Tag: Clinical-Nursing

Medical Organization Strategic Plan

Eisenhower Medical Centre | Strategic Plan for 2020-2022

Purpose

The main purpose of this strategic plan is to serve as a guide for the achievement of the organization’s goals that it envisions to accomplish in the next three years. Eisenhower Medical Centre recognizes the important role that all its stakeholders play to enable it achieve its aims and objectives over the years. This strategic plan takes into consideration the importance of this collaborative effort in the realisation of the goals set here in it.

Mission Statement

Eisenhower Medical Centre (EMC) is there to provide, without seeking profits, the best possible quality healthcare services in the state of California and beyond. It seeks to be the best in this respect and also provide the highest rated healthcare research and supportive patient education.

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Vision

To provide the most ideal patient care sought by our clientele.

To provide the most conducive working environment for all Eisenhower Medical Centre employees and volunteers. Medical Organization Strategic Plan

To partner with donors in generating resources towards the provision of affordable healthcare services.

To be the most attractive healthcare facility for physicians, nurses, nurse practitioners and other medical staff to work in.

To be the strongest and indispensable community resource in the entire state of California and beyond.

Integral Values

Excellence:
We practice only evidence-based interventions all the time to enable us achieve patient outcomes that are beyond set expectations. Our clinician-patient relationships are always the best and we place the highest premium on patient safety.

Courtesy:
Our employees are the most courteous and understanding to our patients, their relatives, and other visitors to the facility.

Efficiency:
We offer the most efficient and effective quality healthcare within the shortest time possible for our patients. Medical Organization Strategic Plan

Strategic Priorities

EMC must acquire new ventilators/ RT equipment and upgrade old medical equipment.

EMC has to do away with unstable permanent positions.

EMC must begin a policy of zero tolerance to discrimination of any sort and sexual harassment at the workplace.

EMC must recruit interpreters on a full-time basis. These have to work in the facility’s emergency department and the intensive care unit where quick intervention may be hampered by language barrier.

EMC to venture into housekeeping services for itself without outsourcing, and provide its own in-house financial services.

EMC to provide all-round security around the perimeter of its health facility to protect patient privacy and ensure their safety from outside intrusion.

EMC to make sure that all patients and their loved ones can at all times access clean, safe, and pure portable drinking water from multiple points within the facility.

The centers for Cancer, Orthopedics, Neuroscience, and Cardiovascular research and treatment at EMC to continue being equipped and supported to provide the latest state-of-the-art treatments. Medical Organization Strategic Plan

EMC to continue innovation concerning novel treatments with non-invasive procedures, for instance E-Zpap.

EMC to equip and staff a new lung laboratory that will cater for the facility’s inpatients.

EMC to continue its close relationship with its benefactors for continued provision of cheap not-for-profit healthcare services.

EMC to come up with a program that assists patients without healthcare insurance coverage to opt for in-house financial services.

EMC to drastically reduce its carbon footprint and encourage its employees and patients to dispose trash within the facility in designated recycling bins and containers.

EMC to remain apolitical and neutral in all political discourse. However, to continue compliance with the state of California and city of Rancho Mirage statutes, regulations, and by-laws. Medical Organization Strategic Plan

Strategic Objectives

Financial

Objective: Achieve better efficiency in the billing process

Lower the period of billing from seven to five days.

Objective: Reduce the cost of operations of the healthcare institution that is EMC

Target a reduction in operating costs from USD 50,000 to 45,000.

Patient Expectations

Objective: Reduce the rate of patient dissatisfaction with the healthcare services

Lower the rate from 25% percent to a target of 18%.

Objective: Do away with lawsuits related to malpractice and other claims

Cut down the number of cases from the current five to none at all.

Learning and Professional Development

Objective: Tackle any matters that still require resolution in the organization

Reduce unresolved issues from the current 12,000 to a target of just 5,000. Medical Organization Strategic Plan

Processes Internal to the Organization

Objective: Increase innovations within the organization’s employee ranks

Promote the emergence of more innovations within the organization from the current twelve to twenty.

Objective: Improve the control of inventory within the organization as a whole

Tighten the process of inventory control from the current 90% to a target of 95%.

Objective: Do better in preventing staff turnover that is preventable

Improve employee retention in their jobs from the current figure of thirty percent to a target figure of fifty percent.

Objective: Reduce the percentage of patient insurance

Lower the w/o insurance for patients from the current figure of 10% to five percent.

References

Eisenhower Health (2020).
Mission statement
. Retrieved 10 march 2020 from
https://eisenhowerhealth.org/about-us/mission-statement/

Healthgrades (2020).
Eisenhower Medical Center
. Retrieved 10 March 2020 from
https://www.healthgrades.com/hospital-directory/california-ca-southern/eisenhower-medical-center-hgste6618d46050573

ResearchGate (n.d.).
Eisenhower Medical Center
. Retrieved 10 March 2020 from
https://www.researchgate.net/institution/Eisenhower_Medical_Center 
 Medical Organization Strategic Plan

CASE STUDY ON MORAL STATUS

The sets of belief patterns, morals, ethics and behavior patterns expressed by people are different and develop over the years as shaped by personal experiences, relations with other people and worldviews.  The aforementioned aspects shape and guide personal decisions about right and wrong in everyday life.

Theories To Determine the Fetus Moral Status and How Each Theory Influences Recommendations for Actions

Maria’s Theory Based on Relationship and Sentient Properties

Maria’s moral decision is to save the life of the unborn child. Based on her actions, she appears to have a sentinel character and is emotionally dramatic. She inspires Maria to have…

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Based on ”Case Study: Fetal Abnormality” and other required topic study materials, write a 750-1,000-word reflection that answers the following questions:

What is the Christian view of the nature of human persons, and which theory of moral status is it compatible with? How is this related to the intrinsic human value and dignity? Case study on moral status

Which theory or theories are being used by Jessica, Marco, Maria, and Dr. Wilson to determine the moral status of the fetus? What from the case study specifically leads you to believe that they hold the theory you selected?

How does the theory determine or influence each of their recommendations for action?

What theory do you agree with? Why? How would that theory determine or influence the recommendation for action?

Remember to support your responses with the topic study materials. NOTE: I AGREE WITH AUNT MARIAS DECISION AND IDEA

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

This Case study on moral status assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

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

 

The sets of belief patterns, morals, ethics and behavior patterns expressed by people are different and develop over the years as shaped by personal experiences, relations with other people and worldviews.  The aforementioned aspects shape and guide personal decisions about right and wrong in everyday life.

Theories To Determine the Fetus Moral Status and How Each Theory Influences Recommendations for Actions

Maria’s Theory Based on Relationship and Sentient Properties

Maria’s moral decision is to save the life of the unborn child. Based on her actions, she appears to have a sentinel character and is emotionally dramatic. She inspires Maria to have faith by carrying the pregnancy to term and allowing Gods intention (Grand Canyon University, 2015). According to Beauchamp & Childress (2013), moral theory based on sentience involves a person’s ability to feel another person’s pleasure and pain as differentiated by perception and thughts. Maria also incorporates relationship properties in an attempt to influence Jessica’s moral decision by asking her to think about her motherly role. Case study on moral status.

The theory grounded on relationships emphasizes that the relationship between humans with those he/she values accounts for moral status (Beauchamp & Childress, 2013). More particularly, in this case, Jessica has a parent-child relationship with well-established roles and responsibilities to her unborn fetus. Applying the moral theory based on sentience and relationships, the best action is that Maria should carry the pregnancy to term and deliver.

Dr. Wilson’s Moral Theory As Supported by Cognitive Properties

Dr. Wilson is of the decision that Jessica should procure a medical abortion. His suggestion is scientism and ethical principles of western medicine. The theory grounded on cognitive properties holds that, for a competent human adult to have moral status, he/she should have cognition failure to which he/she is not valuable or have moral status (Beauchamp & Childress, 2013). He backs his suggestion using scientific facts by explaining how the fetus condition was rare and had an estimated 25% risk of Down’s syndrome (Grand Canyon University, 2015).  From an ethical perspective, he has the obligation to educate Jessica and recommend her the best action from a medical perspective. It is for this reason that the most recommended course of action as suggested by Dr. Wilson and backed by a medical and scientific background is to procure an abortion. Case study on moral status

Marco’s Moral Theory Based on Relationships

Marco is pro-choice on unwanted pregnancies. He requests that Jessica is not informed about the fetus devastating condition. However, after Jessica is informed, he is ready to support her on the water decision she makes. He strongly believes that in this case, there is no wrong or right path. However, Macro has racing thoughts about their financial freedom, which reveals his materialistic mindset (Grand Canyon University, 2015). Marco values material possessions more than spiritual values. Applying this theory, Jessica should procure an abortion. However, Marco is ready to support Jessica’s decision because of the relationship he has with her.

Jessica- theory Based on Moral Agency

Jessica is yet to determine her decision in this case. Her relationship with her physician, Maria, and Marco will have a great impact on her decision regarding the fetus moral status.  Jessica partially agrees with Marco that the fetus might be a hindrance to their independence and socio-economic progress. Case study on moral status. This materialistic perspective devalues spirituality, religion, and faith. On the other hand, Jessica also aligns herself to faith, God and religion and embraces life as sacred. These two views bring conflict, also known as dualism, within her. Dualism is a state where two entities that conflict each other (good vs. evil) separate. Aspects such as scientific values, truth-false, success-failure influence dualism. Moral agency defines Jessica’s moral status. According to this theory, a human is considered a moral agent if they can judge how right or wrong an action is (Beauchamp & Childress, 2013). This evidently illustrates that she is the only decision-maker of her course of action.

The theory I Agree With

The author agrees with Aunt Maria’s decision as influenced by the theory based on sentience and relationships. The latter holds that, the relations that exist between humans also determine moral status. More specifically, a person has moral status if he/she relates with other people who value him/her with well-established roles and responsibilities. A perfect example is a relationship between a parent and a child. Using this theory, it is evident that Jessica has a parent-child relationship with the fetus Case study on moral status. Therefore, as a mother, she has a role to fulfill to the unborn fetus. On the other hand, sentience retains that, a person’s moral status is determined by her conscious such as being able to feel pain and pleasure and differentiate the feelings from thoughts and perceptions (Beauchamp & Childress, 2013). It is for this reason that Maria understands Jessica’s pain and inspires her to have faith. Applying both theories, the recommended course of action is for Jessica to keep the pregnancy to term and deliver.

 

References

Beauchamp, T. & Childress, J. (2013). 
Principles of biomedical ethics.
(7
th
ed.) New York, NY:

Oxford University Press.

Grand Canyon University (2015).
HLT 310V Case Study: Fetal Abnormality.
Phoenix, AZ.

Kim, H., Callan, M. J., Gheorghiu, A. I., & Matthews, W. J. (2017). Social comparison, personal relative deprivation, and materialism. 
British Journal of Social Psychology
, 
56
(2), 373-392. Case study on moral status

Discussion: Organizational Policies and Practices to Support Healthcare Issues – Hospital Acquired Pneumonia Essay

Hospital acquired pneumonia

Competition has typically been encouraged within the health care industry as a strategy for increasing value for all stakeholders. To be more precise, competition ensures the provision of better services and products that satisfy the needs of all stakeholders through improving processes and quality while reducing costs. For instance, capital limitations can restrict hospital control approaches such as having overcrowded wards. In the present case (addressing hospital acquired pneumonia), every resource is considered as scarce and subject to competing needs from other health care agendas. Discussion: Organizational Policies and Practices to Support Healthcare Issues – Hospital Acquired Pneumonia Essay. This makes efforts to prevent hospital acquired pneumonia in the midst of providing affordable and high-quality health care services an increasing challenge (Ruggiero, 2015). There is a conflict over whether to advocate for individual patients or equitable distribution of resources to larger populations. This conflict rests entirely on the role of social justice as it applies to the conflicting roles of non-maleficence (do no harm) and beneficence (do good) (Northouse, 2016). In addition, there are three resources of concern to the specific case owing to their scarcity. Firstly, the medical personnel who include nurses are limited in their capacities, skills, geography and time. Implementing strategies for preventing hospital acquired pneumonia are dependent on personnel awareness and their familiarity with the strategies. Having knowledgeable personnel is preferable since they are primed to understand and apply the prevention strategies. Secondly, facilities for delivering medical services are finite. It is not uncommon to have crowded facilities in the hospital. This situation is unlikely to change unless the facilities are expanded, a truly cost intensive endeavor. The facilities limitation can be addressed through making efficient use of the available resources so that high risk patients are isolated from the general populations. Thirdly, money for making changes to the facility is not unlimited. There are competing needs for money and there is a need to conduct a cost-benefit analysis to identify the agendas that have the least costs and most benefits (Joel, 2018). Discussion: Organizational Policies and Practices to Support Healthcare Issues – Hospital Acquired Pneumonia Essay

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References

Joel, L. (2018).
Advanced practice nursing: essentials for role development
(4
th
ed.). Philadelphia, PA: F. A. Davis Company.

Northouse, P. (2016).
Leadership: theory and practice
(7
th
ed.). Thousand Oaks, CA: Sage Publications.

Ruggiero, V. (2015).
Thinking critically about ethical issues
(9
th
ed.). New York, NY: McGraw-Hill Education.

 

Discussion: Organizational Policies and Practices to Support Healthcare Issues

Quite often, nurse leaders are faced with ethical dilemmas, such as those associated with choices between competing needs and limited resources. Resources are finite, and competition for those resources occurs daily in all organizations.

For example, the use of 12-hour shifts has been a strategy to retain nurses. However, evidence suggests that as nurses work more hours in a shift, they commit more errors. How do effective leaders find a balance between the needs of the organization and the needs of ensuring quality, effective, and safe patient care?

In this Discussion, you will reflect on a national healthcare issue and examine how competing needs may impact the development of polices to address that issue. Discussion: Organizational Policies and Practices to Support Healthcare Issues – Hospital Acquired Pneumonia Essay

To Prepare:

• Review the Resources and think about the national healthcare issue/stressor you previously selected for study in Module 1. NOTE: The national healthcare issue/stressor I addressed in module 1 is “HOSPITAL ACQUIRED PNEUMONIA. So, you are going to use this topic to answer questions related to this discussion.

• Reflect on the competing needs in healthcare delivery as they pertain to the national healthcare issue/stressor you previously examined.

Post an explanation of how competing needs, such as the needs of the workforce, resources, and patients, may impact the development of policy. Then, describe any specific competing needs that may impact the national healthcare issue/stressor you selected. What are the impacts, and how might policy address these competing needs? Be specific and provide examples.

Required Readings

American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. Silver Spring, MD: Author. Retrieved from https://www.nursingworld.org/coe-view-only

Note: Review all, with special attention to “Provision 6” (pp. 23–26). Discussion: Organizational Policies and Practices to Support Healthcare Issues – Hospital Acquired Pneumonia Essay

Kelly, P., & Porr, C. (2018). Ethical nursing care versus cost containment: Considerations to enhance RN practice. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 6. doi:10.3912/OJIN.Vol23No01Man06. Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Nursing-Cost-Containment.html

Milliken, A. (2018). Ethical awareness: What it is and why it matters. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 1. doi:10.3912/OJIN.Vol23No01Man01. Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Awareness.html

 

Hospital-Acquired Pneumonia

Description of the National Healthcare Issue/Stressor

Hospital-acquired pneumonia (HAP) refers to pneumonia that a patient develops within a hospital setting after at least 48–72 hours after being admitted (Pássaro et al.; 2016). HAP is the second leading hospital-acquired infection and cause of death among critically sick patients. HAP is allied to an elevated rate of mortality and morbidity, as well as increased healthcare costs (Torres-García et al., 2019). According to Min et al. (2018), the incidence of HAP worldwide is 5–20 cases per 1000 admissions. The high prevalence of HAP indicates the need to address the issue.

In my healthcare organization, HAP is common among patients in the ICU, and notably patients who are mechanically ventilated. Similarly, the rate of HAP is also relatively high in patients within the medical-surgical ward and the general ward. In the organization, HAP in all units leads to an increased rate of morbidity and mortality, longer period of hospital stays, as well as increased costs for both the patient and the organization. This is consistent with other organizations where hospital-acquired infections like HAP are associated with a high mortality rate, a prolonged period of hospitalization, as well as higher healthcare costs (Pássaro et al., 2016). Discussion: Organizational Policies and Practices to Support Healthcare Issues – Hospital Acquired Pneumonia Essay

In the organization, the rate of HAP is particularly high among older adults, patients in the ICU, as well as patients with prolonged use of antibiotics and glucocorticoids. The high incidence of HAP among patients with lengthy use of glucocorticoids is allied to the reduced immunity that makes individuals susceptible to infections. Similarly, long-term use of antibiotics is a major risk factor for hospital-acquired pneumonia due to resistance to antibiotics. In my healthcare organization, HAP is associated with an increased rate of mortality, admission to the ICU, and an increased period of hospital stay. Besides, the organization, being a government agency, spends a lot of money on financing the treatment and care of HAP.

Summary of the Two Articles

According to Brett et al., (2019), HAP is allied to elevated morbidity and mortality rate and also increased medical costs. HAP is also a leading factor for transfer to the ICU and results in a prolonged hospital stay. Risk factors associated with HAP include advanced age, a longer period of hospital stay, being a male, dysphagia, numerous comorbidities, as well as chronic obstructive pulmonary disease (Brett et al., 2019). Brett et al. (2019) further indicate that poor oral hygiene causes a buildup of dental disease, which is a significant risk factor in HAP. Accordingly, Brett et al. (2019) explain that improved oral hygiene is effective in decreasing the rate of HAP. Other strategies that can reduce the rate of HAP include early mobilization, effective hand hygiene, proper management of dysphagia, and prevention of viral infections (Brett et al., 2019) Discussion: Organizational Policies and Practices to Support Healthcare Issues – Hospital Acquired Pneumonia Essay.

Again, Deng et al. (2019) explain that HAP is a very common hospital-acquired infection and a leading cause of death among hospitalized patients. Multi-drug-resistant organisms (MDROs) are attributed to the numerous cases of HAPs, and particularly within the ICU and emergency departments (Deng et al., 2019). Wide usage of broad-spectrum antibiotics is attributable to bacterial resistance, one of the risk factors for HAP.

Strategies used to Address HAP

The study by Brett et al. (2019) demonstrates that interventions such as improved oral care, increased movement, and mobility, as well as dysphagia management, are effective in preventing HAP. The study indicates that improved oral care is an important modifiable risk factor for HAP. Comprehensive oral care facilitated by nurses is effective in preventing HAP as it prevents the buildup of dental plaque, which is a significant risk factor in HAP.

Increased mobilization is also an intervention that can be used in preventing HAP, especially among patients with acute ischemic stroke. The intervention involves turning the patient from “supine position to right and left lateral resting position” after every two hours and passively mobilizing the four limbs. This intervention is effective in reducing the rate of HAP. The mobilization intervention also integrates pre-operative patient education, breathing exercises, as well as pre-operative physiotherapy (Brett et al.; 2019). Brett et al. (2019) further explain that proper management of dysphagia and particularly among post-stroke patients, is essential in reducing the rate of HAP. This intervention includes nurses screening patients for dysphagia and implementing the appropriate interventions. The reason is that dysphagia is the leading cause of aspiration pneumonia. After all, food or liquids can enter the airway when patients have difficulties in swallowing and hence introduce bacteria to the lungs. Therefore, effective management of dysphagia can prevent aspiration pneumonia. Discussion: Organizational Policies and Practices to Support Healthcare Issues – Hospital Acquired Pneumonia Essay.

Preventing and treating infections caused by multi-drug-resistant organisms can go a long way in preventing HAP (Deng et al., 2019). Long-term use of antibiotics is a significant risk factor for HAP as a result of organisms’ resistance to antibiotic therapy. Interventions used to address the issue of multi-drug resistance include relieving the inflammatory reactions among patients, improving organisms’ clearance, reducing the period of mechanical ventilation, treating patients’ immunity, and increasing the success rate of ventilator weaning (Deng et al., 2019).

References

Brett M, Russo P, Cheng A, Andrew S, Rosebrock H, Curtis S, Robinsion S & Kiernan M. (2019). Strategies to reduce non-ventilator-associated hospital-acquired pneumonia: A systematic review.
Infection, Disease & Health
, 24(4), 229 – 239.

Deng, D., Chen, Z., Jia, L, Bu J, Ye M, Sun L, Gen Y, Wen Z, Chen G & Fang B. (2019)
.
Treatment of hospital-acquired pneumonia with multi-drug resistant organism by
Buzhong Yiqi
decoction based on
Fuzheng Quxie
classical prescription: study protocol for a randomized controlled trial.
Trials,
20(817).

Min, J. Y., Kim, H. J., Yoon, C., Lee, K., Yeo, M., & Min, K. B. (2018). Hospital-Acquired Pneumonia among Inpatients via the Emergency Department: A Propensity-Score Matched Analysis.
International journal of environmental research and public health
,
15
(6), 1178.
https://doi.org/10.3390/ijerph15061178
.

Pássaro, L., Harbarth, S. & Landelle, C. (2016). Prevention of hospital-acquired pneumonia in non-ventilated adult patients: a narrative review.
Antimicrob Resist Infect Control
, 5(43 (20). Discussion: Organizational Policies and Practices to Support Healthcare Issues – Hospital Acquired Pneumonia Essay

Torres-García, M., Pérez Méndez, B. B., Sánchez Huerta, J. L., Villa Guillén, M., Rementería Vazquez, V., Castro Diaz, A. D., López Martinez, B., Laris González, A., Jiménez-Juárez, R. N., & de la Rosa-Zamboni, D. (2019). Healthcare-Associated Pneumonia: Don’t Forget About Respiratory Viruses.
Frontiers in pediatrics
, 7(168).

Advanced Practice Legislation SAVE Act Essay

Advanced Practice Legislation Paper

Select a bill that is related to Advanced Practice nursing and is currently in congress and address the following:

1. Provide a thorough description of the bill including the sponsor of the bill, committees, latest action, amendments, the number co-sponsors (include the name of the congressman from your state if applicable) and the reason the bill was presented. 10points

2. Address how the bill relates to advanced practice nursing. For example, practice authority, reimbursement, collaborative practice, NP’s as primary care providers. What are the challenges to getting the bill passed? 15points

3. Address how this bill affects health care in general including cost savings, patient safety, quality, access to care. 20points

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4. Find an advanced practice professional organization and explain the purpose of the organization and the APN roles who participate in this organization. What are the benefits of joining this organization? Review their political advocacy portal to find out how they are involved political advocacy Advanced Practice Legislation SAVE Act Essay. Include the advocacy efforts they are currently engaged in. Are they involved in contacting legislators regarding current advanced practice legislation and specifically the bill you are discussing. What support or resources does the organization have for new members who want to be involved in legislation? How does the organization keep members abreast of upcoming legislation? For example: Sunset of the nurse practice act in your state. 30points

5. Contact your legislator through the “home” office (in your state, not Washington, D.C.) and convey to speak to someone about health-related legislation and tell them the name of the bill you want to discuss. Find out the legislator’s view point on the bill, whether or not they are in support of the bill and why or why not. 30 points

6. What is your viewpoint on the bill? Do you support passage of the bill? Advanced Practice Legislation SAVE Act Essay Why or why not? How can you as an advanced practice student participate in the passage of the bill? How will passage of the bill influence your practice? 10points

7. APA-10points

 

Advanced Practice Legislation

A description of the Bill (SAVE Act

The SAVE Act is a bipartisan bill (Senate Bill 143 and House Bill 185) that aims to remove requirements for APRNs in North Carolina to work in collaboration with a physician.   The key sponsors of the bill include Senator Ralph Hise and Representatives Donny Lambeth, Josh Dobson, Gale Adcock, and Sarah Stevens.  The bill is co-sponsored by over forty legislators including  Representatives  Ager John,  Jonh Autry, Rep  Lisa Barnes, Deb Butler,   Allison  Dahle, and  George Cleveland and Senators Jim Burgin,   Deanna Ballard, Senator  Danny Britt,  senator, Jim Burgin, and  Ben Clark.  The Bill is aimed at delivering Safe, Accessible, value Directed and Excellent (SAVE) health care by updating APRN regulations. Advanced Practice Legislation SAVE Act Essay. Senate bill 143 is currently before the senate rules committee and while the house bill 185 is before the House health committee.

The bill was presented to update laws regulating APRN practice. For the last four decades,  the laws regulating APRNs as one of health care providers with high training have not been changed. With the SAVE Act, lawmakers aim at modernizing healthcare in  North Carolina by eliminated unnecessary and outdated restrictions on APRNs (NCNA, 2019).  Everybody in the United States is looking at schemes that can be used to save the cost of healthcare while ensuring patients receive excellent care.   The bill proposes the removal of the requirements for clinical CNMs and NPs to be supervised and physicians.  By removing the requirements for APRNs to work under the supervision o physicians, APRNs in North Carolina will be able to deliver care independently and fully exploit their training, and education, which will provide North Carolina residents to have faster access to quality and less costly healthcare.

How the bill relates to advanced practice nursing

The bill relates to advanced practice nursing in that it seeks to eliminate state impediments that hinder APRNs from having independent practice.  The bill addresses outdated state laws and regulations on APRNs, including certified nurse midwives (CNMs), nurse practitioners (NPs), certified registered nurse anesthetists (CRNAs), and clinical nurse specialists (CNSs).   These advance practice roles have attained a certain level of education and become certified. Nevertheless,  restrictions imposed by state laws reduces the ability of APRN to deliver care independently which in turn less access to care and also raises costs of healthcare (Roberts, 2019) Advanced Practice Legislation SAVE Act Essay.

The SAVE aims at accomplishing two goals.  According to Roberts (2019), the first goal addresses the power of the North Carolina Board of Nursing to control the roles of advance practice nursing. Under the present law, certified midwives and nurse practitioners are regulated by the state Board of Nursing as well as the Medical Board.  The bill seeks to provide the Board of Nursing with the exclusive authority of regulating the practice of CNMs and NPs. The North Carolina Board of nursing exclusively supervises CRNAs and CNSs. Advanced Practice Legislation SAVE Act Essay  In addition, the legislation aims at codifying the services being performed by both CRNAs and CNSs and endows each profession with the APRN title.  The scope of practice of CNSDs and CRNAs will not change as a result of the passage of the bill into law, meaning that they will not be providing any novel services.

The other objective of the legislation is to eliminate the mandatory requisite for CNMs and NPs to collaborate with a physician to provide patient care. North Carolina is among the states that restrict CNMs and NPs to practice authority mandating them to have a written collaborative practice agreement supervising physician. The agreement delineates prescribing authorities, patient management, as well as the way the physician and the ARN will be communicating with one another. Roberts (2019) asserts that the problem with requiring APRNs to have practice agreements with Physicians is that the physician does not do much of the supervising. CNMs and NPs are not required to be in the same geographic area as the physician and they meet only biannually. The agreements between NPs and CNMs can be costly because nurses are required to pay collaborating fees to the physician, which increases health care costs. Advanced Practice Legislation SAVE Act Essay.

The challenges to getting the bill passes are opposition from physicians and physician organizations such as the North Carolina Medical Board.  Physicians have the perception that APRNs are not sufficiently trained to provide safe care  As Roberts,  (2019) indicates, antagonists of the bill maintain that the elimination of collaborative practice agreements will put patients at safety risks as nurses are not in a position to provide high-quality care compared to physicians.

How the bill affects health care

The bill will improve access to care by North Carolina residents.   When CNMs and NPs are authorized to practice independently, they will be able to deliver less costly care. When collaborating with a physician and the physician relocates to another state or retires, the nurse is forced to halt his or her practice until they get another physician to collaborate with. Roberts (2019)  claims that the removal of collaborative agreements will increase acre access in the state since nurses with the required education and certification will be able to deliver primary care services since their practice will not be constrained by accessibility or relocation of the collaborating physician. Advanced Practice Legislation SAVE Act Essay.

Apart from improving access to care, the independent practice of APRNs will lead to health cost savings because APRNs provide less costly care compared to physicians. It is approximated that with the passage of the bill, the state will be able to save up to four billion dollars healthcare costs.  According to Roberts (2019, the bill will also address the regional shortages of physicians in the state.  There is a shortage of physicians in remote regions and there is also an uneven distribution of physicians in the region Advanced Practice Legislation SAVE Act Essay.  Giving APRNs more flexibility to practice could alleviate the shortages of health care providers in rural regions of the State.

APN professional organization

The American Association of Nurse Practitioners (AANP) is a professional nursing organization for NPs of different specialties. The organization represents over twenty thousand NPs across the country.  The purpose of AANP is to offer lawmaking leadership at the national and state levels as well as the local level, promote research, education, and practice, and promote health policy. The organization also establishes standards that NPs must adhere to ensure that they serve patients that receive care from nurse practitioners as well as other consumers of health care. ANNP acts as the voice of nurse practitioners and represents NPs’ interests as providers of care that are less costly, of superior quality, comprehensive and centered on the patient.

Nurse practitioner participation in the AANP provides a variety of benefits.  Professional nursing organizations offer the opportunities to engage in advocacy efforts connected in areas like health, policy and regulators issues.  Being a member of the professional organization offers members the networking and training opportunities to advance their careers as well as knowledge in the profession.   Like any other professional organization, AANP   organizes conferences and meetings as networking events for members. Advocacy is another benefit that I can get from joining the AANP.  Goolsby and DuBois (2017) indicate that professional nursing organizations play an important role in advocating for their members’ interests and communities or patients served by nurse practitioners.

Participation in a professional organization enables members to have a say in identifying and developing health policy initiatives. These organizations publish policy agendas and policies related to regulation, reimbursement, safety, and practice. Additionally, professional organizations offer informative educational resources and position statements to inform their members on crucial pertinent policy and support both old and new members to voice their opinions at the institutional, state and federal levels. Resources are aimed at preparing members to have effective communications with policymakers (Goolsby & DuBois, 2017) Advanced Practice Legislation SAVE Act Essay.

AANP has involved in advocacy efforts at the state as well as the federal level.  Federal legislation directly influences the NP role and the patients served by NPs. AANP has a  legislative team that represents NPs along with their patients on significant matters connected with practice, reimbursement, healthcare reform, licensure and access to care. Apart from advocating on policies related to NP practice, AANP represents NPs’ health organizations and national committees, enabling NPs to take their perspectives to health care leaders. With the support of NPs, AANP works in partnership with federal legislators to ensure sufficient coverage of and access to NP services. At the state level, AANP supports NP policy initiatives (AANP, 2020).

The organization AANP is involved in contacting legislators regarding current advanced practice legislation. AANP contacts legislators via phone calls, emails or meetings in Capitol Hill. AANP is currently in numerous advocacy efforts.  The AANP pushes the 116
th
congress to eradicate feeder barriers that restrict the ability of patients to access less-costly, superior care and ensure that legislators do not enact laws that create additional barriers for NPs. Advanced Practice Legislation SAVE Act Essay. AANP is advocating for the passage of S. 296/H.R. 2150 to grant authority to NPs to sign eligibility of patients to receive home health care and S. 237/H.R. 808 to authorize NPs to certify patients’ requirement for therapeutic shoes. AANP is also Advocating for the passage of S. 2842/H.R. 3911 to allow NPs to order and oversee pulmonary and cardiac rehabilitation. The professional nursing organization keeps members up to date of upcoming legislation and healthcare issues through its advocacy center on its website.

Health-related legislation

The Home Health Care Planning Improvement Act of 2019 H.R. 2150/S. 296) is legislation to authorize physician assistants and APRNs to sign eligibility of patients for home healthcare services.  Under the present Medicare regulations, physicians are the only providers authorized to declare that patients are eligible to receive health care (Jaffe, 2019), after calling my legislator and discussing this bill, the legislator supports the legislation because when enacted into laws, the bill will enable patients to easily access home health services by expanding the scope of providers who can endorse the requirement for home health care under the rules set forth by Medicare. The legislator stated that the legislation is a pragmatic and practical approach of increasing access to him health care by elderly individuals who require it the most, entailing those who are provided care by clinicians who are not physicians.

My viewpoint of the bill

I view the Home Health Care Planning Improvement Act of 2019as a legislation that will be beneficial to patients, APRNs and physician assistants. If enacted,   physician assistants and advanced practice nurses would be able to provide certification for home healthcare, possibly cutting the requirement for a physician. I support the passage of the legislation because physician assistants and APRNs provide professional, personal and invaluable care to numerous individuals around United States. When enacted, the bill will enable Medicare patients to more easily and directly access home care and significantly cut the cost of health care services. It will be a win for providers, patients as well as Medicare Advanced Practice Legislation SAVE Act Essay.

As an advanced practice student, I can participate in the passage by asking my congressperson to speak with other lawmakers on how the bill will benefit their constituents and convince them to pass the bill.  As indicate by Edelman et al (2017), knowing local legislators, enlightening them about health care matters affecting their constituents and advising them on the needs of their constituents is a way in which nurses can be involved in policy-making.

The passage of the bill will influence my practice by enabling be provide home care services to my patients in a timely and consistent manner. When Medicare beneficiaries under the Care of APRNs need home care, (a physician, is often not the primary care provider for the patient) must be contacted to certify the requirement for home health care. This leads to incoherent care and the inclusion of a provider who might not know the care needs of the patient. The bill will ensure that as a clinician with a better knowledge of the patient, I will be able to order care that is clinically appropriate for the patient. Advanced Practice Legislation SAVE Act Essay

 

References

AANP. (2020). AANP Advocacy: Championing the NP Role and Amplifying the NP Voice. Retrieved from
https://www.aanp.org/advocacy

Edelman, C., Mandle C., & Kudzma, E.  (2017).
Health Promotion Through the Life Span
.  St. Louis, MO: Elsevier.

Goolsby, M., & DuBois, J.  (2017). Professional organizations membership: Advancing the nurse practitioner role.
Journal of the American Association of Nurse Practitioners, 29
(8), 434-440. Advanced Practice Legislation SAVE Act Essay.

Jaffe, S.  (2019). Home Health Care Providers Struggle With State Laws and Medicare Rules As Demand Rises.
Health Affairs, 38
(6), 981-986. 

North Carolina Nurses Association, (NCNA).   (Feb 26, 2019). NC Legislators Introduces Bipartisan SAVE Act to Increase Access to Quality Health Care.  Retrieved from
https://ncnurses.org/about-ncna/latest-news/nc-legislators-introduce-bipartisan-save-act/

Roberts, J.  (2019). SAVE Act: Increasing Freedom for N.C. Nurses. Retrieved from
https://www.johnlocke.org/update/save-act-increasing-freedom-for-n-c-nurses/ 
 Advanced Practice Legislation SAVE Act Essay

Practicum Journal Entry: Certification Plan

The practice environment for the PMHNP is regulated by the state scope of practice laws. PMHNPs in California practice under a restrictive environment where state law mandates that the PMHNPs collaborate with a physician for them to practice. The PMHNP and the collaborating physician must possess a written protocol that covers all major aspects of care. The protocol is jointly developed by the physician and nurse practitioner.  As indicated by Barton Associates (2020), nurse practitioners in California have the authority to prescribe medications, including schedule two to five controlled drugs but…

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Psychiatric/mental health nurse practitioners currently have only one choice for certification, which is through the American Nurses Credentialing Center (ANCC). The ANCC offers the “psychiatric/mental-health nurse practitioner (across the lifespan)” board certification (PMHNP-BC). In many states, board certification is needed as a prerequisite to being granted an NP license. Practicum Journal Entry: Certification Plan. Even if board certification is not a requirement for state licensure, it may be a requirement to receive privileges in various hospitals and other health care facilities. It may also be required by malpractice insurance providers prior to issuing coverage to NPs.

In this Practicum Journal Assignment, you will develop a plan, which will serve as the road map for you to follow to attain your certification.

Learning Objectives

Students will:

• Analyze state restrictions or limitations for practice

• Compare PMHNP practice environments in various states

• Analyze clinical practice issues Practicum Journal Entry: Certification Plan

• Create plans for passing national certification exams

**Assigned in Week 1 but submitted in Week 4

To prepare for this Practicum Journal:

• Review the interactive nurse practitioner (NP) scope of practice law guide in your Learning Resources.

• Review your state regulations and a neighboring state or state in which you would like to practice.

• Reflect on how to approach relocating licensure from one state to another.

• Review certification exam requirements for PMHNPs.

Write a 2- to 3-page paper in which you do the following:

• Describe the PMHNP practice environment for your home state, highlighting restrictions or limitations for practice.

• Compare the PMHNP practice environment in your home state with a neighboring state or a state in which you would like to practice.

• Describe a professional and/or clinical practice issue a new PMHNP will need to consider and address with the certification, licensure, credentialing, or relocation process.

• Develop a checklist for passing the national certification exam, including a detailed timeline that includes academic preparation (study plan), registration, financial preparation, etc. Practicum Journal Entry: Certification Plan

 

Certification plan

PMHNP practice environment for California State

The practice environment for the PMHNP is regulated by the state scope of practice laws. PMHNPs in California practice under a restrictive environment where state law mandates that the PMHNPs collaborate with a physician for them to practice. The PMHNP and the collaborating physician must possess a written protocol that covers all major aspects of care. The protocol is jointly developed by the physician and nurse practitioner.  As indicated by Barton Associates (2020), nurse practitioners in California have the authority to prescribe medications, including schedule two to five controlled drugs but only under supervision by a physician.  A nurse practitioner in California can refer patients for physical therapy but only if it is outlined in the collaborative agreement. A PMHP is restricted from signing death certificates Practicum Journal Entry: Certification Plan.

Comparing the PMHNP practice environment in California State with the state in which I would like to practice (Maryland)

There are notable differences between the practice environment for PMHNP in California and those in Maryland State. Compared to California where state laws restrict the ability of PMHNPs to practice independently, Maryland state laws allow nurses PMHNPs to practice independently without the requirement for physician supervision. According to Barton Associates (2020), nurse practitioners in Maryland can diagnose, treat and prescribe without the involvement of a physician. Additionally, they are authorized to refer patients for physical therapy and to sign death certificates.

Professional and clinical practice issues a new PMHNP will need to consider and address with the certification, licensure, credentialing, or relocation process
.

There are several professional and clinical issues that a new PMHNP needs to put into consideration and tackle with the process of licensure, certification, credentialing and relocation. To offer patient care, a new PMHNP needs to get licensure as well as certification. Halter (2017) claims that licensure enables the nurse practitioner to practice in psychiatric mental nursing while certification is a demonstration that one is proficient in psychiatric nursing. PMHNP receives state licensure from the Board of Nursing.Practicum Journal Entry: Certification Plan.  Licensure requirements include the completion of a degree program from an accredited institution and completion of the NCLEX examination.  After getting state licensure, a PMHNP can receive certification.

National certification is the process by which the PMHNP demonstrates he or she has competencies in psychiatric mental health nursing.   To receive national certification   A PMHNP must sit and pass the ANCC PMHNP board certification examination. According to Halter (2017), for a PMHNP to certification offers nurse practitioners a sense of accomplishment and mastery, recognizes them as competent care providers. To take the ANCC examination, the PMHNP have complete a master’s program,  must have worked for two years as a full time registered nurse, attained two thousand hours in clinical hours within a psychiatric setting as well as thirty hours of continuing education in psychiatric mental health nursing. After a PMHNP takes the ANCC certification examination and passes, one is rewarded a board-certified credential and given the title PMHNP-Board Certified. Practicum Journal Entry: Certification Plan.

Credentialing is by the process by which healthcare agencies use to ensure that PMHNPs meet all the essential requirements and are properly qualified to provide safe and high-quality care to patients.  According to Stewart and DeNisco (2018), the process of credentialing involves authentication of education, licensure, along with reference checks. The process is utilized by numerous institutions, organizations and agencies to officially provide authority to selected healthcare professionals to practice as licensed providers in the health care delivery scheme.

When a PMHNP want to relocate to and practice in a different state, the first step in relocating licensure involves the PMHNP determining the licensure requirements in his current state and the state one wants to relocate, one should find out if his future home state is part of the nurse licensure compact Practicum Journal Entry: Certification Plan.  Roux and Halstead (2017) assert that the compact allows a licensed nurse who lives in a state that participates in the compact to practice in another state that participates in the compact without the requirement to obtain another practice license. If the PMHNP is relocating from the state that does not participate in the NLC, one should apply for licensure via endorsement from the new state’s board of nursing. Practicum Journal Entry: Certification Plan.

Checklist for passing the national certification exam,

Preparation for national examination includes financial and educational preparation. To be eligible to sit for the national certification examination, I must hold an active license, master’s degree and a minimum of five hundred supervised clinical hours. After confirming pricing and eligibility, I will apply for the ANCC examination online and pay the required examination fees. After receiving an eligibility notice, I will schedule a testing date at the Prometric center. Practicum Journal Entry: Certification Plan.

The next step will involve visiting the ACNN to check the test content outline that marks out areas that will be covered in the examination.  Apart from the test content outline, the ANCC also provides a test reference list as well as sample test questions accompanied by their answers. Around six months before I take the examination, I will develop a formal study plan. I will include study topics, resources, timetable and study methods. I will schedule regular study times, setting two hours a day, for five days a week.  I will also take a review course to evaluate my knowledge of the exam content. I will take a review course before the day of the exam so that I will have enough time to master areas I am weak and concentrate on these areas Practicum Journal Entry: Certification Plan.

 

References

Barton Associates. (2020). Nurse Practitioner Scope of Practice Laws. Retrieved from
https://www.bartonassociates.com/locum-tenens-resources/nurse-practitioner-scope-of-practice-laws

Halter, M. (2017).  
Varcaroli’s Foundations of Psychiatric-Mental Health Nursing –E-Book: A Clinical Approach.
St. Louis, MO: Elsevier.

Stewart, J., & DeNisco, S. (2018).
Role Development for the Nurse Practitioner
. Burlington, MA: Jones & Bartlett Learning.

Roux, G., & Halstead, J. (2017).
Issues and Trends in Nursing
. Burlington, MA: Jones & Bartlett Learning. Practicum Journal Entry: Certification Plan

Politics and the Patient Protection and Affordable Care Act sample essay

It is generally accepted that the Patient Protection and Affordable Care Act of 2010 (ACA) by the Obama administration was a revolutionary piece of policy. It seriously attempted for the first time to address social justice in American healthcare. However, the policy was dogged with political undertones from the start, with Republican lawmakers openly being hostile to the legislation. When the Trump administration came to power, repealing and replacing the Affordable Care Act became one of…

Welcome to NURS 6050: Policy and Advocacy for Improving Population Health

Politics and the Patient Protection and Affordable Care Act

Regardless of political affiliation, individuals often grow concerned when considering perceived competing interests of government and their impact on topics of interest to them. The realm of healthcare is no different. Some people feel that local, state, and federal policies and legislation can be either helped or hindered by interests other than the benefit to society.

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Consider for example that the number one job of a legislator is to be reelected. Cost can be measured in votes as well as dollars. Thus, it is important to consider the legislator’s perspective on either promoting or not promoting a certain initiative in the political landscape. Politics and the Patient Protection and Affordable Care Act sample essay.

To Prepare:

Review the Resources and reflect on efforts to repeal/replace the Affordable Care Act (ACA).

Consider who benefits the most when policy is developed and in the context of policy implementation.

Post an explanation for how you think the cost-benefit analysis in terms of legislators being reelected affected efforts to repeal/replace the ACA. Then, explain how analyses of the votes views may affect decisions by legislative leaders in recommending or positioning national policies (e.g., Congress’ decisions impacting Medicare or Medicaid). Remember, the number one job of a legislator is to be re-elected. Please check your discussion grading rubric to ensure your responses meet the criteria. Politics and the Patient Protection and Affordable Care Act sample essay

 

The Politics of Healthcare Policy Formulation: Efforts to Repeal and Replace Obamacare (Affordable Care Act) and the Reluctance by Legislators to Pass the American Health Care Act that Disadvantages Potential Voters

It is generally accepted that the Patient Protection and Affordable Care Act of 2010 (ACA) by the Obama administration was a revolutionary piece of policy. It seriously attempted for the first time to address social justice in American healthcare. However, the policy was dogged with political undertones from the start, with Republican lawmakers openly being hostile to the legislation. When the Trump administration came to power, repealing and replacing the Affordable Care Act became one of their number one preoccupations. The Republican efforts soon faced lack of across-the-board support because legislators realised that the new ‘repeal and replace’ proposals were going to hurt the common American voter. Many Republican legislators started seeing the chances of their re-election becoming slim if they continued with their support for the repeal and replacement of the ACA or Obamacare. This paper is about this political angle to the important healthcare legislative policies that have been implemented in America lately. Politics and the Patient Protection and Affordable Care Act sample essay.

Repealing and Replacing the ACA

The first stab at repealing and replacing the ACA was taken in May 2017 when the American Health Care Act (AHCA) was passed in the House of Representatives (Amadeo, 2018). It is the AHCA that the Trump administration and Republican legislators sought to use to repeal and replace Obamacare. However, it soon became apparent that under the AHCA, 24 million Americans were going to lose health insurance coverage (ASA, n.d.). The AHCA proposed a tax credit not based on income but based on age. This alone was going to raise healthcare costs for many Americans. It also brought a Patient and State Stability Fund that would reduce premiums after 2026 by twenty percent. The result of this, however, was going to be higher costs for Americans already having pre-existing medical conditions. Furthermore, the new law replacing the ACA would give states the power to suspend several rules currently in the ACA given certain circumstances. This also was going to result in Americans with chronic diseases paying higher rates of premium for health insurance coverage (Amadeo, 2018).

How Re-election Prospects Affected Efforts to Repeal and Replace the ACA

           
A cost-benefit analysis by the legislators, Republicans included, soon showed them that they risked not getting re-elected because of the far-reaching negative aspects of ‘repeal and replace’. As observed above, the new policy was going to deprive many Americans of access to affordable healthcare. Yet this is the very thing that Obamacare had addressed Politics and the Patient Protection and Affordable Care Act sample essay. For instance, the American Academy of Family Physicians opposed the proposals in the AHCA as they raised health insecurity among Americans. According to the AAFP, this new policy was increasing costs and denying patients health coverage on account of age, health status, or socio-economic status (AAFP, 2020).

For these re-election reasons, Senate Majority Leader Mitch McConnell found it hard to get votes for the AHCA as it was. None other than the Congress Budget Office (CBO) found fault with the AHCA. In the end, for their own interests the senators came up with their own overhaul proposal called the Better Care Reconciliation Act of 2017 (ASA, n.d.).

How Voters’ Views Affect the Policy Positions of Legislators

Legislators both in the House of Representatives and the Senate are elective leaders that have to campaign to get elected by voters. Because of this very fact, their decisions and positions on policy matters such as the ACA and the AHCA are normally influenced by what voters think. This is of course due to the fact that as politicians, their overriding interest is to get re-elected to office Politics and the Patient Protection and Affordable Care Act sample essay.

References

Amadeo (October 17, 2018). Obamacare repeal and replacement plans: What a Congressional plan to repeal Obamacare would look like.
The Balance
. Retrieved 10 March 2020 from
https://www.thebalance.com/congressional-plans-to-repeal-and-replace-obamacare-4160599

American Academy of Family Physicians [AAFP] (2020).
ACA repeal and replace
. Retrieved 10 March 2020 from
https://www.aafp.org/media-center/kits/aca-repeal-replace.html

American Society of Anesthesiologists [ASA] (n.d.).
Affordable Care Act repeal and replacement legislation
. Retrieved 10 March 2020 from
https://www.asahq.org/-/media/sites/asahq/files/public/advocacy/federal-activities/legislative-activity/2017626-ahca-summary-with-senate-info-final.pdf?la=en&hash=98051C9116F9B4174B4E02FFAD1AE41347D57347 
  Politics and the Patient Protection and Affordable Care Act sample essay

Developing Organizational Policies and Practices essay

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. Developing Organizational Policies and Practices essay.

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.

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  Developing Organizational Policies and Practices essay

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 Developing Organizational Policies and Practices essay. 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.

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Developing Organizational Policies and Practices

Competing Needs Impacting Upskilling of the Healthcare Workforce

The two competing needs impacting the upskilling of the healthcare workforce in the organization include the need to have competent experts to provide the training during the upskilling process and the need to have the required information technology system and equipment where the staff will be the end-user and utilize the trained skills. The organization has a limited number of skilled experts for retraining the healthcare workforce. A lack of skilled experts may hinder the ability to upskill the healthcare workforce (Chaghari et al., 2017) Developing Organizational Policies and Practices essay. Therefore, this indicates that the organization has a competing need to acquire more experts to bridge the gap existing in ensuring that the organization has an adequate number of experts to regularly retrain the organizational staff. The second competing need is the need to have the required information technology system and equipment where the staff members can always use to carry out organizational operations. Even though information technology can be challenging since it involves a great deal of data sharing with different people and other sectors. The complexity of healthcare information technology needs experts and professionals with the necessary experience, competency, and skills to provide high-quality care (Fukada, 2018). Therefore, there is a need for the healthcare organization to invest in information technology and competent professionals who can provide high-quality care, meet the regulation and legal requirements, and also have a competitive advantage over the other healthcare organizations Developing Organizational Policies and Practices essay.

Policy/Practice to Influence the Healthcare Issue/Stressor

The practice and policy that may influence the upskilling of the healthcare workforce is the need to have the organizational workers engage in mandatory continued professional development regularly. The healthcare workforce is also required to attend all organizational training workshops and conferences that focus on improving the skills and competency of the employees (Abebe et al., 2018). For the healthcare workforce to provide high-quality care and meet the constantly changing healthcare needs, they are supposed to continually update their professional skills, knowledge, practice, and values. Accordingly, our organization has a policy that requires all healthcare works to engage in continuing professional development either formally or informally. The healthcare sector is constantly changing and especially with the technology and this indicates the significance of the policy (Chaghari et al., 2017).

This policy influences the upskilling of the healthcare workforce by ensuring the participation of all healthcare workers in the planning upskilling. The upskilling presents an opportunity for the healthcare workforce to engage in continuing professional development as per the organizational policy Developing Organizational Policies and Practices essay. The upskilling of the healthcare workforce provides the healthcare providers with an opportunity to improve and widen their knowledge base and also enhance skills needed during practice.

The Policy for Ethical Considerations & the Policy’s Strengths and Challenges in Promoting Ethics

The policy supports the professional development of organizational workers through training opportunities such as upskilling. Ethically, the healthcare workforce is required to adhere to the appropriate professional standards and code of ethics. For example, professional standards require the nursing staff to continually improve their skills and competency through professional training. Furthermore, the policy requires all healthcare workers within the organization to take part in continuing professional development. Therefore, the policy helps in creating a workplace culture where all organizational workforce is provided with equal opportunities and access to advance their skills and knowledge, making the work environment a positive nurturing environment. More importantly, ethically healthcare providers are required to have the appropriate skills to be able to provide high-quality care as per the professional standards (Farotimi et al., 2018) Developing Organizational Policies and Practices essay. Healthcare organizations are also required to promote best practices in the organizations and add the knowledge base of the workers through training and development.

The key strength of this policy is that all organizational workers are given equal opportunities to improve their skills and competencies. This policy has significantly contributed to creating strong working relationships among employees who all have the required skills and knowledge to provide care. Additionally, this policy has ensured that the organizational healthcare workforce does not provide low-quality care. Participation in continued professional development among the healthcare workforce is also attributable to reduced nursing turnover, improve morale and motivation among the healthcare workforce, and positively impacts the productivity of the healthcare workforce (Koopmans et al., 2018) Developing Organizational Policies and Practices essay. Currently, there are no notable ethical challenges with the policy requiring the healthcare workforce to take part in continuing professional development.

Policy/Practice Changes Designed to Balance the Competing Needs

There is a need to implement a policy that is stricter when it comes to the sharing of hospital information, workers, and patient information following the implementation of information technology.  Ethically, organizations are required to strictly follow the code of privacy and ensure that no one’s right is violated even with the implementation of information technology systems (Petersen, 2018). One of the competing needs includes the implementation of the latest information technology systems as per the changes in the healthcare industry. Accordingly, there is a need to implement policies that address the confidentiality and security of information shared in the information technology systems. Healthcare organizations are required by the law to safeguard private information and comply with any relevant law and legislation (Petersen, 2018) Developing Organizational Policies and Practices essay. HIPAA laws apply to each patient’s information confidential and private. Therefore, with the updating of the information systems, there is a need to apply more stringent laws regarding personal and contact information that could divulge the identity, and any information allied to the health conditions administered treatment and payments for patients. The policy should thus address private and security purposes. The privacy policy purposes should clearly define the information being safeguarded while procedures should clearly outline individuals with permission to access the patient information. The consequences of not adhering to the set policies should also be clearly outlined. For example, if a healthcare provider divulges patient information to a third party without the patient’s consent, such a healthcare provider should face a specific disciplinary action Developing Organizational Policies and Practices essay.

 

 

References

Abebe, L., Bender, A., & Pittini, R. (2018). Building the Case for Nurses’ Continuous Professional Development in Ethiopia: A Qualitative Study of the Sick Kids-Ethiopia Paediatrics Perioperative Nursing Training Program.
Ethiopian Journal of health sciences
,
28
(5), 607–614.
https://doi.org/10.4314/ejhs.v28i5.12
.

Chaghari, M., Saffari, M., Ebadi, A., & Ameryoun, A. (2017). Empowering Education: A New Model for In-service Training of Nursing Staff.
Journal of advances in medical education & professionalism
,
5
(1), 26–32.

Farotimi, A. A., Ajao, E. O., Ademuyiwa, I. Y., & Nwozichi, C. U. (2018). Effectiveness of training program on attitude and practice of infection control measures among nurses in two teaching hospitals in Ogun State, Nigeria.
Journal of education and health promotion
,
7
, 71. https://doi.org/10.4103/jehp.jehp_178_17. Developing Organizational Policies and Practices essay

Fukada M. (2018). Nursing Competency: Definition, Structure, and Development.
Yonago Acta Medica
,
61
(1), 1–7.
https://doi.org/10.33160/yam.2018.03.001
.

Koopmans, L., Damen, N. & Wagner, C. (2018). Does diverse staff and skill mix of the team’s impact quality of care in long-term elderly health care? An exploratory case study.
BMC Health Serv Res
, 18(988).
https://doi.org/10.1186/s12913-018-3812-4
.

Petersen C. (2018). Through Patients’ Eyes: Regulation, Technology, Privacy, and the Future.
Yearbook of medical informatics
,
27
(1), 10–15. https://doi.org/10.1055/s-0038-1641193 Developing Organizational Policies and Practices essay

Upskilling of the Healthcare Workforce: A Pertinent National Healthcare Issue Affecting Healthcare Organizations in the United States Upskilling of the Healthcare Workforce Essay

There are many national healthcare stressors or issues affecting and impacting healthcare organizations all over the United States. All of them require addressing, although some are more urgent than others. The healthcare issue chosen in this case and one of the most significant stressors at the moment is the issue of upskilling of healthcare professionals. In this context, these would be the nurses working within the healthcare organization. According to Ross (2019), upskilling is the process of retraining employees so that they can acquire new skills for them to continue practicing in their field with ease. Recent developments (particularly technological) within and around healthcare have necessitated the requirement that workers such as nurses possess skillsets that are upgraded. As a matter of fact, upskilling was identified as one of the six important healthcare issues in 2019 by PwC Health Research Institute (Ross, 2019). Currently, whole healthcare workforces are threatened with redundancy by technologies such as artificial intelligence (AI) if they do not upskill. This includes nurses, who have traditionally not been involved with technology in the course of delivering nursing care (Teague, 2019).

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The impact to my healthcare organization of upskilling as a healthcare issue is immense. This is because emerging healthcare technologies are becoming more and more mandatory in diagnostics, therapeutics, and nursing care. Nurses are therefore finding themselves short of skills to deliver quality patient care. This makes the organization set aside resources to retrain and upgrade the skills of its nurses so that they can cope with the emerging technological changes. This, however, is an inevitably resource-intensive undertaking fir the organization. In my organization, for instance, the policy makers have already had to set aside funds for training of the nurses and other healthcare staff on the use of the recently introduced EHR. Already, upskilling is happening in the healthcare sector with the now standard requirement for electronic health records or EHR. That said, the hallmark of upskilling in healthcare is predicted to be artificial intelligence-assisted telehealth interventions (Teague, 2019) Upskilling of the Healthcare Workforce Essay.

Some of the Areas of Concern

Healthcare organizations must invest in the abilities of their workforce if they are to have a competitive advantage over their peers. Not doing so will of course render the organization unable to compete effectively in an ever-changing healthcare marketplace. For instance, AI is more and more used in healthcare at the moment. What this means is that rising sophistication of emerging medical technologies is driving the need for upskilled health workers (Ross, 2019) Upskilling of the Healthcare Workforce Essay. The advent of digital therapeutics is the other area of concern. This is the treatment of disease using healthcare technologies to complement or replace traditional methods in disease management. The reality is that the clinical validation of these digital therapeutics products and connected medical devices is already being done by the Food and Drug Administration or FDA (Siwicki, 2019). This is an indicator of the urgency with which upskilling of healthcare staff like nurses should be treated Upskilling of the Healthcare Workforce Essay.

Two Articles on the Upskilling of Healthcare Workers as a Healthcare Issue of Concern

           
Rimmer (2018) has posited that doctors have to undergo additional training in order to be successful at using emerging healthcare technologies. This particular article addresses doctors as the healthcare workers of concern, but it has been chosen because the very same situation is true for the nurses. This article talks of a report that states that training is needed by doctors in areas such as artificial intelligence algorithms, genomics, and digital literacy. As mentioned above, that is the same treatment that nurse practitioners should also receive. The article goes ahead to stress that training is a must for healthcare staff in order to cope with emerging healthcare technologies.

Fralic (2013) on her part observes that the American healthcare system is undergoing change that is radical and monumental. She states, correctly, that with change there is need to re-strategise and re-organize to deliver quality healthcare. To do this, upskilling is a must to keep up with healthcare technologies. In other organizations in the healthcare sector, the same situation portends. They, too, are adopting the same approach of retraining to upskill nurses, doctors, and other health workers so that they can cope with the recent technological changes and continue to offer quality and safe patient care Upskilling of the Healthcare Workforce Essay.

Strategies to Address the Organizational Impact of Upskilling

Since the reality of upskilling in healthcare organizations is inevitable, it is essential to develop strategies that aim at addressing the organizational impact of this issue. Three strategies are especially helpful. First, the organization needs to introduce new technologies gradually to allow for adaptation and training. Second, upskilling should be made a policy initiative that features in the organization’s goals. Third and last, upskilling should be properly budgeted for like any other expense if it is to succeed (Fralic, 2013; Rimmer, 2018; Teague, 2019). Under no circumstances should upskilling be considered as an afterthought. These strategies impact my organization positively in that they are geared towards giving the organization a competitive advantage. On the negative side, however, budgeting means that this strategy will consume resources that the organization must set aside. Upskilling of the Healthcare Workforce Essay.

References

Fralic, M.F. (2013). Upskilling for new-era healthcare: Lessons from high impact readings.
Nurse Leader, 11
(4).
http://dx.doi.org/10.1016/j.mnl.2013.05.008

Rimmer, A. (2018). Upskill doctors to make the most of new medical technologies, report says.
BMJ,
361
(k2861). Doi: 10.1136/bmj.k2861

Ross, J.R. (2019).
Upskilling could be an ideal treatment for healthcare’s employment woes
. Retrieved 4 March 2020 from
https://www.cardiovascularbusiness.com/topics/healthcare-economics/upskilling-could-be-ideal-rx-healthcares-employment-woes

Siwicki, B. (2019). Here are 6 major issues facing healthcare in 2019, according to PwC.
Healthcare ITNews
. Retrieved 4 March 2020 from
https://www.healthcareitnews.com/news/here-are-6-major-issues-facing-healthcare-2019-according-pwc

Teague, T. (2019).
Will healthcare employees need to be upskilled or reskilled as technology advances?
Retrieved 4 March 2020 from
https://www.whatisbluesky.com/blog/will-healthcare-employees-need-to-be-upskilled-or-reskilled-as-technology-advances 
 Upskilling of the Healthcare Workforce Essay

nursing journal article critique example

1. Address the essential parts of the study addressed within the abstract. 2. What is the problem statement & significance to nursing practice? 3. What is the purpose of the study? 4. What type of research method was used? 5. Detail applications to practice & how you can incorporate this into your own practice. 6. What future studies would you recommend? I have my own research article. It is found in the Journal of Emergency Nursing,vol-46(1),51-58. Ttitle: Experiences of care in the Emergency Department among a sample of homeless male veterans: A qualitative study. nursing journal article critique example.

All sources need to be within the last 5 years. Sources should be journals or medical organization websites, no books.

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Critique a Scholarly Peer-Reviewed Nursing Journal Article

Weber, J. J., Lee, R. C., & Martsolf, D. (2020). Experiences of care in the emergency department among a sample of homeless male veterans: a qualitative study.
Journal of Emergency Nursing
,
46
(1), 51-58.

Parts of the Study Addressed in the Abstract

An abstract should be succinct and clear. Similarly, the abstract of the article is brief, concise and clear and summarizes the content of the article. An abstract should include the introduction, purpose, methodology, results, and conclusions. The abstract of this article has the introduction, method, results, and discussion part. The introduction part concisely introduces the study and stipulates that the purpose of the study is to present the experiences of homeless male veterans during their visits to the emergency department. The methods part indicates the study framework as grounded theory methodology while structured interviews were used to collect the data. The results section is however extremely brief and ambiguous nursing journal article critique example.  The discussion part briefly discusses the findings of the study.

The Problem Statement & Significance to Nursing Practice

The problem statement is about the homeless populations who have been a tendency of using the emergency department even for the low-acuity health issues that can be treated within other settings such as primary care settings (Weber, Lee & Martsolf, 2020). According to Chrystal et al (2015), homeless populations often face social, medical, and environmental challenges to their health. A significant number of the homeless population includes the veterans who are often visiting the community (Weber et al., 2020). This issue is important to nursing practice because homeless populations disproportionately experience medical illnesses, substance abuse, as well as mental disorders. Also, the challenges experienced by the homeless populations are further aggravated by the fact that the homeless underutilize health services with problems in accessing specialty and primary care, as well as the high number of unmet health needs. This leads to unnecessary increased utilization of visits to the emergency department (ED). Therefore, this study sought to explore the experience of homeless male veterans when they try to access care in the ED.

The Purpose of the Study

The purpose of the study was to explore the experience of homeless male veterans when they try to access care in the ED (Weber et al., 2020). The purpose of the study specifies the nature of the population under study. The population being studied is homeless male veterans. Therefore, the study seeks to identify the experiences of the population under the study when they try to seek healthcare in the emergency department.

Type of Research Method

The study adopted a grounded theory methodology as the framework for the study. Grounded theory methodology includes systematic inductive techniques for carrying out qualitative researches to develop a theory (Rahman, 2017). Grounded theory methodology was suitable because it is suitable for exploring the experiences of the study participants to come up with a theory. In this study, the grounded theory methodology depended on the experiences of male homeless veterans about access to healthcare. An unstructured interview does not involve any predetermined questions even though it covers the study topic. Additionally, in unstructured interviews, open-ended questions are used and this allows in-depth exploration of the answers (Rahman, 2017). The unstructured interview was suitable for a qualitative study because the questions are very flexible and produce qualitative data using open questions. This allows collection of in-depth data and assists the researcher to get the reality of the study participant’s understanding of a situation. Additionally, unstructured interviews have higher validity because the interviewer can probe for more understanding, make inquiries, ask for clarification, and also allow study participants to steer to the interview’s direction. This indicates the suitability of using unstructured interviews to collect data (Rahman, 2017). The information from the interviews was audio-recorded and transcription was done for analysis. The grounded theory methods were further used to identify emerging codes. Data analysis for the emerging themes and codes was then performed.

The main strength of the qualitative phenomenological research design that was used in this study is that the method is flexible and therefore ensures flexibility and freedom during the interviews when investigating and exploring experiences and insights from the participants of the study. Moreover, a qualitative research design ensures that there is an in-depth collection of data on the insights, experiences, feelings, and opinions of the study subjects. Accordingly, the research design used in this article ensured that there was a deeper exploration of the experiences and insights from the male homeless veterans (Rahman, 2017).

However, there are a few limitations associated with the study methodology used in the selected article. The unstructured interviews used in phenomenological research design does not cover contextual sensitivities but only focuses on the experiences and meanings. Finally, the sample size in this study was 35; the size of the sample is relatively small and thus may limit the generalization of the findings to the general population or limit application of the findings to practice (Rahman, 2017). nursing journal article critique example

Applications to Practice & how to Incorporate Findings into Practice

The findings of this study showed that homeless populations highly seek care in the emergency department. Findings further indicate that the homeless populations often feel unrecognized and they are not shown compassion when they visit ED. The findings show that the homeless highly seek care in the ED, but that their medical needs may not be met in other healthcare settings such as primary care settings. Services provided in the EDs such as accessibility 24/7, care provision without an appointment, and treatment of acute injuries encourage higher utilization of emergency services (Moulin, et al., 2018) nursing journal article critique example. Acute injuries are common among the homeless and thus a big predictor of ED use by the homeless. However, homeless populations under-utilize health services, especially when it comes to accessing specialty and primary care. The population also has a high number of unmet health needs (Gable et al., 2018). Therefore, there is a need to implement interventions that increase awareness among the homeless populations regarding the need to seek treatment in other settings such as primary care, specialty, and ambulatory care settings. The nursing staff working in the ED need to be actively involved in educating the homeless populations regarding their health problems and alternatives to emergency department care. Besides, there is a need to address the needs of the homeless people who demonstrate repeated utilization of the emergency department. For example, the housing and nutrition needs of the homeless need to be addressed to reduce their vulnerability to illnesses and injuries (Field et al., 2019). In this regard, nurses need to act as the patient advocates and advocate for the implementation of the policies that support the provision of housing and nutrition needs of the homeless populations. nursing journal article critique example.

Recommendations for Future Studies

Homelessness significantly impacts the use of the emergency department. Homeless populations depict a high number of visits to the ED and hospitalizations, and particularly after discharge to shelters or streets.

However, there are few numbers of studies that examine the health needs and health outcomes of the homeless populations. Additionally, there are minimal clinical guidelines that cover the provision of care for homeless populations. Therefore, further research is required to comprehend the health needs of the homeless populations and to guide the care of the homeless within acute care settings nursing journal article critique example.

Moreover, the provision of care to the homeless populations in the emergency departments is complex. Moreover, it is important for the nursing staff working in the ED to be conversant with the social determinants of health as well as the special features of homelessness in their community. Therefore, further research is required to better understand the aspects and needs of the homeless population, to provide care better to this vulnerable population.

 

References

Chrystal JG, Glover DL, Young AS, Whelan F, Austin EL, Johnson NK, et al. (2015) Experience of Primary Care among Homeless Individuals with Mental Health Conditions.
PLoS ONE
, 10(2): e0117395.
https://doi.org/10.1371/journal.pone.0117395
.

Field, H., Hudson, B., Hewett, N.
et al.
(2019). Secondary care usage and characteristics of hospital inpatients referred to a UK homeless health team: a retrospective service evaluation.
BMC Health Serv Res
, 19(857).

Gable, A. R., Der-Martirosian, C., & Dobalian, A. (2018). Access to Care for Homeless Veterans During Disasters.
Journal of Primary Care & Community Health
,
9
, 2150132718815382.
https://doi.org/10.1177/2150132718815382
.

Moulin, A., Evans, E. J., Xing, G., & Melnikow, J. (2018). Substance use, homelessness, mental illness, and Medicaid coverage: a set-up for high emergency department utilization.
Western Journal of Emergency Medicine
,
19
(6), 902.

Rahman S. (2017). The Advantages and Disadvantages of Using Qualitative and Quantitative Approaches and Methods in Language “Testing and Assessment” Research: A Literature Review.
Journal of Education and Learning
, 6(1).

Weber, J. J., Lee, R. C., & Martsolf, D. (2020). Experiences of care in the emergency department among a sample of homeless male veterans: a qualitative study.
Journal of Emergency Nursing
,
46
(1), 51-58. nursing journal article critique example

Innovative approaches to classroom nursing education essay

Two innovative approaches to classroom education for nursing

Simulation

Simulation is an innovative approach to classroom education where learning is centered on the student with the student being permitted to learn within an environment that is identical to the actual clinical environment. Nurse educators use simulation to provide learners with the opportunity to broaden their understanding of different clinical scenarios in a controlled and safe environment.   Simulation, particularly high-fidelity simulation is valuable for the creation of realistic scenarios that imitate the environment for patient care and permit learners to more directly apply theoretical knowledge compared to traditional teaching strategies. Faulcon (2015) asserts that simulation aims at shifting the nursing pedagogy from conventional passive teaching methods to active learning where the learner is engaged Innovative approaches to classroom nursing education essay.  Simulation provides the student with the opportunity to think critically as well as problem-solve utilizing clinical reasoning within a non-threatening environment.

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Simulation as a learning activity permits the instructor to offer scenarios that imitate the realism of the clinical environment.  Faulcon (2015) indicates that simulation is learner-centered, where the educator functioning as a facilitator in the learning process of the student. Simulation inspires the learner to develop affective, cognitive and psychomotor skills before getting into the actual-world clinical setting.  As a facilitator, the nurse educator assesses and evaluates the ability and skill level of the student to meet the expected learning outcomes. For instance, learners can approach a mannequin which acts as a patient, great the mannequin, introduce themselves and explain procedures to be performed as it were an actual patient encounter. This practice might assist learners to gain confidence and feel at ease with patient exchanges in the real clinical environment.

Case study

A case study is a teaching method that involves a description of a real situation, usually involving a problem,  a challenge,  an opportunity, or an issue faced by an individual or a group of individuals. Case studies are used to allow students to apply problem-solving skills and concepts with supporting data and documentation. According to Radha and VijayaNarayanan (2019), case studies are complex and realistic stories, usually involving an issue or conflict that student needs to resolve. The purpose is to seal the gap between theory and practice, as well as promote critical thinking and action planning.  The instructor is required to inform the students of summary propositions to resolve a case study after the students have had the chance to resolve the case on their own. Innovative approaches to classroom nursing education essay.

Case studies do not offer explicit or simple answers but they provoke critical thinking of students, illustrate the way of thinking professionally and urge learners to utilize hypothetical concepts to emphasize a clinical issue.   As indicated by Radha and VijayaNarayanan (2019) case studies integrate notions of experimental learning by facilitating student-centered learning and provide opportunities that inspire learners by actively involving them. Also, case studies offer an avenue for the utilization of problem-solving skills and encourage decision making within an environment that is non-threatening. Bradshaw and Hultquist (2016) claim that case studies can be utilized as a class activity to educate learners to reason on their feet and to strengthen the necessity to comprehend concepts in actual life situations. A case study takes facts and uses them in practical manners. This form of application demonstrates to learners the way chosen interventions focus on patient outcomes.

 

References

Bradshaw, &  Hultquist, B. (2016).
Innovative Teaching Strategies in Nursing and Related Health Professions, Seventh Edition
. Burlington, MA: Jones & Bartlett Learning.

Faulcon, R. (2015). Innovative Teaching Strategies with Simulation Technology in Nursing Education.
Journal of Bermuda College
, 1, 47-50.

Radha, K., & VijayaNarayanan, N. (2019).  A scoping View of Effective Teaching Strategies Vs Learning Dynamics in Nursing Education.
ISOR Journal of Nursing and Health Science, 8
(5), 56-62. Innovative approaches to classroom nursing education essay