...a new procedure that physicians would like nurses to adopt in the hospital. Discuss the process you would apply to determine whether the procedure falls within the RN scope of practice and how you would go about introducing the new procedure with physicians and fellow nurses First, I would inform my direct supervisor about the request from the physician to implement a new procedure. If the request is approved by the nursing supervisor, I would further investigate the procedure in which the physician wants the nurses to adopt in the hospital, as it is imperative to determine whether the procedure is within the nursing scope of practice before deciding to adopt or implement it. I would do this by referring to my state board of nursing decision making flow chart. | 1. Is the function commonly recognized as nursing practice? NO YES ⇒ S.P. not required ⇓ | 2. Is it the standard of practice in the community that RNs perform this function in the clinical area for which it is being considered? NO YES ⇒ S.P. not required ⇓ | 3. Does the function require the nurse to: Diagnose disease, Prescribe medicine or treatment, or Penetrate or sever tissue? NO YES ⇒ S.P. required ⇓ | 4. Does safe performance of the function require judgment based on medical knowledge beyond that usually possessed by the competent RN in the area for which it is being considered? NO YES ⇒ S.P. required ⇓ S.P. not required | If the procedure falls into the nursing scope...
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...You have been asked to investigate a new procedure that physicians would like nurses to adopt in the hospital. Discuss the process you would apply to determine whether the procedure falls within the RN scope of practice and how you would go about introducing the new procedure with physicians and fellow nurses. The Registered Nurse scope of practice is determined by specialty and level at which you are practicing. Therefore, the initial step to take in investigating the new procedure that will be introduced is to be aware of the scope of practice of the stakeholders as well as the policy and procedures of the facility. This is done to ensure that the new policy falls within the scope of practice and is in compliance with the policies and procedure of the facility. The scope of practice defines the who, what, where, when, why and how of nursing practice (rn.com). Following the verification regarding scope of practice I would take the following steps: * Meet with hospital administration to brief them on the physician’s request and give them a time line in which I plan to present to them my findings on the procedure. * Follow up with the the state board to ensure that this is within the nursing process of: : • Assessment—gathering and validating client health data, strengths, risks, and concerns • Diagnosis—analyzing and processing client data to identify appropriate nursing diagnoses∗ • Planning—developing interventions to solve identified problems and build...
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...Max Points: 15.0 You have been asked to investigate a new procedure that physicians would like nurses to adopt in the hospital. Discuss the process you would apply to determine whether the procedure falls within the RN scope of practice and how you would go about introducing the new procedure with physicians and fellow nurses. When it comes to investigating a new procedure, a systematic approach should be applied. It is imperative to determine whether a given procedure is within the nursing scope of practice before deciding to adopt or implement it. Some standard steps that must always be followed are based on the Nurse Practice Act, the ANA Standards of Practice, rights of patients, and safe nursing practice. According to Anderson (2013), determining if a new procedure is within the scope of nursing practice can be accomplished in three steps. First, define the issue, which means clarifying what exactly is being asked and what the new procedure entails. This step also includes gathering any additional information such as conducting a competency assessment to perform the task, as well as any previous experience, current knowledge and skill. Evidence-based practice and nursing research must also support the adoption of any new procedure. Secondly, since evidence is not the only component, the Nurse Practice Act and the policies of the workplace must also be considered. Nurses may be limited by the facility policies/standards to perform certain tasks even though the tasks...
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...Introduction: A tracheotomy is a surgical procedure to create an opening in the neck at the front of the windpipe (trachea). A tube is inserted into the opening and connected to an oxygen supply and /or ventilator to assist with breathing. Fluid may accumulate in the throat and windpipe and the removal through the opening is allowable. Dawson (2014) states nurses caring for patients with tracheostomy require an appreciation of the breadth of knowledge needed to provide individual and safe care. A tracheostomy may be performed as: • An emergency procedure - if someone is unable to breathe following an injury or accident. • A planned procedure - to assist someone who is unable to breath as part of treatment in intensive care, or due to a long-term condition such as laryngeal cancer etc....
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...Evidence based practice is connection of use current knowledge into common patient care decision to guide nursing practice and for better patient outcome in today's complex health care system .EBP came from the increasing public demands and professional demand for accountability to deliver safe and quality care .new medical devices and procedure are introducing into the nursing practice to help to handle clinical issues and provide batter care. It provide opportunity for nurses to learn and implement training into practice. There are important factors to keep in mind like foundation of the clinical problem, evidence to support that and evaluation and also depends on nursing clinical experience according to the patients assessment. Every day there are lot of practice are based on EBP.one practice is use of proper aseptic techniques to change Picc line dressing and inserting a Foley catheter and there are so many other procedure like blood transfusion, inserting IV.TO reduce rate of cross infection, has to use PPE and hand hygiene. IF patient is infection of C-Diff, best possible solution for that is hand hygiene with soap and water, because it was proven in study’s that foam based hand sanitizer not very effective to kill that organism, my facility more stressed on hand hygiene and also they do audit and observe care giver while they are performing their procedure to see how many percentage staff following the proper guidelines and Media Media and Hollywood both are...
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...nurse. I will be discussing a clinical procedure that I have become competent in practising, however I will be focusing on the infection control needs around the procedure as well as the professional and ethical practice of infection control. The patient I shall be referring to shall be known as Patient A, this is to meet the nursing and midwifery code of conduct to protect the patient’s identity and to maintain confidentiality (NMC 2008). (LO 1.8) Patient A is an elderly gentleman living within a residential home, doctors are unable to resolve his underlying medical conditions of Chronic Obstructive Pulmonary Disease (CoPD), Heart Failure and Malignancy, which together resulted in him suffering from recurrent Pleural effusion. A Pleural Effusion is an accumulation of fluid in the chest cavity (Rocket 2012) this area normally contains a small amount of Pleural fluid and aids for optimal function of the lungs during respiration (rocket, 2012). However, Patients A’s conditions interfere with the body’s natural ability to reabsorb the fluid, which results in a larger amount of fluid building up, which in turn made the patient have serve breathing difficulties. Doctors decided rather than submitting Patient A for repeated procedures they inserted an Indwelling Pleural Catheter (IPC) into his chest, which allowed medical staff to drain off excess Pleural fluid and eliminate his respiratory symptoms (Rocket 2012). As part of the Nursing Process (KYN107) my mentor, a registered...
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...In this reflective writing, I will reflect upon my performance in the video undertaking vital signs and therapeutic communication addressing both positive and negative aspects and link my reflections to journal articles and texts. By replaying my video I found a positive aspect of my performing the skills of undertaking vital signs which is performing hand hygiene. Generally, I think that the patients in the ward are already get physical disorders and have very low immunizations, so they have high incidences of diseases. I realize that hand hygiene can remove bacteria and viruses which may spread by touching patients and easily cause infectious diseases to them. So it is essential to perform hand hygiene before and after touching patients. Alemagno, Guten, Warthman, Young & Mackay (2010) state that infectious organisms can harbor and spread by health care workers who touch the patients while providing care. Appropriate hand hygiene is basic to patient health and safety and is the most cost-effective way to decrease bacteria transfer. Barrett & Randle (2008) also state that the prevalence of healthcare-associated infections which are acquired by patients during health care, investigation or rehabilitation in a hospital or community setting can be reduced by effective hand hygiene decontamination. So hand hygiene is an important way to prevent infectious diseases in health care facilities. In my vital signs assessment video, I performed hand hygiene before and after touching...
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...You have been asked to investigate a new procedure that physicians would like nurses to adopt in the hospital. Discuss the process you would apply to determine whether the procedure falls within the RN scope of practice and how you would go about introducing the new procedure with physicians and fellow nurses. The nurses should take a systematic approach when it comes to investigating a new procedure. When investigating a new procedure my main goal will be to identify the benefits and risks of this procedure if it is done by the nurses. To investigate a new procedure I will assess the procedure to find out if the new procedure comes under nurse’s scope of practice. I would contact the state board of nursing to get their advice and I will gather the information from ANA to follow guidelines provided by them. Then my next step will be to find out if the hospital policy allows the nurse to carry out the new procedure. If it comes under the nurse’s scope of practice and the hospital policy allows the nurse to carry out the new procedure the next step is to find out if the nurses can do the procedure safely after adequate training. I will collect opinions from fellow nurses about their thoughts on us adopting a new procedure. If the nurses are confident to do the procedure I will have them demonstrate the procedure. After this I will contact the administrator and doctors to organize a mandatory meeting with the nurse so the nurse can clear their doubts. I will make sure all the...
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...(2014). Essential principles: tracheostomy care in the adult patient. Nursing In Critical Care, 19(2), 63-72 10p. doi:10.1111/nicc.12076 Kalb, K. A., O'Conner-Von, S. K., Brockway, C., Rierson, C. L., & Sendelbach, S. (2015). Evidence-Based Teaching Practice in Nursing Education: Faculty Perspectives and Practices. Nursing Education Perspectives, 36(4), 212-219. doi:10.5480/14-1472 Lewis, Sharon, Shannon Dirksen, Margaret Heitkemper, Linda Bucher. Medical-Surgical Nursing: Assessment and Management of Clinical Problems, 9th Edition. Mosby, 2014. VitalBook file. Nance-Floyd, Betty MSN/Ed, RN, CNE. Tracheostomy Care: An Evidence Based Guide to Suctioning and Dressing Changes. July 2011. Retrieved 10/31/15. Paul, F. (2010). Tracheostomy care and management in general wards and community settings: literature review. Nursing In Critical Care, 15(2), 76-85 10p. doi:10.1111/j.1478-5153.2010.00386.x Potter, Patricia, Anne Perry, Patricia Stockert, Amy Hall. Fundamentals of Nursing, 8th Edition. Mosby, 2013. VitalBook file. Santa Clara Valley Medical Center. (2015). Tracheostomy Tube: Care and Suctioning. Retrieved 10/28/15. Santa Clara Valley Medical Center (2010). Suctioning An Artificial Airway Endotracheal Tube Or Tracheostomy Tube”. Retrieved...
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...There is an increasingly high demand for students going into nursing careers in our society, but there are also varying educational pathways for these students to get into these careers. Are the three educational pathways (Diploma, Associate Degree, and Baccalaureate Degree) preparing prospective nurses to be at the same competency level after schooling? Advancement in education has become an increasingly important topic amongst health care organizations. Educational preparation can indeed affect nursing care and the decision making of nurses. In this paper, an analysis of nursing history and the degree programs themselves will provide evidence of an increased level of patient care by BSN nurses vs. ADN nurses. In order to get a better understanding of nursing and the importance of education we need to first have insight into how nursing began. There was very little education and no attention paid to quality in the early nursing years. Through the dedication and work of people such as Florence Nightingale who pioneered early health care reform and education, we saw nursing go from a profession with little respect to becoming what is known as modern nursing. With the introduction of the American Nurses Association the profession advanced further by introducing formal training programs, advanced degrees and licensing of nurses. The first type of formal education offered was the diploma nurse. It was a three year program that was hospital based and many times the students...
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...Surgery I retrieved this article from The Online Journal of Issues in Nursing (OJIN) because it provides articles that are relevant to nursing. In the article, the authors stated that the prevalence obesity is rising in the United States. Individuals are considered overweight if their body mass index (BMI) is at or higher than 25 kg/m2. Approximately 33.3% of men, 35.3% of women, 17% of children were obese in 2005-2006. Obesity is associated with the chronic illnesses in the following: heart disease, hypertension, sleep apnea, degenerative joint disease, gastroesophageal reflex disease, asthma, and depression (cite). Surgery is an appropriate option for controlling obesity “for people who have a BMI > 40 or BMI > 35...
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...Running head: HOW TO INSERT AN IV 1 How to Insert an IV Neethu Vijayan C0628760 November 24, 2014 The main purpose of this report is to provide adequate instructions to the first year RPN students about the procedure of inserting IV. This instruction will help them to administer fluids, blood products, and medications directly into a patient's bloodstream via a small tube. They should have the theoretical knowledge of injection procedure and how to access the vein. These instructions will be taught in clinical lab. HOW TO INSERT AN IV As a nursing student, it is important to know how to insert an IV in order to...
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...The Benefits of Technology in Nursing and Healthcare Abstract This paper explores nursing informatics and technology in the emergency department of a local level 1 trauma center. The references cited provide discussion and statistics on several types of nursing informatics utilized today by this facility, including benefits and shortcomings. Personal experience from the author are also incorporated as he witnessed first hand the nursing informatics and technology “explosion” and how this facility incorporated this technology into their daily nursing care over the past 15 years. In 1995 I acquired a job as a nurse’s aid at the hospital I am currently employed. At the time, they were just introducing computers at the nurse’s stations. It was used primarily for their first generation of Computer-Assisted Physician Order Entry (CAPOE). With exception to limited order entry, all the documentation was still placed on paper charting. Difficulties I encountered first hand included tracking down the chart while other staff members had possession of it. It made charting in a timely fashion almost impossible, and I often found myself charting late entries. Today I am a Certified Emergency Nurse in the Emergency Department of LVHN. In the grand scheme of things, 15 years is relatively a short time, yet the advances in technology I have been witness to are sometimes overwhelming. “Informatics is a field that’s evolving every day, and there’s much to learn” (Abbott...
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...Urinary Catheterization in Nursing Research task 2 RN to BSN Feb 25th, 2016 Western Governors University The current procedure that is being performed in my facility for the insertion of a urine catheter with one licensed professional is as follows: Introducing yourself to the patient, wash your hands, identify the patient by date of birth and first and last name, and informing them of the procedure that is about to take place. The patient lays down in a supine position and legs are spread apart. After opening the kit the sterile gloves are placed on. One hand is placed on the genital area which no is longer sterile, the other hand is used to clean the area with the provided swabs in the sterile box. The urethral area is swabbed three times from the center of the urethral outward. Once cleaned the catheter is then lubricated and placed inside the urinary tract until you see the return of urine. Once you see the return, the balloon is inflated in order to hold the catheter in place. A secure clip is attached to the patient’s leg and bag is hung below the level of the bladder. The current process that is being performed in the facility is a procedure that has been used for the past 50 years but just recently the infection rate has increased drastically that it needs to be changed. An article that was published in Infection Control & Hospital Epidemiology discusses how aseptic techniques were unsuccessful many times. “A total of 81 insertion attempts among...
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...Grand Theory Nursing theory is determined by a combination of ideas, explanations, relationships, and premise developed by nurses to describe nursing care and practices (Application Theory, 2012). Nursing theories provide knowledge and direction towards the guidelines of how to improve and perfect nursing care (Application Theory, 2012). There are three categories of nursing theories: grand theories, middle-range theories and situation-specific theories (Meleis, 2012). Grand theories focus on a wide range of “experiences, observations, insights, and research findings” (Meleis, 2012, p. 33). These theories are developed over many years of practice and study and are not subjected to empirical testing (Meleis, 2012). Middle range theories have a more limited focus and concentrate on more of a specialized situation in the nursing practice so they are subject to empirical testing (Meleis, 2012). Situation-specific theories concentrate on a specific situation and are limited to that subject matter (Meleis, 2012). The intention of this paper is to explore grand theories. Grand theories are divided into four sub-groups: needs, interaction, outcome and caring (Meleis, 2012). Some of the issues grand theorists concentrate on include the development of the patient to nurse relationship, a patient’s ability to adapt to environmental challenges, and self care deficits (Smith & Parker, 2010). To provide more insight into the specifics of grand theory, 4 theorists were...
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