peer review journal questions

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peer review journal questions

The nurses’ values of “caring, compassion, and community” is one of the most trusted and ethically sound

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professions is due to the contribution of few factors. One of the factors is in the increase of experience nurses received throughout the years due to the effect of wars. In addition, the wars had led to the increased perspective of the low supply of nurses in the medical industry. Experience was also gained from the nurses that were involved during the war; working in a crisis like a war benefited the new recruits. Another factor that affects their ranking is due to their commitment in research to improve their techniques in educating new generation of nurses. In the article of Bixley and Bixley (1945), the criterion influence the nurses values of “caring, commitment, and community” through a few elements. One of the elements is due to the increased number of school establishments in the past years. In addition, the introduction of comprehensive graduate programs with the increase in research methods studies further gain positive impact on the nurses’ values. Positive implication of these new programs aims towards acknowledging the need in caring for the development of nursing profession while providing the community with high quality graduates. Therefore, the essentiality of these progressive developments proves to benefit the community with the increase supply of betterprepared and responsible graduates. Hence, compassion towards the management of their patients would be easier with highly trained graduates when their training exposes them to the expectation that the community required off them. Another element that contributes to this perspective is the increase numbers of scholarships provided in order to assist potential and interested candidates to further themselves in the higher education. The “Criterion Three” that compose as a profession that achieves to improve its knowledge and improve the education of the nurses towards a higher education level. The relevance on this criterion is still applicable today in the sense that the need to grow the nursing profession in the medical industry is a continuous process. Buerhaus, Auerbach, and Staiger (2014, Summary) indicate in their studies that the growth of registered nurse had been rapid and these growths applies to all medical institutions sectors which are public, non-profit private, and proprietary. In respect to “Criterion Five”, the relevance of this perspective remains positive. Although the increase development of nursing in higher education level and experiences has gained throughout the years, they are still considered as assistance to the doctors and are not allowed to perform any medical procedures without the presence of the doctors. In addition, there is also improvement in this perspective where the increase collaboration between nurses and doctors in daily practices improve the outcomes in healthcare industry (Brown, Lindell, Dolansky, and Garber, 2015, Abstract). References Brown, S. S., Lindell, D. F., Dolansky, M. A., & Garber, J. S. (2015). Nurses’ professional values and attitudes toward collaboration with physicians [Abstract]. Nursing ethics, 22(2), 205-216. https://doi.org/10.1177/0969733014533233 Buerhaus, P. I., Auerbach, D. I., & Staiger, D. O. (2014). The rapid growth of graduates from associate, baccalaureate, and graduate programs in nursing [Summary]. Nursing economics, 32(6), 290. Retrieved from https://search.proquest.com/openview/20691fadd117514daf5a8a2109410b30/1 ?pqorigsite=gscholar&cbl=30765 References Find a recent peer-reviewed journal article that describes a research study relating to the Leading Health Indicator you were assigned for your project. and 1) write a brief summary describing the study and 2) describe how the evidence provided could be used to either 1. 2. 3. develop a teaching plan for your patients; or implement a change of practice that may produce improved outcomes. (cite the reference in APA style) The nurses’ values of “caring, compassion, and community” is one of the most trusted and ethically sound professions is due to the contribution of few factors. One of the factors is in the increase of experience nurses received throughout the years due to the effect of wars. In addition, the wars had led to the increased perspective of the low supply of nurses in the medical industry. Experience was also gained from the nurses that were involved during the war; working in a crisis like a war benefited the new recruits. Another factor that affects their ranking is due to their commitment in research to improve their techniques in educating new generation of nurses. In the article of Bixley and Bixley (1945), the criterion influence the nurses values of “caring, commitment, and community” through a few elements. One of the elements is due to the increased number of school establishments in the past years. In addition, the introduction of comprehensive graduate programs with the increase in research methods studies further gain positive impact on the nurses’ values. Positive implication of these new programs aims towards acknowledging the need in caring for the development of nursing profession while providing the community with high quality graduates. Therefore, the essentiality of these progressive developments proves to benefit the community with the increase supply of betterprepared and responsible graduates. Hence, compassion towards the management of their patients would be easier with highly trained graduates when their training exposes them to the expectation that the community required off them. Another element that contributes to this perspective is the increase numbers of scholarships provided in order to assist potential and interested candidates to further themselves in the higher education. The “Criterion Three” that compose as a profession that achieves to improve its knowledge and improve the education of the nurses towards a higher education level. The relevance on this criterion is still applicable today in the sense that the need to grow the nursing profession in the medical industry is a continuous process. Buerhaus, Auerbach, and Staiger (2014, Summary) indicate in their studies that the growth of registered nurse had been rapid and these growths applies to all medical institutions sectors which are public, non-profit private, and proprietary. In respect to “Criterion Five”, the relevance of this perspective remains positive. Although the increase development of nursing in higher education level and experiences has gained throughout the years, they are still considered as assistance to the doctors and are not allowed to perform any medical procedures without the presence of the doctors. In addition, there is also improvement in this perspective where the increase collaboration between nurses and doctors in daily practices improve the outcomes in healthcare industry (Brown, Lindell, Dolansky, and Garber, 2015, Abstract). References Brown, S. S., Lindell, D. F., Dolansky, M. A., & Garber, J. S. (2015). Nurses’ professional values and attitudes toward collaboration with physicians [Abstract]. Nursing ethics, 22(2), 205-216. https://doi.org/10.1177/0969733014533233 Buerhaus, P. I., Auerbach, D. I., & Staiger, D. O. (2014). The rapid growth of graduates from associate, baccalaureate, and graduate programs in nursing [Summary]. Nursing economics, 32(6), 290. Retrieved from https://search.proquest.com/openview/20691fadd117514daf5a8a2109410b30/1 ?pqorigsite=gscholar&cbl=30765 References
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Question for Discussion

Discuss the various reasons why you might need to ensure safety for a hospitalized elder. Please discuss signs and symptoms of traumatic brain Injury in older adults (mention at least 6).

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Discussion: Ethical Dimensions of Research Studies

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In the best-selling book, The Immortal Life of Henrietta Lacks (Skloot, 2010), the author highlights the true story of an African-American woman who died in 1951 from cervical cancer. What makes her story unique is that prior to her death, cells from her tumor were removed and successfully grown in a petri dish. This was the first time scientists were able to successfully replicate cells outside the body, and it is estimated that billions of Lacks’ cells have been used in medical research. However, Henrietta Lacks was never asked for permission to take a sample and her family was never made aware of the widespread use of her cells. Although the culturing of her cells has been pivotal for advancing research, strong ethical concerns later arose about using these cells without patient or family approval.

This week’s readings describe historical examples of unethical research, such as a study of syphilis among African-American men in which treatment was withheld and a study in which live cancer cells were injected into elderly patients. Today, stricter controls that seek to protect study participants are placed on researchers, but breaches still occur. Careful attention must be given toward preventing unethical behavior. In this Discussion, you explore ethical considerations and issues in research.

To prepare:

Select a current health-related case involving research ethics. (If none come to mind, browse the Internet to familiarize yourself with recent cases.)
As you review the case that you have selected, reflect on the ethical principles discussed in “What Are the Major Ethical Issues in Conducting Research?” article found in this week’s Learning Resources. Which principles were breached in the case you have identified

Respond to the 6 statements with a 175 word response also with source APA required

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Respond to the 6 statements with a 175 word response also with source APA required

QUESTION: Dissemination of EBP and research, such as presenting results at a conference or writing an article for a

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journal, is an important part of professional practice. Identify one professional journal and one nursing or health care conference where you might present your project. Discuss why each of your choices is the best option for you to disseminate your new knowledge.

RESPONSE 1: My project focused on correctional nursing and inmate health because that is the field I work in. Correctional nurses are often the first health care professional to see an inmate about a medical condition. Correctional nurses must often work closely with corrections officers in situations such as emergencies in the housing units or monitoring inmates for medical attention. These nurses are challenged to provide maximum health care in a setting with a mission and design for security and public safety. Often resources can be limited and creativity is needed. Like I mentioned in my project every new piece of equipment or idea for something new must be approved by corrections. Submission of my research regarding inmate non-compliance with chronic health conditions would benefit the correctional health field. I would most likely attempt to present my project to The Journal of Correctional Health Care. This journal focused on correctional nursing. It features original research, case studies, best practices, literature reviews and more to keep correctional health care professionals informed of important trends and developments. Topics addressed include clinical care, health services and support, personnel and staffing, ethical issues, medical records, quality improvement, risk management and medical-legal issues (Journal of Correctional Health Care, n.d.). I could also present my project at the National Conference on Correctional Health. The conference addresses major health care issues that commonly affect incarcerated individuals, including diabetes, hepatitis, HIV, hypertension, mental illness, oral health and substance abuse. It also addresses new practices for the treatment of major health care issues in order to better manage common medical, nursing, dental and mental health problems found in correctional settings. It is difficult for people to understand issues that we face in correctional nursing unless you have worked in this field before. The population is very diverse and these people often undereducated and are from low-income communities. Finding ways to take care of these individuals in order for them to be successful members of society is always the goal.

Journal of Correctional Health Care. (n.d.). Retrieved from https://www.ncchc.org/journal-of-correctional-heal…

RESPONSE 2:

Last week we wrote about public speaking and sharing our information with others. As you may recall, my subject is on adopting an opiate abuse risk assessment tool into practice for nurses. I cannot think of a better place to share the information that at Pain Week. Pain Week is a national conference, now in its 12thyear. This year it will be held in Las Vegas in September but has been held at other places as well. Pain Weekendwas held in Scottsdale, Arizona this past March. Continuing education credits are available, and Pain Week also has podcast and a journal available through the website. The website states that those who should attend Pain Week, “includes primary care physicians, physician assistants, nurse practitioners, pharmacists, psychologists, and those in other medical specialties.” (PAINWeek, 2017). It seems to me that it would also be quite beneficial to nurses as well.

If I were to submit my project based on evidence-based practice, I would want to be published in the American Nurses Association’s OJIN, or the Online Journal of Issues in Nursing. The OJIN states on the website, “Authors are encouraged to submit manuscripts, related to any previously posted OJIN topic, that present research, thinking, and/or experiences furthering the discussion of the topic.” (The American Nurses Association, 2017). The website is beneficial in that it provided specifics on how manuscripts are to be submitted and exactly what is needed within each manuscript. The reason I would like to submit to the OJIN is that it is seen by thousands of nurses and is known for its reliability and professionalism. In my opinion the ANA is the benchmark for all other nursing organizations, and much of what we have accomplished as nurses is in part due to the support of the ANA.

References:

PAINWeek.org (2017). FAQS. PAINWeek.org. Retrieved from https://www.painweek.org/attendees/faqs.html

The American Nurses Association (2017). Author submission guidelines. The American Nurses Association. Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/AuthorInformation

RESPONSE 3

Dissemination is an important component of the research process. Effective communication is an important aspect of dissemination. Evidence dissemination has several goals relating to evidence and information such as increasing the reach to a variety of individuals and increasing motivation to use and apply evidence-based practice (Wilson et al., 2010).

One professional journal where I would want to present my project would be the Research and Theory for Nursing Practice International Journal. This journal focuses on issues relevant to improving nursing practice, education and patient care. This international journal also covers topics of significant importance to nurses’, educators, and researchers.

One healthcare conference where I would want to present my project would be the International Conference on Sexually Transmitted Diseases, Infections and AIDS. The aim of this conference is to exchange new scientific and clinical information within the field of sexually transmitted infections and HIV/AIDS. This conference will also unveil the latest in technologies and innovations relevant to STI related fields. Sharing and presenting my project and study findings is essential and beneficial and more importantly can lead to successful implementation (Wilson et al., 2010).

Wilson, P. M., Petticrew, M., Calnan, M. W., & Nazareth, I. (2010). Disseminating research findings: what should researchers do? A systematic scoping review of conceptual frameworks. Implementation Science : IS, 5, 91. http://doi.org/10.1186/1748-5908-5-91

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

 

RESPONSE 4

Intergrading Evidenced based practice is important to the practice of BSN prepared nurses because evidence-based practice is a clinical decision-making process in which clinicians use theory-derived, research-based knowledge to inform their decisions about care delivery (Salinas, 2017). Consideration of individual needs, preferences and resources are also included. EBP replaces policies and procedures based on other sources of evidence such as tradition or authority. It takes into account three things nursing students should consider at all times: best practice evidence, patient preferences and clinical expertise. Having further education like a BSN is needed to better understand research and why it’s needed. Healthcare is constantly changing and to remain relevant within the field you must always stay informed. This means need to continue education, this is why nurses require a certain amount of continuing education credits to renew their licenses. I will continue integrate evidence into practice in my place of work by staying informed on technology and what will work for this particular setting. We will continue to use the patient handout education system that was implemented due to my EBP project. I would also like to propose some type of system to track inmates’ compliance progress after discharge from the prison. I would like to be able to integrate more materials and possible education classes for inmates to take if they are willing obstacles that I will face will be budget and the need for approval of new practices and materials. I would like for the medical team to be able to take a nurse that works in the facility with them to their monthly meetings. This would be beneficial because the nurses can provide insight on the reality of situations we are faced with. I think this will be beneficial in providing reasoning on why we request certain things that are needed within the facility.

Salinas, A. (2017, April 07). Why evidence-based practice matters to students. Retrieved from https://www.nurse.com/blog/2017/02/22/why-evidence…

RESPONSE 5

Not long before I started this class I accepted a position as a Case Manager. I am the CM for a 32-bed ICU in a Level I trauma center. This position allows me to have frequent contact with patients. I do many things, but the main objective is to help patients transition from the inpatient side to returning to their lives as seamlessly as possible. In doing so I also have to be a good problem solver and often be creative in finding solutions to complicated issues. The issues may be physical, emotional, or psycho-social, or any combination of the above. I was able to achieve this position for multiple reasons. First, I have a wide variety of professional experiences. Secondly, the manager knew I was weeks away from obtaining my BSN. If it were not for the BSN I would not have been offered the job. It didn’t hurt that many of my coworkers.

Evidence-based practice plays an important role in my job. I can be called upon to deal with situations that may not fall within my scope of experience and knowledge. EBP, and knowing how to access the information, can provide me with the most up-to-date information quickly. My job is face-paced, I must be able to find information quickly and easily if I am to keep up with my case load. Joo and Huber (2014) found that, “This study gives evidence that Nursing Case Manager’s practice in community-based settings provides coordinated care services while achieving patients’ positive qualitative outcomes”. Throckmorton and Windle (2009), stated that, Evidence-based practice supports professionalism, patient safety, and quality care.” The authors concluded that due to heavy workloads, Case Managers should take advantage of EBP in systemic reviews as to obtain information in the most efficient way. When time is an asset we don’t always get to enjoy, it is important the we understand EBP but also the many forms it comes in. This includes understanding how research is conducted and how we can ge the most out of our limited time.

References

Joo, J., and Huber, D. (2014). Evidence-based nurse case management practice in community health. Professional Case Management. Retrieved from http://alliedhealth.ceconnection.com/files/EvidenceBasedNurseCaseManagementPracticeinCommunityHealth-1412772793478.pdf

Throckmorton, T., and Windle, P. (2009). Evidenced-based case management practice, part 1: the systematic review. Professional Case Management. Retrieved from https://journals.lww.com/professionalcasemanagementjournal/Abstract/2009/03000/Evidenced_Based_Case_Management_Practice,_Part_1_.5.asp

RESPONSE 6

Nursing education is responsible for preparing and providing society with knowledgeable and competent nurses who are ready to engage in evidence-based practice for improved patient outcomes. Studies have revealed that BSN students display above average self-confidence in their evidence-based practice competencies. A workforce that is BSN trained offers a great number of benefits such as enhanced training and skill development in critical thinking, leadership, and evidence-based practice (Ashktorab et al., 2015).

The nursing profession has sometimes been reluctant to change practice even in light of research that challenges the traditional way of doing things. One way to continue to integrate and encourage evidence in practice is to keep staff updated on EBP activities and projects by generating EBP newsletters. Another way to continue use of EBP is conduct sessions to teach staff about EBP practice, integrating EBP into the philosophy of nursing, and building policies and procedures to be evidence-based. Obstacles that can challenge this plan would be lack of support from managers/leaders and staff. Research has shown that support is the key to developing a work environment that supports EBP. While evidence-based activities are critical to transforming the organizations culture, the most important change needs to be the individual nurse’s view about research and evidence (Manspeaker & Van Lunen, 2011).

Ashktorab, T., Pashaeypoor, S., Rassouli, M., & Alavi-Majd, H. (2015). Nursing students’ competencies in evidence-based practice and its related factors. Nursing and Midwifery Studies, 4(4), e23047. http://doi.org/10.17795/nmsjournal23047

Manspeaker, S., & Van Lunen, B. (2011). Overcoming barriers to implementation of evidence-based practice concepts in athletic training education: Perceptions of select educators. Journal of Athletic Training, 46(5), 514–522.

People of Haitian Heritage People of Iranian Heritage

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People of Haitian Heritage People of Iranian Heritage

Transcultural Health Care: A Culturally Competent Approach, 4th Edition Transcultural Health Care Haitian Americans

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Larry Purnell, PhD, RN, FAAN Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition Overview ▪ Haiti shares the Island of Hispaniola with the Dominican Republic. ▪ Dominican Republic and Haiti have little in common culturally. ▪ Haiti is the poorest country in the Western hemisphere with a per capita income of less than $450. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Overview Continued ▪ Over 500,000 Haitians live in the United States, with more arriving after the Haitian earthquake in 2010. Their numbers may exceed 1.5 million. ▪ Most live in NYC, FL, Boston, Chicago, and CA ▪ Most come here for better economic opportunities and political freedom Transcultural Health Care: A Culturally Competent Approach, 4th Edition Overview Continued ▪ Haitians are a mix of Arawak Indian, Spanish, French, and African Black resulting in sharp class stratification and color consciousness ▪ 1791 ended slavery in Haiti Transcultural Health Care: A Culturally Competent Approach, 4th Edition Communications ▪ Languages are primarily Creole (for the poor) and French (wealthier) and English although many speak all three languages ▪ Black, mulatto, or white and colors in-between ▪ Most Blacks are poor and underprivileged Transcultural Health Care: A Culturally Competent Approach, 4th Edition Overview ▪ Early immigration to the United States was the wealthier groups for education, followed by general immigration after 1920 and the United States occupation of Haiti ▪ After 1964, Duvalier became president for life, mass exodus because of oppression politically and economically Transcultural Health Care: A Culturally Competent Approach, 4th Edition Overview Continued ▪ 1980 immigration with the Mariel Boat Lift from Cuba brought first legal and then the Boat People from Haiti. ▪ Many had left Haiti to Cuba in previous generations and this group joined in coming to the United States. ▪ Resulted in Cuban-Haitian entrant: status pending Transcultural Health Care: A Culturally Competent Approach, 4th Edition Overview Continued ▪ French model of education with liberal arts, philosophy, classics, and languages—Latin and Greek and de-emphasizes technical and vocational training and the social and physical sciences ▪ Educated Haitians are multilingual ▪ Only 15% to 20% receive an education—high illiteracy rates Transcultural Health Care: A Culturally Competent Approach, 4th Edition Communications ▪ French and Creole official languages ▪ 15% speak French, 100% speak Creole ▪ Oral communication patterns to pass on culture through proverbs and storytelling ▪ Smile timidly to hide lack of education and understanding ▪ Nod of the head does not mean “I understand” Transcultural Health Care: A Culturally Competent Approach, 4th Edition Communications Continued ▪ Most are private individuals who do not want friends or family to interpret for them ▪ Traditional Haitians do not usually maintain eye contact ▪ Touching is common ▪ Women may hold hands while walking in public Transcultural Health Care: A Culturally Competent Approach, 4th Edition Communications Continued ▪ Most are present oriented out of necessity, the past is cherished and the future is predetermined —many remain rather fatalistic ▪ Punctuality is not valued—flexible time is the norm Transcultural Health Care: A Culturally Competent Approach, 4th Edition Communications Continued ▪ First and middle name are usually hyphenated ▪ Woman takes her husband’s name upon marriage ▪ Last names are usually French or Arabic in origin ▪ Formality in name is the norm Transcultural Health Care: A Culturally Competent Approach, 4th Edition Family Roles ▪ Matriarchal or shared decision-making is the norm—although there are variations ▪ Male is the primary breadwinner ▪ Concept of machismo prevails ▪ Not uncommon to have more than one mistress or for women male partners Transcultural Health Care: A Culturally Competent Approach, 4th Edition Family Roles Continued ▪ Children are valued and expected to be well behaved—otherwise physical punishment may be used ▪ Most feel US society is too permissive ▪ Boys are given more freedom and permissive behavior ▪ Girls cannot go out alone until age 17+ Transcultural Health Care: A Culturally Competent Approach, 4th Edition Family Roles Continued ▪ Nuclear, consanguine, and affinal relatives are the norm ▪ Family lineage is what denotes respect, not money ▪ Children expected to care for parents when selfcare is a concern Transcultural Health Care: A Culturally Competent Approach, 4th Edition Family Roles Continued ▪ Single parenting is well accepted ▪ Homosexuality is taboo—if known, total denial from both sides ▪ Mistress supports her children with little to no financial help Transcultural Health Care: A Culturally Competent Approach, 4th Edition ClickerCheck The nurse is providing insulin injection instructions to Mrs. Paul, a 44-year-old Haitian. When the nurse asks her if she understands the instructions, she nods. To assure understanding, the nurse should a. Ask her to repeat the instructions. b. Give her written instruction to ensure. c. Have her demonstrate an injection. d. Give the instructions to a family member. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Correct Answer Correct answer: C The best way to assure understanding is for the patient to demonstrate the injection. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Health Conditions ▪ Cholera, parasitosis, and malaria without malaria control measures ▪ Hepatitis, tuberculosis, venereal disease have high rates ▪ Most test positive for TBC because of Bacille bilie de Calmette-Guerin vaccinations ▪ High rates of diabetes and hypertension Transcultural Health Care: A Culturally Competent Approach, 4th Edition Nutrition ▪ For many, food means survival ▪ Prefer eating at home and dislike fast food ▪ When hospitalized, many prefer to fast rather than eat hospital food ▪ Dislike yogurt, runny eggs, and cottage cheese ▪ Staples are rice and beans, plantains, salad Transcultural Health Care: A Culturally Competent Approach, 4th Edition Nutrition Continued ▪ Lists of foods are in the Haitian–American chapter ▪ Foods are classified as cold (fret) and hot (cho), acid and non-acid, and heavy and light ▪ Must balance fret and cho foods or illness occurs Transcultural Health Care: A Culturally Competent Approach, 4th Edition Nutrition Continued ▪ ▪ ▪ ▪ ▪ Cough medicines are hot, laxatives are cold Avoid citrus, causes acne After ironing do not open refrigerator door Do not shower when you are hot Do not put warm feet directly on the cold floor Transcultural Health Care: A Culturally Competent Approach, 4th Edition Nutrition Continued ▪ Diet high in carbohydrates and fat ▪ Being overweight is seen as positive ▪ Major portion of meat protein is given to men Transcultural Health Care: A Culturally Competent Approach, 4th Edition Pregnancy ▪ Pregnancy is not an illness so why seek prenatal care ▪ Spicy foods will cause the fetus to be irritable ▪ Vegetables and red fruits build blood for the fetus ▪ Increased salivation—“use a spit cup” Transcultural Health Care: A Culturally Competent Approach, 4th Edition Pregnancy Continued ▪ Prefer natural childbirth, although changing somewhat in the United States ▪ Men usually not present during labor—female family members are preferred ▪ Dress warmly and stay in bed 2 to 3 days after birth and use an abdominal binder to close the bones so cold air does not enter and cause illness Transcultural Health Care: A Culturally Competent Approach, 4th Edition Postpartum ▪ Three baths postpartum, more difficult in the United States ▪ Avoid food believed to increase vaginal discharge—lima beans, okra, mushrooms ▪ Other foods are strength foods ▪ Breastfeeding is encouraged ▪ All infants receive lok to help meconium pass Transcultural Health Care: A Culturally Competent Approach, 4th Edition ClickerCheck Most Haitians practice the hot and cold dichotomy of foods. This is know in Haitian Creole as a. Yin and yang. b. Calor y frio. c. Fret and cho. d. Am and duong. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Correct Answer Correct answer: C Fret and cho are the Haitian Creole words for hot and cold. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Death Rituals ▪ Prefer to die at home ▪ Death watch by family who brings religious pictures and have bedside prayer ▪ Male kinsman responsible for funeral arrangements, notifying all family members, and coordinating the service ▪ Preburial veye to celebrate deceased’s life Transcultural Health Care: A Culturally Competent Approach, 4th Edition Death Rituals Continued ▪ Seven consecutive days of prayer in the home to help the passage of the soul into the next life ▪ Believe in resurrection so no cremation ▪ Autopsy may relieve fear of deceased becoming a zombie Transcultural Health Care: A Culturally Competent Approach, 4th Edition Spirituality ▪ ▪ ▪ ▪ Family is the center of life Catholicism is the primary religion of Haiti Religious practices combined with voodooism Loa, the gods or spirits, believed to receive powers from God can provide protection and wealth Transcultural Health Care: A Culturally Competent Approach, 4th Edition Healthcare Practices ▪ Good health is balance between hot and cold, eat well, be plump, pray, be free of pain, eat and sleep right, and exercise ▪ Illness is seen as punishment and comes of two types—natural and supernatural ▪ Natural illnesses of two types—short duration caused by environmental factors Transcultural Health Care: A Culturally Competent Approach, 4th Edition Healthcare Practices Continued ▪ Natural longer term illness due to disequilibria between hot and cold and bone displacement ▪ Supernatural illnesses are caused by angry spirits, which are placated by ceremonial feasts ▪ Gas is a major cause of illness and can be in any part of the body Transcultural Health Care: A Culturally Competent Approach, 4th Edition Healthcare Practices Continued ▪ Certain foods can dispel gas ▪ Postpartum more susceptible to gas ▪ Traditional Haitians have a low pain (doule) threshold and is difficult to assess because of vague terms used to describe pain ▪ Injections are preferred to oral medications Transcultural Health Care: A Culturally Competent Approach, 4th Edition Healthcare Practices Continued ▪ Condition is deemed very serious if oxygen is needed ▪ Special diet for physical weakness—vitamins, liver, pigeon meat, leafy green vegetables, and cow’s feet ▪ Sezisman, similar to susto or magical fright, is caused by unexpected bad news and fright Transcultural Health Care: A Culturally Competent Approach, 4th Edition Healthcare Practices Continued ▪ Strong stigma with mental illness ▪ Self-treat and self-medicate or take friends medicine ▪ May bring medicines from Haiti ▪ Cultural bound illness—oppression Transcultural Health Care: A Culturally Competent Approach, 4th Edition Barriers ▪ Delay seeking care because of self-care ▪ No health insurance ▪ View that Western medicine does not understand voodooism ▪ Language difficulties ▪ Very reluctant to receive blood transfusions or engage in organ donation Transcultural Health Care: A Culturally Competent Approach, 4th Edition Healthcare Practitioners ▪ Use traditional and Western practices simultaneously ▪ Respectful of Western healthcare providers ▪ May have limited understanding of Western healthcare providers and their functions and capabilities Transcultural Health Care: A Culturally Competent Approach, 4th Edition Iranian Larry Purnell, PhD, RN, FAAN Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition Overview/Heritage ▪ Over 400,000 in the United States with about ½ living in California ▪ Currently about 76 million in Iran with 75% under the age of 30 ▪ Much diversity in Iran (Persia) among its inhabitants and also much diversity among Iranians in the United States Transcultural Health Care: A Culturally Competent Approach, 4th Edition Overview/Heritage Continued ▪ The reform institutions of current Iran are colored by religious traditions and ideology of Islam. ▪ Current industrialization of Iran has been from the outside, not from the inside and is due to the oil production industry. ▪ Political instability continues with clashes between conservatives and liberals. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Overview/Heritage Continued ▪ First wave of immigration between 1950 and 1970 were mostly students and professionals from the social elite and many stayed in the United States. ▪ Second wave between 1970 and 1978 were varied in their background, but most were still affluent and urban and came for education and to be with family. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Overview/Heritage Continued ▪ Not a major influence in the United States because they did not live in ethnic enclaves and assimilated into the United States culture easily ▪ The third wave of immigration began in 1979 at the time of the Islamic revolution and included voluntary and involuntary political exiles and others who come for economic and personal security Transcultural Health Care: A Culturally Competent Approach, 4th Edition Overview/Heritage Continued ▪ The hostage crisis between 1979 and 1981 increased ethnic tension of Iranians in the United States ▪ Many are unable to find work in the United States that is compatible with their education in Iran ▪ Most highly educated immigrant group in the United States Transcultural Health Care: A Culturally Competent Approach, 4th Edition Communications ▪ Farsi (Persian) is the national language of Iran but half speak another language with the educated group speaking three or more languages, including English ▪ Invasions by numerous other nations have caused a mistrust and suspicion of foreigners resulting in not sharing one’s feeling with strangers Transcultural Health Care: A Culturally Competent Approach, 4th Edition Communications Continued ▪ Tell stories rather than being blunt and to the point in conversations leading to politeness and sometimes disguised as modesty ▪ Hierarchical relationships dictate politeness and social communication resulting in a public self and a personal self Transcultural Health Care: A Culturally Competent Approach, 4th Edition Communications Continued ▪ Family affairs remain within the family ▪ Self-control is valued and therefore do not show anger or emotions ▪ Men can show affection for men and women for women in public, but not men and women ▪ Stand close in conversations, regardless of social status between conversants Transcultural Health Care: A Culturally Competent Approach, 4th Edition Communications Continued ▪ Maintain intense eye contact between intimates, but avoid eye contact with superiors and elders ▪ Expressive gesturing ▪ Balance in temporality ▪ Clock time is meaningless, even with appointments unless well acculturated Transcultural Health Care: A Culturally Competent Approach, 4th Edition Communications Continued ▪ Formality in addressing each other unless close friends ▪ More traditional men do not mention their wives’ names in public ▪ Man should wait for woman to extend her hand for a greeting Transcultural Health Care: A Culturally Competent Approach, 4th Edition Name Format ▪ Order of the name is the same as the Western method with the given name followed by the surname. ▪ Traditional women do not take their husband’s last name although some in the United States and elsewhere may upon immigration. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Family Roles ▪ Society is patriarchal and hierarchical ▪ Oldest son takes over if father is not present or unable to carry out decision-making ▪ Male children are more desirable than female children—true in other cultures as well Transcultural Health Care: A Culturally Competent Approach, 4th Edition Family Roles Continued ▪ Men deal with finance and matters outside the home. ▪ Women care for the home and children. ▪ Before 1960s social reform, women were legally expected to be obedient and submissive to their husbands. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Family Roles Continued ▪ Marry early and have children. New law says women cannot marry until age 14—was 12 and marriages may still be arranged, but less so in the United States ▪ Respect elders and never speak rudely to them ▪ Children rarely left with babysitters Transcultural Health Care: A Culturally Competent Approach, 4th Edition Family Roles Continued ▪ Traditional do not allow dating; women are expected to remain virgins until married, but not men ▪ Strong intergenerational ties and family life together or nearby ▪ May dress conservatively outside the home but less so while at home Transcultural Health Care: A Culturally Competent Approach, 4th Edition Family Roles Continued ▪ Divorce uncommon in Iran and carries a stigma—if divorce, it is the woman’s fault, never the man’s—varies in the United States ▪ Pregnancy before marriage can have devastating outcomes and is not talked about, it does not happen—it is just taken care of ▪ Gay and lesbianism highly stigmatized and is a capital crime punishable by death in Iran Transcultural Health Care: A Culturally Competent Approach, 4th Edition Biocultural Ecology ▪ Wide variations in skin color, hair color, and eye color and depends on heritage from previous domination by other countries and cultures ▪ Common illnesses in Iran include malaria, hypertension, meningitis, hookworms, and parasitosis Transcultural Health Care: A Culturally Competent Approach, 4th Edition Biocultural Ecology Continued ▪ Great numbers with genetic disorders brought on by close sanguinity marriages resulting in blindness, epilepsy, anemias, hemophilias ▪ Glucose-6-phosphate dehydrogenase deficiency —fava bean allergies can cause hemolytic crisis Transcultural Health Care: A Culturally Competent Approach, 4th Edition Nutrition ▪ Food is a symbol of hospitality; serve the best food for guests who are expected to eat several servings. ▪ Polite to refuse snacks and beverages when first offered—accept it on the third offering ▪ Rarely eat fast food; fresh food is greatly preferred, and many hours are spent preparing meals Transcultural Health Care: A Culturally Competent Approach, 4th Edition Nutrition Continued ▪ Strict Muslims avoid pork and alcohol and meat must be prepared with ritual slaughter called halal. ▪ Food should be eaten with the right hand (clean hand) and food should be passed with the right hand or both hands. ▪ Traditional prefer family to bring food from home if hospitalized. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Nutrition Continued ▪ Balance food between garm (hot) and sard (cold) —if balance does not occur, one may become “chilled” or “overheated.” ▪ Women are more susceptible to these conditions than are men. ▪ Newer immigrants may have protein and vitamin deficiencies. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Childbearing Family ▪ Menstruating women are not allowed to touch holy objects, have intercourse, exercise, or shower. ▪ Iran is changing from openly discouraging birth control to now cautiously and secretly encouraging birth control because of the population explosion. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Childbearing Family Continued ▪ Cravings must be satisfied because the fetus needs the craved food ▪ Avoid fried foods or foods that cause gas ▪ Eat lots of fruits and vegetables ▪ Balance garm and sard foods ▪ Pregnant woman should not work after the sixth month Transcultural Health Care: A Culturally Competent Approach, 4th Edition Childbearing Family Continued ▪ The father should not be present at birth in the traditional family ▪ 30- to 40-day postpartum period where other women are to care for the new mother ▪ Ritual bath after this period so religious obligations can continue ▪ Eat different foods if a boy baby versus girl baby ▪ Eat an herbal extract (taranjebin) to have a boy Transcultural Health Care: A Culturally Competent Approach, 4th Edition Death Rituals ▪ Okay to begin life support, but usually not okay to end life support ▪ Multiple family members come to bedside of the dying person and recite/read prayers ▪ Bed should be turned to face Mecca ▪ More traditional want to return to Iran to die Transcultural Health Care: A Culturally Competent Approach, 4th Edition Death Rituals Continued ▪ Even though death is seen as a beginning, not an end, mourning and grief are displayed openly and even dramatically to encourage letting go ▪ After death, relatives and friends gather on days 3, 7, and 40 to pray and grieve with family and friends Transcultural Health Care: A Culturally Competent Approach, 4th Edition Death Rituals Continued ▪ All wear black for mourning and women should not wear makeup ▪ On the anniversary of the death, family and friends again gather to express grief and pay respect to their loved one Transcultural Health Care: A Culturally Competent Approach, 4th Edition Death Rituals Continued ▪ Ritual body washing by another Muslim after death and dressed in a white shroud; body orifices stuffed with cotton and ritual prayers said during the cleansing ▪ If non-Muslim, touch the body only with gloves ▪ No embalming in Iran nor is cremation practiced Transcultural Health Care: A Culturally Competent Approach, 4th Edition Spirituality ▪ Specific Muslim practices include praying 5 times each day and need privacy and ritual washing before prayer ▪ During Ramadan, fasting from sunup to sundown unless pregnant or ill ▪ Family relationships and friendships are primary sources of strength Transcultural Health Care: A Culturally Competent Approach, 4th Edition Spirituality Continued ▪ Sadness is valued and a sad person is considered to be deep, thoughtful, and sensitive ▪ God’s Will and power over one’s fate fosters passivity and dependence Transcultural Health Care: A Culturally Competent Approach, 4th Edition ClickerCheck A 76 year old Iranian, Muslim male is in the process of dying after a long debilitating illness. The nurse would a. Have his Imam visit. b. Make sure no one touches him with bare hands. c. Turn him to face Mecca. d. Place him in a supine position. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Correct Answer Correct answer: C At the time of death, the dying person should be positioned to face Mecca. This can be accomplished by moving the bed or at a minimum of turning the patient’s face towards Mecca. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Healthcare Practices ▪ Combination of humoral medicine, Islam, and biomedical practices ▪ Humoral medicine—illness is caused from an imbalance in wet and dry and hot and cold forces ▪ Sacred men are able to heal ▪ Evil eye is alive and well Transcultural Health Care: A Culturally Competent Approach, 4th Edition Healthcare Practices Continued ▪ Good health is a daily way of life ▪ Seek care immediately and shop around for the right treatment ▪ Use traditional herbs and over-the-counter medicine to relieve symptoms and seek care provider to determine the cure ▪ Able to purchase a wide variety of drugs over-thecounter in Iran and bring them to the United States Transcultural Health Care: A Culturally Competent Approach, 4th Edition Healthcare Practices Continued ▪ Narahati—general term to express unpleasant emotional or physical illnesses and somatization is common and accepted and can be treated religiously or medically, depending on what the cause might be ▪ Ghalbam gerefteh—distress of the heart—is an expression of emotional turmoil or homesickness Transcultural Health Care: A Culturally Competent Approach, 4th Edition Healthcare Practices Continued ▪ Various remedies for the evil eye and dependent on the age and family of the person afflicted ▪ Language can be a barrier to care for some ▪ Descriptions of conditions may be different from the US description ▪ Many do not have health insurance Transcultural Health Care: A Culturally Competent Approach, 4th Edition Healthcare Practices Continued ▪ Concept of insurance may not be known to some ▪ Usually very expressive with pain and discomfort ▪ Mental illness is highly stigmatized and may hinder other family members from marriage ▪ Prefer drugs, the stronger the better, and prefer IV over IM, and IM over pills ▪ The more invasive, the better Transcultural Health Care: A Culturally Competent Approach, 4th Edition Healthcare Practitioners ▪ Organ donations and transplantations may be seen as a business transaction ▪ Folk or religious practitioner used for narahatis ▪ Most respected biomedical practitioner is a middle-aged male with a title and white hair ▪ Firm believers in high technology Transcultural Health Care: A Culturally Competent Approach, 4th Edition Healthcare Practitioners Continued ▪ Nurses are usually afforded little respect— partially because of training ▪ Physicians are on top—all other healthcare providers take a lesser position ▪ If self-care is encouraged, it may be seen as non-caring Transcultural Health Care: A Culturally Competent Approach, 4th Edition ClickerCheck Mrs. Said is brought to the nurse practitioner by her daughter because she has naharati. The nurse recognizes this condition as a. Equivalent to congestive heart failure. b. Generalized distress. c. Generalized weakness of aging. d. Abdominal pain. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Correct Answer Correct answer: B Naharati is generalized distress that can be brought on by stress, anxiety, homesickness, or other things that can cause emotional turmoil.
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Global Nursing Shortage

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Global Nursing Shortage

Topic 1: Global Nursing Shortage

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Evaluate the effects of the global nursing shortage on health policy. How has the shortage affected the United Nation’s Millennium Development Goals? Analyze how nursing ideas, values, and beliefs impact policy agenda. Identify when policy can dictate treatment options.

For each Discussion Topic:

Initial posts for each discussion topic must also include a minimum of three peer-reviewed citations.Citations must include outside sources. Additionally, comments should also include a citation to support assertions. While the discussion board tool limits the ability to use APA formatting (e.g., hanging indents), posts must include the required elements of an APA in-text citation and list of references. Each post requires it’s Own answer. They do not require a front face sheet.

Systems Life Cycle and the Nursing Process

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Systems Life Cycle and the Nursing Process

Compare and contrast the Systems Life Cycle and the Nursing Process. How is it that these two processes are similar? Provide two references in APA format to support your posting.

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APA, No Plagarism

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APA, No Plagarism

Guidance Module A Page 1 of 2 NURS4222 Healthcare Teaching Module A Guidance Prepare each Assignment

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following the Course Objectives, Grading Criteria and Grading Rubric of each module. The common thread in each module is the role of the Nurse in teaching and should be emphasized in your writings. Your opportunity to explore and expand your knowledge in analysis of your learner will increase effective communication with your current and future patients. Reference Bastable, S. (2018). Nurse as educator: Principles of teaching and learning for nursing practice 5th ed.). Sudbury, MA: Jones and Bartlett. *Note: chapters & page numbers may not be specific for your textbook edition. Refer to the index with the topic name. Review Chapters 1 – 9 to begin your literature exploration and review. Specific to your assessment — Chapter 7 Use the Grading Criteria as headings to facilitate flow of your writing (Level 1 & 2 headings per APA format). Review Module A Example. • Instructional Material Briefly written in your own words • Analysis of Readability Results written as facts from your findings (no personal thoughts) • Analysis of Suitability Results written as facts from your findings (no personal thoughts) • Critical Analysis Applied to Learner Compare your textbook material and literature review to your chosen learner. Summarize your findings in relation to your chosen learner (no personal thoughts).  Critical analysis is specific to your chosen learner, NOT on how or what you are teaching. Findings on your chosen learner prepares you for presenting to that learner in Module B.  Choose a learner to teach. The learner may be a lay person/s from 3 yrs. to whatever age and/or gender. Professionals may be RN’s, MD’s, Therapists etc. Number to teach may be 1 or any number. Length of time depends on your chosen learner (a 3 yr. old learner may tolerate less than 5 min. where 25 professionals may require an hour presentation).  Assess learning needs of your chosen learner Review the literature & your textbook for characteristics, assets, limitations, & influences of your chosen learner: How do they learn, what works best for learning, do they need someone with them to Guidance Module A Page 2 of 2 NURS4222 Healthcare Teaching assist learning, do they need assistive devices, what is their strength, how do they retain information. Age, gender, culture etc. plays a role in learning which you will need to know in order to prepare & deliver a successful presentation. For example, a class of 7 yr. olds may not remain attentive for 30 minutes with a large amt. of information presented only verbally. Professionals may lose their attention span with a frigid room & a 3 hour verbal presentation without breaks. • Submission  Review Grading Criteria and Grading Rubric before submitting. YOU MUST HAVE CITATIONS & REFERENCES for evidence based findings in order to successfully achieve course objectives.  Length of paper MUST meet module objective (
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Healthy Work Environment

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Healthy Work Environment

Page 1 of 2 Module A Student Name: NURS4233 Art & Science of Nursing Healthy Work Environment Assignment 1.

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The Joint Commission has identified five categories of workplace violence. Please identify the five categories and provide an example of each. (10 points) a. b. c. d. e. 2. List three organizational factors that can lead to workplace bullying. (10 points) 3. The American Nurses Association has developed Civility Best Practices for Nurses. Please list five of the best practices. (10 points) 4. Describe in 2-3 sentences costs of incivility to an organization or hospital. (10 points) 5. Discuss how incivility in nursing and healthcare affects patient safety? (10 points) 6. Identify and describe two strategies you can implement to decrease or prevent incivility in your work environment. (10 points) 7. DESC is a component of TEAMSTEPPS and is a strategy to address incivility. Identify each component of DESC. (10 points) D: E: S: C: 8. Please list your Clark Incivility Score and what the score represents. (10 points) 9. Briefly describe any instances of incivility you have experienced or witnessed. (10 points) Page 2 of 2 Module A NURS4233 Art & Science of Nursing 10. If you could re-visit the situation described above, would you do anything differently? Discuss how one of the strategies learned in this course could have been implemented. (10 points) Issue 24 June 2016 Bullying has no place in health care Issue: Civility is a system value that improves safety in health care settings. The link between civility, workplace safety and patient care is not a new concept. The 2004 Institute of Medicine report, “Keeping Patients Safe: Transforming the Work Environment of Nurses,” emphasizes the importance of the work environment in which nurses provide care.1 Workplace incivility that is expressed as bullying behavior is at epidemic levels. A recent Occupational Safety and Health Administration (OSHA) report on workplace violence in health care highlights the magnitude of the problem: while 21 percent of registered nurses and nursing students reported being physically assaulted, over 50 percent were verbally abused (a category that included bullying) in a 12-month period. In addition, 12 percent of emergency nurses experienced physical violence, and 59 percent experienced verbal abuse during a seven-day period.2 Workplace bullying (also referred to as lateral or horizontal violence) is repeated, health-harming mistreatment of one or more persons (the targets) by one or more perpetrators.3 Bullying is abusive conduct that takes one or more of the following forms:3    Verbal abuse Threatening, intimidating or humiliating behaviors (including nonverbal) Work interference – sabotage – which prevents work from getting done3 There are five recognized categories of workplace violence:4  Threat to professional status (public humiliation)  Threat to personal standing (name calling, insults, teasing)  Isolation (withholding information)  Overwork (impossible deadlines)  Destabilization (failing to give credit where credit is due) In the scientific literature, several types of bullying have been studied: intimidation, harassment, victimization, aggression, emotional abuse, and psychological harassment or mistreatment at workplace, among others. 5 Bullying does not include illegal harassment and discrimination, and while bullying can create a hostile work environment, it is not the same as the organization allowing an illegal hostile work environment (for example, the employer tolerating inappropriate jokes). Other examples that are not bullying include setting high work standards, having differences of opinion or providing constructive feedback. The Workplace Bullying Institute estimates that 65.6 million U.S. workers are directly impacted by or have witnessed bullying. A 2014 Workplace Bullying Institute survey found that 69 percent of bullies are men and 57 percent of targets are women, and that women bullies target women in 68 percent of cases. It is more common than sexual harassment, and can be direct physical, verbal or indirect bullying (such as social isolation).4 Bullying is typically deliberate, causes negative effects on the victim, and is an attempt to control employees. Bullying is behavior that is aggressive, intentional, and frequent. Bullies tend to target employees who have inadequate support or are not able to defend themselves from the aggression. An essential component of bullying is that it is perceived as a hostile act by the target. Some examples of bullying are a manager who is never pleased with performance, gossiping or spreading rumors, intentionally excluding an employee from team meetings, being told “you are too thin skinned,” or being repeatedly called to unplanned meetings with the manager where the employee is denigrated. Factors that contribute to this problem include a culture that allows bullying (normalization of deviance), poor staffing levels, (Cont.) Legal disclaimer: This material is meant as an information piece only; it is not a standard or a Sentinel Event Alert. The intent of Quick Safety is to raise awareness and to be helpful to Joint Commission-accredited organizations. The information in this publication is derived from actual events that occur in health care. ©The Joint Commission, Division of Health Care Improvement Quick Safety Issue 24, June 2016 Page | 2 excessive workloads, power imbalances and poor management skills. Specific organizational factors that can lead to workplace bullying are role conflict and ambiguity, work overload, stress, lack of autonomy and a lack of organizational fairness.6,7 In the health care setting, 44 percent of nursing staff members have been bullied. Nurses tend to accept nurseon-nurse bullying as part of the job, particularly the new or novice nurse, thus the coining of the phrase “nurses eat their young.”8 In a study of 284 health care workers, it was found that 38 percent of U.S. health care workers reported psychological harassment.5 The most common health care settings where bullying is prevalent are behavioral health units, emergency departments and intensive care units. In long term care settings, bullying occurs more frequently during evenings and night hours. The targets of bullying are employees who are typically under 40 years old; female physicians; and unmarried, female employees with less education and who have children at home. Impact of workplace bullying The impact of bullying behaviors on the organization are lower morale, lower productivity and increased absenteeism (due to physical, psychological and emotional harm), followed by rapid and increased turnover, which compromises patient safety. Workplace bullying also leads to lawsuits, compensation for disability, loss of profits, negative impact on organizational reputation, and a corrosion of the patient to health care worker relationship. Employees, patients and families who witness behaviors that are not civil are concerned about how care can be impacted. For example, a nurse who is openly critical of another nurse, or a physician who is openly critical of a nurse. The impacts on patient and care team safety include under-reporting of safety and quality concerns, and increases in harm, errors, infections and costs. As an example, the estimated cost of replacing a nurse is $27,000 to $103,000.9 Bullying exacerbates the stress and demands of already stressful and demanding professions. Bullying contributes to burnout and drives talented and caring people out of the health professions. The kinds of improvements needed in patient safety and health care cannot be achieved if talented people are lost. Battling workplace bullying Gerry Hickson, MD, and his colleagues at Vanderbilt University Medical Center (VUMC) have recognized that a significant barrier to eliminating bullying is under-reporting of the problem by health care professionals. Dr. Hickson includes a risk event reporting system in the VUMC set of “surveillance tools.”10 A team led by Dr. Hickson is implementing a Co-Worker Observation Reporting SystemSM (CORSSM) at VUMC. The CORSSM project aims to encourage collegial respect and accountability and to couple safe, contemporaneous reporting with consistent, timely delivery of the captured stories.11 The indications are that self-reporting of unprofessional and disrespectful behaviors increases self-regulation and civility. Alan Rosenstein, a physician and leading expert in unprofessional behavior, states that, with respect to eliminating behaviors that undermine a safety culture, “The primary goal should be to improve care relationships by increasing understanding and responsiveness to individual (physician, staff, patient) needs (emotional Intelligence), provide training in diversity, stress, anger, and conflict management, improve communication and collaboration skills, and enhance an organizational culture that respects and supports physicians, staff, and patient-centered care.”12 A method used to prevent bullying of novice nurses is cognitive rehearsal. In the original 2004 study,13 26 newly licensed nurses hired by a large acute care tertiary hospital in Boston, Massachusetts, participated in an exploratory descriptive study. They were taught about lateral violence in nursing practice and the use of cognitive rehearsal techniques as a shield from the negative effects of lateral violence on learning and socialization. Knowledge of lateral violence in nursing appeared to allow newly licensed nurses to depersonalize it, thus allowing them to ask questions and continue to learn. The learned cognitive responses helped them confront the lateral violence offender. Confrontation was described as difficult, but it resulted in the Legal disclaimer: This material is meant as an information piece only; it is not a standard or a Sentinel Event Alert. The intent of Quick Safety is to raise awareness and to be helpful to Joint Commission-accredited organizations. The information in this publication is derived from actual events that occur in health care. ©The Joint Commission, Division of Health Care Improvement Quick Safety Issue 24, June 2016 Page | 3 resolution of the lateral violence behavior. Overall, the retention rate in this study population was positively affected.13 Safety Actions to Consider: In the 2013 Joint Commission publication, “Improving Patient and Worker Safety,” civility is described as a necessary precursor for a safety culture in which care teams and patients must be treated with respect. 14 Civility matters, which means behaviors that undermine a culture of safety are not tolerated. W. Edwards Deming stated that “quality is everyone’s responsibility.” Leaders especially have a critical role in battling bullying behaviors, including: Establishing a safety system and culture that does not tolerate bullying behaviors. Make this a core value of all leaders in the organization. Confronting bullies and supporting the targets of bullying.   To correct bullying behaviors that can undermine a safety culture, all health care facilities should consider taking the following specific safety actions, which are highlighted in The Joint Commission’s Sentinel Event Alert, Issue 40:15    Educate all team members on appropriate professional behaviors that are consistent with the organization’s code of conduct Hold all team members accountable for modeling desirable behaviors Develop and implement policies and procedures/processes that address: o Bullying o Reducing fear of retaliation o Responding to patients and families who witness bullying o Beginning disciplinary actions (how and when) In developing these policies and procedures, solicit input from an inter-professional team that includes representation of medical and nursing teams, administrators, and other employees.15 Resources: 1. Institute of Medicine. Keeping Patients Safe: Transforming the Work Environment of Nurses. Nov. 3, 2003 (accessed May 24, 2016) 2. Occupational Safety and Health Administration. Workplace violence in health care: Understanding the challenge. OSHA 3826, 12/2105 (accessed May 18, 2016) 3. Workplace Bullying Institute. The Healthy Workplace Campaign. Healthy Workplace Bill website (accessed May 14, 2016) 4. Rayner C and Hoel H. A summary review of literature relating to workplace bullying. Journal of Community & Applied Social Psychology, 1997;7:181-191 5. Ariza-Montes A. Workplace bullying among healthcare workers. International Journal of Environmental Research & Public Health, 2013;10:3121-3139 6. Bowling NA and Beehr TA. Workplace harassment from the victim’s perspective: A theoretical model and meta-analysis. Journal of Applied Psychology, Sept. 2006;91(5):998-1012 7. Topa G, et al. Acoso laboral: Meta-analisis y modelo intergrador de sus antecedents y consecuencias. Psicotherma, 2007;19:88-94 (English translation available online) 8. Meissner JE. Nursing, Mar. 1996;16(3):51-3 9. Li Y and Jones CB. A literature review of nursing turnover costs. Journal of Nursing Management, 2012;21(3):405-418 10. Hickson GB, et al. From front office to front line. 2nd edition. Oakbrook Terrace, Illinois: Joint Commission Resources, 2012:1-36 11. Hickson GB, et al. Using coworker observations to promote accountability for disrespectful and unsafe behaviors by physicians and advanced practice professionals. The Joint Commission Journal of Quality and Patient Safety, 2016;42:149-161 Legal disclaimer: This material is meant as an information piece only; it is not a standard or a Sentinel Event Alert. The intent of Quick Safety is to raise awareness and to be helpful to Joint Commission-accredited organizations. The information in this publication is derived from actual events that occur in health care. ©The Joint Commission, Division of Health Care Improvement Quick Safety Issue 24, June 2016 Page | 4 12. O’Donnell J and Unger L. ‘Disruptive’ doctors rattle nurses, increase safety risks. USA Today, Sept. 30, 2015 (accessed May 14, 2016) 13. Griffin M. Teaching cognitive rehearsal. Journal of Continuing Education in Nursing, Nov.-Dec. 2004;35(6):257-263. 14. The Joint Commission. Improving patient and worker safety: Opportunities for synergy, collaboration and innovation. Nov. 2012 15. The Joint Commission. Behaviors that undermine a culture of safety. Sentinel Event Alert, July 8, 2008;40 Note: This is not an all-inclusive list. Legal disclaimer: This material is meant as an information piece only; it is not a standard or a Sentinel Event Alert. The intent of Quick Safety is to raise awareness and to be helpful to Joint Commission-accredited organizations. The information in this publication is derived from actual events that occur in health care. ©The Joint Commission, Division of Health Care Improvement
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Peer Response

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Peer Response

Clarissa “Clara” Barton was one of the most extraordinary women in American History. Like most women of her time,

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she began her career as a school teacher at the age of 18 (Michals, 2015). She founded a school for workers’ children at her brother’s mill at the age of 24 and then established the first free school in 1852 in Bordertown, New Jersey (Michals, 2015). in 1854, she worked as a clerk at the US Patent office in Washington, D.C., the first women ever for this position (Michals, 2015). In 1861, during the time of the Civil War, Clara Barton spent the next few years nursing wounded soldiers and providing them with needed supplies on the battlefields risking her own life (Kimball, 2016). It was during this time that she earned the nickname “angel of the battlefield” (Kimball, 2016). Her work in nursing soldiers back to health on the battlefield was a huge contribution for the war. In 1869, Clara Barton needed to regain her health and therefore traveled to Switzerland where she learned about the International Red Cross. Learning about the International Red Cross motivated Barton to bring this organization to the United States. All of her efforts and hard work to establish the American Red Cross came about on May 21, 1881 (Kimball, 2016). Barton was named President of the American Red Cross. As a result of Clara Barton’s establishment of the American Red Cross, healthcare today has continued with her contributions in providing relief for people affected by disasters. From Hurricanes to deadly mass shootings, the American Red Cross has opened their doors to provide shelters, nursing care, food, supplies, and recovery assistance for those in need. Kimball, D. (2016). Clara Barton, Humanitarian and Founder of the American Red Cross. Retrieved from http://www.amazingwomeninhistory.com/clara-barton-americanred-cross-founder. Michals, D. PhD. (2015). Clara Barton. Retrieved from http://www.womenshistory.org/education-resources/biographies/clara-barton. Grading Rubric Module A Page 1 of 3 NURS4233 Art & Science of Nursing Nursing Historical Impact Forum Criteria Expert Proficient Competent Content Information in the posting is accurate and demonstrates student learning. Information in posting is supported by evidence from a resource. Posting should be a minimum of 250 words (excluding references). Five points will be deducted for not meeting word minimum. The initial posting should discuss a leader not already selected by another student. Selection of a leader is determined by who first selected and posted their chosen leader in the forum. A 25 point deduction will be assessed if a student posts an initial posting for a leader that had been previously selected by another student. Exceeds expectations. Outstanding distinction and excellence. Meets all objectives, exceed expectation on some but not all objectives. Content meets objectives. Objectives:  Name of nurse leader  Brief biography  Motivation prompting action  Contribution to nursing/healthcare  Reflection on what has changed in current day nursing/healthcare as a result of the leader’s contributions Engagement Engages in discussion through use of thoughtful replies to the postings of other students. A minimum of one reply to a fellow student is required. “I agree” does not meet objectives. Information in posting is supported by evidence from a resource. Substantial Areas for I Some but not all objectives were met. Unsatisfactory None of the objectives were met. . . 36-40 points 32-35 points More than required number of replies to peers in a thoughtful, reflective, and respectful manner. Content of reply exceeds expectations with evidence supported information relevant to the posting. Replies to required number of peers. Reply is reflective, and respectful. Accurate and relevant information with evidence supported information relevant to the posting. 18-20 points 16-17 points 28-31 points Replies to required number of peers. Accurate and relevant information is supported with evidence relevant to the posting. Lacking reflection and personal thought. 14-15 points 24-27 points Reply incompletely meets objective. Information is not supported evidence relevant to the posting. 12-13 points 0-23 points Engagement not met; required minimum replies not completed. 0-11 points Grading Rubric Module A Evidence Ideas are supported by student-conducted search using the required number of sources. Minimum of 1 resource is required for forum posting and reply. Page 2 of 3 Number of resources exceeds minimum requirement in both initial post AND student reply. 18-20 points Scholarly Presentation Writing style allows for clear communication of thoughts through logical presentation of ideas with correct spelling, grammar, and punctuation. Thoughts are logically organized at the paragraph level without errors in spelling, grammar, or punctuation. APA Style Citations/References Posting is supported by proper citation and use of references following APA guidelines. Points will not be deducted for spacing and italics in the reference list on the discussion forum. Note: Citations should follow every sentence containing information received from another source. If citations are missing, plagiarism will be considered. APA format used for all citations and reference listings with no errors. 10 points 10 points PLAGIARISM: NURS4233 Art & Science of Nursing Number of resources exceeds requirement in the initial post OR the student reply, but not both. Utilized assigned number of resources in both initial post and student reply. 16-17 points 14-15 points 12-13 points Thoughts are logically organized at the paragraph level with no more than 3 errors in spelling, grammar, or punctuation. Thoughts are logically organized at the paragraph level with no more than 4 errors in spelling, grammar, or punctuation. Posting with no more than 5 errors in spelling, grammar, or punctuation. 9 points No more than 3 APA formatting errors noted for citation(s) and reference(s). 9 points 7-8 points 4 to 5 APA formatting errors noted for citation(s) and reference(s). 7-8 points Omitted resource in initial post OR the student reply. 5-6 points 6 to 7 APA formatting errors noted for citation(s) and reference(s). 5-6 points Resources are not used for initial post AND student reply. 0-11 points Posting contains in excess of 6 errors in spelling, grammar, or punctuation. 0-7 points More than 7 APA errors noted for citation(s) and reference(s). 0-2 points Grading Rubric Module A Page 3 of 3 NURS4233 Art & Science of Nursing Plagiarism is considered cheating and is a violation of academic integrity as outlined in the Student Handbook. Any student who plagiarizes any portion of the assignment may receive a grade of zero on the assignment. LATE ASSIGNMENTS: Unless prior faculty notification and negotiation of an extended deadline, ten points will be deducted per day if submitted late. Assignment will not be accepted if submitted more than 3 days late and assigned grade will be 0 (zero).
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