NURS 6600: CAPSTONE SYNTHESIS PRACTICUM – Discussion 1

Discussion: Preparing for Professional Transitions

Consider the following scenario:

Marcus recalls the beginning of his career, when he started as a nurse at Grand View Hospital. He had heard the organization was soliciting proposals from various companies so they could weigh the pros and cons associated with adopting a new health information technology system. He has been curious about the request for proposal (RFP) process ever since. Now, as he looks forward to new professional opportunities, he would like to ensure that he develops the skills and expertise needed to formulate an RFP.

What are your professional aims? How can you apply what you have learned in your coursework to your practicum setting? How will you leverage your experiences in the practicum to facilitate your development as a nurse leader-manager or informaticist?

In this Discussion, you reflect on your aspirations and consider the transitions that may be required to achieve them. You identify professional development objectives and evaluate opportunities for achieving them through your experiences in the practicum.

Think about the professional role changes you have been undergoing or that you may undertake following completion of this MSN program.

Review the information related to professional development and role change in the Learning Resources, and conduct additional research as necessary to address any questions or concerns you may have.

Consider the following questions:

What types of professional positions interest you? Are they significantly different from the types of positions you have held in the past? If so, how?

What challenges are you likely to encounter as you transition into a new role?

What resources could help you to manage this change? Consider your inner resources (e.g., drawing on previous experiences, stress management), resources available to you through your relationships with others, and institutional supports.

Consider how you could use this Practicum Experience to apply what you have learned and enhance or acquire specialization skills and knowledge, regardless of whether you intend to change roles or stay in your current position for the time being.

Review the NURS 6600 Course Outcomes listed in the Syllabus. Determine how your experiences in the practicum could help you to achieve one or more of these outcomes.

Review the information in the Introduction to the Practicum (in this week’s Practicum area) and the School of Nursing Practicum Manual as necessary to ensure you have a clear understanding of the practicum requirements.

Review the suggestions for developing effective learning objectives provided in the Learning Resources.

Think of two or three objectives that could help guide your professional development during your practicum. These objectives, referred to as your practicum professional development objectives, must be:

Specific

Measurable

Attainable

Results-focused

Time-focused

Reflective of the higher-order domains of Bloom’s Taxonomy (i.e., Application level and above)

Select one or more practicum professional development objectives to focus on for this Discussion. (You may continue to hone these objectives as you work on this week’s Application Assignment.)

Reflect on how you could achieve each objective through your Practicum Experience.

Post an explanation of your professional aspirations and how you intend to use the Practicum Experience to promote career change and/or enhance your performance. Describe at least one objective to facilitate your professional growth, and explain the steps you could take to achieve the objective(s) during your Practicum Experience. Support your response with examples from the literature.

Read a selection of your colleagues’ responses.

Respond to at least two of your colleagues on two different days, using one or more of the following approaches:

Suggest strategies for using the Practicum Experience to deepen or broaden their knowledge.

Offer suggestions for refining their practicum professional objective(s).

Required Readings

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Cipriano, P. F., & Murphy, J. (2011). The future of nursing and health IT: The quality elixir. Nursing Economic$, 29(5), 286–289.

Note: Retrieved from the Walden Library databases.

“Technology tools will continue to revolutionize how we plan, deliver, document, review, evaluate, and derive the evidence about care” (p. 289). This article examines how nurses can use information technology to transform nursing and redesign the health care system. It focuses on the use of technology to promote quality and notes that technology can also be used to address challenges in education, research, leadership, and policy.

McKimm, J., & Swanwick, T. (2009). Setting learning objectives. British Journal of Hospital Medicine, 70(7), 406–409.

Note: Retrieved from the Walden Library databases.

This article clarifies the terminology associated with learning objectives and explains how learning objectives relate to professional development and the transformation from novice to expert. It also introduces common pitfalls when setting learning objectives and provides suggestions for avoiding them.

Murphy, J. (2011). The nursing informatics workforce: Who are they and what do they do? Nursing Economic$, 29(3), 150–153.

Note: Retrieved from the Walden Library databases.

The author examines the nursing informatics workforce, explaining that professionals in this well-established specialty area can play an integral role in transforming health care.

Sørensen, E. E., Delmar, C., & Pedersen, B. D. (2011). Leading nurses in dire straits: Head nurses’ navigation between nursing and leadership roles. Journal of Nursing Management, 19(4), 421–430.

Note: Retrieved from the Walden Library databases.

“Successful nursing leaders navigate between nursing and leadership roles while nourishing a double identity” (p. 421). In this article, the authors examine how individuals in key professional roles negotiate between and apply nursing and leadership skills.

Warm, D., & Thomas, B. (2011). A review of the effectiveness of the clinical informaticist role. Nursing Standard, 25(44), 35–38.

Note: Retrieved from the Walden Library databases.

The authors investigate the application of specialized knowledge and expertise to facilitate the appropriate use of emerging technologies in clinical settings. They argue for informaticists’ involvement in strategic development and delivery of information management and technology initiatives to promote patient-centered outcomes.

Wilkinson, J. E., Nutley, S. M., & Davies, H. T. O. (2011). An exploration of the roles of nurse managers in evidence-based practice implementation. Worldviews on Evidence-Based Nursing, 8(4), 236–246.

Note: Retrieved from the Walden Library databases.

In this article, the authors examine the role nurse managers should play in leading and facilitating evidence-based practice.

Armstrong, P. (2013). Bloom’s taxonomy. Retrieved from http://cft.vanderbilt.edu/teaching-guides/pedagogical/blooms-taxonomy/

Vanderbilt University provides this overview of Bloom’s taxonomy. This site also presents the original and updated versions of the taxonomy along with verb suggestions for each level.

Clark, D. (2013). Bloom’s taxonomy of learning domains. Retrieved from http://www.nwlink.com/~donclark/hrd/bloom.html

This article addresses three domains of learning: cognitive, affective, and psychomotor.

University of Central Florida, Office of Experiential Learning (n.d.). Writing SMART learning objectives, Retrieved from http://explearning.ucf.edu/registered-students/tips-for-success/writing-smart-learning-objectives/195

This blog post focuses on the distinction between learning outcomes and objectives. Consider this information as you develop your practicum professional development objectives this week.

The University of North Carolina at Charlotte, Center for Teaching & Learning. (2013). Writing objectives using Bloom’s taxonomy. Retrieved from http://teaching.uncc.edu/articles-books/best-practice-articles/goals-objectives/writing-objectives-using-blooms-taxonomy

This resource outlines elements of Bloom’s Taxonomy.

Document: Practicum Professional Experience Plan (Word Document)

Use this form to develop your Practicum Professional Experience Plan as outlined this week.

Document: Practicum Professional Experience Plan (Word Document)

Use this form to develop your Practicum Professional Experience Plan as outlined this week.

Document: Practicum Journal (Word Document)

During your Practicum Experience, you are  required to submit your time log and three journal entries. You will use this  form to complete your journal reflections.

Document: School of Nursing Practicum Manual: Master of Science in Nursing (MSN): Quarter-Based Programs (PDF)

This comprehensive manual outlines all of the requirements for the Practicum Experience.

Clinical Resources

Document: Introduction to Clinical Experiences (PowerPoint)

Document: Practicum Manual (PDF)

Required Media

Laureate Education (Producer). (2012a). Professional behavior in the practicum setting [Interactive media].

Note: Retrieved from the Walden Library databases.

In this audio presentation, Dr. Jeanne Morrison discusses topics that demonstrate professional behavior in the practicum setting, such as dressing professionally, punctuality, and communication.

Please click here for the Transcript (PDF).

Laureate Education (Producer). (2012b). Professional best practices [Interactive media].

Note: Retrieved from the Walden Library databases.

In this audio segment, Dr. Jeanne Morrison provides an overview of best practices and tips for students engaged in the Practicum Experience. She discusses what activities are included in practicum hours, the importance of staying in touch with your Preceptor, and strategies for dealing with stress.

Please click here for the Transcript (PDF).

Laureate Education (Producer). (2012c). Professionalism and the practicum experience [Interactive media].

Note: Retrieved from the Walden Library databases.

What is the Practicum Experience all about? What are the roles of the Faculty Member and the Preceptor? In this media presentation, Dr. Jeanne Morrison discusses these and other critical aspects of the Practicum Experience. She also provides an overview of the professional demeanor expected of all students throughout the Practicum Experience.

Walden University

Master of Science in Nursing

NURS 6600: Capstone Synthesis Practicum Journal

Student Name:

E-mail Address:

Practicum Placement Agency’s Name:

Preceptor’s Name:

Preceptor’s Telephone:

Preceptor’s E-mail Address:

Practicum Professional Development Objectives

1.

2.

3.

4.

Project Objectives

1.

2.

3.

4.

5.

(Continued on next page)

NURS 6600 Practicum Experience Journal

You must submit a journal entry in each assigned week, even if you are not on-site that week. If you are not on-site for a week in which a journal entry is due, reflect on experiences from any of the previous weeks of this course. Journal entries are due in Weeks 3, 7, and 11. Place the references for each week’s entry immediately after that week’s content. Remember to use APA style when writing your journal entries and listing references.

Begin each journal entry on a new page. The template has a “new page” command inserted before each weekly label. Be sure to delete any blank pages that appear between the weekly entries. Note: This document will serve as a cumulative journal. For each submission, you will add to the document so it contains all of your journal entries.

Journal Entries

· Describe a problem, issue, or situation that you have observed during your Practicum Experience (no more than a half page) (10 points)

· Using no fewer than three peer-reviewed sources, analyze what you have observed within the context of your specialty using appropriate concepts, principles, and theories, giving special attention to observed events that vary from scholarly literature. (30 points)

· Explain how the problem, situation, or issue was handled in a manner that is consistent and a manner that is inconsistent with the theory, concepts, and principles detailed in the evidence. (30 points)

· Given the various evidence-based approaches that can be used in handling the problem, situation, or issue, formulate a plan for approaching the matter differently. (30 points)

· Include references immediately following the content.

· Use APA style for your journal entry and references.

Note that Faculty may deduct up to 20 points for writing style issues/errors and/or citation- or reference-related APA errors.

Practicum Experience Journal Entries NURS 6600

Week 3 Journal (references should immediately follow the content)

Practicum Experience Journal Entries NURS 6600

Week 7 Journal (references should immediately follow the content)

Practicum Experience Journal Entries NURS 6600

Week 11 Journal (references should immediately follow the content)

Heritage Of The Appalachian And Arab People

Read chapter 8 and 9 of the class textbook and review the attached Power Point presentation.  Once done, answer the following questions;

1.  Give an overview of the Appalachian and Arab heritage related to their healthcare beliefs and mention if there is any similarity in both cultures.  Give an example.

2.  How the Appalachian and Arab heritage view the process of death and explain if there is any similarity in any of them?

3.  Explain is there is any similarity in the healthcare beliefs of the Appalachian and Arab heritage with the evidence based nursing care that is provide.

As stated in the syllabus present your assignment in an APA format word document, Arial 12 font attached to the forum in the discussion tab of the blackboard title “Week 4 discussion questions”.  A minimum of two evidence based references no older than 5 years old  besides the class textbook are required.   500 words are required.

HEALTH HERITAGE AND PRACTICES OF THE APPALACHIAN AND ARAB PEOPLE

Nursing 5

Heritage of the Appalachian and Arab People

Health Heritage and Practices of the Appalachian and Arab People

The health heritage of the Appalachian and Arab people as well as their cultural beliefs have an influence on the delivery of health care especially, as concerns community care. Definitively, the Appalachian people are those found in the Appalachia which is the cultural area along the Appalachian Mountains in the eastern part of the United States (Purnell, 2014). The area runs from western New York State to Mississippi and Alabama including regions such as New York, Ohio, Kentucky and Pennsylvania among others within the defined area (Ibid, 2014). They are basically Germans, Scots-Irish, French, Welsh and English people who settled these regions between the 17th and 19th centuries. A key characteristic of the Appalachian people is that typically, they are white, blue collar workers and often rural folk.

Outstanding cultural traits that have influenced communal health care, are their distrust for outsiders which manifests as trust issues. They also have distinct dialects and styles of communication and additionally, the social hierarchy is based on kinship and loyalty is particularly valued within the community (Ibid2, 2014). In terms of communal health, there are difficulties arising from their distrust especially as regards counselling interventions. Therapists who fail to recognize these distinctiveness of culture as compared to the mainstream population, often fail in delivery of such care and thus they must be aware of the differences and utilize acceptable theories and techniques for intervention.

On the other hand, Arabs are identified as people from any of the 22 Arab countries stretching from North Africa to the Arabian Gulf including Libya, Morocco, Syria, Egypt, Iraq, and Yemen among others (Hajaj, 2015). However, contrary to common belief, Turkey and Iran are not Arab countries. Essentially, Arabs are diverse in terms of religion, political standing as well as ethnicity but they have a commonality of understanding the classical Arabic language as formally spoken and printed (Ibid, 2015). In the United States of America, Arabs have substantial numbers in Los Angeles, Detroit, New York and Washington D.C. cities.

In terms of their acculturation, Arabs view discrimination as the greatest barrier with many believing that they are more of a nation in exile than they are immigrants or citizen of America. For this reason, they have often divided loyalties between their home countries and the United States with a common dilemma being the decision as whether to accept or reject assimilation into Western culture and way of life.

In the Arabic culture, mental health is held as most stigmatizing and in particular women fare worse than their male counterparts in that regard (Ibid2, 2015). In general, this group has negative notions and views regarding mental health especially concerning psychiatric and psychological interventions.

A key health practices of the Appalachian people is managing illness by individuals with no medical training and the problem is that effective interventions are hindered. For instance, 70 – 90% of the population are averse to making positive health behavior change such as quitting smoking (Purnell, 2014). For the Arabs, there are misconceptions regarding the causes of illnesses due to the religious and cultural beliefs that view fate as their master rather than being masters of their own fates as Westerners typically do (Hajaj, 2015). As a result, many fail to visit healthcare facilities and when they do there is preference for gender healthcare givers and providers especially among the women. Conclusively, these are both detrimental health practices arising from the cultural aspects of both the Appalachian and Arabic peoples.

References

Hajaj, H. (2015).Working with Arab American Clients: A culturally relevant, sensitive, and competent approach. Retrieved from<http://www.smchealth.org/sites/main/files/file-attachments/arabamericanpresentationjan2015.pdf>

Purnell, L. (2014). Guide to Culturally Competent Health Care. F.A. Davis.

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Balancing School And Life – My Quality Of Life Self-Care Plan

The purpose of developing this Plan is to set a framework and a plan to maintain wellness and to stay motivated and engaged throughout your Program. Doing this will help you achieve success during your coursework and as a professional nurse.

The goal of the Project is to help you become self-aware and reflective as a means of identifying personal self-care strategies that will increase your energy and help you manage your stress. The Project will give you a chance to learn how this is accomplished as you will be doing similar work with clients during the Program and as a professional nurse to assist them in the same way.

Use the Quality of Life Self-Care Wheel to assess your current state. After you determine your scores, in a 2-3 page paper complete the following:

• Discuss those areas that are strengths (higher scores) and those areas that need further development (lower scores).
• Identify two strategies you can use to maintain or maximize each identified strength.
• Identify two strategies you can use to strengthen each area needing development. Explain how you will put these strategies into action. Be specific. For example, instead of stating, “I need to exercise,” your action should state “I will begin to walk 20 minutes a day, 3 days a week.” The action should be SMART- Specific, Measurable, Attainable, Realistic, Timeframe
• Also attach your completed form
• Minimum length 2-3 pages not including cover or referencing. APA formatting

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NURS 6052 ESSENTIALS OF EVIDENCE -BASED PRACTICE

QUESTION 1

1. When trying to determine what type of research study is described in an article, which two sections of the article will give you the best information to make that determination?A.Abstract and conclusionB.Methods and limitationsC.Methods and resultsD.Introduction and resultsE.Abstract and discussionF.Literature review and data analysis

5 points  

QUESTION 2

1. Order the following types of research evidence reviews in order of rigor from most rigorous to least rigorous: – 1. 2. 3. 4. Systematic review with meta-analysis
   – 1. 2. 3. 4. Integrative review
   – 1. 2. 3. 4. Systematic review without meta-analysis
   – 1. 2. 3. 4. Narrative review

5 points  

QUESTION 3

1. What types of information would help you identify a research study as quantitative? (Select all that apply.)A.Data is collected using such approaches as interviews, focus groups, and open-ended questions on surveys.B.Data is collected using Likert scales on surveys.C.Results are reported using numbers and statistics.D.Results are reported using themes and words.

5 points  

QUESTION 4

1. What kind of study is described in the following excerpt?
   Researchers are interested in studying the impact of living in a family where a child has been diagnosed with cancer. They collaborate with the oncology department at a large children’s hospital to identify and receive consent from families that have a child with a cancer diagnosis. Participants are consented and data is collected and triangulated using one-on-one interviews, focus groups, and surveys. Data is analyzed for thematic analysis.A.Quantitative researchB.Qualitative researchC.Mixed-methods researchD.Systematic reviewsE.Literature reviewsF.Cohort studies

5 points  

QUESTION 5

1. Both literature reviews and systematic reviews are types of research evidence reviews. True
   False

5 points  

QUESTION 6

1. Which of the following is a type of quantitative research study?A.PhenomenologyB.Case studyC.Randomized controlled trialD.EthnographyE.Participative action researchF.Ground theory

5 points  

QUESTION 7

1. What type of information would help you identify a research study as qualitative? (Select all that apply.)A.Data is collected using such approaches as interviews, focus groups, and open-ended questions on surveys.B.Data is collected using Likert scales on surveys.C.Results are reported using numbers and statistics.D.Results are reported using themes and words.E.Data is collected using surveys with fill-in-the-blank questions.F.Results are reported using a mixture of numbers and themes.

5 points  

QUESTION 8

1. What type of literature may a systematic review include to be considered Level 1 evidence on the Melnyk & Fineout-Overholt levels of evidence hierarchy?A.Phenomenology studiesB.Grounded theory studiesC.Descriptive studiesD.Cohort studiesE.Controlled trials without randomizationF.Randomized controlled trials

5 points  

QUESTION 9

1. Mixed-methods studies are a combination of which two methodologies?A.Quantitative research methodologies and literature reviewsB.Quantitative and qualitative research methodologiesC.Qualitative research methodologies and systematic reviewsD.Literature reviews and qualitative research methodologiesE.Quasi-experimental and program evaluation

5 points  

QUESTION 10

1. The methods used in conducting a systematic review are specific and rigorous.  True
   False

5 points  

QUESTION 11

1. Which of the following types of research can be categorized as primary research? Select all that apply. A.Cohort studyB.Literature reviewC.Grounded theory studyD.Randomized controlled trialE.Systematic reviewF.Controlled trial without randomization

5 points  

QUESTION 12

1. What type of study is described in the following excerpt?
   Surveys to evaluate nurse satisfaction, medical errors, depression and anxiety, and demographics were given to 5,432 nurses from hospitals of various sizes and geographic locations; some had nurses working 8-hour shifts and 12-hour shifts. Nurses were asked to complete the survey. Upon completion of the survey, nurses were invited to participate in video conference focus groups and one-on-one interviews with a research assistant by video conferencing. Survey results were reported using descriptive statistics, and themes were identified and reported from the data collected in the focus groups and one-on-one interviews.A.Quantitative researchB.Qualitative researchC.Quasi-experimental researchD.Mixed-methods researchE.Systematic reviews

5 points  

QUESTION 13

1. Which of the following statements is true of narrative reviews? (Select all that apply.)A.Narrative reviews engage a highly structured and rigorous approach to reviewing research evidence.B.Narrative reviews provide a general background discussion of a particular issue.C.Narrative reviews require a rigorous, systematic approach to searching the databases for evidence.D.Narrative reviews generally review literature that support the author’s point of view on an issue or topic.E.Narrative reviews are a type of primary research.

5 points  

QUESTION 14

1. You are forming a team to do a systematic review of the literature about interventions to treat post-traumatic stress disorder (PTSD). Which of the following would be your first step?A.Critically appraise the literature identified.B.Conduct an exhaustive search of multiple databases to identify the literature.C.Identify an explicit, reproducible methodology.D.Create a clearly stated set of objectives with predefined eligibility criteria for study inclusion.E.Create a dissemination plan for your systematic review.

5 points  

QUESTION 15

1. Randomized controlled trials are which type of research?A.Quantitative researchB.Qualitative researchC.Mixed-methods researchD.Systematic reviewE.Literature reviewF.Cohort study

5 points  

QUESTION 16

1. What type of study is described in the following excerpt?
   An interprofessional team wants to test a new intervention to see whether it will improve central-line associated bloodstream infection (CLABSI) rates. Subjects were randomized into either the intervention or the control group by pulling a slip of paper with either a one or a two written on it from a manila envelope (those pulling ones were randomized to the intervention group; those pulling twos were randomized to the control group). When the study began, the intervention group received the intervention and the control group received equal attention. Data was collected and analyzed using the Statistical Package for the Social Sciences (SPSS). Descriptive statistics were used to report the data.
   What type of research article is this?A.Quantitative researchB.Qualitative researchC.Systematic reviewsD.Literature reviewsE.Mixed methodsF.Program evaluation

5 points  

QUESTION 17

1. A key characteristic of a systematic review is that it contains a meta-analysis. True
   False

5 points  

QUESTION 18

1. In quantitative studies, results are reported using words or themes. True
   False

5 points  

QUESTION 19

1. In qualitative studies, results are reported using words or themes. True
   False

5 points  

QUESTION 20

1. In a systematic review with a meta-analysis, researchers combine the results of each of the individual studies to create a larger sample size (and therefore greater power), then re-run the statistics to capture the true magnitude of the effect. The single-effect measure calculated and reported when the results from all the studies are combined is called what?A.Summary statisticB.Power analysisC.Confidence Interval
   D.Chi squareE.Pearson’s co-efficient

5 points  

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Developing PICO Questions

Determining the topic of an evaluation is one of the most important steps of the evaluation process. In the process of selecting a topic for evaluation, researchers should reflect on what information needs to be gathered and how it will be used. A PICO question can provide the foundation for this process. The PICO question requires researchers to determine the population to be studied, select the intervention that occurred or will occur (such as a new system), have a baseline with which to compare the evaluation, and finally, have a standard to measure the outcome of the project. Using a PICO question as a guideline helps ensure the evaluation is focused and effective.

In this Discussion, you generate a PICO question that corresponds to the Evaluation Plan Focus you developed last week.

To prepare:

• Develop a PICO question based on the Evaluation Plan Focus Assignment completed last week.
• Reflect on why it is important that this question be answered. Identify the “who cares?” factor.

By Day tomorrow 12/28/2016, write a minimum of 550 words essay in APA format with a minimum of 3 reference from the list provided below. Include the level one headings as numbered below:

1)      Post a summary of key points (evaluation goal, viewpoint, and model) from your Evaluation Plan Focus Assignment.

2)      Post your PICO question. Explain why you developed this question, and why it is important to be considered.

Required Readings

Friedman, C. P., & Wyatt, J. C. (2010). Evaluation methods in biomedical informatics (2nd ed.). New York, NY: Springer Science+Business Media, Inc.

Chapter 3, “Determining What to Study” (pp. 48–84)

This chapter focuses on how to identify the relevant questions to cover in an evaluation and how to ensure that the scope of the question is appropriate. It includes a description of different types of evaluations, including what they specifically focus on and the general type of questions they address.

Gschwandtner, T., Kaiser, K., & Miksch, S. (2011). Information requisition is the core of guideline-based medical care: Which information is needed for whom? Journal of Evaluation in Clinical Practice, 17(4), 713–721.

Retrieved from the Walden Library databases.

This article describes the construction of a comprehensive information source to be used in the development of computerized clinical practice guideline (CPG). The authors emphasize how the information source is designed to meet the informational requirements of anyone developing a CPG for any user group.

Lin, J. W., Chang, C. H., Lin, M. W., Ebell, M. H., & Chiang, J. H. (2011). Automating the process of critical appraisal and assessing the strength of evidence with information extraction technology. Journal of Evaluation in Clinical Practice, 17(4), 832–838.

Retrieved from the Walden Library databases.

The authors of this article explain a study that sought to create and evaluate a system to automatically determine a medical article’s evidence level. The authors describe the accuracy of the system and speculate on the causes of errors.

Swennen, M. H. J., vander Heijden, G. J. M. G., Blijham, G. H., & Kalkman, C. J. (2011). Career stage and work setting create different barriers for evidence-based medicine. Journal of Evaluation in Clinical Practice, 17(4), 775–785.

Retrieved from the Walden Library databases.

This article describes a study that examines how a doctor’s career stage and work setting are related to their perceptions of barriers to practicing evidence-based medicine (EBM). The authors also provide a framework for classifying the identified barriers.

Required Media

Laureate Education (Producer). (n.d.e). PICO question. Retrieved from CDN database. (NURS 6431)

This animation describes the basics of formulating a PICO question. The animation provides an example scenario of effectively generating a PICO question.

Optional Resources

Alliance for Health Reform. (2013). Health Information Technology. Retrieved from http://www.allhealth.org/issues.asp?wi=4

    American Health Information Management Association. Retrieved from http://www.ahima.org/

    Healthcare Information and Management Systems. (2013). Retrieved from http://www.himss.org/

    Kaiser.edu. (n.d.). Health information technology. Retrieved from http://kff.org/health-reform/issue-brief/building-an-information-technology-foundation-for-health/

National Center for Biotechnology Information. (n.d.). Health services/technology assessment texts (HSTAT). Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK16710/

EVALUATION PLAN FOCUS

EVALUATION PLAN FOCUS 1

Evaluation Plan Focus

Student Name

University Affiliations

Date

Professor

Scenario 1:

Your hospital is implementing a new unified acute and ambulatory Electronic Health Record (EHR) system through which patient care documentation will occur. Interdisciplinary assessment forms (including nursing), clinical decision support, and medical notes will be documented in this system. The implementation of the system is anticipated to improve the hospital’s performance in a multitude of areas. In particular, it is hoped that the use of the EHR system will reduce the rate of patient safety events, improve the quality of care, deter sentinel events, reduce patient readmissions, and impact spending. The implementation of the EHR system is also

Introduction

Evaluation plan involves an integral part regarding a grant suggestion providing information aimed at improving a project during the development and implementation. I will participate in the assessment of the scenario system in throughout the project. The scenario includes the hospital that is implementing the new unified as well as the Ambulatory EHR (Electronic Health Record) system that enhances the documentation of patient care. The purpose of the paper is explaining the selected scenario one, explanation of the reasons for selecting it, and summarizing of the research findings on the similar HIT implementations. More so, there is a description of the evaluation viewpoint, and goal guiding the assessment plan and same rationale.

HIT System Selected

The new system to be implemented has various modules that contain interdisciplinary assessment forms, medical notes, and clinical decision support where their documentation is guaranteed. The implementation of the unified system will enhance improved performance of the hospital in several departments. The new EHR system becomes of great importance to the hospital since there is a reduction of medical errors, reduction of the rate of the safety events of each patient, improving the quality of healthcare, deterrence of sentinel events, reduced patients readmissions as well as impact spending. Another reason for choosing the scenario is that the new system will enhance while fulfilling the requirements of meaningful use as stipulated in the HITECH (Health Information Technology for Economic and Clinical Health) Act. Therefore, the need for evaluation regarding the EHR implementation becomes paramount since it will help to identify the associated risks while adjusting the modules required when offering the medication services to the patients (Lanham, Leykum & McDaniel, 2012).

Summary of Research Findings on Similar HIT Implementations

Several evaluations are analogous to the HIT system implementation of the unified system with related differences regarding the outcomes based on the primary goals. For instance, some of the implemented systems fail to meet one hundred percent of the requirements and the expectations. It leads to the need for improving the system to ensure that most of the requirements that it was developed and implemented for have been met. The evaluation regarding several EHRs systems has precisely shown various results as discussed below.

Technology and Patient Care

The critical element regarding healthcare information involves the nursing documentation of the patients’ records. The HIT systems are designed to utilize the literature based on the knowledge related to the quality of care. The established technology enhances improved patient care that has made the nursing work easy and efficient. The EPR (Electronic Patient Record) after the evaluation has proved to be of great significance for the information workflow in the hospital. The use of technology has evidently improved the patient result quality as well as efficiency. The transmission of information electronically reduces medical errors while saving time and related resources. The benefits related to the EHRs in the ambulatory practices are clearly identified to be improved patient care as well as the office efficiency including the potential financial advantages. More so, there are some barriers realized during the implementation of such similar HIT project like costs, resistance to change, the original system uses difficulty and lacking standardization of the products of HER (Board on Health Care Services, 2012).

Patients’ Records Confidentiality

When implementing the HIT systems in the hospital set up, the need to include a module for the transfer of health records to various departments is paramount. However, the information should remain as secret as it would be whenever the patient has his or he papered records while taking them to the departments when asked to produce them. The EHRs transmission has shown to be emphasizing on the need to ensure no sharing of medical information to other parties not directly associated with the patient and without the latter’s approval. However, some disadvantages are identified where a hospital officer may have the access rights to the confidential information of the patients and happen to expose it to other individuals hence denying the patient the right to secrecy regarding medical records.

Clinical Decision Support Systems

The implementation is also aimed at increasing the performance of the hospital with the new technology. According to the evaluation, the previously used CDSS involved the integration of the clinical information systems like the outpatient and inpatient EHRs. The purpose of the implementation includes improving the decision-making process in the hospital hence increasing the quality of healthcare for all patients. The evaluation shows that half of the reviewed systems provided all the appropriate action-oriented, event-driven, and real-time decision support required to initiate the medication interventions. However, there is some feature lacking during the implementation like the ability to provide alternatives for the information provided and analyzed (Levy & Heyes, 2012).

Patient Satisfaction with the System

The EHR system increased the comfort level of the patients. There is a saving of time, an increase in the number of attended patients, patients getting clinical summaries immediately, and subsequent medication reports. After the evaluation, it showed clearly that several patients got satisfied with the services delivery within the hospital with the development and implementation of the system. Reduced clinical information errors proved proper and improved medication hence the need to embrace the system. The system was found to have little technical challenges hence becoming suitable for the healthcare improvement.

Adoption of the HIT System

The system is seen to have faced minimal resistance during its implementation. It is because previous research has proved the system to be of significant benefits when delivering services to the patients. More so, there is reduced medication errors when using the system hence the need to adopt it without resistance. There is the utilization of resources and serving several patients at the same time (Van Gemert-Pijnen et al., 2011).

Describing the Goal and Viewpoint of the Evaluation Plan

The primary goal for the EHR involves improving the healthcare quality based on the patient care documentation. The new system will ensure that the medical recordings are automated leading to minimal or no errors. Proper documentation will provide improved performance of the hospital and related healthcare services. The system is aimed at reducing costs of operations of the hospital while increasing medication benefits for the patients. The patients should be able to have track information of their medication or clinical trend without delay. The system should also coordinate all the departments within the hospital so as to work together in meeting the primary goal of improving the patient care (Bélanger et al., 2012).

Conclusion

The EHRs primary objective of improving the quality of patient care is achieved by ensuring the implementation stage is well analyzed regarding the requirements and the documentation done as a whole. The system should prove to be of great benefit while improving the performance of the hospital. The evaluation should be done at every subtask to ensure the best is regarding the improved quality of healthcare is achieved by the system.

References

Bélanger, E., Bartlett, G., Dawes, M., Rodríguez, G., & Hasson-Gidoni, I. (2012). Examining the evidence of the impact of health information technology in primary care: An argument for participatory research with health professionals and patients. International Journal of Medical Informatics, 81(10), 654–661.

Board on Health Care Services. (2012). Health IT and patient safety: Building safer systems for better care. The National Academies Press: Washington DC. Retrieved from http://www.nap.edu/catalog.php?record_id=13269

Lanham, H. J., Leykum, L. K., & McDaniel, R. R. Jr. (2012). Same organization, same electronic health records (EHRs) system, different use: Exploring the linkage between practice member communication patterns and EHR use patterns in an ambulatory care setting. Journal of the American Medical Informatics Association, 19(3), 382–391.

Levy, S., & Heyes, B. (2012). Information systems that support effective clinical decision making. Nursing Management, 19(7), 20–22.

Van Gemert-Pijnen, J., Nijland, N., van Limburg, M., Ossebarrd, H. C., Kelders, S. M., Eysenbach, G., & Seydel, E. R. (2011). A holistic framework to improve the uptake and impact of eHealth technologies. Journal of Medical Internet Research, 13(4), e111.

Week 5 Journal Entry

                                      Learning Objectives

Students will:

· Develop diagnoses for clients receiving psychotherapy*

· Evaluate the efficacy of therapeutic approaches for clients*

· Analyze legal and ethical implications of counseling clients with psychiatric

disorders*

                                             The Assignment 

Select a client whom you observed or counseled that suffers from a disorder related to trauma. Then, address the following in your Practicum Journal:

· Describe the client (without violating HIPAA regulations) and identify any

pertinent history or medical information, including prescribed medications.

· Using the DSM-5, explain and justify your diagnosis for this client.

· Explain whether any of the therapeutic approaches in this week’s Learning

Resources would be effective with this client. Include expected outcomes based

on these therapeutic approaches. Support your approach with evidence-based

literature.

· Explain any legal and/or ethical implications related to counseling this client.

                                                  Learning Resources

Required Readings

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

• Chapter      13, “Stabilization for Trauma and Dissociation” (pp. 469–508)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Student Name:

E-mail Address:

Practicum Placement Agency’s Name:

Preceptor’s Name:

Preceptor’s Telephone:

Preceptor’s E-mail Address:

(Continued next page)

Time Log

List the objective(s) met and briefly describe the activities you completed during each time period. If you are not on-site for a specific week, enter “Not on site” for that week in the Total Hours for This Time Frame column. Journal entries are due in Weeks 4, 8, and 11; include your Time Log with all hours logged (for current and previous weeks) each time you submit a journal entry.

You are encouraged to complete your practicum hours on a regular schedule, so you will complete the required hours by the END of WEEK 11.

Journal Entries

· Include references immediately following the content.

· Use APA style for your journal entry and references.

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 Research Critiques And PICOT Statement Final Draft

Details:

Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the Topic 1, 2, and 3 assignments and the guidelines below.

PICOT Statement 

Revise the PICOT statement you wrote in the Topic 1 assignment. (See attached)

The final PICOT statement will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Research Critiques

In the Topic 2 and Topic 3 assignments you completed a qualitative and quantitative research critique. Use the feedback you received from your instructor on these assignments to finalize the critical analysis of the study by making appropriate revisions. (Both are attached)

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT statement.

Refer to “Research Critique Guidelines.” Questions under each heading should be addressed as a narrative in the structure of a formal paper. (See attached)

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT statement, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

Running head: RESEARCH CRITIQUE 1

RESEARCH CRITIQUE 3

Qualitative Research Critique

Grand Canyon University: NRS-433V-0503

Professor: Melissa Petrick

April 15, 2018

Research Critique

The development of nursing practice is dependent on the advancement of new knowledge, which is facilitated by new research. Evidence-based practice is an important part of nursing as it helps to ensure that the promotion of healthcare is based on valid and applicable information. To determine the validity, credibility, and applicability of research information, it is required that a research critique is conducted to highlight the strengths and weaknesses of the study and how they affect the applicability of the research (LoBiondo-Wood & Haber, 2017). The following is a critique of the article “Experiences of diabetes self‐management: a focus group study among Australians with type 2 diabetes” by Carolan, Holman, and Ferrari (2015). The critique analyses the study’s background, methodology, results, and the ethical considerations made by the researchers. Comment by Melissa Petrick: analyzes

Background of the Study

The study by Carolan, Holman, and Ferrari (2015) was based in Australia where approximately a million people have been diagnosed with diabetes. The rate of diabetes in Australia has more than doubled in the past four decades. Among all the diabetes cases in the country, 85% of them are Type 2 diabetes cases, which are mainly caused by lifestyle decisions. Some of the risk factors for Type 2 diabetes include old age, obesity, sedentary lifestyle, ethnicity, and low socio-economic status. People with more than one risk factor have a higher chance of getting Type 2 diabetes at some point in their life. Diabetes self-management is an important part of proper diabetes care. Patients are expected to understand the strategies that they should take for glycemic control and to change the lifestyle conditions that contribute to diabetes. However, people in the low socio-economic conditions may lack the resources and services to properly manage their condition. Carolan, Holman, and Ferrari (2015) identified the diabetes issue within the Australian population and developed a study that aimed to determine the treatment and care experiences of type 2 diabetes mellitus patients with reference to access to services and resources. The study was based in a low socio-economic rea where the people are likely to have trouble accessing the resources they need to properly care for their illness. The following are the research questions that this study was designed to answer.

· What are the experiences of a diabetes patient in a low socio-economic setting?

· How does diabetes affect a patient and their family?

· What difficulties do diabetes in low socio-economic areas experience?

The purpose and the research questions of this study relate to the study problem because they are focused on the difficulties that the low socio-economic groups in Australia experience. The problem identified that there is a large number of people in Australia with type 2 diabetes and the people in the low-socio economic groups have a higher risk of having diabetes.

Method of Study

The study was conducted using an exploratory qualitative research design. The research data was collected in the form of focus groups made up of a population of 22 people aged between 40 and 70 years, with type 2 diabetes. There was different focus groups ranging from four to eight participants each where the data was recorded, transcribed, and later analyzed using a thematic analysis approach. Although Carolan, Holman, and Ferrari (2015) do not create the exact framework to demonstrate the use of grounded theory, the research process shows that they used a valid process of research.

The qualitative methods that have been used in this study were appropriate in studying the research questions. This was an exploratory study, meaning that there was no definite hypothesis that the researchers were investigating. Therefore, investigating the research problem with a focus group was a good technique of identifying a variety of information, which was later used in the development of the themes.

In developing this study, Carolan, Holman, and Ferrari (2015) cited various qualitative and quantitative research sources to enhance the validity of the claims that have been made in the study. The sources that have been cited tend to include both recent and slightly old studies. The oldest research cited by the authors was published in 1999, while the most recent was published in 2015. However, the older researches used in this study are only focused on developing the methodology. The literature review of the article only focuses on the more recent studies, which are a more accurate representation of developed facts at the time of the development of the article. As for the older citations, it is highly unlikely that research methods have changed too much to affect the validity of the information included by the researcher. In general, the literature review developed in this study builds a valid argument. It shows the gap in understanding the struggles that low income type 2 diabetes patients undergo and the need for new information to develop better care for the poorer diabetes patients in Australia. The research does not list the limitations that were experienced in the research process.

Results of Study

From the data collected from the focus groups, various themes were developed. These themes include the patients’ personal journey, diabetes as a silent disease, the access to services and resources, and the work of managing diabetes. The researchers found that diabetes patients experience emotional, physical, and social challenges. This study highlighted the impact that diabetes has on the individual and their family and the importance of having a family support system to assist in the self-management efforts. The study concluded that the participants were generally satisfied with their current care but there was a clear need for self-management education to provide additional information on the understanding of this condition.

The results of this study have some implications on the development of nursing practice and nursing research. This study has demonstrated that people in the low socio-economic environments have unique challenges that need to be addressed to improve the quality of service and care that they receive. This was an exploratory study; hence, it can be used as a basis for more in-depth studies that investigate the specific themes that have been identified. Possibly, this can help in the development of new information that can improve diabetes self-management.

Ethical Considerations

Carolan, Holman, and Ferrari (2015) took various steps to make sure that their study was ethical. This study was reviewed by an IRB and was approved before its commencement. The ethical consideration that has been made in the study is the protection of the privacy of the participants. The researchers used pseudonyms in place of the real identities of the participants to protect their privacy. Additionally, the researchers obtained a written consent from the participants before they participated in the focus groups. The participants voluntarily left their details and results of the study were mailed to them after the completion of the analysis.

Conclusion

The study by Carolan, Holman, and Ferrari (2015) has utilized some relevant quantitative techniques to ensure that the study is valid and applicable. The study has a clear aim and uses valid qualitative techniques to meet the research objectives. Valid research sources and methodology has been used in performing this research. From this analysis, it is clear that this is a valid study that can be applied in developing new knowledge for nursing practice. Through the study, one can develop new researches that can help to develop self-management care for diabetic patients.

References

Carolan, M., Holman, J., & Ferrari, M. (2015). Experiences of diabetes self‐management: a focus group study among Australians with type 2 diabetes. Journal of clinical nursing, 24(7-8), 1011-1023. Comment by Melissa Petrick: “Clinical Nursing” should be capitalized.

LoBiondo-Wood, G., & Haber, J. (2017). Nursing Research-E-Book: Methods and Critical Appraisal for Evidence-Based Practice. Elsevier Health Sciences

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Nursing Healthcare

Suppose a community team identifies lack of access to exercise modalities as a public health issue. If the team were to determine that pedestrian walkways need to be constructed, discuss at least two factors that would facilitate the development of the walkways and two that would hinder the development. For the hindrances, discuss ways that the team might work to overcome those hindrances.

Identifying public health issues is an important task that requires attention in order to implement change. Often times, change is opposed and not welcomed. With reference to the situation presented, there are benefits and hindrances that could arise. The need for access to pedestrian walkways would be presented based on the safety that these walkways would offer as well as the health benefit that these walkways would offer. With the walkways, there would be no reason for people to be walking in the roadway or close to the road, risking being injured by a motorist. There is less risk of injury since the walkways would provide safe and level paved ground to walk on. The health benefit would come from the walkways giving persons wanting to walk, a safe spot to walk or run and not be in the way of cars traveling the roadways. Walking has many health benefits that include:

• increased cardiovascular and pulmonary (heart and lung) fitness
• reduced risk of heart disease and stroke
• improved management of conditions such as hypertension (high blood pressure), high cholesterol, joint, and muscular pain or stiffness, and diabetes
• stronger bones and improved balance
• increased muscle strength and endurance
• reduced body fat.

Two different hindrances that could be expected include cost and space. The need for the walkways would be a good tool for encouraging those in the city council and/or county commission to approve the funding. Space may be a problem if the roadways are close to housing and stores. Dealing with the right of way laws, and getting private citizens to be onboard with the construction could also become a problem. Educating the public on what these sidewalks could mean for the health of the community could potentially increase the approval as well as recruit others to promote the idea

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Summary And Descriptive Statistics

Summary And Descriptive Statistics

There is often the requirement to evaluate descriptive statistics for data within the organization or for health care information. Every year the National Cancer Institute collects and publishes data based on patient demographics. Understanding differences between the groups based upon the collected data often inform health care professionals towards research, treatment options, or patient education.

Using the data on the “National Cancer Institute Data” Excel spreadsheet, calculate the descriptive statistics indicated below for each of the Race/Ethnicity groups. Refer to your textbook and the Topic Materials, as needed, for assistance in creating Excel formulas.

Provide the following descriptive statistics:

1. Measures of Central Tendency: Mean, Median, and Mode
2. Measures of Variation: Variance, Standard Deviation, and Range (a formula is not needed for Range).
3. Once the data is calculated, provide a 150-250 word analysis of the descriptive statistics on the spreadsheet. This should include differences and health outcomes between groups.

APA style is not required, but solid academic writing is expected.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to LopesWrite.

Attachments HLT-362V-RS5-NationalCancerInstitutedata.xlsx

Synthesis Paper US English Grammar

Overview: Synthesis Paper

You have been reflecting on changes you have undergone since beginning this program in each of your Journal entries in this course. Now you will synthesize those reflections, plus any other insights into a paper articulating your RN to BSN educational journey. You will use your module Journal entries as well as examples from other RN BSN courses to construct the Synthesis paper.

Objectives

Synthesis Paper in a reflective activity comprised of your experience in the RN BSN program.

You will address your experiences before the RN BSN program, you as a lifelong learner, you in the continuum of novice to expert in the professional nursing role, an account of your role transition to a professional nurse, and an evaluation of the program.

The Synthesis Paper will reflect your understanding and use of APA format and scholarly writing.

The following rubric will be used to grade the Synthesis Paper. The paper has 6 sections:

Introduction

Before RN-BSN Program

Lifelong Learning

Novice to Expert

Synthesis of Role Transition to Professional Nursing

Evaluation

The paper must have title page, reference page, plus no more than 4 pages that address the 6 sections of the paper outlined in the grading rubric. So with the title page, 4 pages for the body of the paper, and the reference page, the Synthesis Paper must not be more than 6 total pages using 12-point Times Roman font.

The first 2 grading criteria noted in the rubric below apply to all sections of the paper. APA format, scholarly writing, grammar and spelling are graded in each section. Use Spell Check and Grammar Check!

In-text citations are required to support each section when you discuss the RN BSN courses or the program. Points will be deducted if this information is not detailed and referenced in the document and on the reference page. References need to be evidence-based if you choose to reference literature instead of information in RN BSN courses.

Instructions

Study the rubric to determine the expectations for each section of the paper. Notice that you are required to cite at least one research article or specific RN-BSN course topic or activity for each section. Locate and record citations for articles you may want to reference, and skim the articles to review the contents. Create an outline that incorporates your main ideas into each section. Follow the outline and the rubric to write a rough draft. You may want to draft your paper by hand, or you might prefer to “type as you go,” editing and making changes both during and after writing the draft.

Your final document should include a title page, all 6 sections of the paper as identified in the grading rubric, and a reference page. Including title and reference pages the paper is not to exceed 6 pages. Part of scholarly writing is to be concise in your writing. The Coach is instructed to grade the title page, the first 4 pages of the body of the paper, and the reference page. If the Synthesis Paper is longer than 6 total pages points may be deducted based on grading rubric sections that were not addressed in the allotted 6 pages.

The title page should be formatted according to UT Arlington College of Nursing format or you may use the title page APA 6th Edition format.

Your writing should be in first person, and is expected to include opinions and personal statements, but have a professional tone. It should flow as a narrative, mostly chronological description your progression through the program including your reflections on specific nursing courses and reflections throughout the program.

Be sure to include a final page titled “References,” and cite your references in correct APA formats. Reference list will include any RN-BSN courses or activities in APA format.

Each section must contain 3-4 well constructed, grammatically correct sentences supported by citations and references (APA 6th Edition Format) as appropriate. Ensure that your writing is informative and interesting, not redundant.

After your write your paper, set it aside and review it again several hours later or the next day. Read it from an objective viewpoint to see if it flows and makes sense. If not, make necessary changes. Have someone else proofread your paper both for content and grammatical accuracy is a vital step. Read your paper out loud before submitting it. Hearing yourself read your own written words can find those last minute mistakes or incomplete thoughts before you submit the paper for grading.

Reflections Paper and Journal attached to provide background information.

Rubric attached to show how points will be awarded for information included in the paper.

Running head: NURSING REFLECTIONS

NURSING REFLECTIONS 2

Nursing Philosophy Reflections

Dera Ogudo

The University of Texas at Arlington

December 9, 2019

Nursing Philosophy Reflections

Every nurse dedicated to growing in her profession has a nursing philosophy that guides their current and future practice. I entered the nursing profession because I have always been drawn to caring for others. Born into a poor African family with many siblings, I learned early in how life that helping to provide others gave me joy and a sense of pride. It takes a selfless and compassionate person to be a nurse and I feel that I am the embodiment of those skills. As I am nearing the end of my BSN program, it is necessary to review my progress towards my earlier established goals and to evaluate whether my nursing philosophy is still relevant.

Career Plans

The first goal I focused on in my nursing philosophy was my two-year plan. My goal was to obtain my BSN and return to working in a hospital. I will be completing my BSN soon, about six months ahead of time. However, I no longer plan to return to working in the hospital. A few months ago, I opened my own home healthcare business. I want to use my personal experience to bridge the practice gaps that exist in this area. I already have a few employees who are well aware of my mission and have been helping me to reach my goals of delivery proficient care to our patient population.

The second goal discussed in my initial nursing philosophy was my five-year goal of getting involved in nursing research. This class has helped me achieve a portion of that goal as my capstone project led me to research alternative ways of treating bipolar disorder that could be used in combination with pharmaceutical regimens. My drive to participate in research is still strong and I have been collaborating with a nurse mentor in one of the local hospitals. My plan is to continue to work towards fulfilling my goal of being actively involved in research. Since creating that philosophy, my attitude towards research has grown as I know see it as a necessity for advanced practice nurses. Nurses need to be able to proactively engage in research opportunities to help further advance the field of nursing.

The last visionary aspect of my nursing philosophy is my 10-year goal of obtaining my doctorate degree in nursing. The initial goal is to get involved in nursing administration to change ineffective policies. While I have not yet thought of applying to nursing schools, I am now part of a nursing administration. I am my own administration. I have used a combination of ineffective policies from my previous experiences to shape my current policies for treating our patient population. My policies are direct, precise, and detailed and they put me in a position to train and guide other nursing staff.

Philosophy Changes

Over the course of my BSN program, my nursing philosophy has not significantly changed. I continue to value honest and trust in the nurse and patient relationship. As a case manager for hospice, when one of my patience requests something within the scope of my practice, I comply. One of my patients recently requested that I limit the hours in which his family visits him to give him optimal peace. Some of his family members weren’t too please with me doing so, but I respect the patient’s autonomy and it is my goal to ensure that I advocate for his needs. Furthermore, to give an example of the selfless and compassionate nature of nursing, I opened my own home healthcare business. It has been hectic and greatly interferes with my personal and professional life, but I am a fulfilling my goals of providing quality and safe care.

Life Long Learner

I feel that all medical professionals will always be life long learners. We constantly must adapt to the changing world around us. The same is true in medicine. There will be many advancements in the upcoming years and nurses must be ready to learn and implement the procedures that accompany these advancements. As long as I am practicing nursing, I will always be in a position that needs learning. I am a new business owner, so I am learning how to merge business and healthcare practicing needs. I am still also working as a case manager, where I openly advocate for the needs of my patients, no matter how difficult the request is.

Overall, my nursing philosophy has grown rather than changed. I have had more experiences to shape my nursing practice and my current knowledge level. I plant to continue to learn as much as I can to help improve the quality of care that I deliver to my patients.

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