Category: Nursing

NRS-434VN 2 DQ 1 Child abuse and maltreatment Essay

Child abuse and maltreatment is not limited to a particular age—it can occur in the infant, toddler, preschool, and school-age years. Choose one of the four age groups and outline the types of abuse most commonly seen among children of that age. Describe warning signs and physical and emotional assessment findings the nurse may see that could indicate child abuse. Discuss cultural variations of health practices that can be misidentified as child abuse. NRS-434VN 2 DQ 1 Child abuse and maltreatment Essay Describe the reporting mechanism in your state and nurse responsibilities related to the reporting of suspected child abuse.

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Research indicates that infants under 12 months old are at the most risk for serious physical abuse (Cannel & Holick, 2018). The warning signs for physical abuse in infants include a non-ambulatory infant with any injury; injury inconsistent with the infant’s physical abilities; bruises on the torso, ear, or neck; burns to genitalia; caregiver being unconcerned about the injury; an unexplained delay in seeking care, as well as inconsistencies in histories provided (Cannel & Holick, 2018). NRS-434VN 2 DQ 1 Child abuse and maltreatment Essay Physical assessment findings that may indicate child abuse in infants include bruising in non-ambulatory infants especially in the face, head, or genitals. Retinal hemorrhages and subdural hematomas may be suggestive of abusive head trauma, a form of child abuse with the highest mortality rate (more than 20 percent). Also, fractures such as posterior and lateral rib fractures, sternal, spinal, and scapular fractures in non-ambulatory infants may indicate abuse (Cannel & Holick, 2018) NRS-434VN 2 DQ 1 Child abuse and maltreatment Essay.

Cupping and coining are ancient healing practices still being practiced today, especially by Russian immigrants and Vietnamese Americans, respectively (Killion, 2017). Cupping typically involves applying a heated cup to the back reportedly to draw out the ailment. Cupping leaves circular burns and bruises from the heat and suction effect which can be mistaken for abuse NRS-434VN 2 DQ 1 Child abuse and maltreatment Essay. Coining, on the other hand, involves rubbing the edge of a coin on oiled skin which results in linear patches that may be interpreted as abuse.

Since they are in frequent contact with children, nurses are mandatory reporters under the North Carolina State Law. They must report cases of suspected child abuse or neglect immediately or within 24 hours to the local Department of Social Services (DSS) in the county where the child resides or is found. This should be followed by filling a mandated reporter form online (Kids Place Incorporated, 2013). NRS-434VN 2 DQ 1 Child abuse and maltreatment Essay

 

References

Cannell, J. J., & Holick, M. F. (2018). Multiple unexplained fractures in infants and child physical abuse. 
The Journal of Steroid Biochemistry and Molecular Biology
, 
175
, 18-22.

Kids Place Incorporated. (2013). How to make a child abuse report. https://www.kidsplacecac.org/how-to-make-abuse-report/

Killion, C. M. (2017). Cultural healing practices that mimic child abuse. 
Annals of Forensic Research and Analysis, 4
(2), 1042. NRS-434VN 2 DQ 1 Child abuse and maltreatment Essay

NURS 6053 Developing Organizational Policies and Practices Nurse Burnout Essay Assignment

Developing Organizational Policies and Practices on Mental health stigmatization

 
The U.S. healthcare system has improved over the years. Technology has dramatically helped improve healthcare systems in many ways. However, the quality of care delivered to patients is still largely dependent on the ability of healthcare professionals to provide adequate care by employing critical thinking, problem-solving skills, and evidence-based approaches. Therefore, when healthcare workers are overwhelmed by the increased workload, increased hours, and mandatory overtime, the ability to provide safe care is depreciated and leads to nurse burnout and a potential danger to patients (Cuff & Forstrag 2019). Burnout among healthcare professionals is now recognized as a problem by many in the healthcare system, hence the addition of a fourth agenda to the “Triple Aim,” which promotes the positive mental health of healthcare providers in the work environment (Fitzpatrick, Bloore, & Blake 2019) NURS 6053 Developing Organizational Policies and Practices Nurse Burnout Essay Assignment. However, not enough research has been done to find evidence-based solutions to address the problem. The lack of sufficient healthcare personnel including nurses, physicians, and other caregivers, as well as the increased workload, hours, and physical, emotional and psychological demands has placed a significant burden on the sparsely available healthcare professionals left caring for a growing number of patients (Costa & Moss, 2018). This paper aims to address the issue of burnout in healthcare systems, identify the competing needs impacting burnout, and evaluate policies that influence staffing and prevent burnout

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Competing Needs Impacting Nurse Burnout

One approach by which healthcare organizations can address burnout is by creating policies that support work-life balance of their staff, promote job satisfaction, improve staffing, and increase nurse retention. However, competing needs and limited resources can potentially create a substantial barrier to implementing any effective policies in decreasing nurse burnout. One of these competing needs is cost. The cost of healthcare delivery for both human and material resources in the United States is a major hindrance to addressing the issue of burnout among healthcare workers and is a major factor contributing to the common practice of understaffing healthcare facilities
 
across the nation (Costa & Moss, 2018). The perceived cost of implementing policies such as mental health time off, appropriate staffing ratios, and employee compensation and appreciation may prevent some organizations from implementing these policies. Therefore, policy proponents need to educate stakeholders on using a cost-benefit analysis of how the implementation of these policies affect cost and revenue in relation to how burnout and high turnover rates also affect cost and revenue. According to Rivas (2018), the estimated cost of nurse burnout related turnover is $14 billion in the U.S. this is money that can be spent in improving the health care delivery system.

The nursing shortage is another competing need that may restrict institutional efforts to address nurse burnout. The introduction of the Affordable Care Act (ACA) has provided millions of Americans with access to healthcare, thus increasing the number of Americans seeking care (Glied, Ma, & Borja, 2017). There has also been an increase in the average life expectancy in the U.S., leaving a growing aged population with chronic conditions needing care (World Health Organization (2020). These are some of the factors that have created a gap between the number of patients needing care and the number of healthcare professionals available to care for them, thus enhancing the nursing shortage. The lack of a standardized staffing ratio is detrimental to the health care system because it leaves organizations to decide policies regarding nurse-patient ratios (Blitchok, 2018).  
Unbalanced staffing ratios increase nurse burnout, which further worsens the unsafe staffing ratios by increasing turnover rates and absenteeism devolving into a repetitive toxic cycle
.
Organizations in these cycles may want to implement policies to address understaffing but find it difficult due to the shortage of nurses to replace nurses who quit or retire.

Policy influencing Nurse Burnout in my Organization

The organization where I work has policies in place to help address nurse burnout. An example of such a policy includes a mandatory break with other nurses as “buddies” to help cover a nurse’s assignments during breaks. This practice helps ensure that nurses can take a 30-minute lunch break and two 15 minutes breaks that can be taken if the unit is not busy. Another policy that could prevent nurse burnout is the use of a matrix for staffing. The matrix helps determine the maximum number of patients that can be assigned to nurses and nursing assistants.

Policy Critique and Ethical Considerations of the Policy

Research has shown that Safe staffing ratios improve patient outcomes and increase patient and staff satisfaction (American Nurses Association, 2019). The use of a staffing matrix at my organization is a policy that guides the nurse-patient matrix. However, there are loopholes that prevent strict adherence to staffing ratios; the matrix is based on the number of patients in the units, and acuity is not considered. Also, the organizational policy allows for a maximum of eight patients to one nurse; however, the matrix only allows for four nurses when the census is 32-35, meaning some nurses end up with nine patients without consideration for new admits that may arrive in the middle of the shift. The matrix also does not account for lack of nursing assistants, so sometimes nurses may end up with eight patients, four of which do not have a nursing assistant assigned to them thereby. Increasing the workload. This policy is lacking ethical standards due to another policy that prevents nursing managers from making discretional decisions based on a given situation. The policy also prevents nurses from questioning their patient assignments, thereby making it difficult for nurses to refuse an unsafe assignment.

Strength of the Policy and Challenges in Promoting Ethic

The strength of this policy is its ability to ensure adequate staffing for this organization, appropriate staffing is one of the most challenging tasks in a healthcare organization, this matrix helps the staffing coordinator plan ahead to ensure a safe staffing ratio. Although policies and procedures are essential and implemented to provide guidance and structure in an organization, the policies should have ongoing evaluation to ensure they do not have adverse effects and that they continue to produce positive outcomes. One challenge in promoting ethical consideration of this policy is the use of a nonclinical staffing coordinator who is unable to make appropriate clinical and ethical decisions relating to staffing problems. Nurses are directly affected by staffing decisions, and their inability to be involved in the decision making regarding staffing and patient care can lead to negative outcomes. Nurses should be involved in making staffing decisions as they have the knowledge to determine ethical issues that may affect staff and patients (Registerednursing.org, 2020).

Policy or Practice Suggestions to Balance Competing Needs of Resources, Workers, and Patients

The healthcare system holds healthcare professionals accountable for the delivery of quality and safe care. Accountability in healthcare is essential to ensure the quality and safety of care and prevent adverse outcomes to patients and the community at large. However, this accountability needs to be inclusive of all aspects of healthcare. In addition to holding healthcare professionals accountable, healthcare organizations and healthcare leaders need to be held to a higher standard of accountability for how healthcare organizations are run. Healthcare organizations need to employ a safety-first culture in how policies are drafted and implemented.

Developing and adhering to safe staffing ratios is an example of employing a safety-first culture. A study by Driscoll et al. (2017), found that safer nurse staffing ratios are associated with a decreased mortality rate in an in-patient hospital.

The ability to balance competing needs and still provide safe care is crucial in health care, healthcare organizations can utilize a policy review committee that involves all stakeholders. For example, staffing decisions should not be made by managers and employers alone. Nurses should also be allowed to voice their concerns and hold their employers accountable for a safe working environment as well as participate in decision making. A study by Kutney-Lee et al. (2016) indicated that engaging nurses in shared decision-making promote positive patient and nursing outcomes; it also improves nurse performance and nurse retention and increases the organization’s profit.

Conclusion

The United States is a nation that values healthcare outcomes and public health, must continue to create an awareness of the emerging trends regarding healthcare personnel shortage and its effect on care delivery and burnout. We must continue to advance our strategies to achieve balanced staffing ratios to prevent burnout in the workforce, decrease the occurrence of adverse events to patients due to this burnout, and promote continuity in the delivery of quality care.

 

 

 

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References

American Nurses Association. (2019). Staffing ratios. Retrieved from 
https://www.nursingworld.org/practice-policy/nurse-staffing/

Blitchok, A. (2018). Proposed federal RN ratios- What you can do about it. Retrieved from

https://nurse.org/articles/federal-staffing-ratios/

Costa, D. K. & Moss, M. (2018). The Cost of Caring: Emotion, Burnout, and Psychological Distress in Critical Care Clinicians. 
AnnalsATS Journal 15(7). 787-790.
 Retrieved from 
https://www.atsjournals.org/doi/pdf/10.1513/AnnalsATS.201804-269PS

Cuff, P. & Forstag, E. H. (2019). A Design Thinking, Systems Approach to Well-Being Within Education and Practice: The Importance of Well-Being in the Health Care Workforce. Retrieved from 
https://www.ncbi.nlm.nih.gov/books/NBK540859/

Driscoll, A., Grant, M. J., Carroll, D., Dalton, S., Deaton, C., Jones, I., Lehwaldt, D., McKee, G., Munyoombwe, T., & Astin, F. (2017). The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: a systematic review and meta-analysis. European Journal of Cardiovascular nursing. Retrieved from

Glied, S. A., Ma, S., & Borja, A. (2017). Effect of the affordable care act on health care access. Retrieved from 
https://www.commonwealthfund.org/publications/issue-briefs/2017/may/effect-affordable-care-act-health-care-access

Kutney-Lee, A., Germack, H., Hatfield, L., Kelly, S., Maguire, P., Dierkes, A., Guidice, D. M., &Aiken. (2016). Nurse Engagement in Shared Governance and Patient and Nurse Outcomes. 
The journal of nursing administration 46
(11). 605-612. Retrieved from 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5117656/

Registerednurisnig.org. (2020). Ethical Practice: NCLEX-RN. Retrieved from 
https://www.registerednursing.org/nclex/ethical-practice/

Rivas, R. (2018). Turning the Lever Down on Burnout and Turning up Resilience, Well-being, and Joy (Part 3). Retrieved from 
https://www.healthcareexcellence.org/2018/05/18/turning-lever-down-on-physician-burnout-cost-turnover-burnout/

World Health Organization. (2020). Global Health Observatory (GHO) data. Life expectancy. Retrieved from 
https://www.who.int/gho/mortality_burden_disease/life_tables/situation_trends_text/en/

 

Assignment: Developing Organizational Policies and Practices

Competing needs arise within any organization as employees seek to meet their targets and leaders seek to meet company goals. As a leader, successful management of these goals requires establishing priorities and allocating resources accordingly.

Within a healthcare setting, the needs of the workforce, resources, and patients are often in conflict. Mandatory overtime, implementation of staffing ratios, use of unlicensed assisting personnel, and employer reductions of education benefits are examples of practices that might lead to conflicting needs in practice.

Leaders can contribute to both the problem and the solution through policies, action, and inaction. In this Assignment, you will further develop the white paper you began work on in Module 1 by addressing competing needs within your organization.

To Prepare:

Review the national healthcare issue/stressor you examined in your Assignment for Module 1, and review the analysis of the healthcare issue/stressor you selected.

Identify and review two evidence-based scholarly resources that focus on proposed policies/practices to apply to your selected healthcare issue/stressor. NURS 6053 Developing Organizational Policies and Practices Nurse Burnout Essay Assignment

Reflect on the feedback you received from your colleagues on your Discussion post regarding competing needs.

The Assignment (4-5 pages):

Developing Organizational Policies and Practices

Add a section to the paper you submitted in Module 1. The new section should address the following:

Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.

Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.

Critique the policy for ethical considerations, and explain the policy’s strengths and challenges in promoting ethics.

Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients, while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.

Cite evidence that informs the healthcare issue/stressor and/or the policies, and provide two scholarly resources in support of your policy or practice recommendations. NURS 6053 Developing Organizational Policies and Practices Nurse Burnout Essay Assignment

By Day 7 of Week 3

Submit your revised paper.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK3Assgn+last name+first initial.(extension)” as the name.

Click the 
Week 3 Assignment Rubric 
to review the Grading Criteria for the Assignment.

Click the 
Week 3 Assignment 
link. You will also be able to “View Rubric” for grading criteria from this area.

Next, from the Attach File area, click on the 
Browse My Computer
 button. Find the document you saved as “WK3Assgn+last name+first initial.(extension)” and click 
Open
.

If applicable: From the Plagiarism Tools area, click the checkbox for 
I agree to submit my paper(s) to the Global Reference Database
.

Click on the 
Submit
button to complete your submission. NURS 6053 Developing Organizational Policies and Practices Nurse Burnout Essay Assignment

NURS_6053_Module02_Week03_Assignment_Rubric

Grid View

List View

Excellent

Good

Fair

Poor

Add a section to the paper you submitted in Module 1. In 4–5 pages, address the following:

·   Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.

23 
(23%)
 – 25 
(25%)

The response accurately and clearly identifies at least two competing needs impacting the healthcare issue/stressor selected.

20 
(20%)
 – 22 
(22%)

The response identifies at least two competing needs impacting the healthcare issue/stressor selected.

NURS 6053 Developing Organizational Policies and Practices Nurse Burnout Essay Assignment

18 
(18%)
 – 19 
(19%)

The response identifies at least two competing needs impacting the healthcare issue/stressor selected that is vague or inaccurate.

0 
(0%)
 – 17 
(17%)

The response describes at least two competing needs impacting the healthcare issue/stressor selected that is vague and inaccurate, or is missing.

·   Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.

·   Critique the policy for ethical considerations and explain the policy’s strengths and challenges in promoting ethics.

27 
(27%)
 – 30 
(30%)

The response accurately and thoroughly describes in detail a relevant policy or practice in an organization that may influence the healthcare issue/stressor selected.

The response accurately and thoroughly critiques in detail the policy for ethical considerations and explains in detail the policy’s strengths and challenges in promoting ethics.

24 
(24%)
 – 26 
(26%)

The response accurately describes a relevant policy or practice in an organization that may influence the healthcare issue/stressor selected.

The response accurately critiques the policy for ethical considerations and explains the policy’s strengths and challenges in promoting ethics.

21 
(21%)
 – 23 
(23%)

The response describes a relevant policy or practice in an organization that may influence the healthcare issue/stressor selected that is vague or inaccurate.

The response critiques the policy for ethical considerations and explains the policy’s strengths and challenges in promoting ethics that is vague or inaccurate.

0 
(0%)
 – 20 
(20%)

The response describes a relevant policy or practice in an organization that may influence the healthcare issue/stressor selected that is vague and inaccurate, or is missing.

The response critiques the policy for ethical considerations and explains the policy’s strengths and challenges in promoting ethics that is vague and inaccurate, or is missing.

·   Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.

·   Cite evidence that informs the healthcare issue/stressor and/or the policies and provide two scholarly resources in support of your policy or practice recommendations.

27 
(27%)
 – 30 
(30%)

The response provide one or more accurate, clear, and thorough recommendations for policy or practice changes designed to balance the competing needs of resources, workers, and patients while addressing any ethical shortcomings of the existing policies.

Specific and accurate examples are provided.

Accurate and detailed evidence is cited that informs the healthcare issue/stressor selected and a specific synthesis of at least two outside scholarly resources in full support of the policy or practice recommendations is provided. The response integrates at least 2 outside resources and 2 or 3 course-specific resources that fully support the healthcare issue/stressor selected.

24 
(24%)
 – 26 
(26%)

The response provides one or more recommendations for policy or practice changes designed to balance the competing needs of resources, workers, and patients while addressing any ethical shortcomings of the existing policies.

Specific examples may be provided.

Evidence is cited that informs the healthcare issue/stressor selected and a synthesis of at least one outside scholarly resource that may support the policy or practice recommendations is provided. The response integrates at least 1 outside resource and 2 or 3 course-specific resources that may support the healthcare issue/stressor selected.

21 
(21%)
 – 23 
(23%)

The response provides one or more recommendations for policy or practice changes designed to balance the competing needs of resources, workers, and patients while addressing any ethical shortcomings of the existing policies that is vague or inaccurate.

Examples may be provided.

Vague or inaccurate evidence is cited from 2 or 3 resources that informs the healthcare issue/stressor selected and may support the policy or practice recommendations provided.

0 
(0%)
 – 20 
(20%)

The response provides one or more recommendations for policy or practice changes designed to balance the competing needs of resources, workers, and patients while addressing any ethical shortcomings of the existing policies that is vague and inaccurate, or is missing. NURS 6053 Developing Organizational Policies and Practices Nurse Burnout Essay Assignment

Examples are missing.

Vague and inaccurate evidence is cited that informs the healthcare issue/stressor and may include at least 1 scholarly resource that vaguely and inaccurately supports the policy practice recommendations is provided, or is missing.

Written Expression and Formatting – Paragraph Development and Organization:

Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.

5 
(5%)
 – 5 
(5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.

4 
(4%)
 – 4 
(4%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.

3.5 
(3.5%)
 – 3.5 
(3.5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.

Purpose, introduction, and conclusion of the assignment is vague or off topic. NURS 6053 Developing Organizational Policies and Practices Nurse Burnout Essay Assignment

0 
(0%)
 – 3 
(3%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion was provided. Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 5  (5%)  – 5  (5%) Uses correct grammar, spelling, and punctuation with no errors. 4  (4%)  – 4  (4%) Contains a few (1 or 2) grammar, spelling, and punctuation errors. 3.5  (3.5%)  – 3.5  (3.5%) Contains several (3 or 4) grammar, spelling, and punctuation errors. 0  (0%)  – 3  (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. 5  (5%)  – 5  (5%) Uses correct APA format with no errors. 4  (4%)  – 4  (4%) Contains a few (1 or 2) APA format errors. 3.5  (3.5%)  – 3.5  (3.5%) Contains several (3 or 4) APA format errors. 0  (0%)  – 3  (3%) Contains many (≥ 5) APA format errors. Total Points: 100 Name: NURS_6053_Module02_Week03_Assignment_Rubric NURS 6053 Developing Organizational Policies and Practices Nurse Burnout Essay Assignment

Quadruple Aim Nurse Burnout Assignment: Analysis of a Pertinent Healthcare Issue

Analysis of Nurse Burnout in Healthcare

Introduction

Nurses play a vital role in healthcare delivery; nursing education includes a broad scope of practice, which places them as an essential part of the healthcare team with many tasks and responsibilities, including direct patient care. However, this broad scope of education comes with even greater responsibility, including decision-making (Nursing.org, 2020). Although rewarding, nursing comes with lots of stress, and when that stress is not addressed, excessive, continuous, or ignored, it may lead to burnout. Nurse burnout is prevalent in the U.S such that a 2017 study by RN’SRN’S network pustulated that about half the population of nurses working in the U.S. have considered leaving the profession, due to feelings of lack of job satisfaction and being overworked (Nursing.org, 2020). Quadruple Aim Nurse Burnout Assignment: Analysis of a Pertinent Healthcare Issue. The purpose of this paper is to describe burnout, its impact in my organization, and strategies to address burnout. It will also include a summary of two articles that discusses burnout and strategies that are being used in other organizations to address burnout.

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Nurse Burnout

Nurse burnout is a state of decreased physiological and psychological energy related to lack of job satisfaction due to being overworked and understaffed. In addition to lack of support, it is often evident by emotional exhaustion, feeling frustrated and poor motivation (Mudallal et al., 2017). Burnout can also be due to increased workloads and demands, long hours, and a lack of flexible schedule (Nursinglicensure.org, 2020). Nursing is a profession at high risk for burnout. It is due to the complex duty to ensure patient safety, the emotional burden in caring for patients, and the demanding and stressful work environment in which they must perform these duties. In addition, the shortage of healthcare workers and increasing demand to increase patient satisfaction scores increased the pressure and rate of burnout amongst nurses. According to Reith (2018), burnout is a major problem in the U.S. healthcare sector. It harms the healthcare delivery system and contributes to the shortage of healthcare workers.

Impact of Burnout in the Organization

The effect of nurse burnout has the capability to impact organizations, including the one where I work negatively. Nurse burnout has the potential to impact patient safety and patient outcomes negatively, it is one of the leading causes of patient safety and quality concerns in the U.S. healthcare system (Nurse.org, 2020). Burnout has generally been found to lead to a high turnover rate and increased absenteeism for nurses. The organization is evidently impacted by nurse burnout. Nurses at this organization have increasingly shown signs of burnout. Quadruple Aim Nurse Burnout Assignment: Analysis of a Pertinent Healthcare Issue. This is evidenced by frequent absenteeism, refusal to work any days other than assigned shifts, and a high turnover rate, which the constant hiring does not solve due to the repeated cycle. As a relief charge nurse, a meeting was recently held with the Human resources manager and unit managers who wanted to understand the reason why the turnover rate for nurses and nursing aides were that high for a new hospital branch less than one year. The organization also does quality measurement by tracking the number of falls, incident reports, and errors. An upward trend has now been noted over time, which is associated with understaffing and overworked staff.

Summary of Articles Related to Burnout and its Prevention Strategies

Article 1: 

This article titled occupational stress management and burnout interventions in nursing and their implications for healthy work environments
 
is a literature review of articles aimed at analyzing workplace interventions associated with providing a healthy work environment and improving the quality of work-life for nurses. The study by Nowrouzi et al. (2015), examined occupational stress and burnout for nurses, they also suggested strategies on how to prevent burnout. A survey aimed at understanding the reasons behind nurses leave their nursing job in a rural area in Canada highlighted reasons such as higher level of self-reported occupational stress, decreased job satisfaction, and little control over their work schedule, being on call and making clinical decisions (Nowrouzi, 2015). Understanding the reasons and feedback from nurses can help organizations make better plans and strategies to improve the work environment for nurses and decrease burnout (Nowrouzi et al., 2015).

Some of the articles reviewed in this study suggested strategies such as mindfulness-based stress reduction and psychosocial intervention training. Participants showed a significant decrease in perceived stress and burnout (Nowrouzi et al., 2015). One article indicated that more psychiatric nurses in a rural environment reported an increased job satisfaction level associated with management support and their ability to be involved in their unit’s decision-making (Nowrouzi et al., 2015). Furthermore, the authors suggested that organizations adopt policy and practice changes that will address issues such as staffing and workload for nurses as well as strategies to decrease stress and improve the recruitment and retention of nurses (Nowrouzi et al., 2015) Quadruple Aim Nurse Burnout Assignment: Analysis of a Pertinent Healthcare Issue.

Article 2: 

The second article titled burnout, and resiliency in peri anesthesia nurses is a study that aimed at analyzing a national pool of nurses who are members of the American Society of peri anesthesia nurses. This study’s objective was to determine the prevalence and factors affecting nurses’ burnout, examining the effects of external activities such as hobbies and mindfulness practice on personal feelings of lack of job satisfaction (Card et al., 2019). The study also aimed to understand the effect of burnout on physical and mental wellbeing, as well as develop strategies that organizations and management can implement to create a healthy work environment and decrease burnout (Card et al., 2019). Findings from the study indicated that burnout is related to fatigue as well as poor physical and mental health, which leads to absenteeism, lack of job satisfaction, and increased call-ins, which negatively affects the team left to work shorthanded (Card et al., 2019).

The study indicated a link between employees’ perception of the organization and burnout, an employees’ positive perception of leadership support, economic satisfaction, acknowledgment of workload, acknowledgment of work accomplishment, and opportunity for growth and advancement decreases the occurrence of burnout (Card et al., 2019). The study results identified strategies such as improving the relationship between organizations and employees, providing opportunities for career advancement, providing opportunities for and supporting employee engagement in extracurricular activities as effective strategies for decreasing nurse burnout in healthcare organizations (Card et al., 2019). The authors further suggested that organizations invest in providing a healthy work environment, uses evidence-based guidelines for staffing, and provide opportunities for social connection. Furthermore, the author also suggested that the organization also acknowledge employees’ hard work and contribution, promote shared decision making between employees and management, and set reasonable expectations and respect employees limit (Card et al., 2019). They reiterated the need for nurses to set boundaries, engage in physical activities and hobbies, and establish a personal support system (Card et al., 2019).

Strategies Used to Address the Organizational Impact of burnout

Various strategies to help decrease nurse burnout were identified in the two articles summarized above. The strategies included reflected the need for a joint effort between organizations, management, and employees to work together and find lasting solutions. Some of the strategies that could be applied to my current organization include the involvement of employees in decision-making, the use of evidence-based guidelines for staffing, and providing employees the opportunity to engage in extracurricular activities. The implementation of these strategies will improve work-life balance for employees, increase their level of job satisfaction and confidence in the organization as well as decrease burnout.

How Burnout Prevent Strategies Impact the Organization

Implementing these strategies in this organization may be difficult due to their long-standing negative attitude towards change. The management may perceive some of these strategies as counterproductive towards their goals, for example, staffing; it would be challenging to adopt evidence-based guidelines for adequate staffing and respecting employees’ limits due to the perceived financial implications. Therefore, education about the relationship between nurse burnout patient safety, medical errors, and low patient satisfaction scores is imperative (Hall et al., 2016). In addition to education, the organization needs to be open to accepting and implementing change, commit to building a better relationship between staff and management. Although not immediate, this will help them work together to decrease the rate of burnout and decrease the high turnover rate with a minimal financial burden as possible. Nurses also need to advocate for themselves by practicing self-care, identifying stressors, and utilizing coping methods such as mindfulness-based stress reduction. These are some of the ways nurses can improve physical and psychosocial wellbeing and decrease burnout (Penque, 2019).

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Conclusion

Nursing is a rewarding but tough profession making it prone to burnout. Nurse burnout affects U.S. healthcare delivery and predisposes patients to preventable harm. Therefore, healthcare organizations, healthcare leaders, and nurses must collaborate to provide a safe work environment for nurses by finding lasting solutions to ensure that nurses maintain a positive outlook on their job, prevent burnout, and increase nurse retention and job satisfaction.

References

Card, E. B., Hyman, S. A., Wells, N., Shi, Y., Shotwell, M. S., & Weinger, M. B. (2019). Burnout and Resiliency in Peri anesthesia Nurses: Findings and Recommendations from a National Study of Members of the American Society of Peri anesthesia Nurses. 
Journal of Peri Anesthesia Nursing, 34(
6), 1130–1145. 
https://doi-org.ezp.waldenulibrary.org/10.1016/j.jopan.2019.05.133

Gaines, K. (2020). Joint commission tackles burnout in a new report. Retrieved from 
https://nurse.org/articles/joint-commission-tackles-nurse-burnout/

Hall, L. H., Johnson, J., Watt, I., Tsipa, A., & O’Connor D. B. (2016). Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review. Retrieved from 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4938539/

Mudallal, R., Othman, W. M., & Al Hassan, N. F. (2017). Nurses’ Burnout: The Influence of Leader Empowering Behaviors, Work Conditions, and Demographic Traits. Retrieved from 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5798741/

Nowrouzi, B., Lightfoot, N., Larivière, M., Carter, L., Rukholm, E., Schinke, R., & Belanger-Gardner, D. (2015). Occupational Stress Management and Burnout Interventions in Nursing and Their Implications for Healthy Work Environments: A Literature Review. Workplace Health & Safety, 63(7), 308–315. 
https://doi-org.ezp.waldenulibrary.org/10.1177/2165079915576931

Nursing.org. (2020). Nurse burnout. Retrieved from 
https://www.nursing.org/resources/nurse-burnout/

NursingLincensure.org. (2020). Nurse Burnout: Epidemic, or Mendable Malady? Retrieved from 
https://www.nursinglicensure.org/articles/nurse-burnout.html

Penque, S. (2019). Wellness series part 1: Open Mindfulness to promote nurses’ wellbeing. 
Nursing Management
, 
50
(5), 38–44. 
https://doi-org.ezp.waldenulibrary.org/10.1097/01.NUMA.0000557621.42684.c4

Reith, T. P. (2018). Burnout in United States Healthcare Professionals: A Narrative Review. Retrieved from 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6367114/

 

NURS 6053: INTERPROFESSIONAL ORGANIZATIONAL AND SYSTEMS LEADERSHIP – Assignment: Analysis of a Pertinent Healthcare Issue

The Quadruple Aim provides broad categories of goals to pursue to maintain and improve healthcare. Within each goal are many issues that, if addressed successfully, may have a positive impact on outcomes. For example, healthcare leaders are being tasked to shift from an emphasis on disease management often provided in an acute care setting to health promotion and disease prevention delivered in primary care settings. Efforts in this area can have significant positive impacts by reducing the need for primary healthcare and by reducing the stress on the healthcare system.

Changes in the industry only serve to stress what has always been true; namely, that the healthcare field has always faced significant challenges, and that goals to improve healthcare will always involve multiple stakeholders. This should not seem surprising given the circumstances. Indeed, when a growing population needs care, there are factors involved such as the demands of providing that care and the rising costs associated with healthcare. Generally, it is not surprising that the field of healthcare is an industry facing multifaceted issues that evolve over time.

In this module’s Discussion, you reviewed some healthcare issues/stressors and selected one for further review. For this Assignment, you will consider in more detail the healthcare issue/stressor you selected. You will also review research that addresses the issue/stressor and write a white paper to your organization’s leadership that addresses the issue/stressor you selected.

To Prepare:

Review the national healthcare issues/stressors presented in the Resources and reflect on the national healthcare issue/stressor you selected for study.

Reflect on the feedback you received from your colleagues on your Discussion post for the national healthcare issue/stressor you selected. Quadruple Aim Nurse Burnout Assignment: Analysis of a Pertinent Healthcare Issue

Identify and review two additional scholarly resources (not included in the Resources for this module) that focus on change strategies implemented by healthcare organizations to address your selected national healthcare issue/stressor.

The Assignment (3-4 Pages):

Analysis of a Pertinent Healthcare Issue

Develop a 3- to 4-page paper, written to your organization’s leadership team, addressing your selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following:

Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization). Quadruple Aim Nurse Burnout Assignment: Analysis of a Pertinent Healthcare Issue

Provide a brief summary of the two articles you reviewed from outside resources on the national healthcare issue/stressor. Explain how the healthcare issue/stressor is being addressed in other organizations.

Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected. Explain how they may impact your organization both positively and negatively. Be specific and provide examples. Quadruple Aim Nurse Burnout Assignment: Analysis of a Pertinent Healthcare Issue

NURS_6053_Module01_Week02_Assignment_Rubric

Grid View

List View

Excellent

Good

Fair

Poor

Develop a 3- to 4-page paper, written to your organization’s leadership team, addressing the selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following:

·   Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization).

23 
(23%)
 – 25 
(25%)

The response accurately and thoroughly describes in detail the national healthcare issue/stressor selected and its impact on an organization.

The response includes accurate, clear, and detailed data to quantify the impact of the national healthcare issue/stressor selected.

20 
(20%)
 – 22 
(22%)

The response describes the national healthcare issue/stressor selected and its impact on an organization.

The response includes accurate data to quantify the impact of the national healthcare issue/stressor selected. Quadruple Aim Nurse Burnout Assignment: Analysis of a Pertinent Healthcare Issue

18 
(18%)
 – 19 
(19%)

The response describes the national healthcare issue/stressor selected and its impact on an organization that is vague or inaccurate.

The response includes vague or inaccurate data to quantify the impact of the national healthcare issue/stressor selected.

0 
(0%)
 – 17 
(17%)

The response describes the national healthcare issue/stressor selected and its impact on an organization that is vague and inaccurate, or is missing.

The response includes vague and inaccurate data to quantify the impact of the national healthcare issue/stressor selected, or is missing.

·   Provide a brief summary of the two articles you reviewed from outside resources, on the national healthcare issue/stressor and explain how the healthcare issue/stressor is being addressed in other organizations.

27 
(27%)
 – 30 
(30%)

A complete, detailed, and specific synthesis of two outside resources reviewed on the national healthcare issue/stressor selected is provided. The response fully integrates at least 2 outside resources and 2 or 3 course-specific resources that fully support the summary provided.

The response accurately and thoroughly explains in detail how the healthcare issue/stressor is being addressed in other organizations.

24 
(24%)
 – 26 
(26%)

An accurate synthesis of at least one outside resource reviewed on the national healthcare issue/stressor selected is provided. The response integrates at least 1 outside resource and 2 or 3 course-specific resources that may support the summary provided.

The response explains how the healthcare issue/stressor is being addressed in other organizations.

21 
(21%)
 – 23 
(23%)

A vague or inaccurate summary of outside resources reviewed on the national healthcare issue/stressor selected is provided. The response minimally integrates resources that may support the summary provided. Quadruple Aim Nurse Burnout Assignment: Analysis of a Pertinent Healthcare Issue

The response explains how the healthcare issue/stressor is being addressed in other organizations that is vague or inaccurate.

0 
(0%)
 – 20 
(20%)

A vague and inaccurate summary of no outside resources reviewed on the national healthcare issue/stressor selected is provided, or is missing.

The response fails to integrate any resources to support the summary provided.

·   Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected and explain how they may impact your organization both positively and negatively. Be specific and provide examples.

27 
(27%)
 – 30 
(30%)

A complete, detailed, and accurate summary of the strategies used to address the organizational impact of the national healthcare issue/stressor is provided.

The response accurately and thoroughly explains in detail how the strategies may impact an organization both positively and negatively, with specific and accurate examples.

24 
(24%)
 – 26 
(26%)

An accurate summary of the strategies used to address the organizational impact of the national healthcare issue/stressor is provided.

The response explains how the strategies may impact an organization both positively and negatively. May include some specific examples.

21 
(21%)
 – 23 
(23%)

A vague or inaccurate summary of the strategies used to address the organizational impact of the national healthcare issue/stressor is provided.

The response explains how the strategies may impact an organization both positively and negatively that is vague or inaccurate. May include some vague or inaccurate examples.

0 
(0%)
 – 20 
(20%)

A vague and inaccurate summary of the strategies used to address the organizational impact of the national healthcare issue/stressor is provided, or is missing.

The response explains how the strategies may impact an organization both positively and negatively that is vague and inaccurate, or is missing. Does not include any examples.

Written Expression and Formatting – Paragraph Development and Organization:

Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.

5 
(5%)
 – 5 
(5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.

4 
(4%)
 – 4 
(4%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.

3.5 
(3.5%)
 – 3.5 
(3.5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.

Purpose, introduction, and conclusion of the assignment is vague or off topic.

Quadruple Aim Nurse Burnout Assignment: Analysis of a Pertinent Healthcare Issue

0 
(0%)
 – 3 
(3%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion was provided. Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 5  (5%)  – 5  (5%) Uses correct grammar, spelling, and punctuation with no errors. 4  (4%)  – 4  (4%) Contains a few (1 or 2) grammar, spelling, and punctuation errors. 3.5  (3.5%)  – 3.5  (3.5%) Contains several (3 or 4) grammar, spelling, and punctuation errors. 0  (0%)  – 3  (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. 5  (5%)  – 5  (5%) Uses correct APA format with no errors. 4  (4%)  – 4  (4%) Contains a few (1 or 2) APA format errors. 3.5  (3.5%)  – 3.5  (3.5%) Contains several (3 or 4) APA format errors. Quadruple Aim Nurse Burnout Assignment: Analysis of a Pertinent Healthcare Issue 0  (0%)  – 3  (3%) Contains many (≥ 5) APA format errors. Total Points: 100 Name: NURS_6053_Module01_Week02_Assignment_Rubric Quadruple Aim Nurse Burnout Assignment: Analysis of a Pertinent Healthcare Issue

NURS 6053 week 1 Discussion: Review of Current Healthcare Issues Discussion – Week 1

Main Post-

    In healthcare there are many healthcare issues and/or stressors that impact nearly everyone in some manner.  As

healthcare professionals, we deal with the impact of various healthcare issues and stressors everyday.  However, as

healthcare professionals, we are in a unique position to help identify healthcare issues and stressors and develop response strategies to these. NURS 6053 week 1 Discussion: Review of Current Healthcare Issue.

It can be seen that there is no shortage of healthcare issues and a need for change.  One healthcare issue of great

discussion currently that is impacting healthcare work settings is the COVID-19 pandemic. The COVID-19 pandemic has greatly impacted how we as a nation how we both receive and provide care.  The pandemic has greatly impacted how my organization provides care to those in our community, leading to the evaluation and change of many of our previous policies and processes.

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I work in a high-acuity CVICU-MSICU and as a unit to help prepare for the influx of patients related to the COVID-19 pandemic, we split our CVICU and MSICU to help prevent cross-contamination of non-COVID patients.  This change has caused increased stress, as we were moved to our old ICU unit which is extremely dated, lacks storage, room space and often necessary supplies and equipment to provide patient care.  According to Vahedian-Azimi, et al., (2017) stress has anegative impact on both nurses and patient outcomes; with a grater impact to those working in critical care areas.NURS 6053 week 1 Discussion: Review of Current Healthcare Issues

Another process change implemented in preparation was the deployment of nursing staff from areas affected by

restrictions implemented, to work in other areas such as the ICU to help combat increased patient volume and patient

shortages.  This has lead to added stress, due to taking non-ICU trained nurses and putting them in an unfamiliar

environment that they often lack the necessary skill-set to provide care to the critical care population.  To help combat this we have switched focus to a team or “pod nursing”. While staffing needs is a moving target, adopting team-based care and task shifting based on the principal of practicing at the top of license and education to help with the variance in skill-matrix to meet the needs of our patients (Pittman & Scully-Russ, 2016).

While the duration of the COVID-19 pandemic and the process changes associated with this is unknown, I feel that as a nation we are better prepared if something such as this occurs again.  I am also hopeful for our “new normal” and that there have been positive changes that have occurred, that we will continue to utilize on a daily basis even after the pandemic is over.

References

Pittman, P., & Scully-Russ, E. (2016). Workforce planning and development in times of delivery system transformation.
Human Resources for Health, 14
(56), 1–15. doi:10.1186/s12960-016-0154-3. Retrieved from https://human-resources-health.biomedcentral.com/track/pdf/10.1186/s12960-016-0154-3

Vahedian-Azimi, A., Hajiesmaeili, M., Kangasniemi, M., Fornes-Vives, J., Hunsucker, R. L., Rahimibashar, F., … Miller, A. C. (2017). Effects of Stress on Critical Care Nurses: A National Cross-Sectional Study. 
Journal of Intensive Care Medicine
, 
34
(4), 311–322. doi: 10.1177/0885066617696853

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Discussion: Review of Current Healthcare Issues

If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption?

These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.

In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.

To Prepare:

Review the Resources and select one current national healthcare issue/stressor to focus on.

Reflect on the current national healthcare issue/stressor you selected and think about how this issue/stressor may be addressed in your work setting.

By Day 3 of Week 1

Post
 a
description of the national healthcare issue/stressor
you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.

Discussion Week One

Laureate education (2015) states, that one thing that individuals and leaders can do to be prepared for healthcare challenges of the future is to develop cultural competency, gain skills to view multiple perspectives, and develop greater understanding the survival side of any healthcare organization. 
 
I can’t think of better wisdom while in the midst of the worldwide COVID-19 pandemic. 
 
This healthcare crisis has, for better or worse, brought out a side of healthcare that no one could have ever imagined. Everything from massive amounts of casualties all over the world to shortages on equipment, that just months ago were in abundant excess. Healthcare workers around the globe are learning new and creative ways to evaluate and treat patients. 
 
According to the Centers for Disease Control and Prevention (2020), the death toll in the United States as of this week is 88,243 people (Table 2).

In my work setting the dealing of this virus has been like receiving a slow-motion form of whip lash for the last three months. 
 
The initial shock of the virus instilled fear and out of fear came administrative decisions of great impact. 
 
With resources immediately being used and unavailable for reorder, special equipment had to be purchased to protect the staff. 
 
After shelter in place orders went out, people stopped coming into the hospitals and therefore the problems began. 
 
With outpatient day surgery being canceled, limited census on hospital floors, and spending what’s left of the budget on PPE stockpiles, money ran out quickly. 
 
Last week at my organization laid off 22 employees permanently and another 57 furloughed for a month. 
 

The American Hospital Association (2020),
 
stated
 
hospitals and health systems all over are facing catastrophic financial challenges in light of the COVID-19 pandemic (para 3). 
 
The impact of the virus has had a full circle effect; impacting every person sick and every person caring for the sick in different horrible ways. 
 
My organization guaranteed our pay from May 1
st
, 2020 to June 8
th
, 2020. 
 
After June 8
th
, the furloughs will begin. 
 
Another wonderful thing my organization did was protect us. 
 
Not one staff member from my hospital got the virus and I believe it is because they went over and above to protect the staff. 
 
I know the layoffs and furloughs are necessary for survival but seeing coworkers and friends being sent home is painful; opening my mind to the survival aspect of healthcare is necessary for my future in it. NURS 6053 week 1 Discussion: Review of Current Healthcare Issues

 

References

American Hospital Association. (2020). Hospital and health systems face unprecedented
 

financial pressures due to COVID-19. Retrieved June 2, 2020 from

https://www.aha.org/guidesreports/2020-05-05-hospitals-and-health-systems-face-unprecedented-financial-pressures-due

Centers for Disease Control and Prevention. (2020). Daily updates of totals by week and state.
 

Retrieved June 2, 2020 from,
 
https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm

Laureate Education (Producer). (2015). Leading in Healthcare Organizations of the Future

[Video file]. Baltimore, MD: Author.
 

By Day 6 of Week 1

Respond
 to at least 
two
 of your colleagues 
on two different days
who chose a different national healthcare issue/stressor than you selected. Explain how their chosen national healthcare issue/stressor may also impact your work setting and what (if anything) is being done to address the national healthcare issue/stressor.NURS 6053 week 1 Discussion: Review of Current Healthcare Issues

It is unfortunate how much impact the COVID-19 crisis has had on every single person in this country and across the world.  it has been very scary for health care providers especially nurse to provide direct care to patients.  with limited PPEs and personnel, nurses risk their lives each day when they step out to care for their patients.  Despite all these dedications, health care workers are laid off as a result of low patient Census.  I believe that there must be a system where jobs are protected for health care workers in any crisis.  the federal government needs to work with each state to ensure job protection for our health care workers.  Another important issue to address is that, there must be federal. state and local regulations that will mandate hospitals and other health care institutions to have surplus PPEs in stock to be used in times of crisis-at least 3 months supply of PPEs.  The federal and state government need to make provision of these PPEs to the various institutions.  Job security and availability of PPEs for health care workers is important especially during this time of uncertainties.

 

thank you for your post

Reference

Marshall, E., & Broome, M. (2017). Transformational leadership in Nursing: From Expert Clinician to Influential Leader (2
nd
 ed). New York, NY: Springer

 

True to your statement, the COV:ID-19 pandemic is affecting everyone, especially the healthcare workers. The healthcare settings are faced with increased exposure, stress and patient load. In addition to their human toll, epidemics and pandemics can have enormous social and economic consequences in a closely interconnected and interdependent world.

In a novel virus outbreak such as COVID-19, there is no existing antiviral drugs nor vaccine available. Police departments, local utility companies and mass transit authorities experience significant personnel shortages that result in severe disruption of routine services. Several major airports close because of high absenteeism among air traffic controllers and risk of passengers contracting the disease. Health and other essential community services deteriorate further as the pandemic sweeps across the world. NURS 6053 week 1 Discussion: Review of Current Healthcare Issues

As what you have stated, hospitals and outpatient clinics are critically short-staffed as doctors, nurses and other healthcare workers themselves become ill or are afraid to come to work. Intensive care units at local hospitals are overwhelmed, and soon there are insufficient ventilators for the treatment of viral complications such as pneumonia patients.

Fearing infection, elderly patients with chronic medical conditions do not dare to leave home. Parents are distraught when their healthy young adult sons and daughters die within days of first becoming ill.

Pandemics, whether mild, moderate or severe, affect a large proportion of the population and require a multisectoral response over several months or even years. For this reason, plans need to be developed by healthcare organizations describing strategies for responding to a pandemic supported by operational plans at the local, national and subnational levels. Great post!

 

Response.

I can totally relate to the feeling of uncertainty during COVID-19 early staffing days in the ICU.
 
I am cath lab nurse that frequently rotates in and out of the ED or ICU. 
 
Being sent back to the ICU while outpatient procedures were on hold and taking a team of med-surg nurses helping for the day was an overwhelming feeling. Laureate education (2015) states, that one thing that individuals and leaders can do to be prepared for healthcare challenges of the future is to develop cultural competency, gain skills to view multiple perspectives, and develop greater understanding the survival side of any healthcare organization. 
 
Having non-ICU trained RNs helping was a blessing and a curse, but all the while knowing that it was vital to the care of these patients. Now that we are on this side of COVID -19 I also feel, as you stated, more comfortable for the future should we be put in this position again, but the learning process was hard, and involved an extensive learning curve of trial and error. 
 
The stressors you talked about on nurses directly effecting patient care is now the situation we have found ourselves in at my organization. 
 
Everyone is exhaling a bit now that the virus is seeming to be on the decline. 
 
The scary and stress filled portion of that is nurses are now losing their jobs due to poor organizational leadership of organizations or that there just aren’t enough people to be taken care of right now coming into the hospital. 
 
I think it is safe to say that there is not one aspect of patient care or one healthcare worker around the globe that hasn’t been touched by this virus! Thanks for sharing your post, it was a great read!

-Kelly
 

References

American Hospital Association. (2020). Hospital and health systems face unprecedented
 

financial pressures due to COVID-19. Retrieved June 6, 2020 from

https://www.aha.org/guidesreports/2020-05-05-hospitals-and-health-systems-face-unprecedented-financial-pressures-due

Laureate Education (Producer). (2015). Leading in Healthcare Organizations of the Future

[Video file]. Baltimore, MD: Author. NURS 6053 week 1 Discussion: Review of Current Healthcare Issues

Discussion – Week 1 -COVID-19 NURS 6053 national healthcare issue/stressor discussion

A national healthcare issue that immediately comes to mind is the ongoing battle against COVID-19. As states across the country (and countries across the world) entered into various versions of lockdown and stay-at-home orders, medical facilities were also impacted by more than simply treated patients. The entire hospital healthcare plan had to be reevaluated, reassessed, and many aspects of daily operations were impacted. Analyzing who was most at risk, the populations such as the elderly and those with compounding comorbidities was first in-line in assessing how the hospital would interact with and protect these individuals (Long, Vo, & Vuong, 2020). COVID-19 NURS 6053 national healthcare issue/stressor discussion. At the same time, another, perhaps more immediate problem were hospitals being overwhelmed by the sheer volume of patients, the need (and lack of) adequate personal protective equipment, and equipment and staffing shortages (Long, Vo, & Vuong 2020).

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For the hospital I work for in particular, I am an Emergency Room Nurse, and as COVID-19 cases began to arrive in our area, there was an overwhelming rush of individuals to our hospital. It didn’t take long for the hospital to realize that we had a major nursing shortage in the ER. While there were other nurses on furlough or shortened hours in other departments, the ER was in a constant state of need. As the volume of patients flooded the emergency room doors, it did not take long to realize the shortage of nurses. Before COVID-19 the hospital system I work for joined a national movement toward seeking higher educated nurses- requiring all nursing staff to obtain their BSN (if they only had their RN) within five years or be terminated (regardless of years of service). Many of those with more than 20 years experience retired, others shifted career fields, or some simply went to other networks that did not have the same requirements. The push for a higher educated staff is not new as is stated in Gerardi, Farmer, and Hoffman (2018); however, this push for higher standards also came at a price in losing experienced and knowledgeable staff that our department, and those across the health care system have acutely felt during this pandemic. COVID-19 NURS 6053 national healthcare issue/stressor discussion

The department I work for has tried to manage patient care through not allowing any visitors, if it is a pediatric patient (only one parent at a time), COVID-19 positive patients are placed in isolation rooms with negative pressure, we are given one set of PPE to last us the entire time however, and that has caused a significant amount of controversy as to why we are not able to have adequate equipment. Our ER has hired traveling nurse practitioners (increase need for provider services) nurses, new graduates, and is offering many paid overtime shifts to current staff (Auebach, Staiger, & Buerhaus 2018). We are screened every day about arrival and must document all of our interactions with COVID-19 patients. COVID-19 will not be leaving anytime soon however; and the hospital and health care system as a whole will need to continue to adapt as we work through the months to come. COVID-19 NURS 6053 national healthcare issue/stressor discussion

References

Auerbach, D. I., D. O., & Buerhaus, P. I. (2018). Growing ranks of advanced practice clinicians-

Implications for the physician workforce.
New England Journal of Medicine, 378
(25),

2358-2360.
doi:10.1056/NEJMp181869

Gerardi, T., Farmer, P., & Hoffman, B. (2018). Moving closer to the 2020 BSN workforce goal.
American Journal of Nursing
, 118(2), 43-45
. doi:10.1097/01.NAJ.0000530244.15217.aa

 

Thanh-Long, G., Dinh-Tri Vo., & Quan-Hoang Vuong, (2020). COVID-19: A relook at

Healthcare system and aged populations. Sustainability, 12 (10), 4200.

doi:http://dx.doi.org.ezproxy.gardner-webb,edu/10.3390/su12104200

 

Response

Great insights, True to your statements, with the advent of the COVID-19 pandemic and the volume of patients flooding not only the ER but the great number of hospitals in the health care system,  it did not take long to realize the on-going issue of shortage of nurses.

The Registered Nurse Safe Staffing Act of 2013 (H.R. 1821) has been introduced by the ANA to Congress last May 8, 2013 which empowers registered nurses (RNs) to drive staffing and scheduling decisions in hospitals and, consequently, protect patients and improve the quality of care.

Staffing has a direct impact on patient safety. Research has shown that inadequate nurse-patient ratios are linked to higher rates of patient falls, injuries, infections, medications, and even death. Determining the appropriate number and mix of nursing staff is critical to the delivery of quality patient care and positive outcomes.

In addition, as what you have stated,  the lack of healthcare providers directly impacts the care able to be given and the quality of life of many patients. The addition of nurse practitioners and physician assistants to the workforce is certainly a viable partial solution.

Likewise, poor management could result to rapid turn-over of staff and contributory to the rapid turnover of staff are pay and benefits, workload and poor relationship with other staff due to intergenerational gap.

The push for a higher educated staff is not new, however, everyone it is a common fact that understaffing is not caused by non-enrollment of nursing students, rather, there is also an existing problem of lack of faculty to teach in the nursing schools because of low wages as compared to the nurses working in clinical practice.

The value hospitals place on their people will have a direct correlation to their commitment, confidence and engagement. Therefore, leaders and managers must enhance the organizational culture and develop orientation programs, provide availability of resources, promote camaraderie empowerment and autonomy among the staff and reinforce these values that are critical to encourage staff’s retention. COVID-19 NURS 6053 national healthcare issue/stressor discussion

True to your statements, the organizational management and nursing leaders need to create ways and means in promoting adequate staffing and scheduling, promoting staff accountability and collaboration among the team, uplift the organizational culture, and enhance autonomy and empowerment among frontline staff to ensure safe quality care of patients. Great post!

 

Response

Great post Marie, I agree I think nobody was prepared for this pandemic nor do I think we are prepared for a second wave either any time soon. I remember thinking it this pandemic will not come to US and if it does we have the resources and supplies to be able to defeat it but I was wrong. The stress of nursing shortage was so bad that I remember when I was working five or six days a week in the ICU. We all know the stress of ICU without a pandemic. The rapid acceleration of transmission, and the lack of preparedness to prevent and treat this virus, the negative impacts of COVID-19 are rippling through every facet of society (Brown & Horesh, 2020). Hospitals did try to accommodate all the patients but it was too much. We did not have enough negative pressure rooms nor did we have enough PPEs, Everything they used to teach us about the spread of infection and PPEs did not apply. Staff would re-use PPEs and N95s because of the shortage. A critical shortage of all of gloves, face masks, air-purifying respirators, goggles, face shields, respirators, and gowns is projected to develop or has already developed in areas of high demand (Desai & Livingston, 2020). COVID-19 NURS 6053 national healthcare issue/stressor discussion

References

Brown, A., & Horesh, D., (2020). Traumatic stress in the age of COVID-19: A call to close

critical gaps and adapt to new realities. Psychological Trauma: Theory, Research,

Practice, and Policy, 12(4), 331–335. COVID-19 NURS 6053 national healthcare issue/stressor discussion

https://doi-org.ezp.waldenulibrary.org/10.1037/tra0000592

Desai A., & Livingston, E., (2020). Sourcing Personal Protective Equipment During the

COVID-19 Pandemic. 
JAMA.
 2020; 323(19):1912–1914. doi:10.1001/jama.2020.5317

 

 

Discussion: Review of Current Healthcare Issues

If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption?

These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.

In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.

To Prepare:

Review the Resources and select one current national healthcare issue/stressor to focus on.

Reflect on the current national healthcare issue/stressor you selected and think about how this issue/stressor may be addressed in your work setting.

By Day 3 of Week 1

Post
 a description of the national healthcare issue/stressor you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.

By Day 6 of Week 1

Respond
 to at least 
two
 of your colleagues 
on two different days
 who chose a different national healthcare issue/stressor than you selected. Explain how their chosen national healthcare issue/stressor may also impact your work setting and what (if anything) is being done to address the national healthcare issue/stressor.

 

NURS_6053_Module01_Week01_Discussion_Rubric

Grid View

List View

Excellent

Good

Fair

Poor

Main Posting

45 
(45%)
 – 50 
(50%)

Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

Supported by at least three current, credible sources.

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

40 
(40%)
 – 44 
(44%)

Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

At least 75% of post has exceptional depth and breadth.

Supported by at least three credible sources.

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.

35 
(35%)
 – 39 
(39%)

Responds to some of the discussion question(s).

One or two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with two credible sources.

Written somewhat concisely; may contain more than two spelling or grammatical errors.

Contains some APA formatting errors.

0 
(0%)
 – 34 
(34%)

Does not respond to the discussion question(s) adequately.

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible sources.

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.

Main Post: Timeliness

10 
(10%)
 – 10 
(10%)

Posts main post by day 3.

0 
(0%)
 – 0 
(0%)

0 
(0%)
 – 0 
(0%)

0 
(0%)
 – 0 
(0%)

Does not post by day 3.

First Response

17 
(17%)
 – 18 
(18%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.

15 
(15%)
 – 16 
(16%)

Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

13 
(13%)
 – 14 
(14%)

Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

0 
(0%)
 – 12 
(12%)

Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.

Second Response

16 
(16%)
 – 17 
(17%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues.

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.

14 
(14%)
 – 15 
(15%)

Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

12 
(12%)
 – 13 
(13%)

Response is on topic and may have some depth. COVID-19 NURS 6053 national healthcare issue/stressor discussion

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.

0 
(0%)
 – 11 
(11%)

Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.

Participation

5 
(5%)
 – 5 
(5%)

Meets requirements for participation by posting on three different days.

0 
(0%)
 – 0 
(0%)

0 
(0%)
 – 0 
(0%)

0 
(0%)
 – 0 
(0%)

Does not meet requirements for participation by posting on 3 different days.

Total Points: 100

Name: NURS_6053_Module01_Week01_Discussion_Rubric COVID-19 NURS 6053 national healthcare issue/stressor discussion

: Discussion – Week 1
NURS 6053 national healthcare issue/stressor

There is a higher level of physical, emotional, and mental stress associated with critical care areas of healthcare. The work demand in critical care areas such as intensive care or post-anesthesia care units directly affects the overall well-being of individuals who work in these areas NURS 6053 national healthcare issue/stressor. A major healthcare stressor that has severely heighten the stress level in these areas is the current Coronavirus pandemic. Covid-19 has made working in critical care areas the most stressful it has been in decades past. Stress negatively impacts nurses and patient outcomes; however, those practicing in critical care areas experience high levels of burnout and other negative health issues (Vahedian-Azimi, et al., 2017).

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I currently work in the second busiest intensive care unit in the state of Maryland. Covid-19 has increased the work-related stress level on the unit tenfold. Covid-19 has caused a rapid spike in individuals admitted to the ICU, increasing the workload of all members on the unit, especially nurses. Covid-19 has had a devastating impact on the unit with increased negative patient outcomes, unsafe working conditions, and even dire staffing issues. Since the beginning of the year, the unit has had five different unit managers, three different directors, and within the past couple months, a significant loss of staff, including fatality. NURS 6053 national healthcare issue/stressor Obesity, cardiovascular disease, decreased mental health, emotional exhaustion, anxiety, and depression are all linked to work-related stress (Alenezi, Aboshaiqah, & Baker, 2018). Each of these work-related stresses has been noticeable throughout the entire unit.

The healthcare system has responded to the current healthcare issue/stressor by implementing new infection control protocols. The new protocols include increased hand cleansing stations as well as shutting off visitation privileges to family members. Furthermore, they have designated areas for donning and doffing all PPE. Lastly, the hospital has created three aromatherapy rooms for staff to utilize when feeling overwhelmed. The rooms are filled with soothing sounds and an array of aromas to help with stress management. Aromatherapy may contribute to a healthy work environment and decrease nurse anxiety associated with occupational stress (Donaldson, Ingrao, & Ocampo, 2017) NURS 6053 national healthcare issue/stressor.

 

References

Alenezi, A. M., Aboshaiqah, A., & Baker, O. (2018). Work‐related stress among nursing staff working in government hospitals and primary health care centres. 
International Journal of Nursing Practice
, 
24
(5). doi: 10.1111/ijn.12676

Donaldson, J., Ingrao, C., Drake, D., & Ocampo, E. (2017). The Effect of Aromatherapy on Anxiety Experienced by Hospital Nurses. 
Medsurg Nursing
, 
26
(3).

Vahedian-Azimi, A., Hajiesmaeili, M., Kangasniemi, M., Fornes-Vives, J., Hunsucker, R. L., Rahimibashar, F., … Miller, A. C. (2017). Effects of Stress on Critical Care Nurses: A National Cross-Sectional Study. 
Journal of Intensive Care Medicine
, 
34
(4), 311–322. doi: 10.1177/0885066617696853

responses

When the World Health Organization (WHO) reported the COVID-19 pandemic in January 2020 it seemed like the bottom fell out everywhere (Long, Vo, and Vuong, 2020). If you were like me, you found yourself exhausted and baffled about what was happening around you and quickly realized that the ever-increasing talk about nursing shortages was in fact true. What has happened to the nursing field of health care workers? What once was a traditional life-long career is now seen as an end to a mean- to spend a year or two in a hospital setting for experience and then continue one’s education to be a Nurse Practitioner, or Doctor of Nurse Practitioner, or leave the field all together (Palumbo, Rambur & Hart 2017). NURS 6053 national healthcare issue/stressor

In the second largest ICU in Maryland I cannot imagine the impact of patients that came through the ICU and that are still coming into the ICU setting. One must look at what causes the shortage of nurses on a larger scale as well as on a local scale; is management effective at a system or site-specific hospital, how is the direct leadership within that department; are there other hospitals or areas with better pay or benefits, (Pittman, & Russ 2016). NURS 6053 national healthcare issue/stressor In the end I think the larger questions are what factors contribute to the nursing shortage crisis and how can we address these factors?

 

References

 

 

Palumbo, M., Rambur, B., & Hart, V. (2017). Is health care payment reform impacting nurses’                work settings, roles, and education preparation?
Journal of Professional Nursing, 33
(6),           400-404.
doi:10.1016/j.profnurs.2016.11.005

 

Pittman, P., & Scully-Russ, E. (2016). Workforce planning and development in times of delivery                            system transformation. Human Resources for Health, 14(56), 1-15. Doi:10.1186/s12960-                             016-0154-3. Retrieved from
https://human-resources-health.biomedcentral.com/track/
                               
pdf/10.1186/s12960-016-0154-3

 

Thanh-Long, G., Dinh-Tri Vo., & Quan-Hoang Vuong, (2020). COVID-19: A relook at

Healthcare system and aged populations. Sustainability, 12 (10), 4200.

doi:http://dx.doi.org.ezproxy.gardner-webb,edu/10.3390/su12104200

I agree with your post regarding critical care nursing  and the stress and emotional trauma it creates for nurses. This already stressful arena was exacerbated with the COVID-19 pandemic. As you related in your post, nurses were put under significant amount of added stress in addition the stress we already faced on a daily basis. The Quadruple Aim in Healthcare was launched to take care of the provider, well before the COVID-19 pandemic. It was recognized years ago that there was a significant need to take care of the provider. With the additional stress faced by health care workers today, the American Nurses Association (ANA) launched the well-being initiative for nurses to help manage and overcome the stress of COVID-19. It is important that we take care of ourselves and each other. There are many resources available to nurses and healthcare workers to seek help to deal with the trauma and stress that we have been facing. NURS 6053 national healthcare issue/stressor

American Nurses Association. (2019, May 19).  
American Nurses Foundation Launches National Well-being Initiative for Nurses
. Retrieved June 4, 2020, from https://www.nursingworld.org/news/news-releases/2020/american-nurses-foundation-launches-national-well-being-initiative-for-nurses/

Bodenheimer, T., Sinsky, C. (2014). From triple to Quadruple Aim: Care of the patient requires care of the provider. 
Annuals of Family Medicine, 12
(6), 573-576. DOI: 10.1370/afm.171

 

Discussion: Review of Current Healthcare Issues

If you were to ask 10 people what they believe to be the most significant issue facing healthcare today, you might get 10 different answers. Escalating costs? Regulation? Technology disruption? NURS 6053 national healthcare issue/stressor

These and many other topics are worthy of discussion. Not surprisingly, much has been said in the research, within the profession, and in the news about these topics. Whether they are issues of finance, quality, workload, or outcomes, there is no shortage of changes to be addressed.

In this Discussion, you examine a national healthcare issue and consider how that issue may impact your work setting. You also analyze how your organization has responded to this issue.

To Prepare:

Review the Resources and select one current national healthcare issue/stressor to focus on.

Reflect on the current national healthcare issue/stressor you selected and think about how this issue/stressor may be addressed in your work setting. NURS 6053 national healthcare issue/stressor

By Day 3 of Week 1

Post
 a
description of the national healthcare issue/stressor
you selected for analysis, and explain how the healthcare issue/stressor may impact your work setting. Then, describe how your health system work setting has responded to the healthcare issue/stressor, including a description of what changes may have been implemented. Be specific and provide examples.

By Day 6 of Week 1

Respond
 to at least 
two
 of your colleagues 
on two different days
who chose a different national healthcare issue/stressor than you selected. Explain how their chosen national healthcare issue/stressor may also impact your work setting and what (if anything) is being done to address the national healthcare issue/stressor. NURS 6053 national healthcare issue/stressor

 

Response

I could not agree more with you that the COVID-19 pandemic has shaken the United States healthcare system to its core.
NURS 6053 national healthcare issue/stressor.
Everything about healthcare practice has changed and I don’t think there is one healthcare worker in the entire world that could say that it hasn’t affected some part of their practice. 
 
According to the Centers for Disease Control and Prevention (2020), the death toll in the United States as of this week is 88,243 people (Table 2). 
 
We have never seen such great loss in one year with one illness in such a short amount of time. 
 
It’s not only the virus itself that is causing stress and early burnout among the healthcare staff, it’s also the overall worry about job security. 
 
The American Hospital Association (2020),
 
stated
 
hospitals and health systems all over are facing catastrophic financial challenges in light of the COVID-19 pandemic (para 3). 
 
This healthcare crisis has, for better or worse, brought out a side of healthcare that no one could have ever imagined. 
 
It sounds like your hospital has a good thing going by providing an area of escape and peace! I am hoping you have been utilizing that resource and that you are staying well and safe while on shift! 
 
Thanks for your post, I enjoyed reading it!
NURS 6053 national healthcare issue/stressor

Resources

American Hospital Association. (2020). Hospital and health systems face unprecedented
 

financial pressures due to COVID-19. Retrieved June 4, 2020 from

https://www.aha.org/guidesreports/2020-05-05-hospitals-and-health-systems-face-unprecedented-financial-pressures-due

Centers for Disease Control and Prevention. (2020). Daily updates of totals by week and state.
 

https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm
Retrieved June 4, 2020 from,
NURS 6053 national healthcare issue/stressor

Acute Kidney Transplant Rejection (AKTR) immunosuppression Essay- NURS 6501 Module 1 Assignment: Case Study Analysis

Introduction

The kidneys are vital organs in humans. They help filter and excrete waste products from the body, remove excess fluid from the body and helps the body maintain homeostasis by regulating acid-base balance as well as fluid and electrolytes (National Institute of Diabetes and Digestive and Kidney Diseases, 2018). Loss of kidney function can alter many essential functions in the body, as seen in patients with kidney failure. End-stage renal disease (ESRD) is the final stage of Chronic Kidney Disease (CKD), resulting in kidneys that cannot independently perform its functions. Many conditions can lead to chronic kidney disease development, some of which include heart disease, hypertension, inflammation, diabetes, and hereditary traits, or some genetic disorders (John Hopkins Medicine, 2018). The treatment options for ESRD are dialysis or a kidney transplant. The purpose of this paper is to analyze a case study of a 34-year-old man diagnosed with Acute Kidney Transplant Rejection (AKTR), to understand the symptoms he presented, and the genes associated with his diagnosis. The paper would also include an analysis of the process of immunosuppression and its effect on body systems.Acute Kidney Transplant Rejection (AKTR) immunosuppression Essay- NURS 6501 Module 1 Assignment: Case Study Analysis. Acute Kidney Transplant Rejection (AKTR) immunosuppression Essay- NURS 6501 Module 1 Assignment: Case Study Analysis.

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Analysis of Diagnosis and its Symptoms

The treatment options for ESRD are dialysis and kidney transplants, and both have benefits and risks associated with them. Kidney transplant as a treatment choice for ESRD may be more appealing to some individuals as opposed to committing to a lifetime of dialysis. However, kidney transplants may have some serious complications, such as AKTR. AKTR is an immune response in which the body attacks the new kidneys like it was a pathogen or foreign substance causing damage or failure of the new kidney. Before a kidney transplant is done, both donor and recipient undergo a series of compatibility tests to prevent a hyperacute rejection, which may happen minutes after surgery (Naik, & Shawar, 2020). However, kidney rejection could still occur at any time, although the chances decrease with time, an AKTR can occur between days to months following surgery for various reasons.

In this scenario, the individual exhibited weight gain, decreased urine output, fatigue, and

fever; these are typical symptoms of AKTR which the subject experienced about six months after receiving a kidney transplant from a cadaver donor. According to Naik and Shawar (2020), there is an increased chance of rejection when receiving a kidney transplant from a cadaver donor. The authors also indicated other causes such as younger recipients, history of rejection, and inadequate immunosuppression, among others, might increase the chances of rejection post-transplant. Other symptoms of AKTR includes pain and tenderness around the kidney, flu-like symptoms including chills, headaches, elevated serum creatinine levels and nausea and vomiting (National Institute of Medicine, 2019). Another possible reason why the patient experienced symptoms of acute kidney transplant rejection is non-adherence and antibody-mediated rejection (Hucker et al.,2017).Acute Kidney Transplant Rejection (AKTR) immunosuppression Essay- NURS 6501 Module 1 Assignment: Case Study Analysis.

Gene Associated with the Condition

ESRD is the last phase of chronic disease. It is often caused by underlying conditions that may be inherited, such as diabetes and hypertension, which are the two leading causes of chronic kidney disease (Centers for Disease Control and Prevention, 2019). Some genetic diseases can

also directly or indirectly lead to Chronic kidney disease and, subsequently, ESRD, for example, conditions like nephronophthisis, autosomal dominant polycystic kidney disease (ADPKD), lowe syndrome, amongst others (The University of Michigan, n.d.). ADPKD occurs as a result of an

inherited abnormal mutation in polycystin, a kidney protein causing kidney problems that could lead to kidney failure even at birth (UNC kidney Center, 2019). a study by Canadas-Garre et al. (2019), indicated a link between shorter telomere and renal dysfunction or the progression of CKD. Abnormalities such as shorter telomer at birth are inherited due to abnormal genetic mutation of DNA predisposes individuals to certain disease conditions, for example, cardiovascular disease. Kidney transplant and how an individual’s body reacts to the new kidneys can be dependent on some genetic traits, for example, Human Leukocyte Antigen (HLA) compatibility between donor and recipient is more favorable with kidney transplant, decreasing the chances for AKTR (Dorr, Oetting, Jacobson, & Israni, 2018). The authors also indicated that high metabolic rates of immunosuppressants in the blood have been linked to an increased risk of having acute rejection.

Immunosuppression and its Effect on the Body

Immunosuppression is a term used to describe the suppression of the body’s immune system and its ability to defend the body against infection (National Cancer Institute, n.d.). Immunosuppression may be due to several disease conditions, genetics, or even medications such as steroids, immunosuppressants, and cancer medications. Immunosuppression therapy

is commonly used to decrease the immune response after organ transplantation to prevent transplant rejection; it can also be used in other conditions such as autoimmune disorders such as rheumatoid arthritis. The immune system is programmed to identify and attack pathogens and foreign bodies that gain entrance to the body (McCance & Huether, 2019). Immunosuppressants work by either inhibiting calcineurin, thereby preventing T cells from activating cytokines or by inhibiting the proliferation of T cells, thereby suppressing the immune response.

Immunosuppression related to genetics or medications generally affects the body by decreasing its immune functions and making it more susceptible to infections and cancer. However, immunosuppression also affects other systems in the body, for example, cardiovascular, respiratory, musculoskeletal, genitourinary, and central nervous systems. They affect the cardiovascular system by causing hypertension and altering the normal functions of blood vessels, which may lead to other cardiovascular diseases, affects the musculoskeletal system causing osteoporosis. It also affects the respiratory system leaving the individual susceptible to many respiratory infections, including tuberculosis (Hucker et al.,2017). Immunosuppression also affects the metabolic functions of the body, causing weight gain, and new-onset diabetes mellitus type 1 or worsening of already present diabetes (Hucker et al.,2017).

Conclusion

Genetics is a crucial aspect of medicine; over time, the study of genetics has been improved, helping clinicians have a better understanding of diagnosis and treatment of disease conditions. Kidney transplants’ success depends on the prevention of AKTR and kidney failure, among other complications. Transplant patients should be monitored closely to assess the effectiveness of immunosuppression therapy, adjust them as needed, and quickly identify symptoms indicating rejection for early intervention. Acute Kidney Transplant Rejection (AKTR) immunosuppression Essay- NURS 6501 Module 1 Assignment: Case Study Analysis. Acute Kidney Transplant Rejection (AKTR) immunosuppression Essay- NURS 6501 Module 1 Assignment: Case Study Analysis

 

 

 

 

References

Canadas-Garre, M., Anderson, K., Cappa, R., Skelly, R., Smyth, L. J., Mcknight, A. J., & Maxwell, A. P. (2019). Genetic Susceptibility to Chronic Kidney Disease – Some More Pieces for the Heritability Puzzle. Retrieved from
https://www.frontiersin.org/articles/10.3389/fgene.2019.00453/full

Centers for Disease Control and Prevention. (2019). Chronic kidney disease initiative. Retrieved from 
https://www.cdc.gov/kidneydisease/publications-resources/2019-national-facts.html

Dorr, C. R., Oetting, W. S., Jacobson, P. A., & Israni, A. K. (2018). Genetics of acute rejection after kidney transplantation. 
Transplant international: official journal of the European Society for Organ Transplantation
, 
31
(3), 263–277.
https://doi.org/10.1111/tri.13084

Hucker, A., Frances, B. Carpenter, L., Lawrence C., Farrington, K., & Sharma, S. (2017). Non-adherence to immunosuppressants following renal transplantation: a protocol for a systematic review.
BMJ Open 7
(9). Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5640118/

John Hopkins Medicine (2018). End-stage Renal Disease (ESRD). Retrieved from
https://www.hopkinsmedicine.org/health/conditions-and-diseases/end-stage-renal-failure

McCance, K. L. & Huether, S. E. (2019).
Pathophysiology: The biologic basis for disease in adults and children
(8th ed.). St. Louis, MO: Mosby/Elsevier.

Naik, R. & Shawar, S. H. (2020). Renal transplant rejection. Retrieved from
https://www.ncbi.nlm.nih.gov/books/NBK553074/

National Cancer Institute. (n.d.). NCI Dictionary of Cancer Terms. Retrieved from
https://www.cancer.gov/publications/dictionaries/cancer-terms/def/immunosuppression

National Institute of Diabetes and Digestive and Kidney Diseases (2018). Your kidneys and how they work. U.S. Department of Health and Human Services. Retrieved from

https://www.niddk.nih.gov/health-information/kidney-disease/kidneys-how-they-work

National Institute of Medicine. (2019). Transplant rejection. U.S. National Library of Medicine. Retrieved from
https://medlineplus.gov/ency/article/000815.htm

The University of Michigan (n.d.). Inherited kidney conditions. Retrieved from 
https://www.uofmhealth.org/conditions-treatments/kidney/inherited-kidney-conditions

UNC Kidney center, (2019). Genetics and kidney disease. Retrieved from 
https://unckidneycenter.org/kidneyhealthlibrary/genetics-kidney-disease-1/

 

Module 1 Assignment: Case Study Analysis

An understanding of cells and cell behavior is a critically important component of disease diagnosis and treatment. But some diseases can be complex in nature, with a variety of factors and circumstances impacting their emergence and severity.

Effective disease analysis often requires an understanding that goes beyond isolated cell behavior. Genes, the environments in which cell processes operate, the impact of patient characteristics, and racial and ethnic variables all can have an important impact.

Photo Credit: Getty Images/Hero Images

An understanding of the signals and symptoms of alterations in cellular processes is a critical step in the diagnosis and treatment of many diseases. For APRNs, this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify cell, gene, and/or process elements that may be factors in the diagnosis, and you explain the implications to patient health. Acute Kidney Transplant Rejection (AKTR) immunosuppression Essay- NURS 6501 Module 1 Assignment: Case Study Analysis.

To prepare:

By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

The Assignment (1- to 2-page case study analysis)

Develop a 1- to 2-page case study analysis in which you:

Explain why you think the patient presented the symptoms described.

Identify the genes that may be associated with the development of the disease.

Acute Kidney Transplant Rejection (AKTR) immunosuppression Essay- NURS 6501 Module 1 Assignment: Case Study Analysis

Explain the process of immunosuppression and the effect it has on body systems.

By Day 7 of Week 2

Submit
 your Case Study Analysis Assignment 
by Day 7 of Week 2
.

Reminder: 
The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at 
https://academicguides.waldenu.edu/writingcenter/templates
). All papers submitted must use this formatting.

 

Case Study_Assignment_Rubric

Grid View

List View

Excellent

Good

Fair

Poor

Develop a 1- to 2-page case study analysis, examining the patient symptoms presented in the case study. Be sure to address the following:

Explain why you think the patient presented the symptoms described.

28 
(28%)
 – 30 
(30%)

The response accurately and thoroughly describes the patient symptoms.

The response includes accurate, clear, and detailed reasons, with explanation for the symptoms supported by evidence and/or research, as appropriate, to support the explanation.

25 
(25%)
 – 27 
(27%)

The response describes the patient symptoms.

The response includes accurate reasons, with explanation for the symptoms supported by evidence and/or research, as appropriate, to support the explanation.

23 
(23%)
 – 24 
(24%)

The response describes the patient symptoms in a manner that is vague or inaccurate. Acute Kidney Transplant Rejection (AKTR) immunosuppression Essay- NURS 6501 Module 1 Assignment: Case Study Analysis

The response includes reasons for the symptoms, with explanations that are vague or based on inappropriate evidence/research.

0 
(0%)
 – 22 
(22%)

The response describes the patient symptoms in a manner that is vague and inaccurate, or the description is missing.

The response does not include reasons for the symptoms, or the explanations are vague or based on inappropriate or no evidence/research.

Identify the genes that may be associated with the development of the disease.

23 
(23%)
 – 25 
(25%)

The response includes an accurate, complete, detailed, and specific analysis of the genes that may be associated with the development of the disease.

20 
(20%)
 – 22 
(22%)

The response includes an accurate analysis of the genes that may be associated with the development of the disease.

18 
(18%)
 – 19 
(19%)

The response includes a vague or inaccurate analysis of the genes that may be associated with the development of the disease.

0 
(0%)
 – 17 
(17%)

The response includes a vague or inaccurate analysis of the genes that may be associated with the development of the disease is missing.

Explain the process of immunosuppression and the effect it has on body systems.

28 
(28%)
 – 30 
(30%)

The response includes an accurate, complete, detailed, and specific explanation of the process of immunosuppression and the effect it has on body systems.

25 
(25%)
 – 27 
(27%)

The response includes an accurate explanation of the process of immunosuppression and the effect it has on body systems.

23 
(23%)
 – 24 
(24%)

The response includes a vague or inaccurate explanation of the process of immunosuppression and the effect it has on body systems.

0 
(0%)
 – 17 
(17%)

The response includes a vague or inaccurate explanation of the process of immunosuppression and the effect it has on body systems.

Written Expression and Formatting – Paragraph Development and Organization:

Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.

5 
(5%)
 – 5 
(5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.

4 
(4%)
 – 4 
(4%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.

3 
(3%)
 – 3 
(3%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.

Purpose, introduction, and conclusion of the assignment are vague or off topic.

0 
(0%)
 – 2 
(2%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided. Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation 5  (5%)  – 5  (5%) Uses correct grammar, spelling, and punctuation with no errors. 4  (4%)  – 4  (4%) Contains a few (1 or 2) grammar, spelling, and punctuation errors. 3  (3%)  – 3  (3%) Contains several (3 or 4) grammar, spelling, and punctuation errors. Acute Kidney Transplant Rejection (AKTR) immunosuppression Essay- NURS 6501 Module 1 Assignment: Case Study Analysis 0  (0%)  – 2  (2%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list. 5  (5%)  – 5  (5%) Uses correct APA format with no errors. 4  (4%)  – 4  (4%) Contains a few (1 or 2) APA format errors. 3  (3%)  – 3  (3%) Contains several (3 or 4) APA format errors. 0  (0%)  – 2  (2%) Contains many (≥ 5) APA format errors. Total Points: 100 Acute Kidney Transplant Rejection (AKTR) immunosuppression Essay- NURS 6501 Module 1 Assignment: Case Study Analysis

Streptococcal pharyngitis (Strep Throat) Alterations in Cellular Processes Discussion Essay

The assigned case study is a 16y.o. male presenting with sore throat and low grade fever. There are two separate conditions or events to describe.  The patient presents with a red pharynx, enlarged tonsils, white patches, enlarged cervical lymph nodes, and low grade fever.  There are differential diagnoses, but for describing the pathophysiology, I will describe the body’s reaction to bacterial pharyngitis, specifically strep throat. Streptococcal pharyngitis (Strep Throat) Alterations in Cellular Processes Discussion Essay. The patient is exhibiting an inflammatory response to a foreign substance that has made it past one of the first lines of defense. In the case that I am describing, a bacterial agent such as group A beta hemolytic streptococcus (
Streptococcus pyogenes
) may likely be the causative agent.  Findings common with this infection are the presence of tonsillar exudate, erythema, and fever (Ebell et al., 2000). Initial, non-specific attempts are made to kill the foreign matter such as mucus secretions, and proteins produced by the epithelial tissue in the pharynx. The streptococci have survived and multiplied to a point that the immune system is launching an inflammatory response. Streptococcal pharyngitis (Strep Throat) Alterations in Cellular Processes Discussion Essay

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The bacterial microbes are now present in the tissue of the pharynx and initial immune response begins with mast cells, as well as damage to normal cells in the affected tissue. Mast cells release histamine which causes blood vessels to dilate and become somewhat permeable as the endothelial cells on the vessels separate slightly.  Plasma will leak out into the surrounding tissue. This results in edema.  The dilation of the vessels and exit of proteins and other solutes creates the red engorged appearance in the throat. The engorgement, edema, and the prostaglandin chemical mediator result in pain. Phagocytes arrive and will engulf and eliminate microbes indiscriminately. Neutrophils have also been signaled, and will enter the area from the now permeable blood vessels. As the neutrophils destroy microbes, they break down and the dead cell matter and other molecules create collections of waste material that present as pus. In the case of our patient, we see these collections as white patches or pockets on the throat. These actions are non-specific to the type of antigen. Streptococcal pharyngitis (Strep Throat) Alterations in Cellular Processes Discussion Essay

While the non-specific processes are taking place, dendritic cells which were present along with the mast cells at the beginning of the response are also destroying the bacterial microbes. Dendritic cells break down microbe and determine if bacteria or virus. Proteins from the microbe adhere to the cell wall. If bacteria, dendritic cell travels to lymph gland to activate T cell response. The proteins on the dendritic cell surface will match up and attach to specific T cells. When one of these helper T cells is activated it quickly begins to reproduce. Some of the resulting cells stay in the lymph node and become memory T cells waiting for an attack at some point in the future. They also go to center of the node and activate B cell which begins antibody production. Antibodies travel to the area of infection and bind to surface of bacteria. Once bound by the antibodies, the bacteria are targets for macrophages, resulting in more phagocytosis. Lymph nodes in the neck as well as the tonsils have become enlarged as they hold newly created T cells as well as waste that will be eliminated by the lymphatic system. The patient’s fever, although considered low grade, is most likely related to endotoxins from damaged tissue or destroyed bacteria, or from an interleukin (IL-1) released by white blood cells and causing the hypothalamus to increase body temperature (Garner & Fendius, 2010).

Based on clinical examination and presumptive diagnosis, the patient received a prescription for the antibiotic amoxicillin. Shortly after the first oral dose, the patient began to have signs and symptoms of allergic reaction. This is the second condition/event in the case study.  The medication amoxicillin has been introduced into the patient’s system via his gastrointestinal tract and has entered into the bloodstream. It is immediately recognized as antigen. Mast cells immediately release histamine which is the major mediator and causes another inflammatory response.  So again there is blood vessel dilation, plasma fluid leaking out of the blood vessels causing edema in lips, tongue, and possibly face and hands. More importantly, the mediator histamine acts on receptors in the bronchi of the lungs causing contraction of the smooth muscle tissue surrounding the airways. The result is difficulty breathing. Dendritic cells attach the antigen and proceed to a lymph node. Streptococcal pharyngitis (Strep Throat) Alterations in Cellular Processes Discussion Essay. Cytokines in the node called interleukins activate T cells and cause B cells to begin production of immunoglobulin E (IgE) antibodies and eosinophil leukocytes. Eosinophils release cytotoxins that cause damage to the allergen, but also to host cells. Streptococcal pharyngitis (Strep Throat) Alterations in Cellular Processes Discussion Essay

The severity of the reaction, if not caused by previous sensitivity could be a genetic predisposition to hypersensitivity. For example, if a parent has an allergy, especially type I which is food or drug, the child is predisposed to developing allergies as well (McCance & Huether, 2019). They will likely generate greater amounts of IgE than other individuals creating the hypersensitivity (McCance & Huether, 2019).

 

References

Ebell MH, Smith MA, Barry HC, Ives K, Carey M, Ebell, M. H., Smith, M. A., Barry, H. C., Ives, K., & Carey, M.

(2000). The rational clinical examination. Does this patient have strep throat? 
JAMA: Journal of the

        American Medical Association
, 
284
(22), 2912–2918.

Garner A, & Fendius A. (2010). Temperature physiology, assessment and control. 
British Journal of

        Neuroscience Nursing
, 
6
(8), 397–400.

McCance, K.L., & Huether, S.E. (2019). Pathophysiology The Biologic basis for desease in adults and children

(8
th
ed.).  Elsiever. Streptococcal pharyngitis (Strep Throat) Alterations in Cellular Processes Discussion Essay

REPLY 
QUOTE 
EMAIL AUTHOR

 

 

9 months ago

CHELSEY GASKIN 

RE: Vania Lauer Week 1 Case Study Post

COLLAPSE

Vania your discussion post was thorough and easily understood. When discussing this infection, I forgot to mention how dendritic cells and their connection to lymph glands. Dendritic cells are “the primary phagocytic cells located in the peripheral organs and skin, where molecules released from infectious agents are encountered, recognized through PRRs, and internalized through phagocytosis” (McCance & Huether, 2019). Though the dendritic cells are phagocytic cells meant to destroy they provide information to our lymph glands to activate our T cells, which then activate out B cells. When talking about our T cells we have the cytotoxic T Cells and Helper T cells fight on our side. The cytotoxic T Cells are going to disrupt or destroy the bacteria cells were the Helper T Cells stimulate our B cells. I feel you described the function of T cells and B cells well. As for the reaction to the medication I would agree with you regarding a possible previous exposure. Cows can receive antibiotics like penicillin or amoxicillin for different types of infections that can be secreted through their milk. Which could’ve been his first exposure to the medication causing a severe reaction this time. Streptococcal pharyngitis (Strep Throat) Alterations in Cellular Processes Discussion Essay

References:

McCance, K. L. & Huether, S. E. (2019). 
Pathophysiology: The biologic basis for disease in adults and children
 (8th ed.). St. Louis, MO: Mosby/Elsevier.

Soo, P. (2018, July 28). 
Pathophysiology Ch 10 alterations in immune function

. Retrieved from 

 

 

Case Study

 

A 16-year-old boy comes to clinic with chief complaint of sore throat for 3 days. Denies fever or chills. PMH negative for recurrent colds, influenza, ear infections or pneumonias. NKDA or food allergies. Physical exam reveals temp of 99.6 F, pulse 78 and regular with respirations of 18. HEENT normal with exception of reddened posterior pharynx with white exudate on tonsils that are enlarged to 3+. Positive anterior and posterior cervical adenopathy. Rapid strep test performed in office was positive. His HCP wrote a prescription for amoxicillin 500 mg po q 12 hours x 10 days disp #20. He took the first capsule when he got home and immediately complained of swelling of his tongue and lips, difficulty breathing with audible wheezing. 911 was called and he was taken to the hospital, where he received emergency treatment for his allergic reaction.

 

The role genetics plays in the disease

According to a study performed by La Jolla Institute of Immunology, reports show a correlation between genetic susceptibility and the predisposition of children having recurrent Group A Strep (La Jolla Institute for Immunology, 2019). Streptococcal pharyngitis (Strep Throat) Alterations in Cellular Processes Discussion Essay

 

Why the patient is presenting with the specific symptoms described
.

Strep throat (Group A Streptococcal Pharyngitis) is an inflammation of the mucous membranes in the throat and tonsils caused by the bacterial streptococcus (Ahmad & Saleem, 2018). Characteristics of the illness can include pharyngeal and tonsillar erythema, tonsillar hypertrophy with or without exudates, palatal petechiae, and anterior cervical lymphadenopathy, fever, and difficulty swallowing (CDC, 2018). The virus (streptococci chains) enters the body through the respiratory system and colonizes. An inflammatory response then occurs due to the release of extracellular toxins by Group A 
Streptococcus
 (MedScape, 2018).

 

The physiologic response to the stimulus presented in the scenario and why you think this response occurred

The physiologic response in this scenario was an anaphylactic response to Amoxicillin. For an allergic reaction to occur there must be prior sensitization of the immune system. After the immune system has been sensitized to a drug, reexposure to that drug can trigger an allergic response. Streptococcal pharyngitis (Strep Throat) Alterations in Cellular Processes Discussion Essay

 

The cells that are involved in this process
.

B-cells and T-cells are lymphocytes that help protect your body from foreign invaders. A foreign invader causes the production of antibodies or also known as an antigen.  After the B-cell lymphocytes identify that antigen, it will change into a plasma cell and produce antibodies specifically made to kill the foreign invader identified. The antibody responsible for the allergic response is IgE. Once the B-cells identify that same foreign invader, a large quantity of IgE antibodies are produced that attach themselves to mast cells and basophils throughout the body. When the mast cells and basophils are destroyed, histamine from those cells is released into the bloodstream and body tissues. This process brings on symptoms such as hives, itching, swelling, sneezing, and wheezing (Beach, 2017).

How another characteristic (e.g., gender, genetics) would change your response

 

According to Faitelson et al., having asthma, being older, and having a family history of amoxicillin allergy are associated with higher risk of allergy (2018). Streptococcal pharyngitis (Strep Throat) Alterations in Cellular Processes Discussion Essay

Resources

Ahmad, S., & Saleem, M. (2018). β-hemolytic streptococcal pharyngitis; diagnosing group a β-hemolytic streptococcal pharyngitis (strep throat) by brisk antigen detection. 
The Professional Medical Journal
, 
25
(12), 1882–1886. doi: 10.29309/TPMJ/18.4585

 

Beach, S. (2017). How allergies work. Retrieved June 3, 2020, from https://health.howstuffworks.com/diseases-conditions/allergies/allergy-basics/allergy2.htm

 

Centers for Disease Control and Prevention. (2018). Group A strep. Retrieved June 3, 2020, from https://www.cdc.gov/groupastrep/diseases-hcp/strep-throat.html

 

Choby, B. A. (2019). Diagnosis and treatment of streptococcal pharyngitis. Retrieved June 3, 2020, from https://www.aafp.org/afp/2019/0301/p383.html

 

Faitelson, Y., Boaz, M., & Dalal, I. (2018). Asthma, family history of drug allergy and age predict amoxicillin allergy in children.
 Journal of Allergy and Clinical Immunology.in Practice
, 6
(4), 1363-1367. doi:http://dx.doi.org.ezp.waldenulibrary.org/10.1016/j.jaip.2017.11.015  Streptococcal pharyngitis (Strep Throat) Alterations in Cellular Processes Discussion Essay

Group A Streptococcal (GAS) Infections. (2019, November 11). Retrieved from https://emedicine.medscape.com/article/228936-overview#a3

La Jolla Institute for Immunology. (2019). Why your kid’s strep throat keeps coming back. Retrieved June 3, 2020, from https://www.lji.org/news-events/news/post/why-your-kids-strep-throat-keeps-coming-back/

 

Rosenthal, L. D., & Burchum, J. R. (2018). 
Lehne’s pharmacotherapeutics for advanced practice providers
. St. Louis, MO: Elsevier. Streptococcal pharyngitis (Strep Throat) Alterations in Cellular Processes Discussion Essay

NURS 6501: Advanced Pathophysiology week 1 Discussion: Alterations in Cellular Processes

Streptococcal pharyngitis (Strep Throat)

There are several disorders that may mimic strep throat (Gottlieb, Long, Koyfman, 2018). However, I am confident that treating this patient for strep throat is a good decision.  Research indicates that strep throat may be genetically -connected, particularly among children who get strep throat frequently. It is believed that an antibody deficiency aberrant TFh cell is involved (Dan et al, 2019) NURS 6501: Advanced Pathophysiology week 1 Discussion: Alterations in Cellular Processes.

The cause of strep throat is group A hmoltic Streptococcus. Children may be at risk of developing strep throat for a number of reasons such as socializing crowded  places at school where someone else is infected, brushes their teeth where moist bacteria is found on uncleaned toothbrushes, and contaminated foods.In most cases, Beta-hemolytic streptocccus leads to acute pharyngiti NURS 6501: Advanced Pathophysiology week 1 Discussion: Alterations in Cellular Processes. The body initiates an inflamamatory response in the pharynx, which ultimately results in fever, pain vasodilation edema, and tissue swelling.

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On the cellular level, the involvement of epithelial cells, neutrophils, macrophages, and dendritic cells , all secret inflammatory mediators. Th1 and Th17 responses  are involved in adaptive immunity in both murine models of GAS pharyngitis and tissues in the tonsil (Soderholm, Barnett, Sweet, & Walker, 2018). Another characteristic would not change my response to diagnosing this illness. This was a relatively strong case for strep throat. NURS 6501: Advanced Pathophysiology week 1 Discussion: Alterations in Cellular Processes

References

Dan, J., Daughton, C., Kendric, K., Al-Kolla, R., Kaushik, K.  (Feb. 2019). Recurrent group A Streptococcus tonsillitis is an immunosusceptibility disease involving antibody deficiency and aberrant TFH cells. Science Translational Medicine, 11, 478. doi:10.1126/scitranslmed.aau3776.

Gottlieb, M; Long, B; Koyfman, A (May 2018). Clinical Mimics: An Emergency Medicine-Focused Review of Streptococcal Pharyngitis Mimics. The Journal of Emergency Medicine. 54 (5): 619–629. doi:10.1016/j.jemermed.2018.01.031

.Soderholm, A.T., Barnett, T.C., Sweet, M.J.,  & Walker, M.J. (2018). Group A streptococcal pharyngitis: Immune responses involved in bacterial clearance and GAS-associated immunopathologies. J Leukoc Biol.,103(2):193‐213. doi:10.1189/jlb.4MR0617-227RR

Responses

Thank you for sharing with us, your discussion post and I would like to offer a few pointers. Strep throat, also known as streptococcal pharyngitis, is caused by a bacterium called Group A streptococcus (GAS) (Centers for Disease Control and Prevention, 2018).  After infecting an individual, GAS lives in the nose or throat and can be easily transmitted as droplet infection through coughing and sneezing. Children are most susceptible to this disease because they tend to congregate in large groups as they play and are not up to the task on matters of hand hygiene.

Like you pointed out, studies have shown that recurrent infections of strep throat could point to a genetic connection. The antibody specific to fighting GAS is anti-streptococcal pyrogenic exotoxin (Anti-SpeA) and lack of it or any genetic alteration in the body of a child makes them vulnerable to infections.  “Recurrent Tonsillitis children exhibited reduced antibody responses to an important GAS virulence factor, streptococcal pyrogenic exotoxin A (SpeA)” (Dan et al, 2019). Children who are born with genetically transmitted immunocompromising conditions are also prone to infections like these. Cases include HIV, hemophilia, leukemia, neutropenia, and systemic lupus erythematosus (SLE).

References

Centers for Disease Control and Prevention (2018). GroupA streptococcal (GAS) Disease. Retrieved from 
https://www.cdc.gov/groupastrep/diseases-public/strep-throat.html

Dan, J, M., Havenar-Daughton, C
 
 Kendric, k., Al-Kolla, R., Kaushik, K., Rosales, S. L., Anderson, E. L., LaRock, C. N., Vijayanand, N., Seumois, G., Layfield, D., Cutress, R. I., Ottensmeier, C. H., Lindestam, C. S., Alessandro A. S., Nizet, V., Bothwell, M., Brigger, M.,
 

& Crotty, S.(2019). Recurrent group A Streptococcus tonsillitis is an immune susceptibility disease involving antibody deficiency and aberrant TFH cells. 
Science translational medicine 11
(478). Retrieved from 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6561727/

 

Great post! It is very true that many illnesses exist that mimic these respiratory symptoms and as nurse practitioners it will be important for us to distinguish between these different illnesses in order to properly treat our patients. Mayo clinic (2019) states the two important tests to help confirm or rule out strep throat is a rapid antigen test or a throat culture. The Provider took the important step of testing the little boy and it came back positive for strep. As you mentioned Strep throat is caused by group A Streptococcus, which is a bacteria, and the appropriate course of treatment for this infection is antibiotic. Per the CDC the common course of treatment is antibiotics, usually penicillin or amoxicillin (2018). Although we did not get the information on the little boy’s allergies, this is an important step when prescribing any medication. It is possible the little boy had never had this medication before, but when he took the medication, he had a severe allergic reaction. There are different levels of allergic reaction but to be considered anaphylaxis there must be a rapid onset of symptoms that may lead to death (Reber, Hernandez, & Galli, 2017). Based off the patient’s rapid allergic response and it was affecting his airway and work of breathing this could be considered an anaphylactic reaction. The characteristic of having an allergy to penicillin or amoxicillin would have changed the course of treatment. There are alternative antibiotics that can be used to treat strep throat, which include narrow spectrum cephalosporins. This was a great scenario in order to learn more about the immune and inflammatory response, but also the important tests and questions to ask when treating our patients.

 

CDC. (2018, November 01). Group A Strep. Retrieved June 03, 2020, from https://www.cdc.gov/groupastrep/diseases-hcp/strep-throat.html

Mayo Clinic. (2018, September 28). 
Strep Throat
. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/strep-throat/diagnosis-treatment/drc-20350344.

Reber, L. L., Hernandez, J. D., & Galli, S. J. (2017). The pathophysiology of anaphylaxis.
 Journal of Allergy and Clinical Immunology, 140
(2), 335-348. doi:http://dx.doi.org.ezproxy.liberty.edu/10.1016/j.jaci.2017.06.003

 

Discussion: Alterations in Cellular Processes

At its core, pathology is the study of disease. Diseases occur for many reasons. But some, such as cystic fibrosis and Parkinson’s Disease, occur because of alterations that prevent cells from functioning normally.

Understanding of signals and symptoms of alterations in cellular processes is a critical step in diagnosis and treatment of many diseases. For the Advanced Practice Registered Nurse (APRN), this understanding can also help educate patients and guide them through their treatment plans.

For this Discussion, you examine a case study and explain the disease that is suggested. You examine the symptoms reported and explain the cells that are involved and potential alterations and impacts.

To prepare:

By Day 1 of this week, you will be assigned to a specific scenario for this Discussion. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

By Day 3 of Week 1

Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation:

The role genetics plays in the disease.

Why the patient is presenting with the specific symptoms described.

The physiologic response to the stimulus presented in the scenario and why you think this response occurred.

The cells that are involved in this process.

How another characteristic (e.g., gender, genetics) would change your response.

Read
 a selection of your colleagues’ responses.

By Day 6 of Week 1

Respond
 to 
at least two
 of your colleagues on 
2 different days 
and respectfully agree or disagree with your colleague’s assessment and explain your reasoning. In your explanation, include why their explanations make physiological sense or why they do not

Note:
 For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on 
Submit!
NURS 6501: Advanced Pathophysiology week 1 Discussion: Alterations in Cellular Processes

Streptococcal Pharyngitis

Strep throat is also known as streptococcal pharyngitis.It is an infection of the throat, pharynx, and tonsils caused by a bacteria called Group A streptococcus (GAS) or streptococcus pyogenes. It is commonly diagnosed with a rapid strep test or throat culture (Cohen, Bertille, Cohen,

& Chalumeau,2016). The rapid strep test is indicated when other differential diagnoses have been eliminated; If symptoms are unclear, a throat culture is more reliable due to the rapid strep test, also showing positive for carriers. The case study indicated a positive rapid strep test for the patient, in addition to presenting signs and symptoms hence the diagnosis of strep throat. Strep throat is highly contagious. The bacteria typically enter the body through the respiratory tract and mouth and spread through direct contact with respiratory droplets from an infected person’s cough, saliva, or sneezes (Centers for Disease Control and Prevention, 2018). It also spreads through

indirect contact by sharing of eating utensils like cup or spoons and touching contaminated surfaces and then touching the mouth or nose. NURS 6501: Advanced Pathophysiology week 1 Discussion: Alterations in Cellular Processes

The Role of Genetics in Strep Throat

Strep throat is commonly seen in children between the ages of three and 15 (American Academy of Family physicians, 2016). The strep A bacteria is highly contagious, and because of its mode of spread, children are more susceptible, especially children in groups. However, some children may have recurring strep throat infections, which may be related to genetics that prevent or disrupt activation of the immune response that helps fight against infections (La Jolla Institute, 2019). Dan, Havenar-Daughton, and Crotty (2019), indicated that children with recurrent strep throat infection were found to have a family history of tonsillectomy, suggesting possible hereditary traits that predispose children to a recurrent strep throat infection.

In humans, when an infectious agent enters the respiratory tract, it is recognized by pattern recognition receptors (PRRs), after which a series of the immune response is activated. The innate and adaptive immunity may be activated in response to infection; if adaptive immunity is activated, a specific antibody is developed to fight against that specific infection. A study by La Jolla Institute, (2019), found a decreased level of the anti-streptococcal pyrogenic exotoxin (anti-SpeA) in some children. Anti-speA is an antibody specific to the streptococcal A bacteria’s antigen, thus indicating a genetic alteration in the development or activation

of the anti-SpeA, which could increase the susceptibility of some children to a recurrent strep throat infection.

Physiological
Response to the Stimulus

The streptococcus A Beta hemolytic bacteria gains entrance into the body through the mouth or the upper respiratory tract and attaches to the upper resp system walls, releasing its toxins. The cell surface of the strep A bacteria contains the M-proteins and hyaluronidase, which promotes adhesion to epithelial cells, attack host cells, and also promotes the spread of the bacteria causing more toxins to be released (Todar, 2015). When these toxins are released, they activate the inflammatory response. Some of these toxins released also cause hemolysis and slow down the process of phagocytosis, thereby making the immune system work harder to fight the infection (Todar, 2015).

The incubation period for streptococcal pharyngitis is2-5 days after which more symptoms begin to manifest (Centers for Disease Control and Prevention, 2018). The presence of phagocytic cells and the toxins in the blood intensify the inflammatory response; the toxins and inflammatory response trigger systemic symptoms such as fever, swelling, and redness of the tonsils and pharynx, production of exudates, palatal petechiae, anterior cervical lymphadenopathy, and sore throat similar to the symptoms of the patient in this case study. The inflammatory response occurred as a defense mechanism against microorganisms in the body. The inflammatory process is characterized by swelling, fever, pain, and redness, which may be local or systemic, depending on the severity of the response needed to fight against the infection (McCance, & Huether, 2019). In the case of strep throat, the symptoms could be mild, moderate or severe. Patients could also be asymptomatic. Some of the physiologic responses, as seen in this scenario, could also be a result of the toxins from the strep pyogenes for example, hyaluronidase released from the microorganism destroys hyaluronic acid causing local inflammation. NURS 6501: Advanced Pathophysiology week 1 Discussion: Alterations in Cellular Processes

Streptococcal pharyngitis can be self-limiting and may resolve by itself within a few days; however, to avoid complications, treatment is recommended with antibiotics. Penicillin or amoxicillin is the recommended antibiotic to treat strep throat unless the patient is allergic to penicillin (Centers for Disease Control and Prevention, 2018). In this scenario, the patient was

prescribed amoxicillin 500mg every 12 hours for ten days; the patient reportedly took the first dose when he got home and complained of swollen tongue and lips, difficulty breathing, and audible wheezing. The patient experienced an anaphylactic reaction to amoxicillin, evidenced by swelling of tongue and lips as well as shortness of breath, anaphylactic reactions are life-threatening and should be treated immediately. This patient will need to be prescribed a different antibiotic to treat the streptococcus pharyngitis. NURS 6501: Advanced Pathophysiology week 1 Discussion: Alterations in Cellular Processes

Cells involved in the process

The cells involved in the process are commensurate with the cells involved in immune response, including the inflammatory process, innate, and adaptive immune response. Some of these cells include; neutrophils, lymphocytes (T-cells and B-cells), macrophages, dendritic, and mast cells around the Respiratory tract (McCance, & Huether, 2019) NURS 6501: Advanced Pathophysiology week 1 Discussion: Alterations in Cellular Processes.

How Gender or genetics affects streptococcal pharyngitis

Streptococcus pharyngitis can affect all age groups, but it is more common in children age three to 15; this is especially true in school-aged children (Centers for Disease Control and Prevention, 2018). Due to the mode of transfer, people, seen in large groups are more susceptible to contracting strep throat, especially children whose immune system is yet to be mature. Genetics play an important role in the infection with strep throat, strep throat can be self-limiting because the immune system can fight against the infection. However, it is recommended to treat with antibiotics due to the risk of overworking the immune system and leading to complications such as rheumatic fever, which occurs as a result of the immune system attacking cells that are similar to group A streptococcus even after the infection has been resolved.

After the immune response is activated to fight streptococcus pyogenes, the adaptive immune system develops specific antibody against the strep A antigen, therefore when reinfection occurs, the body is able to recognize and fight the infection more quickly, the individuals with the compromised immune system are at risks for recurrent infection because they may have a delayed or inadequate immune response, for example, individuals
 
congenital neutropenia may be unable to produce sufficient B-cells and T-cells needed for normal immune response. Also, some genetically inherited conditions may deter the production of antibodies in response to infections; this could be seen with individuals who have genetically transmitted immune deficiencies like HIV or lupus. NURS 6501: Advanced Pathophysiology week 1 Discussion: Alterations in Cellular Processes

References

American Academy of Family physicians (2016). Strep throat.
 
Ame
rican Family Physician,

94
(1). Retrieved from 
https://eds-b-ebscohost
com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=13&sid=bf175544-1fe1-479f-8327-40e4926963d1%40pdc-v-sessmgr03

Centers for Disease Control and Prevention (2018). GroupA streptococcal (GAS) Disease. Retrieved from 
https://www.cdc.gov/groupastrep/diseases-public/strep-throat.html

Cohen, J. F, Bertille, N., Cohen, R., & Chalumeau, M.(2016). Rapid antigen detection test for group A streptococcus in children with pharyngitis. 
Cochrane Database of
 Systematic Reviews,
 
7
. DOI:10.1002/14651858.CD010502.pub2. NURS 6501: Advanced Pathophysiology week 1 Discussion: Alterations in Cellular Processes

Dan, J, M., Havenar-Daughton, C
 
 Kendric, k., Al-kolla, R., Kaushik, K., Rosales, S. L., Anderson, E. L., LaRock, C. N., Vijayanand, N., Seumois, G., Layfield, D., Cutress, R. I., Ottensmeier, C. H., Lindestam, C. S., Alessandro A. S., Nizet, V., Bothwell, M., Brigger, M.,
 

& Crotty, S.(2019). Recurrent group A Streptococcus tonsillitis is an immune susceptibility disease involving antibody deficiency and aberrant TFH cells. 
Science translational medicine 11
(478). Retrieved from 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6561727/

La Jolla Institute for Immunology (2019). Why strep throat comes back. 
Science
& Children, 56
(7), 10–11.Retrieved from 
https://eds-a-ebscohost-com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=4&sid=4f92c9ec-71cf-4939-900b-61dd7f1c1e65%40sdc-v-sessmgr01

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children.
 
Innate Immunity: Inflammation and wound healing
. (8th ed., pp 191-217). St. Louis, MO: Mosby/Elsevier.

Todar, K (2015). Streptococcus pyogenes and StreptococcalDisease (page 2). Retrieved from

http://textbookofbacteriology.net/streptococcus_2.html  
 NURS 6501: Advanced Pathophysiology week 1 Discussion: Alterations in Cellular Processes

NRS 434NV Human Experience Across the Health-Illness Continuum Essay

Health-illness continuum and relevance to healthcare

The health-illness continuum is a model that illustrates a continuously changing process of wellness, good health, normal health, illness, and death. This applies to everyone because it shows the changes that an individual goes through while adapting to various life changes and challenges to maintain good health still. The model’s status can change depending on the current level of health and wellness that an individual is in. This model is relevant to healthcare because it showcases the current state of health of a person (
Brooksidepress.org
, 2015) NRS 434NV Human Experience Across the Health-Illness Continuum Essay.

It is also important to note that having a positive perspective highly influences the health of the patients and the beautiful human experience shared when taking care of them. Empathy and understanding also help in building a connection with the patients. The health-illness continuum refers to physical health and an overall view of a person, including emotional and psychological health, and that is also the reason why having the right perspective is vital to an individual’s well-being regardless of age. A person’s perspective is very powerful in that it can move towards where it wants to be in the health-illness continuum.

BUY A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE

An example of this is a person diagnosed with an autoimmune condition, and he/she can demonstrate either a positive outlook or a negative one. If she chooses to sulk and complain about the condition, his/her place on the spectrum will not move for the better, and it may even worsen the condition in comparison to when he/she views the condition as a positive thing wherein he/she can choose, such as having to control what healthy food to eat and what types of exercise to do.

Understanding the health-illness continuum and the effect of perspective on people’s condition, I realize that the relationship nurses have with their patients is capable of great things. It is also an eye-opener that nurses and healthcare workers should be more conscious about our words and actions on patients. Health care workers can promote and uphold the dignity that each patient has by striving to influence patients’ perspective and turn it into positive ones that will enable them to become healthy.

Reflection on the overall state of health

If I am to decide about my position on the health-illness continuum, I will place myself in the middle, specifically the one labeled “normal health”. I have no grave illnesses, and I consider myself healthy, but I am aware of unhealthy habits that do not contribute to the maintenance of my health. Another aspect that influenced me to put in “normal” is because, in terms of my mental health and perspective, I am aware that there are moments that I tend to overthink and be negative, but this is something that I am continuously working on to further better myself and how I care for my patients including the other people around me.

Building habits is an important aspect when consciously taking care of your body, and one of the first steps is to identify which good behaviors to start or continue doing and which ones should be stopped. Examples of behaviors that I believe are detracting me from wellness are not getting enough sleep or sleeping late, not exercising or moving around as much, and frequently munching on junk foods. For good and positive behaviors, I am trying to drink 2 liters of water a day, keep a diary/journal for my mental health, and constantly wear sunscreen. These are just minimal changes, but these help build healthy habits in my life, one small aspect at a time.

Options and resources toward wellness

After identifying positive and negative behavior, it is important to know the direction where you want to go in terms of the health-illness continuum. From having normal health, I want to work on having high-level wellness, which takes commitment and dedication, but this is definitely worth the effort. To make a step towards wellness, I should start planning how I can effectively fix my sleeping schedule, exercise routine, and meal planning, then stick to the plan.

As a health care worker, I also believe that it is beneficial in the line of work to invest in yourself. This is a great opportunity to enable patients to talk and connect in a professional but deeper manner. This helps better the self while also improving in being a part of a healthcare team. The technical parts and skills of being a healthcare working are and will always be important. Still, another aspect that should not be forgotten is the heartfelt influence that healthcare workers can have on different people.

I have a lot of resources at my fingertips and from the people around me. I should use these opportunities to grow and learn how to become a healthier version of myself without too many elaborate and heavy products. In life, continuous changes are sure to happen, and a linear movement is not very probable, but living a healthy life consists of making good choices and enjoying the journey.

 

References:

Brooksidepress.org
,(2015).brooksidepress.org/nursing_fundamentals_1/?page_id=115&cn-reloaded=1.

 

Benchmark – Human Experience Across the Health-Illness Continuum

Research the health-illness continuum and its relevance to patient care. In a 750-1,000 word paper, discuss the relevance of the continuum to patient care and present a perspective of your current state of health in relation to the wellness spectrum. Include the following:

Examine the health-illness continuum and discuss why this perspective is important to consider in relation to health and the human experience when caring for patients.

Explain how understanding the health-illness continuum enables you, as a health care provider, to better promote the value and dignity of individuals or groups and to serve others in ways that promote human flourishing.

Reflect on your overall state of health. Discuss what behaviors support or detract from your health and well-being. Explain where you currently fall on the health-illness continuum.

NRS 434NV Human Experience Across the Health-Illness Continuum Essay

Discuss the options and resources available to you to help you move toward wellness on the health-illness spectrum. Describe how these would assist in moving you toward wellness (managing a chronic disease, recovering from an illness, self-actualization, etc.).

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. NRS 434NV Human Experience Across the Health-Illness Continuum Essay

You are required to submit this assignment to LopesWrite. Refer to the 
LopesWrite Technical Support articles
 for assistance.

Benchmark Information

This benchmark assesses the following competency:

RN-BSN

5.1. Understand the human experience across the health-illness continuum. NRS 434NV Human Experience Across the Health-Illness Continuum Essay

 

Course Code

Class Code

Assignment Title

Total Points

NRS-434VN

NRS-434VN-OL191

Benchmark – Human Experience Across the Health-Illness Continuum

130.0

Criteria

Percentage

Unsatisfactory (0.00%)

Less than Satisfactory (75.00%)

Satisfactory (79.00%)

Good (89.00%)

Excellent (100.00%)

Content

80.0%

Health-Illness Importance to Health and Patient Care (C5.1)

20.0%

A discussion on the importance of the health-illness continuum is not presented. NRS 434NV Human Experience Across the Health-Illness Continuum Essay

A partial summary on the importance of the health-illness continuum is presented. The summary does not fully include the relation of the continuum to health and the human experience in patient care. There are significant inaccuracies. More evidence or information is needed.

A general discussion on the importance of the health-illness in relation to health and the human experience in patient care is presented. The discussion generally establishes that the health-illness continuum is important to patient care. There are some inaccuracies. More information or rationale is needed.

A discussion on the importance of the health-illness in relation to health and the human experience in patient care is presented. The discussion demonstrates that the health-illness continuum is important to patient care. Some rationale is needed for clarity.

A discussion on the importance of the health-illness continuum in relation to health and the human experience in patient care is presented. The discussion demonstrates that the health-illness continuum is important to patient care. Strong rationale is offered for support.

Relation of Human-Illness Continuum to Value, Dignity, and Promotion of Human Flourishing

20.0%

An explanation of the relationship between the health-illness continuum and the ability of a health care provider to promote the value, dignity, and flourishing of patients is not presented.

A partial explanation of the relationship between the health-illness continuum and the ability of a health care provider to promote the value, dignity, and flourishing of patients is presented, but the connection is tenuous and key elements are omitted, incomplete, or left unexplained.

A general explanation of the relationship between the health-illness continuum and the ability of a health care provider to promote the value, dignity, and flourishing of patients is presented. There are some inaccuracies, and more information or rationale is needed to support the response.

An explanation of the relationship between the health-illness continuum and the ability of a health care provider to promote the value, dignity, and flourishing of patients is presented. The explanation demonstrates that the health care provider does play a role in promoting human flourishing, but some additional rationale is needed for clarity.

A thorough explanation of the relationship between the health-illness continuum and the ability of a health care provider to promote the value, dignity, and flourishing of patients is logically and convincingly presented. The explanation draws clear connections between the role of the health care provider and the promotion of human flourishing. Strong rationale is offered for support.

Refection on Personal State of Health and the Health Illness Continuum

20.0%

Reflection on personal overall state of health is omitted. NRS 434NV Human Experience Across the Health-Illness Continuum Essay

A partial summary of personal overall state of health is included. The summary is not informative. Behaviors supporting or detracting from health and well-being are omitted or incomplete.

A general discussion of personal overall state of health is included. Overall the discussion demonstrates some insight into some behaviors supporting or detracting from health and well-being. The author does not clearly establish where personal health falls on the health-illness continuum.

A discussion of personal state of health is included. The discussion demonstrates personal insight into overall behaviors supporting or detracting from health and well-being.  The author establishes where personal health falls on the health-illness continuum.

A well-developed discussion of personal state of health is included. The discussion demonstrates strong personal insight into behaviors supporting or detracting from health and well-being.  The author clearly establishes where personal health falls on the health-illness continuum.

Resources Supporting Wellness

20.0%

Options and resources available to help the author move toward wellness on the health-illness continuum are omitted.

Partial options and resources available that would help the author move toward wellness on the health-illness continuum are presented. It is unclear how this will assist in moving the author toward wellness.

General options and resources available that would help the author move toward wellness on the health-illness continuum are presented. More information is needed to establish how this will assist in moving the author toward wellness.

Options and resources available that would reasonably help the author move toward wellness on the health-illness continuum are presented. The author establishes how these resources will assist in moving toward wellness.

Options and resources available that would be extremely helpful to help the author move toward wellness on the health-illness continuum are presented. The author clearly establishes how these will assist in moving toward wellness. Insight into wellness as it pertains to the health illness continuum is demonstrated.

Organization and Effectiveness

15.0%

Thesis Development and Purpose

5.0%

Paper lacks any discernible overall purpose or organizing claim.

Thesis is insufficiently developed or vague. Purpose is not clear.

Thesis is apparent and appropriate to purpose.

Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

Argument Logic and Construction

5.0%

Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

Argument is orderly but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.

Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

Mechanics of Writing (includes spelling, punctuation, grammar, language use) NRS 434NV Human Experience Across the Health-Illness Continuum Essay

5.0%

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present.

Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.

Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.

Writer is clearly in command of standard, written, academic English.

Format

5.0%

Paper Format (use of appropriate style for the major and assignment)

2.0%

Template is not used appropriately, or documentation format is rarely followed correctly.

Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.

Template is used, and formatting is correct, although some minor errors may be present.

Template is fully used; There are virtually no errors in formatting style.

All format elements are correct.

Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)

3.0%

Sources are not documented.

Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

Sources are documented, as appropriate to assignment and style, and format is mostly correct.

Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

Total Weightage

100%

NRS 434NV Human Experience Across the Health-Illness Continuum Essay