Category: Nursing

Nursing practicum experience journal entries

This week, you complete and submit your first journal entry. Your journal draws from evidence, concepts, and/or theories you have examined in this program, especially those related to your specialization. What have you observed during your Practicum Experience that you would like to analyze through your journal writing?

To prepare:

Reflect on your Practicum Experiences in Weeks 1–3.

Think about the evidence, concepts, and/or theories (evidence) learned throughout this program and your specialization.

Analyze a problem, issue, or situation that you have observed during your Practicum Experience.

Using a minimum of three peer-reviewed sources of evidence, consider what you have observed within the context of your specialty using appropriate concepts, principles, and theories. Give special attention to observed events that vary from the scholarly literature.

Determine how the problem, situation, or issue was handled in a manner that is consistent and a manner that is inconsistent with the theory, concepts, and principles detailed in the evidence.

Given the various evidence-based approaches that can be used in handling the observed problem, situation, or issue, think about a plan for approaching the matter differently.

To complete
 the Practicum and Journal Entry 1:

In your saved version of the NURS 6600 Practicum Journal document, do the following:

Write a 250- to 300-word journal entry (identified as Journal Entry 1) in which you do the following:

Describe a problem, issue, or situation that you have observed during your Practicum Experience (no more than a half page).

Using no fewer than three peer-reviewed sources of evidence, analyze what you have observed within the context of your specialty using appropriate concepts, principles, and theories. Give special attention to observed events that vary from scholarly literature.

Explain how the problem, situation, or issue was handled in a manner that is consistent and a manner that is inconsistent with the theory, concepts, and principles detailed in the evidence.

Given the various evidence-based approaches that can be used in handling the problem, situation, or issue, formulate a plan for approaching the matter differently.

Include references immediately following the content.

Use APA style for your journal entry and references

Nurse made medication error, because was overworked due to long hours, exhaustion, and being burned out.

This is one issue you need to use and other you can think of.

Internal Environmental Analysis

Overview

Write a 3–4 page report that analyzes the internal environment of the organization. Describe the role of major internal stakeholders, describe internal trends, describe internal barriers to a strategic plan, and analyze the financial performance and position of the organization.

Note:
The assessments in this course are presented in sequence and must be completed in order.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

Competency 3: Analyze the effect of internal and external environments on the strategic planning process within health care organizations.

Describe the role of major internal stakeholders in a strategic plan.

Describe internal trends, key uncertainties, and additional research needed.

Describe the internal barriers to a strategic plan.

Analyze the financial performance and position of the organization.

Competency 4: Recommend evidence-based strategies to improve the operational and financial components of a health care organization.

Identify the quantitative or qualitative methods needed to analyze the project.

Competency 5: Communicate in a manner that is professional and consistent with expectations for business professionals.

Write content clearly and logically with correct use of grammar, punctuation, and mechanics.

Context

According to Zuckerman (2012), “The environmental assessment…has valid and important purposes that should be enumerated and highlighted at the start of the assessment…The environmental assessment largely sets the tone for the strategic plan and is an indicator for how the rest of the planning process is likely to unfold” (p. 35).

In addition to strategic thinking and planning, organizational leaders need to understand the expectations of key internal stakeholders, as well as major internal trends and uncertainties.

Reference

Zuckerman, A. (2012).
Healthcare strategic planning
 (3rd ed.). Chicago, IL: Health Administration Press.

Questions to Consider

To deepen your understanding, you are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community.

What role does a board of directors play in a strategic plan?

How does the organizational structure impact the success or failure of a strategic plan?

Resources

Required Resources

The following template is required to complete Assessment 3:

Worksheet 3.

Internal Environment Analysis

The following resources can offer insight into analyzing the internal organizational environment:

Duncan, W., Ginter, P., & Swayne, L. (1998). Competitive advantage and internal organizational assessment.
Academy of Management Executive, 12
(3), 6–16.

Zuckerman, A. M. (2012).
Healthcare strategic planning
(3rd ed.). Chicago, IL: Health Administration Press. (Available for purchase in the Capella University Bookstore.)

Chapter 3, “Activity 1: Analyzing the Environment,” pages 33–56.

SWOTT Analysis

These resources provide information on conducting and using SWOTT analyses:

Jensen, T. (2014).
SWOTT away distractions with successful analysis
. The Startup Garage. Retrieved from https://thestartupgarage.com/swott-distractions-successful-analysis/

Tyler, C. (2012).
Effective SWOTT analysis implementation
. Business 2 Community. Retrieved from http://www.business2community.com/strategy/effective-swott-analysis-implementation-0349700#FwOBzzTHJHvwTCtu.97

Vogan, P. (2006).
SWOTT your way to success
. Entrepreneur. Retrieved from https://www.entrepreneur.com/article/83052

SWOT Analysis and Organization Summary
|

Complete the interaction and generate a PDF of your inputs. This can be used to help you complete Assessment 3.

For Further Exploration

This resource is provided to expand your knowledge:

Advisory Board. (2015).
Daily briefing primer: What’s the difference between for-profit and not-for-profit hospitals?
Retrieved from https://www.advisory.com/daily-briefing/resources/primers/whats-the-difference-between-for-profit-and-not-for-profit-hospitals

Exemplar resources for the course

It may be helpful for you to review these exemplars prior to beginning your work on the assessment.

Johns Hopkins. (2013). John Hopkins Medicine strategic plan. Retrieved from http://www.hopkinsmedicine.org/strategic_plan/_docs/JHM%20Strategic%20Plan_Sept2013.pdf

Niles, N. J. (2010). A case study in strategic financial planning in health service organizations.
Journal of Business Case Studies, 6
(5), 23–29.

Howard, B. (2015). Michael’s Hospital Strategic Plan 2015–2018 | Transcript. Retrieved from https://www.youtube.com/watch?v=UQ3pOf5JLIM

Strategic Management Case Study

If you do not currently work for a health care organization, or if you prefer not to use the organization where you work for the course assessments, you may choose to use this case study to complete the assessments:

Community Hospital Healthcare System: A Strategic Management Case Study.

Assessment Instructions

Preparation

Continue to use the same organization you used in the first two assessments.

Complete Worksheet 3 located in the Required Resources section of this assessment. You can also use the output generated from the SWOT Analysis and Organization Summary multimedia piece linked in the Suggested Resources section. You will not submit the worksheet or the SWOT output, but will use the information to develop a report on the internal environment relevant to the organization you selected.

As you prepare your analysis, focus on:

The economic and business conditions, premises, policies, and other related forces that impact your plan.

The specific issues of health care management and policy.

Differentiated markets and determinants of supply and demand in each market.

Assessment Requirements

Use the information in Worksheet 3, and the SWOT output if you wish, to prepare a 3–4 page report that addresses the following:

Describe the role of the major internal stakeholders in your strategic plan. Be sure you identify the major internal stakeholders.

Describe the basic internal trends, key uncertainties, and additional research needs.

Identify the quantitative or qualitative methods needed to analyze the project.

Describe the internal barriers, such as structural political policy and other barriers, to be addressed. How will you overcome these barriers?

Analyze the financial performance and position of the company. How will the plan enhance performance and financial sustainability?

Format your assessment as a report and be sure it is organized logically, using headings and sub-headings appropriately. Follow APA guidelines for in-text citations and references.

Additional Requirements

Report length: 3–4 double-spaced pages, not including title page and reference page.

References: A minimum of three professional resources.

Format: Use APA format for all in-text citations and references. Include a title page and reference page.

Font and font size: Times New Roman, 12 point.

What is the importance of cultural competency in nursing practice? Support your response.

The Patient Protection and Affordable Care Act (PPACA) sought to bring to the forefront health promotion and prevention, and ultimately enhance the ability of health care professionals to offer services to all that needed them. Much of the PPACA focuses on incorporating interdisciplinary care in order to deliver more holistic, and efficient, patient care. An example of an innovative health care delivery model the PPACA initiated is that of patient-centered medical homes (PCMHs) and accountable care organizations (ACOs).

A PCMH, “…is a care delivery model whereby patient treatment is coordinated through their primary care physician to ensure they receive the necessary care when and where they need it, in a manner they can understand” (What is the Patient, n.d.). The purpose of PCHMs are to create a centralized setting in which individual patients may easily have communication with their personal physician in a culturally appropriate setting. This is achieved through the use of facilities such as: registries, information technology, health information exchange, etc. This enables patients to access their health care needs at more convenience.

ACOs are defined by the Centers for Medicare and Medicaid Services website as, “…groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high-quality care to their Medicare patients” (Accountable, 2017). With a large population of patients being defined as “chronically ill”, employing coordinated care efforts among health care professionals ensures that these patients get the most appropriate care at the most appropriate times. This eliminates duplicate services, and helps to prevent possible medical errors (Accountable, 2017). Thus, increasing the incidence of accessed care and optimizing the care these patients receive.

Traditionally, nutrition programs were targeted to the indigent and poor populations in developing countries. Many of today’s Americans are malnourished also, but they are inundated with unhealthy foods and require a multidisciplinary approach to nutrition education. What would be the three most important points to include in a public nutrition program? Provide current literature to support your answer and include two nutritional education community resources.

Today, Health care delivery system has been increasingly expensive because of the shortage of health care professionals and costs of health care. Not only that, the costs of medical treatment been doubled with in ten years for each individual. The Affordable Care Act intends to resolve the health care problems in the United States and developing the resources to improve the health care delivery system (Abrams et al., 2015). In this situation, The Patient Protection and Affordable Care Act focus on health promotion and disease prevention for the people. The PPACA build the new models to deliver the care that would be essential to the patients and families in low costs. The PPACA plan is to lower the health costs with in ten years. “The major ways that these cost savings will be accomplished are promoting health and preventing disease, decreasing reliance on fee for service, providing cost-effective care, and using the electronic health record (EHR) across settings. Two of the delivery systems highlighted in PPACA are the “Patient Centered Medical Home” (PCMH) and the “Accountable Care Organization” (ACO)” (Hass, 2011). The PPACA established to deliver the care in health system by involving interdisciplinary care team because they can work together to provide most cost effective care and coordinate each other to achieve better outcomes. For example, Electronic health record information is available to entire health care team to share the information and evaluate the care if action needs to be taken. The interdisciplinary care team can monitor the patients if their chronic health problems need to be managed by educating or counseling them. The entire team members can document their notes and it will be easier to access their documentation to the rest of the team who is involved in patient’s care. Not only that, the results would be also available in timely manner to evaluate as well as it reduces the error on documentation. The EHR is reliable tools to use today and it is a great way to deliver the care to the patients to achieve better outcomes.

Discuss 
current research that links patient safety outcomes
 to ADN and BSN nurses. Based on some real-life experiences, do 
you agree or disagree 
with this research?

Current statistics show that at present, there are 1,048 Associate Degree Nursing (ADN) colleges and 696 Baccalaureate Degree Nursing (BSN) institutions in the United States (Cherry & Jacob, 2017). Recent studies show that a correlation exists between patient safety outcomes and whether a nurse has an ADN or BSN. Linda Aiken, PhD, RN, who is associated with the Robert Wood Johnson Foundation (RWFJ), believes that hospitals who employ more BSN-prepared nurses have better patient outcomes and lower mortality rates (RWJF, 2014).

In 2003, Aikens reported on studies done in Pennsylvania hospitals showing a 5% decrease in patient deaths at hospitals that staffed a 10% increase in BSN-prepared nurses (RWJF, 2014). Challengers of Aikens note that these studies raise further questions (Sentinel Watch, 2014). For example, what were the actual causes of death of these patients, and were they related to the action of an ADN nurse? Could there be other factors or causal relationships that affected patient care in these circumstances?

In defense of Aikens, the Sentinel (2014) states that no one is calling ADN nurses “bad nurses”. In fact, errors, infections, and adverse events are often due to process and system problems. Aikens maintains that by promoting evidence-based practice and leadership, the BSN curriculum will better prepare nurses to correct problems and implement solutions.

I agree that it is advantageous for nurses to expand their knowledge by obtaining a BSN degree, but I do not feel that deaths and adverse outcomes are the result if ADNs care, or lack of. Many other factors need to be considered. For example, poor staffing, long shifts, poor communication, fatigue, documentation errors, etc. affect everyone no matter what type of degree they hold. I have been at the hospital where I am currently employed for almost 20 years and have seen no evidence that the care given by ADNs is substandard to the care given by BSN-prepared nurses.

References

Cherry, B. & Jacob, S. (2017).Contemporary nursing, issues, trends, & management. St. Louis: Elsevier

Robert Wood Johnson Foundation. (2014).  Building the case for more highly educated nurses. Retrieved from http://www.rwjf.org/en/library/articles

The Sentinel Watch. (2014). How does your nursing degree affect patient mortality rates? Retrieved from http://www.american sentinel.edu

What is the 
difference between a DNP and a PhD in nursing
?

Which of 
these would you choose to pursue if you decide
 to continue your education to the doctoral level?

Nursing Informatics competencies

Nursing informatics is a discipline that is still evolving. Yet, there is a set of core skills and knowledge that applies to all individuals who work as nurse informaticists and many competencies that are specific to informatics roles, positions, tasks, and responsibilities. For example, a nurse informaticist who works as a consultant for a health care technology company and a nurse informaticist who works as a professor at a university will share much of the same expertise and knowledge. However, they will also have distinct competencies specific to their unique roles.

In this Discussion, you explore informatics competencies within the informatics functional area you selected for the Week 1 Assignment.

 

To prepare:

Review nursing informatics competencies such as those outlined by the American Nurses Association (ANA), the Technology Informatics Guiding Education Reform (TIGER), and the Quality and Safety Education for Nurses (QSEN).

Review this weeks media presentation 
Competencies for Nurse Informaticists
, and reflect on the competencies outlined by the presenters.

Recall the informatics functional area you identified in the Week 1 Assignment. With this in mind, what competencies would be most important for you to master? How might you go about developing these competencies?

Create a list of competencies you would like to master.

By Day 3

1. 
Post a brief description of the informatics functional area in which you are interested. 
(Leadership in Nursing Informatics)

 

2. Then, identify at least four ANA, TIGER and/or QSEN competencies that you believe to be vital for success in this functional area, and justify your choices.

 

3. Explain how you might successfully develop and master each of these competencies.

APA style with reference, 600 characters minimum

Required Readings

American Nurses Association. (2015).
 Nursing informatics: Scope and standards of practice 
(2nd ed.). Silver Spring, MD: Author.

Read the following chapter: Informatics Competencies: Spanning Careers and Roles In this section, the authors explain the competencies necessary for nurse informaticists to be successful. The section also highlights which competencies are applicable for various informatics roles and functional areas.

Saba, V. K., & McCormick, K. A. (2015). 
Essentials of nursing informatics
 (6th ed.). New York, NY: McGraw-Hill. Chapter 2, Computer Hardware

This chapter discusses introduces the basics of computer hardware used for nursing informatics.

Chapter 4, Computer Software This chapter introduces computer software, as well as the programs that are most relevant to nursing informatics.

Chapter 11, System Life Cycle: A Framework  In this chapter, the authors introduce the systems life cycle (SDLC) and its stages. These stages are often used by organizations for large-scale projects, such as implementing or upgrading health information technology.

Chapter 13, System Life Cycle Tools  Chapter 13 focuses on the tools needed to assist with each phase of the System Life Cycle. Successful implementation projects require clinical expertise as well as technical knowledge from nurse informaticists.

Chapter 9, Computer Interaction This chapter explains the need for nurses to be informed about human-machine interactions to prevent unintended consequences. Increased awareness of these factors can result in improved performance and outcomes in nursing informatics and other technologies. Chapter 30,

The Role of Technology in the Medication-Use Process  In this chapter, the authors discuss how new technologies that can create a safer environment for the patient. This is especially relevant for nurses involved in administering medication and educating patients on its use.

Gooder, V. J. (2011). Nursesperceptions of a (BCMA) bar-coded medication administration system. 
Online Journal of Nursing Informatics
, 
15
(2). Retrieved from the Walden Library databases.

This article explores the outcomes of a bar-coded medication administration (BCMA) system, which included increased patient safety and accuracy of medication. The importance of assessing the impact of a BCMA system on nurses before implementation is also highlighted.

Preheim, G. J., Armstrong, G. E., & Barton, A. J. (2009). The new fundamentals in nursing: Introducing beginning quality and safety education for nurses competencies. 
The Journal of Nursing Education
, 
48
(12), 694 – 697. Retrieved from the Walden Library databases.   This article discusses the Quality and Safety Education for Nurses (QSEN) initiative and its six competencies, including informatics, that are essential for nursing practice. The authors emphasize that nursing education should shift from task-training and development to more current skills and competencies for informatics and patient-centered care.

Quality and Safety Education for Nurses. (2012). Informatics. Retrieved from http://qsen.org/competencies/graduate-ksas/#informatics 
Access this website to explore the knowledge, skills, and attitudes expected of informatics graduates.

Healthcare Information and Management Systems Society. (2015). Informatics competencies for every practicing nurse: Recommendations from the TIGER Collaborative. Retrieved from http://www.himss.org/file/1308906/download?token=zGqfWaqp
‚

This comprehensive report provides you with an overview of the TIGER collaborative as well as informatics competencies. 

Required Media

Laureate Education (Producer). (2012a). 
Competencies for nurse informaticists
 [Video file]. Baltimore, MD: Author.   In this week media presentation, Gail Latimer, Dr. Patricia Button, and Dr. Roy Simpson overview the progress that the ANA and the TIGER initiative have made in outlining key informatics competencies. In addition, each presenter identifies competencies that he or she believes to be vital to working in the informatics field.

 

Laureate Education (Producer). (2012h). 
Selecting new technologies
 [Video file]. Baltimore, MD: Author. Dr. Patricia Button and Dr. Roy Simpson discuss the critical process of selecting the right technology for a health care organization. The presenters discuss the factors to consider, as well as the key skills informaticists should have to successfully lead these processes.

Optional Resources

Kaminski, J. (n.d.). Nursing informatics competencies: Self-assessment. Retrieved August 9, 2012, from http://nursing-informatics.com/niassess/index.html 

Technology Informatics Guiding Educational Reform. (2009). TIGER Informatics Competencies Collaborative (TICC) final report. Retrieved from http://tigercompetencies.pbworks.com/f/TICC_Final.pdf