...Practice Standards Pathway Practice Standards are based upon expert nurse input, nursing literature and research that supports the qualities of a positive practice environment. All 12 standards apply to health care organizations and long term care institutions. Additional standards apply to the long term care environment. 1. Nurses Control the Practice of Nursing A shared governance model centers a healthy work environment for nurses. RNs directly involved in decisions that affect nursing practice with demonstrated autonomy and responsibility experience higher job satisfaction and contribute to improved quality of care and safety for patients. 3, 10, 11, 15 2. The Work Environment is Safe and Healthy An environment where safety is paramount for both nurses and patients is essential to the delivery of quality nursing practice. Studies indicate that work environments with a culture of safety demonstrate a reduction in work-related injuries. 16, 25 A supportive work environment that encourages the health and well-being of staff is also essential. 3. Systems Are in Place to Address Patient Care & Practice Concerns Pathway-designated organizations provide dispute mechanisms to address patient care and practice concerns without retribution. Silence and poor communication lead to patient safety issues and reduced job satisfaction. 2, 20 In 2009, the Joint Commission recognized implemented a standard to address conflict-and-dispute resolution in health care.17...
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...Honesty/Ethics in Professions, nurses rated #1 as the most honest and ethical professionals. There are multiple pathways to follow to become a nurse. The two main pathways is by acquiring an associate degree (ADN) or a baccalaureate degree (BSN) in Nursing. But regardless of what nursing degree you have, to become a registered nurse you will need to challenge the same licensure examination, the NCLEX. Due to its practical and economic advantages, ADN programs nationwide yielded the most nurses (Raines & Taglaireni, 2008). But now that there are plenty of nurses around, there is push to hire nurses with a higher level of education. By comparing the competencies, preparations and advantages made for both degrees, we can explore how earning a higher education will lead to better patient outcome and job satisfaction. The severe shortage of nurses post-WWII enabled the creation of Associate Degrees in Nursing (ADN). To mitigate the shortage in nursing, a nurse educator, Mildred Montag, designed these 2-year programs (Casavant Telford, J & Keeling, A, 2011, p. 14). ADN programs supplied nurses who had the basic level of education and training to safely care for patients. ADN programs are typically offered at community colleges and are affordable and efficient ways to fill the need for more nurses. Although ADN nurses have the same license, Mildred Montag intended for nurses with associate degrees to work under the supervision of baccalaureate prepared nurses (Creasia, J & Reid, K, 2011...
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...Case Study II | NABH awareness and Work Satisfaction at Apex Hospital, Jaipur (Raj.) | Submitted by - Puneet K Jain III Sem MBA-HHC SIHS, Pune puneetkjain@ymail.com | A Case Study On NABH standard Awareness and Work Satisfaction at Apex Hospital, Jaipur Purpose - Accreditation has become major tool for any hospital to create its brand image in today’s competitive market. Main objectives of getting NABH are providing patients’ safety and quality of medical care to its end users i.e. patients. Purpose of this study is to measure awareness standards of NABH and accreditation to its staff so gap can be bridge, if any, with additional inputs and it becomes easy to include get accreditation(s). Field of research – Apex Hospital is a multi-specialty, 152 bed, state-of-art medical center, boasting of a clean and patient friendly environment, internationally trained clinical & managerial team driven with skilled expertise, high morale, and patient focused care. Established in year 1994, Apex became one of the first institutes in India to attain ISO 9001 under the leadership of the Managing Director, Dr S.B. Jhawar. From 1994, Over the next few years, the hospital gained momentum by leaps and bounds as an impressive team of well-known doctors joined in. | | Hospital is growing with...
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...workplace is changing rapidly everyday and with it we must actively participate and voice our concerns to be heard. Becoming proactive in discovering and implementing new ideas whether it is at the management or organizational level, political level or at the patient’s bedside, we must unite and work as a team to excel to the next level. To promote change it takes a strong leader with creative ideas to make a difference. Anyone can be a leader but that does not mean people will follow. We must actively voice our concerns and opinions at meetings, advisory committees and to the boards where policy decisions are made. Nurses were not seen as leaders in the past but we must continue to change that. Creating new partnerships with physicians, clinicians, business owners, elected officials and the public will help them realize these improvements. Changing our roles as nurses has been an effective organizational tool to improve how we improve and place a greater emphasis on health care. According to the Institute of Medicine (IOM), they have demonstrated many changes that have impacted the medical profession. The Geisinger Health System which was...
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...challenge is needed. All healthcare organizations experience transformational change. In the end, transformational change is an approach to better the organization and can create an evolving pathway in learning. In this paper I will discuss two studies of how transformational changes can create learning in organizations. In the first study with the “Transformational Leadership and Shared Governance” article, the problems that lead to the need for change was that the new healthcare reform disempowered the nurses position within the organization. This was caused by the use of the economic model. In this model, nurses were purchased as a product to be purchased rather than a service to be provided (Bamford-Wade, A., et al 2010). The various stakeholders that were affected were the nurses, other employees, patients, hospitals and providers. This process took six years to complete. Some financial resources that were allocated during the change were that most of the money was spent on the unnecessary needs. Since the nurses were unhappy with their jobs, a lot of money was spent on trainings for new nurse managers. This caused the staff nurses to work in an unstable environment. Also with the new market/economic model this caused a gap in understanding between the business staff and the medical staff. Nurses began to have to report to both business managers and the medical managers. The transformational change was completed by using the 4 I’s which are: idealization and influence; inspirational...
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...Standardization of Nursing Protocol for Cardiac Arterial Bypass Patients Abstract Evidence-Based Practice (EBP) is an important factor in determining medical courses of action. Nurses have long used tradition rather than evidence in making decisions about beside care; to convince them to switch practice, it is useful to draw a comparison between the efficacy of these disparate routes. Our study designed a research question based on the PICOT model for the cardiac floors and designed procedures using the Kotter and Cohen’s Model of Change. In order to study the effect discussed in our PICOT question, a web search was conducted and the quality of each pertinent study reviewed. Introduction In the nursing staff of an adult Cardiac Surgical Care unit, how does the buy-in from the staff for Evidence-Based Practice (EBP) changes in a new Coronary Arterial Bypass Graft (CABG) pathway affect the decreases in infection rate among this patient population when compared to the old way of delivering patient care through nursing tradition in a six month time frame? The formation of a guideline for practice in nursing is not a new occurrence; books and manuals have been a reality for many years. However, in the past these resources lacked the evidence for standards of care, which traditionally have been based on professional consensus and tradition. The Joint Commission has recognized processes that can be measured regarding patient outcomes and care in order to meet standards for Medicare...
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...Medicine (IOM) report: The Future of Nursing: Leading Change, Advancing Health. This paper will also discuss how the author will alter personal practice to meet the goals of the IOM report. Education Advancement The Need for Advancement Since its inauguration nursing education has progressed and reformed to meet the needs of the client and the health care delivery system of the time. Issues in health care have influenced the role of education in preparing nurses to deliver safe and effective care and advocate for their patients. Nursing shortages have prompted multiple levels of education for entry level nurses. There are three pathways that have existed for nurses to become an RN. The Bachelor of Science in nursing (BSN), the associate degree in nursing (ADN), and the diploma in nursing. There is also another undergraduate level of nursing for prospective nurses to pursue, the licensed practical/vocational diploma in nursing (LPN/LVN). The LPN/LVN play a crucial role in long term care and nursing homes. The most popular pathway of...
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...Over the last decade, healthcare has evolved and nursing practice has become broader requiring the need for baccalaureate degree in nursing as the minimal standard for Registered Nurse (RN) license. Although also accepted, the associate’s degree in nursing is granted at the technical level rather than at the professional level. (ANA, 1965). In this paper I would like to discuss the differences in competencies between nurses that have been prepared at a BSN vs ADN level of nursing. In addition I would like to discuss a situation in which patient-care shows approaches and decision-making and care based on educational preparation of a BSN RN versus a diploma or ADN degree nurse. Many studies have been done in Nursing Education. The research is based on today's Nursing preparedness. There are three different pathways to reach a Registered Nurse degree. All three pathways 1) Diploma nursing, 2) An associate's degree in nursing, and 3) A bachelor's degree in nursing are required to pass the NCLEX licensing examination. The NCLEX stands for National Council licensure examination. This test is geared for the minimal entry level of competency that is required. Associates Degree Nursing: To achieve this degree from start to completion usually takes 2 to 3 years within the community college or some technical school where the students at the end of their graduation may challenge the NCLEX-RN examination. The associate degree in nursing was first started in the 1960s in the United States...
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...INTRODUCTION I am a 43 year old mother of two teenage daughters and have been taking stock of what I have achieved and where my career may take me. Hence my partaking in this module to assist the journey I hope to pursue. I have been working in my current position as a band 5 registered nurse for 6 years since I completed a returned to nursing course in September 2005 facilitated by the trust where I am now employed on a full time basis. I have enclosed a current job description at Appendix 1 (attached). For the purpose of this study I have chosen to reflect on 3 learning events that have impacted on me to provide positive outcomes and enrich my working practice. Within the main body of the study I will expand on each individual learning experience based on Gibbs’ cycle of reflection (1988) combined with influence from Johns’ cycle of reflection (1994). See Appendix 2 - 2a (attached). I have chosen to incorporate Gibbs model of reflection as I feel it is quite straight forward and clearly outlines a framework to help me logically describe the event, discuss feelings, evaluate the experience and how it impacted on me and my practice. It leads to a final conclusion with considerations for improvement that I will refer to as my action plan. I have incorporated aspects of Johns’ model of reflection as it quite usefully prompts more detailed consideration of the processes of analysing a situation e.g. influencing factors within an experience. I will explore the implications...
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...Nurse Practitioner “To accomplish great things, you must not only act, but also dream, not only plan, but also believe”. The nursing field is one that has very different types of work associated with it. For instance, there are many types of nurses. Some may work in the emergency room, regular hospital, and or they could work in a doctor's office depending on their degree. I chose this career because it will give me the opportunity to broaden my social skills and it will allow me to show the care I have for others. Also, it guaranteed that there will always be a position open for a nurse. To anyone who does not know, a nurse practitioner is a nurse who is qualified to treat certain medical conditions without the direct supervision of a doctor....
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...This plan will be illustrating the care pathway for the 2 physiological disorders and the roles of the practitioners involved. The two physiological disorders are eczema and nephrotic syndrome. The practitioners involved in eczema are the GP and pharmacist. General Practitioners (GP): GPs look after the health of people in the local community and deal with a wide range of health problems. They take into account physical, emotional and social factors when diagnosing treatment and recommending the required treatment (AGGAS, 2013). If a GP is unable to deal with a problem themselves, the usually refer the patient to a hospital for tests, treatment, or to see a consultant with specialist knowledge (NHS Choices, 2013). For example in eczema, if the GP sees that the condition is not getting any better, or is worsening, the will refer the patient to see a dermatologist. Also, they assess, plan, implement and monitor the progress and response to treatment; and provide advice and counselling to the patients (AGGAS, 2013). Goal/Objective Completion Date Action to be taken To identify the physiological disorder Immediately 1) Baseline assessment i.e. medical history to identify clinical background and to identify and themes, patterns etc. 2) Assess baseline measurements: pulse and respiration; and observe the affected area i.e. inner elbows. 3) Confirm diagnosis and identify any potential allergies. To successful control the disorder On-going 1) Prescribe mediation i.e. 2) Refer...
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...you to sit and take the (NCLEX-RN) which is the National Council Licensure Examination for Registered Nurses. This will be able to get your licensure and work in the healthcare field with your learned educational and clinical skills. In 1952 the Associate Degree in Nursing (ADN) was first begun, during to the nursing shortage. Mildred Montag was creator of the two year associated degree in nursing. The plan for Montag was for Associate degree nurses to work under supervision of the more highly skilled baccalaureate leveled nurses (Creasia & Friberg, 2011, p. 27). This was basically an experiment, for future nurses to practice adequate bedside and technical skills (Egenes, 2010, Chapter 1). The Associate Degree of Nursing is a two year program that is mostly taught in community colleges, that teaches clinical nursing courses and general education. It allows you to work in hospitals and long term health care facilities as a bedside nurse (Creasia & Friberg, 2011, Chapter 2). This is a more affordable nursing degree, and is accomplished in a shorter period of time. You are able to work with your learned skills. This provides a pathway into the nursing practice. With the Associate Degree there are some advantages and disadvantages. Even though you are able to start your healthcare career, much sooner, you are unable to pursue a higher education if you desire in the future. Your job offers are limited due to your limited schooling and...
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...registered nurse at Home Sweet Homes Healthcare, in Clarinda Iowa. A few of her many responsibilities include going to peoples homes to give care that is prescribed by a doctor, medicine review and set up, and wound care shots. A personal and emotional experience that shaped her is what led her to the pathway of nursing school. Megan initially was an Aviation major, with the determination to become a pilot. Little did she know her entire first year of college would be full of indecisiveness. She bounced back and forth between a few majors that caught her interest. When her Uncle was diagnosed with Chronic Obstructive Pulmonary Disease she wanted to help as much as she could. Megan felt as if his assigned Nurse flew...
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...admission assessment experienced during placement. It is not a care study. There will be an overview of the nurse-managers responsibilities during the admission assessment and attention drawn to local and government policy. Particular consideration is given to risk assessment, Essence of Care (DoH 2001) in respect of the Waterlow Pressure Damage Assessment (1985), pressure sores, nutritional screening and delegation. Other issues considered will be communication, partnership working, the therapeutic relationship, and the nurse as an agent of change. Findings will be supported by literature. Identifying factors have been changed to respect patient confidentiality. Mary had no previous psychiatric history. She was eighty-four and lived in residential accommodation. She had two adult daughters who were unable to attend Mary’s admission. Prior to admission Mary’s behaviour had changed over several weeks and she had been refusing to get out of bed during the day. During admission she showed occasional signs of confusion but was able to give consent. Physically, Mary was in a wheelchair, had a history of falls, pressure damage, skin flaps. and needed full assistance with mobility. My mentor facilitated her admission assessment. I observed this in preparation of undertaking future ones myself whilst under supervision. From a management perspective my mentor who was the senior nurse needed to consider who would be left on the ward whilst he and I did the admission. He needed to consider...
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...Solutions: Nurses Can Make a Difference Can Nurses make a difference in reducing health disparities? I believe we can make a big difference, Nurses can work with communities in a “grassroots” type movement to bring attention to the gravity of the inequities built into our current healthcare system. Healthcare is first and foremost about people, and care should be directed by the needs of the people it serves. Secondly, caring is foundational to nursing and this is a concept must be deeply woven throughout all points of health care. The third aspect is the vast pit of inequalities in healthcare; the injustices, denial of treatment and quality healthcare to minorities and the disadvantaged poor. Nurses are known patients advocates, therefore nurses are well equipped, to become leaders, in constructing equitable changes in the system and improve the model of care. Nurses are well- appointed in their understanding, negotiating skills, knowledge of healthcare and patient centered care, to provide guidance and direction to implement meaningful changes. Research in health disparities has identified, that the U.S is burdened by huge social and economic inequalities; it identifies, discrimination, social status, income inequality, and policy decisions as the principal causes of health disparities. The nursing profession needs to reconsider its role and its purpose in reducing health disparities, they need to be proactive in establishing, nurse-managed primary...
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