...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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...Caring in nursing Name Professor Institution Course Date Introduction Concept analysis can be referred to as the activity where different concepts, their characteristics as well as their relations with other concepts are brought out clearly and evidently (Fawcett& Desanto, 2012). The creation of a distinct conceptual clarity about the different concepts proves to be of great importance to all the forms as well as the kinds of research. The general outlined guidelines of research as well as the philosophical literature are often in the mentioning of research analysis or on the hand also mention the concept of the research. Different disciplines have formulated different methods or rather devised different methods of concept analysis. These different methods are meant for the development as well as the clarification of their own concepts in their different fields. The methods may at one time share a scholarly view of the problems of concept as well as the methodology, however, since they are discipline specific, they too may also be in need of various modifications before they could be of use and applicable to the different fields in which they are meant to be used. In nursing science, the art of concept analysis is at a greater height seen as an integral part of the development of a theory and a discipline of the science of nursing. This paper evaluate the nursing concept of care in nursing. Caring in nursing Caring in nursing is the active support as well...
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...National League for Nursing Evaluation and Learning Advisory Committee (ELAC) ANNOTATED BIBLIOGRAPHY ON ASSESSMENT AND EVALUATION ELAC Members: Marilyn H. Oermann (Chair) Karen Saewert (Chair-elect) Pamela Rutar Suzanne Yarbrough Sub-committee Members: Reba Childress Dawne-Marie Dunbar Sally Erdel Barbara Haas Evelyn Hayes Debra Hurd Sheila Kyle Gayle Preheim, Chair Linda Siktberg Gale R. Woolley, Chair A comprehensive literature review was completed, reflecting best practices in assessment, evaluation, and grading in nursing. This annotated bibliography of the literature is organized into four areas: assessment and evaluation in (a) the classroom, (b) the online environment, (c) clinical practice, and (d) learning and simulation laboratories. There is a fifth section that provides references on the assessment of psychomotor learning and performance; that section is not annotated. This work was completed by members of ELAC and its subcommittees as noted above. 1 CLASSROOM ASSESSMENT Ahmad, N. (2002). Evaluation of teaching: Through eyes of students. Plano: Institutional Research Office, Collin County Community College District. This article reviews the student evaluations instruments used to evaluate learning and faculty in the classroom. The purpose of this article was to search for come standardized instruments of student evaluations. Instruments used are: Individual Developmental and Educational Assessment (IDEA), Student Assessment of...
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...Ethical and Legal Issues in Nursing NUR/391 Ethical and Legal Issues in Nursing As nurses, it is our duty to advocate for our patients. At times, we are faced with personal and professional challenges that impact how and when we chose to advocate. It is imperative we have a healthy awareness of these potential challenges. Improvements in health care technology have provided patients with an array of treatment options as well as assumed or possible increased chance of survival. As a result, nurses are met with a rise in ethical decision making. This paper will discuss the legal, ethical, social, and personal factors that can impact our decision making process, with the focus on two specific case studies. American Nurses Association Code of Nursing Ethics Role in Practice The American Nursing Association (ANA) has created a set of ethical standards for the profession of nursing to abide by, which is entitled the ANA Nursing Code of Ethics. The ANA Code of Ethics states that collaboration is central to the care nurses deliver and to their ethical commitment to the patient (Garity, 2005). In the end-of-life case study, the nurse (she) has an unwritten obligation to the patient; the family appears to be in conflict with how to proceed with the patient's medical treatment. The medical team has an obligation to give the family all of their options and possible outcomes. If the family remains in conflict, it would then be appropriate for her to refer the family to...
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...Running head: NURSING SENSITIVE INDICATORS 1 RTT1 Task 1 Krista Vandiver, RN, CEN Western Governors University NURSING SENSITIVE INDICATORS Nursing-Sensitive Indicators According to the American Nurses Association, nursing-sensitive indicators “reflect the structure, process and outcomes of nursing care.” ("Nursing Sensitive Indicators," 2015) Understanding the indicators is an important piece of nursing, not only to assist the patient, but the patients loved ones as well, to ensure quality patient care. In this particular case, had the 2 nurse understood the reasoning and data behind the Pressure Ulcer Rate and Restraint indicators, and communicated the necessity to report any pertinent findings the CNA may discover in the nurse’s absence, the CNA would not have dismissed the reddened area over the patient’s lower spine and would have immediately informed the nurse of the finding. Upon returning the patient to bed, the CNA would have also known not to place the patient back in bed on his back and reapply the restraints. Instead, would have had the patient lay to one side and stressed the importance, to the patient and family member, of frequent turning, to reduce the chance of pressure ulcers. Quality patient care can only be achieved with teamwork and open communication. The discussion of pressure ulcers in hospitalized patients has become an increasing issue with more attention to the prevention of such since the early to mid-1990’s. The Centers for Medicare...
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...Ethical and Legal issues in Nursing The nursing profession is very complex. Every day nurses deal with patients and medical care. There are some days when ethics and legal issues play a role. We were given examples of the legal complexities of nursing through two case studies we were to evaluate. For this paper we will discuss the legal responsibilities of nursing, how personal and societal values can influence ethical decision-making and how the ANA’s Code of Nursing Ethics would influence the final decisions. Legal Responsibilities of Nurses Nursing boards are governmental state agencies responsible for regulating the nursing practice. A nursing license obtained through state nursing boards validates that nurses have met standards for providing high quality care. Nurses are legally held accountable for administering medications accurately, educating patients and public on health issues, advocating for the patient regarding health care, and serving as a liaison between the patient and the physician. Professional standards are determined by Standards of Practice Acts and the American Nurses Association’s Code of Ethics. As professionals, nurses must also be familiar with ethical responsibilities and protect the rights of their patients and families. As the definition of liability has continued to expand through the judicial system, courts of laws have placed higher standards on the profession of nursing. Many times professional...
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...Identify a current nursing practice within your healthcare setting that requires change. DEVELOPING OR CREATING AN INDEX TO MINIMIZE RISKS OFPRESSURE SORE 1. Describe the current nursing practice. An instrument specifically designed to aid health care workers evaluate the dangers of pressure sores that a patient faces is called the Braden Scale. After assessment, the victim is categorized depending on six aspects: capability of physical activity, hydration and nutrition status, capacity to alter position, the ability to respond after sensing discomfort related to pressure, shearing or exposure of the skin to friction during locomotion, and skin exposure to moisture. If the overall score is lower it means the risk of pressure sore is higher (Changing Practice, Changing Lives: 10 Landmark Nursing Research Studies, n.d). Prior to this Change, Skin assessment was based on non- formalized risk assessment which varies with each clinical practice. 2. Discuss why the current nursing practice needs to be changed Using non-formalized risk assessment in Predicting pressure ulcer resulted in non-uniformity and personal clinical judgement which varies from one person to another. Using Clinical judgement is more effective where the staffs are experienced and their experience assist in appropriate predictability, but with novice staff, the use of clinical judgment is inappropriate. In a multisite trial, Braden scale was tested by clinics bringing together skilled nursing facilities, Veterans...
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...Nursing 106 Spring 2016 Maternal Child Case Study All questions apply to this case study. You may type or clearly write this assignment. It must be legible. Responses to questions must be in your own words. Scenario M.H. is a three year old boy with cerebral palsy (CP) who has been admitted to your unit preoperatively. He will have surgery for a femoral osteotomy and tendon lengthening to stabilize hip joints and to help reduce spasticity. You are orienting the parents to the unit and have a nursing student assisting you. 1. After getting the family settled, you return to the nursing station, and the nursing student asks you to explain CP and what might have caused cerebral palsy. How would you answer the student’s question? 2. The nursing student asks what the family might have noticed that would indicate CP in M.H. when he was a baby. Which of these findings will you include in your discussion with student? (Select all that apply and state rationale) a. Head lag at 5 months b. Able to sit unassisted at 7 months c. Positive Moro (startle) reflex at 2 months d. Leg scissoring e. Right hand preference at 12 months f. Use of pincher grasp at 9 months g. Increased irritability Case Study Progress You and the nursing student finish a health history with the family and determine that M.H. has impaired vision (wears glasses), speech impairment, seizure disorder, and has had poor weight gain and feeding issues since birth....
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...Journal of Nursing Research, 32(8), 1055-1072. This journal covers the important stages of the Learning needs assessment and how it impacts every educational process that is aimed to inform changes in practice and policy for continuing professional development. Professional opportunities have been widely used as a basis for the development of learning needs assessment. This article reports on the development of a learning needs assessment questionnaire for Community Health Nurses (CHNs). Exploratory and confirmatory factor analyses were conducted to examine the consistency of factors underpinning the Canadian Community Health Nursing (CCHN) Standards. Also, validity and reliability of the questionnaire were evaluated using appropriate techniques. This process resulted in a valid and reliable CHN learning needs assessment questionnaire to measure learning needs of large groups of practitioners, where other forms of measurement cannot be feasibly conducted. Aydin, A.K., & Karadaq, A. (September-October 2010). Assessment of nurses knowledge and practice in prevention and management of deep tissue injury and stage 1 pressure ulcer. Journal of Wound, Ostomy, and Continence Nursing, 37(5), 487-494. This is a good overview from a well-known nursing journal that focuses on a descriptive study on how to determine a nurses knowledge and usual practice and prevention of deep tissue injuries. It gives an in depth explanation on the methods and assessment tools used for nursing education...
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...HE0930A CASE STUDY | 1104964 | Jane Smith aged 16 years, was diagnosed with diabetes aged 7. Last month, whilst attending the practice nurse’s diabetes review clinic Jane expresses concerns that over the past few weeks her blood sugar readings have been elevated. She does not want to increase the dosage of her twice daily insulin regime as she is worried that this will cause her to gain weight. 1. What is meant by the terms anticipatory care, self care and self management? (15%) 2. Critically discuss why current Scottish health policy is actively promoting the self care and self management of long-term conditions. (25%) 3. Critically discuss the practice nurse’s role in supporting Jane to self- manage her long term condition (60%). A long term condition (LTC) can be defined as a prolonged health issue that never goes away and is very rarely cured (Magerson and Trenoweth 2010). These conditions require different degrees of on-going care and support tailored to the individual (Scottish Executive 2009). The government has realised that effective management of these LTC’s is one of the biggest challenges that healthcare faces (McVeigh 2009). This essay will focus on the above case study, defining anticipatory care, self-care and self-management, and analyse and explore current Scottish health policy in relation to self-management and self-care. A fundamental part of this essay will discuss the nurses’ role in supporting Jane to self-manage her diabetes. ...
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...APPLICATION OF NURSING THEORY TO CLINICAL PRACTICE: THE SELF-CARE MODEL OF DOROTHEA OREM Introduction The purpose of this paper is to discuss the application of Dorothea Orem’s Self-Care Model of Nursing to clinical nurse practice. The central thesis of the paper is that Orem’s theory has strong utility for application to modern day clinical practice and can be applied to most any case in order to attain the desired medical and caring outcomes. The presented discussion will support this perspective of Orem’s theory. The paper begins with a brief overview of the theory which is then followed by a delineation of a non-nursing theory that supports one or more of Orem’s self-care notions. The next section of the paper presents a historical overview of the evolution of Orem’s theory, a delineation of the concepts central to the metaparadigm, and an exploration of the theory’s usefulness in education and research. The final section of the paper applies the theory to a particular case. A model of the theory is presented in Appendix A. Orem’s Self-Care Theory Alligood and Marriner-Tomey (2001) state that conceptual or theoretical models of nurse practice are pivotal to the field, providing the profession with a guide to patient care and with a general frame of reference that connects the structural environment to the patters of behavior and relationships within the organization. The Orem Self-Care Model of Nursing (Orem, Taylor & McLaughlin, 2003) is one such model. According...
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...This discussion question is based on a case study. As in all case studies, review the facts of the case and consider the various steps of the nursing process in order to address the critical thinking questions. Case Study: D.Q. is a 57-year-old male who worked in a water treatment plant for many years. He also smoked heavily for approximately 30 years. He has been diagnosed with COPD. During an extremely hot summer, he arrived at the emergency department in severe exacerbation of the COPD. The patient’s heart rate is 123, blood pressure is 163/90, respiratory rate is 34, oxygen saturation is 86% on 2 L NC, and temperature is 37.5 celsius. In preparation for discussion, consider the following process points before posting to the threaded discussion: 1. The drugs you should expect the provider to order for the patient 2. The rationale for each drug you anticipate the provider will order On the discussion boards, respond to the following: 1. What patient teaching would need to be provided for a patient taking each of these drugs: a bronchodilator, a glucocorticoid, and an expectorant? 2. What medications do you anticipate the physician ordering? Why? What are the potential side effects and/or complications of these drugs? Using the nursing process, describe your expected assessment, nursing diagnosis, plan of care, implementation, and evaluation of the patient. Compare and contrast your plan of care with that of your fellow colleagues. Why did you choose your actions...
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...affected staff mentally and physically but the majority of incidents went unreported. The nursing staff, registered nurses and nursing assistants in this environment both acknowledged the seriousness of this on-going problem to them. However the reluctance to report the aggression is because they considered the aggression to be part of the job despite them acknowledging it as a problem. England is an ageing society and as the population ages, health care providers, government, communities and families are faced with the burden of caring for people with dementia (Cubit, 2010). According to Access Economics (2005), dementia is becoming increasingly predominant to the aging population worldwide. A survey of over 15000 care homes in England and Wales found that 78% of residents were cognitively impaired (Bowman et al, 2004). In addition the Alzheimer`s Society (2007) reported that there are around 750 000 people in United Kingdom with a dementing illness. A more recent survey by the Alzheimer`s Society (2009) reported that around one third of older people with dementia in UK live in residential home care settings, representing 200 000 individuals. According to Leonard et al (2006); Zuidema et al (2007) aggressive behaviour may account for 30% of behavioural problems in care homes. The term “dementia” is commonly used for a number of neurodegenerative syndromes and the most common form is Alzheimer`s diseases and cerebrovascular disease (Rodney (2000); Fahey et al. (2007). Aggressive...
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...dollars. Hospitals find themselves in a position of proving they are the better choice than the hospital down the street. To do this many hospitals are looking at how nurses are prepared whether it be Associate degree in nursing (ADN) or Bachelor degree in nursing (BSN) and how this affects patient outcomes. According to Hood, L. J., & Leddy, S. K. (2006) the ADN degree in nursing is a concentrated study of clinical skills at the community college level, while the BSN degree is completed at the 4-year institution, where education is focused on not only skills but also science, liberal studies, research and community health. The ADN was first introduced back in the 1940’s when after the war America found itself in a nursing shortage. Many of women who would have filled nursing positions found other jobs that were now open to them due to the war effort. During this time community colleges and hospitals started programs in which the ADN nurse spent most of their education learning technical skills, in the hospital setting many of the students were taught these skills by on the job training. This training included more practical then theory and there was no continuity in what was taught at the community college level or the hospital programs. Hood, L. J., & Leddy, S. K. (2006). To this day the average healthcare consumer cannot tell you the difference between the ADN or BSN prepared nurse. Now data is available and hospitals attempting to become magnet status or nurse friendly are...
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...Baccalaureate, and RN-to-BSN Nurses There are many differences in the competencies between associate and baccalaureate level nurses. Associate level nursing programs tend to concentrate on the more technical aspects of nursing which allows students once they graduate to provide appropriate care to patients and families, especially during times of illness. They may practice on a more restricted level, making their nursing skills limited to more direct patient care in nursing homes and hospitals. Baccalaureate nursing programs improve on these skills by teaching more critical thinking to allow a more thorough approach to caring for their patients. RN-to-BSN programs allow ADN nurses that have grown confident in their hands-on skills and want to gain more critical thinking skills the ability to build on their education and "prepare...for a broader scope of practice" (American Association of Colleges of Nursing, 2014). The American Association of Colleges of Nursing (AACN) notes multiple research studies linking fewer medication errors, lower mortality rates and more positive patient outcomes to nursing education received at the baccalaureate level (2014). BSN programs also help teach the leadership needed for nursing supervision and prepare their nurses for graduate studies. Critical thinking competency is key to the future of the nursing profession as the nurse's role is becoming increasingly complex. Due to the changing nature of patient populations to include more chronically...
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