Category Archives: Nursing

BOOLEAN TERMINOLOGY

Question

The choice of Boolean terminology can markedly affect your search returns. Select a topic related to your area of practice, and select two scholarly databases to find information on the topic. Describe the search. What key words did you use? How many articles did your initial search yield? How did you narrow or expand the search? How many articles did you find once you narrowed or expanded the search? Summarize the results from the search.
Discussion on academic level for graduate nursing program. Emergency nurse practice.

Sample paper

BOOLEAN TERMINOLOGY

The topic under consideration in this study is the nurses’ role with relation to informed consent. The scholarly databases selected include PubMed, an online collection of peer reviewed journal articles and other forms of publications, and the American Nursing Association database, containing books, journals, and other useful resources. The initial search in PubMed database yielded 57,777 articles. This search utilized the keywords “informed consent.” In order to narrow the research further, the second search utilized the keywords “nurses’ role in informed consent and journal.” This search was narrow and specifically requiring search results for journal articles only. The refined search yielded 72 articles only, all of which are journal articles relating to the topic area. Narrowing the search results is important since it enables one to identify the articles that best describe the topic of interest.

The second search utilized the keywords “informed consent or decision making or ethics”, which yielded 29 results. In order to expand the search results, the keywords “informed consent in health and social care and journal” were used. The search gave 58 search results. This indicates that Boolean searching is useful in enhance search results by either narrowing on search results or expanding the search results. Boolean searching can enable one to narrow down on specific resources such as journals, articles, or publications relating to the topic of interest (Notess, 2006). As such, it is a critical tool for researchers and learners alike.

Reference

Notess, G. R. (2006). Teaching Web search skills: Techniques and strategies of top trainers.        Medford, NJ: Information Today Inc.

Health Care Issue Analysis

Question

Involvement in interdisciplinary professional coalitions/organizations allows the healthcare professional to stay current in one’s field or specialty, gain an understanding regarding navigating socio-

  1. Discuss the pros and cons of the health care scenario noted below.

In a highly unusual outbreak of measles in Springfield, Missouri, 18 children became ill, 10 of which of the children had not been inoculated against the virus because their parents objected. These parents do not perceive risk of the disease, but perceive risk of the vaccine.  They use information gained from mainstream media, connecting the vaccines with neurological disorders, asthma, autism, and immunology—and, decide not vaccinate their children.

  1. Discuss health care implications of school-age vaccinations at the macro system levels.
  2. Discuss your macro-level leadership stance of this controversial health care risk.
  3. Find a professional coalition/organization that supports your stance regarding use of vaccines for school-age children and your involvement with this professional coalition/organization.Description of the Assignment

The purpose of this project will be to address a health care controversy related to school-age vaccination. The project will entail researching the laws entailing the vaccination of school-age children at a state level, and taking a stance on this debatable issue.  Leadership skills at the macro-level will be applied.

Sample paper

Health Care Issue Analysis

Speaker notes

Controversy surrounds the vaccination of school-age children in the society. Some parents object to their children taking vaccines to gain immunity against preventable diseases such as measles, citing various health concerns. Among the major concerns, include the risk developing neurological disorders, asthma, and other complications. The media propagates these health concerns related to inoculation of school-age children against preventable diseases. This is despite overwhelming research showing low association between inoculation and the aforementioned health concerns.

Failure to provide vaccination among school-age children leads to increased risk of future recurrence of preventable and often fatal diseases such as measles, polio, mumps, rubella, and others. Despite the increased risks associated with failure to provide vaccination, moral and legal concerns emerge over whether authorities should force parents to give their children vaccination. The principle of autonomy in health care settings dictate that patients have the right to choose the various forms of treatment or procedures that can be done to their bodies.

Pros and Cons Related to Vaccination of School-Age Children

Children who receive vaccination may enjoy various benefits as relates to the case study. One of the benefits is reduced risk of contracting measles and other preventable diseases. From the case scenario, 10 of the children infected with the virus had not been inoculated against the disease, while 8 had received immunization. Another benefit of receiving vaccination is reduced risk of disease epidemic. Most outbreaks are likely to occur in areas where there are high number of individuals without vaccination. Vaccination reduces the risk of disease transmission. This is because those who are vaccinated are less likely to become ill and pass it to others. This also reduces death rate from preventable diseases such as measles.

Vaccinations may present certain complications among children. In most cases, vaccine-related adverse effects such as fever, mild rash, and temporary joint pain are reported. Information obtained from media indicates that vaccinations increase the risk of developing various illnesses such as neurological disorders, asthma, autism, and problems with the immune system. From the case scenario, 8 children had received vaccination against measles, yet they experience a recurrence of the virus. This indicates that vaccination may fail to prevent diseases.

Related: NURSING ESSENTIALS

Health care Implications

The medical stance of children greatly depends on the attitude of their parents or guardian towards vaccinations. When parents advocate for vaccination as the key to eliminating diseases, children are more likely to develop a positive attitude towards vaccination. Education also plays a critical role in ensuring that children develop a positive attitude towards vaccination. Teachers can play a critical role ensuring that children develop positive attitudes. By educating children on the benefits and the need for vaccination, children are able to recognize its importance and at the same time demystify the myths surrounding vaccination.

The parent’s stance of children receiving vaccinations depends on whether they perceive the risks or the disease or risk of vaccination. According to Browne, Thomson, Rockloff, & Pennycook (2015), about 40% of parents in the U.S. may delay vaccinations or refuse vaccinations of their children sighting various health concerns. The 40% of parents hold a negative attitude regarding vaccination. The major contributing factor towards the negative attitude among parents is lack of proper understanding of the role of public vaccination campaigns. Another factor contributing towards negative attitude on vaccination is lack of trust towards health authorities. Parents may lack confidence in public health authorities to deliver positive health outcomes to their children. This can lead to a negative attitude on vaccinations.

Another reason contributing to negative attitude is inaccurate personal biases that are shaped by one’s interactions with others in the community (Browne et al., 2015). For instance, the media can significantly influence one’s personal biases in favor of or against a particular situation. Another reason contributing towards the negative attitude is the idea of complementary and alternative medicine. Parents who believe in complimentary and alternative medicine hold contradicting medical beliefs to those held in the contemporary medical field. Certain sociocultural factors influence parent’s opinions regarding contemporary medical practices (Browne et al., 2015). For instance, some parents believe in adopting purely natural approaches to health.

There are various benefits to giving school-age vaccination against preventable diseases. First, vaccination helps in reducing pandemics such as measles outbreak among school-age children. Vaccination also prevents deaths that could result from the preventable diseases. According to Whitney et al. (2014), vaccination will prevent about 322 million cases of disease among individuals born between 1994 and 2013. Immunization will prevent a further 732,000 deaths. Receiving vaccination is cost effective among parents and the society. The cost of providing vaccination is lower comparing to that of treatment when affected by the preventable disease. In addition, there are societal costs associated with illnesses. Vaccination helps in elimination of preventable diseases thus making the diseases no longer a pandemic (Whitney et al., 2014). This helps in protecting future generations against consequences of such diseases. Lastly, vaccination helps in reducing incidences of disease transmission. Children who receive vaccination are less likely to develop preventable illnesses. This helps reduce disease transmission rate.

Various implications may emerge when children fail to receive vaccination. One of the implications is higher incidences of epidemics occurring  in the U.S. Vaccination helps prevent various diseases among the population. When a large segment of the population is not vaccinated, it is easy for a particular communicable disease to spread, becoming a pandemic. Another implication is higher death rate. Whitney et al. (2013) notes that death rate is higher in populations with low vaccination rates. Children who do not receive vaccination pose health risks to others. This is because they are likely to easily acquire diseases and infect others who are close to them.

Related: Health Policy Presentation-Long-term Care

Macro Leadership Stance

There is no risk in school-age receiving vaccinations against preventable diseases. An overwhelming body of evidence indicates that adverse health impacts of vaccinations are rare, and thus vaccinations are safe. According to data from the Centers for Disease Control and Prevention (CDC) (2013), only a small fraction of children who receive vaccination experience adverse effects of MMR vaccine. For instance, only 4 in 10,000 children develop febrile seizure. Febrile seizures are convulsions that may occur when a child experiences fever. Since the introduction of vaccines, deaths from preventable diseases such as measles has significantly reduced. In the past, preventable diseases such as measles were a leading cause of death. This shows the efficacy of vaccinations in preventing deaths from diseases such as measles, mumps, and other diseases. According to Whitney et al. (2015), immunization prevents about 322 million illnesses among those born between 1993 and 2013. Vaccinations has helped eliminate some diseases such as polio and measles. For instance in 2000, measles was recognized as less endemic to the population. There is no risk to the population since the vaccines are thoroughly tested before they are availed for countrywide use in inoculation.

It is significant for children to receive vaccinations against preventable diseases. It is every parents’ wish that their children stay healthy. As such, vaccination can help eliminate a number of preventable diseases and thus ensure children remain healthy. Another factor to consider is low complications arising from preventable diseases. Common complications include hearing loss, convulsions, paralysis, and others all which are preventable (Hendriks & Blume, 2013). Vaccination gives children immunity against preventable diseases common in some parts of the world where vaccination has not been effective. Thus while traveling, children can remain safe from such preventable diseases. Lack of vaccination increases the risk of spreading diseases to other children, for example, those who are yet to receive vaccination owing to their young age. There is increased risk of disease outbreaks when parents fail to inoculate their children. Lastly, parents bear a public health commitment to protect others by ensuring vaccination of their children.

Professional Coalition/Organization at the State Level

There are various organizations that address the use of vaccines for school-age children. Every Child By Two (ECBT) is one such organization. Its major aim is to develop awareness among parents about the importance of immunizing their children by age of two. ECBT is a non-profit organization founded in 1991. ECBT is involved in raising awareness of vaccinating children at the appropriate age. The organization also raises critical issues such as the need to ensure vaccine schedule compliance. The organization also dedicates efforts to fighting negative attitude towards vaccination among parents. The organization achieves this by providing key information about vaccine safety drawing on peer reviewed literature (ECBT, 2016).

Every Child By Two organization fully supports my stance. Every Child By Two organization has been critical in voicing various issues regarding vaccination in school-age children. Notable developments include its campaign programs on vaccine benefits and safety. The program on vaccine benefits aims at proving parents with critical scientific information on the number of deaths and infections averted through vaccination. With regard to safety, ECBT emphasizes on the elaborate systems that are put in place ensuring that vaccines are safe for use. The organization also helps provide key information about immunization schedules to both professionals and parents. The organization also provides schedules for parents who have missed vaccination programs and have been left behind as a result (ECBT, 2016).

Another major thing covered involves countering the misinformation that exist among the public regarding vaccinations. The organization details various research countering misinformation that parents have concerning vaccinations. For instance, the organization asserts there is no evidence suggesting that vaccination leads to autism. The professional organization also addresses what it terms as the “questioning parent.” This comprises of parents who are interested in having their children vaccinated but have numerous concerns. One of the greatest concerns raised by parents involves the issue of having too many vaccinations within a relatively short period. The organization notes that children currently receive more vaccinations compared to the past. While this is true, the organization notes that vaccines used in the past contained about 3000 antigens to about 153 antigens today (ECBT, 2016). This means that modern vaccines have fewer bits of the respective vaccine and thus more effective.

Parents play a greater role in influencing children attitudes towards vaccinations. Parents who discuss about the positive benefits of receiving vaccination with their children instill a positive attitude among them with regard to receiving vaccinations. The research indicates that about 40% of parents may refuse or delay vaccination of their children owing to the misinformation that exists. Educational programs that focus on countering the misinformation that exists and on providing information about the benefit of vaccination can help parents in positively changing their attitude towards vaccinations. My macro leadership stance holds the view that vaccination is safe and is key in fighting preventable diseases. Vast literature indicates that vaccination has significantly reduced deaths and eliminated disease outbreaks or pandemics, in particular measles and polio. Every Child By Two (ECBT) is a professional organization that dedicates efforts towards enlightening parents on the importance of having their children receive vaccination.

References

  • Browne, M., Thomson, P., Rockloff, M. J., & Pennycook, G. (2015). Going against the Herd: Psychological and Cultural Factors Underlying the ‘Vaccination Confidence Gap’. PLoS ONE, 10(9).
  • Centers for Disease Control and Prevention (CDC). (2013). Measles, mumps and rubella (MMR) vaccine safety. Retrieved from http://www.cdc.gov/vaccinesafety/vaccines/mmr-vaccine.html
  • Every Child By Two (ECBT). (2016). About. Retrieved from http://www.ecbt.org/
  • Hendriks, J., & Blume, S. (2013). Measles Vaccination Before the Measles-Mumps-Rubella Vaccine. American Journal of Public Health103(8), 1393–1401. http://doi.org/10.2105/AJPH.2012.301075
  • Whitney, C. G., M.D., Zhou, F., PhD., Singleton, J., PhD., & Schuchat, A., M.D. (2014).Benefits from immunization during the vaccines for children program era – united states, 1994-2013.(). Atlanta: U.S. Center for Disease Control.

Related: Collaborative Leadership

Care Clinic Improvement Project -CUSTOMER SATISFACTION

Question

Care Clinic Scenario: The Executive Team of Care Clinic prides itself in the care that is provided to the community of Summerville, Florida.  The Clinic is known for holistic approach to the individuals served at the clinic as well as presenting various community outreach programs.  Annually, the Executive Team of Care Clinic reviews the client satisfaction benchmark results related to client service and quality indicators.  The scores have substantially decreased in the past 12 months in the categories of client satisfaction and quality care.

 

To assist in understanding the quality issues related to client care occurring within the Care Clinic, you are provided with two videos of client situations that have been recorded using Second Life.  You are also required to enter Second Life to observe actions and conversations occurring within the Care Clinic.  When viewing the videos and participating within the Care Clinic located in Second Life, consider yourself to be the manager and identify quality care issues consistent with decreasing client satisfaction scores.  From your leadership perspective, determine how the declining benchmarks can be addressed and improved.  Discuss the actions/changes that need to be implemented in order to improve the satisfaction scores and attained Care Clinic quality outcomes.

The Care Clinic Improvement Project will need to be completed by the end of week six of this course and requires that each of the following areas to be addressed.

  1. Identify ONE satisfaction benchmark that you will be addressing and why this benchmark has been selected. Select the ONE client satisfaction benchmark from the following list:
  2. Decrease in client satisfaction scores related to courtesy and friendliness of staff at the Care Clinic.
  3. Decrease in client satisfaction scores related to staff explaining discharge instructions in a manner that is understandable to the client/client.
  4. Decrease in the quality nursing care related to interventions provided to clients at the Clinic.
  5. Describe the leadership dynamics related to how the improvement/change project will be managed.
  6. Identify the change model that will be used in addressing the selected benchmark.
  7. Describe the course of action/change.

Course Outcomes

Through this assignment, the student will demonstrate the ability to:

CO #2: Analyze goal directed leadership actions that foster positive healthcare outcomes and effective processes at individual, community, and global healthcare settings. 

CO #3: Develop personal and strategic communication modalities that foster negotiation, advocacy and positive work environments within diverse healthcare settings.

CO #5: Incorporate ongoing leadership character development, values and ethical principles into a living leader role that collaborates with and engages individuals, teams, agencies, and organizations locally as well as globally

Sample paper

Care Clinic Improvement Project -CUSTOMER SATISFACTION

The health care industry is important as any other sector in any economy around the globe. With the current innovations and inventions in technology and information technology, doctors and other medical practitioners have an opportunity to research and treat more complex ailments that have been disturbing and infecting people in the recent past. Nursing being a major component of the health care industry has a duty to provide care for individual, families and communities to boost their chances of attaining, maintaining and recovering optimal health care and quality of life. Notably, in health care, everyone is a customer and all employees in the health care industry should put emphasis and efforts in delivering customer-oriented services that are transparent. The professional behavior exhibited by nurses should send a clear message to all clients that they are working in the best interest of their customers and their intent is to battle for their clients and not against them. This essay will attempt to identify and discuss some of the methods and techniques that can be employed by the organization in the health care industry to guarantee high-quality services as well as improving customer satisfaction.

Part 1

The basic purpose and objective of any organization are to attract more customers as possible. However, to achieve this aim any business needs to understand that customer satisfaction is paramount and the needs of the clients should always come first. Customer satisfaction is widely used in marketing to measure how products and services provided and supplied by an organization meets or surpass a customer’s expectation. Customer satisfaction is crucial to the management of any organization considering that it provides a scale through which the company can manage and improve their business (Faezipour, 2013). On the same note, data and information that is obtained from the customer can be used in decision making. Customer satisfaction in the service industry, especially healthcare industry might be complex and complicated compared to the product industry considering that the personality of the service provider is tested.

Improving patient satisfaction, customer service and the customer experience id the dream of every healthcare organization around the globe. One of the techniques that can be used by the most organization if not all to improve their customer satisfaction scores is by being courteous and friendly to the clients at the care clinic. A great customer service in the healthcare industry means systems as well as the smiles that help the pain and tension that may exist between the patient and the care provider. Statistics show that patients, who consider medical practitioners in an organization to be courteous and friendly will recommend to the facility to their friends, will come back to the facility if a need arises and are likely to respond to the treatment and medication provided positively. This benchmark is paramount for any organization because it determines the satisfaction scores and rates of the service provided as well as the success of the treatment offered. In most cases, friendly environment believed to give a patient an ample time to recover from his ailments. To be courteous, the care provider needs to:

  1. Acknowledge the patient and family members – the first impression that a care provider creates in the presence of his or her patients, and their families widely determine their relationship within the duration that the patient will be in the facility. A mere acknowledgment of the patient and his family may make the patient happy and feel appreciated and thus push him or her to fully disclose his or her problem and well as their past medical records. Also, the patient the care provider creates a platform and an opportunity for the patient and any member of the family to enquire anything about the patient’s condition which leads to greater and better understanding of the situation.
  2. The care provider should introduce himself or herself by name and role to the patient and family members – most health care experts believe that referring to a patient or a member of staff by the name creates a friendly environment as both parties are open to conversation. After the acknowledgments, the doctor or the nurse should state his or her name his role in the hospital and the main reason as to why he or she is attending to the patient. Some hospitals have introduced nametags to both the patient and the care provider, but it is always good to for both parties introduce themselves to each other before the commencement of the treatment(Cina, 2013).
  3. The care provider should explain the care, procedures, and diagnosis to be conducted both in the patients and family members present – this process helps to enlighten and prepare the patient and his or her family members of what to come and preparing them for any results. Moreover, the care provider should at least give an estimation of the duration that the patient will be required to remain in the facility as well as fully disclosing how long each diagnosis will take. It is not prudent to take the patient by surprise as it may cause further complications.
  4. The care provider should thank the patient and the family for entrusting him or her to their care – most of the times are when the health care providers provide the notion that they have nothing to thank the client for but rather the client should thank them. However, this is wrong, and both parties should thank each other for entrusting their lives and health on that particular healthcare provider, and the patient should thank the care provider for willingness to treat them and taking care of their lives as well as health.

Related: Health Policy Presentation-Long-term Care

 

Part 2

Leadership is paramount to every form of organization and may consider as a journey rather than a destination.  A good leader provides the sense of direction, lead by example and motivate his or her followers to achieve a predetermined set of goals and objectives. Leadership dynamics taking the form of training and refresher courses are meant to provide staff and employees of an organization with the necessary tools and equipment to make their work easier and enjoyable. Thus, any arrangement made by the leadership or supervisor of a department or an organization should be solely focused on improving the skills and knowledge of the workers to realize their full potential (Lonial, 2013). After identification of the problem that is leading to decreasing in satisfaction scores, in this case, lack of courtesy and friendly environment, the management should focus on:

  • Training employees – considering that people come from varied backgrounds as well as have a different perspective regarding customer services, the leadership o rather the management should put more emphasis on training and guiding employees on the best way to conduct themselves in front of customers and their families. As a matter of fact, not all individuals have that talent, skills, and knowledge to serve the customers by being courteous and friendly, and thus, the organization should take the time to invest in training such workers to improve the quality of service provided which improves the customer satisfaction.
  • To improve customer satisfaction and relations, the care provider needs to learn to make promises to their clients – the care provider should begin by identifying what is important to the customers and then embark on a mission to create a service and behavior that is likely to make the customer happy. The management of an organization should set behavior standards for all employees to meet the needs of their clients fully. However, these standards should be flexible enough to allow changes considering that different clients have different needs and want as well as the level of satisfaction. Besides, creating and developing a written manifesto outlining the standards of behavior of all employees provides common goals and objective for the staff(Faezipour, 2013).
  • Application of professionalism and use of effective communication skills throughout the customer interaction – professionalism in health care widely involves the declaration by the care providers to each other and their clients that they will uphold the shared competency standards and ethical values throughout the treatment and medication process. Promising the client that as the care provider you will do all within your power and knowledge to treat them and save their lives creates a friendly environment as well as acting as an encouragement phrase to the client and his family. Through proper communication, the client can disclose all the details the care provider needs to know to develop a treatment plan.
  • Recognizing the effects of word choices, tone and attitude affect the customer experience and satisfaction – as the management of the hospital there is the need to encourage and lead by example on the word choices, tone, and attitudes that customers need to be fully satisfied. At times, a smile is all the patients’ needs to be satisfied to have a great experience in a particular hospital. The employees should be discouraged from using raised tones and showing outright negative attitude despite the current situation at hand. Rather, the care provider should always to console the patient and ensure them that everything is under control.
  • The performance measure is another technique that can be used to improve courtesy of employees towards the patients. As the leader, there is the need to note and understand that customer satisfaction particularly courtesy can be measured. The health care facility should have systems and databases in place to measure courtesy through CAHPS surveys and other measurement tools. They help to obtain feedback from patients, which in turn help in identifying areas of weaknesses, thus coming up with methods and techniques to improve courtesy as well as creating a friendly and conducive environment for both workers and patients(Cina, 2013).

Related: CLINICAL SIGNIFICANCE

Part 3

Change is necessary for any organization at any level to improve the performance of an organization. As a result, the leadership of this health care organization can utilize Kotter’s 8-step change model to ensure employee’s change their perception when it comes to courtesy and friendliness towards their patients. The leaders should be prepared to:

  1. Create urgency – the leaders should attempt to show their employees the need for courtesy and friendliness in their line of duty thus convincing them that there is a need for change in the way they do their business. This task can be completed through identification of risks associated with their behaviors.
  2. They should form a powerful coalition -leaders should provide physical evidence that the current processes in the organization are not working and change is necessary. After gaining enough support from other members through team building, the leaders can start training the employees.
  3. Creation of vision for a change – the leaders should attempt to link ideas and concepts to an overall vision that other staff can grasp easily and remember. A clear vision gives understanding to every individual the reason as to why they have to adopt a new way. This objective is achievable through determination of values.
  4. Communication of the vision – communication is the most important part of an organization. The leaders should communicate the vision to the members, frequently to ensure that they do not forget why they are doing this. This stage can be completed through often talking about the vision of the incoming change(Lonial, 2013).
  5. Removing obstacles – the chances are that the change is likely to face some resistance from a section of the employees and it is the duty of the leaders to reduce the obstacles if not eliminating them. There is the need to put in place the structure for a change and frequently check barriers to it, to reduce change.
  6. Creation of short-term wins – creating simple and short term targets acts as a motivator for the employees to adopt the change as they work towards the achievement of the long-term objective. These targets should not be ambiguous.
  7. Building on the change – the leader should be careful not to declare victory too early before the full implementation of the change and all the associated skills and knowledge in courtesy and friendliness. After every win, the leadership should evaluate the need for improvement to increase customer satisfaction.
  8. Anchoring the changes in corporate culture – making the change part of the core of the organization increases the chances of making the change stick in the minds and processes of other staff. The more support availed to the change the higher the likelihood that the change will stick(Faezipour, 2013).

Part 4

Over the years, leaders have adopted a various course of action in their attempt to bring changes in their organizations. However, to fully implement the change and reduce resistance it is necessary for the leaders to act as the forerunners and participate in training to learn the necessary skills to be courteous and create a friendly environment for the patient and their families. The departmental supervisors and heads can then spread the skills and knowledge to the rest of the staff through frequent training and workshops. Having their colleagues train them reduces chances of resistance compared to bringing a new individual from outside the organization to train them (Lonial, 2013). However, the leaders should discuss the impending change with all workers before actually implementing it to get their views and opinion. A good leadership takes the views of the employees into considering as the workforce is proving to be valuable assets nowadays. Changes are inevitable, but they should bring success as well as increasing customer satisfaction.

 

References

Cina, C. (2013). Creating an effective customer satisfaction program. . Journal of Consumer                    Marketing.

Faezipour, M. &. (2013). A system dynamics perspective of patient satisfaction in healthcare. .                Procedia Computer Science, 16, , 148-156.

Lonial, S. &. (2013). Impact of service attributes on customer satisfaction and loyalty in a                        healthcare context. Leadership in Health Services, 28(2), , 149-166.

Related paper:

Improvement Science Research Network.  Class is for Clinical Nurse Leader (CNL). I work at a VA Hospital

Collaborative Leadership

Question

  1. In this 5-8 page paper (not including the title or references pages in the page count), the introduction contains a few statements regarding leadership and engaging others. One potential concern that may occur while engaging others is noted.  One potential positive outcome that may occur while engaging others is noted. The sections of the paper are identified. 
  2. Section One provides an explanation of the importance of leadership in engaging others including the role of leadership as well as challenges facing leadership while engaging others. In addition to potential role of teams or engaging others in the healthcare environment is presented.  Scholarly references to support the information are required.
  3. Section Two focuses on an evaluation of the team ability to accomplish tasks. The team, as presented in the scenario, should be evaluated for each of the following elements:
  • Ability to handle differences,
  • Maintaining team order,
  • Communication (both verbal and nonverbal), and
  • Team Cohesiveness.
  1. Section Three is where you assume the role of supervisor in order to develop the team. The evaluation should include the following elements:
  • Overall summary of the discussion and team interactions as presented in the scenario
  • Discussion of one positive action demonstrated by a team member
  • Discussion of three non-productive actions demonstrated during the scenario
  • Discussion of one potential cause for the team dysfunction
  • Discussion of two actions that can foster teams with multiple generations to work as a productive group
  • Discussion of two actions that can foster teams with multiple disciplines to work as a group

Scholarly support for actions is required.

  1. Summary of this paper identifies the key points from the information provides as well as insights gained (what was learned) regarding engaging others with leadership.

Sample paper

Collaborative Leadership

Introduction

The role of leadership is not as easy as most individuals take it to be. For a person to be recognized as a leader, he or she has to do the right thing, in the right manner and at the right time. Thus, leadership is the art of getting another person to do something another different person wants it to be done because he wants to do it. There are many types of leadership styles and skills that may be displayed and utilized by individuals at different levels and the organizations. However, there is no one single leadership style that can be recommended to an organization because the leadership style depends on the organization structure as well as the economic sector and industry. This essay will mainly focus on collaborative leadership which is a management style that focuses on the leadership skills across functional and organizational boundaries where all levels of workers are given an opportunity to participate in the decision-making process (Archer, 2013). One of the most notable positive outcomes of this leadership style is that it helps in setting aside personal interests and gains for the broader gains and achievement of organization goals and objective.  On the other hand, collaborative leadership can lead to conflicts within a team or an organization due to different perspectives of staff as well as different working styles that can lead to a delay in doing business or organizational decisions.

Section 1

An effective leader is usually defined by his personal traits as well as his or her skills that inspire and motivate staff of an organization or community. Collaborative leadership operates by sharing power, duties, authority, and management among the peers, rather than direction from the top through a hierarchy of authority. Considering that for years and decades, hospital administrators and hospital professionals have worked within a challenging, rapidly changing and fragmented healthcare system, there is a need for healthcare to adopt a collaborative leadership style to reduce the impacts of these challenges. For this leadership style to work in the healthcare industry, hospital administrators need to adopt models such as collaborative patient care teams, resource stewardship, talent transformation, boundary spanning, capacity for complexity, innovation, and change, and employee engagement and well-being.

Related: Essentials of Leadership

Collaborative leadership may yield different results depending on the type and organization structure and culture. However, some of the notable importance of collaborative leadership style includes:

1)    This style allows leadership to draw upon the collective insight of the group. Through the participation in the organization as a unit, the leaders can identify the need for change and training and other areas of concern to be addressed to enhance the results realized as well as improving the working environment.

2)    Collaboration leadership allows staff in an organization to grow their strength from one level to another considering that different individuals have different strengths and weaknesses that complement each other. Such a situation helps in creating and developing, momentum for more specialization which creates more momentum for collaboration (VanVactor, 2012).

Despite the fact that collaborative leadership seeks to distribute authority and power among the staffs, it should remain in charge to provide a sense of direction to the overall organization and moving them at the right speed in the right direction. Some of the possible roles of collaborative leadership include:

1)    Governing – governing particularly in the health care sector deals with the creation and development of policies, continuous monitoring of their implementation by members of an organization or a facility. Moreover, governance attempts to balance the power of the members of an organization and their duties.

2)    Coordinating – coordinating widely deals with creating and maintaining communication infrastructures, scheduling common times and ensuring that people have access to good information when they need it to avoid any sought of confusion.

3)    Facilitating – collaborative leadership has the role of intervening to assist an organization or a team in solving problems and making informed decisions to improve the productivity and efficiency of the team and organization in general.

Just like any other leadership style, collaborative leadership faces challenges, and it is for the management, leadership, and the staff to join efforts to find a solution to these problems. Challenges facing collaborative leadership include:

1)    Complex decision making – this style of leadership calls for the involvement of all members of staff in decision making. Considering that different people have different opinions and views and see things from different perspectives, it takes the time to convince every person to follow a certain course of action (Orchard, 2015).

2)    Power wrangles – since everyone is given authority and power to participate in the decision-making process, there are some of the members of an organization who may feel like they have higher stakes than their colleagues thus bringing the idea and concept of power conflict.

3)    Defensive participation – there is also the risk of defensive participation where participants in the decision-making process may not fully participate in the process as they feel they have the duty and responsibility to defend their respective units.

Section 2

In the recent past, teams and organization are encouraged to adopt multiculturalism in their workforce to create a diverse labor force. Notably, diverse workforce faces many challenges compared to other labor forces. Some of the situations that teams have to go through to give the best include:

  1. Have the ability to handle differences: a team that is made of more than one individual will occasionally experience misunderstanding and conflicts due to the difference of ideologies among the members. To handle differences among the team, the team needs to have an open door policy where the team leader should listen to grievances from both parties and guide them in arriving at a decision rather than dedicating a solution to them. Moreover, workers should be encouraged to tackle conflict amicably and build a common workplace culture favoring all individuals from different backgrounds (Orchard, 2015).
  2. Maintaining team order: to maintain order in a team, the leader should involve the team members in performing certain organization duties and in decision making to build the spirit of appreciation and belonging. Moreover, there is the need of the leader to motivate, encourage and listen to their problems and try to help them to find solutions to their problems.
  3. Communication: Communication is very vital in the performance of any organization since communication channels are used in giving instructions to workers as well as getting feedback to the top management of the company. To maintain good communication channels, the leadership of the organization should adopt vertical, horizontal and diagonal communication styles. Moreover, it is also prudent to adopt an open door policy where employees can have access to their superiors and discuss work and other work related issues.
  4. Team cohesiveness: maintaining the unity of any team should be the highest priority of any leader. To be in a position to maintain team cohesiveness, a team leader needs to establish a mission through deciding the goals and laying down the policies and methods necessary to achieve these goals. Moreover, the leader should look for diversity for diversity has a broader access to many people, both old and young with diverse skills and knowledge which may prove valuable to the team.

Section 3

The degree to which individual members of a team willing and want to contribute to the group ability to continue as a functioning work unit determines the overall ability of the team to achieve its mission and objectives.  Team unity and cohesiveness develop over time and results from individual, interpersonal and group level attraction. Group cohesiove4ness allows a group to work through a conflict and emerge as a stronger group that is hungrier to defeat all odds to become successful. Some of the factors that affect the cohesiveness of a group include the stage of the group, trust and group openness to new members (Archer, 2013). To maintain this unity, it is necessary to encourage effective communication and utilize individual strengths for the benefit of the team.

Related: MSN Specialty Executive Leadership

To guarantee team development, there is the need to encourage positive actions from members of the groups. An example of a positive action demonstrated by a member of the team who is willing to take the team to the next level is there when any member of the team needs them. John, the team organizer, visited mercy a team member at the hospital after she was involved in a road accident to encourage her as well as wishing her a quick recovery and this is a good sign of cohesiveness in the team.

To maintain a good and workable team, the team members with the help of the team leadership should devise a way in which they can incorporate both non-productive and productive actions that help in bringing the members of the team together. Some examples of non-productive actions that can be adopted by team members include: holding celebration parties after achievement of certain team objectives, rewarding the best performer to motivate others and assisting each other in times of need and tragedies (VanVactor, 2012).

A good team should be quick in identifying factors that can kill team spirit or bring disintegration in the team. Some of the possible causes of group dysfunction include favoritism of some members. While it is important to recognize good work from individual employees, it is important not to hand the reward to the favorites and ignoring others. Favoritism kills team spirit and cohesiveness.

In recent years, there is increased awareness of the importance of integrating both experience and young blood in a workforce. Some of the commonly, management methods used to manage such workforce include keeping employees engaged through the provision of regular education and training opportunities as well as career advice to keep all workers interested and happy with the team. On the same note, the management can also accommodate various learning styles to suit all generations in the team.

A strong team is made by different disciplines. However, maintaining the cohesiveness of such a team is challenging. To help manage such a team, the team leader should communicate clearly and widely to avoid rumors and misinformation, to raise awareness of the team’s objectives as well as building relationships with the team. Moreover, the leader should set clear objectives and ensure that every individual is aware of his or her role in the achievement of these goals.

To boost the performance of a team, the leadership should implement recognition programs that encourage quality teamwork, encourage social activities that aids in discussing variety issues among team member, and outline clearly the roles of each or department and identifying the existing problem and solving it amicably (VanVactor, 2012).

Section 4

In conclusion, it is correct to say that, leadership is paramount to any organization. However, collaborative leadership promotes team spirit and reduces chances of resistance from the members. Moreover, members of any team should seek to integrate both productive and non-productive activities to help boost the relationship among them. It is also crucial for the leaders to avoid and eliminate favoritism to zero-rate group dysfunction.

Works Cited

Archer, D. &. (2013). Collaborative Leadership: Building Relationships, Handling Conflict,                     Sharing Control. . Routledge.

Orchard, C. &. (2015). Collaborative Leadership within Interprofessional Practice. In Leadership             and Collaboration , (pp. 71-94). Palgrave Macmillan UK.

VanVactor, J. D. (2012). Collaborative leadership model in the management of health care. .                    Journal of Business Research, 65(4), , 555-561.

Related:

Ethics and Leadership

Ethics and Leadership

Question

The purpose of this assignment is to apply ethical principles to current leadership practices within healthcare by a) explaining two ethical principles, b) applying selected ethical principles to lead

  1. In this 3-5 page paper (not including the title or reference pages in the page count), the introduction contains a few statements about ethical principles in general, identification of two ethical principles  to be used in this paper, and the sections of the paper. 
  1. Section One provides a definition and explanation of two ethical principles. Each of the selected ethical principles are then applied to leadership within any healthcare setting. Scholarly support is provided for the definitions, explanations, and application areas.

  2. Section Two presents information on how the selected ethical principles either prevents or solves two different leadership concerns within healthcare. Scholarly support is required

  3. Section Three identifies how you will incorporate each of the selected ethical principles into your own leadership activities within healthcare.

  4. Summary of this paper identifies key points from the presentation as well as of insights gained (what was learned) about applying ethical principles with leadership through writing the paper.

Sample paper

Ethics and Leadership

Ethics refer to moral principles or rules that govern behavior of an individual or group. Ethics identify the kinds of actions, motives or intentions that are valued by the community and those abhorred. In simple terms, ethics helps in describing behaviors as either wrong or right. Ethics have a significant impact on leadership. Ethical principles are the fundamental guidelines that enable leaders to make informed choices. Often, leaders face moral dilemmas that test their decision-making skills. Various ethical dilemmas present challenges in the healthcare field. This study examines the ethical principles of autonomy and beneficence with regard to the health care field. The study comprises of three sections. Section 1 examines the selected ethical principles in general. Section 2 evaluates the efficacy of the two ethical principles in solving two leadership concerns in the healthcare sector. Section 3 examines how an individual can incorporate the ethical principles in own leadership activities.

The principle of autonomy gives individuals the right to make their own decisions. This means that patients have the right to make decisions concerning what they perceive as the best for them (Pozgar, 2005). Nonetheless, this principle does not give individuals the free will to make decisions that may have an impact on another individual. Since the principle of autonomy gives individuals the right to make decision concerning health care, this means that one can choose not to receive some form of treatment, regardless of whether it is beneficial to him or her. In a leadership situation, it is critical that managers respect the autonomy of the patient while making certain decisions. For instance, surgeons should not perform a medical procedure without consent from the patient, or an agent representing the patient in case the patient is unable to make decisions. In addition, a physician must inform the patient of the risks associated with the procedure.

The second principle is beneficence. This principle advocates for doing good, showing compassion, kindness, and the general will to help others (Pozgar, 2005). The principle of beneficence applies in the healthcare field by requiring practitioners to weigh benefits of medical procedures vis-a-vis the risks involved. In doing good, the principle mandates healthcare practitioners to develop a detailed understanding of the patient in order to best serve his or her needs. For instance, practitioner should develop an understanding of the patient’s background, preferences, cultures, beliefs, and values. These are important in providing all round care. For instance, the patient may prefer knowing little information about a severe condition that he/she is suffering from. With regard to leadership, this principle stipulates that decisions made in healthcare settings benefit patients. Caregivers must act with kindness and love while helping patients.

The principle of autonomy solves the leadership concern of harm to patients. Certain medical procedures or treatment may leave the patient with life changing consequences. As a result, the patient may lose the quality of his/her life (Pozgar, 2005). The principle of autonomy gives patient the right to choose whether to accept such procedures. As such, the patient must authorize any treatments or procedures that alter his/her normal functioning. Another leadership concern addressed by the principle of autonomy is the need for personal freedom and the right to make decisions over one’s body. The U.S. Constitution grants every individual certain liberties or freedoms, among the bodily integrity. This means that individuals have personal autonomy over their own bodies. The principle of autonomy helps the leadership in enforcing this fundamental freedom among patients. This is of critical significance in healthcare settings since it establishes limits to what physicians can do to patients without their consent.

Beneficence relates to the leadership concern of the moral obligation among caregivers to help others by taking direct and positive steps. This principle requires caregivers to avoid not only causing harm to patients, but also to take active measures to help them. The principle requires caregivers to conduct beneficence acts at all times. As such, failure to help others in healthcare settings may be regarded as a case of negligence (Pozgar, 2005). On the other hand, such a scenario occurring in the community may not qualify as case of negligence. Another leadership concerned addressed by beneficence relates to patient rights. Caregivers must ensure the protection of patient rights such as the right to communication, informed consent, confidentiality, and among others.

It is possible to incorporate the principle of autonomy into one’s leadership activities. One of the ways of incorporating the principle of autonomy into personal leadership activities is by promoting a healthy work environment. The principle of autonomy improves not only nurses’ satisfaction levels but also other aspects involving patient outcomes such as quality of care and patient safety. As a leader in a healthcare environment, it is important to establish a healthy environment that is conducive for both the patient and caregivers. According to Weston (2010), a positive work environment leads to reduced costs of caregiving. Autonomy gives patients the right to act as per their judgment. Nurses who exhibit greater control over their nursing practice have a greater responsibility to make departmental decisions relating to nursing care. By drawing on the ethical principles such as autonomy, the nurses are able to make correct decisions, which enhance the development of a positive work environment.

The principle of beneficence is applicable in personal leadership activities. This principle is applicable in improving the quality of care in a healthcare setting. By applying the principle of beneficence, nurses should be able to influence the patient care outcomes. Various caregivers such as nurses yield power or influence on various issues concerning patients (Parker, 2007). Nurses can gain power by developing positive working relationships with other individuals involved in caregiving such as physicians, nursing colleagues, and other members. Nurses can use this power to influence the quality of care delivered to patients. For instance, nurses may advocate for a better diet or improved conditions at the facility. This is in line with the principle of beneficence, which calls upon caregivers to demonstrate kindness and the will to help others.

To conclude, ethical principles are critical in guiding behavior especially in relation to healthcare organizations. Ethical principles in healthcare organizations help caregivers in decision-making and thus compliance to rules and regulations guiding behavior. This paper has examine the ethical principles of autonomy and beneficence, noting that they are critical in achieving positive patient outcomes. Autonomy gives patients the rights to make critical decisions pertaining to their bodies. A patient has the right to refuse treatment or a particular medical procedure. The principle of beneficence calls on caregivers to do good. Leaders must draw in ethical principles to help them make the right decisions in healthcare settings.

References

Parker, F., (2007). Ethics Column: “The Power of One”. OJIN: Online Journal of Issues in           Nursing, Vol. 13, No. 1. DOI: 10.3912/OJIN.Vol13No01EthCol01

Pozgar, G. D. (2005). Legal and ethical issues for health professionals. Boston: Jones and            Bartlett Publishers.

Weston, M.J., (Jan. 31, 2010) “Strategies for Enhancing Autonomy and Control Over Nursing             Practice” OJIN: The Online Journal of Issues in Nursing Vol. 15, No. 1, Manuscript 2.             DOI: 10.3912/OJIN.Vol15No01Man02

Essentials of Leadership

Question

A leader has the ability to combine commitment for improvement with knowledge regarding how to exercise influence and engage support (Dickson & Tholl, 2014). In the areas of nursing and public health, the focus is on improving health. Porter-O’Grady and Malloch (2015) noted several major tasks of 21st-century healthcare leaders. Applying essentials of leadership, select two (2) tasks from the following list of tasks and discuss how you would exercise influence and engage support for each of your selected tasks.

Deconstructing the barriers and structures of the 20th century

Alerting staff about the implications of changing what they do

Establishing safety around taking risks and experimenting

Embracing new technologies as a way of doing work

Reading the signposts along the road to the future

Translating the emerging reality of health reform into language that the staff can use

Demonstrating personal engagement with health reform

Helping others adapt to the demands of a value-driven health system

Creating a safe milieu for the struggles and pain of changing practice and service

Enumerating small successes as a basis for supporting staff

Sample paper

Essentials of Leadership

Alerting Staff about the implications of changing what they do

There is need to engage staff constantly about the need to adapt new strategies for doing things due to the evolving nature of the world. Every day there are changes occurring in the nursing and public health sector. As such, there is need for leaders to constantly interact with staff and learn how best they are adapting to changes in the nursing environment (In Dunham-Taylor, & In Pinczuk, 2015). Change is difficult to implement in any kind of organization. Lack of adequate change management can lead to failure of the organization to achieve its financial goals. When employees are not part of the change or when they do not perceive any benefits from changes, they may become frustrated and reduce their productivity. Leaders should take time to ensure employees embrace change. One of the actions that leaders can take to enhance change is training employees about the benefits of the intended change and need for change.

Embracing new technologies as a way of doing work

Technology is radically evolving, shaping various aspects of nursing and public health sector. As new technologies emerge, so does the need to apply effectively these technologies in the workplace. The rate of technology adoption in nursing and public health sector determines the achievement of positive health outcomes. Leaders face the enormous challenge of ensuring that staff is able to use new technologies in a way that promotes achievement of positive health outcomes in nursing and public health sectors. One way of ensuring support for this is by providing continuous training to staff. All staff members should be able to know how to apply correctly new medical technologies. Training should place emphasis on the benefits derived from using new technology. Another way of exercising influence is by encouraging the early adopters. This represents the category of staffs who are quick to learn and apply the new technology. Such a category can encourage the slow learners to adopt the technology.

Reference

In Dunham-Taylor, J., & In Pinczuk, J. Z. (2015). Financial management for nurse managers: Merging the heart with the dollar. Burlington, MA: Jones & Bartlett Learning.

Issue of clinical significance vs statistical significance paper

Issue of clinical significance vs statistical significance paper

Question

Clinical Significance (graded)

Explore these issues on the Internet and through other resources. Share what you find out on these topics:

Confidence Intervals: Why are they useful in helping to determine clinical significance?

There are many controversies surrounding the issue of clinical significance vs. statistical significance. Identify one of them and summarize it. Finish with your opinion about the controversy.

Sample paper

CLINICAL SIGNIFICANCE

Most of the clinical processes encompass tests and research that requires medical practitioners to, measures values and population and that is where confidence interval comes in. A confidence interval is a probability that a value will fall between upper and lower bound of a probability distribution. It helps to measure the probability of a population falling between two set of values (Giles, 2016). Confidence intervals can be useful in many ways to the organization, and they are particularly useful in helping avoid possibly erroneous conclusions that the two groups have similar results when non-significant findings are reported. On the same note, it allows a more flexible and nuanced approach to the analysis of research data. In addition, they allow and enable investigators to test a hypothesis about their data, and they are also more informative about such important parts of research as the sample size as well as helping a scholar to create a correlation between results obtained and the population used in the study (Bray, 2016).

Most of the experts believe that physicians are only interested in the statistical significance of their main objective and there are only interested in establishing whether the obtained p-value is below alpha. However, in clinical research, it is not only paramount to measures and access significance of the differences between the evaluated groups, but it is also recommended. Thus, one of the controversies that exist between the two is that clinical significance is superior and more important than statistical significances as it provides more information and insight on the values obtained (Pontin, 2016). Unfortunately, there is no agreed settlement to this controversy, and thus it depends on individual physicians to choose what to use depending on the research and study he is conducting.

References

Bray, I. K. (2016). Family presence during resuscitation: validation of the risk-benefit &              self-confidence scales for student nurses.

Giles, T. L.‐C. (2016). Factors influencing decision‐making around family presence during                      resuscitation: a grounded theory study. Journal of Advanced Nursing.

Pontin, D. K. (2016). Family-witnessed resuscitation: focus group inquiry into UK student           nurse experiences of simulated resuscitation scenarios. . BMJ Simulation and      Technology Enhanced Learning, 2(3), , 73-77.

Health Policy Presentation-Long-term Care

MSN Specialty Executive Leadership

Question

The purpose of this assignment is to: a) demonstrate how the skills outlined in the AACN Essentials are applicable to the role of a master’s–prepared nurse (CO #5, #6) and b) present ideas in a clear, succinct, and scholarly manner (CO #1).

Course Outcomes

Through this assignment, the student will demonstrate the ability to:

(CO#1) Demonstrate effective verbal, written, and technological communication using legal and ethical standards for transferring knowledge. (PO 3)

(CO#5) Analyze the American Association of Colleges of Nursing (AACN) Essentials of Master’s Education in Nursing [AACN Essentials]. (PO 1)

(CO#6) Assess the roles of the master’s-prepared nurse. (PO 1)

Sample paper

MSN Specialty Executive Leadership

Speaker notes

MSN Specialty Executive Leadership

The executive leadership position for MSN students prepares one for executive and management positions in the healthcare field. MSN specialty executive leadership program is provided at the master’s degree level program. Executive leadership program enables nurses to provide direct care services to patients and staff while still utilizing their clinical judgment knowledge. The executive leadership program trains master’s students to develop positive collaborations with the entire heath care team in order to provide a robust environment that addresses the needs of patients. The MSN specialty executive leadership prepares students assume leadership roles in healthcare settings. It enables nurse leaders to provide effective services in healthcare organizations.

Available areas of Practice

Students who successfully complete the program are able to choose among various fields of practice where they can effectively apply their skills. The various field of practice areas include hospitals, data management firms, community-based clinics, nurse-managed clinics, ambulatory care centers, practice management organizations, corporate organizations, and other areas.

How Executive Leadership Program Prepares Students

The executive leadership programs prepare students to assume delivery of nursing and health care service provision in a number of ways. The program enables students to implement, maintain and define the standards required in quality patient care. The program also enables students to learn how they can manage work teams (American Association of colleges of Nursing (AACN), 2011). In healthcare settings, nursing executives face the main challenge of developing effective teams to implement projects. The program enables students to learn how they can implement programs and policies that help healthcare organizations in achieving both the financial targets and care delivery targets involving continuous improvements. The program equips students with knowledge on how they can mentor staff in order to improve performance and maintain their motivation levels (AACN, 2011). As such, leaders learn the various ways they can develop and sustain motivation among staff. The program enables executive leaders to manage change in healthcare settings. Change is an important component in the healthcare settings. Executive leaders must learn how to implement changes in healthcare organizations by involving the entire team.

The executive leadership program enables nursing leaders to gain a better understanding of the need for research. As such, they are in a better position to participate in research. The program enables executive leaders to learn how to balance the operational, strategic, and financial and the interpersonal responsibilities that relates to the healthcare settings (AACN, 2011). The program teaches nursing executives the various ways in which they can draw on the knowledge and skills of their peers, subordinates, and supervisors and apply this to achieving the organizational goals and objectives. This also enables them to learn how to solve problems collaboratively. Lastly, the program enables nursing executives to develop ethical reasoning or decision-making. Nursing executives should be able to provide patients and staff appropriate advice whenever ethical issues emerge.

How the skills outlined in the (9) AACN Essentials are applicable in Executive Specialization

The skills outlined in the AACN Essentials will greatly assist students in the executive leadership program. The first skill outlined in the AACN Essentials highlight the need for scientific backing for practice. This is essential since executive leadership requires nurses to be able to conduct research and apply the findings in practice (AACN, 2011). This enables the leader to apply scientifically backed theories and solutions in healthcare delivery. The Second AACN Essential relates involves organizational and systems leadership that enhances systems thinking and leads to quality improvement. The AACN Essential is applicable since it equips graduates with skills for working in organizations such as hospitals that deal with the larger community (AACN, 2011). It helps the executives to develop effective management strategies in healthcare settings. The third AACN Essential relates to the ability of the graduate to apply analytical methods in evidence-based practice. The graduate can apply the skills learned under this essential to apply analytic methods in reviewing existing literature in application of evidence-based practice. The essential can also enable a graduate to examine critically the quality improvement practices in place with an aim of promoting an effective patient-centered care.

The fourth skill relates to the application of information systems technology in improving healthcare delivery. The skills obtained from this essential can enable executives to improve healthcare systems, provide better patient care, and to offer better leadership in both academic and healthcare systems (AACN, 2011). The skills obtained in this area also enable executives to apply new knowledge in healthcare delivery. The skills also enable executives to assess the effectiveness of new patient care technologies as applied in particular areas of practice. The fifth essential relates to health care policy and the role played by advocacy in health care (AACN, 2011). This skill is applicable since it enables executives to be aware of the policy development process and to utilize knowledge on advocacy to influence healthcare policies. Appropriate policy development initiatives are critical in ensuring that the healthcare system fulfills the needs of all stakeholders. Skills obtained from this essential can also enable an individual to advocate for health care policy that social injustices and equity in health care.

The sixth essential involves establishing collaborations across the profession for the purpose of improving patient and population health outcomes (AACN, 2011). This essential can be effective in helping executives employ effective and efficient communication skills in the implementation of practice guidelines and practice models. The essential can also enable executives to lead various interprofessional teams in the organization to analyze complex practice issues. The seventh essential relates to clinical prevention and population health (AACN, 2011). Clinical prevention relates to risk reduction or illness prevention for families and individuals. The implementation of population health activities and clinical prevention is critical in helping achieve the national goals of the entire population. Implementing of the two can help an executive develop strategies for combating unhealthy lifestyle behaviors among individuals.

The eighth essential relates involves the advanced nursing practice (AACN, 2011).. Over the years, healthcare has experienced significant changes owing to emergent technologies that lead to sophisticated healthcare systems. It becomes difficult for executives to master all the advanced roles involved in healthcare delivery to patients. Advanced nursing practice thus enables graduates to concentrate in a narrower field of practice such as executive leadership or informatics. As such, the graduate is able to become a master of the particular area or field of specialization. The last essential is the master’s level nursing practice (AACN, 2011). The master’s level nursing practice seeks to improve the healthcare outcomes for patients. Master’s level nursing practice enables graduates to develop appropriate skills and knowledge relating to nursing and the relevant health sciences.

Ways that a master’s prepared nurse would use the AACN Essential skills in nursing practice.

AACN Essential skills can be used by an executive specialty in ethical decision-making. The rising demands for cost control and the increasingly complex health technologies have raised the need for ethical decision-making by leaders (McClearly-Jones et al., 2014). A critical competency required among executives is the ability to provide counseling to patients in situations where ethical dilemmas face them. Another core competency relates to the ability of the executives to lead discussions relating to ethical issues affecting communities and the healthcare facilities. Ethical decision-making becomes the foundation of content in clinical practice, research, management, and evaluation. AACN Essential skills enables executives to gain an understanding of the belief systems, personal values and principles that lay the foundation for nursing practice. AACN Essential skills enable students to explore values and examine how such values shape the professional practice and how they influence the decision-making process.

Executives can apply the AACN Essential skills to analyze ethical dilemmas in their field of practice and evaluate how the ethical dilemmas affect patient care (McClearly-Jones et al., 2014). Executives are more likely to encounter ethical dilemmas during practice involving patients. ACCN Essential skills are also critical in helping executives take responsibility for their own practice outcomes. The quality of one’s practice may vary depending on many factors. Learning the essential skills can enable one to become accountable for their practice outcomes. ACCN Essential skills enable executives to identify areas in which conflicts of interest may emerge. In this way, one might be able to develop alternative solutions and thus avoid personal conflicts. The essential skills enable executives to examine their decision-making processes from an ethical point of view (McClearly-Jones et al., 2014). In other words, the executives can be able to evaluate their decision-making from both an organizational and a personal perspective.

The AACN Essential skills enable executives to operationalize the various norms and principles within their specialty area. The essential skills are fundamental during practice. The AACN Essential skills enable graduates to transition into advanced practice nurses (McClearly-Jones et al., 2014). The content acquired under the AACN Essential skills enables graduates to understand clearly their role in the nursing profession. It also helps them to understand the various requirements and regulations within the nursing practice. An understanding of the AACN skills enables graduates to transform into advanced nursing practitioners and to integrate new activities and new knowledge into their professional practice in the field. It also enables the graduates to provide their services in an effective manner even in multidisciplinary environments. Executives should display certain behaviors in their field of practice. AACN skills enable executives to exhibit the desired professional behaviors and personal qualities in their field of work (McClearly-Jones et al., 2014).

Professional role development enables executives to develop the ability to communicate effectively with other health care professionals. It is important that executives develop effective collaborations and learn to develop interdependent relationships in their field of work. Executives are leaders who must bear the right communication skills in the health care field. Executives are able to assume the role of advocates in the health sector. The role of advocacy is set to benefit the patients and bring appropriate changes in the healthcare system. AACN skills enable executives to advance their knowledge as researchers, consultants, managers of systems, and as clinicians (McClearly-Jones et al., 2014). The skills enable executives to manage changes within health care systems rather than reacting to changes. Thus, executives plan for changes in advance instead of waiting for changes or external forces that move them to change. Nursing executives also gain the knowledge involving proper recruitment procedures in the nursing profession.

An executive who acquaints self with knowledge on AACN may be in a better position to develop effective policies, make appropriate organizational decisions and make sound financial decisions (McClearly-Jones et al., 2014). An executive should be able to develop ways in which patients can receive quality and cost effective health care. The appropriate executive should also be able to design and institute different health care systems, and to manage effectively the human and physical resources available within the health care organization. With regard to policy issues, the skills enable executives to become responsive to an ever increasing participation of the government, the public and other third parties in the running of health care organizations (McClearly-Jones et al., 2014). This enables executives to learn how they can analyze policy research results and apply the knowledge learnt in improving health care delivery systems and processes.

One can use the AACN skills to gain a better understanding of health care financing and the most appropriate ways of managing health care facilities financially. Nurses can use the skills acquired to gain an understanding of the economic implications involved in health planning, the designation of wage systems, examination of the personnel and other resources available in the organization (McClearly-Jones et al., 2014). Nurses can also be able to apply the core principles involved in budgeting, health economics and fiscal management. Nurses or executives can be able to apply cost-benefit analysis and other procedures to determine the effectiveness of particular processes or systems. This can lead to the development of high quality and cost effective decisions, which ensures that only the effective decisions have been implemented.

The executive leadership position for MSN students is important in preparing students for executive and management positions in the healthcare field. MSN specialty executive leadership program is provided at the master’s degree level program. The various fields of practice available for graduates include hospitals, data management firms, community-based clinics, nurse-managed clinics, ambulatory care centers, practice management organizations, corporate organizations, and other areas. The program enables students to implement, maintain and define the standards required in quality patient care. The skills outlined in the AACN Essentials will greatly assist students in the executive leadership program.

References

  • American Association of colleges of Nursing (AACN). (2011). The essentials of Master’s education in nursing. Retrieved from http://www.aacn.nche.edu/education-resources/MastersEssentials11.pdf

McClearly-Jones, V., Smith, P., & Carithers, C. et al. (2014). Collaboration in the face of change: a successful graduate curriculum revision. Journal of Nursing Education and Practice, 4(1): 1-9.

Health Policy Presentation-Long-term Care

Question

The purpose of this assignment is for you to identify an issue of concern for your role as an advanced practice nurse and to formulate a potential policy change to address that issue. There are many potential issues which can influence your practice setting or other issue which may negatively affect the patients with whom you work.

All of the course reading will help you to identify a topic for this assignment. You can think about the issue as related to your health promotion project. The policy you consider may be in reaction to the health promotion issue or something larger that is still related to that issue. There are hundreds of possible issues, but here is a list of a few to consider:

Child and elder care

Civil rights

Domestic violence

Drug abuse/addiction

HIV/AIDS

Homelessness

Native American and migrant workers’ health

Long-term care

Immigration/illegal aliens

Legislative issues affecting advanced practice nursing

Barriers to practice

Access to care

As you begin to work on the possible policy change: the following ideas and steps should be considered:

Definition and description of the issue

Exploration of the background of the issue

Stakeholders

Issue statement or statement of clarity

Possible methods of addressing the issue

Goals and options for changes

Risks and benefits of the changes

Evaluation methodology

Recommendation or solution

Identify the type of legislation, such as state, federal, scope of practice, reimbursement, loan repayment, or others.               

Review of the literature consists of a minimum of 3–4 peer-reviewed articles and 6–7 other outside sources.       

Describe the current policy or health policy issue and specify how it would impact nursing or healthcare.

Describe the specific aspects of the proposed policy or policy change.     

Identify the individuals who would benefit from the policy change and explain where support for the change would be

Describe the impact of the policy change on nursing practice and health care.     

Provide an analysis of the policy from your point of view and how this will influence your practice.

Sample paper

Health Policy Presentation-Long-term Care

Speaker notes

Definition and Description of the Issue

Long-term care refers to the continuum of social and medical services provided to those living with chronic health issues. Long-term care services are a combination of medical services, housing, and social services. Long-term care is considerably different from acute medical care – the latter aims at returning an individual to the state he or she was before the appearance of the medical condition. On the other hand, long-term care aims at helping individuals adjust to their new situation. Long-term care is much broader in terms of the services provided to individuals. While acute medical care focuses on medical services, long-term care also involves social services. The provision of long-term care involves a wide range of specialists or care providers. These include physicians, community caregivers, nursing home care providers, home care agencies, friends, and family members.

Exploration of the Background of the issue

According to Frank (2012), the lifespan of most Americans has tremendously improved owing to better nutrition and improved medical care. In addition, the Baby Boomers (born between 1946 and 1964) have increasingly aged, causing a rise in demand for acute care. Over the next 10 years, the demand for support and long-term care services will significantly increase due to the aging of this generation. In 2010, approximately 10 million Americans were in need of long-term care and support. Surprisingly, only about 20 percent of those in need of long-term care services receive professional care, the rest depending on family and friends. Projections indicate that the number of those seeking long-term care services will reach 15 million by 2020 (CDC, 2013). With the high number of those requiring long-term care and support, it becomes obvious that the cost of providing such services will likely increase in the future – a cost that is already extremely high for most American families.

Stakeholders

There are a number of stakeholders directly affected by the issue. The baby boomers, or those born between 1946 and 1964, are currently entering old age (Bowser, 2013). As they advance in age, majority are increasingly requiring long-term care services due to various conditions such as Alzheimer’s condition associated with aging. These are the main stakeholders. Others stakeholders involved are the caregivers. These range from hospitals to physicians that provide medical services to those in long-term care facilities. Home care agencies are directly involved in providing care to those requiring long-term care. Assisted living facilities and nursing homes are also major stakeholders in long-term care. Family members, friends, and hospice caregivers are also important stakeholders.

Related: Nursing Sensitive Indicators

Issue Statement

The current long-term care system is in a crisis owing to capacity issues. With the current projected increase in the number of individuals requiring long-term care, the future situation may be dire. About 77 million Baby Boomers will retire over the next 10 years. Only a few have enough savings to pay for long-term care (Calmus, 2013). Long-term care is currently expensive and out of reach for majority of Americans. The average annual cost for a typical room in a nursing home will average $90,000. To make it worse, majority of Americans do not have adequate cover or funds for long-term care. According to Butler (2016), the cost of long-term care will rise in the next few years, which will average $138,000 per individual. It has become difficult to acquire private insurance to cover these costs since most private insurance firms either have increased their premiums or have withdrawn their services due to high costs. Currently, government programs have underserved the needs of most Americans, with Medicaid program covering only 40 percent of the total costs and Medicare covering only 23 percent of the total costs. This leaves most individuals with huge financial burden.

Possible Methods of Addressing the Issue

There are a number of possible ways to improve on this issue. First there is need to develop private insurance to increase their contribution to coverage of individuals requiring long-term care. Private insurers have the potential to cover more Americans compared to the state and federal governments. Plans should involve ensuring that those in employment receive automatic enrolment with an insurer of their choice. The second method of addressing the issue is through revamping the Medicaid program. Currently, the program covers 40 percent of the costs. The federal government should develop ways of increasing coverage of the program to about 60 percent of the total costs. This can greatly help individuals requiring long-term care. The next way to address the issue is by developing personal and community initiatives. There is need to educate the public on issues relating to health and financial planning. This can enable them prepare for the future. Lastly, home and community based services can help reduce costs in the sector.

Goals and Options for Changes

The major goals of the changes should be to reduce the current costs of long-term care services. The high cost of long-term care delivery is currently leaving families with huge financial burdens. The changes should aim at lessening the financial burden incurred by families in long-term care. Another goal is to create awareness among individuals about the need to invest in long-term care. According to Freundlich (2014), majority of individuals harbour misconceptions about coverage of long-term care costs. Individuals lack adequate knowledge on what costs are covered by Medicaid and Medicare programs. The next goal is to create awareness among individuals on the need to lead healthier lifestyles. There is need to create awareness on the need to adopt healthier lifestyles even at an advanced age.

Risks and Benefits of the Changes

There are certain inherent risks in the proposed changes. For instance, there is risk of increased taxes associated with increasing the coverage of Medicaid program to 60%. This might be counterproductive to growth. Engaging the private insurance firms may also lead to reduced savings among workers (Freundlich, 2014). Private insurance firms may charge high and unaffordable premiums. The cost of private insurance may be high discouraging majority of workers. There is also risk of failure by the legislature to pass the amendments required to effect the changes. The process may take long worsening the current crisis further. Lastly, there is risk of inadequate information to back up the proposals (Bray, Ren, Masuyer, & Ferlay, 2013). For instance, the actual costs of the proposed changes are not yet known. The major benefit from these changes will be reduced costs of long-term care among individuals.

Evaluation Methodology

The evaluation methodology will lay emphasis on cost. It is important that an appropriate strategy should keep costs down (Nicolle, 2014). An appropriate strategy should aim at reducing costs of long-term care and ensuring that individuals are able to access long-term care without overburdening their loved ones. The appropriate strategy should be able to reduce private spending from personal savings or bond and instead utilize insurance services.

Recommendation or Solution

This research recommends involving the private sector in reducing the high burden of long-term support care cost among families. Long-term insurance plans can help individuals reduce their dependence on the government sponsored Medicaid and Medicare programs. Individuals should start buying insurance premiums while young, which can enable them purchase cheaper premiums or receive discounts (Donald et al., 2013). The government should also work with private insurance firms to ensure that they reduce premium costs to those taking cover for long-term care support. Currently, private insurers are wary of providing comprehensive coverage to the poor. Payroll tax can be used to finance a catastrophic plan or even a short-term plan that can pay benefits up front.

References

  • Bowser, B. A. (2013). Why long-term care for U.S. seniors in headed for crisis. PBS News Hour. Retrieved from http://www.pbs.org/newshour/rundown/americas-looming-long-term-care-crisis-and-what-can-be-done/
  • Bray, F., Ren, J. S., Masuyer, E., & Ferlay, J. (2013). Global estimates of cancer prevalence for 27 sites in the adult population in 2008. International Journal of Cancer132(5), 1133- 1145.
  • Butler, S. M. (2016). Consensus plans emerge to tackle long-term care costs. The Journal of the American Medical Association, 315(14): 1-9.
  • Calmus, D. (2013). The long-term care financing crisis. Center for Policy Innovation Discussion Paper 7 on Health Care. Retrieved from http://www.heritage.org/research/reports/2013/02/the-long-term-care-financing-crisis
  • Centers for Disease Control and Prevention (CDC). (2013). Long-term care services in the United States: 2013 overview. Retrieved from http://www.cdc.gov/nchs/data/nsltcp/long_term_care_services_2013.pdf
  • Donald, F., Martin‐Misener, R., Carter, N., Donald, E. E., Kaasalainen, S., Wickson‐Griffiths, A., ..& DiCenso, A. (2013). A systematic review of the effectiveness of advanced practice nurses in long‐term care. Journal of Advanced Nursing69(10), 2148-2161.
  • Frank, R. G. (2012). Long-term Care Financing in the United States: Sources and Institutions. Applied Economic Perspectives and Policy, 34(2), 333-345. doi:10.1093/aepp/pps016
  • Freundlich, N. (2014). Long-term care: What are the issues? Robert Wood Johnson Foundation. http://www.rwjf.org/en/library/research/2014/02/long-term-care–what-are-the-issues-.html
  • Nicolle, L. E. (2014). Antimicrobial stewardship in long term care facilities: what is effective?. Antimicrobial resistance and infection control3(1), 1.

Related:

Standards and regulations on CPAP and BIPAP

Standards and regulations on CPAP and BIPAP

Question

Reviewed and research evidence of relevant regulations and Standards regarding the use of CPAP and BIPAP. Should also include a chart with the summary.

Sample paper

Standards and regulations on CPAP and BIPAP

Most of the governments around the world are striving to ensure that they fight poverty, disease and ignorance. Providing good medical care for all the citizens has been hectic for a very long time. However, it is the duty of these governments to ensure that there is the availability of crucial machines in all public hospitals to ensure they can reduce the mortality rate of both infants and adults. One of those important machines includes the CPAP and BIPAP.  Continuous positive airway pressure machine is a machine that helps to administer a treatment that uses mild air pressure to keep the airways open (Jensen, 2008). CPAP is used to people who have breathing complications and infants whose lungs have not fully developed. On the other hand, Bilevel positive airways pressure that performs a similar function as that of CPAP. However, the BIPAP treatment is a non-invasive form of therapy and includes breath timing feature that measures the amount of breaths per minute. The only difference between the two machines is that the CPAP has one pressure setting while the BIPAP has two pressure settings making it easy for patients to breath.

There are several rules and regulation and standards that come with the use of CPAP and BIPAP machines and should be observed by both medical practitioners and all patients.

  • The Medicare should cover 3-month trial – a patient who has been diagnosed with obstructive sleep apnea should go for a three month trial with the therapy unless stated otherwise by the concerned doctor.
  • The eligibility of this therapy widely goes for all people with medical insurance and has been diagnosed with this disease. Since the medication and the therapy may be costly to low-income citizens, they are widely advised to have a medical insurance before engaging in this therapy.
  • An oral appliance is not enough- most people tend to think that one or two oral appliance is enough and think that they are fully treated, but this is not the case. Patients who already have gone through oral appliance need to be followed and diagnosed to ensure that the medication worked effectively(Kopelovich, 2012).
  • Positioning- the positioning of the patient should be in slant position to enable him to have a good and spontaneous breathing room. The air should be delivered to the patient at a constant pressure during inspiration and expiration.
  • CPAP proceeds BIPAP – in most cases, patients who are suffering from obstructive sleep apnea are usually subjected to CPAP. If the patient does not respond to the treatment, he is then subjected to BIPAP, which has two levels of pressure to completely eliminate the apneas.

A summary chart of regulation and standards for use CPAP and BIPAP

Rules and standards case
Oral appliances All medical experts should follow their patients to ensure that they are fully treated, and they should not make any assumption if the patient is taking oral appliances.
Positioning The patient should be positioned in an appropriate position to allow him or to breathe spontaneously
Eligibility All patients are eligible to the treatment, but it works best for those with medical insurance because it becomes easy to cater for expenses.
Trial period  It is mandatory for all patients to undergo trial therapy for a minimum of three months and await further instructions from their doctors.
CPAP proceeds BIPAP BIPAP is the last resort that doctors seek after the failure of CPAP, which may not work in some patients.

 

Reference

Jensen, C. T. (2008). Postoperative CPAP and BiPAP use can be safely omitted after laparoscopic Roux-en-Y gastric bypass. urgery for Obesity and Related Diseases, 4(4), , 512-514.

Kopelovich, J. C. (2012). Pneumocephalus with BiPAP use after transsphenoidal surgery. Journal of clinical anesthesia, 24(5),, 415-418.

Nursing Sensitive Indicators