...Do X-rays Requested By Triage Nurses Decrease Waiting Times? Research in Health and Social Care Introduction: Since 1991 when the patient’s charter (Department of Health 1991) was introduced, Accident and Emergency (A&E) departments have been under pressure to see, treat and discharge patients within a certain time period. In 1991 75% of walking wounded who presented to the department had to be discharged within one hour. It was subsequently changed in 2004 when the government decided that 98% of all patients attending an A&E department should be in the department no longer than four hours (Department of Health 2004). And again in 2011 when the department of health introduced the clinical care indicators that relaxed the target to 95% seen, treated and discharged or admitted in 4 hours (Department of Health 2011). Triage nurses within the accident and emergency department are one of the first people to assess the patients who present with an injury or illness. The patient’s condition is assessed and their need for how quickly they require treatment is prioritised. Triage nurses are usually experienced A&E nurses who have many years A&E experience (Dolan et al 2007). Patients are then placed in queues to await assessment by a Doctor or Emergency Nurse Practitioner. Once seen they are then put in another queue to await x-ray if necessary before waiting again to see the doctor/ENP that will interpret their x-ray and decided on the best course of treatment...
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...Abstract Disasters have devastating and severe acute and long-term consequences for individuals and communities. The paper expounds on the social ramifications of disasters, while highlighting a disaster’s effects in vulnerable populations. The collaborative actions of communities, governments, public health, media, and health professionals are also depicted in the paper. Lastly, implications for Advanced Practice Nurses concerning leadership, involvement in public policy and education, and development of advanced disaster planning are illustrated. Keywords: disaster, disaster response and planning, social ramifications, advanced practice nursing. Disaster--the term itself invokes feelings of dread, despair, and devastation. Furthermore, the effects of disasters on human condition are far-reaching and unpredictable. For health care professionals, disaster preparedness and response entails an understanding of the socio-economic issues and the collective responsibilities of multiple agencies when a disaster strikes. Disasters affect individuals, families, societies, and communities, with little time for any warning or preparation.1 The collective obligations of government, communities, hospitals, and medical professionals are underscored during this trying time. Introduction What is a disaster? Calamity, catastrophe, tragedy, are just some of the words uttered when a disaster occurs. Perry and Quarantelli2 explained that disaster has several meanings depending...
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...Cooperation, mutual working relationship and understanding between APNs (advanced practice nurses) other healthcare professionals and agencies is critical for the improvement of health (Edwards, 2009). Such collaborative working relationship promotes research, enhances patient education, increases general public awareness and promotes correct diagnoses and treatment. In this paper. Therefore, my interest is in this collaboration (Fairman et. al, 2011). I seek to find out the ways advanced practice nurses and other groups can collaborate to improve health status and service delivery. Health agencies and organizations include researchers, medical unions, patient advocacy organizations and other associations within the health industry (Freshwater, 2002). APNs are health professionals who emphasize self-care and wellness, manage their workload, and provide diagnosis and treatment of health disorders (Johns, 2000). APNs always focus on the impact of diseases and medications on the patient and the society as a whole. APNs are registered nurses with advanced credentials; they are also certified by the relevant certification bodies (Hoyt, Proehl & Jean, 2012). The common places where APNs work include schools, clinics, health centers, physician offices, hospices, and nursing homes. APNs also work in the business environment to promote the health of the employees’ (Johns, 2000). Far too often, APNs, health care agencies, and health professional do not work together. A consistent...
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...Cooperation, mutual working relationship and understanding between APNs (advanced practice nurses) other healthcare professionals and agencies is critical for the improvement of health (Edwards, 2009). Such collaborative working relationship promotes research, enhances patient education, increases general public awareness and promotes correct diagnoses and treatment. In this paper. Therefore, my interest is in this collaboration (Fairman et. al, 2011). I seek to find out the ways advanced practice nurses and other groups can collaborate to improve health status and service delivery. Health agencies and organizations include researchers, medical unions, patient advocacy organizations and other associations within the health industry (Freshwater, 2002). APNs are health professionals who emphasize self-care and wellness, manage their workload, and provide diagnosis and treatment of health disorders (Johns, 2000). APNs always focus on the impact of diseases and medications on the patient and the society as a whole. APNs are registered nurses with advanced credentials; they are also certified by the relevant certification bodies (Hoyt, Proehl & Jean, 2012). The common places where APNs work include schools, clinics, health centers, physician offices, hospices, and nursing homes. APNs also work in the business environment to promote the health of the employees’ (Johns, 2000). Far too often, APNs, health care agencies, and health professional do not work together. A consistent...
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...The purpose of this research paper is so that I can explain, in my own words, the impact that the Institute of Medicine 2010 report, “The future of Nursing: Leading change, Advancing Health”, has had on nursing education, a nurses role as a leader and on the nurses practice, (particularly in the primary care setting) as well as how I would change my practice to meet the goals of the Institute of Medicine report, in 750-1000 words. I would like to explain the Importance of the Institute of Medicine. The Institute of Medicine is an interdisciplinary committee to our country that focuses on points about our community’s health. This team was formed in 1970 under the charter of the National Academy of Sciences. They give self-governing facts that are researched for policy makers and healthcare providers for both the public & private sectors. As these teams are necessary for yielding reports, the Institute of Medicine is also attributed to having forums and other activities to create discussions and encourage critical-thinking. The Institute Of Medicine will also make recommendations for making health care more desirable and improve health professions education that has a great influence on encouraging change. Dr. Harvey V. Fineberg is president of the Institute of Medicine. “The Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health, is a thorough examination of how nurses’ roles, responsibilities and education should change to meet the needs of...
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...developing acute skills for nurses in critical care wards. In this section of the literature review, we will discuss policies in the nursing profession, case studies and various approaches to work based acute skills learning programmes. For our purposes we conducted a literature search using popular medical databases and terms such as ‘acute skills’ ‘learning programmes’ and ‘critical care learning’. Our review highlights on the several important approaches to work based learning ranging from reflective practice to experiential learning and work based formal practical training to enhance professional skills. A learning programme for acute ward nurses responsible for caring of critically ill patients has been the central focus of nursing practice development. According to Coad et al (2002), a work-based learning approach has been found to empower ward staff with the necessary skills of nursing and the authors studied the efficacy of a five-day competency based high dependency skills course in enhancing professionalism and quality of care in nursing. The aims of comprehensive critical care are developing leadership potential and enhancing networking opportunities for nurses within critical care and acute ward areas. Critical care is the most challenging aspect of nursing care and acute skills in nursing are enhanced not just by work-based learning programs but also from first hand nursing and emergency experiences. Titchen (2003) describes emergency care in which one professional...
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...History can be defined as a study of events that link the past to the present. It also examines how those events have continued to impact and influence events throughout time. The nursing profession is intricately tied to historical influences throughout the ages. Exploring and understanding the history of nursing allows one to achieve an appreciation the role nursing has played in the advancement of the healthcare system. Ninetieth Century Florence Nightingale, conceivably the most famous nurse in history; was well known for making nursing a reputable profession for women, and bringing it to the forefront of the professional world. Wars were increasing during the ninetieth century, and as a result, the demand for nurses had grown exponentially (Nursing Theory, 2013). In 1854, the Crimean War erupted. Nightingale had learned the British troops had no nurses to care for their injured troops while the French had nursing nuns caring for their injured. Nightingale, with a group of nurses, served in the Crimean War by organizing hospitals to help improve the general conditions of the facilities. “In fact, most British soldiers were dying from disease rather than from injuries incurred on the battlefield” (Egenes, n.d.). Nightingale set out on a crusade to methodically scrub the soldiers’ barracks and hospital ward, and allow fresh air in. The death rate had radically decreased within months (Egenes, n.d.). Nightingale had laid the groundwork for modern evidence- based practice...
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...Health care today is becoming more complex with the aging population, multiple comorbidities, and rising health care costs. There are many issues that health care providers face while caring for patients on a daily basis. The two health care problems that will be discussed are hospital acquired infections and how it affects patient outcomes as well as antibiotic resistance related to overuse and misuse. This paper will discuss those two health care problems and how they affect health care delivery as well as costs, access to care, quality of care, and nursing qualities that influence evidence-based practice. Problems That Affect Health Care Delivery and Health Care Policies Hospital acquired infections The first health care problem to be discussed...
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...enhancing patient knowledge and provide additional resources essential for effective health care management. Research evidence provides data that proves patients who are diagnosed with CHF needs a variety of health care needs during admission and after discharge. The proposal will display an evaluation plan, implementation plan and a dissemination of the evidence. Provide at least 1 evidence based literature; for at least 1 evidence based solution. Keywords: congestive heart failure, therapy, education, patient outcomes Description of the Problem Prevention of Hospital Readmissions Related to Symptoms of Congestive Heart Failure Health care providers must ensure skills, knowledge and teaching is effective when providing care to their patients and families about symptoms of CHF. The length of stay for an average hospital visit can be two days however, for more chronic issues warrant an even longer stay. To avoid readmission of the disease processes of CHF warrants additional care and resources during and after discharge. . Some patients cannot follow up with their primary care physician because of transportation, language barriers and economic status. These lessen their chances of follow-up care causing frequent hospitalizations. The strategy used for the study conduct a Cochrane Q and I squared statistics reviewed 141 studies with screening by the title and the abstract. 119 papers were eliminated because of data including the interventions and the electronic data related...
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...nursing licensure in safeguarding the public and developing educational and clinical nursing standards. • Discuss the development of advanced clinical practice nursing from the 1960s through the present. PROFILE IN PRACTICE Laura J. Robinson Adult Primary Care Nurse Practitioner Student, University of Connecticut School of Nursing Nursing history is important to me because it has provided me with the opportunity to fulfill my goal to advance my career as a nurse practitioner, a role that was not existent less than half a century ago. Ambitious nurses before me had to establish themselves in a new career, gain recognition, and succeed in order for the position to be present today. One person whom I particularly admire and who helped pave the way is my grandmother, Olive Shea. Grandma Shea earned her RN diploma in 1944 after completing the 3-year certification program offered by Hartford Hospital in Hartford, Connecticut. After various nursing positions, she was employed by the University of Connecticut at the campus Infirmary in Storrs, Connecticut, beginning in 1968. At that time the facility was the home to physicians whose time was mainly devoted to scheduled appointments with their student patients, as well as two floors of inpatient beds where nurses provided individualized care. Grandma Shea recounted that an integral part of her day as a nurse was the 20-minute back rubs she gave to all five...
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...operational without the oncology department within the next couple of months. Said Debashish Poddar, managing director, BP Poddar Hospital & Medical Research Limited, "It will not be a so called state-of-the-art hospital but a hospital, which will ensure healthcare deliver of international standards within the affordable limits of the common man. The hospital is the culmination of the dream of Arun Poddar, Chairman of the Group and his family to perpetuate the memory of his father Late BP Poddar, he added. Despite being a multispeciality unit, the focus area of the hospital will be oncology. All possible imaging facilities will be provided at the hospital. The management has applied for necessary regulatory clearances from Bhaba Atomic Research Centre (BARC) to start radiation therapy for treatment of cancer. According to Dr Subrata Das, medical director, BP Poddar Hospital & Medical Research Limited, "With a few dedicated hospitals in the region dedicated to oncology, the proposed hospital will take care of all the needs of the cancer patients. We are in the process of installing the latest equipment in the hospital to provide the best possible medical care." The management will be investing substantially on training of human resources. Said Shantanu Ray, a renowned academician and a director of BP Poddar Hospital & Medical Research Limited. To make patient feel that he is not in a hospital, the management has emphasized on adding a dash of colour to the costumes of...
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...The Future of Nursing: Leading Change, Advancing Health http://www.nap.edu/catalog/12956.html Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine PREPUBLICATION COPY: UNCORRECTED PROOFS Copyright © National Academy of Sciences. All rights reserved. The Future of Nursing: Leading Change, Advancing Health http://www.nap.edu/catalog/12956.html THE NATIONAL ACADEMIES PRESS 500 Fifth Street, N.W. Washington, DC 20001 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This study was supported by Contract No. 65815 between the National Academy of Sciences and the Robert Wood Johnson Foundation. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project. International Standard Book Number 0-309-XXXXX-X (Book) International Standard Book Number 0-309- XXXXX -X (PDF) Library of Congress Control Number: 00 XXXXXX Additional copies of this report are available from the National Academies...
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...Patient-Centered Health Care Home Many people in the United States do not have access to high quality primary care. There is substantial evidence indicating that sufficient access to high quality primary care results in lower overall health care costs and lower use of higher cost services, such as specialists, emergency rooms, and inpatient care. A large amount of the nation’s dollars are spent on health care. This large budget affects providers, patients, employers, and payers such as Medicaid, Medicare, and private insurers. This is a primary concern in many states including, Minnesota. There are significant gaps in the quality of health care that patients in the United States receive. The current health care payment and delivery system is particularly poor at providing care for people with chronic conditions. As a result of these factors, policy makers debated over proposals that can actually be effective. Some of these proposals aimed for reducing cost, focusing on patient, and improving quality of care. An example of a proposal that focused on patient-centered care and increased quality of care is the creation and introduction of Patient-Centered Health Care Home (PCHCH), also known as “Medical Home.” The introduction of the PCHCH in Minnesota will increase patients’ accessibility to health care services, give them power to be involved in decisions regarding their care, have continuity of care with their physicians, prevent duplication of services, reduce health care cost, and improve...
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... July 13, 2013 Healing Hospital: a Daring Paradigm Although the physical aspects of patient care are most easily measured, the spiritual dimensions are most often overlooked by caregivers. Healing hospitals have developed a paradigm to address spiritual concerns, which studies have shown to significantly improve patient outcomes and satisfaction. A healing hospital provides health care to patients through application of a healing model with three components that, most importantly, ensure that the patient is surrounded by love. According to Chapman (2007), hospitals have adapted a formal approach to healing consisting of three separate components: the integration of technology, a physical facility design that promotes healing, and a culture of radical love and care. Spiritual healing is not considered to be of traditional pharmacotherapy approach, therefore, the barriers in creating this environment in today’s hospitals are many. The purpose of this paper is to explore these three areas and their relationships, as wells as, barriers to the holistic healing of mind, body, and soul. Relationship to Spirituality It is documented by Allen and Crouch (2005), that spirituality as a subject and the need to address patients’ spiritual needs are issues which are sometimes not addressed by nurses. As the Joint Commission has mandated every hospital to assess the spiritual, emotional, and cultural beliefs upon admission...
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...Abstract It is evident that nursing theorists, scholars and health care professions have varying interpretations of what caring is or should be. In the middle of all these disparity, caring is a vital component of the nursing practice and the key to choosing the concept of caring is because it is very essential when it comes to health care. This paper tries to make clear the concept of caring in the field of nursing and it makes use of the Walker and Avant outline to support the concept. It starts with recognizing the concept and its functions. It then identifies three emerging attributes of caring will be identified and a description of each will be given. At last, the paper will recognize antecedents, the effects or consequences and describe the empirical referents. The importance of analyzing Caring as it relates to Nursing Practice Caring is thought to coincide with good nursing practice. As guided by the concept analysis framework of Avant and Walker (2011), an attempt is made to gain better understanding of the constituent properties of caring. This includes the evaluation of various definitions of caring, key attributes, antecedents, consequences, and the perception of caring from the patients and nurses point of view. Then, drawing a conclusion of the significance of caring, thereof. Caring is the central concept in the discipline of nursing, therefore caring is the principle objective of the nursing profession. If it is delivered correctly, caring...
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