A presentation of a specific patient care situation that compares the nursing carebased on education preparation at the associate degree and baccalaureate degree levels.
Abstract This paper explores nursing education preparation. It specifically compares and differentiates the competencies of nurses prepared at the associate degree and baccalaureate degree levels. The paper then presents a specific patient care situation and compares the nursing carebased on education preparation, specifically in the areas of provider of care, coordinator of care and member of profession.
Table of Contents:
Provider of Care Coordinator of Care Member of Profession
Differentiating Nursing CareBased on Education Preparation Using a Patient Care Situation
Provider of Care Coordinator of Care Member of Profession
From the Paper "The associate degree and baccalaureate degree of nursing education creates different levels competencies. As a provider of care, both are competent in similar behaviors, while the BSN must work to improve on the administration of nursing care. As coordinators of care, both have the same client-centered goals, although the BSN has a larger client focus and contributes to the processes of their organization while encouraging and assisting others. As a member of the profession, the ADN focuses on self-maturation, whereas the BSN enhances themselves as well as being a resource to others in the health care team so that the nursing profession may evolve."
Abstract In this article the writer examines the inequality in health care, based on gender, race or ethnicity, and class. The writer discusses how the changing structure of health care delivery has made access an issue. The rising costs of medical care are examined in this paper. Further, the writer discusses the concept of managed care.
From the Paper "The purpose of this research is to examine issue fronts of class race ethnicity and gender-based inequality with reference to medical-care access. The plan of the research will be to set forth the context in which maldistribution of the benefits of medical care has achieved resonance in the contemporary period and then to supply a review of relevant literature and an assessment of the status of knowledge on the issue as well as to discuss patterns of experiences of medical care of groups in terms of class race ... "
Tags: health, care, inequality, social, institutions
Abstract This paper acts as a critical analysis of evidence-based practice found in modern nursing. The article includes a descriptive history of evidence-based practices found in nursing. This paper also serves as a manner of critiquing this method of care. Before doing this, however, this paper establishes a working definition of evidence basedcare and practice and how it evolves over time to become the modern practice it is today worldwide. This paper also discusses the impact such nursing practice has on patient care and the nursing profession. In doing this, the paper looks at all angles of the issue and provided different academic literature to support each point of view. This paper also searches for possible alternative methods that are acceptable in today's practices but also may be an offspring of this evidence-based nursing and care trend.
Contents
Introduction
Evidence-Based Nursing Description and Critique
Impact on Nursing Practice and Profession
Summary and Conclusion
From the Paper "The United States Agency for Health Care Policy and Research is also a leading developer of evidence-based medicine. Putting evidence-based methods into practice starts with the correct questions to ask and goes down a process of steps including: how to find the best practice and how to critical appraise the evidence for validity. This practice must take into the patient's unique situation and factor in these elements to start the research process for quality treatment. In this respect, nurses must be accountable for their known knowledge, expertise but also understanding of patient preference and scientific findings.
Still even with its long history, nursing was not recognized as a profession until Florence Nightingale published in her statistics and finding on nursing in 1860. It is her groundbreaking work that lead to clearly identifying nursing or naming nursing and evidence-based practices as a professional service for society."
Abstract In this article the writer notes that evidenced-based practice (EBP) implies that decisions about treatment options will depend largely on evidence of their clinical effectiveness. Further, the writer explains that the major purpose of EBP is the elimination of the use of expensive, ineffective, or dangerous medical decision-making. This paper presents and analyzes alternatives that could potentially offer a solution to the issue of EBP gaps and barriers to effective health care. The writer concludes that there must be an improvement of the access that is seen where evidence-based resources are concerned and barriers must be eliminated when it comes to making EBP an integral part of the solution to the problem of better patient care and lower healthcare costs.
Outline:
Executive Summary
Problem Identification
Context of Issue
Issue Statement
The Stakeholders Involved
Policy Goal and Objectives
Evaluation Criteria
Policy Alternatives
Comparison and Conclusion
Alternatives
Result Analysis
Recommendation
References
From the Paper "Many patients today are not seeing the quality of care that they actually need, despite the fact that evidence-based practice (EBP) has been evolving. Patients are too often receiving inconsistent, wasteful, and even harmful interventions when it comes to nursing. There has been an increasing emphasis on the outcomes of patient care, and this is changing the focus of tasks, practices, and opinion-driven decisions to more of a focus on practices that are guided by evidence."
"There are, however, still some problems that remain unresolved, and these include the gap that is seen between evidence and practice, the unnecessary variations in practice, and the rising cost of healthcare, among others."
Abstract The writer states that his/her practicum took place at Mount Sinai Mother and Baby Unit, a place where change is used as a catalyst to enhance quality of care. The writer's project was based on the principles of family centered care. The writer's main learning goal was to understand family centered care and to apply nursing and change theory to his/her own practice of family centered care. It was emphasized during the retreat that family centered care is holistic and that patients and families must be respected and treated with dignity.
Abstract This paper, based in sociological and social psychology concepts, identifies the causal factors for the gap between lower-income Americans and members of visible minorities in the United States and more affluent Americans and members of the majority segment of the population with respect to health care access. The author concludes, after an extensive review of the literature, that a universal system of health care entitlement is required in the United States. The author suggests that an extensive education is required for low-income persons and members of visible minorities to know the benefits and function of health care services, and health care providers require education in the social mores of the diverse populations they must serve.
Table of Contents
Problem Delineation
Background on the Problem
Statement of the Problem
Research Questions
Review of Relevant Social Psychology Theory and Literature
Introduction
Sociological Theory and Health Care The Welfare State
Accessing Contemporary Health Care Role of Ethics in Accessing Health Care Alternative Health Care Delivery Systems
Chapter Conclusions
Social Functioning of Low-Income and Visible Minority Population Groups
Introduction
HIV/AIDS Related Behavior
Initiatives to Improve Health Care Access and Behaviors
The American Health Care System and The Health Care Experiences of Low-Income and Visible Minority Population Groups
Introduction
The American Health Care System
Delivery of Health Care to the Poor
Care Quality
Alternative Approaches to Delivery
Bioethical Issues
Problems of Accessibility
Initiatives to Improve Access
Chapter Conclusions
Assessment of the Problem
Discussion
Recommendations for Further Research
Annotated Bibliography
From the Paper "One of the major impediments to the attainment of universal access to healthcare in the United States is the functioning of for-profit Health Maintenance Organizations (HMOs) and managed care organizations (MCOs). These organizations are investor-owned organizations that are in business to make a profit on healthcare delivery. Non-for-profit healthcare organizations also must earn a profit on their operations in order to be able to compensate and train staff, acquire new technology, and generally improve the quality of their services. Unlike investor-owned healthcare companies, however, non-for-profit organizations are not driven by share prices and the bottom-line mentality of for-profit companies. Thus, patient-centered care in not-for-profit healthcare organizations may be contrasted with the investor orientation of the for-profit healthcare companies. Recent decisions by for-profit healthcare companies to drop their Medicare healthcare groups because of substandard profit growth illustrates as no amount of rhetoric can the precedent of investor concerns over patient concerns in the for-profit healthcare companies."
Abstract This paper analyzes the Jean Watson theory of human caring, used in the nursing curriculum. The paper explains that, according to Watson, the theory of human caring is a focus for the future of nursing practice and provides the standards that should guide nurses in every aspect of their role in the health care field. The paper looks at how, as time has evolved, the issues with which nurses have been confronted have caused a shift in the approach to nursing that is based on quality care. The paper then points out that, although Watson is specific as to the realm of caring that can be applied to nursing and the delivery of service to the patient, it is evident that Watson intended for the caring perspective to be apparent in every facet of nursing and used to understand all issues that affected the individual's health and well being. In conclusion, the paper shows that the theory of human caring should be a vital instrument for all nursing professionals and students, serving nursing through a foundation for care that returns the profession to a focus specifically on the patient and quality care.
Outline:
Define Theory of Human Caring.
Analyze the Jean Watson Theory of Human Caring.
Use of Jean Watson Theory of Human Caring Use in Guiding All Nursing Programs.
Applicability of Jean Watson Theory of Human Caring to Undergraduate Level Nursing Practice.
Applicability of Jean Watson Theory of Human Caring to Graduate Level Nursing Practice.
Conclusion
From the Paper "To care for the complete human means to care for each element of the individual's life that is either positively or negatively impacting him or her. Treating the illness without considering the psychological issues that may be evident will slow recovery time and may hinder the effectiveness of the treatment. Recommending treatments that are not feasible in the life of an impoverished individual or that the person cannot be transported to, will prevent the complete recovery of the person. And advocating surgery for a patient that elects only to utilize Chinese Traditional Medicine for the health care needs, prevents the patient from receiving care that is applicable to the individual's life."
Tags: health, care, needs, patient, surgery, medicine
Abstract This paper analyzes evidence based practice with regards to nursing. In other words, nursing students engaged in evidence-based practice must rely on previous research and scientific findings to develop protocols for caring for patients that are most likely to result in a positive outcome.
Contents:
Evidence Based Practice - Analysis
Predictive Accuracy of the HESI Exit Exam - Article 1
From the Paper "Evidence based practice can be used in nursing to help nursing staff develop (1) effective methods of care, (2) design interventions that are evidence based that apply to a patients specific needs and can (3) enable better follow up care based on evidence based results. Evaluating previous evidence enables nursing staff to make decisions grounded in evidence rather than theory, thus improving the likelihood of a positive patient outcome.
When in a nursing program, the best way to begin having an evidence based practice includes reviewing previous cases and evidence regarding certain health situation. A nursing student should take great care to survey all available research regarding a particular case, condition or situation. From this evidence the student can draw conclusions that are most likely to lead to efficient care and a positive patient outcome. "
Tags: students, nurse, care, patients, Alzheimer, health
Abstract This paper proposes a study to review the efficacy of a disease management program for osteoarthritis (OA) in a primary care setting, based on preservation of joint function as well as adequate pain management. For the purposes of this study, the following question is asked: "How does a primary carebased medical and educational management program effect the disease progression in patients with mild to moderate osteoarthritis as evidenced by a reduction in pain and progression of disease?" The author hypothesizes that it is insufficient to provide self-administered education programs for OA patients and that an interactive program containing education, pain management, hands on evaluation and frequent follow up will demonstrate patient reports of reduction in daily pain as well as objective demonstration of preservation of function, as evidenced by serial physical examination.
Outline:
Introduction
Statement of the Problem
Literature Review
Research Design
From the Paper "Conversely, a study published in the Journal of Rheumatology reports there was no significant improvement in patient function or pain related to implementation of the Arthritis Self Management Program (ASMP). Subjects were recruited for intervention and evaluated at baseline as well as four months after completion of the course or reading of the ASMP manual (This group functioned as the control for the study). No significant clinical benefits were noted at four months in patients who had been recruited from primary care practices, although the authors were able to note an improvement in other patient groups, such as those who had been referred for specialty care. "
Abstract This paper seeks to better understand what hospice care entails in Canada. It reviews some of the barriers faced by patients, families and palliative nurses with end of life issues. It discusses how quality of care at the end of life has many significant issues. The writer notes that countless citizens who could benefit from palliative care do not receive it or obtain it during the last few days or weeks of their illness. The author touches on strategies for overcoming the existing barriers in community based hospice care as well as how nurses can be leaders in ensuring that appropriate palliative care is received.
From the Paper "Hospice care is not only for the patient; but for their family and friends as well. Emotional, spiritual, physical and social needs are addressed by the palliative team. Hospice provides tailored services in a caring community where patients and families attain the required groundwork for a death that is satisfactory to them. The nature of dying is one of a kind so that the goal of the hospice team is to be responsive and receptive to the special needs of each individual and family."
"Although hospice-palliative nurses bring expert knowledge and skills to the delivery of comprehensive and empathetic care to persons and families living with advanced illness, studies reveal that due to enormous barriers in end-of-life care in nursing homes and patients' residences, unnecessary suffering occurs at the bedside."
Abstract This paper presents an assessment of the economics of health care costs. The paper argues that the problem is a complex maze of related issues such as funding mechanisms, delivery structures and individual responsibility. Additionally, the paper recommends a national health care system for managing family health care costs that is based on universal access to health care.
From the Paper "Health care economics is entering another state of turmoil in the United States as the moderating effects of the managed care concept on increasing health care costs appears to have run its course. The Congress and state governments believed the promises of managed care proponents that managed care would lower health care costs dramatically and are resisting rapid increases in health care costs. Managed care companies are responding by dropping governmentally-funded patient groups including Medicare and Medicaid raising charges to..."
Abstract The paper examines three programs that dominate EOL care in the current healthcare sector in the US. These include the inpatient/ICU or hospital-based palliative care program, nursing homes and hospice EOL programs. The paper analyzes their efficiencies, explains the advantages and disadvantages of ICU palliative care programs and finally posits that among the three, both hospice and nursing home programs are determined as better options than the ICU program. The paper explains that this is primarily because these two programs provide the care, efficiency and satisfaction that the elderly need as they go through the end of life phase in their lives.
From the Paper "The argument for the ICU palliative programs is put forth by Imhof (2005), who recommended utilizing the ICU palliative programs provided in hospitals (hospital-based programs). EOL care services, as argued by the author, provide numerous benefits to the facility of the patient's care, that is, hospital-based programs "require limited organizational effort, pose minimal risk, and cause little disruption to the ongoing operations of the organization" (161). Apart from these advantages of the hospital's palliative programs, patients enjoy other services that come with the program, such as the provision of informational literature for the patient and his/her family, consultation services, palliative care rooms, and additional linkages with the community through collaboration with local hospice, home health agencies, and long-term care facilities and integration into the community (of the patient) (162)."
Tags: inpatient, ICU, hospital, palliative, care, nursing, homes, hospice
Abstract This paper is based on a case study of a 17-year-old high-needs foster girl. She has been in foster care for 5 years. She is making some big changes in her life, and to demonstrate where she is at, an ecomap has been made to simulate her life. This map shows her foster parent and social worker where Amanda is emotionally, as well as the people that are significant in her life. It also helps them figure out a living plan for Amanda once she turns 18 and ages out of foster care.
Abstract
Introduction
Case Study
Systems
Amanda's Ecomap
Conclusion
References
Appendix
From the Paper "An ecomap is a map of the family and the larger world in which the family exists. Its primary use is to highlight the relationships between the family and these other systems. It is another assessment tool that provides a tangible, graphic picture of a family's situation. Ecomaps use symbols to depict the nature of the relationships between the family and other systems. They also show the flow of energy. Ideally, there will be a balance between the energy the family expends and the energy that flows into the family. If there is a major imbalance, it may help social workers and the family to target some areas for intervention. However, when constructing an ecomap the most important thing is that everyone involved in the process understands what the ecomaps and the symbols used in them means."
Abstract This paper reviews a professional experience in which this writer was witness to an instance of poor patient care by a nursing care facility. The paper briefly outlines the sequence of events and describes the concerns of senior facility staff. Two separate incidents involving the same dereliction of professional duty were discovered. From there, the paper discusses the broader issues which this incident revealed and cites from outside sources to provide an illustration of just how serious health care problems can become if they are not addressed expeditiously.
From the Paper "As the North American population ages, concerns about the nursing care that elderly patients receive have become more pressing in recent years. The following paper explores a professional experience this writer had while assisting a nursing care institution three years ago. In the process of describing this incident, time will be taken to outline how this occurrence relates to the broader issue of quality care in America. As should soon become evident, while the American health care system has many things about which it can be duly proud, it also has many shortcomings which must be resolved as soon as possible. With that in mind, it is to a discussion of an important issue - health care in America - that this paper now turns."
Abstract The paper relates that the practice of modern medicine often entails dealing with ethical dilemmas. The paper then focuses on three ethical theories, the feminist (or care-based) ethic, Kantian ethics and utilitarian ethics, and applies them to a specific case where a patient has expressed her specific wishes not to notify her family about her medical condition. The paper explains why according to all these theories, the doctor is prohibited from divulging any of her medical information to anyone without her consent.
From the Paper "The practice of modern medicine often entails dealing with ethical dilemmas. Where those decisions are not dictated by law, it is up to the practitioner to make the best possible choice. Sometimes, the issue makes that decision easy; other times, no ideal choice is possible under the circumstances. Bioethics requires the practitioner to consider all reasonable options and to make a good faith attempt to weigh them in a logically sound manner. The problem is that, unlike medicine, "Ethics is not a science; it is an art that requires every ounce of moral imagination, emotion, and thoughtthat we can muster." (Tong 2007)"
