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Paper 2 – Philosophy of Nursing – Discuss your philosophy of nursing. Within this discussion, include your definition of nursing and what led you to pursue your chosen advanced nursing practice role ( psychiatric mental health nurse practitioner role). This paper, and only this paper, may be written in first person as APA (6th ed.) now states that the use of “I” and “my” is preferred over the use of “the author of this paper.

 

10% Introduction – Briefly introduce the focus of the paper.

70% Discussion – Clearly, thoroughly, and succinctly discuss the focus of the paper, showing evidence of reading of professional literature and synthesis of the focus.

10% Summary – Briefly summarize the key points and conclusions from the discussion.

10% Format – Consistently use APA format (6th edition) and correct English grammar across these papers, from the title page through the reference list. These papers must adhere to the following guidelines (all of which are in agreement with APA, 6th ed., format), as well as the other guidelines specified in the APA Manual (6th ed.): (a) be typed in a current version of Microsoft Word that can be opened by the course faculty; (b) be typed in Times New Roman typeface, with 12-point font size; (c) have doublespacing between all lines, including the title page and reference list; (d) have 1-1½ inch margins (top, bottom, right, and left); (e) include a title page and reference page; (f) have headings between sections; and (g) have a running head and page numbers.

 

Required Professional Journal Article Readings (References)*

Carper, B.A. (1978). Fundamental patterns of knowing in nursing. Advances in Nursing Science, 1(1), 13-23.**

Cody, W.K. (1994). Nursing theory-guided practice: What it is and what it is not. Nursing Science Quarterly, 7(4), 144-145. doi: 10.1177/089431849400700402 Fawcett, J. (1978). The relationship between theory and research: A double helix. Advances in Nursing Science, 1(1), 49-62.** Fawcett, J., Watson, J., Neuman, B., Walker, P.H., & Fitzpatrick, J.J. (2001). On nursing theories and evidence. Journal of Nursing Scholarship, 33(2), 115-119. doi: 10.1111/j.1547- 5069.2001.00115.x Schlotfeldt, R.M. (1988). Structuring nursing knowledge: A priority for creating nursing’s future. Nursing Science Quarterly, 1(1), 35-38. doi: 10.1177/089431848800100109mbvhs29

Only primary references may be used in this and all graduate level nursing courses. Magazines, such as Nursing (year), Nursing Made Incredibly Easy, and RN and websites that are not subjected to scientific rigor, such as Wikipedia, are not considered professional literature and may not be used as professional references. Use of secondary references and/or non-professional references will result in a reduction in the grade earned on course assignments when professional references are needed and required. It is important to note that the first editions of publications, such as texts, and primary references are not the same thing. In most cases, first editions are not required though, as noted above, primary references are. Primary references are thoughts, ideas, etc. written by the author whose work you have  accessed; secondary references are thoughts, ideas, etc. of another author and referenced by the author whose work you have accessed within their work.

Paper 3 – Concept Analysis: Rural – Analyze the concept of “rural” following the

order of and including each of the steps of concept analysis as discussed in the recorded

class session on concept analysis and on the Concept Analysis handout posted in the

Blackboard Course Documents: 1) select a concept (Note: Analysis of the concept of

rural is required for this course assignment, 2) clarify your purpose as it relates to your chosen advanced nursing practice

role ( psychiatric mental health nurse practitioner

role), 3) look at sources of evidence, 4) construct contrary and related/borderline cases, 5)

formulate criteria/defining attributes, 6) construct a model case, and 7) pose a concluding

definition. It is recommended that you use the steps as sub-headings in the discussion

section of your paper.

Paper 4 – Nursing or Interprofessional “Theory”: Philosophy, Conceptual Model, or Grand Theory – Describe a nursing or interprofessional “theory” (i.e., a philosophy, conceptual model, or grand theory

Within your Paper 4, in addition to the specifications below, include a brief discussion of the relevance of the theory for your chosen advanced nursing practice role (psychiatric mental health nurse practitioner role) with diverse populations.

10% Introduction – Briefly introduce the focus of the paper.

70% Discussion – Clearly, thoroughly, and succinctly discuss the focus of the paper, showing evidence of reading of professional literature and synthesis of the focus

10% Summary – Briefly summarize the key points and conclusions from the discussion.

10% Format – Consistently use APA format (6th edition) and correct English grammar across these papers, from the title page through the reference list. These papers must adhere to the following guidelines (all of which are in agreement with APA, 6th ed., format), as well as the other guidelines specified in the APA Manual (6th ed.): (a) be typed in a current version of Microsoft Word that can be opened by the course faculty; (b) be typed in Times New Roman typeface, with 12-point font size; (c) have doublespacing between all lines, including the title page and reference list; (d) have 1-1½ inch margins (top, bottom, right, and left); (e) include a title page and reference page; (f) have headings between sections; and (g) have a running head and page numbers.

Grading Rubric for Papers 1-4 The points for the first three criteria for Papers 1-4 are based on the level of evidence of critical thinking and synthesis related to the criteria and specific focus of the paper, including clarity, thoroughness, evidence of reading professional literature (as applicable to the criteria). For the fourth criteria (i.e., Format), the points are based on the level of evidence/achievement in terms of the accuracy of the format (APA, 6th edition), including grammar, across the paper.

*Note: Your grade on your papers will be reduced by 10% within each section of the paper each time that a primary reference is needed and is not included in the section of the paper and/or for each secondary reference used within the section of the paper. Again, it is essential that you only include primary references.

Post a 2-paragraph response (of at least 350 words) to one of the options below. Develop and post cohesive paragraphs and use evidence to support your ideas. The practice of writing paragraphs is essential to good writing. Focus each paragraph on one main idea or goal. Use the writing resources, writing samples, and Discussion Rubric to develop your post.

Option 1

As a result of its deliberations, the IOM committee formulated four key messages to support efforts to improve the health of the U.S. population through the contributions nurses can make to the delivery of care. Provide one or more examples of how you or a colleague has practiced one or more of the IOM recommendations to take the lead effectively or be in charge of an issue or patient rather than just “being at the table.”

OR

Option 2

Fitzpatrick (2015) describes how certain characteristics and competencies set nursing and nurses apart from other professions and practitioners. Describe how your nursing practice and ethical decision-making skills have furthered the quality and safety of patient care.

The article by Fitzpatrick (2015) outlines the need for nurses to get back to the basics of nursing for the purpose of maximizing on the full potential of the nursing profession. Being new in the nursing profession, I was expectant that everything will be centered directly on the care of patients while utilizing basic nursing skills. However, everything has turned out to be different. I have understood that the documentation of patient care is central to high-quality care and ultimately patient satisfaction (Olshansky, 2011). When these requirements are met, it is certain that a hospitals income automatically increases.

I feel that technology is receiving a lot of critiques yet, it contributes to a lot of time being used in the documentation of the care that has already been provided to patients rather than providing the actual care. In my practice as a nurse, I spend more time explaining to clients about a procedure they are supposed to undergo, informing them about the potential risks and benefits, conducting family and patient updates on client progress and health outcomes. I have routinely developed this norm since I realized that patients and their families spend more time with nurses as compared to professionals from other health cadres. This presents nurses with the opportunity to share some knowledge with them about their health concerns and those of their loved ones, which improves patient satisfaction (Auerbach et al., 2013). This means that, by furthering education, nurses gain more knowledge on a wide range of conditions and some of the best ways available that nurses can uniquely approach the needs of each patient. This is an assurance that patients receive safe and high-quality care. As a result, patients experience less anxiety and are able to make more informed health decisions (Thorne, 2015).

The article by Fitzpatrick (2015) mentions how technology has helped to improve the care given to patients. However, it is also worth noting that, the same technology takes us away from the basic skills and care that was learned in school. Although technology seems to make work easier and improve efficiency in healthcare delivery, it is worthwhile to apply critical thinking to determine if patients’ needs are adequately met. Nurses have the ethical responsibility to act in the best interest of patients and their respective families (Gatchel, 2018). Similarly, nurses have the ethical obligation to do no harm to patients and this may include using technology that they might believe to improve the provision of care, without doing a thorough evaluation to ensure that a patient’s well-being may not be affected. For instance, it is not only significant to do no harm to patients than doing good. It is also very significant to have knowledge of how likely the use of technology or a specific treatment may harm a patient.

By applying this ethical thinking in my nursing practice, some of the most relevant questions that I seek to answer when providing care to patients include; did I meet the needs of the patient to the best of my ability? Is there anything that I could have done differently? This analysis ensures that areas which need improvement are sought for and addressed. A perfect example of applying nursing knowledge and efforts to improve safety and quality in our healthcare organization is the use of the SBAR tool to communicate patient care to colleague staff. While it promotes shared perspectives on patient care, nurses are provided with a platform where they can positively critique areas which need improvement to provide safe patient care (Thorne, 2015).

 

References

Auerbach, D. I., Staiger, D. O., Muench, U., & Buerhaus, P. I. (2013). The nursing workforce in an era of health care reform. 
New England Journal of Medicine
, 
368
(16), 1470-1472.

Fitzpatrick, M. A. (2015). The essence of nursing: It’s time to put basic nursing care back in the spotlight. American Nurse Today, 10(5). Available at
http://www.americannursetoday.com//wp-content/uploads/2015/05/Essence-Supplement_page-2.pdf

Gatchel, R. J. (2018). The importance of the profession of nursing in health care: Current and future issues. 
Journal of Applied Biobehavioral Research
, 
23
(1), e12127.

Olshansky, E. (2011). Nursing as the most trusted profession: Why this is important. 
Journal of Professional Nursing
, 
27
(4), 193-194.

Thorne, S. (2015). Does nursing represent a unique angle of vision? If so, what is it?. 
Nursing Inquiry
, 
22
(4), 283-284.

By Day 3

Post a 2-paragraph response (of at least 350 words) to one of the options below. Develop and post 
cohesive paragraphs
 and 
use evidence
 to support your ideas.

Describe at least two current and/or future challenges in nursing and the solutions that are being proposed to meet those challenges. Explain how furthering your education will enable you to build upon your personal nursing legacy in meeting these types of challenges.

How Furthering My Education Will Enable Me to Build My Personal Nursing Legacy in Meeting These Types of Challenges

           
In the recent rapidly changing environment, it is not guaranteed that a person’s ideas will still hold and maintain relevance to the future. The ability of nurses to also function as leaders cannot be measured by the physical institutions that they may establish or build rather, by how best the individuals whom we invested in progressed after the pioneers were gone. This means that legacy is all about investing in people who process with the work.

It is expected that numerous opportunities for registered nurses are expected to emerge at a rate that is faster as compared to other occupations in the health sector. Following healthcare reforms in the United States and more so the implementation of the ACA in the year 2010, it is expected that there will continue to be a shortage of primary care physicians and nurses in the health workforce (Cope, Jones & Hendricks, 2016). These providers are key to achieving the dream of universal primary healthcare for all American citizens, irrespective of race, culture ethnicity or religion.  The issue of a shortage of nurses and primary care physicians has attracted proposals on the need of changes in clinical practice environments that are equally profound in nursing education during the periods before and after practicing licenses are received.

Advanced nurse practitioners are being considered as a solution to the nursing shortage and most preferably the physician shortage.  Therefore, by furthering my education, I will be able to obtain the required skills and knowledge necessary to evaluate, diagnose and manage various illnesses depending on my training and scope of practice. This will help to ease the burden of patients who attend primary care facilities and leave unattended and thereby result in better health outcomes (Hinds et al., 2015). By sharing and applying this knowledge, I will be promoting the efforts of healthcare teams, promoting self-confidence among patients for constructive feedback and helping to build a culture of accountability

Research suggests that the majority of the most recent illnesses are chronic and lifestyle and that they pose a huge burden to individuals, families, communities and the society in general. Furthermore, these illnesses are costly in terms of management since they need highly specialized healthcare teams and expensive drugs to manage (Edwards, 2016).  However, the ability of most families to afford this type of treatment has increasingly been thin, forcing healthcare workers to engage in evidence-based research to help alleviate suffering and disease burden (Saylor, 2017). Therefore, by advancing my education, I will be in a position to develop highly cost-effective care models which lay an emphasis on primary prevention and primary care, in the management of chronically ill patients.

Nurses have several roles to perform and meet the diverse needs of patients. They are leaders at various capacities and advance science which is likely to benefit patients while improving the ability of healthcare providers to deliver high quality and safe patient care. By advancing education, I get prepared to work effectively and collaboratively as a nursing graduate with other professionals in the health sector in a healthcare system that is complex and gradually evolving (Billett, 2016).  This means that I can safely transition from academic preparation to practice environments.  I can also assume my roles in either acute care, primary care, long-term care or other clinical settings and specialties.

 

References

Billett, S. (2016). Learning through health care work: premises, contributions, and practices.
Medical education
, 
50
(1), 124-131.

Cope, V., Jones, B., & Hendricks, J. (2016). Why nurses chose to remain in the workforce: Portraits of resilience. 
Collegian
, 
23
(1), 87-95.

Edwards, S. L. (2016). The personal narrative of a nurse: a journey through practice. 
Journal of Holistic Nursing
, 
34
(2), 154-161.

Hinds, P. S., Britton, D. R., Coleman, L., Engh, E., Humbel, T. K., Keller, S., & Walczak, D. (2015). Creating a career legacy map to help assure meaningful work in nursing. 
Nursing Outlook
, 
63
(2), 211-218.

Saylor, J. L. (2017). Lifelong Learning: Developing Professional and Personal Leadership.

It is important for nurses to stay abreast of current issues and trends in our field. Use this opportunity to develop or enhance your expertise on your chosen topic.

This Assignment introduces you to the Walden Library. The Library is an invaluable resource for discovering nursing and health care–related databases and professional articles. Practice and refine your paraphrasing skills.

To prepare

Review the Week 3 Assignment 1 Rubric, provided in the Course Information area.

Review the AWE Checklist and Additional Resources for your Assignment:

1000 AWE Level Assignment Template

TOP Ten BSN Reference and Citations

Complete Walden SafeAssign and Academic Integrity Online Tutorial, provided in this week’s Learning Resources.

Use the 1000 AWE Level Assignment Template found in the Resources for this week to complete your Assignment.

Explore this week’s Writing Resources and Program Success Tools, and specifically:

Use Google Scholar to search for articles related to the topic you selected. Link Google Scholar to the Walden Library using the instructions provided.

Search for articles related to the topic you selected using the Nursing Databases of the Walden Library.

Use the Walden Library to research the impact of nursing on healthcare quality as viewed through the Magnet professional practice model. Select one current (published within the last 5 years) research article on this topic to address. This week’s Library Learning Resources will guide you through your database search.

Article Response Assignment

Write a one-page summary and response to the article that you selected from the Walden Library. A template is provided in the Learning Resources to guide you in formatting your paper.

As you reflect on the findings in your chosen article, consider how the findings compare to your own professional nursing experience with Magnet, or, if you have no personal experience with Magnet, your thoughts concerning Magnet:

Paraphrase and integrate information from the article into paper.

Include an introduction, body, and a summary (conclusion).

Consider factors or principles from the article that hold true for or resonate with you.

Utilize this week’s Writing Center Course Resources to guide you through the process of paraphrasing and referencing evidence from your article. Review the AWE Checklist, Weeks 1–3, to see where you should be concerning your writing abilities. The Week 3 Assignment Rubric will keep you on track. Use Grammarly to check your writing for errors before submitting your Assignment.

 

 

Impact of Nurses on Healthcare Quality

Student’s Name

Institution of Affiliation

Course Name

Date

Introduction

           
The impact of nursing on the quality of care provided to patients is wide-ranging. Nurses possess adequate skills and knowledge that is used to serve patients with varied needs. Depending on the training and scope of practice of advanced nurse practitioners, nurses are able to take advanced roles in primary healthcare to address patients’ needs. Besides, nurses are equally informed on the expected health outcomes in the populations they serve thus are best placed to understand the services needed the most and those which are least needed. This means that a nurse’s working environment has a significant influence on the quality of nursing. The article by McHugh et al., (2013) titled
lower mortality in magnet hospitals
is chosen for the analysis of this paper. This article critically discusses the mortality and failure rescue rates among post-surgical patients in 56 Magnet and 508 non-magnet hospitals and the effect of nursing on the outcomes.

Impact of Nurses on Healthcare Quality

           
As noted by Friese, et al., (2015), since the year 1994, the criteria for Magnet designation has significantly changed with a continuous increase in the number of Magnet-recognized healthcare organizations. By being a Magnet hospital, the following aspects ought to be met; evidence of transformational leadership, impressive professional practice, innovation, new knowledge, structural empowerment, and continuous improvement. In the study conducted by McHugh et al., (2013), data on mortality rates, failure rates, and rescue rates were critically examined. More than 100,000 nurses were also surveyed and the results showed that nurses were well organized and had a good performance in Magnet institutions as compared to non-Magnet institutions.

It was also notable that, Magnet hospitals have a higher bed capacity and function as non-profit teaching hospitals as compared to non-magnet hospitals. As a result, they have a high potential for the latest healthcare innovations for BSN nurses or even those with higher qualifications. These findings are similar to Kutney-Lee et al., (2015) who mentions that, in Magnet hospitals, nurses take time to educate their patients on diseases processes that may be suffering from and provide them with the necessary resources needed to improve disease outcomes and overall health. Nurses in Magnet hospitals also reported better working environments as compared to those in non-Magnet hospitals (Friese et al., 2015).

Conclusion

           
This article clearly outlined the differences which exist between Magnet and non-magnet hospitals from a statistical reference. Although it failed to mention whether Magnet designation influences high-quality patient outcomes, it revealed how nurses directly impact good patient outcomes and patient satisfaction.

 

 

 

 

References

Beck, S. L., Weiss, M. E., Ryan-Wenger, N., Donaldson, N. E., Aydin, C., Towsley, G. L., & Gardner, W. (2013). Measuring nurses’ impact on health care quality: progress, challenges, and future directions. 
Medical care
, 
51
, S15-S22.

Friese, C. R., Xia, R., Ghaferi, A., Birkmeyer, J. D., & Banerjee, M. (2015). Hospitals in ‘Magnet’program show better patient outcomes on mortality measures compared to non-‘Magnet’hospitals. 
Health Affairs
, 
34
(6), 986-992.

Kutney-Lee, A., Stimpfel, A. W., Sloane, D. M., Cimiotti, J. P., Quinn, L. W., & Aiken, L. H. (2015). Changes in patient and nurse outcomes associated with magnet hospital recognition. 
Medical care
, 
53
(6), 550.

McHugh, M. D., Kelly, L. A., Smith, H. L., Wu, E. S., Vanak, J. M., & Aiken, L. H. (2013). Lower mortality in magnet hospitals. 
Medical care
, 
51
(5), 382.

Richards, M., Lasater, K., & McHugh, M. (2017). A Race to the Top?: Competitive Pressure and Magnet Adoption Among US Hospitals 1997–2012. 
Medical care
, 
55
(4), 384.

Submit a minimum 150-word Journal Assignment. Journal about one aspect of the classroom resources (Assignments, Discussions, or assigned readings) that surprised you. Additionally, journal about one or both of the options below:

Option 1

What concerns do you have about managing distractions and obtaining the support you need to be successful? Include how you plan to make certain that you have support, and how you will take personal responsibility for your own success.

Journal: Time Management

The classroom discussions interested me the most as they provided a platform where students can learn from each other and articulate the contents in the course in their own words. However, the discussions were not conducive to cover huge amounts of content (Turner & Hicks, 2015).  Since discussions are dynamically interactive, they helped me to learn, be motivated, complete homework and to prepare for classes. It is surprising that all discussions were productive and enhanced my ability to invent, create, imagine, take risks and dig deeper for different meanings. Perhaps it was because they took place in an environment where fellow classmates and I felt safer to share ideas. The class instructors also had a vital role to play in making the discussions meaningful; they accomplished this by being mindful of the vital conditions associated with interactive teaching (Lin-Siegler, Dweck & Cohen, 2016). Class instructors also provided leading discussions where each student could contribute meaningfully.

As a student, I value every minute of the day to ensure that I get things done in terms of, completing assignments on time, attending classes as scheduled and solving any personal problems which may arise. However, my greatest concern about managing distractions is the ability to pay attention from the beginning to the end of a class session. Besides, I often find difficult to open up and ask for assistance from classmates, educators or class instructors in any areas in classwork that may prove to be difficult. To adequately address these concerns, I plan to develop a culture where I set boundaries and have expectations about everything I do (Alderman & MacDonald, 2015).   I will build a support system of classmates and class instructors who will be able to regularly hold me accountable and observing and to-do-lists.

 

References

Alderman, M. K., & MacDonald, S. (2015). A self-regulatory approach to classroom management: Empowering students and teachers. 
Kappa Delta Pi Record
, 
51
(2), 52-56.

Lin-Siegler, X., Dweck, C. S., & Cohen, G. L. (2016). Instructional interventions that motivate classroom learning. 
Journal of Educational Psychology
, 
108
(3), 295.

Turner, K. H., & Hicks, T. (2015). Connected reading is the heart of research. 
English Journal
, 
105
(2), 41.

Post a 2-paragraph response (of at least 350 words) to either Option 1 or Option 2.

Use the writing resources, writing samples, and Discussion Rubric to develop your post. Reflect on your reading from this week, and then address one of the following:

Option 1

Provide an overview of a Magnet facility. Include an explanation of how Magnet status drives health care change in the institution. Develop and post cohesive paragraphs and use evidence to support your ideas. The practice of writing cohesive paragraphs is essential to good writing. Focus each paragraph on one main idea or goal.

OR

Option 2

Describe the personal contribution a nurse might make in the process of seeking or maintaining Magnet designation. Develop and post cohesive paragraphs and use evidence to support your ideas. The practice of writing cohesive paragraphs is essential to good writing. Focus each paragraph on one main idea or goal.

 

 

 

 

 

 

 

 

 

 

 

Nurses make the difference

Name

Institution

 

 

Nurses make the difference

Option 2

Magnet designation is an award that is accredited to medical facilities under the authority of the American Nurses Credentialing Center. The designation refers to medical facilities that are acknowledged for recognizing and promoting structures of higher operational standards that seek to improve personnel empowerment, retention and job pleasure. In fact, medical facilities with a Magnet designation must offer evidence of having met the set thresholds of professionalism and quality with regards to nursing services provision (American Nurses Credentialing Center, 2018).

Nursing personnel can make meaningful contributions towards achieving and maintaining Magnet designation. This occurs through the nurse ensuring that he or she has access to opportunities, resources and information that would improve the effectiveness and efficiency in completing professional tasks. To be more precise, the nurse should operate at a higher standard of respect, professional independence and assigning worth to the nursing profession while enhancing communication with other stakeholders (Friese et al., 2015).

In addition, the nurse can make a contribution through professional autonomy and independence. Through having greater control of nursing practice that goes beyond routine decision-making, the nurse gains the capacity to engaged in policy making and design as well as setting up internal nursing management frameworks. This creates opportunities for self-growth and allows the nurse to achieve a higher operational standard (Stimpfel, Rosen & McHugh, 2014).

Besides that, the nurse can contribute by creating and maintaining communication platforms that ensure the right stakeholder is at the right plan at the right time to either pass on or receive information. This improves communication effectiveness so that nurses are given a voice in determining excellence within the facility as well as adding value to the facility. Through this contribution, nursing personnel would feel more respective and appreciated since they are allowed to offer views vital to improve care outcomes (Stimpfel, Rosen & McHugh, 2014).

Also, the nurse can contribute through embracing evidence-based practice. This entails using the latest and best available evidence to support care decisions. Through this contribution, the facility would experience reduced operational costs and improved care quality and outcomes. This is based on the awareness that nursing practice can play an important role in meeting the Magnet objective of quality care through integrating evidence into practice (Wilson et al., 2015).

Yet another contribution can occur through shared governance. This presents adaptive and flexible structures ensures that nursing personnel are included in decision-making processes. This allows them to contribute to dispute resolution, setting objectives and goals, controlling the nursing profession, participating in governance activities, ensuring accountability, and controlling resource access and use. Moreover, shared governance allows the nursing personnel to conduct more comprehensive self-appraisals that identify professional practice areas that require improvements for the best care outcomes (Lamoureux et al., 2014).

It is important to note that the American Nurses Credentialing Center acknowledges and designates Magnet medical facilities on the nurses’ contributions through their experiences and quality of care provided since excelling nursing services are linked with favorable outcomes for patients and other stakeholders. The Center particular looks at good nursing performance as an important aspect when credentialing. That is because performance has a direct correlation with outcomes as an intentional incident. This is based on the awareness that good performance will typically be accompanied by favorable outcomes while bad performance will typically be accompanied by unfavorable outcomes. Additionally, nursing personnel contribute through attaining new knowledge, innovations, leadership, and structural empowerment that are reflected in care outcomes (Wilson et al., 2015). In this respect, nurses can make personal contributions in the process of seeking or maintain Magnet designation.

 

 

References

American Nurses Credentialing Center (2018).
ANCC Magnet Recognition Program
. Retrieved from http://www.nurse credentialing.org/Magnet

Friese, C. R., Xia, R., Ghaferi, A., Birkmeyer, J. D., & Banerjee, M. (2015). Hospitals in ‘magnet’ program show better patient outcomes on mortality measures compared to non-‘magnet’ hospitals.
Health Affairs
, 34(6), 986-992, 1-12.

Lamoureux, J., Judkins-Cohn, T., Butao, R., McCue, V., & Garcia, F. (2014). Measuring perceptions of shared governance in clinical practice: psychometric testing of the RN-focused Index of Professional Governance (IPNG).
Journal of Research in Nursing
, 19(1), 69-87.

Stimpfel, A. W., Rosen, J. E., & McHugh, M. D. (2014). Understanding the role of the professional practice environment on quality of care in magnet® and non-magnet hospitals.
JONA: The Journal of Nursing Administration
, 44(1), 10-16. doi:10.1097/NNA.0000000000000015

Wilson, M., Sleutel, M., Newcomb, P., Behan, D., Walsh, J. & Baldwin, K. (2015). Empowering nurses with evidence-based practice environments: Surveying Magnet, pathway to excellence, and non-magnet facilities in one healthcare system.
Worldviews on Evidence-Based Nursing
, 12(1), 12–21.

Post a 3-paragraph response (of at least 350 words) to one of the following options. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Use the writing resources and the Week 4 Discussion Rubric to develop your post.

Reflect on your readings from this week, and then address one of the following options:

Option 1

According to Ma, Shang, & Bott (2015), it is critical that contemporary nurses have strong leadership and collaboration skills to improve health care. Reflect on the expertise that you expect to acquire with your education at Walden. Envision yourself taking the lead to improve patient care in your practice setting. Describe the knowledge and skills needed to achieve your professional goals.

OR

Option 2

Use the website, http://www.qualityindicators.ahrq.gov/ , found in the Learning Resources to do the following:

• Provide a brief definition of quality indicators.

• Choose a particular indicator that either is being addressed or you would like to see addressed at your place of employment (or previous place of employment), and explain your reasons. Describe both the issue and your involvement in it. Alternatively, discuss your leadership’s role and your role in utilizing the indicator to improve health care.

 

 

 

The essence of nursing

Name

Institution

 

 

The essence of nursing

I anticipated that graduating from the nursing education program at Walden will imbue me with strong leadership and collaboration skills to improve health care outcomes. In fact, I expect to gain resource management skills that allow me to acknowledge that nursing resources are scarce and must be well managed for the best outcomes. In addition, I anticipate to improve my proficiency in integrating professional and technological differentiations with nursing specializations to refine professional care in a manner that reflects the existing environmental reality (Finkelman, 2016). In this respect, I expect to acquire management instruments to direct my professional nursing practice to improve efficiency and effectiveness, while concurrently reducing costs.

As a nurse, my professional goals are to improve nursing care in palliative services provision. I expect that completing this education program will allow me to gain and refine nursing professional experiences, knowledge and skills that will enable me to make the best use of interprofessional practice. Through this, I will be able to improve care quality by identifying what I need in terms of competency in order to provide the best possible care (Weiner & Ronch, 2013). In fact, this will allow me to form integrated teams with other health professionals offering palliative care, allowing them tams to communicate, orate and communicate to offer continuous and reliable care (Dang, Rohde & Sulfita, 2017). The capacity to create complementary teams will ensure that the different and complex care needs of patients are address within this modern environment that requires a mix of medical experiences, skills, knowledge and expertise that are then leveraged to offer patient centered care. Through distinguishing myself in the education program, I will be able to lead the complementary teams in ensuring that patients receive the best possible palliative care (Porter-O’Grady & Malloch, 2016). As a result, I will use the knowledge I gain in the nursing education program at Walden to take the lead in improving patient care by directing interprofessional care teams in palliative care settings.

 

 

References

Dang, D., Rohde, J. & Suflita, J. (2017).
Johns Hopkins Nursing Professional Practice Model: strategies to advance nursing excellence
. Indianapolis, IN: Sigma Theta Tau International.

Finkelman, A. (2016).
Leadership and management for nurses: core competencies for quality care
(3
rd
ed.). London: Pearson Education.

Porter-O’Grady, T. & Malloch, K. (2016).
Leadership in nursing practice: changing the landscape of healthcare
(2
nd
ed.). Burlington, MA: Jones & Bartlett Learning.

Weiner, A. & Ronch, J. (2013).
Culture change in long-term care
. New York, NY: Routledge.

To prepare

• Review the Week 4 Assignment Rubric, provided in the Course Information area.

• Review the AWE Checklist and Additional Resources for your Assignment:

o 2000/3000 AWE Level Assignment Template

o TOP Ten BSN References and Citations

• Review this week’s Writing Resources and Program Success Tools. Revisit the Writing Resources and Program Success Tools from Weeks 1 through 3 as needed. Focus on the QIs at http://www.qualityindicators.ahrq.gov/.

• Choose a QI related to a nursing topic of interest to you. Think about the ways in which following and measuring this crucial health data improve effectiveness and efficiency in your nursing practice. Consider any points that relate your selected topic to the journey ahead in your nursing career.

• Find two articles in the Walden Library to support your scholarly opinion in your paper.

Assignment

Use the Walden Writing Center guidelines titled “Writing a Paper” and “Scholarly Writing: Overview” to do the following:

• Draft a 2- to 3-page paper describing your selected QI in general, and then describe how this QI has the potential to improve the quality, safety, and outcomes of your patients and their families.

• Describe the current data available and leadership’s goal for improvement.

• Draft a solution using 2 sources from professional and scholarly literature to support your proposal.

• Use the 2000/3000 AWE Level Assignment Template in the resources for this week to complete your Assignment.

• Use in-text citations to support your paper. Use essay-level writing skills, including the use of transitional material and organizational frames.

Introduction

Nursing quality involves the improvement of the effectiveness, efficiency, accessibility, and patient safety to those in need. The most critical of nursing quality is patient safety has increased. However, nurses play a significant role in determining the nursing quality to ensure that their practice yields quality care and guarantee patient safety. The purpose of this paper is to describe the ways in which following and measuring Postoperative Respiratory failure health data will improve effectiveness and efficiency in your nursing practice. It will also explain the potential of this the QI to improve the quality, safety, and outcomes in patients and their families.

Postoperative Respiratory Failure

Postoperative Respiratory failure is a critical health data that is used by AHRQ (PSI-11) as an indicator of Patient Safety. It has a higher PSIs rate as compared to other PSIs, making it an effective health data used to measure the patient outcome across a diverse patient population. As a PSIs, Postoperative Respiratory failure determines the level of inpatient safety risks that patients are exposed to during acute care VHA hospitalizations and non-psychiatric (Rajaram, Barnard & Bilimoria, 2015). The PSI is common in veterans with psychotic disorders than those patients who have never had any case of psychotic disorders.

Some potential causes of respiratory failure among patients who have shown signs of psychosis include restriction to aces ambulatory restrictions services, inability to comply with spirometry incentive and any other toileting involving the pulmonary parts of the body. The condition may also be caused as a result of drug interactions with anesthetics taken in response to the remedy the psychotropic condition (Canet, Sabate, Mazo, et al, 2015). Also, the use of antipsychotics or benzodiazepines on an ‘as-needed’ basis in response to insomnia, agitation, or aggression may also cause Postoperative Respiratory failure. Equally, patients with higher levels of cigarette smoking are also at the risk of experiencing Postoperative Respiratory failure (Smith, Zhao & Rosen, 2012).

The Current Data Available and Leadership’s Goal for Improvement

Going by the available literature, Post-operative Respiratory failure is said to be the most common perioperative causes of death especially in adult patients who have undergone thoracic surgery. However, it is important to note that the term respiratory failure brings on board issues such as failures caused by ARDS, pneumonia, and pulmonary emboli (McLean, Diaz-Gil, Farhan, 2015). This broad view has hindered a clear understanding of what postoperative respiratory failure is so as to be well conversant with its causes and then start planning for its prevention.

Postoperative respiratory failure is attributed to the increased cost of care, longer hospital stays, and a high rate of mortality. Ranging between 30 days and five years. The patient factors that are common in patients with PRF smoking are age, past history of using COPD, as well as functional dependence (Winters, Bharmal, Wilson, et al, 2016). The procedural factors associated with PRF include vascular, prolonged and emergency procedures, thoracic, head/neck procedures, and abdominal. The effectiveness preventive measures that can be used to manage PRFs include subjecting the patients to exercises aimed at expanding the lung and discriminative application of nasogastric tubes for patients with abdominal cases (Canet & Gallart, 2014). The patients may also be subjected to a short-acting neuromuscular blockade and advised to practice preoperative smoking behavior and laparoscopic techniques.

Conclusion

In conclusion, patient safety is a key component of nursing quality which can be achieved through the use of PRFs as a PSI. Conversely, nurses must be trained and make their resources available. PRF has become a major patient safety indicators thus increasing the role nurses plays t as they interact with patients, patients’ families and their colleagues in the profession. To facilitate patient safety, nurses monitor patients to ascertain signs of clinical deterioration, near misses, and errors. They also learn the weakness inherent in the care processes to promote high-quality care.

 

 

 

References

Rajaram, R., Barnard, C., & Bilimoria, K. Y. (2015). Concerns about using the patient safety indicator-90 composite in pay-for-performance programs. 
Jama
, 
313
(9), 897-898.

Canet, J., & Gallart, L. (2014). Postoperative respiratory failure: pathogenesis, prediction, and prevention. 
Current opinion in critical care
, 
20
(1), 56-62.

Canet, J., Sabate, S., Mazo, V., Gallart, L., de Abreu, M. G., Belda, J., … & Pelosi, P. (2015). Development and validation of a score to predict postoperative respiratory failure in a multicentre European cohort: a prospective, observational study. 
European Journal of Anaesthesiology (EJA)
, 
32
(7), 458-470.

McLean, D. J., Diaz-Gil, D., Farhan, H. N., Ladha, K. S., Kurth, T., & Eikermann, M. (2015). Dose-dependent association between intermediate-acting neuromuscular-blocking agents and postoperative respiratory complications. 
The Journal of the American Society of Anesthesiologists
, 
122
(6), 1201-1213.

Winters, B. D., Bharmal, A., Wilson, R. F., Zhang, A., Engineer, L., Defoe, D., … & Pronovost, P. J. (2016). The validity of the Agency for Health Care Research and Quality Patient Safety Indicators and the Centers for Medicare and Medicaid Hospital-acquired Conditions.
Medical care
, 
54
(12), 1105-1111.