Uncategorized

Nursing

NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper Nurses can play an integral part in population health, but leadership and technology training needs to be a larger part of nurse training. That’s according to a Robert Wood johnson Foundation (RWJF) study released in September 2017. NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper The report finds that public health nursing at local and state agencies, in community and ambulatory settings, and in schools will continue to grow as population health strategies help identify where the biggest healthcare gaps exist. Permalink: https://nursingpaperessays.com/ nurs-4210-role-o…alth-essay-paper / ? How nurses benefit population health initiatives Many population health strategies include looking at patients holistically, including social, economic, and cultural determinants, and nurses are already trained in those areas to deliver patient care, according to the study. Paul Kuehnert, DNP, RN, FAAN, assistant vice president for RWJF Program staff, “Nurses are trained to think holistically, to consider the context of a patient’s life and how that impacts his or her health,” says Paul Kuehnert, DNP, RN, FAAN, assistant vice president for RWJF Program staff, who commissioned the study. Whole care also means assessments of the patient’s healthcare environment, which can include acute, ambulatory, home, behavioral health and community interventions. “Because of the nature of their roles, nurses often spend more face-to-face time with patients, which allows them to gain insight into the community and societal factors that impact patients’ lives and health. Armed with this insight, nurses can work with primary care physicians to help connect patients to resources within the community that can improve their overall well-being.” NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper ORDER NOW FOR PLAGIARISM-FREE NURSING PAPERS How to better utilize nurses 1. Encourage collaboration and dialogue Unfortunately, nurses aren’t trained for leadership positions and are rarely a part of population health strategy development, the study finds. Kuehnert says that scope of practice regulations that vary based on the state, often restrict nurses’ time and ability to expand their roles. “Culturally and historically, nurses—unless they hold formal leadership roles—tend not to view themselves as leaders. Nurses must understand, internalize, and act on the knowledge that nurses can be and are leaders, irrespective of their titles—and that by collaborating with policymakers, businesses, health systems, and more, nurses can exponentially increase the impact they have, well beyond the healthcare setting,” Kuehnert says. NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper 2. Help them use data to focus efforts Increasing nurses’ capacity to make data-driven decisions is another part of the future of population health nursing. According to the study, nurse care coordination for low-risk patients that utilize healthcare services the most has been found to be the most cost-effective way to improve outcomes. Of all patients with high healthcare utilization, 60% to 75% can be classified as low-risk populations. NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper “We’ll also need to better prepare nurses for key evolving population-focused nursing roles in fields that include care management, chronic disease management, and population data analysis. These roles require core clinical knowledge and understanding combined with skills and abilities to identify and evaluate community resources, make and track referrals to community-based services, and measure outcomes,” Kuehnert says. 3. Increase their technology literacy Rapid advancements in health, EHRs and mobile devices are a part of clinical care, prevention, and health communications that will continue to integrate into daily use for clinicians. “Education should provide students with the technical skills they need to compile and analyze population and community data in order to understand the impact of the community conditions on patients’ health,” Kuehnert says. “And how they, as nurses, can influence change within their communities to improve health.” Kuehnert says the insights nurses gain about patients’ life circumstances need to be systematically shared to inform care by the entire multidisciplinary team. “We need to share bright spots of nursing leadership for population health improvement and spread them widely,” he says. “Widespread adoption of population-focused nursing practice will likely take place over the next five to 10 years as mindsets and expectations shift in nursing and healthcare.” NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper most important public health problems and concerns The CDC’s National Center for Injury Prevention and Control updated its Prevention Status Reports Monday, which ranks the biggest public health issues in all 50 states and the District of Columbia. The Prevention Status Reports organize information on state public health policies and practices in a format that is easy to use for public health professionals, community leaders and policy makers. The reports allow these individuals to understand their state’s status and identify improvement areas. NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper According to the reports, the 10 most important public health problems and concerns are (listed alphabetically): Alcohol-related harms Food safety Healthcare-associated infections Heart disease and stroke HIV Motor vehicle injury Nutrition, physical activity and obesity Prescription drug overdose Teen pregnancy Tobacco use The Nurse’s Role in Community Health In the past, caregivers journeyed on horseback to the homes of their neighbors to provide medical services. These caregivers were crucial to reducing the mortality rates in their communities. After the civil war, hospitals were built. This began the implementation of organized healthcare. Today, nurses practice in a variety of settings and community health is again re-emerging as an integral part of providing care to everyone. NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper What Is Community Health Nursing? Community health nursing is a discipline that incorporates evidenced-based research along with advances in science and new approaches for improving the health The practice takes into consideration the cultural and socioeconomic backgrounds of the people in the community to ensure appropriate interaction and sensitivity when working with them. A community is a group of people in a specific location, which includes places where people live, work and go to school. Most people belong to multiple types of communities. Community health nursing is commonly practiced in geographic locations like cities and rural areas. What Is the Goal of Community Health Nursing? The goal of community health nursing is to promote, protect and preserve the health of the public. Community health nursing involves these basic concepts: Promote healthy lifestyle Prevent disease and health problems Provide direct care Educate community about managing chronic conditions and making healthy choices Evaluate a community’s delivery of patient care and wellness projects Institute health and wellness programs Conduct research to improve healthcare What Is the Role of a Community Health Nurse? NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper The primary role of community health nurses is to provide treatment to patients. Additionally, community health nurses offer education to community members about maintaining their health so that they can decrease the occurrence of diseases and deaths. They plan educational assemblies, hand -out fliers, conduct health screenings, dispense medications and administer immunizations. Nurses also may distribute health-related items like condoms and pregnancy tests. Examples of some health issues that community health nurses try to control or eliminate are: Infectious and sexually transmitted diseases Obesity Poor nutrition Substance abuse Smoking Teen pregnancy Where Do Community Health Nurses Work? NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper Community health nurses work in hospitals, community centers, clinics, schools and government health agencies. Community health nurses are important to regions where healthcare is not easily accessible, so they can travel to remote places and isolated areas of a city. How Do You Become a Community Health Nurse? To become a community health nurse you must first work as a registered nurse. If you only have an associate degree you might want to consider completing a Bachelor of Science in Nursing (BSN) degree program. Many schools like Northeastern State University (NSU) offer RN to BSN programs. NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper NSU has an online RN to BSN program that includes the course Community Health Nursing. This course examines the theory and research used in nursing and the public health practice, which promotes and preserves the health of communities. Students are given the opportunity to apply their current knowledge and what they learn in the course. They are paired with a community and other healthcare professionals to experience community health nursing. Nursing care should be available to every American. Throughout the country, there are entire communities of people prone to chronic illnesses, infectious diseases and economic hardships. Community health nurses have the ability to improve the welfare of individuals and their communities. They are at the forefront of bringing quality patient care to the most vulnerable and under served members of society. NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper Community Health Nurse Roles and Functions Planner/Programmer Identifies needs, priorities, and problems of individuals, families, and communities Formulates municipal health plan in the absence of a medical doctor Interprets and implements nursing plan, program policies, memorandum, and circular for the concerned staff personnel Provides technical assistance to rural health midwives in health matters Provider of Nursing Care Provides direct nursing care to sick or disabled in the home, clinic, school, or workplace Develops the family’s capability to take care of the sick, disabled, or dependent member Community Organizer Motivates and enhances community participation in terms of planning, organizing, implementing, and evaluating health services Initiates and participates in community development activities Coordinator of Services Coordinates with individuals, families, and groups for health related services provided by various members of the health team Coordinates nursing program with other health programs like environmental sanitation, health education, dental health, and mental health Trainer/Health Educator Identifies and interprets training needs of the RHMs, Barangay Health Workers (BHW), and hilots Conducts training for RHMs and helots on promotion and disease prevention Conducts pre and post-consultation conferences for clinic clients; acts as a resource speaker on health and health related services NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper Initiates the use of trio-media (radio/TV, cinema plugs, and print ads) for health education purposes Conducts per-marital counseling Health Monitor Detects deviation from health of individuals, families, groups, and communities through contacts/visits with them Role Model Provides good example of healthful living to the members of the community Change Agent Motivates changes in health behavior in individuals, families, groups, and communities that also include lifestyle in order to promote and maintain health Recorder/Reporter/Statistician Prepares and submits required reports and records Maintain adequate, accurate, and complete recording and reporting Reviews, validates, consolidates, analyzes, and interprets all records and reports NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper Prepares statistical data/chart and other data presentation Researcher Participates in the conduct of survey studies and researches on nursing and health-related subjects Coordinates with government and non-government organization in the implementation of studies/research PUBLIC HEALTH NURSE Public health nurses have been working as community advocates, educators, and providers of critical public health services since 1893. One of the first public health nursing practices was the Henry Street Settlement in New York City where Lillian Wald and other nurses provided home visits, health education, and community development support to immigrant communities on the Lower East Side. The Henry Street Settlement later became the Visiting Nurse Service of New York, a non-profit organization that continues to provide public health nursing and healthcare services to all New York residents. NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper Public health nurses are the largest group of providers of public health services. They provide a variety of essential services to the communities in which they work. Public health nurses are qualified to deliver clinical services such as immunizations, well-baby care, senior home visits, and school health visits. They also work in teams that monitor community health trends and risk factors, help communities set local health priorities, and design and implement health education programs to minimize health risks. Advanced practice public health nurses may serve as leaders of community and state health departments and have responsibilities for planning and implementing programs to support the health of the population. ORDER NOW FOR PLAGIARISM-FREE NURSING PAPERS The U.S. Patient Protection and Affordable Care Act passed in 2010 expands public health and prevention programs to support communities and individuals. This law also establishes a National Prevention and Public Health Council to provide coordination across all federal agencies and government programs concerned with public health, health education and disease prevention services. The emphasis on public health in this legislation signals a significant federal commitment to support the work of health departments and public health professionals throughout the United States. NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper Roles: The primary role of the public health nurse is to work within the community to support population health and deliver preventive health care services. Public health nurses use their skills to support population health in eight domains of practice: Analysis and assessment of communities using available data and collecting additional data to provide the information necessary to assess, plan, implement and evaluate community health. Program planning and policy development to support the health of communities, families and individuals. Communication with community stakeholders, families and individuals to determine knowledge and attitudes about needed and available health and health services. Cultural competency that enables effective practice with diverse individuals, families, and groups within the community of care. NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper Community dimensions of practice including health service planning, advocacy, and program effectiveness evaluation within and for the community. Public health sciences including the utilization of available research, the design and implementation of new research, and the use of epidemiology and other research methods to understand the distribution and determinants of disease in the community. Financial management and planning skills to support careful budget management and use of public resources. Leadership and systems thinking skills to enable professional practice and development of the public health team. Specialties: Public health nursing is recognized as a specialty nursing area and is supported by the Quad Council of Public Health Nursing Organizations composed of: The Association of Community Health Nurse Educators (ACHNE); The Association of State and Territorial Directors of Nursing (ASTDN); The American Public Health Association, Public Health Nursing Section (APHA), and The American Nurses Association’s Congress on Nursing Practice and Economics (ANA). The Quad Council of Public Health Nursing Organizations (Quad Council) provides voice and visibility for public health nurses, sets a national policy agenda on issues related to public health nursing and advocates for excellence in public health nursing education, practice, leadership, and research. National certification as an advanced public health nurse, board certified (APHN-BC) is available from the American Nurse Credentialing Center. NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper The Role of a Community Nurse More and more patients are treated outside a traditional hospital setting. As their numbers grow, the ability of the NHS to provide medical and nursing services is also changing and community nurses (also known as district nurses) play a vital role in this increasingly important aspect of our healthcare system. What does a community nurse do? Working in a variety of environments, from clinics and health centers to residential accommodation and patients’ own homes, community nurses help the NHS meet the needs of elderly, disabled or vulnerable patients who may not be able to easily visit the hospital. Community nurses are trained to perform a variety of nursing procedures which may include: basic care – such as checking temperature, blood pressure and breathing administering injections assisting doctors with examinations and medical procedures cleaning and dressing wounds setting up intravenous drips and monitoring ongoing care Community nurses also provide an important educational and advisory service for patients and families , offering information on various aspects of healthcare. In some situations, community nurses may be expected to provide emergency care – where patients have had accidents or suffered complications, such as cardiac arrest. NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper The role is more than a way to relieve the UK’s busy hospitals and GP surgeries: community nurses offer their patients a level of emotional support and specialize in ‘joint care management’ for situations in which social services or wider care program mes may be involved. What skills does a community nurse need? Community nursing jobs can be high pressure: nurses work in environments which change from day to day and lack many of the resources available in a hospital. Given the demanding nature of the role and the spectrum of patients they are required to treat, community nurses should possess excellent communication and listening skills, while demonstrating sensitivity towards the specifics of each unique situation. Before taking an available nursing post a community nurse must be a qualified and registered nurse (usually with two years’ practical experience) – and will also need additional, degree level training as a ‘specialist practitioner’. Specialist practitioner training courses usually last no less than one academic year but trainees may be able to shorten that training period by counting previous experience towards their qualification. Courses, which can be taken on a full or part time basis, are split into practical and theoretical elements – and focus on four key areas: NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper clinical nursing care and program me management clinical practice development clinical practice leadership Community Health Nursing Community health nursing incorporates several basic concepts, including the promotion of healthy living, prevention of disease and health problems, medical treatment, rehabilitation, evaluation of community health care delivery and prevention systems, and research to further community health and wellness. A community nurse may provide direct care, educate individuals or the public, advocate for health improvements and perform research in community health. She might also lead or collaborate with other health care professionals, organizations, political figures and members of the community to promote health for her community. NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper Public Health Nurses Public health nurses are often the most visible group in a community health improvement setting. They might be specialists in disease prevention with a focus on preventing infectious disease, work with mothers and children to improve nutrition, operate immunization clinics or lead efforts such as smoking cessation, preventing excessive sun exposure and water safety. Like the nurses who worked in Kentucky many years ago, these nurses might provide prenatal health care or teach mothers how to care for their new babies. NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper Community public health nursing is not entirely different in nursing practice with that of clinical nursing confined in the four corners of the hospital. It also promotes wellness and prevents illness through education and health teachings, provides comfort and care through its delicate nursing care interventions, and emphasizes curative and rehabilitative interventions through individualized efficient approaches. But its peculiarity involves not only caring a single client but by extending thru the whole family and the community. NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper Roles and Responsibilities of a Community Health Nurse 1. The main focus of community health nurse is health promotion. Programmer/Planner Identifies the needs and concerns of individuals, groups, families, and the community Formulates health plans, especially in the absence of a community physician Interprets and implements nursing plans and programs Assists other health team members in implementing health programs in the setting Health Educator/Trainer/ Counselor Acts as resource speaker on health and health related services Advocates health programs in the community through dissemination of IEC or Information Education and Communication materials Conducts advocacy educations concerning premarital, breastfeeding, and immunization counselings Organizes orientation/ training of concerned groups like pregnant mothers Identifies and interprets training needs of health team members and formulate appropriate training program for them Conducts and facilitates necessary training or educational orientation to other health team members in the community 2. The recipient of care of community public health nursing practice is extended not only the individual but also to benefit the whole family and community. NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper Community Organizer Promotes self- reliance of community and emphasizes their involvement and participation in planning, organizing, implementing and evaluating of health services Initiates and implements community development activities Coordinator of services Coordinates health services with concerned individuals and families through the community health team members, government organizations and non- government organizations Coordinates nursing plans and programs with other health programs 3. Community health nurse are generalists in terms of their practice through life’s continuum. NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper Provider of Nursing Care Renders direct care to various clients with different needs, may it be at home, in school, clinics or work settings Involves the family in the care of the sick or dependent individual, i.e. sick child 4. Continuity of care with the client, family or and the community extends for a longer time involving individuals of all ages and health needs. Health Monitor Monitors and detects presence of health concerns in the community through contacts or home visits. Utilizes various effective data gathering techniques in keeping an eye on the health status of all recipients of care. Records and reports health status and presence of health problems in the community 5. The nature of nursing practice in the community needs the knowledge of biological and social sciences, ecology, clinical nursing, and community organizing, for it to be effective. NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper Researcher Follows a systematic process of monitoring the health status of the community through the conduct of surveys and home visits Conducts researches concerning the health of the community Coordinates with government and non- government organizations in the conduct and implementation of studies Statistician Records data systematically and ensures its validity through accurate and complete data gathering Reports prepared reports to concerned organizations i.e. government organization for immediate necessary plans or programs Consolidates and reviews reports efficiently. NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper Analyzes and interprets consolidated data for monitoring the development in the health matters of the whole community 6. This field of nursing practice utilizes a dynamic process (assessment, planning, implementation, and evaluation) in the provision of continuous care until termination is implicit. Change Agent Promotes and motivates change in the community in their health practices and lifestyle behaviors for them to promote and maintain good health, be knowledgeable and has initiative in accessing health services Inculcates self- reliance to brought about development and improvement in the community NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper My apologies for I only have included a short list of the roles and responsibilities . A community health nurse could still develop other sorts of roles while working in the setting. It may not be evident because of its vast and intricate tasks. What is important is the impact it produces in those individuals who needed the care of a community health nurse. Paper works, like the graphs and pie charts shown the community health center are not enough to say that a nurse accomplished her work because a much bigger responsibility is laid in front of her – the community. So, despite the short description of the roles and responsibilities of community public health nursing my hopes are up that some of us would like to be one, too or if not, recognize the hardships and efforts of our own nurses in the community in delving with the issues in health in the community. NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper The Role of the Nurse in Preventative Health Care Preventative health care has become an increasingly popular area of the health care sector. Using a variety of methods to educate populations and avoid illnesses, this type of health care works to improve the overall wellness of Americans. Preventative health care informs populations, promotes healthy lifestyles and provides early treatment for illnesses. In the industry, the emergence of health care reform and an increased number of individuals suffering from chronic conditions has led to an amplified role for nurses in disease prevention. NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper Preventative Health Care Nurses in preventative health care are tasked with improving the health of patients through evidence-based recommendations while encouraging individuals to receive preventative services such as screenings, counseling and precautionary medications. Through public health education, nurses can inspire a larger group of people to engage in healthy lifestyles and ultimately live longer lives. Preventative health care nurses encourage: Regular exercise: Nurses promote regular activity (preferably 30 minutes of exercise at least five days a week) to combat heart conditions, high blood pressure and other diseases such as stroke, diabetes and arthritis. NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper Weight management: Exercise also encourages weight management. Preventative care includes maintaining and controlling weight with exercise and healthy eating habits to prevent diseases such as obesity, cardiovascular disease and osteoarthritis. Avoidance of smoking and drug abuse: Aside from the addiction threat associated with smoking and drug use, there is the risk of lung cancer, emphysema and other forms of cancer. Moderated alcohol use: Education about the effects of alcohol consumption, as well as early screening for diseases such as liver disease, stroke or high blood pressure, can significantly increase the chances of illness prevention. Control of existing diseases: Nurses involved with preventative health care work to identify existing conditions in the early stages. Modifying an individual’s behaviors can control or minimize the effects of a particular ailment. Preventative care encompasses a wide range of techniques to identify, educate, prevent and treat diseases in populations. There are three types of prevention that nurses take part in on a regular basis depending on their position in health care facilities or organizations: primary, secondary and tertiary. NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper ORDER NOW FOR PLAGIARISM-FREE NURSING PAPERS Primary Prevention The U.S. Preventative Services Task Force (USPSTF) describes primary prevention as the measures taken to provide individuals with knowledge to prevent the onset of a targeted condition. In this type of prevention, nurses play the part of educators that offer information and counseling to communities and populations that encourage positive health behaviors. From providing immunizations to reinforcing the use of seat belts, programs are designed to avoid suffering and illness in patients, as well as avoid any type of cost supplementary to disease treatment. Primary prevention is typically the most economical method of health care. NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper Secondary Prevention Secondary prevention, a form of early disease detection, identifies individuals with high risk factors or clinical diseases through screenings and regular care to prevent the onset of disease. Once identified, nurses work with these patients to reduce and manage controllable risks, modifying the individuals’ lifestyle choices and using early detection methods to catch diseases in their beginning stages when treatment may be more effective. Regular screenings, conducted by a preventative health care nurse, are the most common method of secondary prevention and can dramatically diminish the development of certain illnesses. NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper Tertiary Prevention The third tier of prevention, tertiary prevention, is slightly different. This method involves the treatment of existing diseases in patients. At this point of care, nurses are tasked with helping individuals execute a care plan and make any additional behavior modifications necessary to improve conditions. As the primary and secondary methods have been unsuccessful, this stage encompasses methods of minimizing negative effects and preventing future complications. NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper Examples of Disease Prevention Traditionally, health care systems were focused on cures for diseases. Today’s system is more focused on effective prevention techniques. Approximately 1.7 million Americans die each year from chronic diseases, including heart disease, cancer, stroke, diabetes and obstructive pulmonary disease. Nurses and other health care professionals are constantly working to prevent such illnesses through a variety of approaches. NURS 4210 – Role of the Nurse Leader in Population Health Essay Paper Heart Disease As the leading cause of death in the Unit

Nursing

The Effect Of Inadequate Nurse Staffing To Patient Care Essay Paper The Effect Of Inadequate Nurse Staffing To Patient Care Essay Paper Many nurses face the issue of understaffing and having too much of a workload during one shift. When a unit is understaffed not only do the nurses get burnt out, but the patients also don’t receive the care they deserve. The nurse-patient ratio is an aspect that gets overlooked in many facilities that could lead to possible devastating errors. Nurse- patient ratio issues have been a widely studied topic and recently new changes have been made to improve the problem. Identifying and maintaining the appropriate number of mixed nursing staff, RN/LPN/CNA, is critical to the delivery of quality patient care. Many studies reveal an association between a higher level of experienced RN staffing and lower rates of adverse patient outcomes The Effect Of Inadequate Nurse Staffing To Patient Care Essay Paper Laws like these are being implemented and changed widely across the United States to help ensure patients are receiving adequate care that they deserve. The American Nurses Association supports a legislative model in which nurses are encouraged to create staffing plans specific to each unit. This approach will aide in establishing staffing levels that are flexible and can be changed based on the patients needs, number of admissions to the unit, discharges and transfers during each shift (“Nurse staffing plans,” 2013). This model will assist in keeping the unit staffed appropriately and organized in need of a change during each shift. Without an organized plan like this, a nurse may be required to take on a new admission and already have too big of a workload. Each facility has their specific way of scheduling and protocol for staffing; not every facility uses a model that has other nurses’ help decide the next shifts nursing assignment. Permalink: https://nursingpaperessays.com/ the-effect-of-in…care-essay-paper / ? Over the past 2 decades, a significant body of research has substantiated the link between nurse staffing factors and patient outcomes. For instance, the number of nurses available to care for patients, measured by full-time equivalents and hours per patient day (HPPD), was found to be inversely correlated with patient mortality and failure to rescue.1,2 Likewise, lower HPPD correlated with longer length of stay.3 And when staffing targets weren’t met, mortality increased.4 Higher levels of education for nurses, especially BSN preparation, correlated with decreased mortality and failure to rescue, and higher RN skill mix was associated with decreased pneumonia and decreased mortality.5,6 These sentinel studies led to significant policy changes. Legislation mandating specific nurse-patient ratios passed in California, with the federal government and other states also considering legislation.7 In addition, the National Academy of Medicine (formerly the Institute of Medicine) recommended increased educational levels for nurses in all areas of practice, with a target of 80% of the American RN workforce being BSN-prepared by 2020.The Effect Of Inadequate Nurse Staffing To Patient Care Essay Paper Despite progress in the healthcare industry toward achieving these goals, nurse managers and administrators working on hospital units continue to struggle with knowing what constitutes the right number and quality of nurses matched to patients’ needs to achieve clinical outcome targets. (See Historical context.) This knowledge is critical in a climate of reimbursement uncertainty given that achieving the right balance of nurses to meet patient care needs defines fiscally responsible staffing. Consider that in 2016, 62.2% of the country’s 2.6 million nurses worked in hospitals with a median pay of $68,450 per year.9 With salaries making up nearly half of U.S. hospitals’ expenses and nursing comprising about 30% of salaries, effective management of nursing resources, including staffing, is imperative for meeting financial outcomes.10 Likewise, managing the safety and quality of patient care is paramount, and failure to do so is expensive. The average cost of a single central line-associated bloodstream infection (CLABSI) is over $45,000, and a patient fall with injury costs $14,000 on average.11,12 Additionally, under the Affordable Care Act, the Centers for Medicare and Medicaid Services (CMS) will withhold payment to hospitals if quality care targets aren’t met.13 With studies showing that these patient outcomes are sensitive to nurse staffing variables, continued development of the evidence base for nurse staffing is vital. The goal must be providing unit-level evidence-based data for frontline managers to predict and monitor staffing factors related to patient care. This article provides a summary of the current body of published nurse staffing research, explores gaps in the literature that explain why translation into clinical practice has been difficult, and suggests ways that hospital nurse managers and administrators can help move the science forward. It’s important to realize the role hospitals must play in advancing unit-level nurse staffing research. It can’t be accomplished without strong collaboration between clinical nurse experts and researchers.The Effect Of Inadequate Nurse Staffing To Patient Care Essay Paper Nurse characteristics The experience and skills of the nurses on any given unit vary in terms of education level; years of experience; the amount of experience working on a specific unit or with a specific patient population; and the knowledge, or competency, to perform certain skills. This variation impacts individual nurse workload, as well as overall unit workload, and is weighed into staffing decisions and patient assignments. Nursing workload has been defined as a combination of factors, including nursing time spent in direct patient care and other work, competency, physical exertion, and complexity of care.15 Several studies have highlighted the importance of an educated, experienced nursing workforce for producing desirable patient outcomes. A workforce with proportionately more BSN preparation was associated with decreased mortality and failure to rescue.5,16,17 Higher levels of specialty certification in a group of nurses correlated with lower patient mortality and fewer failures to rescue if the nurses were baccalaureate-prepared or higher.17 Odds of patient death on CCUs were highest when 20% or more of the nurses had fewer than 2 years’ experience.18 Collectively, the results of these studies support having a nursing workforce with higher levels of experience, education, and certification to produce safer patient care, but they don’t tell us how much is the right amount or allow for causal conclusions, leaving plenty of room for future research. Back to Top | Article Outline Patient acuity, nursing workload, and unit workflow Patient acuity and nursing workload are entwined in clinical practice and in the literature because patient care needs demand nurses’ time and attention. Patient acuity, also called patient classification, is defined as assessing the nursing care requirements of patients to determine the amount of nursing time needed to meet those requirements.14,19,20,21 Patient classification tools have been used since the 1960s, yet there’s no consensus on the best methods for measuring nursing workload or determining the optimal amount of time for completion of specific nursing activities.14,21,22 Confounding variables are numerous and complex, including individual patient characteristics and nursing unit environmental factors.The Effect Of Inadequate Nurse Staffing To Patient Care Essay Paper There’s essentially a tug-of-war in the practice of measuring patient acuity between the desire to objectively determine required nursing work and the need to rely on the professional judgment of nurses to know which patients need more or less of their time. The goal of both strategies is to predict the amount of nursing care, or time, patients will require and use this information to determine staffing levels. Although not perfect, factoring patient acuity into staffing decisions is a better approach than relying solely on nurse-patient ratios or financial targets, such as budgeted HPPD, to determine unit-level nurse staffing needs.21 This approach is supported by the results of a study that examined nurses’ workloads on a unit where patients were assigned to maintain mandated nurse-patient ratios without regard to differences in patient needs. The workloads of the individual nurses were significantly different even though the numbers of patients in their care were similar.24 Unit workflow also impacts nursing workload. Admissions, discharges, and transfers of patients, often called patient turnover, take additional nursing time, which may not be accounted for in prescribed nurse-patient ratios or average budgeted HPPD that doesn’t recognize shift-by-shift variability.25-27 An ethnographic study of patient turnover found that workflow disruptions, such as admissions and discharges, led to increased workload for nurses, noting that dispersed patient turnover was less disruptive to workflow than clustered turnover.26 Another study found that understaffed shifts with high patient turnover were correlated with increased patient mortality risk, linking the combined effect of staffing levels and workload to clinical outcomes.28 Back to Top | Article Outline Unit and hospital characteristics Unit-level hospital staffing decisions occur within a nested framework of unit, hospital, and external factors, yet the body of literature examining the impact of unit and organizational characteristics on nurse staffing is limited. Aiken and colleagues found that a better patient care environment, as measured using the National Quality Forum’s Practice Environment Scale of the Nursing Work Index (PES-NWI), was associated with lower patient mortality and better nurse outcomes.29 The PES-NWI captures nursing foundations for quality of care, nurse manager characteristics, and nurse-physician relations, and is widely administered as part of the National Database of Nursing Quality Indicators® (NDNQI®) nurse satisfaction survey. Other work in this area has focused on staff scheduling factors. Longer shift lengths and shorter time periods away from work for nurses correlated with increased patient mortality in adults and poorer quality outcomes for pediatric patients.30,31 Increased overtime correlated with more catheter-associated urinary tract infections and pressure injuries, but also a slightly lower CLABSI rate.32 Although supportive of the overall theme that nurse staffing factors are tied to patient outcomes, these studies, like many others, used a cross-sectional design. Therefore, conclusions about cause and effect can’t be made.The Effect Of Inadequate Nurse Staffing To Patient Care Essay Paper Back to Top | Article Outline Limitations of current knowledge Translating nurse staffing research findings into practice at the unit level, where staffing decisions are made, is hampered by three major limitations. The most outstanding problem is the use of aggregated hospital-level data, rather than unit-level data, making it nearly impossible to replicate results at the unit level.33 Many nurse staffing studies used data from large national databases, such as the CMS and NDNQI. Databases like these offer the convenience of accessibility and the statistical power that comes from using large data sets. The downside, however, is that researchers are limited to the preexisting definitions and quality of variables in the database, and aren’t necessarily able to define and choose measures based on theoretical constructs that may be more meaningful to those in clinical practice. Although we can conclude that certain factors, such as increased BSN preparation and lower nurse-patient ratios, are important enough to change workforce and staffing resources, this information isn’t helpful to a nurse manager challenged to determine what risk the unit’s current skill mix and available staff levels pose to achieving patient outcome targets. Without knowing the risk a priori, it’s impossible to identify possible solutions. Furthermore, the lack of unit-level data for use by researchers is reflective of the lack of real-time data for decision support on units where staffing decisions are taking place. The use of large databases also presents a second challenge: Preexisting, aggregated data are generally limited to cross-sectional research designs. The large dataset studies indicate that nurse staffing factors correlate with patient outcomes, which allows us to conclude that nurse staffing plays a role in producing those outcomes, yet causal claims can’t be drawn from correlational studies.34 Future research needs to study unit-level data using more complex statistical operations.The Effect Of Inadequate Nurse Staffing To Patient Care Essay Paper For example, studies could control for moderator and mediator variables, such as Magnet® recognition or turnover rate, or use hierarchical linear modeling to study nested data.35 Even better would be using experimental or quasi-experimental study designs to determine which staffing factors or decisions are best for producing target outcomes.34 Different acuity systems could be studied on the same unit or similar units using a quasi-experimental design. Another example is testing which skill mix and staff-patient ratio combinations produce the best patient results over a period of time. A third problem is that the best ways to measure unit-level nurse staffing aren’t yet known through research. Few studies have tried to determine the best measure of nurse staffing, whereas measures have been selected more for convenience or availability than from any underlying construct supporting their use.35,36 A construct is the abstract theme that a researcher is attempting to measure by using variables that are indicators of that theme.37 For example, nursing HPPD is commonly used as a variable indicative of the level or adequacy of nurse staffing. Although nursing HPPD was found to be a reliable measure in three studies, the studies’ small sample sizes limited generalization of the reliability findings to other populations, thus falling short of supporting a claim that nursing HPPD is the best measure.38-41 A systematic review of 29 nurse staffing literature reviews and systematic reviews further highlighted the extent of this problem: It found that the three most common variables used as measures of nurse staffing levels were HPPD, skill mix, and nurse-patient ratio, and that they were calculated 82 different ways across multiple studies.35 For example, HPPD was calculated using midnight census and average census over 24 hours, and using RN-HPPD and total HPPD, which includes RNs, LPNs, and unlicensed assistive personnel (UAP). Skill mix was also calculated in a variety of ways, including combining LPNs with RNs or LPNs with UAP. Two studies stand out as offering possible paths forward through the cluttered field of nurse staffing measures. One study sought to discover which staffing measure was best for determining the effect on patient quality outcomes by correlating HPPD, RN-HPPD, perceived adequacy of nurse staffing as gathered from nurses via the PES-NWI, having enough assistive personnel, and case mix index (CMI)—a DRG-related weight indicative of the hospital resources a patient required that’s often used as a proxy for acuity.42,43 Both HPPD and perceived adequacy of staffing correlated with CMI, but perceived adequacy wasn’t correlated with HPPD; rather, it was strongly associated with whether enough assistive personnel were available, which isn’t included in RN-HPPD. The author concluded that HPPD was likely a better measure than RN-HPPD, but also recommended that researchers conducting quality-of-care studies choose nurse staffing measures based on a conceptual framework and not by availability.The Effect Of Inadequate Nurse Staffing To Patient Care Essay Paper Another group of researchers proposed two composite staffing measures seated within a conceptual framework called “nurse dose.”44 Years of direct nursing experience, levels of nursing education, and skill mix were combined to create a composite measure of nurse qualities called “active ingredient,” whereas total nursing HPPD, RN-HPPD, and average nurse-patient ratio were combined to represent the intensity of nursing applied to patients.44 Both of the composite nurse dose measures were found to be significant predictors of hospital-acquired methicillin-resistant Staphylococcus aureus infections and patient falls.45 Use of composite measures or other means of considering the interactions of multiple staffing variables at once holds merit for use in future research to improve our understanding of how variables combine to affect outcomes. Nursing is a critical factor in determining the quality of care in hospitals and the nature of patient outcomes. Twenty-four hour nursing care is one of the distinctive hallmarks of inpatient care in hospitals. Historically, hospitals have been at the core of the U.S. health care system, and nursing services are central to the provision of hospital care. They have also functioned as the traditional place of work for nursing personnel and especially for registered nurses (RN). Nursing personnel comprise the largest proportion of patient care givers in a hospital. Nursing care in hospitals takes on added importance today because increase in acuity of patients requires intensive nursing care. In recent years, the nursing profession has been especially concerned about the nature of the transformation taking place in the health care sector. Reports of hiring freezes and layoffs of RNs in hospitals have led to increasing apprehension among them and their supporting organizations about the potential threat to the quality of patient care in hospitals as well as their physical and economic well-being. RNs have expressed concerns that hospitals are implementing a variety of nursing care delivery systems involving major staff substitutions, reducing the proportion of RNs to other nursing personnel by replacing them with lesser-trained (and at times untrained), and lower-salaried, personnel at a time when the increasing complexity of hospital inpatient caseloads calls for more skilled nursing care. At the same time, the aggregate quantity of RNs is at a high level, creating uncertainties about job security. Much health care is moving to ambulatory settings, the community, and the home through home health services. The nursing profession also has concerns about the training needs to accommodate these Page 93 Suggested Citation:”5 Staffing and Quality of Care in Hospitals.” Institute of Medicine. 1996. Nursing Staff in Hospitals and Nursing Homes: Is It Adequate?. Washington, DC: The National Academies Press. doi: 10.17226/5151. × Add a note to your bookmark shifts in work settings. With respect to the hospital setting, a rapidly changing health care environment, continuing pressures to contain costs, and the rising levels of severity of illness and comorbidity of inpatients all make it imperative for hospitals to explore innovative ways to redesign delivery of care without compromising quality. Throughout the decade of the 1980s, hospital expansion, scientific advances, and technological development led to the use of an increasing number of nursing personnel, particularly the RN. As discussed in Chapter 4, employment of RNs in hospitals has increased steadily for the past several decades. In 1993, RN employment in hospitals continued to increase, but the rate of growth over the previous year showed a slight decline for the first time in many years (AHA, 1995b). However, a comparison of first-quarter 1994 data with preliminary data for the first quarter of 1995, shows that while total hospital employment was down; RN employment increased by 3.5 percent, and licensed practical nurse (LPN) employment declined by 1.2 percent (see Table 4.3). These figures may represent a 1-year artifact or an indication of an underlying shift in the health care delivery system.The Effect Of Inadequate Nurse Staffing To Patient Care Essay Paper Information about trends in employment levels of RNs and other nursing personnel needs to be understood in the context of the changing health care system, as elaborated in Chapters 3 and 4. In particular, hospital inpatient lengths of stay continued to decline, along with inpatient days; admissions increased in 1995 after remaining relatively level in 1994. The increasing acuity of patients requiring intense nursing care, the large increase in hospital outpatient services, and the relative increase in beds dedicated to intensive care units also may account for at least part of the continued increase in hospital employment of RNs. In sum, although the committee heard reports of widespread layoffs of RNs and other nursing personnel, national statistics suggest that in the aggregate these employment losses appear to have been more than offset by hires. (This generalization does not hold for licensed practical nurses [LPN], whose employment by hospitals has been declining for some years.) The continued growth in RN employment appears to run counter to many assertions the committee heard from nurses during site visits, testimony and numerous written and oral communications throughout the study. Aggregate trends, of course, obscure local and regional variations that respond to local market conditions and other factors, and anecdotal information cannot be discounted totally as it often is a warning indicator of changes that are not yet reflected in national statistics. This chapter examines the relationship of staffing patterns of nursing personnel in hospitals and quality of patient care. The chapter begins with a discussion of the restructuring of hospital care and the changing roles of nursing personnel in hospitals. It then provides a brief overview of the elements of quality of care, measurement issues, and the status of quality in hospitals. Next, it proceeds to assess whether there is any reliable evidence linking nurse staffing to the quality The Effect Of Inadequate Nurse Staffing To Patient Care Essay Paper The Pros and Cons of Required Minimum Nurse-to-Patient Ratios What with hospital downsizing, budget cuts, and a nursing shortage in the United States, it’s no wonder that an American Nurses Association survey found that 54% of their nurse respondents didn’t have sufficient time to spend on each patient.[1] The past two decades have seen overcrowding and understaffing that has led to longer hours and more stressful shifts for nurses, and as a result, higher burnout rates and lower retention rates. To combat this serious problem, in 2004, California became the first state to implement a law requiring all of its hospitals to limit the number of patients its nurses could treat at any given time.[2] Since then, many other states have been looking to follow suit, or at least regulate staffing ratios more closely, so it’s crucial to study not only the specific benefits of such laws, but also the detriments they can pose. Below is a list of those advantages and disadvantages to help enlighten you on this important issue: Benefits of Required Minimum Nurse-to-Patient Ratios: Published studies have shown that appropriate nurse staffing helps decrease nurse fatigue, thus promoting increased safety as well as job satisfaction.[3] Lowering nurse-to-patient ratios decreases nurse burnout, including chronic fatigue, irritability, insomnia, depression, weight gain, and other potential health risks that come from being overworked in a stressful environment.[4] One study found that a lower percentage of California nurses experienced both high burnout and dissatisfaction when compared with nurses in states without minimum staffing ratios.[5] Regulated ratios allow nurses to give better value-based care while also maintaining their own health. Retention and recruitment rates also improve drastically with minimum nurse-to-patient ratios. The year California’s law went into effect, the California Board of Nursing reported that applications for nursing licenses increased by more than 60%, and by 2008, vacancies for registered nurses in the state’s hospitals plummeted by 69%.[6] Patient mortality and the number of preventable mistakes – including patient falls, pressure ulcers, central line infections, and healthcare-associated infections – are all proven to decrease after minimum nurse-to-patient ratios are instigated.[7] After enacting its law, California hospitals saw procedural mistakes decline as well as outcomes improve – fewer patients got sick in hospitals, more recovered, and fewer suffered post-treatment complications that required them to return.[8] Drawbacks of Required Minimum Nurse-to-Patient Ratios: The largest concern that accompanies this change is that of its cost. Minimum nurse-to-patient ratio laws impose steep fiscal costs on hospitals and allow them little say in regards to staffing decisions.[9] Funding for nursing programs would need to be increased, and hospitals would be required to hire more nurses and increase their salaries and benefits so as to attract enough employees to fill the positions required. California’s transformation was certainly an investment, and not all states have the ability to spend the money required to enact such a law.[10]The Effect Of Inadequate Nurse Staffing To Patient Care Essay Paper Ratio laws might cause patients to wait longer for treatment. For patients waiting for admission into a ward, even if a bed is available and there isn’t much activity in the ward, nurses wouldn’t be able to see them due to the ratio requirement law.[11] Additionally, such laws don’t account for larger emergency situations happening within the hospital or the city that might require drastic action and changes in staff assignments.[12] Though some studies have shown that lower nurse-patient ratios improve patient outcomes, others show that the California minimum law has had a limited impact on adverse events in hospitals and mixed effects on quality.[13] Though there is little doubt that nurses are benefited by this law, it is less clear how a patient may benefit. Though everyone may not agree on the extent to which nursing-to-patient ratios should be turned into law, it’s clear that this topic is one that isn’t going away. As healthcare needs morph in this constantly shifting political, economic, and social climate, finding ways to provide better care for both nurses and patients will always be a relevant discussion. [1] “Health experts debate the merits of nurse-staffing ratio law,” NursingLicensure.org, n.d. http://www.nursinglicensure.org/articles/nurse-staffing-ratios.html [2] Ibid [3] “Optimal Nurse Staffing to Improve Quality of Care and Patient Outcomes: Executive Summary,” Avalere Health LLC, Sept. 2015, http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/State/Legislative-Agenda-Reports/State-StaffingPlansRatios/Optimal-Nurse-Staffing-ES-Sep15.pdf [4] Safe Staffing Ratios: Benefiting Nurses and Patients,” Department for Professional Employees AFL-CIO, May 2016, http://dpeaflcio.org/programs-publications/issue-fact-sheets/safe-staffing-ratios-benefiting-nurses-and-patients/ Improved Safety The National Campaign for Safe RN-to-Patient Staffing Ratios is a nationwide effort to ensure safe staffing for nurses and patients across the country. Studies have shown that appropriate nurse staffing helps achieve clinical and economic improvements in patient care, including: Enhancement of patient satisfaction and HCAHPS scores Reduction in medication errors, patient mortality, hospital readmissions, and length of stay Improved safety outcomes by reducing incidents of falls, pressure ulcers, and healthcare-associated infections (HAIs) Reduced patient care costs through avoidance of unplanned readmissions Prevention of nurse fatigue. In addition to supporting models where nurses themselves are empowered to create staffing plans and promoting flexible staffing plans, the ANA and like-minded organizations support public reporting of staffing data to promote transparency, and penalizing institutions that fail to comply with minimal safe staffing standards. Optimal staffing is essential to providing the best care possible and getting the maximum value from RNs. Greater benefit can be derived from staffing models that consider the number of nurses and/or the nurse-to-patient ratios and can be adjusted to account for unit and shift level factors. One strategy to meeting the need for additional nursing staff is opening up the path to a degree for aspiring nurses and encourage more people into the field. Companies such as Wolters Kluwer are working closely with healthcare industry partners, nursing programs and individual educators throughout the country to build world-class nursing education solutions that meet the demands of today’s healthcare field.The Effect Of Inadequate Nurse Staffing To Patient Care Essay Paper But as the transformation of the American healthcare system continues apace, many healthcare professionals are being asked to develop a more holistic approach to addressing the increasing complexity of patients’ health needs. Today’s nurses are now expected to acquire knowledge from several non-nursing disciplines in order to treat patients. In her new whitepaper, “Effective Interprofessional Education and Collaborative Practice in Nursing Education,” Elizabeth Speakman, EdD, RN, ANEF, FNAP, notes that experts argue that the delivery of high-quality care requires an interprofessional approach, where representatives from multiple departments work together to provide care. Recent studies, however, question whether nurses can adapt, given the shortage of nurse faculty and mentors, as well as research indicating the prevalence of poor communication and collaborative practices across the healthcare professional spectrum. From a research tradition in which nurse staffing factors were primarily background variables, the study of nurse staffing and patient outcomes has emerged as a legitimate and strategically crucial field of inquiry. However, despite significant growth in the number and sophistication of studies responding to public policy and provider demand for these findings, results have been inconsistent. This chapter highlights the methodologic challenges inherent in this area of inquiry and explicates how the diversity in measures and units of analyses confound literature synthesis. In the face of myriad pressures to adopt a position for or against mandated nurse-to-patient ratios, the state of the young science does not permit precision in prescribing safe ratios. In fact, it may be concluded that further research is crucial to tease out the nuances in the staffing-outcomes equation. It is essential to advancing the field that future studies replicate, extend, and refine the current body of knowledge, making explicit how characteristics of the workforce, now barely considered (for example, years of experience or professional certification), in addition to the “dose” of the nurse, are linked to processes of care that ultimately result in clinical outcomes (both desirable and adverse). Until then, selected better practices have been noted, with the potential to contribute to pragmatic efforts to improve patient care quality and safety in hospitals. Controlling health system expenditure has been an important policy goal in the UK National Health Service (NHS) and many similar publicly funded health systems.1–3 The tension between the need for greater efficiency and the impact on quality and safety has been compounded by shortages of registered nurses (RNs). In the UK, these shortages have been created by reduced intakes to RN training coupled with severe RN recruitment and retention difficulties.4 5 Service managers have been driven to consider reducing RN staffing levels and diluting the skill mix of nursing teams, substituting RN posts with healthcare assistants (HCAs) who are unregistered and for whom no formal training is required.6–9 Wide variations in staffing policies and practices persist across the NHS, and there is a lack of consensus in many countries on the value of mandated staffing levels and appropriate nursing skill mix.10–12 In the NHS, a number of concerns have been raised about the ability of HCAs to deliver complex compassionate care, although at the same time the

Nursing

Nursing

Alcohol’s Effect on the Body Sample Essay Alcohol’s Effect on the Body Sample Essay Dental hygienists and therapists are encouraged to take a holistic approach to their patients care.Alcohol’s Effect on the Body Sample Essay Holistic medicine is defined as ‘treatment of the whole person, taking into account mental and social factors, rather than just the symptoms of a disease’ Oxford dictionaries (2015). Dental clinicians therefore require an understanding of all alcohol related issues not just that of the oral cavity. The following section highlights the main complications alcohol can cause for the major organs of the body. Permalink: https://nursingpaperessays.com/ alcohols-effect-…y-sample-essay / Brain — Alcohol affects the brain by altering the chemical processes. The short term alterations consist of slurred speech, vision changes, lack of coordination, impaired judgment and memory loss. Alcohol is a depressant, so long term excessive alcohol drinking can lead to mental health issues such as depression, anxiety and suicide (Singleton et al, 2001).Alcohol’s Effect on the Body Sample Essay It can also lead to frontal lobe shrinkage causing poor thinking skills (www.nihseniorhealth.gov). Mukherjee, S (2013 p 256-262) states that “Alcohol interacts with the brain receptors, interfering with the communication between nerve cells” Heart — Regular alcohol consumption can lead to an increased risk of cardiovascular disease. This can cause hypertension, arrhythmia, strokes or myocardial infarction. (National Institute on Alcohol Abuse and Alcoholism) Digestive System — In the short term alcohol can cause stomach disturbances and lead to vomiting or diarrhoea. Excess alcohol is linked with gastrointestinal ulcers, pancreatitis (inflammation of the pancreas caused by cell damage) and malabsorption of essential nutrients such as B vitamins and folic acid. Cancers of the digestive tract (mouth, oesophagus, stomach and colon) are also a threat (www.healthline.com).Alcohol’s Effect on the Body Sample Essay Liver — Our liver’s deal with the breakdown of waste products, this also includes alcohol and drugs. Alcohol causes great harm to the liver due to toxins and the effort the liver must use to deal with alcohol (www.drinkaware.co.uk). Alcohol-related liver disease can be categorised in to three main categories; • Fatty liver (first stage of liver disease but can be reversed if addressed early enough) • Alcoholic hepatitis • Cirrhosis (scarring of the liver) (www.nhs.uk) Reproductive System — Alcohol affects both male and female sex hormones, causing imbalance and potentially infertility. If a woman has conceived, drinking during gestation puts the unborn child at risk of Foetal Alcohol Spectrum Disorder (FASD). Alcohol passes through to the child via the bloodstream, and exposure to alcohol can lead to a host of problems during a person’s lifetime which come under the umbrella term FASD these can include; deformities, mental health problems, memory difficulties and addiction. Drinking alcohol whilst pregnant can also lead to miscarriage, still birth, pre-term delivery and low birth weights (drinkaware.co.uk). Immune System — Drinking regularly can weaken a person’s immune system. A session of binge drinking can make your body vulnerable to infection for up to twenty four hours after (www.niaaa.nih.gov).Alcohol’s Effect on the Body Sample Essay Oral Cavity — As outlined in the introduction to this paper, alcohol has many adverse effects on the oral cavity. These will now be explored in further detail; • Non-carious tooth surface loss — Robb and Smith (1990) showed that in a study of thirty seven alcoholic patients, their teeth had decidedly more erosive wear in comparison to the age and sex matched control subjects. This can be attributed to the acidity of many alcoholic beverages and also the increased incidence of vomiting after excessive alcohol consumption.Alcohol’s Effect on the Body Sample Essay • Dental caries — Dental caries can occur more frequently in patients who regularly expose their mouth to alcohol. This can have multiple root causes; initially we know that the progression of caries begins with the demineralisation of enamel which occurs when the critical pH of 5.4 is breached. This happens during an acid attack, where the microorganisms in the oral cavity feed off a substrate; sugar. We know that alcohol contains large amounts of sugar; an alcopop such as Smirnoff Ice for example contains 7.5 teaspoons of sugar (shropshirestar.co.uk, 2014). In a drinking session when the alcohol may be sipped over a period of time the oral cavity can never revert back to a neutral pH. If a patient is doing this regularly we can presume demineralisation may result and logically, caries. Often excessive alcohol drinkers will have poorer oral hygiene habits also leading to the possibility of caries developing.Alcohol’s Effect on the Body Sample Essay • Periodontal disease — Tezal (2001) found that alcohol consumption may affect the periodontium in the following ways, aside from poor plaque control exhibited by frequent alcohol drinkers; Impaired immune response leading to a decrease in neutrophil function which is vital in the response to periodontal bacterium, decrease in liver function leading to inflamed or bleeding gingivae, alcohol also affects tissue healing.Alcohol’s Effect on the Body Sample Essay • Xerostomia — Use of alcohol can add to dry mouth (Ongole and Praveen, 2012). Consequently it can be deduced that lack of saliva would decrease the antimicrobial benefits especially in dealing with dental caries and periodontitis. • Oral and facial trauma — Hutchinson et al (1998) performed a study of accident and emergency departments over a weekend period in the United Kingdom, to assess how many admittances were dental/facial injuries, they found that fifty five percent of the total admittances were alcohol related. In conclusion they suggested the implementation of a scheme to make young people more aware of the risks associated with drinking and injury.Alcohol’s Effect on the Body Sample Essay • Oral Cancer — The most life threatening of all the oral implications is oral cancer, Brocklehurst et al (2013) states that it is the sixth most prevalent cancer worldwide and is on the increase. Alcohol is a clear risk factor. Dal Maso et al (2015) found that is some cases patients who both drink alcohol and smoke tobacco the synergistic effect increases the chance of head and neck cancer by 35 times. According to Figuero-Ruiz et al (2004) the active component of alcohol is ethanol, this in itself is not carcinogenic, however the primary metabolite acetaldehyde has been established to be a carcinogen. It goes on to explain that the permeability of the oral mucous membrane, coupled with the cytotoxic effect of acetaldehyde and the lack of salivary buffering can cause cellular mutations and damage to the deoxyribonucleic acid (DNA). Oral cancer lesions tend to be pain free and in sheltered areas of the mouth or oropharynx, sometimes leading to late diagnosis, as the patient may be unaware of changes. A specific screening programme including visual examination may be useful in decreasing mortality rates in oral cancer (Brocklehurst et al, 2013).Alcohol’s Effect on the Body Sample Essay United Kingdom Alcohol Statistics According to the charity Alcohol Concern, alcohol is the third biggest risk factor for preventable illness and death in the UK, and costs the National Health Service £3.5 billion per year, this equates to a cost of £120 for each tax payer. The Organisation for Economic Co-operation and Development (from henceforth referred to as OECD) is an organisation combining and analysing data from its member countries, primarily Western countries, but also monitoring countries outside the OECD. In 2015 they conducted research on the drinking habits from thirty four Western countries. Their research highlighted that hazardous drinking (defined as drinking double the amount of safe units — 14 units per week for women and 21 for men) is most common amongst women who are both highly educated and of a high socioeconomic status. This can possibly be attributed to women placing a greater importance on forging a career, higher earning jobs requiring networking after work and the stress of balancing work, childcare and living costs. These women are also more likely to drink at home. The survey also noted that teenage girls are catching up with teenage boys, stating that 43% of boys had experienced being drunk by age 15, and 41% of girls in 2010 compared with 30%:26% ratio in 2001. Men in the high education bracket are also the more hazardous drinkers.Alcohol’s Effect on the Body Sample Essay In light of the findings above, it would be a natural assumption that during the career of a dental clinician, the importance of screening patients using AUDIT (C) and advising as necessary will become an essential part of patient care. This means that dental clinicians need to be equipped with the skillset to give accurate and pertinent advice to the patient and feel confident in doing so.Alcohol’s Effect on the Body Sample Essay Delivering Better Oral Health Delivering Better Oral Health is a guidance tool, collated by experts using information gathered from multiples resources including systematic reviews, research papers and studies. The evidence included is rated dependent on its strength or weakness. DBOH advocates a preventative approach and urges all dental healthcare professionals to give their patients some form of advice or praise relative to the subheadings in DBOH irrespective of their level of risk or need. A range of topics are covered in DBOH including, fluoride, smoking and oral hygiene.Alcohol’s Effect on the Body Sample Essay The behavioural change DBOH sets out to achieve is via ‘brief intervention’ and ‘motivational interviewing’. Brief intervention involves raising the subject with the patient, gauging their reaction, offering brief advice and either signposting the patient to further assistance or revisiting the issue at the next appointment. DBOH understands that true behaviour change is a lengthy process as it is multifactorial. Alcohol’s Effect on the Body Sample EssayFor example a patient may smoke tobacco and drink alcohol regularly putting them in a high risk category, this would mean the clinician would need to address the reasons behind these choices and encourage changing the behaviour for both issues. Another limiting reason for behaviour change is the patient’s lifestyle and social factors, for example a patient who is grieving due to a recent bereavement would be less motivated to change than a woman who has found out she is expecting her first child after a year of trying to conceive. This ties in to motivational interviewing. Experts now recognise that using health risks as an incentive to change behaviour is not successful with everybody. The clinician needs to talk to the patient to identify what motivates them and use that for encouragement. Some examples of this are; highlighting to a patient how much money they could save if they stopped spending on cigarettes or alcohol or the aesthetic benefits a patient could expect to achieve orally if they stopped smoking and had less staining on their teeth.Alcohol’s Effect on the Body Sample Essay Experts also note that the ideal person to achieve change is a person with good motivation and a good support network. It is therefore important to get to know the patient to assess when you can best assist them.Alcohol’s Effect on the Body Sample Essay The alcohol section of DBOH highlights the effect alcohol misuse has generally in the United Kingdom and also specifically to oral health. It illustrates how much a unit of alcohol is using different types of alcohol. It identifies the role dental professionals can have in supporting alcohol misusers and lists useful resources. It also contains AUDIT(C) which stands for ‘Alcohol use disorder identification test’. Once completed the patient can be placed in to a category depending on their level of risk, if a patient scores over 10 the importance of referral to their GP or local alcohol support service must be stressed. The fundamental message DBOH encourages dental clinicians to employ is ‘Ask, Advise, Act’; this should be actioned to every patient who requires it.Alcohol’s Effect on the Body Sample Essay Questionnaire Design and Methodology The aim of this questionnaire (Appendix – Figure A) was to gather data to attempt to answer the primary research question ‘Are dental clinicians implementing the alcohol toolkit from delivering better oral health?’ As stated initially the questionnaire was created using guidance from the University of Leeds website. To create an appropriate questionnaire the research aims must be clear. For this research project the author required demographic information on the participants and to create questions which would provide an insight in to the relationship between the dental clinician and their patients regarding the conversations which take place surrounding alcohol consumption and advice. As the primary research aim is to identify if DBOH is being used or not, the author had to ensure no bias was shown toward DBOH in the questions. To ensure this the questions asked in the survey included the mention of multiple publications; there was only one question which asked specifically about DBOH. The intended sample participants were dentists, dental hygienists and dual qualified dental hygienists and therapists working in dental practices in the United Kingdom. The aim was to achieve one hundred participants to garner an adequate cross section of the population of dental clinicians in the United Kingdom, to gather enough data to deduce meaningful conclusions to the primary question in the time frame set and with the resources available to the author.Alcohol’s Effect on the Body Sample Essay The format of this questionnaire was self-administered and not conducted through one to one interviews. This was chosen to accommodate the resources and time available to the author. The questionnaire was designed on http://www.surveymonkey.com as mentioned in the introduction.Alcohol’s Effect on the Body Sample Essay The link to the questionnaire was primarily distributed through two mediums to attract the most responses. Firstly the website http://www.gdpuk.com which is a website for dental professionals containing new articles, blogs, classified advertisements and importantly a forum. The link was distributed in the forum along with a cover note (Appendix Fig B) explaining that the project would be looking at alcohol and the oral cavity with an emphasis on alcohol advice, DBOH was not mentioned as this would infer bias. Secondly the questionnaire was distributed on the Facebook group Dental Hygienist and Therapist Network which is a non-public group and has over three thousand members. The link was posted, along with a cover letter. Alcohol’s Effect on the Body Sample EssayThe link to the questionnaire was also passed on through the authors contacts within the dental industry. The ideal number of participants was one hundred; within forty eight hours of distributing the questionnaire one hundred and five responses had already been submitted. The final amount at the close of the questionnaire was one hundred and twenty respondents. The layout of the questionnaire was determined mainly by surveymonkey.com, there was a ten question limit due to limited funding available to spend on purchasing more questions. Nine questions were tick box and closed questions with single response answers, unless there was an ‘other’ selection in which case the respondent would need to specify their answer. One question offered the respondent to add anything they wished to write making it an open question. Tick box answers were chosen for simplicity and time management. According to The University of Leeds guidance, the most successful questionnaires are quick, as people tend to be hesitant to commit to completing a questionnaire that they presume will be complex or take a long time.Alcohol’s Effect on the Body Sample Essay There is some conflict amongst questionnaire guides whether easy questions such as gender, occupation and location, should be at the start or the end of a questionnaire. In this questionnaire the simple questions were split and inserted both at the beginning and end. Starting with occupation and ending with gender, age and location. All respondents were reassured of their anonymity by completing the questionnaire on surveymonkey.com and also assured that the data they provided would only be used in connection with this research project.Alcohol’s Effect on the Body Sample Essay Although it is best practice to run a pilot survey first, due to time restraints this was not possible. However the author did ask for proof reading and feedback from colleagues and family to ensure there were no obvious errors or omissions.Alcohol’s Effect on the Body Sample Essay Data Analysis & Discussion Out of one hundred and twenty respondents, one person did not select their occupation; this meant 44% of respondents were dentists, 21% dental hygienists and 35% dual qualified dental hygienist/therapists.Alcohol’s Effect on the Body Sample Essay Question two asked’How often do you ask your patients about their alcohol intake?’. The answer with the most responses was ‘At every appointment/3+ times per year’ with a total of 38, however ‘Once per year’ was close behind with 36 selections (Appendix – Fig 2). It is interesting to note that when the results were broken down in to occupation the most popular selections were as follows; dentists — Twice per year 71%, dental hygienists — Never 41% and dental hygienists/therapists — At every appointment/3+ times per year 55% (Appendix – Fig 3). The survey indicated that the majority of sole qualified dental hygienists in this survey are not asking their patients about their alcohol intake at all. When the author asked a sole qualified dental hygienist colleague why he thought this might be, the colleague disclosed that he had never been taught anything during his studies to do with alcohol, nor DBOH. This response may go some way to establishing the cause, but it also identifies a need for further research to investigate the reason for this.Alcohol’s Effect on the Body Sample Essay Question three is one of the most important questions in the survey as it concerns where dental clinicians are obtaining their alcohol advice. The most popular answer was ‘NICE guidelines’ with 37% (Appendix — Fig 4). Once it has been disseminated in to occupation the results are as follows; Dentists — NHS Scotland: Alcohol and Oral health 70%, Dental hygienists — NHS Live Well Guide 26% and Dental hygienists/therapists — Delivering Better Oral Health 47%.Alcohol’s Effect on the Body Sample Essay When considering range, the age group which uses DBOH the most are 18-24 years at 60%, 65-74 years do not use DBOH at all and 45-54 years comes in second least with 17% (Appendix – Fig 6). A possible reason for this could be the time at which the participant qualified. Currently many dental hygiene and therapy programmes in the United Kingdom promote and encourage the use of DBOH these results may imply that those in the younger age group qualified recently so continued using DBOH in practice as they were in university. Whereas the older age groups may not be as aware or comfortable using it. However this highlights a need for further research.Alcohol’s Effect on the Body Sample Essay Question four asks the question how does a dental clinician decide what advice is appropriate. Interestingly the most popular answer was ‘I do not normally give alcohol advice’ (40%) and the second most popular answer with only a difference of 0.17% was ‘I check to see if their units of alcohol per week are over or under the national recommendations’ (Appendix — Fig 7). Whilst it may be suitable to assess a patients level of risk by checking their weekly units of alcohol, it does not provide as much in depth information as AUDIT (C), nor does it place a person in an official risk category as outlined by DBOH.Alcohol’s Effect on the Body Sample Essay More concerning is the fact that nearly half of the participants surveyed do not offer any alcohol advice at all. Many patients are unaware of what constitutes a unit, how many units per week are advisable and importantly the risks associated with drinking alcohol. The most popular results per occupation are as follows (Appendix — Fig 8); dentists equally chose ‘I do not normally give alcohol advice’ and ‘I check to see if their units of alcohol are over or under the national recommendations’ with 47% each, dental hygienists — ‘I do not normally give alcohol advice’ and dental hygienists/therapists — ‘I ask the patient to complete AUDIT (C) from DBOH’. As mentioned previously further research is needed to highlight any reasons for the varied choices from the three professions.Alcohol’s Effect on the Body Sample Essay Question five relates to the advice advocated by DBOH, which is the aforementioned ‘Ask, Advise, Act’. If it has become apparent the patient requires professional support it is the responsibility of the clinician to encourage referring them on to their GP or local alcohol support service. Whilst only 93% of clinicians had never referred a patient and 7% had (Appendix — Fig 9). More females have referred than males at a ratio of 9%:3%, however this may not be significant if the research was repeated with a larger sample size as this survey had more female respondents than male with a ratio of 86:34. Question six is also important in answering the question for the primary research goal. This question asks for the participant’s opinion on the alcohol chapter of DBOH. Interestingly 71% of respondents replied ‘I do not use it’ and only 16% like it (Appendix — Fig 11). From the occupation groups the highest non-users were the dental hygienists (Appendix – Fig 12). As there are currently no publications regarding the usage or the opinion of clinicians using DBOH, there are no points of comparison or studies for the author to speculate the reasons why such a large proportion does not use DBOH. This study has highlighted a need for a further field of study in to DBOH and patient care, and to identify the best way for patients to receive best practice, standardised care, whether this is via DBOH or other relevant guidelines.Alcohol’s Effect on the Body Sample Essay From the demographic questions we can see that out of 120 participants 86 were female and 34 were male (Appendix — Fig 13). Of the age groups sampled jointly the 25-34 years and 35-44 years had a total of 36 respondents, the highest amount out of all the age categories (Appendix — Fig 14). This may be indicative of the platforms the questionnaire was distributed, via Facebook and a website. Paper copies or emails sent directly to dental practices might allow for more varied age range responses. The most popular location was the South East of England with 24 respondents (Appendix — Fig 15).Alcohol’s Effect on the Body Sample Essay Statistical Significance To test the validity of this research and to identify whether the hypothesis is correct the statistics must be tested. The data in this research consists of categorical variables; this simply means the options can be placed in to categories, for example occupation, the variables are not numeric. For data with categorical variables a chi square test is performed to identify significance. The categorical variables in this research can also be further broken down in to independent and dependent variables. This research consists of mostly dependent variables. Dependent variables are things that can be changed by other factors, some examples of this are; • A dental hygienist may do further training to become a dental therapist. • A dentist may not currently like DBOH but once the publication has been altered or updated they may change their mind. Independent variables are things that cannot be changed by other factors for example eye colour or gender. Using question six ‘How do you feel about section 8’Alcohol misuse and oral health’ in DBOH?’ An online chi-square calculator was used to analyse the relevant information as depicted in Fig 16; This table sets out the observed values, expected values in round brackets and chi-square values for each cell in square brackets. To interpret your chi-square statistic you must first decide your significance value, this is usually 5% or 0.05. Then it is necessary to identify your degree of freedom, this is a table which allows you visualise how much your statistic is allowed to vary. To work out your degree of freedom a simple equation must be calculated; (Number of rows-1) X (Number of columns-1) =Degree of freedom So for this table we have; (3-1) X (5-1) = 8 degrees of freedom Fig 17 is a chi-square degree of freedom table; The chi square statistic for this research is 21.90, and the degree of freedom as highlighted in blue above is 15.51. This means the statistic is greater than the degree of freedom therefore the null hypothesis (H0) ‘Dental clinicians are implementing DBOH’’ is rejected and the alternative hypothesis (H1) ‘Dental clinicians are not implementing the alcohol toolkit from DBOH’’ is accepted.Alcohol’s Effect on the Body Sample Essay The p-value of this study also confirms the above statement. The significance value was set at 0.05, so a small p-value or a p-value of less than 0.05 confirms rejection of the null hypothesis and acceptance of the alternative hypothesis. The p-value was 0.005. Therefore the primary research identifies that the majority of clinicians are either not using the alcohol toolkit of DBOH at all, or are only using some parts of it, not in its entirety.Alcohol’s Effect on the Body Sample Essay Why is there a reluctance to address alcohol consumption? Question seven on the questionnaire asked the participants ‘Anything you would like to add?’. The answers provided a thorough insight in to some of the reasons why dental clinicians may be reluctant to address alcohol with their patients. Many participants commented that alcohol consumption was answered on the medical history form, this may indicate that they believe as long as they have a written record of the patient’s alcohol consumption that would be enough information or they are covered medico-legally. However if they do not discuss it further with the patient they will not know whether the patient understands what a unit of alcohol is or even if the patient understands the risks associated with drinking regularly. The clinician may also be placing themselves in a risky position regarding negligence. In 2013 a patient took dentist Ian Hughes to the high court for failing to diagnose her oral cancer, he was in this instance cleared of the charges (www.manchestereveningnews.co.uk). However it should be a warning to clinicians who fail to either risk assess the patient or perform a thorough examination.Alcohol’s Effect on the Body Sample Essay Another participant stated ‘already too much to do for my £8.30 (Scottish exam fee) without doing this. Writing the notes alone takes long enough!’ this seems to broach the idea that time and money are a factor in what dental professionals should be or are capable of covering in their appointments with patients. Further participants mentioned the constraint of time. There is a huge demand in the United Kingdom for access to dental care, especially National Health Service practices, therefore there is pressure placed upon clinicians to treat as many patients as possible. There may be an argument to suggest that dental clinicians are not afforded the time to cover all the areas necessary as part of a standard dental visit. Some participants made reference to the fact that they would only discuss alcohol consumption if they found an ‘oral development’ they felt could link to alcohol or evidence of acid erosion. However the opposing argument to this is if they had addressed alcohol earlier in their professional relationship where possible, would the patient be exhibiting those oral manifestations.Alcohol’s Effect on the Body Sample Essay A common reaction is that smoking is a topic that is easier to address, one participant divulged ‘I find patients are more defensive about how much they drink than smoking (sic) and many do not understand its relevance to oral health’. The government has spent a lot of money on resources attempting to encourage people to stop smoking by highlighting the associated risk. Some key events were the ban on smoking in all enclosed work places in 2007 (www.politics.co.uk) and graphic images being printed on to cigarette packets in 2008 (www.bbc.co.uk). There has not been such government investment in exploring alcohol related disease and formulating nationwide advertisements or publications to explain the health implications to the general public.Alcohol’s Effect on the Body Sample Essay There seems to be a social acceptance that the risks of smoking and encouragement to quit can be openly discussed with smokers without undue tension. Therefore this ties in with the overwhelming reaction from the participants that there is an awkwardness surrounding discussions about alcohol consumption. One participant stated ‘Patients can be even more coy about alcohol consumption than they are about smoking’, this might suggest that they feel patients would not provide an accurate or truthful answer to begin basing advice on. Some further comments to illustrate participants feeling awkward are ‘Alcohol can be a sensitive issue to approach’; ‘…it is not my responsibility to question their lifestyle choices’, ‘I find it too awkward an area to broach with patients’ and ‘We all have bad habits’. Unlike smoking, historically alcohol tends to still be a socially accepted activity. Fermented drinks can be dated as far back as the Stone Age (www.nytimes.com). Alcohol is commonly consumed as part of a celebration or social time spent with colleagues, family or friends, as part of religious services and might even be a person’s career e.g. professional wine taster. It is therefore not surprising that dental clinicians find it a tricky subject to deal with because the probability is that they too consume alcohol. Underwood, Fox and Manogue (2010) conducted a survey of tobacco, alcohol and drug use among dental undergraduates at an English university. They compared results from 1998 and 2008. Alcohol’s Effect on the Body Sample EssayThe 2008 results showed that 63% of males and 69.5% of females drank alcohol. There has also been an increase in binge drinking amongst both sexes since 1998. Underwood, Hackshaw and Fox (2007) also conducted a survey of tobacco, alcohol and drug use amongst newly qualified dentists completing a year’s vocational training comparing data from 2000 and 2005. The findings showed that whilst the amount of males and females drinking alcohol had decreased since 2000, it was still at a high proportion with 82% of males and 81% of females in 2005. It can consequently be suggested that as many dental clinicians are consuming alcohol despite being aware of the risks, thus they feel it is hypocritical to evaluate and admonish another person for their decisions. The Role of the Dental Hygienist/Therapist From an ethical and medical point of view alcohol intake must be part of gathering a complete history about your patient. Thorough soft and hard tissue checks should be completed to check for any abnormalities. The patient should be informed of their relative level of risk for oral disease from any of their habits. Advice should be offered where appropriate and done with evidence based backing. The clinician must be able to identify where further specialist referral is required.Alcohol’s Effect on the Body Sample Essay How could this research be furthered? If the author were to continue this research the initial changes to implement would be the sample size. A larger sample size would provide more data to analyse and a greater opportunity for knowledge in this field. The questionnaire would also be provided in different formats such as email, paper copies and other modes of internet based distribution. Interestingly question three asked the participants whe

Nursing

Communication Between Patients And Nurse Essay Paper Communication Between Patients And Nurse Essay Paper Breakdowns in communication, within teams or with patients, can occur in many ways. Common examples include outbursts of anger, misunderstandings of tone or volume of voice, cultural differences, inappropriate humor, the use of touch, and others. All of these breakdowns can result in stressful work environments, costly turnover in staff, and poor clinical outcomes. This process-driven, highly interactive, two-day course with extended follow-up is designed to remediate distressed or disruptive clinicians who employ a broad range of unproductive or challenging communication behaviors. The course aims to return clinicians to meaningful careers properly equipped with the tools they need and a Personalized Protection Plan for communicating effectively and professionally in the future.Communication Between Patients And Nurse Essay Paper Permalink: https://nursingpaperessays.com/ communication-be…se-essay-paper / ? Prior to arrival at the seminar, participants begin our course with online pre-course assignments that include a personal essay and a Communication Self-Assessment Test. Our confidential and non-judgmental small-group seminar format creates a safe environment for honest disclosure and self-assessment. Through the use of the PBI Incivility Formula ©, participants are guided by faculty to openly examine their own personal vulnerabilities, risk factors, and resistance to self-assessment. Seminar participation and final presentation of a stratified Personalized Protection Plan to the course faculty and the class are required. Communication Between Patients And Nurse Essay Paper Upon concluding the in-person course, the weekly, telephonic post-course Maintenance and Accountability Seminars (MAS) reinforce what was learned in the classroom. These sessions elevate participants’ accountability through revisiting their Personalized Protection Plans, and engage them in a community of peer review and support. Communication involves the exchange of messages and is a process which all individuals participate in. Whether it is through spoken word, written word, non-verbal means or even silence, messages are constantly being exchanged between individuals or groups of people (Bach & Grant 2009). All behaviour has a message and communication is a process which individuals cannot avoid being involved with (Ellis et al 1995). In nursing practice, communication is essential, and good communication skills are paramount in the development of a therapeutic nurse/patient relationship. This aim of this essay is to discuss the importance of communication in nursing, demonstrating how effective communication facilitates a therapeutic Communication involves information being sent, received and decoded between two or more people (Balzer-Riley 2008) and involves the use of a number of communication skills; which in a nursing context generally focuses on listening and giving information to patients (Weller 2002). This process of sending and receiving messages has been described as both simple and complex (Rosengren 2000 in McCabe 2006, p.4). It is a process which is continually utilised by nurses to convey and receive information from the patient, co-workers, others they come into contact with and the patient’s family. Models of Communication. The Linear Model is the simplest form of communication and involves messages being sent and received by two or more people (McCabe 2006). Whilst this model demonstrates how communication occurs in its simplest form, it fails to consider other factors impacting on the process. Communication in nursing practice can be complicated, involving the conveyance of large amounts of information, for example, when providing patients with information relating to their care and treatment or when offering health promotion advice. Reflection is a vital key for effective communication with patients and their families.Communication Between Patients And Nurse Essay Paper The main claim to this paper, is to prove, to have effective communication with patients and their families, firstly, one must know oneself. Communication is a two-way street Yes…but for effective communication to be understood, one must acknowledge oneself first, Communication starts with ourselves. we need to address that we, too, are human beings, with our own thoughts, feelings, beliefs, attitudes, prejudices and preferences. There is an increase in the healthcare profession that we must care for ourselves before caring for others (Burnard,2001). (Older reference but very supportive towards this paper). The quality of communication is a critical factor in meeting the needs of individuals, families and communities, (Crisp & Taylor 2009). Communication is an expressions of ones thoughts…To convey what one person is trying to say to another. When communicating there is a messenger and a receiver but sometimes due to the way the message is delivered there maybe misunderstandings, and confusion arises and the message Communication Between Patients And Nurse Essay Paper maybe misunderstood. Be clear and precise in what you’re trying to say and why, (Crisp & Taylor 2009). Body language has a great deal to do with communication and it is believed that body language is the greatest form of all communication skills because it is hard to control and therefore, maybe even more acknowledged that the spoken word, (Crisp & Taylor 2009). From birth, body language is the basic skill and the only way a baby has to communicate, as a teenager spoken words are often mixed with bad reactions but again their body language is without doubt the best way of understanding our confused teens, Adulthood is often confronting, their peers may use prominent words, which to the receiver may be complicated, and hard to follow the meaning of. Nurses possess a tremendous amount of medical knowledge and clinical expertise. Yet their greatest challenge — and perhaps most vital task — is communication. Every step of the way, from patient intake to patient discharge and beyond, nurses must communicate well to provide comprehensive care. Using Gibbs: Example of reflective writing in a healthcare assignment Description In a placement during my second year when I was working on a surgical ward, I was working under the supervision of my mentor, caring for a seventy-two year old gentleman, Mr Khan (pseudonym), who had undergone abdominal surgery. I had been asked to remove his wound dressing so that the doctor could assess it on the ward round. I removed the dressing under my mentor’s supervision, using a non-touch procedure, and cleaned the wound, as requested by the doctor. My mentor was called to another patient at this point, so at her request I stayed with Mr Khan while we waited for the doctor to come to see him. Communication Between Patients And Nurse Essay Paper The doctor had been with another patient, examining their wound, and I noticed that she came straight to Mr Khan to examine his wound, without either washing her hands or using alcohol gel first. I also noticed that she was wearing a long-sleeved shirt, and I was concerned that the cuffs could be contaminated. I thought for a moment about what to do or say, but by the time I had summoned enough courage to say something, I thought it was too late as she was already examining Mr Khan. Feelings I was alarmed by this, as I had expected the doctor to wash her hands or use alcohol gel before examining Mr Khan. However, I felt intimidated because I felt that the doctor was more experienced than me as a second year nursing student; and I didn’t want to embarrass her. Also, I didn’t want to make Mr Khan concerned by confronting the doctor in front of him. Later, I spoke to my mentor about the incident. She suggested that we speak to the doctor together about it. My mentor took the doctor aside, and asked her whether she had washed her hands before examining Mr Khan. She looked quite shocked. She said that she had been very busy and hadn’t thought about it. My mentor discussed the importance of hand hygiene with her, and the doctor assured her that she would wash her hands before examining every patient in the future. Communication Between Patients And Nurse Essay Paper Evaluation The incident was extremely challenging for me. I regret that I did not act to challenge the doctor’s practice before she examined Mr Khan. However, I am pleased that the doctor responded so positively to the feedback of my mentor, and I have observed that she has now changed her practice as a result of this incident. I too have learned from the incident, as it has taught me the importance of acting assertively with colleagues, in a sensitive manner, in order to safeguard patients’ well-being. Analysis The Royal College of Nursing (2005) states that hand hygiene is the single most important activity for reducing cross-infection, and points out that many health care professionals do not decontaminate their hands as often as they should. Recent guidance published by the Department of Health (2007) highlights the possibility of staff transmitting infections via uniforms, and the need to review policies on staff dress. The Nursing and Midwifery Council Code of Professional Conduct (2004, section 8) states that as a nurse ‘you must act to identify and minimise the risk to patients and clients’. As the student nurse caring for Mr Khan under my mentor’s supervision, this also applies to my own practice as a student nurse. Communication Between Patients And Nurse Essay Paper Looking back on this incident, I can see that I should have acted sooner, and that I should have ensured that the doctor washed her hands before examining Mr Khan. I can now see that my inaction in this incident put Mr Khan’s well-being at risk. After discussion with my mentor, I recognise that I need to develop the confidence to challenge the practice of colleagues, putting the well-being of clients at the forefront of my mind. I realise that I need to be supportive to colleagues, understanding the pressures that they may be under, but ensuring that their practice does not put clients at risk. Action Plan In future, I will aim to develop my assertive skills when working with colleagues, in order to ensure that the well-being of clients is maintained. In my next placement, I will make this a goal for my learning, and will discuss this with my mentor to work out strategies for how I can achieve this.Communication Between Patients And Nurse Essay Paper Communication can be approached in terms of the skills needed to get a hoped-for response. By seeing communication in terms of skills, it is easier to focus on what skills you already have and use. Once you have a reasonably clear picture about this, it is much easier to see where you might want to increase your communication strengths and decrease any weaknesses. It can be useful to try assessing what you see as someone else’s communication skills before you think about your own. Author Neil Thompson (1996) has pointed out that these verbal aspects of communication can all give important clues about how people are feeling. So it is not just what people say that counts, it is how people say it, too. If someone seems to talk rather quickly, this may be because he or she is angry or worried. In contrast, if someone speaks slowly, this may be because he or she is tired. Or it may indicate a lack of confidence in what that person has to say. It is also possible to interpret why people may use a particular tone of voice. As Thompson (1996, p. 83) points out, tone of voice is “an important indicator of emotional state. It gives important messages about how the person is feeling. It indicates a whole range of feelings: anger, sadness, joy Communication Between Patients And Nurse Essay Paper Similar comments may be made about pitch. Thompson suggests that: flat, unmodulated pitch can reflect a depressed mood, while high or fluctuating pitch can signal … anger, fear or excitement. Thompson (1996, pp. 83–84) Thompson (1996, p. 84) suggests that quiet speech can indicate a lack of confidence, fear or anxiety whereas loud speech can suggest aggression or a lack of sensitivity. Loud speech may also be used by someone who is fearful or anxious. Facial expressions, according to Thompson (1996, p. 95), “are very powerful in conveying information.” As far as eye contact is concerned, it is important not to have too much eye contact as this can be seen as challenging or threatening. On the other hand, too little eye contact can be interpreted as indicating that someone is not trustworthy. It is important to note that these interpretations can vary from one culture to another. Some cultures see it as being polite to avoid eye contact as much as possible.Communication Between Patients And Nurse Essay Paper Experience is sometimes regarded as the best teacher. Many things can be learned in a classroom and by formal academic study, but many cannot. Reflective practice is a form approach to learning through experience. Reflective practice is a lifelong learning process to promote continual development of the nurse. Reflective writing practice helps the nurse to gain knowledge and to challenge their own ideas and concepts. The idea of reflective practice is not only to see what happened, but to see the situation through new eyes, eyes that can help in personal growth and to develop ways to respond differently in the future. Effective reflection helps the practitioner to see the situation from an outsider’s perspective, so that they can develop a better way to respond to a similar scenario in the future. Reflection is meant to achieve a change in practice, rather than simply repeating the same mistakes (Schon, 1983). Many different models exist for structuring the reflective process. Regardless of the framework used, the reflection models are meant to accomplish three things. They are supposed to promote reflecting on events, self-evaluation and analysis, and a plan to change actions in the future. This Reflective essay will utilize Driscoll’s ‘The What?’ model as its structure (Driscoll, 1994).Having the chance to experience clinical rotations on the telemetry, medical surgical, labor and delivery and postpartum floors so far have been incredible. Although, throughout these last few months, I have certainly seen many nurses converse and behave in ways I would never imagine a registered nurse to. From these experiences I learned easier ways to quickly set up equipment, how to properly address situations when the family is present, and how to effectively communicate between doctors, physical therapists and case managers. As for the nurses who improperly cared for their patients, those nurses will be examples of who I tell myself I will never become. The top three priorities I have for myself in my nursing practice as a student and that of which I plan to carry on throughout my career are not to be the cause or route of transmission of any nosocomial infection; to take the time to listen to my patients and their families; and to never stop learning. A common barrier that I will encounter when performing all of my priorities is going to be the essence of time. As a nurse, I have to be ready for any situation to change for the good or bad at any time of the day. I have to be flexible but I also have to take the time to slow down in order to provide the safest and best quality care to my patients. Barriers that are present when trying to avoid being the route of transmission of an infectious bacterium are going from patient to patient and doing an assessment while not wearing a pair of gloves since I did not touch any body fluids or open wounds. Even though I did not come into contact with any known pathogens, It is my duty to protect my patient Communication Between Patients And Nurse Essay Paper Having the chance to experience clinical rotations on the telemetry, medical surgical, labor and delivery and postpartum floors so far have been incredible. Although, throughout these last few months, I have certainly seen many nurses converse and behave in ways I would never imagine a registered nurse to. From these experiences I learned easier ways to quickly set up equipment, how to properly address situations when the family is present, and how to effectively communicate between doctors, physical therapists and case managers. As for the nurses who improperly cared for their patients, those nurses will be examples of who I tell myself I will never become. The top three priorities I have for myself in my nursing practice as a student and that of which I plan to carry on throughout my career are not to be the cause or route of transmission of any nosocomial infection; to take the time to listen to my patients and their families; and to never stop learning. Communication Between Patients And Nurse Essay Paper A common barrier that I will encounter when performing all of my priorities is going to be the essence of time. As a nurse, I have to be ready for any situation to change for the good or bad at any time of the day. I have to be flexible but I also have to take the time to slow down in order to provide the safest and best quality care to my patients. Barriers that are present when trying to avoid being the route of transmission of an infectious bacterium are going from patient to patient and doing an assessment while not wearing a pair of gloves since I did not touch any body fluids or open wounds. Even though I did not come into contact with any known pathogens, It is my duty to protect my patient The aim of this report is to look at a critical incident that occurred in placement and relate this to the theory and knowledge regarding communication and interpersonal skills, so as to demonstrate an understanding of my views on the art and science of reflection and the issues surrounding reflective practice Reflection is part of reflective practice and a skill that is developed. It can be seen as a way of adjusting to life as a qualified healthcare professional and enhancing the development of a professional identity (Atwal & Jones, 2009). Reflection is defined as a process of reviewing an experience which involves description, analysis and evaluation to enhance learning in practice (Rolfe et al 2001). This is supported by Fleming (2006), who described it as a process of reasoned thought. It enables the practitioner to critically assess self and their approach to practice. Reflective practice is advocated in healthcare as a learning process that encourages self-evaluation with subsequent professional development planning (Zuzelo, 2010). Reflective practice has been identified as one of the key ways in which we can learn from our experiences. The incident that was chosen was so for the reasons that the situation made the student aware of inadequacies on his own part and those of the staff on the team, which made him reflect upon the situation and how this could be learned from, so as not to make the same mistake again. Before the critical incident is examined it is important to look at what a critical incident is and why it is important to nursing practice. Communication Between Patients And Nurse Essay Paper The nursing profession is one of the most challenging and rewarded careers in my opinion. Mostly in the XXI century that we are living, with the constant challenge of the healthcare system in our communities that continue to rise with a higher standards of care in all different setting in the nursing care. Everyday our patients and communities expect more from nurse as leaders in the shifting healthcare model. The recognition well deserved that we as nurses find in our patients is all because those many wonderful nurses that came before us and showed to the world how important is the job we do and how critical is taking our word in consideration when in taking care for our patients. I would like to emphasize today in a beacon of acknowledge in our profession and example of a great nurse. Dorothea Orem born in 1914, Maryland and her Theories about Self-Care in Nursing will be the center of our discussion on this article. She earned a Nursing Degree from Providence Hospital School of Nursing in Washington DC in the 1930’s. Later in the early 1940’s she a bachelor degree and later on a master degree both from Catholic University of America in Washington DC. The Self-Care Nursing Theory of Orem’s Model of Nursing was developed by her during her all career between 1959 and 2001. It’s considered a grand theory meaning that covers a broad of general concepts that applied to all fields of nursing. The main idea of Orem’s theory is that patients want to take care of themselves and they will recover sooner and holistically better when they do their own self-care as much as they are able to do it. Assessing someone’s communication skills is always going to be difficult as since different interpretations are always possible. It is not always easy to decide which interpretation is “true.” The point is to become as aware as possible about the messages that other people are sending out so that you can improve the likelihood of reasonably successful communication. Let’s see what Karen has to say about her communication skills.Communication Between Patients And Nurse Essay Paper I think I have learned how to read body language when I am speaking to people—I’m more observant. People don’t always say how they are feeling, so if you can read their body language, it’s easier to pick up on things. I am probably more confident with my questioning. I am listening and taking in the messages I am receiving from people and also giving them a lot more opportunity to make their own choices. A 2014 research paper, Communication in Nursing Practice , found that nurses who display courtesy, kindness and security to their patients — through both their actions and words — are generally more successful in establishing a good rapport. The paper suggested that nurses must go beyond simply demonstrating these niceties though. They need to approach every patient-nurse interaction with the intent to understand the patient’s concerns and experiences as well as demonstrate that they are open to truly hearing patient’s input. To do so, nurses must carefully consider where and when to talk to patients. Nurses should allow sufficient time for each patient interaction. For example, patients may be hesitant, nervous, upset or otherwise incapacitated, which may extend the time needed to have a thorough discussion of the issue at hand. Patients may find a rushed conversation frustrating or even rude. It may hinder the ability of the nurse to establish open communication with the patient, thereby slowing down or negating the treatment process. Nurses must also be mindful of the location in which these interactions occur. Selecting an area that is free from distractions — to the greatest extent possible — may help to facilitate a more positive flow of communication. Additionally, this promotes confidentiality and protects the patient’s personal health information.Communication Between Patients And Nurse Essay Paper Good communication between nurses and patients is essential for the successful outcome of individualized nursing care of each patient. To achieve this, however, nurses must understand and help their patients, demonstrating courtesy, kindness and sincerity. Also they should devote time to the patient to communicate with the necessary confidentiality, and must not forget that this communication includes persons who surround the sick person, which is why the language of communication should be understood by all those involved in it. Good communication also is not only based on the physical abilities of nurses, but also on education and experience. The Nursing and Midwifery Council (NMC) has set out at least four domains of competencies for entry to the register in Adult Nursing. In this brief, I will focus on the second domain of communication and interpersonal skills. Communication plays a crucial role in addressing the needs of the patients. Adult nurses are expected to communicate effectively, listen with empathy and advocate for their patients (Department of Health, 2012a, 2012b). Specifically, the Department of Health (Commissioning Board Chief Nursing Officer and DH Chief Nursing Adviser, 2012) has introduced the 6 Cs of nursing, which encompasses compassion in nursing practice. Compassion in care is only possible when patients feel that their nurses understand their feelings and show empathy (Chambers and Ryder, 2009). Communication is essential in helping patients articulate their needs (Hall, 2005). Similarly, poor communication could result to misunderstanding, anxiety for the patients and poor quality of care (Chambers and Ryder, 2009).Communication Between Patients And Nurse Essay Paper In this brief I will focus on the domain of communication and interpersonal skills since these form the foundation of my relationships with my patients. Developing my competency in this domain would help me identify both verbal and non-verbal messages of the patients and address their needs accordingly. Meanwhile, effective communication is needed when I communicate with my colleagues and other healthcare practitioners. A focus on my communication skills with my patients will be made in this reflective brief. Communicating effectively with my patients and other health and social care professionals would help improve the care received by my patients. Benner’s (1984) stages of clinical competence would be used to underpin my development from novice to competent. Gibb’s (1988) reflective model will be utilised to reflect on my experiences in the last three years from novice to competent.Improving my communication skills has been a work in progress starting back in the early years of my life. I have always been my own worse critic. Usually beating myself down through interpersonal communication. Now as an adult I have made great improvements but still have trouble dealing with perception and self-image. Not being raised in an environment of positive reinforcement and poor communication in the workplace I have made it a point to change that trait in my own family and professional environment. When reading the opening lecture I cringed at the thought of dealing with communication. Sort of that belly ache feeling you get when you had to do an oral presentation in front of the class in elementary school. I understand have a number of strong qualities but self-image and my perception are still traits I long to improve. My self-image is so low that I have a tremendous amount of self-pity or self-hatred. I do however want to find that happy median where I’m comfortable in my own skin. It’s odd how my feelings about myself change from day to day. I engage quite often in interpersonal conversation, question my motives and encouraging myself to move forward. Communication Between Patients And Nurse Essay Paper Professional Development from Novice to Competent Level Reflective practice (Gibbs, 1988) allows healthcare practitioners to improve current practice by learning from incidents and one’s own experiences. Pearson et al. (2009) explains that one’s own experiences are another form of evidence in healthcare. With the focus on patient-centred care, the NHS (Department of Health, 2012b) has encouraged evidence-based care when addressing the needs of the patients. I will use Gibbs (1988) model in reflecting on my communication experiences in years 1 to 3. This model starts with a description of an incident followed by analysis, evaluation, conclusion and action plan.Communication Between Patients And Nurse Essay Paper In this essay, I intend to reflect on a situation I encountered during my first community placement I had the opportunity to develop my communication skills not just theoretically but also practically, facing a real life environment. My placement made me aware of the importance of interpersonal and communication skills which are very important in the delivery of care. Throughout my nursing career, I will be encouraged to develop reflective practice skills and become a reflective practitioner. Reflection refers to a series of steps that you may take to question and explore an experience with the aim of learning from it. I will discuss the importance of communication in order to maintain a therapeutic relationship. Communication Between Patients And Nurse Essay Paper Effective communication in the healthcare setting improves recovery rates and reduces pain and complication rates. (Wilkinson et al, 2003). Many complaints to the NHS are attributed to poor communication. Effective communication is reliant on the nurse working in partnership with the patient. It is essential that the nurse establishes a rapport and most of this will be achieved through the use of facial expressions. In my practice, it is important that develop a therapeutic relationship with the patients so that they can be able to put their trust in me. The therapeutic relationship is solely to meet the needs of the patient. In this relationship, there is a rapport established from a sense of mutual understanding and trust. To build a good nurse-patient relationship, I would have to show qualities of empathy, caring, sincerity and trustworthiness. During practice, if I am approaching a patient and the patient looks anxious, I should approach with empathy.Communication Between Patients And Nurse Essay Paper Composing a reflective essay on effective communication in nursing can be difficult for some. Producing this style of paper will need the basic steps taught and some variations on the way it is written. When writing most types of papers, it is taught to come up with a thesis and explain, in the most informative and clear way, what it is. This style of paper consists of reflections made on the subject including emotions and experiences on the matter. The difference in this introduction is in your own way summarizing the conclusion. Having the room to produce your experiences without concern of facts opens the door for that all important creativity. Emotion is more crucial than facts To say no facts does not mean it is not true. Everyone sees and feels different things when looking at the same thing. The better you are at putting these things down on paper, the more interesting your work will be. Imagination and memory are two strengths that must be paid close attention to. In the world of nursing there is a lot of turmoil and confusion in a life and death situation. Sometimes the difference between saving and losing a life is a very fine line.Communication Between Patients And Nurse Essay Paper Effective communication is crucial The ability to clearly hear instructions or the patient’s needs can be drowned out in the confusion. Working with a regular staff can be a plus when you know the skills of the other personnel. Descriptions of the injuries are a must for not only the nurse but the doctor. The skill of recalling what you see can be very important in order to keep the patient alive. Life as a nurse Explaining how uncomfortable it was in the beginning, working with new staff and injuries, will automatically bring up memories and emotions felt by you personally. There will not be a shortage of sight, smells, and sounds that only a nurse could know and understand. Dealing with the sick and dying is working with man at its worst. Learning the skill of carrying on conversations with these types of people only makes you a stronger and better person. Explain how you felt and worked around these individuals in the beginning and how you handled same situations at this point in your career. People whose scenarios have led them to a visit to a hospital can be very weary of the kind of treatment they receive from personnel. The ability to look back and describe all of those experiences in your own way will make the interest of the reader while they are reading, but will remember those insights well after they have finished. Composing a reflective essay will help others appreciate what nurses go through.Communication Between Patients And Nurse Essay Paper An incident during my year 1 exemplifies how I developed my communication and interpersonal skills as a novice. I was assigned to the mental health ward and assisted an elderly patient with dementia who was admitted for pneumonia. During his first day in the hospital, my senior nurse performed a nutritional assessment and

Nursing