...Evolving Practice of Nursing and Patient Care Delivery Models The Speech Hello, my fello nurses. Thank you for being here at the Summit of Nursing Evolution. My name is Chhay Yann-Ly and I am a nurse. We are living in an era where the United States (US) health care system is going through tremendous changes and challenges, with sky-rocketing health care costs, fragmented and poor quality of care, high volume of aging population, and passage of the Patient Protection and Affordable Care Act (PPACA) in 2010. A summary of the PPACA is basically to improve the health care delivery system, expand coverage, and control cost (Democratics Senate Gov/Reform, n. d.). With these changes, comes the evolutionary nursing professional transformation process. This speech is a crash course on the evolving practice of nursing and patient care delivery models. The goal of this speech is to discuss the continuity or continuum of care in relation to accountable care organizations, medical homes, and nurse-managed clinics health care models. Since nursing is the backbone of health care, all of these care delivery models require a robust nursing contribution for success (American Nurses Association (ANA), 2010). The first model is the accountable care organizations (ACO). ACOs is a “shared savings” with Medicare (part A & B). The ACO, according to the ANA (2010), is “a collaboration among primary care clinicians, a hospital, specialists and other health professionals who accept joint responsibility...
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...Evolving Practice of Nursing and Patient Care Delivery Grand Canyon University: NRS 440V Jane Smith Evolving Practice of Nursing and Patient Care Delivery Hello fellow nurses, welcome to our Professional Nurse Evolution summit. My name is Jane Smith and like you I am a registered nurse, I work at the bedside. I always thought I’d live and die as a staff nurse at a busy level 1 trauma center in the inner city but recently I’ve looked up from the bedside and I see opportunities knocking at my door, and I see a way to help the community in which I serve in a different role. The practice of nursing is changing, growing, shifting in other words: transforming. Over the next decade, we will see nursing move from the acute care setting and into the community. I would like to discuss with you the concepts of accountable care organizations (ACO’s), medical homes, and nurse-managed health clinics, and continuum of care. Our health care system landscape is changing; no longer are we just treating illness, our health care system has evolved to one of disease prevention and wellness. With the signing of the Patient Protections and Affordable Care Act (PPACA), an additional 30 million Americans now have access to affordable and equitable health care (Institute of Medicine [IOM], 2011). The rising cost of health care and the sheer volume of those needing health care has led to reinventions in our care delivery models. According to the American Nurses Association (ANA), an ACO’s is a...
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...Discussing the future of nursing theory can bring up a wide outlook of the direction of nursing. Everyone has different views and interests concerning nursing’s future. In this discussion, we will cover some of the opinions of what has driven nursing theory development, what will drive future development in nursing theory, and how might nursing practice change as a result of evolving nursing theory. According to "Nursing Theory" (2011), “The nursing profession has evolved greatly over time, moving from dependence upon total medical direction providing basic care into an independent practice modality with its own nursing theory practice, nursing models, and distinct nursing interventions” (Nursing Theory).The requirements of nursing education have grown greatly. Nurses used to only take care of basic ADL’s of patients. Today, many nurses have more knowledge than the physicians working with these nurses. It is only logical that nurses have their own set of theories and models that guide their nursing practice. Nursing theories increase the general knowledge within nursing through research implementation. Theories provide the basis for nursing practice, helps to generate future knowledge, and indicates in which direction nursing should develop. Nursing theories are an attempt by the nursing profession to continue within the professional boundaries of nursing (Nursing Theory, 2011). Nursing theory has also been driven by the advanced educations available to nurses. Advanced education...
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...Walden University Nurs-6015-1 Information & Healthcare Technologies Applied to Nursing Practice February 23, 2013 Nursing informatics affecting attitude The professional role of nursing is evolving and nurses are recognizing the integral connection of informatics competencies to evidenced based practice and the roles it plays in clinical decision making, nursing research, measurement of nurse sensitive outcomes, professional development, operational effectiveness, and ultimately the nurse-patient relationship (Schleyer, Burch, & Schoessler, 2011). It is essential with the advancement in technology that nurses become more user friendly and have a higher level of training in the area of nursing informatics. Nursing informatics has taken a step toward advancements in technology over the last decade with many facilities across the nation implementing these new systems. These new systems are designed to assist nurses and providers by reducing repetitive documentation, reducing medical errors, reducing medication and administration errors, increasing the quality of care for patients, and increasing patient outcomes. My attitude is positive and accepting of nursing informatics from the knowledge gained throughout the course. It has given me a higher level of awareness with everything nursing informatics can assist in and it has given me a feel of being more opened to using newer technology. Having a positive attitude can affect the overall implementation of a new...
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...Nursing Theory, Research and Evidence Based Practice Over years nursing has been evolving as a science and the nursing practice became governed and organized now by rules, regulations and theories. Since 1992 Evidence Based practice (EBP) has been formally introduced to the field of nursing, and nursing policies and procedures have been changed accordingly due to the advances in research. Our practice is guided by our beliefs and directed by our advanced knowledge, (Laureate education 2010). Describe a change in practice that came out because of theory based research and evidence As discussed earlier nursing practice is in constant change, the latest change I have seen in my Intensive care unit (ICU) was the emphasis on early removal of unnecessary Foley catheters (Urinary catheters) , as many studied has shown its direct coloration with urinary tract infections, (Dr. L. Brusch MD, 2012). Every day the Foley catheter stays. The incidence of catheter associated urinary tract infection (CAUTI) is increased by 3-10%, and about 80% of nosocomial UTI’s is related to urethral catheterization. What kind of evidence where used The evidence used was urine specimens (urinalysis and urine cultures), blood test and clinical presentation. Urine cultures has showed bacterial colonization, meanwhile CBC showed leukocytosis, more over the clinical picture of fever, chills, puss around the site of insertion, pain, redness also supports the diagnosis of CAUTI, (Dr. L. Brusch...
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...Competency Differences between nurses prepared at the Associate-Degree Level (ADN) or Baccalaureate-Degree Level (BSN) level Competency Differences between nurses prepared at the Associate-Degree Level (ADN) or Baccalaureate-Degree Level (BSN) level It has always been said that the higher level of education one can obtain, the better. Currently for Registered Nurses there are many programs out there that encourage furthering education and enrolling back in school to obtain a Baccalaureate-Degree in Nursing (BSN). Both nurses, whichever program they are enrolled to, are educated through nursing programs that require them and prepare them to take the same National Council Licensure Examination (NCLEX). We will be able to see some differences in competency based on educational level and background based on research and evidenced-based practice. Nurses throughout the United States are being encouraged to enroll back into school to achieve a higher level of education. You can see RN-BSN programs; BSN-MSN, LVN-ADN or LVN-BSN program information anywhere from website advertisements, e-mails, commercials, and magazines. There is no doubt that education is important and that based on the job one is looking to fulfill, certain levels of a degree or certification are required. ADN and BSN nurses, although both RNs, do hold certain traits of differences based on their education level. A nurse with an Associate’s Degree is taught more how to treat the patient medically. They most...
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...Nursing Theory: Compare/contrast two theories Name University Professor Course Date Nursing Theory: Compare/contrast two theoriesIntroduction Theory has so far remained a strategic tool in advanced nursing practice. Firstly, nursing utilizes every feature of management science. Fortunately, the knowledge base of each and every management science takes theory into account. Theory includes methods, principles, and concepts. The principles are usually related, and can be observed and validated or verified when translated into the practice of management. Likewise, concepts are general notions, thoughts, and ideas that tend to form a basis of discussion or action. Therefore, theoretical principles guide clinical nurses to various fundamental nursing concepts and provide productive line of action in a given situation. As a result, nurses should note that taking a hermeneutic or phenomenological approach (strict natural science approach) to nursing is not only naive but also misleading in real-life-settings. Alligood and Tomey, on the other hand, argues that prescriptive theories are often used as fundamental practice guidelines, which play a pivotal role in providing a wide range of practice situations in the nursing and nursing sector (2002). Apart from that, nursing can only become a real profession when it has both a theoretical and a scientific base. This follows the fact that nurses deal mainly with human behavior, thus, nursing is indeed a practice profession. Briefly...
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...Concept Comparison and Analysis Jo Ann Tyler Green NUR/513 10/15/2012 Michelle Johnson Concept Comparison and Analysis The concept, quality of life, as used in nursing theories, is presented in a historically situated context. This approach to concept analysis was selected to illuminate the subjective, contextual, and fluid nature of the concept. Based on this review, quality of life is defined as an intangible, subjective perception of one’s lived experience. From a review of Peplau’s, Rogers’, Leininger’s, King’s, and Parse’s conceptualizations of quality of life, it is concluded that it may be viable to replace health with quality of life as a meta-paradigm concept for nursing. There are numerous definitions of quality of life that exist. Described as experiences of life (Meeberg, 1993), satisfaction with life, and well-being (Ferrans, 1996; Haas, 1999; (Meeberg, 1993), the definition of quality of life lacks precision and specificity. Consistency is important because “differences in meaning can lead to profound differences in outcomes for research, clinical practice, and allocation of health care resources” (Ferrans, 1996, p. 294). Nurses have made important contributions to understanding this concept. The quality of life has been examined in groups of people experiencing a particular illness or health deficit, such as cancer or heart disease (C. R. King, 1998). Quality of life concept analyses have focused on existential aspects of the concept. However, these...
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...The RN to BSN program at Grand Canyon University meets the requirements for clinical competencies as defined by CCNE and AACN using nontraditional experiences for practicing nurses. These experiences come in the form of direct and indirect care experiences in which licensed nursing students engage in learning within the context of their hospital organization, their specific care discipline, and their local communities. As the country focuses on the restructuring of the U.S. health care delivery system, nurses will continue to play an important role. It is expected that more and more nursing jobs will become available out in the community, and fewer will be available in acute care hospitals. 1. Write an informal presentation (500-700 words) to educate nurses about how the practice of nursing is expected to grow and change. Include the concepts of continuity or continuum of care, accountable care organizations (ACO), medical homes, and nurse-managed health clinics. 2. Share your presentation with nurse colleagues on your unit or department and ask them to offer their impressions of the anticipated changes to health care delivery and the new role of nurses in hospital settings, communities, clinics, and medical homes. 3. In 800-1,000 words summarize the feedback shared by three nurse colleagues and discuss whether their impressions are consistent with what you have researched about health reform. 4. A minimum of three scholarly references are required for this assignment...
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...The RN to BSN program at Grand Canyon University meets the requirements for clinical competencies as defined by CCNE and AACN using nontraditional experiences for practicing nurses. These experiences come in the form of direct and indirect care experiences in which licensed nursing students engage in learning within the context of their hospital organization, their specific care discipline, and their local communities. As the country focuses on the restructuring of the U.S. health care delivery system, nurses will continue to play an important role. It is expected that more and more nursing jobs will become available out in the community, and fewer will be available in acute care hospitals. Write an informal presentation (500-700 words) to educate nurses about how the practice of nursing is expected to grow and change. Include the concepts of continuity or continuum of care, accountable care organizations (ACO), medical homes, and nurse-managed health clinics. Share your presentation with nurse colleagues on your unit or department and ask them to offer their impressions of the anticipated changes to health care delivery and the new role of nurses in hospital settings, communities, clinics, and medical homes. In 800-1,000 words summarize the feedback shared by three nurse colleagues and discuss whether their impressions are consistent with what you have researched about health reform. A minimum of three scholarly references are required for this assignment...
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...across Theories The purpose of the nursing theories is to provide an interrelating framework focusing on the nursing practice. The defined nursing theories promote better patient care, improve the status of nursing profession, and improve the communication between the nurses, and provide guidance to the researches and education (Keefe, 2011). Not all nursing theories have the same meanings; however, they play the important role of explaining the key concepts and principles of nursing practice in understanding way. Dorothy Orem’s Self-Care Deficit Theory and Sister Callista Roy’s Adaptation Model are considered as grand nursing theories. The grand nursing theories are a conceptual model, which identifies the focal point of nursing inquiry and guide the development of mid-range theories that will become useful to nurses and also to other health professionals. According to Walker and Avant (2011), these theories contributed in “conceptually sorting the nursing from the practice of medicine by demonstrating the presence of distinct nursing perspectives.” In this essay, Orem’s Health Care Deficit Theory and Sister Callista Roy’s Adaptation Model are compared and analyzed for their importance in nursing. Orem’s Self-Care Deficit Theory Orem’s Self-Care Deficit Theory is one of three grand theories written by Dorothea E. Orem. According to Orem, nursing becomes necessary when an individual can no longer care for him or herself. Nursing provides care through acting, guiding...
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...MODULE 2: Theory Development in Nursing Discuss the five development of nursing theory. Silent Knowledge Stage is the period where nurses practice blind obedience to medical authority. Trainings of nurses and student nurses were limited to hospital settings. There is no independent decision-making by the nurse, and technical skills can only be performed by skilled nurses. Hospital schools believed that the nursing education comprises only of learning technical skills and that there is no need to be educated of theory. It is in this stage that nurses are dependent to doctors, and they carry out orders no questions asked. Received Knowledge Stage is the time when nurses were encouraged to be registered as a professional by taking up state licensure, and pursue graduate education to study nursing functions and purposes. Prominent nursing organizations were formed and books containing lessons on nursing research and theories were published. The publication of the Journal of Nursing Research was then set forth, which goal, according to Parker (2006), was to promote scientific productivity and report scientific investigations for nursing, and contains papers on a variety of topics in relation to health care and current policies. This drove nurses in graduate education to inspire other nurses scholars to improve their awareness on theories and their skills in practice. Subjective Knowledge Stage is the period where authority was internalized and new sense of self emerged...
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...can create a more peaceful end of life, rather than simply complete the tasks at hand in the day to day when caring for the dying. II. Theory Perspective b. Defining “Peaceful” c. Dying is a personal experience and should never be alone. d. Five Outcome Indicators e. 16 Outcome Criteria III. Relationship to Nursing Practice f. Relevancy to Nursing i. Educate ii. Influence iii. Research g. Observe. Look, listen and feel h. Understand and Interpret i. Intervene with dignity, respect and empathy IV. Case Scenario V. Conclusion References Bjarnason, D. (2000, May). End-of-life care: Understanding and enhancing the nurse-patient dialogue. Retrieved May 3, 2011, from Proquest: http://proquest.umi.com/pqdweb?did=732206511&Fmt=2&clientId=14884&RQT=309&VName=PQD George, J. B. (2011). Nursing theories: The base for professional nursing practice. Upper Saddle River, NJ: Pearson. Moore, S. M., & Ruland, C. M. (1998). Theory Construsction based on standards of care: A proposed theory of the peaceful end of life. Nursing Outlook,...
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...According to the Texas Board of Nursing, nurses are advised to use the six-step decision making model developed by the board to assist nurses make a sound professional judgment before undertaking a nursing task or procedure.(Texas Board of Nursing,2010) Step-1: Is the act consistent with the Texas Nursing Practice Act (NPA)? (Texas Board of Nursing: NPA, Ch 301.002(2) Step-2: Is there an appropriate order that authorizes the performance of the activity? Step-3: Is the act supported by conclusive scientific data from nursing research or evidence based practice standards? Has the action approved by a national nursing organization for nurses to practice it in accordance with the guidelines and standards issued by the organization? Step-4: Does the nurse personally posses the knowledge and clinical competency to perform the task safely? Step 5: Is the act within the accepted nursing standards of care which would be provided under similar circumstances by another nurse who have similar training and experience? Does an adverse reaction or consequence of action be resolved by nursing intervention only? Step 6: Is the nurse prepared to accept consequences of the actions? (Accountability).If there is a “no” answer for any of the steps above, then task is not in the nurse’s scope of practice. On top of following this six-step model, the nurse should always take in to consideration any physical, emotional, or institutional ( Eg. Availability of necessary...
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...versus evil through out history, good almost always triumphs in the end. For example the New York Yankees have won a total of twenty seven World Series Championships compared to the Boston Red Sox who have won a meager seven World Series. Another example would be Darth Vader returning from the dark side to vanquish the evil Emperor by means of hurling the villain over a rail to unseen depths and certain death. In the case of Bachelors level nursing compared to Associates level nursing however, there really is no good versus evil to compare. There is no dark versus light there is just a different level of attained educational degree. The question is what does the difference in education level provide in the level of competency of each nurse. The aim of this paper is to discuss what is the definition of competency in nursing and how is it measured, what are the advantages in nursing care for associates and bachelors degree care, and how do the differences in educational level affect overall patient outcomes. What is competency in nursing? The American Nurses Association, or ANA, defines competency by stating, “competency is an expected level of performance that results from an integration of knowledge, skills, abilities, and judgment” (ANA 2004). A nurses’ ability to provide proficient and safe care at the bedside in any setting demonstrates competence. This statement is true for associates and bachelors level education alike. When comparing a BSN level educated nurse to...
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