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Nurs 6565 Week 1 Assignment Paper. Nurs 6565 Week 1 Assignment Paper. Students in this synthesis course will focus on clinical competence in primary care settings by building on knowledge and skills gained in previous courses. Nurs 6565 Week 1 Assignment Paper. Through clinical practice, students will build confidence as they begin the transition from the role of registered nurse to that of advanced practice nurse. Classroom activities and case studies will enable students to explore the salient nurse practitioner practice issues involved in the delivery of safe, competent, high-quality, cost-effective care of patients in a dynamic healthcare system. Clinical experiences in primary care settings will provide students with the continued opportunity to develop, implement, and evaluate management plans for patients with complex health conditions. The application of knowledge in the management of clients and collaboration among the advanced practice nurse and the client, family, and interprofessional healthcare team are emphasized. (Prerequisite(s): NURS 6501, NURS 6512, NURS 6521, NURS 6531 or NUNP 6531, NURS 6541 or NUNP 6541, and NURS 6551 or NUNP 6551.) Note: This course requires a minimum of 160 practicum hours. Permalink: https://nursingpaperessays.com/ nurs-6565-week-1-assignment-paper / According to Antonelli (2017), ‘self-assessment of knowledge and accuracy of skill performance is essential to the practice of healthcare and self-directed life-long learning’. The emphasis on life-long learning is important. Sullivan and Hall (2017) suggest that a self-assessment can promote reflection on personal performance as well as to identify reasons for discrepancies between scores of assessors and assesse. Self-assessment is ‘the act of judging ourselves and making decisions about the next step.’(Boud.,2015). An important principle is that assessment must be followed by action. Nurs 6565 Week 1 Assignment Paper. The three strengths that I possess include; ability to complete accurately and thoroughly any physical exam that encompasses the patients using appropriate techniques as provisioned for in the diagnosis chart. I am also able to effectively communicate verbally as well as establish interpersonal communication with the patients and other staff within the healthcare facility, which is crucial in establishing a collaborative working relationship and a calm environment in which the patients can feel comfortable to articulate what they might be experiencing. Nurs 6565 Week 1 Assignment Paper. The third strength is that I am a strong believer in patient education. All these three strengths complement each other and play a crucial role in ensuring that I am effective in patient handling as well as establishing close relationship with them. For example, the ability to carry out thorough and accurate physical exams and diagnosis on patients ensures that I am able to focus on the patient symptoms with more ease as well as effectively diagnose their condition. The effective verbal communication as well as interpersonal communication helps ensure that I can create a comfortable environment through which the patients can be able to narrate their medical history thus gives me an opportunity to effectively analyze their condition. The provision of patient education about the patient medication or examination helps ensures they gain autonomy and self-empowerment to control and manage their condition. Nurs 6565 Week 1 Assignment Paper. The three weaknesses that I have include; the lack of an understanding of the state’s nursing practice act, inability to add all differential patient diagnosis in my the patient assessment although I might carry out accurate assessments, as well as the need to improve on the use of medical literature and thus be able to plan treatment appropriately. I am currently working on gaining a better understanding of the nursing legal compliance within the state as well as ensuring that each day I undertake patient assessments and fill in the differential diagnosis to ensure that the assessments are not only accurate but also comprehensive (Schober, 2016). I am currently working on improving my understanding of medical literature as well as taking time to research and understand more on the pathology of diseases and their treatment plans. Nurs 6565 Week 1 Assignment Paper. The clinical skills that I intent to acquire before exiting the program include; cultural competency skills, critical thinking skills as well as decision making skills, all which will help ensure that I am able to expedite my duties as a nurse better. The acquisition of the cultural competency skills will help ensure that I am able to not only communicate but also understand information from patients drawn from diverse backgrounds (Buppert, 2015). This will be achieved by ensuring that I spend time with colleagues drawn from different backgrounds as well as read widely on the various cultures and their practices. Nurs 6565 Week 1 Assignment Paper. The critical thinking and decision-making skills will be honed through active practice, in which I will ensure that in every engagement I am involved try to critically think before making the decision as well as evaluating the various scenarios and circumstances at hand before making the final decision. Nurs 6565 Week 1 Assignment Paper. Advanced practice nurses have evolved widely through the years as technology has become integrated into the nursing profession, with the intent of realizing new cost-effective methods of delivering care as well as increasing the ratio of practitioners to patients. The advanced practice nurses are expected to not only obtain health histories of the patients but also perform comprehensive examinations on the patients, develop differential diagnostics, evaluate the response of the patients to treatment as well as engage in research studies (Schober, 2016). As an advanced practice nurse, I will play a crucial role developing therapeutic plan of care, provide patient education and counseling as well as participate in research studies aimed at improving the nature of care that is available for the patients. Nurs 6565 Week 1 Assignment Paper. Students in this synthesis course will focus on clinical competence in primary care settings by building on knowledge and skills gained in previous courses. Through clinical practice, students will build confidence as they begin the transition from the role of registered nurse to that of advanced practice nurse. Classroom activities and case studies will enable students to explore the salient nurse practitioner practice issues involved in the delivery of safe, competent, high-quality, cost-effective care of patients in a dynamic healthcare system. Nurs 6565 Week 1 Assignment Paper. Clinical experiences in primary care settings will provide students with the continued opportunity to develop, implement, and evaluate management plans for patients with complex health conditions. The application of knowledge in the management of clients and collaboration among the advanced practice nurse and the client, family, and interprofessional healthcare team are emphasized. (Prerequisite(s): NURS 6501, NURS 6512, NURS 6521, NURS 6531 or NUNP 6531, NURS 6541 or NUNP 6541, and NURS 6551 or NUNP 6551.) Note: This course requires a minimum of 160 practicum hours. Nurs 6565 Week 1 Assignment Paper. ORDER A CUSTOM-WRITTEN PAPER NOW NURS 6565 Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings Essay Assignment Papers and Exam Questions and Answers NURS 6565 Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings Course Readings Bankston, K., & Glazer, G., (2013) Legislative: Interprofessional collaboration: What’s taking so long?” OJIN: The Online Journal of Issues in Nursing, 19(1). Christensen, C. M., Bohmer, R. M. J., & Kenagy, J. (2000). Will disruptive innovations cure health care? Harvard Business Review, 78(5), 102-112, 199. Ford, L. C.. & Gardenier, D. (2015). Fasten your seat belts – it’s going to be a bumpy ride. The Journal for Nurse Practitioners, 11(6), 575-577. Hain, D., & Fleck, L. (2014). Barriers to nurse practitioner practice that impact healthcare redesign. OJIN: The Online Journal of Issues in Nursing, 19(2). Nurs 6565 Week 1 Assignment Paper. Hayes, E., Chandler, G., Merriam, D., & King, M. C. (2002). The master’s portfolio: Validating a career in advanced practice nursing. Journal of the American Academy of Nurse Practitioners, 14(3), 119. Iglehart, J. K. (2013). Expanding the role of advanced nurse practitioners -risks and rewards. New England Journal of Medicine, 368(20), 1935-1941. Jordan, L. M., Quraishi, J. A., & Liao, J. (2013). The national practitioner data bank and CRNA anesthesia-related malpractice payments. American Association of Nurse Anesthetists Journal, 81(3), 178-182. Nurs 6565 Week 1 Assignment Paper. Kooienga, S.A. & Carryer, J.B. (2015). Globalization and advancing primary care health care nurse practitioner practice. The Journal for Nurse Practitioners, 11(8), 804–811. Miller, K. P. (2013). The national practitioner data bank: An annual update. The Journal for Nurse Practitioners, 9(9), 576-580. O’Connell, J., Gardner, G., & Coyer, F. (2014). Beyond competencies: Using a capability framework in developing practice standards for advanced practice nursing. Journal of Advanced Nursing, 70(12), 2728-2735. Nurs 6565 Week 1 Assignment Paper. Reinisch, C. E. (2014). Loretta Ford: Envisioning the future. Clinical Scholars Review, 7(1), 82-84. Rhodes, C. A., Bechtle, M., & McNett, M. (2015). An incentive plan for advanced practice registered nurses: Impact on provider and organizational outcomes. Nursing Economics, 33(3), 125-131. Silver, H. K,. Ford, L. C., & Day, L. R. (1968). The pediatric nurse-practitioner program: Expanding the role of the nurse to provide increased health care for children. JAMA, 204(4), 298-302. Stanik-Hutt, J., Newhouse, R. P., White, K. M., Johantgen, M., Bass, E. B., Zangaro, G., . . . Weiner, J. P. (2013). The quality and effectiveness of care provided by nurse practitioners. Journal for Nurse Practitioners, 9(8), 492-500. Nurs 6565 Week 1 Assignment Paper. Stelmach, E. I. (2015). Dismissal of the noncompliant patient: Is this what we have come to? The Journal for Nurse Practitioners, 11(7), 723-725. Watson, E. (2014). Nursing malpractice: Costs, trends and issues. Journal of Legal Nurse Consulting, 25(1), 26-31. Weber, S. (2006). Developing nurse practitioner student portfolios. Journal of the American Academy of Nurse Practitioners, 18(7), 301-302. Nurs 6565 Week 1 Assignment Paper. Westrick, Susan J., & Jacob, N. (2016). Disclosure of errors and apology: Law and ethics. The Journal for Nurse Practitioners, 12(2), 120-126. NURS 6565 Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings Essay Assignment Papers and Exam Questions and Answers NURS 6565 Week 2 Discussion: Ethical Challenges in Health Care for Practicing NPs Consider the following case study: Mrs. ABC is a 35 year old woman who has a scheduled business trip today. It is currently 8 am, and her plan is to leave at 6 pm. Mrs. ABC has a sore throat and she thinks it is strep because her 5 year old daughter was recently treated for strep. Mrs. ABC calls her physician for an appointment, but there are no appointments available until next week. Nurs 6565 Week 1 Assignment Paper.She has a mother who is a nurse practitioner and her office is 5 minutes away from where she lives. She calls and schedules an appointment with her mother. Her mother was surprised to see her daughter at the office. Mrs. ABC is frantic and begs her mother for an antibiotic. Her mother tests her and the rapid strep test is negative in office. Her mother (NP) sends out a strep DNA probe. Her mother prescribes an antibiotic and the patient (her daughter) is very satisfied. The results returned for the DNA probe 48 hours later and it confirmed negative for strep. NURS 6565 Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings Essay Assignment Papers and Exam Questions and Answers. By Day 3 OF NURS 6565 Week 2 Discussion Post an explanation of whether NPs should treat family members. What are the ethical dilemmas in this situation? What are the laws in your state for NPs treating themselves, family, or friends? NURS 6565 Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings Essay Assignment Papers and Exam Questions and Answers. Nurs 6565 Week 1 Assignment Paper. ****I live in Texas**** but you can choose any state in the US NURS 6565 Week 2 Discussion Resources http://midlevelu.com/blog/should-providers-treat-their-friends-and-family http://nurse-practitioners-and-physician-assistants.advanceweb.com/Article/Ethical-Dilemmas-2.aspx NURS 6565 Week 2 Discussion CHAPTER CONTENTS Characteristics of Ethical Dilemmas in Nursing, 328 Communication Problems, 329 Interdisciplinary Conflict, 329 Multiple Commitments, 330 Ethical Issues Affecting Advanced Practice Nurses, 330 Primary Care Issues, 330 Acute and Chronic Care, 330 Societal Issues, 331 Access to Resources and Issues of Justice, 332 Legal Issues, 333 Changes in interprofessional roles, advances in medical technology, privacy issues, revisions in patient care delivery systems, and heightened economic constraints have increased the complexity of ethical issues in the health care setting. Nurses in all areas of health care routinely encounter disturbing moral issues, yet the success with which these dilemmas are resolved varies significantly. Because nurses have a unique relationship with the patient and family, the moral position of nursing in the health care arena is distinct. As the complexity of issues intensifies, the role of the advanced practice nurse (APN) becomes particularly important in the identification, deliberation, and resolution of complicated and difficult moral problems. Nurs 6565 Week 1 Assignment Paper. Although all nurses are moral agents, APNs are expected to be leaders in rec- ognizing and resolving moral problems, creating ethical practice environments, and promoting social justice in the larger health care system. It is a basic tenet of the central definition of advanced practice nursing (see Chapter 3) that skill in ethical decision making is one of the core competencies of all APNs. In addition, the Doctor of Nursing Practice {DNP) essential competencies emphasize leadership in developing and evaluating strate- gies to manage ethical dilemmas in patient care and organizational arenas (American Association of Colleges of Nursing [AACN], 2006). This chapter explores the distinctive ethical decision-making competency of advanced practice nursing, the process of developing and evaluating this competency, and barriers to ethical prac- tice that APNs can expect to confront. NURS 6565 Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings Essay Assignment Papers and Exam Questions and Answers. Nurs 6565 Week 1 Assignment Paper. 328 Ethical Decision Making Ann B. Hamric • Sarah A. Delgado Ethical Decision Making Competency of Advanced Practice Nurses, 333 Phases of Core Competency Development, 333 Evaluation of the Ethical Decision Making Competency, 349 Barriers to Ethical Practice and Potential Solutions, 350 Barriers Internal to the Advanced Practice Nurse, 350 lnterprofessional Barriers, 351 Patient-Provider Barriers, 351 Organizational and Environmental Barriers, 352 Conclusion, 354 Characteristics of Ethical Dilemmas lll~l12:’:1’Si~ ~~·-· ~ -······· …. ···~ ·-· In this chapter, the terms ethics and morality or morals are used interchangeably (see Beauchamp & Childress, 2009, for a discussion of the distinctions between these terms). A problem becomes an ethical or moral problem when issues of core values or fundamental obligations are present. Nurs 6565 Week 1 Assignment Paper.An ethical or moral dilemma occurs when obliga- tions require or appear to require that a person adopt two (or more) alternative actions, but the person cannot carry out all the required alternatives. The agent experiences tension because the moral obligations resulting from the dilemma create differing and opposing demands (Beauchamp & Childress, 2009; Purtilo & Doherty, 2011). In some moral dilemmas, the agent must choose between equally unacceptable alternatives; that is, both may have elements that are morally unsatisfactory. For example, based on her evaluation, a family nurse practitioner (FNP) may suspect that a patient is a victim of domestic violence, although the patient denies it. Nurs 6565 Week 1 Assignment Paper. The FNP is faced with two options that are both ethically troubling-connect the patient with existing social services, possibly straining the family and jeopardizing the FNP-patient relationship, or avoid intervention and potentially allow the violence to continue. As described by Silva and Ludwick (2002), hon- oring the FNP’s desire to prevent harm (the principle of beneficence) justifies reporting the suspicion, whereas respect for the patient’s autonomy justifies the opposite course of action. NURS 6565 Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings Essay Assignment Papers and Exam Questions and Answers. Jameton (1984, 1993) has distinguished two additional types of moral problems from the classic moral dilemma, which he termed moral uncertainty and moral distress. In situations of moral uncertainty, the nurse experiences unease and questions the right course of action. In moral distress, nurses believe that they know the ethically appro- priate action but feel constrained from carrying out that action because of institutional obstacles (e.g., lack of time or supervisory support, physician power, institutional policies, legal constraints). Nurs 6565 Week 1 Assignment Paper.Noting that nurses and others often take varied actions in response to moral distress, Varcoe and colleagues (2012) have proposed a revision to Jameton’s definition: “moral distress is the experience of being seriously compromised as a moral agent in prac- ticing in accordance with accepted professional values and standards. It is a relational experience shaped by multiple contexts, including the socio-political and cul- tural context of the workplace environment” (p. 60). The phenomenon of moral distress has received increasing national and international attention in nursing and medical literature. Studies have reported that moral dis- tress is significantly related to unit-level ethical climate and to health care professionals’ decisions to leave clinical practice (Corley, Minick, Elswick, et al., 2005; Epstein & Hamric, 2009; Hamric, Borchers, & Epstein, 2012; Hamric, Davis, & Childress, 2006; Pauly, Varcoe, Storch, et al., 2009; Schluter, Winch, Hozhauser, et al., 2008; Varcoe, Pauly, Webster, & Storch, 2012). APNs work to decrease the incidence of moral uncertainty and moral distress for themselves and their colleagues through edu- cation, empowerment, and problem solving. NURS 6565 Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings Essay Assignment Papers and Exam Questions and Answers. Nurs 6565 Week 1 Assignment Paper. Although the scope and nature of moral problems experienced by nurses and, more specifically APNs, reflect the varied clinical settings in which they practice, three general themes emerge when ethical issues in nursing practice are examined. These are problems with commu- nication, the presence of interdisciplinary conflict, and nurses’ difficulties with managing multiple commitments and obligations. Communication Problems The first theme encountered in many ethical dilemmas is the erosion of open and honest communication. Clear communication is an essential prerequisite for informed and responsible decision making. Some ethical disputes reflect inadequate communication rather than a difference in values (Hamric & Blackball, 2007; Ulrich, 2012). The APN’s communication skills are applied in several arenas. Within the health care team, discussions are most effective when members are accountable for presenting informa- tion in a precise and succinct manner. In patient encoun- ters, disagreements between the patient and a family. Nurs 6565 Week 1 Assignment Paper. C HAP T E R 13 Ethical Decision Making member or within the family can be rooted in faulty com- munication, which then leads to ethical conflict. The skill of listening is just as crucial in effective communication as having proficient verbal skills. Listening involves recog- nizing and appreciating various perspectives and showing respect to individuals with differing ideas. To listen well is to allow others the necessary time to form and present their thoughts and ideas. Nurs 6565 Week 1 Assignment Paper. Understanding the language used in ethical delibera- tions (e.g., terms such as beneficence, autonomy, and utili- tarian justice) helps the APN frame the concern. This can help those involved to see the components of the ethical problem rather than be mired in their own emotional responses. When ethical dilemmas arise, effective com- munication is the first key to negotiating and facilitating a resolution. Jameson (2003) has noted that the long history of conflict between certified registered nurse anes- thetists (CRNAs) and anesthesiologists influences how these providers communicate in practice settings. In inter- views with members of both groups, she found that some transcended role-based conflict whereas others became mired in it, particularly in the emotions around perceived threats to role fulfillment. Nurs 6565 Week 1 Assignment Paper. She recommended enhancing communication through focus on the common goal of patient care, rather than on the conflicting opinions about supervision and autonomous practice. In other words, focusing on shared values rather than the values in conflict can promote effective communication. NURS 6565 Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings Essay Assignment Papers and Exam Questions and Answers. Interdisciplinary Conflict The second theme encountered is that most ethical dilemmas that occur in the health care setting are multidisciplinary in nature. Issues such as refusal of treatment, end-of-life decision making, cost containment, and confidentiality all have interprofessional elements interwoven in the dilemmas, so an interprofessional approach is nec- essary for successful resolution of the issue. Health care professionals bring varied viewpoints and perspectives into discussions of ethical issues (Hamric & Blackball, 2007; Piers, Azoulay, Ricou, et al., 2011; Shannon, Mitchell, & Cain, 2002). NURS 6565 Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings Essay Assignment Papers and Exam Questions and Answers.These differing positions can lead to creative and collaborative decision making or to a breakdown in communication and lack of problem solving. Thus, an interdisciplinary theme is prevalent in the presentation and resolution of ethical problems. Nurs 6565 Week 1 Assignment Paper. For example, a clinical nurse specialist (CNS) is writing discharge orders for an older woman who is terminally ill with heart failure. The plan of care, agreed on by the inter- professional team, patient, and family, is to continue oral medications but discontinue IV inotropic support and all other aggressive measures. Just prior to discharge, the social worker informs the CNS that medical coverage for. NURS 6565 Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings Essay Assignment Papers and Exam Questions and Answers. 330 PART ll Competencies of Advanced Practice Nursing the patient’s care in the skilled nursing facility will only be covered by the insurer if the patient has an IV in place. The attending cardiologist determines that the patient can be discharged to her daughter’s home because she no longer requires skilled care and the social worker agrees to proceed with this plan. However, the CNS is concerned that the patient’s need for physical assistance will over- whelm her daughter and believes that the patient is better off returning to the sldlled nursing facility. Although each team member shares responsibility to ensure that the plan of care is consistent with the patient’s wishes and mini- mizes the cost burden to the patient, they differ in how to achieve these goals. Such legitimate but differing perspec- tives from various team members can lead to ethical conflict. NURS 6565 Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings Essay Assignment Papers and Exam Questions and Answers. Multiple Commitments The third theme that frequently arises when ethical issues in nursing practice are examined is the issue of balancing commitments to multiple parties. Nurses have numerous and, at times, competing fidelity obligations to various stakeholders in the health care and legal systems (Chambliss, 1996; Hamric, 2001). Fidelity is an ethical concept that requires persons to be faithful to their com- mitments and promises. For the APN, these obligations start with the patient and family but also include physi- cians and other colleagues, the institution or employer, the larger profession, and oneself. Ethical deliberation involves analyzing and dealing with the differing and opposing demands that occur as a result of these commitments. An APN may face a dilemma if encouraged by a specialist consultant to pursue a costly intervention on behalf of a patient, whereas the APN’s hiring organization has estab- lished cost containment as a key objective and does not support use of this intervention (Donagrandi & Eddy, 2000). In this and other situations, APNs are faced with an ethical dilemma created by multiple commitments and the need to balance obligations to all parties.NURS 6565 Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings Essay Assignment Papers and Exam Questions and Answers. The general themes of communication, interdisciplin- ary conflict, and balancing multiple commitments are prevalent in most ethical dilemmas. Specific ethical issues may be Wlique to the specialty area and clinical setting in which the APN practices. Ethical Issues Affecting Advanced Practice Nurses Primary Care Issues Situations in which personal values contradict professional responsibilities often confront NPs in a primary care setting. Issues such as abortion, teen pregnancy, patient nonadherence to treatment, childhood immunizations, regulations and laws, and financial constraints that inter- fere with care were cited in one older study as frequently encountered ethical issues (Turner, Marquis, & Burman, 1996). Ethical problems related to insurance reimburse- ment, such as when implementation of a desired plan of care is delayed by the insurance authorization process or restrictive prescription plans, are an issue for APNs. The problem of inadequate reimbursement can also arise when there is a lack of transparency regarding the specifics of services covered by an insurance plan. For example, a patient who has undergone diagnostic testing during an inpatient stay may later be informed that the test is not covered by insurance because it was done on the day of discharge. Had the patient and nurse practitioner (NP) known of this policy, the testing could have been sched- uled on an outpatient basis with prior authorization from the insurance company and thus be a covered expense. NURS 6565 Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings Essay Assignment Papers and Exam Questions and Answers. Nurs 6565 Week 1 Assignment Paper. Viens {1994) found that primary care NPs interpret their moral responsibilities as balancing obligations to the patient, family, colleagues, employer, and society. More recently, Laabs (2005) has found that the issues most often noted by NP respondents as causing moral dilemmas are those of being required to follow policies and procedures that infringe on personal values, needing to bend the rules to ensure appropriate patient care, and dealing with patients who have refused appropriate care. Issues leading to moral distress included pressure to see an excessive number of patients, clinical decisions being made by others, and a lack of power to effect change (Laabs, 2005). Increasing expectations to care for more patients in less time are routine in all types of health care settings as pressures to contain costs escalate. APNs in rural settings may have fewer resources than their col- leagues working in or near academic centers in which ethics committees, ethics consultants, and educational opportunities are more accessible. Nurs 6565 Week 1 Assignment Paper. Issues of quality of life and symptom management tra- verse primary and acute health care settings. Pain relief and symptom management can be problematic for nurses and physicians (Oberle & Hughes, 2001). APNs must con- front the various and sometimes conflicting goals of the patient, family, and other health care providers regarding the plans for treatment, symptom management, and quality of life. The APN is often the individual who coor- dinates the plan of care and thus is faced with clinical and ethical concerns when participants’ goals are not consis- tent or appropriate. NURS 6565 Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings Essay Assignment Papers and Exam Questions and Answers. Acute and Chronic Care In the acute care setting, APNs struggle with dilemmas involving pain management, end-of-life decision making, advance directives, assisted suicide, and medical errors (Shannon, Foglia, Hardy, & Gallagher; 2009). Rajput and Bekes (2002) identified ethical issues faced by hospital- based physicians, including obtaining informed consent, establishing a patient’s competence to make decisions, maintaining confidentiality, and transmitting health information electronically. APNs in acute care settings may experience similar ethical dilemmas. Recent studies of moral distress have revealed that feeling pressured to continue aggressive treatments that respondents thought were not in the patients’ best interest or in situations in which the patient was dying, working with physicians or nurses who were not fully competent, giving false hope to patients and families, poor team communication, and lack of provider continuity were all issues that engen- dered moral distress (Hamric & Blackball, 2007; Hamric, Borchers, & Epstein, 2012). Nurs 6565 Week 1 Assignment Paper. APNs bring a distinct perspective to collaborative decision making and often find themselves bridging com- munication between the medical team and patient or family. For example, the neonatal nurse practitioner (NNP) is responsible for the day-to-day medical manage- ment of the critically ill neonate and may be the first provider to respond in emergency situations (Juretschke, 2001). The NNP establishes a trusting relationship with the family and becomes aware of the values, beliefs, and attitudes that shape the family’s decisions. Thus, the NNP has insight into the perspectives of the health care team and family. This “in-the-middle” position, however, can be accompanied by moral distress (Hamric, 2001), particu- larly when the team’s treatment decision carried out by the NNP is not congruent with the NNP’s professional judg- ment or values. Botwinski (2010) conducted a needs assessment ofNNPs and found that most had not received formal ethics content in their education and desired more education on the management of end-of-life situations, such as delivery room resuscitation of a child on the edge of viability. Nurs 6565 Week 1 Assignment Paper. Knowing the best interests of the infant and balancing those obligations to the infant with the emo- tional, cognitive, financial, and moral concerns that face the family struggling with a critically ill neonate is a complex undertaking. Care must be guided by an NNP and health care team who understand the ethical princi- ples and decision making related to issues confronted in neonatal intensive care unit (NICU) practice. NURS 6565 Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings Essay Assignment Papers and Exam Questions and Answers. Nurs 6565 Week 1 Assignment Paper. Societal Issues Ongoing cost containment pressures in the health care sect01· have significantly changed the traditional practice of delivering hea

Models and Their Role in Healthcare Assignment Papers. Models and Their Role in Healthcare Assignment Papers. Permalink: https://nursingpaperessays.com/ models-and-their…ssignment-papers / ? The study of healthcare is founded upon a few basic ideas like the cell or the concept of disease. Informatics is similarly built upon the concepts of data, models, systems and information. Unlike health, where the core ideas are usually grounded in observations of the physical world, these informatics concepts are abstract ideas. As a consequence, they can be difficult to grasp, and for those used to the study of healthcare, often seem detached from the physical realities of the clinical workplace .Models and Their Role in Healthcare Assignment Papers. Models are abstractions of the real world . What is a model and what does it do? Models are commonplace in our everyday lives. People are familiar with the idea of building model aeroplanes , or looking at a small-scale model of a building to imagine what it will look like when built. In health, models underlie all our clinical activities .Models and Their Role in Healthcare Assignment Papers. Models actually serve two quite distinct purposes, and both of these are of interest . artificial heart is based upon two kinds of model. Firstly, the cardiovascular system has to be modelled, and secondly, a mechanical blueprint is used to model the way the heart will be constructed.Models and Their Role in Healthcare Assignment Papers. When artefacts are created, it is assumed that they too will be used for a particular purpose. If the purpose changes, then a design becomes less effective. Thus, the physical design of the waiting room and treatment areas for a general practice clinic will assume a certain number of patients need to be seen during a day, and that certain kinds of therapy will be given. If the clinic was bought by radiologists, they would have to remodel the clinic’s design to incorporate imaging equipment, and to reflect a different throughput of patients .Models and Their Role in Healthcare Assignment Papers. we can consider a particular treatment of a disease written in a textbook to be a template for what should be done to any given patient. If that treatment was based upon assumptions about the incidence of diseases in a given population, then it may not work well if attempted in a different one. Treating infant diarrhoea in a developed nation is not the same task in underdeveloped nations where poorer resources, malnutrition, and different infecting organisms change the context of treatment. Before a model is used, one therefore has to be clear about what has actually been modelled. This is because, when models are created, the circumstances at the time have a strong influence on the final value of the model. Similarly, a set of rules and procedures might be developed in one hospital, and be spectacularly successful at improving the way it handles its cases.Models and Their Role in Healthcare Assignment Papers. One would have to be very cautious, given that these procedures implicitly model many aspects of that particular institution, before one imposed those procedures on other hospitals. Very small differences, for example in the level of resources, type of patients seen, or experience of the staff, may make what was successful in one context, unhelpful in another.Models and Their Role in Healthcare Assignment Papers. More generally, any designed artefact, whether it is a car, a drug or a computer system, has to be designed with the world within which it will operate in mind. In other words, it has to contain in its design a model of the environment within which it will be used. These specifications constitute its design assumptions. Thus there is a connection between the process of model creation, the construction of artefacts based upon such models, and their eventual effectiveness in satisfying some purpose .Models and Their Role in Healthcare Assignment Papers. Models are the basis of the way we learn about, and interact with, the physical world.Models and Their Role in Healthcare Assignment Papers. Models can act either as copies of the world like maps, or as templates that serve as the blueprints for constructing physical objects, or processes. Models that copy the world are abstractions of the real world: Models are always less detailed than the real world they are drawn from. Models ignore aspects of the world that are not considered essential. Thus abstraction imposes a point of view upon the observed world Many models can be created of any given physical object, depending upon the level of detail and point of view selected.Models and Their Role in Healthcare Assignment Papers. The similarity between models and the physical objects they represent degrades over time. There is no such thing as a truly general-purpose model. There is no such thing as the most ‘correct’ model. Models are simply better or worse suited to accomplishing a particular task. 4. Models can be used as templates and be instantiated to create objects or processes that are used in the world.Models and Their Role in Healthcare Assignment Papers. Templates are less detailed than the artefacts that are created from them. An artefact is a distortion of the original template. No two physical artefacts are similar even if they are instances of the same template. The effect of an artefact may change while the original template stays the same. The process of creating an instance has a variable outcome, and the impact of the instance of an artefact in the real world also varies. As a consequence, there is no such thing as a general purpose template. All we can have are templates or designs that are better or worse suited to our particular circumstances and task.Models and Their Role in Healthcare Assignment Papers. 5. The assumptions used in a model’s creation, whether implicit or explicit, define the limits of a model’s usefulness. When models are created, they assume that they are to accomplish a particular purpose. When models are created they assume a context of use. When objects or processes are built from a model, this context forms a set of design assumptions. 6. We should never forget that the map is not the territory and the blueprint is not the building A 50-year-old woman with a past history diabetes and alcohol and IV drug abuse, presents with symptoms of abdominal pain and vomiting and is diagnosed as having “acute chronic pancreatitis.” Her amylase and lipase levels are normal. She is admitted and treated with IV fluids and analgesics. On hospital day 2 she begins having spiking fevers and antibiotics are administered. The next day, blood cultures are growing gram negative organisms.Models and Their Role in Healthcare Assignment Papers. At this point, the service is clueless about the patient’s correct diagnosis. It only becomes evident the following day when (a) review of laboratory data over the past year shows that patient had four prior blood cultures, each positive with different gram negative organisms; (b) a nurse reports patient was “behaving suspiciously,” rummaging through the supply room where syringes were kept; and (c) a medical student looks up posthospital outpatient records from 4 months earlier and finds several notes stating that “the patient has probable Munchausen syndrome rather than pancreatitis.” Upon discovering these findings, the patient’s IVs are discontinued and sensitive, appropriate followup primary and psychiatric care are arranged.Models and Their Role in Healthcare Assignment Papers. A postscript to this admission: 3 months later, the patient was again readmitted to the same hospital for “pancreatitis” and an unusual “massive leg abscess.” The physicians caring for her were unaware of her past diagnoses and never suspected or discovered the likely etiology of her abscess (self-induced from unsterile injection The magnet hospital model is an international design to provide optimal framework for nursing care and future research. The model is composed of transformational leadership, empirical outcomes, exemplary professional practice, structural empowerment, and new knowledge combined with innovations and improvements. Hospitals that participate in the model and were awarded the title are constantly looking to improve and expand. They strive to provide expert care globally.Models and Their Role in Healthcare Assignment Papers. Scheduling and staffing are done in a way to keep nurses from burning out. The lower the burnout rate the higher the rate of satisfaction and overall health of patients. When nurses are not burnt out they work optimally and want to work with their patients and that creates …show more content… The magnet hospital model is an international design to provide optimal framework for nursing care and future research. The model is composed of transformational leadership, empirical outcomes, exemplary professional practice, structural empowerment, and new knowledge combined with innovations and improvements. Models and Their Role in Healthcare Assignment Papers. Hospitals that participate in the model and were awarded the title are constantly looking to improve and expand. They strive to provide expert care globally. Scheduling and staffing are done in a way to keep nurses from burning out. The lower the burnout rate the higher the rate of satisfaction and overall health of patients. When nurses are not burnt out they work optimally and want to work with their patients and that creates better outcomes for their patients. The steps in the nursing process relate to evidence based practice in many ways. During the diagnostic, and assessment steps of the nursing process important clinical questions are considered and the critical review of existing knowledge is completed. Evidence based practice also begins with identification of the problem and knowing the clinical problem by asking questions, in relation to the nursing process.Models and Their Role in Healthcare Assignment Papers. Abstract: In many areas of the developed world, contemporary hospital care is confronted by workforce challenges, changing consumer expectations and demands, fiscal constraints, increasing demands for access to care, a mandate to improve patient centered care, and issues concerned with levels of quality and safety of health care. Effective governance is crucial to efforts to maximize effective management of care in the hospital setting. Emerging from this complex literature is the role of leadership in the clinical setting. Models and Their Role in Healthcare Assignment Papers. The importance of effective clinical leadership in ensuring a high quality health care system that consistently provides safe and efficient care has been reiterated in the scholarly literature and in various government reports. Recent inquiries, commissions, and reports have promoted clinician engagement and clinical leadership as critical to achieving and sustaining improvements to care quality and patient safety. In this discursive paper, we discuss clinical leadership in health care, consider published definitions of clinical leadership, synthesize the literature to describe the characteristics, qualities, or attributes required to be an effective clinical leader, consider clinical leadership in relation to hospital care, and discuss the facilitators and barriers to effective clinical leadership in the hospital sector. Despite the widespread recognition of the importance of effective clinical leadership to patient outcomes, there are some quite considerable barriers to participation in clinical leadership. Future strategies should aim to address these barriers so as to enhance the quality of clinical leadership in hospital care.Models and Their Role in Healthcare Assignment Papers. Keywords: management, hospital care, barriers, leadership, clinical leadership, discursive paper Introduction Globally, health care systems in the developed world continue to struggle with escalating demands for services and escalating costs. Service design inefficiencies, including outmoded models of care contribute to unsustainable funding demands.1 An example is the continuing practice in many settings to look to hospital emergency departments to provide what are essentially, primary health care services. While some progress and reforms have been achieved, numerous experts point to the need for further system change if services are to be affordable and appropriate in the future.2 They note that […] further change is still needed, despite years of progress in the quality of health care around the world. Models and Their Role in Healthcare Assignment Papers. This transformation will require leadership – and that leadership must come substantially from doctors and other clinicians, whether or not they play formal management roles. Clinicians not only make frontline decisions that determine the quality and efficiency of care but also have the technical knowledge to help make sound strategic choices about longer-term patterns of service delivery.2 Effective clinical leadership has been linked to a wide range of functions. It is a requirement of hospital care, including system performance, achievement of health reform objectives, timely care delivery, system integrity and efficiency, and is an integral component of the health care system.2–4 Though most people are provided with health care within the community setting, hospital care continues to garner the bulk of funding and attract considerable attention in relation to care quality and related concerns. Models and Their Role in Healthcare Assignment Papers. Indeed, hospitals are very costly and diverse environments that vary in size and complexity, determined in part by their overall role and function within the larger health care system. The services provided by individual hospitals are determined and driven by a number of mechanisms, including government policy, population demographics, and the politics and power of service providers.5 However, regardless of the differences, the clinical areas of the hospital are critical to all health care organizations, given that it is at this level where consumers principally engage with the hospital system.Models and Their Role in Healthcare Assignment Papers. It is at this point where consumers are recipients of hospital care and where they witness and experience how the system functions, observing the strengths and inefficiencies of the health care system and conflict and collegiality between and among groups of health professionals. It is also at this point that clinicians, defined as any frontline health care professionals, have opportunities to fulfill leadership roles. For consumers of health care to achieve optimal health outcomes and experience optimal hospital care, many believe effective clinical leadership is essential.Models and Their Role in Healthcare Assignment Papers. In this paper, we discuss clinical leadership in contemporary health care, definitional issues in clinical leadership, roles of hospitals in contemporary health care, preparation for clinical leadership roles, and the facilitators and barriers to effective clinical leadership in the hospital sector.Models and Their Role in Healthcare Assignment Papers. Clinical leadership in contemporary health care The importance of effective clinical leadership in ensuring a high quality health care system that consistently provides safe and efficient care has been reiterated in the scholarly literature and various government reports.6–8 Recent inquiries, commissions, and reports have promoted clinician engagement and clinical leadership as critical to improving quality and safety.9 As one Australian example, a key priority nursing recommendation of the Garling Report was that Nurse Unit Manager (NUM) positions be reviewed and significantly redesigned “to enable the NUM to undertake clinical leadership in the supervision of patients […] to ensure that for at least 70% of the NUM’s time is applied to clinical duties.”8 The remaining time could be spent on administrative and management tasks.Models and Their Role in Healthcare Assignment Papers. In the more recent Francis report7 from the UK, a recommendation was made for similarly positioned ward nurse managers to be more involved in clinical leadership in their ward areas. In the United States, clinical leadership has also been identified as a key driver of health service performance, with the Committee on Quality of Healthcare suggesting considerable improvements in quality can only be achieved by actively engaging clinicians and patients in the reform process.10 However, leadership in health care is often very complex, and some authors claim it faces unique contextual challenges. For example, Schyve5 claims aspects of governance are sui generis in health care, noting healthcare organizations also have a rather unique characteristic. That is, the chief executive is not the only part of the organization’s leadership that is directly accountable to the governing body. In healthcare, because of the unique professional and legal role of licensed independent practitioners within the organization, the organized licensed independent practitioners – in hospitals, the medical staff – are also directly accountable to the governing body for the care provided.Models and Their Role in Healthcare Assignment Papers. So the governing body has the overall responsibility for the quality and safety of care, and has an oversight role in integrating the responsibilities and work of its medical staff, chief executive, and other senior managers into a system that that achieves the goals of safe, high-quality care, financial sustainability, community service, and ethical behaviour. This is also the reason that all three leadership groups – the governing body, chief executive and senior managers, and leaders of medical staff – must collaborate if these goals are to be achieved (Schyve 2009:35).5 While nursing is not specifically named in the above quote, we believe nursing to be implicit and integral to leadership in hospitals. There is recognition of the challenges associated with health care governance, evidenced by significant investment internationally in building systems for leadership development in health care.5,11 For example, the UK advanced leadership programs have been instituted and run for clinical leaders since 2001 by the National Health System Leadership Centre,12 and there are some similar innovations in other countries (see, for example, Ferguson et al13). Models and Their Role in Healthcare Assignment Papers. This points to the realization that the cost and consequences of poor clinical leadership greatly outweigh the costs and potential benefits of provision of formal programs to enhance clinical leadership capacity ideally in a multidisciplinary health care team context.12 Indeed, across the health care sector, evidence exists of the need for clinical leadership to optimize care delivery. In addition to challenges associated with resources and demand, episodes of poor patient outcomes, cultures of poor care, and a range of workplace difficulties have been associated with poor clinical leadership,8,9,14 and these concerns have provided the impetus to examine clinical leadership more closely.Models and Their Role in Healthcare Assignment Papers. Definitional issues in clinical leadership Within the health care system, it has been acknowledged that clinical leadership is not the exclusive domain of any particular professional group.15 Rather, all members of the health care team are identified as potential leaders.16 Like “leadership,” the concept of clinical leadership can be defined in a range of ways; and while a standard definition of clinical leadership providing absolute agreement on meaning is not crucial to progress and is likely to prove difficult,17 it is useful to consider the various ways clinical leadership is conceptualized and presented in the literature. While effective clinical leadership has been offered up as a way of ensuring optimal care and overcoming the problems of the clinical workplace, a standard definition of what defines effective clinical leadership remains elusive.15,18 Indeed, in some ways it is easier to consider what constitutes poor or ineffective clinical leadership.Models and Their Role in Healthcare Assignment Papers. A secondary analysis of studies exploring organizational wrongdoing in hospitals highlighted the nature of ineffectual leadership in the clinical environment. The focus of the analysis was on clinical nurse leader responses to nurses raising concerns. Three forms of avoidant leadership were identified:Models and Their Role in Healthcare Assignment Papers. placating avoidance, where leaders affirmed concerns but abstained from action; equivocal avoidance, where leaders were ambivalent in their response; and hostile avoidance, where the failure of leaders to address concerns escalated hostility towards the complainant.14 These forms of leadership failure were all associated with negative organizational outcomes. Similarly, McKee et al employed interviews, surveys, and ethnographic case studies to assess the state of quality practice in the National Health Service (NHS); they report that one of the most important insurances against failures such as those seen in the Mid-Staffordshire NHS Trust Foundation is active and engaged leaders at all levels in the system.14,19 Despite the definitional uncertainty, a number of writers have sought to describe the characteristics, qualities, or attributes required to be an effective clinical leader.Models and Their Role in Healthcare Assignment Papers. Synthesis of the literature suggests clinical leadership may be framed variously – as situational, as skill driven, as value driven, as vision driven, as collective, co-produced, involving exchange relationships, and as boundary spanning (see Table 1). Effective clinical leaders have been characterized as having advocacy skills and the ability to affect change.20,21 As well, effective clinical leaders have been linked to facilitating and maintaining healthier workplaces,22,23 by driving cultural change among all health professionals in the workplace.24 To achieve these positive outcomes, clinical leaders need to be seen as credible – that is, be recognized by colleagues as having clinical competence18,25–27 and have the skills and capacity to effectively support and communicate with members of multidisciplinary clinical teams.18,25 Taking an individual perspective, effective clinical leaders require personal qualities that reflect positive attitudes toward their own profession, have the courage and capacity to challenge the status quo, effectively address care quality issues, and engage in reflective practice.18,14 Pepin et al found that clinical competence, the capacity to lead a team, and being prepared to challenge the status quo were necessary skills for clinical leaders in one Canadian study.28 In an Australian study, findings indicated that student nurses want clinical leadership attributes from their clinical preceptors to include being supportive, approachable, and motivating, while being effective communicators.29 Table 1 summarizes the characteristics of clinical leadership and the attributes of clinical leaders distilled from the literature.Models and Their Role in Healthcare Assignment Papers. Table 1 The characteristics of clinical leadership and the attributes of clinical leaders Notes: Table distilled from: Clark 2012;31 De Casterle et al 2008;47 Edmonton 2009;11 McKeon et al 2009;73 Stanley 2012;32 Patrick et al 2011;34 McKee et al 2013.19 Despite acknowledging the lack of a standard definition of clinical leadership, the authors in one literature review identified common themes:Models and Their Role in Healthcare Assignment Papers. […] the ability to influence peers to act and enable clinical performance; provide peers with support and motivation; play a role in enacting organizational strategic direction; challenge processes; and to possess the ability to drive and implement the vision of delivering safety in healthcare.30 Many articles assert that clinical leadership is leadership provided by clinicians often recognized as clinical leaders. Indeed, an important driver of the move toward models of clinical leadership is the notion that clinical leaders “are the custodians of the processes and micro-systems of health care.”31 Stanley has contributed a summary of seven clinical leadership characteristics which includes factors such as expertise, direct involvement in patient care, high level interpersonal and motivational skills, commitment to high quality practice, and empowerment of others.32 In contrast to managerial leadership, which operates through hierarchical superior–subordinate organizational relationships, clinical leadership has a collegiate orientation and a focus upon the patient or service interface.11 While some clinical leaders may hold positions of positional authority, primarily the influence of clinical leaders stems from characteristics such as clinical credibility and the capacity for collaboration. Models and Their Role in Healthcare Assignment Papers. While transformational leadership positions the leader as a charismatic shaper of followers,33 clinical leadership is more patient centered and emphasizes collective and collaborative behaviors.19,32,34 It is apparent that the “theory” of clinical leadership is in an early stage of development, and like leadership in general, in health there is very limited empirical support for specific approaches to enacting effective models. Edmonstone notes following the implementation of numerous clinical leadership programs in the UK the little research undertaken has largely focused on program evaluation, rather than the nature or outcomes of clinical leadership.35 As the body of evidence continues to develop, some definitional clarity may be achieved.Models and Their Role in Healthcare Assignment Papers. Role of hospitals in contemporary health care Globally, hospitals are under increased strain and scrutiny. Increased demands and fiscal pressures have increased the pressures on all health professionals as well as clinical and non-clinical staff. Hospitals, once seen as representing “health care,” are now recognized as dangerous places, particularly where the most vulnerable, such as children and older people, are exposed to the risk and actual adverse clinical events. A number of nationally and internationally influential reports6–8 have resulted in changes in visibility, scrutiny, and accountability in relation to hospital care. This scrutiny has increased the emphasis on the role of health professionals, including nurses, in monitoring standards, developing and evaluating better ways of working as well as advocating for patients and their families; and led to a substantial momentum in the quality and safety agenda, including the promotion of various strategies such as promoting evidence-based practice.Models and Their Role in Healthcare Assignment Papers. In the hospital sector, the demands placed upon leaders have become more complex, and the need for different forms of leadership is increasingly evident. Models and Their Role in Healthcare Assignment Papers. To derive cost efficiency and improve productivity, there has been intense reorganization. Coupled with these reforms has been increasing attention upon improving safety and quality, with programs instituted to move attention beyond singular patient–clinician interpretations of safety toward addressing organizational systems and issues of culture.36 Arising from these reforms has been growing recognition that many assumptions of common leadership models are not well suited to delivering change at the point-of-care delivery or to assuring increased clinician and patient engagement in decision making.3 Accordingly, there have been calls for a transition to a new phase of hospital leadership, one that places the clinical frontline and clinicians as crucial to leadership within organizations.13,37 This transformational shift in the conceptualization of leadership has seen debate move from managerial, senior leader, or singular leader interpretations of leadership to a focus upon clinical leaders and clinical leadership.Models and Their Role in Healthcare Assignment Papers. In part, this shift has been in response to growing recognition that while designated leaders in positions of formal authority within hospitals play a key role in administration and espousing values and mission, such leaders are limited in their capacity to reshape fundamental features of clinical practice or ensure change at the frontline.11 There is considerable evidence to suggest nurses may experience dissatisfaction with the working environment in hospitals,38 with poor work environments impacting negatively on the delivery of clinical care and patient outcomes.39 In seeking to understand this dissatisfaction, work engagement among nurses and other health professionals has been explored from the perspective of burnout and emotional exhaustion40–42 with work engagement conceptualized as a positive emotional state in which employees are emotionally connected to the work roles.43 While such studies have examined engagement with work from an emotional perspective, engagement can also be understood as a broader concept that includes an employee’s relationship with their professional role and the broader organization.44 This broader view on employee engagement ties in with the concept of organizational citizenship behavior, which captures discretionary behaviors that are not formally rewarded within the organization that help others, or are displays of organizational loyalty or civic virtue.45 The thrust of much recent attention upon attaining reform in hospitals through clinical leadership has positioned clinical leadership as a vehicle for improving clinician engagement in not only their own work, but also the care delivery microsystems in which they operate.Models and Their Role in Healthcare Assignment Papers. This type of work engagement requires forms of citizenship behaviors that are focused upon improving clinical systems and practices. For individual clinicians, broader engagement within the organization with systems and processes requires the capacity for citizenship behaviors that are clinically focused and motivated, both at the level of one’s own work and also the broader network of relationships and systems. Models and Their Role in Healthcare Assignment Papers. These forms of “clinical citizenship behaviors” require a fair and just work culture in which individuals can openly identify issues and work together toward solutions.45 Importantly, given that clinicians may not necessarily be employees of the hospital in which they work but self-regulated and independent professionals who operate with a level of independence from typical employer–employee relationships, and who may have lower levels of commitment to the institution, understanding clinician engagement beyond the level of engagement with one’s own work, toward engagement with the broader clinical quality and safety agenda within the organization has important implications for the success of clinical leadership agendas.46 A small sample study of head nurses in a large academic hospital47 reported the development of clinical leaders improved the quality of the nursing work environment through enhanced communication, increased responsibility and empowerment, improved patient-centered communication, improved clarity and structure, and improved interdisciplinary collaboration.Models and Their Role in Healthcare Assignment Papers. Hospitals are complex socio-political entities, and the ability for engagement and leadership among clinicians can be hampered by power dynamics, disciplinary boundaries, and competing discourses within the organization. Models and Their Role in Healthcare Assignment Papers. The tension inherent between clinical and administrative discourses is evidenced in the findings from the evaluation of clinical directorate structures in Australian hospitals, with close to two thirds of medical and nursing staff surveyed reporting the primary outcome of such structures was increased organizational politics.48 At the same time as there have been growing calls for clinical leadership, there is evidence from Australia that reform and restructure within hospitals has resulted in a loss of nursing management roles an

Hemolytic Disease of the Newborn and Clinical Manifestations Essay Paper Hemolytic Disease of the Newborn and Clinical Manifestations Essay Paper Hemolytic disease of the newborn (HDN) is a blood disorder in a fetus or newborn infant. In some infants, it can be life threatening. What is hemolytic disease of the newborn? Hemolytic disease of the newborn (HDN) is a blood problem in newborn babies. It occurs when your baby’s red blood cells break down at a fast rate. It’s also called erythroblastosis fetalis. Hemolytic means breaking down of red blood cells. Erythroblastosis means making immature red blood cells. Fetalis means fetus. What causes HDN in a newborn? All people have a blood type (A, B, AB, or O). Everyone also has an Rh factor (positive or negative). There can be a problem if a mother and baby have a different blood type and Rh factor. HDN happens most often when an Rh negative mother has a baby with an Rh positive father. If the baby’s Rh factor is positive, like his or her father’s, this can be an issue if the baby’s red blood cells cross to the Rh negative mother. Hemolytic Disease of the Newborn and Clinical Manifestations Essay Paper Pregnancies potentially affected by HDFN should be cared for by specialist teams with facilities for early diagnosis, intrauterine transfusion and support of high-dependency neonates. Permalink: https://nursingpaperessays.com/ hemolytic-diseas…ions-essay-paper / HDFN occurs when the mother has IgG red cell alloantibodies in her plasma that cross the placenta and bind to fetal red cells possessing the corresponding antigen. Immune haemolysis may then cause variable degrees of fetal anaemia; in the most severe cases the fetus may die of heart failure in utero (hydrops fetalis). After delivery, affected babies may develop jaundice due to high unconjugated bilirubin levels and are at risk of neurological damage. The three most important red cell alloantibodies in clinical practice are to RhD (anti-D), Rhc (anti-c) and Kell (anti-K). The major effect of anti-K is suppression of red cell production in the fetus, rather than haemolysis. Hemolytic disease of the fetus and newborn (HDFN) is rare condition that occurs when maternal red blood cell (RBC) or blood group antibodies cross the placenta during pregnancy and cause fetal red cell destruction. The fetal physiological consequences of severe anemia in the fetus can also lead to edema, ascites, hydrops, heart failure, and death. In less severe cases, the in utero red cell incompatibility can persist postnatally with neonatal anemia due to hemolysis, along with hyperbilirubinemia and erythropoietic suppression. Hemolytic Disease of the Newborn and Clinical Manifestations Essay Paper Previous Section Next Section Epidemiology and pathophysiology There are an estimated 3/100 000 to 80/100 000 cases of HDFN per year in the United States.1 The maternal blood group antibodies that cause HDFN can be naturally occurring ABO antibodies (isohemagglutinins), or develop after exposure to foreign RBC; the latter are called blood group alloantibodies. For HDFN to occur, the fetus must be antigen positive (paternally inherited) and the mother must be antigen negative. Several studies have investigated the prevalence of red cell sensitization. In a large series of 22 102 females in the US, 254 (1.15%) of the women were found to have a red cell alloantibodies, of whom 18% had more than one alloantibody.2 In the Netherlands, the prevalence of red cell alloantibodies detected in the first trimester was 1.2%.3 The most common cause of blood group incompatibility results from the ABO blood group system, with incompatibility present in up to 20% of infants.4 However, because anti-ABO antibodies are predominantly IgM class, most are not effectively transported across the placenta. In addition, the A and B antigens are not well developed on fetal red blood cells. Together, this results in a low rate of clinically severe HDFN due to ABO compatibility, although the incidence of more mild disease varies from 1:150 to 1:3000, depending on the parameters used for the case definition, such as bilirubin levels or neonatal anemia.1 Because maternal ABO antibodies are present without previous sensitization, HDFN due to ABO antibodies can occur in the first pregnancy and has a recurrence rate up to 87%.1 It is most commonly seen in group O mothers with group A infants (European ancestry) or group B infants (African ancestry). Hemolytic Disease of the Newborn and Clinical Manifestations Essay Paper The most clinically significant forms of HDFN are caused by maternal blood group alloantibodies are of IgG1 and IgG subclasses, which cause hemolysis more effectively than other IgG subclasses. IgG1 and IgG3 are transported across the placenta by the Fc receptor from the second trimester onward.5 Once in the fetal circulation, the antibody binds antigen-positive fetal red cells that are then cleared by the fetal spleen. Free hemoglobin is metabolized into bilirubin that is conjugated by the maternal liver. As anemia worsens, fetal hematopoiesis increases, termed “erythroblastosis fetalis” and organs involved in red blood cell synthesis (liver, spleen) may enlarge. In the most severe cases, portal hypertension and reduced hepatic synthesis of albumin leads to low plasma oncotic pressure, edema and ascites. “Hydrops fetalis” refers to the state of widespread effusions and associated high-output cardiac failure and death.6 A large population-based study in Sweden found that the presence of maternal red cell antibodies was significantly associated with adverse outcomes, with a 1.4-2.4 relative risk of preterm delivery and a 1.5-2.6 relative risk of stillbirth in mothers with red cell allosensitization as compared to those without Hemolytic Disease of the Newborn and Clinical Manifestations Essay Paper Antibodies are produced when the body is exposed to an antigen foreign to the make-up of the body. If a mother is exposed to a foreign antigen and produces IgG (as opposed to IgM which does not cross the placenta), the IgG will target the antigen, if present in the fetus, and may affect it in utero and persist after delivery. The three most common models in which a woman becomes sensitized toward (i.e., produces IgG antibodies against) a particular antigen are hemorrhage, blood transfusion, and ABO incompatibility. Fetal-maternal hemorrhage, which is the movement of fetal blood cells across the placenta, can occur during abortion, ectopic pregnancy, childbirth, ruptures in the placenta during pregnancy (often caused by trauma), or medical procedures carried out during pregnancy that breach the uterine wall. In subsequent pregnancies, if there is a similar incompatibility in the fetus, these antibodies are then able to cross the placenta into the fetal bloodstream to attach to the red blood cells and cause their destruction (hemolysis). This is a major cause of HDN, because 75% of pregnancies result in some contact between fetal and maternal blood, and 15-50% of pregnancies have hemorrhages with the potential for immune sensitization. The amount of fetal blood needed to cause maternal sensitization depends on the individual’s immune system and ranges from 0.1 mL to 30 mL Hemolytic Disease of the Newborn and Clinical Manifestations Essay Paper The woman may have received a therapeutic blood transfusion. ABO blood group system and the D antigen of the Rhesus (Rh) blood group system typing are routine prior to transfusion. Suggestions have been made that women of child-bearing age or young girls should not be given a transfusion with Rhc-positive blood or Kell1-positive blood to avoid possible sensitization, but this would strain the resources of blood transfusion services, and it is currently considered uneconomical to screen for these blood groups. HDFN can also be caused by antibodies to a variety of other blood group system antigens, but Kell and Rh are the most frequently encountered. The third sensitization model can occur in women of blood type O. The immune response to A and B antigens, that are widespread in the environment, usually leads to the production of IgM or IgG anti-A and anti-B antibodies early in life. Women of blood type O are more prone than women of types A and B to making IgG anti-A and anti-B antibodies, and these IgG antibodies are able to cross the placenta. For unknown reasons, the incidence of maternal antibodies against type A and B antigens of the IgG type that could potentially cause hemolytic disease of the newborn is greater than the observed incidence of “ABO disease.” About 15% of pregnancies involve a type O mother and a type A or type B child; only 3% of these pregnancies result in hemolytic disease due to A/B/O incompatibility. In contrast to antibodies to A and B antigens, Rhesus antibodies are generally not produced from exposure to environmental antigens.[citation needed] In cases where there is ABO incompatibility and Rh incompatibility, the risk of alloimmunization is decreased because fetal red blood cells are removed from maternal circulation due to anti-ABO antibodies before they can trigger an anti-Rh response. Hemolytic Disease of the Newborn and Clinical Manifestations Essay Paper Hemolytic disease of the fetus and newborn (HDFN) is a condition in which transplacental passage of maternal antibodies results in immune hemolysis of fetal / neonatal red cells. The implicated antibodies could be naturally occurring (anti A, anti B) or immune antibodies which develop following a sensitizing event like transfusion or pregnancy. The hemolytic process may result in anemia or hyperbilirubinemia or both; thereby affecting fetal / neonatal morbidity and mortality. Before the discovery of the Rhesus immunoglobulin (Rh IG), HDFN due to anti D was a significant cause of perinatal mortality. Administration of Rh IG to Rh (D) negative women during pregnancy and shortly after the birth of D positive infants has reduced the incidence of Rh D hemolytic disease.[1] ABO incompatibility is now the single largest cause of HDFN in the western world.[2] Consequent to the introduction of routine Rh IG immunoprophylaxis; alloantibodies other than anti D have emerged as an important cause of HDFN and are now responsible for greater proportion of these cases.[3] Timely detection and close follow up of this condition is necessary to reduce harmful effects on the newborn. Transfusion services play a vital role in the antenatal detection, monitoring and providing transfusion support to such cases. Hemolytic disease of the newborn may result in high levels of bilirubin in the blood (hyperbilirubinemia), a low red blood cell count (anemia), and, very rarely, in the most severe forms, death. Bilirubin is a yellow pigment produced during the normal breakdown of red blood cells. Hemolytic Disease of the Newborn and Clinical Manifestations Essay Paper Rh incompatibility The Rh factor is a molecule on the surface of red blood cells in some people. Blood is Rh-positive if a person’s red blood cells have the Rh factor. Blood is Rh-negative if a person’s red blood cells do not have the Rh factor. Most people are Rh-positive. When a baby has Rh-positive blood and the mother has Rh-negative blood, the two have Rh incompatibility. As a result, the immune system of an Rh-negative mother may recognize the Rh-positive fetus’s red blood cells as “foreign” and produce antibodies against the Rh factor on the fetus’s red blood cells (this process is called Rh sensitization). The mother’s antibodies can pass from her blood through the placenta into the fetus’s blood before delivery. The mother’s antibodies attach to and destroy (hemolyze) the fetus’s red blood cells. The rapid breakdown of red blood cells begins while the fetus is still in the womb and continues after delivery. A mother who is Rh-negative can produce the Rh antibodies if she is exposed to Rh-positive red blood cells. The most common way women are exposed to Rh-positive blood is when they have a fetus who is Rh-positive. Mothers are exposed to the most blood from the fetus during delivery, so that is when most Rh sensitization occurs. However, mothers also can be exposed earlier in pregnancy, for example, during a miscarriage or elective abortion, during a diagnostic test on the fetus (such as amniocentesis or chorionic villus sampling), if they have an injury to their abdomen, or if the placenta separates too early (placental abruption). Thus, most hemolytic disease happens to a fetus whose mother was sensitized during an earlier pregnancy. However, rarely, a mother may produce antibodies early in a pregnancy and then these antibodies affect the same fetus later during that pregnancy. Exposure may also occur outside of pregnancy, for example if the mother was transfused with Rh-positive blood at any time earlier in her life. Once the mother has been exposed and developed antibodies, problems are more likely with each subsequent pregnancy in which the fetus is Rh-positive. Hemolytic Disease of the Newborn and Clinical Manifestations Essay Paper ABO incompatibility Sometimes other blood group incompatibilities may lead to a similar (but milder) hemolytic disease. For example, if the mother has blood type O and the fetus has blood type A or B, then the mother’s body produces anti-A or anti-B antibodies that can cross the placenta, attach to fetal red blood cells, and cause their breakdown (hemolysis), leading to mild anemia and hyperbilirubinemia. This type of incompatibility is called ABO incompatibility. ABO incompatibility usually leads to less severe anemia than Rh incompatibility and, unlike Rh incompatibility, it usually gets less severe with each subsequent pregnancy. Symptoms After delivery, newborns who have hemolytic disease may be swollen, pale, or yellow (a condition called jaundice) or may have a large liver or spleen, anemia, or accumulations of fluid in their body. Diagnosis Blood tests of the mother during pregnancy and sometimes the father At the first prenatal visit during a pregnancy, the mother gets a blood test to determine whether she has Rh-negative or Rh-positive blood. If the mother has Rh-negative blood and tests positive for anti-Rh antibodies or if she tests positive for another antibody that can cause hemolytic disease of the newborn, the father’s blood is checked. Rh sensitization is a risk if the father has Rh-positive blood. In these situations, the mother is given periodic blood tests during the pregnancy to check for Rh antibodies. Nothing further needs to be done as long as no antibodies are detected. If antibodies are detected, special tests on the mother and fetus are done during the pregnancy. Hemolytic Disease of the Newborn and Clinical Manifestations Essay Paper Prevention Injection of immune globulin during pregnancy and after delivery To prevent Rh-negative women from developing antibodies against their fetus’s red blood cells, they are given an injection of an Rh0(D) immune globulin preparation at about 28 weeks of pregnancy and again within 72 hours after delivery. The immune globulin rapidly coats any Rh-positive fetal red blood cells that have entered the mother’s circulation so they are not recognized as “foreign” by the mother’s immune system and thus do not trigger formation of anti-Rh antibodies. This treatment usually prevents hemolytic disease of the newborn from developing. Treatment Before delivery, sometimes blood transfusion for the fetus After delivery, sometimes more transfusions Treatment of jaundice if present If anemia is diagnosed in the fetus, the fetus may be given a blood transfusion before birth. Transfusions may be done until the fetus has matured and can be delivered safely. Before delivery, the mother may be given corticosteroids to help the fetus’s lungs mature to prepare for the possible delivery of the fetus earlier than usual if necessary. After delivery, the newborn may need more transfusions. Hemolytic Disease of the Newborn and Clinical Manifestations Essay Paper Severe anemia caused by hemolytic disease of the newborn is treated in the same way as any other anemia (see treatment of anemia). Doctors also observe the newborn for jaundice. Jaundice is likely to occur because the rapid breakdown of red blood cells produces a lot of bilirubin. Bilirubin is a yellow pigment, and it gives the newborn’s skin and whites of the eyes a yellow appearance. If the bilirubin level gets too high, it can injure the baby. High bilirubin levels can be treated by exposing the newborn to special bright lights (phototherapy or “bili lights”) or, occasionally, by having the newborn undergo an exchange transfusion. Very high levels of bilirubin in the blood can lead to brain damage (kernicterus), unless it is prevented by these measures. RAADP should be offered to all RhD negative, non-sensitised women. They should be supplied with clear written information and informed consent should be obtained. Both two-dose (at 28 and 34 weeks) and larger single-dose (at 28–30 weeks) prophylactic anti-D regimens reduce maternal sensitisation but there are no comparative data to confirm their relative efficacy. The single-dose regimen may achieve better compliance but anti-D levels at term may be low in some women. Hemolytic Disease of the Newborn and Clinical Manifestations Essay Paper Recommended anti-D Ig doses for RAADP: Two-dose regimen – minimum of 500 IU at 28 and 34 weeks. Single-dose regimen – 1500 IU at 28–30 weeks. RAADP should be given even if the woman has received anti-D Ig prophylaxis for a potentially sensitising event earlier in the pregnancy. The transfusion laboratory should be informed of the administration of RAADP in case the woman requires pre-transfusion testing. It is not possible to differentiate between ‘prophylactic’ and ‘immune’ (allo-) anti-D in maternal blood in laboratory tests. 9.5.4: Anti-D Ig prophylaxis after the birth of a RhD positive baby or intrauterine death Following the birth of a child to a RhD negative woman, a cord blood sample should be tested to determine the baby’s ABO and Rh group. If the cord Rh group is unclear, or if a sample cannot be obtained, the baby should be assumed to be RhD positive for anti-D Ig administration purposes. A direct antiglobulin test (DAT) on the cord sample should only be performed if HDFN is suspected. If the baby is RhD positive, a minimum of 500 IU anti-D Ig should be administered to non-sensitised RhD negative women, within 72 hours of the birth. Hemolytic Disease of the Newborn and Clinical Manifestations Essay Paper A maternal blood sample for confirmation of her ABO and RhD status and for FMH screening should be taken within 2 hours of delivery. A dose of 500 IU anti-D Ig given IM will cover a FMH of up to 4 mL. If an additional dose is required, it should be based on 125 IU/mL fetal red cells if given IM or 100 IU/mL if given IV (manufacturer’s instructions on dosing should be followed and anti-D Ig produced for IM use only must not be given IV). If a FMH of >4 mL is detected, follow-up maternal blood samples should be tested 72 hours after an IM dose (48 hours if given IV) to confirm clearance of fetal red cells from the maternal circulation. In the case of very large FMH, administration of IV anti-D Ig may be more convenient and less painful than large-volume or repeated IM administration. If anti-D Ig is inadvertently omitted, there may be some benefit in giving prophylaxis up to 10 days. If intraoperative cell salvage is used at Caesarean section, 1500 IU anti-D Ig should be administered immediately after the procedure if the baby is RhD positive and maternal FMH screening should be performed. 9.5.5: Inadvertent transfusion of RhD positive blood If RhD positive blood is inadvertently transfused to a non-sensitised RhD negative woman of child-bearing potential, the advice of a transfusion medicine specialist should be obtained and the appropriate dose of anti-D Ig administered (125 IU/mL fetal red cells if given IM or 100 IU/mL IV). For transfusions >15 mL, IV anti-D Ig is more practical. FMH testing should be carried out at 48-hour intervals and further anti-D Ig given until clearance of fetal cells is confirmed. If more than one unit of red cells has been transfused, red cell exchange should be considered to reduce the load of RhD positive cells and the dose of anti-D Ig required. Hemolytic Disease of the Newborn and Clinical Manifestations Essay Paper Red cell alloantibodies in the mother occur as a result of previous pregnancies (where fetal red cells containing paternal blood group antigens cross the placenta) or blood transfusion. Naturally occurring IgG anti-A or anti-B antibodies in a group O mother can cross the placenta but rarely cause more than mild jaundice and anaemia in the neonate (ABO haemolytic disease). Recommendations for serological screening for maternal red cell antibodies in pregnancy are summarised in Table 9.1 (see also BCSH Guideline for Blood Grouping and Antibody Testing in Pregnancy – http://www.bcshguidelines.com). Knowledge of any maternal red cell alloantibodies is also important in providing compatible blood without delay in the event of obstetric haemorrhage. HDFN due to anti-D This is the most important cause of HDFN and may occur in RhD negative women carrying a RhD positive fetus. Around 15% of white Europeans are RhD negative. Typically, the mother is sensitised by the transplacental passage of RhD positive fetal red cells during a previous pregnancy – usually at delivery or during the third trimester. HDFN then occurs in subsequent RhD positive pregnancies when further exposure to fetal red cells causes a secondary immune response and increased levels of maternal IgG anti-RhD alloantibodies that can cross the placenta. Before the introduction of routine postnatal prophylaxis with anti-RhD immunoglobulin (anti-D Ig, standard dose 500 IU) in the 1970s, HDFN was a major cause of perinatal mortality in the UK (46/100 000 births). Rates of sensitisation fell further with the introduction of routine antenatal anti-D prophylaxis in the third trimester (RAADP) and mortality is now <1.6/100 000 births. Hemolytic Disease of the Newborn and Clinical Manifestations Essay Paper 9.5.2: Potentially sensitising events RhD negative mothers can also produce anti-RhD in response to potentially sensitising events that may cause feto-maternal haemorrhage (FMH) during pregnancy or by blood transfusion. The BCSH Guideline for the Use of Anti-D Immunoglobulin for the Prevention of Haemolytic Disease of the Fetus and Newborn 2013 lists the following as potentially sensitising events in pregnancy: Amniocentesis, chorionic villus biopsy and cordocentesis Antepartum haemorrhage/vaginal bleeding in pregnancy External cephalic version Fall or abdominal trauma Ectopic pregnancy Evacuation of molar pregnancy Intrauterine death and stillbirth In utero therapeutic interventions (transfusion, surgery, insertion of shunts, laser) Miscarriage, threatened miscarriage Therapeutic termination of pregnancy Delivery – normal, instrumental or Caesarean section Intraoperative cell salvage. Recommendations for the administration of prophylactic anti-D Ig for potentially sensitising events are summarised in Table 9.2 and the reader is referred to the current BCSH Guideline for the Use of Anti-D Immunoglobulin for the Prevention of Haemolytic Disease of the Fetus and Newborn (http://www.bcshguidelines.com) and the Royal College of Obstetricians and Gynaecologists’ Green Top Guideline No. 22 on the use of anti-D immunoglobulin for Rhesus D prophylaxis (http://www.rcog.org.uk/files/rcog-corp/GTG22AntiDJuly2013.pdf) for up-to-date guidance. An intramuscular (IM) injection of 125 IU anti-D Ig, or 100 IU of the appropriate preparation given intravenously (IV), ‘covers’ a FMH of 1 mL red cells. Women with anomalous RhD typing results should be treated as RhD negative until confirmatory testing is completed. Anti-D Ig should be administered within 72 hours of the potentially sensitising event (although some benefit may occur up to 10 days if treatment is inadvertently delayed). Hemolytic Disease of the Newborn and Clinical Manifestations Essay Paper If the pregnancy has reached 20 weeks or more, administration of anti-D Ig should be accompanied by a test on the mother’s blood to estimate the volume of fetal red cells that have entered the maternal circulation (e.g. Kleihauer test) in case it exceeds that covered by the standard dose of anti-D Ig. The Kleihauer test detects fetal cells, which contain HbF, in the maternal blood. If the screening Kleihauer test suggests a FMH >2 mL then the FMH volume should be confirmed by flow cytometry, which accurately measures the population of RhD positive cells. Detailed guidance is given in the 2009 BCSH Guidelines on the Estimation of Fetomaternal Haemorrhage (http://www.bcshguidelines.com). Signs of hemolytic disease of the newborn include a positive direct Coombs test (also called direct agglutination test), elevated cord bilirubin levels, and hemolytic anemia. It is possible for a newborn with this disease to have neutropenia and neonatal alloimmune thrombocytopenia as well. Hemolysis leads to elevated bilirubin levels. After delivery bilirubin is no longer cleared (via the placenta) from the neonate’s blood and the symptoms of jaundice (yellowish skin and yellow discoloration of the whites of the eyes, or icterus) increase within 24 hours after birth. Like other forms of severe neonatal jaundice, there is the possibility of the neonate developing acute or chronic kernicterus, however the risk of kernicterus in HDN is higher because of the rapid and massive destruction of blood cells. It is important to note that isoimmunization is a risk factor for neurotoxicity and lowers the level at which kernicterus can occur. Untreated profound anemia can cause high-output heart failure, with pallor, enlarged liver and/or spleen, generalized swelling, and respiratory distress. Hemolytic Disease of the Newborn and Clinical Manifestations Essay Paper HDN can be the cause of hydrops fetalis, an often-severe form of prenatal heart failure that causes fetal edema.[2] Complications Complications of HDN could include kernicterus, hepatosplenomegaly, inspissated (thickened or dried) bile syndrome and/or greenish staining of the teeth, hemolytic anemia and damage to the liver due to excess bilirubin. Similar conditions include acquired hemolytic anemia, congenital toxoplasma, congenital syphilis infection, congenital obstruction of the bile duct, and cytomegalovirus (CMV) infection. High at birth or rapidly rising bilirubin[3] Prolonged hyperbilirubinemia[3] Bilirubin Induced Neurological Dysfunction[4] Cerebral Palsy[5] Kernicterus[6] Neutropenia[7][8] Thrombocytopenia[7] Hemolytic anemia – Must NOT be treated with iron[9] Late onset anemia – Must NOT be treated with iron. Can persist up to 12 weeks after birth.[10][11][12] Pathophysiology Antibodies are produced when the body is exposed to an antigen foreign to the make-up of the body. If a mother is exposed to a foreign antigen and produces IgG (as opposed to IgM which does not cross the placenta), the IgG will target the antigen, if present in the fetus, and may affect it in utero and persist after delivery. The three most common models in which a woman becomes sensitized toward (i.e., produces IgG antibodies against) a particular antigen are hemorrhage, blood transfusion, and ABO incompatibility. Hemolytic Disease of the Newborn and Clinical Manifestations Essay Paper Fetal-maternal hemorrhage, which is the movement of fetal blood cells across the placenta, can occur during abortion, ectopic pregnancy, childbirth, ruptures in the placenta during pregnancy (often caused by trauma), or medical procedures carried out during pregnancy that breach the uterine wall. In subsequent pregnancies, if there is a similar incompatibility in the fetus, these antibodies are then able to cross the placenta into the fetal bloodstream to attach to the red blood cells and cause their destruction (hemolysis). This is a major cause of HDN, because 75% of pregnancies result in some contact between fetal and maternal blood, and 15-50% of pregnancies have hemorrhages with the potential for immune sensitization. The amount of fetal blood needed to cause maternal sensitization depends on the individual’s immune system and ranges from 0.1 mL to 30 mL.[2] The woman may have received a therapeutic blood transfusion. ABO blood group system and the D antigen of the Rhesus (Rh) blood group system typing are routine prior to transfusion. Suggestions have been made that women of child-bearing age or young girls should not be given a transfusion with Rhc-positive blood or Kell1-positive blood to avoid possible sensitization, but this would strain the resources of blood transfusion services, and it is currently considered uneconomical to screen for these blood groups. HDFN can also be caused by antibodies to a variety of other blood group system antigens, but Kell and Rh are the most frequently encountered. Hemolytic Disease of the Newborn and Clinical Manifestations Essay Paper The third sensitization model can occur in women of blood type O. The immune response to A and B antigens, that are widespread in the environment, usually leads to the production of IgM or IgG anti-A and anti-B antibodies early in life. Women of blood type O are more prone than women of types A and B to making IgG anti-A and anti-B antibodies, and these IgG antibodies are able to cross the placenta. For unknown reasons, the incidence of maternal antibodies against type A and B antigens of the IgG type that could potentially cause hemolytic disease of the newborn is greater than the observed incidence of “ABO disease.” About 15% of pregnancies involve a type O mother and a type A or type B child; only 3% of these pregnancies result in hemolytic disease due to A/B/O incompatibility. In contrast to antibodies to A and B antigens, Rhesus antibodies are generally not produced from exposure to environmental antigens.[citation needed] In cases where there is ABO incompatibility and Rh incompatibility, the risk of alloimmunization is decreased because fetal red blood cells are removed from maternal circulation due to anti-ABO antibodies before they can trigger an anti-Rh response.[2] Antibody Specific Information Anti-D is the only preventable form of HDN. Since the 1968 introduction of Rho-D immunoglobulin, (Rhogam), which prevents the production of maternal Rho-D antibodies, the incidence of anti-D HDN has decreased dramatically.[2][13] Anti-C and anti-c can both show a negative DAT but still have a severely affected infant.[14][15] An indirect Coombs must also be run. Hemolytic Disease of the Newborn and Clinical Manifestations Essay Paper Anti-M also recommends antigen testing to rule out the presence of HDN as the direct coombs can come back negative in a severely affected infant.[16] Anti-Kell can cause severe anemia regardless of titer.[17] Anti-Kell suppresses the bone marrow,[18] by inhibiting the erythroid progenitor cells.[19][20] Kidd antigens are also present on the endothelial cells of the kidneys[21][22] One study done by Moran et al., found that titers are not reliable for anti-E. Their most severe case of hemolytic disease of the newborn occurred with titers 1:2. Moran states that it would be unwise routinely to dismiss anti-E as being of little clinical consequence.[23] Diagnosis The diagnosis of HDN is based on history and laboratory findings: Blood tests done on the newborn baby Biochemistry tests for jaundice Peripheral blood morphology shows increased reticulocytes. Erythroblasts (also known as nucleated red blood cells) occur in moderate and severe disease. Positive direct Coombs test (might be negative after fetal interuterine blood transfusion) Blood tests done on the mother Positive indirect Coombs test Blood tests done on the father Erythrocyte antigen status Types (classified by serology) Types of HDN are classified by the type of antigens involved. The main types are ABO HDN, Rhesus HDN, Kell HDN, and other antibodies. ABO hemolytic disease of the newborn can range from mild to severe, but generally it is a mild disease. It can be caused by anti-A and anti-B antibodies. Rhesus D hemolytic disease of the newborn (often called Rh disease) is the most common form of severe HDN. Rhesus c hemolytic disease of the newborn can range from a mild to severe disease – is the third most common form of severe HDN.[24] Rhesus e and rhesus C hemolytic disease of the newborn are rare. Combinations of antibodies, for example, anti-Rhc and a

Columbus State Nursing Program Assignment Papers. Columbus State Nursing Program Assignment Papers. Permalink: https://nursingpaperessays.com/ columbus-state-n…ignment-papers / Students in the Public Health Nursing specialization are prepared to take a lead role in improving health outcomes for entire populations, particularly those in underserved communities. The focus of the coursework is on skills such as assessing communities and populations; identifying high-risk groups; and developing culturally sensitive, realistic, population-based nursing interventions. Graduates of Walden’s MSN program will have the graduate degree they need to pursue Advanced Public Health Nursing (APHN-BC) certification through portfolio application.*Columbus State Nursing Program Assignment Papers. NURS 3111. Professional Development Perspectives 1 (1-0-1) Prerequisite: Admission into the BSN program. First of a professional development series introducing nursing concepts with an emphasis on nursing student success strategies, professional nursing roles, professional standards, evidence-based practice principles, professional decision making/critical thinking, and basics of professional writing. (Course fee required.)Columbus State Nursing Program Assignment Papers. NURS 3112. Professional Development Perspectives II (2-0-2) Prerequisite: NURS 3111. Continuation of the professional development series, building upon previously acquired concepts with exploration of delegation, prioritization, and legal/ethical principles. (Course fee required.)Columbus State Nursing Program Assignment Papers. NURS 3175. Pharmacology in Nursing (4-0-4) Prerequisite: Admission to upper division nursing. This course provides an introduction to major drug classifications, principles of drug mechanism, distribution and absorption of drugs, actions, toxicity, and regulation of drugs. Knowledge gained in this course serves as a foundation to build upon in the clinical nursing courses where students calculate, administer, and assess the client’s response to medications. (Course fee required.)Columbus State Nursing Program Assignment Papers. NURS 3191. Professional Clinical Nursing RN I (3-0-3) Prerequisite: Admission to RN-BSN Program. This course is designed for registered nurses seeking a BSN degree. Synthesis of concepts, principles, theories and roles foundational to professional nursing practice including health promotion, prevention and wellness, with particular consideration given to older adults, are central to the course. Collaboration, communication, critical thinking, and role transition are included. This course will build on previously mastered nursing concepts with an emphasis on updates in pharmacology, standards of practice, and informatics. (Course fee required.) NURS 3192. Professional Development Perspectives RN I (2-0-2) Prerequisite: Admission to RN-BSN Program. First of two professional development courses describing nursing concepts with an emphasis on roles, delegation, standards, communication, professional writing, quality improvement and critical thinking. (Course fee required.)Columbus State Nursing Program Assignment Papers. NURS 3194. Applied Pathophysiology RN (3-0-3) Prerequisite: Admission to the RN-BSN program. This course provides an overview of the pathophysiology of selected conditions focusing on the etiology, pathogenesis, physiological changes, and clinical manifestations of common health problems. Genetic and cultural influences on health will also be addressed. Emphasis is upon both the physiological changes that contribute to disease production, physiological changes that occur as a result of disease, and the body’s compensation for these changes, as well as the application of this knowledge to the assessment of patients with commonly occurring disease and injury processes. (Course fee required.)Columbus State Nursing Program Assignment Papers. NURS 3195. Evidence Based Practice RN (4-0-4) Prerequisite: Admission into the RN-BSN Program and STAT 1127, “C” or better. Focuses on the evidence-based practice process to enable students to become informed consumers of research and capable of applying evidence, professional experience, and patient preferences in their practices. This course includes research design, appraisal of selected nursing studies, identification and search of PICOT questions. Students will also be involved in developing practice guidelines for dissemination.Columbus State Nursing Program Assignment Papers. NURS 3266. Perioperative Nursing (1-6-3) Prerequisite: Admission to the BSN program. This course introduces the student to the role of the professional perioperative nurse by providing learning opportunities in the classroom, perioperative clinical settings, and professional organization meetings. Students will utilize the nursing process, AORN Perioperative Standards and Recommended Practices, and The Joint Commission National Safety Goals to guide development of evidence-based nursing care for clients throughout the lifespan in pre, intra, and postoperative settings. In addition, this course provides opportunities for students to further develop physical assessment, infection control, and interdisciplinary communication techniques. (S/U grading)Columbus State Nursing Program Assignment Papers. NURS 3275. Professional Clinical Nursing 1 (4-9-7) Prerequisite: Admission into nursing program and NURS 3276. This course provides experiences to foster the development of basic cognitive and psychomotor skills to serve as the foundation for nursing practice for patients of all ages.Columbus State Nursing Program Assignment Papers. The focus is on basic nursing knowledge and skill related to oxygenation, hygiene care, asepsis and infection control, vital signs, mobility, elimination, enteral feeding and nutrition, documentation, safety, wound care, perioperative care, rest and sleep, pain management, care of the elderly, sensory impairment, and loss and grief. Principles of therapeutic communication, growth and development, stress and adaptation, critical thinking, and the nursing process are introduced. Clinical experiences include the ROPES course and patient care in long term care facilities and acute inpatient hospital units. (Course fee required.)Columbus State Nursing Program Assignment Papers. NURS 3276. Introduction to Health Assessment and Wellness (2-3-3) Prerequisite: Admission to upper division nursing courses. This course provides experiences to foster development of the basic knowledge and psychomotor skills necessary for assessing the health of clients throughout the life span, including eliciting a health history, conducting a basic physical examination, and integrating basic techniques of health assessment into patient care in varied settings.Columbus State Nursing Program Assignment Papers. The focus of the course is on basic interviewing and physical assessment techniques in the lab and virtual simulation environment, medical terminology, recognition of normal findings, and differentiating normal from the most common abnormal findings. (Course fee required.)Columbus State Nursing Program Assignment Papers. NURS 3277. Professional Clinical Nursing II (7-10-10) Prerequisite: NURS 3175, NURS 3275, NURS 3111, and NURS 3276 Corequisite: NURS 3112 Professional Development Perspectives II This course provides experiences to foster the development of cognitive and psychomotor skills necessary for the nursing care of patients of all ages with routine needs in medical, surgical, and mental health settings.Columbus State Nursing Program Assignment Papers. The focus is on care of patients experiencing common endocrine, respiratory, cardiovascular, neurological, renal, gastrointestinal, musculoskeletal, blood, neoplastic, acid-base and psychological alterations. Principles of therapeutic communication, group dynamics, growth and development, teaching and learning, stress and adaptation, legal and ethical standards of care, critical thinking, and nursing process are integrated throughout the course. Clinical experiences include in-patient hospital units serving patients with physical and mental health problems. (Course Fee Required).Columbus State Nursing Program Assignment Papers. NURS 3279. Applied Pathophysiology (3-0-3) Prerequisites: Admission into the nursing program. This course provides an overview of the pathophysiology of selected conditions focusing on the etiology, pathogenesis, physiological changes, and clinical manifestations of common health problems.Columbus State Nursing Program Assignment Papers. Emphasis is upon both the physiological changes that contribute to disease production, physiological changes that occur as a result of disease, and the body’s compensation for these changes, as well as the application of this knowledge to the assessment of patients with commonly occurring disease and injury processes. (Course fee required.) NURS 3293. Introduction to Health Assessment and Wellness RN (2-3-3) Prerequisite: Admission to the RN-BSN Program. This course is designed to assist in refining history taking, psychosocial assessment, and physical assessment skills that are necessary for assessing the health of clients throughout the life span, including eliciting a health history, conducting a basic physical examination, and integrating basic techniques of health assessment into patient care in varied settings. The focus of the course is on basic interviewing and physical assessment techniques, in-depth virtual simulation, recognition of normal findings, and differentiating normal from the most common abnormal findings.Columbus State Nursing Program Assignment Papers. NURS 3555. Selected Topics in Professional Nursing ({1-3}-0-{1-3}) Prerequisites: Admission to BSN upper level program and approval of School of Nursing Director. Specialized topics from nursing taught by means of lecture, discussion, special seminar, guided independent study, directed experience in the field of nursing, online learning activities, clinical investigation and/or other methods as appropriate. May be repeated once with different topic. (Course fee required.)Columbus State Nursing Program Assignment Papers. NURS 4111. Professional Development Perspectives III (2-0-2) Prerequisite: all Junior level Nursing courses. Continuation of professional nursing series with an examination of leadership theories and styles, economic and social issues, change theories, and nursing across healthcare systems and delivery within the global arena. (Course fee required.)Columbus State Nursing Program Assignment Papers. NURS 4112. Professional Development Perspectives IV (2-0-2) Prerequisite: NURS 4111. Application of professional nursing concepts with a focus on power and politics, professional maturation process, career management, and professional socialization with an emphasis on transition into practice. This series of courses will culminate in a portfolio incorporating a variety of professional concepts. (Course fee required.)Columbus State Nursing Program Assignment Papers. NURS 4175. Evidence-Based Practice (3-0-3) Prerequisites: STAT 1127 with a grade of “C” or better and all Junior level Nursing courses. Focuses on the evidence-based practice process to enable students to become informed consumers of research and capable of applying evidence, professional experience, and patient preferences in their practice. This course includes research design, appraisal of selected nursing studies, identification and search of PICOT questions. Students will also be involved in developing practice guidelines and presenting those guidelines to staff nurses at local hospitals. (Course fee required.)Columbus State Nursing Program Assignment Papers. NURS 4192. Professional Development Perspectives RN II (2-0-2) Prerequisite: NURS 3192, grade of “C” or better. Second of two professional development courses with a focus on leadership theories and styles, economic and social issues, change theories, power and politics, and career development. (Course fee required.) NURS 4279. Professional Clinical Nursing IV (7-10-10) Prerequisite: all Junior level Nursing courses. This course provides experiences to foster development of advanced cognitive and psychomotor skills necessary for providing nursing care for adults and children experiencing complex and/or multi-system physiological and/or psychological health problems. The focus is on the management and nursing care related to acute threats to life, limb, and/or mental well-being. Clinical experiences include intensive care units, emergency departments, pediatrics, and acute psychiatric facilities. (Course fee required.)Columbus State Nursing Program Assignment Papers. NURS 4280. Professional Clinical Nursing III (7-10-10) Prerequisite: all Junior level Nursing courses. Utilization of the nursing process with families in childbearing and child rearing phase of family development, families at risk, aggregates and communities to promote wellness, prevent illness, and maintain health. Health problems of the reproductive and lactation systems are also included. Selected mental health concepts are integrated throughout. Course content includes the concepts of epidemiology, levels of prevention, ecology and theoretical frameworks applicable to working in community settings. Clinical experiences are provided in a variety of settings. (Course fee required.)Columbus State Nursing Program Assignment Papers. NURS 4292. Professional Clinical Nursing RN II (4-6-6) Prerequisite: NURS 3192 with a grade of “C” or better and Admission to RN-BSN Program. This course is designed for registered nurses seeking a BSN degree. Various roles in population health nursing are examined through the application of theories and concepts from nursing and public health sciences in assessing health status and preventing and controlling disease in families, aggregates, and communities as clients.Columbus State Nursing Program Assignment Papers. The course will provide an overview of global health issues that transcend national borders, class, race, ethnicity, and culture. The use of epidemiological and community assessment techniques to examine populations at risk, health promotion, protection, maintenance and levels of disease prevention with special emphasis on ethnically diverse and vulnerable populations are incorporated. (Course Fee Required) NURS 4377. Senior Preceptorship (0-9-3) Prerequisite: all Junior level and Senior level Nursing courses. A capstone learning experience in which senior nursing students synthesize and apply theories, concepts, knowledge, skills and abilities from the sciences, humanities, and nursing to nursing practice. The course includes precepting, activities to review for NCLEX-RN licensing exam (at student’s expense), and the Nursing Exit Exam. (Course fee required.)Columbus State Nursing Program Assignment Papers. NURS 4698. Senior Project RN (0-9-3) Prerequisite:NURS 3195, NURS 4192, NURS 3279 or NURS 3194, NURS 3276 or NURS 3293, and NURS 4292 with grades of “C” or better and admission to RN-BSN program. This course is designed for registered nurses seeking a BSN degree. A senior project will focus on evidence-based principles and theoretical frameworks to guide the discovery, synthesis, and dissemination of information related to a selected clinical topic. (Course fee required.)Columbus State Nursing Program Assignment Papers. NURS 6100. Principles of Leadership & Management within Healthcare Organizations (3-0-3) Prerequisite: Admission to Graduate program in the School of Nursing. Transitioning from novice to expert in the role of a nursing leader is explored in this course. Content includes theoretical foundations of effective leadership which will enable the student to function effectively in a leadership role in various settings. The management of human, fiscal, and physical health care resources will be emphasized.Columbus State Nursing Program Assignment Papers. NURS 6104. Theory for Graduate Nursing Practice (3-0-3) Prerequisite: Admission to Graduate Nursing Program or Senior Standing in BSN Program with 3.00 GPA. This course prepares nurses to transition into new roles and advanced nursing practice by exploring a wide range of theories from nursing and other sciences. Students will understand the role of knowledge development in advancing a discipline. Students will critique, analyze, and evaluate selected theories and incorporate these theories into their advanced nursing practice roles.Columbus State Nursing Program Assignment Papers. NURS 6105. Research for Evidence-Based Nursing Practice (3-0-3) Prerequisite: Admission to Graduate Nursing Program or Senior Standing in BSN Program with a 3.00 GPA.This course builds upon undergraduate statistics and research courses and will focus on the relationship between nursing theory, research, and practice for evidence-based practice. This course will focus on issues such as the identification of practice and system problems, evaluation of research studies and systematic reviews, development and implementation of evidence-based practice guidelines, use of evidence-based practice to improve outcomes for individuals and groups of patients as well as health care systems, and differentiation of evidence-based and value-based approaches to practice. Students are expected to integrate an evidence-based approach into their practice.Columbus State Nursing Program Assignment Papers. NURS 6106. Advanced Pharmacology (3-0-3) Prerequisite: Admission to Graduate Nursing Program or Senior Standing in BSN Program with 3.00 GPA. This course includes principles of pharmacokinetics, pharmacodynamics, drug metabolism and transport, assessment of drug effects, drug therapy in special populations, and contemporary drug development as a foundation for the use of medications in the clinical management of diseases.Columbus State Nursing Program Assignment Papers. Major classes of drugs will be discussed in terms of actions; therapeutic and other effects; adverse, allergic and idiosyncratic reactions; indications and contraindications. Emphasis is placed on nursing responsibility, accountability, and application of the nursing process regarding drug therapy in a variety of settings with individuals across the life span.Columbus State Nursing Program Assignment Papers. NURS 6107. Advanced Pathophysiology (3-0-3) Prerequisite: Admission to Graduate Nursing Program or Senior Standing in BSN Program with 3.00 GPA. This course focuses on developing an advanced knowledge base of pathophysiology of the human body and the impact of this knowledge base on evidence based practice.Columbus State Nursing Program Assignment Papers. It will prepare advanced practice nurses to understand the mechanism underlying the disease process, its clinical manifestations, and rational therapies. Appropriate screening and diagnostic testing methods will also be included. Emphasis will be placed on important pathophysiological concepts needed to support the goals of Healthy People 2010 to improve clients NURS 6108. Advanced Health Assessment (2-3-3) Prerequisite: Admission to Graduate Nursing Program or Senior Standing in BSN Program with 3.00 GPA. This course will build upon health assessment skills developed in the professional nurse’s basic educational program.Columbus State Nursing Program Assignment Papers. The theoretical and clinical basis for assessment in advanced nursing practice will be developed. The process whereby the advanced practitioner utilizes comprehensive physical, psychosocial, and cultural assessment across the lifespan to gather specific data relevant to common health problems is demonstrated. Faculty and preceptors facilitate laboratory and clinical experiences, which focus on assessment of clients and presentation of findings in a variety of settings. Emphasis will be placed on important assessment concepts needed to support the goals of Healthy People 2010 to improve clients.Columbus State Nursing Program Assignment Papers. NURS 6110. Principles of Education in Nursing (3-0-3) Prerequisite: Admission to the Graduate Nursing Program. This course focuses on the theoretical foundations of teaching, learning innovations, and the multifaceted role of a nurse educator in multiple settings. Expectations of a leader in nursing education are explored.Columbus State Nursing Program Assignment Papers. NURS 6119. Information Technology in Health Care (3-0-3) Prerequisite: Admission to the Graduate Nursing Program. This course examines the implications of the use of health care technology in the workplace as it impacts the areas of advanced clinical practice, nursing administration, and nursing education. Consideration is also given to ethical principles guiding the use of health care technology, and to the organizational and financial issues associated with legislation and public organizational policies This course provides hands-on experience with a certified EHR that accentuates the opportunity for students to assess the potential of such systems to provide decision support and to improve patient outcomes.Columbus State Nursing Program Assignment Papers. NURS 6127. Scientific Underpinnings of the Advanced Practice Role (3-0-3) Prerequisite: Admission to Graduate Nursing program. Students explore components and variations of the advanced practice role and how social policy and healthcare delivery influence are influenced by the role. Legal definitions and professional interpretations of advance practice nursing are examined in relation to healthcare outcomes, resource allocation and cost effectiveness. NURS 6128. Pharmacology for the Advanced Practice Nurse (3-0-3) Prerequisite: Admission to the Graduate Nursing Program. Course focuses on examination of the major categories of pharmacological agents and application of pharmacological concepts in the clinical practice setting. Emphasis is placed on understanding the physiological action of the drugs, expected patient responses and major effects. This course is prerequisite for clinical courses that integrate the knowledge of pharmacotherapeutics into effective nursing practice.Columbus State Nursing Program Assignment Papers. NURS 6129. Health Care Delivery Models, Economics and Policy (2-0-2) Prerequisite: Admission to the Graduate Nursing Program. This course advances the student’s knowledge and skill in health care delivery systems, economics and health policy. The student will critically examine theories in relation to advanced nursing practice in current and emerging health care delivery systems and the concepts of economics as they apply to the healthcare market and financing and delivering health care services.Columbus State Nursing Program Assignment Papers. Particular attention is paid to the impact healthcare economics has on patients, delivery systems, and providers. The student will analyze the forces involved in the formation and implementation of health care policy. Emphasis is on the characteristics of health care policy and politics and the influence of economics on the practice, design and reform of health care in the United States.Columbus State Nursing Program Assignment Papers. NURS 6210. Management of Human Resources in Health Care (3-0-3) Prerequisite: Admission to the Graduate Nursing Program. This course will provide the knowledge needed for the nurse leader/manager to be competent in healthcare human resource management. This course will focus on recruitment, selection, and training issues and also on how human resource management needs to be integrated into the strategic planning of the organization. Legal, ethical, and labor issues will be discussed, as well as health and safety issues, and the regional, national and global influences on human resource planning and management.Columbus State Nursing Program Assignment Papers. NURS 6220. Effective Teaching/Learning Strategies (3-0-3) Prerequisite: Admission to Graduate Nursing Program or Senior Standing in BSN Program with 3.00 GPA. This course is an overview of a variety of learning and instructional strategies to assist in the implementation of teaching plans for the nurse educator. General principles and methodologies related to learning and instruction are integrated into face-to-face and technology enhanced techniques.Columbus State Nursing Program Assignment Papers. NURS 6225. Health Assessment for Advanced Practice Nurses (2-3-3) Prerequisite: Admission to the Graduate Nursing Program. This course in health assessment expands the nurse’s knowledge of cognitive processes and psychomotor skills needed for comprehensive assessment of clients across the lifespan. Techniques and processes of performing a physical, mental, developmental, and nutritional assessment, obtaining a health history, performing selected diagnostic procedures, and recording findings will be conducted. Interviewing skills that enable the nurse to relate to various clients across the life span will be refined.Columbus State Nursing Program Assignment Papers. NURS 6226. Diagnostic and Clinical Reasoning for the Advanced Practice Nurse (2-3-3) Prerequisite: Admission to the Graduate Nursing Program. This course focuses on diagnostic reasoning as a framework to synthesize knowledge for comprehensive assessment of primary care patients throughout the life span. Advance health assessment techniques are emphasized and refined.Columbus State Nursing Program Assignment Papers. Diverse types of approaches are used in expanding proficiency in conducting histories and physical examinations in laboratory and clinical settings including communication techniques unique to the specialty population. Systematic and organized health assessments that are sensitive to cultural and developmental needs are explored.Columbus State Nursing Program Assignment Papers. NURS 6227. Health Promotion of Women and Children (3-0-3) Prerequisite: NURS 6107, NURS 6128, NURS 6225, NURS 6226, NURS 6228, NURS 6328, NURS 6229, and NURS 6329; Coerequisite: NURS 6327. This course is designed to prepare Family Nurse Practitioners to assume responsibility for health promotion, maintenance, and management of common acute and chronic health problems of women of child-bearing age, infants, children, and adolescents in health care settings. Emphasis is on the description of the condition or disease, etiology and incidence, clinical findings, differential diagnosis, management, complications, and preventive and patient education measures. Consideration is given to cultural and ethical issues that affect health care delivery and client adherence to the NURS 6228. Health Promotion of the Elderly (3-0-3) Prerequisite: NURS 6107, NURS 6128, NURS 6225, NURS 6226, NURS 6229 and NURS 6329; Corequisite: NURS 6328. This course prepares family nurse practitioners to assume responsibility for health promotion, disease prevention, early detection and management of common acute and chronic health problems of the elderly client and his/her family.Columbus State Nursing Program Assignment Papers. The nurse practitioner’s role in promoting successful aging, maintaining function and promoting self-care, using community, personal and family resources is explored. The course emphasizes common geriatric syndromes and problems including chronic illnesses and their management. Ethical dilemmas that impact healthcare of older adults are integrated throughout course.Columbus State Nursing Program Assignment Papers. NURS 6229. Health Promotion of Adults (3-0-3) Prerequisite: NURS 6107, NURS 6225, and NURS 6226; Corequisite: NURS 6329, NURS 6128. This course is designed to prepare Family Nurse Practitioners to assume responsibility for health promotion, health maintenance, disease preventions, and the management of common acute and chronic health problems of adults in primary healthcare settings. Emphasis is on the family as the basic unit of nursing care. Discussion will include non-pharmacologic and pharmacologic management of common health problems. Criteria for consultation and indications for referral along with exploration of available community resources will also be considered.Columbus State Nursing Program Assignment Papers. NURS 6230. Health Care Delivery Systems (3-0-3) Prerequisite: Admission to the Graduate Nursing Program. This course is designed for the nurse leader/manager to develop an understanding of the complex regulatory environment in health care delivery systems and the interrelatedness of performance and quality improvement. Also, the framework for understanding the role and contributions of nurse leaders/managers within healthcare systems will be explored. Issues such as public reporting, pay for performance, measurements of patient satisfaction, and other emerging and timely topics will be addressed.Columbus State Nursing Program Assignment Papers. NURS 6240. Health Care Finance (3-0-3) Prerequisite: Admission to the Graduate Nursing Program. This course will examine the economic and financial issues that are unique to organizations in health care delivery. It will include an understanding of accounting principles, financial analysis and decision making tools needed for nurse leaders. Also included are the principles of economics and the role of accounting and finance on the financial decision making of healthcare managers and executives. In addition, reimbursement issues will be discussed, as will the current and future considerations of paying for health care.Columbus State Nursing Program Assignment Papers. NURS 6327. Health Promotion of Women and Children Clinical (0-9-3) Prerequisite: NURS 6107, 6125, NURS 6225, NURS 6226, NURS 6229, NURS 6329, NURS 6228, NURS 6328; Corequisite: NURS 6227. This clinical course is designed to prepare Family Nurse Practitioners to assume responsibility for health promotion, maintenance, and management of common acute and chronic health problems of women of child-bearing age, infants, children, and adolescents in health care settings. Columbus State Nursing Program Assignment Papers. Emphasis is on the description of the condition or disease, etiology and incidence, clinical findings, differential diagnosis, management, complications, and preventive and patient education measures. Consideration is given to cultural and ethical issues that affect health care delivery and client adherence to the management plan. Established protocols for practice are used to indicate the need for consultation, referral, and community resources.Columbus State Nursing Program Assignment Papers. NURS 6328. Health Promotion of the Elderly Clinical (0-9-3) Prerequisite: NURS 6107, NURS 6128, NURS 6225, NURS 6226, NURS 6229 and NURS 6329; Corequisite: NURS 6228. This clinical course prepares family nurse practitioners to assume responsibility for health promotion, disease prevention, early detection and management of common acute and chronic health problems of the elderly client and his/her family. The nurse practitioner’s role in promoting successful aging, maintaining function and promoting self-care, using community, personal and family resources is explored. The course emphasizes common geriatric syndromes and problems including chronic illnesses and their management. Ethical dilemmas that impact healthcare of older adults are integrated throughout course.Columbus State Nursing Program Assignment Papers. NURS 6329. Health Promotion of Adults Clinical (0-9-3) Prerequisite: NURS 6107, NURS 6225, and NURS 6226; Corequisite: NURS 6229, NURS 6128. This clinical course is designed to prepare Family Nurse Practitioners to assume responsibility for health promotion, health maintenance, disease preventions, and the management of common acute and chronic health problems of adults in primary healthcare settings. Emphasis is on the family as the basic unit of nursing care. Discussion will include non-pharmacologic and pharmacologic management of common health problems. Criteria for consultation and indications for referral along with exploration of available community resources will also be considered.Columbus State Nursing Program Assignment Papers. NURS 6330. Evaluation of Learning (3-0-3) Prerequisite: Admission to Graduate Nursing Program. This course will provide methods of assessing learning outcomes for individuals and groups in nursing academic and clinical settings. Emphasis is placed on theoretical reflections and empirical methods used to evaluate educational programs, institutions, personnel, and students.Columbus State Nursing Program Assignment Papers. NURS 6407. Practicum (0-9-3) Prerequisite: For students in Leadership track: NURS 6100, NURS 6210, NURS 6230, and NU

Different Levels of Health Promotion Essay Different Levels of Health Promotion Essay Compare and contrast the three different levels of health promotion (primary, secondary, tertiary). Discuss how the levels of prevention help determine educational needs for a patient.Different Levels of Health Promotion Essay https://www.gcumedia.com/digital-resources/grand-canyon-university/2018/health-promotion_health-and-wellness-across-the-continuum_1e.php https://www.aap.org/en-us/Documents/periodicity_schedule.pdf The three levels of health promotion include primary, secondary, and tertiary. All levels are equally important and key in preventing disease and providing starting points for health care providers to offer patients positive, effective change. All levels are important in nursing because nurses are able to take part in almost every step of the promotion. Within the three levels of promotion, there are five steps. These steps include “health promotion and specific protection (primary prevention); early diagnosis, prompt treatment, and disability limitation (secondary prevention); and restoration and rehabilitation (tertiary prevention)” (Edelman & Mandel, pg. 18). Permalink: https://nursingpaperessays.com/ different-levels…-promotion-essay / ? Get Help With Your Essay If you need assistance with writing your own essay, our professional essay writing service is here to help! Primary prevention includes “health promotion and specific protection” (Edelman et al, pg. 18). In primary prevention, the main focus is to avoid the development of the disease and to focus on interventions to maintain a healthy life. “Its purpose is to [also] decrease the vulnerability of the individual or population to disease or dysfunction” (Edelman et al, p. 14). Nurses must do their part in encouraging preventative and appropriate interventions to improve patient health. Primary prevention also involves two further subdivisions that include health promotion and health protection. An example of health promotion would be educating a patient on their health or on nutrition. This type of promotion includes any type of education that would promote a healthy lifestyle. Health protection would be anything that would protect the patient from a disease. For example, health protection can include administering immunizations to reduce exposure the influenza virus this winter.Different Levels of Health Promotion Essay Secondary prevention refers to activities like screening and early diagnosis that aid in treatment of the existing health problem, disease, or harmful situation. “Secondary prevention ranges from providing screening activities and treating early stages of disease to limiting disability by averting or delaying the consequences of advanced disease” (Edelman et al, p. 18). It is during secondary prevention when “early detection occurs in the window of time just before symptoms are apparent, which fosters early treatment and delays onset of more serious symptoms” (Murray, R., Zentner, J., Yakimo, p. 42). The difference between primary prevention and secondary prevention is simple. In primary prevention, the focus is more on how to prevent or decrease the probability of the disease or problem before it precedes and allots different suggestions to promote a healthy lifestyle. In secondary prevention however, the preventative methods are more focused on the actually screening and encourages early detection and treatment before a serious disease occurs. Tertiary Tertiary prevention is the last level of promotion that promotes health. “Tertiary prevention refers the person to optimum function or maintenance of life skills through long-term treatment and rehabilitation” (Murray et al, p. 42). This form of prevention involves treatment, rehabilitation, prompt treatment, and patient education. Usually, tertiary prevention is used when the disability or disease cannot be reversed or is permanent. This level of prevention is easier to look at more as treatment rather than prevention. At this point, the disease has already been established, and the main focus is to minimize the detrimental effects of the disease process and maintain optimal health. It is important that the nurse “ensure[s] that persons with disabilities receive services that enable them to live and work according to the resources that are still available to them” (Edelman et al, p 19). In primary and secondary prevention, the treatment is geared more towards preventing the actual disease and early diagnosis and detection. In tertiary treatment, the focus turns toward the reduction of any further complications once the disease process has already progressed. All three levels are equally important to prevent disease, but also have a key impact in health promotion in nursing.Different Levels of Health Promotion Essay Health promotion and purpose for nursing Health promotion is “behavior motivated by the person’s desire to increase well-being and health potential” (Murray et al pg. 42). Individually, patients must find that motivation to ensure and attain optimal health. Nurses, as well as many other health care providers play an important role in motivating and encouraging patients to maintain and strive towards better health. Here is where nurses can use all skills learned to use primary, secondary, and tertiary prevention to encourage healthy lifestyles. Nursing roles and responsibilities The role of the nurse in health care promotion can be demanding, and tiresome, but in the end is simply gratifying. Nurses must take on many different roles to ensure that the patients are promoting and maximizing they health. These roles may include: educator, advocate, provider of care, researcher, care manager, and consultant. By incorporating all these different roles, nurses teach people how to remain healthy. “Nurses must have an evidence-based understanding of the significant effect that can be made through health promotion interventions and communicate this understanding to the public at large” (Murray et al, pg.42). The goal is for people to become more aware of lifestyle changes that can consequently worsen their health status and make the lifestyle changes to maintain a healthier lifestyle.Different Levels of Health Promotion Essay Nurses can assist in promoting health in many different ways. Nurses are the educators in providing patients and their families with the proper resources to maintain a healthy life. Whether it means teaching on nutrition, immunizations, or diseases, nurses provide most of the teaching. Nurses can also be advocators by making sure the patient is receiving what they are entitled to in the health care system and from their provider. The nurse is to “go to” person when the provider is not available. Nurses also aid in providing the delivery of care, consulting the patient when any problem exists, and researching and relaying message to the provider when a problem or question exists. For example, in Healthy People 2010, nurses must take on the role in all of these situations to promote a healthier, better lifestyle. Find out how NursingAnswers.net can help you! Our nursing and healthcare experts are ready and waiting to assist with any writing project you may have, from simple essay plans, through to full nursing dissertations.Different Levels of Health Promotion Essay Implementation methods for health promotion In order to implement health promotion, nurses are taught to properly find alternative methods that personalize every patient in contact with their delivery of care. Not all forms of health promotion are done by the bedside nurse, but can also be encompassed by the clinic nurse and the community nurses. These levels of promotion can be brought on by the clinic and community nurse by offering different presentations regarding what is directly affecting the specific community. By involving the community in different methods of health care promotion and prevention, the nurse is doing his/her part to assist in primary and secondary promotion. Then, if the assistance is needed, tertiary prevention can be used. The nurse must learn to encompass and become familiar with every aspect of prevention and promotion in order to do his/her part in preventing and promoting healthier lifestyles. In order to facilitate and accommodate to patients needs, evidence based practice is key. There are many articles that can justify and help solidify the need for prevention and promoting in patient lifestyles. Compares the three levels of health promotion prevention First article The article that I found from the Grand Canyon University Library discussing primary prevention is called Opportunities for the Primary Prevention of Obesity during Infancy. This article discusses the opportunities that physicians have to decrease and prevent obesity during infancy. The article proved that through “early intervention and prevention, great promise [holds] for interrupting the vicious cycle of obese children becoming obese adults who subsequently have obese offspring themselves” (Paul, Bartok, Downs, Stifter, Ventura, and Birch). Evidenced proved that if providers instructed parents on different strategies to promote healthy behaviors, that the infants will have long lasting obesity preventive effects. By using primary prevention, obesity during infancy and possibly throughout the lifetime may be decreased by primary intervention.Different Levels of Health Promotion Essay This article would be beneficial to nursing practice because throughout pregnancy, nurses would be able to show how vital it is to continue to maintain and continue to show healthy eating habits to pregnant mothers and their children to potentially avoid obesity and other health problems for the child. Second article The second article that I found from the Grand Canyon University Library discussing secondary prevention was called Running nurse-led secondary prevention clinics for coronary heart disease in primary care: qualitative study of health professionals’ perspective. This article was based on a nurse led trial that used secondary prevention to improve coronary heart disease and lower all-cause mortality during a four year follow up. This article emphasized on how this clinic was run by nurses and whether or not it was effective. Studies showed how it was viewed “positively by most healthcare professionals that had been involved in running them, but barriers to their implementation had led most to stop running them at some point” (Campbell & Murcia). It also proved that although it might have been effective, many of variables interrupted in proving the study effective. Issues like lack of space and staff shortages, funding training, and communication arose within the practice and eventually ended the study. The study still showed how effective the nurses ran the clinic and seemed to be able to do their part in preventing and lowering the occurrence of coronary heart diseases.Different Levels of Health Promotion Essay Third article The third article I found in the Grand Canyon University Library on tertiary prevention is called Applying epidemiologic concepts of primary, secondary, and tertiary prevention to the elimination of racial disparities in asthma. This article emphasized the importance in prevention in asthma. It stated that the “primary prevention targets reductions in asthma incidence; secondary prevention is the mitigation of established disease and involves disease detection, management, and control; and tertiary prevention is the reduction of complications caused by severe disease,” (Joseph, Williams, Own by, Saltzgaber, and Johnson). This article is good because it is able to illustrate all of the effects of proper primary, secondary, and tertiary prevention. The article showed how by managing, and understanding the disease, “changes that could reduce asthma morbidity in US minorities and ultimately mitigate disparities” (Joseph, et al).Different Levels of Health Promotion Essay Conclusion This purpose of this paper was to inform the reader of the different levels of health promotion and the role that nurses must play in encouraging this care. Nurses can do their part in promoting a healthier lifestyle for their patients by using alternative methods of prevention. Primary prevention involves health promotion and protection, secondary prevention involves screening and early diagnosis, and tertiary prevention focuses on treating the actual disease and preventing any further complications. It is important for nurses to understand that the role they play on patient health care is vital. Patients rely on nurses to help alleviate and advocate for them when any sort of ailment or sickness occurs. In order for nurses to promote health they must become familiar with the different ways of helping to prevent and promote healthier lifestyles. The articles that were chosen in this article illustrated the different positive effects of prevention and the different ways nurses and health care providers can promote a healthier lifestyle.Different Levels of Health Promotion Essay Primary, secondary and tertiary levels of Health Promotion In excess of ten years, health promotion and prevention has been the main focus of healthcare professionals in general, but nurses in particular. Health promotion is “the art and science of helping people discover the synergies between their core passions and optimal health, enhancing their motivation to strive for optimal health and supporting them in changing their lifestyle to move toward a state of optimal health (Edelman & Mandle, 2010, p. 14). Basically it is saying that it is the approach used to augment a sense of health in addition to reducing occurrences of…show more content… In conjunction, there are a few coincidental interventions of the previous health promotion in which nurses dispense knowledge relating to diseases and how to avoid aggravation. The main characteristic is that this populace has previously had the illness and requires aid in decreasing exacerbations of said illness or disease. As an illustration, it is secondary to “help individuals who use tobacco with successful cessation” to prevent lungs, heart and pregnancy complications (Tingen, Andrew & Stevenson, 2010, p. 182). As far as senior, or elder, abuse is concerned, neighborhood nurses are amid the earliest ones to recognize the episode as a result of continual residential visits. When elder abuse is suspected, the nurse corroborates this with the appropriate screening tools like Indicators of Abuse Screen and the Hwalek-Sengstock Elder Abuse Screening Test (Phelan, 2010). Subsequently, it is occasion to designate an acceptable organization for safety and treatment (Phelan, 2010).Different Levels of Health Promotion Essay This assignment proposes to discuss the role of the nurse in health promotion. To facilitate the discussion in the delivery of primary, secondary and tertiary levels of health promotion, the health risk of tobacco smoking in relation to Lung Cancer has been chosen. National policies will be explored in relation to smoking and how these influence the delivery of health promotion by the nurse. The barriers to health promotion will be identified along with ways in which these may be overcome. The intention of the World Health Organisation (WHO) to achieve “Health for All” by the year 2000 was published in their Ottawa Charter, the outcome of which was to build healthy public policy, create supportive environments, strengthen communities, develop personal skills and reorient health services. They identified key factors which can hinder or be conducive to health; political, economic, social, cultural, environmental, behavioural, and biological (WHO 1986).Different Levels of Health Promotion Essay The current health agenda for the UK aims to improve the health of the population and reduce inequalities with particular emphasis on prevention and targeting the number of people who smoke (DH 2010). Inequalities in health have been extensively researched and although attempts have been made to overcome these, there is evidence to support that the divide between the rich and the poor still exists in society. Marmot (2010) highlighted the lower social classes had the poorest health and identified social factors such as low income and deprivation as the root causes which affect health and well being. Increased smoking levels were found to be more prevalent in this cohort. Bilton et al (2002) suggests the environment an individual lives in can have an adverse effect on health in that it can influence patterns of behaviour. For example, families living in poor housing conditions, in poverty or in an environment away from a social support network can suffer psychological stress; which in turn can prompt coping behaviours such as tobacco smoking (Blackburn 1991, Denny & Earle 2005).Different Levels of Health Promotion Essay Smoking is a modifiable risk factor to chronic disease such as Cancer of the Lung, with 90% of these cases being the result of smoking (Cancer Research UK 2009) it is the single biggest preventable cause of premature death and illness and is more detrimental to the poorer in society. Responsible for 80,000 lives per year, the huge financial burden on the NHS to treat illness associated with smoking is estimated at £2.7 billion each year (DH 2010). This illustrates the huge opportunity for public health to address the wider issues associated with inequalities and to target people who smoke. Various White papers have demonstrated the Government’s commitment in reducing smoking figures and preventing uptake, both at individual and population levels, through health promotion activity, empowering individuals and enabling them to make healthier lifestyle choices (DH 2004, DH 2006, DH 2010).Different Levels of Health Promotion Essay Health promotion is a complex activity and is difficult to define. Davies and Macdowall (2006) describe health promotion as “any strategy or intervention that is designed to improve the health of individuals and its population”. However perhaps one of the most recognised definitions is that of the World Health Organisation’s who describes health promotion as “a process of enabling people to increase control over their health and its determinants, and thereby improve their health (WHO 1986). If we look at this in relation to the nurse’s role in smoking cessation and giving advice to a patient, this can be seen as a positive concept in that with the availability of information together with support, the patient is then able to make an informed decision, thus creating empowerment and an element of self control. Bright (1997) supports this notion suggesting that empowerment is created when accurate information and knowledgeable advice is given, thus aiding the development of personal skills and self esteem.Different Levels of Health Promotion Essay A vital component of health promotion is health education which aims to change behaviour by providing people with the knowledge and skills they require to make healthier decisions and enable them to fulfil their potential. Healthy Lives Healthy People (2010) highlight the vital role nurses play in the delivery of health promotion with particular attention on prevention at primary and secondary levels. Nurses have a wealth of skills and knowledge and use this knowledge to empower people to make lifestyle changes and choices. This encourages people to take charge of their own health and to increase feelings of personal autonomy (Christensen 2006). Smoking is one of the biggest threats to public health, therefore nurses are in a prime position to help people to quit by offering encouragement, provide information and refer to smoking cessation services. There are various approaches to health promotion, each approach has a different aim but all share the same desired goal, to promote good health and prevent or avoid ill health (Peate 2006). The medical approach contains three levels of prevention as highlighted by Naidoo and Wills (2000), primary, secondary and tertiary prevention.Different Levels of Health Promotion Essay Primary health promotion aims to reduce the exposure to the causes and risk factors of illness in order to prevent the onset of disease (Tones & Green 2004). In this respect it is the abstinence of smoking and preventing the uptake through health education and preventative measures. One such model of prevention is that of Tannahill’s (1990) which consists of three overlapping circles; health education for example a nurse may be involved in the distribution of leaflets educating individuals or a wider community regarding health risks of smoking, prevention, aimed at reducing the exposure to children, for example, in 2007 the legal age for tobacco sales increased from age 16 to 18 years in an attempt to reduce the availability to young people and prevent them from starting to smoke (DH 2008), health protection such as lobbying for a ban on smoking in public places. If we look at this in relation to the role of the school nurse, this is a positive step when implementing school policies such as no smoking on school premises for staff and visitors, as this legislation supports the nurse’s role when providing information regarding the legal aspects of smoking. Research demonstrates that interventions are most effective when combined with strategies such as mass media and government legislation (Edwards 2010). Having an awareness of such campaigns and legislation is essential to aid best practice and the nurse must ensure that knowledge and skills are regularly updated, a standard set by the Nursing and Midwifery Council (NMC 2008).Different Levels of Health Promotion Essay Croghan & Voogd (2009) identify the school nurse’s role as essential in the health and well-being of children in preventing smoking. Many people begin to smoke as children, the earlier smoking is initiated, the harder the habit is to break (ASH) and this unhealthy behaviour can advance into adulthood. Current statistics illustrate that in 2009 6% of children aged 11-15 years were regular smokers (Office for National Statistics 2009). These figures demonstrate the importance of prevention and intervention at an early stage as identified by the National Service Framework (NSF) for Children, Young People and Maternity Services (DH 2004). Smith (2009) highlights the school nurse as being in an advantageous position to address issues such as smoking and suggests that by empowering children by providing support and advice, this will enable them to adopt healthy lifestyles. NICE (2010) suggest school based interventions to prevent children smoking aimed at improving self esteem and resisting peer pressure, with information on the legal, economic and social aspects of smoking and the harmful effects to health. Walker et al (2006) argue self esteem is determined by childhood experiences and people with a low self esteem are more likely to conform to behaviours of other people. This can be a potential barrier in the successful delivery of health promotion at this level, with young children exposed to pressure to conform; they are more likely to take up unhealthy behaviours such as smoking (Parrott 2004). The nurse can overcome this by working in partnership with teachers and other staff members to promote self-esteem by ensuring an environment conducive to learning, free from disruptive behaviour which promotes autonomy, motivation, problem solving skills and encourages self-worth (NICE 2009).Different Levels of Health Promotion Essay Despite the well known health risks to tobacco smoking, unfortunately 1 in 5 individuals continue to smoke (DH 2010). Whitehead (2001) cited in Davies (2006) argues the nurse must recognise and understand health related behaviour in order to promote health. Therefore, when delivering health promotion the nurse needs to be aware of all the factors which can affect health, some of which can be beyond individual control. Smoking cessation is one of the most important steps a person can make to improve their health and increase life expectancy, as smokers live on average 8 years less than non smokers (Roddy & Ross 2007). Secondary prevention intends to shorten episodes of illness and prevent the progression of ill health through early diagnosis and treatment (Naidoo & Wills 2000). This can be directed towards the role of the practice nurse in a Primary Care setting, where patients attend for treatment and advice that have symptoms of illness or disease as a result of smoking, such as Bronchitis. Nice guidelines (2006) recommend that all individuals who come into contact with health professionals should be advised to cease smoking, unless there are exceptional circumstances where this would not be appropriate, and for those who do not wish to stop, smoking status should be recorded and reviewed once a year. It is therefore essential the nurse maintains accurate and up to date record keeping.Different Levels of Health Promotion Essay Smoking cessation advice can be tailored to the specific individual and therefore it is important that the nurse has the knowledge and counselling skills for this to be effective. The process of any nursing intervention is ultimately assessment, planning, implementing and evaluating (Yura & Walsh 1978), this applies to all nurses in any given situation including health promotion. One such method of smoking cessation which can be used as an assessment tool is known as the 5 ‘A’s approach, ‘ask, assess, advise, assist, arrange’ (Britton 2004). “Ask” about tobacco use, for example how many cigarettes are smoked each day, and “assess” willingness and motivation to quit, taking a detailed history to assess addiction. Objective data can be obtained using a Smokerlyser which measures Carbon Monoxide levels in expired air (Wells & Lusignan 2003). These simple devices can be used as a motivational tool to encourage cessation and abstinence. Castledine (2007) suggests the principle of a good health promoter is to motivate people to enable them to make healthier choices; this is made possible by the ability to engage with individuals at all levels. Individuals who are not motivated are unlikely to succeed (Naidoo & Wills 2000). “Advise” patients to stop smoking and reinforce the health benefits to quitting, “assist” the patient to stop, setting a quit date and discussing ways in which nicotine withdrawal can be overcome. Being unable to cope with the physical symptoms of withdrawal can cause relapse and be a barrier to success, therefore it is essential the nurse possesses a good knowledge base of the products available to assist in reducing these symptoms if she is to persuade people to comply with treatment, such as the use of nicotine replacement therapy (NRT). NRT is useful in assisting people to stop smoking and has proved, in some instances to double the success rate (Upton & Thirlaway 2010). NRT products are continually changed and updated; therefore the nurse must ensure she has the knowledge and skills to identify which products are available, the suitability, how it works and any potential side effects. Identifying triggers and developing coping strategies is useful for maintenance of a new behaviour, measures such as substituting cigarettes for chewing gum and changing habits and routines are just some of the ways in which self control can be achieved (Ewles & Simnett 1999). Finally “arrange” a follow up, providing continual support and engagement. For patients who do not wish to stop smoking, advice should be given with encouragement to seek early medical treatment on detection of any signs and symptoms of disease. Good communication skills are essential to the therapeutic relationship between the nurse and a patient and these must be used effectively by providing clear, accurate and up to date information. The nurse should be an active listener and encourage the patient to talk, using open-ended questions helps demonstrate a willingness to listen, listening and showing concern for a patient’s condition demonstrates respect (Peate 2006).Different Levels of Health Promotion Essay The use of medical jargon and unfamiliar words can be a barrier to communication and should be avoided as these can affect a patients understanding. Leaflets can reinforce information provided by the nurse and increase patient knowledge, however the nurse must ensure these are in a format and language the patient can understand. Lack of literacy skills can prevent a patient reading and understanding the content of a leaflet, the nurse can assist with this by reading and explaining to them. To assist in the assessment process the nurse may utilise a model of behaviour such as Prochaska & DiClemente’s stages of change model (1984). This works on the assumption that individuals go through a number of stages in order to change behaviour, from pre -contemplation where a person has not considered a behaviour change, to maintenance, when a healthier lifestyle has been adopted by the new behaviour. The stage a person is at will determine the intervention given by the nurse; therefore it is essential that an effective assessment takes place. Walsh (2002) highlights patient motivation as central to success using this model, in that a patient will have more motivation; the more involved they are in planning the change.Different Levels of Health Promotion Essay Despite the health promoting activities mentioned and the increasing public awareness of the health risks to smoking, there are people who continue to smoke and some further develop illness as a consequence. Lung cancer has one of the lowest survival rates, and as little as 7% of men and 9% of women in England and Wales will live five years after diagnosis (Cancer Research UK 2011). Acknowledging this, the governments “Cancer Plan” aimed to tackle and reform cancer care in England by raising awareness of the signs and symptoms of cancer by investing in staff and extending the nurses role (DH 2000). This involves further training and education for nurses to develop their skills and knowledge to enable them to provide the treatment and/or advice required. This was succeeded by “Improving outcomes: a strategy for cancer” the aim being to enable patients living with cancer a “healthy life as possible”. The government pledged £10.75 million into advertising a “signs and symptoms” campaign to raise awareness of the three cancers accounting for the most deaths, breast, bowel and lung, to encourage the public to seek early help on detection of any symptoms (DH 2011). Currently no results are available on the effectiveness of this intervention due to its recent publication, however, one national policy that has had a positive effect on the health of individuals and the population is that of the “smoke-free England” policy implemented in 2007 prohibiting smoking in workplaces and enclosed public places. Primarily this policy was enforced to protect the public from second hand smoke; however, on introduction of the law smoking cessation services saw an increase in demand by 20%, as smokers felt the environment was conducive to them being able to quit (DH 2008). This policy also extended to hospital grounds, and the nurse must ensure a patient who smokes is aware of this on admission and use every opportunity possible to promote health.Different Levels of Health Promotion Essay Tertiary prevention aims to halt the progression, or reduce the complications, of established disease by effective treatment or rehabilitation (Tones & Green 2004). A diagnosis of cancer can cause great distress and a patient may go through a whole host of emotions. Naidoo and Wills (2000) suggest the aim of tertiary prevention is to reduce suffering and concerns helping people to cope with their illness. The community nurses role has been identified as pivotal in providing support for patients and families living with cancer (DH 2000). The World Health Organisation describe Palliative care as treatment to relieve, rather than cure, the symptoms caused by cancer, and suggest palliative care can provide relief from physical, psychosocial and spiritual problems in over 90% of cancer patients (WHO 2011). Assessment and the provision of health education and information at this stage remains the same as that in secondary prevention, and it is not uncommon for the two to overlap. Providing advice and education on symptom control may alleviate some of the symptoms the patient experiences, for example breathlessness is a symptom of lung cancer (Lakasing & Tester 2006), and relaxation techniqu

Nursing

Cultural Differences in Emotion Recognition and Expression Assignment Paper Cultural Differences in Emotion Recognition and Expression Assignment Paper The breadth of emotions that our eyes are able to express is truly far-reaching. From joy to longing, from anger to fear, from sadness to disgust – eyes can become powerful windows to our internal states. We use our eyes to take in the world around us, and to reflect the world within us. To reveal our inner emotional states with our facial expressions and to interpret them accurately is one of the foundations of social interaction.Whether emotion is universal or social is a recurrent issue in the history of emotion study among psychologists. Some researchers view emotion as a universal construct, and that a large part of emotional experience is biologically based. However, emotion is not only biologically determined, but is also influenced by the environment. Therefore, cultural differences exist in some aspects of emotions, one such important aspect of emotion being emotional arousal level. All affective states are systematically represented as two bipolar dimensions, valence and arousal. Arousal level of actual and ideal emotions has consistently been found to have cross-cultural differences. In Western or individualist culture, high arousal emotions are valued and promoted more than low arousal emotions. Moreover, Westerners experience high arousal emotions more than low arousal emotions. By contrast, in Eastern or collectivist culture, low arousal emotions are valued more than high arousal emotions. Moreover, people in the East actually experience and prefer to experience low arousal emotions more than high arousal emotions. Mechanism of these cross-cultural differences and implications are also discussed.Cultural Differences in Emotion Recognition and Expression Assignment Paper Permalink: https://nursingpaperessays.com/ cultural-differe…assignment-paper / We investigated the influence of contextual expressions on emotion recognition accuracy and gaze patterns among American and Chinese participants. We expected Chinese participants would be more influenced by, and attend more to, contextual information than Americans. Consistent with our hypothesis, Americans were more accurate than Chinese participants at recognizing emotions embedded in the context of other emotional expressions. Eye tracking data suggest that, for some emotions, Americans attended more to the target faces and made more gaze transitions to the target face than Chinese. For all emotions except anger and disgust, Americans appeared to use more of a contrasting strategy where each face was individually contrasted with the target face, compared with Chinese who used less of a contrasting strategy. Both cultures were influenced by contextual information, although the benefit of contextual information depended upon the perceptual dissimilarity of the contextual emotions to the target emotion and the gaze pattern employed during the recognition task.Culture is a huge factor in determining whether we look someone in the eye or the kisser to interpret facial expressions, according to a new study. For instance, in Japan, people tend to look to the eyes for emotional cues, whereas Americans tend to look to the mouth, says researcher Masaki Yuki, a behavioral scientist at Hokkaido University in Japan. This could be because the Japanese, when in the presence of others, try to suppress their emotions more than Americans do, he said. In any case, the eyes are more difficult to control than the mouth, he said, so they probably provide better clues about a person’s emotional state even if he or she is trying to hide it. Clues from emoticons As a child growing up in Japan, Yuki was fascinated by pictures of American celebrities. “Their smiles looked strange to me,” Yuki told LiveScience. “They opened their mouths too widely, and raised the corners of their mouths in an exaggerated way.” Japanese people tend to shy away from overt displays of emotion, and rarely smile or frown with their mouths, Yuki explained, because the Japanese culture tends to emphasize conformity, humbleness and emotional suppression, traits that are thought to promote better relationships. Cultural Differences in Emotion Recognition and Expression Assignment Paper So when Yuki entered graduate school and began communicating with American scholars over e-mail, he was often confused by their use of emoticons such as smiley faces ?? and sad faces, or :(. “It took some time before I finally understood that they were faces,” he wrote in an e-mail. In Japan, emoticons tend to emphasize the eyes, such as the happy face (^_^) and the sad face (;_;). “After seeing the difference between American and Japanese emoticons, it dawned on me that the faces looked exactly like typical American and Japanese smiles,” he said. Photo research Intrigued, Yuki decided to study this phenomenon. First, he and his colleagues asked groups of American and Japanese students to rate how happy or sad various computer-generated emoticons seemed to them. As Yuki predicted, the Japanese gave more weight to the emoticons’ eyes when gauging emotions, whereas Americans gave more weight to the mouth. For example, the American subjects rated smiling emoticons with sad-looking eyes as happier than the Japanese subjects did. It is important to understand the differences between young and older adults in emotional states and reaction. Many of the theoretical models studying emotional experience across adulthood predict changes throughout this life stage. A growing number of studies find that, as we age, the way we understand, manage, and react to positive and negative events changes. Different theoretical models have been proposed to explain this phenomenon: (a) Socioemotional Selectivity Theory; (b) Strength And Vulnerability Integration; and (c) Dynamic integration theory. One of the most widely espoused theories in recent years is the Socioemotional Selectivity Theory (SST). The SST maintains that time horizons play a key role in motivation (Carstensen, 2006). The future time perspective considers that when the subjective sense of time and its limits changes, our motivational priorities also shift. The theory differentiates two broad categories of goals: one concerning the goals which help us acquire knowledge of the world, and another related to the goals that help us achieve emotional well-being. As people age, they increasingly perceive time as finite. This perception leads older people to prioritize behaviors or goals from which they derive emotional meaning, while younger people prioritize goals related to knowledge acquisition. For example, Hess and his colleagues have shown that older adults, compared to young adults, weighted negative information related to morality more than information regarding competences when judging strangers and rating their likability (Hess, 2005; Leclerc and Hess, 2007). The SST holds that this tendency is even more striking when the categories of goals compete. Moreover, the differences in emotional reactivity do not only manifest in negative emotional states. A recent meta-analysis of 100 independent studies found a reliable positivity effect with older adults showing a positive bias overall and the younger age group showing a negative bias overall (Reed et al., 2014). The “positivity effect” refers to the tendency of older people to prioritize achieving emotional gratification. SST directly connects thinking about a limited future with the emergence of the positivity effect. In short, young adults focused their attention and better remembered negative information while older adults attended to and better remembered positive information (Kennedy et al., 2004). Clearly, individual differences exist. Life events and individuals’ management of such variables may positively or negatively impact on the emergence of the positivity effect (Scheibe and Carstensen, 2010).Cultural Differences in Emotion Recognition and Expression Assignment Paper While emotions and feelings are quite different, we all use the words interchangeably to more or less explain the same thing – how something or someone makes us feel. However, it’s better to think of emotions and feelings as closely related, but distinct instances – basically, they’re two sides of the same coin. It’s no secret that boys and girls are different— very different. The differences between genders, however, extend beyond what the eye can see. Research reveals major distinguishers between male and female brains. Scientists generally study four primary areas of difference in male and female brains: processing, chemistry, structure, and activity. The differences between male and female brains in these areas show up all over the world, but scientists also have discovered exceptions to every so-called genderrule. You may know some boys who are very sensitive, immensely talkative about feelings, and just generally don’t seem to fit the “boy” way of doing things. As with all gender differences, no one way of doing things is better or worse. The differences listed below are simply generalized differences in typical brain functioning, and it is important to remember that all differences have advantages and disadvantages. Processing Male brains utilize nearly seven times more gray matter for activity while female brains utilize nearly ten times more white matter . What does this mean? Gray matter areas of the brain are localized. They are information- and action-processing centers in specific splotches in a specific area of the brain. This can translate to a kind of tunnel vision when they are doing something. Once they are deeply engaged in a task or game, they may not demonstrate much sensitivity to other people or their surroundings. White matter is the networking grid that connects the brain’s gray matter and other processing centers with one another. This profound brain-processing difference is probably one reason you may have noticed that girls tend to more quickly transition between tasks than boys do. The gray-white matter difference may explain why, in adulthood, females are great multi-taskers, while men excel in highly task-focused projects. Chemistry Male and female brains process the same neurochemicals but to different degrees and through gender-specific body-brain connections. Some dominant neurochemicals are serotonin , which, among other things, helps us sit still; testosterone , our sex and aggression chemical; estrogen , a female growth and reproductive chemical; and oxytocin , a bonding-relationship chemical. In part, because of differences in processing these chemicals, males on average tend to be less inclined to sit still for as long as females and tend to be more physically impulsive and aggressive. Additionally, males process less of the bonding chemical oxytocin than females. Overall, a major takeaway of chemistry differences is to realize that our boys at times need different strategies for stress release than our girls. The Basel researchers designed an experiment to determine whether women perform better on memory tests than men because of the way that they process emotional information. The researchers exposed 3,400 test participants to images of emotional content, finding that women rated these images as more emotionally stimulating than men, particularly in the case of negative images. When presented with emotionally neutral imagery, however, the men and women responded similarly.Cultural Differences in Emotion Recognition and Expression Assignment Paper After being exposed to the images, the participants completed a memory test. The female participants were able to recall significantly more of the images than their male counterparts. The women had a particularly enhanced ability to recall the positive images. The study’s lead author, Dr. Annette Milnik, explained, “This would suggest that gender-dependent differences in emotional processing and memory are due to different mechanisms.” Then, fMRI data from 700 participants suggested that womens’ stronger reactivity to negative emotional images is linked with increased activity of motor regions of the brain. Previous studies have suggested that women display heightened facial and motor reactions to negative emotional stimuli. “In our study, we see a similar pattern with the fMRI data,” Milnik said in an email to The Huffington Post. “One possible explanation would be that women might be better prepared to physically react to negative stimuli than males. Another explanation would be from normative expectations, with women being expected to be more emotional, and also to express more emotions.” Here is how they differ. What are emotions? Imagine this: You sprint through the airport, on the run to catch your flight. While you try to make your way through the crowd of people waiting in line at the security check, you spot an old friend you haven’t seen in ages. Before you can say anything, you tear up overwhelmed with excitement (and forget about the rush) while you give your friend a firm hug. Emotions are lower level responses occurring in the subcortical regions of the brain (amygdala, which is part of the limbic system) and the neocortex (ventromedial prefrontal cortices, which deal with conscious thoughts, reasoning, and decision making). Those responses create biochemical and electrical reactions in the body that alter its physical state – technically speaking, emotions are neurological reactions to an emotional stimulus. Strength and Vulnerability Integration (SAVI) is a model associating age-related declines or physiological vulnerabilities with an increase in emotion-regulation strategies (Charles and Luong, 2013). SAVI suggests that in adulthood the functioning of the hypothalamicpituitary-adrenal (HPA) axis and the cardiovascular system diminishes. Activation of these two systems correlates highly with the perception of threat in humans and other species and thus impaired functioning might impact on a subjective decline in negative emotional states. SAVI posits that older adults have self-knowledge about their limited horizon. Then, they are motivated to positive experiences and also the accumulated emotional experience could help them to regulate their emotions. This theory also differentiates between avoidable and unavoidable negative experiences (Charles, 2010). Although elderly are usually oriented and motivated to quickly extricate themselves from negative situations, when negative experiences are highly stressful and inevitable, older adults’ recovery is poorer and presents more serious consequences (Charles and Luong, 2013; Piazza et al., 2013).Cultural Differences in Emotion Recognition and Expression Assignment Paper Dynamic Integration Theory (DIT) relates the decline in cognitive resources to increased vulnerability in situations involving high arousal (Labouvie-Vief, 2003) and a number of studies defend this view. Keil and Freund (2009) showed that in young adults both pleasantness and unpleasantness increased with high emotional arousal, whereas in older adults, low-arousing stimuli were those experienced as most pleasant. Advances in research and the continued interest in understanding how the emotional system functions in both aging adults and other life stages or life circumstances have generated the development of different Mood Induction Procedures (MIPs). These MIPs can be used to induce positive and negative emotions in a laboratory. Of all the methods implemented thus far, the presentation of film clips with affective content is currently one of the most effective and widely used MIPs (Gerrard-Hesse et al., 1994; Westermann et al., 1996). Film emotion induction is popular for various reasons: (a) simple standardization; (b) high ecological validity; (c) effectiveness in generating responses in the psychophysiological, motor and cognitive systems; (d) capacity to sustain an emotion at both subjective and physiological level for a reasonable time (Carvalho et al., 2012; Jenkins and Andrewes, 2012); and (e) facility to generate discrete emotions (Schaefer et al., 2010). Emotion induction by film clips is especially effective in eliciting negative emotions (Gerrard-Hesse et al., 1994; Westermann et al., 1996; Fernández-Aguilar et al., unpublished). In the literature, there are various published catalogs of film clips for use in research requiring elicitation of different emotions. As emotional targets, these catalogs have examined basic emotions such as anger, fear, disgust, sadness and amusement (Philippot, 1993). Some sets of clips have also included emotions such as surprise and satisfaction (Gross and Levenson, 1995; Rottenberg et al., 2007); tenderness (Schaefer et al., 2010); happiness and mixed emotions (Jenkins and Andrewes, 2012; Samson et al., 2016; Gilman et al., 2017). Other mood induction procedures have worked successfully to assess emotional reactivity in older adults. For example, the Italian version of the Affective Norms for English Words (ANEW) worked successfully in both healthy aging individuals and Alzheimer’s Dementia patients (Mammarella et al., 2017; Di Domenico et al., 2016). However, given the large body of work on film clips as an emotion induction procedure, it is striking that only a few studies have examined the effect of this technique in aging research, and with inconsistent results. Beaudreau et al. (2009) studied the emotional reactions in older adults using the set compiled by Gross and Levenson (1995). They found that older adults reported more anger and less amusement compared to younger adults. The findings of Jenkins and Andrewes (2012) were more generalized. They found that older adults reported higher emotional intensity in response to positive and negative stimuli, especially for clips eliciting fear and amusement. The study by Fajula et al. (2013)revealed similar data but only in the case of negative emotions. Using the set compiled by Philippot (1993), they found that older adults reported higher intensity in the four primary negative emotions (fear, anger, disgust, and sadness) and that young adults reported higher intensity on joy and happiness.Cultural Differences in Emotion Recognition and Expression Assignment Paper Furthermore, there is a surprising lack of studies on emotion induction addressing other positive emotions apart from the global category of happiness. Attachment-related emotions such as love or tenderness are not usually included. In fact, to date, they have been included in only one database of film clips (Schaefer et al., 2010). Attachment emotions play a significant role in biological, emotional and social development and thus stimuli related to these emotions should be utilized in research on aging. Moreover, different aging models propose a positivity effect whereby older adults are motivated by emotion regulation strategies that maintain positive affective states and by enhanced emotional regulation to recover from negative affect states (Reed et al., 2014). Older adults have been found to favor positive information over negative information in memory and attention (Mather and Carstensen, 2005). The ambiguity of the previous results motivated us to examine differences in young and older adults as regards their emotional responses when using film clips as the mood induction procedure. This may broaden our knowledge of the characteristics of emotional responses in older adults and how these are explained by models of aging. It also provides the possibility to identify differences between young and older adults in both baseline state and processes of emotional recovery. Our focus on the baseline state draws on the use of neutral stimuli in a wide range of studies on MIPs. As well as using emotional target stimuli, they also include neutral stimuli in their film sets. Neutral stimuli are used as they enable each participant’s’ baseline data to be obtained before starting the experimentation and also because they facilitate emotional recovery following the induction of intense emotions. The literature recommends using stimuli free on any type of emotional content and with idiosyncratic characteristics similar to those of the stimuli to be used in the selected MIP (Hewig et al., 2005; Rottenberg et al., 2007). Furthermore, the use of neutral stimuli may help obtain a precise measure of the induction capacity of a specific MIP, considering intraindividually the differences between the state of the participants during exposure to the neutral stimuli and the emotional target stimuli. The main purpose of this work is to expand our knowledge about fluctuations in positive and negative emotions in older adults when using film clips as a MIP. We compare emotional responses between young and older adults and study the differences between positive and negative induction. To this end, we used clips previously validated in a population of young Spanish adults (see Fernández et al., 2011), the majority of which were elaborated by Schaefer et al. (2010). The following hypotheses were considered: (1) negative mood induction will be more effective compared to positive mood induction both in young and older adults; (2) young and older adults will respond differently to the different negative emotional states induced; (3) young and older adults will respond differently to the different positive emotional states induced; (4) arousal levels will be higher in young adults compared to older adults; (5) baseline state is different in young and older adults and will determine the strength of negative and positive mood induction; and (6) emotion regulation after mood induction will be easier for older adults compared to young adults.Cultural Differences in Emotion Recognition and Expression Assignment Paper Participants The final sample comprised 140 volunteers aged between 18 and 84 years ( M = 39.02, SD = 25.32, 68.83% women). From the initial sample, 4 older adults and 7 young adults were excluded due to depressive symptoms. The participants were recruited from a research volunteer pool at the Department of Psychology at the University of Castilla- La Mancha (UCLM) Medical School, from an association at the Universidad de Mayores (a university program for older adults) and two socio-cultural centers in the city of Albacete. Participants were divided into age groups to form a younger group of 83 participants aged 18–26 ( M = 18.87, SD = 1.63, 69.9% women) and an older group of 57 participants aged 60–84 years ( M = 69.74, SD = 6.56, 68.4% women). Participants were receiving no psychotropic treatment or drug use and had no previous history of psychological, psychiatric or neurological disorder, according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-V). They presented no auditory or visual impairments other than requiring corrective lenses. All were of Caucasian ethnicity and native Spanish speakers. They gave voluntary consent to take part in the study without obtaining any type of remuneration and according to the requirements of the approved ethics procedure of the Clinical Research Ethics Committee of the Albacete University Hospital. Measures Diagnostic Evaluation As depressive symptomatology may affect emotional response, we administered the Beck Depression Inventory II (BDI-II) (Beck et al., 1961) prior to the experiment. The BDI-II is a self-report questionnaire that assesses symptoms of depression including anhedonia, sadness, loss of interest or energy, disturbances in eating and sleeping, loss of concentration or suicidal ideation. On the BDI, scores between 10 and 15 are considered in a dysphoric range and scores of 16 or above represent a depressed range (Kendall et al., 1987). Subjects scoring over 16 were excluded from our study. In the case of the older adults, the Mini Mental State Examination (MMSE) (Folstein et al., 1975) was used to discard cognitive impairment. MMSE is a screening tool measuring symptoms of dementia such as disorientation, alterations in memory, and alterations in the capacity for abstraction or in language. On the MMSE, scores between 9 and 11 are considered in the dementia range, scores between 12 and 24 indicate cognitive impairment, and scores between 24 and 26 suggest suspicion of pathology. Subjects scoring lower than 27 were excluded from our study. Both the BDI-II and the MMSE were administered in a paper-and-pencil version.Cultural Differences in Emotion Recognition and Expression Assignment Paper The Positive and Negative Affect Schedule- state version (PANAS; Watson et al., 1988) was used to assess positive affect (e.g., interested, excited, proud) and negative affect (e.g., distressed, ashamed, upset) through 20 items with answers ranged between 0 (“not at all”) and 4 (“extremely”). This questionnaire was administered telematically just before starting the experimental session and to assess prior mood before the emotion elicitation procedure. Measurement of Emotional Response The subjective emotional response was evaluated using dimensional measures. The Self-Assessment Manikins (SAM) (Bradley and Lang, 1994) is a self-report questionnaire that assesses emotional response, measuring affective valence, arousal and dominance or emotional control. Considering the dimensional structure of affect (Russell and Barrett, 1999), we administered the items measuring valence and arousal. These two dimensions are those most commonly used in the literature (Russell, 1980; Watson et al., 1988) and, furthermore, permit comparison with somato-physiological measures. Thus, participants rated, on a 9-point Likert-type scale, how pleasant/happy/amused (9) or unpleasant/unhappy/sad (1) and how aroused (9) or relaxed (1) they felt while watching the emotional video clips. The questionnaire uses graphic figures which represent the different emotional states and is therefore rapid and simple to administer in both age groups, regardless of participants’ educational level. Procedure We selected 54 scenes from HD films dubbed in Spanish with an average length of 2?38? (see Table 1). These fragments were among those in a battery of audiovisual stimuli validated in a population of young Spanish adults (see Fernández et al., 2011). The selected excerpts maintained the same features used in previous studies (Rottenberg et al., 2007; Schaefer et al., 2010). Furthermore, we added a scene from the film 127 h (Colson et al., 2010) to the disgust category, which presented the characteristics of stimuli used for disgust in previous studies. In accordance with the previously published film clip batteries, each segment was expected to induce an emotion from a specific category: amusement, tenderness, anger, sadness, disgust, fear and neutral state. Philosophical and psychological theory has traditionally focused on intra-individual processes that are entailed in emotions. Recently sociologists, cultural anthropologists, and also social psychologists have drawn attention to the interpersonal nature of emotions. In this chapter we focus on the influence of others on emotional experiences and expressions. We summarise research on social context effects which shows that both emotional expression and experience are affected by the presence and expressiveness of other people. These effects are most straightforward for positive emotions, which are enhanced in the company of others. In the case of negative emotions, the effects of social context depend on the circumstances in which the emotion is elicited, and on the role of other persons in this situation. We discuss these social context effects in the light of a more general theoretical framework of social appraisal processes. In the last post, we focused on the idea that a thought comes before an emotion. So once we’ve had that all important thought, and we end up feeling something, what are the forces out there that control how we express those feelings?Cultural Differences in Emotion Recognition and Expression Assignment Paper Culture Expressions of emotion can differ and mean different things depending on the cultural context. Stereotype alert here – the British stiff upper lip might seem a bit cold here in North America, the way Canadians like to point out their own faults could be seen as a sign of weakness in the US, the lavish outpouring of emotion at an Italian family gathering might seem overwhelming to a Japanese family. Gender Women are more likely to show vulnerability than men. Men are generally less shy about revealing their strengths than women. Women often score higher in tests aimed at measuring how well a person can identify and name the emotions of others than men. Naturally, all of these statements refer to men and women as a group. No one is trying to say every woman or every man is like this, but overall group statistics based on gender can tell us some useful things. Social conventions – at least in North America Sometimes society tell us – hold it – those emotions are not acceptable – none of that, thank you kindly. Men shouldn’t cry in public (unless they are athletes being trading from their team or retiring), women shouldn’t be angry, you don’t tell your life story to the barista at Starbucks when he asks how you’re doing. Society also gives us the message that only positive feelings are acceptable, and not even too much of that, please. If you’ve lost a loved one you do get a period of grief, but life is for the living, you’re meant to get over it, or barring that, don’t talk about it. Social roles Your social role can determine how and what types of emotion you can express, where you can do that expressing, and with whom. The boss doesn’t take an employee aside and talk about a nagging spouse (or at least he or she shouldn’t). The leader of a country doesn’t get on TV and collapse in tears due to feeling overwhelmed with the roles of the office. Emotional contagion Have you ever been to a funeral where you felt in control of your emotions and then you see another person start sobbing and you fall apart? The transfer of emotion from one person to another can affect emotional expression. We can also find that certain people wind up our emotions and others make us feel all mellow yellow.Cultural Differences in Emotion Recognition and Expression Assignment Paper Fear of self-disclosure We often limit our emotional expression because giving away too much to others can be risky. It makes us vulnerable. We might be misunderstood, or maybe we’ll make people uncomfortable, or maybe our emotional honesty will be used against us. So – what’s the point Saying What Matters lady? We’re working at getting to know more about ourselves and our emotional expression so we can get out in the world and say what matters. Being aware of some of the forces that operate behind the scenes when it comes to expressing our emotions is helpful as we pursue this goal. Then he and his colleagues manipulated photographs of real faces to control the degree to which the eyes and the mouth were happy, sad or neutral. Again, the researchers found that Japanese subjects judged expressions based more on the eyes than the Americans, who looked to the mouth. Interestingly, however, both the Americans and Japanese tended to rate faces with so-called “happy” eyes as neutral or sad. This could be because the muscles that are flexed around the eyes in genuine smiles are also quite active in sadness, said James Coan, a psychologist at the University of Virginia who was not involved in the research. Japanese Communication Is the person in front of me right now angry or happy? This may sound like an obvious question, but in fact it is not always as easy to judge as it may seem. It is very likely that the smiling face of an innocent child really does show that they are happy, but your subordinate at work who approaches you with a smile may actually be feeling very angry. Japan has long been regarded as a society where people read the atmosphere . As social animals, we humans live together for better or worse by reading the atmosphere as well as each other’s feelings, to a greater or lesser extent, in order to maintain good relations with each other. The act of guessing how another person is feeling is one part of reading the atmosphere . How then, do we read people and understand how they are feeling? One source of information for doing so is language. However, most of us have had the experience of someone responding to an email by saying, “fine, understood,” which causes you to wonder whe

Community Health Nursing Intervention Strategies Assignment Papers. Community Health Nursing Intervention Strategies Assignment Papers. Towards the end of the last century, health improvement strategies (such as the World Health Organization’s seminal Health for all by the year 2000) tended to use phrases like ‘protecting and promoting health’. In more recent years, the vocabulary has broadened out to place an emphasis on wellbeing as well as health. Today the phrase ‘population health’ is used to convey a way of conceiving health that is wider still. It includes the whole range of determinants of health and wellbeing – many of which, such as town planning or education, are quite separate from health services.Community Health Nursing Intervention Strategies Assignment Papers. Permalink: https://nursingpaperessays.com/ community-health…ssignment-papers / ? Permalink: https://nursingpaperessays.com/ community-health…ssignment-papers / ? Referring to ‘population health’ rather than the more traditional phrase ‘public health’ also helps avoid any perception that this is only the responsibility of public health professionals. Population health is about creating a collective sense of responsibility across many organisations and individuals, in addition to public health specialists.Community Health Nursing Intervention Strategies Assignment Papers. Confusingly, the phrase ‘population health management’ is also widely used, with a specific meaning that is narrower in focus than population health. Population health management refers to ways of bringing together health-related data to identify a specific population that health services may then prioritise. For example, data may be used to identify groups of people who are frequent users of accident and emergency departments. This way of using data is also sometimes called ‘population segmentation’. Throughout all these changes in vocabulary, one element has consistently been essential: an emphasis on reducing inequalities in health, as well as improving health overall. This continues to be important in population health. There are several definitions of population health in use. The King’s Fund defines it as: An approach aimed at improving the health of an entire population. It is about improving the physical and mental health outcomes and wellbeing of people within and across a defined local, regional or national population, while reducing health inequalities. It includes action to reduce the occurrence of ill health, action to deliver appropriate health and care services and action on the wider determinants of health. It requires working with communities and partner agencies.Community Health Nursing Intervention Strategies Assignment Papers. A vision for population health, page 18 What is involved in improving population health? Our health is shaped by a range of factors, as set out in Figure 1. It is hard to be precise about how much each of these factors contributes to our health, but the evidence is convincing that the wider determinants of health in the outer ring have the most impact, followed by our lifestyles and health behaviours, and then the health and care system. There is also now greater recognition of the importance of the communities we live and work in, and the social networks we belong to.Community Health Nursing Intervention Strategies Assignment Papers. Figure 1 – What affects our health? Figure 1: social determinants of health Dahlgren G, Whitehead M (1993). Tackling inequalities in health: what can we learn from what has been tried? Working paper prepared for The King’s Fund International Seminar on Tackling Inequalities in Health, September 1993, Ditchley Park, Oxfordshire. London, The King’s Fund, accessible in: Dahlgren G, Whitehead M. (2007) European strategies for tackling social inequities in health: Levelling up Part 2. Copenhagen: WHO Regional office for Europe: http://www.euro.who.int/__data/assets/pdf_file/0018/103824/E89384.pdf The King’s Fund definition of population health leads to a focus on actions in four broad areas, illustrated in Figure 2. These are the four pillars of population health. Figure 2 – Four pillars of population health Four pillars of population health Improving population health requires action on all four of the pillars and, crucially, the interfaces and overlaps between them. Understanding the interfaces and overlaps between the pillars is essential. For example, housing is well-known to have a powerful impact on health. Healthy New Towns are an example of how an understanding of the overlap between housing, lifestyles and behaviours can lead to housing developments that are designed to encourage physical activity, healthy eating and social interaction. Similarly, sugary drinks have been associated with childhood obesity. Understanding how lifestyle choices – in this case, the choice of drinks – overlap with wider determinants of health – in this case, the affordability of less sugary drinks – helped the government design a soft drinks industry levy (often referred to as a ‘sugar tax’) which has led to a reduction in the sugar content of many soft drinks.Community Health Nursing Intervention Strategies Assignment Papers. The King’s Fund describes this way of thinking about population health as a ‘population health system’ in which the four pillars are inter-connected and action is co-ordinated across them rather than within each in isolation. This is illustrated in Figure 3. Figure 3 – A population health system Figure 2: a population health system How should progress be made on population health? The first step is to recognise that improving population health is an urgent priority. Over the last 100 years we have grown used to people living for longer and longer, but in recent years life expectancy has stopped increasing in England and in some areas has been reducing. Health inequalities are widening and England lags behind comparable nations of many key measures of health outcomes. Demand on NHS services has been increasing, but much of that extra demand is for treatment of conditions which are preventable. At heart, the NHS remains a treatment service for people when they become ill.Community Health Nursing Intervention Strategies Assignment Papers. Importantly, action needs to be taken at three levels: national – eg, government, arm’s length bodies, membership organisations regional – eg, devolution areas, sustainability and transformation partnerships, integrated care systems local – eg, individual cities, towns and neighbourhoods. What needs to happen at the national level to improve population health? In addition to The King’s Fund’s A vision for population health, national bodies in England have started to signal a will to prioritise population health. Notably: the Department of Health and Social Care has issued a new strategy Prevention is better than cure which identifies population health as a priority. It includes a commitment for a Green Paper (consultation document) on the specific steps which the government will take to translate that priority into action.Community Health Nursing Intervention Strategies Assignment Papers. NHS England has been increasingly vocal in its aim of reducing health inequalities, and has identified prevention as one of the key themes in the long-term plan for the NHS. The plan includes a welcome emphasis on population health which will be a key focus for integrated care systems as they are rolled out across the country. National leadership for population health is essential but it needs to be co-ordinated across government. There are different options for how to do so. The last Labour government’s policies set targets for reducing health inequalities which went across government, with accountability through a cabinet sub-committee. The Welsh government has set statutory targets for improving population health, which go beyond the health sector and include requirements for translating them to the local level and for monitoring. The same legislation also set a requirement for health impact assessment of all policies. At the moment, efforts to improve population health lack a common set of high-level goals and robust accountability for improvement. Although progress is being made in many local areas, responsibility for this is fragmented and unclear, rather than joined up as a concerted, nationwide approach. Improving accountability for contributing to national, high level goals is a priority. The King’s Fund has highlighted the potentially important role that Public Health England could have in monitoring and reporting on progress across the health and care system and beyond, if its role were more than only advisory.Community Health Nursing Intervention Strategies Assignment Papers. At present, funding is skewed towards health services providing treatment, such as hospitals. There is good evidence that investment in prevention is cost-effective, but the benefits of that investment may not be realised until several years later and, in the meantime, hospitals need the funding now in order to meet people’s immediate needs. Breaking out of this cycle is fundamental to making progress. One of the challenges for national leaders is to lead a debate about how best to re-balance spending across the four pillars of population health.Community Health Nursing Intervention Strategies Assignment Papers. What needs to happen at a regional level to improve population health? Devolution areas and regional plans made by sustainability and transformation partnerships (STPs) or integrated care systems (ICSs) – which often include several local authorities and clinical commissioning groups – have great potential to improve population health. Greater Manchester, for example, has a population health plan which is fully integrated into broader plans for economic development and growth and for public service reform. It is rooted in a set of principles and values which reflect the overall approach to devolution, and it sets out ambitious plans and programmes. STPs and ICSs are using 2019/20 as a ‘foundation year’ to build up system-wide implementation plans for first five years of the NHS long-term plan, presenting a key opportunity to strengthen their focus on population health:Community Health Nursing Intervention Strategies Assignment Papers. Every ICS will need streamlined commissioning arrangements to enable a single set of commissioning decisions at system level. This will typically involve a single CCG for each ICS area. CCGs will become leaner, more strategic organisations that support providers to partner with local government and other community organisations on population health, service redesign and long-term plan implementation. The NHS long-term plan, page 29 It is implicit within this that although ICSs are being established through the NHS long-term plan, if they are to have impact on population health, they must not behave as just NHS bodies. At the regional level, a priority is to build on the cross-sector partnership approach that many STPs have started to establish.Community Health Nursing Intervention Strategies Assignment Papers. What does a population health approach look like at a local level? There is no single blueprint for a local population health approach: each place will need to work out what approach and – importantly – what arrangements for leadership and accountability will work best for their context. The four pillars of population health provide a framework that can be used for reviewing achievements and gaps, to inform the development of local plans and approaches.Community Health Nursing Intervention Strategies Assignment Papers. The examples below show the different approaches taken by different local areas. Bristol is developing its approach to population health by building on an existing commitment to be a ‘Marmot city’, adopting the approaches advocated by Professor Sir Michael Marmot for improving health and reducing health inequality. The Marmot city infrastructure is the basis for creating partnerships between city planning and development, public health, the local NHS, the local university, the police and others.Community Health Nursing Intervention Strategies Assignment Papers. Devon is using its STP as the framework for improving population health. For example, NHS commissioners and local authorities have jointly established wellbeing hubs. The County Durham Partnership positions the health and wellbeing board as the vehicle for improving population health by bringing together economic development, services for children and families, health improvement, community safety and the environment. There is notable engagement of councillors and NHS chief executives. Cherwell District Council is leading the Bicester Healthy New Town Initiative – a new development of 13,000 homes within the Bicester area – to bring together 20 partner organisations to ensure that the development actively promotes and improves residents’ health. Local politicians – councillors and mayors – have an essential role in bringing different organisations and departments together to work as effective partnerships, and in ensuring a focus on what the local community needs rather than a narrow view of organisational accountability. The King’s Fund’s report on the role of cities in improving population health describes this in more detail. Involving local people and using their insight to draw up plans for improving health are key to population health approaches. The Surrey Heartlands Health and Care Partnership demonstrates a range of methods for engaging people at scale including a citizen’s panel, monthly online surveys, citizen ambassadors and rigorous use of focus groups and deliberative research methods.Community Health Nursing Intervention Strategies Assignment Papers. Conclusion Right now, a number of policy developments are causing population health to have an increasingly high profile. Some of these – such as the NHS long-term plan – are specific to the NHS, although population health is about far more than just NHS services. It is clear that a significant groundswell is building up, creating opportunities for progress. Various secretaries of state for health have prioritised prevention when they first assumed office, only for that initial enthusiasm to evaporate over time. There is also a history of short-term thinking, resulting in prevention budgets being among the first to be cut at times of financial pressure. The key issue now is to ensure that the various commitments that have been made to improving population health go beyond rhetoric, to sustained effort at national, regional and local levels.Community Health Nursing Intervention Strategies Assignment Papers. 5095. Prespecialty Clinical Directed Study [Formerly NURS 262] This clinical course is designed to facilitate prespecialty student maintenance of clinical competencies in the event the student is unable to progress as planned in the clinical course curriculum of the prespecialty level. Students enrolled in this course will complete independent review of prior clinical and non-clinical course content, supervised laboratory practice, and facilitated clinical experience as directed by the faculty to demonstrate maintenance of clinical competency at the level of the last successfully completed prespecialty course. Prerequisite: Successful completion of at least one prespecialty clinical course. [1] 5101. Legal and Ethical Accountability in Professional Nursing Practice [Formerly NURS 215] This course provides an opportunity for the student to explore current legal and ethical issues in health care. Students will gain understanding of legal and ethical concepts, applying them in identification and analysis of complex scenarios affecting professional nursing practice. Legal principles, nursing liability, ethical theories, and decision-making are discussed as foundational concepts for professional nursing practice. Corequisites: 5103, 5105, 5106, 5115. [2] Fall 5103. Human Experience of Health and Illness Across the Lifespan I [Formerly NURS 235] Nursing 5103 is the first of three didactic courses examining the human experience of health and illness across the lifespan from infancy through senescence. Community Health Nursing Intervention Strategies Assignment Papers. The framework incorporates the following concepts and their influence on health and response to illness: growth and development, mental health, gender, lifestyle, value systems, spirituality, ethnicity, environment, and psychosocial, economic, and cultural issues. The impact of these factors on individuals, families, and aggregates will be explored. Basic concepts/knowledge of selected interventions will be introduced. Selected health problems involving the sensory, hematological, endocrine, renal/urinary, cardiovascular, and respiratory systems will be presented; the epidemiology, pathophysiology, medical management (select pharmacologic, non-pharmacologic, and surgical), and nursing management will be addressed. Health promotion, including primary, secondary, and tertiary, anticipatory guidance, and patient education will be discussed. Corequisite: 5101, 5105, 5106, 5115. [4] Fall 5105. Enhancement of Community and Population Health I [Formerly NURS 225] This course is the first in a sequence of three clinical practice courses designed to provide the student with an opportunity to explore population and community-based health care principles that impact the client.Community Health Nursing Intervention Strategies Assignment Papers. Healthy People 2020 will be used as a framework to determine the health status of the community. Notably, the course will provide the student knowledge on how the social determinants of health impact the health of the community. In addition, resources will be discussed in relation to the availability, barriers,and access in the community. The community clinical experience is designed to provide the student the opportunity to work within a community organization or agency to assess and identify specific challenges to maximizing the health of persons in communities and populations. Corequisite: 5101, 5103, 5106, 5115. [3] Fall 5106. Pharmacology for Nursing Care I [Formerly NURS 255A] This course presents an introduction to pharmacologic knowledge, the clinical indications for drug use as a treatment modality, and the role of the nurse in drug therapy.Community Health Nursing Intervention Strategies Assignment Papers. The course will present content on the prototype drug from major drug classifications that serves as a framework for continued self-study of new drug information. Emphasis will be placed on major drug classifications and their respective prototype drug(s) that are more commonly encountered in drug therapy. Corequisite: 5101, 5103, 5105, 5115. [2] Fall 5115. Fundamentals of Clinical Practice [Formerly NURS 245] This course is the first in a sequence of three clinical practice courses. The course is designed to provide the student with the opportunity to acquire the knowledge, skills, and attitudes required to apply the nursing process (assessment, analysis, planning, intervention, and evaluation) in the delivery of client-centered nursing care. Students will learn and practice assessment and intervention skills in a didactic classroom setting and in a simulated laboratory setting and progress to full application of the nursing process in an adult medical/surgical clinical setting with maximum faculty guidance. Corequisite: 5101, 5103, 5105, 5106. [5] Fall 5201. Inquiry and Evidence in Professional Nursing Practice [Formerly NURS 216] This course provides an introduction to nursing research and the evidence based practice process. Special emphasis is placed on integration of nursing science with clinical judgment and patient preferences for care. Students gain knowledge of the contributions of qualitative and quantitative research to clinical practice.Community Health Nursing Intervention Strategies Assignment Papers. Knowledge development and the interrelationships among theory, practice and research are discussed. The nurse’s role as advocate for human subjects in research is presented. Students identify clinical problems, search scholarly literature for information related to those problems, and critically appraise the scholarly information for application to clinical practice. The course culminates with the presentation of an evidence based nursing project addressing a selected clinical problem for the purpose of improving patient outcomes. Prerequisites: 5101, 5102, 5103, 5105, 5106, 5115; corequisites: 5203, 5205, 5206, 5215. [2] Spring 5203. Human Experience of Health and Illness Across the Lifespan II [Formerly NURS 236] Nursing 5203 is the second of three didactic courses examining the human experience of health and illness across the lifespan from infancy through senescence, including the childbearing cycle.Community Health Nursing Intervention Strategies Assignment Papers. The framework incorporates the following concepts and their influence on health and response to illness: growth and development, mental health, gender, lifestyle, value systems, spirituality, ethnicity, environment, and psychosocial, economic, and cultural issues. The impact of these factors on individuals, families, and aggregates will be explored. Basic concepts/knowledge of selected interventions will be introduced. Selected health problems involving mental health disorders with appropriate treatment modalities and settings, gastrointestinal, reproductive (including maternity focus) systems, and care of the client with cancer will be presented. The epidemiology, pathophysiology, medical management (non-pharmacologic, and surgical), and nursing management will be addressed. Health promotion, including primary, secondary, and tertiary, anticipatory guidance, and patient education will be discussed. Prerequisite: 5101, 5102, 5105, 5103, 5115, 5106. Corequisite: 5201, 5205, 5215, 5206. [5] Spring 5205. Enhancement of Community and Population Health II [Formerly NURS 226] This course is the second in a sequence of three clinical practice courses designed to provide the student with an opportunity to explore population and community based health care principles that impact the client.Community Health Nursing Intervention Strategies Assignment Papers. This course will provide the student with an opportunity to use evidence-based practice to enhance the knowledge base regarding factors that impact the client’s health status within the community and population. This course will focus on how evidence-based practice may be used to increase healthy lifespans, decrease discrepancies in health status and improve health outcomes. The course explores population-based care models and environments in which health care is delivered: community agencies, clinics, neighborhoods/communities, schools, the family, and the workplace. Prerequisite: 5101, 5102, 5105, 5103, 5115, 5106. Corequisite: 5201, 5203, 5215, 5206. [3] Spring 5206. Pharmacology for Nursing Care II [Formerly NURS 255B] This course extends and builds upon pharmacological knowledge from earlier pharmacology courses and the Health and Illness Across the Lifespan series. The focus of the course is drug therapy most commonly seen in specific clinical settings and specific patient situations. Community Health Nursing Intervention Strategies Assignment Papers. The course presents a context for safe drug administration and for continued self-study of new drug information. Emphasis is placed on pharmacological interventions to achieve safe and optimal patient outcomes. Prerequisite: 5101, 5102, 5105, 5103, 5115, 5106. Corequisite: 5201, 5205, 5203, 5215. [2] Spring 5215. Integration of Theoretical and Clinical Aspects of Nursing I [Formerly NURS 246] This course is the second of a sequence of three clinical practice courses. Community Health Nursing Intervention Strategies Assignment Papers. It is designed to provide the student with the opportunity to integrate theory, practice, and evidence in the application of the nursing process in a clinical setting for diverse client aggregate populations across the lifespan (child-bearing families/newborn health, pediatric and adolescent health, adult and older adult health, and psychiatric/mental health). Students will analyze and integrate aggregate specific concepts in the provision of client-centered care in a variety of health care settings with moderate faculty guidance. Prerequisite: 5101, 5102, 5105, 5103, 5115, 5106. Corequisite: 5201, 5205, 5203, 5206. [3] Spring 5301. Leadership and Management in Professional Nursing Practice [Formerly NURS 217] This course provides an introduction to leadership and management in nursing. Course content focuses on leadership and decision-making theories, power and influence, team building, communication, and problem solving skills. The course is designed to facilitate transition to practice and management of professional issues that reflect the current complexity in provision of care with respect to patient, organizational, and professional advocacy. Quality improvement and management skills will be emphasized including delegation and assignment, managed care, outcomes management, resource allocation, conflict resolution, and economic principles pertinent to the efficient and effective delivery of health care services. Prerequisite: 5101, 5201; corequisite: 5303, 5305, 5306, 5315, 5325. [2] Summer 5303. Human Experience of Health and Illness Across the Lifespan III [Formerly NURS 237] This is the third of three didactic courses examining the human experience of health and illness across the lifespan – from infancy through senescence – with an emphasis on increasing complex acute and chronic issues. The course provides the student with the theoretical basis to apply principles of chronic illness, including assessment and intervention skills, to at-risk populations. Community Health Nursing Intervention Strategies Assignment Papers. The impact of multi-system factors on individuals, families, and aggregates or populations/communities will be explored. The epidemiology, pathophysiology, medical management (pharmacologic, non-pharmacologic, and surgical), and nursing management for selected health problems will be addressed. Health promotion, anticipatory guidance, and patient education will be discussed. Prerequisite: 5101, 5201, 5102, 5105, 5205, 5103, 5203, 5115, 5215, 5106, 5206. Corequisite: 5301, 5305, 5315, 5325, 5306. [Prerequisites and corequisites apply to non-R.N. students only.] [4] Fall, Summer 5305. Enhancement of Community and Population Health III [Formerly NURS 227] This course is the third in a sequence of three clinical practice courses designed to provide the student with an opportunity to explore population and community-based health care principles that impact the client. This course addresses healthcare systems related issues that impact the client’s ability to maintain and maximize health.Community Health Nursing Intervention Strategies Assignment Papers. Students will have the opportunity to build on their knowledge of clients within communities and populations, collaborate to synthesize and evaluate data, identify appropriate programs, and disseminate findings. Prerequisite: 5101, 5201, 5102, 5105, 5205, 5103, 5203, 5115, 5215, 5106, 5206. Corequisite: 5301, 5303, 5315, 5325, 5306. [2] Summer 5306. Pharmacology for Nursing Care III [Formerly NURS 256] This course presents pharmacologic knowledge, the clinical indications for medication use as a treatment modality, and the role of the nurse in medication therapy. Emphasis is placed on the variations of pharmacologic therapy in critical and complex situations with the goal of achieving safe and optimal client outcomes in specific situations.Community Health Nursing Intervention Strategies Assignment Papers. Major medication classifications and commonly encountered prototype(s) within specialty areas will serve as a framework for continued learning of new pharmacologic information. Additionally, this course engages students in group activities which require collaboration, negotiation, and rationalizations of decisions essential for client centered care.. Prerequisite: 5101, 5201, 5102, 5105, 5205, 5103, 5203, 5115, 5215, 5106, 5206. Corequisite: 5301, 5305, 5303, 5315, 5325. [1] Summer 5315. Integration of Theoretical and Clinical Aspects of Nursing II [Formerly NURS 247A] This course is the final rotation of the second in the sequence of three clinical practice courses. This course is designed to provide the student with the opportunity to integrate theory, practice, and evidence in the application of the nursing process in a clinical setting for diverse client aggregate populations across the life span (child-bearing families/newborn health, pediatric and adolescent health, adult and older adult health, and psychiatric/mental health). Community Health Nursing Intervention Strategies Assignment Papers. Students will analyze and integrate aggregate specific concepts in the provision of client-centered care in variety of health care settings with moderate faculty guidance. Prerequisite: 5101, 5201, 5102, 5105, 5205, 5103, 5203, 5115, 5215, 5106, 5206. Corequisite: 5301, 5305, 5303, 5325, 5306. [1] Summer 5325. Capstone Clinical Practicum [Formerly NURS 247B] This course is the third in a sequence of three clinical practice courses. This course is designed to provide the student with the opportunity to synthesize theory, practice, and evidence in the application of the nursing process for multiple complex adult medical-surgical clients. Students will synthesize acquired knowledge, skills, and attitudes to prevent illness and promote health, prioritize and delegate nursing care, and engage as leaders within the inter-professional health care team to meet the needs of clients on the continuum of health. Prerequisite: 5101, 5201, 5102, 5105, 5205, 5103, 5203, 5115, 5215, 5106, 5206. Corequisite: 5301, 5305, 5303, 5315, 5306. [2] Summer 5401. Critical Thinking, Supporting Evidence and Communication, Part 1 [Formerly NURS 218A] This course focuses on identification of the unique strengths/perceptions of each RN student and a development of an individualized plan for learning. The course assists RN students in identifying and developing strategies to foster critical thinking, lifelong learning, and nursing practice role development.Community Health Nursing Intervention Strategies Assignment Papers. Theory development and research are introduced as processes essential to the organization and development of nursing knowledge. Limited to RN students. [3] Fall 5402. Epidemiology and Population-Based Nursing [Formerly NURS 228] This course provides the student with an opportunity to explore population-based health care principles of prevention, health maintenance and health promotion within the context of Healthy People 2010. Notably, the course will focus on how these principles are used to increase healthy lifespan, decrease discrepancies in health status and health outcomes for different populations and assure access to preventive services for all. It emphasizes epidemiologic principles and population-based holistic health promotion/disease prevention as an integral part of populations at risk for illness, disability, or premature death. Further, the course explores population-based care models and environments in which health care is delivered: community agencies, neighborhoods/communities, schools, the family, and the workplace. Legislation and policy implications for primary, secondary, and tertiary care will be discussed. [3] Fall 5403. Health Care Systems and the Role of the Nurse as Facilitator of Learning [Formerly NURS 238] This course addresses health care systems and the role of the nurse as teacher and facilitator of learning in health care. Course content focuses on leadership concepts, decision-making, team building, communication, managerial skills, and integrates the foundational concepts of teaching and counseling patients and families.Community Health Nursing Intervention Strategies Assignment Papers. The course also provides information on contemporary trends in the organization and delivery of health care to individuals, families and populations to include quality improvement and legal/regulatory issues. In addition, course content will include the impact of managed care and financial pressures on health care providers along with outcomes management, financial management, conflict resolution and economic principles per

NURS 6351 – Role of the Nurse Educator Research Paper NURS 6351 – Role of the Nurse Educator Research Paper A nurse educator is a nurse who teaches and prepares licensed practical nurses (LPN) and registered nurses (RN) for entry into practice positions. They can also teach in various patient care settings to provide continuing education to licensed nursing staff. Nurse Educators teach in graduate programs at Master’s and doctoral level which prepare advanced practice nurses, nurse educators, nurse administrators, nurse researchers, and leaders in complex healthcare and educational organizations.NURS 6351 – Role of the Nurse Educator Research Paper Permalink: https://nursingpaperessays.com/ nurs-6351-role-o…r-research-paper / ? The type of degree required for a nurse educator may be dependent upon the governing nurse practice act or upon the regulatory agencies that define the practice of nursing. In the United States, one such agency is the National Council of State Boards of Nursing.[1] For instance, faculty in the U.S. may be able to teach in an LPN program with an associate degree in nursing. Most baccalaureate and higher degree programs require a minimum of a graduate degree and prefer the doctorate for full-time teaching positions. Many nurse educators have a clinical specialty background blended with coursework in education. Many schools offer the Nurse Educator track which focuses on educating nurses going into any type setting. Individuals may complete a post-Master’s certificate in education to complement their clinical expertise if they choose to enter a faculty role. Nurse educators can choose to teach in a specialized field of their choosing. There is not extra degree needed to be earned other than a Master’s degree in nursing. Most schools will only hire a nurse to teach a class if they have had experience in that area. This is so the students can have a better understanding of the current subject being taught.NURS 6351 – Role of the Nurse Educator Research Paper In Australia, Nurse Educators must be Registered Nurses (RNs/Division 1 Nurses). The Nurse Educator role is not available to Enrolled Nurses (ENs/Division 2 Nurses). Nurse Educators require a minimum of a Certificate IV in Training and Assessment to teach the Diploma of Nursing in both the classroom and clinical placement settings. Bachelor of Nursing Educators do not technically require this qualification, but it is generally favored. A Nurse Educator may also complete post-graduate university study in Nursing or Clinical Education, which may lead to an academic career including research, lecturing or doctoral study. To become a Clinical Nurse Educator in a healthcare setting (e.g on an acute care ward), Registered Nurses are generally required to have 5-10 years clinical experience and 6-8 years of study (a bachelor degree plus post-graduate certificate or diploma).NURS 6351 – Role of the Nurse Educator Research Paper Nurse educators combine clinical expertise and a passion for teaching into rich and rewarding careers. These professionals, who work in the classroom and the practice setting, are responsible for preparing and mentoring current and future generations of nurses. Nurse educators play a pivotal role in strengthening the nursing workforce, serving as role models and providing the leadership needed to implement evidence-based practice. Nurse educators are responsible for designing, implementing, evaluating and revising academic and continuing education programs for nurses. These include formal academic programs that lead to a degree or certificate, or more informal continuing education programs designed to meet individual learning needs. Nurse educators are critical players in assuring quality educational experiences that prepare the nursing workforce for a diverse, ever-changing health care environment. They are the leaders who document the outcomes of educational programs and guide students through the learning process.NURS 6351 – Role of the Nurse Educator Research Paper Nurse educators are prepared at the master’s or doctoral level and practice as faculty in colleges, universities, hospital-based schools of nursing or technical schools, or as staff development educators in health care facilities. They work with recent high school graduates studying nursing for the first time, nurses pursuing advanced degrees and practicing nurses interested in expanding their knowledge and skills related to care of individuals, families and communities. Nurse educators often express a high degree of satisfaction with their work. They typically cite interaction with students and watching future nurses grow in confidence and skill as the most rewarding aspects of their jobs. Other benefits of careers in nursing education include access to cutting-edge knowledge and research, opportunities to collaborate with health professionals, an intellectually stimulating workplace and flexible work scheduling.NURS 6351 – Role of the Nurse Educator Research Paper Given the growing shortage of nurse educators, the career outlook is strong for nurses interested in teaching careers. Nursing schools nationwide are struggling to find new faculty to accommodate the rising interest in nursing among new students. The shortage of nurse educators may actually enhance career prospects since it affords a high level of job security and provides opportunities for nurses to maintain dual roles as educators and direct patient care providers. Roles: A nurse educator is a registered nurse who has advanced education, including advanced clinical training in a health care specialty. Nurse educators serve in a variety of roles that range from adjunct (part-time) clinical faculty to dean of a college of nursing. Professional titles include Instructional or Administrative Nurse Faculty, Clinical Nurse Educator, Staff Development Officer and Continuing Education Specialist among others. NURS 6351 – Role of the Nurse Educator Research Paper Nurse educators combine their clinical abilities with responsibilities related to: Designing curricula Developing courses/programs of study Teaching and guiding learners Evaluating learning Documenting the outcomes of the educational process. Nurse educators also help students and practicing nurses identify their learning needs, strengths and limitations, and they select learning opportunities that will build on strengths and overcome limitations. In addition to teaching, nurse educators who work in academic settings have responsibilities consistent with faculty in other disciplines, including: Advising students Engaging in scholarly work (e.g., research) Participating in professional associations Speaking/presenting at nursing conferences Contributing to the academic community through leadership roles Engaging in peer review Maintaining clinical competence Writing grant proposals A growing number of nurse educators teach part-time while working in a clinical setting. This gives them the opportunity to maintain a high degree of clinical competence while sharing their expertise with novice nurses. Nurse educators who work in practice settings assess the abilities of nurses in practice and collaborate with them and their nurse managers to design learning experiences that will continually strengthen those abilities. NURS 6351 – Role of the Nurse Educator Research Paper Specialties: In most instances, nurse educators teach clinical courses that correspond with their area(s) of clinical expertise and the concentration area of their graduate nursing education program. Those considering a teaching career may choose from dozens of specialty areas, including acute care, cardiology, family health, oncology, pediatrics and psychiatric/mental health. In addition, nurse educators teach in areas that have evolved as “specialties” through personal experience or personal study, such as leadership or assessment. The true specialty of a nurse educator is his or her expertise in teaching/learning, outcomes assessment, curriculum development and advisement/guidance of the learner. Qualifications: Nurse educators need to have excellent communication skills, be creative, have a solid clinical background, be flexible and possess excellent critical thinking skills. They also need to have a substantive knowledge base in their area(s) of instruction and have the skills to convey that knowledge in a variety of ways to those who are less expert. NURS 6351 – Role of the Nurse Educator Research Paper Nurse educators need to display a commitment to lifelong learning, exercise leadership and be concerned with the scholarly development of the discipline. They should have a strong knowledge base in theories of teaching, learning and evaluation; be able to design curricula and programs that reflect sound educational principles; be able to assess learner needs; be innovative; and enjoy teaching. Those who practice in academic settings also need to be future-oriented so they can anticipate the role of the nurse in the future and adapt curriculum and teaching methods in response to innovations in nursing science and ongoing changes in the practice environment. They need advisement and counseling skills, research and other scholarly skills, and an ability to collaborate with other disciplines to plan and deliver a sound educational program. Nurse educators who practice in clinical settings need to anticipate changes and expectations so they can design programs to prepare nurses to meet those challenges. They need to be able to plan educational programs for staff with various levels of ability, develop and manage budgets, and argue for resources and support in an environment where education is not the primary mission. Practice Settings: While nurses who care for patients in any setting engage in patient teaching, nurse educators typically practice in the following settings: Senior colleges and universities Junior or community colleges Hospital-based schools of nursing Technical colleges Hospitals Community health agencies Home care agencies Long-term care facilities Online using distance learning technology. Within the school setting, there are as many options as there are schools. Educators may teach on a rural, suburban or urban campus; at a major private university or local community college; as part of a certificate program in a teaching hospital; or as a research coordinator in a doctoral program. NURS 6351 – Role of the Nurse Educator Research Paper What Is the Nurse’s Role in Patient Education? Effective patient education starts from the time patients are admitted to the hospital and continues until they are discharged. Nurses should take advantage of any appropriate opportunity throughout a patient’s stay to teach the patient about self-care. The self-care instruction may include teaching patients how to inject insulin, bathe an infant or change a colostomy pouching system. Without proper education, a patient may go home and resume unhealthy habits or ignore the management of their medical condition. These actions may lead to a relapse and a return to the hospital. To educate patients, nurses may instruct patients about the following: Self-care steps they need to take. Why they need to maintain self-care. How to recognize warning signs. What to do if a problem occurs. Who to contact if they have questions. How Can Nurses Ensure Patient Comprehension? Many patients lack knowledge about healthcare. Nurses must assess their patients to pinpoint the best way to educate them about their health and determine how much they already know about their medical condition. They need to build a rapport with patients by asking questions to zero in on concerns. Nurses may have to adjust their teaching strategies to fit the patient’s preferences. Many patients want detailed information, though some may request only a checklist. Once nurses complete the patient assessment, they can provide instruction by using the following:NURS 6351 – Role of the Nurse Educator Research Paper Common words and phrases. Reading materials written at a sixth-grade level. Video. Audio. A hands-on approach is instrumental in guaranteeing that a patient understands medical requirements. Nurses should perform a demonstration and have patients repeat back the information or carry out the procedure themselves. Nurses should also teach the patient’s family members, friends or caregivers at home. How Are Patients Different? Not every patient has the same learning ability. Patients may have developmental disorders or literacy limitations. Some patients may respond better to visual content than to plain text. Others may have hearing or vision impairment. Nurses may encounter language or cultural barriers. Consider the following questions when assessing patients. What level of education do they have? Can they read and comprehend directions for medications, diet, procedures and treatments? What is the best teaching method? Reading, viewing or participating in a demonstration? What language does the patient speak? Does the patient want basic information or in-depth instruction? How well does the patient see and hear? In order to create an environment that is conducive to patient education, nurses should develop a supportive relationship with their patients. Patients equipped with knowledge can make lifestyle changes and remain self-sufficient even if they have a chronic medical condition. Education can increase the likelihood of successful outcomes and improve patient safety and satisfaction.NURS 6351 – Role of the Nurse Educator Research Paper In 2008, the Institute of Medicine released a report recommending that 80 percent of the registered nurse (RN) workforce have a bachelor’s degree in nursing (BSN) by 2020, causing many hospitals to reevaluate their criteria for hiring new nurses. Additionally, hospitals aspiring to Magnet status are likely to hire more BSN-prepared nurses, due to better expected patient outcomes. That’s why many hospitals are looking to work with educational institutions such as Herzing University to meet the rising demand of BSN degrees, such as through an online RN-BSN program. As registered nurses return to school and new students seek entry to BSN programs, colleges and universities are under increased pressure to find qualified faculty to educate and train future nurses. Thus, nurse educators’ skills and experience are continually in demand, and essential for expanding the RN workforce to meet the healthcare needs of current and future generations. How are nurse educators preparing nurses for the future? Nurse educators are instrumental in shaping the future of healthcare by providing their students not only with the technical skills that they need to be successful in their field, but also the refined skills and depth of knowledge that will help advance quality of patient care. • The importance of community nursing: As the focus of patient care shifts from acute care to prevention models, a nurse’s role expands to health education and advocacy, community care, agency collaboration and political and social reform. Today’s nurses need to understand their evolving role in the community and how to provide holistic care for patients. As a nurse educator, you help nurses understand the principles behind the work that they do and how they can proactively contribute to the health and well-being of the communities they serve. • Essential leadership skills: Good leaders aren’t born—they’re made! Nurse educators help prepare today’s nurses for future leadership roles by introducing management and organizational theories that will allow nurses to take initiative in a variety of roles. In addition, nurse educators help students learn how to improve patient-care quality, how to make cost-effective decisions and how to evaluate patient outcomes to improve future practice. • How to implement evidence-based practice: Nurse educators can also help nurses learn how to critically evaluate new research. This is an important skill that allows nurses to become more effective decision-makers and problem-solvers and help improve patients’ health and well-being. Becoming a nurse educator: Becoming a nurse educator doesn’t mean that you have to forgo your clinical work; many nurse educators continue to care for patients in addition to their teaching duties. In order to become a nurse educator, you must obtain your MSN. Educational opportunities such as Herzing’s MSN-Nurse Educator program empower students to fulfill the ongoing and vital need for quality instructors in the field.NURS 6351 – Role of the Nurse Educator Research Paper Helping to shape the future generation of nurses is a truly rewarding career, and one that is essential to ensuring quality healthcare for our nation. By choosing to pursue a career in nursing education, today’s nurses can help pave the way for a healthier future. What exactly does a nurse do? This lesson explores some of the different roles a nurse plays in patient care, including caregiver, decision maker, communicator, manager of care, patient advocate, and teacher. Roles and Functions of the Nurse What exactly does a nurse do? Your answer probably depends on the experiences that you have had in the past. Most people think a nurse is someone who gives a shot at the doctor’s office – or simply is a doctor’s assistant. Furthermore, images of nurses in the media also paint a different picture of who a nurse really is. However, a nurse has a number of roles that he or she performs, often at the same time, depending on a patient’s needs. With all of the changes in healthcare over the last few decades, that role has expanded even more. Let’s explore a few of these roles.NURS 6351 – Role of the Nurse Educator Research Paper Caregiver As a caregiver, a nurse provides hands-on care to patients in a variety of settings. This includes physical needs, which can range from total care (doing everything for someone) to helping a patient with illness prevention. The nurse maintains a patient’s dignity while providing knowledgeable, skilled care. In addition, nurses care holistically for a patient. Holistic care emphasizes that the whole person is greater than the sum of their parts. This means that nurses also address psychosocial, developmental, cultural, and spiritual needs. The role of caregiver includes all of the tasks and skills that we associate with nursing care, but also includes the other elements that make up the whole person. Decision Maker Another role of the nurse, as a decision maker, is to use critical thinking skills to make decisions, set goals, and promote outcomes for a patient. These critical thinking skills include assessing the patient, identifying the problem, planning and implementing interventions, and evaluating the outcomes. A nurse uses clinical judgment – his or her ability to discern what is best for the patient – to determine the best course of action for the patient. Communicator As a communicator, the nurse understands that effective communication techniques can help improve the healthcare environment. Barriers to effective communication can inhibit the healing process. The nurse has to communicate effectively with the patient and family members as well as other members of the healthcare team. In addition, the nurse is responsible for written communication, or patient charting, which is a key component to continuity of care.NURS 6351 – Role of the Nurse Educator Research Paper Manager of Care The nurse works with other healthcare workers as the manager of care and ensures that the patient’s care is cohesive. The nurse directs and coordinates care by both professionals and nonprofessionals to confirm that a patient’s goals are being met. The nurse is also responsible for continuity from the moment a patient enters the hospital setting to the time they are discharged home and beyond. This may even include overseeing home care instructions. For nurses in the hospital setting, the nurse is responsible for prioritizing and managing the care of multiple patients at the same time, which adds another dimension to this process. Patient Advocate Being a patient advocate may be the most important of all nursing roles. As a patient advocate, the nurse’s responsibility is to protect a patient’s rights. When a person is sick, they are unable to act as they might when they are well. The nurse acts on the patient’s behalf and supports their decisions, standing up for his or her best interests at all times. This can empower a patient while recognizing that a patient’s values supersede the health care providers’.NURS 6351 – Role of the Nurse Educator Research Paper The Role of the 21st Century School Nurse SUMMARYIt is the position of the National Association of School Nurses (NASN) that every child has access all day, every day to a full time registered professional school nurse (hereinafter referred to as school nurse). The school nurse serves in a pivotal role that bridges health care and education. Grounded by standards of practice, services provided by the school nurse include leadership, community/public health, care coordination, and quality improvement (NASN, 2016a) BACKGROUND The practice of school nursing began in the United States on October 1, 1902, when Lina Rogers, the first school nurse, was hired to reduce absenteeism by intervening with students and families regarding healthcare needs related to communicable diseases. After one month of successful nursing interventions in the New York City schools, she led the implementation of evidence-based nursing care across the city (Struthers, 1917). Since that time, school nurses continue to provide communicable disease management, but their role has expanded and is increasingly diverse.NURS 6351 – Role of the Nurse Educator Research Paper A student’s health is directly related to his or her ability to learn. Children with unmet health needs have a difficult time engaging in the educational process. The school nurse supports student success by providing health care through assessment, intervention, and follow-up for all children within the school setting. The school nurse addresses the physical, mental, emotional, and social health needs of students and supports their achievement in the learning process. Students who are medically fragile or who deal with chronic health issues are coming to school in increasing numbers and with increasingly complex medical problems that require complicated treatments commonly provided by the school nurse (Lineberry & Ikes, 2015). Chronic conditions such as asthma, anaphylaxis, type 1 and type 2 diabetes, epilepsy, obesity, and mental health concerns may affect the student’s ability to be in school and ready to learn. The National Survey of Children with Special Healthcare Needs has determined that 11.2 million U.S. children are at risk for chronic physical, developmental, behavioral, or emotional conditions. These students may require health related services in schools (U.S. Department of Health and Human Services, Maternal and Child Health Bureau, 2013). School nurses address the social determinants of health, such as income, housing, transportation, employment, access to health insurance, and environmental health. Social determinants are identified to be the cause of 80% of health concerns (Booske, Athens, Kindig, Park, & Remington, 2010). In the United States, nearly one quarter of children attending school live in households below the federal poverty level (United States Census Bureau, 2014). Children from lower income families have a more difficult time accessing medical treatment for chronic diseases (Perrin, 2014).NURS 6351 – Role of the Nurse Educator Research Paper RATIONALE School nursing is a specialized practice of nursing that advances the well-being, academic success, and lifelong achievement and health of students. Keeping children healthy, safe, in school, and ready to learn should be a top priority for both healthcare and educational systems. With approximately 55.9 million students in public and private elementary and secondary schools, educational institutions are excellent locations to promote health in children (National Center for Education Statistics, n.d.) and the school nurse is uniquely positioned to meet student health needs. LEADERSHIP School nurses lead in the development of policies, programs, and procedures for the provision of school health services at an individual or district level (NASN, 2016a), relying on student-centered, evidence-based practice and performance data to inform care (Robert Wood Johnson Foundation, 2009). Integrating ethical provisions into all areas of practice, the school nurse leads in delivery of care that preserves and protects student and family autonomy, dignity, privacy, and other rights sensitive to diversity in the school setting (American Nurses Association [ANA] & NASN, 2011). As an advocate for the individual student, the school nurse provides skills and education that encourage self-empowerment, problem solving, effective communication, and collaboration with others (ANA, 2015a). Promoting the concept of self-management is an important aspect of the school nurse role and enables the student to manage his/her condition and to make life decisions (Tengland, 2012). The school nurse advocates for safety by participating in the development of school safety plans to address bullying, school violence, and the full range of emergency incidents that may occur at school (Wolfe, 2013).NURS 6351 – Role of the Nurse Educator Research Paper At the policy development and implementation level, school nurses provide system?level leadership and act as change agents, promoting education and healthcare reform. According to the ANA (2015b), registered nurses believe that it is their obligation to help improve issues related to health care, consumer care, health, and wellness. Educational preparation for the school nurse should be at the baccalaureate level (NASN, 2016b), and school nurses should continue to pursue professional development and continuing nursing education throughout their careers (Wolfe, 2013). COMMUNITY/PUBLIC HEALTH School nursing is grounded in community/public health (Schaffer, Anderson, & Rising, 2015). The goal of community/public health moves beyond the individual to focus on community health promotion and disease prevention and is one of the primary roles of the school nurse (Wold & Selekman, 2013). School nurses employ cultural competency in delivering effective care in culturally diverse communities (Office of Minority Health, 2013).NURS 6351 – Role of the Nurse Educator Research Paper The school nurse employs primary prevention by providing health education that promotes physical and mental health and informs healthcare decisions, prevents disease, and enhances school performance. Addressing such topics as healthy lifestyles, risk?reducing behaviors, developmental needs, activities of daily living, and preventive self?care, and the school nurse uses teaching methods that are appropriate to the student’s developmental level, learning needs, readiness, and ability to learn. Screenings, referrals, and follow?up are secondary prevention strategies that school nurses utilize to detect and treat health-related issues in their early stage (NASN, 2016a). School nurses provide tertiary prevention by addressing diagnosed health conditions and concerns.NURS 6351 – Role of the Nurse Educator Research Paper Student absences due to infectious disease cause the loss of millions of school days each year (Centers for Disease Control and Prevention, 2011). Based on standards of practice and community health perspective, the school nurse provides a safe and healthy school environment through control of infectious disease, which includes promotion of vaccines, utilization of school-wide infection control measures, and disease surveillance and reporting. Immunization compliance is much greater in schools with school nurses (Baisch, Lundeen, & Murphy, 2011). The school nurse strives to promote health equity, assisting students and families in connecting with healthcare services, financial resources, shelter, food, and health promotion. This role encompasses responsibility for all students within the school community, and the school nurse is often the only healthcare professional aware of all the services and agencies involved in a student’s care. NURS 6351 – Role of the Nurse Educator Research Paper CARE COORDINATION School nurses are members of two divergent communities (educational and medical/nursing), and as such are able to communicate fluently and actively collaborate with practitioners from both fields (Wolfe, 2013). As a case manager, the school nurse coordinates student health care between the medical home, family, and school. The school nurse is an essential member of interdisciplinary teams, bringing the health expertise necessary to develop a student’s Individualized Education Plan or Section 504 plan designed to reduce health related barriers to learning (Zimmerman, 2013). Creating, updating, and implementing Individualized Healthcare Plans are fundamental to the school nurse role (McClanahan & Weismuller, 2015). School nurses deliver quality health care and nursing intervention for actual and potential health problems. They provide for the direct care needs of the student, including medication administration and routine treatments and procedures (Lineberry & Ickes, 2015). Education of school staff by the school nurse is imperative to the successful management of a child with a chronic condition or special healthcare need and is codified as a role of the school nurse in the Every Student Succeeds Act (2015).NURS 6351 – Role of the Nurse Educator Research Paper Current school health practice models and school nurse workloads may require school nurses to delegate healthcare tasks to unlicensed assistive personnel in order to support the health and safety needs of students (Shannon & Kubelka, 2013). However, the availability of school nurses to work directly with students to assess symptoms and provide treatment increases students’ time in the classroom and parents’ time at work (Lineberry & Ickes, 2015). QUALITY IMPROVEMENT Quality improvement is a continuous and systematic process that leads to measurable improvements and outcomes (Health Resources and Services Administration, 2011) and is integral to healthcare reform and standards of practice (Agency for Healthcare Research and Quality, 2011). Continuous quality improvement is the nursing process in action: assessment, identification of the issue, development of a plan of action, implementation of the plan, and evaluation of the outcome. Data collection through this process is a necessary role of the school nurse.NURS 6351 – Role of the Nurse Educator Research Paper Formal school nursing research is needed to ensure that delivery of care to students and school communities by the school nurse is based on current evidence. School nurses utilize research data as they advocate and illustrate the impact of their role on meaningful health and academic outcomes (NASN, 2016a). CONCLUSION It is the position of NASN that school nurses play an essential role in keeping children healthy, safe, and ready to learn. The school nurse is a member of a unique discipline of professional nursing and is often the sole healthcare provider in an academic setting. Twenty?first century school nursing practice is student?centered, occurring within the context of the student’s family and school community (NASN, 2016a). It is essential that all students have access to a full time school nurse all day, every day (American Academy of Pediatrics, 2016). Duties of a Nurse Educator Nurse educators teach and mentor the next generation of nurses. They are the role models for nursing students, guiding students through the challenges of learning what it means to be a nurse. Prepared at the master’s or doctoral level, they are the faculty at colleges, universities, vocational/technical schools and hospital-based diploma programs. Master’s prepared nurse educators earned an average annual salary of $72,028 in 2011, according to the American Association of Colleges of Nursing.NURS 6351 – Role of the Nurse Educator Research Paper Academic Programs Nurse educators ensure that students who pass through their hands are prepared for a constantly changing health care environment. They design the academic programs at their institutions in accordance with the state regulations regarding nursing instruction. In addition to teaching the courses, nurse educators evaluat