Discuss the nature of management, financing, and quality issues related to integration and cooperation in the facilities

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Discuss the nature of management, financing, and quality issues related to integration and cooperation in the facilities.

Choose two long-term care facilities—one from nursing facilities, assisted living, or subacute care and another from adult day care, home health care, or hospice care—on which you would want to base your research work. Research Internet to read about your chosen long-term care facilities.

Assume you are responsible for the management and administration of the two facilities. You have to orient the newly appointed manager by providing an overview on managing long-term care. You also need to discuss the programs of the two facilities. From this perspective and based on your research about the facilities, prepare a Microsoft PowerPoint presentation of 10–15 slides including the following:

What are the various multidisciplinary departments (teams) included in your facilities?

Who comprise the target population being served by the various programs provided by your chosen facilities?

What are the major staffing and human resource issues faced by your chosen facilities?

What are the significant trends in long-term care likely to impact the operation of the various programs provided by your chosen facilities, and what is your plan of action to overcome them?

What are the various forms of cooperation and integration existing in your chosen facilities? Discuss the nature of management, financing, and quality issues related to integration and cooperation in the facilities?

localization global standardization transnational strategy

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Please answer the following questions:

In what kind of industries does a localization strategy make sense? Why? When does a global standardization strategy make the most sense? Why?

What do you see as the main organizational problems that are likely to be associated with the implementation of a transnational strategy? Explain.

What is the most appropriate organizational architecture for a firm that is competing in an industry where a global strategy is most appropriate?

Discuss the differences between preventive and corrective discipline.

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Discuss the differences between preventive and corrective discipline.

Paper instructions:
1. Discuss the differences between preventive and corrective discipline. Do you favour one form of discipline over the other? Identify the contexts in which each is most appropriate.

2. Explain the difference between “equal pay for equal work” and “equal pay for work of equal value,” and elucidate the differences in implications for a human resources manager.

These two questions needs to be answered. Page and a half for each question. This is regarding human resources management in health care organization.

Health Essays – Childhood Obesity Overweight

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Childhood Obesity Overweight

Introduction

Childhood obesity in the United States is proving to be a topic of major concern. Throughout the past decades, this issue has been overlooked and simply unattended to. Other health issues such as second-hand smoke and cancer have indeed been the more popular topics addressed. However, people are starting to notice a change in the leaders of tomorrow. Quite frankly, these children are becoming extremely unhealthy and overweight. In the past, it was out of the ordinary to see a child that was obese.

However, overweight children in the United States are actually starting to become a norm (Koplan, Liverman & Kraak, 2005). This is where the problem begins to unfold. Parents are becoming increasingly concerned about their children’s health due to the fact that obesity hinders a wide range of factors. Imagine a child that cannot participate in any extracurricular activities such as baseball, soccer, or basketball due to his or her weight.

Then, try to explain to that child that due to being overweight, he or she might have an increased chance of heart disease, strokes, and high blood pressure (Vessey & MacKenzie, 2000). Above all, imagine being a child and learning that one of their peers has just died due to the fact that he or she was obese. One must begin to realize that the lives of children in the United States are at stake.

Science in the past has told the public that each generation is living longer than its precedent. The tide has turned sadly enough as scientists are predicting that this verity is now untrue (Kimm & Obarzanek, 2002). With that being said, if lives are beginning to shorten, one might conclude that it is now time to take some action.

In an attempt to explore the idea of childhood obesity one must result to an interdisciplinary analysis. The topic involves a wide range of disciplines such as biology, sociology, psychology, and business, which should all be taken into consideration to avoid an oversimplification. There is not one single discipline that can fully address the entire scope of childhood obesity (Repko, 2005). By narrowing down the research, a large amount of data will be looked at using numerous perspectives to try to avoid a biased outcome.

The extent of obesity in children is an extremely multifaceted topic and desperately needs to be approached this way to fully grasp and comprehend the issue. Also, for a complete understanding and resolution to be formulated, every discipline needed to investigate the issue must be used. Childhood obesity contains a vast range of disciplines to help in its characterization. With that being said, these disciplines tend to all be interlocked with one another.

Looking at childhood obesity through the discipline of biology for instance would constantly be leading the researcher to a psychological standpoint every time a page is turned. Simply ignoring certain disciplines would be an extreme mistake in trying to come to a conclusive solution of the issue addressed and would most likely lead to a biased opinion.

Disciplines

The following is a compilation of all the disciplines used along with each of their contributions in the process of addressing the issue of childhood obesity. There is indeed a vast range of disciplines that are included. Chemistry, economics, law, and history all bring important insights to the table when addressing childhood obesity. Chemistry will look at various experimental data to try to assess the various structures of fats and sugars that are involved in a child’s diet.

Economics could be used to try to understand the possible effects that production and distribution of certain foods has when placed in front of children. Why are these extremely unhealthy foods being put on the shelf for kids to buy? Economics would try to investigate this issue and bring forth a decisive explanation. In addition, law would be utilized to help to understand what governmental efforts have been made towards the issue of childhood obesity.

Are the steps being taken by are government in the right direction or are they simply dancing around the heart of the issue? Finally, history is a very helpful discipline in referencing statistical data taken about obese children. Has this problem always been around or is it just now becoming an issue? History with the help of statistics will also illustrate past successes and failures of strategies that were put in action to help to aid the issue being discussed.

Throughout the course of the investigation of childhood obesity all the preceding disciplines listed will be taken into consideration. However, biology, sociology, and business will be most relevant and crucial to the process of defining the issue at hand.

Biology

Biology will be used to try to understand the needs of the human body to progress and function. Each person has a minimum amount of calories that must be consumed to properly run its processes. Likewise, each person has a unique rate of consuming these calories and converting them to energy. The researcher can use biology to place an actually measurement of health of an individual.

Attaining a proper measurement or gauge of health has proven to be a very difficult task. Height, sex, genetics, bone structure, and even ethnicity are all very important factors that determine a child’s proper weight. Biology will help to place a gauge on each of these factors and formulate a proper medium for each person. This discipline will be examined first in the following writing because one needs to understand what obesity is before he or she can begin to examine the problem. Biology will basically lay a foundation for the rest of the disciplines as to how they are to be used to assess obesity in children.

Sociology

Next, a viewpoint based on sociology must be addressed. Demographics of families, along with their ethnicities will be looked at to try to explain the effects of obesity on certain specific populations. Society will be investigated to try to expose the viewpoints of obese children and their parents. Does society really understand the issue? Do children place any concern with health and fitness? These are both very important questions that sociology will help to address through the aid of statistical data.

Also, every child does have the right to choose what he or she consumes on a day-to-day basis. Hence, each child must face all of the problems that arise if he or she becomes obese. Obesity is not purely a biological problem. If the previous statement was true, a child could then simply consume less calories and loose weight. However, a child has to make cognitive choices and observations about what is acceptable.

Sociology will step in and try to uncover any problems that may be resulting in a population of obese children that simply are misguided by the viewpoints of society. This discipline will be used after biology in hopes to build upon the new understanding of the problem. Once a person understands the physical aspects of childhood obesity using biology, then he or she can delve into the societal traits.

Business

Finally, obesity has become such a large issue that it has effectively created an entire new industry to take care of itself. Business is a discipline that will be used to help explain the way industries portray children and how they affect what populations recognize and understand. Business will try to assess ethical issues as to whether the food industry for example is making an effort to help.

There are obviously many businesses in the United States that are trying to educate children about obesity. However, for every positive product formed, there is another marketing scheme that is made to try to take advantage of a very helpless situation. As a result, the structure and function of the food industry needs to be addressed and scanned for possible pitfalls and shortcomings.

Lastly, the discipline of business will be used in the final part of this paper in hopes to illustrate how it relates back to the obese children. The reader will then furthermore understand the extremity of this issue and how it is rooted in almost every aspect of life.

In summation, childhood obesity is an extremely sophisticated problem involving the ethics and morals or our society. Children cannot be expected to solve their own problem and desperately need help from all ends of the spectrum. The purpose of this paper is to lay the foundation for a better understanding and new perspective of childhood obesity.

This perspective will hopefully stem new possible outcomes that are constructed by the synthesis of each of the discipline’s contributions. Furthermore, the following writing will attempt to educate society of the dangers of childhood obesity and show that this is not a problem caused by one situation. Hopefully the reader will realize that through an interdisciplinary understanding, bringing an end to obesity in children is not an unattainable goal.

Background

How is childhood obesity defined? Has this issue been around for a long time or is it merely just beginning to cause trouble for the United States? These are two very important questions that every individual needs to be aware of. One cannot expect to be able to successfully tackle an issue without knowing its history beforehand.

First, childhood obesity is basically defined as a person that has a body mass index that is above the 95

th

percentile. That is, the individual exceeds his or her natural weight by approximately 20%. Body mass index is the most widely accepted procedure for sampling obesity in large populations.

Basically, it is a numerical measurement composed of a person’s height and weight. Although this particular test does not take a persons bone structure into consideration, the average of an overall population remains very accurate (Vessey & MacKenzie, 2000).

The people involved in this issue are individuals between the ages of 6 and 17. Male and female children including every ethnicity that resides in the United States are included in this problem. Although obesity rates are increasing almost exponentially in all age groups, children seem to be of the most concern to health experts today. These children are in the most important stage of their growth. An overweight child is putting his or her entire lifespan in jeopardy (Green & Reese, 2006).

Adolescent obesity has not been around as long as other problems such as cancer, leukemia, or the flu. Yet, it is unique due to the fact that childhood obesity is growing at such an alarming rate. The first signs of childhood obesity began to appear in the 1960’s (Schwartz & Puhl, 2003). What caused this sudden weight gain in children during this time? There are several possible explanations however there does not seem to be one clearly defined culprit.

The fast food industry is just one of the possible causes that is often looked at. Critics believe that during the 1960’s fast food was starting to embed in American culture. McDonalds restaurants were popping up all around the United States offering a quick and effortless meal. Before fast food, most families were dependant upon time consuming home cooked meals. However, for the first time, people were starting to realize that a ready-to-eat meal was just a few dollars away. Consequently, people started putting the healthy meal aside and began to grab a quick sandwich from a fast food restaurant.

Hence, in the 1960’s children’s calorie intake began to rise as their eating habits were basically being altered by society. Statistics showed during this time that the percentage of obese children was approximately 4.5%. As calorie intake began to rise, physical activities began to decrease. Approximately 33% of students in high school do not expose themselves to any strenuous physical activity.

Present day schools are so involved in standardized testing that extracurricular activities have been in some ways taken out of the daily lesson plan. Even technology, which usually always aids in the advancement of society, has played a role in increasing rates of childhood obesity. Computer based games, and highly sophisticated cell phones are a few examples that have placed negative outcomes on beneficial cardiovascular events (Harper, 2006).

Heath experts began to see a problem by the 1970’s. The National Health and Nutrition Examination Survey was one of the first efforts in addressing the issue of childhood obesity. A study was done in three parts during a 25-year span starting in the late 1960’s. The test studied the body mass index of children and adjusted the results as age, sex, and ethnicity of the population of children changed through time.

The results were anything but subtle. There was a 40% increase of overweight children in the ten-year span of the first and second studies. No other illness at this time was even close to growing at such an astounding rate (Rosenbaum & Leibel, 1998). With that being said, the third study that was completed in 1994 delivered a divesting knockout punch. The National Health and Nutrition Survey revealed that the number of obese children in the United States had grown a monstrous 100% in the past 10 years (Dietz & Gortmaker, 2001).

Obesity in children was now considered an epidemic. In the past decade, the percentage of obese adolescents in the 95

th

percentile has once again doubled. Obese children between the ages of 6 and 11 seemed to have the highest grow rates of any other subgroup. Estimates were now showing that almost 15% of the children in the United States are obese or extremely overweight. Obesity does not seem to be biased towards any particular age, race, or gender. However, African American girls, Hispanics, and American Indians were shown to have the largest overweight populations (Koplan, Liverman & Kraak, 2005).

Why are obese children the population that is drawing the most attention? First, biologists studying this epidemic have noted that fact that the gene pool in the United States has basically remained the same over the past 15 years. This tends to rule out any possible explanations dealing with actual evolutionary changes or modifications in the human body. As a result, scientists tend to believe that the causes of the increase in children’s weight are a product of environmental effects on metabolism.

At any rate, it is shown that individuals who are obese as children are most likely beginning a lifelong fight (Dietz & Gortmaker, 2001). Present studies have shown that approximately 95% of obese individuals who succeed in loosing weight tend to gain almost all of it back over time (Koplan, Liverman & Kraak, 2005). This statement is supported by our ever-increasing percentage of obese adults. In 2001, statistics show that there were 29 states containing a percentage of obese adults of 20% or greater.

Hence, prevention at the earliest possible age is said to be the only hope for success in stopping this seemingly out of control problem. It is shown that the younger the child is, the less likely he or she will have developed bad eating habits. Also, younger children tend to be much easier to work with as oppose to stubborn teenagers who may not accept parental influence.

All in all, childhood obesity tends to result in numerous mental, physical and social health disorders for the growing individual. Without immediate intervention at a young age, obesity in children may continue to grow (Kimm & Obarzanek, 2002).

The following writing will continue to decipher the issue of adolescent obesity and will expose crucial concepts, theories and assumptions dealing with each discipline involved. Biology will first be discussed with the goal of further defining the physical and biological effects of childhood obesity. One must understand how the child physically becomes obese and what biological factors are involved.

Next, sociology will be addressed with the goal of educating the reader of the impacts that society has on obese children. Are there any direct causes of obesity that society may have initiated? Finally, business will be mined for possible ways that large companies and organizations have affected the issue. Are these interventions effective or are they merely ways to mask the problem?

In conclusion, each discipline involved offers its own understanding of childhood obesity. One must take each possible approach into consideration in hopes of forming a new more comprehensive explanation. An interdisciplinary approach is used in this situation to help organize the inputs of the disciplines and then synthesize them into a new holistic picture. This process helps to avoid a biased opinion, which is likely formed by increasing specialization of the disciplines. Furthermore it attacks the issue from every angle within the reach of the disciplines used (Repko, 2005).

References

Biology

Dietz, W., & Gortmaker, S. (2001). PREVENTING OBESITY IN CHILDREN AND

ADOLESCENTS.

Annual Review of Public Health

,

22

(1), 337. Retrieved

February 29, 2008, from Academic Search Complete database.

Kimm, S., & Obarzanek, E. (2002, November). Childhood Obesity: A New Pandemic of

the New Millennium.

Pediatrics

,

110

(5), 1003. Retrieved February 8, 2008, from

Academic Search Complete database.

Rosenbaum, M., & Leibel, R. (1998, March). The physiology of body weight regulation:

Relevance to the…

Pediatrics

,

101

(3), 525. Retrieved February 29, 2008, from

Academic Search Complete database.

Vessey, J., & MacKenzie, N. (2000, September). Childhood Obesity: Strategies for

Prevention.

Pediatric Nursing

,

26

(5), 527. Retrieved February 8, 2008, from

Academic Search Complete database.

Sociology

Green, G., & Reese, S. (2006, Fall). CHILDHOOD OBESITY: A GROWING

PHENOMENON FOR PHYSICAL EDUCATORS.

Education

,

127

(1), 121-124.

Retrieved February 29, 2008, from Academic Search Complete database.

Koplan, J., Liverman, C., & Kraak, V. (2005, Spring). Preventing Childhood Obesity.


Issues in Science & Technology

,

21

(3), 57-64. Retrieved February 4, 2008, from

Academic Search Complete database.

Schwartz, M., & Puhl, R. (2003, February). Childhood obesity: a societal problem to

solve.

Obesity Reviews

,

4

(1), 57-71. Retrieved February 29, 2008, from

Academic Search Complete database.

Business

Harper, M. (2006, October). Childhood Obesity.

Family & Community Health

,

29

(4),

288-298. Retrieved February 29, 2008, from Academic Search Complete

database.

Other disciplines

Repko, A (2005).

Interdisciplinary practice a student guide to research and writing

.

Boston, MA: Pearson Custom Publishing.

Advantages and disadvantages of qualitative and qualitative methods in nursing

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Advantages and disadvantages of qualitative and qualitative methods in nursing

The theoretical foundations of qualitative and quantitative methods are very different, but many researchers believe both methods should be used in the research study to increase validity and reliability.

What advantages or disadvantages do you see in using both types of methods in a nursing study? Support your answer with current evidence-based literature.

Analyze the flow of data and information among disparate health information systems to support internal and external business processes

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Analyze the flow of data and information among disparate health information systems to support internal and external business processes

Case Study, Stage 2: Data Flow Among Health Care Systems

Before you begin this assignment, be sure you have read the “UMUC Family Clinic Case Study”, the course readings assigned to date, and feedback on your graded Stage 1 assignment.

Purpose of this Assignment

This assignment specifically addresses the following course outcomes to enable you to:

Analyze the flow of data and information among disparate health information systems to support internal and external business processes
Examine the implications of ethical, legal, and regulatory policy issues on health care information systems

UMUC Family Clinic Medical Practice

In your Stage 1 assignment, you created process models for the patient visit process in the UMUC Family Clinic. For the Stage 3 assignment, you will identify an Electronic Health Records System that will address the process problems at the Clinic. The EHR system you identify will initially be implemented at the UMUC Family Clinic, but will soon need to be able to connect and communicate with external systems. As part of analyzing the requirements for the new system, one step is to consider how that system will enable the UMUC Family Clinic to exchange electronic data with other health organizations – such as other providers, pharmacies, insurance companies, and even patients themselves. The case study mentions several of these. For this assignment you will select two types of external organizations and describe what kind of data would flow between the UMUC Family Clinic and those organizations and how that can be done effectively.

A GROUP OF MEDICAL RESEARCHERS INVESTIGATED THE EFFECTS OF DRUG X ON LOWERING CHOLESTEROL LEVELS IN A GROUP OF MEN BETWEEN THE AGES OF 50 AND 70 YEARS OLD.

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A GROUP OF MEDICAL RESEARCHERS INVESTIGATED THE EFFECTS OF DRUG X ON LOWERING CHOLESTEROL LEVELS IN A GROUP OF MEN BETWEEN THE AGES OF 50 AND 70 YEARS OLD.

THE RESEARCHERS DID THE FOLLOWING EXPERIMENT AND OBTAINED THE INDICATED RESULTS: ONE GROUP OF 150 MEN TOOK A TABLET CONTAINING DRUG X FOR 3 WEEKS – 95 OF THESE MEN DECREASED THEIR CHOLESTEROL LEVELS BY AT LEAST 10% (THREE MEN FROM THIS GROUP DROPPED OUT OF THE STUDY).

1. What is the correct sequence of steps in the scientific method?

Make observations and ask a question
Analyze the data
Develop a hypothesis
Share the results with other scientists
Design and perform an experiment to test the hypothesis

a) I>II > III > IV > V

b) III > I > V > II > IV

c) V> IV > III > II > I

d) I> III > V >II > IV

e) V > II > I > III > IV

2. You have formulated a hypothesis: “Apples contain more vitamin C than oranges.”

To test your hypothesis you measure vitamin C levels in 20 oranges and 20 apples from trees that were grown in the same orchard under the same environmental conditions (temperature, rain, sunlight). This experiment was conducted twice. The control in the experiment is__________________________________.

a) type of soil, temperature, amount of rain and sunlight in the orchard

b) vitamin C levels

c) oranges

d) apples

e) a large sample size and repeated experiment

***Use the following information to answer questions 3, 4,5 & 6 below***:

A group of medical researchers investigated the effects of Drug X on lowering cholesterol levels in a group of men between the ages of 50 and 70 years old. The researchers did the following experiment and obtained the indicated results: One group of 150 men took a tablet containing Drug X for 3 weeks – 95 of these men decreased their cholesterol levels by at least 10% (three men from this group dropped out of the study). Another group of 150 men was given a tablet with no added Drug X for 3 weeks – 10 of these men decreased their cholesterol levels by at least 10% (two men from this group dropped out of the study).

3. Which of the following is the best hypothesis for this experiment?

a) Will drug X lower cholesterol levels in men between the age of 50 and 70 years?

b) Drug X will lower cholesterol levels in men.

c) Since high cholesterol levels significantly increases several health risks for men, drug X is most likely beneficial.

d) Men between the age of 50 and 70 years will have reduced cholesterol levels if they take drug X over a 3 week period.

e) There is no significant difference in cholesterol levels between men that take drug X and those that don’t take it.

4. Which of the following was the control group in this experiment?

a) The amount of Drug X contained in the tablet

b) The number of participants in each group at the end of the experiment

c) The group of participants that received tablets containing Drug X

d) The group of participants that received tablets that did not contain Drug X

e) The number of participants in each group at the beginning of the experiment

5. Which of the following is a dependent variable in this experiment?

Prevention interventions to address the opioid crisis | nursing | Chamberlain College of Nursing

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The alarming opioid crisis, with its staggering death rates, is affecting the life expectancy rates of Americans. Select one of the populations on the map and address the following:

I selected Florida:

Opioid-Related Overdose Death Rates (per 100,000 people) (2016): 14.40

Opioid Pain Reliever Prescriptions (per 100 persons) (2015): 62.80

1-Compare the opioid-related overdose death rates of the selected population to national opioid-related overdose death rates.

2-Identify one primary, one secondary, and one tertiary prevention intervention to reduce the misuse of opioids in the selected population.

3-Describe one evidence-based strategy to address provider opioid prescription rates.

4-Identify the stakeholders charged with addressing the opioid crisis in your community.

5-Share your professional experience related to the topic. (i work in hospice and we use a lot of opiod)

Please answer each question separated and use at least 3 sources no later than 5 years.

Virginia Hendersons Need Based Theory and Implications

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Virginia Henderson’s Need Based Theory and Practice Implications

According to Nicely and DeLario (2010) Virginia Henderson’s theory, Need Based, which is derived from the Principles and Practice of Nursing is a grand theory that focuses on nursing care and

activities of daily living

. This theory is appropriate to my future practice setting as a Family Nurse Practitioner within the Emergency Department or Fast Track/Urgent Care setting. This theory is applicable within this setting since “meeting patient needs in the areas of respiration, nutrition, elimination, body mechanics, rest and sleep, keeping clean and well groomed, controlling the environment, communication, human relations, work, play, and worship (Masters, 2015, p. 384), as these will be advanced nursing care areas that I will need to promote for my patients basic needs.

Henderson’s Background and Theory Development

Virginia Henderson, born in 1897, was a world renowned Nurse educator, researcher and author of many nursing textbooks whose career spanned 60 years; considered by many as the modern day Florence Nightingale (Masters, 2015). A profound change occurred in her life which was around the time of WW one, during this time her nursing experience evolved while in school which resulted in obtaining a bachelors and a masters in nurse education (Masters, 2015). This experience was able to help her see a vision for basic nursing care with patient focus on patient independence with activities of daily living (ADLs), being the basis of her framework and practice. Henderson became a professor at Yale University where she wrote many nursing textbooks that emphasized nursing care, studies, principles and practice (Masters, 2015). She was able to define her personal nursing theory and create the theory that focused on basic nursing care and patients ADL’s. Encouraged by her nursing research she was able to speak around the world and focused on an international approach for better patient care (Masters, 2015). According to Masters (2015) Virginia Henderson received several honorary degrees during her respectable nursing career which included the Christiane Reimann Prize from the International Council of Nursing.

Possible Reference for Theory

Due to Virginia Henderson being an author she received a position collecting, reviewing and chronicling every nursing research that has been published allowing her to write volumes on nursing research and studies (Vera, 2014a). This may have allowed her to come up with analytical applications on what nursing was and could have drawn her strengths and assumptions from her review of researched material. Some may say that Maslow’s Hierarchy of Needs was the reference to her theory as the needs are somewhat similar of what actions or roles one may be or need assistance with in order for independence and wellbeing.

Phenomenon of Nursing and Common Problems

The common problems of Virginia Henderson’s need based theory, this theory outlines the 14 components of fundamental nursing care and interventions that patients have or use as part of their independence and ADLs (Masters, 2015). As a future APRN the common problems that are resolved are 14 components that maintain the patient’s physical functions, safety and maintaining a sense of wellbeing and finding oneself in relation to where they see themselves in life (Masters, 2015).

Deductive Reasoning for Theory

Virginia Henderson utilized scientific method which is considered deductive reasoning to come up with the needs based theory. Deductive reasoning allows for an inquiry decision to arrive at a solution to an issue, an action – reaction system where there is a cause to a component there will be an effect on the component, with independence on its own essence with or without external circumstances (Masters, 2015). According to Masters (2015), Virginia Henderson’s utilized the physical, emotional and mental (psychological components) to deductively arrive to this theory even though she did not intend to imply a new nursing theory; the theory is in relation to Maslow’s theory though Henderson was not aware but the 14 sub-concepts relate and coincide with Maslow’s.

Explanation, Definition and Interpretation of Concepts and the Four Metaparadigms

Henderson made an assumption of her work that it was not a nursing theory so she did not fully identify her concepts but researchers were able to come up with concepts from her work that actually follow the common metaparadigm’s of nursing which she included within her definition of nursing. According to Masters (2015), Virginia “did not intend to develop a theory of nursing, she did not develop the interrelated theoretical statements or operational definitions necessary to provide theory testability (p. 390)”. Concepts include person, environment, health and nursing. Person is defined “as the patient who is composed of biological, psychological, sociological, and spiritual components (Masters, 2015, p. 387)”. These compositional segments are not separate entities but help to assist the nurses towards interventions for the 14 components of care, the person and family are not separate either but are considered a whole item (Masters, 2015). Virginia Henderson was able to keep all concepts of theory and definition consistent throughout since they overlapped and interrelated with each other to include a whole person aspect.

Environment is important to a person’s perception of health and wellbeing but can also affect a person’s physical as well as mental wellbeing. Henderson identified a person’s environment as external elements that help to mold and shape an organisms life and physical change; three areas of environment that are important are biological, physical and behavioral (Masters, 2015). Biological includes anything that is living and breathing organism, such as flora and vertebrate, physical components like basic elements for life such as the sun, elemental chemicals and compounds. Both physical and biological elements work harmoniously together in symbiosis, when something changes it affects the whole ecological system and puts a strain on the symbiotic relationship of the physical and biological environment (Masters, 2015). Behavioral health influences the person and is the last component of environment; influencers include socioeconomic elements, political, cultural, and spiritual aspects.

Health was not a component of Henderson concept that was clearly defined but Henderson did imply that health was in relation to one’s independence (Masters, 2015). Basically, the 14 components of basic needs relate to the persons health as health relates to independence with activities of daily living.

Nursing is very clearly defined by Virginia Henderson and she has one of the best known definitions of nursing. According to Virginia Burggraf (2012) Virginia Henderson defined nursing as:

the unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge. And to do this in such a way as to help him gain independence as rapidly as possible.

As for advanced practice nursing fields Virginia Henderson was a proponent for nurses to be independent practitioners she may have not wanted full practice independence as she was not for nurses taking on what she perceived as physician duties such as diagnosis, treatment, and making judgment calls (Masters, 2015).

Proposition of Concepts

Masters (2015) suggest that nurses are viewed as a helper, assistant and companion to a patient’s health role and wellbeing. The relationship aspect is that when a patient is sick the nurse helps the patient to get better and recover, while the patient is in rehabilitation role the nurse assists the patients in achieving independence. Lastly the nurse is a companion during planning of care, goal setting, and preventive maintenance initiatives.

Assumptions of Needs Theory

According to Masters (2015) there are seventeen assumptions of the Needs theory that were implicated from Henderson’s theory they include: Nurses must assist people with illnesses; nurses must collaborate within an interdisciplinary team and become independent professionally from the physician; 14 concepts of nursing describe patient needs and complete nursing functions; goals are achieved with a symbiotic relationship between patient and nurse with health promotion as the nurses main goal; patient and family are one with mind and body being one within the person; assist patient with independence while the patient controls their physiological and psychological harmony; people function in health at all times and must maintain independence and relationships; people maintain health status with knowledge and awareness; illness effects environment conditions and nurses should maintain a safe environment; nurses must be culturally competent and must maintain best practice methods while relying on evidence-based research methods.

As explained above the four major concepts were defined by Virginia Henderson that also describes the four metaparadigm’s as Henderson theory is the foundation of nursing practice. Henderson theory does include sub-concepts which will be explained. These 14 sub-concepts are: normal respiration, proper nutrition and hydration, waste elimination and management, mobility for posture maintenance, sleep and relaxation, proper appearance and grooming, thermoregulation through external factors, safe environment and preventive injury, communicate emotional concerns and distress, spiritual worship, career leading to achievement, recreational activities, and utilization of health resources and using healthcare facilities (Vera, 2014b). These are all relevant elements to an APRN as these can be used within assessment towards finding the patient’s independence level and to assess patient’s assistance in obtaining or maintaining activities of daily living for basic needs (Masters, 2015).

Theoretical Clarity and Applicability

Virginia Henderson theory is very easily understandable and covers a broad range of nursing especially the APRN as independence was a goal for Henderson’s nursing goal besides patient’s health promotion. The definition of nursing is clear and very lucid and applicable to her assumptions and components of theory. Since it was not her motive to come up with a nursing theory consistency within the theory is adequate though death is not clarified as she maintains that nurses should be there for patient death and comfort but no suggestion as what one must do or grief assistance with the family and patient.

Theory Sub-concepts in Practice and Guidance of Nursing Actions

Utilizing Virginia Henderson’s basic needs theory and its 14 concepts will be beneficial in my practice as a new Family Nurse Practitioner. As I would like to work within the emergency department, putting into action clinical provider interventions would lead to examples such as: concept of breathing normally would lead me to administer my patient oxygen with an Albuterol treatment and treat with intravenous Solu-Medrol.

Eating and drinking appropriately, proper nutrition is vital for diabetes management, weight management, heart health, wound healing, autoimmune disease, and patients overall health.

Body waste removal, imbalanced removal of body waste can indicate if there is an organism illness such as C. difficile, being aware of normal elimination methods and treating with antifungals and antibiotics with probiotic treatment for maintenance for good gut health.

Movement and mobility, it is important to maintain my patients independence so splinting fractures from sports injuries, or advising low impact exercise and flexibility exercises to arthritic and osteoporosis patients are crucial to my practice development.

Sleep and relaxation is important sub-concept of Henderson theory, maintaining my patients sleep rhythm and patterns by decreasing external stimuli while my patient is in the ED at night, and providing privacy and comfort during the day and more importantly at night will allow a calmer and more enhanced patient experience.

Dressing appropriately is important to the patient’s perception of physical self and wellbeing. Being able to dress independently is an important ADL, within the ER this can be seen when patient is able to wear a gown and apply it on themselves without assistance, providing them time to dress themselves without being an inconvenience to acuity.

Body temperature regulation is important to the patient’s physical health, if a patient can not regulate their temperature heat blankets or mechanical regulated blankets like a Bair hugger can be applied to maintain proper thermoregulation.

Clean body and protection of the skin, importance of promoting proper body hygiene and infection prevention practices and isolation procedures for my fellow employees and nurses and educate them to teach patients as well as family upon entering the ED and seeing the patient.

Avoiding a dangerous environment, it is important to teach staff to transport patients within the ED and to other areas of the hospital is important for their physical health. Properly utilizing body mechanics, identifying fall risk patients intervening by locking bed and wheelchair wheels when necessary and maintaining a clean uncluttered patient room and hallway environment for patient safety.

Communication with others about feelings, it is important to use interpersonal and therapeutic communication and as a future APRN it is vital for me to actively listen to my patients and fellow team. Being able to empathize with a patient can open up to psychiatric, emotional and social traumas one may have occurred during an assessment history intake and being able to empathetically listen while making a proper medical judgement call is important for patients wellbeing.

Spiritual worship is important to the person’s mental and emotional wellbeing. As an APRN allowing others cultural and spiritual options influence their medical decision needs to be respected and nurtured as vital for the patients and families. Assimilation into the healthcare system that may or may not nurture their spiritual/cultural decision. This will increase my spiritual/cultural competence.

Work that increases oneself worth, important for patients mental health, leads to feelings of independence. Allowing one to continue their work and hobby benefits them to feel independent and able to fulfill their ADL’s. So maintaining ones finger after a work related accident by suturing and referral or assistance with a plastic surgeon is important knowledge to maintain in allowing ones independence.

Recreation activities benefits the patients physical health, some patients come to the ED after a sports injury so maintaining a sprain ankle by wrapping it and teaching the patient to utilize crutches and slowly introduce low impact, low weight bearing exercise while teaching proper NSAID administration is important in preserving my patients future recreational activities.

Normal health development and its resources, when I become a new APRN learning the different patients and diagnosis I see and utilizing a cohesive interdisciplinary team who is more knowledgeable as a resource is important for best practices towards the patient for their optimum health.

Conclusion

Virginia Henderson’s needs theory is applicable to many disciplines of nursing with various practice scopes. Utilizing this theory and putting it into action within practice is very adaptable and allows one to reflect on their nursing competency when it involves maintaining a person’s health promotion and independence level. As stated by Masters (2015) with Henderson’s philosophy of applying best practice methods which involve evidence-based research, advanced practice application of theory can be a foundation for their nursing process.


References

Burggraf, V. (2012). Overview and summary: The new millennium: Evolving and emerging nursing roles.

OJIN: The Online Journal of Issues in Nursing

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(2). doi:10.3912/OJIN.Vol17No02ManOS

Masters, K. (2015). Models and theories focused on nursing goals and functions. In J. B. Butts, & K. L. Rich (Eds.),

Philosophies and theories for advanced nursing practice

(2nd ed., pp. 377-407). Burlington, MA: Jones & Bartlett Learning.

Nicely, B., & DeLario, G. T. (2011). Virginia henderson’s principles and practice of nursing applied to organ donation after brain death.

Progress in transplantation, 21

(1), 72-77.

Vera, M. (2014).

Virginia henderson – The first lady of nursing

. Retrieved from

http://nurseslabs.com/virginia-henderson/

Vera, M. (2014).

Virginia henderson’s nursing need theory

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http://nurseslabs.com/virginia-hendersons-need-theory/

How has your view of the role of the APN changed from what your view was prior to beginning the program?

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How has your view of the role of the APN changed from what your view was prior to beginning the program?

 

TYPE Reflection
If you have completed courses in the MSN-FNP, or have experienced working with or receiving care from an APN, describe your experience. How has your view of the role of the APN changed from what your view was prior to beginning the program? What has been your biggest revelation about the roles of the NP? If you were asked to talk to a group of undergrad nursing students about opportunities in the field, what would you tell them about pursuing their education to become an APN? Include scholarly reference material to support your ideas and opinions.
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