Dq

re to this discussion post (site sources if applicable)

     Change is a challenging phase to adapt and overcome. Change comes with perseverance, dedication and persistence. Nursing continues to evolve and change over time. “Evidence-based practice (EBP) is a life-long problem-solving approach to the delivery of health care” and improving patient outcomes and work environment (Melnyk, Gallagher-Ford, Long & Fineout-Overholt, 2014). Effectively disseminating my evidence-based change proposal would be to use both internal and external methods. One internal method would be to use the Emergency Department Management Team, including my manager, assistant manager, director and nursing educator to promote my idea of improving policies and practices in place for workplace violence. The use of effective leaders can lead a project proposal to success and with the support and the best intentions of staff to create a healthy and safe emergency department.

     External methods would include presenting to the Emergency Nurses Association to gain their support and enhance ideas of improving workplace violence. Using an organization that is specific to the Emergency Department can help promote ideas of change and can help facilitate changes within a department. 

     Both internal and external methods provide support and guidance to such an important topic. Having both internal and external support will help facilitate the best patient outcomes and the safest environment for employees. These methods also allow the spreading of evidence, information and presenting information to both groups will help facilitate an increase in interest.

     Communication strategies will be different because internal groups will be more patient and employee based where external will include state and regional levels of data to determine the need for change among different facilities. The internal board of the Emergency Department and the hospital will be more interested in its employees and safety whereas an external board like a national organization (ENA) will want to know if this is a facility problem or a national problem.

Urgent, urg

 

Everyone should have an approved topic for your final paper on an ethical dilemma of your choosing. This week’s assignment is to write the first, and most important, part of your paper (my topic “Incompetent/Impaired Nurses”)

This is the Introduction—Summary of What is Known about the Issue (See Grading Rubric for Final Paper)

  1. Why is this topic important to investigate?
  2. What is the scope, context, and significance of the topic as an ethical dilemma?
  3. Highlight the importance of the problem/issue and make general statements about the problem/issue
  4. Summarize the current understanding and background information about the topic
  5. Include one reference source that will support your introductory thoughts about your topic.
  6. APA 7th edition format; full sentences, attention to grammar

Motivation-Due in 4 hours

 

This week’s PowerPoint lecture is about motivation.  As you can see, there are many perspectives on what constitutes motivation and how to engage it. 

Most likely you can imagine many examples of motivating.  If you watched any of the multiple big sports championships over these past weeks, you saw the coaches preparing their teams.  High stakes in the sports world and for host city, team, and fan (i.e. those who pay the salaries) pride.  Yet, in some ways this is easier than the task you face as a healthcare administrator.  Sports teams have a shared goal (no pun intended), a common language and lexicon, and finite circumstances. 

In healthcare, the team is comprised of multiple constituencies, some of which are organizationally separate (e.g., typically the hospital and medical staffs are two independent entities).  As has been discussed this past week, patients come from many backgrounds, with diverse beliefs and myriad expectations.  Navigating that environment take a different set of skills.

Review the concept of Emotional Intelligence at this link: http://psychology.about.com/od/personalitydevelopment/a/emotionalintell.htm

Then, briefly review insights to Servant Leadership, available at: http://ctb.ku.edu/en/table-of-contents/leadership/leadership-ideas/servant-leadership/main and https://www.butler.edu/volunteer/resources/ten-principles-servant-leadership

When you have reviewed these resources, please respond to this week’s Discussion topic.

 

Here is a TEDx presentation that presents a very interesting perspective on the future:

After you watch it (it’s about 17 minutes long), then discuss the following questions:

1. What do think of the video’s basic premise?

2. What do you imagine the future of healthcare to be like?

Here are some additional YouTubes to help spark your thinking:

https://www.youtube.com/watch?v=qkm_7XUDqIY  

 

Nursing and the aging Family DQ week 4 Part 1 student reply Grettel Hernandez

 

The following post is from another student to wish I have to reply adding some extra information related to the post

APA

less than 10 % similarity

short answer

 

With the realization that pain is highly prevalent among older adults, please answer the following questions:  

Part One: What are some ways you as the nurse can utilize to determine pain in the older adult?

                  : What are some of the potential barriers related   to self-reporting of pain in the older adult?

 

Chronic pain is common in older adults but should not be taken as an everyday occurrence. Due to so many barriers, some patients may leave hospitals with unrelieved pain. Undertreatment increases the chances of developing more severe emotional, cognitive, and physical conditions such as anxiety, depression, and sleep problems. Therefore, nurses should perform a thorough pain assessment to prevent these conditions. 

As a nurse, I will carry out a thorough pain assessment to an older patient by obtaining the necessary pain history and performing a complete physical examination. For example, getting to know the patient’s age, any medication they might be taking, surgical history, allergies, and cognitive status will help see the risk and degree of pain. The right communication skills are essential in obtaining this information. I will give patients all the time they might require to consider and answer my question. In areas where I fail to get information from the patient, family members can answer questions on their medical history.

I will also use advanced tools such as pain thermometers, face pain scale, and verbal descriptor scale. Before releasing the patient, I will perform a physical exam on the pain complaint area to determine whether the tissue or site has full mobility without any issues. Overall, proper pain assessment is necessary to prevent treatment that could cause more problems.

Communication and cognitive barriers are the main factors that hinder self-reporting for older adults. The majority of adults at such ages experience sensory and motor ability problems that make them have communication difficulties. They will have a hard time explaining or quantifying pain. Worse still, it is hard to observe pain expressions in older adults. Diagnosis of dementia in people of this age group has also posed a challenge in pain assessment. Some patients fear the side effects and addiction that may result from taking pain medications also makes patients fail to self-report their pain. All these factors increase the risks of pain under treatment for the older people population. However, with proper education for healthcare workers, we can overcome such barriers. 

References

Bonham Howe, B. L. (2015). The Gerontology Nurse’s Guide to the Community-Based Health Network [PDF]. Springer Publishing Company, LLC, NY. Retrieved from https://www.pdfdrive.com/the-gerontology-nurses-guide-to-the-community-based-health-network-e177862497.html

Reviews, C. T. (2020). OUTLINES & HIGHLIGHTS FOR GERONTOLOGICAL NURSING: COMPETENCIES FOR CARE BY MAUK, KRISTEN L., ISB. Retrieved from https://www.pdfdrive.com/gerontological-nursing-e34319591.html

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. 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. 

  • 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.

References that must be used

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

  • Chapter 2, “Contributions of the Psychosocial Sciences” (pp. 93–130)
  • Chapter 6, “Classification in Psychiatry” (pp. 290–299)
  • Chapter 31, “Child Psychiatry” (pp. 1107–1152)

Alternative discussion

 This alternate discussion will provide an opportunity to share your thoughts and experiences managing COVID-19 both professionally and personally. This will also provide a forum for supporting each other during this difficult time. No references are required for this alternative posting. Students are required to respond to a peer or faculty this week using the alternate discussion. Thank you for sharing your thoughts and supporting each other during this difficult time.

1. How are you doing? Are you able to practice self-care in this time of crisis?
2. What ways, both professionally and personally, has your normal life changed? How are you adjusting to the new normal? 

Please answer each question separate and sources is not necessary. Please write the paper as a hospice nurse because i work in hospice.

Project #3

The U.S. population is aging, which brings unique nutritional needs and concerns for older adults. Using the knowledge you have gained this semester, you will complete this assignment as a final assessment of your understanding of the foundations of nutrition and how they apply to a specific demographic – our aging population.

Instructions

Assume you work at a senior center and have been asked to develop a Tip Sheet for Seniors about nutrition. Many of these seniors live at home, prepare their own meals, and are on limited incomes. The senior center is a congregate meal site. This tip sheet will be distributed to the seniors themselves as well as their family members and other people in the community that may assist the seniors.

When writing your tip sheet, please address:

  • hints for assessing and improving nutrient density of meals
  • hints for saving money when grocery shopping or eating at restaurants
  • hints for making meals more enjoyable
  • cultural, social, and psychological factors that may influence an older adult’s ability to obtain adequate nutrition
  • potential problems associated with nutrition for this population
  • health problems that could result from high or low nutrient intakes
  • how the seniors or their family members can recognize potential nutrition related problems quickly, and what can be done. Be sure to do this tactfully and professionally.

Things to Consider

Be sure to think about presentation as well as the information you will include. Present the information in a way that seniors will both read and understand. Be creative!

Thoroughly address each instruction given above. Your tip sheet should be a minimum of 2 pages in length.

Draw upon the course materials for this assignment.

Include your name on your submitted assignment and BE SURE to cite all sources quoted or used in any way (even if it is just our textbook). Always give credit where credit is due.

research article

 

Formal Research Article Critique Paper

 

For the critique, choose a faculty approved peer

reviewed article from a journal with a focus on nursing.

Please follow the APA (6 ed.) format, the critique template, and the 

grading rubric

 2-3 pages (not including title page and references

Evidence-Based Project, Part 4: Critical Appraisal of Research

 

Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers.

Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action.

In this Assignment, you will use an appraisal tool to conduct a critical appraisal of published research. You will then present the results of your efforts.

To Prepare:

  • Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high- level evidence) you selected in Module 3.
  • Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.
  • Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.

The Assignment (Evidence-Based Project)

Part 4A: Critical Appraisal of Research

Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer-reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.

Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.

Part 4B: Critical Appraisal of Research

Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.

 Submit Part 4A and 4B of your Evidence-Based Project. 

Answer to essay-200 words minimum(MelGC)

Use at least 2 references. Not the same that appear. I need an answer based on that assignment.

Discuss the importance of effective communication in the personal relationship, the therapeutic relationship, and the relationship within the interprofessional health-care team.

The importance of communication in the personal aspect is that creating individual relationship is important and effective communication is essential to achieve this. In addition, when a patient has an important relationship with the care provider, then the assistant will feel that the association is important and will try as much as possible to help such a person, (Macken, 2017). With that being said, when it comes to the therapeutic relationship, the individuals involved in this case will feel that the patients feel that their care providers are the people that are within the framework required for offering them the care they need. Health professionals use therapeutic relationships to help patients and provide them with factual information, so effective communication is crucial. Interprofessional relationships involve the transfer of information and communication between two or more individuals working together. This type of relationship requires for all of the health care members to actively engage and effectively communicate in order to provide adequate patient care and complete tasks accurately.

What similarities and differences can you identify among the above interactions?

The essential similarity that is involved in the among interactions is that effective communication is required amongst the types of relationships mentioned in order for the relationship to function properly. However, the differences involved include the professionalism required in each type of relationship mentioned. For example, interprofessional relationships are more formal than personal relationships.

Explain the concept of congruence between verbal and nonverbal communication.

The concept of the congruence between the verbal and the non-verbal communication is incredibly important. The congruence is that the verbal and the non-verbal congruence has a great association in that verbal situation reveals the information that is communicated via spoken words that the patient may share. Non-verbal communication entails information communicated through facial expressions and gestures. The congruence between these two forms of communication is that they provide health care workers information about the patient’s feelings. Additionally, the nurse may even compare what the patient says, meaning verbal communication, to what the patient portrays, in this case non-verbal communication, and find any resemblance.

There are many pitfalls to electronic communication. Identify a situation in which an electronic form of communication may result in a miscommunication. What other method of communication would have been more effective?

Although electronic communication may provide individuals with any benefits, many pitfalls exists with electronic communication. A situation in which electronic communication may result in a miscommunication may be if, for example, an email was not delivered or was delivered late. This miscommunication could have been prevented if a personal meeting or conversation would have been used instead.

How have you seen ISBAR used during your clinical experiences?

In my experience, I have seen ISBAR being used for communication among health care providers. I have experienced that, first, the health care professional introduces himself or herself and gives the reason for calling (I). Then, the situation is explained, including age and gender of the patient and the status (S). The patient’s background is then explained including clinical history and current presenting problems (B). The health care provider then describes the assessment conducted on the patient including their current condition, risks, and results (A). Lastly, the provider calling may make any recommendations of what he or she thinks should best benefit the patient (R). 

Develop a hand-off report for yourself.Include items that you believe are pertinent for safe and effective nursing care. Refer to the information in the chapter for creating this report form.Using the information from the chapter, determine the effectiveness of the system currently in use on your unit for communicating shift-to-shift reports.

Maria Rodriguez, 68, female, admitted to emergency department. Presented with right-lower abdominal pain and mild fever. Reported severe pain. Patient is stable but continues to report pain. Patient was admitted September 28, 2020 with a past medical history of asthma. Patient was diagnosed with appendicitis. Assessment revealed elevated blood pressure and rapid respirations. Pain assessment revealed an 8 out of a 0-10 scale. Patient was taken in for an appendectomy and is currently stable and in recovery. Recommendations for this patient include further pain assessment. Surgical wound incision should be monitored for any deterioration. Vital signs should be taken regularly. 

Dr. Roberts comes into the nurses’station demanding, “Where are Mr. Adams’s lab reports? I ordered these stat,and they’re not here! Who’s responsible for this patient?” How would you, as the nurse, respond?

As a nurse, I would refer to any personnel and staff member with respect. My initial response would be to talk respectfully to Dr. Roberts and assure him that I will conduct the labs stat. I would further apologize for the delay and explain to the doctor the situation which caused the setback in the labs. For example, I would inform the doctor if my patient had coded or if any accident had previously occurred.

Explain the concept of accountability in delegation. What are the legal ramifications of accountability in delegation?

The concept of accountability means that every person will be responsible for the practices or the conclusions that the person might make in the involved organization. In this delegation, the ramification is that when a person fails to deliver the goals that a person promised or was responsible to deliver, then the person will be held responsible for such a failure in delegation.

Dennie and Elias arrive in the unit for the 7:00 p.m. to 7:00 a.m. shift. Both nurses completed orientation 4 weeks ago. They find that they will be the only two RNs on the floor that night.There is a census of 48 clients. The remaining staff consists of two NAPs/UAPs and one LPN. What are the responsibilities of the RN, NAP/UAP, and LPN? Can Dennie and Elias effectively delegate client care tasks and care safely for all 48 clients? Use the Delegation Tree to make your decisions.

Using the delegation tree, the nurse must begin by assessing the needs of the patient in order to decide what can be delegated or what has to be done by his or her own (“Ana’s Principles for Delegation,” 2013). The responsibilities of the RN would include severe cases, sterile procedures, IV meal administration, assessment, teaching, and evaluation of patient care. On the other hand, the responsibilities of the LPN might include caring for stable clients and performing routine procedures. Lastly, unlike the responsibilities of the RN and LPN, those that would pertain to NAP/UAPs might involve activities of daily living, for instance, bathing and dressing patients. Furthermore, according to the delegation tree, in order for delegation to occur, a registered nurse must be present to supervise. If this is not possible, the task cannot be delegated.

Discuss the differences between direct delegation and indirect delegation.

A notable difference exists between a direct delegation and an indirect delegation. A direct delegation means that a nurse specifically assigns or delegates a task to another health care worker to perform according to his or her scope of practice. However, in the case of an indirect delegation, a listing of approved activities and tasks is given to the health care provider that were previously established by the agency based on policies of the facility.

You have to observe delegation procedures in your assigned unit:

What considerations does the RN take into account when delegating patient care?

Whenever delegating procedures into the assigned unit, an individual has to make key considerations. Before delegating any task, a nurse must assure that it involves the right person, right task, right circumstances, right directions and communication, and right supervision and evaluation (“Assignment, delegation and supervision: NCLEX-RN,” 2016). What this means is that the right person must be assigned for the right job under adequate circumstances. The nurse delegating the task must provide the other health care provider with the right directions and communications to perform such tasks accordingly. Lastly, the nurse must provide the right supervision and must evaluate the completed task in order to determine the effectiveness of the task and better improve any skills, if needed.

You have to look at the unit census and prioritize the patient care:

Give the rationale for your choices.

As far as looking at the unit census and prioritizing the care of the patient is concerned, the rationale for the choices is that different patients require different care and protection. As an example, some require immediate attention while the others might require care that may be not be so urgent. Therefore, in this case, the patients that require immediate attention will be given a priority while those that do not require immediate attention will be given second priority. The rationale of the choices is that care will be given according to the condition of the patients in that the critical patients will be given a priority while the least affected will be cared for after.

Answer the following questions during your clinical experiences:

What specific tasks did your patients require that you might have been able to delegate?

Patient needs should be evaluated prior to delegating a task and the job should be within the scope of practice of the other health professional in order to provide safety and well-being, keeping in mind the possibility of causing any harm to the patient (Whitehead, Weiss, & Tappen, 2009).The ideal tasks that my patients required that I might have been able to delegate included giving the patient a bed bath and assisting the patient with dressing changes and activities of daily living.

How effective was your nurse/preceptor in delegating tasks to others?

The nurse/preceptor I observed was highly effective in delegating duties to others. The reason is that the nurse would delegate any task that was under the scope of practice of the other health professional. For instance, she did not delegate any assessment, education, or evaluation of any patients, which falls under the RN’s scope of practice.

How did your nurse/preceptor ensure that the tasks were completed safely and appropriately?

The appropriate way that the nurse made sure that tasks were finished appropriately and safely especially after delegating them was by evaluating the task and revising the work done after being completed. Additionally, after delegating a task, the nurse would still supervise the assigned health professional and would allow him or her to ask any question or clarification in case a need arose.

References

Ana’s Principles for Delegation. (2013). ANA Enterprise | American Nurses Association. https://www.nursingworld.org/~4af4f2/globalassets/docs/ana/ethics/principlesofdelegation.pdf

Assignment, delegation and supervision: NCLEX-RN. (2016) https://www.registerednursing.org/nclex/assignment-delegation-supervision/

Macken, R. (2017). The elements of interpersonal communication.

Whitehead, D. K., Weiss, S. A., & Tappen, R. M. (2009). Essentials of nursing leadership and management. F A Davis Company.