Transcultural Perspectives In The Nursing Care Of Adults

Transcultural Perspectives In The Nursing Care Of Adults

Transcultural Perspectives in the Nursing Care of Adults

Read chapter 7 of the class textbook and review the attached PowerPoint presentation.  Once done write an essay addressing the following;

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  1. Sanya, a 20-year-old woman from India who is attending a university in the United States is seen by a nurse in a clinic for the first time when she is 16 weeks’ pregnant. This is an unplanned pregnancy, and Sanya tells the nurse that she wants an abortion. Sanya feels that, although abortion is discouraged by Indian culture unless it is necessary to save the mother’s life, she should terminate the pregnancy. Her boyfriend, the baby’s father, is a Caucasian American, but her parents have already arranged for her to marry an Indian man in India. Sanya would prefer to marry her American boyfriend.
    1. Using Leininger’s Sunrise Model, discuss the complexities of the cultural traditions and the woman’s situation

How can the nurse offer support to the woman?

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 titled “Week 7 discussion questions” for grading and in Turnitin to verify originality.   If you don’t post your assignment in any of the required forums you will not get the points.  A minimum of 2 evidence-based references besides the class textbook must be used.  . A minimum of 900 words is required.  Please make sure to follow the instructions as given. Transcultural Perspectives In The Nursing Care Of Adults

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    CulturalNursingchapter_071.pptx

    Chapter 7: Transcultural Perspectives in the Nursing Care of Adults

     

    Copyright © 2016 Wolters Kluwer Health | Lippincott Williams & Wilkins

     

     

    Copyright © 2016 Wolters Kluwer • All Rights Reserved

     

    1

    Cultural Influences on Adulthood #1

    Developmental tasks are transitions that occur in a normal successful adulthood.

    A health/illness situational crisis refers to changes or turmoil as individuals struggle to cope with a sudden life-threatening illness.

    Transitions: health or illness events that require an individual to make modifications in his/her lifestyle

     

     

    Copyright © 2016 Wolters Kluwer • All Rights Reserved

     

    2

    Cultural Influences on Adulthood #2

    Physiologic development

    Hormonal changes

    Menopause, loss of sexual potency

    Psychosocial development

    Stages of life

    Divorce, remarriage, career changes

     

     

     

    Copyright © 2016 Wolters Kluwer • All Rights Reserved

    Cultural Influences on Adulthood #3

    Each culture has specific chronologic standards for appropriate adult behavior.

    Social age: Culture defines what is considered an appropriate behavior in each stage of the life cycle.

    Young adult (teens, 20s, 30s): independence, role changes

    Middle adult (40s, 50s): career, family matters

     

     

    Copyright © 2016 Wolters Kluwer • All Rights Reserved

     

    4

    Question #1

    Is the following statement true or false? Transcultural Perspectives In The Nursing Care Of Adults

     

    Midlife adulthood is often a time of stress, dissatisfaction, and unrest.

     

     

    Copyright © 2016 Wolters Kluwer • All Rights Reserved

     

    5

    Answer to Question #1

    False

     

    Rationale: Adulthood is not always a tumultuous, crisis-oriented state; many middle aged persons welcome the space, time, and independence that middle age often brings. Midlife can be a time of challenge, enjoyment, and satisfaction for many persons.

     

     

    Copyright © 2016 Wolters Kluwer • All Rights Reserved

     

    6

    Cultural Influences on Adulthood #4

    Developmental tasks; responses to life situations encountered by all persons experiencing:

    Physiologic

    Psychological

    Spiritual

    Sociologic changes

    Erikson’s generativity versus stagnation

     

     

    Copyright © 2016 Wolters Kluwer • All Rights Reserved

    Cultural Influences on Adulthood #5

    Adult life transitions influenced by culture:

    Career success

    Social and civic responsibility

    Marriage and raising children

    Changing roles and relationships

     

     

     

    Copyright © 2016 Wolters Kluwer • All Rights Reserved

    Question #2

    Which of the following would not be considered a social and/or civic responsibility?

    Serving on the board of a women’s shelter

    Donating blood

    Attending religious ceremonies

    Volunteering at a food bank

     

     

    Copyright © 2016 Wolters Kluwer • All Rights Reserved

    Answer to Question #2

    C. Attending religious ceremonies

     

    Rationale: Social and civic duties include participation in those activities in adulthood that contribute to the “good of society.” Some cultures emphasize activities and contributions within the cultural group. For example, in some groups, religious obligations are given priority over civic responsibilities.

     

     

    Copyright © 2016 Wolters Kluwer • All Rights Reserved

    Health-Related Situational Crises #1

    Situational transitions often occur when a serious illness is diagnosed or other traumatic events occur to individuals and their families.

    Caregiving occurs when an unpaid person, usually a family member, helps another family member who has a chronic illness or disease.

    Culture and ethnicity can influence beliefs, attitudes, and perceptions related to caregiving.

     

     

    Copyright © 2016 Wolters Kluwer • All Rights Reserved

     

    11

    Health-Related Situational Crises #2

    HIV/AIDS and the African American Community considerations:

    Prevention challenges

    Influential factors

    Poverty

    Denial

    Drug use

    Homophobia/concealment of behavior

     

     

    Copyright © 2016 Wolters Kluwer • All Rights Reserved

    Health-Related Situational Crises #3

    Culturally competent nursing care

    Health promotion strategies and nursing interventions for African American women:

    “Stroke belt”

    “High blood”

    “Nerves”

     

     

    Copyright © 2016 Wolters Kluwer • All Rights Reserved

     

    13

    Question #3

    Is the following statement true or false?

     

    “High blood” is a term frequently used by the African American culture in the rural South to identify the condition referred to by the medical term hypertension.

     

     

     

    Copyright © 2016 Wolters Kluwer • All Rights Reserved

     

    14

    Answer to Question #3

    False

    Rationale: “High blood” is an illness condition that is associated with African American culture in the rural South. Many health care professionals make the wrong assumption that “high blood” is the same as high blood pressure or hypertension; although there are similarities, the cultural explanation of “high blood” is different from the biomedical explanation of high blood pressure or hypertension. Transcultural Perspectives In The Nursing Care Of Adults

Nursing Bio Assignment Paper

Nursing Bio Assignment Paper

Homework is to be presented as a short (50-100-word) paragraph response for each question. The assignment is to be submitted as a Microsoft Word document electronically to the instructor.

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  1. Explain the process and purpose of the Five Rights.
  2. What are the various methods of drug administration? Explain why one method may be chosen over another.
  3. Assess the conditions under which a chest tube is placed and the maintenance and precautions needed.
  4. What purpose do arterial venous lines serve and which vessels are they placed in.
  5. Why is a pulmonary arterial line not an arterial line in the strictest sense of the word?
  6. Organize a plan for your participation in a code.
  7. What are the general requirements for a code cart setup?

APA format is not required, but solid academic writing is expected. Nursing Bio Assignment Paper

Models Of Transcultural Nursing

Models Of Transcultural Nursing

The Course Outcome covered this week is CO1.

CO1: Identify theories, concepts, and beliefs related to transcultural nursing. (PO1)

Chapter 1 of Andrews and Boyle (2016) discusses Leininger’s Sunrise Model of transcultural nursing. However, other models are described and are important to acknowledge, as well. Models of Transcultural Nursing

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  • Research the wonderful scholarly resources available to you in the Chamberlain Library. Select a Transcultural Nursing Model/Theory.
  • Briefly explain the model/theory in your own words so your classmates will understand the general premises of the model/theory.
  • Then, explain how you would be able to apply the model in your practice setting.

Readings: Andrews, M. M., & Boyle, J. S. (2016). Transcultural concepts in nursing care (7th ed.). Philadelphia: PA. Wolters Kluwer.

  • Chapter 1: Theoretical Foundations of Transcultural Nursing
  • Chapter 2: Culturally Competent Nursing Care. Models Of Transcultural Nursing

Assignment: Case Study For Chronic Condition

Assignment: Case Study For Chronic Condition

Assignment: Case Study for Chronic Condition

For this Assignment, you are answer the questions regarding this case study. Please make sure to support your answers using evidence based practice.

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Case Study: 

56 y/o Caucasian male presents to the primary care clinic with complains of dizziness and nausea x 4 days. The patient reports he has not been able to get out of bed since the symptoms started. The patient reports symptoms are worse when he tries to get out of bed to stand. He denies any headaches or blurry vision. He states he is urinating more over the last few days and he has noticed increase in thirst. He reports he just drank a large sweet tea before he came into the clinic. Assignment: Case Study for Chronic Condition

The patient reports that he is out of his Lantus and metformin because he cannot afford the refill until he gets his disability check. He is disabled after his second CVA that left his with generalized weakness. His medical history includes DM, HTN, CAD. Assignment: Case Study For Chronic Condition

Upon arrival at the clinic, the patient’s vital signs are as follows- Blood sugar 405, B/P 190/101, HR 102, R-20, T- 98.5.

Using Evidence Based practice, answer the following questions thoroughly. Be sure to use APA formatting.

Use headings while answering questions below:

  1. What is the pertinent positive and negative findings in this patient assessment?
  2. Create a list of differentials with rationales for this patient?
  3. Discuss a medication regimen for this patient considering his financial status?
  4. What is the priority concern for this patient?
  5. How does this patient’s comorbid diagnosis impact his current symptoms?
  6. Discuss how the patient’s’ health beliefs, culture and behaviors impact the potential outcomes for the patient. Assignment: Case Study For Chronic Condition

Discussion: Pharmacotherapy For Hematologic Disorders

Discussion: Pharmacotherapy For Hematologic Disorders

In the 1970s, the average lifespan for patients diagnosed with sickle cell disease was 14 years. Today, the average lifespan has increased to 50 years and beyond (TriHealth, 2012). The patient prognosis for many other hematologic disorders such as hemophilia and cancer continue to improve as well. This can be attributed to advancements in medical care—specifically drug therapy and treatment. When managing drug therapies for patients, it is essential to continuously examine current treatments and evaluate the impact of patient factors on drug effectiveness. To prepare for your role as an advanced practice nurse, you must become familiar with common drug treatments for various hematologic disorders seen in clinical settings. Discussion: Pharmacotherapy For Hematologic Disorders

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To prepare:
  • Select one of the following hematologic disorders: anemia, hemophilia, cancer, sickle cell anemia, thalassemia, thrombolytic disorders, or white blood cell disorders. Consider the types of drugs that would be prescribed to patients to treat symptoms associated with this disorder.
  • Select one of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how this factor might impact the effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.

With these thoughts in mind:

By Day 3

Post a description of the hematologic disorder you selected including types of drugs that would be prescribed to patients to treat associated symptoms. Then, explain how the factor you selected might impact the effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.

APA style, 3 reference above 2013. Discussion: Pharmacotherapy For Hematologic Disorders

NR504 Wk7 Assignment And Discussion

NR504 Wk7 Assignment And Discussion

NR 504 Week 7 Assignment – Professional Coalition Project (Spring Term 2018) 

Involvement in interdisciplinary coalitions allows the healthcare leader to gain an understanding regarding navigating socio-political environments as well as providing macro leadership within a broader community setting. The purpose of this project is to build and provide leadership to a coalition that addresses a healthcare concern. Leadership skills at the macro-level will be applied.

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Due: Week 7

Total Points: 125 Points

NR 504 Week 7 Discussion; Identifying & Associating With Professional Coalitions (Spring Term 2018) 

Involvement in interdisciplinary professional coalition/organizations allows the healthcare professional to stay current in their field or specialty, gain an understanding and navigate socio-political environments, as well as contribute their ideas to their healthcare specialty.

• Research your state’s exemptions and differences within your state regarding laws requiring vaccinations for school-age children.

o Find the professional coalition/organization that supports the use of vaccines for school-age children.

o As a group, discuss the pros and cons of the above scenario and your stance of this controversial public health risk. NR504 Wk7 Assignment And Discussion

Concept Analysis: Mental Stigma

Concept Analysis: Mental Stigma

Purpose

A concept analysis is designed to make the student as familiar with a concept as possible.  A concept is usually one or two words that convey meaning, understanding or feelings between or among individuals within a same discipline. Some concepts relevant to mental health are stigma, recidivism, and deinstitutionalization. Concept Analysis: Mental Stigma

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Activities and Directions

To begin the process, choose a concept you are interested in, a term you encounter with your work or one with which you would like to research. Look for the measurable quality in your topic of interest, problem or question.

– Write down all of the words you can think of which relate to or express your concept.

– Search the literature for journal articles and books related to the concept to get a sense of the beliefs and thoughts of others in the discipline regarding the concept.

– Begin the analysis paper with a introductory paragraph expressing what the concept is and why it is significant to you and mental health.

– Develop the Model Case. The model case is a brief situational description validating the concept including all of the characteristics you have listed which describe or make up the concept. The model case should be able to
reflect that If this is not an example of (concept), then nothing is. Concept Analysis: Mental Stigma

– Close with a summary.
CONCEPT ANALYSIS PAPER
EVALUATION FORM (100 points).

I. Introduction (10 points)
A. Includes the aims & purposes of the analysis    (0-3)_______
B. Justifies concepts significance to mental health         (0-7)_______

II. Definition of Concept (20 points)
A. Describes derivation of definition from common usage, &
nursing use                                                       (0-6)_______
B. Describes & cites a variety of appropriate authoritative
sources from the literature regarding nature of concept  (0-6)_______
C. Definition of concept reflects synthesis &
evaluation of definitions from appropriate sources  (0-8)_______

III. List of defining characteristics (25 points)
A. Each attribute is clearly stated as succinctly as possible (0-5)_______
B. Each attribute is logically an essential element of the
concept as defined                                                      (0-5)_______
C. Each attribute is stated in as measurable a form as the
abstractness of the concept allows                               (0-5)_______
D. The listed attributes comprise all essential attributes of the
concept as defined                                                     (0-10)______

IV. The Model Case (25 points)
A. Is a logical example of the concept                              (0-5)_______
B. Includes all listed attributes of the concept                  (0-10)______
C. Includes no attributes of other concepts                       (0-5)_______
D. Is concisely stated                                                       (0-5)_______

V. Reference List (10 points)
A. Contains a variety of resources             (0-2)_______
B. Resources are authoritative, classic resources are evident  (0-3)_______
C. Nursing resources are explored                                 (0-3)_______
D. Resources are sufficient in number to justify analysis   (0-2)_______

VI. Layout and Presentation of Paper (10 points)
A. Precise APA format              (0-5)_______
B. Grammar, spelling & typing at professional scholarly level   (0-5)_______



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    HanksConceptAnalysis.pdf

    Nursing Forum Volume 42, No. 4, October-December, 2007 171

     

    Blackwell Publishing IncMalden, USANUFNursing Forum0029-6473© Blackwell Publishing 2007XXX

    ORIGINAL ARTICLES

    Barriers to Nursing Advocacy: A Concept Analysis

    AUTHORS RUNNING HEAD:

    Barriers to Nursing Advocacy: A Concept Analysis

     

    Barriers to Nursing Advocacy: A Concept Analysis

     

    Robert G. Hanks, RN, C, MSN, FNP-C

     

    Advocacy for clients is viewed as an essential

    function of nursing; however, to be effective

    advocates for patients, the nurse must often

    overcome barriers to being an effective advocate.

    This concept analysis of barriers to nursing

    advocacy uses the Walker and Avant method of

    concept analysis. By analyzing the barriers to

    effective nursing advocacy for clients, nursing can

    then find strategies to manage those barriers and

    maximize the nurse’s advocacy efforts. Concept Analysis: Mental Stigma

    Search terms

     

    Barriers, concept analysis,

    nursing, patient advocacy

     

    Robert G. Hanks, RN, C, MSN, FNP-C, is a Clinical Instructor at the School of Nursing, University of Texas at Arlington, Arlington, TX.

     

    Introduction and Concept Selection

     

    Advocacy for clients is an important aspect in current professional nursing care and is considered to be a fundamental value of professional nursing by several nursing scholars. Since the origin of the client advocate in the 1970s (Annas & Healey, 1974), nursing has been viewed as the ideal profession to take on this advocate role (Annas, 1974) due to the intimate relationship of the client and nurse. The main act of advocating is viewed as part of nursing ethics by supporting patient autonomy (Gadow, 1989). Advocacy is found in all ethical codes for nursing (Hamric, 2000), including the American Nurses Association (ANA) Code of Ethics for Nurses (2001).

    Nursing has not always practiced advocacy; rather, it is a relatively new role for nursing, emerging in the United States in the 1980s (Hamric, 2000). Barriers exist that prevent nurses from advo- cating for their clients, which will be examined in this article. For nurses to be effective advocates, an examination of the barriers that prevent nurses from fully realizing their role as nursing advocates must be performed in order to overcome these barriers.

     

    Aim of Analysis

     

    The aim of this analysis is to analyze critically the concept of barriers to nursing advocacy in order to provide clarity and direction for future inquiries into this subject. In addition, examining the barriers to nursing advocacy may result in more effective nursing education and interventions regarding nursing advocacy and the possibility of overcoming the barriers to provide effective nursing advocacy. Concept Analysis: Mental Stigma

    172 Nursing Forum Volume 42, No. 4, October-December, 2007

    Barriers to Nursing Advocacy: A Concept Analysis

    Methodology

    The methodology used in this concept analysis is the Walker and Avant (2005) concept analysis method (Table 1), which is derived from Wilson’s (1963) classic concept analysis procedure (Table 2). The Walker and Avant method was selected because it was determined to be more suitable for this novice author to use. Concept Analysis: Mental Stigma

    Sample Selection

    Articles for this concept analysis were selected using searches of Cumulative Index of Nursing and

    Allied Health (CINAHL), MEDLINE, PsychInfo, and Sociological Abstracts. The databases chosen encompass the literature associated with the keyword combinations used. The combination of keywords used for the searches included the following: (a) patient advocacy, (b) nursing, (c) subservience, and (d) barriers. By including PsychInfo and Sociological Abstracts, a larger sample of literature was uncovered. The time period for the literature searches were as follows: (a) CINAHL 1982–2005, (b) MEDLINE 1966–2005, (c) PsychInfo 1967–2005, and (d) Sociological Abstracts 1963–2005, which are the limits of the databases at the library used. The resulting 55 abstracts were reviewed for content about nursing advocacy and barriers to advocacy with a total of 36 articles used for this analysis. Each of the selected articles from the literature was read for themes and contribution to the body of literature about nursing advocacy and barriers to nursing advocacy. Concept Analysis: Mental Stigma

    Relevance of Literature Reviewed to the Selected Concept

    The literature used for this concept analysis reflects the historical progress of nursing advocacy and, imbedded in this progress, the barriers to nursing advocacy. An examination of the barriers to nursing advocacy will help to focus nursing on overcoming the barriers and provide more effective nursing advocacy for clients.

    Relevance to Nursing

    Most nursing scholars and many nonnursing scholars agree that nursing advocacy for clients is a fundamental part of nursing practice (Annas, 1974; Curtin, 1979). This concept is reflected in ethical codes for nurses that include advocacy for clients (ANA, 2001; Hamric, 2000). If nurses are to be effective at nursing advocacy for their clients, then an understanding of barriers, both actual and potential, will help the nurse realize effective nursing advocacy.

    Table 1. Walker and Avant Concept Analysis Method (2005, p. 65)

    1. Select a concept 2. Determine the aims or purposes of analysis 3. Identify all uses of the concept that you can discover 4. Determine the defining attributes 5. Identify a model case 6. Identify borderline, related contrary, invented, and

    illegitimate cases 7. Identify antecedents and consequences 8. Define empirical referents

    Table 2. Wilson Concept Analysis Procedure (1963, pp. 23–36)

    1. Isolate questions of concept 2. Right answers 3. Model cases 4. Contrary cases 5. Related cases 6. Borderline cases 7. Invented cases 8. Social context 9. Underlying anxiety 10. Practical results 11. Results in language. Concept Analysis: Mental Stigma

    Nursing Forum Volume 42, No. 4, October-December, 2007 173

     

    Most nursing scholars and many nonnursing

    scholars agree that nursing advocacy for

    clients is a fundamental part of nursing

    practice (Annas, 1974; Curtin, 1979).

    Uses of Concept

    For the purposes of this article, the definitions have been narrowed to the nursing context accord- ing to the most recent version of the Walker and Avant method of concept analysis (2005). In order to understand the complex nature of the concept of barriers to nursing advocacy, nursing advocacy and barriers to nursing advocacy were analyzed separately.

    Advocacy is derived from advocate, which is a “person that pleads a case on someone else’s behalf” (Oxford Online, 2006). Another source defines advocacy as “the act or process of advocating or supporting a cause or proposal” (Merriam-Webster Online, 2006a). Advocacy has been defined as correcting a deficit of a client by another (Grace, 2001), informing a person of their rights and providing information (Segesten, 1993), supporting the client (Kohnke, 1982), and giving voice to silent patients (Gadow, 1989).

    Nurse is defined as “a person who is skilled or trained in caring for the sick or infirm especially under the supervision of a physician” (Merriam- Webster Online, 2006c). The ANA (2003) defines nursing, in part, as “provision of a caring relationship that facilitates health and healing” and “attention to the range of human experiences and responses to health and illness within the physical and social environments.” However, in nursing literature, nursing advocacy is a combined term that has been used to

    define nurses advocating for their clients (Curtin, 1979). Most definitions of nursing advocacy in the nursing literature sample are describing attributes rather than actual definitions. Concept Analysis: Mental Stigma

    Barriers are defined as “something immaterial that impedes or separates” (Merriam-Webster Online, 2006b). Barriers are not defined per se in the sample of nursing literature, but rather are qualified by the attributes of barriers.

     

    Defining Attributes

    Nursing Advocacy

     

    The attributes of nursing advocacy vary in the sample. The nurse advocate is most commonly associated with protector of patient rights (Bandman, 1987; Becker, 1986; Foley, Minick, & Kee, 2000; Gadow, 1980; Gadow, 1989; Kubsch, Sternard, Hovarter, & Matzke, 2003). In this role, the nurse is protecting the fundamental rights of the patient’s self-determination over the patient’s care. Congruent with this concept is the informer role of the nurse advocate in which the nurse provides information to the patient about the patient’s care (Chafey, Rhea, Shannon, & Spencer, 1998; Curtin, 1979; Kohnke, 1980; Watt, 1997). Empowerment is also cited as an attribute of nursing advocacy (Chafey et al.; Lindahl & Sandman, 1998; Smith & Godfrey, 2002). The role of patient supporter is also contained in the nurse advocate role (Kohnke, 1982; Watt, 1997), with a related term, partnership, also being used in the literature (Gadow, 1983; Lindahl & Sandman; Snoball, 1996). A similar attribute, repre- sentative, is suggested by Copp (1986). Finally, the attribute therapeutic relationship has been recom- mended by Snoball. Concept Analysis: Mental Stigma

    Barriers to Nursing Advocacy

     

    The attributes of barriers to nursing advocacy are infrequently found in the literature. The most common attribute is conflict of interest between the nurse’s

    174 Nursing Forum Volume 42, No. 4, October-December, 2007

    Barriers to Nursing Advocacy: A Concept Analysis

    responsibility to the patient and the nurse’s duty to the institution where the nurse is employed (Jenny, 1979; Miller, Mansen, & Lee, 1983; Pullen, 1995; Robinson, 1985; Walsh, 1985). Similar attributes of institutional constraint (Kohnke, 1980), including lack of support (Millette, 1993) and lack of power (Hewitt, 2002; Miller et al.), have been identified as barriers. An additional barrier to nursing advocacy is the nurse’s lack of education (Pankratz & Pankratz, 1974; Penticuff, 1989) and time (Miller et al.; Segesten, 1993). Threats of punishment are also considered an attribute of barriers to nursing advocacy (Mallik, 1997). Finally, a historical barrier of nursing being a feminine pro- fession with a tradition of subservience to the medical profession is also considered a barrier to nursing advocacy (Hamric, 2000; Winslow, 1984).Concept Analysis: Mental Stigma

    Cases

    Model Case

    F.N. is a new graduate from an associate degree program and she has obtained her first nursing position at a small, private, community hospital. F.N. is very grateful to her new employer for a position, as it is the only hospital within 80 miles, and openings for registered nurses have been curtailed in the past year. The supervisor of F.N. is domineering, and is constantly reminding F.N. of her obligation to the hospital and physicians. The client load is heavy, often leaving F.N. with little time to discuss issues with her clients.

    Mr. J. is a new client that has been admitted for renal disease and cellulitis of the left foot. The physician orders meperidine for pain management, which Mr. J. requests and receives each hour. After a day of this therapy, Mr. J. starts to have twitching movement in his arms. Concerned, F.N. discusses this issue with the supervisor. The supervisor tells F.N. to continue to administer the meperidine and “not ask questions.” The supervisor further informs F.N. that meperidine is the hospital standard and that

    the hospital has “been using it for years.” Mr. J. is having muscle cramps due to the continuous twitching and requests that F.N. call the physician. However, F.N. has 10 other clients to care for, and fearing a reprisal from her supervisor, F.N. administers another dose of meperidine without consulting the physician. Concept Analysis: Mental Stigma

     

    Borderline Case

     

    P.M. is an experienced nurse with 20 years’ experience in the surgical area. She is caring for 10 clients that are postoperative. One of the patients, W.M., complains of incisional pain, but is concerned about the side effects of the medication that is ordered. P.M. administers the pain medication anyway, telling W.M. that she will come back later and discuss his concerns.

    Related Case

     

    Q.D. is a nurse working in a large long-term care facility. The length of employment for the nursing staff is less than 1 year, leaving the facility chronically short staffed. The facility is also undergoing budget constraints due to lower Medicare payments. Q.D. has been working two shifts per week of overtime during the past month, and is fatigued. Her supervisor asks her to work another shift of overtime on her only day off. Q.D. politely states that she needs to rest on her day off and spend time with her family. The supervisor reminds Q.D. how short the facility is of nursing staff. Q.D. replies that although she understands the facility’s position, Q.D. must first assure that she remains healthy and able to provide the best care to her clients by allocating sufficient rest periods from work.

     

    Contrary Case

     

    P.D. is a clinical nurse specialist working on a surgical ward. The floor nurses have asked her to come and evaluate the pain management of Mr. J., a new client

     

     

     

    Nursing Forum Volume 42, No. 4, October-December, 2007 175

     

    that has been admitted for renal disease and cellulitis of the left foot because, according to the floor staff, the charge nurse “won’t do anything.” Mr. J. is receiving large amounts of meperidine and has now developed muscle twitching. P.D. is aware of the neurotoxic metabolites of meperidine. After performing a detailed examination and having Mr. J. express his concerns, P.D. calls the prescribing physician and asks the physician to discontinue the meperidine, even though this is the preferred pain medication at the hospital and this particular physician’s preference. The meperidine is discontinued and morphine is ordered as the pain medication for Mr. J. After 24 hr, Mr. J. is rating minimal pain, and the muscle twitching has subsided. Concept Analysis: Mental Stigma

     

    Invented and Illegitimate Cases

     

    The invented and illegitimate cases are not required using this method of concept analysis (Walker & Avant, 2005). The concept of barriers to nursing advocacy has been sufficiently demonstrated using the model, borderline, related, and contrary cases. Concept Analysis: Mental Stigma

     

    Antecedents

     

    The antecedents to barriers of nursing advocacy are related to the need for nursing advocacy for the client. Advocacy for patients stems from a vulnerable population that loses power to represent or defend itself (Copp, 1986) or an individual that is neglected or intimidated (Chafey et al., 1998). The antecedents of barriers include employment conditions, fear of loss of employment, fatigue, frustration, and burnout (Chafey et al.). Inadequate education has been cited as a barrier to nursing advocacy (Copp; Jenny, 1979; Pankratz & Pankratz, 1974).

     

    Consequences

     

    The consequences of the barriers to nursing advocacy are of great importance but also seem simplistic. The

    major consequence of the barriers to nursing advocacy is ineffective advocacy for the client by the nurse (Mallik, 1997). A secondary but related consequence of the barriers to nursing advocacy is continuing unresolved issues about patient care (Andersen, 1990). Concept Analysis: Mental Stigma

     

    Empirical Referents

     

    The barriers to nursing advocacy are found in the literature; however, the literature identifies few research studies or instruments on nursing advocacy or the barriers to nursing advocacy. In 1991, Hatfield explored the relationship between a nurse’s level of ethical reasoning and the factors that influence the nurse as an advocate, namely, autonomy and agency support. Hatfield authored the “Nursing Advocacy/ Beliefs & Practices” (NABP) scale for her dissertation study. The NABP scale measures the constructs of patient autonomy, nursing autonomy, and agency support (Hatfield, 1991). The correlation coefficient for the relationship between nurses’ beliefs about patient autonomy and ethical judgment was statistically significant (

     

    r

     

    = .5040;

     

    p

     

    = .01), leading to a conclusion that a nurse’s perception of autonomy in practice is influenced by ethical judgment. Concept Analysis: Mental Stigma

    Ingram (1998) modified the NABP scale into the “Patient Advocacy Scale” for use with nurses in the UK. Although this scale was developed in 1998, it has yet to be utilized in studies (Ingram, personal communication, October 6, 2005). With a convenience sample of acute care nurses in the UK (

     

    n

     

    = 86), Ingram concluded that two factors, educational level and attendance in ethics courses, were predictive of PAS scores. However, the relationships between the two variables and PAS were weak: educational level (

     

    r

     

    = .3333;

     

    p

     

    = .002), and ethics course attendance (

     

    r

     

    = .2561;

     

    p

     

    = .017) (Ingram). Further exploration into nursing advocacy was performed in a study by Millette (1993) by asking nurses to choose from three models of advocacy (institutional, physician, and client) in a survey format with the client advocate model being chosen most frequently. Concept Analysis: Mental Stigma

     

     

     

    176 Nursing Forum Volume 42, No. 4, October-December, 2007

     

    Barriers to Nursing Advocacy: A Concept Analysis

     

    Although the direct measurement of barriers to nursing advocacy has not been found in the literature, it may be possible to measure the barriers that have been identified by various authors cited in this article. Three attributes—education, time, and threats of punishment—could be measured without further delineation. Other attributes, including conflict of interest, institutional constraint, lack of support, and lack of power, may require additional inquiry to be measurable. Concept Analysis: Mental Stigma

     

    . . . it may be possible to measure barriers

    that have been identified by various authors

    cited in this article. Three attributes—

    education, time, and threats of

    punishment—could be measured without

     

    further delineation.

     

    Implications for Nursing Practice and Education

     

    The implications for nursing practice are that nurses need to overcome barriers to become effective nursing advocates for their clients. Although this is an ideal situation, the threat of job loss, retribution, intimidation, or ostracism can be real barriers ( Jenny, 1979; Miller et al., 1983; Pullen, 1995; Robinson, 1985; Walsh, 1985). Nurses need strategies to overcome barriers so that they can seek what is best for the client, including advocating in light of institutional and interdisciplinary constraints (Hewitt, 2002; Kohnke, 1980; Miller et al.; Millette, 1993).

    Nursing education has an important role in educat- ing student nurses on the role of client advocacy in

    nursing and how to effectively manage the barriers to be successful nursing advocates for the client ( Jenny, 1979; Pankratz & Pankratz, 1974). This educational approach could include not only the student nurse in the prelicensure program but continuing education for the practicing nurse.

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    Conclusion

     

    Nursing has claimed client advocacy as an important core component of nursing practice. Nursing literature has several articles on philosophical stances on nursing advocacy. What has been found to be lacking is a clear understanding of the barriers to nursing advocacy that have been clearly and separately delineated in the literature. This article represents a concept analysis on the barriers to nursing advocacy in order to clarify the concept and provide a basis for further research into the barriers of nursing advocacy. Concept Analysis: Mental Stigma

     

    This article represents a concept analysis on

    the barriers to nursing advocacy in order to

    clarify the concept and provide a basis for

    further research into the barriers of nursing

     

    advocacy.

     

    Author contact: rghanks@utmb.edu, with a copy to the Editor: nursingforum@gmail.com

     

    References

     

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    (2nd ed.). Washington, DC: Author.

     

     

     

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    Andersen, S. (1990). Patient advocacy and whistle-blowing in nursing: Help for the helpers.

     

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    Gadow, S. (1980). Existential advocacy: Philosophical foundation of nursing. In S. Spicker & S. Gadow (Eds.),

     

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    (2), 535–541. Grace, P. (2001). Professional advocacy: Widening the scope of

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    (2), 151–162. Hamric, A. (2000). What is happening to advocacy?

     

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    The relationship between levels of moral/ethical judgment

     

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    advocacy

     

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    and autonomy among community health nurses

     

    . Doctoral dissertation, Michigan State University, East Lansing, MI.

    Hewitt, J. (2002). A critical review of the arguments debating the role of the nurse advocate.

     

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    The nurse as the patient’s advocate

     

    . Unpublished master’s thesis, University of Portsmouth, Portsmouth, UK.

    Jenny, J. (1979). Patient advocacy—another role for nursing.

     

    Inter- national Nursing Review

     

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    26

     

    (6), 176–181. Kohnke, M. F. (1980). The nurse as advocate.

     

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    (11), 2038–2040. Kohnke, M. F. (1982).

     

    Advocacy: Risk and reality

     

    . St. Louis, MO: CV Mosby.

    Kubsch, S., Sternard, M., Hovarter, R., & Matzke, V. (2003). A holistic model of advocacy: Factors that influence its use.

     

    Complementary Therapies in Nursing & Midwifery

     

    ,

     

    10

     

    (1), 37–45.

    Lindahl, B., & Sandman, P. (1998). The role of advocacy in critical care nursing: A caring response to another.

     

    Intensive and Critical Care Nursing

     

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    14

     

    (4), 179–186. Mallik, M. (1997). Advocacy in nursing—perceptions of practicing

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    6

     

    (4), 303–313. Merriam-Webster Online (2006a).

     

    Advocacy

     

    . Retrieved May 30, 2006, from http://www.m-w.com/dictionary/advocacy

    Merriam-Webster Online (2006b).

     

    Barriers

     

    . Retrieved May 30, 2006, from http://www.m-w.com/dictionary/barriers

    Merriam-Webster Online (2006c).

     

    Nurse

     

    . Retrieved May 30, 2006, from http://www.m-w.com/dictionary/nurse

    Miller, B., Mansen, T., & Lee, H. (1983). Patient advocacy: Do nurses have the power and authority to act as patient advocate?

     

    Nursing Leadership

     

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    (2), 56–60. Millette, B. (1993). Client advocacy and the moral orientation of

    nurses.

     

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    15

     

    (5), 607–618. Oxford Online (2006).

     

    Advocate

     

    . Retrieved May 30, 2006, from www.askoxford.com/results/?viewdict&field12668446=advoacy &branch=13842

    Pankratz, L., & Pankratz, D. (1974). Nursing autonomy and patients’ rights: Development of a nursing attitude scale.

     

    Journal of Health and Social Behavior

     

    ,

     

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    (3), 211–216. Penticuff, J. (1989). Infant suffering and nurse advocacy in neonatal

    intensive care. Concept Analysis: Mental Stigma

     

    Nursing Clinics of North America

     

    ,

     

    24

     

    (4), 987–997. Pullen, F. (1995). Advocacy: A specialist practitioner role.

     

    British Journal of Nursing

     

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    4

     

    (5), 275–278. Robinson, M. (1985). Patient advocacy and the nurse: Is there a

    conflict of interest?

     

    Nursing Forum

     

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    22

     

    (2), 58–63. Segesten, K. (1993). Patient advocacy—an important part of the daily

    work of the expert nurse.

     

    Scholarly Inquiry for Nursing Practice: An International Journal

     

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    (2), 129–135. Smith, K., & Godfrey, N. (2002). Being a good nurse and doing

    the right thing: A qualitative study.

     

    Nursing Ethics

     

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    (3), 301– 312.

    Snoball, J. (1996). Asking nurses about advocating for patients: “Reactive” and “proactive” accounts.

     

    Journal of Advanced Nursing

     

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    24

     

    , 67–75. Walker, L., & Avant, K. (2005).

     

    Strategies for theory construction in nursing

     

    (4th ed.). Upper Saddle River, NJ: Pearson Prentice Hall. Walsh, P. (1985). Mental health dilemmas. Speaking up for the

    patient.

     

    Nursing Times

     

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    81

     

    (18), 24–26. Watt, E. (1997). An exploration of the way in which the concept of

    patient advocacy is perceived by registered nurses working in an acute care hospital.

     

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    (2), 119–127.

    Wilson, J. (1963).

     

    Thinking with concepts

     

    . London: Cambridge University Press.

    Winslow, G. (1984). From loyalty to advocacy: A new metaphor for nursing.

     

    The Hasting Center Report

     

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    14

     

    (3), 32–40.

Discussion: Pharmacotherapy for Respiratory Disorders

Discussion: Pharmacotherapy for Respiratory Disorders

To the untrained ear, most coughs sound the same. However, as you might recall from past clinical experiences, a simple cough can lead to a patient diagnosis of a common cold, pneumonia, or even a chronic obstructive pulmonary disease (COPD). Although it can sometimes be challenging to diagnose a patient based on common respiratory symptoms such as congestion, coughing, and wheezing, it is important to be able to distinguish minor differences as even mild symptoms might require intervention with drug treatments. When recommending potential treatment options, advanced practice nurses must consider how individual patient factors might impact the effects of prescribed drugs.

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To prepare:
  • -Review Chapter 26 and Chapter 27 of the Arcangelo and Peterson text.
  • -Select and research one of the following respiratory disorders: the common cold, pneumonia, or a chronic obstructive —-pulmonary disease (COPD) such as emphysema or chronic bronchitis. Consider types of drugs that would be prescribed to patients to treat symptoms associated with this disorder.
  • -Select one of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how this factor might impact effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects. Discussion: Pharmacotherapy for Respiratory Disorders

With these thoughts in mind:

By Day 3

Post a description of the respiratory disorder you selected including types of drugs that would be prescribed to patients to treat associated symptoms. Then, explain how the factor you selected might impact effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.

THE DISCUSSION IS IN APA, MINIMUM 3 REFERENCES NOT OLDER THAN 2013 AND CITATION.

Required Readings

Arcangelo,  V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.).  (2017). Pharmacotherapeutics for advanced  practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams  & Wilkins.
Chapter 18, “Otitis Media and Otitis Externa” (pp. 243-252)
This chapter compares the causes and pathophysiology of two common ear infections—otitis media and otitis externa. It also identifies types of drugs used to treat these ear infections.

Chapter 24, “Upper Respiratory Infections” (pp. 259-374)
This chapter explores the causes, pathophysiology, and diagnostic criteria of two upper respiratory infections—the common cold and sinusitis—as well as drug therapy for both infections. It also covers monitoring patient response and patient education of drug therapy for these infections. Discussion: Pharmacotherapy for Respiratory Disorders

Chapter 25, “Asthma” (pp. 377-392)
This chapter examines the causes, pathophysiology, pharmacogenomics, and diagnostic criteria of asthma. It also outlines suggested drug therapy plans for asthmatic patients.

Chapter 26, “Chronic Obstructive Pulmonary Disease” (pp. 395-406)
This chapter explains the causes and pathophysiology of chronic obstructive pulmonary disease (COPD). It also examines the process of selecting, administering, and managing drug therapy for COPD patients.

Chapter 27, “Bronchitis and Pneumonia” (pp. 407-424)
This chapter begins by examining the causes, pathophysiology, and diagnostic criteria of acute bronchitis, chronic bronchitis, and community-acquired pneumonia. It then explores the process of selecting, administering, and managing drug therapy for patients with bronchitis and pneumonia.

Drugs.com. (2012). Retrieved from http://www.drugs.com/

This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.

National Heart Lung and Blood Institute. (2007). Expert panel report 3 (EPR3): Guidelines for the diagnosis and management of asthma. Retrieved from http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm

This website presents guidelines for diagnosing and managing asthma and outlines treatment recommendations for specific age groups.

 

Discussion: Pharmacotherapy for Respiratory Disorders

To the untrained ear, most coughs sound the same. However, as you might recall from past clinical experiences, a simple cough can lead to a patient diagnosis of a common cold, pneumonia, or even a chronic obstructive pulmonary disease (COPD). Although it can sometimes be challenging to diagnose a patient based on common respiratory symptoms such as congestion, coughing, and wheezing, it is important to be able to distinguish minor differences as even mild symptoms might require intervention with drug treatments. When recommending potential treatment options, advanced practice nurses must consider how individual patient factors might impact the effects of prescribed drugs.

To prepare:
  • Review Chapter 26 and Chapter 27 of the Arcangelo and Peterson text.
  • Select and research one of the following respiratory disorders: the common cold, pneumonia, or a chronic obstructive pulmonary disease (COPD) such as emphysema or chronic bronchitis. Consider types of drugs that would be prescribed to patients to treat symptoms associated with this disorder.
  • Select one of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how this factor might impact effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.

With these thoughts in mind:

By Day 3

Post a description of the respiratory disorder you selected including types of drugs that would be prescribed to patients to treat associated symptoms. Then, explain how the factor you selected might impact effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.

Required Readings

Arcangelo,  V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.).  (2017). Pharmacotherapeutics for advanced  practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams  & Wilkins.
Chapter 18, “Otitis Media and Otitis Externa” (pp. 243-252)
This chapter compares the causes and pathophysiology of two common ear infections—otitis media and otitis externa. It also identifies types of drugs used to treat these ear infections. Discussion: Pharmacotherapy for Respiratory Disorders

Chapter 24, “Upper Respiratory Infections” (pp. 259-374)
This chapter explores the causes, pathophysiology, and diagnostic criteria of two upper respiratory infections—the common cold and sinusitis—as well as drug therapy for both infections. It also covers monitoring patient response and patient education of drug therapy for these infections.

Chapter 25, “Asthma” (pp. 377-392)
This chapter examines the causes, pathophysiology, pharmacogenomics, and diagnostic criteria of asthma. It also outlines suggested drug therapy plans for asthmatic patients.

Chapter 26, “Chronic Obstructive Pulmonary Disease” (pp. 395-406)
This chapter explains the causes and pathophysiology of chronic obstructive pulmonary disease (COPD). It also examines the process of selecting, administering, and managing drug therapy for COPD patients.

Chapter 27, “Bronchitis and Pneumonia” (pp. 407-424)
This chapter begins by examining the causes, pathophysiology, and diagnostic criteria of acute bronchitis, chronic bronchitis, and community-acquired pneumonia. It then explores the process of selecting, administering, and managing drug therapy for patients with bronchitis and pneumonia.

Drugs.com. (2012). Retrieved from http://www.drugs.com/

This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.

National Heart Lung and Blood Institute. (2007). Expert panel report 3 (EPR3): Guidelines for the diagnosis and management of asthma. Retrieved from http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm

This website presents guidelines for diagnosing and managing asthma and outlines treatment recommendations for specific age groups. Discussion: Pharmacotherapy for Respiratory Disorders

Assignment3: Developing An Intervention And Determining The Impact

Assignment3: Developing An Intervention And Determining The Impact

Sections 3 and 4 of Major Assessment 7: Using an Epidemiological Approach to Critically Analyze a Population Health Problem

Measures of effect are especially important for quantifying health problems. As a DNP-prepared nurse engaged in advanced practice, understanding how to interpret the statistical data in research studies enables you to better present your own findings as well as to determine appropriate interventions based on the data. Assignment3: Developing an Intervention and Determining the Impact

This week, you will begin Assignment 3, Sections 3 and 4 of the Major Assessment 7 paper. For Section 3, you will outline an intervention for your population to address the health problem based on the research literature. As you review the literature, it is essential to critically evaluate each study, including the statistical analysis and outcomes. To further enhance your analysis, select a causal model that applies to your selected population health problem, and consider it in terms of measurement of effect. Utilize this model as you continue to evaluate the literature that supports your proposed intervention (Section 3 of your paper). Assignment3: Developing An Intervention And Determining The Impact

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Review the Major Assessment Overview. Then, begin developing Section 3 and Section 4.

By Wednesday 04/18/2018 3pm, write a 5 to 6-page paper in APA format with at least 7 scholarly references or more. Include the level one headings as numbered below:

Section 3: The Intervention

1) An outline of an intervention you would implement to address the population health problem with your selected population based on the results of the study in Section 2 (Note: If you selected a descriptive study design, you are still required to outline an intervention that might be developed based on future research.)

2) A review of the literature that supports this intervention (Search for scholarly articles which can support the intervention above in question 1. Minimum of 5 articles to review please).

Section 4: The Impact

1) An explanation of the health outcome you would be seeking and the social impact of solving this issue

  • attachment 

    Assignment1PopulationHealthHealthcare-AssociatedInfections.docx

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    Population Health: Healthcare-Associated Infections

    Name

    Walden University

    Class

    Date

     

    Healthcare-Associated Infections

    Healthcare-Associated infections (HAI) are infections acquired by patients in the course of receiving medical or surgical care. In modern healthcare, there are many procedures and invasive techniques that are meant to improve the health of patients. However, some of these healthcare procedures may put the patients at the risk of infection. HAIs are a leading cause of morbidity and mortality in healthcare institutions in the United States (Sievert et al., 2013). Additionally, these infections have led to an increased cost of healthcare. HAIs occur in various healthcare settings such as surgical centers, acute care centers, long-term care facilities, and even outpatient centers. There is need to improve the quality of care to reduce and possibly completely eradicate HAIs to enhance the quality of healthcare. The purpose of this paper is to discuss HAIs as a population health problem and develop a research topic on this health issue.

    About Healthcare-Associated Infections

    Person

    All people who visit healthcare facilities for medical or surgical treatment can acquire HAIs. However, there are some groups of people that are at a greater risk than others. The elderly population is at the highest risk of acquiring HAIs because of their increasing immune deficiencies (Sievert et al., 2013). The elderly people’s deteriorating immune system makes them more susceptible to infections by pathogens that are commonly found in the healthcare environment. Assignment3: Developing An Intervention And Determining The Impact

    Place

    HAIs have been reported in every state in the United States. The Center for Disease Control (CDC) has two HAI surveillance programs that track the rate of infections in all U.S. states and records the trends. According to CDC reports from 2015, at least 1 in every 25 patients acquire infections in the healthcare setting (Umscheid et al., 2011). These infections are most prevalent in specific areas of healthcare such as surgical sites and intensive care units.

    Time

    The occurrence of HAIs is not seasonal. Patients are at the risk of acquiring infections at any time of the year provided they are exposed to an environment containing the pathogens that could cause the infections to occur. However, patients are at a greater risk at a time when they are undergoing surgical procedures or during antibiotic use.

    The significance of this Health Problem

    HAI is one of the major population health issues that affect the United States healthcare system. The United States Department of Health and Human Services has reflected its objective to reduce and eventually eliminate hospital-acquired infections through the Healthy People 2020 initiative. Health People 2020 identifies some of the risk factors that increase the chances of acquiring infections while receiving medical care. These include antibiotic use and medical procedures, organizational factors, lack of handwashing among healthcare workers and individual patient characteristics (Healthy People 2020, 2014). Various preventive strategies have been developed in a bid to eliminate HAIs, but research shows that these strategies have only been effective in reducing 70% of the infections (Sievert et al., 2013). Therefore, there is still the need to make more changes to reduce the infections and the morbidity and mortality that they cause. Research shows that proper education and training of healthcare workers in one of the most important strategies that can help to reduce infections in healthcare (Umscheid et al., 2011). This strategy helps to improve the best practices for healthcare workers to enhance the quality of care that they provide to patients. Assignment3: Developing An Intervention And Determining The Impact

    Research Question

    Does handwashing education among healthcare workers compared to lack of handwashing education help to reduce the rate of healthcare-associated infections among the elderly population in healthcare facilities within a year?

    P: Elderly population within healthcare facilities

    I: handwashing education

    C: lack of handwashing education

    O: reduce the rate of healthcare-associated infections

    T: a year

    Conclusion

    In spite of the many strategies in place to improve the quality of healthcare, HAIs are still a great population issue affecting medical institutions in the United States. Many strategies have been put in place to eliminate these infections, but there are still patients who are affected while in the course of treatment for other medical issues. There is need to create and improve more strategies that will enable the complete eradication of HAIs.

     

     

     

    References

    Healthy People 2020 (2014). Healthcare-associated Infections. Retrieved from: https://www.healthypeople.gov/2020/topics-objectives/topic/healthcare-associated-infections

    Sievert, D. M., Ricks, P., Edwards, J. R., Schneider, A., Patel, J., Srinivasan, A., … & Fridkin, S. (2013). Antimicrobial-resistant pathogens associated with healthcare-associated infections summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2009–2010. Infection Control & Hospital Epidemiology34(1), 1-14. Doi: https://doi.org/10.1086/668770

    Umscheid, C. A., Mitchell, M. D., Doshi, J. A., Agarwal, R., Williams, K., & Brennan, P. J. (2011). Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs. Infection Control & Hospital Epidemiology32(2), 101-114. Doi: https://doi.org/10.1086/657912

  • attachment 

    Assignment2DefiningtheProblemandResearchMethods.docx

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    Defining the Problem and Research Methods

    Name

    Walden University

    Class

    Date

     

    Defining the Problem and Research Questions

    The Problem

    Many strategies have been implemented in the United States health care system to improve the quality of care that patients receive. Many of these strategies have been successful in improving patient outcomes. However, healthcare-acquired infections (HAIs) are still a significant issue affecting the health care system. HAIs are infections that are acquired by patients in the course of receiving surgical and medical care. There are many invasive treatment options in the current health care systems that are designed to improve the health of patients, but in some cases, they put them at the risk of acquiring various types of infections (Healthy People 2020, 2014). HAIs are a serious public health issue because they are one of the leading causes of mortality and morbidity in the United States healthcare institutions (Sievert et al., 2013). In addition to the increased rate of mortality and morbidity, HAIs have also increased the United States’ cost of health care. Therefore, there has been dire need to enhance the quality of healthcare delivery in medical institutions to minimize the rate of the infections that occur in the course of receiving treatment. Eradicating HAIs can help not only to reduce patient deaths but also to reduce the cost of healthcare. The purpose of this paper is to examine the problem of HAIs in the United States and develop a research strategy that can help to devise techniques to be used in reducing the rate of infections in the course of patient care. Assignment3: Developing an Intervention and Determining the Impact

    Environment

    The environment that is the problem is based on the healthcare setting. HAI is a population health problem that affects people who are in healthcare institutions receiving care for various other issues. HAIs may occur across multiple healthcare environments such as acute care centers, surgical centers, outpatient centers, and long-term care facilities. Assignment3: Developing An Intervention And Determining The Impact

    Healthcare-Acquired Infections

    The following is a summary of HAIs as a population health problem regarding epidemiologic factors of person, place, and time.

    Person

    Every person who visits a medical institution is at the risk of acquiring an infection because this environment is usually rich in various pathogens. However, some populations have a higher risk of HAIs than others because of their unique characteristics. The elderly community is one of the population groups that have the highest risk of acquiring HAIs because of their deteriorated immune capabilities (Sievert et al., 2013). The older adults usually have a lower immune system because of the reduced capabilities of the body’s organs; hence, they stand a higher chance of them being infected by the disease-causing pathogens present in the hospital environment.

    Place

    HAIs do not have a specific location of occurrence, as long as it is a healthcare facility. Cases of HAI have been reported in all the states in America. The Centers for Disease Control (CDC) tracks the HAI infection using two surveillance programs which help to record the trends and monitor the rate at which people are getting infected while receiving treatment. According to the CDC reports, at least one in every 25 patients in the healthcare setting acquire some infection originating from this environment (Umscheid et al., 2011). The most common areas where diseases are acquired are in various hospital units such as the intensive care units, and surgical centers.

    Time

    Healthcare-acquired infections are not seasonal as they can be acquired at any time of the year provided that the patient is exposed to the organisms causing the infection. However, the patients tend to be a higher risk when they are undergoing procedures that increase the risk of infection such as surgical care. Assignment3: Developing an Intervention and Determining the Impact

    Research Question/Hypothesis

    Does hand washing education among healthcare workers compared to lack of hand washing education help to reduce the rate of healthcare-associated infections among the elderly population in healthcare facilities within a year?

    P: Elderly population within healthcare facilities

    I: hand washing education

    C: lack of hand washing education

    O: reduce the rate of healthcare-associated infections

    T: a year

    The Research Methods

    Epidemiologic Study Design

    The epidemiologic study design selected for this study is a case-control study. A case-control is a type of observational study that evaluates two different groups of the population, one with the intervention and the other without, to determine the differences in the outcomes based on a given causal attribute (Kleinbaum, Sullivan & Barker, 2013). These two groups which include the control group, where the intervention is not administered, and the case group where the intervention is included.

    This study seeks to investigate the impact of hand washing education for nurses in a healthcare facility on reduced healthcare-acquired infections. The nurses who receive the hand washing education will be considered as the intervention group while those who do not receive the education will be the control group. It is expected that there will be a difference in the outcome of hospital-acquired infections for both groups (Friis & Sellers, 2014). This design is based on the assumption that the case group and the control group will yield different results because of the difference in the administered intervention. Therefore, this will help to determine whether nurses’ education really has an impact on reduced rates of infections on patients in the course of care.

    Assessment Strategies

    In this case-control study, both the case and the control groups are nurses. The only difference between the two is that the case group is expected to receive education on handwashing while the control group is not expected to receive the education on hand washing. A criterion for the inclusion of the case and the control group will be developed to ensure that the results are valid. First, the case and control groups will both come from the United States health care facilities with access to almost similar kinds of medical resources. This will help to ensure that in each facility there is a similarity with the types of risks of infections that the patients face. It will also minimize the impact of other confounding factors that could impact the rates of infections such as poor management. A group of nurses from one of the medical facilities will go through a six weeks’ education program teaching them techniques of enhancing handwashing hygiene to minimize the transfer of pathogens to the patients under their care. On the other hand, the control group will continue handling their care without receiving the education program.

    Data will be collected on the rate of HAIs in both the case and the control group’s areas of work before the education program. After the education program, the data will be collected on the new rate of HAIs in the respective areas of case and control to measure the differences in the rates before and after the education program in each of the groups. The results will later be compared to show the difference between the rates before and after the education for the case group in comparison with those of the control group. Assignment3: Developing an Intervention and Determining the Impact

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    The assessment strategies that have been selected above are convenient for this study because they minimize the impact of external factors on the case and control group. The data will also be easy to collect because each of the medical facilities is expected to keep a record of the hospital-acquired infections.

    Summary of Data Collection Activities

    The data for this study will be collected from the databases of the respective hospital where the research will be done. Each medical facility in the United States keeps a record of the hospital-acquired infections. With the consent of the facilities included in the study, a history of the HAIs from the beginning of the study to its maturity will be collected for analysis to determine the impact of the intervention on the case group and the lack of intervention on the control group. The patient identities from the data collected will be kept private according to the HIPAA guidelines.

    The data will be collected three times in the course of the research. First, the data will be collected at the beginning of the study before the education program is administered. The data will also be collected six months after the education program to assess the immediate impact that the program had on the rates of HAI infections. Lastly, the data will be collected a year after the education program to follow up on the impact of the education program after an extended period. Assignment3: Developing An Intervention And Determining The Impact

    Conclusion

    HAIs are significant public health problems that affect the United States health care system. Even though many strategies have been implemented to eradicate hospital infections, there is still a significantly large percentage of patients who acquire infections in the course of care. Therefore, there is a need for more research to determine new strategies that can reduce HAIs further or possibly eradicate them. This research seeks to investigate whether nurses’ education on hand washing can help to reduce infections among the elderly population in a period of one year. Case-Control study design has been recommended for this study because it will help to investigate the difference between the infection rates in the case population and the control population. If this study is successful, it can help to reduce the rates of HAIs among the elderly community in healthcare facilities, which has a higher risk than other population communities. Assignment3: Developing an Intervention and Determining the Impact

    References

    Friis, R. H., & Sellers, T. A. (2014). Epidemiology for public health practice (5thed.). Sudbury, MA: Jones & Bartlett.

    Healthy People 2020 (2014). Healthcare-associated Infections. Retrieved from: https://www.healthypeople.gov/2020/topics-objectives/topic/healthcare-associated-infections

    Kleinbaum, D. G., Sullivan, K. M., & Barker, N. D. (2013). Epidemiologic Study Designs. In ActivEpi Companion Textbook (pp. 37-66). Springer, New York, NY.

    Sievert, D. M., Ricks, P., Edwards, J. R., Schneider, A., Patel, J., Srinivasan, A., … & Fridkin, S. (2013). Antimicrobial-resistant pathogens associated with healthcare-associated infections summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2009–2010. Infection Control & Hospital Epidemiology34(1), 1-14. Doi: https://doi.org/10.1086/668770

    Umscheid, C. A., Mitchell, M. D., Doshi, J. A., Agarwal, R., Williams, K., & Brennan, P. J. (2011). Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs. Infection Control & Hospital Epidemiology32(2), 101-114. Doi: https://doi.org/10.1086/657912

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    NURS_8310_majorAssessmentOverview1.doc

    NURS 8310: Epidemiology and Population Health

    Major Assessment Overview

    Major Assessment 7: Using an Epidemiological Approach to Critically Analyze a Population Health Issue

    Write a 12- to 15-page paper that addresses the following:

    Section 1: The Problem (developed as Assignment 2; submitted at the end of Week 6)

    · A brief outline of the environment you selected (i.e., home, workplace, school)

    · A summary of your selected population health problem in terms of person, place, and time, and the magnitude of the problem based on data from appropriate data resources (Reference the data resources you used.)

    · Research question/hypothesis

    Section 2: Research Methods (developed as Assignment 2; submitted at the end of Week 6)

    · The epidemiologic study design you would use to assess and address your population health problem.

    · Assessment strategies (i.e., if you were conducting a case-control study, how would you select your cases and controls? Regarding the methods and tools you would use to make these selections, how is it convenient for you as the researcher or as the investigator to use this tool?)

    · Summary of the data collection activities (i.e., how you would collect data—online survey, paper/pen, mailing, etc.)

    Section 3: The Intervention (developed as Assignment 3; submitted in Week 8)

    · An outline of an intervention you would implement to address the population health problem with your selected population based on the results of the study in Section 2. Note: If you selected a descriptive study design, you are still required to outline an intervention that might be developed based on future research on.

    · A review of the literature that supports this intervention

    Section 4: The Impact (developed as Assignment 3; submitted in Week 8)

    · An explanation of the health outcome you would be seeking and the social impact of solving this issue

    Section 5: Evaluation (developed as Assignment 4; submitted at the end of Week 9)

    · An evaluation plan based upon the health outcome that you have chosen and your anticipated results

    The Final Paper (with feedback incorporated) is due by Day 3 of Week 11. This serves as your Major Assessment for this course.

    Your written assignments must follow APA guidelines. Be sure to support your work with specific citations from appropriate Learning Resources and additional scholarly sources as appropriate. Refer to the Publication Manual of the American Psychological Association to ensure that your in-text citations and reference list are correct. Assignment3: Developing An Intervention And Determining The Impact

NURS 6401 Assignment Application

NURS 6401 Assignment Application

Design Considerations and Workarounds

When nurse informaticists are tasked with identifying the most appropriate technology to meet a specific need within a health care setting, there are many questions that must be asked.

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Consider the following scenario:

Riverdale Hospital has come under recent scrutiny for their medication procedures. Many times, paper medication records are not up to date or have been misplaced. As a result, patients have increasingly received their medications at the wrong times. Though each nurse is performing to the best of his or her ability, the fast pace of the hospital has caused some to ineffectively manage patient records.

The lead nurse informaticist, Nancy, has decided that a bar code scanner could help streamline the documentation process while also improving patient quality and safety. Nancy knows that when selecting a bar coding system she must not only examine the hardware and software of the system but also consider the various human factors that can positively and/or negatively affect the outcomes of the system implementation. As such, Nancy asked three of the most reputable bar code vendors to bring sample systems to Riverdale Hospital.

In evaluating each system, Nancy role plays the process of scanning a patient’s bar code. She rolls the coding cart into the room to begin her mock demonstration. First, Nancy scans her identification card to gain access to the medication screen. To scan the patient’s bar code identifier, Nancy then pulls the medication cart to the patient so that the attached scanner reaches the bar code on the patient’s wristband. When the scan is complete, the computer displays a screen that houses the patient’s personal information. By navigating the screens, Nancy finds that she can use the computer to track medication administration. In addition, Nancy is able to view applicable vitals and medication history. As Nancy continues to examine this system, she reflects on the other hardware and software facets she should be sure to consider. She also thinks about how human factors will affect this and other vendor systems. NURS 6401 Assignment Application

In this Assignment, you consider how hardware, software, and human factors can impact the implementation of an informatics system.

To prepare:

· Review Chapter 30, “The Role of Technology in the Medication-Use Process,” in the course text, Essentials of Nursing Informatics. When examining computerized prescriber order entry (CPOE) systems and bar code-enabled technologies, what hardware, software, and human factors did the authors identify?

· Consider how each of these factors can negatively impact patient safety and quality of care.

· How might these factors translate to the usability, implementation, and outcomes of other informatics technologies?

· Review the media presentation Selecting New Technologies in this week’s Learning Resources. How did presenter Dr. Patricia Button take the above factors into consideration when selecting an informatics technology for her health care setting?

· When planning and selecting a new informatics system, what steps should informaticists take to ensure the system will address the needs of their health care setting? In addition, how can informatics leaders encourage all nurses to commit to using a new technology?

To complete:

Submit a 4- to 5-page paper that addresses each part of this Assignment:

· Part 1: Design Considerations

Identify two (2) major design considerations associated with each of the following: hardware, software, human factors. (6 considerations in total).

Describe why informaticists should play close attention to each of these 6 considerations when evaluating an informatics technology. In your description, include the potential dangers each of these pose to patient safety and quality of care.

· Part 2: Employee Workarounds

Even with a carefully thought out design and implementation, nurses and other health care employees may adopt workarounds. With this reality in mind:

What benefits and/or consequences do you associate with workarounds?

When selecting an informatics technology, would you opt to purchase a system that mitigates the opportunity for workarounds; or do you believe that workarounds are sometimes necessary? Justify your response.

Note: Your responses should focus on informatics technologies in general, not just bar code scanners as portrayed in the scenario. You may, however, use specific examples such as bar code scanners and other informatics technologies to justify your responses.

***Important: APA Style, 4 to 5 pages of information, Reference apart.  NURS 6401 Assignment Application