of psychological empowerment. Journal of Organizational Behavior, 31(4), 609-623. doi: 10:1002/job.650.

Polit, D. F., & Beck, C. T. (2012).Nursing research: Generating and assessing evidence for nursing practice(9thed.). Philadelphia: Lippincott Williams &Wilkins.

Raes, E., Decuyper, S., Lismont, B., Van den Bossche, P., Kyndt, E., Demeyere, S., & Dochy, F. (2013). Facilitating team learning through transformational leadership. Instructional Science, 41(2), 287-305.doi: 10.1007/s11251-012-9228-3

Rudisill, P. & Thompson, P. (2012). The American Organization of Nurse Executives System CNE task force: a work in progress. Nursing Administration Quarterly, 36 (4), 289-98.

Sanford, K. (2011). The case for nursing leadership development. Healthcare Financial Management, 65(3), 100-106.

Smith, M. (2011). Are you a transformational leader? Nursing Management, 42(9), 44-50.

Spinelli, R. (2006) The applicability of Bass’s model of transformational, transactional, and laissez-faire leadership in the hospital administrative environment. Hospital Topics: Research and Perspectives on Healthcare 84(2). 11-18. In Smith, M. (2011). Are you a transformational leader? Nursing Management, 42(9), 44-50.

Disseminating Evidence To Nursing Community

Disseminating Evidence To Nursing Community Order Instructions:Disseminating Evidence Details:
Using 250-500 words, summarize your strategy for disseminating the results of the project to key stakeholders and to the greater nursing community.

Refer to the “Topic 4: Checklist.”

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

You are not required to submit this assignment to Turnitin.

6 NRS 441v.11R.Module 4_Checklist.doc

Disseminating Evidence To Nursing Community Sample Answer

Disseminating Evidence

The ultimate desired impact of any project, campaign or process change squarely rests in the dissemination strategy effectiveness and presentation (Mitton, Adair & McKenzie, 2007). According to Lomas (2013), the term dissemination is used to describe a set of actions that are properly and purposefully organized and designed towards promotion and empowering incorporation as well as applications of strategies which are already validated. Thus, dissemination is the actual process through which availability of project outcomes and deliverables is made achievable and presented to stakeholders as well as the wider audience or community (Agency for Healthcare Research and Quality, 2012). This implies that the dissemination of results is imperative in to maintain the practice as well as the outcome for appropriate practices.

The dissemination of the project results will be carried out to the key stakeholders within a 3-month time frame. This dissemination will have a key purpose of presenting the project results to key stakeholders in order to inform project development, strategy of receiving feedback as well as assuring that the practice and outcome are going to be maintained upon the project implementation (Mitton, Adair & McKenzie, 2007). The key stakeholders for the project and to who the project strategy will be disseminate to include: the hospital CEO, Director of Pediatrics, NICU staff, Director of Maternal and Child Health Nursing, NICU Nurse Manager, Nurse Educators, EBP committee, Director of Physical Therapy, and Director of Research and Development. The presentation of the project together with its obtained results will be done through staff meetings, news bulletins as well as e-mails.

Conferences or workshops will also be arranged concerning the project planning and development in order to ensure a high-profile implementation of the project, through which the participants, stakeholders and the community will learn from its achievements. In addition, through this strategy the project outputs and deliverables will be embedded and taken up or incorporated (U.S. Department of Health and Human Services, 2012). There is also another strategy which is offered by workshops or conferences as an appropriate strategy of dissemination because it helps in enabling a communication process with a feedback loop meaning it is two directions i.e. between the NICU community and the project implementers whereby stakeholders and the community can be invited for brainstorming and contribution of ideas on how the project results can be utilized (Lomas, 2013). Furthermore, expanding the invitation of the workshops and conferences to the wider community will be vital in allowing the dissemination significance of the project outcomes or results to the greater nursing community. Evaluation of the project progress through a retrospective evaluation of project reports will ensure proper monitoring.

In conclusion, dissemination of significant importance in uplifting nursing practice, and uplifting of nursing is fundamental outcome and critical to healthcare delivery (National Institutes of Health, 2007). In addition, regular evaluation of the project implementation will play an essential role in monitoring its progress.

Disseminating Evidence To Nursing Community References

Agency for Healthcare Research and Quality. (2012). Effective Health Care: What Is the Effective Health Care Program? Rockville, MD: U.S. Department of Health and Human Services; 2012. Available at www.effectivehealthcare.ahrq.gov/index.cfm/what-is-the-effective-health-care-program1/. Accessed July 5, 2016.

U.S. Department of Health and Human Services. (2012). Health.gov. Washington, DC: Office of the Assistant Secretary for Health, Office of the Secretary, U.S. Department of Health and Human Services. Available at www.health.gov/communication/resources/Default.asp. Accessed July 5, 2016.

Lomas, J. (2013). Diffusion, dissemination, and implementation: who should do what? Ann N Y Acad Science, 703:226-35; discussion 35-7. PMID: 8192299.

Mitton, C., Adair, C.E., & McKenzie, E. (2007). Knowledge transfer and exchange: review and synthesis of the literature. Milbank Q 85(4):729-68. PMID: 18070335.

National Institutes of Health. (2007). NIH Conference. Building the Science of Dissemination and Implementation in the Service of Public Health. 2007 Sep 10-11. Available at www.obssr.od.nih.gov/di2007/about.html. Accessed July 5, 2016.

Identifying The Nursing problem using PICOT

Identifying The Nursing problem using PICOT Order Instructions: Max Points: 40

Details:
Develop a searchable question using the PICOT format. (The question is a single statement identifying the components of PICOT.)

Refer to “Developing a Question” and “Topic 1: Checklist.”

2 NRS 441v.11R.Module1_Checklist.doc 3 NRS 441v.v10.0RDeveloping a Question.docx

Identifying The Nursing problem using PICOT Sample Answer

IDENTIFYING THE PROBLEM

The nursing problem relating to the proper management of the cardiovascular disease and ensuring that administration of statins therapy leads to the desired impact is observed mainly among the patients having heart and liver diseases in the health centers. Statins are the group of drugs that help in lowering the levels low-density lipoprotein in one’s blood.

Identifying The Nursing problem using PICOT

The statins are responsible for blocking the substances that form cholesterol in the liver (Shehata et al, 2015). The recent incidents related to the effectiveness of the statins prompt the researchers to conduct the interventional studies to establish whether the statin drugs cause the increase of the liver diseases among patients (Shehata et al, 2015). The statin drugs ensure that any excess cholesterol within the body is converted into bile salts that absorb the vitamins and fats in the intestines (Shehata et al, 2015). Scientific research gives out evidence that high levels of the low-density lipoprotein cause the progression of the cardiovascular diseases. By the previous studies conducted, there is a significant relationship between the high LDL cholesterol and the cardiovascular disease among the patients. Therefore, cholesterol has been seen as a risk factor for the high mortality rates among the cardiovascular disease patients (Shehata et al, 2015).

Taking the prescribed medication appropriately, maintenance of a healthy diet and involvement in the physical exercises is efficient in controlling the cholesterol levels in the body. The populations that are more vulnerable to the disease are the elderly and the smokers. The people above the age of fifty are the most likely to suffer from diseases. The smokers take in a chemical that transports the cholesterol from the deposits of fat to the liver. The elderly population is vulnerable as the arteries usually narrow causing atherosclerosis. The increased levels of serum cholesterol make the smokers and elderly more vulnerable to the heart disease. The various health institutions are therefore monitoring the liver function test among the patients that have undergone the statin therapy (Shehata et al, 2015).

Joint British Societies and also the NICE has recommended the adoption of statin therapy as the remedy to help in the reduction of cardiovascular disease related mortality rates. There has been a significant reduction in the mortality rate by about 10% which gives credit to the intervention adopted. The remedy is significant in the nursing profession as it enhances the better and more efficient management of the problem. The management of the disease is highly beneficial to the people most vulnerable to developing the disease. The efficient monitoring of the liver function tests among the patients is highly recommended to ensure the proper management (Shehata et al, 2015). Prior to the establishment of the significant results of the tests conducted, the statin therapy seems to be cumbersome in nature. Such a case acts as a fault to the statin drugs been used to manage and properly intervene for the problem. The statin drugs also induce liver enzymes which cause the high levels of alanine transaminase which requires the testing to be done several months in the early weeks of ALT (Shehata et al, 2015). The patients might develop obesity or the drug-induced toxicity influencing the function of the liver. In addition to the liver function tests’ monitoring, it is essential to include the histological techniques. Considering other factors that might influence abnormalities during the liver functions test is essential before identifying the probability of the influence caused by the statins on the disease. Measuring the patient’s baseline during the statin therapy while conducting the liver function test results into reduced cases of the cardiovascular disease which is the required outcome.

Developing and Identifying The Nursing problem using PICOT Question

Population used is the adults between 18-55 years of age who have been clinically diagnosed with the cardiovascular disease in the past and have undergone the statin therapy at least ones during their medication process. The patients facing the liver diseases are also include to identify whether the statin therapy contributes to increased levels of their illness.

Intervention for the problem is the adoption of statin therapy as the remedy to help in the reduction of cardiovascular disease related mortality rates. The management of the disease is highly beneficial to the people most vulnerable to developing the disease. The efficient monitoring of the liver function tests among the patients is highly recommended to ensure the proper management among the patients experiencing the liver disease (Shehata et al, 2015).

The standards supervised process that would not involve the establishment the significant liver test conducted which acts as a control group for the patients is used for comparison. The nitrates used by the cardiovascular patients as drugs to manage the disease would be administered to the patients for comparison with the stating therapy and the effects.

The outcome assessed during the research of the issues includes the changes in a number of LDL receptors in the liver of the patients. The reduced risk of suffering from cardiovascular disease and the mortality and morbidity rates are also measured as an outcome (Shehata et al, 2015). The time frame for the outcome would be evaluated and measured monthly for 6 months.

DEVELOPED PICO QUESTION/STATEMENT

Patients with high levels of cholesterol in their body usually undergo the statin therapy which helps in preventing and reducing the high risks of suffering from the cardiovascular disease, are the statins drugs right for the patients or lead to the increased cases of liver disease

Identifying The Nursing problem using PICOT Reference

Shehata, M., Fayez, G., & Nassar, A. (2015). Intensive Statin Therapy in NSTE-ACS Patients Undergoing PCI: Clinical and Biochemical Effects. Texas Heart Institute Journal, 42(6), 528-536. doi:10.14503/THIJ-14-4891

The Future of Nursing in Leading Change

The Future of Nursing in Leading Change Order Instructions: Reflection Paper

Details: In a reflection of 450-600 words, explain how you see yourself fitting into the following IOM Future of Nursing recommendations:

1.Recommendation 4: Increase the proportion of nurses with a baccalaureate degree to 80% by 2020.
2.Recommendation 5: Double the number of nurses with a doctorate by 2020.
3.Recommendation 6: Ensure that nurses engage in lifelong learning.

Identify your options in the job market based on your educational level.
1. How will increase your level of education effect how you compete in the current job market?
2. How will increase your level of education affect your role in the future of nursing?

While APA format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

The Future of Nursing in Leading Change Sample Answer

Reflection Paper

Introduction

With the changing health care systems, the nursing profession has greatly transformed due to several recommendations by different medical institutions. Some of the notable institutions including the Robert Wood Johnson Foundation and the Institute of Medicine (IOM) developed a task-oriented blueprint in 2011 for future nursing practice. The recommendations highlight that nurses should be permitted to deliver patient care to the full extent of their education, knowledge, and training. The recommendations further point out that the nurses should attain higher education levels and training to align with the future nursing practice (The Institute of Medicine, 2010). This paper presents my reflection in fitting into the recommendations of the IOM report regarding the future of nursing practice that is, to increase the proportion of clinicians that are holders of baccalaureate degrees to 80 percent by 2020, ensuring that the number of nurses with doctorate degree is doubled by 2020 and ascertaining that nurses take part in lifelong learning. The paper further presents job options based on educational levels and how my level of education is likely to affect my future nursing practice.

Nursing Recommendations

The recommendations presented by IOM state that the number of nurses that are holders of a baccalaureate degree should be increased to 80 percent by 2020 (The Institute of Medicine, 2010). In regards to this recommendation, I am currently studying to acquire baccalaureate degree. Currently, several learning institutions have advanced their education system to support academic progression. There are also several opportunities for financial assistance to encourage nurses to go back and study. Advancing my education will enable me to prepare for my future career and become competent. Having acquired my baccalaureate degree I will have the opportunity to work alongside qualified health care providers to improve the quality of health care services. This is a great opportunity for me as a nurse because I will have confidence in my practice. Doubling the number of nurses with a doctorate degree by 2020 will not only ensure that healthcare services are accessible but nurses also encourage nurses to take part in long term learning. The move will also enable nurses to access a variety of jobs in the market.

I need to be updated with current health care changes by acquiring additional knowledge, meaning that continuous education is essential in the process because it will enable me to remain competent. I agree that nurses need to advance their education as proposed by the IOM report to be in line with the ever-changing process of healthcare services. Expanding my nursing knowledge will give me more advantages within the nursing profession. Due to the IOM recommendations, most healthcare settings prefer employing clinicians with a baccalaureate degree to registered nurses. Therefore, I am determined to advance my education so that I can be in a better position of applying for better jobs opportunities.

The Future of Nursing in Leading Change Conclusion

Advanced education will affect my future nursing practices because it will ensure that I remain proficient to deliver quality care that meets the needs of the patients. Since the process of learning is endless, I need to engage in continuous learning so that I can develop my future career. I am inspired by the fact that several nurses are taking leadership roles in all clinical levels including government entities and public-private. My future career as a nurse is to become a nurse leader in one of the renowned hospital to make a contribution within the healthcare sector.

The Future of Nursing in Leading Change References

The Institute of Medicine. (2010). The Future of Nursing Leading Change, Advancing Health.

Retrieved from http://www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx)

The Practice of Nursing and Patient Care Delivery Models

The practice of Nursing and Patient Care Delivery Models Order Instructions: Details: The RN to BSN program at Grand Canyon University meets the requirements for clinical competencies as defined by CCNE and AACN using nontraditional experiences for practicing nurses.

These experiences come in the form of direct and indirect care experiences in which licensed nursing students to engage in learning within the context of their hospital organization, their specific care discipline, and their local communities.

As the country focuses on the restructuring of the U.S. health care delivery system, nurses will continue to play an important role. It is expected that more and more nursing jobs will become available out in the community, and fewer will be available in acute care hospitals.
1. Write an informal presentation (500-700 words) to educate nurses about how the practice of nursing is expected to grow and change. Include the concepts of continuity or continuum of care, accountable care organizations (ACO), medical homes, and nurse-managed health clinics.
2. Share your presentation with nurse colleagues on your unit or department and ask them to offer their impressions of the anticipated changes to health care delivery and the new role of nurses in hospital settings, communities, clinics, and medical homes.
3. In 800-1,000 words summarize the feedback shared by three nurse colleagues and discuss whether their impressions are consistent with what you have researched about health reform.
4. A minimum of three scholarly references is required for this assignment.

In addition to submitting this assignment in the LoudCloud dropbox, email a copy of your submission to RNBSNclientcare@gcu.edu.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

******Rubric********

Evolving Practice of Nursing and Patient Care Delivery Models

1
Unsatisfactory
0.00%

2
Less than Satisfactory
75.00%

3
Satisfactory
79.00%

4
Good
89.00%

5
Excellent
100.00%

80.0 %Content

40.0 % Clearly States How the Practice of Nursing and Patient Delivery Will Evolve, While Addressing Relevant Concepts That Include Continuity or Continuum of Care, Accountable Care Organizations, Medical Homes, and Nurse-Managed Health Clinics

The main concept is not clearly identified, and subconcepts do not consistently branch from the main idea. Does not address any issues related to the evolving practice of nursing and patient care delivery.

The main concept is not clearly identified, and few subconcepts branch appropriately. Addresses at least one issue related to the evolving practice of nursing and patient care delivery.

The main concept is identified, and a few subconcepts branch from the main idea. Addresses many of the issues related to the evolving practice of nursing and patient delivery and patient care delivery.

The main concept is easily identified and most subconcepts branch from the main idea. Addresses all of the issues related to the evolving practice of nursing and patient care delivery.

The main concept is easily identified, and subconcepts branch appropriately from the main idea. Addresses all of the issues related to the evolving practice of nursing and patient care delivery.

20.0 % Evidence of Feedback and Forecasting of Nursing Role From Colleagues

No evidence of feedback and forecasting of the nursing role from colleagues is included.

Evidence of feedback and forecasting of the nursing role from colleagues may be incomplete or lack relevant scope.

Evidence of feedback and forecasting of the nursing role from colleagues is included.

Evidence of feedback and forecasting of the nursing role from colleagues is described in detail.

Evidence of feedback and forecasting of the nursing role from colleagues is described in detail, with relevant personal insight, reflection, or analysis.

20.0 % Use of Vocabulary Regarding Evolving Practice of Nursing and Patient Care Delivery

No recommended terms have been included in the correct context.

Few recommended terms have been included in the correct context.

Some recommended terms have been included in the correct context.

Most recommended terms have been included in the correct context.

All of the recommended terms have been included in the correct context.

15.0 %Organization and Effectiveness

10.0 % Originality

Content is an extensive collection and rehash of other people’s ideas, products, images, or inventions. There is no evidence of new thought or inventiveness.

Content is a minimal collection or rehash of other people’s ideas, products, images, or inventions. There is no evidence of new thought.

Content shows evidence of originality. While based on other people’s ideas, products, images, or inventions, the work does offer some new insights.

Content shows evidence of originality and inventiveness. While based on an extensive collection of other people’s ideas, products, images, or inventions, the work extends beyond that collection to offer new insights.

Content shows significant evidence of originality and inventiveness. The majority of the content and many of the ideas are fresh, original, inventive, and based on logical conclusions and sound research.

15.0 %Organization and Effectiveness

5.0 % Mechanics of Writing (includes spelling, punctuation, grammar, and language use)

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice and/or sentence construction are employed.

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) and/or word choice are present.

Some mechanical errors or typos are present but are not overly distracting to the reader. Audience-appropriate language is employed.

The prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of sentence structures and effective figures of speech.

The writer is clearly in command of standard, written academic English.

5.0 %Format

2.0 % Paper Format (use of appropriate style for the major and assignment)

The template is not used appropriately or documentation format is rarely followed correctly.

The template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.

The template is used, and formatting is correct, although some minor errors may be present.

The template is fully used; There are virtually no errors in formatting style.

All format elements are correct.

3.0 % Research Citations (in-text citations for paraphrasing and direct quotes, and reference page listing and formatting, as appropriate to assignment)

No reference page is included. No citations are used.

The reference page is present. Citations are inconsistently used.

The reference page is included and lists sources used in the paper. Sources are appropriately documented, although some errors may be present.

The reference page is present and fully inclusive of all cited sources. Documentation is appropriate and style is usually correct.

In-text citations and a reference page are complete. The documentation of cited sources is free of error.

100 % Total Weightage

The Practice of Nursing and Patient Care Delivery Models Sample Answer

Evolving Practice of Nursing and Patient Care Delivery Models

Part 1: Informal Presentation

The nursing profession is dynamic and has been gradually evolving. Today, nurses are entrusted with a wider range of healthcare responsibility. It is evident that the practice of nursing is continuously evolving and transforming and tendency indicate that nursing will shift from acute care to community care. The nursing practice is anticipated to evolve not only in terms of nursing exercise but also education and leadership to achieve its goal in offering health care in the United States (Hamric et al., 2013). Nursing practice is no longer about treating illness but has changed to prevention and disease wellness. The notions regarding continuity of care play an important role in primary care in tandem with other ideologies such as coordination of care, patient-centered care, as well as the integration of care.

Continuity of care fundamentally refers to the connotation existing between a patient and a practitioner, of which it goes outside the boundaries of illness (Nyweide et al., 2013). To define the concept of continuity, we must consider its two major aspects; the focus on health necessities of the client, individual content, as well as care over time that is, the past, present, and future. The restructuring process of the U.S delivery system will lead to change in the practice of continuity of care to mostly cover discharge arrangement ensuing acute care, from hospital care to community or self-care.

The primary goal is to ensure a sustainable and reliable approach to care between nurses is attained to customize care to suit the changing necessities of a patient during medication. This types of continuity encompass management continuity referring to a consistent approach to the management of a patient’s illness that tend to be responsive to varying requirements of a patient. Relation continuity, which is a continuous therapeutic relationship that exists between a nurse and the patient. And finally, an informal continuity, which encompasses the use of past incidents information and individual circumstances in tailoring the present care to be relevant for every patient.

A medical home is also one of the methods used today in delivering enhanced primary care. The model is currently being tested globally and is expected to gain prominence in the coming years. The model is gaining more popularities due to the rapid evolution of Accountable care organizations (ACOs) where medical practitioners, health care centers, and other stakeholders join hands to voluntarily offer coordinated quality care to their clients (Bao et al., 2013). The purpose of ACOs is to ensure that patients who are chronically ill access the right care at the right time, whilst deterring medical errors and circumventing any unnecessary duplication services. Coordinated quality care tends to be more effective when offered on the basis of the medical home model where the ACO patients will be cared for efficiently and hence generation of shared savings (Pham et al., 2014). Many researchers have published medical home care model success stories where the model have been used in controlled settings.

Nurse-Managed Health Centers (NMHCs) is another popular model that is gaining prominence in delivering enhanced primary care. This model is community-based primary healthcare services which are run by an advanced practice nurse with other nursing professionals to provide the much-needed health care to vulnerable communities. Their main areas of concern include health education, disease prevention, and health promotions. Nurse-managed health centers deliver primary care at low prices since they are non-profit organizations.

In conclusion, the nursing practice will continue to change. However, there are certain aspects of nursing that would remain the same such as caring for patients, advocating for patients, and ascertaining that patients are able to get the right primary care services. Due to the dynamic nature of nurses, it is imperative that nurses keep abreast with changes in order to understand emerging challenges and master the skills required to cope with them.

Part two: Feedbacks from Students

Student Feedback one

The role of registered nurses has been evolving over the years. Healthcare bodies continuously give new guidelines that affect nursing practice. I have been working as a bedside nurse for the past 3 years. At first, I thought that I will work as a staff nurse in a trauma center for a very long time. However, there are many opportunities that have been presented opening doors for me to serve the community better in a different role apart from working at the bedside. It is true that community care is gaining prominence and nursing practice will be perceived based on community setting rather than acute care setting only. Our responsibilities are tremendously evolving. Nurses no longer treat illness only but also perform other duties such as disease prevention and wellness.

I believe that the concept of medical homes is revolutionary. Accountable care organizations (ACOs) can use medical home models to provide more personalized care to people who are seriously ill and are unable to visit the hospitals. Medical homes provide a conducive setting to provide personalized care to the aged, and clients with health problems such as obesity, cancer among others. Therefore, the model should be implemented within the United States Delivery System.

However, the sustainability of nurse-managed health centers may face barriers because many managed care bodies are not willing to certify nurse consultants as primary care providers. As such may limit these centers from obtaining compensation from private insurers.

Student feedback two

Hello, my name is Jean, I joined nursing to help people in the community by relieving them their pain through primary care. Initially, I thought that I will be providing primary care in a hospital setting. However, there are opportunities that give nurses better ways to serve the community in various ways. The dynamics of healthcare and continual research have transformed the practice of nursing and nursing practice is slowly moving from providing acute care to community care.

Medical homes are becoming to be implemented in the U.S delivery system. Its implementation will lead to enhanced healthcare and generation of savings because it will remove any unnecessary duplication of services to patients. Patient care is much more enhanced with a more personalized therapeutic relationship between the nurse and the patient, understanding of patient history as well as providing care to patients.

Affordable and healthcare act is now active and patients are finally able to obtain affordable healthcare and affordable insurance through programs such as Obama care. Health policy maker’s belief in the notion that expenditure should be lowered and that healthcare providers should be non-profit. Medical home and nurse-managed health clinics are in a better position to advance this ideology and enable the United States citizens to access quality healthcare at an affordable fee.

Implementation of nurse-managed healthcare clinics will also provide primary care to the poor and less privileged people in the United States. The model framework in where nursing professionals collaborate to provide much-needed health care to vulnerable communities. Nursing professionals to provide much-needed healthcare services such as health education, disease prevention and health promotions to vulnerable communities will see that people get better access to medical care. Nurse-managed health centers deliver primary care at low prices because they are non-profit organizations which are in tandem with the Affordable Care Act.

These reinventions of healthcare models in the health care delivery system are also in line with the Patient Protection and Affordable Care Act (PPACA) whose main purpose is to provide equal, affordable and accessible healthcare to all Americans.

Student responds three

It is true that nursing practice is rapidly evolving because of reforms and technology advancement. The new healthcare delivery models are shaped on the basis of portability and mobility. Use of technology has helped in extending patients’ lives and nurses are finding ways to support the hold at their homes through medical homes and other modern primary care delivery models.

Many nurses have been educated to deliver primary care service at the institutional level. These move of healthcare services from hospitals to nursing homes and provision of primary care services at home requires additional knowledge and skills to handle the new challenges as a result of the move of nursing practice from the acute care setting to the community setting.

However, the newly reinvented healthcare delivery models will drive the cost of healthcare down and enable the United States to achieve its goal of providing accessible health care at an affordable price and in an equitable manner. The demand for nurses will increase so as to fill in the spaces in the different healthcare delivery models.

From the three student feedbacks, it is evident that nursing practice is evolving and projections indicate that the future of nursing practice will shift from the acute care setting to a community care setting. Each student impression indicates that the new model will contribute in the provision of quality care that is an affordable and equitable manner as provided in the Affordable Care Act and the Patient Protection and Affordable Care Act (PPACA).

Practice of Nursing and Patient Care Delivery Models Conclusion

Nursing practice plays a significant role in the reformation of the United States health care delivery system. The streamlining process will provide more opportunities for nursing to work in a community setting as compared to acute care hospitals. The new delivery models have improved continuity of care as it has taken primary care to the grassroots through medical homes, accountable care associations and nurse-managed health clinics (Bao et al., 2013). Professional medical practitioners, nurses and health care centers are providing more coordinated quality care to patients through organizations such as accountable care organizations and nurse-managed medical clinics.

These new healthcare delivery models tend to bring valuable benefits such as reducing the cost of healthcare, increasing access to healthcare especially to the less privileged in the society (nurse-managed medical clinics), contribute to shared savings (the case of accountable care organizations) and ensuring equitable access to healthcare in the United States of America. However, careful consideration and due care should be taken when implementing the new delivery models to ensure that they seamlessly fit the healthcare system.

The Practice of Nursing and Patient Care Delivery Models References

Nyweide, D. J., Anthony, D. L., Bynum, J. P., Strawderman, R. L., Weeks, W. B., Casalino, L. P., & Fisher, E. S. (2013). Continuity of care and the risk of preventable hospitalization in older adults. JAMA internal medicine, 173(20), 1879-1885.

Bao, Y., Casalino, L. P., & Pincus, H. A. (2013). Behavioral health and health care reform models: patient-centered medical home, health home, and accountable care organization. The journal of behavioral health services & research, 40(1), 121-132

Pham, H. H., Cohen, M., & Conway, P. H. (2014). The Pioneer accountable care organization model: improving quality and lowering costs. JAMA, 312(16), 1635-1636.

Hamric, A. B., Hanson, C. M., Tracy, M. F., & O’Grady, E. T. (2013).Advanced practice nursing: An integrative approach. Elsevier Health Sciences

Implementation of the IOM Future of Nursing

Implementation of the IOM Future of Nursing Order Instructions: Benchmark Assignment: Implementation of the IOM Future of Nursing Report

View Rubric Details:

In a formal paper of 1,000-1,250 words, you will discuss the work of the Robert Wood Johnson Foundation Committee Initiative on the Future of Nursing and the Institute of Medicine research that led to the IOM report, “Future of Nursing: Leading Change, Advancing Health.” Identify the importance of the IOM “Future of Nursing” report related to nursing practice, nursing education and nursing workforce development. What is the role of state-based action coalitions and how do they advance goals of the Future of Nursing: Campaign for Action?

Explore the Campaign for Action webpage (you may need to research your state’s website independently if it is not active on this site): http://campaignforaction.org/states

Review your state’s progress report by locating your state and clicking on one of the six progress icons for education, leadership, practice, interpersonal collaboration, diversity, and data. You can also download a full progress report for your state by clicking on the box located at the bottom of the webpage.

In a paper of 1,000-1,250 words:
1. Discuss the work of the Robert Wood Johnson Foundation Committee Initiative on the Future of Nursing and the Institute of Medicine research that led to the IOM report, “Future of Nursing: Leading Change, Advancing Health.”
2. Identify the importance of the IOM “Future of Nursing” report related to nursing practice, nursing education and nursing workforce development.
3. What is the role of state-based action coalitions and how do they advance goals of the Future of Nursing: Campaign for Action?

Summarize two initiatives spearheaded by your state’s Action Coalition. In what ways do these initiatives advance the nursing profession? What barriers to advancement currently exist in your state? How can nursing advocates in your state overcome these barriers?

A minimum of three scholarly references is required for this assignment.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

Please Note: Assignment will not be submitted to the faculty member until the “Submit” button under “Final Submission” is clicked.

*******RUBRIC*********

Benchmark Assignment: Implementation of the IOM Future of Nursing Report

1
Unsatisfactory
0.00%

2
Less than Satisfactory
75.00%

3
Satisfactory
79.00%

4
Good
89.00%

5
Excellent
100.00%

80.0 %Content

5.0 % Provided an original summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health. Any specific references should be cited.

Did not attempt to provide a summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health, or failed to cite specific references to the IOM report.

Provided a skeletal summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health. Some of the specific references to the IOM report were cited or were done incorrectly.

Demonstrates a moderate knowledge of the subject. Recognizes the basic ideas. Misinterprets evidence on the committee’s initiative.

Demonstrates good knowledge of the subject. Correctly describes the committee’s initiative. Justifies some of the impacts on the Future of Nursing.

Provided an original summary of the key messages of the IOM report, Future of Nursing: Leading Change, Advancing Health. References specific to the IOM report were properly cited.

15.0 % Identify the role of the Robert Wood Johnson Foundation Initiative and the American Association of Retired Persons on the Future of Nursing Campaign for Action and the State-Based Action Coalitions

Does not demonstrate knowledge of role. Fails to identify the impact of the Robert Wood Johnson Foundation Initiative on the Future of Nursing.

Demonstrates minimal knowledge of the subject. Does not adequately visualize or justify the work of the Committee of the Robert Wood Johnson Foundation Initiative on the Future of Nursing.

Demonstrates a moderate knowledge of the subject. Recognizes the basic ideas. Misinterprets evidence on the committee’s initiative.

Demonstrates good knowledge of the subject. Correctly describes the committee’s initiative. Justifies some of the impacts on the Future of Nursing.

Demonstrates full and deep knowledge of the subject. Develops and explains an informed position on the committee’s initiative, integrates and justifies the impact on the Future of Nursing

15.0 % Identify the importance of the IOM FON report related to the nursing workforce

Does not demonstrate knowledge of the concept or its role. Fails to identify the importance of the IOM FON report related to the nursing workforce.

Demonstrates minimal knowledge of the subject. Does not adequately visualize or justify the importance of the IOM FON report related to the nursing workforce.

Demonstrates a moderate knowledge of the subject. Recognizes the basic ideas. Misinterprets evidence on the importance of the IOM FON report related to the nursing workforce.

Demonstrates good knowledge of the subject. Correctly describes the importance of the IOM FON report related to the nursing workforce.

Demonstrates full and deep knowledge of the subject. Develops and explains the importance of the IOM FON report, integrates and justifies the importance of the IOM FON report related to the nursing workforce.

15.0 % Discuss the intent of the Future of Nursing Campaign for Action

Does not demonstrate knowledge of the concept or its role. Fails to identify the intent of the Future of Nursing Campaign for Action.

Demonstrates minimal knowledge of the subject. Does not adequately visualize or identify the intent of the Future of Nursing Campaign for Action.

Demonstrates a moderate knowledge of the subject. Recognizes the basic ideas. Misinterprets evidence on the intent of the Future of Nursing Campaign for Action.

Demonstrates good knowledge of the subject. Correctly describes the intent of the Future of Nursing Campaign for Action.

Demonstrates full and deep knowledge of the subject. Develops and explains the intent of the Future of Nursing Campaign for Action, integrates and justifies the intent of the Future of Nursing Campaign for Action.

15.0 % Identify the rationale of state-based action coalitions

Does not demonstrate knowledge of the concept or its role. Fails to identify the rationale of state-based action coalitions.

Demonstrates minimal knowledge of the subject. Does not adequately identify the rationale of state-based action coalitions.

Demonstrates a moderate knowledge of the subject. Recognizes the basic ideas. Misinterprets evidence on the rationale of state-based action coalitions.

Demonstrates good knowledge of the subject. Correctly identifies the rationale of state-based action coalitions.

Demonstrates full and deep knowledge of the subject. Develops and explains and identifies the rationale of state-based action coalitions and justifies a rationale for state-based action coalitions.

15.0 % Discuss one state-based action coalition and two initiatives

Does not demonstrate knowledge of the concept or its role. Fails to identify one state-based action coalition and two initiatives.

Demonstrates minimal knowledge of the subject. Does not adequately identify one state-based action coalition and two initiatives.

Demonstrates a moderate knowledge of the subject. Recognizes the basic ideas. Identifies but misinterprets one state-based action coalition and two initiatives.

Demonstrates good knowledge of the subject. Correctly identifies one state-based action coalition and two initiatives.

Demonstrates full and deep knowledge of the subject. Develops and explains the one state-based action coalition and two initiatives, integrates and justifies one state-based action coalition and two initiatives.

15.0 %Organization and Effectiveness

5.0 % Thesis Development and Purpose

Paper lacks any discernible overall purpose or organizing claim.

Thesis and/or main claim are insufficiently developed and/or vague; the purpose is not clear.

Thesis and/or main claim are apparent and appropriate to the purpose.

Thesis and/or main claim are clear and forecast the development of the paper. Is descriptive and reflective of the arguments and appropriate to the purpose.

Thesis and/or main claim are comprehensive; contained within the thesis is the essence of the paper. Thesis statement makes the purpose of the paper clear.

15.0 %Organization and Effectiveness

5.0 % Paragraph Development and Transitions

Paragraphs and transitions consistently lack unity and coherence. No apparent connections between paragraphs are established. Transitions are inappropriate to purpose and scope. The organization is disjointed.

Some paragraphs and transitions may lack logical progression of ideas, unity, coherence, and/or cohesiveness. Some degree of organization is evident.

Paragraphs are generally competent, but ideas may show some inconsistency in the organization and/or in their relationships to each other.

A logical progression of ideas between paragraphs is apparent. Paragraphs exhibit a unity, coherence, and cohesiveness. Topic sentences and concluding remarks are appropriate to the purpose.

There is a sophisticated construction of paragraphs and transitions. Ideas progress and relate to each other. Paragraph and transition construction guide the reader. Paragraph structure is seamless.

15.0 %Organization and Effectiveness

5.0 % Mechanics of Writing (includes spelling, punctuation, grammar, language use)

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice and/or sentence construction are used.

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, and/or word choice are present.

Some mechanical errors or typos are present but are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.

The prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.

The writer is clearly in command of standard, written, academic English.

5.0 %Format

2.0 % Paper Format (1- inch margins;12-point-font;double-spaced;Times New Roman, Arial, or Courier)

The template is not used appropriately or documentation format is rarely followed correctly.

The template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.

The template is used, and formatting is correct, although some minor errors may be present.

The template is fully used; There are virtually no errors in formatting style.

All format elements are correct.

3.0 % Research Citations (In-text citations for paraphrasing and direct quotes, and reference page listing and formatting, as appropriate to assignment)

No reference page is included. No citations are used.

The reference page is present. Citations are inconsistently used.

The reference page is included and lists sources used in the paper. Sources are appropriately documented, although some errors may be present.

The reference page is present and fully inclusive of all cited sources. Documentation is appropriate and GCU style is usually correct.

In-text citations and a reference page are complete. The documentation of cited sources is free of error.

100 % Total Weightage

New York Action Coalition

The Future of Nursing New York State Action Coalition is the driving force for the implementation of the Institute of Medicine recommendations in our state. We are working with diverse stakeholders to create and model innovative solutions that will lead to healthier communities, with nurses leading the way.

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New York Action Coalition

Fostering Interprofessional Collaboration in Health Care

Collaboration is the cornerstone of success in any team. Interprofessional collaboration is one of the trademarks of several highly successful health care innovations. When nurses collaborate as equals with other health care providers, patient outcomes and quality of more

Issues: Fostering Interprofessional Collaboration, Locations: New Jersey, New York,

Transforming Nursing Education

More highly educated nursing workforce needed to provide more complex patient care, experts say. Many registered nurses (RNs) start—and finish—their post-secondary education with an associate degree in nursing (ADN). But health care experts want more nurses to see more

Issues: Transforming Nursing Education, Locations: National, New York, Texas, Wyoming,

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Susan Apold

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New York University College of Nursing

Debbie Stamps

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Newark-Wayne Community Hospital

Implementation of the IOM Future of Nursing Sample Answer

Benchmark Assignment: Implementation of the IOM Future of Nursing Report

With over 3 million practitioners, the profession of nursing forms the largest section of the US’s health care workforce. Nurses play a central role in assisting patients in realizing the objectives of the Affordable Care Act, legislation that forms a wide range of health care overhaul since the creation of Medicare and Medicaid. However, some obstacles have hindered nurses from effectively responding to the ever changing clinical settings as well as an evolving health care system. These challenges include a shortage of nurses, technological changes, and the shortage of educational opportunities for nursing. These barriers need to be addressed so that nurses can be in the best position of leading change and advancing health.

Work of RWJF Committee Initiative

Robert Wood Johnson Foundation (RWJF) in conjunction with the Institute of Medicine (IOM) established a major initiative that has served as a guide in the future of nursing. RWJF partnered with IOM in conducting a study and developed a report meant to transform the future of nursing. The IOM committee through this study determined potential challenges that were facing the nursing profession and compiled a report on the modifications in institutional policies at the local, state, and national levels. RWJF through the IOM’s study committee reviewed innovative models of nursing education and care delivery and provided solutions that could be used to improve the quality of care delivery at an affordable cost.

RWJF established the initiative of the “Future of Nursing” that examined the potential of promoting the quality and accessibility of care through the use of nursing-led solutions. The report had recommendations geared towards determining significant roles for nurses in planning and executing an effective and efficient health care system.

Some of the recommendations that were highlighted in the report include an examination of innovative solutions associated with the delivery of care and nursing education with a focus on nursing and the provision of patient care. It was also recommended that the nursing faculty should be expanded, the capacity of schools increased, and nursing education be redesigned in order to ensure that it produces a sufficient number of well-prepared nurses that are able to meet health care demands. Fineberg & Lavizzo-Mourey, (2013) state that clinical and community care in the US has become more complex. Therefore, the education provided should equip nurses so that they can make important decisions linked to care for frail patients and work with sophisticated, life-saving technology. The report also pointed out that the role of nurses within the context of the health care workforce, future technology, nursing shortage, and societal issues should be re-conceptualized. Nurses are called upon to collaborate with different health care professionals and coordinate care across different settings. Moreover, the committee proposed that for improved patient outcomes to be realized, the health care sector should attract and retain competent nurses in different care settings such as acute, primary care, ambulatory care, long term care, public, and community health.

The RWJF used the report in its extensive communication in conjunction with the IOM. To support the initiative, the RWJF sponsored a team of experts who discussed the issues raised by the IOM committee. The IOM also played a vital role in the development of the report. For instance, it provided evidence-based proposals to clinicians, private stake holders as well as the general public and provided independent, objective, and technical advice to policymakers. Additionally, the IOM ensured that the recommendations that were developed had an agenda that was clearly defined with an action plan that was properly formulated.

The Importance of the IOM Report

The recommendations provided by the IOM in report center around the vital intersection between the actions of the nursing workforce and the health care needs of different people across the lifespan (Reed, 2015, November). They are meant to promote the efforts of improving the health of the people of US through contributions of nurses. They have an impact in various nursing aspects such as;

Nursing Practice

Nurses have a great potential of leading innovative strategies tailored towards improving the health care system. However, a number of state regulations limit the scope of nursing practice. Depending on the state, regulations on the scope of nursing practice of a RN may deny or limit prescriptions of medications, admission of patients, assessment of patient conditions, and evaluation of tests. However, the IOM report insists that nurses should provide care to the full extent of their education and training. This has promoted delivery of quality care as nurses provide necessary care with a little limitation of the potential.

Nursing education

Through the report, profound changes were introduced in nursing education both before and after receiving a license (Keating, 2014). This resulted in the betterment of nursing education which has ensured that the current and future generations of nurses provide quality, patient-centered, safe, care across settings. Nurses have also been encouraged to act in response to the demands of the ever-changing health care sector by attaining higher levels of education and training.

Nursing workforce

To address the issue of a nursing shortage, the implementation of the IOM report has led to the entry of a greater number of nurses with a baccalaureate degree early in their life. The report has also resulted in the transformation of the practice environment through a balance of skills and perspectives among nurses and other health care providers.

Role of State-Based Action Coalitions and the Future of Nursing

States in the US have formed state-based coalitions that are aimed at enhancing the implementation of the proposed IOM recommendations. These coalitions mobilize stakeholders in the health care sector in order to promote the development of a clear plan of action. The state of New York has been in the frontline in shaping the future of nursing practice. For instance, it has adopted an initiative that is geared towards promoting nursing education for it to be in line with set standards necessitate so that is can meet the complex nature of the health care sector (Campaign for Action, 2014). The initiative also proposes that nurses should take up leadership roles in the promotion of the health care system. The objective of this initiative is to make sure that nurses know their roles as leaders and the public acknowledges the competence of nurses when promoting strategies. The state of New York has also built a strong and highly-competent nursing workforce. These initiatives have given the state’s nurses the opportunity of contributing actively in the promotion of care delivery.

The state of New York has been barred by barriers which limit proper advancement of IOM recommendations. One such barrier is the shortage of nursing workforce. This has resulted in overworking of the nursing leading to job burnout which in turn prevent delivery of quality patient care. It is also important to note the insufficient of nursing workforce has also resulted in an increase in hospitalization cases. Nursing advocates can play a central role in ensuring that the IOM recommendations are achieved. For instance, the advocates can engage actively in decision making processes that will introduce transformational policies in the health care sector. The barrier of nursing shortage can be addressed through increasing admission of undergraduate nursing students and increasing nursing schools. The policies should also target nursing education so that it can enlighten the nurses on how to deliver quality care despite the myriad of challenges facing the health care sector.

Implementation of the IOM Future of Nursing Conclusion

The US has the potential of transforming its health care sector and nurses should contribute majorly in this transformation. The IOM report has been essential in the health care sector as it calls on nurses to play a central role in America’s increasingly multifaceted health care system. Moreover, nurses have been urged to adopt leadership roles in all care settings so that they can satisfy the demands of the evolving health care. The health care delivery competencies has enabled nurses to examine the likely evolution of the health care sector, evaluate their career goals, and determine what should be done to achieve the set objectives. Some of the interventions that have been put forward include advancement of academic education, continuing education, as well as certification. These advancements have been necessary in equipping nurses with appropriate skills for tackling the challenges they encounter. However, the efforts of improving the organizational conditions not only rest solely on nurses but also on health care organizations, the government, insurance industry, and professional associations. Collaboration of these diverse parties will help in ensuring that the health sector offers affordable, seamless, quality care that is easily accessible.

Implementation of the IOM Future of Nursing References

Campaign for Action. (2014). Transforming nursing education. Retrieved from http://campaignforaction.org/transforming-nursing-education/

Fineberg, H. V., &Lavizzo-Mourey, R. (2013). The future of nursing: A look back at the landmark IOM report.

Keating, S. B. (2014). Curriculum development and evaluation in nursing. Springer Publishing Company.

Reed, J. (2015, November). Creating a Culture of Health: Opportunities for Public Health Nursing to partner with State Action Coalitions. In 143rd APHA Annual Meeting and Exposition (October 31-November 4, 2015). APHA.

Placement Reflection in Orthopedic Nursing

Placement Reflection in Orthopedic Nursing Order Instructions: Hello writer sir, how are you today
Thank you so much for helping with this paper.

In this reflection, I have to write my experience about my clinical experience at clinical placement. It should be minimum 500 words. For your information, I had my placement in an orthopedic ward, where I looked after the patient with different surgery such as spinal cord lumber of cervical infusion, knee and joint replacement, hip replacement etc.
Please write a good reflection to pass this paper
• APA Referencing
• At least 15 genuine references from 2010 to 2016 study based,
• 90% references have to be research-based Journal article AND books
• Australian and New Zealand based study articles are preferable.
• Please have a look Rubric guideline for the given topic, I need good grades in this assignment so please do me a favor and try to give me the best quality work

Assessment: Critical Reflection on Scope of Practice (500 words)
Instructions
In years one and two you have learned about reflection on practice. That is; you have learned to think reflectively about what you do in practice and have received feedback on this to support your learning. In this assessment, you will be expected to reflect critically on your scope of practice as a nursing student. You need to access the NMBA Competency Standards for the Registered Nurse (2010) available from http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx. Please read Attribute 2.5: Understands and practices within own scope of practice.
Consider a clinical situation where you have had to question your scope of practice, and using The 5 R’s of reflection (Bain, Mills, Ballantyne & Packer, 2010) reflect on how you are developing in readiness for professional practice. For this assessment, it is appropriate to use first person ‘I’ to describe how you responded to the situation and what you learned from it and ways that you can improve. In the rare occurrence that you have not had to question your scope of practice please reflect on Attribute 2.5 and describe how you would incorporate this competency attribute into your own practice as a nursing student.
Some examples for you to consider, how would you respond if you were asked to:
• go to the medication room and collect paracetamol tablets for the patient you are looking after
• work with the Assistant In Nursing and delegate nursing tasks
• check blood products with one registered nurse
• silence the IV pump alarm
There will be others that you could discuss from your own experiences. Remember this is your own reflection and you are to use references to justify the way that you will make improvements in your practice.
I enclosed NMBA Competency Standards for the Registered Nurse (2010) for your kind consideration
Thank you
regards

Placement Reflection in Orthopedic Nursing Sample Answer

Placement Reflection

Orthopedic nursing care has been essential in the management of conditions that affect the musculoskeletal, connective and joint systems of the human body (Goldberg & Quinlan, 2014). As orthopedic nurses, we are charged with the responsibility of providing clinical, surgical and rehabilitation services to debilitating patients (Hommel & Bååth, 2015). During my placement, I learned about the progression of most orthopedic diseases which tend to have a slow progression; a process that is full of pain and compromises the daily activities of a patient as well as their quality of life. The conditions of the patients considerably influenced my delivery of care and development of specific abilities. Research has indicated that the impact of these conditions can be expressed either verbally or non-verbally and it may interfere with the student’s learning and delivery of quality patient care (Faut, 2013; Taraldsen et al., 2013).

Placement Reflection

The concept of student placement has had a huge impact on practice-based professions such as orthopedic nursing. Placement enabled me to ostensibly look at actions, thoughts, and feelings in my bid to learn from experience. According to Gupta & Havelock (2014), learning from practice is the pillar of professional development and it is a crucial aspect of sustaining growth in nursing practice. Sunderland et al., (2013) and McIntyre (2013), argue that if practitioners fail to challenge their practice, chances of perceiving the practice as a ritual or habit are likely to occur. In my placement, I came across several patients. Each case was a learning milestone. A case in point is this female patient who came to the ward complaining of pain on her left knee. Her records indicated that she had a history of arthroscopy in her right hip (reporting). Upon assessment, it was determined that the patient had symptoms of groin pain, catching, and popping in her knee (Ong et al., 2013). She was in intense pain to the extent that she could not answer the questions she was being asked. During my placement, we received several patients complaining of knee pain. What really could have been the cause of this high incidence of patients suffering from pain on their knees? I considered this to be an area that called for sufficient research and an amicable solution implemented (responding). As I was examining at the patient, I wondered what could have been the cause of her intense pain. Arthritis and mechanical injury topped the list of the most likely causes. These were the most recurring diagnoses in patients presenting these kinds of a symptom. Arthritis is a common disorder affecting the musculoskeletal system of the elderly patients (Chen & Hung, 2015; Brennan et al., 2014; Harrison et al., 2013). If the age of this patient is anything to go by, this could be the most likely diagnosis (reasoning). However, upon further diagnosis, it was proven that the patient did not have arthritis. She later reported that she had fallen while alighting from her car and hurt her knee (reconstruction). This was a learning point. More often than not, patients undergo misdiagnosis due to misguided assumptions (Parchi et al., 2013; Instone & Palmer, 2013). For instance, the patient in the case study could have been put on anti-arthritic medications had further diagnosis not been conducted.

It is well documented that the demand for orthopedic care will increase with the aging population (Rankin et al., 2014). As a result, there will be greater challenges associated with the diagnosis and delivery of care. Currently, nurses are being trained on effective procedures to observe when carrying out a diagnosis. For instance, the use of a SOAP note has been of great value in conducting a diagnosis. However, the future of orthopedic nursing care is aimed at developing new technologies, robotics, instruments, and bone substitutes that will be less invasive, but provide accurate during diagnosis (Close, 2013). Computer programs are also being developed to further help in scanning patient trends and give an effective prognosis.

Placement Reflection in Orthopedic Nursing References

Brennan, S. L., Lane, S. E., Lorimer, M., Buchbinder, R., Wluka, A. E., Page, R. S., & Ebeling, P. R. (2014). Associations between socioeconomic status and primary total knee joint replacements performed for osteoarthritis across Australia 2003–10: data from the Australian Orthopaedic Association National Joint Replacement Registry. BMC musculoskeletal disorders, 15(1), 356.

Chen, P., & Hung, W. W. (2015). Geriatric orthopedic co-management of older adults with hip fracture: an emerging standard. Annals of translational medicine, 3(16).

Close, J. C. T. (2013). Hip fracture in Australia: missed opportunities and a chance to improve care. Internal medicine journal, 43(12), 1262-1264.

Faut, R. M. (2013). Orthopedic competencies put to the real test. Orthopedic nursing, 32(3), 135.

Goldberg, S., & Quinlan, P. (2014). Professional Nursing Practice in the Orthopedic Care Setting. In Perioperative Care of the Orthopedic Patient (pp. 333-338). Springer New York.

Gupta, A., & Havelock, W. (2014). A new future for hip fracture care–orthogeriatrician lead in an ‘Acute’Hip Unit. Clinical Medicine, 14(6), 591-596.

Harrison, C., Britt, H., Miller, G., & Henderson, J. (2013). Prevalence of chronic conditions in Australia. PloS one, 8(7), e67494.

Hommel, A., & Bååth, C. (2015). Working with Core Competencies in Orthopedic Nursing. In The 7th international Australia, New Zealand orthopedic nurses association (Arizona) conference 11-13 nov, Sidney Australien.

Instone, S. L., & Palmer, D. M. (2013). Bringing the Institute of Medicine’s report to life: Developing a doctor of nursing practice orthopedic residency. Journal of Nursing Education, 52(2), 116-119.

McIntyre, L. F. (2013). Exploring new practice models delivering orthopedic care: can we significantly decrease delivery costs and improve quality?. Sports medicine and arthroscopy review, 21(3), 152-154.\

Morris, J., Grimmer, K., Gilmore, L., Perera, C., Waddington, G., Kyle, G., … & Murphy, K. (2014). Principles to guide sustainable implementation of extended-scope-of-practice physiotherapy workforce redesign initiatives in Australia: stakeholder perspectives, barriers, supports, and incentives.Journal of multidisciplinary healthcare, 7, 249.

Ong, K. L., Wu, B. J., Cheung, B. M., Barter, P. J., & Rye, K. A. (2013). Arthritis: its prevalence, risk factors, and association with cardiovascular diseases in the United States, from 1999 to 2008. Annals of epidemiology, 23(2), 80-86.

Parchi, P. D., Vittorio, O., Andreani, L., Piolanti, N., Cirillo, G., Iemma, F., & Lisanti, M. (2013). How nanotechnology can really improve the future of orthopedic implants and scaffolds for bone and cartilage defects. Journal of Nanomedicine & Biotherapeutic Discovery, 2013.

Rankin, K. S., Sprowson, A. P., McNamara, I., Akiyama, T., Buchbinder, R., Costa, M. L., & Rangan, A. (2014). The orthopedic research scene and strategies to improve it. Bone & Joint Journal, 96(12), 1578-1585.

Sunderland, M., Newby, J. M., & Andrews, G. (2013). Health anxiety in Australia: prevalence, comorbidity, disability and service use. The British Journal of Psychiatry, 202(1), 56-61.

Taraldsen, K., Sletvold, O., Thingstad, P., Saltvedt, I., Granat, M. H., Lydersen, S., & Helbostad, J. L. (2013). Physical behavior and function early after hip fracture surgery in patients receiving comprehensive geriatric care or orthopedic care—a randomized controlled trial. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, glt097.

Taylor, A. (2015). A day in the life of orthopedic and trauma practitioners: Orthopaedic Nurse Practitioner–Hip Fracture. International journal of orthopedic and trauma nursing, 19(1), 50-51.

Registered nurses Research Paper Available

Registered nurses

Order Instructions:

Module 7

Initial Discussion Post:

Base your initial post on the scenario listed below, your readings and research on this topic.

An RN working in the Intensive Care Unit (ICU) is caring for a patient with an acute gastrointestinal

hemorrhage related to liver failure that resulted from alcoholic cirrhosis. During hand-off report at the

end of the shift, the outgoing RN states to the incoming RN, “I have been in that room all day,

transfusing blood products and giving medications. It’s so much work for really no reason. I don’t know

why this patient drank to the degree he did to destroy his liver. He did this to himself. What a waste of

resources. I heard his family wants to get him on a list for a liver transplant.”

After reflecting on the above scenario, discuss the following points (minimum of 250 words):

What is the most appropriate way for the incoming RN to approach this situation? Include ethical and

legal considerations.

What is the role of the RN in regard to addressing the value system of other health care workers that

may have a negative impact of the delivery of patient care? Include ethical and legal considerations.

SAMPLE ANSWER

Nurses routinely offer 24-hour care to patients in hospital. The role of the staff Registered Nurses (RNs) is typically fulfilled at the bedside where they frequently contact patients who are on illicit drugs but are seeking health care services. The nurses come across complex personal as well as clinical situations that require a high level of expertise, competence, and skill for successful achievement. Research by Van Boekel., 2013 indicated that the attitudes of health care practitioners working with patients on illicit drugs constitute a crucial predictor of the willingness to interact with these patients.

In the case provided, the incoming RN nurse should approach it differently. She should not let the views of her colleague deter her from providing quality care to the patient. It is her moral responsibility to provide quality care to the patient regardless of their health condition. The incoming nurse should also find some time and talk to the outgoing RN letting her know that it is vital for them to maintain close surveillance on this patient so as they can address their multiple medical comorbidities and the patient’s risk of acquiring health problems. Moreover, she emphasize that patients require non-judgmental and emphatic care which is essential in strengthening health seeking behaviors to solving acute and chronic conditions.

Stigmatization attitudes of clinicians toward patients with unhealthy drug use have been associated negatively with empowerment and poor outcomes (Van Boekel., 2013). Therefore, registered nurses should encourage their colleagues to express determination to provide high quality care to patients using drugs. A RN can also be in the recommend healthcare institutions to introduce organizational support and contextual factors such as procedures and policies associated with provision of therapeutic and unbiased care. This will encourage positive encounters to be maintained within the health care system which in turn will encourage patients to adhere to ongoing medical assessment and treatment for their dependency on drugs and other health problems.

References

Van Boekel, L. C., Brouwers, E. P., Van Weeghel, J., & Garretsen, H. F. (2013). Stigma among health professionals towards patients with substance use disorders and its consequences for healthcare delivery: Systematic review. Drug and Alcohol Dependence, 131(1), 23-35.

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Clinical Practice as a Registered Nurse on Back Pain

Clinical Practice as a Registered Nurse on Back Pain Order Instructions: The scenario will be attached in files below All research should be valid in STRICTLY AUSTRALIA.

The purpose of this essay is for students to present a comprehensive discussion and justification identifying two (2) care priorities within a clinical scenario using the Levett-Jones’ Clinical Reasoning Cycle.

How to start assignment?

To begin, before you can prioritize your care and implement a specific intervention you (as in all of your clinical practice as a registered nurse) will first need to perform an assessment that is relevant, this will add strength to your chosen priority by demonstrating to the reader why it is that you’ve chosen this priority. You must then explain the priority, with relevant reference to the chosen client.

This essentially, is the first three components of the clinical reasoning cycle, consider the patient, collect cues and information and process this information and essentially will end with you identifying the priority ( known as identifying problems/issues). You are then required to establish goals relevant to the patient and in doing so you must justify why have you chosen this priority- this is the taking action component of the cycle.

You must support your chosen priority with the most relevant and up to date evidence and then describe how you will assess the success of your suggested intervention or in other words, you will be required to reflect on the practice you have just suggested.

20 APA references not old then 5 years old and only Journals and articles.

Marking guide must be followed.

Clinical Practice as a Registered Nurse on Back Pain Sample Answer

Back Pain

Introduction

Back pain is a common and costly disorder in Australia. Hoy et al., (2014) report that about 25% of Australians suffer from back pain and approximately half of them seek medical attention. The direct costs for treatment of this condition in Australia have been estimated to be approximately $ 1 billion with an addition of $ 8 used in indirect costs (Buchbinder et al., 2013). The condition is also prevalent within the healthcare professionals where nurses have a higher likelihood of developing back pains unlike individuals from other professions. In South Australia alone, back injury accounts for over $2 million in every financial year (Lorig et al., 2013). Surveys of patient self-managing their back pain as well as those managed in primary care have indicated that usual care is not often evidence-based hence hindering provision of best outcomes to patients. Consequently, there has been a growing demand to address the ramifications of back pain through changes in health policies, investments, and service delivery. Healthcare providers are charged with the responsibility of ensuring that patients receive effective prevention and treatment strategies to curb this menace.

There are a number of activities that a nurse will conduct to examine John’s condition and the proper intervention that he needs for effective management of his condition. Some of these activities that the clinician will examine include;

Patient Education Clinical Practice as a Registered Nurse on Back Pain

In the initial visit, the nurse will educate John on chronic back pain by highlighting clearly that the condition may arise due to an injury or diseases on different body structures such as the muscles, joints, ligaments, or nerves. According to Traeger et al., (2014), the type of pain varies and can be felt like muscle pain, bone pain, or nerve pain. The nurse will also emphasize that it is important for patients to seek medical attention the moment they have back pains and not wait until the disorder worsens to promote effective management of the condition. At this point, it will be of great significance for the nurse to let John know that he is not the only one suffering from back pain. He should understand that back pain is a massive problem in Australia that sends more people to seek medical attention more than any other condition except the common cold (Driscoll et al., 2014).

Nutrition and Weight loss

Normally, patients who are overweight, such as John, and suffer from back pain, may not be aware their excess weight aggravates their condition (Brady et al., 2016). It is well known that obese patients are at a greater risk for back pain, muscle strain, and joint pain unlike those that are not overweight. Moreover, obese patients also complain of fatigue and shortness of breath which makes them refrain from exercises worsening their back pain (Heuch et al., 2013). When patients do not get enough exercise for quite some time, the back’s supporting structures become weak, stiff, and deconditioned which further increases pain (Silisteanu & Covasa, 2015, November). It is for these reasons that the clinician will encourage John to have a weight loss program which may involve gentle low-impact activities such as walking, jogging, or water therapy. The clinician will also advise John to avoid eating foods with high-fat content. He should also stick to a rational nutrition plan which involves changes in eating habits as a step toward effective management of his back pain.

During the visit, the healthcare provider will observe John’s posture and position. Reviewing of John’s curvature of the spine, shoulder symmetry, and the iliac crest will also be of great importance. The healthcare provider will conduct a physical examination through palpation of John’s paraspinal muscle to identify any form of tenderness and then initiate proper interventions as per the findings.

Clinical Practice as a Registered Nurse on Back Pain and Pain Alleviation

For pain reduction, the healthcare provider will encourage John to take timed bed rests and adjust his position to improve flexion of the lumbar region. The nurse will teach him to regulate and adjust the pains that traverse through the respiratory diaphragm. Relaxation can also help in reducing muscle tension that contributes to back pain. John should also adjust his sitting position regularly or even engage in other activities such as reading books, watching a movie or take part in yoga. The nurse will advise John to request his wife, Donna, to gently massage his back. It has been proven by Kumar, Beaton & Hughes, 2013; Schulz et al., 2014) that massage aids in the reduction of muscle spasms, reducing damming, and improve blood circulation.

Clinical Practice as a Registered Nurse on Back Pain and Depression

Depression is the most common emotion linked to chronic back pain. Patients with chronic back pain have major depression which is said to be four times greater in such patients than in the general public in Australia. John is not an exception from this statistics since he reports that he is depressed because he can no longer take part in activities such as hiking and cycling that he has always loved. Research has revealed that depression can trigger back pain (Steffens et al., 2012). It affects the intensity, frequency and the rate of healing of back pain. Consequently, the nurse will advise John to communicate about the depression. Mostly, many patients do not talk to their physicians about their depression, anxiety, or stress (Center, 2012). Individuals that are stressed tend to tense their back muscles which in turn trigger the onset of low back pain or make it even worse. They believe that the emotions will go away once the initial pain problem is solved. Therefore, John should regularly keep me updated about his feelings so that I may provide desirable care to him. The nurse will also recommend John to interact with other people, for instance, he can occasionally be visiting his daughter or son or play with his grandchild to avoid being lonely and stressed up.

The two activities that the nurse will give priority in the subsequent visits are;

Adherence to Medication

Generally, healthcare providers are aware of the considerable increase in rates of opioid prescribing. Opioids have long been used as pain management agents. However, they are associated with adverse reactions such as nausea, vomiting, constipation, respiratory depression, addiction, and even death. The side effects usually limit their use by patients. Therefore, in the first visit and subsequent visits, this is an issue the nurse will be reviewing. In these visits, the clinician will assess the effectiveness of the prescribed analgesics and inquire from John on whether what he feels after taking the drug. The clinician will then initiate appropriate adjustments according to the patient’s condition for effective pain management. Besides, other pain management therapies such as acupuncture, yoga, chiropractic care, and herbal medicines such as ginger, capsaicin, and feverfew can be used (Ferreira et al., 2014).

ii) Exercise

According to Searle et al., (2015) exercise should be the first treatment choice for a patient with back problems such as John. This is because exercise matches the fact that individuals with chronic back pain should be physically active and involve themselves in their management. Moreover, treatments such as massage, acupuncture, and manipulative therapy are passive hence the patient is not involved in the therapy. Falla et al., (2014) further highlight that exercise provides other health benefits beyond back pain management, for instance, in terms of bone and cardiovascular health. Therefore, the nurse will encourage John to take part in usually low-grade oscillatory exercises such as knees side to side rotation, knee to chest stretches, pelvic tilts, and press ups. The nurse will also help John to come up with an exercise program which the nurse will be supervising to ensure he follows it.

There are several forms of exercise and there is no genuine reason for expecting that one approach would be better than the other (O’Sullivan, 2012; Elden et al, 2013). As a result, the nurse will give John a list of beneficial exercises he can engage in and enquire from him which type he would prefer so that it is included in the exercise program. The best form of exercise for any patient is the one they are enthusiastic about and willing to continue with. For instance, John says he likes cycling; an activity that has been recorded to have desirable outcomes in patients with back pains. This can be included in his program. The healthcare provider will advise John not to take part in heavy physical activities, circular motions, and sways which often worsen the condition. The nurse will encourage John to switch activities while sitting, lying or walking for a long time.

Clinical Practice as a Registered Nurse on Back Pain Conclusion

Back pain is a common health problem in Australia (Cramer et al., 2013). However, its prevalence can be reduced significantly if patients and clinicians work together. Patients, for instance, should seek early medical attention and adhere to the prescribed medications and the recommended activities. On the other hand, physicians should keep close surveillance on these patients and ensure that desired patient outcomes are realized.

Clinical Practice as a Registered Nurse on Back Pain References

Brady, S. R., Hussain, S., Brown, W. J., Heritier, S., Billah, B., Wang, Y., & Cicuttini, F. M. (2016). Relationships between weight, physical activity and back pain in young adult women. Osteoarthritis and Cartilage, 24, S10-S11.

Buchbinder, R., Blyth, F. M., March, L. M., Brooks, P., Woolf, A. D., & Hoy, D. G. (2013). Placing the global burden of low back pain in context. Best Practice & Research Clinical Rheumatology, 27(5), 575-589.

Center, C., Relief, P., Covington, L. A., & Parr, A. T. (2012). Caudal epidural injections in the management of chronic low back pain: a systematic appraisal of the literature. Pain Physician, 15, E159-E198.

Cramer, H., Lauche, R., Haller, H., & Dobos, G. (2013). A systematic review and meta-analysis of yoga for low back pain. The Clinical journal of pain, 29(5), 450-460.

Depression Goesling, J., Clauw, D. J., & Hassett, A. L. (2013). Pain and depression: an integrative review of neurobiological and psychological factors. Current psychiatry reports, 15(12), 1-8.

Driscoll, T., Jacklyn, G., Orchard, J., Passmore, E., Vos, T., Freedman, G., & Punnett, L. (2014). The global burden of occupationally related low back pain: estimates from the Global Burden of Disease 2010 study. Annals of the rheumatic diseases, annrheumdis-2013.

Elden, H., Gutke, A., Kjellby-Wendt, G., Fagevik Olsén, M., Stankovic, N., & Östgaard, H. C. (2013). Back pain in relation to pregnancy: A longitudinal 10-year follow-up of 369 women diagnosed with pelvic girdle pain during pregnancy. In Advances in multidisciplinary research for better spinal/pelvic care. The 8th Interdisciplinary World Congress on Low Back & Pelvic Pain, Oct 2013. Dubai.

Falla, D., Gizzi, L., Tschapek, M., Erlenwein, J., & Petzke, F. (2014). Reduced task-induced variations in the distribution of activity across back muscle regions in individuals with low back pain. PAIN®, 155(5), 944-953.

Ferreira, P. H., Ferreira, M. L., Maher, C. G., Refshauge, K. M., Latimer, J., & Adams, R. D. (2013). The therapeutic alliance between clinicians and patients predicts outcome in chronic low back pain. Physical therapy, 93(4), 470-478.

Heuch, I., Heuch, I., Hagen, K., & Zwart, J. A. (2013). Body mass index as a risk factor for developing chronic low back pain: a follow-up in the Nord-Trøndelag Health Study. Spine, 38(2), 133-139.

Hoy, D., March, L., Brooks, P., Blyth, F., Woolf, A., Bain, C., & Murray, C. (2014). The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Annals of the rheumatic diseases, annrheumdis-2013.

Kumar, S., Beaton, K., & Hughes, T. (2013). The effectiveness of massage therapy for the treatment of nonspecific low back pain: a systematic review of systematic reviews. Int J Gen Med, 6, 733-741.

Lorig, K., Ritter, P. L., Plant, K., Laurent, D. D., Kelly, P., & Rowe, S. (2013). The South Australia health chronic disease self-management Internet trial. Health Education & Behavior, 40(1), 67-77.

O’Sullivan, P. (2012). It’s time for a change with the management of non-specific chronic low back pain. British journal of sports medicine, 46(4), 224-227.

Schulz, C., Leininger, B., Evans, R., Vavrek, D., Peterson, D., Haas, M., & Bronfort, G. (2014). Spinal manipulation and exercise for low back pain in adolescents: study protocol for a randomized controlled trial. Chiropractic & manual therapies, 22(1), 1.

Searle, A., Spink, M., Ho, A., & Chuter, V. (2015). Exercise interventions for the treatment of chronic low back pain: A systematic review and meta-analysis of randomized controlled trials. Clinical Rehabilitation, 29(12), 1155-1167.

Silisteanu, S. C., & Covasa, M. (2015, November). Reduction of body weight through nutrition intervention reduces chronic low back pain. In E-Health and Bioengineering Conference (EHB), 2015 (pp. 1-3). IEEE.

Steffens, D., Ferreira, M. L., Maher, C. G., Latimer, J., Koes, B. W., Blyth, F. M., & Ferreira, P. H. (2012). Triggers for an episode of sudden onset low back pain: study protocol. BMC musculoskeletal disorders, 13(1), 7.

Tekur, P., Nagarathna, R., Chametcha, S., Hankey, A., & Nagendra, H. R. (2012). A comprehensive yoga program improves pain, anxiety, and depression in chronic low back pain patients more than exercise: an RCT. Complementary therapies in medicine, 20(3), 107-118.

Traeger, A. C., Moseley, G. L., Hübscher, M., Lee, H., Skinner, I. W., Nicholas, M. K., & Hush, J. M. (2014). Pain education to prevent chronic low back pain: a study protocol for a randomized controlled trial. BMJ Open,4(6), e005505.

Role of Nursing In Renal Transplant Surgery

Role of Nursing In Renal Transplant Surgery Order Instructions: Module 6 Initial Discussion Post: Base your initial post on the paragraph below, your readings and research on this topic.

Renal transplant surgery is the oldest and most successful type of organ transplant yet the United Network for Organ Sharing (UNOS) reports there is the insufficient number of available organs to meet the growing needs of individuals who require this surgical procedure. The source of a kidney for transplantation may be from a living or deceased donor.

After reflecting on the above paragraph, discuss the following points (minimum of 250 words):

What is the professional nurse’s role in organ donation?
Are there ethical considerations associated with living donors? Explain.
Should donors or their families be financially compensated for their donation? Why or why not?

Role of Nursing In Renal Transplant Surgery Sample Answer

Renal Transplant Surgery

Role of Nursing In Renal Transplant Surgery

Patients that have undergone kidney transplants require long-term support than most relatives, friends or healthcare providers may realize. The patients need more social support after the procedure alongside interventions to aid in alleviating problematic medical side effects and how they can be managed. Nurses play a key role in kidney transplant. According to Kim (2013), a professional nurse aids the patient in tackling the challenges linked to kidney transplant by providing psychological, physical as well as educational support to the patient, donor, and family members before the procedure. Nurses also use their awareness of transplant positioning in the operating room to provide postoperative care. Additionally, a professional nurse also helps in monitoring and maintaining fluid volume, hemodynamic status, and the patient’s blood pressure at a physiological range.

Role of Nursing In Renal Transplant Surgery and Ethical Consideration

Several ethical considerations have been linked to kidney donation. For instance, worries arise among donors about the intense pressure that is weighed on them resulting to donors who may be reluctant to donate feel coerced. As a result, healthcare providers are compelled to find a plausible medical excuse so that the donor can gracefully bow out. Veatch & Ross (2014) report that donors may feel obligated to donate regardless of the consequences to themselves. Take the case of a parent who opts to donate both lobes of her kidney in a bid to save her child without realizing that she is making a life-threatening sacrifice. Clinicians should conduct thorough scrutiny to identify the motive of some donors (Kjellstran & Dossetor, 2013). For example, cases have been reported whereby an individual donates his/her kidney due to low self-esteem or depression, media attention, or have the intention of harboring the life of the recipient.

Compensation for Family member’s of Organ Donors

Indeed, kidney donors should be compensated. This is because the donors have to absorb and pay the cost of a month spent recovering from the surgical procedure. The donors end up missing work and childcare. They also risk losing their jobs during their recovery period. Donor compensation is the right thing to do. It is unfortunate that the surgeon gets paid, so is the nephrologists, the hospital, insurer, and the patient also gets a new kidney. Why would everyone be paid except the donor?

Role of Nursing In Renal Transplant Surgery References

Kim, S. (2013). Compassion fatigue in liver and kidney transplant nurse coordinators: a descriptive research study. Progress in Transplantation,23(4), 329-335.

Kjellstrand, C., & Dossetor, J. B. (Eds.). (2013). Ethical problems in dialysis and transplantation (Vol. 33). Springer Science & Business Media.

Veatch, R. M., & Ross, L. F. (2014). Transplantation ethics. Georgetown University Press.