Analyzing nursing practice. As a future registered nurse, you need to be able to think critically and analyze nursing practice. As per the NMBA standards for practice, to plan and implement appropriate care for patients, nurses need to access, analyze, and use the best available evidence, which includes research findings for safe quality practice.
This assessment requires you to critique an article:
Wilson, L., Kapp, S., & Santamaria, N. (2019). The direct cost of pressure injuries in an Australian residential aged ace setting. International Wound Journal, 16(1), 64-70. https://onlinelibrary-wiley- com.ezproxy.ecu.edu.au/doi/epdf/10.1111/iwj.12992
you work in an occupational health clinic that provides support to…
you work in an occupational health clinic that provides support to a chemical plant that manufactures chlorine. A patient walks to the clinic after being told to report for an examination by his supervisor since he temporarily removed his PPE while at work. Although he walked to the clinic, he tells you that now his eyes are burning and he is experiencing blurry vision.
a)What evidence-based assessments and interventions would you now implement and why?
A nurse assess the skin of an older adult client. Which finding is of great concern to the nurse. Select all that apply. 1. Cherry angioma on the back, 2. Red area that does not blanch, 3. Striae on lower abdomen, 4. Seborrheic keratosis on arms 5. Perectile on upper chest
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I have to learn about the leadership styles that are used by nurse…
I have to learn about the leadership styles that are used by nurse leaders in health care. I have to “Conduct a face-to-face interview with a nurse leader who has at least 2 years’ experience as a nursing leader”. I am required to provide his or her name, title, employer, years of nursing leadership experience, e-mail address, and phone number in paragraph 1 of your paper. After establishing rapport, ask questions such as the following: * What is the demographic information of the nursing leader interviewed? * Describe your leadership position. * Describe your leadership style. * In what ways do you think your leadership style has changed as you have gained more experience as a leader? * Did you have a mentor? If so, what skills did you gain as a result of that relationship? * Describe a change management project that you led and the steps taken to implement the change and to measure the effectiveness of that change. – What obstacles did you face in implementing the change project? * Describe how you would use your leadership skills to mentor a new nurse leader. * In your opinion, what is the greatest challenge that nurse leaders face today in health care? (This question will be used in a later Discussion Board assignment.) After the interview, write up the narrative of your interview describing the responses of the nurse leader. You should have the following headings in your paper: • Demographic information of the nurse leader. I. Description of the nurse leader’s position. Ill. Description of the nurse leader’s style and where it fits with the theories discussed in Unit 1. IV. Description of the nurse leader’s experience with a change management project, including the implementation of the change and the evaluation of the change. V. Description of obstacles that a nurse leader may face in implementing change. VI. Description of leadership skills used to mentor a new nurse leader. – Discuss the value of a mentor. – Describe what you would look for in a mentor if you were in a new nurse leader position. VI. Conclusion – Based on your interview and what you have learned thus far, is an effective leadership style used by this nurse leader?
What kind of training programs are going to be required for the technology piece for the topic you are working on for Module 8. Will this technology require ongoing training? Support your peers, do have a system at your facility that would work well for their project?
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Discuss the Nursing Assessment and Care Plan for Violet Smith? (1st person)
Consider the Activities of Daily Living (ADL’s) for Violet Smith. Identify 3 of her needs from your assessment and discuss what evidence-based care you plan to implement for her. Remember to consider Person/Family-Centred Care in your plan and include communication strategies and interprofessional collaboration opportunities.
Violet Smith Details below…..
Personal Profile : Violet Smith
Use this information in your assignment to develop your evidence-based description of care for Violet
GP Name
Dr. Glasgow Robinson
GP Address
111 London Road
Canterbury
CT2 5AF
Telephone No
01227 781111
Name : Mrs. Violet Smith – widow
Gender: Female
Age: 82
DoB: 31/12/1937
NHS Number: 4876334531
Address:
8 Tunis Court
Canterbury
CT3 1AH
Telephone: 01227 894545
Occupation : Retired but previously a librarian for 40 years
Next of Kin : Daughter – Eve : Mobile No. 07788617955
Violet Smith : Nursing Model based on Roper, Logan and Tierney.
Activity of living
Assessment
Actual or potential need
Maintaining a safe environment
Violet is an 82-year-old female who lives alone since the death of her husband, Stan, 2 years ago.
Violet now lives in a one bed roomed centrally heated flat. She down-sized after Stan died, having previously lived in the same home together for 35 years.
Violet has difficulty managing the stairs to her flat from the entrance – 6 steps with handrail. There is a rear entrance without steps but the path to access her back door is not well-lit and she does not like to use that entrance.
Violet sometimes feels dizzy when standing up. She has had 2 recent falls – one accidental due to tripping over her cat, but she cannot recall the reason for the second fall. Violet has a telecare pendant.
Violet has diagnosed hypertension – sitting BP 136/84 and standing BP 114/62. After 2 minutes her standing BP recovers to 128/76. Pulse 79.
Once standing Violet uses her husbands stick to steady herself when walking.
Trip hazard – There is a rug in front of Violets chair.
Violet sometimes forgets to take her medications (or does not remember if she has taken them). She takes a prescribed statin and two prescribed anti-hypertensives.
A
Communication
Violet wears reading glasses. Sometimes she forgets to take them off when mobilising so her vision can be blurry.
Violets hearing is good and she does not use aids.
Violet enjoys conversation and company and has a good sense of humour.
Violet is aware of some deterioration in her memory. She can find it difficult to recall things and sometimes forgets medications /conversations which she finds frustrating.
A
Breathing
Violet does not report any shortness of breath.
Self-ventilating – no relevant medications, oxygen or equipment required.
Respiration rate = 17 a minute.
Violet is a non-smoker.
P
Eating and
Drinking
When last recorded Violet weighed 8 stone 11 lbs. She has lost 4kgs in last 3 months – 60kgs to 56kgs.
Her BMI is 21
Violet says she has a lack of motivation to cook. Her daughter visits twice weekly and brings shopping.
Violet states she drinks 1-1.5 litres fluid (finds it difficult to drink more) and enjoys tea and squash (does not like water on its own). Violet enjoys a weekly Guinness.
Violet usually has cereal/toast breakfast and soup for lunch with main meal early evening – her favourite is steak & kidney pie.
She enjoys a chocolate biscuit and a slice of cake
Violet has top and bottom dentures and cleans these daily herself – they fit well and are not loose. Violets tongue is pink and moist and no signs of any furring or ulcers.
MUST risk assessment score – 1 (medium risk) You will discuss this tool in your assessment session.
A
Elimination
Violets bowels open every other day (type 4 Bristol stool chart) You will discuss this tool in your assessment session.
Violet experiences occasional stress incontinence and changes pads herself 1-2 times day (daughter purchases these from local supermarket).
Violet can mobilise to the toilet independently but sometimes struggles to get to the bathroom in time.
A
Washing and dressing
Violet does this independently but is finding this increasingly difficult (especially her legs and feet). She becomes tried and fatigued and the dexterity in her hands has deteriorated.
Violet uses a stool to sit on when she washes at the sink and a walk-in shower with perch stool. Violet uses E45 for dry skin but finds it difficult to get the lid off the pot.
Waterlow score 14. You will discuss this tool in your assessment session.
A
Controlling
temperature
Temp 36.8 centigrade. A routine urine sample has been tested – nothing abnormal detected. No other signs of clinical infection. Violet able to adjust clothing/ bed linen independently.
Violets flat is centrally heated and Violet likes to use fan in the summer months.
P
Mobilisation
Violet lives alone but has difficulty managing stairs to flat from entrance – 6 steps with handrail.
Violet finds it difficult to get up from her chair – sometimes takes up to 3 attempts and sometimes Violet feels dizzy when standing up.
Violet uses her husbands stick to steady herself when walking and does worry about falling/losing her balance.
A
Working and
Playing
Violet misses gardening after moving to smaller property.
Enjoys reading – biographies and romance.
Daughter (Eve) visits twice weekly usually a Tuesday and Saturday but also manages work and looking after her children.
Violets husband Stan died 2 years ago and Violet feels his loss and misses him greatly. This has exacerbated her feelings of loneliness at times.
Violet has stopped going to church due to fear of falling and wide-open space. She also finds it difficult to stand up and sit down with the congregation during a service.
A
Expressing sexuality
Violet has lost some of her identify since Stan died and social activity has reduced greatly, including not attending church and feeling part of her community. She feels lonely at times
Violet also is finding it difficult to meet all her personal hygiene needs including using the shower (sometimes she has a full wash using the basin), washing/drying her hair and apply her lipstick/makeup like she used to. Her daughter Eve does Violets hair when she visits and helps with the shower, although Violet feels embarrassed that her daughter has to shower me.
A
Sleeping
Violet has an interrupted sleep pattern and may get up once or twice to go to the toilet and then reads to get back to sleep. Often her mind drifts to Stan and she feels upset and unable then to go back to sleep or wakes early if she does.
A
Death and dying
Violet talks about Stan dying and says ‘she is not frightened of dying as she will get to be with her Stan’ but would like to enjoy life more whilst she can. Violet believes in spirituality and life after death and misses her church community – the faith leader has offered to visit Violet at home.
P
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FLORIDA HOSPITAL ASSOCIATION LEGISLATIVE SUMMARY FLORIDA HOSPITAL ASSOCIATION
Mission to Care. Vision to Lead.
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SESSION OVERVIEW During the 2018 Legislative Session
decisions were made that impact Florida’s hospitals and the
patients and communities we serve. The following … Show more
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BUDGET General Appropriations Act for Fiscal Year 2018-19 Florida’s budget for State Fiscal Year (SFY)
2018-19 was approved at $88.7 billion, which includes a $6.3 billion increase over the SFY 2017-18 funding.
The budget removed $50 million In non-recurring general revenue from hospital reimbursem… Show more
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2018 FHA LEGISLATIVE SUMMARY Updated Enhanced Ambulatory Patient Group 2019, the parameters
shall ensure budget neutrality in (EAPG) Outpatient Payment Methodology aggregate for SFY 2018-2019
and shall include adjustments Hospital Outpatient Base Rate $266.89 determined separately … Show more
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Graduate Medical Education A total of $242.3 million was appropriated for the Statewide Medicaid
Residency Program and the Graduate Medical Education (GME) Startup Bonus Program. This reflects an
increase of $45 million to address physician shortages in Florida and charity care for statutor… Show more
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2018 FHA LEGISLATIVE SUMMARY Involuntary Examination and Involuntary Admission of Minors: FAILED
House Bill 94? by Rep. Bobby Payne and Rep. David Silvers and Senate Bill 270 by Sen. Greg Steube
proposed to implement three recommendations from the legislatively created Florida Depart… Show more
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REGULATORY Adult Cardiovascular Services: FAILED Senate Bill 144 by Sen. Denise Grimsley and House
Bill 119 by Rep. Cary Pigman would have revised training requirements for staff working in high volume,
level I facilities. Advanced Birth Centers: FAILED House Bill 1099 by Rep. MaryLynn Magar an… Show more
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2018 FHA LEGISLATIVE SUMMARY Institutional Pharmacy Regulation: PASSED House Bill 675 by Rep.
Jason Brodeur and Sen. l<el|l Stargel establishes Class III institutional pharmacies, a new category that
permits hospitals and hospital systems to move drugs from one location to another within the… Show more
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HEALTH INSURANCE / PAYMENT Direct Primary Care (DPC) AGREEMENTS: PASSED House Bill 37 by
Rep. Danny Burgess and Sen. Tom Lee creates a primary ca re medical practice model that allows for
contractual agreements where a patient pays a monthly fee, usually $100 or less per individua… Show more
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2018 FHA LEGISLATIVE SUMMARY Consultant Pharmacist Scope of Practice: FAILED OTHER BILLS OF INTEREST House Bill 689 by Rep. Cord Byrd and Senate Bill 914 by Sen. Rene Garcia would have authorized consultant pharmacists Physician Orders for Life-Sustaining Treatment: FAILED to enter into a collaborative practice agreement with a health Senate Bill 474 by Sen. Jeff Brandes and House Bill 476 by care facility medical director or individual physician to provide Rep. Cary Pigman would have created the Physician Orders specified services. Services would have included the ordering for Life-Sustaining Treatment (POLST) Program within the and evaluation of laboratory testing, patient assessment, Florida Department of Health to implement and administer the administration of medications and initiation or modification development and use of POLST. It also proposed to establish a of medicinal drugs pursuant to a patient-specific order or central registry for advance directives that could be accessed by treatment protocol. The bill did not authorize the consultant a health care provider. pharmacist to modify or discontinue medicinal drug therapy with prescribers other than their collaborative practice Prescription Drug Pricing Transparency: PASSED agreement provider. House Bill 351 by Rep. David Santiago and Sen. Bill Montford requires a pharmacist, or their authorized employee, to inform Diabetes Educators: FAILED customers of lower cost generically-equivalent alternatives for Senate Bill 758 by Sen. Audrey Gibson and House Bill 561 by their prescriptions and whether a prescription’s cost sharing Rep. Rene Plascencia would have established Diabetes Educators amount exceeds the retail price in the absence of insurance as a new health care profession and would have established coverage. The bill also addresses pharmacy benefit managers a defined scope of practice and regulatory oversight by the (PBMs) requiring them to register with the Florida Office of Florida Department of Health. Insurance Regulation and imposing a range of restrictions on their practice. Upon approval by the Governor, this legislation Nurse Staffing Ratio Mandates: FAILED becomes effective on July 1, 2018. Senate Bill 638 by Sen. Daphne Campbell and House Bill 1083 by Rep. Barbara Watson would have imposed prescriptive Reporting of Adverse Incidents in Planned Out-of-Hospital hospital patient care staffing requirements related to minimum Births: PASSED registered nurse-to-patient staffing ratio requirements. It also Senate Bill 510 by Sen. Dana Young and Rep. Mary Lynn Magar specified numerous patient care staffing requirements and requires physicians, certified advanced registered nurse midwives would have prohibited mandatory overtime. and licensed midwives to report to the Florida Department of Health adverse incidents, as defined in the legislation, occurring Pharmacists Scope of Practice: FAILED as a result of an attempted or completed, planned birthing House Bill 431 by Rep. Rene Plascencia and Rep. Byron center or out-of-hospital birth. The bill becomes effective upon Donald and Senate Bill 524 by Sen. Jeff Brandes would have approval by the Governor. authorized pharmacists, working within the framework of a supervisory protocol with a physician, to test for, and treat, influenza and streptococcus. 9
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To provide evidence that you have the essential knowledge required for the following performance criteria and related knowledge evidence.
Gather and review information on available service options and approaches with the person
How would you gather and review information on available service options and approaches with a person?
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You suspect Mary has a fracture after falling off of a stepladder,…
You suspect Mary has a fracture after falling off of a stepladder, complaining of 6/10 pain in her back and hip. Describe at least two diagnostic tests you will order for her:
