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Legal and Ethical Considerations for Group and Family Therapy Essay Paper Legal and Ethical Considerations for Group and Family Therapy Essay Paper Group counseling offers multiple relationships to assist an individual in growth and problem solving. Groups are an excellent treatment choice for numerous intrapersonal and interpersonal issues, and in helping people to change. Groups provide a sense of community to its members allowing them to see that they are not alone. In group therapy sessions, members are encouraged to discuss the issues that brought them to therapy openly and honestly. It is the responsibility of the counselor to work to create an atmosphere of trust and acceptance that encourages members to support one another. Legal and Ethical Considerations for Group and Family Therapy Essay Paper It is the responsibility of the counselor to respect the basic rights of all members. Because of this responsibility, counselors must carefully select members and hold individual consultations with each member to discuss informed consent. This dialogue must also include the risks and benefits of group work (Israel, 2002). During this time it is important for the counselor to stress the importance of confidentiality within the group. A counselor cannot prevent a group member from speaking out during their personal lives, however a counselor must stress the importance of maintaining confidentiality as a way of demonstrating respect for protecting the disclosures of others in the group (Corey et al., 2010). It is a difficult task for the therapist to uphold the legal rights of each individual within the group especially since they have no control over the activities of members outside of the group. Therapists also may interact with group members away from the group setting and have to toe the line of what is and is not appropriate to discuss outside of the group setting (Israel, 2002).Legal and Ethical Considerations for Group and Family Therapy Essay Paper Permalink: https://nursingpaperessays.com/ legal-and-ethica…rapy-essay-paper / ? Ethical issues in a counseling practice lay the foundation of a therapist in practice. Ethics are at the center of how the counseling process functions and operates in a successful manner for the clients who seek help in such a setting. In order for the counseling profession to be ethical and hold professional recognition, there are many facets that need to be examined and outlined to make sure all counselors and practitioners are functioning at the highest level and withholding their duties required by the counseling profession. The first introduction so to speak of the area of ethics also happens to be one of the first steps in counseling, which is the informed consent. The informed consent provides the basis of what happens or will be Why is this important in counseling? The informed consent process involves establishing the basic framework between a therapist and their client that serves as an ethical and legal requirement as well as the formation of a basic working partnership between a therapist and their client. The informed consent is essentially an informational exchange between a therapist and a client that outlines the process of therapy. It also allows the client to be informed of their rights in order to make conscientious and thoughtful decisions related to their therapy. An interesting fact about informed consent is that is it can be provided in written and oral form, or a combination of the two (Corey, 2013). If done orally, the counselor must document what was addressed in the informed consent. The information that must be presented to clients, first and foremost, are their rights and responsibilities as a client working with a particular therapist. Beyond this, an informed consent should outline the goals of the counseling relationship, the responsibilities of the client as well as the therapist, expectations of the client, limitations of the counseling relationships, fees involved Legal and Ethical Considerations for Group and Family Therapy Essay Paper The purpose of this paper is to discuss and evaluate what ethical requirements that are current “hot topics” therapists must employ when working in group and individual settings, respectively. There are subtle differences in ethical considerations but at the same time, there are many similarities. For the purpose, these ethical considerations have been narrowed down to conflict of interest (dual roles), when to refer clients to group or individual counseling or even to another more qualified therapist and when clients need to share and when they don’t. In addition, the discussion of what a therapist must share about the group; what the group is about, what rules are necessary for a successful outcome and the rational of the group – why they are there.Legal and Ethical Considerations for Group and Family Therapy Essay Paper Couple and family therapists arguably face more ethical challenges than individually oriented therapists, yet codes of conduct and ethics have not always been of direct assistance. Often it seems that the principles lack the specificity to really attend to the issues at hand. Further, couple and family therapy presents challenges which are often erroneously assumed to be covered under general principles about counselling and psychotherapy. A significant values difference between couple and family therapy and other mental health services is an appreciation of context, which is grounded in the foundational premise of the family as a system. This means that it is the relationship that is the focus of study, and all relationships are seen to exist within multiple other systems, including the therapeutic system (Wilcoxon et al., 2007).Legal and Ethical Considerations for Group and Family Therapy Essay Paper Relationship issues and the values we hold about relationships are completely entwined with their social and historical context. We are constantly exposed to theories about effective relationships and relationship pathology, whether they be evidence-based or common folklore. We cannot help but be influenced by these ideas, nor by our own experience of relationships. New and emerging issues such as internet pornography, surrogacy, same-sex parenting and working with perpetrators of abuse, offer groundbreaking moments in the therapy room. Couple and family therapists have a unique view into the complexities such circumstances bring and need to be able to respond effectively … or to know when and who to report matters when it all goes belly up. Without an awareness of the potential ethical challenges in the work, psychologists can be insufficiently prepared to face them. This article provides an overview of some of the significant practice issues couple and family therapists face, and outlines some of the considerations required for ethical reflection and decision making. Ethics are a set of moral principles or rules of conduct for an individual or group. The term ethics comes from the Greek ethos meaning custom, habit or character. Ethics determine choices made. In counselling, ethics underpin the nature and course of actions taken by the counsellor. Counsellors and others in helping professions are expected to behave in an ethical manner.Legal and Ethical Considerations for Group and Family Therapy Essay Paper We believe it is important to become familiar with the basic ethical guidelines that therapists should follow before you begin therapy with a new therapist, and we encourage you to do so. Unfortunately, media portrayals of therapy do not always provide examples of ethical, effective therapy experiences and many myths about therapy persist. Although all the therapists and counselors listed in GoodTherapy.org certify that the therapy they provide accords in orientation and attitude to the Elements of Good Therapy, GoodTherapy.org does not provide a specific code of ethics for therapists to follow. However, ethical codes have been developed by mental health associations for the purpose of setting professional standards for appropriate behavior, defining professional expectations, and preventing harm to people who go to therapy. Mental health professionals have an obligation to be familiar with their professional code of ethics and its application to their professional services.Legal and Ethical Considerations for Group and Family Therapy Essay Paper We provide links to ethical codes below because we feel it is important for consumers of psychotherapy to know the difference between ethical and unethical behavior. Most therapists intend to “do no harm” and strictly follow ethical guidelines. Overall, mental health professionals are a good bunch. However, not only do good therapists make mistakes, there are some providers who, unfortunately, are careless and unaware of the importance and purpose of some ethical guidelines. We believe it is in everyone’s best interest to become familiar with basic ethical guidelines before beginning psychotherapy. By nature of the profession, counsellors are to act in the best interest of their client, promoting client goals, protecting client rights, maximising good and minimizing harm (Stein, 1990). This expectation broadens due to the inherent power of the relationship between client and counsellor. Ethics including ethical codes and principles aim to balance the power and ensure that the counsellor operates for the good of the client and not for self.Legal and Ethical Considerations for Group and Family Therapy Essay Paper Primarily, counsellors’ duty of care is to their clients. When making ethical choices, counsellors must consider not only themselves, but also the agency or organisation (if not self-employed), their profession and the greater community (Axten, 2002). Counselling does not occur in a vacuum therefore it is important that counsellors acknowledge all facets of their practice both internally and externally. Ross (2002) draws on this further by asking counselors to look at ethics from a holistic perspective — body (the environment, structures, systems, policies, laws, regulations, moral codes, and societal norms), mind (ethical thinking, philosophy), heart (relationships, emotions, values) and spirit (unknowing, unconscious). A complete awareness of the ethics of a situation can occur when all are taken into consideration.Legal and Ethical Considerations for Group and Family Therapy Essay Paper Code of Ethics The concept of ethics relates to moral consideration. The challenge lies in what is considered moral or ethical. Each counsellor comes to the profession with their own set of values and standards. Individual principles and how they were used to interpret dilemmas would be universally different. Therefore, a Code of Ethics — a general standard that counsellors and therapists adhere to and use co jointly with legal standards to provide ethical practice and work through ethical dilemmas — is required. Ethical codes offer counsellors an outline of what are considered acceptable and unacceptable behaviours. In a region (such as Australia) where counselling is not regulated through licensing, ethical codes provide a valuable tool for developing and maintaining ethical conduct. Numerous professional associations have developed their own Code of Conduct and Ethics. Codes may adopt similar principles whilst also covering behaviours specific to an area of counselling. Professional counselling organisations provide Codes of Conduct and Ethics to members and the inability to stick to these Codes may result in removal of membership.Legal and Ethical Considerations for Group and Family Therapy Essay Paper A professional may belong to more than one organisation and thus have access to additional ethical codes. When faced with an ethical dilemma, a counsellor is to consider all available and applicable codes. It is counsellors’ responsibility to familiarise themselves with relevant codes and regulations governing their area of practice. Clarkson (2001) contends that all members of a professional association subscribe (at least in principle) to their profession’s Code of Ethics for the sake of protecting the public. The degree to which this ‘protection’ occurs is based on four factors: Client awareness and knowledge of the Code of Ethics and the complaints procedure The degree to which the client feels they can discuss his or her feelings about a violation with the counselor The fairness of the Codes The client’s ability to manage the Code or gain assistance in negotiation Legal and Ethical Considerations for Group and Family Therapy Essay Paper A core ethical responsibility to clients is the promotion of beneficence: doing good on the client’s behalf. This is reflected in a number of professional areas, but starts with the therapist’s competence to practise. Interestingly, couple and family therapy is quite commonly practised by therapists with little or no specific training. It seems to be thought that if one is individually trained, then it is not a great stretch to see other family members (Shaw, 2001). Nothing could be further from the truth. Issues surrounding relationships (violence and abuse, family law matters, sexual concerns, infidelity and other betrayals, severe attachment disruptions) all render this work highly complex and specialised. Without core training, duty of care is potentially breached (refer to the professional standards of the Australian Association of Relationship Counsellors and the Australian Family Therapy Association). If you were seeking assistance for your own relationship, what qualifications would you seek in your therapist? We often provide less for our clients than we would require for ourselves.Legal and Ethical Considerations for Group and Family Therapy Essay Paper The very act of asking the initial caller to gather other family members for an appointment raises questions about the forms of ‘social coercion’ that this might involve (Wilcoxon et al., 2007; Ramisch, 2010). There are different levels of power and opportunity in families. One member can decide for the group, while others can be unfairly excluded from key decision making. How the therapist is positioned within this is crucial to consider. Further, there are complexities around informed consent with people across ages and circumstances, and about how one might consider sending therapeutic letters or other communications. Are the adults always the best gatekeepers for other family members? Not uncommonly, I have had children say to me that they have ‘no idea’ about why they are in my room, despite my parental preparation. Arranging for individual consultations within relational work raises a myriad of difficulties. While it can be important for assessing dynamics such as abuse, it also provides opportunities for disclosures that will significantly shape the work ahead. Further, issues of confidentiality and privacy are often confused, and therapists can find themselves unwittingly silenced and compromised through promises they have made in good faith. There are certain principles about moving between individual and couple or family sessions, but these are not articulated within accessible guidelines, leaving therapists to work things out on their own. It is not uncommon for well intentioned therapists to find themselves in breach of confidentiality by juggling too many agendas and finding themselves the ‘fall guy’.Legal and Ethical Considerations for Group and Family Therapy Essay Paper Frequently couples will ask for assistance when on a covert level they want a referee or a judgment about the behaviour of the other. Individual sessions and phone calls can be invitations to take sides, and neutrality can be called into question. There are complex issues around being engaged to ‘save relationships’ and then having notes subpoenaed for divorce proceedings. Besides the feelings this can evoke for the therapist, there are invitations into conflicting roles, e.g., couple/family therapist versus advocate in court. Working with relationships involves managing multiple alliances. It is not always possible to have everyone on side at the one time. Members of the family may have conflicting or competing needs which they want equally acknowledged. Even trying to develop a focus for the work is fraught with challenges, as you question: whose voice will prevail? Improvement for one member must not occur at the expense of another.Legal and Ethical Considerations for Group and Family Therapy Essay Paper Commonly relationship therapists will think it might be a good idea to offer individual therapy to one family member, and may well be pursued to do so by the client. This is not considered good practice, but it can be tempting to do. Really good relational work can be brought asunder by selecting/engaging in work with one member. What might be defendable reasons (not justifications) to take on individual work in this context? Working with systems means being able to hold the relationship in mind over and above individual contributions: the notion that the sum is more than its parts. However, one still has to attend to:Legal and Ethical Considerations for Group and Family Therapy Essay Paper Individual responsibilities for pain and suffering, and for the stressors of addiction, mental health or family of origin trauma for example. How to address this in a relational context without pathologising one member and getting them off-side can be tricky. Perceived inequities in the tasks for therapy. For example, perpetrators of hurt have different tasks and responsibilities than those who have been hurt. Different ages and life stages Ensuring that safety is attended to, and knowing how to take a position when necessary, for example with mandatory reporting. Further important issues in the field which involve specialised ethical and practice considerations include: The perennial question of working with whoever can come to sessions or insisting that all must attend sessions Working effectively and respectfully with culturally diverse clients and communities Working with gay and lesbian clients and same-sex parents (Negash & Hecker, 2010).Legal and Ethical Considerations for Group and Family Therapy Essay Paper Ethics Checklist Are you trained in couple/family intervention? What is your role going to be? Individual or relationship therapist, not both. How are you going to communicate effectively with all family members? How are you going to obtain informed consent? What is your plan to manage multiple alliances and diverse needs? Have you organised specialised professional development to support your work, especially on emerging social issues for families? How often do you take ethical issues to supervision? Couple and family therapy has advanced different models of practice. Over time, therapeutic strategies (e.g., use of paradox, strategic manoeuvres, prescriptions, triangulation) have been critically analysed in terms of how much stress is acceptable in achieving change (Wilcoxon et al., 2007) and a post modern framework has been adopted as more respectful. In terms of our role, while we may have preferences for therapeutic intervention, we have to be prepared to also be advocates, to take positions (on abuse and violence for example) and to be strategic in our case management. We need to enhance growth and positive relationships, not act as social control agents or gatekeepers of community values not in keeping with the client’s own (notwithstanding where people are at risk).Legal and Ethical Considerations for Group and Family Therapy Essay Paper As is evident, ethics is as much about critical and responsible reflection as it is about compliance with a professional code. Reason, intuition and experience all play a role in developing effective and justifiable responses (Shaw, in press). Finding opportunities for professional development and rigorous debate about ethical issues in practice is crucial. Ask yourself: how often do I reflect on ethical challenges in supervision? There are some valuable decision making models for therapists (e.g., Gilligan (1982) in Newfield et al., 2000; Kitchener, 1984; Hecker, 2010). It behoves effective therapists to establish frameworks to support their practice ahead of needing them! Finally, our best work will occur when we are also in the best possible shape. Self care is foundational to good ethical practice, and something we can tend to under emphasise.Legal and Ethical Considerations for Group and Family Therapy Essay Paper Ethical considerations in group counseling Ethics are parameters by which professionals in different fields use (Jacobs, Masson, Harvill, & Schimmel, 2012). They are, in a sense, the rules that professionals follow to be fair to their clients, their profession and to themselves. While not all ethical considerations are the same for every profession, there are similarities. This also holds true for different situations in counseling. The scope of this paper is to discuss the “hot topics” of ethical considerations for group therapy and individual therapy; and to compare them accordingly. Also, to answer why a therapist may choose individual counseling over group therapy or vice versa.Legal and Ethical Considerations for Group and Family Therapy Essay Paper There are many ethical considerations for therapists who choose to counsel on an individual and group basis. For this context however, the focus is on the conflict of interest, when to refer clients on to other professionals or from individual counseling to group counseling and whether forcing clients to share their deepest, darkest sorrows and secrets are ethical. A conflict of interest in counseling can range from too much therapist self-disclosure to having dual relationships, or relationships with clients outside of the therapy sessions (Jacobs, et al., 2012). These ethical dilemmas may be seemingly innocent enough and may, in some cases be unavoidable (i.e. in rural communities where there are not many therapists) (Gonyeah, Wright & Earl-Kulkosky, 2014; Gottlieb, 1993) but when the therapist and client are in a situation where knowing each others lives outside of the office setting, certain rules and ethical considerations come into play. Attending functions together may require a lot of thought on both sides to determine the safety of both the client and therapist. In a group therapy setting, the stakes for safety and protection are even higher because of the many lives and families involved (Burian & O’Connor Slimp, 2000).Legal and Ethical Considerations for Group and Family Therapy Essay Paper Therapists must be aware and mindful of when a client needs to move on to other more qualified therapists or from an individual setting to a group session. Knowing the time to move on is the responsibility of the therapist as is knowing when they are not qualified to do their client justice with their own limitations (Jacobs, et al., 2012). This is when the therapist should refer the client to a more qualified therapist who has the experience required to further help the client. With groups, it is the therapist’s job to know when being in a group setting is more beneficial and will challenge the client to move on in their recovery. If the client within a group setting is struggling in the group and can’t seem to connect, it is the job of the therapist to refer them back to individual counseling or a group setting that is more suited to the clients issues.Legal and Ethical Considerations for Group and Family Therapy Essay Paper Clients and sharing Letting clients know that they are free to share whatever they’d like, as long as it is relevant to the topic of the group (i.e. substance abuse, child abuse, anger management, etc.) is important to establish early on (Corey, Schneider-Corey, & Haynes, 2014). Letting the client know that they do not have to share anything that they are uncomfortable with is also important. For some clients, it may take more time to warm up and become comfortable but most importantly, trusting of the group enough to share what they are going through or have experienced and want to work on or heal is vital. REPORT THIS AD Therapists, according to Hartman & Zimberoff (2012), should also disclose their experience and training on a honest level; to falsify information is an ethical infraction. It is also the therapist’s job to establish to their client(s) that they are trained for this type of therapy, and that they are competent to lead the group (or single individual) effectively (Scher & Kozlowska, 2012).Legal and Ethical Considerations for Group and Family Therapy Essay Paper Unique issues in group therapy There are several ethical standards that apply to both group and individual therapy. In looking at the list of ethical considerations in Groups in action: Evolution and challenges (Corey et al., 2014), there were many that applied to both types of therapy in one way or another. In example, the screening of clients, to ensure that they were in the right group for the topics being discussed is important in group therapy but by the same token, screening clients to ensure that they and their issues are a good fit for the therapist and their level of expertise; and experience with those issues is important. Another similarity is that of clear roles. What the roles of the clients are in direct correlation with the roles of the therapist and what the group’s rational and purpose is.Legal and Ethical Considerations for Group and Family Therapy Essay Paper Therapist roles and client roles Therapists must know their business. They must spend time keeping up their own education and constantly evolving into better therapists and including the latest information into their knowledge base. They must also learn new techniques and theories that will aid them in understanding their clients needs, the needs of the group as a whole and what will work in advancing the healing process of their clients (Brabender, 2006). They must also believe in their clients and that change is possible (Stalker, Horton & Cait, 2012). Therapists must also know the cultural and religious variables of their clients and know how those variables will affect each client within the group setting (Cornish, Wade, Tucker & Post, 2014; Henrikson, Polonyi, Bornsheuer-Boswell, Greger & Watts, 2015; Ibrahim & Dykeman, 2012). Therapists must also know how to show empathy for their clients and while not making the client feel awkward, the therapist must give emotional support throughout the group experience; this is especially true of young adolescents (Bruns & Frewer, 2011; Yamuna, 2013; Scher & Kozlowska, 2012). A unique dynamic here is co-leadership of a group or “cotherapy” where two therapists share the job of co-leading a group. A study on this dynamic discovered that in order for co-leading to be effective and succeed, a healthy working relationship between the therapists must exist as well as the ‘sibling’ dynamic in the therapist’s personal life (Shapiro & Ginzberg, 2001).Legal and Ethical Considerations for Group and Family Therapy Essay Paper Clients must come to a place in which they want to change for the better (Stalker, et. al., 2015). Clients must also come to a place where they become honest with themselves, their role in their issues and problems as well as the role that others played in those problems. They need to understand that therapy is hard work that can result in a painful but hopefully, a cathartic and healing journey (Jacobs, et al., 2012). The client has a responsibility to keep working toward healing or the process outcome will be limited (Corey, et al., 2014). Group rational and purpose Establishing the group’s purpose and why the clients are there is vitally important to the success of the group. This information gives the group a clear direction and knowledge of what to expect throughout the process and what to think about bringing to the table as others talk about their own experiences and emotions. When the group knows the parameters and begins to share with one another, they often can identify with more than one person (i.e. the therapist) (Forsyth, 2014). There are more perspectives with a collective life experience to draw from.Legal and Ethical Considerations for Group and Family Therapy Essay Paper Therapists must also have a clear plan for the group (Vinella, 2013). Corey, Corey and Haynes (2014) reiterate this need of a plan for a successful group. Knowing what is needed to be achieved on the first day to the last day (assuming there is an end) but also what events will happen from the start to the finish of the group session. Aversions to group therapy REPORT THIS AD Some clients may come into the session already upset and uptight over having to ‘be there.’ This is more likely the case with court-mandated therapy where clients have no choice but to attend (i.e. drug and alcohol counseling, anger management, parenting classes, etc.). Some clients may have preconceived notions of what group therapy is all about and not want to open up out of embarrassment, fear of judgment, ridicule, bias, rejection and speaking in a group forum rather than one on one (Jacobs et al., 2012). The lack of privacy in a group setting may also scare clients into silence. This is where the therapist needs to establish from the beginning that confidentiality is vital to the group and the more others open up and share, the more likely the fearful client will also relax and begin to share and join in the conversations and dialogs (Barros-Bailey & Saunders, 2010; Hartman & Zimberoff, 2012). Clients may have had bad experiences in the past with other therapy programs so knowing about these experiences and what the client expects to gain or lose in a group session or even an individual setting is important to furthering their growth (Garzon, Worthington & Tan, 2009).Legal and Ethical Considerations for Group and Family Therapy Essay Paper This statement, Ethics for Counselling and Psychotherapy, unifies and replaces all the earlier codes for counsellors, trainers and supervisors. It is intended to guide the practice of counselling and psychotherapy by all members of the British Association for Counselling and Psychotherapy (BACP) and inform the practice of closely related roles that are delivered in association with counselling and psychotherapy or as part of the infrastructure to deliver these services. Being ethically mindful and willing to be accountable for the ethical basis of practice are essential requirements of membership of this Association. In this statement the term ‘practitioner’ is used generically to refer to anyone with responsibility for the provision of counselling or psychotherapy-related services. ‘Practitioner’ includes anyone undertaking the role(s) of counsellor, psychotherapist, trainers and educators for these roles, providers of coaching and mentoring in association with counselling and psychotherapy, supervisors, and practitioner researchers. Members of this Association who are providers of services using counselling skills, embedded counsellors, managers and researchers of therapeutic services, are required to be accountable in accordance with the Ethical Framework in ways appropriate to their role and to communicate appropriately the basis of their ethical accountability and expectations. The term ‘client’ is used as a generic term to refer to the recipient of any of these services. The client may be an individual, couple, family, group, organisation or other specifiable social unit. Alternative names may be substituted for ‘practitioner’ and ‘client’ in the practice setting, according to custom and context. Legal and Ethical Considerations for Group and Family Therapy Essay Paper Ethical Issues Unique to Group Therapy Group therapy is a form of counseling that involves a small group of people coming together under one trained therapist who helps them and encourages them to help one another to overcome their challenges. The group members are usually peers facing the same kind of problem for example, anxiety (Forti, et al., 2007). This therapy has been in use for over fifty years and it has produced tremendous results in the lives of the group members. The group members not only learn from personal experiences of other members, but also gain different viewpoints and ideas on the issues they are facing. Like individual therapy, group therapy very powerfully influences growth and change and helps those involved to increase their self-awareness and gain sup

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

Feminist Theory in Social Work Assignment Essay Feminist Theory in Social Work Assignment Essay This research considers the application of feminist thought in social work practise. Specific areas of consideration include the gap from social workers’ personal acceptance of feminist constructs and their use of such constructs in daily practise, the effects of perpetuation of hegemonic gender roles by social workers, and domestic violence victims perceptions of the effectiveness of social work based on the perspectives of their social workers as considered above. This research further describes a focus group of college social work students who are also domestic violence victims. Permalink: https://nursingpaperessays.com/ feminist-theory-…assignment-essay / ? It records their perceptions of social workers’ worldviews and the impact of such on service. Conclusions include that there is a significant gap between the understanding or acceptance of feminist constructs amongst social workers and its application in daily field practise, that social workers are often likely to perpetuate hegemonic gender roles, and because of such perpetuation view domestic violence situations as individual occurrences rather than part of a greater societal pattern of oppression, and that domestic violence survivors feel best served when work with them uses a feminist theoretical framework. INTRODUCTION Feminism and social work have been associated for many years; however,although many social workers personally espouse working from a feminist perspective, the systems of social work still favour work from a traditional or patriarchal perspective. This research, therefore,seeks to first consider findings from previous study regarding this phenomenon and the theoretical frameworks for both social work and feminist thought. In this light of information gleaned from these findings, it became apparent that hegemonic gender roles, a common topic of feminist research, play a relevant part in work with survivors of domestic violence. Specifically, domestic violence survivors are often directed, either explicitly or implicitly, that their situation is personal and should be considered and dealt with from a personal and pathological perspective rather than applying the tenets of feminist thought that view such situations as manifestations of structural and power problems in our greater society. This study then seeks to document whether this gap between social work theory supportive of feminist worldviews and social work application of practise exists, and if so, how prevalent a gap it is. This is accomplished through use of a focus group of college students, all of whom have taken at least one course in social work theory and are themselves domestic violence survivors who have been served, to whatever level of quality, by social workers. Discussions within the focus group involved ideas of gender roles and social worker advocacy of hegemonic gender roles, whether explicit or implicit. The focus group then built on this foundation to consider group participants’experiences with social workers and whether they presented an individual / pathological perspective of domestic violence, or whether they presented a perspective that consider the wider influence of society and its systems. This was further related to the effect of such perceptions on the understanding of and service to group participants at the time of intervention. Feminist Theory in Social Work Assignment Essay Feminist Theory in Social Work Assignment Essay LITERATURE REVIEW Feminism has emerged in the past thirty years as a viable worldview. Dietz (2000), quoting Bunch (1980), defined feminism as“transformational politics that aims at the dismantling of all permanent power hierarchies in which one category of humans dominates or controls another category of humans” (372). “In the feminist and empowerment traditions, the personal is political, and individual change and social change are seen as interdependent” (Deitz 2000,372). Feminism contends it is not adequate to simply include women in the world’s political and power systems, as these were designed by and for men and therefore favour a highly masculinised mechanism for responding to issues and require women working within these systems to do the same (Scott 1988, Moylan 2003). Simply including women is not enough; society must give women’s experiences equal time and consideration, eventually recasting the very meanings of the topics it considers (Scott 1988). Rather, feminism argues women must be engaged in both the system development and decision-making processes that shape our society (Moylan 2003). Feminist Theory in Social Work Assignment Essay Consequently, one area where feminism has particularly challenged traditional views is in the area of gender roles. For example,Dominelli and McLeod (1989) examine the way in which social problems are defined, recognising gender as particularly important in understanding client groups, and stress egalitarian relationships between therapists and clients. Gender is also an important consideration of social work due to the patriarchal society that still dominates most of our world. This power framework rests on a basis of hegemonic masculinity (Cohn and Enloe 2003). Connell (1995) created the term ‘hegemonic masculinity’ to describe the valued definition of manhood in a society. He argues that whilst there are multiple possible masculinities in a culture, only one or a few are most valued or considered ideal (Connell 1995). This gender definition is constructed both in relation to femininity and to other, subordinated masculinities, and is used to justify both men’s domination of women,and the hegemonically masculine man’s power over other men (Cohn and Weber 1999). Feminist Theory in Social Work Assignment Essay Whilst women are increasingly being included in world systems, the systems themselves still were designed for and operate by and for men. Therefore, women who participate within the system must do so from male paradigm, even if it is sometimes at odds with their own preferences for how to go about dealing with a situation (Cohn and Enloe 2003). Feminism historically is a “critique of male supremacy, the belief that gender order was socially constructed and could not be changed” (Cott, 1989,205). Masculinity is often defined as what is not feminine, and femininity as what is not masculine, although understanding the dynamics of one requires considering both the workings of the other and the relationship and overlap between the two (Cohn and Enloe 2003). Masculine definitions are often based on strength, domination and violence, whilst feminine on weakness, nurturing, compassion and passitivity (Rabrenovic and Roskos 2001). The result is pressure on men adhering to a hegemonic definition of masculinity to view forms of addressing conflict other than a physical or “masculine” response as feminine and a threat to their manhood (Moylan 2003). The popular concept of gender holds that “masculinity” and “femininity”are unchanging expressions based on the chromosomal male and female bodies (Butler 1990). “Gender is assumed to be ‘hard-wired,’ at least in part” (Hawkesworth 1997). Masculine actions and desires for men and feminine actions and desires for women alone are normal, these masculine and feminine traits are not a matter of choice, and all individuals can be classified as one or the other (Hawkesworth 1997). However, whilst our society men are considered strong and dominant, and women passive and nurturing, “the meanings of male and female bodies differ from one culture to another, and change (even in our own culture) over time” (Connell 1993, 75). For example, there have been“periods in Western history when the modern convention that men suppress displays of emotion did not apply at all, when men wereeffusive to their male friends and demonstrative about their feelings”(Connell 1993, 75). “Masculinities and feminities are constructed or accomplished in social processes such as child rearing, emotional and sexual relationships, work and politics” (Connell 1993, 75). Feminist Theory in Social Work Assignment Essay Feminism, however, contends gender is a constructed by each culture,and as a social practice involves the incorporation of specific symbols, which support or distort human potential (Hawkesworth 1997). Gender is created through “discursively constrained performative acts,”and the repetition of these acts over time creates gender for the individual in society (Butler 1990, x). People learn to “act” like women or men are supposed to; women are taught to behave in a feminine manner, men are taught to act in a masculine manner. This is often reinforced by authority figures, such as social workers. Barnes (2003)cites a number of studies which find social workers often assume the“disciplinary gaze” of notions of “what and how to be woman,”perpetuating traditional gender roles (149). “Armed with rigid codes of gender appropriate behaviors, social workers often sought to regulate and mediate women’s interactions with the social, economic,and political world” (Barns 2003, 149). Feminism and social work share a number of similarities. Both believe“in the inherent worth and dignity of all persons, the value of process over product, the appreciation of unity-diversity, the importance of considering the person-in- environment, and a commitment to personal empowerment and active participation in society as a means to bringa bout meaningful social change” (Baretti 2001, 266-267). Similarly,both feminism and social work address multiple approaches to handling situations, challenging the institutionalized oppression common in many power structures and supporting “the reconceptualization and redistribution of that power” (Baretti 2001, 267). It follows that one impact of feminism on social work practise is the consideration of issues from a societal rather than personal perspective. For example, this might include viewing a domestic violence situation not from the perspective that the family is dysfunctional, but from the perspective of the society that created the family. The psychology-based focus of clinical social work “often leads to individualizing social problems, rather than to viewing them as the result of relations of power, primarily oppression and abuse”(Deitz 2000, 369). As such, individuals experiencing such difficulties are “taught” that their particular experiences are inappropriate,rather than addressing the systems that created the difficulties in the first place (Deitz 2000, 369). Feminist Theory in Social Work Assignment Essay Dominelli and McLeod (1989) re-evaluate social work practice from a feminist perspective, considering the functions of social work such as therapy, community interaction, and policy making not from apathological standpoint but from one of defined roles endorsed by societal conditions. As such, they contend that working from a feminist perspective allows the social worker to address the causes of social issues, rather than the symptoms played out in individual’s lives (Dominelli and McLeod 1989). One area of difference in social work practise between those operating from a feminist framework and a traditional framework is the concept of distance. Traditionally, the “patriarchal bias against relationality and connection” is intended to lead to “connection without harm, love without power abuse, touching without sexual abuse in psychotherapy”(Deitz 2000, 377). Unfortunately, in practise it often results in“power over” relationships where those receiving services feel “less than” those providing them. “Healing happens when someone feels seen,heard, held, and empowered, not when one is interpreted, held at adistance, and pathologized” (Deitz 2000, 377). Deitz (2000) finds that social workers often institutionalize a “power over” stance from professional training and discourse that constructs the identities of clients as somehow disordered, dysfunctional or impaired. “Whether between parents and children; physicians and patients; social workersand consumers of services; Whites and Blacks; or heterosexuals andlesbians, gays, bisexuals, and transgendered persons, power overrelationships give the dominant partners or group the right to definethe meanings of subordinates’ experiences (including their resistance)and thus their opportunities for self-affirmation” (Deitz 2000,373).This creates professional relationships that ignore theenvironmental, historical, and social contexts of the problem, discountpeople’s strengths and resilience in assessment and intervention, andlead “to the objectification of people as diagnoses, rather than toempowerment” (Deitz 2000, 370). “The keys to empowerment in feministmicro practice are reconnection and transformation through politicalactivity; survivors of oppression and abuse experience reconnectionthrough relationships based on mutuality, collaboration, andtrustworthiness” (Deitz 2000, 376). Theories from social work, psychology, and particularly developmentalpsychology describe empowerment as primarily a process, with thepersonal transformation of the individual becoming empowered at itsfoundation (Carr 2003, 8). Barriers to empowerment and problems ofdisenfranchisement caused by powerlessness are primarily political,rather than psychological. Powerlessness is defined as the inabilityto effectively manage one’s emotions, knowledge, skills, or resources;it is “derived from the absence of external supports and the existenceof ontological “power blocks” that become incorporated into a person’sdevelopment” (Carr 2003, 13). As such, many survivors also work toreconnect to others in their communities, often seeking politicalactivity that “emphasizes the empowerment of others, such as byorganizing Take Back the Night marches or speak-outs, volunteering forcrisis hot lines, seeking legislative changes, or becoming socialworkers or human service professionals” (Deitz 2000, 376). Feminist Theory in Social Work Assignment Essay For example, feminist work with abuse survivors “emphasizes therelationship between abuse and oppressive social relations (Deitz 2000,374). On the other hand, the dominant clinical social work approach tooppression and abuse relocates the problem of oppression in victims.Psychological theories are typically employed, which “locates pathologyin individuals, rather than in oppressive relationships and systems,and considers the long-term effects of oppression to be symptoms ofindividual pathology” (Deitz 2000, 374). Unfortunately, whilst manysocial workers have been exposed to or even personally supportoperating from a feminist framework, the systems in which they workprevent them from actively utilising feminist insight in their dailypractise. Feminist Theory in Social Work Assignment Essay RESEARCH PLAN This research seeks to study the prevalence and impact of traditionaland feminist practitioner constructs from the perspective of thoseserved. Specifically, a focus group study will be conducted with agroup of college students, all of whom are currently studying socialwork and therefore have some concept regarding social work practice,feminist and traditional worldviews. In addition, all students in thefocus group will have experienced domestic violence and have beenprovided the services of a social worker in some form during theirteenage years. Three areas of discussion will be undertaken by the group. These willbe provided to individual group participants in writing several daysbefore the group in order for students to have time to consider whatthey would like to share regarding their opinions and own experiences. The first group activity will involve creating definitions of“masculine” and “feminine” from the perspective of a typical socialworker based on the students’ teenage experiences. Students will thenbe asked to discuss where, if at all, they personally feel they andtheir family members who were involved in the domestic violencesituation(s) “fit” regarding these preconceived definitions. It isanticipated some students will have been uncomfortable with societalconstraints they or their family experienced as teenagers. As all arestudying social work, they are also anticipated to make moreconnections between societal power issues, hegemonic gender roles, andtheir influence on domestic violence than a focus group without suchbackground. The third area of discussion will centre on how thestudents’ perceptions of their social worker(s) understanding of genderroles influenced their and their families reception of adequateservice. The researcher will both tape record and take notes on the groupdiscussions. Data gathered from the group will then be compiled andanalysed. In addition, students from the focus group will be given theoption to write a response to the group activity, if they so desire. These will be further included in the group data. Feminist Theory in Social Work Assignment Essay METHODOLOGY Data collection involved four means. Prior to the group starting,each participant was given a questionnaire (see Appendix 3) to gatherbasic demographic information. The questionnaire also asked for abrief summary of their abusive situation. Regarding data collection ofthe group proceedings, as described above the focus group session wastape-recorded and the researcher took notes to supplement the recordingof group discussion. The recorded sessions were then transcribed intoprint form, with research notes added in at the chronologicallyappropriate points of the transcription to provide a more completewritten overview of the focus group discussion. In addition, groupparticipants had an option to write a response the group to be includedin the group data. Four participants wrote responses, which wereconsidered with the group data following analysis of the focus groupdiscussion. Participants were provided with the three areas of groupdiscussion several days prior to the actual focus group meeting. Theywere not given any directions or guidance regarding the optionalwritten responses to the group activity. Feminist Theory in Social Work Assignment Essay Data analysis first involved dividing and coding group data. Responsesto the first topic of discussion were divided into three categories: those representing a traditional worldview, those representing afeminist worldview, and those that did not clearly represent eitherworldview. From these groupings, overall findings regarding theworldviews typically experienced by the group participants weresummarised. This was then further compared with the definitions oftraditional gender roles identified by the group. Data from the second topic of discussion were also broken down intothose representing a traditional worldview, those representing afeminist worldview, and those that did not clearly represent eitherworldview. It was important to then note participant perceptions andemotional responses to these codings, and in which worldview groupingthey and their families were reported to feel best served andempowered. Data from the specific discussion regarding service were then similarlyanalysed, and combined with previous findings to present a picture ofthe impact of traditional versus feminist worldviews on social workpractise, emphasising work with teenage domestic violence survivors andtheir understanding of gender roles in society. Feminist Theory in Social Work Assignment Essay It was anticipated at the conclusion of such research, a view could beasserted as to whether feminist perspective has a significant impact onthe practise of social work as it is currently undertaken and whetherthis impact, if any, leads to improved service. As the focus group involved a relatively small number of participants(nine total) and data from their interactions were primarilyqualitative in nature, it was decided not to perform any complexstatistical analysis on focus group data. It was felt that such typesof analysis would neither reveal findings that could be consideredstatistically significant nor provide a more accurate understanding ofthe issues under consideration than a more qualitative analyticalapproach. In consideration of space and relevance portions of thediscussion were used to support conclusions in the findings andanalysis sections of this dissertation, whilst an overall summary ofthe most relevant portions of the discussion are included in Appendix2. Feminist Theory in Social Work Assignment Essay Feminist Theory in Social Work Assignment Essay IMPLEMENTATION OF PROJECT Nine students meeting the criteria laid out in the research planagreed to participate in the focus group. They were primarilyorganised by one group participant, who had discovered other domesticviolence survivors through classroom discussions and throughparticipation in a survivors’ group in the local community. All ninestudents were currently studying social work or had taken at least onesocial work course as part of a related course of study, such aseducation or criminal justice. There were six women and three men,ranging in age from nineteen to twenty-seven. Racially, seven wereCaucasian, one was Black, and one was Asian. All present as comingfrom upper working class to middle class backgrounds. All hadexperienced domestic violence as teenagers, making their experiencesfairly recent and therefore providing a relatively current depiction of social work practise. Five students (three women, two men) had been removed from their biological parents at some point during their teenage years. All had been involved in interventions into the family by a social worker representing either a government organisation, or in the case of one woman, a local church. Some of the participants previously knew each other and were somewhat aware of each other’s experiences, which should be considered in group analysis. Five regularly participated in a survivors’ support group in the community. One man and one woman were cousins. In addition, two of the men had known each other as teenagers from intervention through the school system. Jennifer, a twenty-four year-old Caucasian woman, was chosen to be themoderator, as she had been the one who had assisted the researcher byarranging for most of the participants to become involved in thestudy. The group then moved almost immediately into discussion of thetopics provided. The group had been provided a whiteboard for its use,which Jennifer implemented to organise individual comments and ideas. It is surmised that the easy manner with which the group undertook thediscussion was based on the fact that they were all students andtherefore used to having study groups, group discussions, and the like,and that all of them had at least publicly shared their experiencespreviously, either as part of a classroom discussion or survivors’group, or both, and were therefore more comfortable in engaging in suchdiscussion than might be typical for a focus group dealing with suchexperiences. Feminist Theory in Social Work Assignment Essay FINDINGS AND ANALYSIS The first finding of this research is that the majority of socialworkers in service or domestic violence survivors to not consistentlyemploy feminist constructs in practise, despite the likelihood ofhaving been exposed to such constructs. This manifested itself inthree significant ways. First, families were overwhelming dealt withas individuals with problems. That is, the abuser was described asmaking poor choices or having some type of pathological issues that ledto his or her decision to abuse (in one participant’s family, bothparents were abusive). As such, the abuser was described from apsychoanalytical standpoint by the social worker(s), and his or herbehaviour labelled as individually deviant. Feminist Theory in Social Work Assignment Essay The survivors of the domestic violence situations, particularly themothers, as the majority of abusers from the groups’ experiences weremale family members or boyfriends of the mother, were also reported tobe consistently dealt with from an individual perspective. In thissense, their behaviour was also reported to be categorised by thesocial workers involved as unhealthy, pathological, and coming fromsome sort of unresolved personal issues, such as low self-esteem. Inthe case of only one participant did the social workers involved ineither intervention or therapy consistently relate the domesticviolence situation to broader issues of oppression, societal powerstructures and the related hegemonic gender roles, or patriarchal normsof society. It is of note that this participant received service froma progressive women-helping-women organisation, rather than atraditional government-organised social work programme. Group participants also repeatedly described their family situationsas unhealthy, and they certainly were, but from the perspective thatboth the abuser and abused were reacting or displaying emotioninappropriately, rather than that the motivation or norming behind thebehaviour was at fault. For example, Trent described his mother asdrawn to violent, alcoholic men. “She always seemed to go for theseguys that didn’t know how to express anything except by breaking stuff,yelling, hitting, you know.” His further descriptions of his mothers’boyfriends indicated an assumption that if these men had been raisedwith or taught proper means of dealing with their frustrations andemotions, the abuse to him and his mother would have been lessened oreliminated. This idea was supported by at least one social worker, whosuggested counselling for Trent, his mother, and the then boyfriend asone possible way of addressing the abusive situation. Several participants did bring feminist theory and thought into groupdiscussion, pointing out, for example, that dominance or aggression bymen in any form was unhealthy, and questioning why it was only seen asunhealthy by most of the social workers they had encountered, and byothers they knew in the community, when physical violence was actuallyinvolved. Feminist Theory in Social Work Assignment Essay There was a related discussion, albeit brief, about the unwillingnessof neighbours, relatives, and others in the community, such as membersof the same church, to intervene in the domestic violence situation. Participants indicated their perception that whilst this was often dueto a fear of getting involved or knowing how to help the situation,there were repeated occurrences in everyone’s experience where anunwillingness to intervene derived from others’ implications that theman of the house had some right to choose the way in which thehousehold operated, or that he had a right to discipline his wife /girlfriend and children as he saw fit. Wendy reports hearing an auntstate “Well, its his family, their kids, she wants to stay with him,”and dismiss the ongoing violence as therefore an acceptable familylifestyle, or at least one in which none of the rest of the familyshould be expected to intervene. Participants then acknowledged thisand several other systemic situations that perpetuated their abuse,such as reluctance of authority figures to continue questioning wheninitially told nothing was wrong, and unwillingness of police tointervene repeatedly. Similarly, regarding gender roles, discussion indicated a belief bymost participants that their social workers believed a traditionalstereotype of what was appropriate behaviour for a man and a woman, andthat these behaviours were different. There were reports of acceptanceof physical response as an appropriate masculine reaction, but thelevel of physical response not being considered appropriate. Maleparticipants were encouraged to talk about their experiences, butreport never being given permission to express fear, or an emotionalresponse such as crying. One male participant reported starting to cryas part of a group experience, and being discouraged rather thanencouraged to continue, whilst female members of the group were allowedto and even supported in such emotional expression. There were similarreports of various hegemonically feminine expressions, such as crying,fear, and nurturing behaviours, being supported and encouraged bysocial workers for male family members but not female, as well as anacceptance or assumption of weakness on the part of adult females whochose to remain in an abusive situation. Feminist Theory in Social Work Assignment Essay The discussion then moved to the effect of traditional and feministperspective on social work service. Participants overwhelminglyreported feeling better served when social workers sought to empowerthem and their families. This did usually involve practise of methodsderived from a feminist view, such as the use of reflective journalingand support groups, as well as encouragement from the social workers tothe mother that she could, indeed, survive and prosper outside thedomestic violence situation, that she did have the inner reserves toaddress the situation and move to a healthier lifestyle, and thatsocietal pressure to be with a man, either as a romantic partner or asa father / father-figure for children was not necessary for asuccessful life. Participants also report feeling personally empoweredby such encouragement, and therefore able to support their mothers inattempts to leave relationships. From their own study in social work theory, focus group participantswere able to briefly discuss the ramifications of the patriarchalsocietal power structure on a woman’s decision to stay in a violentsituation. One issue brought up included the perception that societywill view a woman as a failure and undesirable if she does not have aromantic relationship with a man in her life. A number of womenparticipants in the group reported feeling similar pressure to maintaina romantic relationship with a man in their life, regardless of theirother commitments or interests, and an expectation that they would notbe successful women if they did not ultimately get married and havechildren. When questioned by other participants, the three maleparticipants reported not feeling such pressures. Another issue raisedwas the mothers’ perception that they needed a father figure tosuccessfully raise children, particularly boys. This was perpetuatedin the life experiences of group participants even though the menoccupying these roles were viewed by the male participants asdestructive, rather than constructive, influences. Issues of supportin disciplining children and managing household operations were alsoindicated, as was the financial support provided by the batterer. Thegroup indicated all these issues were societal, rather than individual,and lack of addressing of them affected the effectiveness of the socialservices they had received. Overall, the participants were generally positive about at least onesocial worker with whom they had a relationship during their teenageyears. Participants typically felt feeling most encouraged and bestserved by those social workers who did not present themselves as beingdistant or above the participants and their families, and who did notoverly emphasise their family’s issues from a perspective of individualdysfunction. These findings indicated that a feminist interactiveconstruct, which avoids “power over” methods and practise is perceivedto be most effective by domestic violence survivors. Feminist Theory in Social Work Assignment Essay RECOMMENDATIONS It is recommended from findings of this study that social workersare first provided greater exposure to and training in feminist methodsand theory as it relates to their practical, day-to-day practise. Forexample, all participants reported some positive experiences inresponse to reflective methods such as reflective journaling andsurvivor support groups. Considerations of ways to more greatlyinclude such methods in typical practise are therefore indicated. Feminist Theory in Social Work Assignment Essay Of greater concern are the systems in which social workers operate. Whilst most of the social workers in these focus group participants’experiences had some familiarity with feminist theory or methods, as indicated by their emphasis on empowerment or use of specific strategies, there is something within the government-sponsored social services structure that prohibits practise truly based on feminist tenets. A sharp contrast was provided by the young woman served at a progressive, private service, where feminist theory was the obvious framework on which service was based. She was by far the most positive about her experiences and workers, and reported insights, understanding and empowerment to chang

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NURS 6401 – Informatics in Nursing and Healthcare Assignment Case Study Paper NURS 6401 – Informatics in Nursing and Healthcare Assignment Case Study Paper Informatics is changing the face of healthcare. As technology advances, healthcare organizations and providers are able to collect, analyze and leverage data more effectively, influencing the way care is delivered, resources are managed and teams operate each day. You would be hard-pressed to find an aspect of medicine that has yet to be touched by the mass collection and analysis of data that has been ushered in by the Information Age. NURS 6401 – Informatics in Nursing and Healthcare Assignment Case Study Paper One specific area that health informatics is having a significant impact on is the practice of nursing. Though the mission of nursing remains unchanged, the daily work of these professionals is being strongly influenced by informatics, with particular attention to the accuracy and communication of patient data and care. Permalink: https://nursingpaperessays.com/ nurs-6401-inform…case-study-paper / ? Health informatics in nursing The nursing profession is rapidly changing to keep up with advancements and new challenges in the healthcare field. As direct caregivers, nurses are in the front lines of patient care and consequently often feel the impact of changes in best practices more immediately than other healthcare professionals. NURS 6401 – Informatics in Nursing and Healthcare Assignment Case Study Paper Spyros Kitsiou, Assistant Professor of Biomedical and Health Information Sciences at the University of Illinois at Chicago, reported that there are three specific challenges that healthcare is currently facing: the aging population, the incidence and prevalence of chronic diseases – such as cardiovascular disease, diabetes and pulmonary disease – and the shortage of doctors and nurses. Though these problems are diverse, there is a solution that addresses all three: data. “A lot of these challenges can be supported by the avocation of information and communication technologies, particularly as hospitals are becoming more and more interested in reducing their costs and shifting care from hospital care to home care,” Spyros said. “Information and communication technologies, mobile health devices, wearable technologies are all becoming very, very important for supporting remote patient monitoring and home care.” NURS 6401 – Informatics in Nursing and Healthcare Assignment Case Study Paper In nursing, as with healthcare in general, informatics is being used to address the challenges of the day, significantly impacting the way nurses function in patient care. One of the primary ways that informatics has changed nursing practice is through documentation. Gone are the days of paper charts that had to be meticulously updated with handwritten notes. Today, nurses are more likely to input notes into electronic health records and other systems that keep a patient’s medical history up-to-date and easily accessible. The Healthcare Information and Management Systems Society reported that as the result of electronic charting, nurses are able to obtain information quickly and efficiently, using the information to improve the daily workflow. Storing the information electronically is more easily available to all members of the care team, including the physician and other care providers, as well as staff teams at other healthcare organizations that the patient may visit. As the U.S. population becomes more mobile, it is increasingly important that their personal medical records can travel with them to any office or medical organization they may visit during their lifetime. NURS 6401 – Informatics in Nursing and Healthcare Assignment Case Study Paper Health informatics is also an important part of care coordination in nursing. The ability to track staffing, workflow and communication can help nurses to identify areas where current processes can be improved. This can also help ensure that staffing levels remain adequate, which is critical for providing patients with the best possible care. If the nurse-to-patient ratio drops too low, patients are more likely to suffer adverse results. Maintaining adequate levels helps nurses provide the best possible care each day without burning out. Evidence-based practices have long been an essential part of nursing. Today, determining those best practices involves the use of health informatics. Analyzing the mass quantities of data collected regarding patient care and outcomes helps to determine how best to treat these conditions and situations in the future. The more data that is collected and analyzed, the more accurate the resulting conclusions tend to be, providing the best possible information for determining how best to care for patients in the future. NURS 6401 – Informatics in Nursing and Healthcare Assignment Case Study Paper The growing role of informatics in nursing has also created a number of new job titles for those with clinical experience and an interest in working with data. A nursing career in informatics Nurses at every level now work with informatics through patient records and other technology. However, some nurses choose to specifically focus their career on the intersection of informatics and clinical practice. There are a number of career options available in this lane, including the following: NURS 6401 – Informatics in Nursing and Healthcare Assignment Case Study Paper Clinical informatics specialist Nursing informatics specialist Clinical analyst Clinical informatics manager Clinical informatics coordinator Nursing informatics analyst These roles can be found at every level and facet of healthcare organizations, including leadership and management, advocacy, risk analysis, compliance, consultation, research, evaluation and education. As informatics becomes a more prominent component of the nursing field, job opportunities will likely continue to develop. While health informatics roles are open to professionals from a variety of backgrounds, nurses are particularly well-suited for these roles due to their knowledge of clinical workflow, previous healthcare education and experience with healthcare technology and information systems. If you already have a clinical background in nursing, your next step en route to one of these jobs is to pursue training specifically in health informatics. Though there are several ways to do this, one option is to earn a Master of Science in Health Informatics degree. In a master’s program, you will take courses on important topics such as healthcare information systems, healthcare IT vendor management, health information systems analysis and design and organizational issues in health informatics to prepare for a career in health informatics. NURS 6401 – Informatics in Nursing and Healthcare Assignment Case Study Paper The Healthcare Information and Management Systems Society defines nursing informatics as “a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice.” Informatics is becoming increasingly present in our profession due to rapidly changing techno logic advances. Healthcare systems are assimilating technology into daily practice at a quick pace. Security and patient privacy must be upheld while achieving the goal of transforming data into useful knowledge. Integrating informatics with evidence-based practice (EBP) can only help improve the care we provide to our patients. Applying technology to knowledge may help identify potential problems earlier. For example, with the use of electronic documentation, identifying changes in patient status can occur quickly because the information is readily available. Trending of patient vital signs is always accessible and the data are interpreted, systematized, and arranged. The nurse is able to use this knowledge to formalize an appropriate plan of action. NURS 6401 – Informatics in Nursing and Healthcare Assignment Case Study Paper Standardizing nursing language will facilitate acceptance of new methods of documentation in the electronic health record. A template for nursing notes is one method of assisting with our daily workload. The use of a template can remind you of important information required in the documentation of patient care. Research studies, patient care data, and national and local standards are used to develop informatics programs at healthcare organizations. Other measures include return on investment analysis, patient preferences and/or needs, and infection control data. How’s the need for technology addressed? Let’s say a high rate of medication errors is identified. Analysis of how and why the errors are occurring must be conducted. The research can include collecting data from other facilities in the area to determine if the same problem exists elsewhere. Following data collection, the findings are presented to a review board. A plan to improve the problem is implemented, such as the use of bar code scanners. Data collection continues to determine if implementation is successful. The most important piece of implementation is presentation of the evidence to staff to identify how the change will improve the day-to-day actions of nurses. NURS 6401 – Informatics in Nursing and Healthcare Assignment Case Study Paper Nursing informatics is a growing field. As nurses, we face ever changing and challenging practice situations; competency in nursing informatics promises to strengthen our clinical decision-making skills. Although new technology may be a challenge for some, informatics will enhance nursing practice. We’ll have quicker access to patient information, improve overall efficiency, and see a reduction in potential errors. How Nurses Are Using Health Informatics to Improve Patient Care Nursing is increasingly becoming as “high tech” as it is a “high touch” profession. Today’s nurses have more technology at their disposal than any nurses ever before, and as one might expect, it’s considerably improving patient care. One area where nurses are putting technology to use is in informatics. Officially known as the study of information, in the world of health care, health informatics is the management of health information. Using electronic medical records, devices that collect health information electronically, and other electronic information standards, health informatics nurses are responsible for managing, interpreting, and communicating the data that comes in and out of health care facilities, all with one primary purpose: Improving the quality of patient care. NURS 6401 – Informatics in Nursing and Healthcare Assignment Case Study Paper But how does that happen, specifically? How are nurses using informatics as a way to improve the care they — and their colleagues — provide to patients? As it turns out, there are several key ways that informatics is part of that effort. Improved Documentation Documentation has long been considered an important part of the nursing profession, but it’s more vital than ever to the delivery of quality care. While the theory and practice of nursing, the standards of nursing practice, legal and ethical considerations, and other points that are taught in advanced nursing programs all influence the practice of nursing, it’s information, and specifically, electronic documentation, that is having the greatest influence on modern nursing. Modern nursing care is driven by individual patient needs and history — information that is collected and organized in electronic patient records. By documenting a patient’s condition, and sharing that information electronically, nurses are able to more effectively manage care, and by extension, improve the quality of that care. NURS 6401 – Informatics in Nursing and Healthcare Assignment Case Study Paper A great deal of documentation takes place automatically thanks to connected devices, which collect specific information in real time and transmit it to patient records. By looking at the documentation of a patient’s condition over time, nurses can make better decisions about how to provide care and when changes or adjustments need to be made. Reduced Medical Errors Patient safety is a primary concern of any health care provider, and nurses are often on the front lines of ensuring that their patients are kept safe and preventing medication errors, misdiagnoses, falls, and other problems. Health informatics provides important data that can prevent these errors; for example, an electronic record can provide information about a possible dangerous medication interaction or allergy that might not otherwise be immediately apparent. Armed with data, nurses can make quick decisions that keep their patients safe. NURS 6401 – Informatics in Nursing and Healthcare Assignment Case Study Paper In fact, in a study by the Agency for Healthcare Research and Quality (AHRQ), a majority of nurses reported that when they have access to EHRs, they have fewer problems with getting patients ready for discharge, fewer medication errors, and better quality of care. And when it comes to transfers between departments, nearly 15 percent of the nurses surveyed reported that information was more likely to be shared and less likely to “fall between the cracks” when electronic systems are used. Reduced Costs Medical errors cost nearly $40 billion every year, and many of those errors are preventable with informatics. Not only does information provide nurses with alerts to avoid errors, it also helps to automate certain tasks, both improving nurse productivity and preventing some of the costs associated with health care. NURS 6401 – Informatics in Nursing and Healthcare Assignment Case Study Paper Improved Coordination of Care Nurses are often called upon to help coordinate the care of their patients. This often means relaying information from physicians, therapists, pharmacy, billing, and more, both during care and at discharge. Without all of the necessary information, patient care could suffer. Informatics improves the coordination of this information, allowing nurses to give their patients all of the information they need, improving both outcomes and the satisfaction with care. While there are some who criticize the use of informatics and technology to help manage care, arguing that it makes health care more impersonal, with the provider-patient relationship being replaced with data and algorithms, there is actually overwhelming evidence that informatics actually improves care. Nurses who are trained in this technology and how to best incorporate data into their workflow are often more productive and able to provide better care than ever before. NURS 6401 – Informatics in Nursing and Healthcare Assignment Case Study Paper The healthcare industry recognizing the need for communication between information technology personnel and healthcare practitioners in order to address the issues of patient care, created nurse informatics specialist positions. Nurse informatics specialists are an integral part of the healthcare delivery process and a deciding factor in the selection, implementation and evaluation of healthcare, which supports safe, high-quality and patient-centered care (Elkind, 2009). The American Nurses Association (2008) defined Nursing informatics as “A specialty that integrates nursing science and computer science to manage and communicate data, information and knowledge in nursing practice (p. 1). Nursing informatics can also be defined as any use of information technology by nurses for the purpose of enhanced patient outcomes, the management of healthcare facilities, nurse education and nursing research. NURS 6401 – Informatics in Nursing and Healthcare Assignment Case Study Paper Many healthcare individuals associate the field of nurse informatics as having two types of roles, the clinician who uses the health information technology and the specialist, who creates, facilitates, tests, and implements new information technology. Healthcare settings now integrate electronic medication prescribing, tele-health, online appointment scheduling and mobile laboratories where informatics nurses are essential in guaranteeing that the computerized solutions interface with each other (HIMSS, 2011). In order to accomplish information related activities, informatics nurses must synchronize and exchange significant clinical and technical information with the goal of supporting and coordinating safe, effective patient care and assuring an efficient workflow. NURS 6401 – Informatics in Nursing and Healthcare Assignment Case Study Paper A vital element of healthcare information is nursing documentation. Information systems are designed for nurses where documentation can be best utilized to expand their knowledge of quality of care. The evolution of knowing has been exponential in the past forty years due to the new ways of learning that have been discovered. Nursing in particular has benefited from these new concepts and continues to find newer and better methods to improve patient care. Nurses bring to their practice a personal history that develops the way their nursing care is performed. Nursing theory, standards of practice, legal and ethical obligations must be understood and utilized to enhance the quality of nursing care. The electronic patient record has become an important aspect in the information workflow, and using information technology will result in improving patient outcome quality and efficiency. Patient documentation is a vital skill in communicating the patient’s condition and organizing their care according to the patient’s needs. Nursing practice is primarily guided by patients’ needs and depending on those needs and their environments, different theories can be applied for individualized care. The application of individual nursing practice is based on an combination of medical, philosophical, psychological and other nursing theories. NURS 6401 – Informatics in Nursing and Healthcare Assignment Case Study Paper Barbara Carper, a professor at the College of Nursing at Texas Woman’s University, wrote an essay in 1978 titled the “Fundamental Patterns of Knowing in Nursing,” that has identified four ways of knowing that nurses apply to meet patients’ needs. Today many universities and nursing colleges are using her fundamental patterns to help nursing students gain a more universal approach to assessing, understanding and treating patients. One of Carper’s patterns is the empirical knowing that is based on the result of the most relevant and supported evidence derived from research. This includes research related to nursing informatics and the use of technology in healthcare. Before the digital age, nurses were utilizing paper forms to document important patient information. A significant factor in the nursing profession and healthcare systems is the transition to electronic documentation. Electronic documentation contains flow sheets that help in assembling information about the patient’s needs, improve the patient’s information accuracy, and enhance the quality of patient care. A well designed information system can facilitate and provide an easier and faster information flow that is needed for efficient documentation processing. Nurses play an essential role in patient’s safety where the quality of the nursing environment and electronic documentation has a positive influence on patients. The electronic documentation method has evolved to provide a plan of care for patients, efficient communication between clinicians, and direct patient care processes. Nurses are very diligent in coordinating, monitoring and delivering patient care to guarantee effective documentation flow. Nursing computer based software allows nurses to collect, store, recover data and integrate clinical data with nursing management resources. NURS 6401 – Informatics in Nursing and Healthcare Assignment Case Study Paper Among multiple healthcare organizations, nurses represent the largest technology user group. In the beginning nurses believed that electronic documentation and information systems were an interruption to their daily workflow and a disruption from bedside care (Lee, 2004). Over the years however, nurses have become more accustomed to the technology, which is positive since their acceptance of it is imperative to successful system implementation. Today, nurses are more proficient in all aspects of information technology while maintaining superior levels of patient care. Most nurses now have a positive attitude related to the improved quality of electronic documentation and a new appreciation of the decreased workload afforded when using a well- designed system. However, despite the benefits of electronic documentation for nursing workflow, there are barriers that can obstruct the utilization of computerized documentation systems. Some of these barriers can result from behavioral issues in regards to perception and satisfaction toward information technology and the time spent documenting the patient information. The challenge comes when some nurses (i.e. older nurses) have doubts about working in a nursing environment filled with technology. Even though they are provided with reference guides, screen shots, and cheat sheets that are helpful, some nurses still have a hard time adjusting to electronic charting. Some of them have a fear of clicking in the wrong place as they work with computerized charts and they become aggravated when they cannot perform their electronic tasks. NURS 6401 – Informatics in Nursing and Healthcare Assignment Case Study Paper With electronic charting, nurses have the capability of accessing information quickly and efficiently and are able to use information to improve the quality of nursing workflow. In most of these situations, nurse informatics specialists play a pivotal role in assisting nurses in identifying and addressing these challenges. Many nursing theories have been developed to promote nursing practice efficiency. For an informatics nurse, change theory is the most integrated theory in their practice. Nurse informatics specialists apply theories in directing patient care, while providing guidance and technical assistance for staff nurse workflow as well as providing leadership for system change. NURS 6401 – Informatics in Nursing and Healthcare Assignment Case Study Paper Kurt Lewin’s theory of change offers a tactical approach that can help informatics nurses in implementing and evaluating the projected changes in the system processes. An interesting article was written by Polly Ryan in 2009 where she stated that: “the integrated theory of health behavior change suggests that health behavior change can be enhanced by fostering knowledge and beliefs, increasing self-regulation skills and abilities, and enhancing social facilitation” (p. 161). Informatics nurses motivate and encourage nurses to use innovative problem-solving methods by providing them with support. The informatics nurse is part of the delivery of care, the building of knowledge, skills, and the experience in the use of information technology. They often lead clinical informatics committee meetings that have a major influence for nurses in assisting them to coordinate all the multifaceted technology activities in regards to patient care, documentation and safety. Informatics committees provide continuing guidance in the development and implementation of information technology and digital solutions for nursing practice and patient care. The significance of developing and maintaining positive attitudes and computer-use acceptance among nursing staff have been discovered in multiple literature reviews. For a successful implementation of an electronic documentation system, it is important to understand the various levels of computer familiarity, and acknowledge nurses’ computer use needs, attitudes, skills, beliefs and readiness to learn. An informatics committee also provides structure, support and staff development to nurses from different departments who interface with or are impacted by information technology. NURS 6401 – Informatics in Nursing and Healthcare Assignment Case Study Paper Informatics and nurses support for ongoing professional development that implements the work knowledge of nurses leads to high quality care and patient satisfaction. Research reveals the importance of nurse’s involvement in informatics committee meetings where they can participate in system design, redesigning workflow, and improving interdisciplinary communication (Lee, 2007). Many nurses are professionally and ethically motivated to contribute to new knowledge, high quality improvement, and innovation through evidence based decision making. Evidence-based practice and decision-making began with Florence Nightingale in the 1850s during the Crimean War. She realized a correlation between poor sanitary situations in the hospitals and rising death rates among wounded soldiers. Her consequent efforts to keep the hospitals disinfected in order to save soldiers resulted in a remarkable drop in patient mortality (Alligood, 2014). Since Nightingale’s work in improving healthcare conditions, the progress of evidence based practice has evolved over time. Effective nursing care relies on the gathering and use of nursing evidence. The pattern of empirical knowledge is founded in evidence-based research and objective experience, and has been identified as the most prevalent in nursing practice. Evidence based practice functions as the key standard for quality in nursing practice by enhancing patient satisfaction. Evidence-based quality improvement was redesigned to transform healthcare into an environment of care that is effective, safe, and efficient. Research is being used progressively as the basis for clinical decisions in many organizations. The stream of information through the increase of technology, has transformed the decision-making process for clinicians. Research authenticates, enhances and creates a scientific base for nursing practice and is facilitated and disseminated through the use of information technology and nursing informatics. The nurse’s ultimate goal through the use of information technology is patient education, while providing high quality care and most importantly patient safety. NURS 6401 – Informatics in Nursing and Healthcare Assignment Case Study Paper It has been observed that patient education has slowly become a major concern and that hospitals want to get involved in implementing better education for patients and their families. The importance of patient education is an example of critical study and evidence based practice by nurses that has shown that knowledge, on the part of patients and their families, can reduce re-admission rates, decrease healing time, improve mental discomfort, and produce better patient results. Today, patients are educated with the help of technology including modern televisions, I-pads and other sophisticated electronic devices where the patient can watch, learn and explore their illnesses and care. Partnership with team members and families is essential to optimal treatment. The application of individual nursing practice is based on an arrangement of the clinician and the patient. Traditional patient education relied on written material about disease processes, medication, medical management, and self-care instruction guidelines. Today, patients benefit from many forms of education and with all these forms of education nurses can provide patients with knowledge that enables them to understand the disease process and make important decisions about their health. Nursing interventions in proper patient education improves patient self-care, satisfaction, moral support, coping skills and mental stability. Addressing improvement in nursing workflow is essential to the improvement of patient stability and safety. NURS 6401 – Informatics in Nursing and Healthcare Assignment Case Study Paper Healthcare outcomes including quality of life measures are the result of a multifaceted relationship between the patient, the nurse, the treatment and the information healthcare system. A strong foundation for addressing the challenges of electronic documentation is the informatics nurse’s capability to understand and direct the balance of patient care with the technology systems and organizational structure that supports this balance. In order to guarantee a successful implementation of a computer system while managing patient care it is important to integrate nurses’ perceptions, beliefs, and knowledge in the use of new technology and how nurses implement this technology into their daily nursing practice. Finding the right balance of information science in conjunction with nursing science is a continuing process that will rely on the forward thinking and perseverance of today’s modern nurse and the support of nursing informatics specialists. How Nursing Informatics Improves Patient Care The healthcare information revolution is upon us. Clinicians have more access than ever to electronic health records, diagnostics, and treatment plans. Clinical communication and collaboration platforms are making it easier to manage healthcare workflows, improve coordination, and enhance patient outcomes. Systems integration and data access mean that information and analysis are more vital than ever. NURS 6401 – Informatics in Nursing and Healthcare Assignment Case Study Paper The secret to using this data to provide better care comes down to nursing informatics — integrating nursing science with other areas to identify, define, manage, and communicate data, information, knowledge, and wisdom to provide better care. As the Healthcare Information and Management Systems Society says, “The informatics nurse is part of the delivery of care, the building of knowledge, skills, and experience in the use of information technology. They often lead clinical informatics committee meetings that have a major influence for nurses in assisting them to coordinate all the multifaceted technology activities in regards to patient care, documentation, and safety.” Let’s dig into exactly how nursing informatics achieves that. Aligning Nursing Best Practice with Clinical Workflows and Care Nursing informatics is focused on the best ways to achieve good patient outcomes — it is about applying the overall process and best practice to maximize patient care wherever possible. As a result, nurse informatics are often involved in process design, clinical workflow reviews, and new diagnostics and treatment plans. They take into account the various options for providing care and use objective facts and analysis to determine the actions that will lead to the most patient-centered, value-based care. Improving Clinical Policies, Protocols, Processes, and Procedures Data is the lifeblood of nursing informatics. That data and information can be used to measure the success of the various protocols, processes, and procedures used in a healthcare organization. A nurse informatics will measure and analyze how specific parts of the organization are performing, with a focus on the resulting patient outcomes. They can then make changes to specific parts of the process to streamline activities, avoid bottlenecks, and improve care. Informatics will see what the results are and continue making changes to enhance every part of the clinical care process. NURS 6401 – Informatics in Nursing and Healthcare Assignment Case Study Paper Providing Training and Learning Based on Objective Data One of the most valuable ways a nursing informatics can enhance patient outcomes is through providing training to clinical staff. They can use data to identify endemic issues in a healthcare organization and consult on the best way to resolve these problems. These leanings can be integrated with on boarding new staff, ongoing in-house training, or external education and certification. Nursing informatics can help to create highly-targeted educational programs to deal with specific gaps between ability and provider expectations. Selecting and Testing New Medical Devices Connected IoT medical devices can provide vast amounts of health data on patients. Nursing informatics are ideally positioned to understand the true value of that data and provide recommendations on how it can be recorded, accessed, and used. Involving informatics in the selection of medical devices will ensure you have additional criteria for understanding how device data can inform diagnostics, treatment plans, and ulti

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