Case Study: Susan Wong

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Case Study: Susan Wong

Instructions: Read the following case study and answer the reflective questions. Please provide rationales for your answers. Make sure to provide citations/references for your answers in APA 7 format.

CASE STUDY: Active Labor: Susan Wong

Mrs. Wong, a first-time mother, is admitted to the birthing suite in early labor after spontaneous rupture of membranes at home. She is at 38 weeks of gestation with a history of abnormal alpha-fetoprotein levels at 16 weeks of pregnancy. She was scheduled for ultrasonography to visualize the fetus to rule out an open spinal defect or Down syndrome, but never followed through. Mrs. Wong and her husband disagreed about what to do (keep or terminate the pregnancy) if the ultrasonography indicated a spinal problem, so they felt they did not want this information.

Reflective Questions

  1. As the nurse, what priority data would you collect from this couple to help define relevant interventions to meet their needs?
  2. How can you help this couple if they experience a negative outcome in the birthing suite? What are your personal views on terminating or continuing a pregnancy with a risk of a potential anomaly? What factors may influence your views?
  3. With the influence of the recent Human Genome Project and the possibility of predicting open spinal defects earlier in pregnancy, how will maternity care change in the future?

Case Study: Susan Wong

Case Study: Active Labor – Susan Wong

Reflective Questions

1. As the nurse, what priority data would you collect from this couple to help define relevant interventions to meet their needs?

In this scenario, as a nurse, the first priority is to gather comprehensive obstetric history, including Mrs. Wong’s prenatal care, abnormal alpha-fetoprotein levels, and her decision to forgo the recommended ultrasound. Additionally, it is important to assess the psychosocial and emotional state of both Mrs. Wong and her husband regarding their decision not to undergo ultrasonography. Since they have different views about the pregnancy outcome, gathering data on how they have coped with this conflict is critical to ensure appropriate emotional support is provided. Moreover, collecting information on labor progression, fetal heart rate, and any signs of distress in the mother or fetus is essential to ensure safe delivery. Finally, it is necessary to identify cultural, spiritual, or religious beliefs that may influence their decisions or coping mechanisms, as this will help tailor the interventions.

2. How can you help this couple if they experience a negative outcome in the birthing suite? What are your personal views on terminating or continuing a pregnancy with a risk of a potential anomaly? What factors may influence your views?

If the couple experiences a negative outcome, offering compassionate emotional support is critical. Providing nonjudgmental listening and allowing them to express their emotions will help them navigate through grief. Referring the couple to bereavement services, pastoral care, or a mental health professional may provide additional support during this difficult time. Encouraging memory-making, such as taking photographs or creating keepsakes, may help them honor their child, which can be part of the healing process.

As a nurse, personal views on terminating or continuing a pregnancy should remain non-influential in clinical care. However, it is important to acknowledge that factors such as cultural, ethical, or religious beliefs may shape these views. Professional nursing standards prioritize patient autonomy, meaning the couple’s decision should be supported regardless of the nurse’s personal stance. Nurses must maintain professional boundaries, ensuring that personal opinions do not interfere with patient care.

3. With the influence of the recent Human Genome Project and the possibility of predicting open spinal defects earlier in pregnancy, how will maternity care change in the future?

The Human Genome Project has significantly advanced prenatal care, allowing for early detection of genetic abnormalities. In the future, maternity care will likely see more routine genetic screening, enabling earlier diagnosis of conditions like open spinal defects. This may lead to a rise in personalized care plans based on genetic profiles, giving expectant parents more information to make informed decisions about their pregnancies. Ethical considerations will play a critical role in guiding how this information is used, and healthcare providers will need to be well-versed in genetic counseling to help parents understand and navigate their options.

References

Pillitteri, A. (2018). Maternal & child health nursing: Care of the childbearing and childrearing family (8th ed.). Philadelphia: Lippincott Williams & Wilkins. https://lww.com

American College of Obstetricians and Gynecologists (ACOG). (2021). Alpha-Fetoprotein Screening. https://www.acog.org/en/womens-health/faqs/alpha-fetoprotein

National Human Genome Research Institute. (2023). The Human Genome Project. https://www.genome.gov/human-genome-project

Lachman, P. (2018). Understanding the ethical implications of the Human Genome Project. The Journal of Perinatal Education, 17(4), 20-29. https://jpe.org

 
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The Frankenstein Application Essay

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The Frankenstein Application Essay

Your thesis statement and paper must address both the literary qualities and the social issues as you evaluate the novel, Frankenstein. However, keep in mind, your essay does not have to answer ALL of the questions listed under each topic. Only answer the questions you feel are the most relevant to the thesis statement you choose.

Develop your essay so it has a clear introduction, body, and conclusion. Ensure that each of your claims is supported with valid evidence from the novel, Frankenstein, and at least three other credible external sources.

Using proper MLA style, insert parenthetical citations and signal phrases for all borrowed information in addition to a Works Cited page for Frankenstein and your chosen external sources.
The Frankenstein Application Essay

You have several options for this assignment:

Option #1: Can science go too far?

There is an ongoing battle between faith or spirituality and science that has been active even before the time of Mary Shelley. What are some of the dilemmas she addresses that are still important today? What are some of the ethical questions she brings up regarding the scientific definition of life and death?

What does she illustrate about the power science has to blur the line between life and death? What is a current news item that is similar to this issue?

Hint: Develop a thesis that answers a question like this one: “How and how well does Mary Shelley’s Frankenstein address ethical issues of science and/or faith for audiences, regardless of when they read the novel?”

Option #2: Discovery

Both Frankenstein and Walton are trying to discover something important to them. What parts of their real lives drive them to discovery? Does that drive still exist today? While we’ve mapped the globe, are there still geographical places for people to explore?

In science, are people still trying to discover the meaning of life, how to save life, and how to defeat death? What methods do they use? Are there better ways to accomplish these goals than others? What are some of today’s motivations for discovery?

Note: Develop a thesis that answers questions like this one: “How and how well does Mary Shelley’s Frankenstein address human discovery as a theme?” (The Frankenstein Application Essay)

Option #3: World Perception and Prejudice

Reread the paragraph where the creature describes the book from which Felix teaches Safie. It begins: “The book from which Felix instructed Safie was Volney’s Ruins of Empires…”

What are some of the perceptions and prejudices from the book that Felix teaches Safie? How have these perceptions and prejudices changed, if they have, in today’s society? What are some present-day situations and references that may claim a lack of prejudice or an open-mindedness, but, in fact, are still very prejudiced, racist, sexist, etc.?

Why do you think these situations still happen? Can anything be done about it?

Hint: Develop a thesis that answers a question like this one: “How and how well does Mary Shelley’s Frankenstein address human prejudice in the world throughout time?”

Option #4: Personal Perception

It could be argued that the creature did not consider itself a monster and didn’t do awful things until people treated him like a monster. What are some real-world instances in which people’s actions could be a reaction to abuse from others? Who do you feel is accountable in these situations? Why?

Hint: Develop a thesis that answers a question like this one: “How and how well does Mary Shelley’s Frankenstein address the effect of peer perceptions on personal development?”

Option #5: Death and Suicide

At the end of the book, the creature promises to destroy himself. Is this a justifiable end for him? Could he have been redeemed? Would he have had a place in the world of Shelley’s novel?

How could this relate to current-day issues like suicide or the death penalty?

Hint: Develop a thesis that answers a question like this one: “How and how well does Mary Shelley’s Frankenstein address the value of an individual’s life and death?”

Option #6: Nature vs. Nurture

The creature argues that had someone properly guided him, he would not have been so wretched. Frankenstein argues that the creature was evil to begin with, so it would have been useless to teach him at all.

What are some current debates – especially in education – where these kinds of arguments still arise? How much of behavior do you think is based on nature (how a person IS) and how much is based on nurture (what a person LEARNS or EXPERIENCES)? What examples from the present support your opinion? What do you feel is the truth? Why?

Hint: Develop a thesis that answers a question like this one: “How and how well does Mary Shelley’s Frankenstein address existing personality traits versus how a person is taught to act?”

Option #7: Feminism

The feminist perspective is often explored in Mary Shelley’s Frankenstein. How are the women characters treated in the novel? What perceptions of women did Shelley use and comment on? How did she handle the theme of motherhood?

Hint: Develop a thesis that answers a question like this one: “How and how well does Mary Shelley incorporate responses to feminist issues into the novel, Frankenstein?” (The Frankenstein Application Essay)

 

References

Mary Shelley’s Frankenstein (Annotated Edition)

Shelley, M. (1831). Frankenstein; or, The Modern Prometheus (1831 edition). Retrieved from Project Gutenberg. https://www.gutenberg.org/ebooks/42324

Literary Criticism and Analysis of Frankenstein

Baldick, C. (1987). In Frankenstein’s Shadow: Myth, Monstrosity, and Nineteenth-Century Writing. Oxford University Press. https://global.oup.com/academic/product/in-frankensteins-shadow-9780198129493

Exploring the Ethical Issues in Frankenstein

Levine, G. (1991). The Endurance of Frankenstein: Essays on Mary Shelley’s Novel. University of California Press. https://www.ucpress.edu/book/9780520051786/the-endurance-of-frankenstein

Feminism in Frankenstein

Mellor, A. K. (1988). Mary Shelley: Her Life, Her Fiction, Her Monsters. Routledge. https://www.routledge.com/Mary-Shelley-Her-Life-Her-Fiction-Her-Monsters/Mellor/p/book/9780415900559

Nature vs. Nurture Themes in Frankenstein

Veeder, W. (1986). Mary Shelley and the Trials of Interpretation. University of Chicago Press. https://press.uchicago.edu/ucp/books/book/chicago/M/bo3633961.html

Science and Ethics in Frankenstein

Smith, J. (2000). The Gothic and the Scientific Imagination: Science, Fiction, and the Meaning of Life. Palgrave Macmillan. https://link.springer.com/book/10.1057/9780230288311

 
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Health Policy and Promotion

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Health Policy and Promotion

Instructions

This written assignment requires the student to investigate his/her local, state and federal legislators and explore their assigned committees and legislative commitments. The student is expected to investigate current and actual legislative initiatives that have either passed or pending approval by the house, senate or Governor’s office.
Health Policy and Promotion

The student will draft a letter to a specific legislator and offer support or constructive argument against pending policy or legislation. The letter must be supported with a minimum of 3 evidence based primary citations. (See Rubric)

The letter must include a discussion regarding your local, state and federal legislator and his/her assigned committees and legislative commitments.

The letter must discuss the specific policy or legislation (Bill or Act).

The letter must offer support or constructive argument against pending policy or legislation.

The letter must be supported with a minimum of 3 evidence based primary citations.

Follow the Grading Rubric Closely (Health Policy and Promotion)

Rubric

Legislation Type State or federal, scope of practice, reimbursement, loan repayment etc.

Review of the Literature Use a min of 3-4 primary sources of evidence. Not older than 5 years

Current Policy What is the current policy or health policy issue and how might it impact nursing or healthcare?

Proposed Policy or Pending Changes to Policy What are they? Be specific. You may have multiple changes in one piece of legislation

Stakeholders Who benefits from the changes? Who supports the changes/legislation?

Outcomes How will this impact nursing practice and the healthcare system?

Uses correct spelling, grammar, and professional vocabulary. Provides credible resources using correct APA format.

The state I want the project focused on is Florida.

Example of the letter

Date

The Honorable________________

The State Senate (or House of Representatives)

State Capitol

Santa Fe, NM 87503

Dear Senator (or Representative)____________:

Letter Content

Cite appropriate References in the content of the Letter

Sincerely,

Your Name

References Page Must be included after the Letter

List References in APA format

I have attached weeks two assignment. for reference its on Florida.

References

Florida Health Care Association. (2021). 2021 Health Care Legislative Priorities. https://www.fhca.org/advocacy/2021-health-care-legislative-priorities

Florida Senate. (2023). Legislation.  https://www.flsenate.gov/Legislation

National Conference of State Legislatures. (2021). State Legislatures and the Future of Health Care: The Role of State Legislatures in Implementing Health Care Reform. https://www.ncsl.org/research/health/state-legislatures-and-the-future-of-health-care.aspx

Florida Department of Health. (2022). Legislative Affairs.  https://www.floridahealth.gov/about/legislative-affairs/index.html

American Nurses Association. (2022). Advocacy for Health Policy.  https://www.nursingworld.org/our-certifications/advocacy-for-health-policy/

Centers for Medicare & Medicaid Services. (2021). Florida Medicaid.  https://www.medicaid.gov/state-overviews/stateprofile.html?state=fl

Florida Nursing Association. (2023). Advocacy and Legislative Updates.  https://www.floridanurse.org/advocacy/

 
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Nursing Professional Development Paper

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Nursing Professional Development Paper

Requirements

The APN Professional Development Plan paper is worth 200 points and will be graded on the quality of the content, use of citations, use of Standard English grammar, sentence structure, and overall organization based on the required components as summarized in the directions and grading criteria/rubric. (Nursing Professional Development Paper)

Submit the paper as a Microsoft Word Document, which is the required format at Chamberlain University. You are encouraged to use the APA Academic Writer and Grammarly tools when creating your assignment.

Follow the directions below and the grading criteria located in the rubric closely. Any questions about this paper may be posted under the Q & A Forum or emailed to your faculty.

The length of the paper should be 5-8 pages, excluding title page and reference page(s). Support ideas with a minimum of 3 scholarly resources. Scholarly resources do not include your textbook. You may need to use more than 3 scholarly resources to fully support your ideas.

You may use first person voice when discussing information specific to your personal practice or skills. Current edition APA format is required with both a title page and reference page(s). Use the following as Level 1 headings to denote the sections of your paper (Level 1 headings use upper- and lower-case letters and are bold and centered):

  • APN Professional Development Plan (This is the paper introduction. In APA format, a restatement of the paper title, centered and not bold serves as the heading of the introduction section)
  • APN Scope of Practice
  • Nurse Practitioner (NONPF) Core Competencies
  • Leadership Skills
  • Conclusion

Nursing Professional Development Paper

Directions

Introduction: Provide an overview of what will be covered in the paper. Introduction should include general statements on scope of practice, competencies, and leadership, and identification of the purpose of the paper.

APN Scope of Practice: Research the Nurse Practice Act and APN scope of practice guidelines for the state in which you intend to practice after graduation. Describe the educational, licensure, and regulatory requirements for that state in your own words. Identify whether your state allows full, limited, or restricted NP practice. Discuss NP prescriptive authority in your state. Provide support from at least one scholarly source. Source may be the regulatory body that governs nursing practice in your state.

Nurse Practitioner (NONPF) Core Competencies: Review the NONPF Core Competencies. Describe two competency areas you believe to be personal strengths and two competency areas in which you have opportunities for growth. Discuss two scholarly activities you could do during the master’s program to help yourself achieve NP competencies. Provide support from at least one scholarly source. Source may be NONPF Core Competencies document provided via the link in the week 2 readings.

Leadership Skills: Analyze three leadership skills required to lead as an NP within complex systems. Describe two strategies you could use to help you develop NP leadership skills. Provide support from at least one scholarly source. Textbooks are not considered scholarly sources.

Conclusion: Provide a conclusion, including a brief summary of what you discussed in the paper. (Nursing Professional Development Paper)

Introduction (168%)

Provides an overview of what will be covered in the paper. Introduction should include:

  • general statements on scope of practice.
  • general statements on NP competencies.
  • general statements on leadership.
  • identification of the purpose of the paper.

APN Scope of Practice (7236%)

Identify the intended state of practice after graduation.

Describe the educational, licensure, and regulatory requirements for state.

Identify whether the state allows full, limited, or restricted NP practice.

Discuss NP prescriptive authority in the state.

Provides support from at least one scholarly source. Source may be the regulatory body that governs nursing practice in the state.

Nurse Practitioner (NONPF) Core Competencies (3819%)

Describe two competency areas believed to be student’s personal strengths.

Describes two competency areas in which student has opportunities for growth.

Discuss two scholarly activities to do during the master’s program to help student achieve NP competencies.

Provide support from at least one scholarly source. Source may be NONPF Core Competencies document provided via the link in the week 2 readings.

Leadership Skills (3819%)

Analyze three leadership skills required to lead as an NP within complex systems.

Describe two strategies student could use to help develop NP leadership skills.

Provide support from at least one scholarly source.

Conclusion (168%)

Provide a conclusion, including a brief summary of what was discussed in the paper.

18090% Total CONTENT Points= 180 points

ASSIGNMENT FORMAT

Category Points % Description

APA Formatting 105% Formatting follows current edition APA Manual guidelines for title page, body of paper (including citations and headings), reference page.

Writing Mechanics 105% Writing mechanics follow the rules of grammar, spelling, word usage, punctuation, and other aspects of formal written work as found in the current edition of the APA manual. The length of the paper is at least 5 pages but no more than 8 pages.

2010% Total FORMAT Points= 20 points

200100% ASSIGNMENT TOTAL=200 points

(Nursing Professional Development Paper)

 

References

American Association of Nurse Practitioners. (2021). Nurse practitioner core competencies.  https://www.aanp.org/advocacy/advocacy-resources/nurse-practitioner-core-competencies

American Nurses Association. (2015). Nursing: Scope and standards of practice (3rd ed.). Silver Spring, MD: Author. https://www.nursingworld.org/our-certifications/nursing-scope-and-standards/

National Organization of Nurse Practitioner Faculties. (2018). Nurse practitioner core competencies content. https://www.nonpf.org/page/NPCompetencies

Florida Department of Health. (2023). Nurse Practice Act.  https://floridasnursing.gov/ (Specific link to the Nurse Practice Act section on the Florida Department of Health website)

D’Arcy, Y. (2020). Advanced practice nursing: A guide for nurse practitioners. Jones & Bartlett Learning.

Zaccagnini, M. E., & White, K. W. (2017). The Doctor of Nursing Practice Essentials: A New Model for Advanced Practice Nursing (3rd ed.). Jones & Bartlett Learning.

U.S. Department of Health and Human Services. (2021). Advanced practice registered nursing. https://www.hhs.gov/about/agencies/ahrq/advanced-practice-registered-nursing/index.html

Beeman, J. (2021). Leadership in nursing practice: Theoretical and practical approaches. Nursing Leadership. https://journals.lww.com/nursingmanagement/Abstract/2021/07000/Leadership_in_nursing_practice__Theoretical_and.5.aspx

 
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Patient Education Plan for Sister Mary

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Patient Education Plan for Sister Mary

Sister Mary is a patient in Level 2 Emergency Department. She must have a neural examination, physical assessment, radiographs of her facial bones, and a computed tomography scan of the head. Taking into consideration that she is a Roman Catholic nun, what would be the ideal course of patient education as this woman progresses from department to department?
Patient Education Plan for Sister Mary

Sister Mary, a Roman Catholic nun, is admitted to the Level 2 Emergency Department. She requires a neural examination, physical assessment, radiographs of her facial bones, and a computed tomography scan of the head. When educating Sister Mary, it is essential to consider her religious beliefs and values, ensuring that the information is delivered respectfully and compassionately throughout her care journey.

1. Initial Interaction and Assessment

  • Introduction of the Healthcare Team: Begin by introducing the healthcare team members who will be involved in Sister Mary’s care. This establishes trust and comfort, allowing her to feel more at ease.
  • Explain the Need for Assessments: Provide a clear and concise explanation of why each assessment (neural examination, physical assessment, radiographs, and computed tomography scan) is necessary. Use layman’s terms to explain any medical jargon, ensuring she understands the importance of these procedures for her health and well-being.
  • Address Emotional Concerns: Acknowledge that being in the hospital can be overwhelming. Encourage Sister Mary to express any fears or concerns she may have. Address her spiritual needs and offer to connect her with a chaplain if desired.

2. Neural Examination and Physical Assessment

  • Purpose of the Assessments: Explain that the neural examination and physical assessment are crucial to evaluate her neurological function and identify any issues related to her condition.
  • Procedure Description: Describe what she can expect during the neural examination and physical assessment, emphasizing that these will not be painful but may involve some tests that require her cooperation.
  • Informed Consent: Ensure that Sister Mary understands the procedures and obtains her informed consent, highlighting her autonomy in decision-making. Discuss any religious or personal beliefs she may have that could impact her care choices.

3. Radiographs and Computed Tomography Scan

  • Purpose of Imaging: Explain the purpose of the radiographs of the facial bones and the computed tomography scan. Discuss how these imaging studies help in diagnosing any potential issues and how they will assist in determining the best treatment plan.
  • Radiation Concerns: Address any concerns about radiation exposure from the imaging studies. Provide information about the safety measures in place to minimize risks, and reassure her that the benefits of obtaining accurate results far outweigh potential risks.
  • Procedural Explanation: Describe what she will experience during the imaging procedures. For instance, explain that she may be asked to lie still for a short time during the CT scan, and there may be sounds from the machine.

4. Providing Spiritual Support

  • Respect for Religious Beliefs: Throughout the education process, consistently show respect for Sister Mary’s religious beliefs. Offer prayers or time for reflection if she expresses a desire for it.
  • Encouraging Family Support: If Sister Mary wishes, encourage her to have family or fellow sisters present during her procedures. Familiar faces can provide emotional support.

5. Follow-Up and Care Transition

  • Post-Procedure Education: Once Sister Mary has completed her assessments, provide her with information about what to expect next, including potential results and next steps in her treatment plan.
  • Discharge Instructions: If applicable, discuss any discharge instructions, including follow-up appointments or referrals, and how she can continue to care for herself at home.
  • Continued Support: Reinforce that she can reach out to the healthcare team with any questions or concerns that arise in the future. Ensure she knows that her spiritual and emotional needs will continue to be addressed during her stay.
    (Patient Education Plan for Sister Mary)

References

Ben Natan, M., Mahajna, M., & Mahajna, S. (2014). The effect of spiritual care on the quality of life of patients with cancer: A systematic review. Journal of Holistic Nursing, 32(3), 163-174. https://journals.sagepub.com/doi/abs/10.1177/0898010113503868

Guba, E. G., & Lincoln, Y. S. (2005). Paradigmatic controversies, contradictions, and emerging confluences. In N. K. Denzin & Y. S. Lincoln (Eds.), The Sage handbook of qualitative research (3rd ed., pp. 191-215). Sage Publications.https://us.sagepub.com/en-us/nam/the-sage-handbook-of-qualitative-research/book227463

Taylor, E. J., & Lenz, K. (2021). The influence of spirituality and religious beliefs on the health and well-being of patients. Nursing Clinics of North America, 56(2), 231-241. https://www.nursing.theclinics.com/article/S0029-6465(21)00010-1/fulltext

Weathers, C., & Smith, J. (2019). Patient education: The key to success in healthcare. Journal of Health Education Research & Development, 37(1), 5-10. https://www.hoajonline.com/journals/pdf/10.7243/2052-4994-7-1.pdf

Wiggins, M., & Kain, Z. N. (2018). Understanding and addressing patients’ religious and spiritual needs in the hospital. American Journal of Nursing, 118(9), 26-32.  https://journals.lww.com/ajnonline/Abstract/2018/09000/Understanding_and_Addressing_Patients__Religious.26.aspx

 
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Mrs. Walsh CABG Surgery

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Coronary Artery Bypass Graft Surgery
Mrs. Walsh CABG Surgery

Mrs. Walsh, a woman in her 70s, was in critical condition after repeat coronary artery bypass graft (CABG) surgery. Her family lived nearby when Mrs. Walsh had her first CABG surgery. They had moved out of town but returned to our institution, where the first surgery had been performed successfully. Mrs. Walsh remained critically ill and unstable for several weeks before her death. Her family was very anxious because of Mrs. Walsh’s unstable and deteriorating condition, and a family member was always with her 24 hours a day for the first few weeks.

The nurse became involved with this family while Mrs. Walsh was still in surgery because family members were very anxious that the procedure was taking longer than it had the first time and made repeated calls to the critical care unit to ask about the patient. The nurse met with the family and offered to go into the operating room to talk with the cardiac surgeon to better inform the family of their mother’s status.

One of the helpful things the nurse did to assist this family was to establish a consistent group of nurses to work with Mrs. Walsh, so that family members could establish trust and feel more confident about the care their mother was receiving. This eventually enabled family members to leave the hospital for intervals to get some rest. The nurse related that this was a family whose members were affluent, educated, and well informed, and that they came in prepared with lists of questions. A consistent group of nurses who were familiar with Mrs. Walsh’s particular situation helped both family members and nurses to be more satisfied and less anxious. The family developed a close relationship with the three nurses who consistently cared for Mrs. Walsh and shared with them details about Mrs. Walsh and her life.

The nurse related that there was a tradition in this particular critical care unit not to involve family members in care. She broke that tradition when she responded to the son’s and the daughter’s helpless feelings by teaching them some simple things that they could do for their mother. They learned to give some basic care, such as bathing her. The nurse acknowledged that involving family members in direct patient care with a critically ill patient is complex and requires knowledge and sensitivity. She believes that a developmental process is involved when nurses learn to work with families.

She noted that after a nurse has lots of experience and feels very comfortable with highly technical skills, it becomes okay for family members to be in the room when care is provided. She pointed out that direct observation by anxious family members can be disconcerting to those who are insecure with their skills when family members ask things like, “Why are you doing this? Nurse ‘So and So’ does it differently.” She commented that nurses learn to be flexible and to reset priorities. They should be able to let some things wait that do not need to be done right away to give the family some time with the patient.

(Mrs. Walsh CABG Surgery)

One of the things that the nurse did to coordinate care was to meet with the family to see what times worked best for them; then she posted family time on the patient’s activity schedule outside her cubicle to communicate the plan to others involved in Mrs. Walsh’s care.

When Mrs. Walsh died, the son and daughter wanted to participate in preparing her body. This had never been done in this unit, but after checking to see that there was no policy forbidding it, the nurse invited them to participate. They turned down the lights, closed the doors, and put music on; the nurse, the patient’s daughter, and the patient’s son all cried together while they prepared Mrs. Walsh to be taken to the morgue. The nurse took care of all intravenous lines and tubes while the children bathed her. The nurse provided evidence of how finely tuned her skill of involvement was with this family when she explained that she felt uncomfortable at first because she thought that the son and daughter should be sharing this time alone with their mother.

Then she realized that they really wanted her to be there with them. This situation taught her that families of critically ill patients need care as well. The nurse explained that this was a paradigm case that motivated her to move into a CNS role, with expansion of her sphere of influence from her patients during her shift to other shifts, other patients and their families, and other disciplines.”

Critical thinking activities

  1. Discuss the clinical narrative provided here using the unfolding case study format to promote situated learning of clinical reasoning (Benner, Hooper-Kyriakidis, & Stannard, 2011).
  2. Regarding the various aspects of the case as they unfold over time, consider questions that encourage thinking, increase understanding, and promote dialogue, such as: What are your concerns in this situation? What aspects stand out as salient? What would you say to the family at given points in time? How would you respond to your nursing colleagues who may question your inclusion of the family in care?
  3. Using Benner’s approach, describe the five levels of competency and identify the characteristic intentions and meanings inherent at each level of practice.

 

References

Benner, P., Hooper-Kyriakidis, P., & Stannard, D. (2011). Clinical wisdom and interventions in critical care: A thought process approach. Jones & Bartlett Learning. https://www.jblearning.com/catalog/productdetails/9781284044192

Cox, C. L., & Kahn, D. L. (2016). Family involvement in care of critically ill patients: An integrative review. American Journal of Critical Care, 25(5), 399-409. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5077376/

Lindley, L. C., & Smith, M. D. (2015). Nursing care of the critically ill: Family-centered care. Nursing Clinics of North America, 50(3), 523-532.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5117861/

Mason, D. J., Leavitt, J. K., & Chaffee, M. W. (2016). Policy & Politics in Nursing and Health Care. Elsevier. https://www.elsevier.com/books/policy-and-politics-in-nursing-and-health-care/mason/978-0-323-39481-2

National Organization of Nurse Practitioner Faculties (NONPF). (2018). Core Competencies for Nurse Practitioners. https://www.nonpf.org/resource/resmgr/competencies/2018_Nonpf_Core_Competencies.pdf

 
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Team Building

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Team Building
Team Building

Read and watch the lecture resources & materials below early in the week to help you respond to the discussion questions and to complete your assignment(s).

Read
Yoder-Wise, P. S. (2015). Chapters 16 – 18

Watch
Team building tutorial: Motivating your team (5:03)
LinkedIn Learning. (2013, May 30). Team building tutorial: Motivating your team | lynda.com [Video file]. https://youtu.be/B6I8vAF08i8
Team building tutorial: Motivating your team | lynda.com (Links to an external site.)

Online Materials & Resources
Change Management Models: A Guide to Best Practice (Links to an external site.)
Change-Management-Coach.com. (2019). Change Management Models: A Guide to Best Practices. http://www.change-management-coach.com/change-management-models.html (Links to an external site.)

Visit the CINAHL Complete under the A-to-Z Databases on the University Library’s website and locate/read the articles below:
Lockart, L. (2015). The art of team building. Nursing Made Incredibly Easy! 13(3), 51-52.

Select one of the change management models you reviewed. How can you apply the model to your practice? Include an example using the model.

Submission Instructions: Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.

Application of the Kotter’s Change Management Model in Nursing Practice

Change is a constant in healthcare settings, particularly in nursing, where policies, technologies, and protocols continually evolve. One effective change management model is John Kotter’s Eight-Step Change Model, which provides a structured approach to managing change. This model is particularly relevant in nursing practice due to the necessity for collaboration, communication, and effective leadership in implementing changes that impact patient care.

Overview of Kotter’s Change Management Model

  1. Establish a Sense of Urgency: Create awareness about the need for change.
  2. Form a Powerful Coalition: Assemble a group with enough power to lead the change.
  3. Create a Vision for Change: Develop a clear vision to guide the change.
  4. Communicate the Vision: Ensure as many people as possible understand and accept the vision.
  5. Empower Action: Remove obstacles to change, and encourage risk-taking and creative problem-solving.
  6. Create Quick Wins: Recognize and reward short-term wins to build momentum.
  7. Build on the Change: Use the credibility from early wins to drive further change.
  8. Anchor the Changes in Corporate Culture: Ensure the changes are reflected in the organization’s culture.

Application of the Model to Nursing Practice

In nursing practice, implementing new protocols for patient care is essential for improving outcomes. For example, consider a hospital looking to enhance hand hygiene compliance among staff to reduce hospital-acquired infections. The following illustrates how Kotter’s model can be applied:

  1. Establish a Sense of Urgency: The nursing leadership can present data showing the high rates of hospital-acquired infections and the potential risks to patient safety. This data can highlight the importance of improving hand hygiene practices.
  2. Form a Powerful Coalition: A coalition of nurse leaders, infection control specialists, and staff nurses can be formed to spearhead the initiative. This coalition should be empowered to influence change and involve key stakeholders.
  3. Create a Vision for Change: The coalition can articulate a vision that emphasizes the importance of hand hygiene in preventing infections and ensuring patient safety, such as “To achieve a 95% compliance rate in hand hygiene practices within six months.”
  4. Communicate the Vision: Regular meetings, newsletters, and staff training sessions can be used to disseminate the vision and educate all staff members on hand hygiene protocols.
  5. Empower Action: The coalition can identify barriers to compliance, such as lack of supplies or insufficient staff education, and work to address these obstacles.
  6. Create Quick Wins: Recognizing departments that achieve high compliance rates during the initial stages can boost morale and encourage others to follow suit.
  7. Build on the Change: After achieving initial success, the coalition can introduce additional training sessions and refine protocols based on feedback from staff.
  8. Anchor the Changes in Corporate Culture: Finally, incorporating hand hygiene compliance into performance evaluations and ensuring that it is included in onboarding training for new staff will help solidify the changes in the organization’s culture.

Conclusion

The application of Kotter’s Eight-Step Change Model in nursing practice facilitates a structured approach to implementing changes that can lead to improved patient outcomes. By fostering a culture of communication, collaboration, and continuous improvement, nurses can effectively manage change and enhance the quality of care provided to patients. Implementing such models not only aligns with best practices in nursing but also emphasizes the importance of evidence-based approaches in delivering high-quality healthcare.

 
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Characteristics of Psychotic Disorders

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Characteristics of Psychotic Disorders

Compose a 400 words or less discussion to respond the following: Discuss the characteristics of psychotic disorders.

Characteristics of Psychotic Disorders

Characteristics of Psychotic Disorders

Psychotic disorders are severe mental health conditions characterized by an impaired relationship with reality. They affect perception, thought, emotion, and behavior, often making it difficult for individuals to function in everyday life. The main characteristics of psychotic disorders include hallucinations, delusions, disorganized thinking, disorganized behavior, and negative symptoms.

Hallucinations are sensory experiences that occur in the absence of an external stimulus. These may involve hearing voices, seeing things, or feeling sensations that are not present. Auditory hallucinations are the most common type, with individuals hearing voices that others cannot hear. These experiences can be frightening or confusing, causing distress and fear.

Delusions are fixed false beliefs that are not aligned with reality. Individuals may hold onto these beliefs despite contradictory evidence. Common types of delusions include paranoid delusions, where a person believes they are being watched or persecuted, and grandiose delusions, where one has an inflated sense of power or importance.

Disorganized thinking refers to the inability to form coherent thoughts. Speech may be difficult to follow, with ideas jumping from one topic to another in a disconnected or illogical manner. This disorganization can affect communication, making it hard for individuals to express themselves or understand others.

Disorganized behavior includes unpredictable, inappropriate, or bizarre actions. People may exhibit strange postures, display unprovoked aggression, or behave in ways that are difficult to explain. In some cases, this behavior may interfere with personal hygiene or other aspects of daily living.

Negative symptoms refer to the absence or reduction of normal behaviors. These may include a lack of emotional expression, reduced ability to experience pleasure, decreased motivation, and social withdrawal. Individuals with negative symptoms often appear emotionally flat, speak in a monotone voice, and show little interest in social interaction.

Psychotic disorders such as schizophrenia, schizoaffective disorder, and brief psychotic disorder often develop in early adulthood. They tend to be chronic, requiring long-term treatment, which may include antipsychotic medication, psychotherapy, and support from family and mental health professionals.

The impact of psychotic disorders on a person’s life is profound, affecting their social, occupational, and interpersonal functioning. Early detection and intervention are key to improving the prognosis and reducing the long-term effects of the disorder.

 

References

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: American Psychiatric Publishing. https://doi.org/10.1176/appi.books.9780890425596

National Institute of Mental Health. (2021). Schizophrenia. http://www.nimh.nih.gov/health/topics/schizophrenia

World Health Organization. (2022). Mental health: Schizophrenia. http://www.who.int/news-room/fact-sheets/detail/schizophrenia

Tandon, R., Nasrallah, H. A., & Keshavan, M. S. (2009). Schizophrenia: “Just the Facts” 5. Treatment and Prevention. Schizophrenia Research, 107(1), 1–23. https://doi.org/10.1016/j.schres.2009.09.048

van Os, J., Kapur, S. (2009). Schizophrenia. The Lancet, 374(9690), 635-645. https://doi.org/10.1016/S0140-6736(09)60995-8

 
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Leading Health Promotion for Populations

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Leading Health Promotion for Populations

The Doctor of Nurse Practice (DNP) priority is health promotion by providing education and awareness on those health behaviors to enhance longevity. Population health focuses on promoting health outcomes. The DNP role is crucial in promoting health activities by preventing diseases and disability on the local, regional, national, and global scale. Through assessment, implementation, the DNP evaluates outcomes of population health and intervention to promote the improvement of the health of those he or she serves. The discussion will focus on the future role of the DNP in leading and promoting the population (Chamberlain College of Nursing, 2019).

Identification of One Evidence-Based Strategy for Leading Efforts to Attain Optimal Health for Populations, on a Local, National, or Global Scale

Attaining optimal population health is the goal and top priority of the healthcare system and the Doctor of Nurse Practice (DNP). One evidence-based strategy of leading efforts to attain optimal health for populations on a local, national, and global scale is through prevention. Preventing disease is obtained through health education and immunizations (Chamberlain College of Nursing, 2019).

Leading Health Promotion for Populations

Studies show a population-based approach to health promotion that addresses social and structural factors, focusing on the communities, cities, state, national and global, enhances the population health. Addressing social and structural factors affecting population health is an integrated approach that aims for health promotion (Assefa et al., 2019; Chamberlain College of Nursing, 2019).

Health education involves providing awareness of disease conditions, health behaviors, and healthy lifestyles to promote health. Providing education at the local, national, and global scales enables the population to be aware of vital steps to enhance their health. Providing immunization and vaccination is primary prevention to improve population health by preventing or reducing the spread of diseases. Education is crucial across the healthcare system.

Health education provides an awareness of risk factors and healthcare information to promote optimal health to the vulnerable population such as the minority, children, pregnant women, low income, and the poor. Providing immunization reduces the risk of disease to improve health outcomes. The DNP collaborates with stakeholders and advocates in meeting the challenges of improving population health at the local, national, and global scale (Assefa et al., 2019; Chamberlain College of Nursing, 2019).

The DNP promotes population health in the communities he or she serves to prevent diseases and improve population health through health promotion. The DNP analyzes epidemiological, statistical data in the environment as relating to population health. The DNP uses the information, including the consideration of cultural diversity, to design services for prevention and implementation of measurement intervention.

The DNP evaluates the interventions in addressing health promotion and prevention of disease effort to improve health and promote access to healthcare services and resources. The DNP uses healthcare information to evaluate gaps in access to healthcare to enhance population health outcomes. The DNP assessed strategies used in healthcare delivery in preventing diseases as relating to the community, cultural and socioeconomic dimensions of health (Assefa et al., 2019; Chamberlain College of Nursing, 2019).

(Leading Health Promotion for Populations)

Description of One Evidence-Based Strategy for Leading Population Healthcare Reform Efforts Within and Across Healthcare Systems

Improving population health outcomes involves action. The DNP is shaping the future of healthcare (Chamberlain College of Nursing, 2019). One evidence-based strategy for leading population health across healthcare systems is increasing healthcare practices supported by research.

The evidence-based strategy involves using data and information systems in making healthcare decisions based on peer review and evidence in planning healthcare interventions, evaluation, and outcome measurement. Evidence-based practice (EBP) has demonstrated effectiveness and potential to improve health outcomes if adopted widely (Assefa et al., 2019; Chamberlain College of Nursing, 2019).

The DNP must lead and advocate for patients’ health. The DNP must collaborate with leaders, stakeholders, and policymakers to promote EBP implementation. Factors that support the implementation and sustainability of EBP are healthcare organizations, groups, and leaders. The DNP has a crucial role to play across healthcare systems in developing a strategic environment for EBP implementation across healthcare organizations and the context of healthcare systems.

Aligning stakeholders and leaderships to supports EBP implementation and sustainability enhances population health. Building a population health strategy includes focusing on how healthcare organizations effectively collaborate, communicate, and promote population health. An evidence-based approach for leading population healthcare reform across healthcare systems has direct and indirect benefits. There is access to numerous information on best practices, prevention programs, policies, and work productivity for safe, effective, and efficient healthcare (Assefa et al., 2019; Chamberlain College of Nursing, 2019).

The DNP uses effective communication and collaborative skills to design and implement EBP, peer review, practice guidelines, health policy, and standard of care to enhance practices to promote population health. The DNP leads the interprofessional teams in assessing practice and organizational problems preventing implementation and sustainability of EBP. The DNP uses leadership skills in collaboration with interprofessional groups to create change across and within healthcare and the healthcare delivery system for population health outcomes (Assefa et al., 2019; Chamberlain College of Nursing, 2019).

The DNP is in the position to advocate for patients and their health to improve health outcomes. The ability of the DNP to bring her perspective in improving population health is crucial to enhancing population health across healthcare settings. Healthcare complexity with increasing practices, policies, and information systems has prompted the role of the DNP scholar as a health advocate for all populations across settings (Chamberlain College of Nursing, 2019).

Description of A Program Designed to Improve the Health of Populations. How To Advance the Outcomes of this Program

One Program Design to Improve Population Health

Improving population health is crucial to promoting the health of the population. One program designed to improve the health of the population is behavioral health programs. The DNP developed behavioral health programs to target population health on the community, state, national, and global scale.

The approach involves prevention of mental disorders, specifically major depressive disorders, early identification through screening, early diagnosis, and adequate treatment through the combination of medication management and cognitive behavior therapy to reduce disability, morbidity, and mortality rate due to suicide (Gutierrez-Galve et al., 2019; Yamamoto, 2018).

The incidence of depression increases after puberty and is twice as high in girls and women. Family history and exposure to psychosocial stress are contributory factors. Study shows depression is due to genetics, stressors, emotional problems, complicated situations, and circumstances experienced by the individual. Depression rates increase with age from 5.7 percent in youth aged 12 to 17 years to 7.4 percent among adults aged 18 to 39 years in the United States population.

Early detection and treatment of depression have helped save population health. Population-based healthcare focused on the system established to improve the population’s health outcomes and the fair distribution of the results within the population (Gutierrez-Galve et al., 2019; Yamamoto, 2018).

Advancing the Outcomes of The Program

One will advance in the outcome of a behavioral health program. The study shows an integrated approach to screening for behavioral health, specifically the risk of depression; combined with timely access with community resources, brief intervention, and services targeting high-risk populations for depression, enhance mental health promotion.

There has been increasing concern of depression for the health of the people. Adequate screening, diagnosis, intervention, and proper treatment are crucial in promoting mental health (Price et al., 2017). One currently practices in mental health outpatient rendering services for health promotion, prevention, screening, diagnosing, and providing intervention to reduce disability.

Integrated screening and early intervention enhance early diagnosis and treatment to reduce disability, morbidity, and mortality rate. In my practice, one uses combination treatment of medication management and cognitive-behavioral therapy in all patients referred for depression after thorough evaluation and identification.

The practice problem with treating depression is non-adherence. Careful education promotes treatment adherence. It is crucial to carry out behavioral health screening at the first point of contact of patients in community systems. Study shows screening for behavioral health risk in the community is beneficial. The early assessment facilitates prompt delivery of mental healthcare. Implementing EBP serves in addressing population health and reduces the gap in access to treatment (Assefa et al., 2019; Price et al., 2017).

In conclusion, healthcare is continuously changing. The demand for healthcare and population health requires a high level of scientific knowledge and practice to enhance patient health outcomes. Population health includes promoting safe, effective, client-centered, timely, efficient, and equitable healthcare, emphasizing EBP, quality improvement, and informatics. The DNP can execute the care through collaboration with stakeholders and interdisciplinary teams (Chamberlain College of Nursing, 2019).

(Leading Health Promotion for Populations)

 

References

Assefa, M.T., Ford II, J.H., Osborne, E., McIlvaine, A., King, A., Campbell, K., Jo, B., & McGovern, M.P. (2019). Implementing integrated services in routine behavioral health care: Primary outcomes from a cluster randomized controlled trial. BMC Health Services Research, 19(1), 1-13. https://doi.org/10.1186/s12913-019-4624-x

Chamberlain College of Nursing. (2019). NR-704 Week Eight: Leading health promotion for populations. [Online lesson]. Downers Grove, IL: Adtalem.

Gutierrez-Galve, L., Stein, A., Hanington, L., Heron, J., Lewis, G., O’Farrelly, C., & Ramchandani, P.G. (2019). The association of maternal and paternal depression in the postnatal period with offspring depression at age 18 years. JAMA Psychiatry, 76(3), 290-296. https://doi.org/10.1001/jamapsychiatry.2018.3667

Price, S.K., Coles, D.C., & Wingold, T. (2017). Integrating behavioral health risk assessment into the centralized intake for maternal and child health services. Health & Social Work, 42(4), 231-238. https://doi.org/10.1093/hsw/hlx037

Yamamoto, M. (2018). Perceived neighborhood conditions and depression: Positive local news as a buffering factor. Health Communication, 33(2), 156-163. https://doi.org/10.1080/10410236.2016.1250192

 
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Culturally Competent Nursing Care

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Culturally Competent Nursing Care

How does the community health nurse recognize bias, stereotypes, and implicit bias within the community? How should the nurse address these concepts to ensure health promotion activities are culturally competent? Propose strategies that you can employ to reduce cultural dissonance and bias to deliver culturally competent care. Include an evidence-based article that address the cultural issue. Cite and reference the article in APA format.

Culturally Competent Nursing Care

Recognizing Bias, Stereotypes, and Implicit Bias within the Community

A community health nurse plays a crucial role in delivering healthcare to diverse populations, which often exposes them to different cultural, ethnic, and socioeconomic groups. To recognize bias, stereotypes, and implicit bias within the community, the nurse must first engage in self-awareness. Nurses must reflect on their personal beliefs, assumptions, and attitudes that might influence their care. Implicit biases, which are unconscious attitudes or stereotypes, may affect clinical decisions and patient interactions without the nurse even realizing it. For example, assuming a specific ethnic group has certain health behaviors or attributing a patient’s symptoms to their cultural background without proper assessment can negatively impact care.

Active listening and direct communication with patients are essential tools for identifying any underlying biases. The nurse must recognize when patient care is influenced by preconceived ideas or when certain cultural norms are misinterpreted as negative behaviors. In addition, community health assessments that involve direct interactions with individuals and groups can provide the nurse with the opportunity to identify social determinants of health and stereotypes that may be influencing health outcomes within a specific population.

(Culturally Competent Nursing Care)

Addressing Bias for Culturally Competent Health Promotion

Once biases are recognized, the nurse should take steps to ensure health promotion activities are culturally competent by integrating cultural humility and cultural awareness into their practice. Cultural competence involves understanding and respecting the diverse beliefs, values, and customs of the communities served. This can be achieved by:

  1. Education and Training: Continuous cultural competence education can help the nurse develop a deeper understanding of different cultures, thus preventing biased care. Programs that address unconscious bias are particularly useful in helping healthcare providers recognize and mitigate biases.
  2. Patient-Centered Care: Health promotion activities should be tailored to the unique needs of the community. This can be done by involving community members in the design and implementation of these activities to ensure they are respectful of cultural beliefs and practices. The nurse must also communicate in a way that aligns with the health literacy levels of the community, ensuring clear understanding.
  3. Advocacy: Nurses must act as advocates for populations that are marginalized or underserved, ensuring that care is equitable and culturally relevant. This involves addressing social determinants of health and creating interventions that are inclusive and respectful of diversity.

Strategies to Reduce Cultural Dissonance and Bias

  1. Cultural Competence Training: Nurses should participate in workshops that focus on cultural competence and implicit bias. These sessions help healthcare professionals understand their own biases and how to mitigate them, fostering a more inclusive healthcare environment.
  2. Interprofessional Collaboration: Engaging with interdisciplinary teams that include community members and other healthcare providers can foster a broader understanding of different cultural perspectives. Nurses can share knowledge and best practices with colleagues to collectively reduce bias in care delivery.
  3. Community Engagement: Active engagement with the community through focus groups or health promotion initiatives provides nurses with firsthand insights into cultural practices and preferences. Involving community leaders in health programs can ensure that activities are relevant and sensitive to the community’s cultural values.
  4. Reflection and Self-Awareness: Nurses should routinely reflect on their practices to identify areas where cultural dissonance may arise. Maintaining cultural humility, where the nurse continually learns from patients and acknowledges that they may not fully understand every cultural nuance, is essential.
  5. Patient-Centered Communication: Communication is key in delivering culturally competent care. Asking open-ended questions about a patient’s cultural practices, beliefs, and values can create a respectful and trusting relationship between the nurse and the patient. The nurse should also avoid making assumptions and take into account the patient’s preferences in their care plan.

(Culturally Competent Nursing Care)

Evidence-Based Article on Cultural Competence

An evidence-based article addressing cultural competence in nursing is “Cultural competence in nursing: A concept analysis” by Renzaho, Romios, Crock, and Sønderlund (2013). This article discusses how cultural competence involves recognizing the diverse cultural needs of patients, and it emphasizes the importance of self-awareness and ongoing education for healthcare providers. The study highlights strategies that nurses can implement to mitigate the impact of bias and provide equitable, culturally sensitive care.

Citation in APA format:

Renzaho, A. M., Romios, P., Crock, C., & Sønderlund, A. L. (2013). Cultural competence in nursing: A concept analysis. International Journal of Nursing Studies, 50(3), 350-361. https://doi.org/10.1016/j.ijnurstu.2012.11.012

By recognizing biases and engaging in culturally competent practices, nurses can create an inclusive healthcare environment where all patients feel respected and valued. Culturally competent care promotes better health outcomes and helps build trust between healthcare providers and the communities they serve.

 
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