...Patient Services/Intensive Care Nurses/Compassion Fatigue Intervention/BESt 173 Best Evidence Statement (BESt) Date: July 17, 2013 Title: Decreasing Compassion Fatigue* among Pediatric Intensive Care Nurses Using Self-Care Skills* and Compassion Fatigue Training* Clinical Question: P (Population/Problem) I (Intervention) C (Comparison) O (Outcome) Among pediatric intensive care nurses does functional knowledge of compassion fatigue and the practice of self-care skills, compared to not, demonstrate less compassion fatigue? Definitions for terms marked with * may be found in the Supporting Information section. Target Population for the Recommendation: Nurses working in pediatric intensive care settings who provide direct patient care Recommendation: It is recommended that nurses working in pediatric intensive care settings receive training that includes compassion fatigue awareness, coping strategies, stress management, relaxation techniques and self-care interventions to decrease the level of compassion fatigue experienced in the work environment (Marine, Ruotsalainen, Serra, & Verbeek (2009) [1a]; Gunusen, & Ustun (2010) [2a]; Kravits, McAllister-Black, Grant, & Kirk (2010) [4a]; Meadors & Lamson (2008) [4a]). Discussion/Synthesis of Evidence related to the recommendation: The evidence referred to a variety of concepts related to the manifestation of compassion fatigue, including burnout, emotional exhaustion, and workplace stress. The concepts...
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...get the information into the system while in with the patient. If they don’t enter the information into the system in a timely manner, they may either forget parts of the visit or they won’t get reimbursed by insurance companies. A study was done in an emergency room that found 43% of a provider’s time was spent imputing medical records online and only 28% of time was spent on direct care with the patient (S. Hoffman ET AL. 2014). To deal with the problem of interaction between the provider and patient with electronic health records, some physicians have an assistant go with then in every exam room to type the notes while the physician interacts with the patient. Many patients over the age of 65 reported a problem with their face to face communication with their doctor due to electronic...
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...Sentinel Event: Sentinel events are a subset of medical adverse events. Events that require immediate attention are called Sentinel Events. Joint Commission defines a sentinel event as an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof. Serious injury specifically includes loss of limb or function. The phrase “or the risk thereof” includes any process variation for which a recurrence would carry a significant chance of a serious adverse outcome. Sentinel Event identified by Joint Commission also include infant abduction or discharge to the wrong family. Summary of the Sentinel event in the Case Study: Sentinel event presented in the case study involves discharge of a minor to the wrong family. Joint Commission requires immediate attention to such matters so that it may be avoided in the future. The summary of the event is that a 13 year old teenager, Tina, was admitted for day surgery. Tina was accompanied by her mother. After dropping Tina for the surgery at the hospital, her mother left to run some errands. Before leaving, she left her contact phone number with the pre-op nurse. After the surgery, Tina was inappropriately released to her father when her mother was delayed in returning to pick-up the daughter from the hospital. The hospital staff had no awareness of the family situation. Upon arrival at the hospital after the errands, mother was informed that Tina’s father had picked up Tina from the hospital because...
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...formal or informal. A formal leader is one that is associated with a particular title or position while informal leaders guide through their ability to influence others. They make a positive contribution or inspire others despite the strains of the healthcare system (Gillis, 2003). Kouzes and Posner have found that for people to follow someone willingly, they must believe the leader is honest, competent, forward-looking, and inspiring (2002). The nursing profession faces many challenges in developing future nurse leaders. All nurses, regardless of roles, from direct care to top management positions, need powerful leadership skills. This is because anyone who is looked to as an authority (such as a nurse taking care of a patient) or who is responsible for giving assistance to others is considered a leader (Mahoney, 2001). Cook describes a clinical nursing leader as one who is involved in direct care and who...
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...multi-cultural rich county of Orange, California since 1960. For more than 50 years, Madison Children’s hospital (MCH) has been steadfastly committed to providing the highest quality medical care to children. MCH has provided medical care to over 1 million children in the county of Orange. Our regional pediatric healthcare network includes a state-of-the-art main hospital facility in the City of Orange. Madison Children’s Clinic also offers many primary and specialty care services to the community. Madison Children’s hospital has recorded an increase in the amount of children and adolescents ages 0-21 with chronic illnesses. This has brought a concern to the community as well as Madison Children’s Hospital. MCH is dedicated to assisting and enriching health services, as well as developing programs to benefit the families of Orange County. MCH is proposing a funding opportunity to become a leader in research and discover, educated future generations, and enhance the health and well being of not only the children in the county of Orange, but worldwide. Madison Children’s Hospital is proposing funding for the Chronic Health Illness Program (CHIP). The CHIP program will provide all its services in a family-centered in-patient and out-patient facility to ensure continuity and cost effective care. The program serves infants to young adults in need of stabilization of chronic conditions such as diabetes, pain management, antibiotic therapy, and insulin management. The CHIP program...
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...University, North Sydney, NSW, Australia. SUBMITTED DATE : January 25, 2007 ACCEPTED DATE FOR PUBLICATION : July 21, 2007 PUBLISHED DATE : April, 2008 JOURNAL : Journal for Specialists in Pediatric Nursing INTRODUCTION It can be observed today that nursing is a dynamic profession,both internally and externally due to constant change occurring in the profession. As a dynamic profession, nursing is responsive and is adapting to meets the needs of patients and the public.Nursing is a practice discipline, which is dependant upon a high level of professionalism,ethics and human values that demand for intellect, skills and a high sense of social responsibility.The knowledge and essential skill that increased dramatically make nurses leading and developing new services in health care delivery. Nurses roles and resposibilities will continue to change in line with the health reforms that are improving care for patients.Therefore, nurses need to be encouraged to integrate the best available evidence with clinical judgment and the current climate in health care requires nuses to be able to apply the best evidence, usually through using research in order to provide the most effective health care. EVIDENCE BASED PRACTICE Evidence- based practice(EBP) is currently seen as being central to the delivery of quality healthcare. EBP has been...
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...When a baby is born their birth parents keep the new baby. In some cases the birth parents cannot or will not keep their new baby. Some children later in their young lives are without parents. These babies and children can be put in foster care or can be adopted. Adoption is when another family legally becomes their new parents. There are appropriate ways to let a child know they are adopted and to answer their following questions as well as address their feelings. Children can believe they were not wanted because they may have done something bad and her parents did not want them. It is up to the adoptive parents to answer any and all questions. Some children from another country are adopted. The parents have to tell the child...
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...Evidence Based Practice Task 1 Western Governors University Evidence Based Practice and Applied Nursing Research The nursing topic of interest is bedside handover, which is the concept of conducting shift handover at the patient’s bed instead of doing it at the front desk. Part A The article being analysed is: Tobiano, G., Chaboyer, W. & Murray, A. (2012). Family Members’ Perceptions of the Nursing Bedside Handover. Journal of Clinical Nursing, 22, 192-200. The analysis of the primary research report is done in the form of a graph (figure 1). Each of the four analysis areas is rated within a scale of 1-10; 1 denotes extremely weak while 10 denotes very strong. Table 1 then gives justifications for the rating by explaining why each area of analysis was rated that way in the analysis chart. [pic] Figure 1 Table 1 |A1 Article: Tobiano, G., Chaboyer, W. & Murray, A. (2012). Family Members’ Perceptions of the Nursing Bedside Handover. Journal | |of Clinical Nursing, 22, 192-200. | |A2 Background or introduction |The researchers provided an in depth introduction of the research topic outlining | | |important issues, previous research on the topic and their findings. The introduction | | ...
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... Part I: Clinical Narrative and Clinical Question: It was my 2nd pediatric clinical weekend; I was still trying to cope with my first clinical experiences at Shriners. I couldn’t sleep the night before, checked on my daughter several times (more than usual) to make sure she was safe. It was an overcast, dark, very quiet Saturday morning as I made my way into Shriner’s Hospital. All the way to the hospital from my home, the only thing on my mind was “who is waiting for me today”? Is the patient going to be a toddler, infant, or adolescent? Can he or she speak English? If not how am I going to communicate with him or her? My heart started beating even faster, while I was waiting for my instructor to come and take us to the patient floor. At 6:30, we went up to the 3rd floor and our instructor assigned each of us a patient. My patient Flora, is a thirteen year old adolescent female from Guatemala. She has sustained 70% body surface area flame burn including face, chest, and back, upper and lower extremities in November of 2001. It was a total mystery what had happened, how she was burned. The person who saved her stated that the patient’s legs were tied together by her sister. Some others stated that she was burned from the flames of the fire crackers. After going to the 7th floor I got the patient’s report from the night nurse and made my plan for the patient care. It was time for me to meet the patient and to do morning care. I walked down the hallway...
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...highly unlikely stories of adventure and escapes and being one of the most notorious liars in the century. In 1737 as a German soldier, he served in the Russian–Turkish war and returned with exaggerated stories of adventure. Every evening after supper in the banqueting-hall he would gather his friends and those in attendance and tell stories of his past. He loved the attention he received from the stories he would tell.His stories were so extreme and extravagant that an author named Rudolph Erich Raspe, who was seeking refuge in England from the German law, decided to write about the adventures of Munchausen.The first edition of Munchausen's tales that was attributed to him appeared anonymously in 1785 and was called Baron Munchausen's Narrative of his Marvelous Travels and Campaigns in Russia. Gottfried August Burger edited the first German version the following year. Rudolph Erich Raspe never claimed his rights over the success from his books. Some still debate whether Raspe or Burger actually published the first book about the tales of Baron von Munchausen. Munchausen’s tales are so outrageous; many of the stories attributed to him have appeared in French, Spanish, Welsh and Greek literature. (Heritage, 2013) Today his name is known for boasting, fabrications and exaggerated stories. Definition In 1951the name Munchausen made its way into healthcare by Dr. Richard Asher. Because of the correlation between Baron Munchausen’s fictional stories and the exaggerated and made up...
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...[pic] Profesional journals are peer-reviewed, checked for factuality, consistency, citing relevant work, and drawing appropriate conclusions supported by the data. The concept of profesional journal as a means of developing reflective practice has become a popular topic in classrooms, professional journals, conferences, and continuing education programs (Boud & Walker, 1998). Many other names for profesional journal appear in nursing literature, including log, journaling, narrative pedagogy, dialogue journals, reflective practice, and reflective writing. Whatever people says, reflective profesional journal requires writing, a great deal of it. However, journals are an integral part of the teaching/learning in many nursing programs as well as in allied health programs and education in general. The purpose of this essay is to review the literature related to profesional journal and reflective practice and how it can be beneficial in the teaching/learning process. Reflective practice is a means of self-examination that involves looking back over what has happened in practice in an effort to improve performance or to encourage professional growth (Ruth-Sahd, 2003). Profesional journal is a method that is frequently used in nursing education as an active learning technique to enhance reflective practice. Why is reflective practice so important? The literature cites numerous reasons for utilizing...
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...Parenting Autism Shannon Schillings COM/156 Parenting Autism Children are a blessing and should always be seen as such regardless of how they are born. However rearing children always comes with a degree of difficulty, they are not born with a handbook telling us how and what to do. Could you see yourself having and loving a child with a disability such as autism? Raising an autistic child is a challenge for families, since the child cannot show emotion or express themselves, however with help and patients it is achievable. Having children is a struggle all on its own, however having a child with a disability, such as autism, makes it an even more challenging endeavor. Mothers, who carry the child for nine months, tend to be the one who take on the majority of the responsibility in terms of raising the children and who also have a tendency to blame themselves for how a child is born. When a child is diagnosed with autism it can cause a mother to feel a variety of emotions, anger and grief happening to be the strongest among them (Lutz, Patterson, & Klein, 2012). As one mother, named Suzanna states “I was lost, blaming myself or figuring out who to blame, I was angry” (Lutz, Patterson, & Klein, 2012, p.209). These among an array of other emotions also plague the entire family, where the mom is usually the rock and gets affected the most. Fathers also suffer in many ways when dealt this type of diagnosis. They have a tendency to undergo extreme stress because of...
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...Reactive Attachment Disorder in Children and Adolescents in Institutionalized and in Foster Care, and Adoptive Families Lisa W. Marshall Liberty University Abstract It is believed children exposed to early institutional rearing are at risk for developing psychopathology (McGoron, et. al., 2012). Comparisons were made to discover if Reactive Attachment Disorder (RAD) was more prevalent in children raised institutions, foster care or adoptive families. Measurements included the Observational Record of the Caregiving Environment, Strange Situation Procedure, Disturbances of Attachment Interview, and the Preschool Aged Psychiatric Assessment (Smyke, et. al. 2012), the Reynolds Adolescent Adjustment Screening Interview (Cone, et. al., 2009) in addition to the Reactive Affective Disorder Checklist (RAD-C) and the Relationships Problem Questionnaire (RPQ), in the diagnosis of Reactive Attachment Disorder (Thrall, et al., 2009). These measurements were not only utilized to discover the existence of RAD, but to test the validity of the methods. Additionally, treatment studies including holding, narrative therapy, parenting skills training, Eye Movement Desensitization and Reprocessing, psychodrama, and/or neurofeedback (Wimmer, et. al.,2009) and cognitive-behavioral therapy (Cone, et. al.,2009) are examined. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) lists Reactive Attachment Disorder (RAD) as a serious, directly linked...
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...evidence in making decisions about beside care; to convince them to switch practice, it is useful to draw a comparison between the efficacy of these disparate routes. Our study designed a research question based on the PICOT model for the cardiac floors and designed procedures using the Kotter and Cohen’s Model of Change. In order to study the effect discussed in our PICOT question, a web search was conducted and the quality of each pertinent study reviewed. Introduction In the nursing staff of an adult Cardiac Surgical Care unit, how does the buy-in from the staff for Evidence-Based Practice (EBP) changes in a new Coronary Arterial Bypass Graft (CABG) pathway affect the decreases in infection rate among this patient population when compared to the old way of delivering patient care through nursing tradition in a six month time frame? The formation of a guideline for practice in nursing is not a new occurrence; books and manuals have been a reality for many years. However, in the past these resources lacked the evidence for standards of care, which traditionally have been based on professional consensus and tradition. The Joint Commission has recognized processes that can be measured regarding patient outcomes and care in order to meet standards for Medicare qualification. These standards, known in cardiac care as the Surgical Care Incision Protocol (SCIP), help to guarantee that cardiac surgical patients receive the best standard of care because it is based on evidence-based...
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...Impact of Childhood Sexual Abuse Shobila Kaligounder Marymount University Introduction As per UNICEF’s (2014) definition, sexual violence against children comprises any sexual activities imposed by an adult on a child against which the child is entitled to protection by criminal law. This includes: (a) The inducement or coercion of a child to engage in any unlawful or psychologically harmful sexual activity; (b) The use of children in commercial sexual exploitation; (c) The use of children in audio or visual images of child sexual abuse; and (d) Child prostitution, sexual slavery, sexual exploitation in travel and tourism, trafficking for purposes of sexual exploitation (within and between countries), sale of children for sexual purposes and forced marriage. Sexual activities are also considered as abuse when committed against a child by another child if the offender is significantly older than the victim or uses power, threat or other means of pressure. Consensual sexual activities between children are not considered as sexual abuse if the children are older than the age limit defined by the State Party. In spite of a clear definition for child sexual abuse violence in the lives of children is so real and as an international community we do very little to protect them. There is also a dearth of data to prove the prevalence of violence due to the hidden nature of the abuse and gives a false notion that it is a rare occurrence. Children are vulnerable to sexual victimization...
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