NR 500 Week 5: Systems Theory and Practice Issues
NR 500 Week 5: Systems Theory and Practice Issues
NR 500 Week 5: Systems Theory and Practice Issues
Health organizations function in highly challenging environments. As a result, they have grown to be complex and adaptive in nature. The complexity arises from the unpredictability of the healthcare environment, which demand responsive and adaptive interventions (Chesnay & Anderson, 2019). Several issues are likely to affect my practice as a nurse practitioner in the future. One of them explored in this paper is nursing shortage. Therefore, the paper examines the issue of nursing shortage, addressing it, impact on other system levels, and use of interprofessional collaboration to solve it.
Issue or Concern
The selected issue that will affect my future practice is nursing shortage. Statistics shows that America will experience an acute shortage of nurses by 2030. The American Association of Colleges of Nursing (AACN) notes that about 1 million nurses will be retiring by 2030, creating a sharp demand for nurses in the county. The county will require an average of 175900 nurses yearly to meet its demand for nurses by 2030 (Graystone, 2018). The implications of the shortage to my practice are the increased workload for nurses. There will also be an increased risk of poor quality of life for nurses because of work-related challenges such as burnout and low job dissatisfaction. The impacts of nurses’ shortage on the quality, safety, and efficiency of care are evident. For example, nursing shortage has been associated with errors in the care process, missed or delays in service provision (Alexander & Johnson, 2021). Therefore, the issue should be addressed to promote the health and wellbeing of the nurses in the future as well as the quality, safety, and efficiency of patient care. The issue of nursing shortage is a meso-system problem. It arises from factors that are beyond the healthcare system. Retirement is an external factor that that the hospitals cannot influence.
Addressing the Issue
Some interventions can be adopted to address the anticipated nursing shortage. One of them is advocating for an increased enrollment of nurses into the bachelor’s program. The number of students joining nursing education has been low as compared to the anticipated population of retiring nurses. Advocating for increased training of nurses would offset the anticipated nursing shortage (Chesnay & Anderson, 2019). The other solution is advocating for government support for nursing training institutions. Often, nursing institutions turn away students interested in training to become nurses because of the lack of adequate resources to train a high number of learners. As a result, it is essential for the government to increase financing for nursing training institutions, as an approach to addressing the issue of nursing shortage (Rosseter, 2019). The last strategy is ensuring organizations strive to retain their existing nursing staff. Strategies such as promoting their continuous professional development, rewarding performance, and offering safe working conditions minimize the risk of poor retention in healthcare organizations (Feyereisen et al., 2021).
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Impact on other Levels of the System
The proposed solutions will affect the other system levels. For example, it will lower the workload that
other healthcare providers experience in their respective workplaces. The solution will also affect meso-system by enhancing care coordination and interprofessional collaboration among care teams. It will also enhance the care given in healthcare organization, hence, effective community-health organization interactions at the macrosystem level (Kennedy, 2019). Interprofessional collaboration could be used to address the issue of nursing shortage. Accordingly, nurses and other healthcare providers could collaborate in identifying effective strategies that can be adopted to enhance employee retention in their organizations. They can also advocate the adoption of policies that address the factors that contribute to nursing shortage (Feyereisen et al., 2021).
Conclusion
In summary, nursing shortage will affect my future nursing practice. Strategies such as organizations striving to maintain their existing workforce and governments supporting nursing training institutions can address the issue of nursing shortage. Interprofessional collaboration also helps organization embrace best practices for employee retention. Therefore, I would explore these strategies to mitigate the effects of nursing shortage on my future practice.
References
Alexander, G. R., & Johnson, J. H. J. (2021). Disruptive Demographics: Their Effects on Nursing Demand, Supply and Academic Preparation. Nursing Administration Quarterly, 45(1), 58–64. https://doi.org/10.1097/NAQ.0000000000000449
Chesnay, M. de, & Anderson, B. (2019). Caring for the Vulnerable. Jones & Bartlett Learning.
Feyereisen, S. L., Puro, N., & McConnell, W. (2021). Addressing Provider Shortages in Rural America: The Role of State Opt-Out Policy Adoptions in Promoting Hospital Anesthesia Provision. The Journal of Rural Health, 37(4), 684–691. https://doi.org/10.1111/jrh.12487
Graystone, R. (2018). How Magnet® Designation Helps Hospitals Tackle the Nursing Shortage. JONA: The Journal of Nursing Administration, 48(9), 415–416. https://doi.org/10.1097/NNA.0000000000000640
Kennedy, A. (2019). Nurse Preceptors and Preceptor Education: Implications for Preceptor Programs, Retention Strategies, and Managerial Support. Medsurg Nursing, 28(2).
Rosseter, R. (2019). Fact sheet: Nursing faculty shortage. Washington, DC: American Association of Colleges of Nursing.
Systems Theory and Practice Issues
Health organizations function in highly challenging environments. As a result, they have grown to be complex and adaptive in nature. The complexity arises from the unpredictability of the healthcare environment, which demand responsive and adaptive interventions (Chandler et al., 2016). Several issues are likely to affect my practice as a nurse practitioner in the future. One of them explored in this paper is nursing shortage. Therefore, the paper examines the issue of nursing shortage, addressing it, impact on other system levels, and use of interprofessional collaboration to solve it.
Issue or Concern
The selected issue that will affect my future practice is nursing shortage. Statistics shows that America will experience an acute shortage of nurses by 2030. The American Association of Colleges of Nursing (AACN) notes that about 1 million nurses will be retiring by 2030, creating a sharp demand for nurses in the county. The county will require an average of 175900 nurses yearly to meet its demand for nurses by 2030 (Graystone, 2018). The implications of the shortage to my practice are the increased workload for nurses. There will also be an increased risk of poor quality of life for nurses because of work-related challenges such as burnout and low job dissatisfaction. The impacts of nurses’ shortage on the quality, safety, and efficiency of care are evident. For example, nursing shortage has been associated with errors in the care process, missed or delays in service provision (Alexander & Johnson, 2021). Therefore, the issue should be addressed to promote the health and wellbeing of the nurses in the future as well as the quality, safety, and efficiency of patient care. The issue of nursing shortage is a meso-system problem. It arises from factors that are beyond the healthcare system. Retirement is an external factor that that the hospitals cannot influence.
Addressing the Issue
Some interventions can be adopted to address the anticipated nursing shortage. One of them is advocating for an increased enrollment of nurses into the bachelor’s program. The number of students joining nursing education has been low as compared to the anticipated population of retiring nurses. Advocating for increased training of nurses would offset the anticipated nursing shortage (Marć et al., 2019). The other solution is advocating for government support for nursing training institutions. Often, nursing institutions turn away students interested in training to become nurses because of the lack of adequate resources to train a high number of learners. As a result, it is essential for the government to increase financing for nursing training institutions, as an approach to addressing the issue of nursing shortage. The last strategy is ensuring organizations strive to retain their existing nursing staff. Strategies such as promoting their continuous professional development, rewarding performance, and offering safe working conditions minimize the risk of poor retention in healthcare organizations (Feyereisen et al., 2021).
Impact on other Levels of the System
The proposed solutions will affect the other system levels. For example, it will lower the workload that other healthcare providers experience in their respective workplaces. The solution will also affect meso-system by enhancing care coordination and interprofessional collaboration among care teams. It will also enhance the care given in healthcare organization, hence, effective community-health organization interactions at the macrosystem level (Kennedy, 2019). Interprofessional collaboration could be used to address the issue of nursing shortage. Accordingly, nurses and other healthcare providers could collaborate in identifying effective strategies that can be adopted to enhance employee retention in their organizations. They can also advocate the adoption of policies that address the factors that contribute to nursing shortage (Feyereisen et al., 2021).
Conclusion
In summary, nursing shortage will affect my future nursing practice. Strategies such as organizations striving to maintain their existing workforce and governments supporting nursing training institutions can address the issue of nursing shortage. Interprofessional collaboration also helps organization embrace best practices for employee retention. Therefore, I would explore these strategies to mitigate the effects of nursing shortage on my future practice.
References
Alexander, G. R., & Johnson, J. H. J. (2021). Disruptive demographics: Their effects on nursing demand, supply and academic preparation. Nursing Administration Quarterly, 45(1), 58–64. https://doi.org/10.1097/NAQ.0000000000000449
Chandler, J., Rycroft-Malone, J., Hawkes, C., & Noyes, J. (2016). Application of simplified Complexity Theory concepts for healthcare social systems to explain the implementation of evidence into practice. Journal of Advanced Nursing, 72(2), 461–480. https://doi.org/10.1111/jan.12815
Feyereisen, S. L., Puro, N., & McConnell, W. (2021). Addressing provider Shortages in rural America: The role of state opt-out policy adoptions in promoting hospital anesthesia provision. The Journal of Rural Health, 37(4), 684–691. https://doi.org/10.1111/jrh.12487
Graystone, R. (2018). How magnet® designation helps hospitals tackle the nursing shortage. JONA: The Journal of Nursing Administration, 48(9), 415–416. https://doi.org/10.1097/NNA.0000000000000640
Kennedy, A. (2019). Nurse preceptors and preceptor education: Implications for preceptor programs, retention strategies, and managerial support. Medsurg Nursing, 28(2).
Marć, M., Bartosiewicz, A., Burzyńska, J., Chmiel, Z., & Januszewicz, P. (2019). A nursing shortage – a prospect of global and local policies. International Nursing Review, 66(1), 9–16. https://doi.org/10.1111/inr.12473
PEER REPLY
This is an outstanding post. Nursing is an extremely rewarding career to everyone. However, securing employment as a registered nurse and remaining relevant in the nursing profession requires all the pertinent certifications. ACLS/PALS certifications are crucial for nurses. However, the precise certification needed depends on various factors including the facility and state of work, the environment of work, and the type of nursing specialization. There are various benefits associated with ACLS/PALS certifications. They help in raising the standards of nurses in the nursing practice. Patients tend to entrust their lives to the most qualified and certified professionals. Having ACLS/PALS certifications enhances the confidence and trust in the ability of the nurse to properly address any kind of medical issues or emergencies that may come up (Powers & Reeve, 2020). Also, the training that nurses undergo to obtain such certifications is vigorous and provides nurses with skills and understanding critical in informing critical decision-making during an emergency.
Obtaining ACLS/PALS certifications is also crucial for nurses to save lives as first responders. The certifications enable nurses to evaluate all types of situations and assist in saving at-risk lives. The training nurses get gives them the skills and competencies needed to address medical emergencies (Conoscenti et al., 2021). Nurses learn how to identify emergencies and provide first-aid and CPR. The courses are covering various topics including pharmacology, ECGs, and life support. Indeed, every second matters when it comes to life-saving situations. Possessing ACLS/PALS certifications is critical in giving nurses confidence and the ability to address any type of medical emergency. Emergencies are often terrifying, but with appropriate training, nurses are prepared to address any emergency that crosses their way.
References
Conoscenti, E., Martucci, G., Piazza, M., Tuzzolino, F., Ragonese, B., Burgio, G., … & Chiaramonte, G. (2021). Post-Crisis debriefing: A tool for improving quality in the medical emergency team system. Intensive and Critical Care Nursing, 63, 102977. https://doi.org/10.1016/j.iccn.2020.102977
Powers, K., & Reeve, C. L. (2020). Family Presence During Resuscitation: Medical–Surgical Nurses’ Perceptions, Self-Confidence, and Use of Invitations. AJN The American Journal of Nursing, 120(11), 28-38. Doi: 10.1097/01.NAJ.0000721244.16344.ee
Ethical and legal issues are likely to impact my current practice in Rehab and medical-surgical nursing and my future practice area in psychiatric-mental health nursing. Ethical issues in nursing practice are increasingly becoming challenging for nurses globally (van Bruchem-Visser et al., 2020). Nurses often find it uncomfortable to address the ethical issues they encounter in patient care. Nurses are expected to make ethical decisions when providing quality and safe care, which sometimes create ethical dilemmas (Ohnishi et al., 2019). An ethical dilemma occurs when moral claims are at odds with one another, especially when there is a choice between equally unsatisfactory options. Besides, making ethical decisions often result in ethical issues and legal consequences to med-surgical and psychiatric nurses.
Ethical and legal issues occur at the micro-level of healthcare in delivering direct patient care to patients. It impacts the system since ethical dilemmas cause nurse fatigue and leave them feeling powerless and frustrated when dealing with ethical issues. Furthermore, nurses perceive that there are some ethical issues they have no power over and thus can do nothing about them (Ohnishi et al., 2019). The issue at the micro-level can be addressed by creating a framework for ethical decision-making that comprises a step-by-step strategy, ethical values, and a guide to finding balance. The framework can guide nurses during complex ethical decision-making scenarios and provide moral guidance on what would make up an ethically acceptable decision (van Bruchem-Visser et al., 2020). As a result, this would reduce the fatigue and frustration among nurses and other providers when making clinical decisions. It would also avoid ethical implications such as legal charges and revoke of licences. Interprofessional collaboration can address the issue by having members of the care team make collaborative patient care decisions when employing ethical frameworks.
References
Ohnishi, K., Kitaoka, K., Nakahara, J., Välimäki, M., Kontio, R., & Anttila, M. (2019). Impact of moral sensitivity on moral distress among psychiatric nurses. Nursing ethics, 26(5), 1473-1483. https://doi.org/10.1177/0969733017751264
van Bruchem-Visser, R. L., van Dijk, G., de Beaufort, I., & Mattace-Raso, F. (2020). Ethical frameworks for complex medical decision making in older patients: A narrative review. Archives of Gerontology and Geriatrics, 90, 104160. https://doi.org/10.1016/j.archger.2020.104160
NR500NP-60450
Week 5: Systems Theory and Practice Issues
This is a graded discussion: 75 points possible
Week 5: Systems Theory and Practice Issues
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Purpose
The purpose of the graded collaborative discussions is to engage faculty and students in an interactive dialogue to assist the student in organizing, integrating, applying, and critically appraising knowledge regarding advanced nursing practice. Scholarly information obtained from credible sources as well as professional communication are required. Application of information to professional experiences promotes the analysis and use of principles, knowledge, and information learned and related to real-life professional situations. Meaningful dialogue among faculty and students fosters the development of a learning community as ideas, perspectives, and knowledge are shared.
Activity Learning Outcomes
Through this discussion, the student will demonstrate the ability to:
- Examine roles and competencies of advanced practice nurses essential to performing as leaders and advocates of holistic, safe, and quality care (CO1)
- Apply concepts of person-centered care to nursing practice situations (CO2)
- Analyze essential skills needed to lead within the context of complex systems (CO3)
- Explore the process of scholarship engagement to improve health and healthcare outcomes in various settings (CO4)
Due Date
A 10% late penalty will be imposed for discussions posted after the deadline on Wednesday, regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0 for any portion of the discussion not posted by that time). Week 8 discussion closes on Saturday at 11:59pm MT.
NOTE: To receive credit for a week’s discussion, students may begin posting no earlier than the Sunday immediately before each week opens. Unless otherwise specified, access to most weeks begins on Sunday at 12:01 a.m. MT, and that week’s assignments are due by the next Sunday by 11:59 p.m. MT. Week 8 opens at 12:01 a.m. MT Sunday and closes at 11:59 p.m. MT Saturday.
A zero is the lowest score that a student can be assigned.
Faculty may submit any collaborative discussion posting to Turnitin in order to verify originality.
Systems Theory and Practice Issues
The concern in my current practice area of acute care is rising healthcare costs. This concern primarily occurs at the macro level. I would address this system by attempting to change the healthcare culture starting at the micro level. To fully understand the need for complex adaptive systems in healthcare, one must first understand the different theories and constructs of healthcare systems. “High-income countries healthcare systems generally are organized top-down” (Sturmberg, 2019). This type of system is hierarchical and goes from the government down to the doctors, nurses, and staff in hospitals. Government/political measures that have been considered the magical answer to this concern, have made little or no impact. Along with not reducing healthcare costs, patients’ and citizens’ best interest have been negatively impacted. Efforts to lower healthcare costs by limiting services, capping or bundling payments or lean management have been tried in different settings and geographic regions. These efforts were found to have a limited or unconvincing evaluation of their impact on the financial burden on society or population health outcomes (Sturmberg, 2019). All employees must contribute based on the rules above in this type of organization. On the other hand, the bottom-up method is that the physicians and nurses who work with the patients best know how to do their work. According to Sturmberg, bottom-up organizations create the best-adapted solutions to changing problems and needs. These systems are complex adaptive systems and are based on heterarchy and personal leadership.
The drivers in these systems are either of being controlled in a government sense, “bureaucratic” top-down, or bottom-up “grass-roots” (Sturmberg, 2019). This boils down to the top-down motivation of its co-workers being extrinsic by command and control. Supervisors focus on the efficiency of the system. Relationships are contractual. The motivation of the co-workers in the “bottom-up” is intrinsic by the co-workers identifying with the organization’s purpose, goals, and values. Relationships are based on personal commitment and the focus of employees is problem oriented. Supervisors of this method assess the outcomes.
Changing the culture at any level is a challenge. I would address the healthcare cost issue for educating and supporting a culture change toward a complex adaptive system (CAS) approach. By personal leadership driving the change, interprofessional collaboration could be used to resolve the issue by different professions taking personal leadership and intrinsic motivators to evaluate their outcomes and then collaborating with other professions working toward the common goal of what is best for the patient.
References:
Sturmberg, & Bircher, J. (2019). Better and fulfilling healthcare at lower costs: The need to manage health systems as complex adaptive systems [version 1; peer review: 2 approved]. F1000 Research, 8, 789–789. https://doi.org/10.12688/f1000research.19414.1
Total Points Possible: 75
Requirements:
Discussion Criteria
-
Application of Course Knowledge: of Course Knowledge:
The student post contributes unique perspectives or insights gleaned from personal experience or examples from the healthcare field. The student must accurately and fully discuss the topic for the week in addition to providing personal or professional examples. The student must completely answer the entire initial question.
- Engagement in Meaningful Dialogue: I. The student responds to a student peer and course faculty to further dialogue.
- Peer Response: The student responds substantively to at least one topic-related post by a student peer. A substantive post adds content or insights or asks a question that will add to the learning experience and/or generate discussion.
- A post of “I agree” with a repeat of the other student’s post does not count as a substantive post. A collection of shallow posts does not equal a substantive post.
- The peer response must occur on a separate day from the initial posting.
- The peer response must occur before Sunday, 11:59 p.m. MT.
- The peer response does not require a scholarly citation and reference unless the information is paraphrased and/or direct quotes are used, in which APA style standards then apply.
Faculty Response: The student responds substantively to at least one question by course faculty. The faculty question may be directed to the student, to another student, or to the entire class.
- A post of “I agree” with a repeat of the faculty’s post does not count as a substantive post. A collection of shallow posts does not equal a substantive post.
- The faculty response must occur on a separate day from the initial posting.
- Responses to the faculty member must occur by Sunday, 11:59 p.m. MT.
- This response does not require a scholarly citation and reference unless the information is paraphrased and/or direct quotes are used, in which APA style standards then apply.
III. Integration of Evidence: The student post provides support from a minimum of one scholarly in-text citation with a matching reference AND assigned readings OR online lessons, per discussion topic per week.
- What is a scholarly resource? A scholarly resource is one that comes from a professional, peer-reviewed publication (e.g., journals and government reports such as those from the FDA or CDC).
- Contains references for sources cited
- Written by a professional or scholar in the field and indicates credentials of the author(s)
- Is no more than 5 years old for clinical or research article
- What is not considered a scholarly resource?
- Newspaper articles and layperson literature (e.g., Readers Digest, Healthy Life Magazine, Food, and Fitness)
- Information from Wikipedia or any wiki
- Textbooks
- Website homepages
- The weekly lesson
- Articles in healthcare and nursing-oriented trade magazines, such as Nursing Made Incredibly Easy and RNMagazine (Source: What is a scholarly article.docx; Created 06/09 CK/CL Revised: 02/17/11, 09/02/11 nlh/clm)
- Can the lesson for the week be used as a scholarly source?
- Information from the weekly lesson can be cited in a posting; however, it is not to be the sole source used in the post.
- Are resources provided from CU acceptable sources (e.g., the readings for the week)?
- Not as a sole source within the post. The textbook and/or assigned (required) articles for the week can be used, but another outside source must be cited for full credit. Textbooks are not considered scholarly sources for the purpose of discussions.
- Are websites acceptable as scholarly resources for discussions?
- Yes, if they are documents or data cited from credible websites. Credible websites usually end in .gov or .edu; however, some .org sites that belong to professional associations (e.g., American Heart Association, National League for Nursing, American Diabetes Association) are also considered credible websites. Websites ending with .com are not to be used as scholarly resources
- Professionalism in Communication: The post presents information in logical, meaningful, and understandable sequence, and is clearly relevant to the discussion topic. Grammar, spelling, and/or punctuation are accurate.
- Wednesday Participation Requirement: The student provides a substantive response to the graded discussion question(s) or topic(s), posted by the course faculty (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week.
- Total Participation Requirement: The student provides at least three substantive posts (one to the initial question or topic, one to a student peer, and one to a faculty question) on two different days during the week.
| DISCUSSION CONTENT | |||
| Category | Points | % | Description |
| Application of Course Knowledge | 20 | 27 | Answers the initial discussion question(s)/topic(s), demonstrating knowledge and understanding of the concepts for the week. |
| Engagement in Meaningful Dialogue With Peers and Faculty | 20 | 27 | Responds to a student peer AND course faculty furthering the dialogue by providing more information and clarification, adding depth to the conversation |
| Integration of Evidence | 20 | 27 | Assigned readings OR online lesson AND at least one outside scholarly source are included. The scholarly source is:
1) evidence-based, 2) scholarly in nature, 3) published within the last 5 years |
| 60 | 81% | Total CONTENT Points= 60 pts | |
| DISCUSSION FORMAT | |||
| Category | Points | % | Description |
| Grammar and Communication | 8 | 10 | Presents information using clear and concise language in an organized manner |
| Reference Citation | 7 | 9 | References have complete information as required by APA
In-text citations included for all references AND references included for all in-text citation |
| 15 | 19% | Total FORMAT Points= 15 pts | |
| DISCUSSION TOTAL=75 points | |||
Preparing the Assignment
Introduction
This graded discussion will explore the impact of systems theory on a practice problem or issue. Please provide an initial response to the discussion question by Wednesday at 11:59pm MT and two interactive dialogue responses no later than Sunday 11:59 PM MT at the end of WEEK 5. The discussion is worth 75 points. Please refer to the discussion grading rubric for additional criteria.
Discussion Question:
Many of you have experience in complex adaptive systems whether you realize it or not. Thinking about your current or future practice area, identify an issue or concern. In your initial response, please describe the concern. Does the concern primarily occur at the micro, meso, or macro level? How would you address this issue? What impact might your solution have on the other levels of the system? In what ways could interprofessional collaboration be used to resolve the issue?
**To see view the grading criteria/rubric, please click on the 3 dots in the box at the end of the solid gray bar above the discussion board title and then Show Rubric.
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NR 500 Week 5 Discussion: Evidence-Based Practice
Huddles have become a popular concept in healthcare settings today. The concept actually comes from football, where the team members come together for about 25 seconds before a game to discuss strategy and execution of their plays. Similarly, a pre-shift or pre-procedure huddle can be an effective way to gather the healthcare team together to discuss safety concerns, staffing plans for the shift, and the promotion of education geared towards improving patient safety and care. Criscitelli (2015) considers huddles as a micro meeting that has structure and focuses upon communication and safe patient care.
In the perioperative environment, the Joint Commission has reported that poor communication is the cause of over two-thirds adverse events (Criscitelli, 2015). I found that report quite humbling. For huddles to be effective, they should be mandatory, have an agenda and time limit, be consistent at the same times every day, and display a recognizable structure to all who participate (Criscitelli, 2015). In my department, our team of nurses and surgical techs huddle 5 minutes before every shift to address safety concerns, plans for the shift, staffing assignments, and sometimes a brief in-service is provided by our nurse educator. Typically, huddles are led by charge nurses or nurse managers. Huddles can improve communication and workflow and are more effective when they are interdisciplinary. Pre-procedure huddles have actually been shown to reduce errors and unintended events (Criscitelli, 2015). In regards to surgical site infections, huddling can improve patient outcomes by increasing timely prophylactic antibiotic administration (Criscitelli, 2015). Huddling helps perioperative team members address the surgical safety checklist, keeping the patients safe care as a forerunner in the plan for the day.
Safety huddles can reflect the nursing profession’s commitment to improving safe care and thus supports evidence-based practice. It is a very simple concept that carries great benefits by bringing team members together and can inevitably reduce patient harm (Foster, 2017). As a nurse educator, I plan to foster the concept of huddles in the classroom and clinical setting.
Criscitelli, T. (2015). Fostering a culture of safety: The OR huddle. AORN Journal, 102(6), 656-659. doi:10.1016/j.aorn.2015.10.002
Foster, S. (2017). Implementing safety huddles. British Journal of Medicine, 26(16), 953. doi:10.1298.bjon.2017.26.16.953
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Response posts: Minimum of one (1) total reference: one (1) from peer-reviewed or course materials reference per response.Post a thoughtful response to at least two (2) other colleagues’ initial postings. Responses to colleagues should be supportive and helpful (examples of an acceptable comment are: “This is interesting – in my practice, we treated or resolved (diagnosis or issue) with (x, y, z meds, theory, management principle) and according to the literature…” and add supportive reference. Avoid comments such as “I agree” or “good comment.” Below are the two initial posts of two peers need to respond to.:1. Gayle Scope of Nursing PracticeThe purpose of this posting is to discuss the scope of nursing practice. The nursing scope of practice as described by the American Nursing Association “as the “who,” “what,” “where,” “when,” and “how” of nursing practice.” (2018) As Registered Nurses, there are many components that we apply to our everyday practice without realizing it. From assessing situations, advocating, educating, and administering treatment or interventions for all patients in need and remaining compassionate and caring.
The Ohio Administrative Code defines the Scope of RN practice as: “Providing to individuals and groups nursing care requiring specialized knowledge, judgment, and skill derived from the principles of biological, physical, behavior, social, and nursing sciences.” (Lawriter, 2017).How did I provide this care and uphold theses definitions? One example is a patient that was I was taking care of in an acute hospital setting was 1 day post-op from colorectal surgery in which he received an ileostomy. After receiving routine labs, his Hemoglobin resulted in <7.0. Per protocol, the Resident on call was notified. After assessment, 2 units of PRBC were ordered. After 1 unit was administered, new onset of symptoms including hypotension, dizziness, pallor, lightheadedness and an ostomy bag now displaying bright red blood. Our Rapid Response team was notified and the ultimate result was a transfer to the Surgical ICU. The Resident was furious that I paged the RR team rather than to notify him again. I upheld the scope of nursing practice by utilizing my knowledge, judgement and skills that came from education, advocating and interventions. It is important to know the nursing practice act as it upholds you to react to keep the patient safe. If I had reacted by just hanging the 2nd unit of blood or ignoring the new onset of symptoms, the nursing practice act may determine that I am not competent to care for patients. Nurses have a duty of reasonable care. (ANJ, 2019). At the end of the day, it’s my duty as a nurse to protect, promote and optimize health. (ANA, 2018).
References:
American Nurses Association. (2018). Nursing: scope and standards of practice (3rd ed.). Silver Spring, Maryland.The Elements of a Nursing Malpractice Case, Part 1: Duty : AJN The American Journal of Nursing. (2019, July). Retrieved November 13, 2019, from https://journals.lww.com/ajnonline/Fulltext/2019/0… Lawriter Ohio rules and laws. (2017). Retrieved November 13, 2019, from http://codes.ohio.gov/oac/Search/scope of rn.2.
Andrea Scope of Nursing Practice
The purpose of this posting is to discuss the understanding of the nurse’s scope of practice as defined by the ANA and through the Ohio Board of Nursing. It is important to each nurse to have a clear understanding to provide safe and efficient care to each patient. The standards of practice are guidelines of how every nurse should be caring for each individual patient. They describe a competent level of nursing care as demonstrated by the critical thinking model, assessment, diagnosis, outcomes, identification, planning, implementation and evaluation, otherwise known as the nursing process. The Ohio Board of Nursing defines the nursing scope of practice as providing to individuals and groups nursing care requiring specialized knowledge, judgment, and skills derived from the principles of biological, physical, behavioral, social, and nursing sciences.A scenario that I have encountered that pertains to this discussion is a patient who came into the Emergency Department experiencing shortness of breath. Upon arrival to the ED through triage the patient was pale and tachypnic. When I attached the pulse oximeter the patient’s oxygen saturation read 89%, after this assessment I applied 2 liters via nasal cannula. I made sure my patient remained stable, performed the EKG and then found the provider to obtain an order for oxygenation administration. It is within our scope of practice to administer O2 with an oxygenation saturation below 92%. After reassessing my patient, the O2 saturation read 95% and the patient was breathing within normal limits. By implementing the nursing process, I was able to stabilize the patient and prevent them from going into further respiratory distress.Understanding the nursing scope of practice is extremely important due to the fact that nurses can be put into situation and I believe it is better to ask yourself, a manager or check with someone else before you perform an action that is out of your scope of practice. When you step out of your scope of practice you are putting that license you worked so hard for on the line. Our patients depend on us and trust us, we must be able to provide the care that they deserve.American Nurses Association (2010). Nursing: Scope and Standards of Practice (2nd ed.). Silver Spring, MD: American Nurses Association.Ohio Board of Nursing (2018). Scopes of Practice: RN and LPN. Retrieved from http://nursing.ohio.gov/wp-content/uploads/2019/10…
Grading Rubric Guidelines
NOTE: To receive credit for a week’s discussion, students may begin posting no earlier than the Sunday immediately before each week opens. Unless otherwise specified, access to most weeks begins on Sunday at 12:01 a.m. MT, and that week’s assignments are due by the next Sunday by 11:59 p.m. MT. Week 8 opens at 12:01 a.m. MT Sunday and closes at 11:59 p.m. MT Wednesday. Any assignments and all discussion requirements must be completed by 11:59 p.m. MT Wednesday of the eighth week.
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