Week 3: Discussion on Priority Actions to Take When Floating

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Participation Requirement: You are required to post a minimum of three (3) times in each discussion. These three (3) posts must be on a minimum of two (2) separate days. You must respond to the initial discussion question by 11:59 p.m. on Wednesday.  On additional days, respond to your peers’ posts as well as additional faculty posts. Responses to peers must be posted by 11:59 p.m. on Sunday each week a discussion is due.

Step 1: Read the following articles

American Nurse Association. The American nurse. On less familiar ground. Strategies aim to reduce random floating, improve the experience. August 31, 2017. (Attached to discussion)  (Links to an external site.)

Brown T. Nurses are talking about: floating and rapid response duty. Medscape Sunday September 17, 2017. http://blog.diversitynursing.com/blog/nurses-are-talking-about-floating-and-rapid-response-duty (Links to an external site.)

Davies K. Advance healthcare networks for nurses. Float assignments. Nursing advisor. http://nurseadvisormagazine.com/nurse-advisor/in-the-breakroom/float-nursing-to-reduce-healthcare-costs/ (Links to an external site.)

Nurse.com. Do registered nurses have to float to areas where they have not been trained or feel comfortable working? Is this legal? December 11, 2013. https://www.nurse.com/blog/2013/12/11/do-rns-have-to-float-to-units-where-they-have-not-been-trained-or-feel-comfortable-working-is-this-legal/ (Links to an external site.)

O’Connor K, Dugan LJ. Addressing floating and patient safety. RN Nursing February 2017-Vol 47-Issue2-page 57-58 doi:10.1097/01. NURSE.0000511820.95903-78. https://journals.lww.com/nursing/Fulltext/2017/02000/Addressing_floating_and_patient_safety.15.aspx#:~:text=%20Addressing%20floating%20and%20patient%20safety%20%201,nurses%20may%20perceive%20floating%20negatively%2C%20it%27s…%20More%20 (Links to an external site.)

RN responsibility when floating to new patient care unit or assigned to new population. https://www.rn.ca.gov/pdfs/regulations/npr-b-21.pdf (Links to an external site.)

Priority Actions to take when Floating

Floating is defined as “the reassignment of staff from one nursing unit to another based upon the patient census and acuities”. Floating is difficult and has always been a problem for nurses but safe patient care is always the goal. Floating is a reality that often cannot be avoided, particularly in the hospital setting. Floating may cause anxiety, stress, overwhelming, scary, draining, dissatisfaction, disruptive, and feeling of frustration even to a very experienced and skillful nurse to be pulled to work on a unit outside her/ his comfort zone. This might be caused by discomfort from unfamiliarity related to diverse patient population, staff, unit, and the processes to a work on a different department. Working in unfamiliar area makes nurses uneasy by not knowing what to expect. Yes, they know how to take care of the patients but without proper orientation to the unit/ area one will be floating is not easy. Whenever staff members are sent to float to an unfamiliar unit, it is expected that at least they will be able to perform the basic assessment and skills.

What Should the Registered Nurse Do When She/He Has to Float?

Before accepting patient assignment when floating to a different unit…

1. Make sure you have the necessary knowledge, judgement, skills, and ability to provide the required patient care. The nurse should not accept any patient care assignment he/ she is not competent to deliver the care but instead accept limited assignment of nursing care duties you can utilize your current competence.
2. Remember that the department you are floating will be glad to have you to help them decrease their patient work load. You will be responsible for your own actions and will be the one to face disciplinary action by a State Board of Nursing if you are not competent to perform the assignment delegated to you.
3. Talk to the Charge Nurse of the unit you are floating if you refuse the assignment being given to you and discuss the reason of your refusal. Let him/ her know that you are there to help but they should give you patient assignments that you are competent and comfortable to handle. The Charge Nurse of your permanent unit may be able to help you as well in talking to the unit you are floating If they insist for you to take the assignment. You may seek the help of the Nursing Supervisor. You can write an incident report to cover yourself.

According to American Nurses Association (ANA), “Registered Nurses must have the professional right to accept, reject, or object in writing to any assignment that puts patients or themselves at serious risk for harm.” The Joint Commission on floating clearly states that when an employee is asked to float to a different unit, that unit must be similar to his or her own and that the nurse must demonstrate competencies specific to that unit. Furthermore, the assigned employees should be floated to areas of comparable clinical diagnoses and acuities.

Initial Discussion Assignment:

You are a nurse on a medical-surgical unit that is currently well staffed with each nurse at a 3:1 ratio. There were two call outs in the oncology unit and it is your turn to float. The charge nurse informs you that you are being floated to the oncology unit and that you have been assigned to care for four patients.

Your discussion posting must address all of the following issues:

1. Summarize the concepts of floating that were addressed in the attached articles.
2. What steps would you take in this scenario to ensure a safe transition into the unfamiliar unit?
3. Why are these steps important?
4. What are some of the legal ramifications that can occur if you accept an assigned that is out of your scope of practice?

On less familiar ground Strategies aim to reduce random floating, improve the experience.pdf

These estimates include the influence of other extraneous variables, such as confounders. Confounding is often considered a type of bias, but it is a real relationship that requires an adjustment in the study design or analysis. Understanding how to identify confounding is important as most associations have multiple causal factors. Recognizing if a study adjusted for the appropriate confounding variables is important to determine the validity of the association. To assist your proficiency with the concept of confounding, and how it ultimately affects public health, this practice assignment has been provided.

Complete Problems 1 to 4 from the “Multicausality: Confounding – Assignment” by Schoenbach, located in your Topic Materials. Check your answers against the solutions presented in the “Multicausality: Confounding – Assignment Solutions” Topic Material.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

You are not required to submit this assignment to LopesWrite.

 

For this assignment you will be given a case study about a young lady named Sarah Smith. Review the information provided and answer the questions following. Be sure to cite your references. Look at Sarah as if she is a patient in your office seeking care. What are your immediate concerns? What needs to be done for her? Be thorough and succinct in your responses.

Case Study:

Sarah Smith is a 28 y/o African American female who presents to the office with c/o wound to her left foot for the past few days. States she had tripped and fell while barefoot scraping the top of her foot on the pavement. She denies any other injury from the incident. Over the past 24 hours the wound has had “smelly” drainage. Has been experiencing generalized achiness, but denies fever and chills. Did not seek medical attention at the time of injury. Has been using hydrogen peroxide to clean her wound. Is unclear of her last tetanus vaccination. Patient PMHx significant for DM II. States that she takes her medications when she remembers, and does not always check her blood sugar.

PMHx:

Asthma: no hospitalizations for exacerbation.

DM II

PSHx:

Denies

SHx:

Former tobacco user: ceased smoking 2 years ago. Had smoked 1ppd x 5 years

ETOH: socially

Illicit drugs: denies

FHx:

Significant for paternal DM, otherwise unremarkable

Medications:

Metformin: 500mg BID po – did not take the last few days

Albuterol MDI: 2 puffs every 6 hours prn – last use just PTA

Singulair: 10mg po daily

Trinessa: 1 tab po daily – last taken this am

Allergies:

PCN: hives

LNMP: 2 weeks ago.

G0p0

ROS:

General: denies any weight changes, fatigue or fever; + body aches

Skin: denies any rashes; + wound to left foot

HEENT: denies headache, head injury, dizziness, lightheadedness;

            Denies any vision changes

            Denies any hearing changes, tinnitus, vertigo, earache

            Denies any nasal congestion, discharge, nose bleeds or sinus tenderness

            Denies any sore throat, difficulty swallowing

Neck: denies any swollen glands, pain

Breasts: denies any pain, discharge

Respiratory: denies any dyspnea; positive cough and wheezing

CV: denies any chest pain, edema

GI: denies any nausea/vomiting/diarrhea/constipation; denies bloody stools

PV: denies claudication, swelling to LE

GU: denies frequency, urgency, burning;

            Denies vaginal discharge, itching, sores

            Denies penile discharge, itching or sores

MS: positive pain to left foot

Psych: denies nervousness, depression

Neuro: denies Headache, dizziness, vertigo, syncope, weakness; + numbness to right LE

Heme: denies any easy bruising

Physical Exam:

Vital signs: 100.5 (tympanic), 162/88, 118, 22, O2 sat 95% on RA

                        Height: 5’5”     Weight: 250 lbs.

            Blood glucose: 230 (Fasting; states has not eaten yet today)

patient awake, alert, oriented x 4 in NAD

Skin: warm, dry, color WNL. 4 cm lesion noted to anterior left foot with crusting and purulent drng; + surrounding erythema extending up 7 cm proximally

HEENT: head nontraumatic, normocephalic

Pupils PERRLA, EOMs intact; disc margins sharp, without hemorrhages, exudates; no AV nicking noted

Ears: bilateral TM with good cone of light and intact

Nose: mucosa pink, septum midline; no sinus tenderness appreciated

Mouth: mucosa pink, moist; tongue midline; tonsils 1+ without exudate

Neck: supple; trachea midline; no LAD

Resp: regular and unlabored; lungs with end expiratory wheezing throughout

CV: RRR, S1 and S2 noted; no s3, s4 or murmur appreciated

Abdomen: soft, non-distended; Bs + x 4; no tenderness with palpation; no CVA tenderness with percussion

Genitalia: deferred

Rectal: deferred

Extremities: warm and without edema; calves supple, non-tender

PV: no LE edema

MS: + swelling to left foot; + tenderness of 2-4th left metatarsals; + left pedal pulse; CMS intact; Cap refill < 2 sec.

Neuro: alert, cooperative; thought coherent; oriented x 4; cranial nerves II-XII intact

Questions:

1. List your differentials for her current problems. Remember you should have at least three different differentials for each problem. Include rationale for each differential.

2. At this time what medical diagnoses are you most concerned about? Do they impact other diagnoses? If so, how?

3. What diagnostic images would you order? Provide your rationale. What are you trying to rule in or out?

4. What laboratory work would you order? What would you anticipate to be abnormal? Provide your rationale for each.

5. What is your comprehensive plan of care? Include your rationales.

To view the Grading Rubric for this Assignment, please visit the Grading Rubrics section of the Course Resources.

Assignment Requirements

Before finalizing your work, you should:

• be sure to read the Assignment description carefully (as displayed above)
• consult the Grading Rubric to make sure you have included everything necessary; and
• utilize spelling and grammar check to minimize errors.

• For this assessment, you will develop a 3-4 page critique of the quantitative design, methods, and results of a scholarly study.
  The ability to use quantitative approaches to analyze health care data is a vital skill for today’s doctoral prepared professional. You will be expected to have the skills to critically assess the deeper analytical qualities of an article and ultimately comment on its overall validity and practical relevance. This assessment will provide you with an opportunity to demonstrate and hone your ability to analyze and critique the quantitative methods of a research study using an example from the literature.
  For the learner who has finished the data collection process for the doctoral project, analysis of that data offers an exciting (and sometimes challenging) opportunity of discovery. One of the most common statistical techniques for examining the relationship of two variables is correlation analysis. The specific kind of correlational technique depends on the combination of the measurement level (that is, categorical, ordinal, or interval or ratio) of the two data variables being examined. Correlation analysis can tell us the direction and strength of relationships between two variables.
  Overview
  Whether preparing a scholarly document for your doctoral program or simply trying to stay current in your professional field, you must continuously grow in your ability to read research. As an undergraduate, you probably just skimmed over an article’s abstract and introduction, focusing most of your attention on the interpretation of the results at the conclusion. As a doctoral-level professional, your colleagues will expect you to have the skills to critically assess the deeper analytical qualities of an article and ultimately comment on its overall validity and practical relevance.
  Using the readings, media, and various resources in this course, you have an opportunity to engage in critical thinking to assess the analytical results of a peer-reviewed quantitative study. This assessment parallels and complements the literature critique skill set you have developed previously in your program.
  The following will help provide you with potential approaches and frameworks to completing the critique and assessment portions of this assessment:
  
  • Shahnazi, H., Hosseintalaei, M., Esteki Ghashghaei, F., Charkazi, A., Yahyavi, Y., & Sharifirad, G. (2016). Effect of educational intervention on perceived susceptibility self-efficacy and DMFT of pregnant women. Iranian Red Crescent Medical Journal, 18(5), e24960.
  • Coughlan, M., Cronin, P., & Ryan, F. (2007). Step-by-step guide to critiquing research. Part 1 – Quantitative research. British Journal of Nursing, 16(11), 658–663.
  • The Value of a Research Critique to Translate Evidence Into Practice.
  • Demonstration of Proficiency
    By successfully completing this assessment you will address the following scoring guide criteria, which align to the indicated course competencies.
  • Competency 1: Describe underlying concepts and reasoning related to the collection and evaluation of quantitative data in health care research. 
    • Describe the study results for a quantitative study published in scholarly literature.
  • Competency 3: Interpret the results and practical significance of statistical health care data analyses. 
    • Interpret and critique the analytical testing approach used in a quantitative study described in scholarly literature.
  • Competency 4: Assess the quality of quantitative research methods reported in peer-reviewed health care literature. 
    • Cite and summarize a selected article.
    • Assess the overall methodological quality of an article using critique guidelines.
  • Competency 5: Address assignment purpose in a well-organized text, incorporating appropriate evidence and tone in grammatically sound sentences. 
    • Articulate meaning relevant to the main topic, scope, and purpose of the prompt. 
    • Apply APA formatting to in-text citations and references.
  • Instructions
  1. Read the article by Shahnazi et al. linked earlier in these instructions.
  2. Cite and summarize the article. 
     • Include study PICO, goals, intervention, and assessment data collected.
  3. Describe, interpret, and critique the statistical testing approach. 
     • Include preanalytic normal distribution and post-intervention analytical testing. The article by Shahnazi et al. may be a helpful reference.
  4. Describe, interpret, and critique the study’s results from the analysis. 
     • Address issues of significance; type I and II errors, confidence intervals, and effect sizes.
  5. Assess the overall methodological quality of the article using the step-by-step critique guidelines in the article by Coughlan, Cronin, and Ryan, linked above.
  6. Additional Requirements
  • Length: Your paper will be 3–4 double-spaced pages of content plus title and reference pages.
  • Font: Times New Roman, 12 points.
  • APA Format: Your title and reference pages must follow APA format and style guidelines. See the APA Module for more information. The body of your paper does not need to conform to APA guidelines. Do make sure that it is clear, persuasive, organized, and well written, without grammatical, punctuation, or spelling errors. You also must cite your sources according to APA guidelines.
  • Please review the assessment scoring guide before submitting your paper. The requirements outlined above correspond to the grading criteria in the scoring guide, so be sure to address each point. In addition, you may wish to review the performance-level descriptions for each criterion to see how your work will be assessed.

 800 words Health informatics due 11/5/2020 

Social Media in Education and Healthcare case study 

Grace Speak is a fourth-year student at Best University. She and her fellow classmates are

working hard in their final courses and preparing for exams. Inspired by the teamwork that the

healthcare profession espouses, Grace gets an idea for a study group. She thinks it will really help

share case experiences, course notes, and study tips. Unfortunately, several members of her peer

group live out of town, which makes it difficult for them to participate fully. Grace is torn, as she

does not want to exclude them from the study group. When she voices her concerns to a classmate,

her friend suggests using social media tools as the primary medium for sharing information.

Discussion Questions

1. 200 words–What types of social media tools could Grace’s study group use?

2. 200 words–How would those tools facilitate the objectives of the study group?

3. 200 words–What are some of the risks associated with using social media for such purposes?

4. 200 words–What might Grace need to do from the outset when she forms the study group?

Use the attached textbook and 4 other resource to respond to the case study in APA 7th essay format.