Tag: Clinical-Nursing

Quantitative Research Critique and Ethical Considerations PICOT

Details:

Use the practice problem and a quantitative, peer-reviewed research article you identified in the Topic 1 assignment to complete this assignment.

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In a 1000-1,250 word essay, summarize the study, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study. Quantitative Research Critique and Ethical Considerations PICOT.

Refer to the resource ”Research Critique Guidelines” for suggested headings and content for your paper.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center. Quantitative Research Critique and Ethical Considerations PICOT.

PICOT Question and Literature Search

Nursing practice problem

Although nicotine replacement therapy is acknowledged as a strategy for smoking cessation, its efficacy is not well established. As such, there is a need to provide tangible evidence that compares nicotine replacement therapy with other strategies applied for the same purpose. The intention is to establish whether nicotine replacement therapy is worth receiving special attention from nursing practitioners. Quantitative Research Critique and Ethical Considerations PICOT.

PICOT Statement

Population:
in cigarette smokers older than 17 years

Intervention:
does nicotine replacement therapy

Control:
versus using other smoking cessation therapies

Outcome:
affect smoking cessation outcomes

Quantitative Research Critique and Ethical Considerations PICOT

Time:
over a period of three months?

Literature Search (References List and Abstract)

Silla, K., Beard, E. & Shahab, L. (2014). Nicotine replacement therapy use among smokers and ex-smokers: associated attitudes and beliefs: a qualitative study.
BMC Public Health
, 14, 1311. doi: 10.1186/1471-2458-14-1311

Abstract

Background: Smokers who are unwilling or unable to quit smoking may benefit from using nicotine replacement therapy (NRT) for harm reduction. This may include the partial or complete substitution of cigarettes with NRT. Quantitative Research Critique and Ethical Considerations PICOT. A taxonomy of the characteristics of those using NRT for harm reduction would be helpful in tailoring advice and treatment. Although attempts to categorize those using NRT for harm reduction have been made, these have largely been based on quantitative data. In order to provide further in-depth exploration of views, beliefs and experiences, the current study probed issues surrounding NRT and harm reduction qualitatively to better understand barriers and facilitators to this approach. Quantitative Research Critique and Ethical Considerations PICOT.

Methods: Three groups of participants (n = 15) were recruited from a student sample: current smokers with a history of NRT use, smokers without a history of NRT use, and ex-smokers with a history of NRT use. Participants were asked about their demographic characteristics, smoking behaviors, intention and perceived ability to quit smoking, awareness and use of NRT, beliefs about the health consequences of using NRT, and the safety and efficacy of NRT, using semi-structured telephone interviews. Quantitative Research Critique and Ethical Considerations PICOT.

Results: Twenty-four themes were identified; these themes were clustered into three main issues of cross-cutting themes: attitudes towards smoking and motivation to quit; smoking reduction and quit attempts; and beliefs, use and concerns about NRT. Quantitative Research Critique and Ethical Considerations PICOT. Those with a history of NRT use were more motivated and engaged with the quitting process than non-users. However, irrespective of smoking status and past NRT use, all participants showed misperceptions about NRT, such as the health consequences associated with NRT use.

Conclusions: NRT users are more motivated to quit smoking than non-users and are more likely to employ techniques to assist their cessation attempts. The majority of smokers have misperceptions regarding the safety and efficacy of NRT which may act as a barrier to its usage.

Barbeau, A., Burda, J. & Siegel, M. (2013). Perceived efficacy of e-cigarettes versus nicotine replacement therapy among successful e-cigarette users: a qualitative approach.
Addict Sci Clin Pract.
, 8, 5. doi: 10.1186/1940-0640-8-5 Quantitative Research Critique and Ethical Considerations PICOT.

Abstract

Background: Nicotine is widely recognized as an addictive psychoactive drug. Since most smokers are bio-behaviorally addicted, quitting can be very difficult and is often accompanied by withdrawal symptoms. Research indicates that nicotine replacement therapy (NRT) can double quit rates. However, the success rate for quitting remains low. E-cigarettes (electronic cigarettes) are battery-powered nicotine delivery devices used to inhale doses of vaporized nicotine from a handheld device similar in shape to a cigarette without the harmful chemicals present in tobacco products. Anecdotal evidence strongly suggests that e-cigarettes may be effective in helping smokers quit and preventing relapse, but there have been few published qualitative studies, especially among successful e-cigarette users, to support this evidence Quantitative Research Critique and Ethical Considerations PICOT.

Methods: Qualitative design using focus groups (N = 11); 9 men and 2 women. Focus groups were conducted by posing open-ended questions relating to the use of e-cigarettes, comparison of effectiveness between NRTs and e-cigarettes, barriers to quitting, and reasons for choosing e-cigarettes over other methods. Quantitative Research Critique and Ethical Considerations PICOT.

Results: Five themes emerged that describe users’ perceptions of why e-cigarettes are efficacious in quitting smoking: 1) bio-behavioral feedback, 2) social benefits, 3) hobby elements, 4) personal identity, and 5) distinction between smoking cessation and nicotine cessation. Additionally, subjects reported their experiences with NRTs compared with e-cigarettes, citing negative side effects of NRTs and their ineffectiveness at preventing relapse Quantitative Research Critique and Ethical Considerations PICOT.

Conclusion: These findings suggest tobacco control practitioners must pay increased attention to the importance of the behavioral and social components of smoking addiction. By addressing these components in addition to nicotine dependence, e-cigarettes appear to help some tobacco smokers transition to a less harmful replacement tool, thereby maintaining cigarette abstinence.

Buller, D., Halperin, A., Severson, H., Borland, R., Slater, M., Bettinghaus, E., Tinkelman, D., Cutter, G. & Woodall, G. (2014). Effect of Nicotine Replacement Therapy on Quitting by Young Adults in a Trial Comparing Cessation Services.
J Public Health Manag Pract.
, 20(2), E7-E15. doi: 10.1097/PHH.0b013e3182a0b8c7

Abstract

Context: Young adult smokers have the highest smoking prevalence among all US age groups but are least likely to use evidence-based cessation counseling or medication to quit.

Objective: Use and effectiveness of nicotine patch were explored in a randomized trial evaluating smoking cessation interventions with this population. Quantitative Research Critique and Ethical Considerations PICOT.

Participants: Smokers aged 18 to 30 (n = 3094) were recruited through online and off-line methods and from telephone quit lines and analyzed.

Design: Smokers were enrolled in a pretest-posttest trial, and randomized to 1 of 3 cessation services.

Setting: Trial delivering counseling services by self-help booklet, telephone quit lines, or online expert system in the 48 continental United States.

Intervention: Smokers could request a free 2-week course of nicotine replacement therapy (NRT) patches from the project.

Main Outcome Measure: Follow-up surveys at 12 and 26 weeks assessed smoking abstinence, use of NRT, counseling, and other cessation medications, and smoking-related variables. Quantitative Research Critique and Ethical Considerations PICOT.

Results: Overall, 69.0% of smokers reported using NRT (M = 3.2 weeks) at 12 weeks and 74.8% (M = 3.3 weeks) at 26 weeks. More smokers who were sent the free nicotine patches (n = 1695; 54.8%) reported using NRT than those who did not receive them (12 weeks: 84.3% vs 41.9%, P < .001; 26 weeks: 87.6% vs 51.1%, P < .001). The use of NRT was associated with greater smoking abstinence at 12 weeks (P < .001) and 26 weeks (P < .05), especially if used for more than 2 weeks (P < .001). Smokers assigned to a self-help booklet or cessation Web site and heavier smokers were most likely to use NRT (P < .05), whereas those reporting marijuana use and binge drinking used NRT less (P < .05). Conclusions: Many young adults were willing to try NRT, and it appeared to help them quit in the context of community-based cessation services. Strategies should be developed to make NRT available to this age group and support them in using it to prevent lifelong smoking. Quantitative Research Critique and Ethical Considerations PICOT. Rath, J., Villanti, A., Abrams, D. & Vallone, D. (2012). Patterns of Tobacco Use and Dual Use in US Young Adults: The Missing Link between Youth Prevention and Adult Cessation. Journal of Environmental and Public Health , Volume 2012 (2012), Article ID 679134. doi: 10.1155/2012/679134 Abstract Few studies address the developmental transition from youth tobacco use uptake to regular adulthood use, especially for noncigarette tobacco products. The current study uses online panel data from the Legacy Young Adult Cohort Study to describe the prevalence of cigarette, other tobacco product, and dual use in a nationally representative sample of young adults aged 18-34 (N = 4,201). Of the 23% of young adults who were current tobacco users, 30% reported dual use. Ever use, first product used, and current use were highest for cigarettes, cigars, little cigars, and hookah. Thirty-two percent of ever tobacco users reported tobacco product initiation after the age of 18 and 39% of regular users reported progressing to regular use during young adulthood. This study highlights the need for improved monitoring of polytobacco use across the life course and developing tailored efforts for young adults to prevent progression and further reduce overall population prevalence. Quantitative Research Critique and Ethical Considerations PICOT. Thurgood, S., McNeill, A., Clark-Carter, D. & Brose, L. (2015). A Systematic Review of Smoking Cessation Interventions for Adults in Substance Abuse Treatment or Recovery. Nicotine & Tobacco Research , 18(5), 993-1001. doi: 10.1093/ntr/ntv127 Abstract Introduction: The aim was to evaluate the effectiveness of smoking cessation interventions for patients with substance use disorders. The secondary aim was to evaluate the impact on substance use treatment outcomes. Methods: Randomized controlled trials involving adult smokers, recently or currently receiving inpatient or outpatient treatment for substance use disorders were reviewed. Databases, grey literature, reference lists, and journals were searched for relevant studies between 1990 and August 2014. Two authors extracted data and assessed quality. The primary outcome was biochemically verified continuous abstinence from smoking at 6 or 12 months, secondary outcomes were biochemically verified 7-day point prevalence smoking abstinence (PPA) at 6 or 12 months and substance use outcomes. Quantitative Research Critique and Ethical Considerations PICOT. Heterogeneity between studies precluded pooled analyses of the data. Results: Seventeen of 847 publications were included. Five studies reported significant effects on smoking cessation: (1) nicotine patches improved continuous abstinence at 6 months; (2) nicotine gum improved continuous abstinence at 12 months; (3) counseling, contingency management and relapse prevention improved continuous abstinence at 6 and 12 months; (4) cognitive behavioral therapy, plus nicotine replacement therapy (NRT), improved PPA at 6 months; and (5) a combination of bupropion, NRT, counseling and contingency management improved PPA at 6 months. Two studies showed some evidence of improved substance use outcomes with the remaining eight studies measuring substance use outcomes showing no difference. Quantitative Research Critique and Ethical Considerations PICOT. Conclusions: NRT, behavioral support, and combination approaches appear to increase smoking abstinence in those treated for substance use disorders. Higher quality studies are required to strengthen the evidence base. Garcia-Rodriguez, O., Secades-Villa, R., Florez-Salamanca, L., Okuda, M., Liu, S. & Blanco, C. (2014). Effect of Nicotine Replacement Therapy on Quitting by Young Adults in a Trial Comparing Cessation Services. Drug Alcohol Depend. , 132(3), 479-485. doi: 10.1016/j.drugalcdep.2013.03.008 Quantitative Research Critique and Ethical Considerations PICOT. Abstract Context: Young adult smokers have the highest smoking prevalence among all US age groups but are least likely to use evidence-based cessation counseling or medication to quit. Objective: Use and effectiveness of nicotine patch were explored in a randomized trial evaluating smoking cessation interventions with this population. Participants: Smokers aged 18 to 30 (n = 3094) were recruited through online and off-line methods and from telephone quit lines and analyzed. Quantitative Research Critique and Ethical Considerations PICOT. Design: Smokers were enrolled in a pretest-posttest trial, and randomized to 1 of 3 cessation services. Setting: Trial delivering counseling services by self-help booklet, telephone quit lines, or online expert system in the 48 continental United States. Intervention: Smokers could request a free 2-week course of nicotine replacement therapy (NRT) patches from the project Quantitative Research Critique and Ethical Considerations PICOT. Main Outcome Measure: Follow-up surveys at 12 and 26 weeks assessed smoking abstinence, use of NRT, counseling, and other cessation medications, and smoking-related variables. Results: Overall, 69.0% of smokers reported using NRT (M = 3.2 weeks) at 12 weeks and 74.8% (M = 3.3 weeks) at 26 weeks. More smokers who were sent the free nicotine patches (n = 1695; 54.8%) reported using NRT than those who did not receive them (12 weeks: 84.3% vs 41.9%, P < .001; 26 weeks: 87.6% vs 51.1%, P < .001). The use of NRT was associated with greater smoking abstinence at 12 weeks (P < .001) and 26 weeks (P < .05), especially if used for more than 2 weeks (P < .001). Smokers assigned to a self-help booklet or cessation Web site and heavier smokers were most likely to use NRT (P < .05), whereas those reporting marijuana use and binge drinking used NRT less (P < .05). Quantitative Research Critique and Ethical Considerations PICOT. Conclusions: Many young adults were willing to try NRT, and it appeared to help them quit in the context of community-based cessation services. Strategies should be developed to make NRT available to this age group and support them in using it to prevent lifelong smoking. Research Critique Guidelines Qualitative Study Background of Study: Identify the clinical problem and research problem that led to the study. What was not known about the clinical problem that, if understood, could be used to improve health care delivery or patient outcomes? This gap in knowledge is the research problem. How did the author establish the significance of the study? In other words, why should the reader care about this study? Look for statements about human suffering, costs of treatment, or the number of people affected by the clinical problem. Quantitative Research Critique and Ethical Considerations PICOT. Identify the purpose of the study. An author may clearly state the purpose of the study or may describe the purpose as the study goals, objectives, or aims. List research questions that the study was designed to answer. If the author does not explicitly provide the questions, attempt to infer the questions from the answers. Were the purpose and research questions related to the problem? Method of Study: Were qualitative methods appropriate to answer the research questions? Did the author identify a specific perspective from which the study was developed? If so, what was it? Did the author cite quantitative and qualitative studies relevant to the focus of the study? What other types of literature did the author include? Are the references current? For qualitative studies, the author may have included studies older than the 5-year limit typically used for quantitative studies. Findings of older qualitative studies may be relevant to a qualitative study. Quantitative Research Critique and Ethical Considerations PICOT. Did the author evaluate or indicate the weaknesses of the available studies? Did the literature review include adequate information to build a logical argument? When a researcher uses the grounded theory method of qualitative inquiry, the researcher may develop a framework or diagram as part of the findings of the study. Was a framework developed from the study findings?   Results of Study What were the study findings? What are the implications to nursing? Explain how the findings contribute to nursing knowledge/science. Would this impact practice, education, administration, or all areas of nursing? Ethical Considerations Was the study approved by an Institutional Review Board? Was patient privacy protected? Were there ethical considerations regarding the treatment or lack of? Quantitative Research Critique and Ethical Considerations PICOT. Conclusion Emphasize the importance and congruity of the thesis statement. Provide a logical wrap-up to bring the appraisal to completion and to leave a lasting impression and take-away points useful in nursing practice. Incorporate a critical appraisal and a brief analysis of the utility and applicability of the findings to nursing practice. Quantitative Research Critique and Ethical Considerations PICOT. Integrate a summary of the knowledge learned.   Quantitative Study Background of Study: Identify the clinical problem and research problem that led to the study. What was not known about the clinical problem that, if understood, could be used to improve health care delivery or patient outcomes? This gap in knowledge is the research problem. How did the author establish the significance of the study? Quantitative Research Critique and Ethical Considerations PICOT. In other words, why should the reader care about this study? Look for statements about human suffering, costs of treatment, or the number of people affected by the clinical problem. Identify the purpose of the study. An author may clearly state the purpose of the study or may describe the purpose as the study goals, objectives, or aims. List research questions that the study was designed to answer. If the author does not explicitly provide the questions, attempt to infer the questions from the answers. Quantitative Research Critique and Ethical Considerations PICOT. Were the purpose and research questions related to the problem?  Methods of Study Identify the benefits and risks of participation addressed by the authors. Were there benefits or risks the authors do not identify? Was informed consent obtained from the subjects or participants? Did it seem that the subjects participated voluntarily in the study? Was institutional review board approval obtained from the agency in which the study was conducted? Quantitative Research Critique and Ethical Considerations PICOT. Are the major variables (independent and dependent variables) identified and defined? What were these variables? How were data collected in this study? What rationale did the author provide for using this data collection method? Identify the time period for data collection of the study. Describe the sequence of data collection events for a participant. Describe the data management and analysis methods used in the study. Did the author discuss how the rigor of the process was assured? For example, does the author describe maintaining a paper trail of critical decisions that were made during the analysis of the data? Was statistical software used to ensure accuracy of the analysis? What measures were used to minimize the effects of researcher bias (their experiences and perspectives)? For example, did two researchers independently analyze the data and compare their analyses? Quantitative Research Critique and Ethical Considerations PICOT. Results of Study What is the researcher’s interpretation of findings? Are the findings valid or an accurate reflection of reality? Do you have confidence in the findings? What limitations of the study were identified by researchers? Was there a coherent logic to the presentation of findings? What implications do the findings have for nursing practice? For example, can the findings of the study be applied to general nursing practice, to a specific population, or to a specific area of nursing? What suggestions are made for further studies? Ethical Considerations Was the study approved by an Institutional Review Board? Was patient privacy protected? Quantitative Research Critique and Ethical Considerations PICOT. Were there ethical considerations regarding the treatment or lack of? Conclusion Emphasize the importance and congruity of the thesis statement. Provide a logical wrap-up to bring the appraisal to completion and to leave a lasting impression and take-away points useful in nursing practice. Incorporate a critical appraisal and a brief analysis of the utility and applicability of the findings to nursing practice. Quantitative Research Critique and Ethical Considerations PICOT. Integrate a summary of the knowledge learned. Reference Burns, N., & Grove, S. (2011). Understanding nursing research (5th ed.). St. Louis, MO: Elsevier.   Quantitative Research Critique Background of Study The article presented the outcome of a research where the effectiveness of nicotine replacement therapy use among young adults was determined. It presented the understanding that the therapy is a tool that facilitates smoking cessation, allowing smokers to quit with minimal risk of reversion or experiencing other undesirable side effects such as withdrawal symptoms. Quantitative Research Critique and Ethical Considerations PICOT. In line with this awareness, the study objective was to review the effectiveness of nicotine patch as a nicotine replacement therapy for use when quitting smoking. The underlying intention was to address smoking cessation needs among young adults in the US since they represent the single largest age group with results to smoking prevalence. In this respect, the article explores the likelihood of positioning nicotine patches as useful for young adult smokers who seek to cease smoking. Quantitative Research Critique and Ethical Considerations PICOT. Methods of Study The research applied a quantitative methodology that used a post-test and pre-test trial design. In this case, 3,094 young adult (between 18 and 30 years) smoking participants were recruited using online and offline methods. Other than age and identity as current smokers, the participants also had to exhibit an intention to quit smoking before inclusion in the study. Once all the participants had been recruited, they were enrolled into the trial before being randomized into three groups that include a nicotine patch group representing nicotine replacement therapy, counselling, and medication to facilitate cessation. Quantitative Research Critique and Ethical Considerations PICOT. Once the trial began and the participants were subjected to the interventions in the three groups, they were then subjected to two evaluation surveys at the 12-week and 26-week points of the trial. The data collected from the evaluations was then subjected to statistical analysis that compared the cessation figures for the three groups. The data focus was on smoking abstinence with the comparison showing how the three programs performed in terms of effectiveness. Quantitative Research Critique and Ethical Considerations PICOT. The research methodology can be considered appropriate since it allowed for a large sample to be recruited for the research, the right data to be collected, and interpretation carried out on the data. It presented a true comparison between nicotine patches, counselling and medication so that the results were reliable. Also, the detailed presentation of the research methodology facilitates the research replication. In addition, researcher bias was minimized by using pre-structured tools to collect primary data directly from the participants. Perhaps, the only shortcoming in the methodology is that there is no mention of whether the data analysis was verified by a third party to confirm its accuracy. Another shortcoming is that the specific software that was used for data analysis has not been mentioned thereby making it difficult to ascertain the truthfulness of the analysis. These shortcomings create an opportunity for researcher bias since a third party cannot verify the truthfulness of the results analysis. Quantitative Research Critique and Ethical Considerations PICOT. Results of Study The data analysis determined that nicotine patches produce comparably favorable results when used by young adult smokers. That is because they increased the possibility of enrolling for and adhering to the process set by nicotine replacement therapy. At the 12 th week evaluation, 84.3% of the participants using nicotine patches enrolled for nicotine replacement therapy when compared to 41.9% who used other programs ( p <0.001). At the 26 th week evaluation, 87.6% of the participants using nicotine patches enrolled for nicotine replacement therapy when compared to 51.1% who used other programs ( p <0.001). Following this results that showed greater willingness for the persons who use patches to pursue other smoking cessation programs concurrently, the research made the recommendation that nicotine patches should be offered as part of the smoking cessation standard package program for young adult smokers who have enrolled in a cessation program Quantitative Research Critique and Ethical Considerations PICOT. These results are valuable to nursing practitioners since it presents evidence to supports advice they may offer young adult smokers to use nicotine patches to improve enrollment in smoking cessation programs. Although the research does not make suggestions for future studies, it is cautious when advocating for nicotine patches use. This implies that there is need for additional research to ascertain the exact value of nicotine patches. Quantitative Research Critique and Ethical Considerations PICOT. Ethical Considerations There is evidence to show that the research was carried out following ethical considerations. Firstly, the research mentions that approval was sought and received from the Western Institutional Review Board before the research could proceed. The approval shows that the board was convinced that the research would not harm the participants (whether the harm was intentional or unintentional) and sufficient measures had been put in place for their protection. Secondly, although there is no mention of a consent form and whether the participants signed one to show that they were cognizant of the study objectives and voluntarily agree to participate, the fact that they were not coerced and were politely asked to participate in the study and allowed to withdraw without a penalty is sufficient to show that their participation was voluntary. Quantitative Research Critique and Ethical Considerations PICOT. Thirdly, the participants were not offered any remuneration for their participation in the study thereby showing that they were motivated to advance the research (and would be truthful by extension) and eliminated the possibility that they would haphazardly participate in the research (not being truthful) just to get paid. Finally, the treatments (nicotine replacement therapy, counseling and medication) applied in the three groups did not pose any harm to the participants since they are approved therapies for smoking cessation programs. The four measures show that the research was conducted in an ethical manner Quantitative Research Critique and Ethical Considerations PICOT. Conclusion The research evaluates the effectiveness of nicotine replacement therapy as a smoking cessation tool for use among young adult smokers. This is based on the understanding that the therapy is a tool that facilitates smoking cessation, allowing smokers to quit with minimal risk of reversion or experiencing other undesirable side effects such as withdrawal symptoms. Applying a quantitative methodology that recruited 3,094 young adult smokers between 18 and 30 years of age, the research randomized the participants’ group assignment into nicotine patch (nicotine replacement therapy), counseling and medication groups. Ethical consideration were undertaken to ensure that the participants were protected to include receiving approval from a review board, voluntary participation, no remuneration was offered, and treatment did not pose any harm. The three randomized groups were then evaluated for program effectiveness at the 12-week and 26-week milestones. Quantitative Research Critique and Ethical Considerations PICOT. The results showed that using the nicotine patch improved enrollment in nicotine replacement therapy from 84.3% at the 12th week to 87.6% at the 26th week, almost doubling the figures reported by the other programs. Following this results that showed greater willingness for the persons who use patches to pursue other smoking cessation programs concurrently, the research made the recommendation that nicotine patches should be offered as part of the smoking cessation standard package program for young adult smokers who have enrolled in a cessation program. As such, nicotine patches should be included in cessation services for young adult smokers. Quantitative Research Critique and Ethical Considerations PICOT. Reference Buller, D., Halperin, A., Severson, H., Borland, R., Slater, M., Bettinghaus, E., Tinkelman, D., Cutter, G. & Woodall, G. (2014). Effect of Nicotine Replacement Therapy on Quitting by Young Adults in a Trial Comparing Cessation Services. J Public Health Manag Pract. , 20(2), E7-E15. doi: 10.1097/PHH.0b013e3182a0b8c7 Quantitative Research Critique and Ethical Considerations PICOT.

Changes in Sites of Care essay

Post a description of a case from your personal or clinical experiences in the last five years that involves an elderly patient who had been in at least two different sites of care. Explain whether thepatient had advanced directive in place at the time ofthe time of the change in sites of care, if do, whether any difficult treatment decisions had a result. Finally, explain the I.pact of financial issues on site placement and treatment decisions. impact of differences in the settings themselves, inherent culture of the settings, and ethical practices of thses sites on the patient Changes in Sites of Care essay.

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Transitional care encompasses an array of services and environments that facilitate timely and safe passage of patients from one care giver to the other. High quality transitional care is most appropriate for older patients who suffer from multiple chronic conditions. Changes in Sites of Care essay. It is normal to witness older people receiving care from more than one institution, due to regular movements. It is therefore important to ensure better transitions during the handover of patients by considering financial, ethical and environmental aspects (Anderson et al., 2014). This way, patients and their relatives are guaranteed of better outcomes.

Description of Case

Recently, I witnessed an old woman suffering from cancer and chronic lung bronchitis being moved for our institution to another health care facility. The patient was under rehabilitative care for the elders, where the nurses literally dressed, fed and bathed her. Since she was suffering from cancer, our radiotherapist administered chemotherapy as a way to control further defects on the normal body cells. She was prescribed painkillers, which reduced the pain she experienced after chemotherapy sessions. However, the family decided to move her to a normal palliative care institution since they could not afford services offered at our institution anymore Changes in Sites of Care essay.

Advanced instructions and its health and financial effects

The patient had prior instructions from her relatives about the transfer to another care. She knew that the destined facility did not offer chemotherapy and therefore, was convinced of the availability of another option at the institution. However, the facility was a step-down due to lack of chemotherapy machines, leading to deterioration of her condition (Starmer et al., 2014) Changes in Sites of Care essay. The treatment decision proved erroneous, leading to stress and discomfort on her relatives. Specifically, the patient was prescribed of expensive drugs, which bore a psychological effect on the relatives.

Impact of setting due to its organizational culture

Transitions of patients suffering from chronic ailments more often lead to serious errors during medication. Besides, institutions charge different fees in accordance to the type of care offered (Friedberg et al., 2015). Besides, different institutions offer different care services depending on their specialization and capability. However, cite placement may save the relative medical fees depending on the care services required at a particular time. Contrariwise, it may cost a lot of money due to errors during medication that may require corrective medicine.

References

Anderson, D. J., Podgorny, K., Berríos-Torres, S. I., Bratzler, D. W., Dellinger, E. P., Greene, L., … Kaye, K. S. (2014). Strategies to prevent surgical site infections in acute care hospitals: 2014 update.
Infection Control & Hospital Epidemiology
,
35
(S2), S66-S88. Changes in Sites of Care essay.

https://doi.org/10.1086/591064

Friedberg, M. W., Schneider, E. C., Rosenthal, M. B., Volpp, K. G., & Werner, R. M. (2014). Association between participation in a multipayer medical home intervention and changes in quality, utilization, and costs of care.
Jama
,
311
(8), 815-825.

doi:10.1001/jama.2014.353

Starmer, A. J., Spector, N. D., Srivastava, R., West, D. C., Rosenbluth, G., Allen, A. D., … Lipsitz, S. R. (2014). Changes in medical errors after implementation of a handoff program.
New England Journal of Medicine
,
371
(19), 1803-1812. Changes in Sites of Care essay doi: 10.1056/nejmsa1405556

Systems Theory in healthcare delivery essay

To prepare:

Review the Meyer article, “Nursing Services Delivery Theory: An Open System Approach,” in this week’s Learning Resources. Focus especially on the information presented in Table 1 (p. 2831) and Figure 2 (p. 2833).

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Reflect on your organization or one with which you are familiar. Within a particular department or unit in this organization, identify a problem the staff is encountering.

Using Table 1 in the Meyer article as a guide, analyze the department or unit, identifying inputs, throughput, output, cycles of events, and negative feedback. Consider whether the problem you have selected relates to input, throughput, output, cycles of events, and/or negative feedback.

Think about how you could address the problem: Consider what a desired outcome would be, then formulate related goals and objectives, and translate those goals into policies and procedures. Systems Theory in healthcare delivery essay.

Research professional standards that are pertinent to your identified problem.

Reflect on the organization’s mission statement and values. In addition, consider how addressing this problem would uphold the mission and values, while improving the organizational culture and climate. (Depending on the organization you have selected, you may have explored these in the Week 1 Discussion.) Systems Theory in healthcare delivery essay.

To complete:

By Day 7

Write a 3- to 5-page Systems Theory in healthcare delivery essay paper (page count does not include title and reference page) that addresses the following:

Describe a department or unit within a health care organization using systems theory terminology. Include a description of inputs, throughput, output, cycles of events, and negative feedback.

Describe the problem you identified within the department or unit using an open- systems approach, and state where the problem exists using the systems theory model (input, throughput, output, cycles of events, or negative feedback).

Based on this information, explain how you would address the problem as follows:

Formulate a desired outcome.

Identify goals and objectives that would facilitate that outcome.

Translate those goals and objectives into policies and procedures for the department or unit.

Describe relevant professional standards.

Explain how your proposed resolution to the problem would uphold the organization’s mission and values and improve the culture and climate Systems Theory in healthcare delivery essay.

 

 

Systems Theory

Meyer and O’Brien’s article entitled, “
Nursing services delivery theory: An open system approach,”
highlights the problems that affect nursing outcomes in health organizations. The authors base their argument on the theory of nursing services delivery and the application of the open system theory. The principles of these theories inform on the influence of availability of resources to the performance of the hospital staff. Through these theories, the authors managed to link nursing responsibilities, staffing, to the work environment and results from different departments. Systems Theory in healthcare delivery essay. Meyer &O’Brien, (2016) collected data from CINAHL and Business Source Premier between 1980 and 2008. The research framework comprised of theories, models, organizational structure, nursing units, and administration.

From a succinct literature review, the authors determined that many health organizations employ traditional nurse staffing methods, which later compromise the patient outcomes due to poor performance. For this reason, Meyer & O’Brien (2016) suggested that there is a need for a theory explains the strategies for quality service delivery in healthcare organizations. The authors established that healthcare organizations are open systems comprised of energy transformation, dynamic state, and cycles of events, negative feedback, differentiation, and coordination Systems Theory in healthcare delivery essay.

Problem and Relation to Work Place

According to the open systems theory, nursing practice is likened to a continuous coordination of inputs and outputs. The inputs entail an inflow of information from an external environment. Resultantly, the throughputs transform the inputs, which re-energize the entire system. The output refers to the products that exported to the external environment. Verleye, Gemmel and Rangarajan (2014) explain that the theory applies to the Nursing Services Delivery Theory, which explains that the inputs in a healthcare organization refer to the people, materials, resources, and labor .The throughputs include the nursing interventions and their roles in promoting patient care. Similarly, the outputs are the revenues and accreditation criteria, while negative feedback shows an organization’s performance indicators. Systems Theory in healthcare delivery essay. The theories help in cumulative need for coherency in frameworks that explain the relationship of organizational activities and outcome variables from a nursing perspective.

In my current organization, there is a growing trend of clinical errors in the department in charge of acute care. Particularly, student trainees tend to perform inaccuracies, especially during night shifts. The errors not only cause poor patient outcomes, but also an unfriendly working environment. In other extreme cases, medical blunders result to reduced nurse-patient relationships. In relation to Meyer and O’Brien’s perspective, the problem of clinical errors relates with people as the staff in the Nursing Services Delivery. The main reason for faults in the department is long hours of work with no breaks. Besides, understaffing in the same department also aggravates the rate of mistakes, since there are few trained nurses who guide the trainees. In other circumstances, trainees face difficulties yet a professional nurse is not available to provide necessary guidance. Systems Theory in healthcare delivery essay.

Addressing the Problem

Understaffing is a crucial problem in many health care facilities that handle a large patient influx. Normally, short-staffed institutions experience frequent burnouts, leading to high employee turnovers (Schwartz,& Mazouni, 2017). To alleviate this situation, employers ought to invest more when hiring personnel.  It is important to provide for a better nurse-patient ration to ensure patient-centered care. Besides, enhancing proper working environments by investing in more technological infrastructure is vital.  Health care institutions ought to ensure enough room for patients and nursing staff Systems Theory in healthcare delivery essay.

Outcomes

Through equipping health institution with enough employees, the patient-nurse ratio is standardized. Cho, Kim, Yeon,You and Lee (2015) explain that through this way, medical practitioners dedicate more time on patients and attend to their problems. It is through such interventions that better patient outcomes are achieved.  Besides, improved working environments in health care facilities provide for easier maneuvering and faster service delivery. Equipping hospitals with adequate technology provides for easier and precise storage of data. This way, retrieval and analysis of information becomes easier. Systems Theory in healthcare delivery essay.

Policies to facilitate the Outcomes

Health care facilities ought to operate under a set of relevant guidelines, which stipulate clear procedures for execution of duties. For instance, it is essential that the institutions invest in qualified personnel, who guarantee minimal errors during medications. Besides, they ought to ensure they work under proper management, with adaptive and productive subsystems, leading to self-efficacy. Systems Theory in healthcare delivery essay. Administrators should be competent, by ensuring the staff practice in accordance to stipulated provisions.

Professional Standards

Professional standards are important in healthcare, since they outline frameworks which help institutions achieve the desired performances. They direct and maintain safe and competent nursing practice (Masters, 2015). In this case, health care professionals ought to provide enough personnel to ensure patients are served diligently. Employing fewer staff overburdens them, and this contravenes the professional standards of work amongst employees. Systems Theory in healthcare delivery essay. Facilities with enough nurses are guaranteed of minimal medical errors and low readmission rates.

Proposed Solutions and upholding Mission and Vision

Through the open systems theory, institutions ought to observe a steady flow between inputs and through puts to ensure desirable outputs. In a healthcare setting, nurses play an integral role to achieve improved health of patients, which is the primary desirable outcome that each health institution anticipates. Specifically, lack of enough staff is the major problems in many of the healthcare facilities. To achieve the mission and vision of providing quality services in the best way possible, these institutions ought to invest more in the hiring processes. This includes offering respectable salaries to qualified staff. This way, the facilities experience lower employee turnovers and increased nurse-patient interactions. Systems Theory in healthcare delivery essay.

References

Cho, S. H., Kim, Y. S., Yeon, K. N., You, S. J., & Lee, I. D. (2015). Effects of increasing nurse staffing on missed nursing care.
International nursing review
,
62
(2), 267-274.

doi: 10.1111/inr.12173

Masters, K. (2015).
Role development in professional nursing practice
. Jones & Bartlett Publishers.

Retrieved from https://books.google.co.ke/books?hl=en&lr=&id=ftkBCwAAQBAJ&oi=fnd&pg=PR1&dq=professional+standards+in+nursing+2015&ots=nhSdA1SmBt&sig=DhtlnHS0hCRJocN1yu6F2dskA9A&redir_esc=y#v=onepage&q=professional%20standards%20in%20nursing%202015&f=false

Meyer, R. M., & O’Brien‐Pallas, L. L. (2010). Nursing services delivery theory: an open system approach.
Journal of Advanced Nursing
,
66
(12), 2828-2838. Systems Theory in healthcare delivery essay.

doi:  10.1111/j.1365-2648.2010.05449.x

Schwartz, A., & Mazouni, A. (2017). Medical student, nursing student, and non-health care respondents’ implicit attitudes toward doctors and patients: Development and a pilot study of a new implicit attitudes test (IAT). 
Plos ONE
, 
12
(8), 1-12. Systems Theory in healthcare delivery essay.

doi:10.1371/journal.pone.0183352

Verleye, K., Gemmel, P., & Rangarajan, D. (2014). Managing engagement behaviors in a network of customers and stakeholders: Evidence from the nursing home sector.
Journal of Service Research
,
17
(1), 68-84.

Retrieved from http://journals.sagepub.com/doi/abs/10.1177/1094670513494015 Systems Theory in healthcare delivery essay

For this Organizational Culture and climate Sample Essay Discussion, you explore the culture and climate of your current organization or one with which you are familiar. You also consider decisions and day-to-day practices and the way they relate to the organization’s mission, vision, and values.

To prepare:

Review the information related to planning and decision making in health care organizations presented in the textbook, Leadership Roles and Management Functions in Nursing: Theory and Application. Consider how planning and decision making relate to an organization’s mission, vision, and values, as well as its culture and its climate. Organizational Culture and climate Sample Essay.

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Familiarize yourself with the mission, vision, and values of your organization or one with which you are familiar. Consider how the statements and actions of leaders and others within the organization support or demonstrate the organizational mission, vision, and values. In addition, note any apparent discrepancies between word and deed. Think about how this translates into expectations for direct service providers. Organizational Culture and climate Sample Essay. Note any data or artifacts that seem to indicate whether behaviors within the organization are congruent with its mission, vision, and values.

Begin to examine and reflect on the culture and climate of the organization. How do culture and climate differ?

Why is it important for you, as a master’s-prepared nurse leader, to be cognizant of these matters?

Post a description of your selected organization’s mission, vision, and values. Describe relevant data, or artifacts, words, and actions of leaders and others in the organization that support, or perhaps appear to contradict the organization’s mission, vision, and values statement. In addition, discuss the organization’s culture and its climate, differentiating between the two. Explain why examining these matters is significant to your role as a nurse leader. Organizational Culture and climate Sample Essay.

Please references should be within the last five years. With in text citation please include page number or paragraph number. Thank You.

 

Organizational Culture and climate

Description of selected organization’s mission, vision, and values

My organization’s mission statement lays emphasis on provision of quality care to all patients, assurance of heightened safety, and commitment to offer unparalleled healthcare. Consequently, the institution envisions being a revered community member recognized for commitment in provision of highest standards of patient care for the wellbeing of the society. The institution operations are grounded in values of dignity, trust, teamwork, and integrity Organizational Culture and climate Sample Essay.

Supportive actions of leaders

The conduct of the management and employees in my organization serves to strengthen the underlying mission and vision. For instance, the organization’s leadership lays a significant emphasis on open communication and interaction with the employees. This interactivity and openness in turn has facilitated teamwork and commitment in service delivery, which illuminates reverence to the institutions values (Spear, 2017, p162). Organizational Culture and climate Sample Essay.

Culture and climate

An organization culture denotes values that guide the conduct of individuals in an institution. According to Huber (2017, p57), culture acts as map defining the most appropriate way to conduct ones duty. My organization has developed a safety culture illustrated by the heightened emphasis on corroboration amongst practitioners to ensure patient safety. This culture has been cultivated by the institutions values including dignity and teamwork, and the mission statement’s emphasis on provision of highest standards of safety. On the other hand, organizational climate is the product of underlying culture and is defined as the manner in which individuals experience culture (Taplay, Jack, Baxter, Eva, & Martin, 2014, p2). In this regard, climate denotes what employees view as the disposition of the values emphasized in an institution. Notably, my organization harbors a safety climate in whereby all employees view patient safety and quality healthcare as an individual responsibility Organizational Culture and climate Sample Essay.

Why examining these matters is significant to your role as a nurse leader

As a nurse leader, it is imperative to understand the correlation between an institution’s mission, and values and the resultant organizational culture and climate. For instance, when the leaders cultivate certain values and lay emphasis on given behaviors the other employs follow suit which with time becomes the culture of the organization (Taplay, et al., 2014, p2).. As such, nurse leaders should strive to cultivate the values that strengthen the mission since the resultant culture and climate would uphold the same enabling the organization to achieve its vision (McNaught, & Shaw, 2017, p6) Organizational Culture and climate Sample Essay.

References

Huber, D. (2017). Leadership and Nursing Care Management-E-Book. Elsevier Health Sciences. Retrieved from. https://books.google.co.ke/books?id=CZx5AAAAQBAJ&pg=PA57&lpg=PA57&dq=how+mission+statement+impacts+organization%E2%80%99s+culture+and+its+climate+nursing&source=bl&ots=u_yNFGbHVj&sig=bYXtyge5aKXm3zchWpkO-V0i05U&hl=en&sa=X&ved=0ahUKEwjI99Gnu8TZAhVKXBQKHT5WBa4Q6AEIXzAG#v=onepage&q=how%20mission%20statement%20impacts%20organization%E2%80%99s%20culture%20and%20its%20climate%20nursing&f=false

McNaught, K., & Shaw, G. (2017). Orientation to mission: Assessing the perceptions of effectiveness of an in-house orientation program focused on mission, vision and values within a large-scale, not-for-profit, private hospital. Organizational Culture and climate Sample Essay.

Spear, S. (2017). Impression management activity in vision, mission, and values statements: A comparison of commercial and charitable organizations. International Studies of Management & Organization, 47(2), 159-175.

Taplay, K., Jack, S. M., Baxter, P., Eva, K., & Martin, L. (2014). Organizational culture shapes the adoption and incorporation of simulation into nursing curricula: a grounded theory study. 
Nursing research and practice
, 
2014
. 1-12 Organizational Culture and climate Sample Essay

Working With Children and Adolescents Versus Adults discussion essay

Discussion: Working With Children and Adolescents Versus Adults

Infant, childhood, and adolescent development are a continual interplay between nature (genetic or biologic predisposition) and nurture (environmental experiences). The nature/nurture continuum and debate will always be a part of your career as a PMHNP. Knowing common developmental milestone is important in the role as a child provider. Working With Children and Adolescents Versus Adults discussion essay. Not only is it essential to the diagnostic process, but it is also important to the interdisciplinary interactions with other mental health professionals. The study of normal developmental processes, however, is only one tool that allows the mental health professional to understand the child being evaluated. There are many different assessment instruments and interviewing techniques that PMHNPs can have in their toolkit when working with children and adolescents. Working With Children and Adolescents Versus Adults discussion essay.

In this Discussion, you examine the differences in assessing and treating children and adolescents versus adults. You take into consideration your own clinical experiences, as well as your experiences in your clinical rotation, and the information from the readings thus far.

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Post your answers to the following:

• Explain why a developmental assessment of children and adolescents is important.

• Describe two assessment instruments and explain why they are used for children and adolescents but not adults. Working With Children and Adolescents Versus Adults discussion essay.

• Describe two treatment options for children and adolescents that may not be used when treating adults.

• Explain the role parents play in assessment and treatment.

Child and Adolescent Mental Health

Achenbach Child Behavior Checklist (CBCL) is a children and adolescents assessment tool employed in the assessment of behavioral and emotional alterations in children and adolescents between the age 6 and 18 years. According to Raiker and associates the Achenbach uses the “Child Behavior Checklist (CBCL), Teacher Report Form (TRF), and Youth Self-Report Form (YSR)” as some of its scales in children and adolescents (Raiker, Freeman, Perez-Algorta, Frazier, & Youngstrom, 2017, p. 3) Working With Children and Adolescents Versus Adults discussion essay.

Consequently, Child and Adolescent Needs and Strengths-Mental Health (CANS-MH) is an assessment tool that centers in unearthing the needs and areas of strengths to indicate the necessary care and “assist in planning” the level of monitoring to be enacted (Ebesutani et al., 2017, p. 1). Like the CBCL, CANS also require the parents to complete the questions.

The two assessment instruments are restricted to children assessments since they measures focus on the child’s development context. While some behaviors may be considered normal to children, the same behaviors at an older age signify metal disorders. Moreover, the assessment dependence of the caregiver’s observations emanates from the inadequacy of cognitive and linguistic development in children, which inhibits accurate expression of the systems. Working With Children and Adolescents Versus Adults discussion essay. However, with adults, self-expression of symptoms provides a more accurate assessment than observation would.

With children and adults, some treatment options require incorporation of the primary caregivers in their approach and therefore are unlikely to be used when treating adults. For instance, “behavioral therapies conducted on both the child and the parent,” is different from adult cases where the therapy is conducted on the adult patient (Abbas et al., 2017, p. 2). Consequently, instigation of “educational courses and behavioral management tactics for the parents” or other caregivers as a treatment option would only be adequate in children and adolescents cases (Abbas et al., 2017, p. 2). Working With Children and Adolescents Versus Adults discussion essay.

Parents play a critical role in ensuring the success a child’s assessment and treatment. According to (Raiker et al., 2017, p. 3) Parent participation engagement (PPE) correlates to a positive outcome in the treatment of a childhood disorder. Consequently, parents monitor the behavioral change in the child’s development process and provide the necessary information during the assessment process. Lastly, the parents ensure that the child complies with the treatment and consequently monitor the progress of the treatment to the physician. Finally, the parent should provide behavioral and emotional support to the affected children within the family context. Working With Children and Adolescents Versus Adults discussion essay.

References

Abbas, S., Ihle, P., Adler, J. B., Engel, S., Günster, C., Holtmann, M., … & Schubert, I. (2017). Predictors of non-drug psychiatric/psychotherapeutic treatment in children and adolescents with mental or behavioural disorders. 
European child & adolescent psychiatry
, 
26
(4), 433-444.

Ebesutani, C., Daleiden, E., Becker, K. D., Schmidt, L., Bernstein, A., Rith-Najarian, L., … & Chorpita, B. F. (2017). Facilitating Communication of Ideas and Evidence to Enhance Mental Health Service Quality: Coding the Treatment Services Literature Using the Child and Adolescent Needs and Strengths-Mental Health Assessment Scales.
Journal of Child and Family Studies
, 26(11), 3123-3134.

Raiker, J. S., Freeman, A. J., Perez-Algorta, G., Frazier, T. W., Findling, R. L., & Youngstrom, E. A. (2017). Accuracy of Achenbach scales in the screening of attention-deficit/hyperactivity disorder in a community mental health clinic.
Journal of the American Academy of Child & Adolescent Psychiatry
, 56(5), 401-409. Working With Children and Adolescents Versus Adults discussion essay.

Discussion: Working With Children and Adolescents Versus Adults

Infant, childhood, and adolescent development are a continual interplay between nature (genetic or biologic predisposition) and nurture (environmental experiences). The nature/nurture continuum and debate will always be a part of your career as a PMHNP. Knowing common developmental milestone is important in the role as a child provider. Not only is it essential to the diagnostic process, but it is also important to the interdisciplinary interactions with other mental health professionals. Working With Children and Adolescents Versus Adults discussion essay. The study of normal developmental processes, however, is only one tool that allows the mental health professional to understand the child being evaluated. There are many different assessment instruments and interviewing techniques that PMHNPs can have in their toolkit when working with children and adolescents.

In this Discussion, you examine the differences in assessing and treating children and adolescents versus adults. You take into consideration your own clinical experiences, as well as your experiences in your clinical rotation, and the information from the readings thus far. Working With Children and Adolescents Versus Adults discussion essay.

Post your answers to the following:

• Explain why a developmental assessment of children and adolescents is important.

• Describe two assessment instruments and explain why they are used for children and adolescents but not adults.

• Describe two treatment options for children and adolescents that may not be used when treating adults.

• Explain the role parents play in assessment and treatment. Working With Children and Adolescents Versus Adults discussion essay.

For this week’s systems theory essay – Transitioning From Closed to Open Systems Discussion, you identify an issue or process that could be improved and apply knowledge and strategies related to systems theory.

To prepare:

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Review the information presented in this week’s Learning Resources on systems theory and the difference between open and closed systems.

Reflect on the practices and processes with which you are familiar in your organization. Identify one problematic issue or process that could be improved.

Consider the problem from a closed-system perspective. Then think about how the issue or process you selected could be addressed by viewing it from an open-system perspective. How would the transition from a closed- to an open-system view help you and others to address the problem and improve outcomes? systems theory essay – Transitioning From Closed to Open Systems.

Post a description of the problem that you identified in your selected organization. Explain the problem from a closed-system perspective. Then, describe how the problem could be addressed by viewing it from an open-system perspective, and explain how this modification would help you and others improve health care outcomes.

Please include introduction, summary and references should be within the last five years. in text citation should have the page numbers or paragraph. Thank you. systems theory essay – Transitioning From Closed to Open Systems.

 

Transitioning From Closed to Open Systems

Introduction

In systems theory, a system is defined as a whole entity comprised of various individual components but which are interdependent. According to Peters (2014), p. 2), “the healthcare system harbors complexity” cultivated by the multifaceted nature of its stakeholders and roles to the society. systems theory essay – Transitioning From Closed to Open Systems. As an organization strives to adapt amid the complexity, the system perspective –open or closed – guiding the adaptation acts as the success determinant either facilitating or hindering the optimal performance of the system as it interacts with the environment. This paper provides an example of healthcare problem rooted in the closed system perspective and discuss its alternative, the open system perspective, as an adequate solution.

Problem highlight

I interned in a healthcare organization with clear-cut hierarchy amongst the different professionals with an eminent dominance of the physicians over the rest. As such, the nurses and the physicians seemingly worked as different independent teams with little interaction between the two. As a result, the management-received complaints from the patients that when they aired their concerns to nurses in most cases the physicians did not seem to take into count. In this case, it was evident that the department was marred by misunderstandings instigated by miscommunication.

Problem from a closed-system perspective

The eminent misunderstandings and inadequate information flow is fueled by adopted closed system operation. In a closed system, the components of the system restrict the flow of information internally without adequate external information flow, which “inhibits the system’s ability to respond to external environment effectively” (Cordon, 2013, p. 4). In the case of the healthcare organization, the professional hierarchies act as individual components with adequate communication only happening within each circle. The professional hierarchies often hinder free interaction amongst the team members working in different departments prompting each to work independently. However, as Dobrzykowski, and Tarafdar (2015) observes, “information exchange relationship among the physician and a hospital’s healthcare providers is an essential element of coordination and key to delivering experiences which patients find valuable.” In this regard, when communication breakdown occurs between the healthcare providers the result is the organization’s inability to respond to the dynamics in both their internal and external environments, in this case, the patient’s concerns. systems theory essay – Transitioning From Closed to Open Systems.

Addressing problem from an open-system perspective

Healthcare institutions constitute of different professionals each with a distinct role but all serving as a single entity. In this regard, the institution should nurture adequate communication between the professionals by crippling the professional superiority complex. Adoption of an open system would sufficiently counter the challenges resulting from the culture of “us versus them” in terms of professions. According to May, Johnson, and Finch (2016, p. 9), entities in an open system although distinct in their roles recognize “the dynamic features of context that shape self-organization in complex adaptive social systems.” As such, components in open systems uphold the interrelation and symbiotic relation required for the benefit of the whole system, which in turn heightens the system’s ability to react with their environments by adapting to external and internal factors. As such, adoption of the open system perspective would facilitate interaction of healthcare administrators and practitioners in different departments systems theory essay – Transitioning From Closed to Open Systems.

Summary

In conclusion, there is a need for adoption of open systems in healthcare organizations to enhance efficiency in healthcare provision. Open system operations in healthcare services would go a long way in fostering communication and ensure that healthcare institutions meet the dynamic needs emanating from the external environment thus facilitating efficiency in healthcare provision systems theory essay – Transitioning From Closed to Open Systems

 

References

Cordon, C. P. (2013). System theories: An overview of various system theories and its application in healthcare.
American Journal of Systems Science,
2(1), 13-22.

Dobrzykowski, D. D., & Tarafdar, M. (2015). Understanding information exchange in healthcare operations: Evidence from hospitals and patients.
Journal of Operations Management
, 36, 201-214.

May, C. R., Johnson, M., & Finch, T. (2016). Implementation, context and complexity.
Implementation Science,
11(1), 141 systems theory essay – Transitioning From Closed to Open Systems.

Peters, D. H. (2014). The application of systems thinking in health: why use systems thinking?.
Health Research Policy and Systems
, 12(1), 51.

For this systems theory essay – Transitioning From Closed to Open Systems Assignment, you apply systems theory to the examination of a problem in a department or a unit within a health care organization. (Note: You may use the same problem you identified for the Discussion as long as it meets the criteria for this assignment.)

To prepare:

Review the Meyer article, “Nursing Services Delivery Theory: An Open System Approach,” in this week’s Learning Resources. Focus especially on the information presented in Table 1 (p. 2831) and Figure 2 (p. 2833).

Reflect on your organization or one with which you are familiar. Within a particular department or unit in this organization, identify a problem the staff is encountering.

Using Table 1 in the Meyer article as a guide, analyze the department or unit, identifying inputs, throughput, output, cycles of events, and negative feedback. Consider whether the problem you have selected relates to input, throughput, output, cycles of events, and/or negative feedback.

Think about how you could address the problem: Consider what a desired outcome would be, then formulate related goals and objectives, and translate those goals into policies and procedures.

Research professional standards that are pertinent to your identified problem.

Reflect on the organization’s mission statement and values. In addition, consider how addressing this problem would uphold the mission and values, while improving the organizational culture and climate. (Depending on the organization you have selected, you may have explored these in the Week 1 Discussion.) systems theory essay – Transitioning From Closed to Open Systems.

Write a 4 page paper (page count does not include title and reference page) that addresses the following:

Describe a department or unit within a health care organization using systems theory terminology. Include a description of inputs, throughput, output, cycles of events, and negative feedback.

Describe the problem you identified within the department or unit using an open- systems approach, and state where the problem exists using the systems theory model (input, throughput, output, cycles of events, or negative feedback).

Based on this information, explain how you would address the problem as follows:

Formulate a desired outcome systems theory essay – Transitioning From Closed to Open Systems.

Identify goals and objectives that would facilitate that outcome.

Translate those goals and objectives into policies and procedures for the department or unit.

Describe relevant professional standards.

Explain how your proposed resolution to the problem would uphold the organization’s mission and values and improve the culture and climate.

Please paper should have introduction, summary and in text citation should have paragraph number or page number. References should be within the last five years. Thank you

Applying Systems Theory systems theory essay – Transitioning From Closed to Open Systems.

Question 1. Describing the department using systems theory terminology

As a nursing professional, I am employed in the emergency department of Morgan Stanley Children’s Hospital. I am engaged in offering nursing services. The facility is located in New York City and is under the management of Presbyterian Hospital within the same city (New York – Presbyterian Hospital, 2018). The emergency department serves three critical functions. Firstly, it is concerned with accurately assessing the patients who arrive at the facility. Secondly, it is concerned with diagnosis. systems theory essay – Transitioning From Closed to Open Systems. Finally, it offers the appropriate emergency medical care. In order to carry out the three core functions, the department has employed a multidisciplinary team of medical professionals that includes nurses and physicians. The team integrates the efforts of each individual and profession, focusing on concerted exertions to ensure that all patients who access the department receive the best possible emergency care that includes a safe environment, alleviating and stabilizing their condition, and facilitating speedy recovery. To facilitate the realization of these objectives, the facility has dedicated resources towards acquiring medical equipment and employing adequate staff levels. As a result, the medical equipment, staff and resources employed in the department can be considered as the facility’s input in the emergency department. Additionally, the management services in the emergency department is that throughput that systemizes the inputs, and orders and organizes medical services with a view to achieve the department’s primary goals. Reasonably, the patients who pass through the emergency department having received care are the output. Also, the turnover volumes reported for the patients is the measure of effectiveness for the emergency department. Given that the facility, including the emergency department, is profit oriented as a sustainability measure interpreted through offering the best possible care, then revenue and profit figures would be considered as the cycle of events. In addition, the performance indicators for the medical department, particularly the reviews offered by the public on staff and services performance, acts as the feedback for the department (Huber, 2013; Meyer & O’Brien-Pallas, 2010).

Question 2. Describing the problem using an open- systems approach, and stating where the problem exists using the systems theory model

In spite of the emergency department reporting a devotion and commitment to offering the best possible care to its patients, the patients have reported a general inability by the nursing personnel to correctly evaluate and manage their pain levels. In fact, the department scores poorly in pain management since the patients indicate that their pain is either inadequately addressed or ignored. The patient reviews show that pain management measures applied in the facility are largely ineffective with the nursing personnel receiving some negative reviews in that regard. To put it more succinctly, some of the patients who pass through the emergency department have indicated that nursing efforts are inadequate systems theory essay – Transitioning From Closed to Open Systems. The implication is that the performance indicators for the department presents subpar figures as nurses are unable to accurately perceive the patients’ pain levels (Meyer & O’Brien-Pallas, 2010). Pope and Deer (2017) explores the issue of ineffective pain management within a medical facility by reporting that it is a common problem. In fact, pain evaluation is only reported to capture 20% of the required information while losing 80% information. Should this statistics turn true for the emergency department, then there is a need to develop and apply better pain evaluation methods that would capture the remaining 80% of the information that had previously been lost. At the very least, inefficient pain evaluation holds true for the nursing personnel in the emergency department since one of their key responsibility is to apply assertive strategies in collecting and disseminating pain assessment information. When the patients complain that their pain has not been well managed, then it implies that nurses have failed to collect and disseminate the right information. To address this issue, there is a need for the nursing personnel to assume a leadership position in the multidisciplinary teams, focusing on developing appropriate solutions to the existing problem, executing the solution, and interpreting the feedback to identify areas that should be improved systems theory essay – Transitioning From Closed to Open Systems.

Question 3. Explaining the desired outcome

The problem existing in the emergency department has been identified the patients’ complaints about ineffective pain management strategies. The nursing personnel do not collect all the required information and end up applying the wrong pain management strategies. As such, the desired outcome is to ensure that pain is well managed in the department by collecting all the information on pain and development a management strategy based on the collected information.

Question 4. The goal and objective that will facilitate the desired outcome

The goal is to improve pain management results in the department. This would be assessed through patients’ reviews that report whether or not the applied pain management strategy was effective. The objective is to improve revenues and profits by receiving positive reviews from patients that increases their possibility for patronage or recommending the facility to others systems theory essay – Transitioning From Closed to Open Systems.

Question 5. Goal and objective translation into policies and procedures

Translating the identified goal and objective into policies and procedures for the department takes the form of improving pain assessment to allow for more pain information to be collected thus allowing for an effective pain management strategy to be selected and applied. Decoding this would entail actively engaging the patients through communication so that the nurses have an accurate awareness of the patients’ pain levels. This means that the new policies and procedures would focus on improving the interactions between the nurses in the emergency department and their patients. Also, the new procedures would be reviewed to prioritize costs so that the department does not report unfavorable revenues and profits. systems theory essay – Transitioning From Closed to Open Systems. Besides that, drug interactions, adverse reactions, tolerance and addiction must also be accounted for within the new policies.

Question 6. The relevant professional standards

All through the pain management process as applied within the emergency department, the nursing staff will ensure that their focus does not move away from addressing the patients’ pain. Any duties that are acknowledged as exceeding the nurses’ capabilities and scope will be transferred to the appropriate individuals or offices (Tintinalli et al., 2016). For example, if the pain medication being used within the department turns harmful, then the hospital administrators will be informed to assess the medication and approve the acquisition of safe medication. Besides that, the nursing staff will receive pain assessment and management training that improves their interactions with the patients to collect the right information (Cherry & Jacob, 2013). In this respect, the nursing staff will establish a pain baseline, scrutinize the currently applied strategies, formulate an appropriate response for the patients’ complaints, and develop an action plan to ensure that patients present a positive review about their pain management. systems theory essay – Transitioning From Closed to Open Systems.

Question 7. How the proposed resolution will uphold the organization’s mission and values and improve the culture and climate

The proposed solution will uphold the facility’s mission and values while improving culture and climate by ensuring that pain management in the department is effective. This would allow the department to offer appropriate care that is accompanied by high satisfaction levels by the patients to improve profit and revenue figures.

References

Cherry, B. & Jacob, S. (2013).
Contemporary Nursing, Issues, Trends, & Management
(6
th
ed.). Amsterdam: Elsevier Health Sciences.

Huber, D. (2013).
Leadership and Nursing Care Management
(5
th
ed.). St, Louis, MO: Elsevier/Saunders. systems theory essay – Transitioning From Closed to Open Systems.

Meyer, R. & O’Brien-Pallas, L. (2010). Nursing Services Delivery Theory: An open system approach.
Journal of Advanced Nursing
, 66(12), 2828-2838.

New York – Presbyterian Hospital (2018).
Morgan Stanley Children’s Hospital
. Retrieved from http://www.nyp.org/morganstanley

Pope, J. & Deer, T. (2017).
Treatment of Chronic Pain Conditions: A comprehensive handbook
. New York, NY: Springer.

Tintinalli, J., Stapczynski, S., Ma, J., Cline, D. & Meckler, G. (2016).
Tintinalli’s Emergency Medicine: A comprehensive study guide
(8
th
ed.). New York, NY: McGraw Hill Professional systems theory essay – Transitioning From Closed to Open Systems.

 

Transitioning From Closed to Open Systems

Introduction

In systems theory, a system is defined as a whole entity comprised of various individual components but which are interdependent. According to Peters (2014), p. 2), “the healthcare system harbors complexity” cultivated by the multifaceted nature of its stakeholders and roles to the society. systems theory essay – Transitioning From Closed to Open Systems. As an organization strives to adapt amid the complexity, the system perspective –open or closed – guiding the adaptation acts as the success determinant either facilitating or hindering the optimal performance of the system as it interacts with the environment. This paper provides an example of healthcare problem rooted in the closed system perspective and discuss its alternative, the open system perspective, as an adequate solution.

Problem highlight

I interned in a healthcare organization with clear-cut hierarchy amongst the different professionals with an eminent dominance of the physicians over the rest. As such, the nurses and the physicians seemingly worked as different independent teams with little interaction between the two. As a result, the management-received complaints from the patients that when they aired their concerns to nurses in most cases the physicians did not seem to take into count. In this case, it was evident that the department was marred by misunderstandings instigated by miscommunication.

Problem from a closed-system perspective

The eminent misunderstandings and inadequate information flow is fueled by adopted closed system operation. In a closed system, the components of the system restrict the flow of information internally without adequate external information flow, which “inhibits the system’s ability to respond to external environment effectively” (Cordon, 2013, p. 4). In the case of the healthcare organization, the professional hierarchies act as individual components with adequate communication only happening within each circle. The professional hierarchies often hinder free interaction amongst the team members working in different departments prompting each to work independently. However, as Dobrzykowski, and Tarafdar (2015) observes, “information exchange relationship among the physician and a hospital’s healthcare providers is an essential element of coordination and key to delivering experiences which patients find valuable.” In this regard, when communication breakdown occurs between the healthcare providers the result is the organization’s inability to respond to the dynamics in both their internal and external environments, in this case, the patient’s concerns. systems theory essay – Transitioning From Closed to Open Systems.

Addressing problem from an open-system perspective

Healthcare institutions constitute of different professionals each with a distinct role but all serving as a single entity. In this regard, the institution should nurture adequate communication between the professionals by crippling the professional superiority complex. Adoption of an open system would sufficiently counter the challenges resulting from the culture of “us versus them” in terms of professions. According to May, Johnson, and Finch (2016, p. 9), entities in an open system although distinct in their roles recognize “the dynamic features of context that shape self-organization in complex adaptive social systems.” As such, components in open systems uphold the interrelation and symbiotic relation required for the benefit of the whole system, which in turn heightens the system’s ability to react with their environments by adapting to external and internal factors. As such, adoption of the open system perspective would facilitate interaction of healthcare administrators and practitioners in different departments.

Summary

In conclusion, there is a need for adoption of open systems in healthcare organizations to enhance efficiency in healthcare provision. Open system operations in healthcare services would go a long way in fostering communication and ensure that healthcare institutions meet the dynamic needs emanating from the external environment thus facilitating efficiency in healthcare provision systems theory essay – Transitioning From Closed to Open Systems.

References

Cordon, C. P. (2013). System theories: An overview of various system theories and its application in healthcare.
American Journal of Systems Science,
2(1), 13-22.

Dobrzykowski, D. D., & Tarafdar, M. (2015). Understanding information exchange in healthcare operations: Evidence from hospitals and patients.
Journal of Operations Management
, 36, 201-214.

May, C. R., Johnson, M., & Finch, T. (2016). Implementation, context and complexity.
Implementation Science,
11(1), 141.

Peters, D. H. (2014). The application of systems thinking in health: why use systems thinking?.
Health Research Policy and Systems
, 12(1), 51. systems theory essay – Transitioning From Closed to Open Systems.

Role of Care Neglect and Supervisory Neglect in Childhood Obesity Article Critique

Journal Article Critiques

Instructions:

These critiques should be between 1.5 and 2 pages, double-spaced, in Times New Roman (12 point) font, and with 1” margins on all sides. Please include and APA style cover page, page numbers and headers/sub headers, in text citations, and works cited page.

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Summary: The summary should be between 1 and 2 paragraphs. This should briefly explain the authors’ purpose(s), method, and results (main findings in your own words. No numbers.) Keep the summary informative, but concise (less than a page) Role of Care Neglect and Supervisory Neglect in Childhood Obesity Article Critique.

Critique: You should critique the articles based on the following criteria. Be sure to completely and concisely address each point. Remember this should be a critical assessment or the study (objective). DO NOT INCLUDE YOUR OPINION. Paraphrase , no direct quotes.

1. Purpose/Research Question: Determine the authors’ purpose of the research and state it in your own words. Comment on how clearly this was presented in the article.

2. Method: Comment on how appropriate the method used was for addressing the purpose. State if the method was employed effectively.

3. Evidence of Support: Examine the method and results of the article and determine if they helped the authors effectively address the purpose presented. Also discuss the strengths and weaknesses of the evidence and the study as a whole.

4. Real World Application: After reading the discussion section summarize any real world implications the authors suggest. Also give your own suggestions for the real world application of the study and its’ findings.

5. Recommendations: Determine who might benefit from the article, what the benefit may be, and the importance of the benefit. Here you may summarize your subjective judgments of the work and suggestions on how to improve or extend the work.

Summary:

Cases of childhood obesity have been on the rise in the modern society eliciting various studies on its causality with parental care. In one study, investigating the roles of parental care in childhood obesity, Knutson and associates found out that child neglect had a high correlation with childhood obesity (Knutson, Taber, Murray, Valles, & Koeppl, 2009). Notably, child neglect amongst the disadvantaged children was the greatest risk factor for childhood obesity. However, the study also highlighted that neglect was not limited to the disadvantaged but was also evident to children in the middle and high-class families. Role of Care Neglect and Supervisory Neglect in Childhood Obesity Article Critique. This critic indulges in the specifics of Knutson and colleagues study before concluding with a discussion on its implications to the real word and recommendations to build on highlighted gaps.

Purpose/Research Question:

The primary objective of this study was to assess the roles of childcare and supervisory neglect as a factor contributing to childhood obesity. The study was founded on the assertion that parental supervisory plays a significant role in child development and young children are more likely to be neglected which is liable to facilitate obesity. To ascertain or nullify the hypothesis two research questions can be deduced including; what is the influence of parental care in facilitating childhood obesity? and, is a child’s age a factor in childhood obesity. Role of Care Neglect and Supervisory Neglect in Childhood Obesity Article Critique.

Method:

The study employed a multi-source survey analysis approach with questionnaires as the primary data collection tools. Notably, the scope of the study was in two counties in Southeastern Lowa with the sample derived from the neglected and disadvantaged children between the age of 3 years 7 months to 9 years 6 months with the children 571 children constituting the study sample. The methodology was employed effectively since by adopting a multi-source survey and the structured parent-child interaction the study eliminated possible interviewee (parents) bias, which was further heightened by the child’s BMI tests. Role of Care Neglect and Supervisory Neglect in Childhood Obesity Article Critique.

Evidence of Support:

Use of an age range for the sampled children and conducting structured parent-child interaction was effective for the study’s objective. Notably, the Bivariate correlations between the BMI, demographic variables, and the indices of neglect were found to be less than 10 which ascertained the study’s hypothesis. Role of Care Neglect and Supervisory Neglect in Childhood Obesity Article Critique. For instance, the study results highlighted the B.M.I of the neglected children as ranging from11.6 to 37 (M ¼ 16.7, SD ¼ 3.03; n ¼ 569. Additionally, 14.9% of the children in the study sample was found to be within the at-risk range, with 16.3% considered obese.

Real World Application:

The findings of this study exemplify the correlation between parental care neglect and childhood obesity. As a result, the study pinpoints the need for parental care intervention in controlling childhood obesity. Moreover, although factors such as hereditary genetics and social disadvantage do facilitate the occurrence of childhood obesity, the study underlines childhood obesity as a multidimensional aspect thus the magnitude of parental care. As such, the findings of this study are insightful to both health practitioners and parents, in diagnosing and controlling the health issues emanating from childhood obesity Role of Care Neglect and Supervisory Neglect in Childhood Obesity Article Critique.

Recommendations:

Future research studies need to adopt a wider scoop by involving children with a broader age in the study sample. Such an approach will facilitate clarification the link between childhood obesity and differential care neglect in the different aspects of parenting. Role of Care Neglect and Supervisory Neglect in Childhood Obesity Article Critique. Additionally, prospective research studies should purposely isolate the unique implications of child neglect in facilitating the occurrence of child obesity.

References

Knutson, J. F., Taber, S. M., Murray, A. J., Valles, N. L., & Koeppl, G. (2009). The role of care neglect and supervisory neglect in childhood obesity in a disadvantaged sample. Journal of Pediatric Psychology, 35(5), 523-532. Role of Care Neglect and Supervisory Neglect in Childhood Obesity Article Critique.

Child Food Requests Journal Article Critique

Journal Article Critiques

Instructions:

These critiques should be between 1.5 and 2 pages, double-spaced, in Times New Roman (12 point) font, and with 1” margins on all sides. Please include and APA style cover page, page numbers and headers/sub headers, in text citations, and works cited page.

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Summary: The summary should be between 1 and 2 paragraphs. This should briefly explain the authors’ purpose(s), method, and results (main findings in your own words. No numbers.) Keep the summary informative, but concise (less than a page) Child Food Requests Journal Article Critique.

Critique: You should critique the articles based on the following criteria. Be sure to completely and concisely address each point. Remember this should be a critical assessment or the study (objective). DO NOT INCLUDE YOUR OPINION. Paraphrase , no direct quotes.

1. Purpose/Research Question: Determine the authors’ purpose of the research and state it in your own words. Comment on how clearly this was presented in the article.

2. Method: Comment on how appropriate the method used was for addressing the purpose. State if the method was employed effectively.

3. Evidence of Support: Examine the method and results of the article and determine if they helped the authors effectively address the purpose presented. Also discuss the strengths and weaknesses of the evidence and the study as a whole Child Food Requests Journal Article Critique.

4. Real World Application: After reading the discussion section summarize any real world implications the authors suggest. Also give your own suggestions for the real world application of the study and its’ findings.

5. Recommendations: Determine who might benefit from the article, what the benefit may be, and the importance of the benefit. Here you may summarize your subjective judgments of the work and suggestions on how to improve or extend the work.

 

 
Child Food Request: Article Critique

Summary

Most children exhibit fewer problems related to health compared to adults. However, obese children bear the risk of becoming overweight in adulthood. They are more susceptible to chronic conditions such as high cholesterol levels, high blood pressure musculoskeletal issues, breathing problems and insulin resistance. According to a research conducted by Center of Disease Control (CDC), obesity affects close to 17% of children in the United States alone (2013) Child Food Requests Journal Article Critique. However, the trend displays great disparities within racial and minority groups.

Specifically, children from minority and immigrant parents are more likely to develop obesity than those from non-minority and non-migrant families. Similarly, children that come from low-income earning families develop prevalence to obesity compared to those from middle-income and high-income earning households. Child Food Requests Journal Article Critique. Children develop obesity due to regular consumption of foods high in sugar, fast foods that contain too much salt and fat, low fruit and vegetable intake, and sedentary behaviors.  It is therefore important to implement nutrition strategies that focus on the determinants of obesity amongst the low- income earning, minority and immigrant families.

Purpose

Haroldson, Cordell and Haldeman (2015) conducted a research to ascertain the food requests made by pre-school children and the maternal compliance to the children from low-income earning families. Besides, the researchers sought to compare the types of foods preferred by Hispanic and Non-Hispanic families, and the rates of requests.  Their choice of population sample was perfect, since it encompassed a group that experiences the problems enlisted in their topic of study. Child Food Requests Journal Article Critique.

Methodology

The researchers used a community-based cross-sectional design, where they chose a group from a southern metropolitan area that consisted of 40% African-American Blacks, 50% Caucasians and 8% Hispanics. Participants were recruited in clinics and filled in questionnaires after prior and thorough screening. Collected data was analyzed using the quota and snowball techniques. The methodology used by the researchers was appropriate, since it encompassed a diverse population. Haroldson et al (2015) clearly outlined the main aspects in the research, which included maternal compliance in the form of primary care givers fulfilling a meal request by a youngster, and child food request, outlining the literal request for any foodstuff a child made in a given family. This way, the researchers eradicated any confusion that would arise. Besides, prior screening of participants ensured the scholars obtained accurate results Child Food Requests Journal Article Critique.

Evidence of Support

Haroldson et al (2015) found out that most Hispanic families had less education and low income. Besides, 80% of the mothers fulfilled their maternal compliance by giving out the requested foods without objection. All the children who participated in the sample requested to buy food from the groceries. Flour-based foods were the most requested foods, followed by cheese and sweets. The results from the study confirmed researchers’ purpose. Child Food Requests Journal Article Critique. They were helpful, since they provided a baseline for discussing the causes of obesity in minority and poor households. However, the research did not clearly disclose substantial results on non-minority and high-income families.

Application

The study was instrumental in ascertaining causes of obesity among low-income earning families. Interestingly, low-income earners depict lives where basic needs are not met. However, cases of obesity amongst their children continue to rise. Besides, high rates of compliance may lead to bad choices when buying foods. From the research findings, one can infer that authoritative parenting is vital to good health among young children. Child Food Requests Journal Article Critique.

Recommendations

From the research, parents can learn on how to control their children’s eating habits. Besides, they ought to educate their youngsters on appropriate diets to guarantee proper health.  Government officials ought to review the findings and suggest on appropriate interventions based on causative factors of obesity among marginalized groups in the society. This way, they ensure reduced mortality rates and a healthy population. Child Food Requests Journal Article Critique.

Reference

Haroldson, A., Cordell, Z., & Haldeman, L. (2015). Analysis of Child Food Requests and Maternal Compliance in Low‐income Hispanic and Non‐Hispanic Families.
Family and Consumer Sciences Research Journal
,
44
(1), 37-50.

Retrieved from http://sci-hub.la/http://onlinelibrary.wiley.com/doi/10.1111/fcsr.12126/full Child Food Requests Journal Article Critique.

Adaptive Response Essay Assignment

As an advanced practice nurse, you will examine patients presenting with a variety of disorders. You must, therefore, understand how the body normally functions so that you can identify when it is reacting to changes. Often, when changes occur in body systems, the body reacts with compensatory mechanisms. These compensatory mechanisms, such as adaptive responses, might be signs and symptoms of alterations or underlying disorders Adaptive Response Essay. In the clinical setting, you use these responses, along with other patient factors, to lead you to a diagnosis.

Consider the following scenarios:

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Scenario 1:

Jennifer is a 2-year-old female who presents with her mother. Mom is concerned because Jennifer has been “running a temperature” for the last 3 days. Mom says that Jennifer is usually healthy and has no significant medical history. She was in her usual state of good health until 3 days ago when she started to get fussy, would not eat her breakfast, and would not sit still for her favorite television cartoon. Since then she has had a fever off and on, anywhere between 101oF and today’s high of 103.2oF. Mom has been giving her ibuprofen, but when the fever went up to 103.2oF today, she felt that she should come in for evaluation. Adaptive Response Essay. A physical examination reveals a height and weight appropriate 2-year-old female who appears acutely unwell. Her skin is hot and dry. The tympanic membranes are slightly reddened on the periphery, but otherwise normal in appearance. The throat is erythematous with 4+ tonsils and diffuse exudates. Anterior cervical nodes are readily palpable and clearly tender to touch on the left side. The child indicates that her throat hurts “a lot” and it is painful to swallow. Vital signs reveal a temperature of 102.8oF, a pulse of 128 beats per minute, and a respiratory rate of 24 beats per minute Adaptive Response Essay.

Scenario 2:

Jack is a 27-year-old male who presents with redness and irritation of his hands. He reports that he has never had a problem like this before, but about 2 weeks ago he noticed that both his hands seemed to be really red and flaky. He denies any discomfort, stating that sometimes they feel “a little bit hot,” but otherwise they feel fine. He does not understand why they are so red. His wife told him that he might have an allergy and he should get some steroid cream. Jack has no known allergies and no significant medical history except for recurrent ear infections as a child. He denies any traumatic injury or known exposure to irritants. He is a maintenance engineer in a newspaper building and admits that he often works with abrasive solvents and chemicals. Normally he wears protective gloves, but lately they seem to be in short supply so sometimes he does not use them. He has exposed his hands to some of these cleaning fluids, but says that it never hurt and he always washed his hands when he was finished.

Scenario 3:

Martha is a 65-year-old woman who recently retired from her job as an administrative assistant at a local hospital. Her medical history is significant for hypertension, which has been controlled for years with hydrochlorothiazide. She reports that lately she is having a lot of trouble sleeping, she occasionally feels like she has a “racing heartbeat,” and she is losing her appetite. She emphasizes that she is not hungry like she used to be. The only significant change that has occurred lately in her life is that her 87-year-old mother moved into her home a few years ago. Mom had always been healthy, but she fell down a flight of stairs and broke her hip. Her recovery was a difficult one, as she has lost a lot of mobility and independence and needs to rely on her daughter for assistance with activities of daily living. Martha says it is not the retirement she dreamed about, but she is an only child and is happy to care for her mother. Mom wakes up early in the morning, likes to bathe every day, and has always eaten 5 small meals daily. Martha has to put a lot of time into caring for her mother, so it is almost a “blessing” that Martha is sleeping and eating less. She is worried about her own health though and wants to know why, at her age, she suddenly needs less sleep.

To Prepare

• Review the three scenarios, as well as Chapter 6 in the Huether and McCance text.

• Identify the pathophysiology of the disorders presented in each of the three scenarios, including their associated alterations. Consider the adaptive responses to the alterations.

• Review the examples of “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in this week’s Learning Resources. Then select one of the disorders you identified from the scenarios. Use the examples in the media as a guide to construct a mind map for the disorder you selected. Consider the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.

• Review the Application Assignment Rubric found under Course Information

To Complete

Write a 3-page paper excluding the title page, reference page and Mind Map that addresses the following:

• For each of the three scenarios explain the pathophysiology, associated alterations and the patients’ adaptive responses to the alterations caused by the disease processes. You are required to discuss all three scenarios within the paper component of this assignment.

• Construct one mind map on a selected disorder presented in one of the scenarios. Your Mind Map must include the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.

Please include introduction, summary and in text citations should have page number or paragraph number. Reference should be within the last five years.

 

Adaptive Response

Introduction

Adaptive response comprises of cell-mediated and antibody response that is facilitated by T-cells, B-cells and lymphocyte cells. The three cell types present antibodies that circulate in the lymph and plasma where they come into contact with and bind the antigen from the foreign material. When the antibody binds the antigen, it inactivates the foreign material (such as microbial toxins and viruses) by obstructive its capacity to bind host cell receptors. The antibodies produced by B-cells, also referred to as immunoglobulin, have a Y-shaped protein structure that is comprised of two light and two heavy chains. Typically, three types of immunoglobulin exist to include IgA, IgD, IgE, IgG, and IgM. Each type is differentiated by structure and function, having evolved to handle specific antigens. Humoral immunity (response mounted by antibodies) is just one type of adaptive response. Another type of adaptive response is cell-mediated immunity from T-cell activation that fights against foreign antigens on the host cell’s surface. Besides that, T-cells are present signal molecules that release cytokines, and activate antigen-specific cytotoxic T-lymphocytes, NK, and macrophages (Coico & Sunshine, 2015). As such, it is clear that the adaptive response mounted is dependent on the specific foreign material that gains access to the body and the antigen that it produces. The present paper explains the concept of adaptive response by explaining the pathophysiology, associated alterations, and the patients’ adaptive response of different disorders as presented.

Scenario 1

Jennifer appears to be suffering from tonsillitis, a tonsils inflammation that results from respiratory issues, allergies or bacteria. Once the tonsils are inflamed, they turn red in color and become swollen with yellowish or grayish surface coating. The conditions first presents as a sudden sore throat that then swells up. This makes it difficult to swallow. From the throat, the tonsils also well up and obstruct respiration. The condition typically occurs in children younger than six years of age with incidences among adults and teenagers very rare. An adaptive response occurs in this case when T-cells and B-cells are activated to eliminate the homeostatic change and return the body to normal (Parham, 2014).

Scenario 2

Jack appears to be suffering from dermatitis. This a common non-immunological mediated inflation that results from the keratinocytes in the skin cells releasing pro-inflammatory cytokines in response to chemical stimuli that include soap detergents and cleansers. The major pathophysiological change from the condition is cytokines being releases, changes to the epidermal cells and disruption of the skin barrier. 40% of reported cases of dermatitis are resultant of occupational hazards thus explaining why skin appearance and work history is important before making this diagnosis. Jack’s treatment will entail using topical agents that prevent additional skin irritation to include corticoid skin moisturizers, emollients, and creams (Gaspari, Tyring & Kaplan, 2017).

Scenario 3

Martha appears to be suffering from stress. This is a condition typically referred to as stress response whereby the body undergoes adaptations that are mobilized in the body to correct allostatic imbalance. The imbalance is from endocrine and neural changes to include secretion of norepinephrine and catecholamines-epinephrine from the sympathetic nervous system, particularly the nerve endings. The secretions induce vasoconstriction that increase the blood pressure and heart rate. They also increase oxygen and nutrient availability in the muscles. Additionally, glucocorticoids are secreted as steroid hormones by the adrenal glands. Although a lot of hormone changes occur in the body to constitute a stress response (such as decrease in reproductive hormones and insulin, and increase in beta-endorphin, prolactin and glucagon), the most significant changes involve sympathetic nervous system activation and glucocorticoids secretion. When the changes occur in the body, symptoms will present to include insomnia, depression, poor appetite, chest pains, and elevated heart rate. Once stress presents in a body, an adaptive response is initiated that prepares the body for either a flight or fight response as a strategy for correcting the imbalance (Copstead-Kirkhorn & Banasik, 2014).

Mind Map for

Scenario 2 – Dermatitis

Figure 1. Mind map for dermatitis

Epidemiology

Dermatitis commonly occurs as an occupational hazard for persons whose skins come into regular contact with chemical irritants. Examples of occupations at high risk of dermatitis include hair stylists, medical personnel, and maintenance workers. The condition is significantly more common among females and blamed on environmental factors instead of genetic factors
(Gaspari, Tyring & Kaplan, 2017)
.

Pathophysiology

Dermatitis is an inflammation that is non-immunologically mediated by the skin cells releasing pro-inflammatory cytokines when it comes into contact with chemical stimuli. Some of the pathophysiological changes that occur include release of cytokines and modifications to the epidermal cells
(Gaspari, Tyring & Kaplan, 2017)
.

Risk factors

Dermatitis is an occupational hazard for persons whose skins come into regular contact with chemical irritants. This is seen in persons who work in the agricultural industry, mechanics, nurses and cleaners
(Gaspari, Tyring & Kaplan, 2017)
.

Clinical presentation

Dermatitis presents as skin fissures, dryness, inflammation, cracking and erythematous plaques. It begins with web spaces that extend to the ventral and dorsal surfaces of the fingers. Other symptoms include pain, burning sensation, stinging and mild pruritus
(Gaspari, Tyring & Kaplan, 2017)
.

Diagnosis

Diagnosis occurs through the history and clinical examination that includes the dermatitis distribution in the fingernails, web spaces, abdomen, face, dorsal and palmar, as well as extension to wrist and forearms. The history focuses on the possibility of occupational hazards and whether the patient regularly handles chemical irritants
(Gaspari, Tyring & Kaplan, 2017)
.

Adaptive responses to alteration

The skin hardens as an adaptation to the expression of inflammatory mediators and cytokines. Also, an inelastic accommodation could occur in the skin where a thicker, mildly scaly, and glossy stratum granulosum occurs to replace normal skin
(Gaspari, Tyring & Kaplan, 2017)
.

Summary

Adaptive response represents a natural reaction that the body mounts to counter a homeostatic imbalance. In fact, it occurs to offer protection and terminate infection from pathogens, a process that evolves over an individual’s lifetime even as the lymphocyte population changes. It is notable that the response is not passed on in the genes or inherited, rather it is developed during an individual’s lifetime to determine fitness level and disease susceptibility. In inability to successfully develop adaptive response leaves the body susceptible to pathogenic infection. Still, it is notable that the immunity resultant from adaptive response is important to the body, acting as a line of defense that eliminates pathogens. Once pathogens breach the external barrier and find an activated compromised immunity, the body mounts an adaptive response that is specific and slow with an inflammatory response that has memory to recognize the signature antibodies for the pathogen. Overall, adaptive response allows the body to destroy infectious pathogens that are inflammation-resistant even as it offers long-term protection that protects the body against future infection by the same pathogenic agents.

 

 

References

Coico, R. & Sunshine, G. (2015).
Immunology: A short course
(7
th
ed.). Hoboken, NJ: Wiley Blackwell.

Copstead-Kirkhorn, L. & Banasik, J. (2014).
Pathophysiology
(5
th
ed.). Amsterdam: Elsevier Health Sciences.

Gaspari, A., Tyring, S. & Kaplan, D. (2017).
Clinical and Basic Immunodermatology
(2
nd
ed.). Cham: Springer International Publishing Switzerland.

Parham, P. (2014).
The Immune System
(4
th
ed.). New York, NY: Garland Science, Taylor & Francis Group.

Consider the following scenarios:

Scenario 1:

Jennifer is a 2-year-old female who presents with her mother. Mom is concerned because Jennifer has been “running a temperature” for the last 3 days. Mom says that Jennifer is usually healthy and has no significant medical history. She was in her usual state of good health until 3 days ago when she started to get fussy, would not eat her breakfast, and would not sit still for her favorite television cartoon. Adaptive Response Essay. Since then she has had a fever off and on, anywhere between 101oF and today’s high of 103.2oF. Mom has been giving her ibuprofen, but when the fever went up to 103.2oF today, she felt that she should come in for evaluation. A physical examination reveals a height and weight appropriate 2-year-old female who appears acutely unwell. Her skin is hot and dry. The tympanic membranes are slightly reddened on the periphery, but otherwise normal in appearance. The throat is erythematous with 4+ tonsils and diffuse exudates. Anterior cervical nodes are readily palpable and clearly tender to touch on the left side. The child indicates that her throat hurts “a lot” and it is painful to swallow. Vital signs reveal a temperature of 102.8oF, a pulse of 128 beats per minute, and a respiratory rate of 24 beats per minute Adaptive Response Essay.

Scenario 2:

Jack is a 27-year-old male who presents with redness and irritation of his hands. He reports that he has never had a problem like this before, but about 2 weeks ago he noticed that both his hands seemed to be really red and flaky. He denies any discomfort, stating that sometimes they feel “a little bit hot,” but otherwise they feel fine. He does not understand why they are so red. His wife told him that he might have an allergy and he should get some steroid cream. Jack has no known allergies and no significant medical history except for recurrent ear infections as a child. He denies any traumatic injury or known exposure to irritants Adaptive Response Essay. He is a maintenance engineer in a newspaper building and admits that he often works with abrasive solvents and chemicals. Normally he wears protective gloves, but lately they seem to be in short supply so sometimes he does not use them. He has exposed his hands to some of these cleaning fluids, but says that it never hurt and he always washed his hands when he was finished Adaptive Response Essay.

Scenario 3:

Martha is a 65-year-old woman who recently retired from her job as an administrative assistant at a local hospital. Her medical history is significant for hypertension, which has been controlled for years with hydrochlorothiazide. She reports that lately she is having a lot of trouble sleeping, she occasionally feels like she has a “racing heartbeat,” and she is losing her appetite. She emphasizes that she is not hungry like she used to be. The only significant change that has occurred lately in her life is that her 87-year-old mother moved into her home a few years ago. Mom had always been healthy, but she fell down a flight of stairs and broke her hip. Her recovery was a difficult one, as she has lost a lot of mobility and independence and needs to rely on her daughter for assistance with activities of daily living. Adaptive Response Essay. Martha says it is not the retirement she dreamed about, but she is an only child and is happy to care for her mother. Mom wakes up early in the morning, likes to bathe every day, and has always eaten 5 small meals daily. Martha has to put a lot of time into caring for her mother, so it is almost a “blessing” that Martha is sleeping and eating less. She is worried about her own health though and wants to know why, at her age, she suddenly needs less sleep.

To Prepare

Review the three scenarios, as well as Chapter 6 in the Huether and McCance text.

Identify the pathophysiology of the disorders presented in each of the three scenarios, including their associated alterations. Consider the adaptive responses to the alterations.

Review the examples of “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in this week’s Learning Resources. Then select one of the disorders you identified from the scenarios. Use the examples in the media as a guide to construct a mind map for the disorder you selected. Consider the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.

Review the Application Assignment Rubric found under Course Information

To Complete Adaptive Response Essay

Write a 2- to 3-page Adaptive Response Essay paper excluding the title page, reference page and Mind Map that addresses the following:

For each of the three scenarios explain the pathophysiology, associated alterations and the patients’ adaptive responses to the alterations caused by the disease processes. You are required to discuss all three scenarios within the paper component of this assignment.

Construct one mind map on a selected disorder presented in one of the scenarios. Your Mind Map must include the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.

Scenario 1

Disease identification

The underlying condition in Jennifer’s case presents clinical manifestations of pharyngitis. According to Cohen and colleagues (2017) children with beta-hemolytic streptococci ( GABHS) pharyngitis manifest symptoms such as elevated fever( above 101.O F), tender and palpable anterior cervical lymph nodes, increased heart rate and complaint of a sore throat (Cohen et al., 2017). Further, upon physical examination, Jennifer’s skin is hot and dry a symptom associated with the disease. Notably, the physical examination confirmed the clinical manifestation of staphylococcus pharyngitis.

Pathophysiology

Pharyngitis is a disease resulting from type 2 hypersensitivity reaction in the body. According to Ivaska and colleagues (2015), the pharyngitis causing beta hemolytic staphylococcal bacteria invades the pharyngeal mucosa resulting in a hypersensitivity response. In this regard, the bacterial invasion triggers a local inflammation response at the site of infection, which, primarily emanates from the immune system producing antibodies against extracellular fluids. Therefore, the inflammation response in the affected pharynx nodes is responsible for pharyngitis in children. Further, Somro et al. (2012) pinpoint that the M protein fragments of GAS serotypes may result in rheumatoid fever if the underlying disease in children is not treated. Adaptive Response Essay.

Disease-associated alterations

Upon invasion by staphylococcus bacteria, the resultant inflammation response in the affected throat tissues stimulates the body to increase blood flow to the throat. In this regard, the patient experiences episodes of increased heart rate. Consequently, there is increased lymphocytes production in the blood circulating to the throat since the body’s immune system responds to the invasion, resulting to redness and pain in the throat (Somro et al., 2012). In this regard, an alteration in the body normal function is an indication that the immune system is fighting back the invasion by the disease-causing pathogens Adaptive Response Essay.

Patients’ adaptive responses

Patients’ adaptive response is subject to early and late activation of the immunological memory cells. According to Somro et al. (2012), previous exposure of the body’s immune system to pharyngitis causing staphylococcus, either by immunization or previous infection, stimulates the production of antigen-specific antibodies in the body. In this regard, when a patient is re-infected by the disease-causing pathogen, the immune system is induced to rapidly initiate a fast response in fighting the pathogen (Somro et al., 2012). As such, during reinfection by the pathogens, the disease-associated alterations in the body tend to minimal Occurs more rapidly as compared

Scenario 2

Disease identification

In this scenario, Jack’s underlying condition would be irritant-induced contact dermatitis (ICD) resulting from a type 4 hypersensitivity allergic reaction. According to Shrotriya, Ranpise, and Vidhate (2017), the clinical manifestations of ICD include redness in the affected skin, itchiness and dryness in the affected areas. Notably, the allergic hypersensitivity resulted from exposure the exposure of Jack’s hand to chemicals such as poison ivy. In this regard, upon exposure to the chemical s, the body’s immune system became activated resulting in eczema.

Pathophysiology and associated alterations

Irritant contact dermatitis (ICD) results from activation of the innate immune system primarily due to exposure to chemical irritants. Shrotriya, Ranpise, and Vidhate (2017) assert that the condition emanates from the activation of cytokines and macrophages on initial exposure to a chemical allergen. Notably, ICD triggers the release of release of T cells ( CD8) which destroy the target cells, while macrophages release hydrolytic enzymes that hydrolyze target cells upon contact.immune system  In this regard, ICD causes alterations in the layers of the skins, notably. Further, practices such as repeated hand washing upon chemical exposure facilitate the occurrence of ICD (Shrotriya, Ranpise, & Vidhate, 2017). The research also attributes the occurrence to the removal of essential components of the skin layers such fats and oils thus facilitating skin susceptibility to toxic chemicals (Shrotriya, Ranpise, & Vidhate, 2017).

Adaptive response

Irritant-induced inflammatory response results to the release of allergen-specific cells. Notably, Jung et al. (2018) observe that the body keeps an immunological memory on initial exposure. Therefore, upon re-exposure to the allergens, the T effector cells are rapidly stimulated which results in allergic contact dermatitis (ACD). Adaptive Response Essay. In this regard, Jung et al. (2018), assert that continuous exposure to ICD allergens facilitates pathogenesis of ACD. However, Shrotriya, Ranpise, and Vidhate (2017) assert that other cells including the Natural killer cells and mast cells play a role in facilitating the pathogenesis of ACD when a patient is repeatedly exposed to ICD allergens Adaptive Response Essay.

Scenario 3

Disease identification

In the third scenario, the clinical manifestations reveal that Martha has developed a posttraumatic stress disorder. According to Joshi et al. (2017), PTSD is a psychological condition that develops in individuals who have experienced a traumatic event. On the other hand, Shalev, Liberzon, and Marmar (2017) assert that fear, sleep disturbance, hyper-vigilance and a frequent flashback of traumatic events as some of the clinical manifestations of PTSD. In this regard, considering that Martha’s recent turn of events was traumatic, I can attribute the clinical manifestations in the scenario to PSTD.

Pathophysiology

Pathophysiology of PSTD reveals endocrinological alterations emanating from the disease facilitates hormonal imbalance in patients. According to Joshi et al. (2017), recent studies reveal that PSDT results in a decreased volume in the hippocampus left amygada and cingulate cortex in patients. On the other hand, studies by Shalev, Liberzon, and Marmar (2017), revealed that PSDT patients have increased norepinephrine levels in their body. Further, there inhibition in the activity of adrenergic receptors in the body and consequently increased activation of glucocorticoid receptors. In this regard, hormone imbalance is a common occurrence in Patients with the disease revealing the underlying causes of the disease clinical manifestations (Shalev, Liberzon, & Marmar, 2017). Adaptive Response Essay.

Disease alterations

PSTD facilitates the release of the Adrenocortropicoid hormone (ACTH) in the brain, which results in illness disorder in patients. According to Joshi et al. (2017), the patients tend to be more concerned about their health condition and in most cases, most end up developing emotional distress. In this regard, uncertainty and dissatisfaction predominantly facilitate development misperceptions in the normal body functioning such as loss appetite. Furthermore, Joshi et al. (2017), asserts that illness disorders in PSTD may progress to a life-threatening condition, such as the development of suicidal thoughts Adaptive Response Essay.

Adaptive response

The body responds by realizing the flight or fight hormone when confronted with a dangerous situation. In this regard, PSTD patients tend to release the release the two hormones when exposed to traumatic events. However, as Joshi et al. (2017), observes in some cases PSTD patients are unable to recover from traumatic events. As such, when exposed to stressors, patients respond differently depending on novelty, level of trauma and the predisposing environmental factors.

Pharyngitis Mind Map

References

Cohen, J. F., Cohen, R., Bidet, P., Elbez, A., Levy, C., Bossuyt, P. M., & Chalumeau, M. (2017). Efficiency of a clinical prediction model for selective rapid testing in children with pharyngitis: A prospective, multicenter study. PloS one, 12(2), e0172871.

Ivaska, L., Niemelä, J., Vuorinen, T., Waris, M., Rantakokko-Jalava, K., & Peltola, V. (2015) Viral and Bacterial Etiology of Acute Pharyngitis in Children. In Open Forum Infectious Diseases Infectious.
Diseases Society of America
1(2),1769

Joshi, M., Bartter, T., Joshi, A., Glare, P. A., Nicholas, M. K., & Blyth, F. M. (2017). Post-Traumatic Stress Disorder.retrieved from http://78.39.227.9/handle/Hannan/110235 Adaptive Response Essay

Jung, Y., Kim, J. C., Park, N. J., Bong, S. K., Lee, S., Jegal, H., … & Kim, S. N. (2018). Eupatilin, an activator of PPARα, inhibits the development of oxazolone-induced atopic dermatitis symptoms in Balb/c mice. Biochemical and Biophysical Research Communications.

Shalev, A., Liberzon, I., & Marmar, C. (2017). Post-traumatic stress disorder.
New England Journal of Medicine,
376(25), 2459-2469.

Shrotriya, S. N., Ranpise, N. S., & Vidhate, B. V. (2017). Skin targeting of resveratrol utilizing solid lipid nanoparticle-engrossed gel for chemically induced irritant contact dermatitis. 
Drug delivery and translational research
, 
7
(1), 37-52.

Somro, A., Akram, M., Khan, M. I., Asif, H. M., Sami, A., Shah, S. A. M., … & Rehman, R. U. (2012). Pharyngitis and sore throat: A review. 
African Journal of Biotechnology
, 
10
(33), 6190-6197 Adaptive Response Essay.

Foundations of Ethical Nursing Practice Essay

Introduction

Nursing practice is centered on the tenets of ethical professionalism. Ethical based professional nursing practice can be dated back to the 18th century in England (Butts, & Rich, 2015). In the wake of the 21st century, aspects of ethical nursing have been a central theme of discussion with diverse views in the society. The rapidly evolving nursing practice has resulted in the expansion of nursing roles in the provision of advanced patient care. Notably, formulation of new health care policies accompanied by increased medical based scientific research activities has resulted in eminent conflicts with regard to nursing ethics. Foundations of Ethical Nursing Practice Essay. The result is nurses having difficulties distinguishing ethical and legal aspects when confronted with clinical ethical cases. In this regard, this paper provides a review foundations underlying ethical nursing practice.

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Bioethics

Bioethics is a subgroup of ethics, which deals with healthcare moral issues. According to Fanning (2018), bioethics strives to provide answers on philosophical issues in healthcare scientific research. In this regard, professional nursing ethics align with the bioethical moral theories and concepts. Notably, in distinguishing between legal and ethical issues such as who should live or die, bioethical principles provide nursing the practitioners with guidelines that help in their decision-making process. However, Fanning (2018), asserts that bioethical principles may lead to conflict between nurses and other healthcare professionals Foundations of Ethical Nursing Practice Essay.

In this regard, nursing ethics, a subset of healthcare bioethics, strives to distinctively provide nursing practitioners with answers to moral issues. According to Grace (2017), provisions in nursing ethics provide a reference point on moral issues where nursing practice may conflict with other healthcare professionals. Further, since ethical issues in healthcare practice are often viewed from a nursing perspective rather than a medical angle, professional nursing ethics form the basis of nursing advocacy in advanced nursing care. Further, nurses spend considerable time with patient thus the need for their intervention on ethical issues pertaining patient safety.

Nursing ethics

Nursing ethics are based on moral theories and approaches. According to Butts, and Rich (2015), moral theories form a general guideline to individuals share the same belief, concepts, and values. In this regard, professional nursing care is based on theoretical concepts and principles such care, virtue ethics, deontology, virtue ethics, non-maleficence, and beneficence. Additionally, Grace (2017) observers that nurses incorporate the concepts of moral reasoning in the provision of patient care. As such, the integration of moral theories and moral reasoning facilitate the decision-making process in nurses when encountered with ethical issues Foundations of Ethical Nursing Practice Essay.

Nursing values

The nursing moral reasoning is integral in developing professional nursing values. The American Association of Nurses ( AAN) defines values as a group or self-evaluative judgments on what makes something good. Aspects such as dignity, integrity, and wholeness constitute to nursing values. In this regard, nursing values entail the ability to appreciate on what is good for all in the provision of healthcare. Foundations of Ethical Nursing Practice Essay. Notably, nursing values play a critical role in professional nursing practice Foundations of Ethical Nursing Practice Essay.

Professional Nursing ethics and codes

The American Association of Nurses (AAN) and the International Nursing Council (ICN) are some of the professional nursing organizations with well-stipulated nursing ethics. According to Grace (2017), ANA first adopted its code of ethics in 1950. In this regard, ANA  codes of ethics for nurses contains moral guidelines and standards which nurses can refer to when confronted with ethical issues. Notably, the AAN’s code of ethics is not negotiable with regard to nursing practice. On the other hand, the ICN code of ethics was first adopted in 1953 (Grace, 2017). This code highlights its four critical elements as standard related nursing practice, people, and coworkers. In this regard, both the AAN and ICN codes of ethics stipulates standards relating to the effective provision of nursing care to patients. However, as Grace (2017) pinpoints, nursing practitioners should not only use the conveyed professional codes but should also utilize the concepts of moral in their decision-making models. Foundations of Ethical Nursing Practice Essay.

Ethical analysis and decision-making model in nursing

Ethical analysis is an integral step in the decision-making process in ethical clinical cases. According to Grace (2017), ethical analysis entails four steps including evaluation of a medical condition, patient preferences, quality of life, and the prevailing contextual features. In this regard, by evaluating the aspects, nurses are able to make an informed decision with regard to the patient’s interest. Further, incorporating of nursing values and moral reasoning are among the critical considerations essential in decision-making. However, Butts and Rich (2015) assert that while executing their role as patient’s advocates, nurses may at times find themselves entangled in conflicts resulting in moral suffering. For instance, a nurse may be required to abide by hospital policies, government legislation, or hierarchical directives, which obstructs them from providing the best care to patients. In this regard, the existence of nursing ethics does not sufficiently enhance efficiency in nursing practice and which calls for a collective effort from the entire stakeholder in the healthcare sector Foundations of Ethical Nursing Practice Essay.

References

Butts, J., & Rich, K. (2015). Foundations of ethical nursing practice. Role development in professional nursing practice, 117.

Grace, P. J. (2017). Nursing ethics and professional responsibility in advanced practice. Jones & Bartlett Learning.

Fanning, J. B. (2018). Review of American Society for Bioethics and Humanities’ Clinical Ethics Consultation Affairs Committee, Addressing Patient-Centered Ethical Issues in Health Care: A Case-Based Study Guide1.

In this written assignment, identify one specific contemporary issue or trend that you are interested in learning more about. Choose from the categories below. For example you might want to learn more about why it is more difficult for some groups to receive care than others, which would fall under Client Access to Care. Or, you might want to compare nursing practice in the U.S. with how nurses practice in Japan, which would fall under the category of Global Healthcare and Nursing Foundations of Ethical Nursing Practice Essay.

Global Healthcare and Nursing

Healthcare Reform

U.S. Healthcare Financing

Nursing’s Role in the U.S. Healthcare System

Integrative Healthcare

Nursing Leadership and Management

Nursing Education

Nursing Practice

Nursing Professionalism

Advancing Nursing as a Profession

Client Access to Care

Delivering Client Care

Interdisciplinary Teamwork and Collaboration

Ethical Practices in Healthcare

Quality and Safety in Healthcare Delivery

Health/Nursing Informatics

Once the issue or trend is identified, find five important/significant facts about it, substantiated by an evidence-based article or reference. Include the article or references in your submission.

Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.

Save your assignment as a Microsoft Word document. (Mac users, please remember to append the ’.docx’ extension to the filename.) The name of the file should be your first initial and last name, followed by an underscore and the name of the assignment, and an underscore and the date Foundations of Ethical Nursing Practice Essay.