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NR394 Transcultural Nursing Essay

Week 6 Discussion

Standards of Practice

CO3: Describe standards of practice for culturally competent nursing care. (PO6)

The basis for our lesson this week came from the Standards of Practice for Culturally Competent Nursing Care Executive Summary, Transcultural Nursing Society: https://www.tcns.org/standards (Links to an external site.)NR394 Transcultural Nursing Essay Links to an external site.

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Assume your nursing leader has decided that the department needs to better incorporate these Standards of Practice for Culturally Competent Nursing Care into the nursing care delivery model at your organization. There are 12 Standards.

Download and read the Executive Summary, and select one of the 12 standards as the basis for the discussion. Think about the standards as they relate to culturally sensitive care.

Explain how your department or organization currently gives credence to this standard.

If it does not, from your newfound knowledge, offer suggestions of how the standard can be incorporated into patient care in your department or organization.

Note: Make sure you choose a standard that another student has not selected. Keep in mind that each of us does not work in an acute care setting, so examples from other practice settings will add to a more robust NR394 Transcultural Nursing Essay discussion.

NUR3805 Dimensions of Professional Practice Essay

Chapter 9 Discussion

Follow the instructions under Discussion Board Rubric and Discussion Guidelines and APA Tips to create your post and respond to at least one other student. Internal citations and references are required.

Ladies and gentlemen ~

I believe that the grand theorists were important to getting nursing where it is today ~ I believe that as nurses, we need to understand their contribution and give them a nod of thanks.This module is focused on the utilization and application of nursing theory as a guide for excellence in nursing practice. As a BSN student, it is important that you learn to critique nursing research and become an informed consumer of research relevant to evidence based practice. That’s where the middle range theories come in. NUR3805 Dimensions of Professional Practice Essay. Middle range theories provide the theoretical framework that link grand nursing theories with nursing practice.

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Discussion topic: Middle Range Theories

1. Identify ONE middle-range nursing theory from your text, from the list in the Learning Plan, or one you identify on your own that applies to your area of practice or simply peaks your interest. (I am hopeful that you will all have different ones)

2. Summarize your chosen middle-range theory, including the development of it as a middle-range theory, how to utilize it and the theoretical framework for it. Most middle-range theories have a theoretical framework. For example, the framework for the middle range theory of Unpleasant Symptoms:

Framework for Unpleasant Symptoms MRT

Of course, many have their own designed model for how they perceive the framework should be ~ that’s okay. Which one makes the most sense to YOU? And if you don’t like theirs, design your own framework for the theory!

3. Identify how this middle range theory can help you organize your thoughts for critical thinking and decision making in nursing practice. NUR3805 Dimensions of Professional Practice Essay.

NRS433 Introduction to Nursing Research Essay Discussion papers

Week 1 Discussion

DQ1 Identify two areas of nursing practice, which evidence-based practice has improved patient outcomes. State the study and its impact on patient care. How have these findings changed your nursing practice? Please support your response with a minimum of two supporting peer reviewed articles.

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DQ2 Nursing research is used to study a dilemma or a problem in nursing. Examine a problem you have seen in nursing. Why should it be studied? Justify your rationale.

NRS433 Introduction to Nursing Research

Week 2 Discussion

DQ1 Qualitative data has been described as voluminous and sometimes overwhelming to the researcher. In what ways could a researcher manage and organize the data?

DQ2 The three types of qualitative research are phenomenological, grounded theory, and ethnographic research. What are the differences and similarities between two of the three types of studies? NRS433 Introduction to Nursing Research Essay Discussion papers.

NRS433 Introduction to Nursing Research

Week 3 Discussion

DQ1 Provide examples of experimental and nonexperimental research design. Contrast the levels of control applied to each.

DQ2 What is sampling theory? Describe it and provide examples to illustrate your definition. Discuss generalizability as it applies to nursing research.

NRS433 Introduction to Nursing Research

Week 4 Discussion

DQ1 Extraneous variables may have an influence on the dependent variable. In what ways do researchers attempt to control extraneous variables? Support your answer with current literature.

DQ2 Describe the levels of evidence and provide an example of the type of practice change that could result from each. NRS433 Introduction to Nursing Research Essay Discussion papers.

NRS433 Introduction to Nursing Research

Week 5 Discussion

DQ1 The theoretical foundations of qualitative and quantitative methods are very different, but many researchers believe both methods should be used in the research study to increase validity and reliability. What advantages or disadvantages do you see in using both types of methods in a nursing study? Support your answer with current evidence-based literature.

DQ2 According to the textbook, nurses in various settings are adopting a research-based (or evidence-based) practice that incorporates research findings into their decisions and interaction with clients. How do you see this being applied in your workplace? NRS433 Introduction to Nursing Research Essay Discussion papers.

NR392 Quality Improvement in Nursing Essay Assignments

Week 1 Discussion

Defining a Quality Care Issue in Nursing

CO1 Identify the role of the BSN nurse in the quality improvement process as a member of the collaborative interprofessional team. (POs 2 and 7)

Think of an area of opportunity within your current or former clinical setting that is quality driven. Define (D) one nursing care issue (not a workforce issue such as staffing) from a current or former nursing workplace (or clinical setting) that could be impacted by improved quality. NR392 Quality Improvement in Nursing Essay Assignments. This nursing care issue should not be one that has already undergone a quality improvement process. Tell us details of this issue and how it this issue impacts nursing care quality at that facility.

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NR392 Quality Improvement in Nursing

Week 2 Discussion

DMAIC Process for a Real Life Issue

CO2 Discuss effective processes and strategies to improve quality in nursing. (POs 2 and 8)

Why is it important to have a structured process to approach and improve nursing care quality? How can use of this structured process help to improve quality nursing care in your setting?

NR392 Quality Improvement in Nursing

Week 3 Discussion

Quality Improvement Education

CO1 Identify the role of the BSN nurse in the quality improvement process as a member of the collaborative interprofessional team. (POs 2 and 7)

CO3 Examine culture of safety principles that improve patient outcomes based on current evidence. (POs 7 and 8) NR392 Quality Improvement in Nursing Essay Assignments.

In your prelicensure nursing education program, what did you learn about quality improvement in nursing? How was quality improvement emphasized? As you consider nursing education today, what would you suggest be included in future education or orientation programs about the important topic of quality improvement in nursing?

NR392 Quality Improvement in Nursing

Week 4 Discussion

Culture of Safety

CO1 Identify the role of the BSN nurse in the quality improvement process as a member of the collaborative interprofessional team. (POs 2 and 7) NR392 Quality Improvement in Nursing Essay Assignments.

CO2 Discuss effective processes and strategies to improve quality in nursing. (POs 2 and 8)

How does your current or former clinical environment maintain a culture of safety? How are errors reported and managed to improve quality? What suggestions would you make as a nurse leader to improve the culture of safety?

NR392 Quality Improvement in Nursing

Week 5 Discussion

Strategies for Interprofessional Collaboration to Promote Quality

CO1 Identify the role of the BSN nurse in the quality improvement process as a member of the collaborative interprofessional team. (POs 2 and 7)

CO2 Discuss effective processes and strategies to improve quality in nursing. (POs 2 and 8)

This week as we focus on interprofessional collaboration to promote quality, please remember that professionals include dietitians, therapists (respiratory, physical, occupational, and speech), social workers/case managers, psychologists, physicians, pharmacists, and others. Professionals do not include patients, families, aides, or unlicensed assistive personnel. NR392 Quality Improvement in Nursing Essay Assignments.

Working as an interdisciplinary team helps promote positive patient outcomes. What strategies do you use to successfully work with other professions in your workplace to promote quality care? What strategies are not successful? What are the barriers to interprofessional collaboration, and how will you overcome these barriers?

NR392 Quality Improvement in Nursing

Week 6 Discussion

Quality Improvement Using Evidence-Based Practice in Nursing

CO3 Examine culture of safety principles that improve patient outcomes based on current evidence. (POs 7 and 8)

Consider a single nursing care issue at your facility where quality has already been improved by implementation of evidence. Answer the following:

How was evidence on that topic located in scholarly professional nursing journal articles and evaluated? NR392 Quality Improvement in Nursing Essay Assignments.

What was the implementation plan?

How was the improvement in quality measured after the implementation?

What do you suggest that would have improved this implementation and maintenance of improved quality?

NR392 Quality Improvement in Nursing

Week 7 Discussion

The Role of Patients in Your Course Project Nursing Issue

CO1 Identify the role of the BSN nurse in the quality improvement process as a member of the collaborative interprofessional team. (POs 2 and 7)

CO3 Examine culture of safety principles that improve patient outcomes based on current evidence. (POs 7 and 8)

Considering the nursing issue for your Course Project, address the following:

Provide a brief summary of your Course Project for the class NR392 Quality Improvement in Nursing Essay Assignments.

What patient data is collected? What data do you want collected?

How will this actual and desired data help you to continue to improve quality on this nursing issue?

NR392 Quality Improvement in Nursing

Week 8 Discussion

Reflection on AACN BSN Essential II

CO1 Identify the role of the BSN nurse in the quality improvement process as a member of the collaborative interprofessional team. (POs 2 and 7)

CO2 Discuss effective processes and strategies to improve quality in nursing. (POs 2 and 8)

Quality is an overriding principle in the AACN BSN Essentials document. Essential II specifically describes the role of the baccalaureate nurse in quality improvement. As you complete this course, reflect on how you will implement lessons learned about quality improvement into your future nursing practice. Provide details about what you plan to do to improve quality in your current or ideal future professional nursing position. NR392 Quality Improvement in Nursing Essay Assignments Think big!

NR-706 Healthcare Informatics & Information Systems Essay Assignments

NR706 Week 1 Discussion 1 & 2

dq 1

Week 1: Nursing Informatics and Advanced Nursing Practice

5151 unread replies.6767 replies.

Derived from your healthcare experience, describe the relationships among computer science, information science, and nursing science from an advanced nursing practice perspective.

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dq 2

Week 1: Nursing Information Systems and Advanced Nursing Practice

4040 unread replies.6363 replies.

Derived from your healthcare experience, describe the impact of a selected nursing information system on a selected healthcare stakeholder (patient, family, or nurse) from an advanced nursing practice perspective. NR-706 Healthcare Informatics & Information Systems Essay Assignments.

NR706 Week 2 Discussion 1 & 2 Latest 2018 May

dq 1

Week 2: Nursing Informatics Roles and Advanced Nursing Practice

4646 unread replies.5858 replies.

Derived from your healthcare experience, determine selected nursing informatics roles and their utility from an advanced nursing practice perspective

dq 2

.

Week 2: Standardized Terminology and Advanced Nursing Practice

4848 unread replies.6060 replies NR-706 Healthcare Informatics & Information Systems Essay Assignments.

Derived from your healthcare experience, determine the utility of standardized terminology and nomenclature in nursing informatics from an advanced nursing practice perspective.

NR706 Week 3 Discussion 1 & 2 Latest 2018 May

dq 1

Week 3: Knowledge Management and Advanced Nursing Practice

5050 unread replies.6060 replies.

Derived from your healthcare experience, distinguish the components of knowledge management from an advanced nursing practice perspective.

dq 2

Week 3: Translation Science and Advanced Nursing Practice

4545 unread replies.5656 replies.

Derived from your healthcare experience, distinguish components of translation science from an advanced nursing practice perspective.

NR706 Week 4 Discussion 1 & 2 Latest 2018 May

dq 1

Week 4: Creating a Translation Science Culture in Advanced Nursing Practice

4747 unread replies.5858 NR-706 Healthcare Informatics & Information Systems Essay Assignments replies.

Articulate the potential benefits and/or barriers from selected translation science methods that serve to shape the advanced nursing practice environment.

dq 2

Week 4: The Human Factor and Systems Management Issues in Evidence-Based Practice

4646 unread replies.5555 replies.

Articulate the driving forces and restraining factors of the human factor and systems management issues that serve to shape the evidence-based practice environment.

NR706 Week 5 Discussion 1 & 2 Latest 2018 May

dq 1

Week 5: Information System Contributions to Advanced Nursing Practice

4545 unread replies.5757 replies.

Examine potential information system contributions that serve to shape the advanced nursing practice environment.

dq 2

Week 5: Information System Contributions to the Improved Quality of DNP-Prepared Nurse Healthcare

4343 unread replies.5656 replies.

Examine potential information system contributions that serve to improve DNP-prepared nurse healthcare delivery.

NR706 Week 6 Discussion 1 & 2 Latest 2018 May

dq 1

Week 6: Information System Contributions to Decision Making in Research and in Education

4545 unread replies.5858 NR-706 Healthcare Informatics & Information Systems Essay Assignments replies.

Differentiate potential information system contributions that serve to foster decision making in research and in education.

dq 2

Week 6: Information System Contributions to Evidence-Based Practice

4444 unread replies.5353 replies.

Differentiate potential information system contributions that serve to shape a preferred evidence-based practice environment.

NR706 Week 7 Discussion 1 & 2 Latest 2018 May

dq 1

Week 7: Web-Based Continuing Education and the Improvement of Advanced Nursing Practice and Healthcare

4949 unread replies.6060 replies.

Formulate effective strategies for Web-based continuing education that might serve to improve advanced nursing practice and healthcare.

dq 2

Week 7: Web-Based Patient Education and the Transformation of Advanced Nursing Practice and Healthcare NR-706 Healthcare Informatics & Information Systems Essay Assignments.

5454 unread replies.6666 replies.

Formulate effective strategies for Web-based patient education that might serve to transform advanced nursing practice and healthcare.

NR706 Week 8 Discussion Latest 2018 May

Week 8: Future Trends for Informatics in Advanced Nursing Practice

5151 unread replies.6363 replies.

NR-706 Healthcare Informatics & Information Systems Essay Assignments Differentiate future trends of nursing informatics that may serve to further shape advanced nursing practice environment.

NRS 440 Trends and Issues in Today’s Health Care Essay Assignment Discussions

NRS440 Week 1 Discussion 1 & 2 Latest 2018 May

dq 1

What is the impact to the nursing profession and to the public related to the projected nursing shortage? Discuss at least one way that the nursing profession is working toward a resolution of this problem.

dq 2

What is the role of health care reform in shifting the focus from a disease-oriented health care system toward one of wellness and prevention, and how does nursing fit into this shift? NRS 440 Trends and Issues in Today’s Health Care Essay Assignment Discussions.

NRS440 Week 2 Discussion 1 & 2 Latest 2018 May

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dq 1

The Patient Protection and Affordable Care Act (PPACA) was passed into legislation in March of 2010. Identify the impact of this legislation on your nursing practice by choosing two key nursing provisions outlined in the topic material “Nursing and Health Reform.” Discuss how these two provisions have impacted, or will impact, your current practice of nursing.

dq 2

Describe one innovative health care delivery model that incorporates an interdisciplinary care delivery team. How is this advantageous to patient outcomes?

NRS440 Week 3 Discussion 1 & 2 Latest 2018 May

dq 1

Discuss current research that links patient safety outcomes to ADN and BSN nurses. NRS 440 Trends and Issues in Today’s Health Care Essay Assignment Discussions. Based on some real-life experiences, do you agree or disagree with this research?

dq 2

What is the difference between a DNP and a PhD in nursing? Which of these would you choose to pursue if you decide to continue your education to the doctoral level?

NRS440 Week 4 Discussion 1 & 2 Latest 2018 May

dq 1

Choose one legislator on the state or federal level who is also a nurse, and discuss the importance of their role as advocate for improving health care delivery. What specific bill(s) have they sponsored or supported that has/have influenced health care?

dq 2

Discuss how the CMS reimbursement rules for never events required a shift in the patient care delivery model in inpatient facilities.

NRS440 Week 5 Discussion 1 & 2 Latest 2018 May

dq 1

Identify the educational preparation and role(s) of the clinical nurse leader (CNL) designation. Give an example of how the CNL influences direct patient care whether in a hospital or out in the community NRS 440 Trends and Issues in Today’s Health Care Essay Assignment Discussions.

dq 2

Identify advocacy strategies that you can use to create change in your current workplace. NRS 440 Trends and Issues in Today’s Health Care Essay Assignment Discussions.

Changing role of nursing essay example NRS 440

Our role as a nurse changing to more home health jobs:

The country is facing many changes especially with Obama Care being up in the air with the new president. The Affordable Care Act has restructured how we receive our health care in the United States. Nurses have and always will play a very important role in our health care today. Changing role of nursing essay example NRS 440. The one change that is very different from how we receive our health care today is the simple fact that in years to come it is expected that nursing will be in high demand outside of the hospital compared to just having nurses in and around hospitals delivering acute care.

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The practice of nursing is an ever evolving career. As we grow and evolve as a country so does the career in nursing. The concept of continuity of care used to be considered inside a hospital setting only but because our culture is changing so much it reflects on how nursing is approached. My goal is to provide you with information showing the recent trend of providing in home health care compared to the traditional hospital care we are all used to receiving. Changing role of nursing essay example NRS 440.

Traditional roles vs. more opportunities

The traditional role of nursing has been to provide care inside the hospital. As a nurse we tend to think if we would like to work as a RN the place to apply would be a hospital. This is no longer the case. Job opportunities are going to be in the community especially because the Affordable Care Act has placed programs for the elderly to be at home for as long as possible. There are more and more rehabs, assisted living places being opened up by the 100’s.  The need for nurses at these facilities is only going to become greater as the bigger hospitals increase these types of programs. In a recent article by ANA Career Center Staff the topic being looked at was heath care and the affect it had on the nurses. It addressed things like the fact over half of the nurses were looking at retirement. They went as far as to state, “More than half of working nurses are over 50, which means there will be a lot of empty positions to fill in the coming years as they retire, says Susan Yox, EdD, RN, director of editorial content at Medscape.” (ANA, 2015). Changing role of nursing essay example NRS 440.  Peggy Crabtree is from the Camden group and she believes that there will be more opportunities for the nurse to work considering how many patients will be discharged to one of the facilities outside of the hospital. The opportunities are really endless for nurses because there are now programs for this very thing everywhere. One of the options are ACO’s which are Accountable Care Organizations. These are a great alternative for the patient and the nurse to provide care in an environment other than the hospital. The ACO has been defined as a “model of care, an ACO generally consists of an interrelated system of providers that may comprise hospitals, home care and long-term care agencies, physician group practices, and other health care entities, such as medical homes, whose focus is primary care. The ACO assumes responsibility for managing the care of the patient and the delivery of services across the continuum of care, with a strong emphasis on primary care and prevention”. (Hart, 21012) Changing role of nursing essay example NRS 440.

Home Hemodialysis

One program that I happened to know a bit more about is Home Hemodialysis. I just switched jobs recently and this is now what I am presently learning.  The home dialysis program is amazing for patient’s. These patients are tied down to the dialyzer for three to four times a week and it usually is for a 4-hour time period. Changing role of nursing essay example NRS 440. So if you can only imagine the life style commitment these people make. So, if you can imagine this machine is the patient’s life line. It really helps that patient feel the least bit of freedom by giving them a bit of control with a home dialysis machine. It can do wonders for their health both mentally and physically. The patient is actually able to travel to different areas in the United States due to the Affordable Health Care Act. Most of them will qualify for the home dialysis unit which is portable if they are at a pretty high functioning level. It has made things like home dialysis an everyday topic rather than a wish that the patient longs for and dreams about. It can make it a reality. Changing role of nursing essay example NRS 440.

Many years ago these things like home dialysis were not an option. Overtime things like rehab facilities, home health care, hospice, assisted living facilities are all fairly new. With these types of health care being offered over just the acute care units in the hospitals it requires a more diverse set of skills for the nurse to have. While all of this new and upcoming healthcare is great it definitely causes a nursing shortage. It requires the nursing community to rethink about how they are training the new nurses.

Nurses Response

I shared this with three colleagues on my floor and asked for their feedback. The following is some of their responses to my presentation. All three basically had the same thing to say in general. They all felt like they knew how fast our health care was changing but were not aware that it was changing towards home health more than the acute care in the hospital. The more all three were talking I saw that they also agreed that in general all of the programs offered were starting to have an affect on the patient census Changing role of nursing essay example NRS 440. There are times of the year we see more patients especially now with the holidays but they also stated that having programs like home Hemodialysis is amazing. It allows our center the ability to see at least 100 more people in need. I think their point was that right now they really have not seen a change in the jobs for nursing dwindling in any way at the hospital but they have seen many of the jobs open up at home because of these new programs. I personally would have to agree with this point they were making too. Basically, in home dialysis there is so many patients waiting to be seen that yes many nursing jobs have been created at the home level but it still is in high demand at the acute care center in the hospital due to how many patients have needed this. Changing role of nursing essay example NRS 440.

Another point they were making was about the funding for these programs and if it was truly available. They were questioning the fact that like in many clinics or hospitals they never want to pay the nurse what she is truly valued at. They were asking about the load of work a nurse would be expected to do at a home treatment rather than the treatment in the hospital where they have access to PCT’s and CNS’s that help them tremendously. They raised some really good questions and points. They agreed that in general our health care is starting to use things like home health care over coming into the ER room and getting saline due to being dehydrated. They also agreed that these options were so much healthier for a family with a sick loved one Changing role of nursing essay example NRS 440. The amount of time and energy it takes on the family to bring the patient to the hospital and then to be around all the other people that are sick when that person is likely immunocompromised to begin with.

Our Nursing Future

Once I shared with them some of the good these home clinics are capable of I think all tree were more likely to be on board with the fact our health care system is changing and it will affect nursing in the areas we actually are providing care to our patients. When you spend time explaining personal stories about how home health care has not only helped a patient but also has allowed the patient to feel a sense of control again over their own life all three of the nurses were listening with a new sense of hearing. We all get complacent with our job and all it took for a renewed outlook on things was for these three nurses was to listen to a presentation. I actually could tell when we went back into the clinic for the acute care hemodialysis that they were extra careful and sensitive with their patients. It made me realize just how much it helps our health care team see things as they are. We all might need to have an open mind about working and providing care in a home, rehab, or assisted care facility rather than the traditional hospital. It will do the whole nursing community a world of good. Changing role of nursing essay example NRS 440.

References

Accountable care organizations: the future of care delivery? (n.d.). Retrieved December 18, 2016, from
https://www.ncbi.nlm.nih.gov/pubmed/22277862

(n.d.). Affordable Care Act Summary. Retrieved December 17, 2016, from

Affordable Care Act Summary

4 Health Care Trends That Will Affect American Nurses. (n.d.). Retrieved December 17, 2016, from

http://nursingworld.org/MainMenuCategories/Career-Center/Resources/4-Health-Care-Trends-That-Will-Affect-American-Nurses.html

Nather, D. (n.d.). Understanding Obamacare: A guide about the Affordable Care Act by POLITICO. Retrieved December 17, 2016, from
http://www.politico.com/obamacare-guide
/ Changing role of nursing essay example NRS 440.

NR392 Quality Improvement in Nursing Project Milestone 1 Completed

Project Milestone 1

 
Directions: Prior to completing this template,
carefully review Course Project Milestone 1 Guidelines paying particular attention to how to name the document and all rubric requirements.
After saving the document to your computer, type your answers directly on this template and save again. This assignment is due by Sunday end of Week 1 by 11:59 p.m. Mountain Time.

Your Name:
_____ _____________________

Assignment Criteria

Your Answers:

NOTE: See Milestone 1 Rubric for details required in each area.

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Nursing Issue

 

30 points

Medication error is defined by the NIH as “a failure in the treatment process that leads to, or has the potential to lead to, harm to the patient’ (NIH.gov) Medication error has been a serious problem in the healthcare industry. Mistakes involving medications are among the most common health care errors. There different types of medication errors; failing to perform any of the 6 rights of medication administration can lead to medication error, cross sensitivity, wrong diagnosis etc. Medication error could sometimes generate from the prescriber, the dispenser, the manufacturer, monitoring of blood levels, educating patient correctly and administration. The nurses are usually the ones administering these medication directly to the patient, therefore is our responsibility to do last safety check before medication administration. Now there are certain instances where the nurse has no control over the error that is being made because they are not trained to identify the mistakes of the doctor or pharmacist. For example misdiagnosing a patient and giving the medications inappropriately and sometime pharmacy failing to recognize problems like cross sensitivity of certain medications given to the patient. NR392 Quality Improvement in Nursing Project Milestone 1 Completed. Nurses have direct contact with patients daily and in the acute care setting, they are usually the ones administering these medications directly to the patients, and so that makes medication errors a big issue in nursing.

Details of the Issue

 

45 points

According to NIH, It has been estimated by the Institute of Medicine that medication errors cause 1 of 131 outpatients and 1 of 854 inpatient deaths (Nih.gov). When medication error occurs a lot of people are held responsible for the mistake, especially the nurses who are suppose to be performing the last check prior to administration. Medication errors can and has had a wide range of effects on patients. NR392 Quality Improvement in Nursing Project Milestone 1 Completed. The effects of medication error ranges from nothing happening to the something as serious as death of the patient. Even though they have been significant improvement with prevention of medication errors, there are still serious errors being made by members of the care team. Is no denying fact that acute care facilities have taken great steps to prevent medication errors from occurring, such as the electronic medication record which is linked to the pharmacy, scanning patients wrist band before giving medications, having two nurses verify certain medications, pharmacy reviewing PT/INR and ordering Coumadin on a daily basis etc. As nurses we are trained to review lab results, diagnostic results, and patient’s diagnosis and also understand why certain medications are prescribed for patients before administering the medication. Sometimes the nurses fail to do so and encounter the possibility of a medication error. We had a situation where a patient INR was 3.1 and patient was on 5mg of Coumadin, the INR goal for the patient was 2-3. The pharmacist made a mistake and orders 3mg of Coumadin but fails to discontinue the 5mg making it a total of 8mg. The nurse failed to question the order, administer the 8mg and the next INR was 4.8. Although the pharmacy made an error, the nurse administering the mediation was held accountable as well for not reviewing the labs and questioning the order. This example goes to emphasize the fact that, although we have certain measures put in place, it is very essential for nurses to follow the 6 rights of medication administration and review labs results before giving any medications. NR392 Quality Improvement in Nursing Project Milestone 1 Completed.

 

My facility has put forward a series of measures to try and decrease the amount mediation error that occurs. We have access to the patient’s  medication record for their community pharmacy. This enables us view the medication the patient is on, compare it with the home list the patient brought in and ask question if we have any doubts. It eliminates the problem of missed doses and wrong prescription by the provider. The hospital discourages the use of home medications. We ask their loved ones to take their medications back home after comparing the bottles to their home list. NR392 Quality Improvement in Nursing Project Milestone 1 Completed. The only exception to this is, if the patient is taking a medication that is in not in our pharmacy formulary, then the pharmacy has to verify the medication, label it with a barcode and the nurses must lock it up in the medication drawer and administer it to the patient as directed until discharge. Two nurses have to verify insulin prior to administration as well as heparin drip. All medications that are not scanned are reported to the manager at the end of the month an each nurse need s to score 98% scanning rate or above. All medications entered has to be verified by the pharmacy before it could be pulled out of the pyxis or administered to patients.

Reporting the errors as soon as you realize it can produce a better outcome for the patient. For example mistakenly administering 60units of short acting insulin instead of long acting insulin to a patient needs to be reported right away or it might be detrimental to the patient’s life. I will encourage my colleagues to talk to patient about their  home medication regimen on admission and question any orders if they have doubts. If any errors occur, I will encourage the staff to report it in a timely manner and not hide it. Creating a non punitive environment for staff could encourage staff to report the issue without fear of been punished.

 

Reason Issue Selected

 

25 points

In the acute care setting that I work in, I have seen so many mediation errors stemming from different levels of the care team. I recently witnessed an actual medication error which thankfully did not cause any harm to the patient. Two months ago, I had a patient that was misdiagnosed by the Radiologist for having a blood clot in the pelvis.  The patient was started on Coumadin/Lovenox bridge because her INR was 1.0. She was getting 60mg of Lovenox twice daily and Coumadin 5mg daily which was subjected to change based on the daily PT/INR. The Coumadin went as far up as 10mg. The patient goal was to bring the INR between 2-3 NR392 Quality Improvement in Nursing Project Milestone 1 Completed. The PA was assigned to the patient for the first 5 days after her diagnosis. On the 4
th
day when a doctor took that assignment, he questioned the MRI results based on the images he reviewed. The Radilogist was called and he was later concluded that the patient was misdiagnosed. So the patient did receive such high dosage of blood thinners for no apparent reason. The patient and her family were notified by the hospital. The patient daughter made it very clear she was taking legal actions against the hospital. The patient INR only came up to 1.8 thankfully. In this situation, the medication error stems from the provider esp. the Radiologist who misdiagnosed the patient. I thought this particular incident actually highlighted the fact that medication error still occur in acute care settings even with several measures put in place to prevent errors from happening. Although the person who originated this error was the diagnosing doctor, so many people were held accountable. The radiologist, the prescriber, the nurses who administer the medication. NR392 Quality Improvement in Nursing Project Milestone 1 Completed.

REFERENCES:

https://learn.ana-nursingknowledge.org/products/Preventing-High-Alert-Medication-Errors-in-Hospital-Patients
, Retrieved, October 2016.

https://www.ncbi.nlm.nih.gov/pubmed/24981217
, Retrieved, October 2016.

 

Course Project Milestone 2 Template

Directions: Prior to completing this template,
carefully review Course Project Milestone 2 Guidelines paying particular attention to how to name the document and all rubric requirements.
After saving the document to your computer, type your answers directly on this template and save again. This assignment is due by Sunday end of Week 3 by 11:59 p.m. Mountain Time.

Your Name:
Latoya Harrison

Assignment Criteria

Answers:

(
NOTE: See Milestone 2 Rubric

for details required in each area
.)

Define
:

Approved Nursing Issue from Milestone 1

25 points

My Approved Nursing issue that was thoroughly explained in my Milestone 1 assignment is Nurse Mentoring. Nurse mentoring can be defined as a continuous collaborative relationship between two individuals. One of which is a novice and an expert/senior. Nurse mentoring is a reciprocal learning relationship between two persons, who have mutual goals as it relates to the care being provided. At some point in our lives, many of us go through numerous working experiences where everything is new to us, and to be quite honest, this is a rather unpleasant feeling. It is the fear of the unknown, or just that generalized uncomfortable feeling. We’ve all been there and will continue to experience this as we navigate our way through different working experiences. What would have made these experiences more pleasant, is a mentor. The concept of nurse mentoring continues to be an overlooked issue that is need of Quality improvement. NR392 Quality Improvement in Nursing Project Milestone 1 Completed.

 

Measure
:

Identify Measures (Indicators) to Support the Issue

75 points

The lack of nurse mentoring/mentorship is a worldwide issue that affects both patient outcomes, and nurse retention rates in hospital facilities. Take my experience for example. At my former facility, there were always a shortage of new nurses. Over the span of 1 year, the facility has had difficulties retaining nurses. I will briefly explain why. This facility lacked the teamwork/collaboration approach. It was almost as if I was thrown to the wolves as soon as I got to the floor. A warm accepting environment did not exist. I received constant attitudes whenever I asked for help, and had no one to orient me to the areas that I was unfamiliar with. Most of the nurses were in their own little worlds and preferred to work independently. I believe they looked at it as if I would be slowing them down. Myself, along with other new nurses, faced feelings of uncertainty and we all yearned for consistent guidance. We began to feel resistance from the more experienced nurses. It was almost like they were “eating their young”. Retention rates decreased significantly. At this specific time, my facility hired 14 new RN’s. Within a 6-month time frame, 10 quit their positions including myself. There are a multitude of things that could have been better had there been effective mentoring relationships, and or mandatory programs putting this in place. My self confidence level would have been increased, leadership skills enhanced, stress levels reduced, improved networking abilities, and enhanced communication skills. NR392 Quality Improvement in Nursing Project Milestone 1 Completed.

 

 

 

Measure
:

List Stakeholders (important persons) in Improving this Nursing Issue

50 points

There are in fact several stakeholders that can impact this continuous issue in a positive way. These include nurses, physicians, advocacy groups, policy makers, professional society groups, health care coordinators and health care administrators.

Experienced nurses are able to improve this issue by using their knowledge and wisdom in order to provide a meaningful learning experience, for novice nurses, in addition to striving to offer warm, accepting environments for new nurses, during their transition phase. This is key. Physicians, advocacy groups and professional societies can all serve as spokespersons as it relates to this issue, by advocating and voicing concerns, as well as the negative impacts for both the health care professional and patient outcomes. Policy makers, health care coordinators and administrators can strive to enforce that there be mandatory orientation and mentorship programs available at all times NR392 Quality Improvement in Nursing Project Milestone 1 Completed. If you really look into it, in the end, everyone is affected by this issue, most importantly, the patients. By having these stakeholders push to make a change, hospital retention rates and the quality of care being provided will make a remarkable turn.

Analyze
:

Analyze the Causes of the Nursing Issue

50 points

The cause of this nursing issue is simple. There is a lack of orientation and mentorship programs available in health care facilities. Due to this, policies are not in place that pushes health care providers to help others in need of assistance. Often times nurses also get too caught up with their health care tasks, that they believe helping others will throw their process off or slow their process down. We cannot think like this nor allow others to think this way. It should always feel like a team work approach because ultimately, patient care is what’s affected. “Mentoring has proven to be a successful way of facilitating the professional growth and development of recently graduated nurses and other nurses transitioning to a new role” (Minority Nurse, 2016).

Reference

Mentoring Nurses Toward Success. (2016, March 23). Retrieved March 21, 2018, from 
https://minoritynurse.com/mentoring-nurses-toward-success/

NR392 Quality Improvement in Nursing Project Milestone 1 Completed

nr392 all weeks discussions

Week 1 discussion

Defining a Quality Care Issue in Nursing

Think of an area of opportunity within your current or former clinical setting that is quality driven. Define (D) one nursing care issue (not a workforce issue such as staffing) from a current or former nursing workplace (or clinical setting) that could be impacted by improved quality. This nursing care issue should not be one that has already undergone a quality improvement process. Tell us details of this issue and how it this issue impacts nursing care quality at that facility.

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Week 2 discussion

DMAIC Process for a Real Life Issue

Why is it important to have a structured process to approach and improve nursing care quality? How can use of this structured process help to improve quality nursing care in your setting? nr392 all weeks discussions.

Week 3 discussion

Quality Improvement Education

In your prelicensure nursing education program, what did you learn about quality improvement in nursing? How was quality improvement emphasized? As you consider nursing education today, what would you suggest be included in future education or orientation programs about the important topic of quality improvement in nursing?

Week 4 discussion

Culture of Safety

How does your current or former clinical environment maintain a culture of safety? How are errors reported and managed to improve quality? nr392 all weeks discussions What suggestions would you make as a nurse leader to improve the culture of safety?

Week 5 discussion

Strategies for Interprofessional Collaboration to Promote Quality

This week as we focus on interprofessional collaboration to promote quality, please remember that professionals include dietitians, therapists (respiratory, physical, occupational, and speech), social workers/case managers, psychologists, physicians, pharmacists, and others. Professionals do not include patients, families, aides, or unlicensed assistive personnel.

Working as an interdisciplinary team helps promote positive patient outcomes. What strategies do you use to successfully work with other professions in your workplace to promote quality care? What strategies are not successful? nr392 all weeks discussions. What are the barriers to interprofessional collaboration, and how will you overcome these barriers?

Week 6 discussion

Quality Improvement Using Evidence-Based Practice in Nursing

Consider a single nursing care issue at your facility where quality has already been improved by implementation of evidence. Answer the following:

How was evidence on that topic located in scholarly professional nursing journal articles and evaluated?

What was the implementation plan?

How was the improvement in quality measured after the implementation?

What do you suggest that would have improved this implementation and maintenance of improved quality? nr392 all weeks discussions.

Week 7 discussion

The Role of Patients in Your Course Project Nursing Issue

Considering the nursing issue for your Course Project, address the following:

Provide a brief summary of your Course Project for the class.

What patient data is collected? What data do you want collected?

How will this actual and desired data help you to continue to improve quality on this nursing issue?

Week 8 discussion

Reflection on AACN BSN Essential II

Quality is an overriding principle in the AACN BSN Essentials document. Essential II specifically describes the role of the baccalaureate nurse in quality improvement. As you complete this course, reflect on how you will implement lessons learned about quality improvement into your future nursing practice. Provide details about what you plan to do to improve quality in your current or ideal future professional nursing position. Think big! nr392 all weeks discussions.

NR392 Quality Improvement in Nursing

Week 2 Discussion

Quality Improvement Processes

This week’s graded topics relate to the following Course Outcome (CO).

CO2: Discuss effective processes and strategies to improve quality in nursing. (POs 2 and 8)

For this week’s discussion, answer the following:

Why is it important to have a structured process to approach and improve nursing care quality?

How can the use of this structured process help to improve quality nursing care in your current or former setting?

NR392 Quality Improvement in Nursing

Week 4 Discussion

Quality Improvement Data

This week’s graded topics relate to the following Course Outcome (CO).

CO2: Discuss effective processes and strategies to improve quality in nursing. (POs 2 and 8)

Consider the following questions:

How does your current or former clinical environment share data collected on quality measures or initiatives with the staff? nr392 all weeks discussions.

What further data would you like to have shared and why?

NR392 Quality Improvement in Nursing

Week 5 Discussion

Culture of Safety

This week’s graded topics relate to the following Course Outcome (CO).

CO3: Examine culture of safety principles that improve patient outcomes based on current evidence. (POs 7 and 8)

Consider the following questions:

How does your current or former clinical environment maintain a culture of safety?

What suggestions would you make as a nurse leader to improve the culture of safety?

NR392 Quality Improvement in Nursing

Week 7 Discussion

Sustaining Quality After Improvement

This week’s graded topics relate to the following Course Outcome (CO).

CO1: Identify the role of the BSN nurse in the quality improvement process as a member of the collaborative interprofessional team. (POs 2 and 7)

Considering the nursing issue for your Course Project, address the following:

Provide a brief summary of your Course Project nr392 all weeks discussions.

How could your plans sustain quality in your setting?

NR392 Quality Improvement in Nursing

Week 8 Discussion

Reflection on AACN BSN Essential II

This week’s graded topics relate to the following Course Outcomes (COs).

CO1: Identify the role of the BSN nurse in the quality improvement process as a member of the collaborative interprofessional team. (POs 2 and 7)

CO2: Discuss effective processes and strategies to improve quality in nursing. (POs 2 and 8)

Quality is an overriding principle in the AACN BSN Essentials document. Essential II specifically describes the role of the baccalaureate nurse in quality improvement.

As you complete this course, reflect on how you will implement lessons learned about quality improvement into your future nursing practice. Provide details about what you plan to do to improve quality in your current or ideal future professional nursing position nr392 all weeks discussions.

MN501 Advanced Nursing Roles Essay Assignment Discussions

MN501 Advanced Nursing Roles

Unit 1 Discussion

Definitions of Advanced Nursing Practice

Identify the three elements of Hamric’s definition of advanced nursing practice that you think are most important. Why did you pick these three?

MN501 Advanced Nursing Roles

Unit 2 Discussion

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Role Transition

Transition from Registered Nurse to an advanced practice nursing role occurs through acquiring the educational component of role acquisition and the occupational or work component of role implementation. Discuss three strategies for enhancing advanced practice nursing role development. MN501 Advanced Nursing Roles Essay Assignment Discussions.

MN501 Advanced Nursing Roles

Unit 3 Discussion

Guidance and Coaching Competencies

Guidance and coaching is a core competency of advanced practice nursing.

How do you think guidance and coaching in the advanced practice role is different from the RN role of teaching/coaching?

Are there certain elements of this competency that are more important than others? MN501 Advanced Nursing Roles Essay Assignment Discussions.

How does the teaching and coaching role fit with a wellness versus sickness model of care?

MN501 Advanced Nursing Roles

Unit 4 Discussion

Team Dynamics

Reflect on your experiences as a member of an interdisciplinary team.

What makes a team effective in terms of achieving expected outcomes for patients, staff, students, and agencies?

What situations or conditions make it difficult for teams to work together?

Provide an example of an interdisciplinary team from your current nursing practice. Was this team effective or ineffective? Provide an example to justify your answer.

MN501 Advanced Nursing Roles

Unit 5 Discussion

Opinion Leader Perspectives

Consider some of the situations that motivated you to return to graduate school.

Describe one in which you were (or wished you could have been) an opinion leader.

What are the characteristics of opinion leaders? MN501 Advanced Nursing Roles Essay Assignment Discussions.

In what ways do you see yourself being an opinion leader?

MN501 Advanced Nursing Roles

Unit 6 Discussion

NP and APN Roles Comparison

Compare and contrast the primary care NP role with other APN roles and the role of physician assistants. What are the similarities among the roles and what are the differences

MN501 Advanced Nursing Roles

Unit 7 Discussion

The Four P’s of Marketing

What are the four P’s of marketing and how can they applied to marketing advanced practice nursing?

MN501 Advanced Nursing Roles

Unit 8 Discussion

Political Competence

Advanced practice nurses can serve as content experts for policymakers and their staff. Discuss methods that you can use to stay current with your health policy knowledge. Be specific with your response and share names of publications, websites, and other resources. MN501 Advanced Nursing Roles Essay Assignment Discussions.

MN501 Advanced Nursing Roles

Unit 9 Discussion

Data Management

Reflect on your experience with different aspects of data management — for example, identifying the target population and relevant measures, access to data sources, strategies for data collection, coordination of data entry, and data analysis to final deliverable to stakeholders. Discuss those areas in which you feel skilled versus those areas that will require more skill development.  MN501 Advanced Nursing Roles Essay Assignment Discussions List at least three activities in which you might engage in your current practice setting that would increase your competencies in the area of data management.