Tag: Clinical-Nursing

Leadership Theories in Practice in Nursing Discussion – Week 4

            This paper will make reference to three formal leadership theories namely health-promoting, transformational, and transactional leadership theories. Health-promoting leadership aims at indirectly supporting the health of employees by creating healthy working conditions. Such working conditions are those that reduce the risk of stress and burnout (Jimenez et al., 2017). Transformational leadership is mainly concerned with the creation of motivation and relationships among employees Leadership Theories in Practice in Nursing. Transformational leaders inspire employee respect, confidence and loyalty (Sfantou et al., 2017). As for transactional leadership, the focus is on results. There is conformity to the organizational structure and success is measured based on the organization’s system of penalties and rewards (Asiri et al., 2016).

            The article by Jimenez et al (2017) documents a study that sought to determine the impact of health-promoting leadership on the working environment. The study established that health-promoting leadership can be defined as the capability and dedication of a leader to create the right working conditions for the organization’s employees. According to the study, such conditions constitute increased access to resources as a result of which the risk of the employees experiencing stress and burnout is reduced (Jimenez et al., 2017) Leadership Theories in Practice in Nursing. In the study explained in the article by Sfantou et al (2017), the author’s aim was to establish the impact of leadership style on the quality of care provided in healthcare settings. The researchers narrowed down to two leadership styles namely transformational and transactional leadership styles. They found that effective leadership is associated with a high-quality work environment that ultimately produces positive patient outcomes that serve as a motivation for the employees to do more. Transformational leadership was particularly linked to lower patient mortality. The study by Asiri et al (2016) was focused on determining the relationship between leadership styles and empowerment and the organizational commitment that nurses show in an acute healthcare setting. The study evaluated transactional and transformational leadership styles. The finding was that the nurse managers did not display the right level of transformational leadership behaviors and this negatively affected the nurses’ commitment to the organization. The transactional leadership style was, however, employed appropriately and this was associated with a higher commitment. Leadership Theories in Practice in Nursing

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From the above resources, it is clear that leadership behaviors are extremely important in the healthcare setting where the safety of patients has to be upheld. One key insight is that in accordance to health-promoting leadership theory, leaders should ensure that employees have adequate access to resources as a way of cushioning them from stress and burnout. Stress and burnout leave nurses unable to appropriately attend to the need of patients, thereby compromising patient safety. A second insight is that a leadership theory or style, no matter how good it is, has to be adopted fully for it to produce the desired results. This can be seen in that whereas transformational leadership was associated with lower patient mortality in Sfantou et al (2017)’s study, inadequate transformational leadership behaviors resulted in a lower commitment to the organization in Asiri et al (2016)’s study.

I have seen the use of health-promoting leadership behaviors at my workplace. I work in a very busy inner-city Emergency Room/Trauma Center. This means that the flow of patients is high and the staff often has to attend to many patients within a short time; or fast enough to stabilize them. The patient acuity is very high, and it is imperative that we as a team, have the necessary resources in order to provide the most effective patient-centered care. To do this, it is extremely important that we have access to all required resources. For instance, our nurse manager arrives very early in the morning and secures all resources that are required on a typical day. It is a skill she has mastered over the years and we are almost always assured that we will get what we need when we need it. This approach has been extremely effective in ensuring that we do not move around looking for equipment and other resources thereby wasting precious time and opportunity to save the lives of our patients. Transformational leadership is also evident in the organization. Every end of the week, the nurse managers debrief the nursing staff, during which we reflect on accomplishments on the unit, as well as identifying opportunities for improvement. Any problematic issues, including those that interfere with the staff relationships such as the failure of one nurse to cooperate, are addressed therein. Doing this over time has produced staff that is highly cooperative and motivated to work together towards common outstanding results. Although I prefer a transformational form of leadership, I have adapted to be able to follow a transactional leadership style. Leadership Theories in Practice in Nursing.

 

References

Asirir, A., Rohrer, W., Al-Surimi, K., Da’ar, O. & Ahmed, A. (2016). The association of leadership styles and empowerment with nurses’ organizational                                 commitment in an acute         health care setting: a cross-sectional study. 
BMC Nursing,
 
15
:38

Jimenez, P., Bregenzer, A., Kallus, W., Fruhwirth, B. & Wagner-Hartl, V. (2017). Enhancing      Resources at the Workplace with Health-Promoting Leadership.                   
International Journal of        Environmental and Public Health, 14
(10):1264

Sfantou, D., Laliotis, A., Patelarou, A., Sifaki-Pistolla, D., Matalliotakis, M. & Patelarou, E.        (2017). Importance of Leadership Style towards Quality of Care                    Measures in Healthcare        Settings: A Systematic Review. 
Healthcare (Basel), 5
(4):73

Discussion 1: Leadership Theories in Practice

A walk through the Business section of any bookstore or a quick Internet search on the topic will reveal a seemingly endless supply of writings on leadership. Formal research literature is also teeming with volumes on the subject.

However, your own observation and experiences may suggest these theories are not always so easily found in practice. Not that the potential isn’t there; current evidence suggests that leadership factors such as emotional intelligence and transformational leadership behaviors, for example, can be highly effective for leading nurses and organizations. Leadership Theories in Practice in Nursing

Yet, how well are these theories put to practice? In this Discussion, you will examine formal leadership theories. You will compare these theories to behaviors you have observed firsthand and discuss their effectiveness in impacting your organization.

To Prepare:

Review the Resources and examine the leadership theories and behaviors introduced.

Identify two to three scholarly resources, in addition to this Module’s readings, that evaluate the impact of leadership behaviors in creating healthy work environments.

Reflect on the leadership behaviors presented in the three resources that you selected for review.

By Day 3 of Week 4

Post
 two key insights you had from the scholarly resources you selected. Describe a leader whom you have seen use such behaviors and skills, or a situation where you have seen these behaviors and skills used in practice. Be specific and provide examples. Then, explain to what extent these skills were effective and how their practice impacted the workplace.

By Day 6 of Week 4

Respond
 to at least 
two
 of your colleagues 
on two different days
by explaining how the leadership skills they described may impact your organization or your personal leadership, or by identifying challenges you see in applying the skills described Leadership Theories in Practice in Nursing

Great discussion, True to your statement, health-promoting leadership aims at indirectly supporting the health of employees by creating healthy working conditions and transformational leadership as defined is a general set of behaviors applicable across various settings where the leader wishes to inspire, motivate, and present a value-based vision that inspires action.

Effective leadership has been identified as crucial to positive patient/client outcomes across all clinical settings and strong leadership is critical for an organization if the vision of a transformed healthcare system is to be realized.

Transformational leaders are leaders that are equipped with effective leadership style, be it democratic or autocratic or a combination of other styles and should not just be present at the highest level of nursing. Rather, transformational leaders should be present at every level of the organization to inspire future leaders, empower the staff and share in the decision making. Leadership Theories in Practice in Nursing

The nursing leadership should set the standard for a transformational leadership and develops a well-articulated philosophy, professional practice model, strategic and quality plans in leading the nursing services.

In addition, nursing leaders must be knowledgeable and competent to be able to support the move for change to meet the current trends of the organization and to improve staff’s performance and satisfaction as well as ensure positive patients’ outcomes. Great post!

I also agree that transformational leaders are focus driven and work to make things happen in a timely and seamless manner- creating and enacting mandates are frequent measures of transformational leaders; however, it is important to note that even when a leader has a clear vision, lasting leadership occurs when people “follow you not because they must but because they want to” (Armstrong, 2018, p140). 
 
Everyone likes to be encouraged and to work in a collaborative environment, creating a more effective work environment through heightened morale, team building, and a desire to come together for the good of the unit.
Leadership Theories in Practice in Nursing

Reading of how your department operates is how the department I work in used to operate- and it is a good reminder that these places do exist. The leadership within your department echoes what Marshall and Brome (2017) describes as critical to leadership through
 
“leadership development, coaching, and mentoring,” as all critical to developing transformational leadership (p. 164).
 
 Within our department, we had an amazing leader; however, when she moved on to a higher role within the organization, there was a vacancy in her position for a long time, and now there doesn’t seem to be cohesion, I am the only nurse left with more than ten years’ experience, we can’t seem to keep nurses in the department, and there is no sense of teamwork.
Leadership Theories in Practice in Nursing

Our former director, was always available for questions, she actively worked on the floor, and wasn’t just an administrator (though I understand sometimes this isn’t possible). Nevertheless, through her involvement with the staff, even the small things such as celebrating birthdays, milestones in years of service, etc., she was able to create an atmosphere of a true work family and everyone wanted to work in the department. She demonstrated true leadership through being goal-driven, supportive, and through recognizing the value of teamwork, feedback, collaboration, and making decisions effectively, efficiently, and collaboratively when appropriate (Marshall and Broome, 2017). Leadership Theories in Practice in Nursing

 

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References

Armstrong, Lori, DNPc, MSN, R.N., N.E.A.B.C. (2018). CNE describes inseparable linkbetween nursing care and patient outcomes. Biomedical Instrumentation & Technology,
 
       
 
52(2), 140-142. Retrieved from              
 
                                                                                                                                     
http://ezproxy.gardner-webb.edu/login?url=https://search-proqust-com.ezproxy.gardner-webb.edu/docview/2018965296?accountid=11041

Marshall, E., and. Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2
nd
ed). New York, NY: Springer.(pp.145-170) Leadership Theories in Practice in Nursing.

NRS-434VN Developmental Assessment and the School-Aged Child Essay

Developmental Assessment for Children

Children undergo a series of stages indicating their growth and development, and obtaining important data through assessments are vital. Various aspects are included in the assessment such as speech, cognition, motor skills, etc. Developmental assessments help monitor the developmental stage that a child is in and if it is appropriate for his or her age. In addition to this, the assessments will determine whether there are children with special needs that require extra attention and some modifications in some areas of their lives NRS-434VN Developmental Assessment and the School-Aged Child Essay. The assessment skills of the one conducting the assessment are important, but the process does not solely lie on the assessor, it also requires the involvement of the parents and the caregiver of the children.

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The data gathered during an assessment is subject to differences because of the varying needs of children depending on their age. Aside from age, the data gathering is also different depending on the developmental stage, and skills of a child. An example of this is the level of involvement of the child’s caregiver which appears higher for 5-year-old children in comparison to 12-year old ones because younger children are still learning how to communicate more effectively. Another example is conducting a standardized examination in written form, which is a good technique for children who are skilled in reading and writing but is not appropriate for younger children who have not yet acquired these skills. In addition to these, the exposure of children to different stimuli such as school highly affects the child’s developmental progress (Li, et al. 2017). These factors alter the approach during the assessment of children because the specific needs of children of varying ages and stages should be met (Milner, et al. 2019) NRS-434VN Developmental Assessment and the School-Aged Child Essay.

The physical development of children also varies, most especially during their growing years. School-age children have good motor skills described as smooth and strong execution, but some aspects are still developing such as endurance, balance, and coordination. These skills including fine motor heavily dictate their ability to perform daily activities like washing the dishes, writing, and buttoning shirts.

Clyde is a 7-year-old boy, delivered as a full-term baby without significant birth issues. Clyde received nutrition through breastfeeding for the first 6 months before he was slowly weaned off to try ingesting soft foods. He demonstrated rolling over at 4 months, sitting without support at 6 months, and standing with a high guard at 9 months which are all considered as expected physical development of children at the given ages. Stair negotiation, ball-kicking, and skipping are also demonstrated promptly. During the following years, improvement in communication skills also became evident. Clyde can follow and understand simple instructions at 2 years of age at 5 years of age, Clyde can speak in clear, full sentences when engaging in a conversation, and can narrate stories with knowledge of reality versus fantasy (Edgar, et al. 2018). Clyde has a great relationship with both parents, and with other members of the family. Some limitations were noted by the mother when Clyde suffered a fracture in the distal radius of his left hand due to a bad fall at 6 years old. This injury resulted in deformation and some limitations in movement minimally affecting fine motor activities. Clyde is showing positive behavior despite dependence on his parents and caregivers due to his past injury.

Piaget’s cognitive developmental theory focuses on an individual’s thought processes. This also tackles how these thought processes influence an individual’s perspective and how he or she interacts with the environment (Sanghvi, 2020). The theory of Piaget mentions four stages of development and at 7 years of age, Clyde is in the concrete operational stage. This stage is when a child begins to have a better understanding of mental operations, wherein logical train of thoughts can be expected regarding a concrete event, but still has difficulty in grasping abstract thoughts (Marwaha, et al. 2017).

During the assessment, Piaget’s cognitive development theory will be helpful with the aid of Clyde’s mother or caregiver to bring out the skills and abilities of Clyde. The child already has skills in communicating with other people and this will make the assessment easier, most especially when giving out instructions to gather data. Using Piaget’s theory, props and other learning aids may be useful when conducting the assessment, because this will not only make Clyde understand and communicate better, but it will also lengthen his attention span and engagement in the activities required by the assessor. Being at a stage that is already logical, physical, behavioral, cognitive skills, and responses of Clyde can be challenged to also address the reported difficulty of Clyde in certain activities. His perspective about the injury and its impact on his life should be also considered as it also affects his mental state and his behavior towards his environment. Activity modification should be provided to aid in a holistic intervention that will improve the quality of life of Clyde NRS-434VN Developmental Assessment and the School-Aged Child Essay.

 

References:

Edgar, L., Roberts, S., & Holmboe, E. (2018). Milestones 2.0: a step forward. 
Journal of graduate medical education
, 
10
(3), 367-369.

Li, Y. W., Han, X., & Wang, T. Y. (2017). Innovation: an eternal theme in the development of pediatrics. 
Chinese Medical Journal
, 
130
(23), 2773.

Marwaha, S., Goswami, M., & Vashist, B. (2017). Prevalence of Principles of Piaget’s Theory Among 4-7-year-old Children and their Correlation with IQ. 
Journal of clinical and diagnostic research: JCDR
, 
11
(8), ZC111.

Milner, K. M., Bhopal, S., Black, M., Dua, T., Gladstone, M., Hamadani, J., … & Lawn, J. E. (2019). Counting outcomes, coverage and quality for early child development programmes. 
Archives of disease in childhood
, 
104
(Suppl 1), S13-S21. NRS-434VN Developmental Assessment and the School-Aged Child Essay.

Sanghvi, P. (2020). Piaget’s theory of cognitive development: a review. 
Indian Journal of Mental Health
, 
7
(2).

 

The needs of the pediatric patient differ depending on age, as do the stages of development and the expected assessment findings for each stage. In a 500-750-word paper, examine the needs of a school-aged child between the ages of 5 and 12 years old and discuss the following:

Compare the physical assessments among school-aged children. Describe how you would modify assessment techniques to match the age and developmental stage of the child. NRS-434VN Developmental Assessment and the School-Aged Child Essay

Choose a child between the ages of 5 and 12 years old. Identify the age of the child and describe the typical developmental stages of children that age.

Applying developmental theory based on Erickson, Piaget, or Kohlberg, explain how you would developmentally assess the child. Include how you would offer explanations during the assessment, strategies you would use to gain cooperation, and potential findings from the assessment.

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

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion NRS-434VN Developmental Assessment and the School-Aged Child Essay.

You are required to submit this assignment to LopesWrite. Refer to the 
LopesWrite Technical Support articles
for assistance. NRS-434VN Developmental Assessment and the School-Aged Child Essay

Week 4 Discussion Main Post – Nursing Leadership Theories in Practice

 
Broome & Marshall (2021) state, the power of a leader is magnified by an effective team and the leader who empowers team members to expand the capacity of the whole organization at all levels (p.213) Nursing Leadership Theories in Practice.
 
This first key insight was helpful to come across in the text because it affirms the idea of team empowerment. 
 
I have been a nurse for 12 years in 3 different hospitals and many different floors; I have never felt so autonomous or cared for than by my current leadership who pushes us to always strive for excellence in our specialty. 
 
The second key insight I came across was speaking of leaders and their ability to craft a compelling vision while inspiring others to follow them (Laureate Education, 2018, Video File). 
 
This hit home because I have served under many people in leadership positions that despite their role, they had little influence over staff because of their personal leadership traits that drove people away instead of bringing them together for a common goal. 
Nursing Leadership Theories in Practice

 
The president of my hospital took over about 2 years ago in his leadership position of president. 
 
His personality is not one that is loud, demanding, or over the top but rather one that commands the room because he is calm, open-minded, and servant-hearted. 
 
He has totally turned our hospital around by empowering and encouraging everyone from physicians, kitchen staff, nurses, EVS workers, and so on, to be excellent in their own personal walk so that they may be the best version of themselves for our patients. 
 
He has the qualities of a leader described above and so many more. 
 
I would say his best leadership trait is serving others, without expectation of a return, but so that they can be made to feel of worth and value. I have seen him do this with a hospital-wide pancake breakfast where he is the one flipping pancakes, holding open office hours for drop-ins weekly for all staff, putting on scrubs, and helping the floors where he can be of help. 
 
During these events where I see him serving, I see him listening to staff and taking note of our needs. Nursing Leadership Theories in Practice

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By taking care of the staff in the ways that staff members specially request he gains respect, trust, and loyalty. 
 
 Watching him advocate for his team in leadership meetings and out in the community because he chose to listen makes me feel seen as a team member. 
 
The Moore foundation (2016) leadership video says that a great leader shows up and uses their voice. 
 
I can’t think of a better person than my hospital president that displays servant leadership, active listening, and who shows up when needed. 
 
He uses his voice to command a room and his hands to serve those he is commanding. 
 
As a product of this type of leadership, he has an entire hospital of staff that will follow wherever he leads. 
Nursing Leadership Theories in Practice

References

Laureate Education (Producer). (2018).
 
The Leader in You
 
[Video File]. Baltimore, MD: Author.
 

Marshall, E., & Broome, M. (2021).
 
Transformational leadership in nursing: From expert

clinician to influential leader
 
(3
rd
 
ed.). New York, NY: Springer

Moore Foundation. (2016).
 
Nurses share lessons in leadership.
 
Retrieved June 22, 2020, from

http://www.youtube.com/playlist
?
 

 

Discussion 1: Leadership Theories in Practice

A walk through the Business section of any bookstore or a quick Internet search on the topic will reveal a seemingly endless supply of writings on leadership. Formal research literature is also teeming with volumes on the subject.

However, your own observation and experiences may suggest these theories are not always so easily found in practice. Not that the potential isn’t there; current evidence suggests that leadership factors such as emotional intelligence and transformational leadership behaviors, for example, can be highly effective for leading nurses and organizations. Nursing Leadership Theories in Practice

Yet, how well are these theories put to practice? In this Discussion, you will examine formal leadership theories. You will compare these theories to behaviors you have observed firsthand and discuss their effectiveness in impacting your organization.

To Prepare:

Review the Resources and examine the leadership theories and behaviors introduced.

Identify two to three scholarly resources, in addition to this Module’s readings, that evaluate the impact of leadership behaviors in creating healthy work environments.

Reflect on the leadership behaviors presented in the three resources that you selected for review. Nursing Leadership Theories in Practice

By Day 3 of Week 4

Post
two key insights you had from the scholarly resources you selected. Describe a leader whom you have seen use such behaviors and skills, or a situation where you have seen these behaviors and skills used in practice. Be specific and provide examples. Then, explain to what extent these skills were effective and how their practice impacted the workplace. Nursing Leadership Theories in Practice

By Day 6 of Week 4

Respond
 to at least 
two
 of your colleagues 
on two different days
 by explaining how the leadership skills they described may impact your organization or your personal leadership, or by identifying challenges you see in applying the skills described.

Great post, I enjoyed reading your post and I agree with you that a good leader can change the whole atmosphere at work.  A person put into leadership is not expected to go around barking orders and trying to run a hospital his/her way but instead a leader is supposed to change the atmosphere in a good way and work with their employees for a better work environment.  Improving the nurse work environments has been recommended as a system-level intervention to improve quality of care and patient safety and it also is a key factor for retaining a competent nursing workforce (Chenjuan, & Shang, 2015) Nursing Leadership Theories in Practice. Being a good leader is understanding that the little things count and showing appreciation to your staff goes a long way. As you said, the simple things like buying food for the staff or just voicing your appreciation to the staff on a job well done can go a long way. Working a nursing supervisor I usually tell the nursing staff what a good job their doing and their appreciated during shift huddles because I do not want them to only hear what needs to be done or what wasn’t done. Nurse turnover is a global concern that is both costly for health-care organizations and in the context of the work environment, affects quality and safety (Heidari, Seifi, & Gharebagh, 2017).

References

Chenjuan, M., & Shang, J., (2015). Linking Unit Collaboration and Nursing Leadership to Nurse

Outcomes and Quality of Care. 
Journal of Nursing Administration
, 
45
, 435-442.

https://doi.org/10.1097/NNA.0000000000000229

Heidari, M., Seifi, B., & Gharebagh, Z. (2017). Nursing staff retention: Effective factors.
 Annals

            of Tropical Medicine and Public Health, 10
(6)

doi:http://dx.doi.org.ezp.waldenulibrary.org/10.4103/ATMPH.ATMPH_353_17 Nursing Leadership Theories in Practice

NRS-434VN 2 DQ 2 Physical assessment of a child

Nurses are taught that the physical assessments begin the moment you encounter the patient whether it is a child or an adult; while simultaneously taking note of their appearance, nutritional status, hygiene, level of consciousness, skin color, body posture, respiratory rate, and movements (Dean, Falkner, & Green, 2018, ch. 1, & Dean, Falkner, & Green, 2018, ch. 4). The physical assessment has both similarities and differences, and they both focus on the collection of objective and subjective data. NRS-434VN 2 DQ 2 Physical assessment of a child. In nursing school, nurses are taught to conduct an assessment from head to toe leaving the area or areas associated with pain last. When assessing a child, the nurse must mindful that they dictate the course of the assessment and should be flexible leaving the most invasive assessments for last (Dean, Falkner, & Green, 2018, ch. 1). During the assessment, it is important for the nurse to be watchful of the interaction of the child and older adults with their caregiver for signs of abuse or neglect (Dean, Falkner, & Green, 2018, ch. 1) NRS-434VN 2 DQ 2 Physical assessment of a child.

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As the physical contact begins, “talking to the infant and playing peekaboo, or other age-appropriate play helps to build infant trust” (Dean, Falkner, & Green, 2018, ch. 1). With the infant or child interaction with the parent is an integral part of the assessment because they are the means of gaining information. With an adult, the interview process not only helps the nurse gain information regarding main complaints, history, and social details,” it also aids in building trust between nurse and patient (Dean, Falkner, & Green, 2018, ch. 4). NRS-434VN 2 DQ 2 Physical assessment of a child.

During the assessment process communication and the way, it is delivered are key. While it is safe to say nurses can do baby talk with an infant or child, it is never a good idea to interact with an adult in that manner. In both cases, they must speak to the patient on their level of understanding. Children learn by touching and can also reduce fear so allowing the child to hold instruments and act as if they are doing an assessment would be acceptable (Dean, Falkner, & Green, 2018, ch. 1). For an adult, you would simply explain what needed at the time of assessment and access how the instruction is followed (Dean, Falkner, & Green, 2018, ch. 4). NRS-434VN 2 DQ 2 Physical assessment of a child

References

Dean, J. K., Falkner, A., Green, S. Z. (2018). Health Assessment: Foundations for Effective Practice. Retrieved January 21, 2021 from 
https://www.gcumedia.com/digital-resources/grand-canyon-university/2018/health-assessment_foundations-for-effective-practice_1e.php

 

Compare the physical assessment of a child to that of an adult. In addition to describing the similar/different aspects of the physical assessment, explain how the nurse would offer instruction during the assessment, how communication would be adapted to offer explanations, and what strategies the nurse would use to encourage engagement.

 

I work oncology with a strictly adult population. I have not assessed a child other than my own since nursing school. There are similarities in physical assessments, but there are also stark differences. Some of the similarities are rather obvious, such as assessing cardiac sounds, lung sounds, and gastrointestinal sounds in both patient populations. In addition, both physical examinations include pain assessments, but the pain scale used will vary based on population. For example, I most often use the Numerical Pain Rating Scale (NPRS) with alert and oriented adults, the Pain Assessment in Advanced Dementia (PAINAD) for confused adults, and Assume Pain Present with my comfort care/inpatient hospice patients when they are sedated on drips. With pediatric patients, I would use the Neonatal Infant Pain Scale (NIPS) with infants, Wong-Baker FACES pain rating scale with toddlers, and the NPRS with school-aged children NRS-434VN 2 DQ 2 Physical assessment of a child.

Moreover, adult patients typically present to the hospital with extensive medical histories and numerous comorbidities that require assessment. For example, many patients present with a combination of conditions such as hypertension, congestive heart failure, hyperlipidemia, deep vein thrombosis, chronic obstructive pulmonary disease, gastroesophageal reflux disease, and diabetes. As such, these adults are likely receiving an array of different medications. On the other hand, many pediatric patients have very limited medical histories and take little to no medications. Their physical assessment will more often than not be less disease-oriented and aimed more towards progression of developmental stages. NRS-434VN 2 DQ 2 Physical assessment of a child

When I conduct a physical assessment on an adult, I usually proceed in a head-to-toe fashion unless it is an emergent situation where I need to start with a focused assessment instead. This can differ with pediatric assessments, especially with younger pediatric patients where you will assess in the least threatening order possible. When assessing an adult, assessment data is usually gathered from the patient themselves. In pediatric populations, assessment data, is often collected through second-hand observations from the parent at the bedside. However, history gathering can be difficult when the most appropriate person to answer assessment questions is not at the bedside. Dersch-Mills (2018) believes this introduces the potential for inaccuracy as “Changing custody or living arrangements may impact a caregiver’s ability to provide a history, or one parent may be ‘in charge’ of the medical care of the child. However, the registered nurse should always include the child in the assessment if old enough to participate, offering instructions in short sentences using age-appropriate terms. NRS-434VN 2 DQ 2 Physical assessment of a child. With younger children, the nurse should provide encouragement by forming rapport with the caregiver. It is also a good idea to incorporate play into the assessment, and allow children to touch equipment used whenever possible to alleviate anxiety. Another strategy is to communicate with the child at eye-level to minimize appearing intimidating to the child. NRS-434VN 2 DQ 2 Physical assessment of a child

References

Dersch-Mills, D. (2018). Assessment considerations in pediatric patients. 
Patient Assessment in Clinical Pharmacy
. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7123523/ NRS-434VN 2 DQ 2 Physical assessment of a child

Organizational Policies and Practices to Support Healthcare Issues Main Discussion Post

Patient’s experiences are being monitored by healthcare institutions to help evaluate and improve the quality of care. Patient’s experiences are impacted by nurses. Nurses spend the most time with patients and are the vital element to improving quality patient care and experiences because they know what factors influence the work environment (Kieft, Brouwer, Francke, & Delnoij, 2014). There has been an increase in focusing on and dealing with workforce issues in organizations globally (Bridges & Meyer, 2007). It is essential for nurses to possess the ability to identify any ethical problems they come across Organizational Policies and Practices to Support Healthcare Issues. Moral action is the first process in the direction of recognizing ethical implications (Milliken, 2018). Kelly and Porr state, “Registered nurses (RNs) are constantly challenged to provide quality nursing care while resources are chipped away, sometimes along with their energy, pride, and ability to provide holistic patient care. Many experience frustration and a sense of powerlessness to change their circumstances (2018).

During this COVID-19 pandemic, there have been many speculations and trials and tribulations in managing and addressing this virus. What was initially thought to be an “elderly” disease turned out to be a disease that didn’t discriminate against sex, age, or race. The whole world went into a panic. Healthcare workers stressed and fearful of how we were going to combat this disease while keeping ourselves safe and protected. Organizational Policies and Practices to Support Healthcare Issues.

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In the beginning of the pandemic, we had a couple of cases on our unit that are considered PUIs (patient under investigation). I was one of the first to care for these patients. At the time, testing kits were scarce and the time for results to come back took a minimum of 5 days. During the time I was caring for the patient, I was not provided with proper PPE. I had a surgical mask and gown. There were no N95s, goggles, face shields, hair or shoe covers. Doctors actually told me that I do not need an N95 and that my surgical mask is sufficient. I believe it had to do with the shortage of N95 because I could not get my hands on one even if I wanted to. Organizational Policies and Practices to Support Healthcare Issues My anxiety was high. I worried about getting infected and bringing it home to my children, especially my child with type 1 diabetes. I was also concerned about my other patients that I was caring for.  I was on the verge of tears. Despite my fear and extreme anxiety, I cared for the patient throughout the night.  We were supposed to rotate caring for PUIs, but the rotation was quick and short. Before I know it, it was my turn again. Many nurses went on stress leave which made us short staff. Nurses are already in a high-stress environment, therefore piling on additional stress may result in nurse burnout (Maben & Bridges, 2020). Despite several complaints and cry for help, the unit manager refused to hire more nurses. We didn’t think caring for PUIs and non-PUIs are safe and effective. Not only are putting other patients at risk, but the quality of care will also diminish and unethical. “Effective nursing leaders confront ethical dilemmas by demonstrating moral leadership” (Laureate Education, 2018). We gathered together and demanded more and proper PPE.  Although, PUIs are basically “rule outs”, we have to treat it like they are positive. We also suggested to management that it would be more beneficial to all patients if we change the acuity to a one to one. We can be the primary nurse, housekeeping, labs, and PCA. This way we can eliminate unnecessary exposure to other employees and patients and also provide high-quality care. As a result of our relentless requests and engagement with management, we were able to meet our needs. We were provided with N95 masks and although we have to reuse it, we felt more protected than before. This does mean we no longer have fear and anxiety, but it helps eliminate the added stress. Organizational Policies and Practices to Support Healthcare Issues

References

Bridges, J. & Meyer, J. (2007). Policy on new workforce roles: A discussion paper. International Journal of Nursing Studies, 44(4), 635-644. Elsevier

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.

Kieft, R.A., Brouwer, B.B., Francke, A.L., & Delnoij, D.M. (2014). How nurses and their work environment affect patient experiences of the quality

of care: a qualitative study. BioMed Central, 14, 249-255. Organizational Policies and Practices to Support Healthcare Issues

Laureate Education (Producer). (2018). Moral Leadership (Video file). Baltimore, MD: Author.

Maben, J. & Bridges, J. (2020). Covid‐19: Supporting nurses’ psychological and mental health. JCN: Journal of Clinical Nursing.

https://doi.org/10.1111/jocn.15307

Milliken, A. (2018). Ethical Awareness: What It Is and Why It Matters. OJIN: Online Journal of Issues in Nursing, 23(1), Manuscript 1.

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? Organizational Policies and Practices to Support Healthcare Issues

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.

To Prepare:

Review the Resources and think about the national healthcare issue/stressor you previously selected for study in Module 1.

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

By Day 3 of Week 3

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.

By Day 6 of Week 3

Respond
 to at least 
two
 of your colleagues 
on two different days
 by providing additional thoughts about competing needs that may impact your colleagues’ selected issues, or additional ideas for applying policy to address the impacts described.

Your post hits home for me. I have experienced some of these same struggles at my place of employment as well. I was also the first nurse on my unit to care for a PUI, however, this was at the beginning of March when PPE supplies were in greater numbers. It’s very interesting how policies change according to what is available to work with. After we cared for this patient, our management and house supervisors stated that if we were to get more PUI that every patient room would be converted to negative airflow. That never happened. As time went on, we converted from a medical ICU to a COVID ICU. Concerns about staffing and supplies grew as every day passed. We all knew that we needed more nurses, but we didn’t know if management was willing to listen Organizational Policies and Practices to Support Healthcare Issues.

RNs may experience tension when they are faced with what the right thing to do is versus their hospital policy, thus causing ethical distress, which could interfere with providing safe and ethical nursing care (Kelly & Porr, 2018). Being unable to provide safe nursing care with staffing shortages became increasingly challenging. We asked for more nurses to be hired so we could deliver the care the patients needed. Weekly Webex meetings on the phone were set up with higher management and all employees so we could voice our concerns. Our management ended up hiring travelers to fill open positions. We realized that the more people we got to speak up about how our staffing shortage was affecting patient care, the management might be more engaged to help. By making these ethical complications known it can better ensure that patient needs are met (Milliken, 2018). I’m glad you were able to get the needs met for the benefit of your patients and yourselves because providing safe and ethical care is what we are all here to do.

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.Vol23No1Man1. Retrieved from 
http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-23-2018/No1-Jan-2018/Ethical-Awareness.html

 

Geat post, people do not understand what we go through as nurses on a daily basis. Nurses are the center of the whole patient care. Nurses deal with family, doctors, case managers and all other departments Organizational Policies and Practices to Support Healthcare Issues. They look at nurses for all the solutions and all the answers. So it is already a stressful job and to add a pandemic to the mix and lack of resources just makes it worse. Covid-19 has put a big strain on health care and staff. Work-related stress can be damaging to a person’s physical and mental health, while its’ high levels have been related/connected to high staff truancy and low levels of productivity (Sarafis, Rousaki, & Tsounis, 2016). Almost every nurse I talked to was burnt out and still are. Even though COVID-19 has slowed down it is still stressful. Stress and burn out to staff effects not only the staff but also effects patient outcomes. Findings clearly indicate that nurse burnout is associated with increased odds of reporting negative patient outcomes (Nantsupawat, 2016).

References

Nantsupawat, A., (2016). Nurse burnout, nurse-reported quality of care, and patient outcomes in

Thai hospitals.
 Journal of Nursing Scholarship, 48
(1), 83-90.

doi:http://dx.doi.org.ezp.waldenulibrary.org/10.1111/jnu.12187

Sarafis, P., Rousaki, E., & Tsounis, P., (2016). The impact of occupational stress on nurses

caring behaviors and their health related quality of life.
 BMC Nursing, 15

            
doi:http://dx.doi.org.ezp.waldenulibrary.org/10.1186/s12912-016-0178-y Organizational Policies and Practices to Support Healthcare Issues

NRS-434VN Topic 2: Health Assessment of the Toddler, Preschool, and School-Aged Child

Topic 2 DQ 1

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

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Child abuse can occur in different forms, such as physical or emotional. Whenever such abuse occurs, it leaves the child emotionally disturbed. It takes the intervention of a professional for the child to get back to their normal self. School-age children are prone to the two types of child abuse. NRS-434VN Topic 2: Health Assessment of the Toddler, Preschool, and School-Aged Child. The abuse could range from mistreatment to sexual abuse. Regardless of the type of abuse the child is subjected to, it can have a great emotional impact on their lives.

Among the emotional signs of an abused child is social withdrawal, delayed emotional development, and low self-esteem. The child could also avoid a situation that used to be fun for them. For instance, if the child is no longer excited about going to school or hanging out with friends, it could indicate abuse. The physical warning signs that the nurse can identify is the poor growth rate and injury marks on the child’s body. If the child is not willing to talk about their emotions with the nurse, it could indicate abuse (Hoft & Haddad, 2017).

One of the cultural practices that might seem to be a form of child abuse is circumcision without the use of anesthesia. The practice is carried out to show the child’s strength and perseverance. Failure to cry during the process indicates how strong the child would be in the future. Crying is a sign of weakness. If the nurse notices any signs of abuse, they should notify a physician as soon as possible. The examination should also be carried out in the absence of the suspected victim. Such would allow the child to express their feelings without the fear of being victimized. Once abuse has been proven, the child is given the necessary help.

 Reference

Hoft, M., & Haddad, L. (2017). Screening children for abuse and neglect: a review of the literature. 
Journal of forensic nursing
, 
13
(1), 26-34. NRS-434VN Topic 2: Health Assessment of the Toddler, Preschool, and School-Aged Child

 

 

Objectives:

Demonstrate clinical reasoning in conducting a child health assessment.

Apply Erikson’s stages of child development to health assessment.

Examine factors that increase the vulnerability of a child.

Compare the physical assessment of a child to that of an adult.

 

The needs of the pediatric patient differ depending on age, as do the stages of development and the expected assessment findings for each stage. In a 500-750-word NRS-434VN Topic 2: Health Assessment of the Toddler, Preschool, and School-Aged Child paper, examine the needs of a school-aged child between the ages of 5 and 12 years old and discuss the following:

Compare the physical assessments among school-aged children. Describe how you would modify assessment techniques to match the age and developmental stage of the child.

Choose a child between the ages of 5 and 12 years old. Identify the age of the child and describe the typical developmental stages of children that age.

Applying developmental theory based on Erickson, Piaget, or Kohlberg, explain how you would developmentally assess the child. Include how you would offer explanations during the assessment, strategies you would use to gain cooperation, and potential findings from the assessment. NRS-434VN Topic 2: Health Assessment of the Toddler, Preschool, and School-Aged Child

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

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

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

Topic 2 DQ 1

 
NRS-434VN Topic 2: Health Assessment of the Toddler, Preschool, and School-Aged Child

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

Topic 2 DQ 2

 

Compare the physical assessment of a child to that of an adult. In addition to describing the similar/different aspects of the physical assessment, explain how the nurse would offer instruction during the assessment, how communication would be adapted to offer explanations, and what strategies the nurse would use to encourage engagement.

“Health assessment of young and middle-aged adults extends beyond physical examination. The nurse uses a holistic outlook with consideration for mental, physical, emotional, and spiritual aspects of the individuals” (Falkner, 2018). An adult would receive a head to toe assessment and may receive a more focused cardiac or respiratory assessment. The adult would be asked about medical history and current medications being taken. With an adult you could speak more plainly than you can with a child. You may need to give examples or comparisons to a child. You should still instruct the patient as to what you are doing during the assessment. You could also give the adult patient handouts to learn more about their assessment. NRS-434VN Topic 2: Health Assessment of the Toddler, Preschool, and School-Aged Child

A child assessment would be done differently than an adult. The child more than likely would be more apprehensive than an adult. Before the assessment started the nurse should interact with the child’s parent that way the child would be more apt to interact with the nurse and this would also begin a trusting rapport. The nurse should get eye level with the child and explain in terms the child can understand while the nurse is explaining what is being done. The nurse would start with less invasive assessments first. The parent may hold the child during the assessment. The nurse may have to ask the parent instead of the child about some of the problems the child may be having. Another thing the nurse would do is let the child see the equipment before using it. Before I take a temporal temperature on a child, I run the thermometer over my forehead first. This lets the child know what I’m about to do to them and that it doesn’t hurt. I tell the child what I’m doing every step of the way. I reassure them and speak kindly to them.

In both assessments, I would inform the patient as to what part of the assessment would be performed next. I would ask questions (if possible) to both of the patients as well. I would be compassionate and attentive while the patient spoke and these strategies would encourage engagement. NRS-434VN Topic 2: Health Assessment of the Toddler, Preschool, and School-Aged Child

References

Falkner, A. (2018). Adult Health Assessment. 
In Health assessment: Foundations for effective practice
. Retrieved from 
https://lc.gcumedia.com/nrs434vn/health-assessment-foundations-for-effective-practice/v1.1/#/chapter/4

NRS-434VN Topic 2: Health Assessment of the Toddler, Preschool, and School-Aged Child

Discussion: Organizational Policies and Practices to Support Healthcare Issues

The cost of healthcare in the US has continued to elicit concerns and debates towards healthcare system reforms. The ensuing debates have culminated into unanimity for an affordable and quality healthcare system. The realization of policy reforms towards this direction is a lengthy and complex process characterized by competing demands that require careful consideration due to subverting influence they may have on the policy process.  Oliver (2006) terms policy processes as being political, characterized by power, control, and influence which determine the translation of evidence-based solutions into policy actions. As the process involves multiple stakeholders, multiple interests come into play. Based on how they are affected, they will exert influence and power in support of or against the policy which could ultimately result in abandonment of a policy or its fast-tracking. Political institutions also play a crucial role Discussion: Organizational Policies and Practices to Support Healthcare Issues. When there is political good will from federal and state governments, policy development process gunner support and is faster. Further, the financial affordability of a policy determines its potential to sail through as it involves fiscal ability of government to take additional responsibilities (Oliver, 2006).

A healthcare system is characterized by multiple stakeholders whose interest and power on a policy significantly influence policy development process and outcome. Patients are keen on accessing affordable quality healthcare services while hospitals, care providers, pharmaceuticals, and drug manufacturers struggle to balance between offering the best care at affordable costs while meeting their business interests. Balancing such needs put policy developers at a dilemma. The Affordable Care Act for instance has elicited different reactions from different stakeholders depending on who benefits and who loses. Among the critics has been the insurance industry whose business has been severely affected with 37.9% decline in their application for Medicaid and Medicare Services enrollment. Discussion: Organizational Policies and Practices to Support Healthcare Issues. Some have had to close their businesses while others have had to opt for mergers. This has created an uncompetitive environment resulting in increased premium rates not favorable for patients (Patterson, 2018). On the other hand, are the pharmaceutical manufacturers that have been blamed for increasing costs of healthcare costs. Campbell (2019), noted that prescription drugs in US costed 56% less in developed countries resulting in 8% of Americans attaining their drugs from Canada while others have had to cut on their prescriptions which have been fatal. To address these concerns, a single-payer system is proposed which will replace private insurers as well as promote price negotiations with drug manufacturers reducing cost of healthcare and of drugs respectively. According to
Himmelstein
 and 
Woolhandler
(2020), this model would also save doctors the expense and agony of contract negotiations and billing bureaucracies while reducing hospitals’ administrative costs related to billing estimated at $ 401 billion as at 2017. Discussion: Organizational Policies and Practices to Support Healthcare Issues.

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Political institutions are the regulators and administrators of health policies and therefore, alignment of policy reform proposes to political agenda facilitates buy in, ownership and support. For example, the need for value-based care has received unmatched support from US Department of Health and Human Services as well as from five State Governors of Ohio, Nevada, Colorado, Alaska and Pennsylvania and has thus been widely adopted with several strategies towards its implementation developed (Karapiperis, 2018). As proposed, the value-based model offers the current administration opportunity to offer affordable healthcare that is quality-based and aligned to the current price and quality transparency (HHS, 2019). Moreover, it facilitates healthcare organizations to be more cost-effective and affordable hence being more competitive. Discussion: Organizational Policies and Practices to Support Healthcare Issues

Anticipated costs of policy implementation often determine the successful development of a policy. The cost considerations include cost justification against benefits, opportunity costs, and availability of finances. For instance, the current government healthcare expenditure particularly Medicaid and Medicare Services has been heavily criticized. The basis of criticism has been among others increased cost of healthcare expenditure and failure for such investments to translate to better health outcomes, with US healthcare outcomes lagging behind those of comparable countries (Karapiperis, 2018). Shift to single-payer system is anticipated to result in $600 in cost savings (
Himmelstein
 and 
Woolhandler
, 2020).

 

References

Campbell, K. (2019, August 6). 
Trump Administration’s Plan to Lower Healthcare Costs.
 Retrieved from MedPageToday: https://www.medpagetoday.com/blogs/campbells-scoop/81446

HHS. (2019, November 15). 
Trump Administration Announces Historic Price Transparency Requirements to Increase Competition and Lower Healthcare Costs for All Americans.
Retrieved from HHS: https://www.hhs.gov/about/news/2019/11/15/trump-administration-announces-historic-price-transparency-and-lower-healthcare-costs-for-all-americans.html Discussion: Organizational Policies and Practices to Support Healthcare Issues

Himmelstein, D., & Woolhandler, S. (2020). Single-Payer Reform: Heed the Evidence, Not the Soothsayers. 
American Journal of Public Health
.

Karapiperis, D. (2018). A Brief Exploration of Rising Health Care Costs. 
The Centre for Insurance Policy and Research
.

Oliver, T. (2006). The Politics of Public Health Policy. 
Annual Review Public Health
, 175-233.

Patterson, L. (2018). The Pricing Impact of Decreasing Competitiveness of the Health Insurance Market. 
University of Tennessee Honors Thesis Projects
. Retrieved from https://trace.tennessee.edu/utk_chanhonoproj/2202

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. Discussion: Organizational Policies and Practices to Support Healthcare Issues

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? Discussion: Organizational Policies and Practices to Support Healthcare Issues

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.

To Prepare:

Review the Resources and think about the national healthcare issue/stressor you previously selected for study in Module 1.

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

By Day 3 of Week 3

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.

By Day 6 of Week 3

Respond
 to at least 
two
 of your colleagues 
on two different days
by providing additional thoughts about competing needs that may impact your colleagues’ selected issues, or additional ideas for applying policy to address the impacts described. Discussion: Organizational Policies and Practices to Support Healthcare Issues

 

I enjoyed reading your post and likewise believe that health care in the United States presents itself as a rather confusing conundrum. On the one hand, you are told you must have insurance of be fined at the end of each year, but on the other hand many individuals say they can’t afford the required payments each month for insurance coverage Discussion: Organizational Policies and Practices to Support Healthcare Issues. So, the question becomes how to provide healthcare for everyone at an equitable rate, but even more so, how do you reach the uninsured? For example, something I see in my daily practice as an ER nurse is uninsured individuals coming into the ER because they couldn’t pay the out-of-pocket cost a primary care physician would charge to see them. These individuals are not denied health care outright, but the offices require all or most of a visit cost upfront for uninsured patients as a way to protect themselves, but oftentimes an individual cannot afford the out-of-pocket expensive of even a routine or simple health care visit. So, they leave the office and drive a few miles to the ER to be seen, the bill is then paid over time or is not paid at all, and ultimately this does not benefit the individual or the health care system. One specific example, my daughter had to see a podiatrist for custom orthotics- normal office visit, meet the doctor, x-ray her feet, make a mold for her feet, go over exercises and stretches for her feet, and then out the door. The breakdown of her medical bill was pretty outlandish I feel like. Discussion: Organizational Policies and Practices to Support Healthcare Issues. Just the billing to her insurance for the visit- none of the casting and x-rays, just the visit to see the podiatrist was $2,500. Yes, $2,500. Now again, insurance will pay the bulk of that fee, but the point is when you broke down the billing cost for each thing the podiatrist charged for, her 1-hour doctor visit equated to over $4,000. We will have to pay a few hundred out of that total, but what if she didn’t have insurance? What then? If a person in uninsured they more than likely do not have the funds for insurance, but may not qualify for Medicare, so how do they receive treatment? Could you afford a $4,000 out-of-pocket office visit for a visit to the podiatrist, and more importantly, even if you could would you want to? I feel like for most people the answer is no (if not to the first question then most certainly the last). So, then what happens? You don’t go to the appointment, you don’t get the custom orthotics, your feet give you more and more problems, maybe you are in pain all of the time, maybe you can’t work because it becomes debilitating, maybe you just can’t do things like run or walk for exercise- things that are good for your body. The point is the way uninsured individuals have to interact with the healthcare system is a problem, and is a relatively silent problem since their voices are often overlooked and not considered- it’s easy to forget and leave out those whom you don’t see receiving medical care.
Discussion: Organizational Policies and Practices to Support Healthcare Issues.

One step in the right direction was President Obama’s Affordable Care Act, which was signed into existence in 2010 right are the peak of the Great Recession (Blumenthal, Abrams, & Nuzum, 2015). The Affordable Care Act sought to lower medical costs for individuals and provided a longer time in which children could be carried on parental insurance, letting many young adults, recent college graduates, and those working their way through various career fields a few additional years to be financially secure and to cover themselves for insurance. Remarkably, in an analysis of the Affordable Care Act Blumenthal, Abrams, and Nuzum (2015) demonstrate the ACA creating a decline in the need for federal funding to cover health-expenditures, specifically demonstrating federal funding for health care at an all-time low “3.2% annually as compared with 5.6% annually over the previous 10 years” (p. 2456). Discussion: Organizational Policies and Practices to Support Healthcare Issues.

Another potential to limit the cost of these visits is to work with more and more remote technologies and to do simple things such as paramedicine and have licensed medical workers go to patients, take bloodwork, conduct a physical, and act as an intermediary for physicians. The technology exists, and costs could be lessened with the use of current medical professionals and expertise, without necessarily accruing a large medical bill for an office visit (Laureate Education Producer, 2012 [Video File]).
 

 

References

Bulmenthal, D,. Abrams, M., & Nuzum, R. (2015). The affordable care act at 5 years.
 
The New
 
   
 
England Journal of Medicare, 372(25), 2451-2458.
 

 
doi:http://dx.doi.org.ezproxy.gardner-webb.edu/10.1056/NEJMhpr1503614

 

Laureate Education (Producer). (2012). Ethical, Moral, and Legal Leadership [Video file].
 

 
Baltimore, MD: Author.
Discussion: Organizational Policies and Practices to Support Healthcare Issues.

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

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

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

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

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

 

References

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

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

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

NURS 6053 Developing Organizational Policies and Practices Nurse Burnout Essay Assignment

Developing Organizational Policies and Practices on Mental health stigmatization

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

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Competing Needs Impacting Nurse Burnout

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

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

Policy influencing Nurse Burnout in my Organization

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

Policy Critique and Ethical Considerations of the Policy

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

Strength of the Policy and Challenges in Promoting Ethic

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

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

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

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

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

Conclusion

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

 

 

 

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References

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

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

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

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

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

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

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

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

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

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

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

 

Assignment: Developing Organizational Policies and Practices

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

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

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

To Prepare:

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

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

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

The Assignment (4-5 pages):

Developing Organizational Policies and Practices

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

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

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

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

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

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

By Day 7 of Week 3

Submit your revised paper.

Submission and Grading Information

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

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

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

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

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

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

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

NURS_6053_Module02_Week03_Assignment_Rubric

Grid View

List View

Excellent

Good

Fair

Poor

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

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

23 
(23%)
 – 25 
(25%)

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

20 
(20%)
 – 22 
(22%)

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

NURS 6053 Developing Organizational Policies and Practices Nurse Burnout Essay Assignment

18 
(18%)
 – 19 
(19%)

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

0 
(0%)
 – 17 
(17%)

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

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

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

27 
(27%)
 – 30 
(30%)

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

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

24 
(24%)
 – 26 
(26%)

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

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

21 
(21%)
 – 23 
(23%)

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

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

0 
(0%)
 – 20 
(20%)

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

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

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

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

27 
(27%)
 – 30 
(30%)

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

Specific and accurate examples are provided.

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

24 
(24%)
 – 26 
(26%)

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

Specific examples may be provided.

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

21 
(21%)
 – 23 
(23%)

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

Examples may be provided.

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

0 
(0%)
 – 20 
(20%)

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

Examples are missing.

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

Written Expression and Formatting – Paragraph Development and Organization:

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

5 
(5%)
 – 5 
(5%)

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

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

4 
(4%)
 – 4 
(4%)

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

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

3.5 
(3.5%)
 – 3.5 
(3.5%)

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

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

0 
(0%)
 – 3 
(3%)

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

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

Analysis of Nurse Burnout in Healthcare

Introduction

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

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Nurse Burnout

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

Impact of Burnout in the Organization

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

Summary of Articles Related to Burnout and its Prevention Strategies

Article 1: 

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

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

Article 2: 

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

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

Strategies Used to Address the Organizational Impact of burnout

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

How Burnout Prevent Strategies Impact the Organization

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

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Conclusion

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

References

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

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

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

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

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

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

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

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

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

 

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

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

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

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

To Prepare:

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

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

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

The Assignment (3-4 Pages):

Analysis of a Pertinent Healthcare Issue

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

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

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

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

NURS_6053_Module01_Week02_Assignment_Rubric

Grid View

List View

Excellent

Good

Fair

Poor

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

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

23 
(23%)
 – 25 
(25%)

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

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

20 
(20%)
 – 22 
(22%)

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

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

18 
(18%)
 – 19 
(19%)

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

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

0 
(0%)
 – 17 
(17%)

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

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

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

27 
(27%)
 – 30 
(30%)

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

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

24 
(24%)
 – 26 
(26%)

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

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

21 
(21%)
 – 23 
(23%)

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

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

0 
(0%)
 – 20 
(20%)

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

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

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

27 
(27%)
 – 30 
(30%)

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

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

24 
(24%)
 – 26 
(26%)

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

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

21 
(21%)
 – 23 
(23%)

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

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

0 
(0%)
 – 20 
(20%)

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

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

Written Expression and Formatting – Paragraph Development and Organization:

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

5 
(5%)
 – 5 
(5%)

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

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

4 
(4%)
 – 4 
(4%)

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

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

3.5 
(3.5%)
 – 3.5 
(3.5%)

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

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

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

0 
(0%)
 – 3 
(3%)

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