Community Nursing

Community Nursing

Health in the Global Community.

Women’s health.

Read chapter 15 and 17 of the class textbook and review the attached PowerPoint presentation. Once done, answer the following questions;

1. Describe globalization and international patterns of health and disease.

2. Identify international health care organizations and how they collaborate to improve global nursing and health care.

3. Identify and discuss the major indicators of women’s health.

4. Identify and discuss the barriers to adequate health care for women.

Present your assignment in an APA format word document, Arial 12 font. A minimum of 2 evidence-based references besides the class textbook must be used. A minimum of 700 words is required. Please make sure to follow the instructions as given.

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Nursing Role and Scope

Nursing Role and Scope

2 The Pedagogy Role Development in Professional Nursing Practice, Fourth Edition drives comprehension through various strategies that meet the learning needs of students, while also generating enthusiasm about the topic. This interactive approach addresses different learning styles, making this the ideal text to ensure mastery of key concepts. The pedagogical aids that appear in most chapters include the following: 3 4 5 6 World Headquarters Jones & Bartlett Learning 5 Wall Street Burlington, MA 01803 978-443-5000 info@jblearning.com www.jblearning.com Jones & Bartlett Learning books and products are available through most bookstores and online booksellers. To contact Jones & Bartlett Learning directly, call 800-832-0034, fax 978-443-8000, or visit our website, www.jblearning.com. Substantial discounts on bulk quantities of Jones & Bartlett Learning publications are available to corporations, professional associations, and other qualified organizations. 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Any individuals and scenarios featured in the case studies throughout this product may be real or fictitious, but are used for instructional purposes only. The authors, editor, and publisher have made every effort to provide accurate information. However, they are not responsible for errors, omissions, or for any outcomes related to the use of the contents of this book and take no responsibility for the use of the products and procedures described. Treatments and side effects described in this book may not be applicable to all people; likewise, some people may require a dose or experience a side effect that is not described herein. Drugs and medical devices are discussed that may have limited availability controlled by the Food and Drug Administration (FDA) for use only in a research study or clinical trial. Research, clinical practice, and government regulations often change the accepted standard in this field. When consideration is being given to use of any drug in the clinical setting, the health care provider or reader is responsible for determining FDA status of the drug, reading the package insert, and reviewing prescribing information for the most up-to-date recommendations on dose, precautions, and contraindications, and determining the appropriate usage for the product. This is especially important in the case of drugs that are new or seldom used. 08323-1 7 Production Credits VP, Executive Publisher: David D. Cella Executive Editor: Amanda Martin Acquisitions Editor: Teresa Reilly Editorial Assistant: Danielle Bessette Production Editor: Vanessa Richards Senior Marketing Manager: Jennifer Scherzay VP, Manufacturing and Inventory Control: Therese Connell Composition: Integra Software Services Pvt. Ltd. Cover Design: Kristin E. Parker Rights & Media Specialist: Wes DeShano Media Development Editor: Shannon Sheehan Cover Image: © robertiez/iStock/Getty Images Plus/Getty Printing and Binding: RR Donnelley Cover Printing: RR Donnelley Library of Congress Cataloging-in-Publication Data Role development in professional nursing practice / [edited by] Kathleen Masters. – Fourth edition. p. ; cm. Includes bibliographical references and index. ISBN 978-1-284-07832-9 (pbk.) I. Masters, Kathleen, editor. [DNLM: 1. Nursing–standards. 2. Nursing–trends. 3. Nurse’s Role. 4. Philosophy, Nursing. 5. Professional Practice. WY 16] RT82 610.73–dc23 2015022040 6048 Printed in the United States of America 19 18 17 16 15 10 9 8 7 6 5 4 3 2 1 8 Dedication This book is dedicated to my Heavenly Father and to my loving family: my husband, Eddie, and my two daughters, Rebecca and Rachel. Words cannot express my appreciation for their ongoing encouragement and support throughout my career. 9 CONTENTS Preface Contributors UNIT I: FOUNDATIONS OF PROFESSIONAL NURSING PRACTICE 1 A History of Health Care and Nursing Karen Saucier Lundy and Kathleen Masters Classical Era Middle Ages The Renaissance The Dark Period of Nursing The Industrial Revolution And Then There Was Nightingale… Continued Development of Professional Nursing in the United Kingdom The Development of Professional Nursing in Canada The Development of Professional Nursing in Australia Early Nursing Education and Organization in the United States The Evolution of Nursing in the United States: The First Century of Professional Nursing The New Century International Council of Nurses Conclusion References 2 Frameworks for Professional Nursing Practice Kathleen Masters 10 Overview of Selected Nursing Theories Nurse of the Future: Nursing Core Competencies Overview of Selected Non-Nursing Theories Relationship of Theory to Professional Nursing Practice Conclusion References 3 Philosophy of Nursing Mary W. Stewart Philosophy Early Philosophy Paradigms Beliefs Values Developing a Personal Philosophy of Nursing Conclusion References 4 Foundations of Ethical Nursing Practice Janie B. Butts and Karen L. Rich Ethics Ethical Theories and Approaches Professional Ethics and Codes Ethical Analysis and Decision Making in Nursing Conclusion References 5 Social Context of Professional Nursing Mary W. Stewart, Katherine Elizabeth Nugent, Rowena W. Elliott, and 11 Kathleen Masters Nursing’s Social Contract with Society Public Image of Nursing The Gender Gap Changing Demographics and Cultural Competence Access to Health Care Societal Trends Trends in Nursing Conclusion References 6 Education and Socialization to the Professional Nursing Role Kathleen Masters and Melanie Gilmore Professional Nursing Roles and Values The Socialization (or Formation) Process Facilitating the Transition to Professional Practice Conclusion References 7 Advancing and Managing Your Professional Nursing Career Mary Louise Coyne and Cynthia Chatham Nursing: A Job or a Career? Trends That Impact Nursing Career Decisions Showcasing Your Professional Self Mentoring Education and Lifelong Learning Professional Engagement Expectations for Your Performance 12 Taking Care of Self Conclusion References UNIT II: PROFESSIONAL NURSING PRACTICE AND THE MANAGEMENT OF PATIENT CARE 8 Patient Safety and Professional Nursing Practice Jill Rushing and Kathleen Masters Patient Safety Critical Thinking, Clinical Judgment, and Clinical Reasoning in Nursing Practice Conclusion References 9 Quality Improvement and Professional Nursing Practice Kathleen Masters Healthcare Quality Measurement of Quality The Role of the Nurse in Quality Improvement Conclusion References Professional Nursing Practice 10 Evidence-Based Kathleen Masters Evidence-Based Practice: What Is It? Barriers to Evidence-Based Practice Promoting Evidence-Based Practice Searching for Evidence Evaluating the Evidence Implementation Models for Evidence-Based Practice 13 Conclusion References 11 Patient-Centered Care and Professional Nursing Practice Kathleen Masters Dimensions of Patient-Centered Care Communication as a Strategy to Support Patient-Centered Care Patient Education as a Strategy to Support Patient-Centered Care Evaluation of Patient-Centered Care Conclusion References in Professional Nursing Practice 12 Informatics Kathleen Masters and Cathy K. Hughes Informatics: What Is It? The Impact of Legislation on Health Informatics Nursing Informatics Competencies Basic Computer Competencies Information Literacy Information Management Current and Future Trends Conclusion References and Collaboration in Professional Nursing Practice 13 Teamwork Sharon Vincent and Kathleen Masters Healthcare Delivery System Nursing Models of Patient Care Roles of the Professional Nurse 14 Interprofessional Teams and Healthcare Quality and Safety Interprofessional Collaborative Practice Domains Interprofessional Team Performance and Communication Conclusion References Issues in Professional Nursing Practice 14 Ethical Janie B. Butts and Karen L. Rich Relationships in Professional Practice Moral Rights and Autonomy Social Justice Death and End-of-Life Care Conclusion References and the Professional Nurse 15 Law Kathleen Driscoll, Kathleen Masters, and Evadna Lyons The Sources of Law Classification and Enforcement of the Law Nursing Scope and Standards Malpractice and Negligence Nursing Licensure Professional Accountability Conclusion References Appendix A Standards of Professional Nursing Practice Appendix B Provisions of Code of Ethics for Nurses Appendix C The ICN Code of Ethics for Nurses 15 Glossary Index 16 PREFACE Although the process of professional development is a lifelong journey, it is a journey that begins in earnest during the time of initial academic preparation. The goal of this book is to provide nursing students with a road map to help guide them along their journey as a professional nurse. This book is organized into two units. The chapters in the first unit focus on the foundational concepts that are essential to the development of the individual professional nurse. The chapters in Unit II address issues related to professional nursing practice and the management of patient care, specifically in the context of quality and safety. In the fourth edition, the chapter content is conceptualized, when applicable, around nursing competencies, professional standards, and recommendations from national groups, such as Institute of Medicine reports. The chapters included in Unit I provide the student nurse with a basic foundation in areas such as nursing history, theory, philosophy, ethics, socialization into the nursing role, and the social context of nursing. All chapters have been updated, and several chapters in Unit I have been expanded in this edition. Revisions to the chapter on nursing history include the addition of contributions of prominent nurses and achievements related to nursing in the United Kingdom, Canada, and Australia. The theory chapter now includes additional nursing theorists as well as a brief overview of several non-nursing theories frequently used in nursing research and practice. The social context of nursing chapter now incorporates not only societal trends, but also trends in nursing practice and education. The chapter related to professional career development in nursing has been completely rewritten for this edition. The chapters in Unit II are more directly related to patient care management. In the fourth edition, Unit II chapter topics are presented in the context of quality and safety. Chapter topics include the role of the nurse in patient safety, the role of the nurse in quality improvement, evidence-based nursing practice, the role of the nurse in patient-centered care, informatics in nursing practice, the role of the nurse related to teamwork and collaboration, ethical issues in nursing practice, and the law as it relates to patient care and nursing. Most Unit II chapters have undergone major revisions with a refocus of the content on recommended nursing and healthcare competencies. The fourth edition continues to incorporate the Nurse of the Future: Nursing Core Competencies throughout each chapter. The Nurse of the Future: Nursing Core Competencies “emanate from the foundation of nursing knowledge” (Massachusetts Department of Higher Education, 2010, 17 p. 4) and are based on the American Association of Colleges of Nursing’s Essentials of Baccalaureate Education for Professional Nursing Practice, National League for Nursing Council of Associate Degree Nursing competencies, Institute of Medicine recommendations, Quality and Safety Education for Nurses (QSEN) competencies, and American Nurses Association standards, as well as other professional organization standards and recommendations. The 10 competencies included in the model are patient-centered care, professionalism, informatics and technology, evidencebased practice, leadership, systems-based practice, safety, communication, teamwork and collaboration, and quality improvement. Essential knowledge, skills, and attitudes (KSA) reflecting cognitive, psychomotor, and affective learning domains are specified for each competency. The KSA identified in the model reflect the expectations for initial nursing practice following the completion of a prelicensure professional nursing education program (Massachusetts Department of Higher Education, 2010, p. 4). 18 Source: Modified from Massachusetts Department of Higher Education. (2010). Nurse of the future: Nursing core competencies (p. 5). Retrieved from http://www.mass.edu/currentinit/documents/NursingCoreCompetencies.pdf The Nurse of the Future: Nursing Core Competencies graphic illustrates through the use of broken lines the reciprocal and continuous relationship between each of the competencies and nursing knowledge, that the competencies can overlap and are not mutually exclusive, and that all competencies are of equal importance. In addition, nursing knowledge is placed as the core in the graphic to illustrate that nursing knowledge reflects the overarching art and science of professional nursing practice (Massachusetts Department of Higher Education, 2010, p. 4). This new edition has competency boxes throughout the chapters that link examples of the KSA appropriate to the chapter content to Nurse of the Future: Nursing Core Competencies required of entry-level professional 19 nurses. The competency model in its entirety is available online at www.mass.edu/currentinit/documents/NursingCoreCompetencies.pdf. This new edition continues to use case studies, congruent with Benner, Sutphen, Leonard, and Day’s (2010) Carnegie Report recommendations that nursing educators teach for “situated cognition” using narrative strategies to lead to “situated action,” thus increasing the clinical connection in our teaching or that we teach for “clinical salience.” In addition, critical thinking questions are included throughout each chapter to promote student reflection on the chapter concepts. Classroom activities are also provided based on chapter content. Additional resources not connected to this text, but applicable to the content herein, include a toolkit focused on the nursing core competencies available at www.mass.edu/nahi/documents/ToolkitFirst%20Edition-May%202014-r1.pdf and teaching activities related to nursing competencies available on the QSEN website at www.qsen.org/teaching-strategies/. Although the topics included in this textbook are not inclusive of all that could be discussed in relationship to the broad theme of role development in professional nursing practice, it is my prayer that the subjects herein make a contribution to the profession of nursing by providing the student with a solid foundation and a desire to grow as a professional nurse throughout the journey that we call a professional nursing career. Let the journey begin. —Kathleen Masters References Benner, P., Sutphen, M., Leonard, V., & Day, L. (2010). Educating nurses: A call for radical transformation. San Francisco, CA: Jossey-Bass. Massachusetts Department of Higher Education. (2010). Nurse of the future: Nursing core competencies. Retrieved from http://www.mass.edu/currentinit/documents/NursingCoreCompetencies.pdf 20 CONTRIBUTORS Janie B. Butts, PhD, RN University of Southern Mississippi College of Nursing Hattiesburg, Mississippi Cynthia Chatham, DSN, RN University of Southern Mississippi College of Nursing Long Beach, Mississippi Mary Louise Coyne, DNSc, RN University of Southern Mississippi College of Nursing Long Beach, Mississippi Kathleen Driscoll, JD, MS, RN University of Cincinnati College of Nursing Cincinnati, Ohio Rowena W. Elliott, PhD, RN, FAAN University of Southern Mississippi College of Nursing Hattiesburg, Mississippi Melanie Gilmore, PhD, RN University of Southern Mississippi College of Nursing Hattiesburg, Mississippi Cathy K. Hughes, DNP, RN University of Southern Mississippi College of Nursing Hattiesburg, Mississippi Karen Saucier Lundy, PhD, RN, FAAN Professor Emeritus University of Southern Mississippi College of Nursing Hattiesburg, Mississippi Evadna Lyons, PhD, RN East Central Community College School of Nursing Decatur, Mississippi Katherine Elizabeth Nugent, PhD, RN Dean, College of Nursing University of Southern Mississippi Hattiesburg, Mississippi Karen L. Rich, PhD, RN University of Southern Mississippi College of Nursing Long Beach, Mississippi 21 Jill Rushing, MSN, RN University of Southern Mississippi College of Nursing Hattiesburg, Mississippi Mary W. Stewart, PhD, RN Director of PhD Program University of Mississippi Medical Center School of Nursing Jackson, Mississippi Sharon Vincent, DNP, RN, CNOR University of North Carolina College of Nursing Charlotte, North Carolina 22 UNIT I Foundations of Professional Nursing Practice 23 CHAPTER 1 A History of Health Care and Nursing Karen Saucier Lundy and Kathleen Masters 24 Learning Objectives After completing this chapter, the student should be able to: 1. Identify social, political, and economic influences on the development of professional nursing practice. 2. Identify important leaders and events that have significantly affected the development of professional nursing practice. 25 Key Terms and Concepts » Greek era » Roman era » Deaconesses » Florence Nightingale » Reformation » Chadwick Report » Shattuck Report » William Rathbone » Ethel Fenwick » Jeanne Mance » Mary Agnes Snively » Goldmark Report » Brown Report » Isabel Hampton Robb » American Nurses Association (ANA) » Lavinia Lloyd Dock » American Journal of Nursing (AJN) » Margaret Sanger » Lillian Wald » Jane A. Delano » Annie Goodrich » Mary Brewster » Henry Street Settlement » Elizabeth Tyler » Jessie Sleet Scales » Dorothea Lynde Dix » Clara Barton 26 » Frontier Nursing Service » Mary Breckinridge » Mary D. Osborne » Frances Payne Bolton » International Council of Nurses (ICN) Although no specialized nurse role per se developed in early civilizations, human cultures recognized the need for nursing care. The truly sick person was weak and helpless and could not fulfill the duties that were normally expected of a member of the community. In such cases, someone had to watch over the patient, nurse him or her, and provide care. In most societies, this nurse role was filled by a family member, usually female. As in most cultures, the childbearing woman had special needs that often resulted in a specialized role for the caregiver. Every society since the dawn of time had someone to nurse and take care of the mother and infant around the childbearing events. In whatever form the nurse took, the role was associated with compassion, health promotion, and kindness (Bullough & Bullough, 1978). 27 Classical Era More than 4,000 years ago, Egyptian physicians and nurses used an abundant pharmacological repertoire to cure the ill and injured. The Ebers Papyrus lists more than 700 remedies for ailments ranging from snakebites to puerperal fever (Kalisch & Kalisch, 1986). Healing appeared in the Egyptian culture as the successful result of a contest between invisible beings of good and evil (Shryock, 1959). Around 1000 B.C., the Egyptians constructed elaborate drainage systems, developed pharmaceutical herbs and preparations, and embalmed the dead. The Hebrews formulated an elaborate hygiene code that dealt with laws governing both personal and community hygiene, such as contagion, disinfection, and sanitation through the preparation of food and water. The Jewish contribution to health is greater in sanitation than in their concept of disease. Garbage and excreta were disposed of outside the city or camp, infectious diseases were quarantined, spitting was outlawed as unhygienic, and bodily cleanliness became a prerequisite for moral purity. Although many of the Hebrew ideas about hygiene were Egyptian in origin, the Hebrews were the first to codify them and link them with spiritual godliness (Bullough & Bullough, 1978). Disease and disability in the Mesopotamian area were considered a great curse, a divine punishment for grievous acts against the gods. Experiencing illness as punishment for a sin linked the sick person to anything even remotely deviant. Not only was the person suffering from the illness, but he or she also was branded by all of society as having deserved it. Those who obeyed God’s law lived in health and happiness, and those who transgressed the law were punished with illness and suffering. The sick person then had to make atonement for the sins, enlist a priest or other spiritual healer to lift the curse, or live with the illness to its ultimate outcome (Bullough & Bullough, 1978). Nursing care by a family member or relative would be needed, regardless of the outcome of the sin, curse, disease-atonement-recovery, or death cycle. This logic became the basis for explanation of why some people “get sick and some don’t” for many centuries and still persists to some degree in most cultures today. The Greeks and Health In Greek mythology, the god of medicine, Asclepias, cured disease. One of his daughters, Hygeia, from whom we derive the word hygiene, was the goddess of preventive health and protected humans from disease. Panacea, Asclepias’ other daughter, was known as the all-healing “universal remedy,” and today her name is used to describe any ultimate cure-all in medicine. She 28 was known as the “light” of the day, and her name was invoked and shrines built to her during times of epidemics (Brooke, 1997). During the Greek era, Hippocrates of Cos emphasized the rational treatment of sickness as a natural rather than god-inflicted phenomenon. Hippocrates (460–370 B.C.) is considered the father of medicine because of his arrangements of the oral and written remedies and diseases, which had long been secrets held by priests and religious healers, into a textbook of medicine that was used for centuries (Bullough & Bullough, 1978). In Greek society, health was considered to result from a balance between mind and body. Hippocrates wrote a most important book, Air, Water and Places, which detailed the relationship between humans and the environment. This is considered a milestone in the eventual development of the science of epidemiology as the first such treatise on the connectedness of the web of life. This topic of the relationship between humans and their environment did not reoccur until the development of bacteriology in the late 1800s (Rosen, 1958). Perhaps the idea that most damaged the practice and scientific theory of medicine and health for centuries was the doctrine of the four humors, first spoken of by Empedocles of Acragas (493–433 B.C.). Empedocles was a philosopher and a physician, and as a result, he synthesized his cosmological ideas with his medical theory. He believed that the same four elements that made up the universe were found in humans and in all animate beings (Bullough & Bullough, 1978). Empedocles believed that man was a microcosm, a small world within the macrocosm, or external environment. The four humors of the body (blood, bile, phlegm, and black bile) corresponded to the four elements of the larger world (fire, air, water, and earth) (Kalisch & Kalisch, 1986). Depending on the prevailing humor, a person was sanguine, choleric, phlegmatic, or melancholic. Because of this strongly held and persistent belief in the connection between the balance of the four humors and health status, treatment was aimed at restoring the appropriate balance of the four humors through the control of their corresponding elements. Through manipulating the two sets of opposite qualities—hot and cold, wet and dry—balance was the goal of the intervention. Fire was hot and dry, air was hot and wet, water was cold and wet, and earth was cold and dry. For example, if a person had a fever, cold compresses would be prescribed; for a chill the person would be warmed. Such doctrine gave rise to faulty and ineffective treatment of disease that influenced medical education for many years (Taylor, 1922). Plato, in The Republic, details the importance of recreation, a balanced mind and body, nutrition, and exercise. A distinction was made among gender, class, and health as early as the Greek era; only males of the aristocracy could afford the luxury of maintaining a healthful lifestyle 29 (Rosen, 1958). In The Iliad, a poem about the attempts to capture Troy and rescue Helen from her lover Paris, 140 different wounds are described. The mortality rate averaged 77.6%, the highest as a result of sword and spear thrusts and the lowest from superficial arrow wounds. There was considerable need for nursing care, and Achilles, Patroclus, and other princes often acted as nurses to the injured. The early stages of Greek medicine reflected the influences of Egyptian, Babylonian, and Hebrew medicine. Therefore, good medical and nursing techniques were used to treat these war wounds: The arrow was drawn or cut out, the wound washed, soothing herbs applied, and the wound bandaged. However, in sickness in which no wound occurred, an evil spirit was considered the cause. The Greeks applied rational causes and cures to external injuries, while internal ailments continued to be linked to spiritual maladies (Bullough & Bullough, 1978). Roman Era During the rise and the fall of the Roman era (31 B.C.–A.D. 476), Greek culture continued to be a strong influence. The Romans easily adopted Greek culture and expanded the Greeks’ accomplishments, especially in the fields of engineering, law, and government. For Romans, the government had an obligation to protect its citizens, not only from outside aggression such as warring neighbors, but from inside the civilization, in the form of health laws. According to Bullough and Bullough (1978), Rome was essentially a “Greek cultural colony” (p. 20). Galen of Pergamum (A.D. 129–199), often known as the greatest Greek physician after Hippocrates, left for Rome after studying medicine in Greece and Egypt and gained great fame as a medical practitioner, lecturer, and experimenter. In his lifetime, medicine evolved into a science; he submitted traditional healing practices to experimentation and was possibly the greatest medical researcher before the 1600s (Bullough & Bullough, 1978). He was considered the last of the great physicians of antiquity (Kalisch & Kalisch, 1986). The Greek physicians and healers certainly made the most contributions to medicine, but the Romans surpassed the Greeks in promoting the evolution of nursing. Roman armies developed the notion of a mobile war nursing unit because their battles took them far from home where they could be cared for by wives and family. This portable hospital was a series of tents arranged in corridors; as battles wore on, these tents gave way to buildings that became permanent convalescent camps at the battle sites (Rosen, 1958). Many of these early military hospitals have been excavated by archaeologists along the banks of the Rhine and Danube Rivers. They had wards, recreation areas, baths, pharmacies, and even rooms for officers who needed a “rest 30 cure” (Bullough & Bullough, 1978). Coexisting were the Greek dispensary forms of temples, or the iatreia, which started out as a type of physician waiting room. These eventually developed into a primitive type of hospital, places for surgical clients to stay until they could be taken home by their families. Although nurses during the Roman era were usually family members, servants, or slaves, nursing had strengthened its position in medical care and emerged during the Roman era as a separate and distinct specialty. The Romans developed massive aqueducts, bathhouses, and sewer systems during this era. At the height of the Roman Empire, Rome provided 40 gallons of water per person per day to its 1 million inhabitants, which is comparable to our rates of consumption today (Rosen, 1958). 31 Middle Ages Many of the advancements of the Greco-Roman era were reversed during the Middle Ages (A.D. 476–1453) after the decline of the Roman Empire. The Middle Ages, or the medieval era, served as a transition between ancient and modern civilizations. Once again, myth, magic, and religion were explanations and cures for illness and health problems. The medieval world was the result of a fusion of three streams of thought, actions, and ways of life—Greco-Roman, Germanic, and Christian—into one (Donahue, 1985). Nursing was most influenced by Christianity with the beginning of deaconesses, or female servants, doing the work of God by ministering to the needs of others. Deacons in the early Christian churches were apparently available only to care for men, while deaconesses cared for the needs of women. The role of deaconesses in the church was considered a forward step in the development of nursing and in the 1800s would strongly influence the young Florence Nightingale. During this era, Roman military hospitals were replaced by civilian ones. In early Christianity, the Diakonia, a kind of combination outpatient and welfare office, was managed by deacons and deaconesses and served as the equivalent of a hospital. Jesus served as the example of charity and compassion for the poor and marginal of society. Communicable diseases were rampant during the Middle Ages, primarily because of the walled cities that emerged in response to the paranoia and isolation of the populations. Infection was next to impossible to control. Physicians had little to offer, deferring to the church for management of disease. Nursing roles were carried out primarily by religious orders. The oldest hospital (other than military hospitals in the Roman era) in Europe was most likely the Hôtel-Dieu in Lyons, France, founded about 542 by Childebert I, king of France. The Hôtel-Dieu in Paris was founded around 652 by Saint Landry, bishop of Paris. During the Middle Ages, charitable institutions, hospitals, and medical schools increased in number, with the religious leaders as caregivers. The word hospital, which is derived from the Latin word hospitalis, meaning service of guests, was most likely more of a shelter for travelers and other pilgrims as well as the occasional person who needed extra care (Kalisch & Kalisch, 1986). Early European hospitals were more like hospices or homes for the aged, sick pilgrims, or orphans. Nurses in these early hospitals were religious deaconesses who chose to care for others in a life of servitude and spiritual sacrifice. Black Death During the Middle Ages, a series of horrible epidemics, including the Black 32 Death or bubonic plague, ravaged the civilized world (Diamond, 1997). In the 1300s, Europe, Asia, and Africa saw nearly half their populations lost to the bubonic plague. Worldwide, more than 60 million deaths were attributed to this horrible plague. In some parts of Europe, only one-fourth of the population survived, with some places having too few survivors alive to bury the dead. Families abandoned sick children and the sick were often left to die alone (Cartwright, 1972). Nurses and physicians were powerless to avert the disease. Black spots and tumors on the skin appeared, and petechiae and hemorrhages gave the skin a darkened appearance. There was also acute inflammation of the lungs, burning sensations, unquenchable thirst, and inflammation of the entire body. Hardly anyone afflicted survived the third day of the attack. So great was the fear of contagion that ships carrying bodies of infected persons were set to sail without a crew to drift from port to port through the North, Black, and Mediterranean Seas with their dead passengers (Cohen, 1989). Medieval people knew that this disease was in some way communicable, but they were unsure of the mode of transmission (Diamond, 1997); hence the avoidance of victims and a reliance on isolation techniques. During this time, the practice of quarantine in city ports was developed as a preventive measure that is still used today (Bullough & Bullough, 1978; Kalisch & Kalisch, 1986). 33 The Renaissance During the rebirth of Europe, political, social, and economic advances occurred along with a tremendous revival of learning. Donahue (1985) contends that the Renaissance has been “viewed as both a blessing and a curse” (p. 188). There was a renewed interest in the arts and sciences, which helped advance medical science (Boorstin, 1985; Bullough & Bullough, 1978). Columbus and other explorers discovered new worlds, and belief in a sun-centered rather than an Earth-centered universe was promoted by Copernicus (1473–1543). Sir Isaac Newton’s (1642–1727) theory of gravity changed the world forever. Gunpowder was introduced, and social and religious upheavals resulted in the American and French Revolutions at the end of the 1700s. In the arts and sciences, Leonardo da Vinci, known as one of “the greatest geniuses of all time,” made a number of anatomic drawings based on dissection experiences. These drawings have become classics in the progression of knowledge about the human anatomy. Many artists of this time left an indelible mark and continue to exert influence today, including Michelangelo, Raphael, and Titian (Donahue, 1985). The Reformation Religious changes during the Renaissance influenced nursing perhaps more than any other aspect of society. Particularly important was the rise of Protestantism as a result of the reform movements of Martin Luther (1483– 1546) in Germany and John Calvin (1509–1564) in France and Switzerland. Although the various sects were numerous in the Protestant movement, the agreement among the leaders was almost unanimous on the abolition of the monastic or cloistered career. The effects on nursing were drastic: Monasticaffiliated institutions, including hospitals and schools, were closed, and orders of nuns, including nurses, were dissolved. Even in countries where Catholicism flourished, royal leaders seized monasteries frequently. Religious leaders, such as Martin Luther, who led the Reformation in 1517, were well aware of the lack of adequate nursing care as a result of these sweeping changes. Luther advocated that each town establish something akin to a “community chest” to raise funds for hospitals and nurse visitors for the poor (Dietz & Lehozky, 1963). Thus, the closures of the monasteries eventually resulted in the creation of public hospitals where laywomen performed nursing care. It was difficult to find laywomen who were willing to work in these hospitals to care for the sick, so judges began giving prostitutes, publically intoxicated women, and poverty-stricken women the option of going to jail, going to the poorhouse, or working in the 34 public hospital. Unlike the sick wards in monasteries, which were generally considered to be clean and well managed, the public hospitals were filthy, disorganized buildings where people went to die while being cared for by laywomen who were not trained, motivated, or qualified to care for the sick (Sitzman & Judd, 2014a). In England, where there had been at least 450 charitable foundations before the Reformation, only a few survived the reign of Henry VIII, who closed most of the monastic hospitals (Donahue, 1985). Eventually, Henry VIII’s son, Edward VI, who reigned from 1547 to 1553, endowed some hospitals, namely, St. Bartholomew’s Hospital and St. Thomas’ Hospital, which would eventually house the Nightingale School of Nursing later in the 1800s (Bullough & Bullough, 1978). 35 The Dark Period of Nursing The last half of the period between 1500 and 1860 is widely regarded as the “dark period of nursing” because nursing conditions were at their worst (Donahue, 1985). Education for girls, which had been provided by the nuns in religious schools, was lost. Because of the elimination of hospitals and schools, there was no one to pass on knowledge about caring for the sick. As a result, the hospitals were managed and staffed by municipal authorities; women entering nursing service often came from illiterate classes, and even then, there were too few to serve (Dietz & Lehozky, 1963). The lay attendants who filled the nursing role were illiterate, rough, inconsiderate, and often immoral and alcoholic. Intelligent women and men could not be persuaded to accept such a degraded and low-status position in the offensive municipal hospitals of London. Nursing slipped back into a role of servitude as menial, low-status work. According to Donahue (1985), when a woman could no longer make it as a gambler, prostitute, or thief, she might become a nurse. Eventually, women serving jail sentences for crimes such as prostitution and stealing were ordered to care for the sick in the hospitals instead of serving their sentences in the city jail (Dietz & Lehozky, 1963). The nurses of this era took bribes from clients, became inappropriately involved with them, and survived the best way they could, often at the expense of their assigned clients. Nursing had, during this era, virtually no social standing or organization. Even Catholic sisters of the religious orders throughout Europe “came to a complete standstill” professionally because of the intolerance of society (Donahue, 1985, p. 231). Charles Dickens, in Martin Chuzzlewit (1844), created the enduring characters of Sairey Gamp and Betsy Prig. Sairey Gamp was a visiting nurse based on an actual hired attendant whom Dickens had met in a friend’s home. Sairey Gamp was hired to care for sick family members but was instead cruel to her clients, stole from them, and ate their rations; she was an alcoholic and has been immortalized forever as a reminder of the world in which Florence Nightingale came of age (Donahue, 1985). In the New World, the first hospital in the Americas, the Hospital de la Purísima Concepción, was founded some time before 1524 by Hernando Cortez, the conqueror of Mexico. The first hospital in the continental United States was erected in Manhattan in 1658 for the care of sick soldiers and slaves. In 1717, a hospita

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Benchmark – Capstone Project Change Proposal

Benchmark – Capstone Project Change Proposal

Obesity amid Adolescent in the United States.

It’s finally here. The week you all have been waiting for. Your Capstone Project is due!!

The following is a reiteration of the instructions. Make sure you have covered all points.

In this assignment, students will pull together the change proposal project components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. At the conclusion of this project, the student will be able to apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.

Students will develop a 1,250-1,500 word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

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MDC Nursing Inquiry & Evidence Based Parctice Continuation Research Project

MDC Nursing Inquiry & Evidence Based Parctice Continuation Research Project

PROJECT OUTLINE 1 Research Project Outline Miami Dade College PROJECT OUTLINE 2 Research Project Outline Title: Fall Caution to Decrease Risk Fall and Patient Falls at UM Hospital Miami Problem Statement: Patient fall is one of the leading unintentional cause of hospital-related injuries and death of patient globally becoming one of the major public health issues. In a report by the World Health Organization (WHO) in January 2018 indicated that there are approximated 646,000 fatal patient falls annually. Patient fall is an occurrence that leads to an ailing individual descending to the floor resulting in patient injury in some fatal instances. Agency for Healthcare Research and Quality (2013) notes that patient’s fall could lead to internal bleeding, fractures and even the death of a sick person. In addition, Joint Commission (2015) outline patient fall is a sentinel event that requires an appropriate assessment to reduce the risk of patients falling in hospitals, thereby attaining the goal of national patient safety (NPSG). Project Goals: i. A decreased number of recorded patients fall during the year 2019 at UM Hospital in Miami. ii. Increased compliance rate by the nursing staffs in performing fall risk evaluation and indicating the severity of fall for a patient in the hospital. Behavioral Objectives: i. The nursing staffs will acquire foundational knowledge and skills required in the prevention of patients fall as well as fall-related injuries. ii. The nursing staffs, as well as health care personnel, will understand the necessity of a safe environment, open reporting, and teamwork in reducing injurious patient falls. iii. The nursing staffs will understand the benefits of performing a correct patient fall risk assessment with respect to safety care and increased patient satisfaction. PROJECT OUTLINE 3 Teaching Strategies: The teaching will involve adequate research and preparation of poster board about preventing patient fall and subsequent patient fall-related morbidities and mortality in a health care facility. Evaluation Method: i. The nursing staffs will demonstrate the understanding of classifying the admitted patient based on the severity of the risk of a patient falling. ii. There will be a verbal assessment to evaluate the understanding of the nursing staff about patient fall risk assessment and prevention measures. Implication to Nursing Staff: Patient fall is one of the major public health issues to date, with a significant implication to the nursing staffs as the primary custodians in the assessment and prevention of fall and fall-associated injuries. Notably, patient fall is the leading cause of hospital-related patient injuries such as mortality, fractures, and functional dependence by the involved patients (Kalisch, Tschannen, & Lee,2012).Hospitals are places where patients with different ailments, for instance, visual impairment, aged, and mobility issues among other sicknesses seek medical care, conditions that expose the patient to high risk of fall. Oliver, Healey, and Haines (2010) note that fall prevention and management is a pressing risk and a challenge for health facilities that pose a threat to the safety of the patient. Educating nurses about falls would enhance the taking of necessary precautionary measures to prevent falls in hospitals, which increases patient safety. Murray (2016) postulates that enhancing compliance with set policies by the nursing staff in the assessment of fall risk would result in the attainment the goal of reduced falls in healthcare facilities. Thus, educating the nurses and relevant health professional about the risk of patient falls is therefore recommended in hospitals. PROJECT OUTLINE 4 Reference List Agency for Healthcare Research and Quality. (2013). Preventing Falls in Hospitals. Retrieved from https://www.ahrq.gov/professionals/systems/hospital/fallpxtoolkit/fallpxtkover.html Joint Commission (2015). Sentinel Event Alert 55: Preventing falls and fall-related injuries in health care facilities. Retrieved from https://www.jointcommission.org/assets/1/6/SEA_55add_falls_requirements.pdf Kalisch, B. J., Tschannen, D., & Lee, K. H. (2012). Missed nursing care, staffing, and patient fall. Journal of nursing care quality, 27(1), 6-12. Murray, E. (2016). Quality Improvement. Implementing a Pediatric Fall Prevention Policy and Program. Pediatric Nursing, 42(5), 256–259. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=tfh&AN=118640418&site=ehost -live Oliver, D., Healey, F., & Haines, T. P. (2010). Preventing falls and fall-related injuries in hospitals. Clinics in geriatric medicine, 26(4), 645-692. World Health Organization (2018, January 16). Key Facts about Falls. Retrieved from https://www.who.int/news-room/fact-sheets/detail/falls CATEGORIES Rubric for Scholarly Paper Possible Actual Points Points CONTENT • Topic Match Proposal 5 • Cover page • Introduction 2 5 • Background 5 • Aim/Purpose 10 • Review of Literature 10 • Content of scholarly paper to include Research Method 5-7 pages for the body • Implications for Nursing Practice • Conclusion 10 • Reference page 4-6 EBP references 8 10 5 10 ORGANIZATION APA FORMAT with APPROPRIATE CITATIONS 10 10 CLARITY / STYLE / SPELLING / GRAMMAR PUNCTUATION TOTALS 100 COMMENTS
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ANHO Healthcare Associated Infections (HAI) Perspectives Peer Responses

ANHO Healthcare Associated Infections (HAI) Perspectives Peer Responses

A professional presentation can be quite intimidating on a personal level due to the makeup of the audience. For me, personally, presenting to an audience of my peers whether it be fellow students, friends or coworkers is easier than presenting to management and other stakeholders. This would probably be my greatest weakness in a professional presentation, not becoming intimidated by those in the audience. To help combat this issue I believe interacting with the audience prior to beginning my speech would be beneficial to help ease my nerves. Getting the opportunity to chat and do a little meet and greet with those that will be sitting in the audience could help dispel the separation of management and stakeholders and just turn them into “normal” people to me. Talking to someone face-to-face or one-on-one can help to give you a personal connection and assist (at least me) in viewing them as less intimidating (Kim, L., 2014).

A personal strength of mine regarding a presentation is my ability to appear (whether it Is true or not) calm and easily relatable. I am able to transform any possible nervous energy I have and use it as enthusiasm for what I am presenting. I have been told on multiple occasions that I seem so calm and knowledgeable in specific topics or presentations due to my calm demeanor when in truth I was as nervous as can be prior to beginning. Some may do this by giving themselves a big boost in caffeine right before the presentation, I am not a huge caffeine drinker so I manifest my energy by giving myself a little pep talk right before I begin. Working to reassure myself that I know and am confident in the information that I am presentation helps to give me a little boost of energy as well as an added confidence in what I am saying (Kim, L., 2014).

2—————I have made presentations before in front of small audiences. My attitude depends on if I know the room very well. If it was my class I tend to feel more comfortable and have less anxiety. With a crowd of people I don’t know I worry about how they will like me, and I worry about messing up the entire time. I think that my biggest strength is that I have an outgoing personality and I like talking to people, and engaging with them. Making the presentation more of a conversation makes it more useful and interesting for the audience. This enables the presenter to involve the audience with questions and can really have the room engaged in the topic at hand (Doyle, 2016). Once I get going my nerves calm a little and I can focus on the details of my presentation.

I would say that my biggest weakness is anxiety before my presentation. I try to go as soon as possible. Because, if I wait to go I sit there and my anxiety increases about how I am going to do. This takes away my attention from the presenters that I should also be listening to. So, I try to go up as soon as possible so I can go up and present my material. I have already prepared beforehand and know what I want to say. So it is better to get it out of the way so I can focus on the rest of the presentations after I have finished mine.

3——–Public presentations aren’t a topic that I typically struggle with, however, as with any topic, there is always room for improvement. One topic that I feel I can improve upon regarding public presentations is practicing; after all, practice makes perfect. At one point in my career, I had to present on a topic in a round robin format; in other words, there were three different presentations going on at the same time and each group in the conference center would change rooms every half hour until every group had seen all three presentations. Drawing from this experience, I recognize that my later presentations were better, more concise, and I was more relaxed. This demonstrated to me that even though I felt relaxed, there was something to be said about actually delivering the presentation that made if flow more cohesively. Kim (2018) emphasizes that recording your presentation may allow you to critically evaluate areas that need work and even clue you in on bad habits that you may not be aware of. With this being said, some ways that I can improve upon this topic is by recording my presentation and practicing the presentation out loud along with the PowerPoint slides or other media that I plan on using. These efforts should help mitigate this issue and allow me to consistently present upon a topic.

Alternatively, one topic that I would consider a strength is that of organizing my thoughts on one centralized topic. I try to stay consistent to this in efforts to not deviate too far off topic and into territory that I may not be as well versed in. Some of the best presentations revolve around a single focus- sometimes even needing to be narrowed down from an event broader topic (Heinrich, 2012). With this, I find that my strength lies in staying focused on the topic at hand.

As we near the finish line of our capstone project, the emphasis that is placed on how we present the need for change, our project findings, and why this will benefit our patients is critical. The future presentations that may be required of us may contribute to the success of our projects. In this respect it is important that we appreciate the gravity that is asked of us and take every effort to ensure a strong presentation is offered.

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MN507 Purdue Global Synthesize the Effects that Healthcare Reform Has on Stake Holders

MN507 Purdue Global Synthesize the Effects that Healthcare Reform Has on Stake Holders

Course Outcome covered in this Assignment:

MN507-4: Synthesize the effect that healthcare reform has on stakeholders

Directions

For this Assignment, you will examine the stakeholders impacted by the implementation of the Affordable Care Act (ACA). Your paper must include the following topics:

Differentiate between at least three groups of stakeholders impacted by the ACA.
Examine the financial impact of the ACA on each group of stakeholders.
Summarize benefits of the ACA on each group of stakeholders.
Summarize drawbacks of the ACA on each group of stakeholders.
The word count for your paper, excluding the title page and references page, will be 800-1200 words. You must include a minimum of (5) different scholarly references.

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Community Nursing- Discussion week 10

Community Nursing- Discussion week 10

Chapter 17 Women’s Health Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. Women’s Health “… essential to the development of health care for women are the concepts of health promotion, disease and accident prevention, education for self-care and responsibility, health risk identification and coordination for illness care when needed.” – Preamble to a New Paradigm for Women’s Health, Choi (1985) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 2 Major Indicators of Health Life expectancy for Americans is at an all-time high.  Mortality rates ➢ ➢ ➢ ➢ Cardiovascular disease (CVD) continues to be the number one overall killer of women. Cancer rates are increasing because of lifestyle choices, environmental carcinogens, and increase in life expectancy. Diabetes mellitus causes the premature death of many women and is a risk factor for CVD. Gaps exist in the availability and quality of reproductive health care services globally. From http://www.nhlbi.nih.gov/educat ional/hearttruth/ From http://ndep.nih.gov/partn ers-communityorganization/campaigns/ SmallStepsBigRewards. aspx Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 3 Major Indicators of Health (Cont.)  Morbidity rates ➢ More women than men are hospitalized each year in the United States. ➢ Women are more likely than men to be disabled from chronic conditions. ➢ Women are more likely than men to have surgery; many surgeries relate to reproductive health. ➢ The most frequently occurring interruption in women’s mental health relates to depression. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 4 Social Factors Affecting Women’s Health      Health care access Education and work Employment and wages Working women and home life Family configuration and marital status Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 5 Health Promotion Strategies for Women       Collaboration and an interdisciplinary approach are necessary to meet the health care needs of women. Women should receive services that promote health and detect disease at an early stage. Many women seek information that will allow them to be in control of their own health. Women desire to become more knowledgeable about their own health. Health promotion for low-income, underserved women may differ from that for middle-class women. Knowledge deficits about one’s own health prevail among women regardless of socioeconomic or educational level. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 6 Common Acute Illnesses in Women   Urinary tract infection and dysuria Diseases of the reproductive tract ➢  Chronic diseases ➢  Vaginitis, vulvovaginitis, pelvic inflammatory disease (PID), and toxic shock syndrome (TSS) Coronary vascular disease (CVD) and metabolic syndrome, hypertension, diabetes, arthritis, osteoporosis, and cancer (breast, lung, gynecological) Mental disorders and stress Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 7 Reproductive Health Concerns  Nutrition ➢   Dysmenorrhea Family planning ➢ ➢  Includes total life nutritional experience Includes fertility control and infertility Need multiple safe options designed to meet the individual needs of all women STIs, HIV, and AIDS ➢ ➢ Women need age-appropriate STI prevention, education, and counseling. Worldwide, AIDS is a leading cause of death among young women. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 8 Other Issues in Women’s Health  Unintentional injury or accidents ➢  Domestic violence is the single largest cause of injury to women between the ages of 15 and 44 in the United States. Disabilities resulting from acute and chronic conditions ➢ Women have fewer disabilities than men because they tend to report their symptoms earlier and receive necessary treatment. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 9 Major Legislation Affecting Women’s Health Services  Public Health Service Act (1982) ➢ Provides biomedical and health services research, information dissemination, resource development, technical assistance, and service delivery. ➢ Includes the Family Planning Public Service Act  Title VII of the Civil Rights Act of 1964 ➢ ➢ ➢ Prevents discrimination based on sex, race, color, religion, or national origin Amended to also include pregnancy and childbirth Sexual harassment is violation of Civil Rights Act Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 10 Major Legislation Affecting Women’s Health Services (Cont.)  Social Security Act ➢  Occupational Safety and Health Act (OSHA) ➢ ➢  Provides monthly retirement and disability benefits to workers and survivor benefits to families Enacted in 1970 Ensures safe and healthful working conditions Family and Medical Leave Act (FMLA) ➢ ➢ Enacted in 1993 Provides 12 weeks of unpaid leave each year for family and medical reasons Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 11 Health and Social Services to Promote the Health of Women  Affordable Care Act (ACA) of 2010 ➢ ➢ ➢ Protection from being denied coverage by insurance companies Protection from being charged more for health care services because of their gender Preventive care without copays including: • Well-women visits with screening and counseling for gestational diabetes, HPV, STIs, HIV, contraception, and domestic violence • Breastfeeding counseling support and supplies Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 12 Health and Social Services to Promote the Health of Women (Cont.)  Medicaid (1965) ➢ ➢ ➢ ➢ A federal- and state-funded health insurance program for the poor Expanded under ACA to persons under 65 with an income below 133% of poverty level Largest source of funding for people with limited income, regardless of age eligibility Five broad coverage groups: • Children, pregnant women, adults in families with dependent children, individuals with disabilities, individuals 65 years or older Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 13 Health and Social Services to Promote the Health of Women (Cont.)  Women’s health services ➢ Provide primary health care needs, as well as reproductive and maternity care services including: • Eating disorders • All forms of abuse • Disease prevention, including smoking cessation • Health promotion focusing on nutrition, exercise, and stress management ➢ The National Women’s Health Network is a strong advocate for women’s concerns. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 14 Other Community Voluntary Services  Women’s organizations ➢  Networking ➢  Promote voluntary involvement with community; many others have made women’s health a major item on their agenda. Help women advance careers, improve lifestyles, and increase income and success. Crisis hotline services ➢ Provide counseling to battered women, battering parents, rape victims, those considering suicide, and those with multiple needs. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 15 Levels of Prevention  Primary prevention ➢ ➢  Secondary prevention ➢  Recognize risk for disease and target health care behaviors to reduce risk Never smoking, following a nutritious diet, safe sex practice, avoiding drugs, limiting alcohol consumption, and staying physically active Routine screening for cervical cancer, STIs, breast self-exams, and mammograms Tertiary prevention ➢ Education and resource utilization Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 16 Roles of the Community Health Nurse     Direct care Educator Counselor Researcher Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 17 Research in Women’s Health     Research efforts to include women in studies have grown; not based only on male subjects NIH Office of Research on Women’s Health (ORWH) established in 1990 Many topics examined based on special task force recommendations Research on financing and delivery of health services for women Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 18 Office of Research on Women’s Health  Overarching themes for research: ➢ Developmental, psychological, spiritual, and physiological factors effect on lifespan ➢ Female determinants’ (such as genetics and gender expectations) effect on health ➢ Health disparities and diversity ➢ Diseases and conditions affecting women ➢ Career development and advancement of women in the sciences Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 19 “Women are at the center of the health of the United States; therefore, if better models are developed for improving the health of women, the health of the entire nation will benefit.” – Nies and McEwen (2015) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 20 Chapter 15 Health in the Global Community Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. Human health and its influence on every aspect of life are central to the global agenda. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 2 Health in the Global Community        Population characteristics Environmental factors Patterns of health and disease International agencies and organizations International health care delivery systems The CHN’s role in the global community Research in international health Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 3 International Community Assessment Model Courtesy J. C. Novak. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 4 Population Characteristics   Large populations create pressures Goal is to improve quality of life (QOL) ➢ ➢ ➢  Health promotion Effective health care delivery systems Enhancement of the environmental infrastructure World population distribution is uneven ➢ More than 50% live in China, India, United States, and Indonesia; 30% are children; 8% are over 60 Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 5 Population Characteristics (Cont.)  Life expectancy varies significantly in different countries. ➢  Japan 86 years, Zambia 43 years As the world population grows, a global trend toward urbanization occurs. ➢ ➢ Live closer together and migrate to urban areas for employment Increased living density and global travel threatens health of general population by environmental factors Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 6 Environmental Factors  Environmental stressors ➢ Directly assault human health ➢ Damage society’s goods and services ➢ Affect quality of life (QOL) ➢ Interfere with the ecological balance ➢ Natural disasters, terrorism, and war affect all of the above  The field of environmental health and sustainable development has exploded since 1990. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 7 Patterns of Health and Disease    Lifestyles, health and cultural beliefs, infrastructure, economics, and politics affect existing illnesses and society’s commitment to prevention. Disease patterns vary throughout the world. Racial, ethnic, and access disparities exist within and between countries. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 8 International Organizations       WHO (World Health Organization) PAHO (Pan American Health Organization) UN (United Nations) UNICEF (United Nations International Children’s Fund) World Bank CDC (Centers for Disease Control and Prevention) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 9 “Health for All by the Year 2000” (WHO Goal, 1978)   Goal framed at the Alma-Ata conference in the Soviet Union in 1978; now extended to 2010 again without attainment Concept of primary health care ➢ ➢ ➢ ➢ Health as a fundamental human right for individuals, families, and communities Unacceptability of the gross inequalities in health status Importance of community involvement Active role for all sectors Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 10 Millennium Development Goals (United Nations, 2000, 2006)  Target date of 2015 1. 2. 3. 4. 5. 6. Eradicate extreme hunger and poverty Achieve universal primary education Promote gender equality, and empower women Reduce child mortality Improve maternal health Combat HIV/AIDS, malaria, and other infectious diseases 7. Ensure environmental sustainability 8. Develop global partnerships Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 11 Other Organizations Impacting International Health  Nongovernmental organizations (NGOs) ➢ ➢   Carter Center Bill and Melinda Gates Foundation ICN (International Council of Nurses) HHS (U.S. Department of Health and Human Services) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 12 HHS and Healthy People  Serves as a foundation for efforts across the HHS to create a healthier nation ➢ ➢ ➢ ➢ ➢ 1979 Surgeon General’s Report, Healthy People: The Surgeon General’s Report on Health Promotion and Disease Prevention Healthy People 1990: Promoting Health/Preventing Disease: Objectives for the Nation Healthy People 2000: National Health Promotion and Disease Prevention Objectives Healthy People 2010: Objectives for Improving Health Healthy People 2020: Improving the Health of Americans Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 13 International Health Care Delivery Systems        Much to learn from one another. Research and development must be relevant to infectious diseases that affect the poor. Need to systematically generate an information base. Need to consider determinants of health. Use population-based approaches to address access, cost, efficiency, and effectiveness. Collaborate to solve the problems of health care delivery systems. Market- and population-based approaches need to learn from each other. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 14 International Health Care Delivery Systems (Cont.)  Effective health care delivery systems must: ➢ Increase access and efficiency. ➢ Improve health status through health promotion and disease prevention. ➢ Eliminate health disparities. ➢ Protect individuals, families, and communities from financial loss caused by catastrophic illness. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 15 Role of the CHN in International Health Care     Seek to ensure the attainment of health for all in a cost-effective, efficient, accessible health care system. Be involved in research, community assessment, planning, implementation, management, evaluation, health services delivery, emergency response, health policy, and legislation. Coordinate work with other health care personnel and community leaders as well as local and global community leaders. Utilize changes in the health environment to form the basis for the nursing role. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 16 Role of the CHN in International Health Care (Cont.)  Primary health care ➢ ➢ Essential services that support a healthy life. Involves access, availability, service delivery, community participation, and the citizen’s right to health care.  Primary care ➢ ➢ First line or point-ofaccess medical and nursing care controlled by providers and focused on the individual. May not be the norm as needs of the group outweigh the needs of the individual. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 17 Role of the CHN in International Health Care (Cont.)    All nurses in the world must understand and learn from one another. Nurses are health care’s most valuable assets. Community public health nurses can improve access to care for the most vulnerable and hard-to-reach groups in any country. The future demands evidence-based learning, engagement, service, and growth in information technology and local and global health policy. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 18 Figure 15-2 Distinction Among Service Programs. Furco, Andrew. “Service-Learning: A Balanced Approach to Experiential Education.” Expanding Boundaries: Service and Learning. Washington DC: Corporation for National Service, 1996. 2-6. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 19 Population-based nursing experts are critical to solving the challenges of the fragmented, mismanaged, expensive, ineffective, inefficient health care delivery system that exists in many parts of the global community. – Nies and McEwen (2015) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 20 Research in International Health  Since 1990, international nursing research has focused predominantly on: ➢ ➢ ➢  Student and faculty educational exchange programs Diverse clinical experiences The international development of home care or transition from hospital to home WHO Collaborating Centers contributed to a partnership for educational programming, clinical practice, and research for graduate students in primary health care nursing and community health Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 21
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University of West Florida Professional Nursing Liability Insurance Discussion

University of West Florida Professional Nursing Liability Insurance Discussion

n order to complete this assignment correctly, you should first become knowledgeable about professional liability insurance so that you may provide additional information, dispel any myths, and be able to articulate your own position clearly and accurately.

Interview a minimum of four nurses (individually, not as a group) with whom you work or who know about professional liability insurance.

Do those you interviewed have individual policies?

List the reasons given for having or not having individual policies. Which reasons are listed most frequently?

Were the reasons valid as opposed to mere guesses by the nurses you interviewed?

Do the nurses know what the hospital policy coverage provides, or if they are covered at all (especially if part time or PRN)?

Did the nurses indicate any change in knowledge or intent to acquire a policy after your interview/discussion?

What did you learn from this assignment?

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Use of Complementary and Alternative Medicine in US Discussion

Use of Complementary and Alternative Medicine in US Discussion

Discussion 1- Using the NIH website ( https://nccih.nih.gov/research/statistics/2007/cam… ) how would you describe CAM (Complementary and Alternative Medicine) and the typical person who uses CAM?

 

Discussion 2- What are the percentages of people using CAM with prayer and those who do not?

 

Each discussion answer must be a paragraph with reference.

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Nursing Role and Scope- discussion week 10

Nursing Role and Scope- discussion week 10

After reading Chapter 10 and reviewing the lecture power point (located in lectures tab), please answer the following questions. Each question must have at least 3 paragraphs and you must use at 3 least references (APA) included in your post.

Additionally, you are expected to reply to two other students and include a reference that justifies your post. Your reply must be at least 3 paragraphs.

1. Describe the importance of evidence-based practice.

2. Describe how and where to search for evidence.

3. Describe strategies for the implementation of evidenced-based practice in nursing practice.

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