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2023 Comment1 While nurses have high turn over it is higher with home health aides During the research for this assignment the
by adminNursing 2023 Comment
Comment1 While nurses have high turn over it is higher with home health aides During the research for this assignment the 2023 Assignment
Comment1
While nurses have high turn-over, it is higher with home health aides. During the research for this assignment, the information I was able to find in regards to HHA and home care setting turnover, information is few and far between. The possible impact that this shortage can have on nursing from my perspective: high turnover is more likely to breed less experienced staff with many fleeing the profession. Shortage of home health aide can affect nursing through home health care agencies lacking the ability to provide services for elderly at home “a lack of skilled aides forces individuals to rely more on family, neighbors and friends, and increases the chance that they will end up in the Emergency Room” (Wexler, 2017).
It also increases the likelihood of frequent hospital admission. Having more admissions adds pressure to the ever mounting healthcare cost for the country, and impacts jobs. Services provided by nurse practitioners in the home care setting would be affected with less people at home living in the community. Homecare is still plagued with the same clinical or staff issues that an acute care setting might come across. and when those type of issues take place, then patients’ care suffer, for inpatient and outpatient activities alike.
comment2
The issue that the organization is currently facing is an increase in hospital acquired pressure injuries (HAPI’s). The hospital started noticing an increase trend in HAPIs in patients, which is a big matter of concern. Currently there is a wound care team that does monthly surveys on wounds and prevalence trends. The organization started several initiatives and investigations to see what is going on and possible solutions. During the investigation’s, management found gaps in turning for high risk patients, gaps in documenting on Braden risk assessment, and gaps in care documentation. In this some causes may be that nurses and nurse aides feel overwhelmed with the amount and high acuity of patients they have to care for. I personally saw where the nurses and nurses’ aides looked very busy and overwhelmed with all the tasks they needed to complete.
One implication of nursing is for them to involve clinical leadership in a way that leadership can see what the staff goes through and why there are gaps in turning and documentation. One journal article stated that by using positive clinical leadership to support a culture of pressure injury prevention. In the article it states that pressure injury prevention. In the article it states that pressure injury rounds were done by leadership and they looked at trends on equipment being used, how the ward feels about their trend, what the ward would like more help with, and look around the ward including review of the equipment and clinical assessments. The results were that the rounds led to safety huddles focused on skin topics (Sage & Tudor, 2017)>
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2023 comment1 Home Care is found to be more desirable than assisted living for many who can afford it and
by adminNursing 2023 Comment
comment1 Home Care is found to be more desirable than assisted living for many who can afford it and 2023 Assignment
comment1
Home Care is found to be more desirable than assisted living for many who can afford it, and “according to AARP, more than 95 percent of seniors want to stay in their home as long as possible, even if they need help with day-to-day activities” (First Light Home Care, 2014). If we are paving the way through home care for elderly, and other vulnerable individuals to stay in the community, where they can be safe at home and be around things which they love and are familiar to them, then we have to get behind the science of how to keep them safe through the same EBP we take pride into when it comes to research topics (North Dakota Center for Nursing, n.d.), such as “spinal immobilization and pressure ulcers”, or EBP for complementary and alternative medicine “cinnamon and Diabetes Mellitus” are example of different areas EBP research is conducted. However, very little about homecare can be found from that same website.
comment2
One of the main issues for my organization in addressing a solution in evidence-based nursing practice is due to the fact that we do not have a designated educator that has the time or the job in educating and introducing how evidence-based practice (EBP). The organization has educators but they focus on orienting the new hires and asking about online education modules that need to be completed. I believe that if the organization would set aside time for an educator to provide the nurses and staff with education on EBP to incorporate into our practice it would be a good and effective way to learn.
The first step in addressing and resolving this issue is by having one of the four educators we assigned to teach and implement new EBP as approved by nursing leadership and the medical board.
According to a journal article, it states that a way to overcome the barrier of time constraints is by providing an EBP facilitator. This might be a staff educator, manager, or an interdisciplinary team member. The facilitator can present evidence review for the busy provider.
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2023 Create a Power Point Presentation to discuss the following You have been asked to implement a new
by adminNursing 2023 computer charting system
Create a Power Point Presentation to discuss the following You have been asked to implement a new 2023 Assignment
Create a Power Point Presentation to discuss the following:
You have been asked to implement a new computer charting system within your hospital. The staff at the hospital has been using paper charting and the staff’s age range is from 20 to 72. You will need to address the following:
Power Point should include at least 3 outside references and the textbook. It should include title and reference slides and be 14-20 slides.
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2023 1 There are many areas in nursing where evidence based practice has improved care processes and patient outcomes including the bundles
by adminNursing 2023 2-Please answer based on these answers as they are listed, each one must be answered in APAform and not less than 150 words
1 There are many areas in nursing where evidence based practice has improved care processes and patient outcomes including the bundles 2023 Assignment
1-There are many areas in nursing where evidence-based practice has improved care processes and patient outcomes including the bundles of checklist to prevent pneumonia related to mechanical ventilation and central line-associated blood stream infection or CLABSI.
To prevent healthcare-associated infection such as the ventilator-associated pneumonia (VAP) for patient who had been intubated for more than 48 hours, the VAP bundles of care are often used. Recommended bundle of interventions for the prevention of VAP includes elevation of the head of the bed at a 30° to 45° angle to prevent aspiration of gastric content, reducing the duration of mechanical ventilation by daily sedation interruption (DSI) and daily spontaneous breathing trials (SBT), peptic ulcer disease (PUD) prophylaxis, and deep-vein thrombosis (DVT) prophylaxis. Moreover, performing oral care every two hours and as needed, maintaining ET tube cuff pressure above 20 cm H20, and managing ventilator circuits and changing only when visibly soiled showed improvements in VAP in critically ill patients.
Another area where evidence-based practice has improved patient outcome is through the use of bundles or interventions to prevent or decreased central line-associated blood stream infections. Those recommended bundle of interventions for the prevention of CLABSI includes proper hand hygiene, skin preparation using chlorhexidine solution greater than 0.5%, adhering to aseptic technique and use of sterile gloves, regular assessment and inspection of site, and daily evaluation whether the use of central line is still necessary.
According to the ANA (2018), when patient received the optimal intervention bundle, the expected time for any ventilator-associated pneumonia to occur takes almost 3.5 times longer that those who did not. At the hospital I work for, when we chart our lines/drains/airways one of the question we are asked is if the patient still meets the criteria for continuing the line. When no longer necessary, it prompts immediate consideration for removal. The bundles/checklist does not only act as a learning tool but also serves as a guideline. By knowing the bundles of interventions we can better care for our patients and avoid unnecessary and preventable infections.
References:
Stevens, K. (2013, May 31). “The Impact of Evidence-Based Practice in Nursing and the Next Big Ideas” OJIN: The Online Journal of Issues in Nursing Vol. 18, No. 2, Manuscript 4. Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-18-2013/No2-May-2013/Impact-of-Evidence-Based-Practice.html
American Nurse Today. (2018). Preventing ventilator-associated pneumonia: A nursing-intervention bundle. Retrieved from https://www.americannursetoday.com/preventing-ventilator-associated-pneumonia-a-nursing-intervention-bundle/
Perin, D. C., Erdmann, A. L., Higashi, G. D., & Sasso, G. T. (2016). Evidence-based measures to prevent central line-associated bloodstream infections: a systematic review. Revista latino-americana de enfermagem, 24, e2787. doi:10.1590/1518-8345.1233.2787
2-In wound care it seems like new products are becoming available everyday and current products are continually evolving to improve patient outcomes. Thankfully, the clinic that I work in is smaller and there are only three nurses on staff, so our continuous education is typically done as a group. We usually meet with the product representative face to face and receive instant feedback regarding any questions and concerns we may have about the product. When information needs to be disseminated throughout the facility and to all nursing staff, the education happens is various forms. Least common is face to face in servicing as it is often difficult to get multiple staff members in the same location at the same time (due to staffing shortages). The most utilized form of education is online via an electronic learning forum (E-Learning) staff members can access the “assignments” 24 hours a day 7 days a week from most computers within the facility. Assignments are assigned with a due date and typically have a test following the educational portion in which the staff members must pass to receive credit and meet the educational requirement.
3-The implementation phase of any change can be difficult. In the nursing profession, evidence-based practices have been observed as the best and safest practices as there is proof in the research. However, there will always be those who question, or doubt said proof because some people are afraid of change, even if the change benefits them or others. To implement change, I would begin by addressing the following key factors: why, what, and how. First, the why- what is the issue that lead to the change. Next, the what- the research, the facts, the failures and successes that became the change. Lastly, the how- the demonstration or explanation of the change. Depending on the change and the aspects of our practice that would be affected determines the length of time the implementation phase would take. In my experience (when allowable) taking time to incorporate change over a period has proven least likely to create resistance from others.
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