Nurs 3100 , Nurs 3000 – Issues and Trends in Nursing
We will learn an overview of the evolution of nursing as a profession and be introduced to their new role as scholar-practitioners. They examine changes in the U.S. healthcare delivery system, the importance of information technology, and measures that promote quality, safety, and better health outcomes in patient care. Students consider major issues and trends in contemporary nursing and healthcare practise, including the influence of socioeconomic, ethical, legal, and political variables and professional values. Through weekly discussions and assignments, students explore and share personal experiences in the context of contemporary nursing issues, such as the nursing shortage, workforce challenges, healthcare financing, professional organizations, and diversity. They are challenged to examine and propose solutions to these nursing issues and those in their workplace. Students reflect on Walden’s mission of social change and its impact on their future nursing practice as a scholar-practitioner. Because this is the first nursing course within the RN/BSN program, students learn to use Walden University’s resources to enhance their writing skills. Students are also introduced to the tools essential to success at Walden.
Quality Nursing Part 1 : Issues and trends in nursing
This paper aims to select a Quality Indicator related to a nursing topic of interest, describe how it improves quality, safety, and outcomes for patients and families, and describe the current data and leadership’s goals for improvement.
According to the U.S. Department of Health and Human Services and Agency for Healthcare Research and Quality (2015) in “Quality Improvement and Monitoring at Your Fingertips” (2015), Quality Indicators (Q.I.) are defined as a standard evidence-based measure that is used to track performance. Preventive Quality Indicators (PPIs) identify, track, and measure issues within the outpatient setting to prevent inpatient hospital stays. Preventable issues tracked within this quality indicator are inpatient hospital stays with an admission diagnosis of diabetes, urinary tract infections, hypertension, and many more. First, using Preventive Quality Indicators to decrease inpatient hospital stay increases patient and family satisfaction. This is due to the patient being treated at home, which decreases money spent out of the patient pockets. Also, patients are usually happier at home treating their condition or disease than sitting in the hospital. If a patient does have a hospital admission due to their condition, good discharge teaching and follow-up care may help prevent a reoccurrence of admission. Secondly, using Preventive Quality Indicators improves quality and safety by identifying issues such as diabetes within the community to know what education needs to be given to patients. Patients with diabetes need to be taught how to control their blood glucose with medications prescribed by physicians, diet, and exercise. The Preventive Quality Indicators related to diabetes include short-term, long-term, and uncontrolled diabetes admissions. Teaching patients how to treat diabetes at home can help prevent these admissions and possibly prevent diabetes type two in patients that have not been diagnosed with diabetes. World Health Organization’s (2018) article “Diabetes” (2018) states type two diabetes is on the rise worldwide, and communities can identify issues with diabetes type two by screening patients with high-risk factors either personally or within family history. Early screenings may detect diabetes that may not have been diagnosed before or may help patients with risk factors realize how to do lifestyle changes to prevent them from becoming diagnosed with diabetes. This may decrease hospitalizations related to complications from undiagnosed diabetes type two.
Lastly, Patel, Vakharia, Pile, Howell, and Rothberg (2016), in “Preventable Admissions on General Medicine Service: Prevalence, Causes and Comparison with AHRQ Prevention Quality Indicators-A Cross-Sectional Analysis” (2016) states 9-36% of hospital admissions within the United States are preventable. Identifying specific admissions as preventable and assessing factors that if they were addressed within weeks before the admission is one approach leadership needs to take to decrease hospitalizations using Preventive Quality Indicators. According to Ma, Shang, and Bott(2015) in “Linking Unit Collaboration and Nursing Leadership to Nurse Outcomes and Quality of Care,” (2015) to improve healthcare, providing education and training to students, nurses, and physicians will help improve the collaboration process and will, in turn, build a stable work environment and achieve positive patient outcomes. Conclusion In conclusion, some hospitalizations are preventable. It is up to leadership to identify and address those admissions to decrease hospital stays and increase patient satisfaction. Using Preventive Quality Indicators can aid in this process and help prevent diseases and prevent hospital admissions. Collaboration within the healthcare system is key in decreasing hospitalizations and patient safety and satisfaction.
Patel, K. K., Vakharia, N., Pile, J., Howell, E. H., & Rothberg, M. B. (2016). Preventable Admissions on a General Medicine Service: Prevalence, Causes, and Comparison with AHRQ Prevention Quality Indicators— A Cross-Sectional Analysis. J Gen Intern Med 31(6): 597-601. doi: 10.1007/s11606-016-3615-4
Ma, C., Shang, J., & Bott, M. J. (2015). Linking Unit Collaboration and Nursing Leadership to Nurse Outcomes and Quality of Care. JONA: The Journal of Nursing Administration, 45(9), 435-442. doi: 10.1097/NNA.0000000000000229.
World Health Organization. (2018). Diabetes. Retrieved December 22, 2019, from https://www.whi.int/en/news-room/fact-sheets/detail/diabetes.
Discussion Post #1- Quality of Work Life in Nursing : Issues and trends in nursing
Researchers strive to understand better the quality of work-life in nursing and the implications for healthcare and organizations. Please go to the Library database and search using the keywords “quality work-life nursing” or an examination of your creation related to the topic. Read a selected peer-reviewed scholarly article and share with us what the main elements of the article are suggesting (be sure to use citations and references in keeping with APA and proper posting format). Critique the information and its relevance to nursing practice. Are the results valid? What are the results? Do you agree/disagree, and why? The post engages in a professional dialogue on this discussion board for your response. An initial and a response post are required. Please review the rubric. Also, upload your postings to Assessments / Assignments for evaluation.
The quality of nursing work life (QNWL) is defined as “the degree to which nurses can satisfy important personal needs through their experiences in their work organization while achieving the organization’s goal” (Kaddourah, Abu-Shaheen & Al-Tannir, 2018, p. 1). This study examines the correlation between QNWL and nurses’ turnover intention rate. Nurse turnover rates have an overall negative impact on an organization and health care providers’ ability to deliver high standards of care that meets their patient’s needs (Kaddourah et al., 2018, p.1). As a result, turnover leads to a lack of staffing available to provide care for patients and increases other nurses’ workload. This increased workload will eventually result in nurses experiencing higher levels of stress and burnout, leading to lower work satisfaction and productivity (Kaddourah et al., 2018). By examining QNWL (Kaddourah et al., 2018), more awareness can be brought to the attention of organizations on the effects of nurses’ ability to work due to challenges they encounter within their work environments as turnover rates. A cross-sectional study was done at two-four tertiary hospitals in Saudi Arabia on 364 nurses with at least one year of nursing work experience. They completed self-administered questionnaires (Kaddourah et al., 2018, p. 1). The study results revealed, “low indication satisfaction of nurses QNWL and a high turnover intention” (Kaddourah et al., 2018, p.3). According to Kaddourah et al. (2018), results show that “54.7% of the nurses included in this study were not satisfied with the quality of work-life, and 94% were willing to leave their current positions” (p. 3). Although Kaddourah et al. (2018) discuss the correlation between the two is not significant, these are recurring challenges within the health care organization that negatively impact nurses’ ability to provide care to their patients properly. The information in the study is relevant to nursing as the quality of nurses’ work life and turnover rates significantly impact the quality of care provided to the patients. Although this study’s findings reveal that the correlation between QNWL and nurses’ turnover rate is weak (Kaddourah et al., 2018), these are still prevalent issues within the healthcare system. In my opinion, I believe the ideas discussed in this article are valid. Although there isn’t a significant correlation between the two, having a high nurse turnover rate or intention can significantly impact nurses’ ability to provide high care to patients and cause higher burnout rates in nurses.
Moreover, I agree that the “results of this study can be used as a guide for the development of regulations and practical strategies to enhance QNWL and decrease turnover” (Kaddourah et al., 2018, p.6).
Kaddourah, B., Abu- Shaheen, A. K., & Al- Tannir, M. (2018). Quality of nursing work life and turnover intention among nurses of tertiary care hospitals in Riyadh: A cross-sectional survey. BMC Nursing, 17(1), 1-7. doi:10.1186/s12912- 018-0312-0
Discussion Post #2- Developing Health Promotion in the Community : Issues and trends in nursing
You are a CHN in a community with an increasing number of obese children in the elementary school that you visit. Describe an upstream approach to community health promotion in this situation. Using the social determinants of health as your framework, select three social determinants, identify two questions per determinant you might want to ask, and explain the importance of your inquiry. Please post to the Discussion Board and upload to Assessments / Assignments for evaluation. There are a variety of social determinants of health linked to the increasing number of obese children (Potter, Perry, Stockert, & Hall, 2018). As Stamler, Yiu, and Dosani (2015) state, ” the health of Canada’s children is closely linked to their social determinants of health” (p. 319). Income and social status play a crucial role in children’s health.
Families of lower incomes may be living in poverty and have reduced access to healthier food choices (Stamler, Yiu, & Dosani, 2015, p. 331). As a result of this impact, I would ask what the annual household income of the families is about the number of dependent children in the household. Another question will be whether there is dual income coming from both parents or if it is just one primary parent financially responsible. In contrast, this is closely linked to education and literacy, another critical aspect of children’s health and development. Lower levels of education and literacy may be reflected by lower income—for example, the lack of accessibility to education in poverty areas. Thus, there may be a lack of knowledge about health available for families and their children. Stamler, Yiu, and Dosani (2015) discuss children’s health and the importance of “active living habits, including healthy eating and physical activity” (p. 324). I would ask a few questions if the parents are aware of the number of exercise children are expected to engage in daily and its positive effects on their health. Following up with the amount of screen time their children are exposed to daily, “higher levels of screen time impose negative effects on decreased measures of psychosocial and cognitive development” (Stamler, Yiu, & Dosani, 2015, p. 324).
Furthermore, I would also ask the parents if they know the Canadian nutritional food guidelines for an adequate healthy diet and the impact that healthy nutrition has on their children’s weight. A final determinant of health is culture. Stamler, Yiu, & Dosani (2015) states, “some persons or groups may face additional health risks due to socioeconomic environment, which is largely determined by dominant cultural values that contribute to the perception of conditions such as loss or devaluation of language and culture, and lack of access to culturally appropriate healthcare and services” (p.176). Culture has a vast impact on family health as it may influence factors such as access to health services and different cultural views about it. I would ask the parents how often the family schedules doctor appointments. Another question would be their opinions and understandings of obesity as an illness, as this may be strongly influenced by culture.
In conclusion, an upstream approach to community health promotion that may be implemented in this situation is providing access to a free program running all day on the weekends that allow children to engage in several different types of physical activities. This program will enable children to engage in the maximum amount of weekly exercise. It would be an excellent opportunity for parents of low income to expose their children to different activities such as football, soccer, obstacles, dance, etc. In addition, healthy snacks will be available with an educational program that educates children about health. Furthermore, this health-promotion strategy is significant in providing access to children to make healthier lifestyle choices and “set the foundation for the rest of their lives” (Stamler, Yiu, & Dosani, 2015, p. 319). This approach is accessible and inclusive for all and creates an environment that encourages safe and affordable exercise, making it easier for people to make healthy lifestyle choices (Stamler, Yiu, & Dosani, 2015, p. 153).
Potter, P. A., Perry, A.G., Stockert, P. A., & Hall, A. M. (2018). Canadian fundamentals of nursing. (6th ed.). Toronto, ON: Elsevier.Stamler, L.L, Yiu, L., & Dosani, A. (2015). Community health nursing: A Canadian perspective. (4th ed.). Toronto, ON: Pearson
Discussion Post #3: Determinants of Health : Issues and trends in nursing
As part of the Social Domain of Issues and Trends, the group will have the opportunity to engage with First Nations guest speakers who will provide an overview of Cultural Issues from the Canadian Perspective. Complete your post after the guest speaker presentation as your learning, and the new material may give you new insights. Review the specific instructions for this posting under Assignment #1 Discussion Post Instructions for Cultural Safety Post. Please post it here and upload it to Assessments / Assignments for evaluation. Determinants of Health: After residential schools & the healing process, residential schooling has significantly impacted the health of the Indigenous culture. As stated by Burkhardt, Nathaniel, and Walton (2018), “the Indigenous culture suffers from discrimination, social isolation, and lack of access to basic needs and health care” (p. 455). The Canadian government believed Indigenous people were “savages who needed to be civilized and Christianized” (Braganza, McKinley, & Sibbald, 2018, p. 3). This was done by taking children away from their families and stripping them from their culture, prohibiting them from speaking their language, wearing traditional clothing, and ultimately leading to cultural assimilation (Burkhardt, Nathaniel, & Walton, 2018, p. 473). During this time, children within residential schools were abused physically, mentally, sexually, and emotionally (Braganza, McKinley, & Sibbald, 2018, p. 3). Today, Braganza, McKinley, and Sibbald (2018) state that “there are approximately 80,000 residential school survivors living with this trauma and are dealing with the process of healing” (p. 3-4). Although they were deprived of many social determinants of health – more significant risk for poverty, low socioeconomic status (SES), higher mortality rates, lack of education, literacy, social support, and lack of access to health services, many display a significant amount of resilience (Stamler, Yiu, & Dosani, 2015, p. 405). Indigenous people who did not attend the schools had also suffered from this trauma (Braganza, McKinley, & Sibbald, 2018, p. 2).
Moreover, many of those who survived the residential schooling were able to pass down traditions and the languages of their culture. Customs and practices stemming from indigenous cultural roots, such as smudging ceremonies, singing, the medicine wheel, and healing circles, may aid in the healing process (Stamler, Yiu, & Dosani, 2015, p. 405-408). For example, herbs such as sage are used during smudging ceremonies and cleanse negative energy and toxins from the body and mind (Stamler, Yiu, & Dosani, 2015). A main component of the healing process involves “understanding and returning to traditional Indigenous methods of healing, strengthening cultural identity, community integration and political empowerment as this can enhance and improve their PTSD and mental health from the trauma they’ve endured” (Braganza, McKinley, & Sibbald, 2018, p.11). Furthermore, this healing process can be found through reconnecting with their traditional ceremonies and practices, as well as voicing out about all they have endured through the residential school system so that Canadians can be aware and educated about the history of their culture. Health care professionals must allow for culturally competent care and be mindful of using holistic and culturally sensitive approaches when providing care to Indigenous people. This presentation and research have broadened my scope of the impact residential schooling has had not only directly on those who attended but also on their family members and the Indigenous culture. As a future nurse and current nursing student, I must understand their history and cultural practices to support Indigenous people when providing care. An example used from this presentation was allowing for smudging ceremonies to be performed within the hospital environment for indigenous individuals who wish to have the smudging take place for whatever reason. I learned that these ceremonies might be done for all stages of life, and allowing them to do so within the hospital may aid in their healing process. It is essential to understand these cultural needs and advocate for your patient to provide the best culturally competent care.
Braganza, B., McKinley, G. P., & Sibbald, S. L. (2018). The construction of “trauma” in Canadian residential school survivors impacts healing interventions and reconciliation initiatives. The Canadian Journal of Native Studies, 38(1), 1-18. Retrieved from https://search-proquest-com.library.sheridanc.on.ca/docview/2178546390/fulltextPDF/DFD32C9CF9D84BBFPQ/1?accountid=3455Burkhardt, M., Nathaniel, A., & Walton, N. (2018). Ethics and issues in contemporary nursing. (3rd Ed.). Toronto, ON: Nelson Education Ltd. Stamler, L., Yiu, L., & Dosani, A. (2015). Community health nursing – A Canadian perspective. (4th Ed.). Don Mills, ON: Pearson Canada Inc.
Discussion Post #4: Advocacy and Global Citizenship : Issues and trends in nursing
Consider what it means to be a global citizen. How might you demonstrate reflexivity, moral cosmopolitanism, and narrative imagination in your life? What might change (or change) about your day-to-day living by truly embracing global citizenship? For your response, the post engages in a professional online dialogue with a colleague—Initial Post due and Response Post. An initial and a response post are required. Also, upload your postings to Assessments / Assignments for evaluation. As nurses, we “have a moral responsibility and professional competency to care and promote health beyond our local communities and institutions,” which defines what it means to be a global citizen (Stamler, Yiu, & Dosani, 2016, p. 604). Although this may be a broad term, three main factors contribute to what it means to be a global citizen. One of the factors of being a global citizen is reflexivity, which is the ability to scrutinize ourselves, traditions, and beliefs to ensure reasonably (Stamler, Yiu, & Dosani, 2016, p. 604). Ensuring that we know our traditions and beliefs is essential to avoid being biased towards patients and families while providing care. Moral cosmopolitanism is another factor that involves viewing everyone as equals (Stamler, Yiu, & Dosani, 2016, p. 605). The third factor is narrative imagination, defined as “the ability to imagine what it might be like to be a person different from yourself and to allow such imaginings to inform an understanding of others, experiences, emotions, desires, and life stories” (Stamler, Yiu, &Dosani, 2016, p. 605). It is being able to place yourselves in someone else’s position and view their experiences and feelings from their perspective. Moreover, being a global citizen involves being professionally responsible and developing “an inward personal awareness and commitment to global issues and outward actions on local or global issues” (Potter, Perry, Stockert, & Hall, 2018, p. 120).
This past summer, I worked as a nursing assistant in a rehabilitation children’s hospital, where I was exposed to a vast amount of diversity, cultures, and different traditions and beliefs. As Stamler, Yiu, & Dosani (2016) states, “becoming a global citizen may begin in nursing training when nursing students become sensitized to their own culturally established perspectives on healthcare” (p. 605). I was able to develop a better understanding of the different disabilities of each child, their view on it, and how they approach their health care in their culture/family. There were many ethical dilemmas I was faced with daily. It involved cultural differences, which allowed me to identify my own beliefs, traditions, and practices to provide competent care and work through the dilemmas. Through this, I have communicated with their family members, guardians, and the children themselves about their personal stories and was able to develop my narrative imagination, empathizing with them. This has also grounded me to view others as equals. Despite their physical and mental differences, they must still be treated with the same respect and seen as equal. There was and is still a lot of stigmatization regarding physical and mental disabilities, along with these children’s health issues but being a part of a community that promoted the need for change in this specific demographic is a part of my development of becoming a global citizen.
Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. M. (2018). Canadian fundamentals of nursing (6th Ed.). Toronto, ON. Elsevier, Canada. Stamler, L., Yui, L., Dosani, A. (2016). Community Health Nursing – A Canadian Perspective. (4th Ed.) Toronto, ON: Pearson Canada Inc.