Dq12 19367035

Re: Topic 1 DQ 2  Great post also in 2010 the Institute of Medicine(IOM) issued the Future  of Nursing leading  changes in Advancing Health (Institute of Medicine, 2010a)The report not  only informs and highlightes the needs for changes in nursing education  to meet the  changing face fo healthcare but also recommends  the nursing profession increase  the number of registered nurses (RNs) with bachelors degree in nursing (BSN) to 80% by the year 2020(IOM,2010a).The increase in complexity of care is one of the many reasons  driving the IOM recommendation.(NursingLicense.org,2016)with facilities believing that the associate  degree nurses are well trained to manage the day -to -day task  but healthcare today requires more than what is  taught in ADN program. Need APA RERENCE AND INTEX CITATION FOR THIS RESPONSE 

 
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Dq102 Response

Anne Kolsky    3 posts   Re: Topic 10 DQ 2  Importance of EBP for BSN-RN  Sustainability of evidence-based practice has waned. One thing I have noticed in my workplace is that people (including myself) tend to take the path of least resistance. “It’s easier to…” My mentor and I have had many conversations about this. It’s easier to just give a ‘Band-Aid or bag of ice’ then take the time to assess the situation and treat appropriately. Another example, comparing my last workplace to current, one striking difference is stock medications. We did not give out or stock any kind of medication in the former. My new workplace not only stocks but does not require a doctor’s order to administer. Although it is more work, I insist on an order for stock medications. I also call the parent before giving, as appropriate. It is my license and it is for the safety of the students that are at stake.  I have already had conversations with staff and nursing staff about these practices.  Although they know the risks, they are choosing to keep status quo for themselves.  Of 6 nurses on staff, there is one other that holds similar practice.  She stated at our last meeting that “Kids come down asking for a Tylenol, just to get out of class.”  She made it clear that without an order and parent permission, she will not give out any medications.     Another difference noted is charting practices. Currently, other nurses use a one word drop down menu to chart. SOAP notes are not done consistently. I will continue to make notes. I will continue to chart more fully. It has saved my skin more than once when a student, a teacher, or even a parent will claim that “the nurse didn’t do anything.” It gives such good data for what is trending with that student, why wouldn’t one want to do that? I understand that the office is super busy, but so is the courtroom. I’m not here to make friends, I’m here to do my job.   Another practice I will continue to implement, but with a new perspective, are the various screenings given to students. I will make a more concerted effort to make sure the student and family is aware of all the services available. In my former workplace, I compiled a list of resources for families. I need to make a new one for this community. I have a new perspective towards screenings and a fuller understanding of how important these are in the bigger picture.  In the study by Meyer, et al., (2019) of 1,600 clinicians only 51 reported no obstacles to implementing new treatments. The biggest obstacles reported related to time, cost, location for training, demographic mismatch with resources and difficulty finding resources. New trainees are not given evidence-based training nor supervision experiences, either. Participants in the study requested greater access to existing resources. Handouts, journals, training modules, and workshops (Meyer, et al., 2019).   Meyer, A. E., Reilly, E. E., Daniel, K. E., Hollon, S. D., Jensen-Doss, A., Mennin, D. S., … Teachman, B. A. (2019). Characterizing evidence-based practice and training resource barriers: A needs assessment. Training and Education in Professional Psychology. doi:10.1037/tep0000261.supp (Supplemental)

 
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Dq2 1 Response

Re: Topic 2 DQ 1  Workplace violence in the health industry is greater than any other sector of employment, in fact the Federal Bureau of Statistics reports that violence in the healthcare is “3.8 times higher than all of private industry.” (Wolfe, 2018) In fact, the National Nurses United, the largest union of registered nurses reported workplace violence rates increased by 110% from 2005 to 2014. Examples of workplace violence include direct physical assaults (with or without weapons), written or verbal threats, physical or verbal harassment, and homicide (Occupational Safety and Health Administration OSHA, 2015). Nurses in the Emergency Room are at greatest risk for violence. Three out of four nurses routinely experience acts of verbal and physical violence, including, hitting, kicking, yelling and cursing from patients and visitors according to the January 2015 issue Journal of Emergency Nursing.  Statistically violence in emergency rooms is on the rise, however, our organization has specifically seen a drastic increase of violence in the emergency room. Long wait times due to failing healthcare systems, patients suffering from mental health issues and substance abuse are contributing factors. Law enforcement in our county readily bring patients who are altered on drugs or suffering from mental health issues to our facility because other hospitals mental health services have shrunk or they have removed the programs their services and other hospitals require them to stay with the patient while we readily accept them and dismiss the officers, making our hospital the easier and more time efficient option for them. Because of the growing higher population of older adults in our specific area due to several large senior living communities and long term care/rehab facilities within the vicinity of our campus, we see a large number of patients that suffer from situations and diseases that alter the mental status of the individual.  The implications are devastating. Nurses who experience violence in the workplace often suffer emotional, psychological, physical and professional consequences. Nurses often experience symptoms of post-traumatic stress after a violent incident. They may avoid talking about the event, have flashbacks, feel fearful angry, frustrated or helpless, they may also avoid patients or situations that may trigger all of these feelings. Nurses lose cognitive focus after a violent event. (Gillespie et al, 2010). Workplace violence is very costly. It is estimated that it costs billions of dollars a year. (Higazee and Rayan, 2017). Not to mention loss of work for the professional due to injury. Some nurses choose to leave the profession all together.  Busby,G. ( Jan, 2017). Incidence and Costs of Workplace Violence. Journal of Emergency Nursing. Vol. 41. Issue 1.  Gillespie,G.L., Gates, D.M., Miller, M. & Howard, P.K. (2010). Violence Against Healthcare workers in the Pediatric Emergency Department. Advanced Journal Emergency Nursing Journal. 32 (1), p.68-82  Higazee, M.Z.A., Rayan, A. (2017). Consequences and Control Measures of Workplace Violence among Nurses. Journal of Nursing and Health Studies.Vol.2 No.3:22.  OSHA (2015). Caring for our Caregivers. Preventing Violence a Roadmap for Healthcare Facilities. Retrieved o https://www.osha.gov/Publications/OSHA3827.pdfn October 20, 2019 from  Wolfe, E., (3 Oct. 2018). Violence Against Emergency Staffers Seen as Increasing. Fairwarning reports. Retrieved on October 20, 2019, from https://www.fairwarning.org/2018/10/violence-emergency-rooms-workplace-physicians-nurses/

 
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Dq102 Response 19368803

Kimberly Morris    2 posts   Re: Topic 10 DQ 2  Over the past couple decades, nursing has taken a turn becoming more knowledge driven (Stevens, 2013). We are now expected not only to just care for our patients but also educate them and increase their health outcomes by recognizing and knowing what care would be best for them. We are now supposed to make recommendations to providers where before we just made sure patients were comfortable and their needs were met. Because the role of the nurse is changing and becoming a much more active participant in patient care, it is important for the nurse to continue to seek new information and advanced practices by utilizing evidence-based practices.  One way in which I will continue to integrate evidence into my practice is by using the literature review strategy. Our facility is currently doing a literature review four step problem solving on falls. We have currently had a large number of patient falls on our floor and we are doing evidence-based research to see if we can find a practice which would work for us to help decrease the number of falls. The second way I will integrate evidence would be to continue to read and research on my own time. If there is a topic which I feel I need to be educated on, I will look at journal articles or attend conferences or trainings to help increase my knowledge of the subject. This will help me in patient care and will give me necessary information to increase the health outcomes of my patients. If I notice an area within my department in which I feel we need to be better educated or I come across information which could be of interest to my coworkers, I will share this information with them in our weekly huddle or our monthly staff meetings. If I start doing this, maybe it would encourage others to do the same, thus encouraging increased use of evidence-based practice.  Obstacles which would challenge this is lack of interest from my coworkers. If they do not buy in to the idea of sharing knowledge, then they will not listen or learn. But I feel we have a team which is always looking at how to grow and how to become better. The manager of our floor is a driving force behind this. She is continually wanting us to move forward in our careers and encouraging us to learn and become better nurses. She is a great manager and encourager.  Reference  Stevens, K. (2013). The impact of evidence-based practice in nursing and the next big ideas. The Online   Journal of Issues in Nursing. Vol. 18, No. 2, Manuscript 4. doi:10.3912/OJIN.Vol18No02Man04

 
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Dq1wk5 Lideisy

 

Professional nursing organizations are the backbone for the development of the nursing profession. They play an essential role in advocating for the profession’s key aspects such as education, certification opportunities, and role-related competences. These establishments generate the flow of ideas, energy and practical work required to maintain a healthy nursing profession. They promote the needs of nurses, patient needs as well as acceptance to societal code of conduct. Besides, they draw people’s attention to the stress challenges that faces nurses. 

Moreover, the establishments develop the code of ethics. They encourage members to subscribe to the code. The code serves to assert values and commitment to excellence for nurses, patients, and society (Matthews, 2012). These advocacy efforts affirm nurses’ commitment to serve patients. The organizations also develop the standards and the scope of nursing practice, which delineates the practice of nursing. Besides, they set out the competencies for practice. Another role played by such an organization is to set guidelines for regulation of practicing nursing.

Furthermore, nursing professional organizations develop social policy statement. The statement outlines the social responsibility of the nursing profession to society. Besides, it defines the profession’s authority about social responsibility. They also document a contract between the nursing profession and the society with the intent to uphold the highest values and standards in the delivery of nursing care services. These documents are prepared by professional organizations entirely. The organizations demand subscription to the ideologies of the documents. Further to this, these organizations raise the alarm on potential challenges that nurses undergo evoking action.

 
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Dq102 Response 19368781

Dorothy Troutman    1 posts   Re: Topic 10 DQ 2  Evidence-based practice is foundational to the BSN-prepared nurse because it allows us to provide the highest level of care to our patients. One way that I will continue to integrate evidence into my practice will be to read journal articles, and publications from the Association of Women’s Health, Obstetrical and Neonatal Nursing. This will allow me to have the most up to date information on caring for women in my field. One obstacle that may challenge my ability to implement the information I learn would be our hospital policies. To overcome this, I will actively participate in hospital committees and focus groups to change the policies at the hospital.  Another way that I will integrate evidence-based practice into my care will be to attend conferences that focus on labor and delivery. One challenge that may come up is that other nurses in my unit may not attend the same conferences. The way I can overcome this obstacle would be to ask permission to present the information to our labor and delivery unit. If the information is presented to all of the nurses at the hospital, we will have a better chance of changing necessary practices to make sure we are providing the best care to our patients.  Farokhzadian, Khajouei, and Ahmadian (2015) discuss common barriers to implementing evidence-based practice. Some of those barriers include: inability of nurses to distinguish quality of research, lack of resources, and difficulty finding time to read or attend conferences.  Reference  Farokhzadian, J., Khajouei, R., & Ahmadian, L. (2015). Evaluating factors associated with implementing evidence-based  practice in nursing. Journal of Evaluation in Clinical Practice, 21(6), 1107–1113. doi:10.1111/jep.12480

 
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Dq1wk5 Ans Stephani Wriegh

 

Professional nursing organizations are designed for the patient’s safety and quality care as well as ensuring nurses are competent and safe to perform quality and safe patient care (Helbig, 2018).  For example, (ANA) American Nurse Association is a professional organization with goals of improving health care and setting standards for nursing practice improving the nursing  profession and supporting nurses (ANA, n.d.c).  Another is the (NCSBN) National Council of State Boards of Nursing which was created to protect the public from incompetent nurses and require knowledge, skill, and independent decision making in order to be licensed as an RN.  There are also others like the (IOM) Institute of Medicine which protects and informs the public and focuses on suggestions to improve health care (Helbig, 2018), and the (TJC) The Joint Commission which is an organization that identifies issues of patient safety within health care organizations and then designs a plan to correct the issues (The Joint Commission [TJC], 2017).  All of these organizations advocate for patients and their safety while creating standards of practice for the nursing profession and push for change within the health care system while giving suggestions of how to give safe quality care to patients.

 I am thankful for these organizations and what they are doing for us as nurses and for the patients we care for.  This allows best safe practice and gives guidelines to follow to ensure competent nurses give safe quality care.

 
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Dq10 2

Discuss why EBP is an essential component of the practice of a BSN-prepared RN. Identify two ways in which you will continue to integrate evidence into your practice and encourage it within your work environment. What obstacles could challenge this plan, and what steps will you take to minimize their impact?(My EBP is on hand washing)

 
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Dq1wk5 Ans Sita Subedi

 

There are several professional nursing organizations including the American Nursing Association (ANA), National League for Nursing (NLN), National Council State Boards of Nursing (NCSBN) and so on. These organizations work to the favor of nurses and delivered their voice to the policy makers, which makes the big impact to the nursing workforce development, health care delivery, patient outcomes and other issues of concern to the nursing profession (Minority Nurse 2017). Moreover, these nursing organizations helping nurses with their continuing education, updated research articles on specialty areas, competencies, encouraging the use of evidence-based practice, as well as many other professional and personal advantages. Many nursing organizations hold annual nursing conferences. These conferences bring nurses together from across the country, and oftentimes worldwide, to share advanced nursing education and best practice. These organizations also offer the opportunity to network with nursing colleagues from around the globe. According to Guerrieri, “Belonging to a professional nursing organization brings increased professionalism, autonomy, and self-regulation while offering additional benefits such as social interactions and peer support” (Guerrieri, 2010).

The nursing organizations work carefully and ensure that today’s nursing workforce is well prepared to meet the demands of providing high-quality health care services in an ever-changing complex and challenging health care environment. The nursing organizations and associations are critical for generating the energy, idea and positive work needed to maintain a healthy profession that advocates for the clients and nurses, and the accountability of society (Mathews, 2012). These organizations work with congress and state legislatures to have the needs of nurses and general public and changes for the betterment of both. The goals of professional nursing organization advocacy include greater nurse involvement in providing access to care, determining the scope and authority of practice, and increasing and improving the healthcare workforce. These professional organizations provide webinars, scholarly manuscripts and publish the latest advanced knowledge in a specialty area and the profession that help nurses maintain current knowledge of changes in practices and continued education in their nursing career.

 
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Dq10 2 Response

Dorothy Troutman    1 posts   Re: Topic 10 DQ 2  Evidence-based practice is foundational to the BSN-prepared nurse because it allows us to provide the highest level of care to our patients. One way that I will continue to integrate evidence into my practice will be to read journal articles, and publications from the Association of Women’s Health, Obstetrical and Neonatal Nursing. This will allow me to have the most up to date information on caring for women in my field. One obstacle that may challenge my ability to implement the information I learn would be our hospital policies. To overcome this, I will actively participate in hospital committees and focus groups to change the policies at the hospital.  Another way that I will integrate evidence-based practice into my care will be to attend conferences that focus on labor and delivery. One challenge that may come up is that other nurses in my unit may not attend the same conferences. The way I can overcome this obstacle would be to ask permission to present the information to our labor and delivery unit. If the information is presented to all of the nurses at the hospital, we will have a better chance of changing necessary practices to make sure we are providing the best care to our patients.  Farokhzadian, Khajouei, and Ahmadian (2015) discuss common barriers to implementing evidence-based practice. Some of those barriers include: inability of nurses to distinguish quality of research, lack of resources, and difficulty finding time to read or attend conferences.  Reference  Farokhzadian, J., Khajouei, R., & Ahmadian, L. (2015). Evaluating factors associated with implementing evidence-based  practice in nursing. Journal of Evaluation in Clinical Practice, 21(6), 1107–1113. doi:10.1111/jep.12480

 
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