...Systematic Approach to Care through Effective Person-Centred Care Planning. The NHS places a strong emphasis on delivering person-centred care to patients. Patient-centred planning was adopted as national government policy in 2001 via the “Valuing People” paper and more recently as part of the “Valuing People Now” document (DOH,2009). Person-centred planning is now promoted as a key method in delivering the personalisation objectives of the Governments “Putting People First” programme for social care (DOH, 2007). The Coalition continues this commitment towards personalisation of care with its “Capable Communities and Active Citizens” document (DOH, 2010). One key area to ensure that care is delivered in a systematic person-centred way is through effective care planning that involves the patient in the process as a key stake holder. Several systematic models to nursing care are available that will facilitate practitioners in ensuring that all needs of the individual are identified and met. This essay will define what is meant by the term “person centred care”, will explore the systematic nursing models of care delivery and will highlight good practice in constructing person-centred care plans. This will be done using examples of an original care plan (constructed by the author for a real patient whose name has been changed) - and will draw upon information and evidence from a range of contemporary sources. It is appropriate in the context of this essay to firstly define...
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...Systematic Review Analysis: “A systematic review of nurses’ inter-shift handoff reports in acute care hospitals” 2013 Outline: A) Introduction. B) Article Analysis. C) Conclusion. Thesis: The present paper provides the analysis of the systematic review “A systematic review of nurses’ inter-shift handoff reports in acute care hospitals” by Poletick & Holly (2010). The influence of this review on clinical practice is discussed. The article “A systematic review of nurses’ inter-shift handoff reports in acute care hospitals” by Poletick & Holly (2010) provides the systematic review of the handoff reports between and among the nurses which ensure the quality exchange of information for the improved health care service. The continuity of care is the major concern for nurses, and the procedure of patient care transfer should take that into account. The objective of the review was stated clearly and mentioned the appraisal and synthesis of the qualitative evidence related to the nursing handoff report. Moreover, the authors aimed at recommending the improvements which would facilitate and enhance the information transfer. by reviewing the qualitative studies which dealt with the real experience of nurses with their inter-shift handoff reports. As the authors admit, this is likely to contribute to the improvement of the patient care. The conclusion on the potential...
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...Nursing Process The nursing process is a systematic and organized way nurses are required to give care to patients at a hospital setting. Nursing process follows a simple rule flexible rule by using the acronym ADPIE, it stands for accessing, diagnosing, planning, implementing, and evaluating. The purpose of the nursing process is to build on nurse’s critical thinking skill, allow for nurses to think outside the box and most importantly to provide excellent services to patients every time. Accessing in terms of nursing process refers to the gathering of information about a patient, objective information (directly from the patient) or subjective information (from family, friends and electronic health record). The next stage of the nursing process is the diagnosis, the nurse takes the information from the assessment, analyzes the information and through critical thinking process the nurse creates an intervention. The next phase is the planning, the nurse prioritize which diagnoses need to be focused on. A nursing diagnosis is different from a medical diagnosis because the nursing diagnosis focuses on the problem that results in the disease process and medical diagnosis focuses on the disease process alone. According to American Nurses Association the planning phase is based on the assessment and diagnosis, the nurse sets measurable and achievable short- and long-range goals for this patient that might include moving from bed to chair at least three times per day; maintaining...
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...improvement is one of the most important topics within businesses for the past twenty years. This is mainly true for health care, as the debate continues on how our current American system should be restructured. The current health care reform is aimed at decreasing costs and guaranteeing access to all Americans. It cannot be allowed to put the quality of care at risk. Quality improvement has become the main element to strategic planning within the health care domain. A strategic concept can help save our healthcare business in more way than you think. This cannot be effectively applied unless quality improvement can be accurately defined, measured, evaluated, and monitored at all times. Through such analysis a hospital can choose how to narrow resources toward those quality improvement projects which will effect a customer’s perceptions of service quality the most. The purpose of this research paper is to establish a concept by which to approach the issue of quality improvement, define the numerous components of quality improvement that exist in health care, and understand how these elements will affect one another. Quality improvement is a hard topic to have success in within this century. I have chosen to speak to do my research on quality improvement within a hospital. Hospitals are always trying to improve their quality of service to the ultimate patient experience. So I am going to start this research paper off with a twist that you would believe. Let begin to think about...
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...Current English 2005)”. In healthcare and clinical context, the term “handover” applies to the transferring of a patient’s information between two health care providers, when the patient receives care in a different location, or when another healthcare provider is responsible of the patient (ACSQHC 2005). The American word “handoff” also signifies the same meaning. Nursing handovers are often being described as a ritual, which stemmed from the medical concept preliminarily in the 1880s, whereby the nursing sister would direct the nurses on duty after hearing reports from the night shift nurses and the doctors’ rounds (Walsh and Ford 1989). The repetitive characteristic of the traditional handover does not encourage nurses to think critically or share different views, therefore depicted as a “ritual” (Kerr et al 2011). 1.1 BACKGROUND OFTHE STUDY The aim of a nursing shift handover is to precisely inform the patient’s general condition, care plan, treatment and expectations in a timely manner (Runy 2008). The process, if made without a systematic standardized method, would lead to errors and jeopardizes patient’s safety (ACSQHC 2010). Reported adverse events from handovers include unnecessary procedure and investigations, delayed diagnosis or treatments, prolonged hospitalization, increased cost, and dissatisfied patients (Patterson and Wears 2010). Therefore The Joint Commission (2009) and the WHO (2008) have emphasized on the necessity for organizations to develop standard...
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...Chapter 17- Evidence-based practice in therapeutic health care Objective: What evidence-based practice is About a 5-step approach to evidence-based practice To discuss evidence hierarchies and evidence quality To apply the evidence to current practice To provide a case study for a therapy question To provide a case study for a diagnostic question Key terms: Clinical practice guidelines Evidence-based practice Randomised controlled trial Systematic review Evidence-based practice: the use of best research evidence, along with clinical expertise, available resources and the patient's preferences to determine the optimal management option in a specific situation. Randomised controlled trail: a clinical trail where participants are randomly assigned to groups in order to receive different interventions. This randomization removes many of the effects that may bias the true result. Systematic review: a comprehensive identification and synthesis of the available literature on a specified topic. Clinical practice guidelines: systematically developed statements that assist the health professional and the patient to make decisions about what is the appropriate health care in specific circumstances. Critical summaries (systemic reviews and clinical practice guidelines) now provide practitioners with readily accessible access to research evidence. The availability of theses documents on the web means that patients have almost as much access to the 'critical summaries'...
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...Palliative and End of Life Care provide a holistic approach to care for those who are suffering from illnesses with a poor prognosis. It focuses on symptom management in an effort to improve quality of life (Ranallo, 2017). This approach to care for pediatric oncology patients with a terminal prognosis is not focused on a cure, rather emphasizes comfort when the patients and their families need it most. Various research studies explain the importance of initiating Palliative and End of Life Care early after the patient’s diagnosis. Given nurses’ roles, they have the opportunity to help provide this care. The purpose of this paper is to discuss ways to improve the quality of life of pediatric oncology patients through nurses helping to facilitate...
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...nursing care to patients and their families with complex healthcare needs” (Practice- Registered Nurse n.d.). One of the standards set forth by TX BON is “the maintenance of health, or prevention of illness”. Leininger’s theory says when an individual’s cultural expectations are not met or overlooked can delay progress or lead to worsening health. A nurse is not able to maintain health or prevent illness if he/she is faced with the obstacle lacking cultural knowledge and awareness. Therefore, nurses must approach each patient encounter uniquely with what is learned through literature and from clinical experiences in developing a nursing care plan. Another scope of practice defined by TX BON is the supervision and...
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...creative abilities of awareness, enlightenment, and faith, according to Masters RN, DNS (2010), (Chapter 10). Roy’s theory provides a systematic approach to nursing practice known as the nursing process. Ram utilizes a bi-level assessment to problem solve the nursing process in everyday patient care. Assessment of Behavior * The first step of the nursing process, which involves gathering data about the behavior of the person as an adaptive system in each of the adaptive modes("Nursing Theories", 2012). Assessment of Stimuli * The second step of the nursing process involves the identification of internal and external stimuli that are influencing the person’s adaptive behaviors. * Stimuli are classified as: 1. Focal- those most immediately affecting the person, 2. Contextual-all other stimuli present that are affecting the situation 3. Residual- other stimuli whose effect on the situation are unclear. ("Nursing Theories", 2012). Nursing Diagnosis * Step three of the nursing process involves the formulation of statements that interpret data about the adaptation status of the person, including the behavior and most relevant stimuli ("Nursing Theories", 2012). Goal Setting * The forth step of the nursing process involves the establishment of clear statements of the behavioral outcomes for nursing care with specified time frame("Nursing Theories", 2012).. Intervention * The fifth step of the nursing is determination of how best...
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...Position Statement Evidence-Based Practice Background Increased attention is being directed toward the development of methods that can provide valid and reliable information about what works best in healthcare. The careful scientific evaluation of clinical practice became a prominent focus during the second half of the 20th century.1 More recently, attention has been paid to methods of determining which of multiple proven approaches to a healthcare problem works best for which patients.2 Evidence-based practice encompasses implementing the best-known practices into the clinical setting using a scientific approach. It evolved from evidence-based medicine, which was developed in Canada to teach medical students. “Evidence-based medicine has been defined as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.”3, p. 3 The National Quality Forum’s report A National Framework and Preferred Practices for Palliative and Hospice Care Quality is a consensus report that is a first step toward introducing evidence-based measures into palliative practice on a formal, national level.4 The Agency for Healthcare Research and Quality (AHRQ) supports organizations in their efforts to improve the quality and efficiency of healthcare by facilitating the use of evidence-based research findings in clinical practice.5 The nursing discipline has also embraced evidence-based practice over the past 25 years, initially through...
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...to research, and how Sam can apply the evidence generated from a quantitative approach to evidence based clinical practice will be detailed below. Evidence based practice can be defined as clinical decisions for individual patients derived from the most appropriate evidence available (Facchiano & Snyder, 2012). It is a nurse’s care of duty to use appropriate clinical practice that will best suit the needs of the patient. Implementation of EBP based on an understanding of research findings is a requirement of competency standards for Australian and New Zealand nurses and midwifes (Borbasi & Jackson, 2012). Sam noticed conflicting practices while watching a routine wound clean; tap water was used instead of saline solution by one of his fellow nurses. This made Sam begin to think about what evidence there was to support using water, or if the nurse should have used saline instead. Sam decided to research this topic further, which comprised of him asking a targeted question that he could then translate into research. The clinical question was defined using PICO(T) which Borbasi & Jackson (2012) define as “Patient or population, intervention of interest or interest area, comparison intervention or comparison interest area and outcome of interest; now you can add T for time, although it is not always required” (p.197). By following this strategy the following criteria was determined; P – Patients with wounds requiring cleaning, I...
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...Integrated Approach to Care of Common Genitourinary Problems Student’s Name Institution Integrated Approach to Care of Common Genitourinary Problems This approach will incorporate techniques for care and treatment for the infected persons. Genitourinary infections are diseases that are caused by either virus, bacteria or even parasites that are transmitted during sexual association with an infected partner (Barlow, 2011). Efforts or attempts to develop a comprehensive approach to care for people with common genitourinary infections will have to analyze several features of the problem. The first characteristic of this problem is that there is a rapid increasing prevalence rate for people with genitourinary infections (Gross, 2011). The second aspect of this problem that will be included in the integrated approach is that. Genitourinary infections are not caused by bacteria alone, parasites and bacteria also cause these diseases too (Iannini, 2003). We also need to understand the risk factors associated with untreated genitourinary infections as most of these infections do not have symptoms during certain stages (Markos, 2003). The last characteristic of this problem to incorporate is the impact of genitourinary infections on costs and healthcare utilization. To develop an integrated approach to care for patients with common genitourinary infections, I formulated three elements for a comprehensive approach to addressing this problem. I identified them...
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...Annotated Bibliographies Lisa Stevens Kaplan University Annotated Bibliographies Au, A., McAlister, F., Bakal, J., Ezekowitz, J., Kaul, P., & vanWalraven, C. (2012). Predicting the risk of unplanned readmission or death within 30 days of discharge after a heart failure hospitalization. American Heart Journal, 164(3). 365-372. Retrieved from: http://www.medscape.com/viewarticle/771215_print This article sought to find an appropriate model to predict the risk of unplanned heart failure readmissions. The primary outcome from chart reviews also included death of heart failure patients within 30 days of discharge. The study looked at Centers for Medicaid and Medicare Services (CMS) models and the LACE+ index, to mention two of many that looked at prediction ability. The LACE+ index is a model that looks at length of stay, acuity, the Charlson comorbidity score and age, to predict readmissions. They found that no one model was appropriate in predicting the 30-day readmission rates, although using a combination of the models was an improvement to that predictor. The authors are all physicians, PhDs, or have a Master’s degree- helping to establish credibility. The authors also make a statement as to the funding of the project and that they (the authors) were solely responsible for all data collection, design and submission approval writing for the project, also lending credibility to the study. The references used for this study were appropriate in age, of the 28; 13 were...
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...Comparing Jean Watson’s Theory of Human Caring And The Neuman Systems Model Jayanna Volm Concordia University Comparing Jean Watson’s Theory of Human Caring And The Neuman Systems Model Nursing frameworks and conceptual models are imperative as a foundation for nursing practice. These frameworks provide recognition, understanding, and the ability to manage phenomena in which nursing comes into contact. These frameworks also provide the nurse with a systematic approach to interventions and goal attainment. The purpose of this paper is to compare Neuman Systems Model to Jean Watson’s Theory of Human Caring. According to Alligood and Tomey the Neuman Systems Model is classified as a nursing conceptual model. “Nursing conceptual models are concepts and their relationships that specify a perspective from which to view phenomena specific to the discipline of nursing. Different conceptual models provide various perspectives or frameworks for thinking critically and making nursing decisions” (Alligood & Tomey, 2010, p. 223). The nursing conceptual models are comprehensive and define the metaparadigm according to their framework. Tourville and Ingalls categorize the Neuman Systems Model as a systems model. They define a systems model of nursing as viewing “the person as a multidimensional being who reacts continually to a world of stressors” (2003, Systems Model, para. 1). Systems may be organizations, communities, businesses, or social structures. Within the large...
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...Post Traumatic Stress Disorder Aria Hospital School of Nursing Abstract Post traumatic stress disorder is a severe anxiety disorder that affects “5 million people each year,” (Valente, 2010). PTSD effects more women than, with approximately 58% of at risk individuals including combat veterans. If left untreated, PTSD leaves those affected with quality of life issues, social interactions, daily functioning, and psychological issues. Over the years, there has been an increase in the awareness of post traumatic stress, and the impact of its diagnosis, (Bastien, 2010). Treatment relies on a multidimensional approach, including supportive patient education, cognitive therapy, and psychopharmacology. This paper will review PTSD, including clinical manifestations, diagnosis, medical and nursing management and community resources available to those affected by this disease. Description of Disease “Posttraumatic stress disorder (PTSD) is an anxiety disorder with a sustained and dysfunctional emotional reaction to a traumatic event, threat of injury or death, and pain,” (Valente, 2010). A traumatic event can be military combat, natural disasters, terrorist incidents, serious accidents, or physical or sexual assault. Most people who are exposed to a traumatic event will have stress reactions for the immediate days or weeks following the incident, however with some time will be able to deal with the event and return to normal. However, some people will have stress reactions...
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