...practice nurse is employed as a British Heart Foundation (BHF) Heart Failure (HF) nurse and is based in secondary care. Along with networking with a wide range of health care practitioners providing a seamless service between primary and secondary care her role also involves evidence-based care to clients with chronic heart failure (CHF). CHF is a complex syndrome that results from a structural or functional cardiac disorder that impairs the ability of the heart to function as a pump. This results in the heart not being able to pump enough blood to meet metabolic demands of the body (Clinical Resource Efficiency Support Team (CREST), 2005). The most common cause of HF is coronary artery disease, hypertension and valvular disease. It is a chronic condition, which may fluctuate, and result in repeated hospital admissions. The incidence and prevalence of heart failure is on the increase and with the current ageing population it is likely to continue along this trend. It is currently the most common cause of hospital admission in clients over the age of 65 years and accounts for 1 - 3 % of the National Health Service’ expenditure, the majority of which is associated with inpatient care (CREST, 2005). The Nursing and Midwifery Council (NMC, 2010) defined specialist practice as “...the exercising of higher levels of judgement, discretion and decision making in clinical care” and requires that specialist practice nurse is competent in clinical assessment and diagnosis in their area...
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...201307517 BSc Nursing (Adult) 92510 Adult Nursing The Problem-solving Approach Monday 15th September, 2014 Word Count: 4111 Introduction: In care and nursing, problems arise all the time which need to be resolved in order for effective care to take place. This assignment will discuss the nursing process of the APIE (Assessing, Planning, Implementation and Evaluation) approach to solving issues, and how effective it can be. A nursing process is a systematic approach which focuses on patients as individuals and ensures all their holistic needs are met. It needs to address ‘the individual’s full range of needs, taking into account their health, personal, family, social, economic, educational, mental health, ethnic and cultural background and circumstances’ (Margereson and Trenoweth, 2010). Throughout the assignment there will be references to authors and theories relating to Sociology, Psychology and Biology, where applicable, to add support to the discussion. It will demonstrate how the stages of the problem-solving approach deal with problems that are encountered; it will describe how theoretical knowledge is used to enhance the problem-solving approach when dealing with encountered problems; and finally, it will demonstrate ways in which to plan using the problem-solving approach to enhance future practice. This discussion and assignment will be based on the audio-visual clip from the Nursing and Midwifery Council, (NMC), (NMC, 2010). Assessing: Assessing...
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...each school. It was apparent that providing equal opportunity to raise standards of education for the all the pupils required the recognition that every teacher had to change their way of thinking, every teacher matters. Introduction Four years ago, nine special schools embarked on a development program to work out an inclusive curriculum. When they met the schools were all designated with different disability responsibilities and each of them had their own separate curriculum. They decided to work to one common curriculum based on the central curriculum for all of the mainstream schools in Hong Kong. The project was coordinated by staff at the University of Hong Kong and led by a consultant from the United Kingdom. An action research approach was taken progressively focusing on the teacher’s changing understanding...
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...THE CASE FOR A MODEL OF CARE Contemporary health care systems are constantly challenged to revise traditional methods of health care delivery. These challenges are multifaceted and stem from: 1. novel pharmacological and non-pharmacological treatments; 2. changes in consumer demands and expectations; 3. fiscal and resource constraints; 4. changes in societal demographics in particular the ageing of society; 5. an increasing burden of chronic disease; 6. documentation of limitations in traditional health care delivery; 7. an increasing emphasis on transparency and accountability, 8. evidence based practice (EBP) and clinical governance structures; and 9. the increasing cultural diversity of the community. These challenges provoke discussion of the necessity of developing services around a model of care. What do we mean by a model of care? Ambiguity exists in the literature, with the terms, model of care, nursing model, philosophy, paradigm, framework and theory often used interchangeably, despite referring to diverse, yet parallel concepts (Tierney 1998). In their recent review of the literature, the Queensland Government (Australia) reported that they found no consistent definition of ‘model of care’ (Queensland Health 2000). They concluded that a model of care is a multidimensional concept that defines the way in which health care services are delivered (Queensland Health 2000). More specifically, Davidson and Elliott...
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...Health and Safety Management Systems - An Analysis of System Types and Effectiveness EXECUTIVE SUMMARY 1. INTRODUCTION 2. HEALTH AND SAFETY MANAGEMENT SYSTEMS 3. TYPES OF HEALTH AND SAFETY MANAGEMENT SYSTEMS PART ONE: LITERATURE AND FRAMEWORK FOR ASSESSMENT 3.1 INTRODUCTION 3.2 LITERATURE ON TYPES OF HEALTH AND SAFETY MANAGEMENT SYSTEMS PART TWO: CASE EVIDENCE 3.3 SYSTEM TYPES - CASE STUDY FINDINGS 3.4 SUMMARY 4. ASSESSING HEALTH AND SAFETY MANAGEMENT SYSTEM EFFECTIVENESS PART ONE: LITERATURE AND FRAMEWORK FOR ASSESSMENT 4.1 INTRODUCTION 4.2 LITERATURE ON EFFECTIVENESS OF HEALTH AND SAFETY MANAGEMENT SYSTEMS PART TWO: CASE EVIDENCE 4.3 THE TWENTY CASES: CONTENT AND LEVEL OF DEVELOPMENT OF HEALTH AND SAFETY MANAGEMENT SYSTEMS 4.4 THE TWENTY CASES: OUTCOME DATA 4.5 SUMMARY 5. FACTORS SHAPING PERFORMANCE AND THE ROLE OF SYSTEM TYPE 5.1 INTRODUCTION 5.2 BASICS AND EXTRAS 5.3 SYSTEM-RELATED CHARACTERISTICS 5.4 THE ROLES OF THE KEY WORKPLACE PLAYERS 5.5 THE LINKAGES BETWEEN HEALTH AND SAFETY PERFORMANCE AND SYSTEM TYPE 5.6 SUMMARY 6. CONCLUSIONS REFERENCES APPENDIX ONE: CASE STUDY PROTOCOL APPENDIX TWO: ASSESSMENT CRITERIA APPENDIX THREE: CASE SUMMARIES AND SYSTEM TYPES Executive Summary This report examines planned approaches to health and safety management in the workplace. It is the result of a two-year study of enterprise-level health and safety management systems, funded by Worksafe Australia, and conducted from late 1994 to late 1996. The need...
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...and change. Thus, the purpose of this literature review is to establish the current perspectives of patients, family and nurses on the factors that improve dignity in the end of life. Resultantly, this literature review will explore the role of nurses’ based on the findings of the perspectives that patients, family and health professionals have concerning the issue of dignity in the end of life care. In that regard, the paper follows a systematic approach which involves an introduction that explains the concept of end of life and the types of end of life care available. The paper then proceeds to explore the concept of dignity as viewed from several perspectives through the use of literature on the models of dignity means of measuring dignity and the themes associated with this conception. Consequently, the factors that improve dignity are laid out and discussed at length. Eventually, the paper will achieve its secondary goal which is to determine and expound on the topic of the roles that a nurse plays in end of life care not only for the patient but also for their family. End of life care Before the discussion of the main topic of this literature review which is determining the factors that promote dignity in the end of life in order to determine the role of nurses in the end of life, there is need to understand the meaning of the concepts of end of life and dignity. It is imperative...
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...NMHD 5003 Practice & Pharmacological Issues in Mental Health Nursing By Neil Drummond Essay 3048 words Care Plan 1676 words Overall wordage 7186 The aim of this essay is to show how I have formed, maintained and disengaged from a therapeutic relationship within a practice setting. This will include a profile of the client from their perspective. For the purpose of this essay, the therapeutic relationship was formed within the community mental health team. Their role is the primary intervention service promoting awareness, growth and helping people to work through difficulties (Mind.org, 2013). The interventions provided aim to facilitate comfort, support and a provision of care. The client I have chosen to write this essay on is called Angelo. Angelo is a fictitious name created to protect the individual’s right to confidentiality (NHS, 2012, N.M.C, 2008). The interaction was conducted because of a 6 month cognitive enhancer medication (galantamine) review. I will show an understanding of the importance of a therapeutic relationship building and the values that influence the formulation of mental health nursing assessment and care planning (Schultz and Videbeck, 2009). Appendix 1 will show the plan of management including risk and relapse. Appendix 2 will show the individualised Risk Assessment (profile). In my conclusion I will reflect upon my therapeutic encounter and will address the importance of knowledge and qualities needed to form, maintain and disengage...
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...Enhancing end-of-life care (EoLC) is a core component of international governments’ health policies. Across the globe, nurses make significant contributions to EoLC and, at this delicate time, have the power to positively influence the health and wellbeing of those facing death. Indeed, health promotion is a core component of the nurse’s role. Originating in the UK, EoLC pathways have been adopted around the world.Their broad aim is to optimise the quality of the dying process, enabling people to ‘die well’ across care settings. This paper examines EoLC pathways in terms of promoting health and wellbeing in this discrete stage of the dying trajectory. Concepts of health and health promotion are described briefly and the idea of health-promoting palliative care and its association with a good death examined. The ensuing discussion relates to two EoLC documents. While acknowledging that much has been achieved it is argued that, despite the potential for promoting health and wellbeing, a professionally led, biomedical approach predominates, and in terms of promoting health and wellbeing at the end of life there is a pressing need for proactive advance care planning at an earlier point in the illness trajectory. Key words: End-of-life care l Care pathways l Terminal care l Health promotion Michael Allen is Staff Nurse, Chemotherapy Day Unit, Singleton Hospital, Abertawe Bro- Morgannwg University Hospital Board, Swansea, Wales; Tessa Watts is Senior Lecturer, Swansea University,...
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...important to focus on organisational values and engaging stakeholders, including patients, when working to improve care quality and patient experience? Introduction This paper examines how organisational values and stakeholder engagement can improve patient quality, experience and care. The author will do this by exploring what stakeholder engagement is and how it is being used in the healthcare arena to improve care quality and patient experience. The author’s critical analysis will discuss the relationship between organisational values, stakeholder engagement and the delivery of quality patient care, before relating this to his professional practice, prior to drawing and presenting conclusions. The author having worked in the NHS for a number of years as a Commissioning Manager in a non-clinical role has often found it difficult to see the impact that sound organisational values and robust stakeholder engagement can directly have on the delivery of patient quality, experience and care, working through Module 3 has been a truly eye opening experience for the author. Having completed Module 1 and 2 of the EGA course and now coming to the end of Module 3, there have been many opportunities for self-reflection and time to make sense of how and why organisational values, engagement and service delivery are all interlinked. Analysis Engaging Stakeholders to Improve Care & Quality “Stakeholder engagement is the process by which an organisation involves people who may be affected...
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...Yanique Scott Evidence Base Health Care Research 20/06/12 A critique of a qualitative study focusing on self- efficacy of staff managing people with learning disabilities who have challenging behaviour. This essay discusses in some details a qualitative study that explores the importance of self- efficacy in staff for managing challenging behaviour (Cudre’-Mauroux, 2010). The purpose of this study is to critically evaluate the article titled ‘’Self- efficacy of staff managing people with learning disabilities who have challenging behaviour’’. A framework devised by Cormack (2000) has been used to help the process of critiquing this article. This particular framework had been chosen as it is comprehensive framework covering most points needed in the critiquing process. It will evaluate the strength and weakness of the article in a systematic way discussing the title, abstract, introduction, sampling method, data collection tool, data analysed, literature and ethical issues, result and conclusion. The evidence retrieved will be analytically discussed in regards to the usefulness to clinical practice. The title of the study is ‘’Self- efficacy of staff managing people with learning disabilities who have challenging behaviour (Cudre’-Maurox,2010). According Grinnel and Unrau (2011) a title succinctly conveys the nature of the study. The title includes central phenomenon and group under investigation which is professional caregivers and person with learning disabilities. The...
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...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 learns from...
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...Dementia Supporting people with dementia and their carers in health and social care Issued: November 2006 NICE clinical guideline 42 guidance.nice.org.uk/cg42 NICE has accredited the process used by the Centre for Clinical Practice at NICE to produce guidelines. Accreditation is valid for 5 years from September 2009 and applies to guidelines produced since April 2007 using the processes described in NICE's 'The guidelines manual' (2007, updated 2009). More information on accreditation can be viewed at www.nice.org.uk/accreditation © NICE 2006 Dementia NICE clinical guideline 42 Contents Introduction................................................................................................................................... 4 Person-centred care ..................................................................................................................... 6 Key priorities for implementation .................................................................................................. 8 1 Guidance ................................................................................................................................... 11 1.1 Principles of care for people with dementia ...................................................................................... 11 1.2 Integrated health and social care ..................................................................................................... 17 1.3 Risk factors, prevention and early identification...
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...curriculum: nursing education in the next century The present research focused on an interim evaluation of a new nursing curriculum made by ®rst- and second-year undergraduates. Study 1 examined the assessments made by 90 students of the new, actual programme of their studies, as well as an ideal one, on 21 bipolar criteria re¯ecting the developing changes in health care practices and higher educational processes in western society. The results of study 1 indicated that students perceived the actual programme as compatible with health care changes, but lacking in terms of the learning process. Study 2 investigated the same assessments among 105 registered nurses who evaluated the traditional nursing programme under which they were trained as well as an ideal one. The results of study 2 showed that registered nurses perceived past curricula as lower than the ideal on both health care and process of learning. The results of this interim evaluation imply that the new nursing curriculum follows health care trends, but a shift in the educational process is required. Keywords: curriculum, nursing, education, evaluation, health-care, baccalaureate society, with existing knowledge becoming...
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...Using ‘Person Centred’ Communication Skills and Models to Help Clients Admitted for the First Time to a Mental Health Hospital Introduction Communication is one way of exchanging information and feelings from one person to another (Bach and Grant 2009). It is transmitted through verbal and non-verbal behaviour. Communication is an essential and fundamental aspect of nursing care (Timmins 2011). It is a major and important part of daily nursing practice in the nurse-client relationship (Sheldon et al. 2006). Communication in nursing is unique and it is different from communication between healthcare providers because nurses are at the start of the healthcare service as they spend more time with the client than other healthcare professionals (McCabe and Timmins 2006). Therefore, nurses have to pay more attention to improving their communication skills for better client care. In order to establish a positive relationship with the client, it is necessary to communicate effectively and subsequently improve the quality of nursing care (McCabe and Timmins 2006). Effective communication is key to a therapeutic relationship with the client. It is defined as a ''purposeful form of communication used in the helping relationship'' (Ruesch 1961 cited in Arnold and Boggs 2007, p18). It is developed by the nurse for the purpose of assessing, planning, implementing and evaluating client care (Arnold and Boggs 2007). The establishment of a nurse-client relationship was a key element...
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.............................................................................. 7 Recommendation 1 Develop a local behaviour change policy and strategy .......................................... 7 Recommendation 2 Ensure organisation policies, strategies, resources and training all support behaviour change.................................................................................................................................... 8 Recommendation 3 Commission interventions from services willing to share intervention details and data ......................................................................................................................................................... 9 Recommendation 4 Commission high quality, effective behaviour change interventions ....................... 10 Recommendation 5 Plan behaviour change interventions and programmes taking local needs into account.................................................................................................................................................... 11...
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