...The University of Alabama Capstone College of Nursing NUR 522: Organizational Assessments for Clinical Nurse Leaders Fall, 2010 Tanner Medical Center's ICU Organizational Assessment Tanner Health System is a nonprofit regional health system serving a nine county area of West Georgia and East Alabama. Tanner facilities include: a 202-bed acute care Tanner Medical Center/Carrollton, a 40-bed acute care Tanner Medical Center/Villa Rica, a 25-bed critical access Higgins General Hospital in Bremen, and a 52-bed behavioral health facility Willow Brooke in Villa Rica (Retrieved from http://www.tanner.org) The micro system that I am going to describe consists of the Intensive Care Unit (ICU) located in Carrollton, Georgia. The purpose of this paper is to describe the current microsystem in the ICU and how Clinical Nurse Leader can help the ICU can run more efficiently. The critical care department is composed of a joint eight bed intensive care unit (ICU) and a four bed coronary care unit (CCU) in a horse shoe design. Because Tanner’s provides highly complex medical care requiring precision, synchronization, and coordination of multiple services and personnel, the ICU functions as a closed unit that is self sufficiently ran. Because we are a closed unit, our nursing staff is required to take 36 hours of call every 6 weeks and work every other weekend. The nurse to patient ratio is 2:1. Patients that require more intense focused care have a 1:1 nurse to patient ratio. Illnesses...
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...PRACTICUM EXPERIENCE 1 Nursing 740 Practicum Experience Ginger VanDenBerg Ferris State University PRACTICUM EXPERIENCE Abstract 2 Orienting to the role of an academic nurse educator is a dynamic and challenging process. While engaging in this role with a preceptor, this novice nurse educator was guided by the core competencies developed by the National League for Nursing to teach Bachelor’s of Science in Nursing (BSN) degree students. Utilizing teaching, assessment, and evaluation strategies learned throughout the Master’s in Nursing Science program, this educator developed a didactic presentation on building cultural competence for Health Assessment nursing students, demonstrated and assisted in the development of essential skills to conduct an adult physical examination, and coordinated a perioperative clinical rotation for senior level nursing students. This practicum experience has played a pivotal role in strengthening this novice educator’s ability to assist students in identifying their learning needs, strengths, and limitations, while providing opportunity to experience the teaching-learning environment of the academic arena. Keywords: nursing students, learning, practicum learning, nurse educator PRACTICUM EXPERIENCE Nursing 740 Practicum Experience New nurse educators transforming into their new role often discover they are not as prepared as they would hope to be (Poindexter, 2008). Being an experienced or expert nurse is not sufficient to assume...
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...REDUCE WITH FOAM DRESSING Sacrum Pressure Ulcer Reduce With Strict Use of Foam Dressing Chamberlain School of Nursing Penni-Lynn Rolen NR 451 Capstone Course Sacrum Pressure Ulcer Reduce With Strict Use of Foam Dressing Despite advancement of technology, pressure ulcer continues to be a primordial in the health care system. Prevention of pressure ulcer remains an important issue in the health care facility. The critically ill ICU patient is the main target of this disease. Prevention remains the key for this problem. Some facility have standard policy for the eradication of pressure ulcer However the question is will the sacrum pressure ulcer formation be reduced in adult critically ill clients in the ICU by implementation of strict use of foam dressing? Reviews of evidenced base article, and foam dressing trail will turn on the light. Contribution to the Future of Healthcare According to recent literature and research, pressure ulcer remains one of the problems confronted by hospitals and other health care facilities around the countries. Intensive care patients are the largest group of patients who end up with pressure ulcer during their stay in hospitals. Taking care of patients with pressure ulcer consume a large part of hospitals budget. Prevention of pressure ulcer is not only the job of bedside nurses, but also the responsibilities of nurse educators as well as administrators. Prevention of pressure ulcer will contribute to the future of healthcare by allow hospitals...
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...Prevention of Hospital Readmissions Related to Symptoms of Congestive Heart Failure NRS 441V Professional Capstone March 1, 2014 Abstract Providing patients diagnosed with Congestive Heart Failure effective teaching can eliminate reoccurring hospitalizations. Patients are discharged with CHF and readmitted within 30 days. The information provided will examine the process of enhancing patient knowledge and provide additional resources essential for effective health care management. Research evidence provides data that proves patients who are diagnosed with CHF needs a variety of health care needs during admission and after discharge. The proposal will display an evaluation plan, implementation plan and a dissemination of the evidence. Provide at least 1 evidence based literature; for at least 1 evidence based solution. Keywords: congestive heart failure, therapy, education, patient outcomes Description of the Problem Prevention of Hospital Readmissions Related to Symptoms of Congestive Heart Failure Health care providers must ensure skills, knowledge and teaching is effective when providing care to their patients and families about symptoms of CHF. The length of stay for an average hospital visit can be two days however, for more chronic issues warrant an even longer stay. To avoid readmission of the disease processes of CHF warrants additional care and resources during and after discharge. . Some patients cannot follow up with their primary care physician because...
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...51. Enhancing Patient Safety in Nursing Education Through Patient Simulation Carol Fowler Durham, Kathryn R. Alden Background The alarming rise in morbidity and mortality among hospitalized patients throughout the United States heightens concerns about professional competency.1 Nurses and other health care professionals are under increased scrutiny to provide safe, effective care. Likewise, nursing education programs are faced with increased pressure to produce graduates who are capable of providing safe patient care. Toward that end, nursing education programs develop curricula, hire qualified faculty, and select learning experiences for students in an effort to train and graduate competent, effective nurses. The instructional strategies utilized in both didactic and clinical components of nursing education courses are highly influential in determining critical thinking and clinical decisionmaking ability as well as in developing the psychomotor skill performance of new graduates. Of course, it is unrealistic to think that graduates of nursing education programs have received all the training they need when they depart the doors of academia. Orientation programs for new graduates and continuing education for nurses are essential tools to help practitioners improve their knowledge, skills, and expertise so that quality patient care is provided and outcomes are optimized while errors are minimized. Ongoing evaluation of nursing competence is necessary to promote...
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...the pertinent facilities. The solution is to have interprofessional collaboration. The utilization of current advanced practice nursing staff as a resource for floor nurses and other involved healthcare workers is a must. This would obtain certification in wound care and be responsible for the ongoing continued education for wound prevention, monitoring and maintenance. The staff will be educated and trained at quarterly intervals on wound identification, staging, prevention, maintenance and monitoring. Key words: wound care, evaluation, pressure ulcers, multidisciplinary, specialist, evidence The Significance of Having a Multidisciplinary Team 4 Problem Identified The Centers for Medicare & Medicaid Services (CMS) declared in October of 2008 that it will no longer provide reimbursement for hospital acquired pressure ulcers (HAPUs) because it is a preventable occurrence (CMS, 2014). Even though the percentages of occurrences have declined since then, HAPUs continue to cause financial strain on institutions (estimated $9.1- $11.6 billion dollars loss annually) (Leaf Healthcare Inc., 2014). Nurses are in a position to decrease these numbers but barriers remain. Staff nurses in acute care settings, as well as hospital based transitional units provide care for patients with multiple diagnoses. These nurses are required to identify potential risk factors and put in place preventative measures. Wound prevention remains one of the top...
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...Running head: DOES SHARED GOVERNANCE IMPROVE NURSING RETENTION? Does Shared 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...
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...Design for Change in Practice Dustin Ashenfelter Chamberlain College of Nursing Capstone in Nursing NR 451 Professor Linda Fry Winter 2011 Design for Change in Practice The increasing prevalence of Hospital Acquired Pressure Ulcers (HAPU) is a problem that is plaguing hospital’s across the nation. The estimated added expense in managing a single full thickness pressure ulcer can be as high as $70,000.00, and the total cost to hospitals across the nation could be as high as $11 billion/year (Lynch & Vickery, 2010). Initial identification of at risk patients has been one of the keys to successfully reducing stage 3 and 4 reported pressure ulcers. The Braden scale for predicting pressure sore risk is a universally accepted tool used to help nurses identify patients who are at risk of developing pressure ulcers. The scale evaluates each patient in the following six areas exposure to moisture, sensory perception, activity, and ability to change positions, nutrition, and exposure to shear (Rosenfeld, 2010). The identification of unit specific champions is a key strategy for the continued reduction of the prevalence of pressure ulcers. These leaders on the units serve as the educators for the remaining staff on the unit. These champions would be part of a multidisciplinary team, which reviews all new research, assistive devices, and evidence-based practice concerning the treatment and prevention of pressure ulcers. The multidisciplinary team would focus on key...
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...RN-BSN Capstone Proposal The Attitudes and Barriers of Nurses towards Pressure Ulcers in Long Term Care Facilities that Hinders Prevention & Treatment Takoya Walker College of Costal Georgia Introduction and Background Pressure ulcers (PUs) have post a problem to healthcare for thousands of years. Since at least the 1980s, pressure ulcers have been considered a result of poor quality of care (Lyder & Ayello, 2012). In response to the Institute of Medicine’s landmark report To Err is Human: Building a Safer Health System, the National Quality Forum designated hospital-acquired Stage III or Stage IV PUs as “never events” (considered avoidable health care incidents) (Agency for Healthcare Research and Quality [AHRQ], 2012). Since 2008, the Centers for Medicare & Medicaid Services no longer reimburse providers for treatment of facility acquired Stage III or Stage IV PUs. Populations at risk for PU development include older adults, patients with dementia, and any person with conditions of immobility (Ratliff, Tomaselli, & The Guideline Task Force, 2010). Because an older adult is more likely than a younger person to have impaired mobility and co-morbid health conditions, elders are especially vulnerable for PU development. This is of particular concern given the large population of these individuals in our nursing home facilities. In 1992, the AHRQ developed early guidelines for preventing pressure ulcers. In general, prevention guidelines...
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...Reduction of Nosocomial Wounds Phillip Cook American Sentinel University Hospital acquired wounds or nosocomial wounds have been a problem to the health systems across America for some time. They can be caused by several factors such as pressure, friction, or shear. In 2008, The Centers for Medicaid and Medicare (CMS) began withholding payment for hospital acquired conditions such as pressure ulcers ("Centers for Medicare," 2012). Hospitals have placed a priority on identifying those patients that are high risk for nosocomial wounds as well as protocols for preventing the wounds. Background of the Project Nosocomial wounds are a possibility for any patient that is admitted to the hospital. Patients are admitted to hospitals in various physical conditions and nosocomial wounds are caused by several factors. According to the Mayo Clinic (Mayo Clinic staff, 2011), nosocomial wounds are a result of pressure on the skin that inhibits the blood flow to skin and underlying tissues. This may come as a result of different problems such as: 1. Sustained pressure from the skim being trapped between a boney prominence and a surface such as a wheelchair or a bed. 2. Friction from moist skin being pulled across a surface 3. Shear from two surfaces moving in the opposite direction such as the bed and the patient. This movement damages the tissue making it more vulnerable to sustained pressure. Add to this the compromised nutritional status of the patients and...
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...Capstone Project Abstract Background Hand washing and hand hygiene are consider to be the number one, cheap essential measure of preventing and controlling spread of hospital acquired infections (HAIs). Hand washing and hygiene can significantly reduce the burden of disease, in particular in hospitalized patient Unfortunately compliance to hand hygiene recommended standard procedures by the health care workers (HCWs) has been unacceptably poor. In order to design education program, identification of several risk factors associated with poor hand hygiene (HH) compliance is of extreme importance. Objective: The purpose of this study is to implement a hand hygiene program for increase compliance with hand hygiene among health care worker in 97 beds hospital. The key target for compliance to HH is not only health-care workers but also policy-makers and organizational leaders and managers. Methods.: Compliance to hand hygiene will be evaluated through direct observation of HCWs ,to helps pinpoint areas of strength or weaknesses in HH behavior, so as to develop training program that will help HCWs to complaint with HH . Evaluation will be based on direct observation and survey audit, observing the HCWs during routine patient care to ensure that hands hygiene are performed before and after getting in contact with patient and patient environment. In addition, survey audit based on the HCWs perception, knowledge and attitude...
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... Of Social Issues, 8(4), 16-30. 2. Dr Elyse R. Pork PhD from, Massachusetts General Hospital/Harvard Medical School, Boston, MA, (2006) 3. http://xculture.org/why-cultural-competency 4. Used: Schwartz, M. C. (1978). Helping the worker with counter-transference. Social Work, 23(3), 204. 5. Cultural Competence in Psychosocial and Psychiatric Care: A Critical Perspective with Reference to Research and Clinical Experiences in California, US and in Germany. Social Work In Health Care, 39(3-4), 231-247. doi:10.1300/J010v39n03_ 6. Used:Easterby, L. M., Siebert, B., Woodfield, C. J., Holloway, K., Gilbert, P., Zoucha, R., & Turk, M. W. (2012). A Transcultural Immersion Experience: Implications for Nursing Education. ABNF Journal, 23(4), 81-84 What are the...
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...2012 Catalog Volume 20 Issue 1 March 5, 2012 – December 31, 2012 This Catalog contains information, policies, procedures, regulations and requirements that were correct at the time of publication and are subject to the terms and conditions of the Enrollment Agreement entered into between the Student and ECPI University. In keeping with the educational mission of the University, the information, policies, procedures, regulations and requirements contained herein are continually being reviewed, changed and updated. Consequently, this document cannot be considered binding. Students are responsible for keeping informed of official policies and meeting all relevant requirements. When required changes to the Catalog occur, they will be communicated through catalog inserts and other means until a revised edition of the Catalog is published. The policies in this Catalog have been approved under the authority of the ECPI University Board of Trustees and, therefore, constitute official University policy. Students should become familiar with the policies in this Catalog. These policies outline both student rights and student responsibilities. The University reserves the right and authority at any time to alter any or all of the statements contained herein, to modify the requirements for admission and graduation, to change or discontinue programs of study, to amend any regulation or policy affecting the student body, to increase tuition and fees, to deny admission, to revoke an offer...
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...OFFICIAL CATALOG This Catalog contains information, policies, procedures, regulations and requirements that were correct at the time of publication and are subject to the terms and conditions of the Enrollment Agreement entered into between the Student and ECPI University. In keeping with the educational mission of the University, the information, policies, procedures, regulations and requirements contained herein are continually being reviewed, changed and updated. Consequently, this document cannot be considered binding. Students are responsible for keeping informed of official policies and meeting all relevant requirements. When required changes to the Catalog occur, they will be communicated through catalog inserts and other means until a revised edition of the Catalog is published. The policies in this Catalog have been approved under the authority of the ECPI University Board of Trustees and, therefore, constitute official University policy. Students should become familiar with the policies in this Catalog. These policies outline both student rights and student responsibilities. The University reserves the right and authority at any time to alter any or all of the statements contained herein, to modify the requirements for admission and graduation, to change or discontinue programs of study, to amend any regulation or policy affecting the student body, to increase tuition and fees, to deny admission, to revoke an offer of admission and to dismiss from the...
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...Pagination and Page Header: See APA p. 288. Use the “header and footer feature” in Microsoft Word. See Appendix A for directions. APA Writing Style 1 APA requires a Running Head for publication. See APA, p. 296, section 5.15. The title is in upper and lowercase letters, centered between the left and right margins and positioned in the upper half of the page (See APA, p. 296) An example is available on p. 306 (please note the example has different requirements, this is only to be used for illustration of where to begin the title) APA Writing Style and Mechanics Student Name University of Phoenix Include Course Number and Title for the course in which you are enrolled. GEN/300: Skills for Professional Development Faculty Name and Title February 18, 2004 UOP REQUIRED TITLE PAGE Centered on the page (as shown above), include in this order: • Title of Paper (Mixed upper and lower case letters; centered, see APA p. 296) • Your Name (first and last, do not include academic or license information, i.e., BSN, RN) • University of Phoenix • Course Number and Course Title • Facilitator’s Name and Title (first and last, with academic title, i.e., MSN, MBA, PhD) • Date Submitted **All lines are double-spaced (no single or triple-spacing) throughout the entire document. The standards outlined in this sample paper are within APA guidelines; however, your instructor may have additional requirements. APA Writing Style APA does not permit use of the word “Introduction”...
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