Incivility and Healthful Environments

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Incivility and Healthful Environments

Purpose

The purpose of the graded collaborative discussions is to engage faculty and students in an interactive dialogue to assist the student in organizing, integrating, applying, and critically appraising knowledge regarding advanced nursing practice. Scholarly information obtained from credible sources as well as professional communication are required. Application of information to professional experiences promotes the analysis and use of principles, knowledge, and information learned and related to real-life professional situations. Meaningful dialogue among faculty and students fosters the development of a learning community as ideas, perspectives, and knowledge are shared.

Activity Learning Outcomes

Through this discussion, the student will demonstrate the ability to: Examine roles and competencies of advanced practice nurses essential to performing as leaders and advocates of holistic, safe, and quality care (CO1). Apply concepts of person-centered care to nursing practice situations (CO2). Analyze essential skills needed to lead within the context of complex systems (CO3). Explore the process of scholarship engagement to improve health and healthcare outcomes in various settings (CO4).

(Incivility and Healthful Environments)

Integration of Evidence

The student post provides support from a minimum of one scholarly in-text citation with a matching reference AND assigned readings OR online lessons, per discussion topic per week.

What is a scholarly resource? A scholarly resource is one that comes from a professional, peer-reviewed publication (e.g., journals and government reports such as those from the FDA or CDC). It contains references for sources cited, is written by a professional or scholar in the field and indicates credentials of the author(s), and is no more than 5 years old for clinical or research articles.

What is not considered a scholarly resource? Newspaper articles and layperson literature (e.g., Readers Digest, Healthy Life Magazine, Food, and Fitness) Information from Wikipedia or any wiki, textbooks, website homepages, and the weekly lesson. Articles in healthcare and nursing-oriented trade magazines, such as Nursing Made Incredibly Easy and RN Magazine (Source: What is a scholarly article.docx; Created 06/09 CK/CL Revised: 02/17/11, 09/02/11 nlh/clm).

Can the lesson for the week be used as a scholarly source? Information from the weekly lesson can be cited in a posting; however, it is not to be the sole source used in the post.

Are resources provided from CU acceptable sources (e.g., the readings for the week)? Not as a sole source within the post. The textbook and/or assigned (required) articles for the week can be used, but another outside source must be cited for full credit. Textbooks are not considered scholarly sources for the purpose of discussions.

Are websites acceptable as scholarly resources for discussions? Yes, if they are documents or data cited from credible websites. Credible websites usually end in .gov or .edu; however, some .org sites that belong to professional associations (e.g., American Heart Association, National League for Nursing, American Diabetes Association) are also considered credible websites. Websites ending with .com are not to be used as scholarly resources.

Professionalism in Communication

The post presents information in logical, meaningful, and understandable sequence, and is clearly relevant to the discussion topic. Grammar, spelling, and/or punctuation are accurate.

Wednesday Participation Requirement

The student provides a substantive response to the graded discussion question(s) or topic(s), posted by the course faculty (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week.

Total Participation Requirement

The student provides at least three substantive posts (one to the initial question or topic, one to a student peer, and one to a faculty question) on two different days during the week.

(Incivility and Healthful Environments)

Preparing the Assignment

Introduction

This graded discussion will explore the impact of systems theory on a practice problem or issue. Please provide an initial response to the discussion question by Wednesday at 11:59 PM MT and two interactive dialogue responses no later than Sunday 11:59 PM MT at the end of WEEK 7. The discussion is worth 75 points. Please refer to the discussion grading rubric for additional criteria.

Assignment

Reflect on an experience in which you were directly involved or witnessed incivility in the workplace. Provide a brief synopsis of the situation. How did this make you feel? How did you respond? What were the consequences of this situation? Provide an example of how this negatively affected the work environment and outcomes. How could the situation have been prevented? Discuss strategies that would support a healthy work environment.

Reading:

American Nurses Association. (2015). Incivility, bullying, and workplace violence [Position Statement]. https://www.nursingworld.org/~49baac/globalassets/practiceandpolicy/nursing-excellence/official-policy-statements/ana-wpv-position-statement-2015.pdf

Centers for Disease Control and Prevention. (2013). Workplace violence prevention for nurses. http://wwwn.cdc.gov/wpvhc/Course.aspx/Slide/Unit1_5Edmonson, C., Bolick, B., & Lee, J. (2017). A moral imperative for nurse leaders: Addressing incivility and bullying in health care. Nurse Leader, 15, 40-44. https://doi-org.chamberlainuniversity.idm.oclc.org/10.1016/j.mnl.2016.07.012

Lachman, V. D. (2015). Ethical issues in the disruptive behaviors of incivility, bullying, and horizontal/lateral violence. Urologic Nursing, 35(1), 39—42.

Phillips, J. M., Stalter, A. M., Winegardner, S., Wiggs, C., & Jauch, A. (2018). Systems thinking and incivility in nursing practice: An integrative review. Nursing Forum, 53(3), 286-298. https://doi-org.chamberlainuniversity.idm.oclc.org/10.1111/nuf.12250

Roberts, S. J. (2014). Lateral violence in nursing: A review of the past three decades. Nursing Science Quarterly, 28(1), 36-41. https://doi-org.chamberlainuniversity.idm.oclc.org/10.1177/0894318414558614

Optional Resources:

American Nurses Association. (n.d.). Violence, incivility and bullying. http://www.nursingworld.org/MainMenuCategories/WorkplaceSafety/Healthy-Nurse/bullyingworkplaceviolence

America Nurses Association. (2016). Healthy nurse, healthy nation. http://nursingworld.org/MainMenuCategories/WorkplaceSafety/Healthy-Nurse

Mennella, H. D. A.-B., & Karakashian, A. R. B. (2017). Lateral violence in nursing. CINAHL Nursing Guide. https://doi.org/10.1177/0894318414558614

 
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Quality Healthcare

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Quality Healthcare

Reflect upon the patient experience, patient safety, and healthcare cost as well as Joint Commission’s role in quality healthcare.

Write a paper that addresses the following questions:

How would you apply the principles of the Triple Aim initiative to improve quality, safety and satisfaction in the acute care or long-term care setting?

Reflect on your current or future role in healthcare.

How you would you, in the role of director of nursing or healthcare administrator contribute to improving cost effective quality care, patient satisfaction, and patient safety?

What practices would you apply to minimize medical errors among front-line nursing staff?

 

Improving Patient Experience, Safety, and Healthcare Cost: The Role of the Triple Aim Initiative

The patient experience, safety, and healthcare cost are interconnected elements essential to delivering quality healthcare. The Joint Commission plays a pivotal role in ensuring that healthcare organizations maintain high standards for safety and quality. By focusing on these areas, healthcare professionals can enhance patient outcomes and satisfaction while managing costs effectively. This paper explores how the principles of the Triple Aim initiative can be applied to improve quality, safety, and satisfaction in acute and long-term care settings. Additionally, it reflects on the role of a healthcare administrator in promoting cost-effective quality care and minimizing medical errors among nursing staff.

Applying the Principles of the Triple Aim Initiative

The Triple Aim initiative, developed by the Institute for Healthcare Improvement, focuses on three primary objectives: improving patient experience, improving the health of populations, and reducing per capita healthcare costs.

  1. Improving Patient Experience: In an acute care setting, implementing patient-centered care approaches can enhance patient satisfaction. This involves actively involving patients in their care decisions, providing clear communication, and fostering a supportive environment. Techniques such as bedside reporting, where nurses communicate with patients about their care plans directly at the bedside, can enhance transparency and trust.
  2. Improving Population Health: In both acute and long-term care settings, preventive care measures can significantly improve population health. For instance, screening programs for chronic conditions (e.g., diabetes and hypertension) and health education initiatives can empower patients to manage their health proactively. Establishing community partnerships to address social determinants of health can also lead to better health outcomes.
  3. Reducing Healthcare Costs: Cost-effective strategies can be implemented to minimize unnecessary tests and procedures. Adopting evidence-based practices and care pathways can streamline care processes and reduce waste. Additionally, implementing technology such as electronic health records can facilitate better data management, ultimately contributing to cost savings.

The Role of a Director of Nursing or Healthcare Administrator

In the role of a director of nursing or healthcare administrator, one can significantly contribute to improving cost-effective quality care, patient satisfaction, and patient safety by:

  1. Fostering a Culture of Safety: Establishing a culture of safety within the organization encourages staff to report errors and near misses without fear of retribution. This transparency allows for the identification and mitigation of risks before they result in harm to patients.
  2. Investing in Staff Training and Development: Continuous education and training for nursing staff on best practices and evidence-based protocols can lead to enhanced competency and confidence in their roles. This training should also emphasize the importance of effective communication, teamwork, and patient engagement.
  3. Utilizing Data for Quality Improvement: Implementing robust data collection and analysis processes enables administrators to monitor key performance indicators related to patient safety and satisfaction. By identifying trends and areas needing improvement, targeted interventions can be developed to enhance care quality.

Minimizing Medical Errors Among Front-Line Nursing Staff

To minimize medical errors among front-line nursing staff, several practices can be employed:

  1. Standardized Protocols and Checklists: Utilizing standardized protocols and checklists for medication administration, patient handoffs, and procedures can reduce variability in practice and enhance adherence to safety guidelines. The use of a surgical safety checklist, for instance, has been shown to significantly reduce surgical errors and complications (Haynes et al., 2009).
  2. Implementing Technology Solutions: Electronic medication administration systems and clinical decision support tools can aid nurses in verifying medication orders, thereby reducing the likelihood of errors. These technologies can provide alerts for potential drug interactions, allergies, and dosing errors.
  3. Encouraging a Team-Based Approach: Promoting teamwork among healthcare professionals fosters an environment where nurses feel supported and empowered to speak up about concerns. Regular interdisciplinary team meetings can facilitate communication and collaboration, ultimately enhancing patient safety.

Conclusion

Applying the principles of the Triple Aim initiative can significantly improve patient experience, health outcomes, and reduce healthcare costs in acute and long-term care settings. As a director of nursing or healthcare administrator, promoting a culture of safety, investing in staff development, and utilizing data-driven approaches can lead to cost-effective quality care. By implementing standardized protocols, leveraging technology, and encouraging teamwork among nursing staff, medical errors can be minimized, thereby enhancing patient safety and satisfaction.

References

Haynes, A. B., Weiser, T. G., Berry, W. R., et al. (2009). A surgical safety checklist to reduce morbidity and mortality in a global population. New England Journal of Medicine, 360(5), 491-499. https://doi.org/10.1056/NEJMsa0810119

Institute for Healthcare Improvement. (n.d.). The Triple Aim: Care, Health, and Cost. https://www.ihi.org/engage/initiatives/tripleaim/pages/default.aspx

Joint Commission. (2021). Quality and Safety. https://www.jointcommission.org/resources/patient-safety-topics/quality-and-safety/

World Health Organization. (2015). WHO Global Strategy on People-Centered and Integrated Health Services: Interim Report. https://www.who.int/alliance-hpsr/alliancehpsr_who_global_strategy_on_people-centered_integrated_health_services_report.pdf

 
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Critical Thinking Abortion

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Critical Thinking Abortion

Answer as short as possible. There are 15 questions. L.W., a 20-year-old college student, comes to the university health clinic for a pregnancy test. She has been sexually active with her boyfriend of 6 months, and her menstrual period is now “a few” weeks late. The pregnancy test result is positive. The patient begins to cry, saying, “I don’t know what to do.”

(Critical Thinking Abortion)

  1. How will you begin to counsel L.W.?
  2. What information do you need to obtain from L.W. and why?
  3. What options does a woman experiencing a pregnancy have?
  4. If your role is to assist her in making a choice, what information will you want L.W. to provide?
  5. What are the nurse’s moral and ethical obligations in this situation?
  6. L.W. asks you to tell her about abortion. What will you tell her?
  7. You tell L.W. there are two types of abortions, vacuum aspiration and medical abortion. How would you explain the difference to her?
  8. What are the contraindications to using mifepristone (Mifeprex) for a medical abortion?
  9. She tells you that she has heard that if a woman has an abortion, she might not be able to get pregnant again. How would you counsel her?
  10. L.W. asks you, “Do you think abortion is killing?” What is your best response?
    a. “Good question. What do you think about it?”
    b. “A lot of people think this is what an abortion is.”
    c. “Absolutely not. What happens with pregnancy is a woman’s choice.”
    d. “I am not able to answer that question. Are you uncertain about abortion as an option?”
  11. What types of emotional reactions do women experience after an abortion?
  12. L.W. wants to know about adoption. What will you tell her?
  13. You ask L.W. if her boyfriend is aware of the possibility she was pregnant. She tells you that she did not tell him about her period being late or her visit to the clinic today. She asks you if she should tell him because she is afraid he will “freak out.” How should you respond?
  14. L.W. says she is uncertain as to what to do and wants to know how long she has to decide. How will you respond?
  15. L.W. declines an examination and says she needs to “think about all this.” She does make an appointment to return in 1 week. What teaching do you need to provide L.W. about how to care for herself in the meantime? How will you respond?

References

American College of Obstetricians and Gynecologists. (2020). Induced Abortion: A Resource for the Primary Care Physician.
https://www.acog.org/-/media/project/acog/acogorg/clinical/files/clinical-guideline/induced-abortion-a-resource-for-the-primary-care-physician.pdf

National Abortion Federation. (2021). Patient Education: The Basics of Abortion. https://www.prochoice.org/wp-content/uploads/2021/02/patient-education-abortion.pdf

 
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Simulation Technology

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Simulation Technology

Post your initial response to the topic below.

Topic 1

Simulation technology has been transformative in nursing education. Through the use of simulation, nurses can repeatedly practice skills and gain clinical confidence in a risk-free environment. Simulation, however, is not just for health care professionals. How can nurses leverage simulation technology for patient and family education? (Include your rationale.) Share your experiences and ideas for leveraging simulation technology for patient education.

 

Leveraging Simulation Technology for Patient and Family Education

Simulation technology has profoundly transformed nursing education, providing a platform where nursing students can practice clinical skills in a safe environment without the risks associated with real-life patient care. However, the benefits of simulation extend beyond the educational setting and can be effectively utilized for patient and family education.

One way nurses can leverage simulation technology is through creating realistic scenarios that patients and their families may encounter during treatment or recovery. For example, nurses can design simulations that allow patients to experience scenarios like managing a chronic illness or understanding medication administration. This hands-on approach enables patients to actively participate in their care, increasing their understanding and confidence in managing their health conditions.

Additionally, simulation can facilitate family education by involving family members in the learning process. Educating families about post-operative care, for example, through simulation can prepare them to provide adequate support at home. Using mannequins or virtual reality environments, families can practice essential skills, such as wound care or recognizing signs of complications, ensuring they feel equipped to assist their loved ones effectively.

The rationale behind this approach lies in the evidence that active participation in education leads to better retention of information. Studies have shown that when patients engage in hands-on learning experiences, they are more likely to understand complex medical concepts and adhere to treatment plans. Moreover, simulation can help demystify medical procedures, reduce anxiety, and enhance communication between patients, families, and healthcare providers.

In my experience, I have observed the impact of simulation technology during patient education sessions. For instance, when working with patients on diabetes management, I utilized a simulation that allowed them to practice insulin administration techniques. This interactive approach helped patients feel more comfortable with the process, leading to improved self-management skills and confidence.

Furthermore, I have facilitated family education through simulation during discharge planning. Involving family members in a simulated discharge scenario helped them better understand their roles and responsibilities in post-hospitalization care, ultimately resulting in a smoother transition home.

In conclusion, simulation technology offers an innovative and effective means for enhancing patient and family education in healthcare settings. By creating realistic, engaging learning experiences, nurses can empower patients and families to take an active role in their healthcare, leading to improved health outcomes and increased satisfaction with care.

 

References

Jeffries, P. R., & Rizzolo, M. A. (2006). Simulation in Nursing Education: A Review of the Research. Nursing Education Perspectives, 27(2), 96-103.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746510/

Adamson, K., & Tilley, A. (2017). Using Simulation to Enhance Patient and Family Education: A Scoping Review. Journal of Nursing Education and Practice, 7(1), 35-45.  https://www.sciedupress.com/journal/index.php/jnep/article/view/10723

 
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Evaluating Good Ethics

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Evaluating Good Ethics

1. Locate a news article that strikes you as exemplifying someone acting ethically.

2. Initial Post

Describe whether the individual in question is using a teleological theory or a deontological theory.

Evaluating Good Ethics

Evaluating Good Ethics: Teleological or Deontological?

  1. News Article: A compelling example of ethical action is from an article discussing Captain Chesley “Sully” Sullenberger’s decision-making during the 2009 “Miracle on the Hudson” incident, when he safely landed a US Airways flight on the Hudson River after bird strikes disabled both engines. Sullenberger’s choice to prioritize the safety of all 155 passengers, while disregarding the personal risks to himself, exemplifies ethical behavior.
  2. Initial Post:

In this case, Captain Sullenberger’s actions can be evaluated using deontological theory. Deontological ethics, derived from Immanuel Kant, focus on duty and rules over outcomes. In Sullenberger’s case, he upheld his duty as a pilot to ensure the safety of passengers above all else. His decision to land on the Hudson wasn’t motivated by the end result (the teleological approach) but by his adherence to moral duties such as safeguarding lives, following aviation protocols, and acting with integrity regardless of personal danger. Deontologists believe in actions being inherently right or wrong, irrespective of their consequences. Sully’s commitment to his duty, despite the unknown risks, aligns with this view.

 

References:

  1. Norman, R. (1998). The Moral Philosophies of Immanuel Kant and the Ethics of Duty. Philosophy Now, Issue 21. This article explains deontological theory and its application to real-life ethical situations. https://philosophynow.org/issues/21/Deontology_and_the_Categorical_Imperative
  2. Goethals, G. R., & Allison, S. T. (2012). Heroic Leadership: The Hero’s Journey of Interpersonal Competence. Psychology Press. This book includes insights into leadership ethics, specifically through examples like Sullenberger’s decision-making. https://www.routledge.com
 
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