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NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper Challenges and opportunities to making EBP a universal reality Not many could argue against the idea that adopting evidence-based practice (EBP) improves quality; however, not everyone knows how to apply it. NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper The call for evidence-based quality improvement underscores the need for realigning care to make it more effective, safe and efficient. But, as we think about how to apply EBP at the point-of-care, we must consider how EBP is incorporated into the workflow with different technology tools. Both workflow and technology are critical elements to apply EBP. We must also think about having a culture that invites inquiry and new knowledge. NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper Permalink: https://nursingpaperessays.com/ 2036-2 / ? Why Adopting EBP is Important Looking back to the mid-1990s, nurses realized that to affect better patient outcomes, new knowledge must be transformed into clinically-useful forms that are effectively implemented across the entire care team and measured in terms of meaningful impact on performance and health outcomes. With that, the goal of EBP was to take current knowledge and connect it to standardize care to improve care processes and, ultimately, patient outcomes. Without EBP, healthcare providers are at risk for significant variances in care. So, not only is it important to adopt EBP, it’s also necessary to have methodologies in place to apply it and make it sustainable. From a holistic perspective, EBP can be defined as looking at the literature of the best, currently available clinical research, as well as the clinical expertise within a specialty area, and connecting it to clinical experience. In addition, EBP considers patient values (or preferences) within a situation. These three components must work together. NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper Ultimately, for clinicians to apply EBP, they’ll need: The necessary tools The right culture to embrace it The engagement skills to bring patient values into the care process In February 2016, Elsevier conducted a national study in collaboration with the Ohio State University College of Nursing. 1 A total of 256 nurse executives across the country were surveyed about their beliefs and perceptions of EBP, along with some environmental aspects of their organization. The study also included outcomes related to HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores, patient satisfaction information and data from the NDNQI, the National Database of Nursing Quality Indicators. NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper One of the study’s cardinal findings was that, even though all the respondents indicated that quality and safety were the highest priority within an organization, focusing on EBP was the lowest. This is an extremely telling finding, considering that in order to achieve quality and safety, EBP must be applied. Why is there such a gap between making quality and safety the highest priority in healthcare, and the actual adoption or application of EBP within an organization? Closing the Gap Patients expect to receive evidence-based care at the point-of-care. The reality though, is that this is not happening. So, we need to ask ourselves why and how we make EBP a reality so that a level of safe, quality care is delivered to patients across the care continuum. NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper While numerous perceived barriers to adoption have been identified, the most common are: The enormous amount of healthcare literature available, making it impossible for medical professionals to keep current Inadequate access to information technology The lack of time and autonomy to change practice There are, however, several ways the industry can expand its focus on EBP: Make EBP an inter professional priority and lead with nurses. Nurses are the largest workforce in the U.S. healthcare system. If we start with nurses, we can make a tremendous impact. This means pushing nurses to practice at the top of their license and embrace EBP. Ultimately, this is not just a nursing solution; it is an inter professional team concept. Employ models and frameworks. These are critical to EBP. Having a model and/or framework that organizations can embrace to either implement or align with proprietary professional practice models makes a significant difference. Models and/or frameworks make transparent that this a way to apply EBP. Too often, EBP is thought of as a theoretical concept that is difficult to embrace, and that’s just not the case. Employing models and/or frameworks also engages clinicians and clinical scholars who are experts in their respective fields. NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper Cultivate the right culture. If organizational culture simply accepts things the way they are and doesn’t question why, practice will never advance. Leaders that truly embrace cultures of EBP encourage their clinicians to ask why something is always done one particular way or another. Also, inquiry can bring about positive change. If a culture of inquiry does not exist in which people who don’t understand ask questions, practice will not change. What if an organization has evidence-based tools but they are not immediately accessible to staff? This is a problem that exists in many organizations. Evidence-based tools are available, but the staff that cares for patients doesn’t always know where to find them. A solution to this problem is to integrate evidence-based decision-making into the Electronic Health Record (EHR) in a way that it is actionable for the clinician. To help bridge the gap between quality, safety and EBP, organizations need return on investment (ROI) tools to help make the case for why they should invest in areas such as care planning, methodologies that ensure nurses have the latest information, and help CFOs make the connection between these types of purchasing decisions and the bottom line. Also, know that these tools aren’t just for patient safety exclusively; they keep the clinicians safe as well. NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper EBP Opportunities and Challenges Probably one of the greatest challenges and opportunities is applying EBP across the continuum of care. This is very much aligned with the Affordable Care Act and movement from fee-based to value-based service. Does it make sense for a patient with heart failure to receive care at an inpatient hospital setting that uses evidence-based guidelines and methodologies, to then be sent home and receive care at a heart failure clinic that doesn’t use an evidence-based approach to care? There’s a great opportunity to establish EBP as a standard pillar across all healthcare settings to ensure the patient receives evidence-based, consistent care from all providers while engaging them in their own healthcare as well. The key to advancing quality and safety in healthcare To significantly impact the improvement of quality in healthcare, one needs to apply evidence-based practice (EBP). Without EBP, healthcare providers are at risk for variances in care that could seriously affect patient outcomes. A “no-brainier,” right? Yet, healthcare organizations throughout the U.S. continue to grapple with how to apply EBP. A recently published study conducted in collaboration with Elsevier Clinical Solutions and the Ohio State University College of Nursing surveyed 256 nurse executives about their beliefs and perceptions of EBP, along with some environmental aspects of their organizations. 1 Among the study’s cardinal findings: even though all the respondents indicated that quality and safety were the highest priority within their organizations, focusing on EBP was the lowest. This presents a dilemma of sorts, because In order to achieve quality and safety, EBP must be applied. NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper Why is there such a contradiction between focusing on quality and safety, and EBP? And what must healthcare organizations do to achieve parity among these three goals? The answer lies in: • Developing the right organizational culture • Education and leading with nurses • Employing models and framework and, • Advancing an inter professional approach. Establishing the right organizational culture Simply disseminating evidence-based resources throughout an organization and expecting clinicians to implement evidence-based guidelines is not enough. In fact, clinicians often admit that they do not know where to find the evidence-based resources within their organization. EBP requires real behavior change, from long-held practices and organizational cultures of “this is the way we’ve always done it here,” to practice supported by science. Leaders who truly embrace a culture of EBP encourage their clinicians to ask questions. If a culture of inquiry does not exist in which people who don’t understand ask questions, practice will not change. NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper Transformation to an EBP culture requires a dynamic team vision along with clear expectations from leaders that EBP is the foundation of all care delivered within their organization. One way to do this is to embed the organization’s vision, mission and strategic plan with its expectations for EBP, as well as making sure that EBP is incorporated in the on boarding process for all new clinicians. Also, those clinicians who fall short on some EBP competencies when hired should be provided with some form of continuing education, including skill-building activities, until they achieve full competency. NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper Education and leading with nurses Nurses are the largest workforce in the U.S. healthcare system. If we lead with nurses, we can make a tremendous impact. According to The Future of Nursing Report by the Institute of Medicine, this means pushing nurses to practice at the top of their license and embrace EBP. We must bridge the gap between education and practice. For per-licensure in nursing schools, both faculty and students are hungry for tools that help them apply EBP. Post-censurer, using EBP in the work setting helps nurses apply it and advances their critical thinking. Overall, nurses should be expected to meet new EBP competencies for practicing, which means that baccalaureate and associate degree programs must teach students EBP. Employing Models and Framework Models and frameworks are critical to EBP. Having a model and/or framework can guide the transformational process by applying evidence at the point of care while integrating the commitment of EBP with other organizational goals. 2 Too often, EBP is thought of as a theoretical concept that is difficult to embrace, but that’s just not the case. Employing models and/or frameworks also engages clinicians and scholars who are experts in their respective fields. NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper Advancing an inter professional approach Nursing and other inter professional healthcare executives must build a culture and environment that supports evidence-based care implementation and sustainability to achieve the best patient outcomes. 3 Evidence-based councils composed of a team of interdisciplinary clinicians can also enhance EBP throughout an organization and lead to a higher quality of care and improved outcomes. Physicians in particular, who have primarily relied on clinical trials in the past are now viewing evidence-based methodologies as additional options to arriving at quality-focused, value-based care. Along with nurses and other allied health professionals, they are beginning to adopt inter professional EBP as a cornerstone to greatly improve the momentum of this movement. NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper Probably one of the greatest challenges – and opportunities – for EBP is applying it across the care continuum. EBP is very much aligned with the Affordable Care Act and movement from fee-based to value-based service. So, in looking at EBP’s application across the continuum of care, consider this: does it make sense for a patient with heart failure to receive care as an inpatient in a hospital setting that employs evidence-based guidelines and methodologies, to then be sent home and receive care at a heart clinic that doesn’t use an evidence-based approach to care? We now have a great opportunity to establish EBP as a standard pillar across all healthcare settings to ensure that each patient receives evidence-based, consistent care from all providers. In addition, using EBP can enable patients to become more active participants in their healthcare. NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper As we look ahead to the future, EBP can be incorporated as a standard component of healthcare in all care settings in several ways: first, we need for the evidence to become more evident in the workflow. This involves transitioning from static documents to information that is actionable and evident to clinicians. Next, it is important that integration of EBP with EHR vendors is facilitated in a way that makes it usable to clinicians in their everyday practice. And let’s not forget to continue to advance an inter professional approach. Evidence-based practice can provide an exceptional opportunity to optimize patient care and outcomes by creating and leveraging the right tools, culture, education and patient engagement skills in the overall care process. NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper Evidence-based practice is a problem-solving approach in which the best available and useful evidence is used by integrating research evidence, clinical expertise, and patient values and preferences to improve health outcomes, service quality, patient safety and clinical effectiveness, and employee performance. This study aimed to identify the effects of nurses’ patient safety culture perceptions and their evidence-based nursing attitudes on the hospital’s patient safety level and employee performance. A cross-sectional design was employed in this study. Participants included nurses working in a state hospital in Burdur, Turkey, and 218 nurses responded to the research instrument (participation rate: 55.7%). Data were collected through face to face interviews that were conducted from February 20–May 20, 2016. The results of the analyses revealed that evidence-based nursing attitudes and hospital safety culture dimensions explained 29.2% of the total variance in the hospital patient safety level, while evidence-based nursing attitudes and hospital safety culture dimensions explained 15.5% of the total variance in nurse performance. The “evidence-based nursing related beliefs and expectations” aspect of the evidence-based nursing attitude dimension, and the “management support for patient safety” aspect of the patient safety culture dimension were significant predictors of nurses’ performance. The present findings add to the increasing interest in improving evidence-based practice and service quality in order to achieve better patient outcomes. NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper What Is Evidence-Based Practice? Evidence-based practice (EBP) is a patient-centered approach founded on independent scientific research, clinical expertise and patient experiences. Nurses and other healthcare providers who utilize this approach must consider the most recent healthcare research when determining the course of care and treatment. The field of nursing earned recognition as an applied science in the 1960s, and research efforts intensified. The accumulation of research may have led to increasing knowledge levels; however, healthcare leaders began to express concern at the widening gap between the ideal healthcare environment and what patients were actually experiencing. Moreover, they were worried that the growing amount of scientific background and research was not being transferred and applied consistently to clinical patient care, thereby failing to meet the goal of improved and consistent outcomes. NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper In response, the Institute of Medicine (IOM) — which changed its name to the National Academy of Medicine (NAM) in 2015 — issued Crossing the Quality Chasm: A New Health System for the 21st Century in 2001. This report noted prior research that indicated the current system was causing preventable harm. It also reiterated the need for uniformity across the healthcare system to ensure that all patients were receiving the highest quality of care no matter where they sought treatment. To reach that goal, it was theorized that incremental changes would not be enough — a complete overhaul would be necessary. One of the recommendations was to implement EBP. NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper How Is Evidence-Based Practice Used in Nursing? The transition to EBP has impacted nursing in several ways. First, nursing education has changed. Colleges and universities have altered their BSN program curricula to incorporate EBP. Students pursuing the degree, even through accelerated online RN to BSN programs, will find coursework that focuses not only on increasing a nurse’s overall knowledge base, but also on the importance of professional accountability. These programs emphasize critical thinking skills and encourage students to consider the patient’s clinical, cultural, religious and socioeconomic backgrounds, as well as relevant scientific research. The growing use of EBP has also led to a greater interest in and emphasis on nursing research. While bachelor’s programs may contain at least one course related to nursing research, students may find it beneficial to further hone their skills. Although research may not frequently be a task assigned to entry-level nurses, it can be helpful to know about new and emerging scientific data since it can have a more direct influence on current and future professional nursing practices than in the past. NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper Becoming familiar with various research methodologies may prepare nurses for careers away from the bedside. With the accumulation of clinical experience and the completion of a Master of Science in Nursing (MSN) degree, nurses will find many more opportunities in research. These roles are often more independent and require less patient contact. Nurse researchers may design studies or trials, collect and review data, and write and publish their findings. What Are the Benefits of Evidence-Based Practice? The ultimate goal of the EBP movement is to standardize and improve access and quality of care across the healthcare system. Certain patient and nurse benefits include the following: Improved patient outcomes . The heavy focus on raising the overall quality of care may lead to improved outcomes and health for patients. Using the most current healthcare research can help minimize complications associated with chronic illness and prevent additional illness or disease. NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper Lower costs of care . Roughly one in four Americans are living with multiple chronic illnesses and the cost of caring for these patients can often be substantial. Using EBP’s patient-centered approach may help eliminate unnecessary costs linked to treating chronically ill patients as well as reduce expenses for healthier patients, too. Superior nursing skills . Incorporating EBP throughout a nurse’s education and clinical experiences develops more advanced critical thinking and decision-making skills. Nurses are better able to adapt to situations, utilize informatics and work in interdisciplinary teams. They also feel a greater sense of confidence and pride in their work. Advancing Patient Care Evidence-based practice has become an integral component of delivering high-quality, patient-centered care. Nursing students in an RN to BSN program will learn EBP theories and apply this knowledge in their careers. Offering benefits to both patients and nurses, evidence-based practice is helping to lead the way in advancing patient care. NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper The Benefits of Evidence-Based Practice in Nursing Benefits for Patients Providing the best possible patient care is the hallmark of nursing practice. Evidence-based practice allows nurses to direct patient care according to scientific research, including randomized controlled trials, patient care studies and compiled patient data, relying on nursing interventions that have proven successful in the past with similar patient populations. “Patients and families receive more consistent nursing interventions and achieve better clinical outcomes. Patients fall less often and suffer from fewer pressure ulcers,” writes Debra Wood, RN, for Nurse Zone. NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper Benefits for Health Care The health care industry’s embrace of evidence-based practice as health care costs continue to rise is not coincidental. Evidence-based practice across the health care spectrum often results in better patient outcomes — meaning fewer demands on health care resources — and lowered health care costs. Wood cites as an example the traditional nursing practice of instilling normal saline before suctioning a mechanically ventilated patient. “Now, nurses know that the saline offers no benefit and just wastes time and supplies,” Wood writes. Benefits for Nurses The benefits of evidence-based practice for patients and healthcare do not, fortunately, come at a cost for nurses. Rather than referring to outdated academic texts or facility traditions to make decisions about patient care, evidence-based practice allows nurses to contribute research to the science of nursing and apply the most recent research and practices while discarding unproven methods. It also provides something just as important — a sense of authority in practice. “Nurses who embrace evidence-based practice feel empowered and enjoy a greater satisfaction with their care giving role,” Wood writes. NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper Evidence-based healthcare and quality improvement This is the tenth in a series of articles about the science of quality improvement. We explore how evidence-based healthcare relates to quality improvement, implementation science and the translation of evidence to improve healthcare practice and patient outcomes. Evidence-based practice integrates the individual practitioner’s experience, patient preferences and the best available research information. Incorporating the best available research evidence in decision making involves five steps: asking answerable questions, accessing the best information, appraising the information for validity and relevance, applying the information to care of patients and populations, and evaluating the impact for evidence of change and expected outcomes. Major barriers to implementing evidence-based practice include the impression among practitioners that their professional freedom is being constrained, lack of appropriate training and resource constraints. Incentives including financial incentives, guidance and regulation are increasingly being used to encourage evidence-based practice. NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper Keywords evidence-based medicine, general practice, implementation, primary care, quality improvement Introduction For quality improvement initiatives to be effective, they should be based on sound evidence. However, there are two main considerations relating to this evidence base. First, the intervention or interventions that the quality improvement initiative seeks to implement should have evidence of benefit: they should lead to improvements in patient outcomes that are, ideally, both clinically important and cost-effective. Evidence that translates basic research into its clinical application through new health technologies (either products or approaches) has been termed the ‘first translation al gap’. Second, quality improvement initiatives should be based on sound evidence of what works to implement these products or approaches. This is the ‘second translation al gap’, which forms the basis of quality improvement and implementation science.[1] We now consider evidence-based healthcare in the context of both these translation al gaps. NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper What is evidence-based healthcare? How much of what health and other professionals do is based soundly in science? Answers to the question ‘is our practice evidence based?’ depend on what we mean by practice and what we mean by evidence. This varies from discipline to discipline. A study in general practice found that around 31% of therapeutic clinical decisions were based on evidence from randomized controlled trials (RCTs), whereas 51% were based on convincing non-experimental evidence.[2] Sacker et al defined evidence-based medicine (EBM) as ‘the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients … integrating individual clinical expertise with the best available external clinical evidence from systematic research’.[3] The expansion of EBM has been a major influence on clinical practice over the last 20 years. The demands of purchasers of healthcare keen to optimize value for money have been one driver. A growing awareness among health professionals and their patients of medicine’s potential to cause harm has been another. In this article, we examine the nature of what is nowadays more broadly referred to as evidence-based healthcare (EBHC) in the context of quality improvement and discuss its strengths and limitations. NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper The tools necessary for evidence-based healthcare The tools needed to practice in an evidence-based way are common across healthcare disciplines. Doctors, nurses and allied health professionals all need the skills to ensure that the work they do – whether with individual clients or patients, or in the development of policies for quality improvement – is based on sound knowledge of what is likely to work. Of the following five essential steps, the first is probably the most important: • convert information needs into answerable questions, i.e. by asking a focused question • track down the best available evidence • appraise evidence critically • change practice in the light of evidence • evaluate your performance. Step 1. Asking a focused question Before seeking the best evidence, you need to convert your information needs into a tightly focused question. For example, it is not enough to ask ‘Are antibiotics effective for Otis media?’ We need to convert this into an answerable question: ‘Do antibiotics reduce the duration of symptoms when prescribed to children with Otis media?’ NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper The PICOT approach can be used as a framework to focus a question by considering the necessary elements. It contains four components: • Patient or population (children under 5 years) • Intervention (antibiotics) • Comparison intervention (placebo) • Outcome (duration of specific symptoms, e.g. pain, or rate of complications). Question Form a focused clinical question using the PICOT format to find the evidence for the effectiveness of smoking-cessation interventions in adult smokers who have had a heart attack. Answer • P Adult smokers who have had a heart attack. • I Providing smoking cessation intervention. • C Providing usual care. • O Mortality and quit rates. This gives us the question ‘In smokers who have had a heart attack does a smoking-cessation intervention in comparison with usual care reduce mortality and improve quit rate?’.[4] NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper Step 2. Tracking down the evidence The second step in the practice of evidence-based healthcare is to track down the best evidence. Doctors and nurses often assess outcomes in terms of surrogate pathological end points rather than commonplace changes in quality of life or the ability to perform routine activities (‘the operation was a success, but the patient died’). Traditionally, doctors making decisions about what works have attached much weight to personal experience or the views of respected colleagues. Over time, knowledge of up-to-date care diminishes so there is a constant need for the latest evidence and simple ways to access and use it.[5,6] A study of North American physicians has shown that up-to-date clinical information is needed twice for every three patients seen, but they only receive 30% of this due to lack of time, dated textbooks and disorganized journals.[7] Quality Care and Patient Safety Evidence-based practice is established as a proven intervention. This has been a growing trend over the past few decades; as more research reveals proven practices, nurses are relying more upon such proven methods. This is driven by the growing demand for the provision of higher quality of care and patent safety, reduced costs, and greater efficiency. Research has revealed that EBP also provides greater consistency in care from institution to institution and provider to provider. According to Majid et al., “Evidence-based practice (EBP) provides nurses with a method to use critically appraised and scientifically proven evidence for delivering quality health care to a specific population.” 1 NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper Patient Advocacy The nursing role is one of patient advocate. An advocate is one who defends or promotes the rights of others (in this case, patients). In the process of patient care, nurses learn about their patients and know their needs. Nurses act as advocates and liaisons between the patient and the doctor, the family and doctor, or the patient and family and the health care system. In the state of California, patient advocacy is built into the state’s nurse practice act. 2 Patients often cannot speak for themselves, and nurses must be able to speak on behalf of their patients. Nursing Informatics At many medical facilities, the electronic health record, or EHR, is how patient information is recorded. Departments such as lab, x-ray, and physical therapy can access the EHR to document their care, share information about the patient, and request additional assistance from others – all within the medical record software on computers. Nursing informatics , then, is a partnership between information technology and nursing practice. NURS 4100 – Quality and Safety Through Evidence-Based Practice Case Study Paper Let’s look at how informatics is used in patient safety and evidence-based practice. Patient Safety Patient safety encompasses the entire spectrum of patient contact from the beginning of the visit at registration to the follow-up after discharge. At the registration area, where patient-identifying information is collected, informatics helps design the questions that are asked. Correct identification of the patient and their condition is critical to ensure the correct care is provided. Patient safety events are negative incidents that can, or actually did, cause injury or harm. Many of these events are preventable by using previous data and current information available to staff in the medical record software. Patient safety occurrences can be investigated through the patient’s record and the data collected from behind the front lines of bedside nursing. Usually, events occur due to a system failure, not a person failure. Once the problem is identi

NURS 6551 – Primary Care of Women Assignment Paper NURS 6551 – Primary Care of Women Assignment Paper Women’s Health Women’s health refers to the health of women, which differs from that of men in many unique ways. Women’s health is an example of population health, where health is defined by the World Health Organization as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. Often treated as simply women’s reproductive health, many groups argue for a broader definition pertaining to the overall health of women, better expressed as “The health of women”. These differences are further exacerbated in developing countries where women, whose health includes both their risks and experiences, are further disadvantaged. NURS 6551 – Primary Care of Women Assignment Paper Permalink: https://nursingpaperessays.com/ nurs-6551-primar…assignment-paper / ? Although women in industrialized countries have narrowed the gender gap in life expectancy and now live longer than men, in many areas of health they experience earlier and more severe disease with poorer outcomes. Gender remains an important social determinant of health, since women’s health is influenced not just by their biology but also by conditions such as poverty, employment, and family responsibilities. Women have long been disadvantaged in many respects such as social and economic power which restricts their access to the necessities of life including health care, and the greater the level of disadvantage, such as in developing countries, the greater adverse impact on health. NURS 6551 – Primary Care of Women Assignment Paper Women’s reproductive and sexual health has a distinct difference compared to men’s health. Even in developed countries pregnancy and childbirth are associated with substantial risks to women with maternal mortality accounting for more than a quarter of a million deaths per year, with large gaps between the developing and developed countries. Comorbidity from other non reproductive disease such as cardiovascular disease contribute to both the mortality and morbidity of pregnancy, including Precambrian. Sexually transmitted infections have serious consequences for women and infants, with mother-to-child transmission leading to outcomes such as stillbirths and neonatal deaths, and pelvic inflammatory disease leading to infertility. In addition infertility from many other causes, birth control, unplanned pregnancy, un consensual sexual activity and the struggle for access to abortion create other burdens for women. While the rates of the leading causes of death, cardiovascular disease, cancer and lung disease, are similar in women and men, women have different experiences. Lung cancer has overtaken all other types of cancer as the leading cause of cancer death in women, followed by breast cancer, collector, ovarian, uterine and cervical cancers. While smoking is the major cause of lung cancer, among st nonsmoking women the risk of developing cancer is three times greater than among st nonsmoking men. NURS 6551 – Primary Care of Women Assignment Paper Despite this, breast cancer remains the commonest cancer in women in developed countries, and is one of the more important chronic diseases of women, while cervical cancer remains one of the commonest cancers in developing countries, associated with human papilloma virus (HPV), an important sexually transmitted disease. HPV vaccine together with screening offers the promise of controlling these diseases. Other important health issues for women include cardiovascular disease, depression, dementia, osteoporosis and anemia. A major impediment to advancing women’s health has been their under representation in research studies, an inequity being addressed in the United States and other western nations by the establishment of centers of excellence in women’s health research and large scale clinical trials such as the Women’s Health Initiative. At Primary Care Center, women’s health services focus on women’s health concerns and needs with unconditional positive regard. The health needs of today’s women cover a wide spectrum of healthcare services. The most basic service offered is a pelvic exam which is designed for doctors to look for and diagnose signs of illness in the reproductive organs of a woman’s body. A Pap smear is routinely performed during the pelvic exam, which is a screen for cervical cancer. Our doctors can discuss with you how often you should have this test performed. NURS 6551 – Primary Care of Women Assignment Paper Other women’s health issues we cover include menopause and a woman can be counseled on ways to cope with the many symptoms associated with menopause, including the benefits and risks of hormone replacement therapy. Because breast cancer is a primary concern of most women, you will be taught methods of breast self-examination. Our physicians can discuss your medical options and treatments which may include counseling on treatment and prevention of sexually transmitted diseases, including HIV, herpes, syphilis, gonorrhea, Chlamydia, hepatitis, and many more. If necessary, our primary care physicians will consult and refer to appropriate specialists, including but not limited to, gynecologists, infectious disease specialists, endocrinologists, psychologists, dermatologists, and genetic counselors. For more detailed information regarding women’s health issues, including pelvic exams, Pap smear, menopause, hormone replacement therapy, osteoporosis, breast cancer, and ovarian cancer, please refer to the disease-specific links provided on this website. These days patient care in the primary care setting can be a daunting task. With the influx of patients who had, until the Affordable Care Act (ACA), been largely neglected and had gone untreated now presenting with a myriad of ailments and an array of complicated and muddled complaints, the Primary Care Provider (PCP) is being challenged like never before. NURS 6551 – Primary Care of Women Assignment Paper Confounding our critical time limitations, much of which is spent in efforts geared toward determining what will be covered by the patient’s insurance, is the challenge to implement the most progressive and effective standards of care given the complexity of judging the benefits and risks of modalities that may not be considered as traditional areas of focus for the PCP. Perhaps no other treatment modality has sparked more debate then that of Bio identical Hormone Replacement Therapy (BHRT). With the immense interest generated by popular media, social networking and internet based information, patients often turn to their PCP for evidence based information and education. For the PCP this presents a unique opportunity as this can often be a critical period to evaluate risk for future health problems, provide proactive preventive care guidelines, prevent morbidity and decrease mortality. The primary care setting is on the front line of healthcare services and often serves to facilitate a cascade of all future healthcare needs of the patient. Proper evaluation and diagnosis is essential in providing efficient and effective care. In a time when financial expenditure, budgets and profits are an unfortunate reality of healthcare the decisions made at the primary care level can impact not only the patient but the entire health care system. [1] NURS 6551 – Primary Care of Women Assignment Paper The aim of this paper is to specifically discuss BHRT in menopausal women and the unique role of the Primary Care Provider in assessment, evaluation, initiation and follow up of such patients in the primary care setting. Due to limitations in space and the reader’s time, this conversation will be restricted to discussion of basic protocols and guidelines that can be easily implemented in a primary care setting. The main goal is to familiarize the PCP with typical characteristics a patient may present with who may be an appropriate candidate for hormonal therapy that may otherwise, in less astute eyes, be incorrectly assessed thus leading to needless exposure to redundant diagnostic evaluation, inappropriate interventions and pointless therapeutic modalities. [2] ORDER A FREE PAPER HERE Women and the Physiology of Aging Aging is the natural change in structure and function that results from the passage of time in absence of known pathology and disease. During the transition from reproductive years through menopause and beyond women experience many physiological changes that are normal consequences of the aging process. Although the observed changes around the time of menopause are often due to the natural decline in hormone production, these signs and symptoms may often mimic and erroneously be mistaken for, signs of illness or disease. [3] NURS 6551 – Primary Care of Women Assignment Paper Menopause represents the permanent cessation of menses. Most women reach menopause between the ages of 45 and 55, with average onset in the Western world being at age 52. Due to the relatively wide age range for natural menopause, chronological age may not be an adequate indicator of the beginning or end of the transition process. Although menopause is perhaps the most obvious and expected physical event, general knowledge about the process, symptoms and effective management is often inadequate. [4] Thus this presents a unique opportunity for the primary care provider to effectively and efficiently manage what could potentially influence a woman’s perceived well being, overall quality of life and health status. Midlife Physiological Changes: Is this Disease or Menopause? All women will experience menopause. However, each will do so in a very individual and unique way. Although the majority of women will report experiencing common symptoms in relation to the physiologic hormonal changes associated with menopause (night sweats, hot flashes and menstrual irregularities) there are numerous other presenting entomology that may otherwise mimic alternate pathology and disease. Depression, anxiety, fatigue, muscle and joint pain, hair loss and/or growth, skin changes, dry eye syndrome, hearing impairment, onset of periodontal disease, memory changes, insulin resistance, cardiac palpitations and other cardiovascular related ailments are often generalized complaints patients present with in midlife. [5] Since such entomology may easily be attributed to an array of possible pathological including autoimmune disease, heart disease, diabetes and possible cancer related disorders, women and their primary care providers may be challenged to distinguish whether such symptoms are attributable to onset of midlife pathology or simply menopause related changes. The PCP, working in collaboration with the female patient, can be a vital influence in helping guide the female patient in evaluation of personal health practices, facilitate improvement and enhance an overall sense of well being and self-determination. NURS 6551 – Primary Care of Women Assignment Paper Baseline Diagnostic Hormonal Evaluation In addition to the general laboratory tests that are commonly performed as part of a complete health care evaluation (lipid panel, comprehensive metabolic panel, fasting blood sugar, etc.) hormonal evaluation can be an important component in compiling a complete profile of a woman presenting with a barrage of symptoms and complaints. Presently, a single test of ovarian function capable of predicting or confirming menopause does not exist. Therefore, a comprehensive history review (including a complete review of the patient’s medical and menstrual history) accompanied by a complete laboratory profile will be vital in confirming menopause status and for ruling out other causes of presenting symptoms. [6] For the PCP in the primary care setting, baseline levels of ovarian related function would be beneficial in helping attain a complete picture and analysis of the patient. The following are commonly included in the baseline hormonal panel: Estradiol, Testosterone, Progesterone, SHBG (sex hormone binding globulin), Thyroid panel (TSH, T3, T4, TPO) NURS 6551 – Primary Care of Women Assignment Paper Implementing Hormone Therapy in the Primary Care Setting The effective management of menopause related symptoms requires a collaborative approach between the patient and the PCP. A thorough discussion of entomology, goals, expectations and areas of concern is essential between the patient and health care professional. Based on the review of labs the PCP can effectively counsel the patient as to the basic guidelines for initiation of bio identical hormone therapy (BHT). This also serves as an opportunity for the PCP to determine whether to continue in the role of a primary coordinator of care or to better refer to someone more experienced in the treatment modalities. [7] Once again there is opportunity for a unique collaborative moment in the relationship between the patient and PCP that will extend into future interactions between the professional and the patient. NURS 6551 – Primary Care of Women Assignment Paper As it is beyond the scope of this article to discuss the specifics regarding precise individualized BHRT dosage it is left to the PCP to seek relevant evidence based approaches as to the nuances of prescribing BHRT regimens. Multiple references at the end of this commentary provide excellent guidelines that may be of interest and can help guide the provider in development of standardized institutional protocols for BHRT management. Basic guidelines for initiation and follow up recommend that first follow-up be scheduled 3 months post regimen initiation. At that visit the PCP needs to revisit the patient’s initial presenting symptoms, discuss progress in symptom management, and discuss any new or persistent concerns. Adjustments in dosage based on presenting symptoms should be done at that time. Lab tests to be performed at these follow up visits should correspond with the prescribed BHT regimen. [8] Routine labs should be checked annually. If changes in therapy are required a 3 month follow up is recommended. If no changes are needed follow up visits can be extended for 6 months. After that annual visits are appropriate and serve to continue the collaborative relationship between the patient and the PCP provider. [9] NURS 6551 – Primary Care of Women Assignment Paper Conclusion In consensus with the latest recommendations from the North American Menopause Society the objective of hormone therapy in women having gone through menopause is to provide relief of symptoms found to be disruptive of normal activities of living. While conventional medical therapies often provide a simple cookie cutter approach to patient management, BHRT is a more holistic, individualized approach that not only helps manage entomology but also provides a comprehensive and prevention based approach that encompasses medical, lifestyle and behavioral based therapies in effort to prevent initiation and progression of chronic disease associated with the aging process. BHRT is a unique tool that assists in caring for women not only during the transition years, where the PCP is first likely to encounter the patient in the primary care setting, but also into later years when age and menopause related symptoms progress into development of chronic age related disease.10 It is often in the primary care setting where non-experienced care providers may feel that their role is no more effective than merely the band aiding of superficial symptoms. In this setting there is often missed opportunity to treat the underlying cause and instead there exists a reliance on providing treatment to merely adequately mask the symptoms the patient presents with. How often has a middle aged female patient presented with complaint of headache? Depression? Weight gain? Fatigue or anxiety…and we quickly conclude that a prescription for an anti-depressant, or pain medication, or muscle relaxer, or an appetite suppressant is the appropriate prescription to write the patient after a 7 min conversation? Could it be that we as PCP’s are missing an opportunity to make a difference and are, instead, settling on providing only temporary and often ineffective resolutions? NURS 6551 – Primary Care of Women Assignment Paper The science of BHRT is constantly evolving so it is important that the primary care provider stay informed and keep an open mind/perspective as the understanding of such agents expands and improves. Since a large percentage of menopausal women will suffer the consequences of age related disorders further innovative, evidence based research regarding the role of BHRT is needed. As primary care providers, we must not miss the opportunity to be in the forefront of care in coordinating the needs of the menopausal patient. PCP is the gatekeepers in the health care arena. We should not take this role casually. Women’s Primary Care Because women have unique health concerns, Bay front Health Seven Rivers offers specialized care to address the needs of women of all ages, from adolescence through menopause. Whether you need preventive care and annual screenings or need a specialist to manage osteoporosis, heart disease or another condition, we offer comprehensive services to meet all your health needs. NURS 6551 – Primary Care of Women Assignment Paper Bay front Health Seven Rivers offers a full range of services for women, including: Comprehensive gynecological care, including contraceptive counseling, care for urinary incontinence, menopause management and more Minimally invasive treatment options including laparoscopic and robotic gynecologic surgery Osteoporosis screening and treatment Preventive screenings and education on cancer, heart disease and other diseases that affect women Well-woman care, including Pap tests, and pelvic and breast exams NURS 6551 – Primary Care of Women Assignment Paper Women have a higher prevalence of depressive disorders compared to men. The current system of care for women with depressive disorders provides significant financial barriers for patients with lower incomes to access mental health services. Primary care systems are used extensively by women and have the potential to diagnose patients at early stages of mental illness and to provide evidence-based treatments, but this potential is largely unfulfilled because of significant system-level barriers inherent in primary care. Recent effectiveness research provides an excellent framework for cost-effectively improving care of depression using stepped care principles and strategies effective for improving care of other chronic conditions. Psychologists have the potential to help implement stepped care models by providing training, consultation and ongoing quality assurance, as well as by delivering collaborative care models of acute-phase treatment and relapse prevention interventions. NURS 6551 – Primary Care of Women Assignment Paper This discussion paper brings together evidence and experience from around the world focusing on making health systems more gender responsive. The paper uses a framework that combines WHO’s six building blocks for health systems and the primary health care reforms propounded in the World Health Report 2008 on primary health care. Furthermore, the paper provides examples of what has worked and how, and ends with an agenda for action to strengthen the work of policy-makers, their advisers and development partners as well as practitioners as they seek to integrate gender equality perspectives into health systems strengthening, including primary health care reforms. Facts on women’s health Women and men share many similar health problems, but women have their own health issues, which deserve special consideration. Women’s lives have changed over the centuries. Historically, life was particularly difficult for most women. Aside from the numerous dangers and diseases, women became wives and mothers often when they were just emerging from their own childhood. Many women had a large number of pregnancies which may or may not have been wanted. In the past, childbirth itself was risky and frequently, led to the death of the mother. Most women in the past did not live long enough to be concerned about menopause or old age. NURS 6551 – Primary Care of Women Assignment Paper In 1900, a woman’s life span was about 50 years. Now, in the new millennium, average life expectancy for American women is 82 years of age, and it is continuing to rise. Not only are women living longer, but they also can anticipate the possibility of enjoying a better quality of life throughout their span of years. In order to accomplish this, it is essential that women take charge of their own bodies and that they comprehend how they can maximize their personal health and fitness. It is also helpful that men understand and are supportive of the health concerns of the women. Gynecology is the primary branch of medical science concerned with women’s health issues. The word “gynecology” is a word consisting of “gyneco,” meaning “woman,” and “logic,” meaning “knowledge.” Taken together, it is “woman knowledge.” It is important that every woman has access to knowledge related to the spectrum of women’s health issues, not only about her reproductive system, but about all aspects of her body. Women’s general health and wellness There is credible information available to women not only on such problems as eating disorders, stress, alcoholism, addictions, and depression, but also on basic topics such as good nutrition, heart health, and exercise. For example, it is beneficial that a woman maintain her optimum weight. If a woman’s waist size measures more than 35 inches (89 cm), she is more likely to develop heart disease, high blood pressure, and diabetes. Eating sensible meals, eliminating after-dinner snacks, and making physical activity a part of daily life are significant ways to help control weight and lower the risk of a long list of health problems. NURS 6551 – Primary Care of Women Assignment Paper Smoking is detrimental to anyone’s health, as well as the health of those around them. Unfortunately, women continue to smoke despite the known health risks. Even though the number of female smokers is declining, still about 16% of women in the U.S. continue to smoke. Women are smoking in spite of the well-publicized risks including cancer, heart disease, and innumerable other health issues. Drinking an excessive amount of alcohol is also harmful to health. Although women typically begin drinking at a later age than men and tend to drink somewhat less, lower doses of alcohol are required for women to develop alcohol-related medical problems including alcohol toxicity, cirrhosis, and hepatitis. Women should be aware that they metabolize a number of drugs differently than men. In some cases and for some medications, the rate of metabolism may be slower, and in other cases, faster. It is, therefore, essential that women are well informed about the kinds and correct dosages of any drugs they are taking. Here are ten of the main issues regarding women’s health that keep me awake at night: Cancer : Two of the most common cancers affecting women are breast and cervical cancers. Detecting both these cancers early is key to keeping women alive and healthy. The latest global figures show that around half a million women die from cervical cancer and half a million from breast cancer each year. The vast majority of these deaths occur in low and middle income countries where screening, prevention and treatment are almost non-existent, and where vaccination against human papilla virus needs to take hold. NURS 6551 – Primary Care of Women Assignment Paper Reproductive health : Sexual and reproductive health problems are responsible for one third of health issues for women between the ages of 15 and 44 years. Unsafe sex is a major risk factor – particularly among women and girls in developing countries. This is why it is so important to get services to the 222 million women who aren’t getting the contraception services they need. Maternal health : Many women are now benefiting from massive improvements in care during pregnancy and childbirth introduced in the last century. But those benefits do not extend everywhere and in 2013, almost 300 000 women died from complications in pregnancy and childbirth. Most of these deaths could have been prevented, had access to family planning and to some quite basic services been in place. HIV : Three decades into the AIDS epidemic, it is young women who bear the brunt of new HIV infections. Too many young women still struggle to protect themselves against sexual transmission of HIV and to get the treatment they require. This also leaves them particularly vulnerable to tuberculosis – one of the leading causes of death in low-income countries of women 20–59 years. Sexually transmitted infections : I’ve already mentioned the importance of protecting against HIV and human papillary (HPV) infection (the world’s most common STI). But it is also vital to do a better job of preventing and treating diseases like gonorrhea, chlamydia and syphilis. Untreated syphilis is responsible for more than 200,000 stillbirths and early fetal deaths every year, and for the deaths of over 90 000 newborns. NURS 6551 – Primary Care of Women Assignment Paper Violence against women : Women can be subject to a range of different forms of violence, but physical and sexual violence – either by a partner or someone else – is particularly invidious. Today, one in three women under 50 has experienced physical and/or sexual violence by a partner, or non-partner sexual violence – violence which affects their physical and mental health in the short and long-term. It’s important for health workers to be alert to violence so they can help prevent it, as well as provide support to people who experience it. Mental health : Evidence suggests that women are more prone than men to experience anxiety, depression, and somatic complaints – physical symptoms that cannot be explained medically. Depression is the most common mental health problem for women and suicide a leading cause of death for women under 60. Helping sensitize women to mental health issues, and giving them the confidence to seek assistance, is vital. Noncommunicable diseases : In 2012, some 4.7 million women died from noncommunicable diseases before they reached the age of 70 —most of them in low- and middle-income countries. They died as a result of road traffic accidents, harmful use of tobacco, abuse of alcohol, drugs and substances, and obesity — more than 50% of women are overweight in Europe and the Americas. Helping girls and women adopt healthy lifestyles early on is key to a long and healthy life. NURS 6551 – Primary Care of Women Assignment Paper Being young : Adolescent girls face a number of sexual and reproductive health challenges: STIs, HIV, and pregnancy. About 13 million adolescent girls (under 20) give birth every year. Complications from those pregnancies and childbirth are a leading cause of death for those young mothers. Many suffer the consequences of unsafe abortion. Getting older : Having often worked in the home, older women may have fewer pensions and benefits, less access to health care and social services than their male counterparts. Combine the greater risk of poverty with other conditions of old age, like dementia, and older women also have a higher risk of abuse and generally, poor health. Primary Care of Refugee Women Refugees flee their country because of persecution, war, and violence; thus, all have well-founded fears for their safety should they return. To become a legal refugee, an individual must first apply to the United Nations High Commissioner for Refugees. Those who are referred to the U.S. begin the screening and vetting process, which takes 18 to 24 months. The health of refugee women is largely framed by their culture and the nature of their trauma. The shock of deprivation, persecution, and forced migration occurs throughout the path to resettlement: It begins before women are forced to leave their homes and continues during migration, at refugee camps, and after resettlement. Factors such as language barriers, health literacy, and beliefs about women’s roles all influence refugees’ health status and ability to access and engage in U.S. medical systems (see EthnoMed). 1, 2, 3 NURS 6551 – Primary Care of Women Assignment Paper Cultural Influences Language differences and lack of health literacy can impair a refugee’s capacity for self-care. Routines such as filling a prescription can be confusing if one does not understand the language and has never received a prescribed medication. What to do with the piece of paper, where to go to the pharmacy, and how to manage prescription refills are common issues. Moreover, not understanding the U.S. healthcare system makes use of services less likely. 2 Communication barriers can negatively affect care, so bilingual health educators, case managers, and patient navigators are all beneficial. Vetted female interpreters can increase refugees’ comfort, knowledge, and participation. 3 Refugee women have unique competing concerns. The process of resettlement itself is stressful and time consuming as women and their families prioritize housing, transportation, and finances. Thus, undergoing screening evaluations such as mammograms or Pap smears in the absence of symptoms is often difficult for refugee women to comprehend, especially in the context of their culture. 1, 4 While some providers may feel uncomfortable downward adjusting their goals to promote screening, putting the patient’s cultural background as well as her psychological and physical suffering first can actually lead to more-frequent screening and better outcomes. NURS 6551 – Primary Care of Women Assignment Paper Nature of Trauma Pr emigration trauma can take many forms. Healthcare resources might have been inadequate in the country of origin — and war, deprivation, and persecution leave lasting physical and psychological marks. Furthermore, the impact and sequel of torture predict multiple physical and psychological problems. 5, 6 A 2015 meta-analysis suggests that up to 44% of all refugees and asylees have been tortured (see CVT). Rape was reported in almost one third of female torture survivors, 80% of whom experienced at least two forms of torture. 7 Refugees may have also experienced other abuses including concussive trauma, witnessing torture and executions, cutting, asphyxiation, forced postures, and electric shock. 7, 8 Documenting a woman’s torture history can prevent the triggering of re-dramatization while helping her provider understand many of her complex physical and mental health issues, ultimately augmenting her adherence to healthcare. 9 NURS 6551 – Primary Care of Women Assignment Paper The sequelae of torture are severe both physically and mentally. Physical condition often varies based on the severity of the trauma and the methods used. Even in the absence of any visible deformities, there may be complaints of unexplained complex pain. A comprehensive plan of care that includes physical and occupational therapies as well as psychological and psychiatric support can be beneficial. 9 The process of migration itself is heterogeneous; while some refugee women locate resettlement camps easily, others may not. Because they may be forced to flee with only what they can carry, women might leave essential medications behind or be separated from their families (including small children). While they are displaced, they may experience limited nutrition, hygiene, sanitation, and safety. They are often exposed to extreme environmental conditions and their health is further threatened by infectious diseases. The healthcare available in refugee camps may be difficult to access, leading to — or worsening — anemia, dental issues, eosinophilic, vitamin deficiencies, parasites, abnormal cervical cytology, hepatitis, and HIV infection. 10 Because chronic health issues also often go neglected, refugee women should be checked for associated complications and provided with culturally specific interventions to achieve and maintain health. NURS 6551 – Primary Care of Women Assignment Paper At the Intersection of Trauma and Culture Female genital cutting (FGC; removing parts of the external female genitalia) is practiced in over 30 countries in Africa, the Middle East, and Asia. The procedures can cause severe bleeding, infection, and chronic problems with

Nursing

The Importance Of Nursing Informatics In Patient Safety In The Operating Room Essay Paper The Importance Of Nursing Informatics In Patient Safety In The Operating Room Essay Paper Nursing informatics is a combination of cognitive science, computer science, information science, and nursing science. It includes the development, analysis, and evaluation of information systems augmented by technologies that support, enhance and manage patient care. Information Technology in Health Care: The Next Consumer Revolution Over the past 20 years, our nation has undergone a major transformation due to information technology (IT). Today, we have at our fingertips access to a variety of information and services to help us manage our relationships with the organizations that are part of our lives: banks, utilities, government offices — even entertainment companies.The Importance Of Nursing Informatics In Patient Safety In The Operating Room Essay Paper Information Technology in Health Care: The Next Consumer Revolution Over the past 20 years, our nation has undergone a major transformation due to information technology (IT). Today, we have at our fingertips access to a variety of information and services to help us manage our relationships with the organizations that are part of our lives: banks, utilities, government offices — even entertainment companies. Advancing the Role of Nursing, Optimizing Quality Clinical Care August 3, 2016 ? PSQH Today, nursing informatics is focused on optimizing processes that directly affect patient care. Informatics nurses are using data and trends to design processes that decrease the time between information availability and direct action related to patient care, enabling quicker delivery of safer care for improved outcomes. According to HIMSS’ 2015 Impact of the Informatics Nurse Survey, more than 80% of healthcare professionals believe that informatics nurses are most valuable in implementing and optimizing clinical system processes (HIMSS, 2015). This reinforces the use of informatics nurses as subject matter experts during the implementation process and demonstrates their growth potential in the healthcare setting.The Importance Of Nursing Informatics In Patient Safety In The Operating Room Essay Paper New roles and responsibilities As healthcare IT continues to change, with more complex and integrated systems capturing information related to the patient and the care environment, nursing informatics will have a progressively larger influence on nurses’ responsibilities. Nursing informatics creates a path for nurses to transition from traditional care delivery to analytic roles while still being involved in patient care. Nurses who may otherwise have left the patient care workforce due to retirement or burnout are now transitioning to informatics. This is a win-win, as these nurses hold a vast amount of clinical experience that can be leveraged in informatics, directly impacting patient care and quality. As the role of nursing informatics continues to mature, nurses are helping to design new units or departments as hospitals upgrade facilities for better efficiency in patient care and technology. Nurses are also working with vendors on the design and execution of systems that are more user-friendly—for patients and providers alike—so that care becomes safer and quality rises. Additionally, informatics nurses are providing real-time information to proactively educate, notify, and monitor patients and patient populations, improving the health and wellness of communities. Creating meaningful groups of patients based on diseases, locations, and treatments, informatics nurses can look for opportunities to increase the quality of care and better educate patients on everything from current health issues to health and wellness opportunities available to them and their families. Informatics nurses work to empower patients to manage their own health through health information literacy, patient-friendly language, personal health records, and Web- or portal-based resources.The Importance Of Nursing Informatics In Patient Safety In The Operating Room Essay Paper Business intelligence and data analytics initiatives continue to grow within nursing informatics departments. Today we see an emphasis on analytics and the development of dashboards that can push relevant information directly to providers, prompting quality decision-making and patient care. With the push for population health and much greater consumer engagement, health systems are also using analytics to proactively drive quality information to the general patient population. Systems are using tactics ranging from marketing and advertising during high-profile events, like the Super Bowl or the Grammy Awards, to roadside billboards that display a local hospital’s emergency room wait times to its patient community. Such efforts are the direct result of analytics cultivated by informatics nurses, illustrating another example of the expanded role of nursing informatics programs. These tactics use analytics to engage consumers before they need to make healthcare decisions. The prevalence of nursing informatics Nursing informatics is a fast-growing discipline. Twelve percent of healthcare facilities reported their organizations created their first informatics position prior to 1995, while the majority (almost 62%) initiated the position in the last 10 years (2005–2015). In 2015, 61% of organizations employed informatics professionals in leadership roles, and 20% had a chief nursing information officer within their organizations (HIMSS, 2015). However, leadership roles aren’t the only positive trend for nursing informatics. The survey also found that the longer a healthcare organization employs informatics professionals, the larger the impact and value these professionals have on clinical systems and overall patient care quality.The Importance Of Nursing Informatics In Patient Safety In The Operating Room Essay Paper Until now, relatively few Americans have had the opportunity to use this kind of technology to enhance some of the most important relationships: those related to your health. Relationships with your doctors, your pharmacy, your hospital, and other organizations that make up your circle of care are now about to benefit from the next transformation in information technology: health IT. For patients and consumers, this transformation will enhance both relationships with providers and providers’ relationships with each other. This change will place you at the center of your care. Although it will take years for health care to realize all these improvements and fully address any pitfalls, the first changes in this transformation are already underway. At the same time, numerous technology tools are becoming available to improve health for you, your family, and your community. Most consumers will first encounter the benefits of health IT through an electronic health record, or EHR, at their doctor’s office or at a hospital. Benefits of Health IT for You and Your Family On a basic level, an EHR provides a digitized version of the “paper chart” you often see doctors, nurses, and others using. But when an EHR is connected to all of your health care providers (and often, to you as a patient), it can offer so much more.The Importance Of Nursing Informatics In Patient Safety In The Operating Room Essay Paper EHRs reduce your paperwork. The clipboard and new patient questionnaire may remain a feature of your doctor’s office for some time to come. But as more information gets added to your EHR, your doctor and hospital will have more of that data available as soon as you arrive. This means fewer and shorter forms for you to complete, reducing the health care “hassle factor.” EHRs get your information accurately into the hands of people who need it. Even if you have relatively simple health care needs, coordinating information among care providers can be a daunting task, and one that can lead to medical mistakes if done incorrectly. When all of your providers can share your health information via EHRs, each of them has access to more accurate and up-to-date information about your care. That enables your providers to make the best possible decisions, particularly in a crisis. EHRs help your doctors coordinate your care and protect your safety. Suppose you see three specialists in addition to your primary care physician. Each of them may prescribe different drugs, and sometimes, these drugs may interact in harmful ways. EHRs can warn your care providers if they try to prescribe a drug that could cause that kind of interaction. An EHR may also alert one of your doctors if another doctor has already prescribed a drug that did not work out for you, saving you from the risks and costs of taking ineffective medication. EHRs reduce unnecessary tests and procedures. Have you ever had to repeat medical tests ordered by one doctor because the results weren’t readily available to another doctor? Those tests may have been uncomfortable and inconvenient or have posed some risk, and they also cost money. Repeating tests—whether a $20 blood test or a $2,000 MRI – results in higher costs to you in the form of bigger bills and increased insurance premiums. With EHRs, all of your care providers can have access to all your test results and records at once, reducing the potential for unnecessary repeat tests. EHRs give you direct access to your health records. In the United States, you already have a Federally guaranteed right to see your health records, identify wrong and missing information, and make additions or corrections as needed. Some health care providers with EHR systems give their patients direct access to their health information online in ways that help preserve privacy and security. This access enables you to keep better track of your care, and in some cases, answer your questions immediately rather than waiting hours or days for a returned phone call. This access may also allow you to communicate directly and securely with your health care provider.The Importance Of Nursing Informatics In Patient Safety In The Operating Room Essay Paper Until now, relatively few Americans have had the opportunity to use this kind of technology to enhance some of the most important relationships: those related to your health. Relationships with your doctors, your pharmacy, your hospital, and other organizations that make up your circle of care are now about to benefit from the next transformation in information technology: health IT. For patients and consumers, this transformation will enhance both relationships with providers and providers’ relationships with each other. This change will place you at the center of your care. Although it will take years for health care to realize all these improvements and fully address any pitfalls, the first changes in this transformation are already underway. At the same time, numerous technology tools are becoming available to improve health for you, your family, and your community. Most consumers will first encounter the benefits of health IT through an electronic health record, or EHR, at their doctor’s office or at a hospital. Benefits of Health IT for You and Your Family On a basic level, an EHR provides a digitized version of the “paper chart” you often see doctors, nurses, and others using. But when an EHR is connected to all of your health care providers (and often, to you as a patient), it can offer so much more.The Importance Of Nursing Informatics In Patient Safety In The Operating Room Essay Paper EHRs reduce your paperwork. The clipboard and new patient questionnaire may remain a feature of your doctor’s office for some time to come. But as more information gets added to your EHR, your doctor and hospital will have more of that data available as soon as you arrive. This means fewer and shorter forms for you to complete, reducing the health care “hassle factor.” EHRs get your information accurately into the hands of people who need it. Even if you have relatively simple health care needs, coordinating information among care providers can be a daunting task, and one that can lead to medical mistakes if done incorrectly. When all of your providers can share your health information via EHRs, each of them has access to more accurate and up-to-date information about your care. That enables your providers to make the best possible decisions, particularly in a crisis. EHRs help your doctors coordinate your care and protect your safety. Suppose you see three specialists in addition to your primary care physician. Each of them may prescribe different drugs, and sometimes, these drugs may interact in harmful ways. EHRs can warn your care providers if they try to prescribe a drug that could cause that kind of interaction. An EHR may also alert one of your doctors if another doctor has already prescribed a drug that did not work out for you, saving you from the risks and costs of taking ineffective medication. EHRs reduce unnecessary tests and procedures. Have you ever had to repeat medical tests ordered by one doctor because the results weren’t readily available to another doctor? Those tests may have been uncomfortable and inconvenient or have posed some risk, and they also cost money. Repeating tests—whether a $20 blood test or a $2,000 MRI – results in higher costs to you in the form of bigger bills and increased insurance premiums. With EHRs, all of your care providers can have access to all your test results and records at once, reducing the potential for unnecessary repeat tests. EHRs give you direct access to your health records. In the United States, you already have a Federally guaranteed right to see your health records, identify wrong and missing information, and make additions or corrections as needed. Some health care providers with EHR systems give their patients direct access to their health information online in ways that help preserve privacy and security. This access enables you to keep better track of your care, and in some cases, answer your questions immediately rather than waiting hours or days for a returned phone call. This access may also allow you to communicate directly and securely with your health care provider.The Importance Of Nursing Informatics In Patient Safety In The Operating Room Essay Paper The general public believes that technology will improve health care efficiency, quality, safety, and cost. However, few people consider that these same technologies may also introduce errors and adverse events.1 Given that nearly 5,000 types of medical devices are used by millions of health care providers around the world, device-related problems are inevitable.2 While technology holds much promise, the benefits of a specific technology may not be realized due to four common pitfalls: (1) poor technology design that does not adhere to human factors and ergonomic principles,3 (2) poor technology interface with the patient or environment,3 (3) inadequate plan for implementing a new technology into practice, and (4) inadequate maintenance plan.4 Patient care technology has become increasingly complex, transforming the way nursing care is conceptualized and delivered. Before extensive application of technology, nurses relied heavily on their senses of sight, touch, smell, and hearing to monitor patient status and to detect changes. Over time, the nurses’ unaided senses were replaced with technology designed to detect physical changes in patient conditions.5 Consider the case of pulse oxymetry. Before its widespread use, nurses relied on subtle changes in mental status and skin color to detect early changes in oxygen saturation, and they used arterial blood gasses to confirm their suspicions. Now pulse oxymetry allows nurses to identify decreased oxygenation before clinical symptoms appear, and thus more promptly diagnose and treat underlying causes. Common Uses of Healthcare Information Technology Health IT has been used sporadically for decades in the form of electronic medical records (EMRs), which are digital versions of patient charts and medical histories from a single provider. In 2014, the federal government disbursed more than $19 billion in incentives for hospitals to use EMRs. Since then, the number of providers using EMRs skyrocketed.The Importance Of Nursing Informatics In Patient Safety In The Operating Room Essay Paper As of 2016 (the most recent data), more than 95 percent of all eligible hospitals have demonstrated “meaningful use of certified health IT,” the HHS’s Office of the National Coordinator for Health Information Technology (ONC) said. In addition to EMRs, health IT is commonly used in other areas of healthcare: Electronic health records (EHR) EHRs have a similar function to EMRs but EHRs refer to records kept on the patient’s overall health from a multitude of providers. The ONC said EHRs “go beyond standard clinical data collected in the provider’s office and are inclusive of a broader view on a patient’s care.” Patient portals Patient portals allow patients to access their EMRs, EHRs and other pertinent information such as lab results, immunization records, prescription records and information about recent medical visits. Some portals also allow patients to download information and request new prescriptions or prescription refills. E-prescribing Electronic prescribing, or e-prescribing, allows providers to use electronic tools to write and submit prescriptions. When used in conjunction with EMRs and EHRs, providers can better determine the best prescriptions for treatments. One study linked e-prescriptions to better health outcomes in diabetic patients. Patient scheduling Patient scheduling is considered an essential step in providing care, but studies show effective scheduling is lacking. A 2016 survey by the AHRQ found 10 percent of adults said they frequently have difficulties getting timely appointments with providers.The Importance Of Nursing Informatics In Patient Safety In The Operating Room Essay Paper DNPs and Healthcare Leaders Using Health Information Technology While nursing leaders are increasingly using health IT in clinical practice, a lot remains to be accomplished. Barriers that include capital costs, inadequate staff training and unfamiliarity of the benefits of health IT have hindered progress in some areas, the AHRQ said. To increase the use of IT for quality improvements, the AHRQ made the following recommendations: Share samples of exemplary use of health IT to inspire staff Develop and refine high-functioning IT tools Empower staff with the knowledge, guidance and tools to maximize the use of IT Expand the availability of financial incentives for IT use. Healthcare leaders say DNP-prepared nurses can take on advanced roles in IT through a DNP curriculum that examines and evaluates the importance of technology in nursing leadership. In 2012, Jason T. Shuffitt, DNP FNP-BC, recommended that DNP education programs develop “innovative and creative ways of integrating healthcare informatics throughout the curriculum.” His recommendations resonate today. “These clinicians are on the front line of care delivery and must have not only the knowledge and skills necessary to provide competent and quality clinical care but also the ability to manage care effectively in an information-centric and ever evolving complex healthcare system,” he said in the Online Journal of Nursing Informatics. APRNs considering advancing their careers with a DNP degree have an opportunity to utilize a DNP curriculum that includes coursework in healthcare information systems, leadership and safety initiatives. Duquesne University’s online DNP program allows APRNs to delve into health IT and other topics for a well-rounded education.The Importance Of Nursing Informatics In Patient Safety In The Operating Room Essay Paper Nursing informatics plays a huge role in patient safety A reader submitted a question about using her experience with electronic health records, her clinical practice and her background in risk management to develop a niche focusing on EHRs and the legal issues therein to improve patient safety. My simple response is, “Go for it!” EHRs are here to stay, and concern about patient safety will always be an issue for healthcare providers. Analyzing EHRs’ role in patient safety is necessary in today’s healthcare arena, and the investigation has already begun, as illustrated in the article, “Health Information Technology, Patient Safety and Professional Nursing Care Documentation in Acute Care Settings”. Nurses working in nursing informatics are thriving in healthcare. Two major roles seem to have emerged in the arena — the clinician who utilizes health information technology and the specialist who creates, facilitates, tests and implements new information technology. Both are essential roles. According to the American Nurses Association, some of the major functional areas for specialists in nursing informatics include implementing EHRs, designing and training others in the use of EHRs, serving as consultants, developing policies within their respective institutions, and analyzing and managing outcomes. These roles can be seen in many healthcare settings, including acute care, long-term care and in physician and APRN offices. One of the greatest contributions made to patient safety by these nurses is in the documentation of the care in the EHR. Electronic documentation allows nurse informatics clinicians to access information quickly and to utilize that information to improve patient safety. Several organizations have published definitions of nursing informatics. The definitions all have similar elements combining patient care (nursing) and computer-based technology. While people and organizations may not have agreed on a common phrasing, the following definitions agree in spirit. The Nursing Informatics: Special Interest Group of International Medical Informatics Association defines nursing informatics as “the integration of nursing, its information and information management with information processing and communication technology, to support the health of people worldwide.” The American Nurses Association Web site states: “Nursing informatics combines nursing science with computer science together with information processing theory and technology.”The Importance Of Nursing Informatics In Patient Safety In The Operating Room Essay Paper In October 2001, the American Nurses Association published this definition: “Nursing Informatics is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information and knowledge in nursing practice. Nursing informatics facilitates the integration of data, information and knowledge to support patients, nurses and other providers in their decision-making in all roles and settings. This support is accomplished through the use of information structures, information processes, and information technology.” What Does a Nurse Informaticist Do? Much like nursing, nursing informatics has applications in the areas of clinical information, education, and administration. The most successful information technology implementations take advantage of the user-perspective. Users play a critical role in every phase from the needs assessment through the post-implementation review. Frequently, one challenge for information technology projects is gaining the involvement and support of the end-users. In the case of clinical systems, those end-users are clinicians–nurses and physicians. With the time of caregivers at a precious premium, it is not easy to balance the time requirements of the project with the demands of their “day job.” But without clinician input to the requirements, the design, and the deployment, the technology implementation project stands a good chance of failing. Nursing informatics can help vendors design better technology solutions and healthcare organizations select and implement solutions that will help nurses as well as have the potential to improve patient care. If you were to survey the vendors of electronic health record systems, you would find that each has hired nurses to provide input, assist in the sales and help with the project implementation of their solutions. You will find nurses in the technology departments of health care organizations. And, where there is a technology implementation project, there are consultants. Consulting firms are no exception; they too are hiring nurses with nursing informatics interest and/or training.The Importance Of Nursing Informatics In Patient Safety In The Operating Room Essay Paper How Can This Help in the “Real World”? In September 2003, Health Information Management and Systems Society (HIMSS) published the results of the 2003 HIMSS Patient Safety Survey sponsored by the Information Solutions division of McKesson Corporation. The results indicate that in most organizations, nurses are represented on the patient safety committee (95 percent). The study further demonstrates “the fact that nearly all of the respondents reported that technology can address at least one patient safety issue at their facility, only 41 percent of the respondents reported that a representative from the information technology department sits on the formal patient safety committee.” If organizations are not going to place information technology staff at the patient safety table, a nurse with information technology knowledge could play a vital role on the committee as well as the successful selection and implementation of technology tools to help improve patient safety. According to the survey, the two technologies most likely to improve patient safety are bar codes for medication administration (80 percent) and computerized provider order entry (76 percent). Computerized provider (or physician) order entry (CPOE) as part of an advanced clinical information solution “can help health care organizations address important strategic concerns that will deliver improved patient care while impacting the bottom line.” These technologies can contribute to the reduction of the potential of medical errors as well as duplication of efforts.The Importance Of Nursing Informatics In Patient Safety In The Operating Room Essay Paper – See more at: https://www.americanmobile.com/nursezone/nursing-news/nursing-informatics-improving-patient-safety-with-technology.aspx#sthash.Ciczekr3.dpuf The healthcare information revolution is upon us. Clinicians have more access than ever to electronic health records, diagnostics, and treatment plans. Clinical communication and collaboration platforms are making it easier to manage healthcare workflows, improve coordination, and enhance patient outcomes. Systems integration and data access mean that information and analysis are more vital than ever. The secret to using this data to provide better care comes down to nursing informatics — integrating nursing science with other areas to identify, define, manage, and communicate data, information, knowledge, and wisdom to provide better care. As the Healthcare Information and Management Systems Society says, “The informatics nurse is part of the delivery of care, the building of knowledge, skills, and experience in the use of information technology. They often lead clinical informatics committee meetings that have a major influence for nurses in assisting them to coordinate all the multifaceted technology activities in regards to patient care, documentation, and safety.”The Importance Of Nursing Informatics In Patient Safety In The Operating Room Essay Paper Let’s dig into exactly how nursing informatics achieves that. Aligning Nursing Best Practice with Clinical Workflows and Care Nursing informatics is focussed on the best ways to achieve good patient outcomes — it is about applying the overall process and best practice to maximize patient care wherever possible. As a result, nurse informaticists are often involved in process design, clinical workflow reviews, and new diagnostics and treatment plans. They take into account the various options for providing care and use objective facts and analysis to determine the actions that will lead to the most patient-centered, value-based care. Improving Clinical Policies, Protocols, Processes, and Procedures Data is the lifeblood of nursing informatics. That data and information can be used to measure the success of the various protocols, processes, and procedures used in a healthcare organization. A nurse informaticist will measure and analyze how specific parts of the organization are performing, with a focus on the resulting patient outcomes. They can then make changes to specific parts of the process to streamline activities, avoid bottlenecks, and improve care. Informaticists will see what the results are and continue making changes to enhance every part of the clinical care process. Providing Training and Learning Based on Objective Data One of the most valuable ways a nursing informaticist can enhance patient outcomes is through providing training to clinical staff. They can use data to identify endemic issues in a healthcare organization and consult on the best way to resolve these problems. These learnings can be integrated with onboarding new staff, ongoing in-house training, or external education and certification. Nursing informaticists can help to create highly-targeted educational programs to deal with specific gaps between ability and provider expectations. Selecting and Testing New Medical Devices Connected IoT medical devices can provide vast amounts of health data on patients. Nursing informaticists are ideally positioned to understand the true value of that data and provide recommendations on how it can be recorded, accessed, and used. Involving informaticists in the selection of medical devices will ensure you have additional criteria for understanding how device data can inform diagnostics, treatment plans, and ultimately patient outcomes.The Importance Of Nursing Informatics In Patient Safety In The Operating Room Essay Paper Reducing Medical Errors and Costs Nursing informaticists can reduce the chance of medical errors in a healthcare organization, together with associated costs. A combination of staff training, process improvement, and best practice will enhance the quality of care and limit patient risks. There are four main areas that drive medical errors: Communication doesn’t take place when it should Incorrect or incomplete information is communicated Information is shared with the wrong recipient or third party The message lacks critical facts or is unclear, meaning it isn’t understood correctly Informaticists can look at how your organization communicates and collaborates around patient information. They can audit individual cases, identify gaps, and provide recommendations for avoiding errors in the future. In 2015, an analysis discovered medical errors cost healthcare providers $1.7 billion, over a five year period. The general public believes that technology will improve health care efficiency, quality, safety, and cost. However, few people consider that these same technologies may also introduce errors and adverse events.1 Given that nearly 5,000 types of medical devices are used by millions of health care providers around the world, device-related problems are inevitable.2 While technology holds much promise, the benefits of a specific technology may not be realized due to four common pitfalls: (1) poor technology design that does not adhere to human factors and ergonomic principles,3 (2) poor technology interface with the patient or environment,3 (3) inadequate plan for implementing a new technology into practice, and (4) inadequate maintenance plan.The Importance Of Nursing Informatics In Patient Safety In The Operating Room Essay Paper Patient care technology has become increasingly complex, transforming the way nursing care is conceptualized and delivered. Before extensive application of technology, nurses relied heavily on their senses of sight, touch, smell, and hearing to monitor patient status and to detect changes. Over time, the nurses’ unaided senses were replaced with technology designed to detect physical changes in patient conditions.5 Consider the case of pulse oxymetry. Before its widespread use, nurses relied on subtle changes in mental status and skin color to detect early changes in oxygen saturation, and they used arterial blood gasses to confirm their suspicions. Now pulse oxymetry allows nurses to identify decreased oxygenation before clinical sy

NURS 4105 – Advocacy Through Healthcare Policy Research Paper NURS 4105 – Advocacy Through Healthcare Policy Research Paper What is Health Policy Advocacy? Advocacy is defined as the support or defense of a cause and the act of leading on behalf of another person. Nurses engage in advocacy every day on behalf of their patients. In nursing practice, this means that nurses promote and strive to protect the health, safety, and rights of patients. Nurses also collaborate with other health professionals and the public to promote community, national, and international efforts to meet health needs. Furthermore, nurses advocate for the nursing profession and professional standards of practice. Health Policy & Advocacy Committee The HP&A Committee of NAAN/NANNI (hereafter referred to collectively as NANN) acts to promote NANN as the professional voice that shapes neonatal nursing through excellence in practice, research, education and professional development.NURS 4105 – Advocacy Through Healthcare Policy Research Paper On behalf of NANN, the Committee pursues and promotes NANN’s legislative agenda by monitoring and responding to legislation, governmental regulations, and administrative actions that affect neonatal nurses, neonatal nurse practitioners, and the patients and families they serve. The Committee also encourages and assists NANN members to become involved in grassroots legislative activities in pursuit of common goals. NANN is not large enough to have, like some organizations, our own legislative representative or lobbyist. Even so, there is much we can do at the grassroots level, and to increase our effectiveness, NANN and NANNP are joined in these activities. Turning Outrage into Action Every day, people have experiences that are frustrating, unbelievable, or so outrageous that they think, “How can this be? There ought to be a law!” Nurses often experience this frustration in their day-to-day practice- fighting with managed care, facing inadequate Medicare reimbursement, and struggling with inadequate staffing or unsafe working conditions. Also every day, federal and state legislators are making decisions that affect neonatal nursing and our patients, often with very little knowledge or understanding of the issues and with little or no input from nurses. We can’t afford to let this happen. We must contribute our authority, leadership, and unique knowledge of neonatal nursing to the legislative process, or suffer the consequences.NURS 4105 – Advocacy Through Healthcare Policy Research Paper Permalink: https://nursingpaperessays.com/ nurs-4105-advoca…research-paper / ? Health policy advocacy means channeling this sense of outrage about inadequately conceived laws, policies, and regulations or about the absence of a law when the need for one is clear. Advocates let policymakers know what they, as citizens and constituents, believe elected officials should do. Health policy advocacy can be easy, and it can make a difference in the outcome of our nation’s policy decisions. It doesn’t require any new skills, it just involves applying skills you already have, such as communication and building relationships, in a new context. Advocacy is a Right and a Responsibility Polls have found that Americans’ knowledge of television shows such as The Simpsons and American Idol far surpasses their familiarity with the First Amendment of the U.S. Constitution. The First Amendment guarantees freedom of speech, the press, religion, the right to peacefully assemble, and the right to petition the government for a redress of grievances. So if you are thinking, who am I to lobby Congress? I am just a nurse! The U.S. Constitution grants us the right to tell our elected officials our concerns and to take action to address them. Policymakers work for the citizens. Your tax dollars pay their salaries, their health insurance, retirement benefits, and travel. As their “employer,” you have every right to hold them accountable for their actions, tell them what you want them to do, and give feedback on how you think they are doing at their jobs.NURS 4105 – Advocacy Through Healthcare Policy Research Paper The ultimate job review you can give your public officials is by voting – either returning them to office or ending their service. The United States has a participatory democracy and representative government. Becoming involved is not only a right, but also a responsibility. And finally, Congress needs the expertise of nurses. Nurses have first-hand direct bedside experience and understanding of how decisions in Washington affect constituents. Nurses understand the “big picture,” relating to health issues. Nurses are trusted, tenacious, and reliable. Advocacy and health policy have important implications for what we do every day. Unless we communicate with lawmakers about key issues, laws and regulations will be created and enacted without the benefit of our expertise and unique perspectives. Nurse are a powerful and well-respected constituency; our active involvement in health policy issues helps policymakers take action on key issues, such as the nursing shortage. Engaging nurses in health policy advocacy is essential to ensuring that nursing and NANN’s priorities are received and addressed by policymakers. We can and must become involved in health policy advocacy. The following sections of this Health Policy & Advocacy Toolkit provide the tools needed to become effective health policy advocates at the national, state, and local level.NURS 4105 – Advocacy Through Healthcare Policy Research Paper What is a Healthcare Policy Advocate? One of the newest professions to emerge in the burgeoning healthcare system is that of a Healthcare Policy Advocate. This person speaks for patients who are at their most vulnerable state in an environment of increasing healthcare costs and privacy concerns that sometimes block access to resources. What does this profession entail and who are the people that work in the advocate position? Why Advocates are Needed The average household in the United States spends roughly $15,000 on healthcare each year, according to an article in a New York Times blog. That includes insurance premiums, Medicare taxes, Medicaid expenses and other costs in addition to out-of-pocket charges. The U.S. also spends a sixth of its annual gross product on providing healthcare. The health industry is big business. According to an article found in the Journal of Medical Ethics, the medical profession has, at its core, the goal of promoting a patient’s best interests, but, in reality, that must be tempered with an eye to the good of the community. In other words, what is good NURS 4105 – Advocacy Through Healthcare Policy Research Paper Who are Advocates? Some advocates work for healthcare facilities, some are employed by insurance companies, some work for “advocacy agencies” and some work as private practitioners. Obviously, the best advocate would be the patient, but advocacy is needed at a point when the patient is most vulnerable. Family or friends are also sometimes advocates. With all of these people, though, there may be a conflict of interests. Even family members sometimes struggle with how the wishes of the patient will impact their lives. What Do Advocates Do? There are two kinds of advocates: those who advocate for a class, and those who advocate for the individual. Nurses advocate for patients by attempting to change the system. Other advocates work on a more personal level, in face-to-face contact with their clients. Some of their duties are:NURS 4105 – Advocacy Through Healthcare Policy Research Paper Helping with insurance claims Informing patients of all treatment options Negotiate bills. This is especially true of an advocate who works for an insurance company or a healthcare facility. Support the patient emotionally Support patient decisions and make sure these are expressed to the healthcare providers. Educate the patient about his illness and possible treatments. The role of the advocate is not well-defined, because the position is so new and there are advocates from so many entities. The focus of the advocacy will depend upon who employs the advocate. In addition, there is a debate over whether the advocate should push for all patient requests or act in a parental capacity to advocate for what is actually in the patient’s best interests.NURS 4105 – Advocacy Through Healthcare Policy Research Paper Policy & Advocacy With experience across a range of policy areas and issues, combined with our strong record working side-by-side with business, government, and community-based organizations, PHI and its programs are effective, influential advocates for public health in local, state and federal policy. Building on this success, PHI is now working to strengthen its role in U.S.-based policy that has implications for health domestically and worldwide. With strategic policy platforms, PHI addresses policy in areas such as obesity prevention, climate change and health reform. In addition, PHI tracks federal and state legislation, regulations and budgeting processes across a wide range of issues that impact the public’s health, and advances policy solutions that address the social determinants of health.NURS 4105 – Advocacy Through Healthcare Policy Research Paper PHI continues to produce forward-thinking research to support the public health perspective as it relates to many of the most complex policy challenges facing the nation today, including: agriculture and nutrition, transportation planning, climate change, economic development, obesity prevention, healthy communities, telehealth and health information technology, and alcohol, tobacco and substance use.NURS 4105 – Advocacy Through Healthcare Policy Research Paper Policy advocacy is defined as active, covert, or inadvertent support of a particular policy or class of policies. [1] Whether it is proper for scientists and other technical experts to act as advocates for their personal policy preferences is contentious. In the scientific community, much of the controversy around policy advocacy involves precisely defining the proper role of science and scientists in the political process. [2] Some scientists choose to act as policy advocates, while others regard such a dichotomous role as inappropriate. [3] Providing technical and scientific information to inform policy deliberations in an objective and relevant way is recognized as a difficult problem in many scientific and technical professions. [4] The challenge and conflicts have been studied for those working as stock analysts in brokerage firms, [5] for medical experts testifying in malpractice trials, [6] for funding officers at international development agencies, [7] and for intelligence analysts within governmental national security agencies. [8] The job of providing accurate, relevant, and policy neutral information is especially challenging if highly controversial policy issues (such as climate change) that have a significant scientific component. [9] The use of normative science by scientists is a common method used to subtly advocate for preferred policy choices. [10]NURS 4105 – Advocacy Through Healthcare Policy Research Paper Defining policy advocacy The most basic meaning of advocacy is to represent, promote, or defend some person(s), interest, or opinion. Such a broad idea encompasses many types of activities such as rights’ representation 1 and social marketing 2 , but the focus of this manual is on the approaches adopted by organizations and coalitions in trying to change or preserve specific government programs, that is, approaches focused on influencing decisions of public policy. In order to distinguish this from other types of advocacy activities, it is often referred to as “policy advocacy.” This is also the term we use throughout the guide to make this distinction clear. There are many definitions of policy advocacy available from multiple authors and perspectives 3 . At their core are a number of ideas that continually come up, characterizing policy advocacy as follows: a strategy to affect policy change or action — an advocacy effort or campaign is a structured and sequenced plan of action with the purpose to start, direct, or prevent a specific policy change.NURS 4105 – Advocacy Through Healthcare Policy Research Paper a primary audience of decision makers — the ultimate target of any advocacy effort is to influence those who hold decision-making power. In some cases, advocates can speak directly to these people in their advocacy efforts; in other cases, they need to put pressure on these people by addressing secondary audiences (for example, their advisors, the media, the public). a deliberate process of persuasive communication — in all activities and communication tools, advocates are trying to get the target audiences to understand, be convinced, and take ownership of the ideas presented. Ultimately, they should feel the urgency to take action based on the arguments presented. a process that normally requires the building of momentum and support behind the proposed policy idea or recommendation. Trying to make a change in public policy is usually a relatively slow process as changing attitudes and positions requires ongoing engagement, discussion, argument, and negotiation.NURS 4105 – Advocacy Through Healthcare Policy Research Paper conducted by groups of organized citizens —normally advocacy efforts are carried out by organizations, associations, or coalitions represent the interests or positions of certain populations, but an individual may, of course, spearhead the effort. However, taking these basic elements outlined above a little further and emphasizing the specific challenge that we develop in this chapter, our definition is as follows: Policy advocacy is the process of negotiating and mediating a dialogue through which influential networks, opinion leaders, and ultimately, decision makers take ownership of your ideas, evidence, and proposals, and subsequently act upon them. In our definition, we place a great emphasis on the idea of the transfer of ownership of core ideas and thinking. In essence, this implies preparing decision makers and opinion leaders for the next policy window or even pushing them to open one in order to take action. If advocates do their job well, decision makers will take the ideas that have been put forward and make changes to the current policy approach in line with that thinking.NURS 4105 – Advocacy Through Healthcare Policy Research Paper Health advocacy encompasses direct service to the individual or family as well as activities that promote health and access to health care in communities and the larger public. Advocates support and promote the rights of the patient in the health care arena, help build capacity to improve community health and enhance health policy initiatives focused on available, safe and quality care. Health advocates are best suited to address the challenge of patient-centered care in our complex healthcare system. The Institute of Medicine (IOM) defines patient-centered care as: Health care that establishes a partnership among practitioners, patients, and their families (when appropriate) to ensure that decisions respect patients’ wants, needs, and preferences and that patients have the education and support they need to make decisions and participate in their own care. [1] Patient-centered care is also one of the overreaching goals of health advocacy, in addition to safer medical systems, and greater patient involvement in healthcare delivery and design. [2] Patient representatives, ombudsmen, educators, care managers, patient navigators and health advisers are health advocates who work in direct patient care environments, including hospitals, community health centers, long term care facilities, patient services programs of non-profit organizations or in private, independent practice. They collaborate with other health care providers to mediate conflict and facilitate positive change, and as educators and health information specialists, advocates work to empower others.NURS 4105 – Advocacy Through Healthcare Policy Research Paper In the policy arenas health advocates work for positive change in the health care system, improved access to quality care, protection and enhancement of patient’s rights from positions in government agencies, disease-specific voluntary associations, grassroots and national health policy organizations and the media. There may be a distinction between patient advocates, who work specifically with or on behalf of individual patients and families, or in disease-specific voluntary associations, and health advocates, whose work is more focused on communities, policies or the system as a whole. Often, however, the terms “patient advocate” and “health advocate” are used interchangeably NURS 4105 – Advocacy Through Healthcare Policy Research Paper Rapidly growing areas of health advocacy include advocates in clinical research settings, particularly those focused on protecting the human subjects of medical research, advocates in the many disease-specific associations, particularly those centered on genetic disorders or widespread chronic conditions, and advocates who serve clients in private practice, alone or in larger companies. With member hospitals, the Children’s Hospital Association works with policymakers—both in Congress and in the administration (White House and federal agencies)—to ensure children’s unique health care needs are considered and that every child has access to high quality, cost effective health care services tailored to meet their needs. We are the nation’s leading voice advocating on behalf of children’s hospitals and the millions of children they serve. NURS 4105 – Advocacy Through Healthcare Policy Research Paper Through its advocacy efforts, the association: Works with member hospitals and Congress to craft, reform and promote health care legislation to benefit children, especially those with complex medical conditions Educates federal policymakers, both during legislative drafting and policy implementation about key issues that impact children’s health and children’s hospitals Analyzes and synthesizes federal legislation and regulations for their impact on children’s health care, and organizes input from a network of more than 220 children’s hospitals Assist children’s hospitals in understanding how federal policy may impact children’s health care in their communities Mobilizes a grassroots network of thousands of parents, health care providers and others concerned about children’s health to influence Congressional action Provides tools to advance children’s hospitals’ advocacy efforts at national, state and local levels Collaborates with other organizations concerned with children’s health to advance shared policy goals and amplify our reach on Capitol Hill, within the White House and key federal agencies, and in traditional and social media Health advocacy Advocacy is one strategy to raise levels of familiarity with an issue and promote health and access to quality health care and public health services at the individual and community levels. When trying to gain political commitment, policy support, social acceptance and systems support for a particular public health goal or program-me, a combination of individual and social actions may be used to try to affect change. This is one way of understanding Health Advocacy. The adoption of a health advocacy model can focus on an educational dimension when it identifies emerging public health issues that require action. It encompasses gathering information on existing practice related to public health, related legislation monitoring and providing feedback on how specific regulations impact local groups and communities. It may also help guiding health policy reforms. Often, health advocacy is carried out using mass and multi-media, direct political lobbying and community mobilization. It may materialize within an institution or through public health associations, patients’ organizations, private sector and NGOs. All health professionals have a major responsibility to act as advocates for public health at all levels in society.NURS 4105 – Advocacy Through Healthcare Policy Research Paper The National Association of Healthcare Advocacy is the professional healthcare advocacy organization; we are dedicated to the improvement of patient outcomes through continuing education, promotion of national standards of practice, and active pursuit of policy changes, leading to a high standard of person-centered healthcare. We promote rigorous standards for the practice of advocacy including ethical considerations and codes of conduct when providing medical decision-making support. We educate consumers and healthcare professionals on research and current trends in patient-centered navigation, advocacy and decision-making support. We partner with individual advocates and other grassroots organizations to collaborate on patient-centered reforms that maximize use of the healthcare system, protect consumer choice and improve access to high quality, affordable care. Health Policy and Advocacy Group The purpose of the Health Policy and Advocacy Group is to identify public policy issues and concerns affecting surgeons and our patients; prioritize these issues and concerns, identify those on which the American College of Surgeons (ACS) should focus its attention and resources, and recommend these priorities to the Board of Regents; develop action plans for addressing these issues, including recommending positions and initiatives the College should adopt; expand and monitor mechanisms by which the ACS makes surgeons, our patients, and the public aware of our health policies and agendas; and develop and maintain mechanisms by which legislative and regulatory issues can be addressed in a timely and effective manner.NURS 4105 – Advocacy Through Healthcare Policy Research Paper Nursing Advocacy: Standing Up for Patients and the Profession When it comes to patient care, nurses consistently play the role of advocate as they support each patient’s emotional well-being, contribute to the healing process and speak on their patients’ behalf. Nurses can also put their advocacy skills to work in advocating for each other and for the nursing profession as a whole. “As nursing advocates we start with the foundation that we are servants to others and stewards of our profession,” said Ellen Noel, MN, RN-BC, clinical nurse specialist at Virginia Mason Medical Center (VMMC) in Seattle. “As an advocate we choose to lead from that servant position, making sure peoples’ needs are being met through wise and thoughtful interactions.” VMMC is creating a model of care based on the caring theory developed by Kristen Swanson, RN, Ph.D., FAAN, which provides a clear outline for advocating for patients and co-workers. Swanson’s five steps of caring are: knowing, being with, doing for, enabling and maintaining belief.NURS 4105 – Advocacy Through Healthcare Policy Research Paper “With the caring model, you start with the assumption that the person you are working with has valuable skills, that they are trying hard, that they want to improve and learn and that they have the best intentions,” explained Noel. “When you start with that attitude you give that person the best chance of taking control of their circumstances and reaching success.” “While we are just at the beginning of working out the logistics of implementing the caring model, we are already seeing an increase in awareness, empathy and understanding with others on the team,” remarked Alison Pyle, MN, MPH, RN, clinical director of the hospital’s nephrology/urology/neurology unit that is taking part in the pilot project. While a lot is written about the bullying that can go on within the nursing profession, Christine Szweda RN, BSN, MS, NE-BC, director of nursing education for competency and assessment at The Cleveland Clinic, believes nurses can instead provide each other with a powerful support network.NURS 4105 – Advocacy Through Healthcare Policy Research Paper “When it comes to supporting each other, it is great when nurses not only encourage a peer who is considering furthering his or her education, but when co-workers are also willing to be flexible with schedule changes that accommodate another nurse’s schooling needs,” she said. “Early in my career I decided I wasn’t going to talk about people in terms of their nursing education, because it was only divisive,” reflected Connie Curran, Ed.D., RN, FAAN, editor emeritus, Nursing Economic$ . “I have also made a commitment that when I find myself in a position of privilege, to respond by trying to get another nurse there as well. I was serving on a hospital board and realized I was the only nurse on the board. It turns out that nurses only make up 2 percent of hospital board members, but they are the ones who are there evenings and nights and know how the hospital works.” In response to this commitment, Curran started the company Best On Board, which is an educational program to help nurses get the education and certification they need to serve on boards. As board members, nurses have the influence and the know-how to create good environments for patients and caregivers. There are a number of ways that nurses can be involved in advocating for the nursing profession. Sometimes it is as simple as being the best nurse you can be and speaking with pride about the work you and other nurses do; it can also mean being involved in research, politics or with one’s professional organization. Most often, working to improve the profession also benefits patient care. “It is increasingly common for even young nurses to have opportunities to be involved in research that contributes to the body of knowledge of nursing science,” commented Szweda. “But even if you aren’t personally involved in research, you can be quick to share and implement best practices and support the research that has been done.”NURS 4105 – Advocacy Through Healthcare Policy Research Paper “Along those lines, be quick to embrace technology,” she continued. “I read a lot about nurses resisting the electronic medical record, but the richness of data that can be kept there will not only contribute to the body of knowledge, but having a consistent and integrated patient health record drives patient safety and better care.” Noel believes that a key component of nursing advocacy is to hold tight to procedures and competencies that ensure patients are safe, while also including staff nurses in determining how these evidence-based practices will be implemented. Through this approach VMMC has made significant improvements in the areas of preventing pressure wounds, patient falls and medication errors. “Participating in your professional society is a powerful way to advocate for the nursing profession and for patients,” remarked Charlotte L. Guglielmi, RN, BSN, MA, CNOR, preoperative nurse specialist at Beth Israel Deaconess Medical Center and immediate past president of the Association of preoperative Nurses (AORN). Ways Nurses Can Advocate for Patients Many nurses think of advocacy as the most important role we play in patient care. We need to remember that to best serve patients, we must have our own house in order. That house includes the other healthcare professionals with whom we and our patients interact, as well as the organizations providing those services and the policies and legislation that influence them. How can oncology nurses advocate for patients every day? Here are some examples.NURS 4105 – Advocacy Through Healthcare Policy Research Paper Ensure Safety. Ensure that the patient is safe when being treated in a healthcare facility, and when they are discharged by communicating with case managers or social workers about the patient’s need for home health or assistance after discharge, so that it is arranged before they go home. Give Patients a Voice. Give patients a voice when they are vulnerable by staying in the room with them while the doctor explains their diagnosis and treatment options to help them ask questions, get answers, and translate information from medical jargon. Educate. Educate patients on how to manage their current or chronic condition to improve the quality of their everyday life is an important way nurses can make a difference. Patients undergoing chemotherapy can benefit from the nurse teaching them how to take their anti-nausea medication in a way that will be most effective for them and will allow them to feel better between treatments. Protect Patients’ Rights. Protect patients’ rights by knowing their wishes¾this might include communicating those to a difficult family member who might disagree with the patient’s choices and could upset the patient. Double Check for Errors. Everyone makes mistakes. Nurses can catch, stop, and fix errors, and flag conflicting orders, information, or oversights by physicians or others caring for the patient. Read the orders and previous documentation carefully, double check with other nurses and the pharmacist, and call the doctor if something is unclear before administering chemotherapy.NURS 4105 – Advocacy Through Healthcare Policy Research Paper Connect Patients to Resources. Help patients find resources inside or outside the hospital to support their well-being. Be aware of resources in the community that you can share with the patient such as financial assistance, transportation, patient or caregiver support networks, or helping them meet other needs. While we function as advocates for patients, many of the tasks we do become automatic and we can forget they are really about advocacy. When we are short-staffed or tired, our ability to advocate becomes compromised. Advocacy for patients doesn’t happen in a vacuum. Every patient’s care is affected by the environment in which their care is provided, and the individuals providing that care. This means nurses need to have the time to be able to do these things and to become aware of patient needs, communicate, and follow through. The nurse needs to come to work not exhausted or burned out. A safe patient load is necessary, as well as support and backup from other staff in the facility. Administrators must understand our role as advocates for patients, so they can provide adequate staffing levels and an environment that allows us to fully care for our patients. When the administration does not understand, it is part of our advocacy duty to inform them. NURS 4105 – Advocacy Through Healthcare Policy Research Paper In my next post I will explore how nurses also play important roles as advocates for their own profession, and within the greater healthcare space where we exist, intertwined with physicians and other healthcare professionals who ultimately serve patients. Effective nurse advocacy Advocacy means using one’s position to support, protect, or speak out for the rights and interests of another. Nurses have long claimed patient advocacy as fundamental to their practice. The American Nurses Association’s Code of Ethics for Nurses and Scope and Standards of Nursing Practice clearly identify nurses’ ethical and professional responsibility for protecting the safety and rights of their patients. State nursing practice acts may establish a legal duty for patient advocacy as well.NURS 4105 – Advocacy Through Healthcare Policy Research Paper Why must nurses advocate? Patient safety depends on nurse advocacy. Over 10 years ago, the Institute of Medicine (IOM) shocked the nation when it reported in To Err is Human: Building a Safer Health System that an amazing 100,000 deaths each year were attributable to medical errors. In 2004, the IOM report Keeping Patients Safe: Transforming the Work Environment of Nurses highlighted the critical role of nurses in safety efforts and challenged organizations to design work environments in which nurses can provide safe care. Nurses are at the “sharp end” of errors in health care. Because of their proximity and continuity with patients, nurses are often the last opportunity to prevent an error—to spot a mislabeled I.V. bag before it’s infused, to recognize that a patient’s allergy band doesn’t match the medication administration record, to identify slight changes in a patient’s condition that could signal a significant complication. Keeping Patients Safe urged the establishment of “cultures of safety” within healthcare organizations to achieve safe practice

Nursing

Nursing

NURS 6001 – Foundations for Graduate Study Case Study Paper NURS 6001 – Foundations for Graduate Study Case Study Paper The Graduate Foundations Program allows you to develop your own curriculum at a world-class institution and enhance your application for a Ph.D. or master’s degree.NURS 6001 – Foundations for Graduate Study Case Study Paper The program is flexible, allowing you to custom design your path of study with the help of an academic advisor to meet your individual needs, enabling you to select the specific classes that will help strengthen your graduate school application or meet specific program prerequisites. Permalink: https://nursingpaperessays.com/ nurs-6001-founda…case-study-paper / The program has two options: Enroll in fewer than four classes. Complete four or more classes and pursue a non-degree Graduate Foundations Certification of Professional Achievement (CPA). Students who successfully complete four courses, with a cumulative grade of B or better will be awarded a Certification of Professional Achievement in Graduate Foundations and an official Columbia University transcript detailing the course of study.NURS 6001 – Foundations for Graduate Study Case Study Paper (For the CPA option, Students are required to maintain an overall minimum GPA of 3.0 (B). Every course creditable toward the CPA must be taken for a letter grade. Courses with a grade below a C will not count toward the completion of the CPA.) Students in the Graduate Foundations Program have access to: Individualized Advising . You may work closely with an advisor to select your course of study and ensure it is rigorous and appropriate for your desired path. This advising continues throughout your time as a student in the program.NURS 6001 – Foundations for Graduate Study Case Study Paper University Courses . Choose from undergraduate and graduate courses that span more than 100 disciplines. You will have the opportunity to take classes taught by Columbia University faculty alongside students in degree programs at Columbia and engage in the rich intellectual discourse found at an Ivy League institution. 4 Keys to Starting Strong: Developing a Foundation for Graduate School Success NURS 6001 – Foundations for Graduate Study Case Study Paper Graduate school can be a rewarding journey with many ups, downs, and curves along the way. By becoming aware of strategies and services here at Duke and beyond, you can find advice and assistance in navigating your passage through your graduate school experience. Although the list of tips for new graduate students may be endless, a few good focus points can get you started on the right foot.NURS 6001 – Foundations for Graduate Study Case Study Paper Mentor ship Seeking out mentor ship and relational support can create a strong and supportive base for your graduate student experience. The AMA has a great web resource to get you focused while you can also locate resources to suite your personal values and needs. Begin by connecting with faculty and student graduate and professional organizations on campus. NURS 6001 – Foundations for Graduate Study Case Study Paper Self-Care Self-care is an often-overlooked aspect of the daily graduate students€™s existence. General study and academic management strategies can be helpful and provide a sense of control, but caring for oneself physically and emotionally will provide a healthy foundation for dealing with the stresses of graduate school. To help battle burnout , connect with Duke CAPS and Duke Health and Wellness where you will find helpful resources, workshops, activities and guidance for self-care.NURS 6001 – Foundations for Graduate Study Case Study Paper Finances Don€™t let knowledge about your finances fall to the wayside during graduate school. Explore Personal Finance@Duke to create and maintain a budget while getting to better understand your finances with the future in mind. Understand your finances and know assistance is available. Career Development Although you may feel as though a career may be far away or right around the corner, it is important to begin your career development where you are today.NURS 6001 – Foundations for Graduate Study Case Study Paper The Duke Career Center Graduate Student Services offers countless opportunities for career development and support. Just check out our events page for up to date information concerning all career events on campus and beyond. The Foundations of Education The foundations of education are three distinct scholarly traditions of practice – philosophy of education, history of education, and sociology of education – that inform education and conceptualize frameworks for education research.NURS 6001 – Foundations for Graduate Study Case Study Paper Here are three suggested areas of study in Foundations, each built around core course offerings: Philosophy, History & Sociology of Education : study all the foundations or specialize in one; learn how to use a method of inquiry for individual or collective practice. Value, Bias & Social Justice : examine key themes, their socio-historical influence and value for decision-making in policy and practice. Arts, Media & Culture : study the arts as historical, sociological, and philosophical projects in teaching, learning and research.NURS 6001 – Foundations for Graduate Study Case Study Paper Graduate Fellowship Award The Hertz Graduate Fellowship Award is based on merit (not need) and consists of a cost-of-education allowance and a personal-support stipend. The cost-of-education allowance is accepted by all of the participating schools in lieu of all fees and tuition. Hertz Fellows therefore have no liability for any ordinary educational costs, regardless of their choice among participating schools. In addition to providing the necessary funding along with the research freedom to pursue their PhD, we also provide mentorship and counsel through the lifelong community of peers to which they now belong—the Hertz Community. This Community is comprised of current in-school Fellows who are pursuing their graduate degree, as well as the entire group of alumni Fellows (now totaling over 1,200). When Hertz Fellows complete graduate school, we intend that they do so armed with more than their degree, research experience, and colleagues from that university, but also with a set of collaborators across disciplines, geography, and generations, all ready to help them succeed throughout their careers.NURS 6001 – Foundations for Graduate Study Case Study Paper Why major in educational foundations? The educational foundations (EdF) program is for undergraduates who are committed to social change and are pursuing a future in education or related fields. This major prepares aspiring future professionals in education and related fields to be critical thinkers, well informed about theory and practice, and to possess the knowledge and skills that will enable them to be change agents in economically, racially, culturally, and linguistically diverse communities.NURS 6001 – Foundations for Graduate Study Case Study Paper If you are interested in graduate study, such as our UOTeach program, to become an elementary teacher, you should begin your undergraduate study as a pre-education major and then apply to the Educational Foundations major before your junior year. If you aspire to be a future middle or high school teacher, you should major as an undergraduate in the content area you wish to teach, and then pursue graduate study in a program such as UOTeach. NURS 6001 – Foundations for Graduate Study Case Study Paper For those students pursuing a different undergraduate major, but considering a career in education, the certificate in educational foundations: secondary is a good option to prepare for graduate study in education. One of the many strengths of the educational foundation (EdF) major is the 120 hours of diverse field experiences that are an integral part of the curriculum.NURS 6001 – Foundations for Graduate Study Case Study Paper Our program is designed as a two-year cohort program completed during the undergraduate junior and senior year. Pathway courses are offered by different types of bodies. You could take a program me at your chosen institution if one is available. They are also offered by partner universities and education companies, such as ON CAMPUS Global, Kaplan International, INTO University Partnerships, and Gravitas, among many others. Pathways come in several different forms, each tailored to different types of students. There are specific pathway courses, and these tend to be designed for particular undergraduate degree courses. There are also foundation courses, which are perfect if you wish to study an undergraduate degree but did not meet the entry requirements. Although the terms pathway program mes and foundation program mes can sometimes be used in reference to the same thing, there is usually a difference. Foundation program mes can be studied as a stand alone degree, and you do not need to top them up if you do not wish. A pathway program-me cannot be studied as a stand alone degree, and are created specifically to lead you onto a degree program me.NURS 6001 – Foundations for Graduate Study Case Study Paper If you are wishing to study a postgraduate degree but do not meet the entry requirements, you may wish to explore the per-masters options that are available to you. A per-masters program-me is useful for students who studied one subject at undergraduate and now wish to change their course with a postgraduate degree. Sometimes masters degree will require you to have studied a certain subject to make sure you will be able to keep up with the higher level of course content. If you have not studied one of these subjects, but still wish to do the specific masters degree, taking a per-masters can allow you to meet the requirements in a shorter amount of time. A per-masters is also helpful for students whose undergraduate degree results do not meet the entry requirements for their chosen masters degree.NURS 6001 – Foundations for Graduate Study Case Study Paper There are also preparation courses that are perfect if you do not meet the English language requirements for your chosen degree. If English is not your first language, or your previous studies were not in English, you may be asked to provide evidence of your English language proficiency. Having a good standard of English will allow you to fully understand and engage in your degree, as well as increasing your chance of gaining high grades in assessments. If you do not meet the language requirements for your course, your institution may offer you the chance to take a short preparation course that will focus on improving your language skills prior to the start of your studies. These can be offered as stand alone program mes, or as a combination with a per-masters or pathways program-me.NURS 6001 – Foundations for Graduate Study Case Study Paper Waiver of Foundation Courses Students may seek waiver of any of the six foundation courses*. Waivers are granted to any student who successfully completed a comparable course at an accredited undergraduate institution within seven years of admission. An application for a waiver of foundation courses must accompany the application for admission and must include the undergraduate syllabi (no syllabi submission is required for Berkeley graduates). Students must have achieved a grade of B or better in order to be granted a waiver. Foundation courses may also be waived based upon successful demonstration of prior learning designated by the Graduate Admissions Committee. The Dean of the School of Graduate Studies is responsible for granting such waivers once the designated remediation has been successfully completed.NURS 6001 – Foundations for Graduate Study Case Study Paper Foundation courses may also be waived by examination. Students must receive the approval of the Dean of the School of Graduate Studies to seek waiver by examination. Examination for foundation courses must be completed prior to enrolling in the M.B.A. program. Foundation courses taken at the graduate level are designated pass/fail and are not included in the calculation of GPA.NURS 6001 – Foundations for Graduate Study Case Study Paper Through the Graduate Foundations Program, you’ll develop your own curriculum at a world-class institution and enhance your application for a Ph.D. or master’s degree. Custom-design your path of study with the help of an academic advisor to meet your individual needs, and select the specific classes that will help strengthen your graduate school application or meet specific program prerequisites. The Graduate Foundations Program has two options: Enroll in fewer than four classes. Complete four or more classes and pursue a Certification of Professional Achievement in Graduate Foundations. Students who successfully complete four courses, with a cumulative grade of B or better will be awarded a Certification of Professional Achievement in Graduate Foundations and an official Columbia University transcript detailing the course of study.NURS 6001 – Foundations for Graduate Study Case Study Paper (For the certification option, students are required to maintain an overall minimum GPA of 3.0 (B). Every course creditable toward the certification must be taken for a letter grade. Courses with a grade below a C will not count toward the completion of the certification.) For either choice, you will work closely with an advisor to select your course of study and ensure it is rigorous and appropriate for your desired path. This advising continues throughout your time as a student in the program.NURS 6001 – Foundations for Graduate Study Case Study Paper Uo People Graduate Foundations The Uo People Graduate Foundations Courses provide students with an understanding of the unique Uo People method and determine whether online learning is right for them. Uo People Graduate Foundations consists of a minimum of 3 courses all students must successfully complete. They are designed to equip students with the necessary skills needed to thrive in their academic degree studies at the University. Once students complete their online application, they will be considered for admission to the Uo People Graduate Foundations Courses and may begin studying in the upcoming term. After students have successfully passed the Uo People Graduate Foundations Courses and sent proof of Bachelor’s degree completion, they may continue on to their Graduate degree program. Credits earned in the Foundations Courses count towards the Graduate degree credit requirements.NURS 6001 – Foundations for Graduate Study Case Study Paper Foundation Course – Entrance Exam This 12-week Foundation Course – Entrance Exam, is the perfect solution for those students that do not full fill the entry requirements for the three-year Bachelor of Arts Validated program mes. Those that do not full fill the entrance requirements for entering the 3 year BA Validated program mes. Those that are in doubt as to which Higher Education in Design program-me to choose. The aim of this intensive Foundation Course – Entrance Exam is to introduce the students to the practice of being a designer. It will help them develop their creative expression, their ideas, add meaning and context to their designs and identify where their design skill best lie.NURS 6001 – Foundations for Graduate Study Case Study Paper On successful completion of the Foundation Course you will be eligible to enroll in whichever of our three-year Bachelor of Arts Validated program mes you choose. Computer help for students: Should you have a problem with your computer, then we can strongly recommend using WEB COMUNICA in Monda. JJ (the owner) is a genius when it comes to fixing computer problems. JJ can help students with their PC or MAC problems for a special Marbella Design Academy student price. You can call JJ any time on: +34 686515 371 or you can pass by his shop in Monda in Calle Hospital 6, 29110 Monda. Also known as the Integrated Master of Education, research in this program explores: the interdisciplinary and international study of Indigenous education anti-racist and anti-oppressive education ecological and environmental education teacher education sexual orientation and gender study You can complete this degree as thesis or course based program through on-line classes or face-to-face approaches over two years. There is the opportunity to take courses online and then participate in a Summer Institute. The course based route may include a capstone component. In consultation with faculty advisors, both thesis and course-based students will design their program around a specific theme.NURS 6001 – Foundations for Graduate Study Case Study Paper Graduate Programs / Pre-Master Foundation Program Introduction This optional program allows students who do not hold a business-related Bachelor degree or equivalent to earn up to an additional 30 credits in leveling courses in order to be fully prepared for our graduate programs. Refer to the graduate admission requirements for further details. Students who do not hold a business-related Bachelor degree or equivalent may be required to complete an inbound assessment test prior to starting the graduate program, and, depending on the results, earn an additional number of credits in leveling courses from the Pre-Master program in order to be fully prepared for our graduate programs. Students who do not hold a Bachelor degree or equivalent should apply for a Bachelor degree program, or for the Undergraduate Diploma top-up program. Refer to the undergraduate admissions catalog for further details. Students who have 15 or more years of relevant work experience may apply directly for the Pre-Master program and will be required to complete an inbound assessment test prior to starting the graduate program, and, depending on the results, earn an additional number of credits in specific undergraduate courses.NURS 6001 – Foundations for Graduate Study Case Study Paper General Information The “foundations of education” are three distinct scholarly traditions of practice – philosophy of education, history of education, and sociology of education – that inform education and conceptualize frameworks for education research. Sociologists of education study social phenomena such as racism and homophobia and how they exist in and are affected by formal and informal educational contexts. Historians of education research documents and artifacts of value to our understanding of past educational practices and their influence today. Philosophers of education analyze key educational concepts such as ‘teaching’ and ‘authority’ and make significant distinctions for educational policy-making and practice. Our core course offerings in Foundations of Education are the GFDD courses described in the graduate calendar. (To do Foundations at the PhD level, consult webpage.) In our Master’s programs GFDD credit is also given for courses called “foundations designates.” These are courses designated from other graduate programs to support our suggested areas of study. View the list of Designated Foundational Courses. Students may take a limited number of graduate courses from another Mount program or from another university if, in consultation with the Coordinator, this is deemed appropriate to their program. NURS 6001 – Foundations for Graduate Study Case Study Paper Here are three suggested areas of study in Foundations, each built around core course offerings: Philosophy, History & Sociology of Education: study all the foundations or specialize in one; learn how to use a method of inquiry for individual or collective practice. Value, Bias & Social Justice: examine key themes, their sociology-historical influence and value for decision-making in policy and practice. Arts, Media & Culture: study the arts as historical, sociological, and philosophical projects in teaching, learning and research. Please note that these areas of study are only suggestions of how you might concentrate your program. Our Program Coordinator will help you design a program plan. Once admitted, you will be assigned a faculty advisor for on-going consultation. Periodically, Educational Foundations will offer a MEd cohort program (e.g. Feminist Leadership, Foundations of Leadership) in which a specific cohort of students takes a per-designed program of courses over a two-year period including the summer session. The courses to be taken are all specified in advance and the students in the cohort take the program together. Typically, information sessions are advertised and held in March and the programs commence in September.NURS 6001 – Foundations for Graduate Study Case Study Paper Graduate School Proposal Before choosing a graduate or professional school, you should know: in what area(s) you wish to concentrate; the most appropriate schools for these studies; the main faculty under whom you want to study; the environment in which you feel comfortable and perform well; and the desired public service employment upon completion of graduate study. The Truman Foundation wants to be helpful as you figure out the right path and the right graduate school. You are encouraged to stay in regular contact, via email, phone, and in-person meetings with the Executive Secretary, about your graduate school plans. In the late fall of the year before you intend to begin graduate school, you should prepare and submit a detailed proposal for graduate study and receive written approval from the Foundation. The field of study and career interests may differ from the original proposal for a Truman Scholarship. The proposal should be submitted through our website (not emailed to a specific staff member) no later than December 1 prior to the year the Scholar plans to commence graduate studies supported by the Foundation. Truman.gov is not able to receive PDFs, so you can cut and paste your proposal into the textbox. Proposals submitted after this date are not likely to be reviewed until April (after the selection of new Scholars has been completed), and proposals received and approved late may not be eligible for immediate fall semester funding. Often, proposals are returned for additional work. Proposals are not accepted after July 1. NURS 6001 – Foundations for Graduate Study Case Study Paper Contents of the Proposal The proposal should include the following information: Your name, full contact information, the degree sought, and the institution(s) to which you are applying. A narrative that outlines the specific problems or needs of society you want to address and how you expect to address them in the three to five years following graduate school; Type(s) of employment you plan to seek immediately upon completing your graduate studies and what you expect to seek three to five years later; Your proposed graduate school curriculum and why this curriculum is appropriate for addressing the problems or needs and attaining the positions you seek; Your scores from standardized tests for graduate school, for example, GRE results; Your first choice for a graduate school and why this would be the best place to achieve your public service ambitions. If this is an optimistic choice, your back up schools and why these would be appropriate choices; Percent of recent graduates of the first choice program who are now employed in the public service; and, The types of summer jobs, part time jobs and/or internships you expect to seek to complement your graduate studies.NURS 6001 – Foundations for Graduate Study Case Study Paper Important Reminders About Graduate Study Proposals Scholars who are proposing study in programs not given priority by the Foundation (such as the MBA, MD, and engineering), must include the following information in order to be considered for the full amount of their graduate stipend: Whether their program has a formal track specifically targeted toward employment in government or the non-profit sector (for example, a public-sector orientated MD program or the non-profit management track at a graduate school of business administration). If the program has a formal public service track, Scholars must explain how they will participate in that track. If the selected program does not have a formal public service track, the Scholar must identify why they have selected that program in the absence of a formal public service track. Scholars should also explain, in detail how they would develop a public service focused program using existing resources. Whether Scholars intend to supplement their degree with another degree or program funded from other sources. For instance, a Scholar who plans to pursue a career in international public health may petition for Foundation funding for a MD with the hopes to obtain a MPH from another funding source (e.g. Rhodes, Marshall or support from the graduate institution).NURS 6001 – Foundations for Graduate Study Case Study Paper This information should be included in the graduate school proposal as it provides helpful information on the Scholar’s commitment to public service. Should Scholars need to change any aspect of their graduate school proposal after it is approved, the changes must be submitted in writing to the Foundation’s website, and you should notify the Foundation’s Executive Secretary, Andrew Rich, at [email protected]. Minor changes in program or institution can generally be approved within a few working days. More significant changes, such as a total change in program or a request for drastically different funding, may take longer to approve and may require additional documentation. All Scholars must submit a graduate study proposal, receive written approval from the Executive Secretary and meet the requirements of Section 1801.51 before funding for graduate study will be available. [Requirements are set out in the Harry S. Truman Scholarship Foundation’s Rules and regulations, 45CFR Part 1801. Section 1801.51 refers to the required submission of Payment Request Form, Educational Expenses and Support Form, and Direct Deposit/EFT Form.] NURS 6001 – Foundations for Graduate Study Case Study Paper Visiting Graduate Schools We strongly encourage you to visit the graduate institution you plan to attend before making a final commitment. Some Things to Look for When Visiting a Prospective Graduate Institution: The priorities of the program in such terms as subject matter, types of students sought, and types of career placements emphasized; Average GRE (or equivalent) scores; Diversity among the student body; Public service placement success: Percent of recent graduates currently in public service jobs and percent of graduates in the last year who received one or more job offers in the public service. Percent of students receiving paying internships and summer jobs during their graduate study. Number of recent graduates who have obtained the type of position(s) you seek; Merit-based aid and loan forgiveness programs in the event the Truman award does not cover all expenses; Research funds available to students in your field of interest; Practitioners and public service leaders who have spoken on the campus or served as adjunct faculty during the past year; Teaching schedules and graduate student access to the faculty of interest to you and the availability of the courses you wish to take; and,NURS 6001 – Foundations for Graduate Study Case Study Paper Experiences of Truman Scholars attending the institution. Professional Skills Foundations is a new professional skills credential for graduate students at the University of Waterloo. Foundations is designed to offer master’s and doctoral students broad exposure to and experience in four key skill areas: career preparation, communication, leadership and personal effectiveness. How it works This program is completed in three steps: 1) Introductory activities Before you sign up for core workshops and engage in Foundations activities, you must first: Attend a Professional Skills Foundations: Introductory Workshop The last workshop for the Winter 2019 term was held on March 26. Check back soon for Spring 2019 dates! Create an Individual Development Plan (IDP) Meet with Graduate Studies and Postdoctoral Affairs (GSPA) staff to have your IDP reviewed/approved 2) Core workshops and activities Complete one approved workshop and one approved activity within each skill area Write a brief report (approximately 500 words) reflecting on the benefits or learning outcomes of participating in each activity NURS 6001 – Foundations for Graduate Study Case Study Paper Write 4-5 learning outcomes or “key takeaways” of the workshops you attended 3) Capstone Once GSPA staff have confirmed you have completed the core workshops and activities, you will be eligible to: Complete a mock interview with a staff interviewer Receive feedback from the mock interviewer Program completion confirmation Upon completion of the capstone, you will be provided with confirmation of program completion in the form of a letter from Associate Vice-President, GSPA, Jeff Casello. Program goals and outcomes By the end of the program, participants will: be able to identify and articulate their skills develop key skills in career preparation, communication, leadership and personal effectiveness assess their own skills, interests and values relative to their career goals increase their confidence and self-awareness as advanced degree candidates exploring career opportunities This program is primarily designed for graduates of law degree programs from outside Canada who are interested in pursuing graduate legal studies in Canada. We also welcome applications from professionals without a law degree who have some law-related work experience or education and who are interested in pursuing further education in law.NURS 6001 – Foundations for Graduate Study Case Study Paper The Certificate in Foundations for Graduate Legal Studies is designed to provide you with the foundation you need for successful graduate legal study. Students in this program: Study the foundations of Canadian public and private law in an interactive class setting Learn and practice common law legal, analytical and writing skills by building from simple to more complex problems and documents, with an opportunity for small group and individual feedback and tutoring. Lay the foundation for successful performance in LLM courses and in your future legal career. The Aga Khan Foundation provides a limited number of scholarships each year for postgraduate studies to outstanding students from select developing countries who have no other means of financing their studies, in order to develop effective scholars and leaders and to prepare them for employment, primarily within the AKDN. Scholarships are awarded on a 50% grant : 50% loan basis through a competitive application process once a year in June or July. NURS 6001 – Foundations for Graduate Study Case Study Paper The Foundation gives priority to requests for Master’s level courses but is willing to consider applications for PhD program mes, only in the case of outstanding students who are highly recommended for doctoral studies by their professors and who need a PhD for the fulfillment of their career objectives (academic or research oriented). Applications for short-term courses are not considered; neither are applications from students who have already started their course of study. ELIGIBILITY Geographic Scope The Foundation accepts applications from nationals of the following countries: Bangladesh, India, Pakistan, Afghanistan, Tajikistan, Kyrgyzstan, Syria, Egypt, Kenya, Tanzania, Uganda, Madagascar and Mozambique. In France, Portugal, UK, USA and Canada, applications are accepted from those who are originally from one of the above developing countries, are interested in development-related studies and who have no other means of financing their education.NURS 6001 – Foundations for Graduate Study Case Study Paper Residency Requirement The Foundation only accepts applications of eligible nationals listed above who are residing in one of the countries where there are local Aga Khan Foundation (AKF), Aga Khan Education Services (AKES), or Aga Khan Education Board (AKEB) offices which process applications and interview candidates. Age Limit Preference is given to students under 30 years of age. SELECTION CRITERIA The main criteria for selecting award

NURS 8000 – Foundations and Essentials of Doctoral Assignment Papers. NURS 8000 – Foundations and Essentials of Doctoral Assignment Papers. Permalink: https://nursingpaperessays.com/ nurs-8000-founda…ssignment-papers / Only federal grant funded program option in Ohio University ranked as a military friendly school for six consecutive years by GI Jobs and Military Advanced Education—home to over 1,000 veteran and military-affiliated students, ROTC cadets, guardsmen, and reservists.NURS 8000 – Foundations and Essentials of Doctoral Assignment Papers. Waived application fee for veterans – visit the veterans admission page for instructions on how to apply State-of-the-art Veteran and Military Center with full-time staff and student veterans to facilitate student support Nationally and internationally recognized faculty—including retired Air Force project director Emphasis on disaster recovery and response, with option to pursue disaster certification in conjunction with local National Center for Medical Readiness.NURS 8000 – Foundations and Essentials of Doctoral Assignment Papers. Nationally accredited nursing program with NCLEX pass rates exceeding national averages For more information about healthcare specialty training opportunities in the military, see the Military Education and Training Campus website LEARN MORE ABOUT ADMISSION REQUIREMENTS Veteran/Medic Option Highlights Apply Now. Eligible applicants with military medical experience will receive first preference. NURS 8000 – Foundations and Essentials of Doctoral Assignment Papers. Opportunities to obtain college credit for military training and experience Program of study option allows completion of nursing sequence in shorter time than traditional pre-licensure BSN program Full-time nursing veterans advisor on-site that understands the unique needs of veterans Full-time student success coordinator and tutors available for academic assistance Faculty trained to understand the unique veteran student population.NURS 8000 – Foundations and Essentials of Doctoral Assignment Papers. A Bachelor of Science in Nursing (BSN) degree from Mount Carmel College of Nursing is the firm foundation to an exciting career in the profession of nursing. Mount Carmel College of Nursing boasts one of the largest baccalaureate programs among Ohio private college nursing programs. Our small classes, personal attention, diverse student body, and affiliation with Mount Carmel Health System, one of the largest healthcare providers in central Ohio, all contribute to a rich and diverse educational experience that prepares students to competently and confidently assume the role of a professional nurse.NURS 8000 – Foundations and Essentials of Doctoral Assignment Papers. The Mount Carmel College of Nursing is fully accredited as an institution of higher learning by both the North Central Association of Colleges and Schools and by the Commission on Collegiate Nursing Education. The Commission on Collegiate Nursing Education is recognized by the United States Department of Education as the national accrediting body for all types of nursing education programs.NURS 8000 – Foundations and Essentials of Doctoral Assignment Papers. Baccalaureate Nursing Program Outcomes The undergraduate program prepares a graduate who: Applies the knowledge of the relationship of the physical and social sciences and humanities as a basis for professional nursing. Exhibits the values of dignity of persons, service to others, social justice, altruism, autonomy, and integrity in the care of clients. Practices culturally competent caring behaviors. Uses evidence-based practice to promote the health of clients; Incorporates professional behaviors within one’s role as a member of the nursing profession and society; Implements the nursing process to maximize the health outcomes of clients through the use of evidence based practice; Implements the communication process within the professional role;NURS 8000 – Foundations and Essentials of Doctoral Assignment Papers. Uses leadership skills to design, provide, coordinate, and manage health care in the achievement of safety and quality in client care; Collaborates with interdisciplinary and multidisciplinary teams to provide quality care for clients through the efficient management of resources; Implements critical thinking; and Demonstrates clinical competence in a variety of settings with diverse populations.NURS 8000 – Foundations and Essentials of Doctoral Assignment Papers. Four options are available that will lead to a BSN degree: Traditional Four-Year Program Designed for students without previous nursing experience. Advanced Placement Program Enables students with the right coursework to complete a Bachelor of Science in Nursing (BSN) degree in five semesters. Second Degree Accelerated Program An accelerated 13-month program for students who already have a baccalaureate or advanced degree.NURS 8000 – Foundations and Essentials of Doctoral Assignment Papers. Online RN-BSN Completion Program A dedicated program for registered nurses who want to further their education. View our Undergraduate Handbook for more information. We’ll help you get the most out of the benefits you’ve earned—from your GI Bill and grant programs to scholarships and tuition waivers—so you can earn your degree conveniently and affordably. Full-Service Veterans Office Staffed by fellow veterans, our Veterans Services Office provides year-round support and guidance, including academic advisement, tutoring, counseling, and organizing cultural and social events.NURS 8000 – Foundations and Essentials of Doctoral Assignment Papers. Leave of Absence Policy We understand the demands of military life. We’ll work with you to plan your degree program and course schedule around your exercises and deployments. We’ll even adjust your course schedule if you receive orders unexpectedly.NURS 8000 – Foundations and Essentials of Doctoral Assignment Papers. Counseling & Guidance Get professional, confidential guidance and counseling from qualified professionals to help you (and your dependents) through issues related to your service, education, or life in general. Your emotional well-being is a top priority. Doctoral programs in nursing fall into two principal types: research-focused and practicefocused. Most research-focused programs grant the Doctor of Philosophy degree (PhD), while a small percentage offers the Doctor of Nursing Science degree (DNS, DSN, or DNSc). Designed to prepare nurse scientists and scholars, these programs focus heavily on scientific content and research methodology; and all require an original research project and the completion and defense of a dissertation or linked research papers.NURS 8000 – Foundations and Essentials of Doctoral Assignment Papers. Practice-focused doctoral programs are designed to prepare experts in specialized advanced nursing practice. They focus heavily on practice that is innovative and evidence-based, reflecting the application of credible research findings. The two types of doctoral programs differ in their goals and the competencies of their graduates. They represent complementary, alternative approaches to the highest level of educational preparation in nursing. The concept of a practice doctorate in nursing is not new. However, this course of study has evolved considerably over the 20 years since the first practice-focused nursing doctorate, the Doctor of Nursing (ND), was initiated as an entry-level degree. Because research- and practice-focused programs are distinctly different, the current position of the American Association of Colleges of Nursing (AACN, 2004) [detailed in the Position Statement on the Practice Doctorate in Nursing] is that: “The two types of doctorates, research-focused and practice-focused, may coexist within the same education unit” and that the practice-focused degree should be the Doctor of Nursing Practice (DNP). Recognizing the need for consistency in the degrees required for advanced nursing practice, all existing ND programs have transitioned to the DNP. Comparison Between Research-Focused and Practice-Focused Doctoral Education Research- and practice-focused doctoral programs in nursing share rigorous and demanding expectations: a scholarly approach to the discipline, and a commitment to the advancement of the profession. Both are terminal degrees in the discipline, one in practice and one in research. However, there are distinct differences between the two degree programs. For example, practice-focused programs understandably place greater emphasis on practice, and less emphasis on theory, meta-theory, research methodology, and statistics than is apparent in research-focused programs. Whereas all researchfocused programs require an extensive research study that is reported in a dissertation or through the development of linked research papers, practice-focused doctoral programs generally include integrative practice experiences and an intense practice immersion experience.NURS 8000 – Foundations and Essentials of Doctoral Assignment Papers. Rather than a knowledge-generating research effort, the student in a practicefocused program generally carries out a practice application-oriented “final DNP project,” which is an integral part of the integrative practice experience. 4 AACN Task Force on the Practice Doctorate in Nursing The AACN Task Force to Revise Quality Indicators for Doctoral Education found that the Indicators of Quality in Research-Focused Doctoral Programs in Nursing are applicable to doctoral programs leading to a PhD or a DNS degree (AACN, 2001b, p. 1). Therefore, practice-focused doctoral programs will need to be examined separately from research-focused programs. This finding coupled with the growing interest in practice doctorates prompted the establishment of the AACN Task Force on the Practice Doctorate in Nursing in 2002. This task force was convened to examine trends in practice-focused doctoral education and make recommendations about the need for and nature of such programs in nursing. Task force members included representatives from universities that already offered or were planning to offer the practice doctorate, from universities that offered only the research doctorate in nursing, from a specialty professional organization, and from nursing service administration. The task force was charged to describe patterns in existing practice-focused doctoral programs; clarify the purpose of the practice doctorate, particularly as differentiated from the research doctorate; identify preferred goals, titles, and tracks; and identify and make recommendations about key issues. Over a two-year period, this task force adopted an inclusive approach that included: 1) securing information from multiple sources about existing programs, trends and potential benefits of a practice doctorate; 2) providing multiple opportunities for open discussion of related issues at AACN and other professional meetings; and 3) subjecting draft recommendations to discussion and input from multiple stakeholder groups. The final position statement was approved by the AACN Board of Directors in March 2004 and subsequently adopted by the membership. The 2004 DNP position statement calls for a transformational change in the education required for professional nurses who will practice at the most advanced level of nursing. The recommendation that nurses practicing at the highest level should receive doctoral level preparation emerged from multiple factors including the expansion of scientific knowledge required for safe nursing practice and growing concerns regarding the quality of patient care delivery and outcomes. Practice demands associated with an increasingly complex health care system created a mandate for reassessing the education for clinical practice for all health professionals, including nurses. A significant component of the work by the task force that developed the 2004 position statement was the development of a definition that described the scope of advanced nursing practice. Advanced nursing practice is broadly defined by AACN (2004) as: any form of nursing intervention that influences health care outcomes for individuals or populations, including the direct care of individual patients, management of care for individuals and populations, administration of nursing and health care organizations, and the development and implementation of health policy. (p. 2) 5 Furthermore, the DNP position statement (AACN, 2004, p. 4) identifies the benefits of practice focused doctoral programs as: • development of needed advanced competencies for increasingly complex practice, faculty, and leadership roles; • enhanced knowledge to improve nursing practice and patient outcomes; • enhanced leadership skills to strengthen practice and health care delivery; • better match of program requirements and credits and time with the credential earned; • provision of an advanced educational credential for those who require advanced practice knowledge but do not need or want a strong research focus (e.g., practice faculty); • enhanced ability to attract individuals to nursing from non-nursing backgrounds; and • increased supply of faculty for practice instruction. As a result of the membership vote to adopt the recommendation that the nursing profession establish the DNP as its highest practice degree, the AACN Board of Directors, in January 2005, created the Task Force on the Essentials of Nursing Education for the Doctorate of Nursing Practice and charged this task force with development of the curricular expectations that will guide and shape DNP education. The DNP Essentials Task Force is comprised of individuals representing multiple constituencies in advanced nursing practice (see Appendix B). The task force conducted regional hearings from September 2005 to January 2006 to provide opportunities for feedback from a diverse group of stakeholders. These hearings were designed using an iterative process to develop this document. In total, 620 participants representing 231 educational institutions and a wide variety of professional organizations participated in the regional meetings. Additionally, a national stakeholders’ conference was held in October 2005 in which 65 leaders from 45 professional organizations participated. Context of Graduate Education in Nursing Graduate education in nursing occurs within the context of societal demands and needs as well as the interprofessional work environment. The Institute of Medicine (IOM, 2003) and the National Research Council of the National Academies (2005, p. 74) have called for nursing education that prepares individuals for practice with interdisciplinary, information systems, quality improvement, and patient safety expertise.NURS 8000 – Foundations and Essentials of Doctoral Assignment Papers. In hallmark reports, the IOM (1999, 2001, 2003) has focused attention on the state of health care delivery, patient safety issues, health professions education, and leadership for nursing practice. These reports highlight the human errors and financial burden caused by fragmentation and system failures in health care. In addition, the IOM calls for dramatic restructuring of all health professionals’ education. Among the recommendations resulting from these reports are that health care organizations and 6 groups promote health care that is safe, effective, client-centered, timely, efficient, and equitable; that health professionals should be educated to deliver patient-centered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement, and informatics; and, that the best prepared senior level nurses should be in key leadership positions and participating in executive decisions. Since AACN published The Essentials of Master’s Education for Advanced Practice Nursing in 1996 and the first set of indicators for quality doctoral nursing education in 1986, several trends in health professional education and health care delivery have emerged. Over the past two decades, graduate programs in nursing have expanded from 220 institutions offering 39 doctoral programs and 180 master’s programs in 1986 to 518 institutions offering 101 doctoral programs and 417 master’s programs in 2006.NURS 8000 – Foundations and Essentials of Doctoral Assignment Papers. Increasing numbers of these programs offer preparation for certification in advanced practice specialty roles such as nurse practitioners, nurse midwives, nurse anesthetists, and clinical nurse specialists. Specialization is also a trend in other health professional education. During this same time period, the explosion in information, technology, and new scientific evidence to guide practice has extended the length of educational programs in nursing and the other health professions. In response to these trends, several other health professions such as pharmacy, physical therapy, occupational therapy, and audiology have moved to the professional or practice doctorate for entry into these respective professions. Further, support for doctoral education for nursing practice was found in a review of current master’s level nursing programs (AACN, 2004, p. 4). This review indicated that many programs already have expanded significantly in response to the above concerns, creating curricula that exceed the usual credit load and duration for a typical master’s degree. The expansion of credit requirements in these programs beyond the norm for a master’s degree raises additional concerns that professional nurse graduates are not receiving the appropriate degree for a very complex and demanding academic experience. Many of these programs, in reality, require a program of study closer to the curricular expectations for other professional doctoral programs rather than for master’s level study. Relationships of Master’s, Practice Doctorate, and Research Doctorate Programs The master’s degree (MSN) historically has been the degree for specialized advanced nursing practice. With development of DNP programs, this new degree will become the preferred preparation for specialty nursing practice. As educational institutions transition from the master’s to DNP degree for advanced practice specialty preparation, a variety of program articulations and pathways are planned. One constant is true for all of these models. The DNP is a graduate degree and is built upon the generalist foundation acquired through a baccalaureate or advanced generalist master’s in nursing. The Essentials of Baccalaureate Education (AACN, 1998) summarizes the core knowledge and competencies of the baccalaureate prepared nurse. Building on this foundation, the DNP core competencies establish a base for advanced nursing practice in an area of specialization. Ultimately, the terminal degree options in nursing will fall into two 7 primary education pathways: professional entry degree (baccalaureate or master’s) to DNP degree or professional entry degree (baccalaureate or master’s) to PhD degree. As in other disciplines with practice doctorates, some individuals may choose to combine a DNP with a PhD. Regardless of the entry point, DNP curricula are designed so that all students attain DNP end-of-program competencies. Because different entry points exist, the curricula must be individualized for candidates based on their prior education and experience. For example, early in the transition period, many students entering DNP programs will have a master’s degree that has been built on AACN’s Master’s Essentials. Graduates of such programs would already have attained many of the competencies defined in the DNP Essentials. Therefore, their program will be designed to provide those DNP competencies not previously attained. If a candidate is entering the program with a nonnursing baccalaureate degree, his/her program of study likely will be longer than a candidate entering the program with a baccalaureate or master’s in nursing. While specialty advanced nursing education will be provided at the doctoral level in DNP programs, new options for advanced generalist master’s education are being developed. DNP Graduates and Academic Roles Nursing as a practice profession requires both practice experts and nurse scientists to expand the scientific basis for patient care. Doctoral education in nursing is designed to prepare nurses for the highest level of leadership in practice and scientific inquiry. The DNP is a degree designed specifically to prepare individuals for specialized nursing practice, and The Essentials of Doctoral Education for Advanced Nursing Practice articulates the competencies for all nurses practicing at this level. In some instances, individuals who acquire the DNP will seek to fill roles as educators and will use their considerable practice expertise to educate the next generation of nurses.NURS 8000 – Foundations and Essentials of Doctoral Assignment Papers. As in other disciplines (e.g., engineering, business, law), the major focus of the educational program must be on the area of practice specialization within the discipline, not the process of teaching. However, individuals who desire a role as an educator, whether that role is operationalized in a practice environment or the academy, should have additional preparation in the science of pedagogy to augment their ability to transmit the science of the profession they practice and teach. This additional preparation may occur in formal course work during the DNP program. Some teaching strategies and learning principles will be incorporated into the DNP curriculum as it relates to patient education. However, the basic DNP curriculum does not prepare the graduate for a faculty teaching role any more than the PhD curriculum does. Graduates of either program planning a faculty career will need preparation in teaching methodologies, curriculum design and development, and program evaluation. This preparation is in addition to that required for their area of specialized nursing practice or research in the case of the PhD graduate. 8 The Essentials of Doctoral Education for Advanced Nursing Practice The following DNP Essentials outline the curricular elements and competencies that must be present in programs conferring the Doctor of Nursing Practice degree. The DNP is a degree title, like the PhD or MSN, and does not designate in what specialty a graduate is prepared. DNP graduates will be prepared for a variety of nursing practice roles. The DNP Essentials delineated here address the foundational competencies that are core to all advanced nursing practice roles. However, the depth and focus of the core competencies will vary based on the particular role for which the student is preparing.NURS 8000 – Foundations and Essentials of Doctoral Assignment Papers. For example, students preparing for organizational leadership or administrative roles will have increased depth in organizational and systems’ leadership; those preparing for policy roles will have increased depth in health care policy; and those preparing for APN roles (nurse practitioners, clinical nurse specialists, nurse anesthetists, and nurse midwives) will have more specialized content in an area of advanced practice nursing. Additionally, it is important to understand that the delineation of these competencies should not be interpreted to mean that a separate course for each of the DNP Essentials should be offered. Curricula will differ in emphases based on the particular specialties for which students are being prepared. The DNP curriculum is conceptualized as having two components: 1. DNP Essentials 1 through 8 are the foundational outcome competencies deemed essential for all graduates of a DNP program regardless of specialty or functional focus. 2. Specialty competencies/content prepare the DNP graduate for those practice and didactic learning experiences for a particular specialty. Competencies, content, and practica experiences needed for specific roles in specialty areas are delineated by national specialty nursing organizations. The DNP Essentials document outlines and defines the eight foundational Essentials and provides some introductory comments on specialty competencies/content. The specialized content, as defined by specialty organizations, complements the areas of core content defined by the DNP Essentials and constitutes the major component of DNP programs. DNP curricula should include these two components as appropriate to the specific advanced nursing practice specialist being prepared. Additionally, the faculty of each DNP program has the academic freedom to create innovative and integrated curricula to meet the competencies outlined in the Essentials document.NURS 8000 – Foundations and Essentials of Doctoral Assignment Papers. Essential I: Scientific Underpinnings for Practice The practice doctorate in nursing provides the terminal academic preparation for nursing practice. The scientific underpinnings of this education reflect the complexity of practice 9 at the doctoral level and the rich heritage that is the conceptual foundation of nursing. The discipline of nursing is focused on: • The principles and laws that govern the life-process, well-being, and optimal function of human beings, sick or well; • The patterning of human behavior in interaction with the environment in normal life events and critical life situations; • The nursing actions or processes by which positive changes in health status are affected; and • The wholeness or health of human beings recognizing that they are in continuous interaction with their environments (Donaldson & Crowley, 1978; Fawcett, 2005; Gortner, 1980). DNP graduates possess a wide array of knowledge gleaned from the sciences and have the ability to translate that knowledge quickly and effectively to benefit patients in the daily demands of practice environments (Porter-O’Grady, 2003). Preparation to address current and future practice issues requires a strong scientific foundation for practice. NURS 8000 – Foundations and Essentials of Doctoral Assignment Papers. The scientific foundation of nursing practice has expanded and includes a focus on both the natural and social sciences. These sciences that provide a foundation for nursing practice include human biology, genomics, the science of therapeutics, the psychosocial sciences, as well as the science of complex organizational structures. In addition, philosophical, ethical, and historical issues inherent in the development of science create a context for the application of the natural and social sciences. Nursing science also has created a significant body of knowledge to guide nursing practice and has expanded the scientific underpinnings of the discipline. Nursing science frames the development of middle range theories and concepts to guide nursing practice. Advances in the foundational and nursing sciences will occur continuously and nursing curricula must remain sensitive to emerging and new scientific findings to prepare the DNP for evolving practice realities. The DNP program prepares the graduate to: 1. Integrate nursing science with knowledge from ethics, the biophysical, psychosocial, analytical, and organizational sciences as the basis for the highest level of nursing practice.NURS 8000 – Foundations and Essentials of Doctoral Assignment Papers. 2. Use science-based theories and concepts to: • determine the nature and significance of health and health care delivery phenomena; • describe the actions and advanced strategies to enhance, alleviate, and ameliorate health and health care delivery phenomena as appropriate; and • evaluate outcomes.NURS 8000 – Foundations and Essentials of Doctoral Assignment Papers. 3. Develop and evaluate new practice approaches based on nursing theories and theories from other disciplines. 10 Essential II: Organizational and Systems Leadership for Quality Improvement and Systems Thinking Organizational and systems leadership are critical for DNP graduates to improve patient and healthcare outcomes. Doctoral level knowledge and skills in these areas are consistent with nursing and health care goals to eliminate health disparities and to promote patient safety and excellence in practice. DNP graduates’ practice includes not only direct care but also a focus on the needs of a panel of patients, a target population, a set of populations, or a broad community. These graduates are distinguished by their abilities to conceptualize new care delivery models that are based in contemporary nursing science and that are feasible within current organizational, political, cultural, and economic perspectives. Graduates must be skilled in working within organizational and policy arenas and in the actual provision of patient care by themselves and/or others. For example, DNP graduates must understand principles of practice management, including conceptual and practical strategies for balancing productivity with quality of care. They must be able to assess the impact of practice policies and procedures on meeting the health needs of the patient populations with whom they practice. DNP graduates must be proficient in quality improvement strategies and in creating and sustaining changes at the organizational and policy levels. Improvements in practice are neither sustainable nor measurable without corresponding changes in organizational arrangements, organizational and professional culture, and the financial structures to support practice. DNP graduates have the ability to evaluate the cost effectiveness of care and use principles of economics and finance to redesign effective and realistic care delivery strategies. In addition, DNP graduates have the ability to organize care to address emerging practice problems and the ethical dilemmas that emerge as new diagnostic and therapeutic technologies evolve. Accordingly, DNP graduates are able to assess risk and collaborate with others to manage risks ethically, based on professional standards. Thus, advanced nursing practice includes an organizational and systems leadership component that emphasizes practice, ongoing improvement of health outcomes, and ensuring patient safety. In each case, nurses should be prepared with sophisticated expertise in assessing organizations, identifying systems’ issues, and facilitating organization-wide changes in practice delivery. In addition, advanced nursing practice requires political skills, systems thinking, and the business and financial acumen needed for the analysis of practice quality and costs. The DNP program prepares the graduate to: 1. Develop and evaluate care delivery approaches that meet current and future needs of patient populations based on scientific findings in nursing and other clinical sciences, as well as organizational, political, and economic sciences. 2. Ensure accountability for quality of health care and patient safety for populations with whom they work. 11 a. Use advanced communication skills/processes to lead quality improvement and patient safety initiatives in health care systems. b. Employ principles of business, finance, economics, and health policy to develop and implement effective plans for practice-level and/or system-wide practice initiatives that will improve the quality of care delivery. c. Develop and/or monitor budgets for practice initiatives. d. Analyze the cost-effectiveness of practice initiatives accounting for risk and improvement of health care outcomes. e. Demonstrate sensitivity to diverse organizational cultures and populations, including patients and providers. 3. Develop and/or evaluate effective strategies for managing the ethical dilemmas inherent in patient care, the health care organization, and research. Essential III: Clinical Scholarship and Analytical Methods for Evidence-Based Practice Scholarship and research are the hallmarks of doctoral education. Although basic research has been viewed as the first and most essential form of scholarly activity, an enlarged perspective of scholarship has emerged through alternative paradigms that involve more than discovery of new knowledge (Boyer, 1990). These paradigms recognize that (1) the scholarship of discovery and integration “reflects the investigative and synthesizing traditions of academic life” (Boyer, p. 21); (2) scholars give meaning to isolated facts and make connections across disciplines through the scholarship of integration; and (3) the scholar applies knowledge to solve a problem via the scholarship of application (referred to as the scholarship of practice in nursing). This application involves the translation of research into pract

Role Of The Nurse Informaticist In The Systems Development And Implementation Paper Role Of The Nurse Informaticist In The Systems Development And Implementation Paper Nursing informatics is a combination of cognitive science, computer science, information science, and nursing science. It includes the development, analysis, and evaluation of information systems augmented by technologies that support, enhance and manage patient care. In practice, students have an opportunity to observe, apply, analyze, and practice processes and skills relevant to nursing informatics. The Nursing Informatics concentration stresses the development of leadership in nursing.Role Of The Nurse Informaticist In The Systems Development And Implementation Paper Permalink: https://nursingpaperessays.com/ role-of-the-nurs…entation-paper / ? Career opportunities for graduates with this specialty are numerous. Informatics nurses are involved in practice, education, research, administration, and consultation and can work in public, private, or corporate settings. There are three different options in Nursing Informatics; a major: a minor, and Post-Professional certificate. All may be completed on a full or part-time basis. Informatics Online Building on the strength and reputation of its graduate programs, the School of Nursing is offering a MSN with the Nursing Informatics area of concentration online. The interactive online classroom, led by University of Pittsburgh faculty, provides opportunities for active learning, discussion, problem solving, debating, critical thinking, research, networking, and community building. One much-discussed topic in modern health care is informatics, the application of computers and information technology to health care. A fundamental competency in informatics is especially important for nurses. They are the largest health care profession, with over 2.7 million registered nurses and a further 750,000 licensed practical and vocational nurses practicing in the United States as of 2011. For contemporary nurses to achieve their full career potential, there are several reasons they need to embrace informatics.Role Of The Nurse Informaticist In The Systems Development And Implementation Paper Electronic Health Records One of the most fundamental reasons for nurses to focus on informatics is the advent of the national system of electronic health records. Then-President Bush announced the initiative in 2004, with a target date of 2014 for implementation. This electronic system will make it necessary for all nurses to have a basic familiarity with computer systems to carry out their day-to-day duties of administration and patient care. At a minimum, nurses need to know how to document a patient’s care and observe appropriate privacy precautions on the hospital’s computer system. Technology in Practice Increasingly powerful microprocessors have made it possible for a new generation of smartphones, tablet computers and specialized medical devices to play a role in daily patient care. As front-line care providers, technologically savvy nurses in all clinical specialties will play a crucial role in field-testing new devices and their corresponding software applications. Some might even find work as consultants to software developers working on applications for the health care market. Advancement Ambitious nurses have a number of career paths open to them in management, consulting, research and academia. Good computer skills, ranging from the use of industry-specific software to commercial programs including Word, Excel, Access and Visio, are important to all of these career paths. Nascent informatics certifications are available for those seeking advancement in their careers. It’s now a recognized nursing specialty, offered in formal training programs. The Healthcare Management and Information Systems Society, a non-profit informatics training organization, also offers a Certified Professional in Healthcare Information and Management Systems credential to qualified health care professionals. Education One of the gravest responsibilities in any knowledge-based profession is passing that knowledge to a new generation of practitioners. The next generation of nurse educators will need a solid grounding in nursing informatics to teach new nurses the computer skills they’ll need in the workplace. This will also be crucial for more experienced educators, especially those who came late to computer use and must expend extra time and effort on the necessary professional upgrades and continuing education. Being successful in the field of Nursing Informatics takes a combination of different skills. Clinicians already have many of these skills, but there are several that she or he will still need to develop as well. Here is a run-down of some of the most important ones:Role Of The Nurse Informaticist In The Systems Development And Implementation Paper CLINICAL EXPERIENCE AND COMPETENCE Clinical experience is the foundation of a clinician’s effectiveness in the Informatics field stands. A nurse who transitions to the Informatics field must first of all have an adequate amount of clinical experience, preferably in a variety of settings, in order to be able to analyze and decide with confidence how certain technical functionality can be applied in the clinical setting. The Informatics nurse is often designated, and expected, to be the bridge between the clinical and technical world, and speak the language of each fluently. It would be very difficult for an Informatics Nurse to “talk the talk” of clinicians, if he or she has not had sufficient clinical experience. Without this base of experience, a nurse can only theorize and imagine the impact of technology at the bedside. This is not to say that some nurses with very little experience will not be successful in the Informatics field, because there are examples of such professionals. However, those nurses are rare and they have other skills and knowledge that balance their lack of experience. However, for the vast majority, a solid background in the clinical setting, and competence in the basics of related workflows, helps ensure future success in the Informatics arena. CRITICAL THINKING, ANALYSIS, AND PROBLEM-SOLVING The unique value that a clinician brings to any Nursing Informatics role is his or her experience in patient care. Because of that, a clinician is expected to be able to think through problems or issues and analyze them based on this wealth of knowledge and experience. They are expected not only to understand and accept technical functionality, but to analyze and even sometimes question the validity of the functionality, in light of their knowledge of clinical workflows, best practices, and regulatory standards.Role Of The Nurse Informaticist In The Systems Development And Implementation Paper TECHNICAL/COMPUTER SKILLS While an Informatics Nurse may not be the technical expert of a project team, by the nature of the work she or he is expected to have some kind of technical aptitude. Informatics nurses should be able to perform their own analysis and offer suggestions to resolve issues, and this is more effective when they have a certain store of training, experience, and understanding of how certain technical functionality works. As the liaison between the clinical end-users and the more technical members of the team, informatics nurses are expected to be able to wrap their head around technical functionality and limitations. They are also expected to know how to use business productivity tools such as document-creation software, spreadsheets, email systems, and project tracking tools, among others. BUSINESS CORRESPONDENCE SKILLS One of the things that an Informatics Nurse will need to do on a daily basis is write and answer emails. Clinicians must remember that business correspondence is different from personal correspondence, and take the necessary steps to learn the basics of business communication. The main thing to remember with business correspondence is to always be professional. This may sound very easy and common-sense, but it is a business etiquette rule that many professionals break at one time or another. Being professional means always being careful with an email’s tone, and to aim to be respectful and cordial even in stressful or emotionally charged situations. One rule of thumb is to never put in a business email anything that can be damaging when forwarded, either intentionally or unintentionally. This also includes avoiding sarcasm at all cost, because on email it is often very difficult to identify this communication mode, and it can often be misunderstood and taken literally. Avoid writing all capitals, which in email is generally considered shouting – even when the intention was simply to emphasize a point, that may not be what comes across to the recipient(s).Role Of The Nurse Informaticist In The Systems Development And Implementation Paper There are other helpful rules which you can find here and here. INTERPERSONAL SKILLS From nursing school, most nurses are taught that interpersonal skills are some of the most important skills clinicians can have, right up there with clinical competence. Nurses are trained and expected to care, not just perform procedures, create plans, or implement orders. The interpersonal skills that a clinician develops when dealing with patients and their families, as well the the other members of the healthcare team, are very useful and highly portable into the Nursing Informatics field. This includes the ability to listen actively and with empathy, collaborate proactively, and negotiate assertively. PROJECT MANAGEMENT SKILLS As mentioned in another post, project management skills are important in any Nursing Informatics role. It doesn’t matter whether your title has the phrase “project management” in it or not – at some point most Informatics Nurses will be called on to be part of projects, and having the necessary project management skills will be advantageous whether they are a team member or a team lead. Fortunately, the Project Management process is very similar to the Nursing Process. The main difference is most probably in the tools being used – while nurses use the care planning tools and methods to initiate, execute, and evaluate a plan of care, Informatics Nursing professionals may use a variety of business productivity tools to perform the same process. Nurses are at forefront to change the face of healthcare as they take a step forward in successful implementation of Health IT. It has been observed that with digitalization, adoption of IT in healthcare has followed the same pattern as in other fields. It was during 1950s that the new technology was utilized to automate standardized and repetitive tasks like accounting and payroll. Healthcare also used IT to process statistical data. After twenty years,­ similar IT revolution took over the world. It did affect the health care with the introduction of electronic health care. Though biotechnology has continued to advance in terms of disease management, the IT application in terms of health care management is still in its infancy.Role Of The Nurse Informaticist In The Systems Development And Implementation Paper Some healthcare institutions have moved beyond and have gone to stage of full digitalization, incorporating IT in services sector, channels, and processes, as well as advanced analytics that enable entirely new operating models. Nursing informatics is emerging as promising field with a challenge being thrown at the professionals to understand and participate in the field of Health IT with efficient training and leadership. The facilities provided by digitalization are enormous. It has opened many avenues for the patients to utilize healthcare facilities proficiently. A patient can now access an application to look for a disease related information, seek opinion from any specialist globally, manage appointments and access electronic health record for previous disease history. However, it has been observed that the patients can have reservations about sharing health related information with professionals online and may not be comfortable about their health-related information being available on the internet. To strengthen this, collaborative effort towards e-health, it is obligatory to improve the standards in health care information and digitalization. This adoption of electronic interaction between patients and professionals, demands an active involvement of healthcare professionals in the development process as well as implementation of quality clinical applications. Nurses are eager to improve clinical processes through adoption of Health IT. Measurement of essential quality improvement standards like patient safety, strategic development, monitoring and efficient reporting involve more prompt systems like well-defined clinical decision support systems and integrated patient care records where active engagement of clinical professionals is indispensable. Digitalization has immensely benefited all, by providing the opportunity to have access to patient care information through user-centered electronic medical records. On a macro level, information management systems have opened doors of research, monitoring and pivotal public health. Nursing is the central component to efficient patient care. Electronic health record (EHR) must be maintained by the nurses, being the connecting link between professionals. As per HIMSS the role of nurse has grown beyond helping the IT folks design electronic medical record (EMR) screens and choose equipment. It is now an integral part of the healthcare delivery and a differentiating factor in the selection, implementation, and evaluation of health IT in order to support safe, high quality, patient-centric care. Nursing and Information System Management: The information systems used by healthcare organizations like admission, discharge, order entry, clinical documentation, communication system and critical pathways require professional guidance as the data collected is utilized in variant clinical systems. The current focus areas in nursing informatics are standardizing terminologies, clinical decision support, patient safety, data exchange and interoperability, and clinical quality measures. It has been emphasized that standard nursing terminologies can be used in patient care systems as it would make documentation process more understandable. The basic principles for successful implementation of any software are the same. One word to define a good software would be ‘user friendly’. User friendly software in healthcare would be the one which would have the following features:Role Of The Nurse Informaticist In The Systems Development And Implementation Paper · Easy to understand · Requires minimal effort at the user end · Is clinically relevant · Provides easily retrievable information Nurse informaticists are required to be part of the development process of software as they understand clinical flow and patient care processes better. This becomes more relevant as EHR are now looked upon as not only a source of convenience, but a mode to enhance patient care processes and quality improvement. Nurses working in clinical setting are in a better position to judge whether a software is useful and facilitates patient care, or just adds to the burden of formality for the healthcare professionals. Involvement of nurses could also address common problems that may arise due to ill-designed software, as well as ensure better allocation of healthcare resources. The need of nurses to be a part of the software development process has long being recognized. It is important that nurses be involved in selection, development and implementation of any system. (Glancey TS, Brooks GM, Vaughan VS, 1990). Software Development Phases: Software development is a step wise process, which is targeted to plan and develop a software. System development life cycle is a term used to define the various phases in development of a software. Following are the phases of software development Role Of The Nurse Informaticist In The Systems Development And Implementation Paper Fig 1: System development cycle 1. Understanding the Problem: Before a product is developed for healthcare professionals, the software developers need to understand the need of the users. The users in healthcare involve frontline nurses in majority as nurses coordinate and conduct a lot of patient care related activities. Clinical nurse leaders and managers can contribute significantly in explaining and putting the requirement in a coherent manner so that the product that comes out is not redundant. Involvement of nurses in initial phases of software development would ensure a better product which is different and more relevant clinically (Plochg and Hamer, 2012). Nurses need to participate in initial stages to identify improvement areas for quality patient care, where IT can contribute. For example, development of standard operating procedures to prevent medication errors, antibiotic resistance etc. engagement of nurses here, will be helpful in tracking such important areas. Nurses can take up roles of project and operation manager to supervise the project plan and provide strategic guidance towards product development. 2. Coding Planned Solution: The next step in software development cycle is to code the program i.e. translating it into the program language. A software developer can understand the requirements but there are many terminologies that may require the guidance of a healthcare professionals for example use of medical terminology or patient care data relevant to acuity system which can create a false clinical picture if not put aptly. A standardized nursing language used in patient care systems must be defined in order to be able to communicate patient care information accurately among nurses and other healthcare providers. Nurses must work closely with the IT team for defining standardized nursing terminology to outline and define the nursing scope in patient care and hence reflect on the healthcare software. As we know that the terminology used by medical professionals and nurses may vary in terms of patient care and expected outcome, hence it is necessary to have clear language instructions in healthcare software. Nurse informaticist can learn coding and take up the role of a coder. It would enhance collaboration and understanding between the software team and healthcare professionals. It would also ensure effective integration of technology into practice.Role Of The Nurse Informaticist In The Systems Development And Implementation Paper 3. Testing actual program: Clinical nurses are the best judge to assess the positive aspects and to identify the challenges that may hinder the functioning of software created for patient care. It is important for the decision makers to involve nurses before a system or software is adopted as nurses remain important link to many clinical processes in healthcare (O’Cathain A, Sampson FC, Munro JF, Thomas KJ, Nicholl JP, 2004). Testing is an important phase as a system’s design can greatly influence its acceptability by the users. An example is the use of learning management system for online learning (Table 1). The sections defined are essential fields under any e-learning platform that need to be organized well. When such platforms are used for healthcare professionals, that role of nurse becomes more important as they would be able to contribute highly to identification of innovative strategies for making it successful. Nurse informatics can take up role of a test analyst or a tester to check the credibility of software. Nurses conventionally are involved in beta testing of software which means that they test the software as users. Now is the time that the nursing professionals take up primary roles as they can participate in alpha testing when the product is tested before it is available for implementation. 4. Deployment and Maintenance of Product: The last step is to implement the solution in the clinical setting. This phase is the most interesting and challenging part of the process. The software is adopted and used by many users. Usually, at this stage, the system encounters unthinkable problems as the IT goes live. The system may or may not produce desired results as expected. A well-designed system can be exploited to extract information in multiple dimension and various clinical processes. The guidance at this point cannot be ignored in order to smart track data using checklists, nursing alerts and clinical guidelines that promote evidence-based practices. Data can be structured systematically to check performance through dashboards and compliance records. At this point, the system is utilized to understand the information obtained as multiple users use the system. The system can track progress of individual user and identify problems faced by them in using the system. For example, a software is developed with an intent to save nursing time, but the data indicates otherwise as the nurses are not comfortable using the system and find it difficult to access. Such problems can be identified when the software is put in action in the clinical setting. Nurses can not only identify such issues but would be in better position to suggest an alternative that is more practical and clinically relevant. Nurses can work as solution architects to guide the team about development of software as per client’s requirement and improvise it with time.Role Of The Nurse Informaticist In The Systems Development And Implementation Paper Nurses Need to be Involved in Software Development: In the current scenario, nurses are a part of the process only when the software is tested and at later stages when the software is ready to be deployed throughout the organization. The issues like interaoperability are already producing a glitch for healthcare. Nurse informaticists has listed it as one of the key areas of research in near future. But the question remains that if the nurses are not involved in software development process, how would such issues be addressed. Another problem commonly encountered as highlighted earlier is the system being not user friendly. The argument here is, who is the best to suggest what suits the users? The answer is ‘the user’; someone who will be using it in the clinical setting for the patient care. Clinical nursing leaders do participate in earlier stages and provide consultation to vendors. Nurses must be involved in the earlier stages of software development cycle in order to have an efficient system which literally translates the language of health into the software being used. Implementation and adoption of such systems require identification of champions or problem solvers. Yet nurses are still portrayed as professionals who are not willing to adopt technology readily, which causes another hurdle for their involvement in this process. The responsibility to break this stereotype remains not only with leaders but also with the frontline nurses. Frontline nurses can coherently put forward requirements such as recording of content, format of content, linkage with other systems, reporting capabilities of the system, access and training implementation.Role Of The Nurse Informaticist In The Systems Development And Implementation Paper The Role of the Nurse Informaticist in Systems Development and Implementation Assume you are a nurse manager on a unit where a new nursing documentation system is to be implemented. You want to ensure that the system will be usable and acceptable for the nurses impacted. You realize a nurse leader must be on the implementation team. To Prepare: Review the steps of the Systems Development Life Cycle (SDLC) and reflect on the scenario presented. Consider the benefits and challenges associated with involving a nurse leader on an implementation team for health information technology. The Assignment: (2 pages) In preparation of filling this role, develop a 2 pages role description for a graduate-level nurse to guide his/her participation on the implementation team. The role description should be based on the SDLC stages and tasks and should clearly define how this individual will participate in and impact each of the following steps: The discussion addresses the role of the nurse in the Systems Development Life Cycle. After you have reviewed the course resources, please submit your initial post describing the following: Describe the role of the nurse in each stage of the SDLC when purchasing and implementing a new health information technology system Provide specific examples of potential issues at each stage of the SDLC, describe how nurses may be part of the solution Explain whether you had any input in the selection and planning of new health information technology systems in your nursing practice. Explain potential impacts of being included or excluded in the decision- making process By Day 7 Submit your completed Role Description. Nurses has been working in the field of informatics near four decades, the term “nursing informatics” has been considered a specialization in nursing resources since 1984 (Guenther & Peters, 2006). Many aspects such as data recovery, ethics, patient care, decision support systems, human-computer interaction, information systems, imaging informatics, computer science, information science, security, electronic patient records, intelligent systems, e-learning and telenursing have been added to the field. Hana has defined Nursing Informatics as the application of IT in the nursing duties including education, management & practice in 1985. Integration of information science, computer science and nursing science to support nursing practice and knowledge management was the definition offered in 1989 by Graves and Corcoran. The American Nurses Association (ANA) published its aim and standards in 1994-1995 and presented the Nursing Informatics as a specialty that integrates nursing science, computer and information science to provide data communication management, knowledge and nursing work in 2001. Now most of nursing professionals believe that it is defined as the integration of information technology and all aspects of nursing such as clinical nursing, management, research or education (Guenther & Peters, 2006).Role Of The Nurse Informaticist In The Systems Development And Implementation Paper 1.2 Competencies The competency of nursing informatics specialists was determined through studying three categories including computer skills, informatics knowledge and informatics skills. It investigates four levels of nursing practice: beginning nurse, experienced nurse, informatics specialist, and informatics innovator. The following competencies were rejected: diagnostic coding, desktop publishing, managing central facilities to enable data sharing and writing an original computer program (Staggers et al., 2002). Some components of accepted competencies are shown below in brief. 1.2.1 Computer Skills Selected computer skill competencies contain computerized searches and retrieving patient demographics data, the use of telecommunication devices, the documentation of patient care, the use of information technologies for improving nursing care, and the use of networks and computer technology safely. 1.2.2 Informatics Knowledge Selected informatics knowledge competencies are the recognition of the use or importance of nursing data for improving practice, and the recognition of the fact that the computer can only facilitate nursing care and that there are human functions that cannot be performed by computers, the formulation of ethical decisions in computing, the recognition of the value of clinicians’ involvement in the design, selection, implementation, and evaluation of systems in health care, the description of the present manual systems, the definition of the impact of computerized information management on the role of the nurse and the determination of the limitations and the reliability of computerized patient monitoring systems.Role Of The Nurse Informaticist In The Systems Development And Implementation Paper 1.2.3 Informatics Skills Informatics skills competencies includes the interpretation of information flow within the organization, the preparation of process information flow charts for all aspects of clinical systems, the development of standards and database structures to facilitate clinical care, education, administration or research. It also includes the development of innovative and analytic techniques for scientific inquiry in nursing informatics and new data organizing methods and research designs with the aim of examining the impacts of computer technology on nursing, and the conducting of basic science research to support the theoretical development of informatics. Information literacy skills, competencies, and knowledge are investigated among educators, administrators and clinicians of nursing groups nationally. 1.3 The Importance of Nursing Informatics The history, definition and competencies of nursing informatics indicate the importance of this field. It shows nurses are integrated into the field of IT automatically. So they should be able to deal with it successfully to improve quality of care outcome. In this regard it is required to study the influence of nursing informatics on health care and make bold the appropriate information technology educational needs for nurses.Role Of The Nurse Informaticist In The Systems Development And Implementation Paper An extensive literature search was performed by using databases Pubmed, Google Scholar, Ovid, Science Direct and SID. Search terms were “education, nursing”; “quality of health care”; “nursing informatics” and technology. The study was carried out from January to April, 2014. A library search was also performed. As many as 135 articles were retrieved. With a critical point of view, 40 articles in English were selected that specifically focused on nursing informatics education and its influence on nursing outcomes and the quality of health care (Staggers et al., 2002). The study mentions the followings as the key elements of nursing informatics implementation:Role Of The Nurse Informaticist In The Systems Development And Implementation Paper 3.1 Health Care Promotion The advantages of applying information technology in all aspects of nursing, including clinical areas, management, education and research and its influence on health care have been reviewed. Today, the subjects of clinical nursing information systems, decision support systems and medical diagnostic systems are associated with collecting patient information. Regarding the technology-rich environment, health care and hospital information systems developers, the quality of care is improving. For increasing patient safety and its leading to an evidence-based nursing, nursing informatics has been enhanced for students and graduates by Columbia school of nursing. The study has proved that informatics competence is a prerequisite to improving patient care (Bakken et al., 2003). Technology and using multimedia integrated into nursing curriculum can promote the use of informatics tools as an integral practice component and increase patient safety (Norton et al., 2006). Managers can improve efficiency and performance through information systems and new technologies. In addition, several studies have confirmed the impact of careful shift planning and efficient management on nurse’s work and the quality of health care. Information is the source of all management activities. Nursing care is an industry service and its product is patient care. Information technology can promote the nursing management outcome. Internet-based nurse scheduling systems are mostly designed according to the self-scheduling model and need refining by the manager who overviews proper distribution, it causes uniform resource allocation in scheduling and increases patient direct care time (Pierce et al., 2003). Implementing information systems can provide better access to evidence; it can affect the patient care quality and support evidence-based nursing. Software tools to facilitate research are available in all medical fields (Kardan & Darvish, 2008). Nursing information system had an influence on clinical patterns and decreased the time nurses spent on indirect care (Darvish & Salsali, 2010). This is critical to the health care professionals to assess, apply, report and manage data by the help of new tools of the information age (Hall, 1995). 3.2 Ad