NR 351 Week 5 Discussion Leadership in Diverse Situations Recent
NR 351 Week 5 Discussion Leadership in Diverse Situations Recent
I must consider skin integrity of my patients as one issue of great importance. I have mentioned in previous discussions, I work in an acute rehab unit which means my patients stay on our unit for as long as a month or more. This prolonged stay adds to their risk of skin breakdown. “Pressure ulcers are serious clinical complications that can lead to increased length of stay, pain, infection, and death.” (Armour-Burton, 2013). To establish best practice regarding the issue of pressure ulcers and their prevention I would utilize research of the subject to expand my knowledge.
To formulate my research question I would employ the PICOT (population, intervention, comparison, outcome, and optimal timing) acronym (Melnyk and Fineout-Overholt, 2011, 2015, as cited in Hood, 2018).
P..my population is acute rehabilitation patients
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I..my intervention is providing EBP care to prevent the breakdown of patient skin during hospitalization
C..my comparison would be not providing interventions prior to skin breakdown
O..my outcome would be the skin condition of patients at discharge
T..timing would be the period of time the patient is hospitalized
In searching CINAHL for information I would begin with terms such as “pressure ulcers during long term hospitalization”, “EBP regarding pressure ulcer prevention” and “the use of skin assessments in preventing pressure ulcers”. This search could be expanded with additional terms to obtain adequate material to address the subject if necessary.
Armour-Burton T., Fields W., Outlaw L., Deleon E. (2013). The health skin project: Changing nursing
practice to prevent and treat hospital-aquired pressure ulcers. Critical Care Nurse, 33(3), 32-40.
Melnyk, B., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing and healthcare: A guide to
best practice (2nd ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
Melnyk, B., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing and healthcare: A guide to
best practice (3rd ed.). Philadelphia, PA: Wolters-Kluwer.
According to Rowlands, incorrect surgical counts are a common occurrence after surgery. In reviewing incident reports from six hospitals during a three-year period, researchers found that incorrect surgical counts (25%) were the most frequently reported event. Despite the availability of AORN standards and recommended practices and hospital policies, this type of error continues to occur (2012).
Rowlands also states, “the OR is a highly complex, error-prone environment characterized by nonstop activity, specialization, and intricate interdisciplinary processes. The complexity is manifested not only in the patient and his or her condition but also in the sophistication of instrumentation and technology, which may increase the risk for error”. “From the stories of preoperative personnel involved in incorrect surgical counts, three distinct themes emerged: bad behavior, general chaos, and communication difficulties”.
Working in the OR first hand I deal with the three themes mentioned. I find it difficult to have everyone participate in the correct sequence as well as visualizing each item counted. When I correct someone, I receive “looks”, hissing and a feeling that I am being too strict while I feel that other are too lax and do not take into consideration that policies dictate our process. The patient and their safety, following policies and maintaining my licensure are the core of my practice. Recently, I had a surgical technologist berate me for correcting a new surgical technologist in the way they were performing the count. I received attitude from the new employee and was berated by the preceptor during the procedure. I structure my counting based on the policy and so I know that I am performing my count according to AORN standards.
Moving forward in my practice, I will continue my counts as outlined in our policy. I will continue to correct others when necessary and I will hold others accountable to follow the policy. I do not play into unprofessionalism in my OR and I will address each situation as it arises. When others disrupt the OR with unprofessionalism, I simply explain that we can discuss the situation at a later time.
Researching in the Chamberlain Library for information regarding surgical counts, I began my search in the CINAHL complete tab, entered surgical counts on the first line and extended my search further with “risk factors associated with incorrect surgical counts”. I found a great journal article and used it along with my experience to complete my week 5 assignment.
Hood, L. J. Leddy and Pepper’s Professional Nursing (9th ed.). Philadelphia, PA Wolters Kluwer
Rowlands, A. (2012). Risk Factors Associated with Incorrect Surgical Counts. https://doi.org/10.1016/j.aorn.2012.06.012Links to an external site.
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Leadership in Diverse Situations
Nurses demonstrate leadership in many situations. For this discussion, select one of the following situations that you have not previously experienced and tell us how the nurse would demonstrate leadership in that situation:
• Communicating with legislators to influence health policy
• Clinical leadership at the bedside
• Nursing management of units or facilities
• Impact of systems-based practice on leadership
APA Writing Checklist
Use this document as a checklist for each paper you will write throughout your GCU graduate program. Follow specific instructions indicated in the assignment and use this checklist to help ensure correct grammar and APA formatting. Refer to the APA resources available in the GCU Library and Student Success Center.
☐ APA paper template (located in the Student Success Center/Writing Center) is utilized for the correct format of the paper. APA style is applied, and format is correct throughout.
☐The title page is present. APA format is applied correctly. There are no errors.
☐ The introduction is present. APA format is applied correctly. There are no errors.
☐ Topic is well defined.
☐ Strong thesis statement is included in the introduction of the paper.
☐ The thesis statement is consistently threaded throughout the paper and included in the conclusion.
☐ Paragraph development: Each paragraph has an introductory statement, two or three sentences as the body of the paragraph, and a transition sentence to facilitate the flow of information. The sections of the main body are organized to reflect the main points of the author. APA format is applied correctly. There are no errors.
☐ All sources are cited. APA style and format are correctly applied and are free from error.
☐ Sources are completely and correctly documented on a References page, as appropriate to assignment and APA style, and format is free of error.
Scholarly Resources:Scholarly resources are written with a focus on a specific subject discipline and usually written by an expert in the same subject field. Scholarly resources are written for an academic audience.
Examples of Scholarly Resources include:Academic journals, books written by experts in a field, and formally published encyclopedias and dictionaries.
It is admirable that you would like to find a solution to deficiencies in maintaining the integrity of the patients’ skin to aid in administering optimal healthcare to your patients. Turning and positioning your immobile patients every hour is definitely a technique that would decrease the amount of pressure injury wounds you and your team will have to manage. The problem I foresee with having to turn and position the patient every hour is that the patient record would require documentation for the administration of the service rendered to show that the care was given. The problem with this idea is that most nurses and unlicensed professionals have large workloads of patients and an increase of the workload has led to a decrease of the quality of documentation (Shihundla, R.C. et al, 2016.) Having to turn and position so often and document so often will lead to mismanagement of patients due to omission of documentation caused by nurses forgetting to document due to the volume of the workload (Shihundla, R.C., et al, 2016). “Nurses find it difficult to cope with the increased workload associated with documenting patient information on the multiple records that are utilized at PHC facilities, leading to incomplete information. The number of nurses at facilities should be increased to reduce the increased workload” (Shihundla, R.C., et al, 2016, abstract). Here is where documenting and actual implementing the technique of hourly documentation on turning and positioning will be somewhat addressed. Until there is an increase in staff available or a decrease in the amount of documentation that is required, the implementation of increased rounding would possibly be better to wait on just to prevent mismanagement of patients due omission of patient information from nurse forgetfulness (Shihundla, R.C., et al, 2016).
Peer-Reviewed Journals:Peer-reviewed journals are evaluated prior to publication by experts in the journal’s subject discipline. This process ensures that the articles published within the journal are academically rigorous and meet the required expectations of an article in that subject discipline.
Empirical Journal Article: This type of scholarly resource is a subset of scholarly articles that reports the original finding of an observational or experimental research study. Common aspects found within an empirical article include: literature review, methodology, results, and discussion.
Adapted from “Evaluating Resources: Defining Scholarly Resources,” located in Research Guides in the GCU Library.
☐ The writer is clearly in command of standard, written, academic English. Utilize writing resources such as Grammarly, LopesWrite report, and ThinkingStormto check your writing.
In discussions, you, as a student, will interact with your instructor and classmates to explore topics related to the content of this course. You will be graded for the following.
Discussions (graded): Discussions are a critical learning experience in the online classroom. Participation in all discussions is required.
2. Guidelines and Rubric for Discussions
PURPOSE: Threaded discussions are designed to promote dialogue between faculty and students, and students and their peers. In the discussions students:
- Demonstrate understanding of concepts for the week
- Integrate scholarly resources
- Engage in meaningful dialogue with classmates
- Express opinions clearly and logically, in a professional manner
Participation Requirement: You are required to post a minimum of three (3) times in each graded discussion. These three (3) posts must be on a minimum of two (2) separate days. You must respond to the initial discussion question by 11:59 p.m. MT on Wednesday.
Participation points: It is expected that you will meet the minimum participation requirement described above. If not:
- You will receive a 10% point deduction in a thread if your response to the initial question is not posted by 11:59 p.m. MT on Wednesday
- You will also receive a 10% point deduction in a thread if you do not post at least three (3) times in each thread on at least two (2) separate days.
3. Threaded Discussion Guiding Principles
The ideas and beliefs underpinning the threaded discussions (TDs) guide students through engaging dialogues as they achieve the desired learning outcomes/competencies associated with their course in a manner that empowers them to organize, integrate, apply and critically appraise their knowledge to their selected field of practice. The use of TDs provides students with opportunities to contribute level-appropriate knowledge and experience to the topic in a safe, caring, and fluid environment that models professional and social interaction. The TD’s ebb and flow is based upon the composition of student and faculty interaction in the quest for relevant scholarship. Participation in the TDs generates opportunities for students to actively engage in the written ideas of others by carefully reading, researching, reflecting, and responding to the contributions of their peers and course faculty. TDs foster the development of members into a community of learners as they share ideas and inquiries, consider perspectives that may be different from their own, and integrate knowledge from other disciplines.
4. Participation Guidelines
You are required to post a minimum of three (3) times in each graded discussion. These three (3) posts must be on a minimum of two (2) separate days. You must respond to the initial discussion question by 11:59 p.m. MT on Wednesday. Discussions for each week close on Sunday at 11:59 p.m. Mountain Time (MT). To receive credit for a week’s discussion, students may begin posting no earlier than the Sunday immediately before each week opens. For courses with Week 8 graded discussions, the threads will close on Wednesday at 11:59 p.m. MT. All discussion requirements must be met by that deadline.
5. Grading Rubric
|Discussion Criteria|| A
Outstanding or highest level of performance
Very good or high level of performance
Competent or satisfactory level of performance
Poor or failing or unsatisfactory level of performance
|Answers the initial graded threaded discussion question(s)/topic(s), demonstrating knowledge and understanding of concepts for the week.
|Addresses all aspects of the initial discussion question(s) applying experiences, knowledge, and understanding regarding all weekly concepts.
|Addresses most aspects of the initial discussion question(s) applying experiences, knowledge, and understanding of most of the weekly concepts.
|Addresses some aspects of the initial discussion question(s) applying experiences, knowledge, and understanding of some of the weekly concepts.
|Minimally addresses the initial discussion question(s) or does not address the initial question(s).
|Integrates evidence to support discussion. Sources are credited.*
( APA format not required)
|Integrates evidence to support your discussion from:
Sources are credited.*
|Integrates evidence to support discussion from:
Sources are credited.*
|Integrates evidence to support discussion only from an outside source with no mention of assigned reading or lesson.
Sources are credited.*
|Does not integrate any evidence.
|Engages in meaningful dialogue with classmates or instructor before the end of the week.
|Responds to a classmate and/or instructor’s post furthering the dialogue by providing more information and clarification, thereby adding much depth to the discussion.
|Responds to a classmate and/or instructor furthering the dialogue by adding some depth to the discussion.
|Responds to a classmate and/or instructor but does not further the discussion.
|No response post to another student or instructor.
|Communicates in a professional manner.
|Presents information using clear and concise language in an organized manner (minimal errors in English grammar, spelling, syntax, and punctuation).
|Presents information in an organized manner (few errors in English grammar, spelling, syntax, and punctuation).
|Presents information using understandable language but is somewhat disorganized (some errors in English grammar, spelling, syntax, and punctuation).
|Presents information that is not clear, logical, professional or organized to the point that the reader has difficulty understanding the message (numerous errors in English grammar, spelling, syntax, and/or punctuation).
Response to initial question: Responds to initial discussion question(s) by
Wednesday, 11:59 p.m. M.T.
|0 points lost
Student posts an answer to the initial discussion question(s) by Wednesday, 11:59 p . m. MT.
Student does not post an answer to the initial discussion question(s) by Wednesday, 11:59 p . m. MT.
Total posts: Participates in the discussion thread at least three times on at least two different days.
|0 points lost
Posts in the discussion at least three times AND on two different days.
Posts fewer than three times OR does not participate on at least two different days.
* Credited means stating where the information came from (specific article, text, or lesson). Examples: Our text discusses…. The information from our lesson states…, Smith (2010) claimed that…, Mary Manners (personal communication, November 17, 2011)…. APA formatting is not required.
|** Assigned readings are those listed on the syllabus or assignments page as required reading. This may include text readings, required articles, or required websites.|
|*** Scholarly source – per the APA Guidelines in Doc Sharing, only scholarly sources should be used in assignments. These include peer reviewed publications, government reports, or sources written by a professional or scholar in the field. Wikipedia, Wikis, .com website or blogs should not be used as anyone can add to these. For the discussions, reputable internet sources such as websites by government agencies (URL ends in .gov) and respected organizations (often ends in .org) can be counted as scholarly sources. Outside sources do not include assigned required readings.|
|NOTE: A zero is the lowest score that a student can be assigned.|
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