Discussion Week 4- Nurse/Patient Empowerment

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A female health professional explains health options to an elderly woman patient.Currently Reading

Week 4: Nurse/Patient Empowerment in Practice

Introduction

As a registered nurse, you have the power to influence change in patient outcomes. An important aspect of influencing change is identifying areas that need improvement. This is done primarily through measurement of data. There are several different measures to gather data within organizations as well as on a national scale. Some of these measurements include core measures, standards, best practices, evidence-based practices, and the National Database of Nursing Quality Indicators (NDNQI). These support mechanisms have also been discussed as a means for helping nurses to deliver quality care and improve patient safety. Each measurement essentially focuses on providing care that is safe, effective, patient-centered, timely, efficient, and equitable. 

Although there are several different measurements, NDNQI data is used in the process of attaining Magnet Recognition. Magnet Recognition is the highest honor a health care organization can receive for nursing excellence and high-quality patient care. The nurse-specific measures presented in the NDNQI help inform nursing staffs and their organizations of areas where nursing practices can be improved and where nursing practice efforts are producing positive clinical outcomes. Nurses must be directly involved in developing and implementing action plans based on the data presented by the NDNQI.

This week, you will explore the importance of nurse empowerment in effecting change and how action plans are created based on the results of the NDNQI as presented on a dashboard. You will also consider how nurses advocate for patients’ rights, even when that means supporting a patient whose personal choices may have negative health outcomes. 

Learning Objectives

Students will:
  • Evaluate strategies to empower both the nurse and the patient to improve quality of care
  • Analyze the use of National Database of Nursing Quality Indictors for nurse empowerment in practice
  • Analyze nurse empowerment in relation to use of quality improvement data for practice 
  • Analyze practice experiences for patient or nurse empowerment
  • Analyze quality improvement dashboards for nursing plans 

Note: The Assignment related to these Learning Objectives is introduced this week and submitted in Week 5.

Photo Credit: [Eva Katalin Kondoros]/[iStock / Getty Images Plus]/Getty Images

 

Learning Resources 

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Brown, D. S., Aydin, C. E., & Donaldson, N. (2008). Quartile dashboards: Translating large data sets into performance improvement priorities. Journal of Healthcare Quality, 30(6), 18–30. doi: 10.1111/j.1945-1474.2008.tb01166.x

Note: You will access this article from the Walden Library databases.

 

Typically, references should be within five to seven years of publication. However, this publication is considered a classical research reference pertaining to quality improvement and the use of data sets.

Cole, C., Wellard, S., & Mummery, J. (2014). Problematising autonomy and advocacy in nursing. Nursing Ethics, 21(5), 576–582. doi: 10.1177/0969733013511362

Note: You will access this article from the Walden Library databases.

Garrard, L., Boyle, D. K., Simon, M., Dunton, N., & Gajewski, B. (2016). Reliability and validity of the NDNQI® injury falls measure. Western Journal of Nursing Research, 38(1), 111–128. doi: 10.1177/019394591454281

Note: You will access this article from the Walden Library databases.

Giancarlo, C., Comparcini, D., & Simonetti, V. (2014). Workplace empowerment and nurses’ job satisfaction: A systematic literature review. Journal of Nursing Management, 22(7), 855–871. doi: 10.1111/jonm.12028

Note: You will access this article from the Walden Library databases.

Guglielmi, C. L., Stratton, M., Healy, G. B., Shapiro, D., Duffy, W. J., Dean, B. L., & Groah, L. K. (2014). The growing role of patient engagement: Relationship-based care in a changing health care system. AORN, 99(4), 517–528. doi: 10.1016/j.aorn.2014.02.007

Note: You will access this article from the Walden Library databases.

Rock, M. J., & Hoebeke, R. (2014). Informed consent: Whose duty to inform? MEDSURG Nursing, 23(3), 189–194. Retrieved from http://web.b.ebscohost.com.ezp.waldenulibrary.org/ehost/pdfviewer/pdfviewer?vid=9&sid=273f009b-d8f5-4cd8-8f01-0973c944bcf7%40sessionmgr104&hid=107

Note: You will access this article from the Walden Library databases.

American Hospital Association. (2003). The patient care partnership: Understanding expectations, rights and responsibilities. Retrieved from http://www.aha.org/content/00-10/pcp_english_030730.pdf

 

Read through this document created by the American Hospital Association. This document was created for inpatient hospital stays. However, it is applicable to other practice settings as well.

Montalvo, I. (2007). The national database of nursing quality indicators. The Online Journal of Issues in Nursing, 12(3). Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume122007/No3Sept07/NursingQualityIndicators.html

Institute for Healthcare Improvement. (2016). Retrieved from http://www.ihi.org/Pages/default.aspx

 

The IHI offers numerous resources for improving nursing practice and patient care. Explore a variety of topics and examine some of the resources available.

National Quality Forum. (2016b). Retrieved from http://www.qualityforum.org/Home.aspx

 

The National Quality Forum (NQF) strives to improve patient safety and reduce medical errors. Explore the NQF’s endorsed standards and consider how they apply to nursing practice.

Document: Dashboard Directions (Word document)

Document: Sample Dashboard (Excel spreadsheet)

Required Media

Laureate Education. (Producer). (2009a). Topics in clinical nursing: Accountability and nursing practice [Video file]. Baltimore, MD: Author.

 

Note: The approximate length of this media piece is 15 minutes.

 

 

Discussion: Nurse/Patient Empowerment 

As a nurse, you are the individual who has the ability to empower patients in the decision-making process pertaining to their health care. In addition, you are in a unique position to empower your nursing colleagues to improve job satisfaction and use performance indicator data from dashboards to effect social change. 

In this week’s Learning Resources, you examined both the National Database of Nursing Quality Indicators (NDNQI) and the key role nurses play as advocates for patient rights. To assist nurses in being better prepared for this role, programs such as Patient Care Partnership provide guidance. 

For this Discussion, you will analyze the use of quality improvement data and discuss how this data can help empower both patients and nurses. Review the Patient Care Partnership information presented in this week’s Learning Resources. In addition, reflect on the media presentation and the information shared by Ms. Manna on patients’ rights. 

By Day 3

Respond to the following: 

  • What are the best strategies the nurse can employ to empower patients and support patients’ rights to improve quality of care? (Some considerations to keep in mind may include: providing information on effectiveness, risks, and benefits of alternative treatments.)
  • In what ways can NDNQI data from dashboards or quality improvement data be used to support nurse empowerment in practice? 
  • How has your institution empowered the nursing staff through the use of quality improvement data?
  • Provide an example of how you have personally empowered either a patient or a fellow nurse.

Support your response with references from the professional nursing literature.

Note Initial Post: A 3-paragraph (at least 250–350 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Avoid quotes; paraphrase to incorporate evidence into your own writing. A reference list is required. Use the most current evidence (usually ≤ 5 years old).

Post#3

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Hello i need a good and positive comment related with this argument .A paragraph  with no more  90 words.

 

 Deactivated

 

Judith Inyinbor 

 

1 posts

 

Re:Topic 2 DQ 2

 

In today’s interconnected world, a disease threat anywhere is a disease threat everywhere. With the ease and speed of global travel and a rapidly expanding business network, it is very easy for diseases to spread within cities, nations and globally. It is with this need the United States department of Health and Human Services Office of Global Affairs is supporting implementation of global health security agenda to accelerate progress toward a world safe and secure from infectious disease threat.

 

A global issue that should deserves serious attention is HIV/AIDS. HIV stands for human immunodeficiency virus. It weakens a person’s immune system by destroying important cells that fight disease and infection. While AIDS stands for acquired immunodeficiency syndrome. This HIV/AIDS pandemic is the world’s leading infectious killer. Worldwide, there are 37 million people living with HIV. 1.2 of 10.4 million people with active TB each year also have HIV (CDC,2017).

 

Most states have now implemented HIV surveillance reports and thus, the prevalence estimates of HIV cases are more reliable, Nonetheless, these HIV surveillance reports may not reflect the true number of HIV-positive persons because many people do not want to know their HIV status and are not tested, while others use widely available home testing kits and do not share their HIV status with at-risk intimate partners. An estimated 21% of HIV-infected persons are unaware of their HIV status (CDC, 2010m).

 

The United States and other governmental agencies are coming together to work collaboratively to address the HIV/AIDS pandemic.  Some agencies such as the Department of the State to provide essential leadership to interagency by providing human resource services, budget tracking, funds transfers to other agencies, and by providing office space and other important technologies.  The Department of Health and Human Services (HHS) work to provide prevention, treatment and care programs to developing countries in conjunction with the Presidents Emergency Plan for AIDS Relief (PEPFAR).  The HHS and PEPFAR work in conjunction with the Center for Disease Control (CDC), Food and Drug Administration (FDA), National Institute of Health (NIH), Office of Global Affairs (OGA), Substance Abuse and Mental Health Services Administration (SAMHSA), Department of Commerce (DOC), Department of Defense (DOD), Department of Labor (DOL), United States Agency for International Development (USAID), and the Peace Corps all in the common tide to turn against HIV/AIDS. CDC in its fight against HIV/AIDS, provides antiretroviral treatment for men, women and children, antiretroviral treatment to prevent mother-to-child transmission, voluntary medical male circumcisions, Screenings of HIV-positive persons in care for TB and HIV counselling and testing.

 

It is evident that the United States in conjunction with other countries are taking necessary measures to fight against the HIV/AIDS pandemic.

 

Post#1

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Hello i need a good and positive comment related with this argument .A paragraph  with no more 100 words.

 

Re:Topic 5 DQ 1

 

Assessment of the geriatric patient focuses on the promotion of quality of life, maintaining self-care, and preventing disease and its complications.    Often there are chronic diseases that need to be addressed.    Some of the major issues are weight and diet, activity, fall prevention and home safety.    Pneumococcal and seasonal influenza immunizations are important for this population  (Edelman, Mandle, & Kudzma, 2014, p. 616) .    The comprehensive assessment of the geriatric patient incorporates physical and mental assessments, functional status, social and economic status, pain, and safety of environment.    The goal is to identify the strengths and weaknesses to provide adequate interventions for promotion of independence and prevent  decline (Jarvis, 2016, p. 831) .      Functional status must be determined, it is one’s ability to live in society and function as they did in their younger years.    The nurse can observe functional ability or ask questions of the patient or the caregivers.    There are tools for assessing activities of daily living that can aid in this assessment.    In the Lawton Instrumental Activities of Daily Living, contains assessment of eight items; use of telephone, shopping, meal preparation, housekeeping, laundry, transportation, self-medication, and management of finances.    Final scoring does not matter as much as identifying strengths and needs  (Jarvis, 2016, p. 833) .

 

The quality of life for an older person is closely linked to the social function.    Social assessment focus is on family relationships, social groups, and community support.    Is the person in pain?    Assess pain right from the start, address the pain with medication and then move on to the assessment.    Pain impairs the assessment.    The geriatric patient will need more time for their assessment.    Consider the feelings of the patient, they may be frightened if they cannot answer questions or perform physical function testing, they may be fearful of the consequences of the results of  assessment (Jarvis, 2016, p. 843) .    The assessment is multidimensional with many aspects to consider.    Knowing the normal aging process and results of chronic disease will aid the nurse in this assessment.

 

Need this paper to be a first time paper!!!!!!!

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Assignment 3: Healthcare Quality
Due Week 6 and worth 200 points

Assume that you are a Quality Officer who is responsible for one of the state’s largest healthcare organizations. You have been told that the quality of patient care has decreased, and you have been assigned a project that is geared toward increasing quality of care for the patients. Your Chief Executive Officer has requested a six to eight-page summary of your recommended initiatives.

Note: You may create and /or make all necessary assumptions needed for the completion of this assignment.

Write a 6-8 page paper in which you:

  1. Analyze three (3) quality initiatives for your organization.
  2. Determine the supporting factors that would aid in the reduction of healthcare cost in your organization without reducing quality of care for the patients.
  3. Differentiate between quality in a free market healthcare system and in single payer government system with three (3) examples for each.
  4. Specify three (3) common law quality initiatives that are still found in 21st century healthcare organizations.
  5. Defend your position on the importance of healthcare quality for your organization. Provide support with at least three (3) examples that illustrate your position.
  6. Assemble a plan to protect patient information that complies with all legal requirements.
  7. Use at least three (3) quality references. Note: Wikipedia and other Websites do not qualify as academic resources.

Your assignment must follow these formatting requirements:

  • Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.
  • Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.

The specific course learning outcomes associated with this assignment are:

  • Describe the evolution of hospitals and sources of law.
  • Examine tort law and the criminal aspects of health care.
  • Analyze the impact of healthcare financing and health insurance on healthcare access, quality, and cost.
  • Determine the factors that affect healthcare quality in healthcare organizations.
  • Examine information management and health care records and how the legal reporting requirements impact health care. 
  • Assess the legal implications of ethical decisions that impact consent for treatment, right-to-die, and patient rights and responsibilities.
  • Use technology and information resources to research issues in healthcare policy, law, and ethics.
  • Write clearly and concisely about healthcare policy and law using proper writing mechanics.

 

position paper

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Position Paper Written Assignment

A position paper is a document you could present to a legislator to seek support for an issue you endorse. Present your position on a current health-care issue in a one-page paper, following the assignment guidelines below. You can select your issue topic from newspapers, national news magazine articles, professional journals, or professional association literature; and this can be the topic you choose for your ethical issues debate. 

Your position paper should:

  • Be quickly and easily understood.
  • Be succinct and clear.
  • Appear very professional with the legislator’s name and title on top and your name and your credentials at the bottom.
  • Condense essential information in one, single-spaced page, excluding the title and reference list pages.
  • Be written using correct grammar, spelling, punctuation, syntax, and APA format.
  • Clearly describe the issue that you are addressing in the opening paragraph.
  • Include 3–4 bullet points regarding why you are seeking the legislator’s vote, support, or opposition. Bullet points should be clear and concise but not repetitive and should reflect current literature that substantiates your position.
  • Summarize the implications for the nursing profession and/or patients.
  • Conclude with two recommendations that you wish to see happen related to your issue, such as a vote for or against, a change in policy, or the introduction of new legislation.
  • Use APA format (6th ed.), correct grammar, and references as appropriate.

Using SBAR to communication to a Dr.(Nursing discussion)

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General Survey/Skin/Nutrition (graded)

Your home health agency has received an order from a local hospital to evaluate and treat an elderly woman being discharged from its medical surgical unit.

Millie Gardner, an 83-year-old female patient, is being discharged home today to the care of her husband Fred (87 years old) following a 9-day hospitalization for pneumonia, dehydration, and failure to thrive. She has a history of hypertension (HTN), Type II Diabetes, and cerebral vascular accident (CVA) with left-sided weakness. Patient is alert and oriented but does have periods of forgetfulness during the overnight hours. Patient has intermittent incontinence of bowel and bladder and requires assistance with all activities of daily living (ADLs).

Medications:

  • Lopressor
  • Lisinopril
  • Plavix
  • Metformin
  • Novolin R per sliding scale *NEW*
  • Multivitamin
  • Colace
  • Zithromax *NEW*

Upon arrival you are greeted by Champ, the couple’s rambunctious miniature Doberman pinscher dog. Millie is in her wheelchair staring blankly out the window, and Fred is busy in the kitchen preparing the couple’s lunch.

  • Based on the scenario above, please use the general survey process to describe the areas that you would be observing immediately upon entry to the home.
  • What, if any, concerns related to Millie’s skin and nutritional status do you have?
  • What nursing interventions will you include in the plan of care to address these concerns?
  • What teaching strategies will you use to educate Millie and Fred on the new medications?
  • Using the SBAR(situation, background, assessment, and recommendation) , please include the information that you will communicate to the physician’s office at the completion of the visit.
 

p1

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  • Hello i need a Good and Positive Comment related with this argument .A paragraph  with no more  100 words.

  • Raksha Tiwari 

    3 posts

    Re:Topic 1 DQ 1

    Scientism is based on truth and evidence and accepted universally but religion is beliefs based on cultural backgrounds of any individual. People can be Christian, Muslim, Hindus or atheistic. Any issue can be right for one religion but same issue might consider wrong for other religion. For example marrying within families (cousin) is not acceptable in Hindus society while Muslim society marrying with cousins is acceptable.  There is still more issues that science is not still able to answer. The dilemmas between science and religion in health care setting is costly as it is related to life and death matter. Both aspects goes side by side.

     I believe having religious belief feed patient with healing power along with scientifically approved treatment. Respecting and acknowledging patient’s culture /religion help in maintaining their dignity.

    However people have their own point of view toward science and religion. Religion and science are often seen as opposite poles in our understanding of the world. And yet while religion and science are in some sense polar opposites, there is also much in common between them. Both are carefully crafted systems of thought, concerned with establishing the real truth behind the world we see in experience. (Lehar, S. (n.d.), A system of ethics based on reason without recourse to supernatural belief )

    Reference:

    Lehar, S. (n.d.). A system of ethics based on reason without recourse to supernatural belief. Retrieved May 22, 2017, from http://cns-alumni.bu.edu/~slehar/

     

p6

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Hello i need a Good and Positive Comment related with this argument .A paragraph  with no more  100 words.

 

Lauren Martell 

 

2 posts

 

Re:Topic 2 DQ 2

 

From my understanding of the reading a child who is begotten is made from the love of a mother and father.  A child who is made is then made through artificial means.  I do not agree with this. I believe if this were true then parents in loving committed relationships who want children should be able to have them, because that is love.  This also leads to another point, if children are to be begotten by the love of a mother and father then why do people who have experienced rape get pregnant, this is not an example of love from a mother and father. 

 

My sister and her husband were not able to conceive by natural means and had to resort to in vitro, they had longed to be parents and it was the only way possible.  They are in a loving committed relationship, married, and devout Christians. They are also great parents to the 2 children they have been able to have since in vitro.

 

In the reading one quote stuck out for me, “From eternity the father begets the son that is, gives all that he is and has to the son.”(Meilaender, 2013)  I believe this is powerful because if you have a child from whatever means and are able to raise and nurture that child then you should be able to do so.  However with that being said I do not believe that it is ok to have genetic testing done in order to have a specific child. I personally believe that is taking it too far.   I believe we are given the children we are supposed to teach and those we are supposed to learn from. Whether that be from natural means, adoption, or in vitro. 

 

 

 

 

POST#1

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Hello i need a good and positive comment related with this argument .A paragraph  with no more 100 words.

 

Tammy Wagner  

 

Re:Topic 4 DQ 1

 

Health is defined as the balance of the person, both within one’s being and in the outside world.    Among Chinese, no translation exists for “sadness”, yet it is a universal emotion.    Asian-Americans somaticize their symptoms into bodily symptoms.    Some Asians believe in the yin/yang theory where health exists when all aspects of the person are in perfect balance  (Jarvis, 2016, Chapter 2) .    To know Asian-American culture can help to appropriately assess your patient.  

 

Asian-Americans are an incredibly diverse population.    Asian-American women have some of the highest life expectancy of any group in the United States.    Cultural beliefs often collide with Western medicine.    Asian-Americans still face the same limitations to good health as other ethnic  groups (“Minority women’s health,” 2012) .    Asian-Americans tend to consult their family members on health care matters which can delay treatment.    Questions about traditional methods being used should be asked.    Avoid stereotyping, do not make assumptions when in doubt, ask questions  (Harrah, 2013) .

 

Violence can happen to all women of all races.    Asian-Americans are reluctant to seek help with abuse from the police.    In this culture seeking help is seen as shameful to the victim and victim’s family.    Many Asian men deal with the pressures of life by physically abusing their wives.    In a survey conducted by the Asian & Islander Institute on Domestic Violence, 41% to 60% of Asian-American and Pacific Islander respondents reported physical or sexual abuse during their lifetime.    Nurses can play an important role in addressing this.    Many women report that they were never asked about abuse in their assessment screening.    Establishing trust and projecting a non-judgmental attitude is essential.    Nurses have a duty to treat each person with respect and compassion, listening without judgment.    Assessing this 20-year old’s habits on substances also would be an avenue for education, living on college campuses with the high use of alcohol increases the chances of abuse  (“Minority women,” 2013) . Nurses should be familiar with the abuse hot lines that can protect the women and her children.    Providing these numbers can empower the women when she is ready.

 

 

 

 

 

comment nelly janua 23 12:07 Pm

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I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT. BETWEEN 250-300  WORDS

 

Each culture has their own beliefs and values. Health care professionals need to be sensitive to these beliefs and values when obtaining information from these different groups. Asian Americans view health as a balance between the physical, social, and mental aspects of the person as a whole. They view illness as a disharmony of these things leading to bad luck and diseases.

 

Asians are known to believe in the Ying and Yang. They have been using eastern medicines for many years. These medicines are either in pill form, tinctures, raw herbs or balms. These medications are used to restore harmony. They also use treatments such as coining and cupping to cure some illnesses and diseases. They are open to some western medicine. Health care providers must establish role and assume authority. It is important to remember that Asians are family oriented. Asians decisions are made as a family. When communicating to Asian families one needs to be sensitive to gestures and other nonverbal cues. Asians are known to smile and nod their heads symbolizing respect and not necessarily understanding. Therefore, one needs to assess understanding frequently (Carteret, 2011). 

 

When performing abuse assessment, one needs to be aware of the nonverbal cues and physical cues, keeping in mind their use of coining and cupping. When one suspect patient abuse, it is important to ask the individual specific question when alone. Any suspected abuse should be reported to supervisor as well as authorities (Carteret, 2011). It is known that Asians are reluctant to seek help or report abuse. They fear to ashame their family’s. It’s believed that many don’t seek help due to language barrier as well as the lack of knowledge of resources available (Cho & Henion, 2012). Nurses need to establish trust with their patients and make them aware of the services available.

 

Every culture has their own beliefs and values. One needs to keep these things in mind when dealing with different cultural groups. Being sensitive to these things will create better understanding, better implementation, and better outcomes. If abuse is suspected one needs to report it immediately, nurses have the duty to save lives.

 

References

 

Carteret, M. 2011, Cultural Values of Asian Patients and Families. Retrieved from http://www.dimensionsofculture.com/2010/10/traditional-asian-health-beliefs-healing-practices/

Cho, H., Henion, A. 2012. Asian Reluctant To Seek Help For Domestic Violence. Retreived from http://www.msutoday.msu.edu/news/2012/asians-reluctant-to-seek-help-for-domestic-violence/