...Application 1 The Nurse’s Role in Supporting the Organization’s Strategic Agenda NURS 6022 Alisa Gafeney Walden University May 7, 2011 The Nurse’s Role in Supporting the Organization’s Strategic Agenda Nurses are on the front lines of patient care, as delivery of care relies heavily on the nurse to provide excellent patient outcomes. The purpose of this paper is to gain insight into the nurse’s role as a supporter of an organization’s strategic plan from the perspective of a quality manager. Summary of the Interview The interview was conducted with Jennifer Price, the director of an intermediate stroke unit within a 794-bed hospital. The unit’s population of patients consists of stroke, seizure, back surgery and other types of intermediate care patients. The unit employs nineteen RNs, nine nursing assistants and three supervisors. During the interview, the nurse’s role in supporting the organization’s strategic agenda was discussed at length, along with ways to improve the nurse’s role in support of the organization’s agenda. The first question asked was how important is the nurse’s role in clinical outcomes. Jennifer stated that the impact that a nurse has on clinical outcomes is “huge,” due to the fact that nurses are responsible for all patient outcomes. Care of the patient in the hospital usually begins and ends with the nurse. With public hospital reporting...
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...SYNTHESIS OF ADVANCED NURSING ROLES BROWN_K_W5A2_SU_NSG5000 Kerry Ann Brown South University Due to the changing health care environment, the nursing profession is currently in a process of evolution. Scopes of practice and role expansions are being prepared. Some of these roles are traditional, such as nurse practitioners who have been fighting for equality and recognition since the early 19th century. With the advent of technological advancements in health care new roles such as nurse informaticists, recognized as a specialty in the later part of the 20th century, are being put into practice and defined. More responsibilities are being given to the nursing profession due to its knowledge base within the constructs of organization, implementation, and evaluation skills with a human approach. During the context of this class much knowledge was gained in respect to the nurse practitioner (NP), nurse administrator, nurse educator, and nurse informaticist (nurse informatics specialist). Because health care is changing, the aforementioned roles are also evolving, this paper will explore the commonalities with each advance practice role and analyze the roles and contributions of the nurse informatics specialist. The nurse practitioner is a postgraduate prepared registered nurse, who has either a master’s degree or doctorate. Upon graduation, NPs possess a wealth of knowledge allowing them to independently manage direct clinical aspects of patient-centered holistic...
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...Gender and the Experience of Moral Distress in Critical Care Nurses Jessy Thomas Grand Canyon University: NRS-433V May 24, 2015 Gender and the experience of moral distress in critical care nurses Patricia Banner, an American nurse theorist defined the ethical compartment as “the embodied skilled know-how of relating to others” in ways that are respectful and support their concerns (Corley MC, Nurses Ethics 2002). Moral distress is fairly new topic of discussion in the print and media. The term begins when Jameton recognized the negative feelings when one person realize the morally correct course to be taken but can’t practice due to the restriction imposed by the place they work. Moral distress can happen in variety of setting and roles. Many researchers studied this topic among various health care workers among nurse educators, students, critical care and medical-surgical nurses and administrators. The moral distress among nurses may vary depending upon many factors such as gender, ethnic back ground or the context in which they practice. A meta-analysis of 19 studies on moral sensitivity and moral judgment found that females are higher in the case of moral sensitivity scores. (Christopher B, Gender and moral distress) Problem Statement The problem of this study aimed to address was: “Critical care settings are highly technical, dynamic patient care environments”. Often nurses need to make sudden judgments and decisions of complex nature that can take care of patients...
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...Conflict Resolution at General Hospital August 28, 2010 Conflict Resolution at General Hospital The current conflict Conflict as defined in the text is a process in which one party perceives that its interests are being opposed or negatively affected by another party (Hellriegel/Slocum, 2011). In the case of General Hospital, the two parties at odds are the CEO Mike Hammer and the physicians represented by the Director of Medicine Dr. Mark Williams. Mr. Hammer also faced opposition from the hospitals’ board of trustees. The conflict stemmed from the fact that the hospital was no longer competitive and was losing money. Mr. Hammer was unable to convince the physicians or the board to adhere to any cost containing measures or solutions. To compound this problem, he delegated authority to Marge Harding the Chief Operating Officer of the hospital to address and resolve the situation. Ms. Harding had personal goals to achieve and would utilize this opportunity to achieve them. The level of this conflict would be classified as Intergroup Conflict. “[This] refers to opposition, disagreements, and disputes between groups or teams” (pg. 388), in this case between the physicians, the board of trustees and management. The physicians had taken a very rigid stand and they did not listen to any suggestions or ideas from the CEO regarding cost containment. Conflicting Management Styles The text identifies five conflict handling styles, Collaborating Style, Compromising Style...
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...medical sector, and it was first established in 2000 as an anesthesiology freelance practice in the city of Rotterdam. Although the author of this report works three to five days per week as a clinician, his function in AA also includes quality management and strategy. The Dutch medical sector where AA operates is highly intervened and regulated. The financing of hospitals and medical services is done by an oligopoly of insurance companies. The government, under advice from the insurers, imposes capped hourly wages for anesthesia services. Non-compliance with the price limitation is a criminal offence. Between 2002 and 2007 the demand for anesthesia locum tenens was so high that AA expanded to eighteen anesthesiologists and nine nurse anesthetists, while it expanded from Rotterdam to all corners of the Netherlands. Today, our client portfolio includes sixty-one Dutch university, tertiary, secondary and primary level hospitals. AA enjoyed a monopoly from 2000 till 2006. While the author of this report still viewed the company as a medical group, by 2006 he came to realize that AA was nothing more than a temporary work agency with strong resemblances to a cab company: available resources needed to be matched with opportunities that arouse at unpredictable sites...
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...HEALTH 1 ***Draft 2B*** Introduction If well-managed, migration has been recognized by the UN System-wide Task Team’s report Post 2015 Agenda: Realizing the Future We Want for All as an important tool “to ensure that globalization becomes a positive force for all the world’s peoples of present and future generations”. Migration can be an enabler of human development by enhancing people’s income, health and education. An improved standard of education and of physical, mental and social wellbeing not only empowers migrants, but also allows them to substantially contribute towards the social and economic development of their home communities and host societies. However, this can only happen when the rights and wellbeing of all those affected by migration are fulfilled and they are recognized as “positive agents of innovation with human rights.” The post-2015 development agenda concerns more than anyone the generation being born now. Healthy, safe and well-educated children are the cornerstone of thriving societies, sustainable growth and proper management of natural resources. For over a decade, the Millennium Development Goals (MDGs) have widely benefited children, both boys and girls, and young people. However, “there is major unfinished business as well as emerging and neglected issues that must be addressed boldly in the post-2015 development agenda, to ensure a world fit for children”. 2 One of the flaws of the MDGs is that by relying on national averages they tended to mask inequalities...
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...Governance Improve Nursing Retention? La Quinta Roberts Kaplan University NU499 Bachelor’s Capstone in Nursing Natasha Zurcher, MSN/ED, RN, CPN April 6, 2014 Abstract The global nursing shortage has prompted health care systems to seek new strategies to attract and retain nurses. The growing evidence points to the shared governance model of management are as a possible strategy to improve productivity, nurse job satisfaction and nurse retention. There are different models of shared governance, but a clear relationship exists between nurse practice environment and higher retention rates. Research found long hours, and unsupportive practice environments contribute to high turnover rates. Here is a look at the evidence which promote the creation of a shared governance model for a positive practice environment and better retention rates. Shared Governance and Nurse Retention Introduction Shared governance models are being promoted as a plan to decrease nurse turnover, but there are many variable elements to the Shared governance model. True shared governance characteristics are a practice environment that has a process by which nurses take an active participatory role in the decisions of the hospital nursing practice. Most shared governance models are associated with Magnet status hospitals, but more and more hospitals are adopting this style of management without the designation. This is a relatively new concept because nursing in hospitals was paternalistic...
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...organizing factors of inpatient psychiatric care environments were associated with the occurrence of these events. The events examined were wrong medication, patient falls with injuries, complaints from patients and families, work-related staff injuries, and verbal abuse directed toward nurses. Methods: This cross-sectional study used data from a 1999 nurse survey linked with hospital data. Nurse surveys from 353 psychiatric registered nurses working in 67 Pennsylvania general hospitals provided information on nurse characteristics, organizational factors, and the occurrence of adverse events. Linear regression models and robust clustering methods at the hospital level were used to study the relationship of organizational factors of psychiatric care environments and adverse event outcomes. Results: Verbal abuse toward registered nurses (79%), complaints (61%), patient falls with injuries (44%), and work-related injuries (39%) were frequent occurrences. Better management skill was associated with fewer patient falls and fewer work-related injuries to staff. In addition, fewer occurrences of staff injuries were associated with better nurse-physician relationship and lower patient-to-nurse staffing ratios. Conclusions: Adverse events are frequent for inpatient psychiatric care in general hospitals, and organizational factors of care environments are associated with adverse event...
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...Annotated Bibliographies Lisa Stevens Kaplan University Annotated Bibliographies Au, A., McAlister, F., Bakal, J., Ezekowitz, J., Kaul, P., & vanWalraven, C. (2012). Predicting the risk of unplanned readmission or death within 30 days of discharge after a heart failure hospitalization. American Heart Journal, 164(3). 365-372. Retrieved from: http://www.medscape.com/viewarticle/771215_print This article sought to find an appropriate model to predict the risk of unplanned heart failure readmissions. The primary outcome from chart reviews also included death of heart failure patients within 30 days of discharge. The study looked at Centers for Medicaid and Medicare Services (CMS) models and the LACE+ index, to mention two of many that looked at prediction ability. The LACE+ index is a model that looks at length of stay, acuity, the Charlson comorbidity score and age, to predict readmissions. They found that no one model was appropriate in predicting the 30-day readmission rates, although using a combination of the models was an improvement to that predictor. The authors are all physicians, PhDs, or have a Master’s degree- helping to establish credibility. The authors also make a statement as to the funding of the project and that they (the authors) were solely responsible for all data collection, design and submission approval writing for the project, also lending credibility to the study. The references used for this study were appropriate in age, of the 28; 13 were...
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...T E R W O R T H S . ( 2 0 0 3 ) Journal of Advanced Nursing 43(5), 432–440 Time management strategies in nursing practice Background. With the increasing emphasis on efficiency and effectiveness in health care, how a nurse manages her time is an important consideration. Whilst time management is recognized as an important component of work performance and professional nursing practice, the reality of this process in nursing practice has been subject to scant empirical investigation. Aim. To explore how nurses organize and manage their time. Methods. A qualitative study was carried out, incorporating narratives (22 nurses), focus groups (24 nurses) and semi-structured interviews (22 nurses). In my role as practitioner researcher I undertook observation and had informal conversations, which provided further data. Study sites were five health care organizations in the United Kingdom during 1995–1999. Findings. Time management is complex, with nurses using a range of time management strategies and a repertoire of actions. Two of these strategies, namely routinization and prioritizing, are discussed, including their implications for understanding time management by nurses in clinical practice. Conclusions. Ignoring the influence of ‘others’, the team and the organization perpetuates a rather individualistic and self-critical perspective...
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...Barriers to Using Evidence-Based Medicine Melanie Ossman Granite State College Professor Philip Wyzik HLTC 600 March 4, 2011 Thesis The Institute of Medicine recommends the use of evidence-based medicine as a primary tool for achieving the aims outlined by their six themes of improvement. Specifically, EBM relates to their aim to make health care more effective: “to provide health care that is effective and efficient.” (Institute of Medicine, 2001) In recent years, evidence-based medicine has gained increasingly broad-based support in health care, but many doctors still aren’t using it. With a lean towards Pharmacy management, I researched the barriers providers and institutions are faced with in successfully incorporating evidence-based medicine and how initiating organizational improvements can help. The research highlights some important considerations to be aware of that gives evidence-based medicine a bad name, the pitfalls to avoid, and some ways providers and institutions are working to overcome them. Introduction This paper begins by giving an overview of evidence-based medicine, what it is, and the benefits to be realized by providers, insurers, and patients. I compared that to what providers were using before EBM. Next, I examine the barriers to successfully incorporating evidence-based medicine, and the negative perceptions that dissuade their use by clinicians. Identified are the disadvantages such as source information bias, ethics considerations...
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...Including women, who until then were limited in their roles they could play within America and the capitalist system. The Majority of women who did work during this time period were limited to jobs as teachers, nurses, or secretaries, and equality in the workplace was nothing more than a thought to most women. During this era, men preferred women to be housewives and caretakers for the home and children, however, there were a group of single independent women, who this did not sit well with. One of the best known voices of the second-wave feminist movement was Better Friedan, who authored a book titled “Feminine Mystique.” In the book she expressed the sadness of college educated women who were confined to the home, she advocated for these women to rise up and take a stance against these limited and confined roles. The early focus of the feminist movement was centered on workplace inequalities, for example women wanted access to better jobs and salaries that were equal to men. In light of equality laws not being enforced this sparked Betty Friedan and other women to start the National Organization for Women (NOW). In spite of this newly found organization the agenda for the feminist movement changed gears, from that of a workplace issue, to women being oppressed as a whole and not having equal rights to that of a white male. This resulted in a radical...
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... Commissioning Based Health Care Environment. Specialism: BSc (Hons) Specialist Community Public Health Nursing Submission Date: 15/09/2014 Word Count: 3949 Leadership and Management in a Commissioning Based Health Care environment. In any organization good leadership is not just important but fundamental for the success of the organization. For the purpose of this assignment leadership and management will be explored within today’s rapidly changing health care. This shall be discussed in more depth and in relation to the commissioning of the new service as proposed in the report to the trust board for consideration. As highlighted by the Nursing and Midwifery Council (NMC) Standards of proficiency for specialist community public health nurses (MNC, 2008), nurses are expected to work in partnership with all team members and clients in delivering the best care. A clear understanding of the quality issues in clinical care will be discussed by analyzing the process of change and leadership styles and how this can influence the quality of care in line with the new policy and legislation. Furthermore strengths and weaknesses given to conflict...
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...was passed during the first term of President Franklin Roosevelt in 1933, helped many women get employed. During World War I, women played a very important rule back home and in the battle field; they gained a lot more respect with all the hard work they did. Towards the end of nineteenth century, press gave the “New Women” title to those who were active in the public. A key person who was holding an important position in the government and used her powers to help women gain their grounds was Anna Eleanor Roosevelt who was the first lady from 1933 to 1945. She contributed a lot by supporting and conducting many organizations. Colored women had also started their own organization which later on came together with the white women’s organizations; however, they were facing a harder battle due to the fact they were slaves who gained their freedom in 1865. Over all, women were able to change their roles in society...
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...Series Alma-Ata: Rebirth and Revision 7 Integrating health interventions for women, newborn babies, and children: a framework for action Björn Ekman, Indra Pathmanathan, Jerker Liljestrand Lancet 2008; 372: 990–1000 See Editorial page 863 This is the seventh in a Series of eight papers about Alma-Ata: rebirth and revision Lund University, Lund Sweden (B Ekman PhD); Kuala Lumpur, Malaysia (I Pathmanathan PhD); Ystad, Sweden (J Liljestrand PhD) Correspondence to: Dr Jerker Liljestrand, Götgången 12 27144 YSTAD, Sweden jerker@ystad.nu For women and children, especially those who are poor and disadvantaged, to benefit from primary health care, they need to access and use cost-effective interventions for maternal, newborn, and child health. The challenge facing weak health systems is how to deliver such packages. Experiences from countries such as Iran, Malaysia, Sri Lanka, and China, and from projects in countries like Tanzania and India, show that outcomes in maternal, newborn, and child health can be improved through integrated packages of cost-effective health-care interventions that are implemented incrementally in accordance with the capacity of health systems. Such packages should include community-based interventions that act in combination with social protection and intersectoral action in education, infrastructure, and poverty reduction. Interventions need to be planned and implemented at the district level, which requires strengthening of district planning and management...
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