Category: Nursing

Holistic Care in Nursing Essay Notes

Introduction 

Caring is a central concept to nursing and has been since the beginning of the profession. Over time, healthcare delivery and settings have changed as a result of technological and knowledge advancements, an increasingly diverse patient population, a  shifting focus to decreased healthcare costs, increased quality and safety outcomes, and promoting person-centered care, among other factors. With these changes, a transformation of nursing is occurring. However, nurses must be mindful not to lose sight of caring at the core of nursing practice. Caring frameworks that include holistic and person-centered care can be used to guide the practice of the master’s- prepared nurses in advanced practice roles as leaders of nursing care in varied healthcare settings.

Holistic Care in Nursing

Caring as a Nursing Concept 

Caring can be classified in two ways: as a noun and as an adjective (Adams, 2016). As a noun, it is the act of care, or as an adjective, it is the demonstration or action of caring. Nursing has a scientific knowledge base of empirical care practices and personal, ethical, and aesthetic knowledge that are demonstrated in attitudes and behaviors that portray caring. Drahošová and Jarošová (2016) discussed many aspects of caring, including protection and support of patients through evidence-based interventions, developing relationships, and a way of nursing practice. Caring is influenced by the nurse’s knowledge, skills, and attitudes formed through lifelong learning and experiences.

The concept of caring has been a focus area of nursing for years. Interestingly, the American Nurses Association (2016) defines nursing as:

…the protection, promotion, and optimization of health and abilities, prevention of illness and injury, facilitation of healing, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, groups, communities, and populations.

The concept of caring is not explicit in this definition, so why is caring a central focus of nursing? Nursing theorist Jean Watson contended that caring is the moral ideal and essence of nursing (Watson, 1990). Adams and Maykut (2015) acknowledged nursing as a helping profession, and therefore, caring is a unique and relational practice of nurses. Similarly, Duffy (2015) defines caring as a series of kind acts and an attitude in addition to collective values and knowledge-based actions that are guided by human-to-human relationships.

Caring is manifested in relationships. As a master’s- prepared advanced practice nurse you will have daily opportunities to demonstrate caring behaviors that establish relationships and promote positive outcomes in varied professional practice settings. Drahošová and Jarošová (2016) identified caring behaviors as attentiveness to patients; communicating openly and honestly ; providing dignity, respect, and comfort; and connecting with patients and families.

Holistic Care in Nursing Essay Reflection

Take a moment to reflect on how you demonstrate caring in your current professional practice. What are barriers to practicing care? How can you enhance caring behaviors?

Caring in Complex Systems

Over time, healthcare systems have increased in complexity in part due to technological advances and increased knowledge and skills. Focus on quality, safe, and cost- effective care is paramount to the 21st-century healthcare delivery system. These changes in the healthcare environment have led to an expanded professional role of the nurse that includes a focus on institutional and/or organizational and professional regulation and compliance and technology -driven tasks, all which shift focus and time from the patient care experience and the fundamental nursing principle of caring.

Another change in the delivery of healthcare is driven by people becoming more involved in making decisions regarding their health and health practices. People are now actively participating in their own care. This change is shifting the focus from provider-driven care to person-centered care. “The current focus on person-centeredness in practice illustrates society’s drive to redress the current imbalance in care, moving away from an ethos that is medically dominated, disease orientated, and often fragmented toward one that is relationship focused, collaborative, and holistic” (McCance, McCormack, & Dewing, 2011, para 8). All of these changes contribute to the increasing complexity of the healthcare environment and shape the role of master’s- prepared advanced practice nurses.

Holistic Nursing Practice

Nurses in all settings are tasked with providing care in a caring manner with attention to all aspects of the person, health, and environment. A holistic approach to care is recommended for master’s- prepared nurses in advanced practice roles (Papathanasiou, Sklavou, & Kourkouta, 2013) who are instrumental in implementing and evaluating person-centered care and care environments. Although nurses must certainly be knowledgeable about how disease physiologically affects the patient; it is important to care for the whole person and not just 
a diagnosis
 or piece of equipment. Holistic care expands beyond the physiological aspects of health (illness and/or disease) and incorporates additional psychological, sociological, developmental, spiritual, and cultural aspects. Also, included in holistic care are environmental and economic factors.

Reflection

Consider ways in which you incorporate holistic care principles in your professional practice.

Holism is more than certain actions performed or words spoken to a patient. Holistic care is a philosophy; it’s a method to ensure care for all parts of the patient. Holistic nurses are those who recognize and treat each individual as a unique human being connected to family and community (Papathanasiou, Sklavou, & Kourkouta, 2013). Holism represents an ability of the nurse to work with the healthcare team and available resources to promote optimal health outcomes
 with the person as the central focus
. This also means recognizing that the nurses’ relationships with patients will also grow and hopefully change into positive patterns of mutual trust and caring interactions. Holistic nursing moves the nurse mindset from linear, task-oriented practices to complex and multidimensional care in any healthcare setting. Holistic nursing also encourages nurses to integrate self-care, self-responsibility, spirituality, and reflection in their lives. Hence, holistic approaches to person-centered care leads to better outcomes of patient care and improved nurse satisfaction with their own professional endeavors.

Person-Centred Care Nursing Framework 

Caring continues to be a central concept in nursing; however, the context for caring is transforming, resulting in conceptual and theoretical advancements related to the evolving healthcare practice settings. McCormack and McCance originally developed a Person-Centred Nursing (PCN) Framework in 2006 and updated it in 2010 that can be applied to practice in complex healthcare systems (McCormack & McCance, 2006; McCormack & McCance, 2017). The PCN Framework provides a standard of care for practice and is a multidimensional process that places emphasis on the person as the center of care delivery (McCance, McCormack, & Dewing, 2011). The PCN Framework fosters outcomes related to therapeutic relationships through respecting individuals as persons and partners in care. The Person-Centred Care Nursing Framework consists of four constructs: prerequisites, the care environment, person-centred processes, and outcomes (McCance et al., 2011). To deliver effective care, one must work from the outer circle first to the core.

Prerequisites focus on the attributes of the nurses and include being professionally competent, having developed interpersonal skills, being committed to the job, being able to demonstrate clarity of beliefs and values, and knowing self. 
The care environment
 focuses on the context in which care is delivered and includes appropriate skill mix, systems that facilitate shared decision making, effective staff relationships, organizational systems that are supportive, the sharing of power, the potential for innovation and risk taking, and the physical environment. 
Person-centred processes
 focus on delivering care through a range of activities and include working with a patient’s beliefs and values to overcome this gap between the concept and the reality of person-centred care we have developed the Person-Centred Nursing Framework…engagement, having sympathetic presence, sharing decision making, and providing holistic care. O
utcomes, 
the central component of the Framework, are the results of effective, person-centred nursing and include: satisfaction with care, involvement in care, feeling of well-being, and creating a therapeutic environment. (McCance, McCormack, & Dewing, 2011).

Reflection

Consider how the Person-Centred Care Framework can support quality and safety outcomes. Identify three ways in which you can use the Person-Centred Nursing Framework to improve outcomes in your future professional practice setting.

Conclusion

Nursing practice is both an art and a science with foundational knowledge, skills, and attitudes based in caring. Over time, the health care setting has changed and continues to increasingly evolve in complexity. The complexity of the current healthcare practice environment has led to conceptual and theoretical advancements that support nursing practices. Caring remains a central concept to nursing practice and the profession of nursing. This week’s lesson included definitions of caring and an exploration of caring behaviors. Students were introduced to the Chamberlain College of Nursing care focus. Also emphasized in this lesson were principles of holistic nursing and the Person-Centred Nursing Framework as a model for practice. Students were encouraged to reflect on current nursing practices and implement a caring framework to guide future professional nursing practices.

Holistic Care in Nursing

This week’s topic is centered on the concept of caring in contemporary nursing practice. In your initial response, provide a definition of caring that aligns with your perspective on the concept of caring. Identify your selected program of study specialty track (Executive). Describe how you will apply the principles of caring and holistic nursing in your future professional practice. Use at least one outside scholarly article to support your position. Provide an example to illustrate an application to professional practice.

Systems Theory in Nursing Essay

Assignment: Application: Systems Theory For this Assignment, you apply systems theory to the examination of a problem in a department or a unit within a health care organization. To prepare:

1. Review the Meyer article, “Nursing Services Delivery Theory: An Open System Approach,” in this week’s Learning Resources. Focus especially on the information presented in Table 1 (p. 2831) and Figure 2 (p. 2833). 2. Reflect on your organization or one with which you are familiar. Within a particular department or unit in this organization, identify a problem the staff is encountering. 3. Using Table 1 in the Meyer article as a guide, analyze the department or unit, identifying inputs, throughput, output, cycles of events, and negative feedback. Consider whether the problem you have selected relates to input, throughput, output, cycles of events, and/or negative feedback. 4. Think about how you could address the problem: Consider what a desired outcome would be, then formulate related goals and objectives, and translate those goals into policies and procedures. 5. Research professional standards that are pertinent to your identified problem. 6. Reflect on the organization’s mission statement and values. In addition, consider how addressing this problem would uphold the mission and values, while improving the organizational culture and climate. (Depending on the organization you have selected, you may have explored these in the Week 1 Discussion.) To complete: Write a 3- to 5-page paper (page count does not include title and reference page) that addresses the following:

1. Describe a department or unit within a health care organization using systems theory terminology. Include a description of inputs, throughput, output, cycles of events, and negative feedback. 2. Describe the problem you identified within the department or unit using an open- systems approach, and state where the problem exists using the systems theory model (input, throughput, output, cycles of events, or negative feedback). 3. Based on this information, explain how you would address the problem as follows: a. Formulate a desired outcome. b. Identify goals and objectives that would facilitate that outcome. c. Translate those goals and objectives into policies and procedures for the department or unit. d. Describe relevant professional standards. 4. Explain how your proposed resolution to the problem would uphold the organization’s mission and values and improve the culture and climate.

Federal responsibility to provide treatment for infertility coverage by insurance companies essay

Based on this topic “Federal responsibility to provide treatment for infertility coverage by insurance companies”. write a 1,050- to 1,400-word paper on your topic becoming a policy. In your paper, include the following: •Define the evaluation stage. ◦Describe the ethical considerations within the evaluation stage. ◦Explain the evaluation process that would be used to determine if your stated policy objective(s) could be met. •Define the analysis stage. ◦Explain what factors could prevent your policy objective(s) from being implemented. ◦Explain what factors you feel could contribute to your policy meeting its objective(s). •Define the revision stage. ◦Explain potential revisions to the policy resulting from factors identified in the analysis stage. •Explain the impact of court rulings on the analysis and revision stages.  Cite a minimum of 2 references.  Format your paper according to APA guidelines.  Click the Assignment Files tab to submit your assignment.

Cyber security in California Health Care Company

Company background

California health care has increased the use of health records therefore, the providers has worked diligently in order to eradicate breaches in patient health information. According to Voeller (2014, p.67), the cyber security risks are increasing as the role of technology in the delivery of health care activities. The organization find itself mitigating a variety of emerging cyber-attacks to a broad range of operational technology systems.California health care works with it is team of information management system in order to develop a stable cyber security defense.

Due to the risks of cyber-attacks, California health care has developed a health care cyber security document viewed at a glance. This is resourceful to the firm since it urgently addressesthe cyber security. Therefore, the firm is working with information management team to identify health net security need for strong cyber security defense and proper analysis of comprehensive hazard vulnerability. The stake holders are regional Associations that develops cyber security at-a-glance document. These stakeholders, uses electronic health record to mitigate various cyber-attacks as it is noticed that, risk posed to organizations and individuals by other entities with bad objectives, increases.

State selection and resources

The state selected for the project is the health Net office in California. In California, there is a Cyber California which is actively growing as a coalition of academic institutions, state agencies and businesses who understands the need of addressing the concern of cyber security as well as the opportunities associated with technologies for the next generation. This cyber California was formed in 2015 with conjunction with the innovation Network to develop numerous cyber security partnerships that include pending chain supply grant application, youth innovation challenge and summit of industry in governor office (Sculler, 2016).

IT Audit and Compliance, is one of the helpful resource to use in analyzing the cyber security legislative impact. This ensures that, there is compliance, audit and regulatory maintenance plans that successfully maintain a persistent assessment approach. Use of IT risks assessment and management. It entails a proactive cyber security strategy, managing risk and real-time approach to assessing to defend against current’s cyber-attacks. Finally, the use of IT Policies and Governance that entails laws, rules, guidelines, regulations and procedures which outlines the structure processes and authority needed to do the cyber security mission. Therefore, it is governance, serves as the base of entire proactive cyber security program. The use of this resource as cyber security legislative impact in California State is very effective as it governs a clear defined stratification of authority and a well-communicated policy (Izuakor, 2016, p.33).

 

 

 

 

 

 

References

Izuakor, C. (2016). Understanding the impact of cyber security risks on safety.
 Proceeding of the 2
nd
international conference on information systems security and privacy.
doi:10.5220/0005796805090513

Sculler, F. (2016).
Governance, Risk and Compliance.
Proactive cyber security. Http/www.lazarusalliance.com/proactive-cyber. Retrieved 7
th
Sept, 2017

Voeller, J.G. (2014).
Cyber Security
. Wiley.

The Nurse’s Role in Supporting the Organization’s Strategic Agenda Essay Assignment

As hospitals seek to reduce the incidence of Never Events and improve the overall quality of health care provided, it is apparent that ultimate success will require the effort of the entire medical staff. Consider the nurse’s role in supporting the organization’s strategic agenda as it relates to improving clinical outcomes.

For this application you are asked to interview a quality manager in an acute care or long-term care agency of your choice. Your goal is to determine the manager’s view regarding the impact of the direct care nurse’s role in clinical outcomes for the organization. How does this influence the ability of the organization to achieve its strategic agenda? Before you attend the interview, create a list of relevant questions that will help you better understand the effect a nurse can have on the successful treatment of the patient.

Write a 2- to 3-page paper discussing what you learned from this interview. How will what you learned impact how you approach your nursing responsibilities?

Working in groups or as a team essay

Describe your experience working in groups or as a team.

I have been involved in group work since pre-school. My experience with group work

throughout the years has mainly been the same. I notice that when there are smaller groups,

such as with 3-5 members, there are always one or two people who take the lead, one member

who contributes minimally and one who does what they are asked.

Explain the importance of collaborating with different groups and building

coalitions in order to advocate for community and policy change.

In order to advocate for community and policy change there needs to be

collaboration. The community that the agency I currently work for, Connections, serves is

cross cultural, diverse, and all inclusive, we do not turn individuals away, regardless of their

financial state and or ability to pay. The community that we serve is Cuyahoga county and

the strength of this community is the services available for mental health and chemical

dependency treatment. There are great community outreach programs that we collaborate

with on a daily basis such as the fatherhood initiative which seeks to strengthen families in

our community by encouraging fathers to play a more active role in nurturing and raising

their children and frontlines services mobile crisis, which is a 24/7 Suicide Prevention Hotline

for children and adults and their Crisis Stabilization Unit which is also available 24/7 for

individuals in psychiatric crisis as an alternative to inpatient psychiatric hospitalization.

Luckily there is a positive community perception of our agency which helps us better

assist our clients with their issues. All of our locations have a great relationship with law

enforcement and we are currently working with them to assist with crisis intervention team

training, also known as CIT training. CIT provides law enforcement-based crisis intervention

training for assisting those individuals with a mental illness. We have successful relationships

with other community resources such as detox centers and residential facilities for those

afflicted with chemical dependency and or mental illnesses such as Stella Maris and Orca

House. Connections also has a great relationship with The Alcohol, Drug Addiction and

Mental Health Services (ADAMHS) Board of Cuyahoga County who assists with funding for

our uninsured individuals along with assisting our clients with emergency shelter programs

such as RESPITE and group home placement and funding.

List one strength you will bring to your group.

I believe the strength that I will bring to this group is thoroughness. I have always

done assignments on time and with attention to detail. I take group work very seriously as I

know that it is a project that not only affects me but others as well based on my performance. I

am able to work effectively with others to get the task at hand done.

Describe a potential difficulty that may occur within the group and explain a

strategy you will recommend to your group to address that difficulty.

One potential difficulty that may occur in this group is that one or more members

may not do the work that is asked of them. Since there are only three individuals in this group,

all members need to take their role seriously. A strategy that can be utilized in order to deal

with member/s who are not contributing would be to communicate to see if there are

underlying issues that are contributing to this such as a family emergency, or medical

emergency, and take the necessary steps if that is the case such as asking the instructor for an

extension. If the member does not communicate back with the group, then the other

member/s will need to complete their portion of the project to best of their ability and

communicate with their instructor the ineffective dynamics of the group.

Leadership Smart Goal Assignment

Purpose The purpose of this assignment is to develop a SMART-formatted goal related to your professional leadership applicable to your current practice setting or future leadership aspirations. This goal is about YOUR leadership development, not those of the organization or the department where you work. Many organizations have developed the SMART-goal framework as they strive for performance improvement. Your goal may tie to one of the departmental or organizational SMART goals but the components of the goal are about YOUR leadership development The Institute of Medicine’s quality initiative has identified five core healthcare profession competencies. This assignment focuses on only two of those initiatives. Either Patient-Centered Care or Working in Interdisciplinary and/or Interprofessional Teams will serve as a framework for identification of YOUR leadership SMART goal. Course Outcomes Completion of this assignment enables the student to meet the following course outcomes. CO 1: Apply leadership concepts, skills, and decision making in the provision of high quality nursing care, healthcare team management, and the oversight and accountability for care delivery in a variety of settings. (PO #2) CO 4: Apply concepts of leadership and team coordination to promote the achievement of safe and quality outcomes of care for diverse populations. (PO #4) CO 5: In your Leadership Smart Goal Assignment, apply improvement methods, based on data from the outcomes of care processes, to design and test changes to continuously improve the quality and safety of healthcare. (PO #8) CO 8: Apply concepts of quality and safety using structure, process, and outcome measures to identify clinical questions as the beginning process of changing current practice. (PO #8) Due Dates This assignment consists of the completion of the My Leadership SMART Goal paper. Submit assignment to the Dropbox by Sunday, 11:59 p.m. MT, by the end of Week 4. Points This assignment is worth 200 points. Directions Review the Institute of Medicine’s (IOM) core healthcare competencies. Select ONE of the competencies that you will work on for developing a Leadership SMART Goal. You are to select one of the following competencies for YOUR SMART goal. Managing Patient-Centered Care or Working in interdisciplinary and/or interprofessional teams; 1. Create ONE leadership goal that is in the SMART goal format. You practiced this in the Week 3 Discussion, and received valuable feedback from your instructor and peers. Please refer to this as you work on the assignment. S – Specific(Who besides YOU is involved in the goal, what is YOUR goal, where will it take place?) M – Measurable (How are YOU going to achieve the goal?) Be specific with measureable outcomes. A – Attainable(What resources and/or experts are available to assist YOU with attaining YOUR goal?) R – Realistic(Is YOUR goal something that is realistically obtainable in YOUR professional practice?) Be specific. T – Time bound(What specific dates or weeks will YOU accomplish each task related to your leadership goal?) · Example NOT in SMART format: I will learn how to be a manager. This goal is lofty, not measurable, and unattainable in the time allotted, probably not realistic, and not time bound. · Examplein SMART Format: I will learn the disciplinary process of an employee who has excessive absences, by locating the organization’s attendance policy and meeting with the unit manager, reviewing peer-reviewed articles and credible websites to obtain information on the disciplinary process by Week 4 (or specified date). Note: This particular example relates to Core Competency: Managing Patient-Centered Care. This example is a SMART goal that is Specific, Measurable, Attainable, Realistic, and Time-bound. S-Specific o Who- Your name, or “I” Indicate others who may be involved. o What- Learn the disciplinary process of employees who have excessive absences o Where- Your organization M-Measurable o How: Through locating the organization’s attendance policy and passing a quiz on the content of the policy. A-Attainable o Resources and/or Expert: Meeting with the unit manager, reviewing peer-reviewed articles, and credible websites R-Realistic o Realistically obtainable: Access to the organization, policies, and unit manager. Various resources are available. T-Time bound o Specific dates:By Week 4 (or specific date) 2. Go to and search the databases (under Menu tab) to locate scholarly articles related to your SMART goal. Also, search for credible websites to gain insight into how to accomplish your goal. 3. Construct a plan of action to reach My Leadership SMART goal. Be specific by creating a timeline of when you plan on doing each action; explain how, when, and where you plan to communicate with an expert; and identify specific resources you will use to help you achieve your goal. a. Example Plan of Action for above mentioned example: o Seek approval to review the organization’s policies and schedule a meeting/interview with the unit manager by _____ (fill in date). o Review the policies on disciplinary action by _____ (fill in date). o Review the American Nurses Association website and peer-reviewed articles in the American Journal of Nursing and Journal of Advanced Nursing by _____ (fill in date). o Evaluate the findings from the above resources by _____ (fill in date). Pass the quiz. 4. Write a scholarly paper that follows APA formatting guidelines. Organize your content logically and express your thoughts clearly. Use appropriate headers to separate sections of your paper. Check for any grammar or spelling errors before submission. 5. Submit your completed NR 447 My Leadership SMART Goal paper, which should be approximately six pages (excluding title page and references) to the Week 4 My Leadership SMART Goal Paper Dropbox by Sunday, 11:59 p.m. MT at the end of Week 4.Note: This Leadership Smart Goal Assignment is automatically submitted to Turn It In.

Mental illness is a prevalent, bleak reality in today’s society, with anxiety and mood

disorders, comprising the majority of diagnosed cases (Corrigan, 2004). While there is often

stigma attached to the term “mental illness,” for a variety of reasons, less common are cultural

considerations accounted for when diagnosing and treating mental illness. Sellers, Ward and

Pate (2006) examine depression as it affects Black African immigrant women. Although this

was a relatively small exploratory study, with only five participants, each woman reported

depression to be a major health concern, adversely affecting their current daily living

circumstances. This determination was made when four primary factors were considered,

including perception, context, symptomatology and culturally supported coping strategies,

gathered via an extensive interview process (Sellers, Ward and Pate, 2006). These factors all

contributed to the subjects’ perceptions of effective, culturally sensitive treatment, further

providing insight into sound social work interventions for this population.

The Cultural Formulation Interview, included in the DSM – IV, was designed to identify

the impact culture has on both the treatment and potential outcomes of diverse individuals

(American Psychiatric Association, 2013). This 16 question assessment takes into account the

perceptions of the patient, as well as the other contributing factors related to culture, that may

adversely affect the delivery of effective treatment. This interview would be utilized when

working with an individual to gain information regarding their perceptions of their diagnosis, as

well as their perceived treatment options (American Psychiatric Association,

2013). Additionally, this interview would provide insight into the client’s support network, as well

as their coping skills. Cultural factors will weigh on the client’s responses.

Acculturation, the complex process of gradually blending cultures, can potentially have

significant effects on the individual who has undergone the process (Berry, 2005). The lens with

which the person views this process can determine whether these effects are positive or

negative. To expand, should the individual view the meshing of two cultures as a sign of losing

his/ her original culture, there can potentially be psychological ramifications. As a result

sociocultural immersion can be compromised (Berry, 2005). On the contrary, should the

individual see the initial benefits of acculturation, the process can be a positive experience,

having positive psychological effects regarding the transition, further reinforcing the patient’s

journey.

As a clinician working with individuals undergoing this process, it is vital to recognize the

perceptions of the client, first and foremost. Perhaps the client is not choosing to mesh with a

second culture, but feels pressured to do so. Validating the journey, therefore, becomes the

responsibility of the social worker. Encouraging the client to journal their experiences, while

becoming familiarized with the nuances of the secondary culture, would be an appropriate

approach to employ.

In a two- to three-page critical thinking paper:

Select one the following vulnerable populations:

High-risk mothers and infants

Chronically ill and disabled

Persons living with HIV/AIDS

Mentally Ill and Disabled

Alcohol or Substance Abusers

Suicide or Homicide Prone

Abusing Families

Homeless Persons

Immigrants and Refugees

Describe applicable variables related to vulnerability for the population

selected:

Age: – infants/children and oldest old are more vulnerable

Gender- Chronic illness: Menare more likely to die of chronic

diseases/women are more likely to experiences more physical limitations  due to

chronic illness

Race- Minority populations (African American, Hispanic, and Native American)

are much more likely to be in poor health than the majority populations

(Caucasians)

Income and education- More years of formal education and higher incomes are

directly associated with better health

Analyze the effect of multiple variables on the population selected in terms

of morbidity, mortality, and health.

 

The paper must be a minimum of two pages in length (excluding the title and

reference pages) and utilize APA format.  Include a minimum of 3 references, in

addition to the textbook, cited in APA format.