Create an academic poster that critically analyses the evidence-based interventions that inform your chosen case study.
The summative assessment for this module is a 4000 word essay based on a potential clinical service improvement initiative. No student should be introducing an actual service improvement in their clinical area.
The main focus of this assignment is the service improvement process which will help students to become aware of the processes involved with improving practice and the relevant evidence that informs this process. The service improvement should be focused on improving the patient’s experience of care and must be managed in accordance with current improvement methodology. Students would be expected to explain the rationale for the required improvement and describe the evidence base underpinning this change.
Students would be expected to demonstrate how they would test out a small scale service improvement applying appropriate theoretical and service models of change such as the Plan Do Study Act (PDSA) cycles.
Topic
Model frameworks for quality improvements
Introduction
Main body.
Conclusion
Write a 1500-1750 word APA paper addressing each of the following points. Be sure to completely answer all the questions for each bullet point. Separate each section in your paper with a clear heading that allows your professor to know which bullet you are addressing in that section of your paper. Support your ideas with at least two (2) sources and the textbook using citations in your essay. Make sure to cite using the APA writing style for the essay. The cover page and reference page in correct APA do not count towards the minimum word amount. Review the rubric criteria for this assignment.
Case study #1
Mrs. Franklin-Jones was admitted from the Emergency Room to Cardiac Intensive Care one week ago with a diagnosis of acute myocardial infarction. She has recovered as expected and is moving to the cardiac step down unit today. She is talking with Nurse Julie Hernandez, as she gets settled in her new room, “I was really surprised when I got that bad pain in my chest! I knew I had high pressure but I just didn’t think it was that bad. I try to take my medicine like they told me to in the clinic but sometimes I forget. I guess that I need to study those papers they gave me about what foods I should eat and not eat. I better take care of myself! Momma had bad pressure and it killed her! Who knows—I may even have to learn to cook different than I was taught in Jamaica! I may have to let Tomas do the cooking. He’s got more time at home now than I do since he lost his job. There isn’t too much time between my shifts at the school cafeteria and my new housecleaning job. You know my sister is coming up from Jamaica to see me. I think she is bringing me some bush tea. That’ll set me right!”
• Using Leininger’s Culture Care Model, what factors in the story shared by Mrs. Franklin-Jones should be considered by Nurse Hernandez when planning for the patient’s discharge?
• Why is the theory of Culture Care Diversity important in the delivery of nursing care for all patients?
• Using Leininger’s Theory of Culture Care Diversity and Universality, develop a plan of care for Mrs. Franklin-Jones.
• Discuss the strengths and limits to Leininger’s Theory.
Case Study #2
Claude Jean-Baptiste is recovering from post-hip replacement surgery and has been transferred to the Rehabilitation Institute adjacent to the hospital. When he enters the unit, he sees welcoming signs written in several languages including his own, Creole. Since there are no nurses on that shift that speak Creole, they use a language line to ask for translation services. During this initial nursing assessment, the translator informs Mr. Jean-Baptiste that the nurses invite him to have a relative at his side so that they can be sure to understand and meet his needs. He is asked about Haitian customs and beliefs that they might honor. Mr. Jean-Baptiste is encouraged to bring food and spiritual care items, and to share the warmth of his culture with the nursing staff.
• Discuss assumptions of the Transpersonal Caring relationship. What is the nurse’s role?
• How is love, as defined by Watson, evident in this caring moment?
• How can the nurse creatively use self to create a healing environment?
• Discuss the strengths and limits to Watson’s Theory.
Review the scope of practice for the advanced practice nurse in the state of California. How does it compare to Florida?
Assessment Description: This assignment is divided into two parts: you will watch a video about nursing practice and reflect on the situation contained in the video. Next you will write an essay which demonstrates your understanding of the application of professional practice models in different clinical settings.
Task Instructions:
Part One: Pre-Writing Activity
1. Visit the following link
2. Watch the 10-minute video ‘Near-fatal medication error leads nurse to make patient safety a priority’.
3. Identify several issues with the nursing practice in the video that are of concern.
Part Two: Writing Activity
1. Select ONE of these issues and write an essay that discusses the challenges of different professional practice models in nursing and evaluates how these models of practice contribute to improving patient care.
2. Use a minimum of 8 references from peer-reviewed journals from the last 10 years and professional websites to support your points.
3. Include the following components but do not use subheadings:
• Introduction: gives background to the topic and states precisely what the essay intends to cover
• Body Text: provides relevant content, shows evidence of critical thinking and analysis; and uses current evidence-based research to support the argument
• Conclusion: draws evidence together, does not over-generalise or introduce new material
• Reference list: contains details of all sources cited in your essay
Presentation Guidelines
1. Write 1500 words (+/- 10%). The reference list is NOT included in the word count.
2. Use Calibri 12-point font.
3. Provide your student number and page number on each page
4. Write in the third person. Avoid personal pronouns such as ‘I’ and ‘you’.
5. Use CDU APA 7th referencing.
Writing Tips:
1. Follow the task instructions and presentation guidelines to write your essay.
2. Use correct punctuation, spelling and syntax (sentence structure).
3. Provide a well structured, logically sequenced essay in academic English.
4. Paraphrase ideas from your reading/research. DO NOT just copy the content.
5. Use direct quotations appropriately (e.g. when quoting National Standards).
6. Use relevant and reputable resources to support your arguments.
7. Do not use Wikipedia or dictionaries.
8. View the marking rubric to ensure that you are maximising your marks in your submission.
Submission Instructions
1. Make sure you have completed a 1500 word essay that addresses the task components
2. Save your file as a Microsoft Word document
3. Load your file onto Turnitin via Learnline. Watch the Turnitin instruction video before submission.
4. It is your responsibility to ensure that you have submitted the correct file.
Review of Literature
Using empathy as a concept on its own is highlighted in nursing literature. Empathy is thought to have therapeutic benefit in patient-nurse relationships and might thus make nurses more appealing to patients. Teaching nurses how to be empathic in order to enhance their interactions with patients is one of the proven efforts in nursing practice.
Relationship, communication, and understanding are three essential characteristics of empathy. Patient-nurse relationships are built on open and honest exchanges of information. This helps the nurse and patient form a therapeutic relationship by including vital information about the patient’s health and circumstances. Being empathetic means being aware of the events and experiences of the patients as well as the ramifications they have for both them and the nurses (Reeves et al., 2021).
When a concept is used in a model case, it shows all of its distinguishing characteristics.
A nurse visits a patient’s room to see how he is doing. The patient’s cries of anguish were discovered by the nurse. Asking the patient what’s wrong and if they need any support is an integral part of the nursing process. Despite the fact that this was his first time having surgery, the patient expressed his fear to the nurse. Here, the nurse shows empathy by recalling a time when he too was filled with anxiety and terror. When confronted with a new and frightening scenario, the nurse reassures the patient that he is not alone. Next, the nurse went through the significance of surgery and the need of not being afraid with the patient.
When communicating with the patient, the nurse demonstrated empathy by recognizing and responding to the patient’s feelings.
A borderline case is an individual or something that cannot be categorically defined as some were immediately struck out because they were ineligible.
After hearing the patient’s cries, a nurse approached. Asked about the cause of her tears, he inquires. The patient said that he was afraid about the upcoming procedure. The nurse answers and explains to the patient that the process was required if he was to live.
In this instance, the nurse has talked with the patient, but she has not utilized empathy to comprehend the patient’s sentiments and provide him with hope.
Unlike a model example, a contrary situation is the polar opposite of what one would expect.
There was a patient in the ward who was wailing in anguish when the nurse entered. The nurse tells the patient to be quiet and that everything is okay. Despite being in excruciating agony, the patient resolves to keep quiet.
Empathy was absent from the nurse’s performance in this instance.
Empathy’s antecedents may include a desire to assist patients and the spread of knowledge. Nurses may not search for circumstances or places in which they can aid if they lack the motivation to do so. Empathy in patient health care is predicated on a desire to assist the patients. In order for nurses to be helpful, they must be aware of the patient’s behavior and be able to identify when and how they require assistance (Hunt et al., 2017). The patient-nurse relationship thrives on mutual understanding. As a nurse, it is essential to have empathy for the patient in order to be able to communicate effectively with them.
The patient’s contentment and the patient’s sense of care would be the outcomes of the nurse-patient interaction. Positive interactions between patients and nurses in an empathic encounter lead to a sense of respect by the nurse, which results in patient satisfaction (Sedaghati Kesbakhi et al., 2017). As a result of the good contact between the patient and the nurse, job satisfaction and lower turnover rates may be achieved.
Sympathy and communication skills are two closely connected concepts in the idea of empathy. These terms are often used interchangeably by those in the fields of nursing and clinical practice. According to Wilkinson et al. (2017), listening and communicating are critical to empathy. In order to convey empathy, nurses rely on active listening. Comprehension of the patient’s predicament is made possible via the use of empathy, a communication skill.
Nurses must analyze diverse ideas by doing concept evaluations to improve their grasp of them. Exploring a subject’s concepts helps researchers find different elements of it. The notion of empathy in nursing has been discussed in this paper, which assists in comprehending the patient’s position, emotions, comprehension, and verifying the scenario’s correctness in order to provide the necessary assistance. The sympathetic nurse-patient interaction has been highlighted by dissecting the empathy notion into its antecedents, consequences, and qualities. According to the paper, empathy is a crucial notion for nurses to understand. Nurses are able to empathize with patients in a hospital setting because they are trained to do so. Patients are given hope by nurses who demonstrate empathy by recognizing and communicating their own sentiments of empathy for them.
State 3–4 objectives for the presentation that are targeted, clear, use appropriate verbs from Bloom’s taxonomy, and address what the audience will know or be able to do after viewing.
Present the full complex case study. Include chief complaint; history of present illness; any pertinent past psychiatric, substance use, medical, social, family history; most recent mental status exam; current psychiatric diagnosis including differentials that were ruled out; and plan for treatment and management.
Report normal diagnostic results as the name of the test and “normal” (rather than specific value). Abnormal results should be reported as a specific value.
Pose three questions or discussion prompts, based on your presentation, that your colleagues can respond to after viewing your video.
Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
Objective: What observations did you make during the psychiatric assessment?
Assessment: Discuss their mental status examination results. What were your differential diagnoses? Provide a minimum of 3 possible diagnoses and why you chose them. List them from highest priority to lowest priority. What was your primary diagnosis, and why? Describe how your primary diagnosis aligns with DSM-5 diagnostic criteria and is supported by the patient’s symptoms.
Plan: What was your plan for psychotherapy (include one health promotion activity and patient education)? What was your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan.
Reflection notes: What would you do differently with this patient if you could conduct the session again? If you are able to follow up with your patient, explain whether these interventions were successful and why or why not. If you were not able to conduct a follow-up, discuss what your next intervention would be.
Based on the readings, viewing the online materials & resources on the Module 4: Lecture Materials & Resources page, and your own experience, what strategies would you recommend encouraging culturally competent care of Native Americans?
One purpose of the research is to serve as evidence to address nursing problems that are important for nursing practice. For this assignment, you will choose a sub-topic of your group poster presentation topic and focus on a problem/issue that interests you. You will:
1. Identify the problem/issue (what is wrong with the current situation), g., increasing prevalence of a health condition and insufficient evidence for a solution;
2. Describe the background (what is the nature of the problem, or the context of the situation, that readers need to understand);
3. Explain the scope of the problem (how big is the problem and how many people are affected);
4. Describe the consequences of the problem (economic implications; the impact of the problem on population health; what will happen if we don’t address the issue);
5. Identify the knowledge gaps (what information about the problem is lacking)
5. Describe the proposed solution (how will the new study contribute to the solution of the problem) and;
7. Indicate a research question that arises for you as you consider the literature related to the problem/issue and its significance (questions end in a question mark).
The references for this paper can come from professional journals and reputable government websites (such as the Center for Disease Control website, National Institutes of Health). All references do not need to be research papers. The paper needs to be presented in the format of a professional article, including a title page, margins, font size, and grammar as described in the 7th edition of the APA Manual of Style. The maximum length of this paper must be two pages (excluding the title and reference pages).
Summative Assignment Scenario and Questions
Read below case study and choose one of the following questions to discuss professional issues relevant to the scenario. You are expected to comprehensively discuss professional aspects of nursing practice and draw to conclusions covering all learning outcomes of the module.
Leila’s is a newly registered nurse who has been working for 6 month as a community nurse. In one particular busy day she was allocated 5 patients to visit within the radius of her working area. She was not sure about visiting Albert, an African –Caribbean patient who is disabled and has multiple diabetes leg ulcers. She had visited him once together with a senior community nurse. stated to the manager that Albert always needed two nurses for his visit as his partner leaves the house to do chores once she knows Albert is due to be visited by nurses . The manager dismissed Leila’s concern and told her that she was allocated as a Practice Supervisor to a Year 2 student nurse, Abigail, and she can use her as a good pair of hand to care for patients with complicated nursing needs. Leila quietly whispered, ‘’Albert shouts at me and does not like me to do his dressings either’’ to which she gets no response. Leila was scheduled to first visit Albert to dress his leg ulcers. On the way to Albert’s house, Leila learnt from Albert’s electronic file on her Ipad that he had been discharged from hospital two days ago after an episode of UTI (Urinary Tract Infection) with new indwelling catheter. This took Leila by surprise as it had not been mentioned during handover. Leila and Abigail found Albert in bed on arrival. Albert’s pillow was on the floor and his duvet was hanging off the bed. He asked if they would first give him his insulin injection today and then would help him into his wheelchair using the hoist provided by the local authority. Leila was unfamiliar with the type of hoist he used but agreed to help him asking Abigail if she could help her operating the hoist . She then asked Albert if he has a correct dose set on the Insulin pen. Albert nodded and Leila gave him his insulin injection . She followed Albert’s instructions on how to secure the straps of the hoist but during the move from bed to chair Albert fell out of the hoist and on to the floor. He was in severe pain. Leila asked Abigail to stay with Albert so she could go out of the room and immediately call for an ambulance as she was not getting any signals on her mobile phone. Abigail kept Albert calm and as comfortable as possible as she could; but suddenly noticed that he was getting clammy with heavy breathing, not quite responsive anymore and his body was shaking violently. Abigail panicked and started shouting Leila’s name and left Albert to quickly find her but returned within 30 seconds as she was worried about him. Leila returned and upon noticing Albert’s shaking; asked Abigail to make a clear safe space around him but the hoist legs has stuck under the bed and it was impossible to make more space so they covered his surrounding with pillows and duvet from his bed. Leila suddenly noticed that the insulin pen on Albert’s bedside table was Novorapid. She realised that in a hurry to help Albert she had not checked this before injecting Albert. She put him in recovery position, and asked Abigail to find some sugar tablets in Albert’s house. Shortly after the ambulance arrived and the paramedics took over. Albert was given glucose 20% by ambulance crew and he was stabilised and regained his alertness . Leila kept apologising and continued to reassure and comfort Albert till he was transferred to the ambulance to be taken to the local hospital. When the patient was safely in the care of others Leila immediately reported the incident to her line manager in line with the organisation’s policy for reporting adverse incidents. However the manager told her she should have got on with the rest of her patient and hand over on her return as some patients were already calling and complaining that their nurse was late. This made Leila agitated and tearful. Abigail tried comforting her but she did not know how she could help. Leila managed to compose herself and continue visiting the rest of her patients with Abigail without any further events, however she finished an hour later than usual.
Leila filled in an incident form on her return and asked Abigail to be her witness. Abigail was happy to help Leila as she thought that it was a good day for her and she had learnt a lot from Leila who patiently answered all her questions during the day. Leila learnt that Albert had suffered a fractured left hip, she asked the manager to go and visit him in hospital. The manager told Leila that he is well looked after in hospital and she should focus on her patients in community during her working hours. A week later Leila went to visit Albert after her working hours to apologise again. At the hospital she learnt from Albert’s partner that he had endured severe pain and discomfort and had developed a chest infection due to lack of mobility which led to an extended stay in hospital. Albert and his partner were not happy with Leila, therefore Leila left his bedside after 5 minutes. Later Leila’s manager told her that a complaint has been filed against her by Albert’s partner.
Question 1: Consider the current NMC Code, relevant legislation, policies and guidelines and ethical principles and identify, discuss and analyse the appropriateness of behaviours of the nurses involved in the scenario.
Question 2: What Professional approach would you take in a similar situation if you were the registered nurse? Discuss appropriate professional behaviour, supported by the NMC code, Key ethical principles, legislation and policies and guidelines relevant to professional nursing practice.
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