Question:

Discuss the various ways in which Florence Nightingale’s model of care can be applied in current nursing practice. Identify the most important factor of Nightingale’s theory that you utilize in your current practice.

 

 

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"

 

Preventing use of tobacco and helping those who utilize it to stop can have continuing benefits for people and for the public health in general. Advanced practice nurses can engage in activism and prevent Big Tobacco from further disabling the health of many communities by developing and implementing tobacco management programs to assist to reduce or prevent the use of tobacco. These programs can make use of taxation, mass-media campaigns, restrictions and easily accessible and effective behavioral analysis and tobacco ending medications. The programs can provide services to different target audiences, including young individuals, people with co morbid health issues, those of different socioeconomic status and ethnicities, and women (Diem & Moyer, 2015). A comprehensive approach to tobacco management results in changes that affect the whole population, from the person to the community level, by addressing the social, political economic, cultural and environmental aspects that sustain the using and not using of tobacco. 

Another way that advanced practice nurses can engage in activism and prevent Big Tobacco from further disabling the health of many communities is through the use of Evidence-based best practices for tobacco control (Stanhope & Lancaster, 2014). Programs for tobacco control reduce use of tobacco at the populace level by building tobacco-free outdoor and indoor areas, limiting the access of young people to tobacco products, restricting tobacco marketing, having continuous counter marketing campaigns, increasing the price of tobacco products, and offering easily available tobacco termination services and products.

References

Diem, E. & Moyer, A. (2015). Community and public health nursing: learning to make a difference through teamwork. Toronto: Canadian Scholars’ Press.

Stanhope, M. & Lancaster, J. (2014). Public health nursing: population-centered health care in the community. Maryland Heights, Missouri: Elsevier Mosby.

 Running head: THE ROLE OF HEALTH ACTIVISM BY NURSES IN CONTROLLING TOBACCO USE Carlos Ortiz Florida National University Prof. Crevecoeur 11/13/2017 THE ROLE OF HEALTH ACTIVISM BY NURSES IN CONTROLLING TOBACCO USE Practicing nurses can engage in health activism as form of communication to empower communities to mitigate the devastating health effects evident in many health facilities. One way in which this can be achieved is through nurses becoming active members in coalition groups that campaign against tobacco use. They can then use their healthcare experience to craft attention-drawing advertisements to be broadcasted in mass media and social media on why the masses need to avoid tobacco use ( Hamilton ,2014). They can also design effective posters to be displayed in health facilities and other public places highlighting the steps a tobacco user can take to quit the practice. Further, such campaign groups can organize public presentations in public gatherings, schools, churches and other learning institutions to sensitize the public on the dangers of using tobacco in its various forms and ways of quitting when even addicted. In the political arena, practicing nurses can engage legislatures while seeking office and present their proposals on what they could like to be passed into law in the quest to mitigate negative effects of tobacco use. In addition, they can utilize their advocacy abilities to push for policy changes by the various policy makers including as the total retail outlets, increasing the number and area of ‘no smoking zones’ and pushing for exponential escalation of tobacco taxes. The change in policy may also seek to limit the advertisement of tobacco products in mass media while making it a condition to explicitly display warning signs on the packets containing the products. Moreover, the nursing activism groups can involve people who have quit tobacco use to testify to the public spreading the message of the need to end tobacco use (Smith,,2015). References Hamilton, N. A. (2014). American social leaders and activists. Infobase Publishing. Smith, S. A. (2015). The Pernicious Weed: Anti‐Tobacco Sentiments in Periodical Literature, 1800–1870. Historian, 77(1), 26-54. 

 

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"

Comment 1

Development of an evidence-based practice project must include the direct and indirect impact that will be encountered through implementation. Staff retention of newly hired nurses specific to the night shift is the focus of my project and its impact on the nurses, facility and community that is served. According to published reports, a supportive work environment, especially between managers and employees, creates a strong deterrent to nurses leaving an organization by improving perception of organizational support, employee engagement, team cohesion, and connection to the mission of the health-care setting (Kurnat-Thoma, Ganger, Peterson, & Channell, 2017).

Financial aspect – staffing cost/turnover cost

Hospital staffing turnover is projected to 5% to 5.8% of total hospital annual operating budget and is largely driven by the loss and necessary replacement of qualified nurses according to  Waldman, J., Kelly, F., Arora, S., Smith, H. (2010).

Proposal direct impact – hospital revenue/staffing costs,

Proposal indirect impact – patient outcomes, positive healing environment perception by staff/patients

Quality Aspect – High turnover in any industry can be a concern, especially those that are customer-centric. Industries that deal with people’s health are in an even more precarious position. Institutions with high attrition must consider how a “revolving door” of care providers affects the quality of care an institution is able to provide, and the satisfaction of patients with their overall experience according to Arena (2018).

Proposal direct impact –

Separation Costs – Continued benefits, temporary labor, overtime to existing employees

• Recruitment Costs – Job description, posting on job boards, screening candidates, interviewing candidates, assessing candidates

• Onboarding Costs – Orientation and training of new hire

Proposal indirect impact –

Loss of productivity

• Lack of staff while positions are being filled

• Increased pressure on existing staff to cover and pick up the extra work often leading to burnout

• Patients receiving less attention

• Pressure on current staff to train and then gel with the new employees

• Lack and lag of knowledge with new employees concerning institutional practices, workplace norms, team behaviors, and patient knowledge, familiarity, and care experience

Clinical aspect – unit cohesiveness/patient care

Many nurses leave their positions because of negative experiences with heavy or unrealistic workloads and due to feeling unheard and undervalued. Clinical nurses’ sense of disempowerment can be related to lack of leadership interventions. Clinical nurses may feel that managers are insensitive to their staffing needs, don’t support employee well-being, and don’t invest enough in staff education or clinical advancement according to Linnen and Rowley (February 2014).

Proposal direct impact – nurses will see themselves as stewards for their unit. “Nurses are leaders by virtue of their responsibilities; for them, empowerment isn’t a privilege, but a professional necessity” (Linnen and Rowley, 2014).

Proposal indirect impact –

–          Nurse advancement

–          Staff participation in policy and governance

–          Leadership support

–          Adequate staff and resources

–          Nurse/physician relations

Comment 2

My mentor is a wound care nurse and my proposal is about quality improvement and how it affects pressure ulcers. After discussing with my mentor, we discussed that a financial aspect for developing an evidence-based practice project would be a reduction in billing for treatment, such as special ointments, creams, and dressings that are billed to the patient, patient’s payer source, and facility. A quality aspect would be an improvement of the quality of care. Evidence-based practice would prevent the development of pressure ulcers and/or improve the healing of current pressure ulcers. A clinical care aspect would be understanding who the target population is and what type of facility they are in.

My proposal would directly impact all of these aspects because treating these types of wounds can be very costly to not only the patient or patient’s payer, but also the facility. The facility usually has a house supply of basic dressings and wound care supplies, such as calcium alginate with and without silver, different types of dressings, collagen, etc. Over time, this can become very costly because dressing changes need to be done on a daily basis and as needed. To improve healing and prevent wound development, evidence-based studies have proven that turning patients at least every two and keeping them clean and dry significantly decreases the development of pressure ulcers. The use of preventive materials (types of mattresses, positioning devices, etc.), characteristics of the residents (personal preference of preventive materials, presence of existing ulcers, and positioning), protocols based on four themes (observation of the skin, frequency of repositioning and postures, use of support surfaces, and elevation of heels also helps as well (Beeckman, Clays, Van Hecke, et al., 2013).

Comment 3 6DQ1

Proposed solution to address issue of staff retention – Implementation of Mentor/Mentee partnership program that addresses the perception of job expectations from the viewpoint of new staff. How this idea relates to how the unit runs and aid in transforming perception to reality in the workplace.  Solicitation of nurse’s feedback regarding orientation/mentoring process, satisfaction with job description, and reasons for job change or shift changes if any in past year.

How this proposal has changed since I began – My proposal has changed to include adding a more inclusive program to orient and mentor newly hired staff that includes a broader spectrum of resources. Leadership, peer, and instruction involvement in a process that develops confidence, and well-being in nurses and that provides follow through that lasts through a full year of mentorship.

What led to current perspective and direction – Seeing the frustration in nursing staff that are left on the unit to fill in the empty spots where new nurses have left or changed shifts due to feelings of lack of support and comradery. Building an orientation program that respects the individual needs of nurses and that places nurses in a position to be confident and feel supported throughout their orientation. Also, to understand what is expected in the job that they have been hired for and that they will have a source or resource that will be available for continued feedback.

Comment 4

My proposed solution would be to increase quality improvement for the residents in Windsor Rosewood Care Center and decrease the incidence of pressure ulcers. Implementation would be based on evidence-based practices, such as turning at-risk patients at least every two hours, keep them clean and dry, and make sure they are getting enough nutrition, and for those that have diabetes, help manage it better. Based on my research, there are many ways to increase quality improvement in nursing homes. One article used a pay-for-performance plan by performing regular inspections and assessments based on a Minimum Data Set and Online Survey, Certification, and Reporting data. It provided information about how clinical weights, staffing ratios, and inspection deficiencies impact clinical outcomes (Konetzka, Skira, & Werner, 2018). Another article by Hartmann, Mills, Pimentel, Palmer, Allen, Zhao…& Snow (2018), provided valuable information about how patient-staff interaction plays a significant role in clinical outcomes. Nurses are constantly in contact with their patients and how they interact with one another can have a positive or negative on patient outcomes. Medication can only go so far, but caring for the well-being and meeting the needs of their patients emotionally can help them get better, and/or ease their suffering and pain. I have also learned that efforts need to be made on all organizational levels and all health care professionals must work with one another.

My proposed solution has changed in that I was focused quality improvement as a whole, such as wounds, falls, and diseases (pneumonia, catheter-associated infections, and respiratory illnesses). After writing what my PICOT question was on one of the threads, the instructor suggested that I need to be more specific. I decided to write a solution about wound care and falls because my mentor is a wound care nurse and many of the residents are at risk for falls. Then this past week, I decided that I should focus on just pressure wounds because many of the residents are at great risk and it continues to be a very big problem. There is also a lot of valuable information that I have learned from scholarly articles and implement the ideas into my own nursing practice.

 

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"

Comment 1

Diane Black is a register nurse who represents Tennessee in Congress.  Mrs. Black was the first woman to chair the influential House Budget Committee. She serves on the House Ways and Means Committee and was quick to establish herself as a leader.  She is focused on dismantling the president’s health care law and advancing true market-based, patient-centered reforms that will bring down the rising cost of care by increasing private sector competition and consumer choice.Her goal was to reform the U.S. tax code which has not been initiated in over twenty five years. She was selected to chair the Ways and Means Education and Family Benefits Tax Reform Working Group during the 113th Congress.  During her career as a nurse, she saw a loophole in the Patient Protection and Affordable Act (PPACA)that allowed some higher paid middle class Americans to receive Medicaid benefits. She pointed out that the PPACA, unintentionally, would allow a couple who made close to $60,000 in income to qualify to receive Medicaid benefits. This loophole would allow for individuals whose incomes were up four hundred percent of the federal poverty level to also qualify to receive Medicaid benefits. The PPACA set a new income formula to calculate the income levels and make the determination for Medicaid eligibility. This formula did not include incomes received from all Social Security benefits including Supplemental Security Income, Supplemental Nutrition Assistance Program (food stamps), Temporary Assistance to Needy Families, and public housing.  After her election to Tennessee representative, Mrs. Black started lobbying to change the bill H.R 2576. She made her claim that Medicaid should only be used for those who are in the most need and Medicaid needed to get back in line with all other public assistance. Mrs. Black made her claim to Congress that by passing her bill that America would save $13 billion dollars over ten years. She made it clear that they would be saving this money without taking away any benefits from anyone who currently has Medicaid. Mrs. Black’s bill was passed and signed into law. She was the first member of Congress to have legislation signed into law that repeals the health care provision in Obamacare.

Comment 2

Congresswoman Mrs. Deb Soholt is some of the current nurses who are currently serving in Congress. Mrs. Deb Soholt is an RN and also a senator in South Dakota (American Nurses Association, 2015). She is a Senate for South Dacota congressional District 14 before joining politics.
She had sponsored several bills that have influenced health care. For example, “the Senate Bill 61 is to update, revise, and repeal certain provisions relating to nurse practitioners and nurse midwives” (South Dakota Legislature, n.d.). The bill can help redefine the role and function of nurse practitioners and nurse midwives to change the health care delivery and resolve the health provider shortage. Health care can be more accessible and affordable.
The nurse role gives the legislators the ability to understand and recognize nursing and health care issues. Therefore, the legislators who are also nurses can use the political power to alter and guide the direction of health care delivery in an optimal way. Health policies at the state level impact the health and safety of the state’s residents, as well as lead the nursing and other health professions’ scope, practice, and performance through the state’s professional practice acts (Cherry & Jacob, 2016) “The federal government’s role in health care includes significant funding for health and disease prevention and research; supplemental funding for education for health professionals, including nurses and physicians; and paying for individual health care services “(Cherry & Jacob, 2016, pg. 400). Therefore, the legislators in the federal level will focus on these categories to shape health care delivery.
She firmly believes that there is a strong need for more healthcare professionals in Congress. After all, health care is at the forefront of many political debates. Since she was the nurse, she sees the importance of having lawmakers with the healthcare background, that way the issues could better be addressed. In 2011 she was the first to engage in the debate on the Affordable Care Act.

Comment 3

The legislator that I consider to answer the above question is Erin Murphy. Murphy has a long career advocating on legislation related to health care and childcare issues.  As a nurse, Murphy serves as state representative in the Minnesota of Representatives. The new elected representative participated on the Health and Human Services Finance Committee.

In that capacity, she was instrumental and active to help craft reforms to “Minnesota’s health care system that aimed to expand access to affordable coverage and care” (Diane, S., 2017).  The legislator has worked on various health care reforms such as women’s health, affordable childcare, and expanding access to health care for school employees.

One of the bills that Murphy sponsored and supported is the “Health Care Homes.” This specific bill is part of a “statewide health care reform initiative” (2017). The legislation embraces and endorses a health care strategy that focuses primarily on prevention, self-management, and community services. This health care model guarantees better outcomes and quality of life people with chronic and acute health conditions.    

 

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"