discussion 1

 

Since the dawn of time, there has always been a need for more workers or employees. Very rarely was there a time with little to no job openings. In recent years the healthcare field has become in desperate need of more employees, especially nurses. With the covid-19 pandemic stress, workplace burnout, and payment issues, hospital units are growing sparse. Units which were not up to staffing before the pandemic are working extremely understaffed now. Some of the shortages are due to high levels of RN retirements with not enough new nurses entering the workforce to take their place (Buerhaus, 2021). There are many other influencing factors “including working conditions, increased number of patients, violence in the healthcare system… difficulty retaining new graduate nurses, lack of seats in nursing programs, and a nursing faculty shortage” (Perkins, 2021, p. 50). There is also work that nursing working under the stress of the shortages will become burnt out and leave the profession (Perkins, 2021).

Some hospitals in my area have been recently working under tight conditions and in some cases diverting patients to other hospitals with more staff and resources. I work in labor and delivery at my organization. At current, we have not had to divert obstetric patients, but that does not mean our ratios have been safe. Our unit is also very understaffed. With the specialty population of obstetrics, there is never a time when we know how many patients we will have on the unit. A woman can go into labor at any moment, which makes our staffing and assignments more difficult. Throughout our organization, agency or travel nurses have been hired to assist with the ongoing needs. On our unit, we have opened up incentive and contract shifts for interested staff members. We are staffing our own unit with our experienced nurses, while providing extra incentive and shift pay. This solution has saved our unit budget from hiring agency nurses, while keeping the unit closed to just our experienced employees. Although this is a good solution, it should be used temporarily to prevent burnout of current employees. It remains in use and many employees have left the unit due to work-life balance, burnout, and increased salary elsewhere. Burnout and compassion fatigue have created a huge issue in the healthcare workplace (Trepanier et al., 2022). I hope our organizations, litigators, and peers fight for workplace safety and allow for our wonderful nursing profession to remain strong and make a huge comeback.  Nursing homework help

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References

Buerhaus, P. I. (2021). Current nursing shortages could have long-lasting consequences: Time to change our present course. Nursing Economic$, 39(5), 247–250.

Perkins, A. (2021). Nursing shortage: Consequences and solutions. Nursing Made Incredibly Easy!, 19(5), 49–54. https://doi.org/10.1097/01.NME.0000767268.61806.d9

Trepanier, S., Henderson, R., & Waghray, A. (2022). A health care system’s approach to support nursing leaders in mitigating burnout amid a COVID-19 world pandemic. Nursing Administration Quarterly, 46(1), 52–59.

Discussion 2

 

A national healthcare stressor that I have personally experienced is the national nursing shortage. I wanted to elaborate more on this issue as I feel more attention is being given due to the pandemic. According to the US Bureau of Labor Statistics, the RN turnover rate within the first year of work was estimated to range between 35 to 60% (Bakhamis et al., 2019). Unfortunately, nursing shortages can expedite burnout syndrome where nurses experience negative side effects like emotional exhaustion, depression, and risks the nurse leaving healthcare completely (Bakhamis et al., 2019). Burnout can also impact the healthcare organization and patients due to increased risk of medical errors, decreased quality of care, decreased patient satisfaction, and increased organization costs (Jacobs et al., 2018). In my healthcare organization, I have noticed nurses will work longer hours up to 16-hour shifts due to other nurses calling in and finding a replacement very difficult. According to Broome and Marshall (2021), when nurses are under high-stress conditions there is a delay of treatment and decreased patient outcomes.

How My Organization is Responding to Nursing Shortages

In my healthcare organization, there have been several solutions offered in order to address the nursing shortage. From my experience, there have been sign-on bonuses as much as $20,000 for experienced nurses and $5,000 for newly licensed nurses who sign a two-year contract. My organization has also addressed wage increases, where there have been market adjustments to be more competitive with the increasing costs of living. The organization has also increased the amount of tuition reimbursement from $3,000 to $5,000 for nurses seeking to advance their education. Finally, there has been an increased investment in hiring travel nurses as short-term relief.

Other strategies I would like to see being utilized include showing recognition to nurses, shared decision-making, and increased involvement from leadership groups. According to a recent study of an emergency department in Texas, the implementation of an appreciation system has been shown to statistically improve nursing burnout and improve retention (Adams et al., 2019). This appreciation system is an online store where managers can send their employees points to be redeemed for gift cards. Nursing homework help

Another strategy to consider would be to address nurse mental health through programs sponsored by the organization. For example, my organization uses Inspire Wellbeing, an online group that provides education and support material for improving physical and mental health. The program is free to employees and offers discounts to employees who complete different tasks and learning modules.

Conclusion

Patient outcomes will benefit the most when nurse to patient ratios are appropriate as the nurses will experience less burnout, improving productivity and reducing patient errors (Bakhamis et al., 2019). Through the utilization of the strategies mentioned, it can improve staffing and decrease turnover in the long term. This will lead to an improved work environment and improve the mental health of nurses overall.

References

Adams, A., Hollingsworth, A., & Osman, A. (2019). The implementation of a cultural change toolkit to reduce nursing burnout and mitigate nurse turnover in the emergency department. Journal of emergency nursing, 45(4), 452-456.

Bakhamis, L., Paul III, D. P., Smith, H., & Coustasse, A. (2019). Still an epidemic: the burnout syndrome in hospital registered nurses. The health care manager, 38(1), 3-10.

Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). New York, NY: Springer.

Jacobs, B., McGovern, J., Heinmiller, J., & Drenkard, K. (2018). Engaging employees in well-being: Moving from the Triple Aim to the Quadruple Aim. Nursing Administration Quarterly, 42(3), 231-245 Nursing homework help

The priority nursing interventions for Roslyn are to assess and monitor her vital signs, especially her respiratory rate, and perform a pain assessment. The nurse should also administer medication to relieve pain, and considering she is pale and weak; a blood transfusion may be needed. The nurse should prepare Roslyn for that. As the nurse, it is vital to inform Roslyn and her family that her condition can cause pain and avoid students who may be sick when attending school. She should also inform them to let the school know about her condition and need to take medication to treat her symptoms while in school. The nurse can encourage them to keep Roslyn updated with her immunizations to help prevent infections.

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“Support groups for children with sickle cell anemia can help learn ways to cope with these conditions. These support groups can also be helpful for sharing their worries with peers who have similar concerns and feelings.” (Stanford Children’s Health, 2022, para.10) The nurse can support the family and Roslyn by providing information about support groups. The nurse needs to educate them about Sickle Cell Anemia and crisis. The nurse should instruct the family and Roslyn about the importance of handwashing. The nurse can educate them about different ways to manage pain and symptoms. Instruct them to avoid different foods and monitor things that can trigger Roslyn’s symptoms. It is vital to instruct Roslyn to avoid strenuous exercises because they can cause a crisis. Nursing homework help

Healthcare Informatics And Health Promotion And Health

APA format

1) Minimum  4 full pages (No word count per page)- Follow the 3 x 3 rule: minimum three paragraphs per page

           Part 1: minimum  1 page

           Part 2: minimum 1 page

           Part 3: minimum 1 page

           Part 4: minimum 1 page

   Submit 1 document per part

2)¨******APA norms

All paragraphs must be narrative and cited in the text- each paragraph

         Bulleted responses are not accepted

         Don’t write in the first person 

Don’t copy and paste the questions.

Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph

Submit 1 document per part

3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks)

********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks)

4) Minimum 3 references (APA format) per part not older than 5 years  (Journals, books) (No websites) Healthcare Informatics And Health Promotion And Health

All references must be consistent with the topic-purpose-focus of the parts. Different references are not allowed.

5) Identify your answer with the numbers, according to the question. Start your answer on the same line, not the next

Example:

Q 1. Nursing is XXXXX

Q 2. Health is XXXX

6) You must name the files according to the part you are answering: 

Example:

Part 1.doc 

Part 2.doc

__________________________________________________________________________________

 

Parts  1 and 2 have the same questions, however, you must answer with references and different writing always addressing them objectively, that is as if you were different students. Similar responses in wording or references will not be accepted.

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Part 1: Healthcare Informatics

1. What is the definition of an EHR?

2. Define an EHR system.

3. What are five advantages of a EHR over a pap3r-based record?

4.  What are three limitations of an EHR?

5. Discuss three ways in which a computer system could facilitate information transfer between hospitals and ambulatory care facilities, thus enhancing continuity of care for previously hospitalized patients who have been discharged and are now being followed up by their primary physicians.

Part 2: Healthcare Informatics

1. What is the definition of an EHR?

2. Define an EHR system.

3. What are five advantages of a EHR over a pap3r-based record?

4.  What are three limitations of an EHR?

5. Discuss three ways in which a computer system could facilitate information transfer between hospitals and ambulatory care facilities, thus enhancing continuity of care for previously hospitalized patients who have been discharged and are now being followed up by their primary physicians.

Parts  3 and 4 have the same questions, however, you must answer with references and different writing always addressing them objectively, that is as if you were different students. Similar responses in wording or references will not be accepted.

Part 3: Health Promotion

Health Problem:    Lung Cancer in Smokers

SMART goals help improve achievement and success. A SMART goal clarifies exactly what is expected and the measures used to determine if the goal is achieved and successfully completed.

1 Suggest a communication methodology to reach your target population.

2.  Describe the dynamics of a functional focus group, the setting, and technology use.

3. How you can enhance engagement and productive discussions?

Part 4: Health Promotion

Health Problem:  Diabetes in elderly men

SMART goal: Elderly men patients diagnosed with diabetes should have HbA1c level is 48mmol/mol (6.5%)(Measurable) or below (Specific) during the next two months (Timely) to identify adherence to pharmacological and non-pharmacological treatment (Actionable and Realistic)

1 Suggest a communication methodology to reach your target population.

2.  Describe the dynamics of a functional focus group, the setting, and technology use.

3. How you can enhance engagement and productive discussions? Healthcare Informatics And Health Promotion And Health

Module 09 Assignment – Impaired Immune System Care Map

Module 09 Content

1. Click here to open a word document with the assignment instructions and rubric.

   NUR2356_Module 09 Assignment_.docx

   Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.
   Save your assignment as a Microsoft Word document. (Mac users, please remember to append the “.docx” extension to the filename.) The name of the file should be your first initial and last name, followed by an underscore and the name of the assignment, and an underscore and the date. An example is shown below:
   Jstudent_exampleproblem_101504 Module 09 Assignment – Impaired Immune System Care Map

System Care Map

Purpose of Assignment

For this assignment, you will demonstrate knowledge of the diagnostic process using the template below.  You will identify common assessment data, three priority nursing diagnoses, client-centered outcomes, and nursing interventions with rationale for a client with impaired immunity.

Course Competency

• Describe strategies for safe effective multidimensional nursing practice when providing care for clients experiencing immunologic, infectious and inflammatory disorders.

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Instructions

Tom Howard, a 45-year old man with HIV from the community, has come to the clinic because he reports he had not been feeling well recently.  During the intake process, Tom complains of a dry cough and chilling.  The intake nurse takes his vital signs, and they are:  Temp 102 degrees Fahrenheit, Pulse 102, Respirations 28 breaths per minute, Blood pressure 135/86.  The clinic physician refers Tom to the local hospital for a suspected opportunistic infection.

Suspected opportunistic infections for this patient are: (choose ONE to complete this template)

• Cryptococcosis
• Cytomegalovirus
• Histoplasmosis
• Kaposi’s sarcoma
• Toxoplasmosis

 

Use the template directly below these instructions to complete a care map to design care for a client with impaired immunity. For this assignment, include the following: assessment and data collection (including disease process, common labwork/diagnostics, subjective, objective, and health history data), three NANDA-I approved nursing diagnosis, one SMART goal for each nursing diagnosis, and two nursing interventions with rationale for each SMART goal for a client with a immune system disorder.

 

Assessment and Data Collection	Three NANDA-I Approved                    Nursing Diagnosis *Risk: Nursing diagnosis____Related to_____ *Actual: Nursing diagnosis____Related to____ as evidenced by	One Smart Goal for EACH Nursing Diagnosis *Specific and measurable with a timeline. Find from the nursing diagnosis book (under client or expected outcomes section) and individualize to your patient-ONE SENTENCE	3 Nursing Interventions with Rationale for EACH Nursing Diagnosis
Disease Process: (short description of patho of disorder- cite this):               Common Labwork/Diagnostics: Module 09 Assignment – Impaired Immune System Care Map                 Assessment Data (consider subjective, objective, and heath history):	Nursing Diagnosis:                 Nursing Diagnosis:                 Nursing Diagnosis	SMART Goal:                  SMART Goal:                 SMART Goal:	1. Rationale: 2. Rationale: 3. Rationale: Cite:     1. Rationale: 2. Rationale: 3. Rationale: Cite:       1. Rationale:   2. Rationale:   3. Rationale: Cite:

 

 Module 09 Assignment – Impaired Immune System Care Map Rubric

Total Assessment Points – 65

Levels of Achievement
Criteria	Emerging	Competence	Proficiency	Mastery
Assessment / Data Collection (10 Pts)	Lacks basic factors of the disease process, common labs, diagnostic tests, and subjective, objective, and health history data. Failure to submit Assessment/Data Collection will result in zero points for this criterion.	Briefly identifies the factors including the disease process, common labs, diagnostic tests, and subjective, objective, and health history data.	Clearly identifies the factors including the disease process, common labs, and diagnostic tests, and subjective, objective, and health history data.	Thoroughly identifies all factors including the disease process, common labs, diagnostic tests, and subjective, objective, and health history data with a deep understanding.
	Points – 7	Points – 8	Points – 9	Points – 10
Nursing Diagnosis  (should fit the data) (10 Pts)	Nursing diagnoses are insufficient and/or do not fit the data. Failure to submit Nursing Diagnosis will result in zero points for this criterion.	Writes ONE NANDA-I approved nursing diagnosis in the correct format (including related to/as evidenced by) with a strong connection to identified data.	Writes TWO NANDA-I approved nursing diagnoses in the correct format (including related to/as evidenced by) with a strong connection to identified data.	Writes THREE NANDA-I approved nursing diagnoses in the correct format (including related to/as evidenced by) with a strong connection to identified data.
	Points – 7	Points – 8	Points – 9	Points – 10
SMART Goal (should reflect the diagnosis and follow guidelines)  (15 Pts)	The goals meet few SMART goal guidelines and/or are not related to the nursing diagnoses. Failure to submit SMART goals will result in zero points for this criterion.	Writes ONE goal for ONE nursing diagnosis and the goal meets all the SMART goal guidelines and are related to the nursing diagnosis.	Writes ONE goal for TWO nursing diagnoses and the goals meet all the SMART goal guidelines and are related to the nursing diagnoses.	Writes ONE goal for THREE nursing diagnoses and the goals meet all the SMART goal guidelines and are related to the nursing diagnoses.
	Points – 11	Points – 12	Points – 13	Points – 15
Interventions and Rationale (20 Pts)	Lacks appropriate interventions and rationale to assist the client in resolving the issues leading to the problem. Failure to submit Interventions and Rationale will result in zero points for this criterion.	Writes 3 interventions with rationale to assist the client in resolving the issues leading to the problem with appropriate references.	Writes 5 interventions with rationale to assist the client in resolving the issues leading to the problem with appropriate references.	Writes 3 interventions with rationale to assist the client in resolving the issues leading to the problem with appropriate references.
	Points – 15	Points – 16	Points – 18	Points –20
APA Citation (5 Pts)	APA in-text citations and references are missing.	Attempted to use APA in-text citations and references.	APA in-text citations and references are used with few errors.	APA in-text citations and references are used correctly.
	Points- 2	Points- 3	Points- 4	Points- 5
Spelling and Grammar  (5 Pts)	Numerous spelling and grammar errors, which detract from the audience’s ability to comprehend material.	Some spelling and grammar errors, which detract from the audience’s ability to comprehend material.	Few spelling and grammar errors.	Minimal to no spelling and grammar errors.
	Points- 2	Points- 3	Points- 4	Points- 5

 

 

In this video a 12 year old girl, Briana, is struggling with morbid obesity. She weighs over 300 pounds. She has been told that being this overweight will affect her health. She also feels very self-conscious about her weight and is bullied by her classmates. Briana’s parents express concern about her health as well. When her mother is interviewed about what food she serves the family she appears to be very interested in making any necessary changes. A trip to the market to find out what she purchases for family meals reveals that she does not seem to know what would be best to prepare for Briana so she can lose weight. Briana’s mother appears to be “stuck” on buying what she thinks are healthy foods which includes canned vegetables and very little fresh fruit and vegetables.

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Here is the link to the video, “A 12 Year Old’s Struggle with Morbid Obesity”

Describe how Briana’s mother should change meal preparations to be healthier. Describe strategies that might engage Briana in the process of preparing the meals. Nursing homework help