...provide an overview of the Meaningful Use program. An analysis of Meaningful Use implications for nurses, nursing, national health policy, patient outcomes and population health associated with the collection of core criteria will also be discussed. Recommendations for additional core criteria will also be presented. Overview of Meaningful Use NANDA International (NANDA-I) was developed to identify and classify health problems within nursing, increase the visibility of nursing, organize nursing data and allow for accurate reimbursement for nursing care (Thede & Schwirian, 2015). NANDA-I states that it’s diagnoses are intended to communicate the professional judgements that nurses make every day to patients, other healthcare professional and the public (NANDA International, 2015). NANDA-I diagnoses relevant to the patient scenario given are 1) fluid volume deficit related to increased fluid loss and insufficient fluid intake 2) electrolyte imbalance related to increased fluid loss and insufficient fluid intake 3) knowledge deficit. The Center for Nursing Classification and Clinical Effectiveness, CNC (2015) defines the Nursing Intervention Classification (NIC) as a comprehensive, research-based, standardized classification of nursing interventions. “The Classification includes the interventions that nurses do on behalf of patients, both independent and collaborative interventions, both direct and indirect care” (CNC, 2015). NIC interventions relevant to the discussed scenario are...
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...ICNP has led to a large database that validates nursing specific diagnoses, interventions and outcomes. It is cross-referenced with different nursing classification systems to compile common information across the continuum. A nurse in the medical unit is able to utilize a care plan that is formulated based on information compiled and translated into best evidenced based practice. “Information gathered is also useful in the educational setting expands nursing knowledge of interventions, outcomes and languages” (Rutherford, 2008). The nurse would choose a nursing diagnosis based on the assessment and collection of patient information. ICNP can be utilized incorporating other systems of classification such as Omaha System, NANDA, NIC, and HHCC (Hynn & Park, 2002). A nursing diagnosis is formulated and a recognized set of interventions would be initiated. With the added benefit of an electronic format at the bedside, the nurse is able to document at the bedside with more precision and timeliness, improving the accuracy of documentation. For example, a patient admitted with the diagnosis of COPD, the nurse could use the nursing diagnosis of impaired gas exchange. A care plan would be created with appropriate interventions and outcome criteria. Care would be more precise based on standardized interventions and outcomes derived from ICNP. A study in 2005 to assess the “expressiveness” of an ICNP based computerized nursing record system. The study discovered that bedside...
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...and demented, have the greatest risk for being restrained in medical facilities (Kope et al., 2012). Physical restraints include hand mitts, waist belts, and wrist restraints to prevent body movements. The most common misconception among nurses is that restraints prevent falls or injuries (Kope et al., 2012). Data Bases and Key Terms The data base used to research effects of physical restraints in reducing injuries was CINAHL. The key words used for the search were adults, physical restraints, falls and injuries, alternative methods, education, knowledge, attitudes, and evidence-based practice. Interventional Study One In 2010, the Department of Nursing Research, University of Sweden conducted a study on restraint...
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...increase. Change, however, is never easy to implement. Once change begins, monitoring the implementation process is important to evaluate the effectiveness, the quality of the change, and how it will affect staffing. Communication also plays a vital role in the implementing process, as keeping everyone informed and empowered is important in order for change to be successful. The proposed solution to help implement the change would be to hold educational programs about pain management and assessments that each and every medical-surgical unit nurse would need to attend. The educational program will be held three times per week for each shift to complete. The program will be mandatory and each week a certain nursing unit will be assigned until all units/nurses have attended the educational program. The educational program for pain management and assessment will teach nurses about the pain process, how to assess it visually and through communication, and what interventions can be done to help manage it. The educational program will also teach nurses on how to use assessment tools for pain and how to explain the importance on educating the patient on an achievable pain goal. The rationale for selecting this type of proposed solution is based...
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... Community health nursing assessment (Priority problem for this zip code and justification for the identified problem): The priority problem for Plymouth, MI 48170 is heart disease. During my survey of the community, I did notice a lot of people dining in restaurants/bars, eating outside on restaurant patios smoking and drinking alcohol. Some of these people were obese. Smoking, drinking and obesity are contributors to heart disease that could be easily modified; ethnicity cannot be modified which is a small factor in this community. Hispanics are more susceptible to diabetes and African-Americans to hypertension. These are disease processes that may lead to heart disease. Sometimes lack of knowledge and education can also contribute to these problems. Community health nursing diagnosis (Used at least one nursing diagnosis for the community). Deficient knowledge regarding condition, treatment plan, selfcare r/t unavailability of health education as evidenced by increased heart disease in community. Risk of decreased cardiac output r/t smoking, drinking and obesity. Community health nursing plan (Identified at least one short term and one long term goal for the community. The goal/objective is related to the priority problem and is a measurable statement): Short Term Goal: By 2017, 25% of people will be educated on heart disease and risk factors. They will be provided with programs to help quit smoking, diet and exercise programs and pamphlets on alcohol...
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...Nursing Reflection The role opportunities for nurses in a community of mostly elderly people, farming as the main occupation, and lack of health resources are endless. According to city-data.com, the adult obesity rate for Conecuh County is 32.6% whereas the state of Alabama is 31%. The rate of child obesity is 18.9% and the state is 13.5% (City-data.com, 2013). The first nursing diagnosis is imbalanced nutrition: more than body requirements (obesity) among residents of my community related to increased food consumption and insufficient energy expenditure for intake. The first goal for this diagnosis is to reduce the prevalence of obesity among the residents. An objective for this goal is that 50% of the obese residents will engage in an exercise plan that will promote adequate weight loss. The interventions for this objective include establishing a community wide exercise program or fitness plan that will promote weight reduction; and develop a meal plan that will enhance weight loss and promote better eating habits. We will work with local health care providers to provide sample menus and meal plans for the citizens who will participate in the weight reduction program. A second objective states that residents will lose 5% of total body weight over a period of six weeks. The interventions used to make this objective a reality include motivating residents by organizing a competition program to see which team can lose the most weight in a specific time period; and establishing...
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...Faust University of Tennessee- College of Nursing The purpose of this paper is to analyze and critique the research study conducted by Hersch et al. (2016). This study is about stress in the nursing occupation. The independent variables, clearly stated in the title, are the web-based program (BREATHE) and stress, and the dependent variables are nurse burnout and patient care. The population tested were nurses. The researchers were analyzing the effects of a web-based program (BREATHE) designed to relieve stress in nurses. If web-based programs are effective, then these can be used as an intervention to decrease stress among nurses. Problem, Purpose, Hypotheses, Research Questions The problem of stress within the nursing occupation was clearly stated in the beginning of the background section. It is clear because they list all the stresses with nursing, and there have been several studies conducted over the past 25 years on this topic. They began the background section very broad by identifying that nursing stress is prevalent and that many studies have been done over the past several years, but they ended the section by narrowing down their specific focus to web-based program (BREATHE) helping to relieve nursing stress. This problem is significant because all nurses experience stress, and when nurses are stressed patient care can be compromised. Nurse burnout can be an unfortunate outcome of nursing stress. This web-based program offers the nurses an opportunity to relieve...
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...this is mainly attributed to the fact that both research paradigms have axiological and epistemological assumptions that are considered distinct. This paper, therefore, seeks to identify some research components within a research project, and evaluating the results of these projects by assessing the studies strengths and weaknesses of the study articles, within the qualitative and quantitative paradigms. The two principal articles of this study include; Impact of a smoking cessation educational program on nurses interventions, and the conceptualizations of culture and cultural care among undergraduate nursing students. Overview of Quantitative Article Vandenberg & Kalischuk (2014) in their article titled, “Conceptualizations of culture and cultural care among undergraduate nursing students”, pursues the audience of their readers by giving insights into the culture and cultural care. These authors depict the reasons why these elements have significantly become necessary within the nursing and healthcare industry. According to them, the values that underlie the conceptualization of these approaches differ, a factor that has resulted in critical analysis...
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...Critical Appraisal #1 of Scott, Hofmeister, Rogness, and Rogers Article The University of Texas at Arlington College of Nursing Shirley McKenzie-Pace In partial fulfillment of the requirements for N5301 Research in Nursing Susan K. Grove, PhD, RN, ANP-BC, GNP-BC July 12, 2014 Critical Appraisal #1 Theoretical Framework The study framework is not clearly identified; however, a tentative theory is proposed since a tentative theory “has had minimal exposure to critique by the discipline, and has had little testing, (Burns and Grove, 2009). The conceptual framework is limited to the model impaired sleep. The linking of the concept impaired sleep to independent variables of the fatigue countermeasures program for nurses (FCMPN). The FCMPN in this study was “modeled after the National Aeronautics and Space Administration Ames Research Center’s Fatigue Countermeasures Program and the Sleep, Alertness, and Fatigue Education in Residency Program” (Scott et al., 2010, p. 253). The major study concepts include: “sleep deprivation (inadequate sleep), sleep disruption (fragmented sleep), lifestyle situation, and health related issues” (p. 251). There is no map or model of the impaired sleep model purposed by Lee et al., 2004 (as cited in Scott et al., 2010) in the article; however, there is a diagram of the conceptual framework for the FCMPN. Variable Identification and Definitions The research variables that Scott et al. (2010) observed and measured were the FCMPN, sleep...
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...Mapping Care Using Standardized Terminology BY Bolajoko Olagbaju American Sentinel University Introduction Knowledge deficit is a prevalent condition among patients, characterized by the lack of both cognitive information and psychomotor skills that are necessary for promotion and maintenance of health, and for a healthy recovery. The nursing profession is faced with the need to address this problem, whether in the hospital, in ambulatory care, or in-home setting. To address knowledge deficit, the learning process involves three domains: the psychomotor domain, the affective domain, and the cognitive domain. The involved nurse engages the patients in making vital decisions on what and how the patient will be taught. Addressing knowledge deficit in nursing care is necessitated by the high number of patients with inaccurate perception concerning their health statuses (Billay, Myrick, Luhanga, & Yonge, 2007). Misinformation and lack of information associated with knowledge deficit can culminate in psychological alteration, which manifests in anxiety and depression. NANDA Nursing Diagnoses, Definition and Classification As mentioned above, knowledge deficit is marked by lack of crucial cognitive information, which is related to specific health topics. This problem is classified as among the main health conditions inherent in patients who have suffered from chronic illnesses. The defining characteristics of knowledge deficit are inaccuracy in adhering to instruction...
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...Risk Management Nursing Documentation Oscar Chavez NUR 492 May 4, 2012 Susan Dean, RN, MSN, FNP Risk Management Nursing Documentation The issue of documentation of patient care has received considerable attention in the last few years for an array of reasons. Trends in society such as increased consumer education, informed consent, expectation for healthy baby, and an increasingly litigious society all contribute to increased risk management awareness on behalf of healthcare facilities. Risk management deals with the probability that a given risk will result in poor outcome and then attempts to reduce probability. El Centro Regional Medical Center (ECRMC) has identified nursing documentation as an area of greatest risk management. In this era of unprecedented change in healthcare, ECRMC has determined it was time to reengineer our existing approach to risk management consulting services to address more current needs for our patients and staff. The primary technique utilized in overcoming these limitations is to view training not as a stand-alone solution, rather as one element of a full performance improvement plan to address specific areas of concern. Instead of providing a general program on documentation, risk management has been working with nursing departments and other professionals to focus on the areas of deficiency or situations that need improvement. The foundation of risk management was broken into four separate issues. One was to pinpoint the exact nature...
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...deal with women experiencing stress incontinence. In current practice we will teach them behavioral intervention program (pelvic floor exercise and bladder training) to lower the severity of urine leakage. That is why I want to explore more on this issue and see whether the use of vaginal cones also effective in treatment with behavioral intervention program. Obesity is a common problem in developed countries, with an incidence of 33% (Roreyt 1998), this problem may directly leading to stress urinary incontinence (Ouslander 1996) which may hinder the normal daily life of an adult. In Hong Kong Hospital Authority (HA) policy, there are no guideline in related to treatment regarding stress incontinence, it is always depends on surgeon’s preferences. Therefore I want to search for research evidence in associated with treatment of urinary stress incontinence which may beneficial in my working place. Main Body The two answerable questions formulated using PICO tool are: Quantitative Question – In women with obesity, how does behavioral intervention program compared to vaginal cones influence the occurrence of stress urinary incontinence? Qualitative Question – How do obesity women perceive the method of behavioral intervention program in comparison to vaginal cones in regards to stress urinary incontinence? P – Women with obesity I – Behavioral Intervention Program C – Vaginal Cones O – Stress Urinary incontinence In developing these two questions, first of...
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...EVALUATION The sixth phase of the nursing process Is defined as the judgment of the effectiveness of nursing care to meet clients goals based on client’s behavioral responses. Nurses use a variety of skills to judge the effectiveness of nursing care. This skills include knowledge of standards of care, normal client responses, and conceptual models and theories of nursing; ability to monitor the effectiveness of nursing interventions; and the awareness of clinical research . critical appraisal of goal attainment is determined jointly by the nurse and client. The plan of care is the foundation for evaluation. The identified nursing diagnoses, client goals, outcome criteria, and nursing interventions are the guides . through this process, nurses determine the appropriateness, accuracy, and relevance of these nursing care components. Also helps to discover any errors that may have occurred in previous steps. * Figure 13-4 illustrate the relationship of the activities of the evaluation phase to the other phases of the nursing process. *( se debe adjuntar esa imagen a la presentacion ) There are several purposes for carrying evaluation: • To collect subjective and objective data to make judgments about nursing care delivered. • To examine the client’s behavioral responses to nursing interventions. • To compare the client’s behavioral responses with predetermined outcome criteria. • To appraise the extent to which client goals were attained or problems resolved. •...
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...adults requiring long-term care of some kind increases. These adults have varying needs, but most adults have problems with skin integrity, muscle weakness, and emotional issues in long-term care facilities. Interventions to meet these needs focus on preventing skin break down, improving muscle strength to prevent falls, and settings that promote usefulness and a feeling of not being alone. Current options available to older adults may not meet all of their needs, and creativity is needed in devising interventions to meet these needs. Structuring long-term care settings to encourage activity in older adults and connecting with other generations can help prevent feelings of loneliness and uselessness, and help older adults live meaningful and productive lives in long-term care settings. Long-Term Healthcare Needs of the Elderly As adults age many will require long-term health care. The evolving needs of the older adult population will require creative and new ways to meet their health care needs. This paper will look at the needs older adults have, and options that are currently available to meet these long-term care needs. This paper will also present new options that have been proposed for long-term health care settings, how these options compare with current interventions, and what outcomes can be expected if these new options are implemented. The Problem As life expectancies increase the older adult population will also increase. According to the 2000 Census there was a...
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...SCHOOL OF NURSING Models of Capstone Projects: A Conversation Terri E. Weaver, PhD, RN, FAAN Professor and Dean University of Illinois at Chicago College of Nursing © Weaver, 2012 Jane M. Kirkpatrick, PhD, MSN, RNC-OB Head, School of Nursing Associate Dean, College of Health and Human Sciences Purdue University Objectives for this session Discuss the intent and scope of the DNP capstone scholarly project: – Differentiating from the PhD thesis – How the project demonstrates competencies Determine similarities and differences among multiple forms of DNP projects/capstones in terms of scope and expected deliverables Examine the issues that surround the DNP project/capstone If it Walks Like a Duck and Talks Like a Duck – Is it a capstone project? An endeavor by any other name: capstone, practice inquiry, scholarly project focused on practice May benefit group, population, or community (NONPF, 2007) Scholarly work that translates (is implemented) evidence into practice – Sustainability (Ahmed, et al., 2013) AACN description of DNP project “Rather than a knowledge-generating research effort, the student in a practice focused program generally carries out a practice applicationoriented “final DNP project,” which is an integral part of the integrative practice experience (AACN, 2006, p.3) Project possibilities (NONPF, 2006) Translate research into practice Quality improvement (care processes, patient outcomes) ...
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