...Improvement in Health Assessment Erin Graham West Texas A&M September 14, 2012 Improvement in Health Assessment A nurse’s role in health assessment has multiple parts to make it complete. An evaluation of a person’s health status consists of obtaining a full health history as well as a physical examination. The nurse must incorporate the use of inspection, palpation, percussion and auscultation when performing a health assessment, all which are skills learned throughout the nursing education we obtained. However, we all need to improve on certain things in our practice. After reading the assigned chapters for this week and evaluating myself as a nurse, two keys things stood out in my practice that could use some improvement. The way I listen to my patients is the first item of improvement. I have always felt confident in the way I approach someone and the way I react when I am approached about the health issues of my patients, but as I think back to the many experiences I have had as a nurse, I recognize that the way I listen to some of them is not done to the best of my ability. I have many times found myself jumping into the conversation before I have heard everything that needs to be said by the patient, therefore leading to my own back tracking of given information. I need to improve the way I listen, by first, hearing the whole topic of concern or question and then proceeding to give my help through my response. The area of nursing I work in comes...
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...what it is today. It helps to guide how patients are taken care of, how assessments are done and the health education that it is provided to the community and patients (Edelman & Mandle, 2010). Nurses are responsible for viewing patients as a whole rather than as just an illness. Holistic nursing provides a context for the patient’s environment to be included in the plan of care. By including all aspects of a person in an assessment, the nurse is promoting patterns of vigor which, in turn, support beneficial patterns of health behaviors (Edelman & Mandle, 2010). Without the keys of health promotion, nursing would not have the guidelines needed to provide excellent and individualized patient care. Nursing plays a key role in health promotion throughout various health care settings through key assessments and health education (Edelman & Mandle, 2010). As patients come into the hospital, nurses make the initial and continued assessments to ensure an individual’s motivation and attitude towards lifestyle changes and well-being. Assessments made regarding a person’s cultural and religious preferences are discovered by the nurse to make sure the plan of care is tailored individually. As each plan of care is individualized, the patient will be more willing to take part in the plan of care and required lifestyle changes in order to protect the overall well-being. Nurses are also responsible for proper health education to not only patients, but the community as a whole (Edelman &...
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...benefit of health and that as nurses we are designated to assess and find the self-care deficits and recognize who is needed to be able to perform the action (nursing) for the individual, and this relates to many nursing issues because it basically defines the role of the nurse to the patient in recognition to total care of the patient. And no matter what specialty you are in the main goal is adequate patient care. This paper will discuss a problem that happens far too often in home health. Patients are turned away daily because of assessment. Nurses in leadership positions such as administrators, directors, and admissions nurses are turning away patients because their needs are not expressed well in referrals and discharge / admission assessments. Also, discussed, will be the strategy to fix this problem by using the middle range theory on self-care deficit by Orem. Problem in Nursing Leadership Home Health Care is a very up and coming nursing specialty. Many patients are discharged to home health from the hospital daily. Nursing leaders such as Administrators or Directors are in charge of okaying referrals and sending admission nurses out to do the assessment. After the admission assessment is...
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...Literature Review Patient Education for Post-Hospitalization Home Care Debra Scully Walden University NURS 6010-11 Advancing Nursing through Inquiry and Research April 8, 2012 Patient Education for Post-Hospitalization Home Care Changes in health care delivery brought on by financial constraints have affected the length of stay for certain patient procedures, resulting in an early discharge. Patients discharged from hospitals sooner than anticipated are finding themselves ill prepared, regarding insufficient education and instructions on self-management for home care, post-hospitalization. Patient education in nursing should be a focal priority, yet is often slighted due to time constraints, and lack of staff, preparation and materials. The purpose of this paper is to discuss the importance of sufficient patient education prior to discharge for patients with residual home care. Research on this topic could have beneficial implications for patient satisfaction pertaining to quality education for home care prior to discharge. Evidenced-based research has illustrated that the development of educational tools to aid nursing in providing succinct and pertinent information of discharge criteria has attributed to a rise in patient satisfaction. Considerations for educational materials were preferred language, specificity of patient concerns, and simplicity of educational materials. Summary Contemporary day surgery: patients’ experience of discharge and recovery ...
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...Education on Wound Care for Diabetic Patients Education on Wound Care for Diabetic Patients Abstract Non-compliance of wound care management has increased the risk of infection and amputations. Diabetes wound care management is an important and fundamental aspect when it comes to diabetes teaching and education. Assessment of the feet daily and at a primary care office will provide information such as noncompliance, risks for neuropathy, peripheral vascular disease, macro-vascular disease, and possible amputation. Education provided by health care practitioners to the diabetic population will promote decrease in risk for further complications and the patient to be involved in their own care. Assessment, treatment, and education on wound care management with the involvement of the patient will increase the patient’s quality of life and be very beneficial to both the practitioner and the patient. Keywords: diabetic wound care management, diabetic ulcer care, outpatient diabetes management, diabetic care management Introduction Working in a primary care setting will involve a multitude of disease processes- diabetes mellitus being one of them. Diabetes is a disease that is characterized by high levels of blood glucose with a defect in insulin secretion and cell resistance. Without proper management, diabetes may lead to other issues in health. Examples of such, would be, delay in wound healing, leading to foot ulcerations, which thus increases the risk for amputations...
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...Professional Dynamics NRS-430 V Monica Kidder RN, MSN May 11, 2013 ADN VS BSN: Differences in Competencies The complexity of modern healthcare and the patients of today mandate a higher level of academic preparation than in the past. Advanced critical thinking skills are a must. Nurses need to function independently, making clinical decisions, providing bedside care, case management, education to patient and family in regards to disease process, treatment, and how to adapt to a healthier lifestyle. As healthcare continues to evolve and become more complex, it is necessary to assure proper education has been achieved. Controversy among the nursing profession has existed for many years regarding what is the acceptable minimum education for nursing practice. The ADN program takes 2-3 years to complete. The ADN programs started due to a need for nurses during a nursing shortage brought on by WWII. The ADN program provided a shorter period of time to acquire the necessary minimal skill to obtain licensure, and practice safe entry level nursing without the emphasis on leadership, nursing theory and critical thinking. The focus of ADN programs has been to prepare the nurse with considerable clinical experience and technical nursing tools needed to provide patient care at the bedside (Cresia & Friberg, 2011). They do not have the education to perform research activities which becomes the basis for the nursing care of today, as evidence-based practice. The BSN program takes about 4 years...
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...2 years of education in nursing at a Community college and earned a registered nurse license. On the other hand, Baccalaureate degree nurse is a nurse that completed 4 years of education in nursing known as Baccalaureate-degree at a university or college and also earned a registered nurse license. Associate degree program focuses on the clinical skills and is more task-oriented. It lacks the theory and science behind nursing as a profession. Baccalaureate program is knowledge, theory and research based. It emphasizes the entire field of nursing. The differences in competencies between nurses prepared at the associate degree- level verses the baccalaureate-degree level could be seen in their leadership roles, critical thinking skills, ability to work independently, communication skills, knowledge, problem-solving, assessment, providing care, teaching health promotion, disease prevention, early detection of health deterioration/deviations, prompt and adequate treatment of the human response to acute and chronic illness and compassionate care to those experiencing death. Associate degree RN’s cannot become managers or supervisors, due to their limited education and knowledge. They lack the skill and experience that are required. A baccalaureate degree RN has the opportunity for advancement in their career. They could become nurse anesthetists, nurse practitioners and managers. They have knowledge and leadership skills to inspire others to promote patient-centered care...
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...pediatric patients. Pediatric postoperative pain management has long been overlooked and treated differently than adult pain management. There tend to many misconceptions when it comes to pediatric pain management stemming from the belief that children do not experience pain the same way as adults. Since the pediatric population is not legally allowed to make medical decisions, guardians must make these decisions for them. Postoperative pain in the pediatric patient may be hard to assess and therefore healthcare professionals have begun to involve family members and caregivers in the pain management process. Pain can stem from many sources and thus must be holistic, involve multiple disciplines, provide education and apply to each individual patient. In practice, advocacy for these young children is important in helping them and their families understand about the situation and make education decisions on how to proceed with care. The concept of postoperative pediatric pain management must be analyzed to help resolve these misconceptions and not ignore the population who at times cannot speak for themselves. Review of Literature After a surgical procedure, the pediatric patient will come into contact with many healthcare professionals including nurses, doctors, and psychologists. Each of these disciplines plays a key role in aiding the pediatric patient in the management of their pain. Nursing Discipline Sutters et al. (2007) examined pediatric patients following...
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...EESS (Education and Examination for Social Skill): Medical Students Pre-clinic Education and Assessment System based on "Socio Cultural Community" to face the AEC Jodii Arlan Kurnia1 and Arlinda Silva Prameswari2 1Third Year Medical Student, University of Muhammadiyah Malang (UMM), Indonesia 2Second Year Medical Student, University of Muhammadiyah Malang (UMM), Indonesia Abstract Problems of communication in medical field, exactly for clinical phase frequently happen. Fault diagnosis on patients is one of those effect. In some case, doctor and patient himself have different perception to understand the meaning of "mbliyur" (dizziness) from Javanese Language. In fact, 60% diagnosis comes from anamnesis, which is one implementation of the ability to communicate in society. On the other hand, the graduates of Indonesian doctors will be faced with the medical world job competition as an impact of the AEC (ASEAN Economic Community). In order to answer these two problems, new education system and assessment needed and must be developed. EESS (Education and Examination for Social Skill) expected to be a solution to train and develop the capacity of “community-based physicians” who only owned by Indonesian doctor (something unique). EESS is able to educate students to understand the socio-cultural community, Includes two aspects: communication and socialization. As the education system and assessment, EESS final score will be added in the total assessment system within...
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...of Care | Met | Unmet | Example | Recommendation | 1. Patients have access to the health care organizations’ services based on their identified health care needs and the organizations’ mission and resources. | * | | Patients are being cared of according to their complaint: * The patient is complaining of flank pain, the health care provider in the institution performs assessment and laboratory examinations. | | 2. The patient has a process for admitting patients to the organization. | * | | The institution has the TRIAGE system. * The institution utilizes this system in determining priorities and intervening to needs. | | 3. Patients with emergency or immediate needs are given priority for assessment and treatment. | * | | | | 4. At admission, the health care organization provides the following information to patients’ and appropriate family member and decision makers; information on the proposed care, the expected results of the care, and any expected cost to the patient for the care. | * | | Consent for admission is being explained to and signed by the significant other and the patient. | | 5. The organization seeks to reduce physical, language, cultural and other barriers to access and delivery of service. | * | | * As much as possible, patients having different dialect are being entertained by using the same dialect. * During blood transfusion, patients’ cultures are being respected after proper and complete explanation...
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...Valerie Johnson AMT2 Task 2 Western Governor’s University May 1, 2014 Trinity Community Hospital conducted a focused community health needs assessment centering on cancer, orthopedic and cardiovascular services. The information was obtained through a multitude of sources including: epidemiological surveys, focus groups, interviews with healthcare professionals and healthcare facilities’ planning guidelines. Risk Factors Oncology Services The needs assessment revealed that 15% of the population will be older than age 65 within the next 5 years. 50% of men and 33% of women are expected to develop cancer during their lifetime. New cases of cancer are expected to grow by 34% in the next 5 years. Current physician practices that serve oncology patients are at their full capacity. Additional facilities and equipment are needed to be able to provide the care that is needed. There is poor coordination of care between the different disciplines that provide care to these patients. There are delays in scheduling care for oncology patients. There are no established programs focused on cancer prevention and control. Educational programs on the risk factors for cancer are limited. Orthopedic Services The needs assessment reveals that there will be anticipated growth in orthopedics. Orthopedic cases are expected to increase by 46%. Inpatient volume is expected to increase by 30% and outpatient procedures by 350%. The community needs additional physicians in order to accommodate...
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...Needs Assessment Paper Vicky Doss, RN, BSN NUR 588-Developing and Evaluating Educational Programs May 7, 2012 Monie Nuckles, MSN, RN, PhD(c) Learning Needs Assessment Continuing education is of the utmost importance to any organization regardless of type. In order for nurses to remain current and updated within their profession there must be access and motivation to education. Nurses must strive to increase their knowledge base to provide the best and most effective care based on the most recent evidence available. Nurses must have the necessary skills to remain competent in a quickly evolving health care system. “The provision of adequate, suitable, flexible, and quality continuing education that takes into account the needs of the individual nurse can lead to improvements in the quality of nursing care” (Claflin, 2005, p. 263). It is essential to provide the appropriate type of education, depending on the learner’s style in order for nurses to stay informed and adjust to the changes in the healthcare system and provide adequate care for the patients he/she treat. One of the most influential factors in the need for continuing education is the need to make sure that patients are treated in a cost and time effective manner to prevent readmissions and prolonged stays. In order for any of this to be effective, first the learning needs of the staff need to be assessed to discover what is important to them. Performing this needs assessment will...
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...Ida Jean Orlando Ida Jean Orlando's Deliberative Nursing Process is set in motion by the behavior of the patient. According to the theory, all patient behavior can be a cry for help, both verbal and non-verbal, and it is up to the nurse to interpret the behavior and determine the needs of the patient. The Deliberative Nursing Process has five stages: assessment, diagnosis, planning, implementation, and evaluation. In the assessment stage, the nurse completes a holistic assessment of the patient's needs. The diagnosis stage uses the nurse's clinical judgment about health problems. The planning stage addresses each of the problems identified in the diagnosis. In the implementation stage, the nurse begins using the nursing care plan. In the evaluation stage, the nurse looks at the progress of the patient toward the goals set in the nursing care plan. This is the ADPIE that we use every day. Nursing care has to be flexible. Not only does a nursing care plan depend on the needs of the patient at the time of admittance, but it also needs to be able to change when and if any complications come up during the treatment and recovery process. Ida Jean Orlando's Deliberative Nursing Process directly addresses this need for flexibility, and helps nurses focus on the patient rather than simply sticking to a nursing care plan no matter what. Specialty areas Emergency Nurse- a. How to get there- ASN or BSN b. Pass NCLEX c. You need two years before you can take a licensure...
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...essential components of nursing care. It is critical for patient care providers to ensure an accurate portrayal of the patient. The situation background assessment recommendation (SBAR) protocol is a technique that provides a structure for communication between patient care providers. SBAR was a tool designed to promote efficient care that ensures patient safety. SBAR: Improving Communication Between Healthcare Providers Missed or ineffective communication can have severe consequences to the life of a patient. A patient’s clinical condition can deteriorate very quickly and the ability to communicate nursing assessment data rapidly and in a way that will be effectively received can mean the different between life and death. Situation, background, assessment, recommendation (SBAR) is a communication tool that can help patient care providers improve communication during information transfer. Effectiveness in information transfer is important and urgent in high acuity situations where clear and concise communication is critical to patient outcomes. According to Cinahl Information Systems (2012), SBAR has been adopted by many United States hospitals as the preferred form of communication between nurses and physicians. Current process According to Hannibal Regional Hospital (2007), policy 503.077 patient care providers use a standardized approach when giving report/hand-off called, SHARED. “SHARED: the situation, history, assessment, results/request, evaluate need to inform others...
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...Interventions for Patient Safety Nursing Interventions for Patient Safety The evolution of nursing is one that is rich in history and clinical practices and has existed for hundreds of years for health care issues. This author has work experiences from 1978 to 1996 as a nurse and nursing consultant in long term care and has a personal interest in how the use of restraints has evolved to a patient focused and caring approach that has reduced the rates of restraint use and patient injuries. Nursing evidence based practices for patient safety evolves from current technological advances, research and nursing theory. The purpose of this paper is to address how nursing clinical practices evolved for the use of patient restraints in health care facilities. Identification and Discussion of Health Care Issue The Centers for Medicare & Medicaid Services (CMS) defines a physical restraint as “any manual method or physical or mechanical device, material, or equipment attached or adjacent to the resident’s body that the individual cannot remove easily which restricts freedom of movement or normal access to one’s body” (U.S. Department of Health and Human Services, 2001). Physical force can be human, mechanical devices, or a combination. Some Items that can be used to physically restrain people include bed side rails, waist belts, vests or jackets, hand mitts, arm and leg restraints. This author has witnessed wheel chairs being tied to hallways handrails; patients tied into...
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