MTBI Post-Blast Exposure in US Military

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MTBI Post-Blast Exposure in US Military

Identifying Mild Traumatic Brain Injuries Post-Blast Exposure in US Military

Identifying Mild Traumatic Brain Injuries Post-Blast Exposure in US Military

Mild traumatic brain injury (MTBI) is characterized by a head injury that causes memory loss, a change in the mental state during the moment of the accident, or the absence of consciousness for no more than thirty minutes. Patients with MTBI have GCS scores between 13 and 15 at the time they present for medical care.1 Between 1.5 million and 2 million patients seek treatment for head trauma in North American emergency departments each year, with 70 to 90 percent suffering from MTBI.1 It excludes the numerous individuals who suffer brain injuries yet decide against seeking medical assistance. Teenagers and young adults are at an increased risk for mTBI, while older individuals and young children also have significant morbidity.1 Men are more likely than women to suffer from mTBI. Falls and auto accidents are the most frequent causes.1 Military personnel are another group at a high risk of experiencing mTBI and will be the focus population in this project.

Head trauma from blast exposure is a growingly serious health concern as a consequence of armed conflict, especially for military duty members. Blast-related injuries are the most militarily distinctive kind of mild traumatic brain injury (mTBI), which has been dubbed one of the signature wounds of war.2 Physical injury to the brain from blast-related accidents has many potential causes, including direct and/or indirect exposure to high-pressure conditions. Blast injuries sustained while serving in the military are frequently caused by improvised explosive devices, occupational training, and the discharge of heavy armaments.2 The origin, treatment, and recovery from blast-related mTBI are still poorly understood despite more than ten years of research.

(MTBI Post-Blast Exposure in US Military)

Although blast exposure is widespread among service members, its long-term psychological repercussions, separate from any subsequent mild traumatic brain injury, are not well understood. It is partly because there is no universally accepted definition of what blast exposure entails.3 Although the physical injuries caused by bomb exposure can be classified as primary, secondary, tertiary, or quaternary, many blasts that service members face do not cause these brain injuries. Additionally, experiencing a blast or explosive incident may not always cause symptoms consistent with a mild traumatic brain injury.3 The project seeks to develop interventions to help identify mTBI post-blast exposure and improve scientific knowledge on blast-related mTBI detection and implications.

References

Georges A. Traumatic brain injury. In: StatPearls [Internet]. StatPearls Publishing. 2022.

Martindale S L, Ord A S, Rule L G, Rowland J A. Effects of blast exposure on psychiatric and health symptoms in combat veterans. Journal of psychiatric research, 143, 189-195. 2021. https://www.sciencedirect.com/science/article/pii/S0022395621005616

Phipps H, Mondello S, Wilson A, Dittmer T, Rohde NN, Schroeder PJ, Nichols J, McGirt C, Hoffman J, Tanksley K, Chohan M. Characteristics and impact of US military blast-related mild traumatic brain injury: a systematic review. Frontiers in neurology. 2020.

 
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Literature Review Research Matrix

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Literature Review Research Matrix

Please note that the first row of data is meant as an example. Please read the example article (Garriott, Hudyma, Keene, & Santiago, 2015) as a guide for how to dissect each article assigned.

Literature Review Research Matrix

Reference  Main Themes/Constructs Research Questions Theoretical Framework or Model Population & Sample description & “N=” Methodology and Design Summary of Findings
Garriott, P. O., Hudyma, A., Keene, C., & Santiago, D. (2015). Social cognitive predictors of first and non-first-generation college students’ academic and life satisfaction. Journal of Counseling Psychology, 62(2), 253–263. doi: https://doi.org/10.1037/cou0000066 Academic Progress, academic satisfaction, college outcome expectations, college life efficacy, environmental supports, life satisfaction, positive affect. What are the predictors of students’ academic and life satisfaction? Lent’s model of normative well-being. N=414

Students from two 4-year universities.

 Quantitative, Quasi-Experimental, Multiple Measures. Results suggested the hypothesized model provided an adequate fit to the data while hypothesized relationships in the model were partially supported. Environmental supports predicted college self-efficacy, college outcome expectations, and academic satisfaction. Furthermore, college self-efficacy predicted academic progress while college outcome expectations predicted academic satisfaction. Academic satisfaction, but not academic progress predicted life satisfaction.
DiGuiseppi, G. T., Davis, J. P., Meisel, M. K., Clark, M. A., Roberson, M. L., Ott, M. Q., & Barnett, N. P. (2020). The influence of peer and parental norms on first-generation college students’ binge drinking trajectories. Addictive Behaviors, 103, 1-7. https://doi.org/10.1016/j.addbeh.2019.106227. First-generation college student’s alcohol use, drinking trajectories of first-generation and continuing generation students, relationship between first-generation status and social norms, binge drinking frequency, parental alcohol problems and norms. What is the relationship between first-generational students and alcohol use? NA N = 1,342

Continuing-generation students (n = 1,117)

First-generation students (n = 225)

Students from a private university

  Quantitative, experimental, Multiple measures. Per the analysis and tests, binge drinking frequency reduced over the initial three semesters in college.

The tests were controlled for demographics, substance-free dormitory residence, parental alcohol problems and norms, and researchers found that binge drinking frequency declined more for first-generation status.

There was astronger association between parental injuctive norms and binge drinking frequency during the first semester for first generation students than continuing-generation ones.

This effect reduced over time for first-genertion students.

Peer descriptive norms influence on binge drinked increased for continuing-generation students and remained the same for first-generation students.
Ma, P.-W. W., & Shea, M. (2021). First-generation college students’ perceived barriers and career outcome expectations: Exploring contextual and cognitive factors. Journal of Career Development, 48(2), 91–104. https://doi-org.library.capella.edu/10.1177/0894845319827650 Percieved barriers and career outcome expectations for first-generation students, effect of perceived educational and career barriers on the vocational outcomes expectations of first-generation students What is the effect of perceived educational and career barriers on the vocational outcome expectations of first-generation students? NA N = 153,

Etnically diverse

From public universities

  Quantitative, correlational, Multiple measures Per the moderational analysis, the campus connectdness significantly moderated for FGCS experiencing low or average level campus connectdness, higher levels of barriers were related to more negative career outcome expectations.

Per the mediation analysus, perceived barriers were related to career outcome expectations, mediated by sense of coherence.

The other social variables were not statistically significant moderators.
O’Hara, E. M. (2022). Latino student retention: A case study in perseverance and retention. Journal of Hispanic Higher Education, 21(3), 315-332. https://doi.org/10.1177/1538192720968509 Student perserverance and retention, lived experience of first-generation latino college students, supportive system, respect for the culuture. What are the lived experiences of first-generation latino students in a four-year higher education setting? NA NA Qualitative, Case study A supportive system and respect for culuture were linked to higher latino studentretention.

Leaving the comfort zone is needed to grow academically and personally.
Roksa, Silver, B. R., Deutschlander, D., & Whitley, S. E. (2020). Navigating the first year of college: Siblings, parents, and first‐generation students’ experiences. Sociological Forum, 35(3), 565–586. https://doi.org/10.1111/socf.12617 College education, socioeconomic status and college entry, cultural capital, social mobility. Hypothesis: Exposure to education can benefit indivduals and their families. Cultural Capital theory NA * Quantitative, correlational.

 

 

  The experience of younger college students does not depend on older siblings, unless they attended the same insititution.

Topics and nature if conversations between students and parents differ between families with or without college-educated siblings.

Support from parents influences the benefit of having college-educated siblings in relation to student’s engagement.

(Literature Review Research Matrix)

 
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Continuing Education vs Continuing Professional Development

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Continuing Education vs Continuing Professional Development

Discussion Board Post

Difference Between Continuing Education and Continuing Professional Development

Particularly in the fields of nursing and healthcare, professional development and continuing education are frequently used interchangeably. They are two distinct concepts, even though they are both necessary for job advancement.1 Professional development refers to a variety of methods, usually involving the acquisition of new talents and skills relevant to a chosen field. Training courses and workshops are part of professional development to help people be better in their current position. Continuing education, on the contrary, refers to ongoing professional education by enrollment in a facility or academic program. Continuing education involves acquiring more education after receiving a first degree. It usually implies formal education, like PhD programs or higher education.1 It might also entail finishing short courses or training to earn a diploma, license, or other qualifications. Continuing education helps healthcare personnel to stay current with procedures and knowledge.2 It also helps advance professionally by enabling people to establish themselves as experts in their professions.

Continuing Education vs Continuing Professional Development

Employees can advance in their professions through both professional development and continuing education, but continuing education is a more structured means of doing so. Another significant distinction between the two is that some occupations, like becoming a doctor or university professor, even mandate continuing education.2 Professional development is often not an industry mandate but a means of achieving individual career goals. Additionally, since someone might need to take out a student loan to seek a second or higher degree, continuing education will probably require a larger investment than professional development.1 Professional development opportunities, including workshops offered by employers for employee training, may be free.

(Continuing Education vs Continuing Professional Development)

 References

Columbia Southern University. the difference between continuing education and professional development. 2021. https://www.columbiasouthern.edu/articles/2021/april/continuing-education-and-professional-development/

Public Health Degrees. Continuing education and professional development in public health. 2020. https://www.publichealthdegrees.org/resources/continuing-education-and-professional-development/

 
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Supply Chain Paper

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Supply Chain Paper

Contemporary Trends in Supply Chain

Supply chain management (SCM) involves actively managing supply chain activities, and it is done to increase customer value and create a long-lasting competitive advantage. It shows a deliberate effort on the part of supply chain management companies to create and manage supply chains as effectively and efficiently as they can. Product creation, sourcing, production, logistics, and the information systems required to coordinate these activities are all covered by supply chain activities. Almost every product that is used by an end-user is the result of the combined efforts of various businesses. Supply chain management is evolving daily to cater for the current trends in the market and ensure businesses remain relevant and able to fulfil today’s customers’ needs. This paper discusses the evolution of supply chain management, current trends in SCM, barriers to their adoption in businesses, and recommendations for successful implementation.

Supply Chain Paper

Evolution of Supply Chain Management

Since the 1960s supply chain management has evolved from a fragmented one in the 1960s to a consolidated SCM in the 1980s, integrated SCM in the 1990s, value capture in the 2000s and automated SCM in the 2010s and currently. Since the system was extremely fragmented in the 1960s, this tendency was highlighted as a significant area for future efficiency improvements. Supply chain management has evolved by enhancing the integration of various jobs (Rodrigue, 2020). The 1970s and 1980s saw the initial consolidation of logistics duties into two separate areas linked to materials management and physical distribution, despite the fact that these tasks have remained largely the same. As globalization sparked functional integration and the genuine birth of logistics in the 1990s, this trend advanced (Rodrigue, 2020). The entire supply chain was integrated into a single management viewpoint.

However, the development of supply chain management made a more thorough integration only conceivable with information and communication technology practicable. It opens the door to a new spectrum of production and distribution systems by enabling the integrated administration and control of information, financial, and commodities flow (Rodrigue, 2020). Supply chain management has developed into a complicated series of tasks aimed at competitiveness and value capture. More recently, the evolution of physical distribution and materials management has been significantly influenced by the growing degree of automation in supply chains (Rodrigue, 2020). This digitalization is most noticeable in distribution centers where areas like storage, materials handling, and packaging have seen a considerable push toward automation. Automated delivery cars may one day be available.

Contemporary Trends in Supply Chain Management

As the business environment changes, so does the supply chain and the need for supply change management to respond to the changes. Supply chain management (SCM) is a critical element in the business world, widely influenced by globalization and other changes in the business environment. The supply chains are increasingly becoming complex, especially with new technologies and innovations. Companies seek innovative strategies to manage their supply chains more effectively and efficiently and cultivate resilient supply chain operations. Current trends in supply chain management include artificial intelligence and automation, Supply Chain as a Service, and circular supply chain.

Artificial Intelligence and Automation

Every company entity needs a working supply chain in order to be successful. A significant competitive advantage can be gained by accurately projecting inventory. The performance of the supply chain is influenced by both internal and external elements, including weather, extreme seasonality, changes in customer perception, and media attention (Dash et al., 2019). Internal factors include the introduction of new products and the growth of the distribution network. Artificial intelligence (AI) has recently been shown to function as an extension of the human brain, enhancing our cognitive capacities to heights we never imagined imaginable.

AI has been incorporated into many commercial sectors and has been shown to lower costs, boost revenue, and improve asset utilization. Businesses are using AI to estimate customer demand with almost 100% accuracy, improve their R&D, expand manufacturing with lower costs and higher quality, assist in marketing, and give their customers a better experience (Dash et al., 2019). For an advantage in the marketplace, these four value-generating areas are crucial. Supply-chain executives employ AI-powered solutions to a) create waste-free designs; b) monitor production in real-time and ensure accuracy; and c) speed up process cycle times (Dash et al., 2019). These procedures are essential for delivering Innovation to the market more quickly.

Artificial intelligence and automation are primarily driven by the need to streamline and optimize supply chain processes and automate humdrum and repetitive tasks (Dash et al., 2019). AI-based solutions can be used to spot and handle possible supply chain problems like delays, bottlenecks, and interruptions brought on by unplanned events. Additionally, these technologies can be used to increase the forecasting and inventory management processes’ precision and speed. Robotic process automation (RPA), which combines AI with automation, is also growing in popularity for managing supply chains across the globe. RPA makes it possible to automate repetitive processes like data entry, document processing, and order tracking, which reduces manual labor and boosts supply chain efficiency (Dash et al., 2019). For instance, Amazon warehouse automation enables the company to handle inventory using robotics arms, Robin and Cardinal, which helps streamline processes and sped up order fulfilment. However, the complexity of implementing AI and automating supply chains is a significant barrier to successful implementation (Couvillon, 2019). The cost of adopting AI and automation is also considerably beyond the capacity and ability of many businesses, especially small businesses.

Supply Chain as a Service

Businesses are embracing the concept of Supply Chain as a Service (SCaaS) as they invite the idea of outsourcing supply chain operations to external actors that will manage the whole process from procurement to delivery (Lopienski, 2021). SCaaS is a technologically driven, end-to-end supply chain management solution. It is a highly adaptable logistics approach and makes use of one or more logistics partners to handle the management of production, manufacturing, warehousing, inventory tracking, order fulfilment, and shipping. In the end, SCaaS provides the infrastructure and technology to lower logistics costs, offers customizable fulfillment solutions, and applies technology and automation to enhance speed, visibility, and consistency throughout a whole supply chain network. Generally, it involves outsourcing supply chain activities to a 3PL.

Outsourcing is perceived as cost-effective and transfers the risks of a project or activity to a third party, which is a positive for many companies. In this case, cost-effectiveness is imperative to achieving financial growth and health. Outsourcing labor, projects, and other business elements is a way to achieve cost-effectiveness and risk transfer, hence the need to learn and understand SCaaS (Lou et al., 2020). For instance, Apple outsources its supply chain and assembly operations and focuses on product design with rich functionality and easy usability. Although it does not outsource the core software technologies, it outsources across business intelligence and data warehousing, application development and maintenance, and enterprise application (Rikap, 2018). The company outsources multiple manufacturing jobs to Mongolia, China, Korea, and Taiwan, areas considered to have a high talent pool and low labor costs, adding to the company’s cost-effectiveness. However, loss of control of outsourced manufacturing jobs, risk of low commitment that may lead to poor production and substantial materials, unclear requirements and expectations, and poor transition of activities and jobs can impend the implementation of SCaaS.

Circular Supply Chain

Environmental sustainability and net zero are important considerations for companies. Businesses are embracing the idea of a closed-loop supply chain, which encourages material reusing and recycling to achieve sustainable and efficient supply chains (Lahane et al., 2020). Due to the growing attention being paid to sustainability and environmental protection on a worldwide scale, the circular supply chain is becoming more and more significant. Companies are seeking ways to lessen their carbon footprint and employ more environmentally friendly practices, and an excellent approach to accomplish this is through the circular supply chain.

The circular supply chain prioritizes maximizing the lifecycle of a product by returning components to start a new journey through the supply chain rather than having them end up in a landfill. If this cannot be done, alternative adjustments to the product or process can be made to cut down on waste and carbon emissions (Lahane et al., 2020). The circular supply chain, also known as supply chain stewardship, places more responsibility on individuals in charge of managing supply chains to choose manufacturing and procurement strategies that have a beneficial impact on sustainable results. The circular supply chain is an important component of a larger movement among manufacturers and retailers to reduce waste and adopt more environmentally friendly methods. As a result, companies that have established circular supply chains frequently combine them with other sustainable measures, such as cutting back on energy use or switching to cleaner energy sources and coming up with substitutes for single-use plastics (Del Giudice et al., 2021). For instance, PepsiCo works with stakeholders, educating them and establishing opportunities for people to recycle beverage containers to respond to the shift towards the circular economy. However, the knowledge gap between stakeholders, the high investment required to employ recycling and reusing strategies, and loss of control at the point of sale are barriers preventing the successful implementation of circular supply chains.

Recommendations

Artificial intelligence and automation, Supply Chain as a Service, and circular supply chain can be valuable to a company and help attain a competitive advantage. However, their implementation is not smooth due to the multiple barriers highlighted above. To successfully adopt artificial intelligence and automation, which is impeded by the high complexity of associated technologies and the high implementation cost, companies should make the implementation strategy to ensure it is worth the investment. Companies should first identify opportunities for AI and automation, map the opportunities, plan for strategic implementation per the opportunities, and evaluate the impact on supply chains (Couvillon, 2019). For instance, Amazon can begin by identifying processes that can be automated to ensure the investment is worth it because not all processes require automation. To successfully outsource business operations, companies should develop outsourcing goals and rules, evaluate the existing system and process of the company and their correspondence to those of 3PL, develop accurate job descriptions for offshore teams, ensure offshore team management is inhouse and there is documentation of internal processes to ensure the transition and integration is seamless. For instance, Apple should ensure that 3PLs handling outsourced manufacturing jobs have the same level of commitment, skill set, and quality assurance as Apple itself. Stakeholder education, particularly the consumers can help close the knowledge gap between stakeholders and increase control at the point of sale to ensure a successful circular supply chain. For example, PepsiCo can bolster its success in adopting a circular supply chain by educating customers on the importance of recycling.

Conclusion

Companies handle the entire production flow of products and services through supply chain management, beginning from raw materials acquisition to final product delivery to their customers. Supply chain management is a significant part of business, which is evolving with time due to changes in the market scenario, technology, customer needs, competitiveness, and external factors like a focus on environmental sustainability. Some of the current trends in SCM include artificial intelligence and AI, which is driven by the need to make supply chains more efficient, SCaaS driven by the need to outsource and enhance the cost-effectiveness of SCM and circular supply chains that have risen in importance to respond to the call to ensure environmentally friendly and sustainable supply chains. However, multiple barriers impend the implementation of these elements, and businesses need to adopt the recommended strategies to enhance their chances of success.

References

Couvillon, B. (2019). Barriers to Automation in Supply Chain and Logistics. Titanium Consulting.

Dash, R., McMurtrey, M., Rebman, C., & Kar, U. K. (2019). Application of artificial intelligence in automation of supply chain management. Journal of Strategic Innovation and Sustainability, 14(3), 43-53.

Del Giudice, M., Chierici, R., Mazzucchelli, A., & Fiano, F. (2021). Supply chain management in the era of circular economy: the moderating effect of big data. The International Journal of Logistics Management, 32(2), 337-356.

Lahane, S., Kant, R., & Shankar, R. (2020). Circular supply chain management: A state-of-art review and future opportunities. Journal of Cleaner Production, 258, 120859. https://www.sciencedirect.com/science/article/abs/pii/S0959652620309069

Lopienski, K. (2021). What Is Supply Chain as a Service? A Complete Guide.

Lou, Y., Feng, L., He, S., He, Z., & Zhao, X. (2020). Logistics service outsourcing choices in a retailer-led supply chain. Transportation Research Part E: Logistics and Transportation Review, 141, 101944. https://www.sciencedirect.com/science/article/abs/pii/S1366554520305950

Rikap, C. (2018). Innovation as economic power in global value chains. Revue d’économie industrielle, (163), 35-75.

Rodrigue, J. P. (2020). The geography of transport systems. Routledge.

 
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Rebuttal From Doctorate Plan

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Rebuttal From Doctorate Plan

The author provides a compelling argument on dementia, its prevalence and its impact on the United States population. According to the CDC, dementia does not describe a particular disease but rather an umbrella term for impaired memory, thinking, and decision-making ability that interferes with an individual’s ability to perform activities of daily living. Indeed Alzheimer’s disease is the most common form of dementia, primarily affecting older adults.1 Dementia cannot be attributed to age, although it occurs progressively and persistently through cognitive function deterioration. Patients experience memory loss and have no or slight insight into their deficiencies.1 Dementia is perceived as a major neurocognitive disorder with 13 etiological subtypes, including Alzheimer’s disease, Lewy body disease, Parkinson’s disease, traumatic brain injury, Huntington’s disease, vascular disease, and HIV infection. A patient can present with more than one etiology, for instance, Alzheimer’s and vascular disease in a single patient.2 Progressive supranuclear palsy, corticobasal syndrome, and, less commonly, multiple system atrophy are other medical conditions that can cause dementia.

(Rebuttal From Doctorate Plan)

Rebuttal From Doctorate Plan

Alsheimer’s disease is responsible for 70-80% of all dementia cases and can happen sporadically or be familial.2 Vascular dementia is about 15% of the cases, with incidences doubling every 5.3 years due to risk factors such as the increasing prevalence of hypertension, hypercholesteremia, smoking, and diabetes mellitus.2 Lewy body dementia is responsible for 5% of dementia cases, although diagnosis is often missed.2 The specific type of dementia can only be determined through an autopsy, but a clinical history can help establish a probable diagnosis. Indeed the aging population is increasing, and considering age is a risk factor for dementia, the cases are expected to increase.2 Nurses should brace for it by equipping themselves with more and new knowledge to respond to the increasing health needs of dementia patients.

References

Arvanitakis Z, Shah RC, Bennett DA. Diagnosis and Management of Dementia: Review. JAMA. 2019;322(16):1589-1599. doi:10.1001/jama.2019.4782

Emmady PD, Schoo C, Tadi P. Major Neurocognitive Disorder (Dementia). 2022. https://europepmc.org/article/NBK/nbk557444

 
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Reflective Journal – DNP 830

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Reflective Journal – DNP 830

This reflective journal essay aims to demonstrate individual perspectives about the course, DNP 830. It provides the breakthroughs and difficulties experienced during the course in achieving course objectives and the competencies provided by the American Association of Colleges of Nursing’s (AACN) Essential of Doctoral for Advanced Nursing Practice. These essentials are core to every advanced nursing practice role. The course offered opportunities to develop these core competencies aligned with the AACN essentials through the various course activities.

Reflective Journal - DNP 830

 

Reflection

This reflective journal demonstrates the individual learning experiences throughout the course, strategies adopted to achieve course objectives, and knowledge gained. It summarizes the weekly reflections and the competencies gained through the weekly course activities. Throughout the course, the following essentials were accomplished:

Essential I: Scientific Underpinnings for Practice

The DNP course presented multiple challenges and complexities, besides opportunities to advance knowledge and skills on DNP essentials. The course was demanding and required high-level engagement, especially in completing weekly assignments that align with the scientific underpinnings of practice. From identifying healthcare issues affecting the patient to PICOT-D question development, literature search and evaluation, and the development of annotated bibliography, this student developed an understanding of scientific knowledge development and the process of scientific research aimed to develop knowledge and intervention to improve patient outcomes. It was my first time developing a PICOT-D question because, previously, this nurse scholar was required to develop PICO or PICOT question. It was challenging at first to understand how to integrate the “D” or data element in the PICIOT question, but the instructor feedback and the PICOT-D question template guided the nurse scholar to successfully develop a PICOT-D question.

All weekly assignments were aligned with the first essential. This nurse scholar discovered high-level elements of the research process but experienced challenges with the literature search and evaluation. This course required using quantitative research only to support the PICOT-D elements and proposed intervention. It is easier when both qualitative and quantitative sources are used because it requires a robust search of databases to establish quantitative sources only. However, it was an opportunity to discover and learn more about different types of quantitative research designs and how to identify them based on the methodology adopted. The research process allowed this nurse scholar to link the research question or PICOT-D question to evaluated research methodologies and outcomes and discover how the sources identified supported or informed current research. The weekly course resources, including reading materials, discussions, and learning activities reinforced the understanding of this course competency.

Essential II: Organizational and Systems Leadership for Quality Improvement and Systems Thinking

The primary aim of the research is to influence change by generating deeper insights into a research problem and developing new thinking approaches to address situations for more desirable futures or outcomes. This nurse scholar is required to identify a quality improvement opportunity or a research opportunity focusing on the patients. This course provides materials and resources that supported the identification of the patient’s health issue through the weekly assignments, discussions, and readings. This nurse scholar developed the skills and capacities required to catalyze, enable, and promote systems-level change. The course combines collaborative leadership and systems insights critical for quality improvement and system thinking needed to develop effective action and solutions in complex situations, enabling systems change. Collaborative leadership calls for effective communication skills for the successful development of quality improvement initiatives to enhance patient quality and safety. Although the process was challenging for this nurse scholar, it enhances career preparedness, particularly enabling change.

Essential III: Clinical Scholarship and Analytical Methods for Evidence-Based Practice

Evidence-based practice is a requirement in current practice to ensure informed nursing decisions. The DNP course was practice-based, and learners are required to practice per evidence-based practice. The course activities, from developing a PICOT-D question to literature evaluation and review align with this essential, which requires the DNP to search for the best available evidence and use it in practice to solve a patient health issue. The learner is responsible for understanding nurse practice and increasing clinical and leadership skills through research translation into standard care. The course offers valuable insights into adopting the evidence-based practice to improve care systems and examine patient outcomes for the selected patient population. In disseminating best practices, this nurse scholar reviewed quantitative data, sorting out studies that are relevant and accurate to support the quality improvement initiative.

Conclusion

This reflective journal sought to offer individual experiences with the DNP course and the strategies adopted to accomplish the course objectives and attain the core competencies per the AACN’s essentials. Despite the numerous challenges experienced during the course, this nurse scholar accomplished essentials I, II, and II. The competencies developed will help advance career and ability to care for patients at the highest level.

 
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 Hospital-based Violence Intervention Programs

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 Hospital-based Violence Intervention Programs

Annotated Bibliography

Bonne, S., Hink, A., Violano, P., Allee, L., Duncan, T., Burke, P., … & Dicker, R. (2022). Understanding the makeup of a growing field: A committee on trauma survey of the national network of hospital-based violence intervention programs. The American Journal of Surgery, 223(1), 137-145. https://www.sciencedirect.com/science/article/abs/pii/S000296102100413X

 Hospital-based Violence Intervention Programs

The article addresses hospital-based violence intervention programs, their implementation, and their effectiveness in addressing IPV. The authors identify the programmatic components of existing HAVI and assess program and service hurdles to implementation to inform the American College of Surgeons Committee on Trauma (ACS-COT) on how trauma centers might collaborate on this project most effectively. The researchers discovered that hospital-based violence intervention programs successfully address IPV but struggle with funding, hiring enough staff, and gaining buy-in. The study offers insights into the implementation of HAVI programs and the factors that should be considered in the process. The findings are evidence-supported and consistent with other studies reviewed by the authors, enhancing their validity and reliability. However, there are limitations to the study. The sample size adopted in the study is inadequate and limits generalization. Also, only 38 participants, all HAVI members, were invited, resulting in a selection bias in the study. Future studies should concentrate on finding ways to increase HVIP implementation, funding, and data gathering. The article supports the intervention by providing information on how hospital-based violence intervention programs can prevent IPV and suggestions on how they can be made better.

Halliwell, G., Dheensa, S., Fenu, E., Jones, S. K., Asato, J., Jacob, S., & Feder, G. (2019). Cry for health: a quantitative evaluation of a hospital-based advocacy intervention for domestic violence and abuse. BMC health services research, 19(1), 1-12. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-4621-0

The authors explored hospital-based advocacy’s impact on home-based violence, including IPV. In addition to examining the impact on improving support access, health outcomes, and cost-effectiveness, the authors examined how an advocacy approach benefited domestic violence survivors in a hospital context. By working with survivors who were less obvious to community IDVA programs, hospital IDVAs helped with earlier intervention. The researchers found that hospital IDVAs increased referrals from medical services and made additional health resources accessible, and hospital survivors were more likely to report abuse reductions and cessations. However, for hospital survivors, there were no changes in health outcomes. In this case, hospital survivors’ odds of staying safe increased by a factor of two if they made more than five contacts with an IDVA or used at least six resources or programs over a more extended period and the cost of accessing services by survivors reduced. The methodology adopted supports the thesis and the research purpose, bolstering the quality of the research study. Also, the findings are reported in other studies reviewed in this article, implying consistent results, hence high reliability and validity. However, the evaluation design and the data quality had limitations. The researchers’ non-experimental methodology caused them to overstate the effectiveness of the intervention. The approaches employed to estimate cost also limited the analysis because it relied on patient collection. The effectiveness of the intervention should be the subject of further study, often using an experimental methodology. Nonetheless, the study supports the effectiveness of the hospital-based approaches as an intervention to addressing IPV by demonstrating with specificity the usefulness of hospital-based advocacy interventions for treating domestic violence and abuse.

Olson, C., Aboutanos, M., Thomson, N., Vincent, A., & Kevorkian, S. (2022). Adapting Hospital-based Intimate Partner Violence Programs to the COVID-19 Pandemic. Panamerican Journal of Trauma, Critical Care & Emergency Surgery, 11(1), 3-8. https://www.researchgate.net/profile/Nicholas-Thomson-2/publication/360294052_Adapting_Hospital-based_Intimate_Partner_Violence_Programs_to_the_COVID-19_Pandemic/links/62a0e4b36886635d5cc9c908/Adapting-Hospital-based-Intimate-Partner-Violence-Programs-to-the-COVID-19-Pandemic.pdf

The author investigated how hospital-based advocacy programs or interventions have affected domestic violence during the Covid-19 pandemic. The researchers looked into how the EMPOWER program modified intervention and community case management procedures to assist patients during the pandemic. The findings indicate patients had access to a range of services through EMPOWER, including crisis intervention (84%), emotional support (89%), victim rights (53%), and advocacy for patients while they were undergoing medical treatment (49%). The victims noted the following dangers and risks: A total of 30% of patients reported the presenting domestic violence incident to the police, 19% of patients seeking advocacy services claimed the perpetrator used a weapon, including a firearm, against the victim, and 8% of patients were forced to move or become homeless as a result of domestic violence. The study depicts accurate findings of similar programs outside the study, demonstrating high validity and reliability. However, given that chosen patients are enrolled in the particular program or services, the study suggests a selection bias. Therefore, applying the findings outside of the research context would be challenging. Future studies should examine the program’s effectiveness and potential for expansion into other contexts. Despite the limitations, the article is relevant to the research paper because it offers insightful information about one illustration of a hospital-based intervention to deal with IPV and victims of violence.

Yount, K. M., Cheong, Y. F., Khan, Z., Bergenfeld, I., Kaslow, N., & Clark, C. J. (2022). Global measurement of intimate partner violence to monitor Sustainable Development Goal 5. BMC public health, 22(1), 1-14.

Authors seek to measure intimate partner violence to monitor sustainable development 5 (to eliminate violence against women, including IPV). This goal prompts states to monitor IPV to eliminate it successfully. The authors performed a measurement-invariance assessment of standardized IPV items. Data was collected through the Demographic and Health Surveys (DHS) from Lower-/Middle-Income Countries (LMICs). 18 IPV items were administered and analyzed on two item sets, lifetime physical IPV and controlling behaviors. The article’s findings indicate varying national physical IPV and controlling behavior rates. Also, both tests had similar national rankings based on prevalence. Physical IPV items, including slapping, twisting, chocking and controlling behaviors like meeting female friends and contacting family, warranted cognitive testing to enhance their psychometric properties. This article has high reliability and validity because the findings are consistent with those of other research articles reviewed in this article. The findings are related to the PICOT-D elements as they offer items to measure IPV. However, the results are limited to the seven selected physical-IPV and five controlling-behavior items analyzed. Therefore, these findings cannot be extended to other IPV items.

Troisi, G. (2018). Measuring intimate partner violence and traumatic affect: Development of VITA, an Italian scale. Frontiers in psychology, 9, 1282.

The authors investigate measurements for IPV and traumatic affect. The authors seek to develop and assess tools or instruments to identify post-traumatic affectivity. Developing these instruments would help IP victims and services recognize and respond to IPV with higher sensitivity and structure. The authors investigated a self-report instrument to detect post-traumatic affect intensity due to IPV. A 28-item set was identified and administered to 302 IPV victims. The article adopted explorative and confirmatory analysis to measure the items. Findings indicate that the instrument could help clinicians and researchers investigate the affective state intensity of IPV victims. It could help address clinical practice and therapeutic intervention planning. These findings are reported in other studies, increasing the reliability and validity of the article. The study is also relevant and supports the PICOT-D elements by providing insights into IPV and traumatic affect measurement. However, the tool does not consider the women’s emotional reaction’s complexity after trauma, and the sample was not entirely discriminant of a clinical sample.

References

Bonne, S., Hink, A., Violano, P., Allee, L., Duncan, T., Burke, P., … & Dicker, R. (2022). Understanding the makeup of a growing field: A committee on trauma survey of the national network of hospital-based violence intervention programs. The American Journal of Surgery, 223(1), 137-145. https://www.sciencedirect.com/science/article/abs/pii/S000296102100413X

Halliwell, G., Dheensa, S., Fenu, E., Jones, S. K., Asato, J., Jacob, S., & Feder, G. (2019). Cry for health: a quantitative evaluation of a hospital-based advocacy intervention for domestic violence and abuse. BMC health services research, 19(1), 1-12. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-4621-0

Olson, C., Aboutanos, M., Thomson, N., Vincent, A., & Kevorkian, S. (2022). Adapting Hospital-based Intimate Partner Violence Programs to the COVID-19 Pandemic. Panamerican Journal of Trauma, Critical Care & Emergency Surgery, 11(1), 3-8. https://www.researchgate.net/profile/Nicholas-Thomson-2/publication/360294052_Adapting_Hospital-based_Intimate_Partner_Violence_Programs_to_the_COVID-19_Pandemic/links/62a0e4b36886635d5cc9c908/Adapting-Hospital-based-Intimate-Partner-Violence-Programs-to-the-COVID-19-Pandemic.pdf

Troisi, G. (2018). Measuring intimate partner violence and traumatic affect: Development of VITA, an Italian scale. Frontiers in psychology, 9, 1282.

Yount, K. M., Cheong, Y. F., Khan, Z., Bergenfeld, I., Kaslow, N., & Clark, C. J. (2022). Global measurement of intimate partner violence to monitor Sustainable Development Goal 5. BMC public health, 22(1), 1-14.

 

 

Appendix A

Table 1: Primary Quantitative Research – Supports Element of PICOT-D Question


APA Reference (Include the GCU permalink or working link used to access the article.)		 Research Questions/ Hypothesis, and Purpose/Aim of Study Type of Primary Research Design Research Methodology

·         Setting/Sample (type, country, number of participants in study)

·         Methods (instruments used; state if instruments can be used in the DPI Project)

·         How were the data collected?

 Interpretation of Data

(State p-value: acceptable range is p= 0.000 – p= 0.05)

 Outcomes/
Key Findings(Succinctly states all study results applicable to the DPI Project.)		 Limitations of Study and Biases Recommendations for Future Research

 

 Explanation of How the Article Supports Your Proposed PICOT-D Question (P.C.O.T or D)
Yount, K. M., Cheong, Y. F., Khan, Z., Bergenfeld, I., Kaslow, N., & Clark, C. J. (2022). Global measurement of intimate partner violence to monitor Sustainable Development Goal 5. BMC public health, 22(1), 1-14.

https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-12822-9

 The paper aimed to conduct the first robust, global psychometric evaluation of items established to measure IPV in the DHS DVM Quantitative Descriptive Research The researchers administered the Demographic and Health Surveys (DHS) to 36 lower-Middle-Income countries (LMICs) between 2012-2018. The surveys had 18 IPV items.

The surveys were administered to large, nationally-representative samples of households and randomly selected women of reproductive age (15-49 years).

 National rates of physical IPV (5.6–50.5%) and controlling behavior (25.9–84.7%) varied. The article’s findings indicate varying national physical IPV and controlling behavior rates. Also, both tests had similar national rankings based on prevalence. Physical IPV items, including slapping, twisting, chocking and controlling behaviors like meeting female friends and contacting family, warranted cognitive testing to enhance their psychometric properties. The results are limited to the seven selected physical-IPV and five controlling-behavior items analyzed. Therefore, these findings cannot be extended to other IPV items. The analyses should be replicated for high-income countries (HICs).

Future research surveys should be completed before or after (2012-2018).

Larger national samples would help future research minimize sampling errors and bolster statistical power.

 The findings are related to the PICOT-D elements as they offer items to measure IPV.
Troisi, G. (2018). Measuring intimate partner violence and traumatic affect: Development of VITA, an Italian scale. Frontiers in psychology, 9, 1282. https://www.frontiersin.org/articles/10.3389/fpsyg.2018.01282/full The study aimed to investigate measurements for IPV and traumatic affect and develop and assess tools or instruments to identify post-traumatic affectivity.

This study emphasizes emotional factors maintaining the violent relationship in particular guilt, shame, fear, and terror.

 

 Correlational Quantitative Research Design The sample included 32 Italian women (M: 30.63; SD: 18.5 years).

The recruitment was online, via mailing lists and social networks.

The participants were grouped randomly into two congruous subsamples, A and B.

A 28-item set was identified and administered.

The data was collected using the VITA Scale and the IPV Check List.

 A factorial structure composed of four factors (guilt, shame, fear, and terror), consistent with theoretical scales and a good internal consistency (Cronbach’s alphas from 0.80 to 0.90) emerged The authors investigated a self-report instrument to detect post-traumatic affect intensity due to IPV.

Findings indicate that the instrument could help clinicians and researchers investigate the affective state intensity of IPV victims. It could help address clinical practice and therapeutic intervention planning.

 The tool does not consider the women’s emotional reaction’s complexity after trauma, and the sample was not entirely discriminant of a clinical sample. A clinical sample should be adopted to confirm the results.

Future researcher should determine if the instrument is sensitive to changes in the therapeutic process with women who are IPV victims.

A more in-depth investigation of violence consequences for women’s emotional experience is needed to refine the scale’s content validity.

 The study is relevant and supports the PICOT-D elements by providing insights into IPV and traumatic affect, including guilt, shame, fear, and terror, measurement.

 

Table 2: Primary Quantitative Research – Supports Intervention Directly


APA Reference (Include the GCU permalink or working link used to access the article.)		 Research Questions/ Hypothesis, and Purpose/Aim of Study Type of Primary Research Design Research Methodology

·         Setting/Sample (type, country, number of participants in study)

·         Methods (instruments used; state if instruments can be used in the DPI Project)

·         How were the data collected?

 Interpretation of Data

(State p-value: acceptable range is p= 0.000 – p= 0.05)

 Outcomes/
Key Findings(Succinctly states all study results applicable to the DPI Project.)		 Limitations of Study and Biases Recommendations for Future Research

 

 Explanation of How the Article Supports the Intervention for Your Proposed PICOT-D Question
Bonne, S., Hink, A., Violano, P., Allee, L., Duncan, T., Burke, P., … & Dicker, R. (2022). Understanding the makeup of a growing field: A committee on trauma survey of the national network of hospital-based violence intervention programs. The American Journal of Surgery, 223(1), 137-145. https://www.sciencedirect.com/science/article/abs/pii/S000296102100413X The study’s aim is to identify the programmatic components of existing HAVI programs and to understand program and service barriers to implementation, to inform the ACS-COT as to the best way trauma centers can partner in this work. The study design adopted a survey provided by the American College of Surgeons Committee on Trauma Twenty-eight Health Alliance for Violence Intervention member programs participated in the survey.

The survey instrument by the Hospital Based Violence Intervention Program was used to collect the data.

The researchers submitted the survey via Qualtrics.

 Well-funded programs received equal or over $300,000 every year and low-funded programs received less. The researchers found that Hospital Based Violence Intervention program were effective in addressing IPV, but face funding, adequate staffing, and buy-in problems. The sample size was small.

The study had a selection bias as only 38 members were invited, all who were members of the HAVI.

 Future research should focus on exploring opportunities to expand the implementation, funding, and data collection of HVIPs. The article offers evidence on how hospital-based violence intervention program can help address IPV and insights into how these programs can be improved.
Halliwell, G., Dheensa, S., Fenu, E., Jones, S. K., Asato, J., Jacob, S., & Feder, G. (2019). Cry for health: a quantitative evaluation of a hospital-based advocacy intervention for domestic violence and abuse. BMC health services research, 19(1), 1-12. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-4621-0 The study aimed to explore how an advocacy approach supported domestic violence survivors in a hospital setting, explore impact on enhancing support access, health outcomes, and cost effectiveness. Causal-Comparative research design The researchers invited independent Domestic Violence Advisors (IDVA) in five UK hospitals.

The researchers collected case-level data at initial referral and case closure from survivors accessing hospital (T1 N = 692; T2 N = 476) and community IDVA services (T1 N = 3544; T2 N = 2780).

 Survivors who had accessed a hospital IDVA service were two times more likely to report feeling safer at case closure (AOR = 2.03, 95% CI 1.18 to 3.49)

Accessing six or more resources / programmes increased safety by one and a half times AOR = 2.38, 95% CI 1.41 to 3.87) and odds of achieving this outcome increased progressively with a greater number of support days provided by the IDVA (AOR = 2.00, 95% CI 1.00 to 1.01).

Survivors who had accessed a hospital IDVA service were more likely to report no change or feeling less safe at exit if they had experienced suicidal ideation or behaviors at the point of initial referral (AOR = 2.00, 95% CI 0.28 to 0.74).

feelings of safety were increased in line with more intensive support in terms of more frequent contact with a community IDVA (AOR = 1.45, 95% CI 1.12 to 1.89) and access to a range of resources / programs (AOR = 1.82, 95% CI = 1.43 to 2.31)

 Hospital IDVAs assisted with earlier intervention by working with survivors who were less noticeable to community IDVA programs.

Hospital IDVAs enabled access to more health resources and saw an increase in referrals from medical services. Abuse reductions and cessations were more frequently reported by hospital survivors.

In terms of health outcomes, there were no differences found for hospital survivors.

If hospital survivors made more than five contacts with an IDVA or used at least six resources or programs over a longer period of time, their chances of remaining safe improved by a factor of two.

Hospital survivors used healthcare services on average for £2463 each in the six months prior to IDVA intervention, while community survivors used healthcare services for £533 each.

 Limitations were linked to the evaluation design and data quality.

The researchers used a non-experimental design that led to an over-statement of intervention effectiveness.

The resources used to estimate cost limited analysis because it was based on patient collection.

 Further research should seek to determine the efficacy of the intervention, typically adopting an experimental design. This study offers concrete evidence on the effectiveness of hospital-based advocacy intervention for addressing domestic violence and abuse.
Olson, C., Aboutanos, M., Thomson, N., Vincent, A., & Kevorkian, S. (2022). Adapting Hospital-based Intimate Partner Violence Programs to the COVID-19 Pandemic. Panamerican Journal of Trauma, Critical Care & Emergency Surgery, 11(1), 3-8. https://www.researchgate.net/profile/Nicholas-Thomson-2/publication/360294052_Adapting_Hospital-based_Intimate_Partner_Violence_Programs_to_the_COVID-19_Pandemic/links/62a0e4b36886635d5cc9c908/Adapting-Hospital-based-Intimate-Partner-Violence-Programs-to-the-COVID-19-Pandemic.pdf The aim of the study is exploring the impact of a hospital-based advocacy program or intervention on intimate partner violence during the Covid-19 pandemic.

The researchers investigated the EMPOWER program and how it adapted intervention and community case management practices to serve patients during the Pandemic.

 Descriptive research design 67 enrollees in the services participated in the study.

The researchers evaluated EMPOWER case logs on remote crisis intervention, safety planning, ongoing counselling, case management, and community-based referrals.

 Victimization types identified included IPV (61%), physical assault (40%), and sexual violence (35%). Around 28% of patients had a prior history of IPV or DV. Around 49% of patients were assaulted by their partner/spouse, 41% were assaulted while on a date Through EMPOWER, patients were given access to a variety of services, such as crisis intervention (84%), emotional support (89%), victim rights (53%), and advocacy for patients while they were receiving medical treatment (49%). The following safety and risk factors were mentioned by victims: Domestic violence caused 8% of patients to move or become homeless, 19% of patients seeking advocacy services claimed the perpetrator utilized a weapon, including a firearm, against the victim, and 30% of patients reported the presenting domestic violence incident to the police. The paper does not discuss limitations to the study.

Based on the analysis, a selection bias is likely given that selected patients are enrollees to the specific program or services, and it would be difficult to generalize the results outside the research setting.

 Future research should seek to determine the effectiveness of the program and how it can be adopted in other settings. The study provides valuable insights into an example of a hospital-based intervention to address IPV and victims of violence.

 

 

 
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Transformational Leadership

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Transformational Leadership

Professional nursing organizations I currently participate in

I am a member of the American Nurses Association (ANA). I joined ANA to access the many professional development opportunities and the support for nurses across the country the organization offers. Through ANA, I have achieved high standards of nursing practice, including ensuring a safe and ethical work environment, advocating for nurses’ health and wellness, and health care problems impacting the nursing profession and patients. My professional values and career goals align with the ANA mission to promote and improve the quality of health care for every individual. Additionally, ANA understands and promotes the power of nursing and its relevance in the healthcare system and drives ethical obligations for every member, a reason I became a member.

Transformational Leadership

Nursing certifications or continuing education that (graduate degree) might fit into my future plans

I currently hold the CCRN certification, a specialty nurses’ certification that allows nurses to offer direct care to critically ill adult patients irrespective of their geographical location. It is vital to continuing excellence in acute or critical care nursing. I plan to change it to CCRN_K because I’m changing roles from ICU to supervision. The CCRN_K is also suitable and appropriate as I seek membership in the American Organization of Nurse Executives (ANOE), which involves nurses who design, facilitate, and manage care. The organization offers leadership development opportunities and advocacy to advance nursing practice, something I wish to be a part of.

Aspects of the TEACH values discussed that would most benefit my work environment if adopted

Transformational leadership skills are essential in my practice as I intend to drive change and inspire new approaches to doing things, and harness team members’ creativity to address areas that need change. Transformational leadership skills will be critical in my supervisory role in the dynamic healthcare environment. I am open to new ways of thinking and ideas, inspire people to see and do things differently by broadening their minds, committed to active listening, tolerate intelligent risks, and willing to accept responsibility. I believe in teamwork and trust my team members to deliver and inspire everyone’s participation in the course of action.

The aspect of the TEACH values that would be more influential and beneficial in my work environment would be teamwork. Teamwork aligns with the skill set of transformational leaders (Ree & Wiig, 2019). I have to adopt teamwork skills to ensure team members are emotionally committed to the team’s responsibilities. Moreover, I am committed to adopting innovative ways of working as a team and improving team processes to ensure a better experience of teamwork and team viability. I will encourage team members to ensure the ongoing development of values and skills to encourage leadership in them. Every team member has to demonstrate leadership ability and lead actions and changes. Embracing teamwork best practices will ensure increased confidence and greater team cohesion, which is positive and needed for the team’s success (Ree & Wiig, 2019). To ensure teamwork, I will build a diverse and inclusive team, clearly define each member’s roles and responsibilities, cultivate trust within the team, promote clear and frequent communication, promote autonomous decision-making, and ensure team meetings are productive through active participation. I will focus on individual requirements and establish strong relationships with team members to help achieve the team’s objectives. I will enhance intrinsic motivation associated with low burnout and increased engagement with the team’s activities. Additionally, I will respect every team member’s values, personality, and background and demonstrate compassion, trust, and empathy. I will also create a sense of collective identity for the team to encourage collaboration and teamwork.

Reference

Ree, E., & Wiig, S. (2019). Linking transformational leadership, patient safety culture and work engagement in-home care services. Nursing Open, 7(1), 256–264. https://doi.org/10.1002/nop2.386

 
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Classical Argument: Health-Promoting Self-Care in Nursing

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Classical Argument: Health-Promoting Self-Care in Nursing

The healthcare environment is challenging and pressuring for nurses, impacting their health and well-being. Nurses have in-depth knowledge regarding health-promoting behaviors and practices, but they continue to report high overweight and obesity levels and mental health issues. Contributing factors include work-related stress, heavy workloads, shift work, poor engagement and communication, increasing patient health demands, and working overtime, which leaves nurses with little time to practice self-care.

Classical Argument: Health-Promoting Self-Care in Nursing

 

Lack of self-care is linked to unhealthy nurses, physically and psychologically, which negatively impacts nursing practice and patient outcomes. It is also related to health-risk behaviors like excessive alcohol consumption, smoking, and substance use. However, health-promoting self-care impacts nurses’ health and well-being, nursing practice, and overall institutional and patient outcomes. Therefore, adopting self-care strategies such as emotional regulation, self-compassion, mindfulness, healthy eating patterns, regular physical activity, staying connected, and continued individual and professional growth would help minimize the adverse effects of poor health-promoting self-care.

Background

Self-care is related to any intentional effort to activity to cater to one’s mental, physical, and spiritual well-being. Nurses spend extended periods caring for others, and they can forget about themselves, which is detrimental to their and other people’s health (Ross et al., 2019). The American Nurses Association completed a survey that indicated the increased urgency to improve nurses’ health, especially in nutrition, safety, life quality, and physical activity. About 70% of the nurses surveyed admitted prioritizing patients’ needs, safety, health, and wellness before theirs (Purdue University Global, 2021). Also, 77% of the nurses reported being at a significant risk level for work-related stress (Purdue University Global, 2021). To care for others, nurses should first care for themselves because compassion fatigue is associated with poor health-promoting self-care. Nurses’ health impact patient care in all healthcare settings.

The nursing field can be traumatic for nurses because of increased exposure to trauma, suffering, and pain, ending up traumatized without realizing it most of the time. However, the Code of Ethics recognizes self-care as a nurse’s responsibility because when nurses are not caring for themselves, they cannot care for their patients (Purdue University Global, 2021). In addition, the American Nurses Association Code of Ethics posits that nurses should extend to themselves the moral respect they extend to others, and nurses owe themselves the same duty they owe to other individuals (Purdue University Global, 2021).

Nurses are responsible for promoting their health and safety, preserving their character and integrity’s wholeness, maintaining competence, and ensuring personal and professional growth through continuing education and training. Self-care is considered a self-management tool for nurses to reduce the stress from working in the healthcare environment. Lack of self-care is linked with burnout, poor physical and mental health, depression, weight gain or extreme weight loss, unhealthy eating patterns, demoralization, back injury, and reduced job satisfaction (Williams et al., 2022). More attention is needed to enhance self-care in nurses because self-care helps minimize stress, replenish nurses’ compassion capacity and ability to care for others, and improve the quality of care.

(Classical Argument: Health-Promoting Self-Care in Nursing)

Self-Care Minimizes Stress

Self-care serves as a stress management tool, helping nurses reduce work-related stress. Adopting self-care practices like mindfulness, self-compassion, and emotional regulation can help nurses reduce stress and attend to their physical, mental, emotional, and spiritual needs (Hofmeyer et al., 2020). In this case, nurses should perceive self-care as integral to preventative care. Although individual factors can impact an individual’s ability to cope, control themselves, tolerate uncertainties, and resilience, self-care helps acquire and sustain these positive aspects of life. Per Hofmeyer et al. (2020), control is critical to an individual’s well-being. Still, work-related factors beyond a nurse’s control can disrupt the power to self-regulate and the need for control, adding to work-related stress.

Self-care begins with self-awareness, understanding how difficult events, uncertainties, and powerlessness impact oneself. For instance, it is normal to feel anxious, sad, and grief in difficult situations or crises, begging individuals to accept their vulnerability and learn how to self-regulate to control emotions and feelings attached to such conditions. In this case, self-regulation, self-compassion, and mindfulness allow nurses to focus on the positives rather than the negatives and uncertainties, accept situations, especially those that cannot be changed, like the death of a patient, and find meaningful ways to cope with the nursing environment, which helps reduce stress (Hofmeyer et al., 2020). Additionally, self-care builds resilience, allowing nurses to manage stress, maintain their health and well-being, and respond appropriately and effectively when facing crises and uncertainties. Self-efficacy, mindfulness, and emotional regulation strengthen psychological resilience.

Self-Care Replenishes Nurses’ Compassion Capacity and Ability to Care for Others

The ANA Code of Ethics highlight that nurses should extend to themselves the moral respect they extend to others, and nurses owe themselves the same duty they owe to others. Poor health-promoting self-care is associated with burnout and compassion fatigue, leading to poor patient outcomes and the risk of medical errors. Nursing care relies on empathy and compassion; the more burned out or stressed a nurse is, the more their capacity to offer kindness and compassion suffers (Monroe et al., 2021). Nurses often show empathy and compassion to their patients daily without a chance of replenishing them. However, nurses should learn and be able to extend empathy and compassion to themselves because failure to invest in themselves puts their and patients’ health and well-being at risk.

Moreover, nurses tend to be difficult on themselves when they make a mistake, and they do not console or talk to themselves as they would talk to a patient or a friend. Nurses are overly critical and judgmental of themselves, which, according to Hofmeyer et al. (2020), stimulates the sympathetic nervous system, activating a stress response that is harmful to an individual’s health and well-being. Engaging in self-care strategies, including having enough sleep, healthy eating patterns, regular physical activity, mindfulness, and social connections, can help replenish nurses’ compassion capacity and ability to care for others.

Therefore, nurses must practice self-compassion and understand their needs before helping others. Nurses should also learn to talk kindly to themselves because kind self-talk is linked to increased compassion capacity and pro-social behaviors like kindness, empathy, and altruism, helping them communicate better with colleagues, patients, and their families (Hofmeyer et al., 2020). In addition, acting with kindness and compassion helps reduce patient suffering and distress.

(Classical Argument: Health-Promoting Self-Care in Nursing)

Self-Care Improves the Quality and Safety of Care

Nurses caring for themselves and bringing the effects to the workplace helps promote safe and high-quality care. Nurses with self-compassion have better physical and psychological health, motivation, happiness, relationship-building, and perspective-taking, which are linked to better health outcomes (Hofmeyer et al., 2020). In addition, self-compassionate nurses report decreased anxiety, depressive symptoms, fear of failure, shame, and rumination, implying a greater capacity to work for others.

On the contrary, stressed, burned out, overwhelmed, and unsatisfied nurses are more likely to be involved in medical errors, including medication administration errors that negatively impact the quality of care and patient safety (Hofmeyer et al., 2020). Therefore, adopting self-care strategies like seeking a therapist’s support, taking breaks, engaging colleagues to stay connected, and maintaining physical activity can help reduce burnout, stress, and feeling confused, overwhelmed, frustrated, and angry, increasing nurses’ capacity to promote quality and safe care.

Opposition and Barriers to Implementing Self-Care

Implementing self-care requires commitment, planning, and joint efforts of nurses and hospital administrators. There are multiple factors presented as hindering nurses from implementing self-care to ensure a healthy workforce. A survey reported that nurses complained about insufficient time and overwork as barriers to implementing self-care activities (Wolters Kluwer, 2020). Most nurses are overworked with poorer health and well-being and lack time to participate in healthy habits. Additionally, nurses reported a lack of facilities and resources and other commitments as reasons for not engaging in self-care. About 25% of nurses point to lack of access to a gym, exercise classes, changing facilities, showers, and lack of refrigerators or microwaves as barriers to implementing self-care (Wolters Kluwer, 2020). Over 50% of nurses stressed outside commitments like family responsibilities and school activities as interfering with the ability to live more healthily.

Refutation

These barriers are genuine concerns about the nurses’ ability and capacity to implement self-care. The barriers are true across the board, but there are ways to encourage nurses to embrace healthy habits and self-care, like eating healthy and exercising regularly. Leadership and peer support can help guide and adopt healthier practices. Leaders can expand opportunities for nurses to have more breaks and provide facilities like gyms, showers, and refrigerators to store healthy food snacks (Wolters Kluwer, 2020). Allowing breaks at the facility would help schedule time for self-care practices like establishing supportive connections with colleagues and exercising.

(Classical Argument: Health-Promoting Self-Care in Nursing)

Conclusion

Health-promoting self-care can help improve nurses’ health and well-being, reduce stress, replenish nurses’ compassion capacity and ability to care for others, and improve the quality and safety of care. Conversely, poor health-promoting self-care is associated with increased nurses’ stress, burnout, lack of job satisfaction, compassion fatigue, chances of making medical errors, and decreased motivation. Nurses can adopt self-care strategies, including mindfulness, emotional regulation, self-compassion, regular physical activity, healthy eating patterns, personal and professional growth, and maintaining connectivity to promote health and well-being. Self-care is multifaceted, and improving self-care should address intrinsic and extrinsic motivators.

References

Hofmeyer, A., Taylor, R., & Kennedy, K. (2020). Knowledge for nurses to better care for themselves so they can better care for others during the Covid-19 pandemic and beyond. Nurse education today, 94, 104503. https://doi.org/10.1016/j.nedt.2020.104503

Wolters Kluwer. (2020). Nurses and self-care: Factors influencing healthy behaviors during COVID-19. https://www.wolterskluwer.com/en/expert-insights/nurses-and-selfcare-factors-influencing-healthy-behaviors-during-covid19/

Monroe, C., Loresto, F., Horton-Deutsch, S., Kleiner, C., Eron, K., Varney, R., & Grimm, S. (2021). The value of intentional self-care practices: The effects of mindfulness on improving job satisfaction, teamwork, and workplace environments. Archives of psychiatric nursing, 35(2), 189–194. https://doi.org/10.1016/j.apnu.2020.10.003

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Business Education Paper – Create Welcome Message

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Business Education Paper – Create Welcome Message

(Business Education Paper – Create Welcome Message) Supply Chain Management Course

Hello, MBA students.

Welcome to the Supply Chain Management Course, I will teach this semester. I have engaged many students before you, some of whom have graduated and become supply chain managers at various companies. I have taught this Supply Chain Management for the past ten years, and I believe I have the right knowledge and experience to help you succeed. My classes are highly interactive and engaging; therefore, I expect active, passionate, committed students who are willing to learn.

Business Education Paper - Create Welcome Message

General Overview of Course Content

Multiple learning resources are available for students on the institution’s website, including books, articles, course notes, and presentations. I expect students to engage in these materials regularly to expand their knowledge of course concepts and help complete course discussions, assignments, and quizzes. Your performance will be evaluated through discussions, assignments, and small quizzes to ensure high engagement that students are expected to complete to measure their grasp and understanding of course concepts. Throughout the course you will be required to:

  1. Identify the elements of a supply chain.
  2. Describe the challenges of coordinating a supply chain.
  3. Explain the role of the supply chain in enabling business competitiveness.
  4. Recommend a framework for supply chain management.
  5. Analyze contemporary trends and issues in effective supply chain management.

Current Trends or Issues in Supply Chain Management the Course Will Cover

Supply chain management (SCM) is a critical element in the business world, widely influenced by globalization and other changes in the business environment. The supply chains are increasingly becoming complex, especially with new technologies and innovations. Companies seek innovative strategies to manage their supply chains more effectively and efficiently and cultivate resilient supply chain operations. Current trends in supply chain management include artificial intelligence and automation, primarily driven by the need to streamline and optimize supply chain processes and automate humdrum and repetitive tasks (Dash et al., 2019). Also, the concept of Supply Chain as a Service is experiencing a trajectory in supply chain management as companies embrace the idea of outsourcing supply chain operations to external actors that will manage the whole process from procurement to delivery (Lopienski, 2021). You will also learn about circular supply chain as a current trend that is gaining trajectory in SCM. Businesses are embracing the idea of a closed-loop supply chain, which encourages material reusing and recycling to achieve sustainable and efficient supply chains (Lahane et al., 2020). You learn about other current trends during the course, and I also encourage you to research more.

(Business Education Paper – Create Welcome Message)

Course Policies and Expectations

The course has critical policies on attendance, participation, tardiness, missing homework and assignments, academic integrity, and classroom activities. There are points for attendance and participation to encourage learners to participate in course activities actively. There are also consequences for failing to attend at least a third of the classes, including online. Lateness is discouraged, especially concerning deadlines for discussions, assignments, and quizzes. Points will be deducted for discussion and assignments submitted late. Points will be deducted for missing homework and assignments. Students should ensure academic integrity by avoiding plagiarism. You are encouraged to participate in all class activities to increase your chances of success.

Contact Information and Communication Preferences

You can contact me through [Phone Number] or [Email]. I prefer using email for questions and other inquiries about the course.

Examples of how Key Course Takeaways Will Help Students in their Current or Future Professional Lives

Succeeding in this course is paramount to your current and future professional lives. For instance, students are expected to identify supply chain elements, describe the challenges of coordinating a supply chain, and analyze contemporary trends and issues in effective supply chain management. Understanding the supply chain elements will help you, as a supply chain manager or having a role in the supply chain, properly design supply chain strategies that support the business strategy. Also, understanding and describing the challenges of coordinating a supply chain will help you develop interventions and solutions to increase lead times and cost-effectiveness and reduce the risk of recalls and lawsuits. Understanding and analyzing current trends will help students adapt to constant disruption in supply chain management and develop strategic plans that consider current trends and their influence on the company’s future.

References

Dash, R., McMurtrey, M., Rebman, C., & Kar, U. K. (2019). Application of artificial intelligence in automation of supply chain management. Journal of Strategic Innovation and Sustainability, 14(3), 43-53. https://articlegateway.com/index.php/JSIS/article/view/2105

Lahane, S., Kant, R., & Shankar, R. (2020). Circular supply chain management: A state-of-art review and future opportunities. Journal of Cleaner Production, 258, 120859.

Lopienski, K. (2021). What Is Supply Chain as a Service? A Complete Guide.

 
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