Essay on Nursing Education

/in /by

As the profession of nursing continues to evolve, from a profession of ensuring that patients are well fed, clean and are healing in a clean environment to one of technical and life-saving interventions, nursing education must also change from a face to face experience to one that delivers information quickly and with a dash of entertainment (Ridley, 2007), Nursing educators today have many different means at their disposal to accomplish this, they can use simulations, distance learning and games to teach skills and technology needed in nursing today.


Educational Games

One of the fastest growing areas of teaching is the use of educational games. Educational games are drawing a great deal of attention and funding and can allow educators another avenue to explore in the constantly changing area of technological education (McGonigle & Mastrian, 2015). People tend to play games due to the fact that games are fun, motivational and contain a fixed set of rules (Salen & Zimmerman, 2003). Games also allow for diversion, and the best games provide a challenge for player and allows for feedback at the end of the game session (Csiksznetmihalyi, 1990). This allows players the opportunity for improvement within the game.

There are many different types of games that can be used in the educational setting. There are actions games, which often require quick reflexes and the ability to think fast, building and puzzle games, which require critical thinking skills and the ability to look ahead to plan the next move, and strategy games which require the player or student needs to think on their feet, and up-front planning to achieve a positive outcome. Another type of educational game is a learning simulation. Simulations mirror real-life scenarios and allow for nursing students and others to practice in a safe setting without the fear of causing actual patient harm (Alessi, 1988). All games and game genres have the ability and potential to be used in the educational setting (Mastrian et al., 2011).

As education continues to evolve, the use of games in education continues to rise. The use of evidence-based practice along with research and technology will eventually lead to more widespread use of this type of technology for learning (New Media Consortium, 2007). Another aspect of games in education is the cost. Some educators and institutions may balk at using games as an educational tool based on the overall cost.

Today, games and the technology that goes into making them are less expensive to produce and cheaper than in years past. The reasoning for this is that the game development engines are now more widely available and more and more companies are providing development tools within the game itself to further reduce costs (Dyer-Witheford & de Peuter, 2009). Also, more and more independent (indie) gaming studios exist providing a cheaper alternative for games that are less expensive but still provide a high-quality gaming experience (McGonigle & Mastrian, 2015).

As the cost of educational games and simulations continues to decrease, they share the potential to be used as legitimate teaching tools. The use of games as an educational tool will allow nursing educators to supplement current curricula and allow for a new generation of learners to learn in an environment that they are more familiar with, and perhaps replace the current learning methods in use today.


Informatics Competency

As technology continues to get better and the field of nursing informatics continues to grow, the competency of nurses in informatics becomes important. Nurses must be able to use the technology available to them and be competent in its use to provide safe and competent patient care. The American Association of Colleges of Nursing has stated that all health care professionals must have a good working knowledge and also skills when it comes to the field of informatics (1997). It has also been stated that the field of information technology is a key component for improved patient safety and a key indicator of quality care (American Academy of Nursing, 2003). To achieve informatics competency, it is important for nurse educators to fully integrate informatics as a full time study within nursing programs.

In designing a simulated electronic health record (EHR), I would focus on two main informatics competencies: the ability to use the application to document and the ability to use the application to build a patient care plan. According to Fetter (2009), these were the two competencies student nurses states they had little or no experience with.

The use of a simulated EHR has distinct advantages. First it allows students to use the EHR in an environment suitable for learning and they can also be scaled back to allow for more exploration of the database in timeless environment (McGonigle & Mastrian, 2015). In designing a simulated EHR that focuses on the use of the application to chart patient data and to use the application to build and document against a patient care plan will allow student nurses the ability to feel more comfortable in using an electronic charting system and allow the student to better manage their time while in the clinical setting. Documentation and care plans are two fundamental skills that all nurses must be competent and compliant in. If either of these aspects of nursing and especially student nursing are lacking is substance, then that nurse may not be providing adequate patient care. Also in developing and using a simulated EHR, the nursing instructor can get a better understanding of the knowledge and skills needed to navigate the system and the time constraints involved in actual charting and building of care plans.


Simulations, Scenarios and Virtual Reality

Nursing education continues to evolve as the profession of nursing has also evolved. In using new and more technological methods of teaching, the use of simulations, scenarios and virtual reality have become more and more prevalent.

Simulations range in intricacy from simple computer-based simulations where students interact with a computer program and feedback is received based on the outcome of the simulation, to life-like full scale simulations using mannequins that can talk and mimic real patient problems and conditions. These type of simulations provide students a real immersive experience they might encounter in a clinical situation (Seropian, Brown, Gavailanes, & Driggers, 2004).

Virtual reality training is also becoming more popular among nursing educators. In using virtual reality, students can control the most important aspects of the scenario they are involved in. One aspect of virtual reality programs that make them more attractive to educators is their flexibility and their ability to be customized for any situation (EDUCASE, 2006). Scenarios can also be used in educating students. Scenarios are usually problems laid out in question form that allows students to figure out and use critical thinking skills to solve problems (McGonigle & Mastrian, 2015).

In the case study in the textbook, Victoria has been wonders about nursing in the big city versus staying where she is in her small hometown. In moving to the city, Victoria could probably expect more technology in use with both day to day elements such as computer charting, medication scanning and other wireless technology. I feel that the need for Victoria to be more information and technology competent would be increased if she were to move to the city. She is studying technology in using scenarios, virtual reality and simulation learning. However, I feel that more training would be required for her to make a smooth transition to the metropolitan medical center.

Nursing educators today, need to advocate for more computer based learning in the nursing classroom. This can be computer scenarios, simulation labs and virtual reality trainers. In doing so, nursing educators are teaching and catering to a new generation of learner that has basically been using a computer for learning since kindergarten. In using this type of educational tool, nursing educators will be teaching the latest and best evidence-based practices to students and allowing students to learn in environment more suitable to their learning needs. This in turn will lead to nursing students giving better quality of care and reduce mistakes made by nursing students and nurses.


References

Alessi, S. M. (1988). Fidelity in the design of instructional simulations.

Journal of Computer-Based Instruction, 15

(2), 40-47.

American Academy of Nursing. (2003). Proceedings of the American Academy of Nursing conference on using innovative technology to decrease nursing demand and enhance patient care delivery.

Nursing Outlook, 51,

1-41.

American Association of Colleges of Nursing (1997).

A vision of baccalaureate and graduate nursing education: The next decade

. Washington, DC: Author.

Csikszentmihalyi, M. (1990).

Flow: The psychology of optimal experience

. New York, NY: Harper Collins.

Dyer-Witheford, N., & dePeuter, G. (2009).

Games of empire: Global capitalism and video games.

Minneapolis, MN: University of Minnesota Press.

EDUCASE Learning Initiative. (2006, June). 7 things you should now about virtual worlds. http://www.educase.edu/library/resources/7-things-you-should-know-about-virtual-worlds.

Fetter, M. (2009). Graduating nurses’ self-evaluation of information technology competencies.

Journal of Nursing Education, 48

(2), 86.

Mastrian, K. G., McGonigle, D., Mahan, W. L., & Bixler, B. (2011).

Integrating technology in nursing education: Tools for the knowledge era.

Sudbury, MA: Jones & Bartlett Learning.

McGonigle, D., & Mastrian, K. (2015).

Nursing informatics and the foundation of knowledge

(3

rd

ed.). Burlington, MA: Jones & Bartlett Learning.

New Media Consortium. (2007). Massively multiplayer educational gaming. The Horizon Report 2007 Edition. Retrieved from: http://www.nms.org/horizonproject/2007/massively-multiplayer-educational-gaming.

Salen, K., & Zimmerman, E. (2003).

Rules of play: Game design fundamentals

. Cambridge, MA: MIT Press.

Seropian, M. A., Brown, K., Gavilanes, J. S., & Driggers, B. (2004). Simulation: Not just a manikin.

Journal of Nursing Education

,

43

(4), 164-169.

Associate Degree versus Bachelor Degree in Nursing

/in /by

Associate Degree versus Bachelor Degree in Nursing

Associate Degree versus Bachelor Degree in Nursing
Throughout history, a nurse has been defined as “a person caring for the sick”(Merriam-Webster, Inc., 2004, p. 853). At the completion of school, whether from an Associate Degree in Applied Science or a Bachelor of Science Degree, all candidates must pass the national licensure exam. This enables the new graduate nurse to practice as a registered nurse. This new R.N. graduate is permitted to work in health care facilities in entry level positions. Both begin their career similarly with an extended orientation period being mentored by a “seasoned” colleague.

Argue the importance of value-added patient services in health care organizations.

/in /by

Argue the importance of value-added patient services in health care organizations.

 

Argue the importance of value-added patient services in health care organizations. Support your response with two to three (2-3) examples of value-added patient services that health care providers
can offer to patients, hypothesize the long-term impact of the Affordable Care Act on children’s overall health in the U.S. Support your response with at least two (2) examples of said impact

Biomedical and Traditional Chinese Medicine Views on Lower Back Pain

/in /by


Why this topic is chosen

Lower back pain affects almost everyone at some point at a time.  It can be destabilising and severely affect one’s quality of life and mobility. It not only impacts one’s physical and mental well being, it also affects one’s financial and results in extensive social costs for the patients, family members and the economy as a whole. (Dawn W, et al 2018).  It is also one of the most common and costly medical conditions (Castillo Et al 2015).  According to Castillo Et al 2015, lower back pain is attributed to the lumbar to sacral spine.

There are many factors that can cause back pain but the problem originates from lumbar to scarum.

According to (Otis, 2007), 15% to 45% of adults suffer from lower back pain annually with more than 70% in their life.

In my clinical practice, we see patients from all walks of life with low to severe back pain resulting from slight sprain to prolapsed disc who has suffered chronic pain ranging from 6 months to 25 years.


Difference perspective from biomedicine and Traditional Chinese Medicine

From a biomedicine point of view

Prolapsed disc occurs when a disc bulge compresses against a a nerve root or spinal ligament or which will cause a lot of pain. It usually affects lumbar 5 to sacrum 1 because there are the main movement occurring in the lumbar.  Although it primary affect Lumbar 4 to Lumbar 5, it can also occasionally affect the lower cervical 6 and 7 and to the rest of the lumbar and rarely also affect the thoracic.  This usually occurs backwards or sideways with the symptoms arising from the irritation of the nerves.  After a few days, the inflammation will spread to other areas causing back pain or sciatica nerve pain.

Prolapsed disc usually occurs sideways or backwards. This can cause the affected vertebrate to be irritated and result in inflammation. After a few days, it will spread to surrounding tissues nearby thus causing pain in the lumbar, sciatic or piriformis area or all of them. (Choice Books, 1994].

According to (Choice Books, 1994].  Prolapsed discs can result from trauma, heavy exercises, twisting and, heavy lifting.  Flexion of the trunk cause the nucleus at the anterior side to be compressed which cause the anterior space to be affected. Therefore any twisting motion carrying a heavy object in an erect position will compress the nucleus pulpous into the posterior space.  The end result will be disc bulges against the weakest area in the posterior annulus. Similarly, the other trauma can include slipping and falling on the buttock with great force usually cause around 50% of disc hernia.

Normally, by twenty five years old, the annulus fibrosis starts to degenerate although it can still withstand several micro traumas.  This marks the beginning of degenerative disc conditions. By middle age, the nucleus pulposus tends to dry up gradually and shrink slowly. (Choice Books, 1944,). From middle age, the nucleus in their discs will lose much of its moisture and start to shrink considerably. However, the bulge may spread out, but they are less apt to leak out of the casting. This will however result in a loss in the ability to distribute the shock and pressure. (Choice Books, 1944).

From a Traditional Chinese Medicine point of view

According to (Sherwin, 1992), Yin and Yang form the basic and fundamental beginning of all life and is a very vital principle in based in TCM short for Traditional Chinese Medicine. TCM is still widely used in treating all kind of diseases in South East Asia for over 2000 years.

In (胡 et al, 2008), lower back pain is related to the kidney qi deficiency, blood stagnation and other Bi syndrome (obstruction by pathogenic coldness or dampness) of which refers to the syndrome presented with unilateral or bilateral back governed by the kidneys

According to (Goto et al, 23014), blood stasis is not only related to circulation disorders, it can also give rise to other diseases as well. In a study using the Terasawa’s Blood Stasis Score, it was discovered that blood stasis can show hem rheological abnormalities, which can also cause back pain.

According to (Xiong et al 2011), in a study conducted in four hospital with Yunnan university in Chinese medicine, 4 main syndromes were identified and associated with chronic lower back pain.

Firstly: Qi and or with blood stagnation with symptoms such as sharp pain, limited lumbar movements with purple coating at the tongue.

Secondly: In a study by Wang et al (2012), damp heat syndrome show a high correlation for severe pain due to inflammation in the joints.  The primary symptoms are redness at the localised area with swelling and redness:  the local area has a heavy sensation.  The secondary symptoms can include thirst or fever. The urine will be yellow in colour.  Tongue texture will be red with yellow and greasy.

Pulse will be  quick and slippery.

Thirdly: Cold Damp is more of a chronic condition.  According to Wang et al (2012),  cold-damp displayed coldness and pain with heaviness in the joint.  Secondary symptoms include constant pain which worsen at night especially during cold or rainy weather.  Tongue diagnosis will display: swollen and a pale texture with white greasy tongue coating.  Pulse will be stagnant or slow.

Fourthly: Kidney Deficiency

The key signs or symptoms of Kidney Qi Xu pattern include lumbar pain, weak knees with fatigue after any activities, painful heel, industrial deafness, premature ejaculation with fine, weak pulse in the Chi region.  A pale and enlarged tongue indicates poor promotion and filling of blood/ qi circulation.

As Kidney qi is weakened and its declining functions resulting in poor promotion of qi and blood circulation which make it harder to nourish the body resulting in lumbar pain and weak knee with tiredness.  Kidney is associated to bone health , impairment in the Kidney could lead to bone problem.  As the kidney is opened to the ears, any malfunction of kidney could relate to hearing dysfunction or industrial deafness.  Deficient Kidney qi and the uncontrolled jing chamber also lead to sexual dysfunction; the decline of Life Gate fire leads to poor consolidation of semen thus resulting in premature ejaculation.


Discussions

In a study by Lam (2001) in Hong Kong , it was concluded that Chinese medicine work slower but eliminate the root cause compared to western medicine which clear the signs and symptoms faster.  It was also believed and known that western medicine comes with undesirable side effects such as gastrointestinal issues.

One of the problem arising from the interaction between Chinese medicine and biomedicine is the unfavourable result from these two interactions be it acupuncture or herbs or remedial techniques.

The majority of patients living in western countries consume pharmaceutical drugs, undertake western remedial treatment such as chiropractic or physiotherapy.  To complement western treatment with Chinese medicine treatment such as acupuncture, herbs, tuina or bone setting techniques, this would entail an understanding of what has been done by western doctors to avoid double work and minimise any harm

According to Wong (2005), Traditional Chinese Medicine has been around for over three thousand years, there must be some credibility in it to last that long, it is still been practised widely and gaining prominence in western countries as a alternative or complementary to western medicine.  There was discussion that with collaboration between Chinese medicine and biomedicine, there exist a need to establish a reliable clinical research on the safety of Chinese medicine to offer better cost effective and holistic treatments to patients resulting in better health.


Conclusion

There has been several sufficient clinical research and evidence of successful integration of TCM with western medicine.  I gathered that the difficulties faced would be overcoming the mental obstacle faced by people with cultural differences.  Westerners have been brought up with biomedicine and are more comfortable with biomedicine despite its risk compared to Chinese medicine unknown to them.

Based on the above evidence, it is clear that chinese medicine can play a dominant or complementary  role in assisting patient during their rehabilitation.

The increasing popular use of TCM cannot be ignored considering a $4billion market share in alternative medicine with an annual growth of 1.4% in Australia. (

http://www.ibisworld.com.au/industry/default.aspx?indid=1914

).

The signed agreement between china in joint cooperation of clinical research and chinese medicine at the University of Western Sydney-UWS, aims at creating better education amongst westerners to benefit the Australian public.. (

http://www.labonline.com.au/news/70993-UWS-and-Beijing-University-of-Chinese-Medicine-sign-MoU

)

I would recommend patients undergoing rehabilitation to include Traditional Chinese Medicine as part of their complementary treatment to hasten their recovery so as to get back to their normal life as soon as possible.


References:

  • Castillo, E. R., & Lieberman, D. E. (2015). Lower back pain.

    Evolution, Medicine, and Public Health

    ,

    2015

    (1), 2–3.

    http://doi.org.ezproxy.uws.edu.au/10.1093/emph/eou034
  • Dawn M. W, Lee A. T, (2018), Chronic Lower Back Pain: Cognitive Behavioral Therapy With Family Therapy Interventions. page 1.
  • Goto, H. Chin. J. Integr. Med. (2014) 20: 490.

    https://doi-org.ezproxy.uws.edu.au/10.1007/s11655-014-1882-7
  • Lam, T. (2001). Strengths and weaknesses of traditional Chinese medicine and Western medicine in the eyes of some Hong Kong Chinese.

    Journal of Epidemiology and Community Health,


    55

    (10), 762-765.
  • Lao L, Xu L, Xu S (2012) Traditional Chinese medicine. Integrative Pediatric Oncology: Springer. pp. 125–135.
  • Otis, J. D. (2007). Managing chronic pain: A cognitive behavioral therapy approach. New York, NY: Oxford University Press.
  • Qi-ling, Y., Tuan-mao, G., Liu, L., Fu, S., & Yin-gang, Z. (2015). Traditional chinese medicine for neck pain and low back pain: A systematic review and meta-analysis.

    PLoS One, 10

    (2) doi:http://dx.doi.org.ezproxy.uws.edu.au/10.1371/journal.pone.0117146
  • Sherwin DC (1992) Traditional Chinese medicine in rehabilitation nursing practice. Rehabil Nurs 17: 253–255. pmid:1448606
  • Sit, R. W. S., Wong, W., Law, S. W., & Wu, J. C. Y. (2016). Integrative western and traditional chinese medicine service model for low back pain.

    International Journal of Clinical Pharmacology and Therapeutics, 54

    (7), 539. doi:http://dx.doi.org.ezproxy.uws.edu.au/10.5414/CP202625
  • Understanding back trouble: Practical advice on how to prevent, treat and cope with back trouble. (1994). In

    Choice.

    Marrickvill, NSW: Choice Books. Pg 22
  • Wong, L. (2005).

    Chinese medicine: A critical look from the health care angle. its value, methodology of research and utilisation

    (Order No. 3203222). Available from British Nursing Database; ProQuest Central; ProQuest Dissertations & Theses Global. (305354012). Retrieved from

    https://search-proquest

    com.ezproxy.uws.edu.au/docview/305354012?accountid=36155
  • 胡永華, 吳雪挺, 韋貴康. 中醫對脊柱相關疾 病中眩暈與腰痛的認識. 中國骨傷. 2008; 1: 7071.
  • Xiong G, Virasakdi C, Geater A, Zhang Y, Li M, Lerkiatbundit S. Factor analysis on symptoms and signs of chronic low-back pain based on traditional chinese medicine theory.

    Journal of Alternative & Complementary Medicine

    . 2011;17(1):51-55. doi:10.1089/acm.2009.0559.kj
  • Wang, Z., Fang, Y., Wang, Y. et al. Chin. J. Integr. Med. (2012) 18: 575. https://doi-org.ezproxy.uws.edu.au/10.1007/s11655-012-1172-1

 

American Nurses Association. (2010). Nursing: Scope and standards of practice (2nd ed.). Silver Spring MD: Author.

/in /by

American Nurses Association. (2010). Nursing: Scope and standards of practice (2nd ed.). Silver Spring MD: Author.

Scope of Nursing Practice page 21
Review Appendix D pages 93143
Websites:
Explore the quality and safety reports on the Institute of Medicine Website: www.iom.edu. Review the American Nurses Association (ANA) website on workplace safety (http://www.nursingworld.org/MainMenuCategories/WorkplaceSafety/Healthy-Work-Environment) (www.nursingworld.org).
Dearholt S. L. & Dang D. (2012). Johns Hopkins nursing evidence-based practice: Model and guidelines (2nd ed.). Indianapolis IN: Sigma Theta Tau International.
Implementing Change Despite Resistance (graded)
Change can be difficult to implement. Now that you are almost finished with your change project if you were to implement your project in your clinical practice what type of resistance do you expect from staff? List at least three ways that you can lessen the resistance you may encounter to help ensure the success of your project.
Change can be challenging because of underlying fear of the unknown. Nurses must be change agents since change can be good. We have noted the positive impact of EBP changes on patient outcomes. I am including a link to a website which shares about the difference stages of the change cycle and how to facilitate change. I look forward to your discussions.
http://www.mindtools.com/pages/article/bridges-transition-model.htm

How nurse leaders can use professional organizations to stay aware of political actions in the nursing and health care industry and the importance of doing so.

/in /by

How nurse leaders can use professional organizations to stay aware of political actions in the nursing and health care industry and the importance of doing so.

 

Select a professional organization in the nursing industry.

Research a current political issue addressed through the organization.

Write a 350- to 700-word paper in which you explain how nurse leaders can use professional organizations to stay aware of political actions in the nursing and health care industry and the importance of doing so.

Format your paper consistent with APA guidelines.

Content

3 points possible
Points available Points earned
· Explains how nurse leaders use professional organizations to stay informed of political actions in the nursing and health care industry. 1
· Discusses importance of maintaining awareness of political actions related to the nursing and health care industry. 2
Format

2 points possible
Points available Points earned
· Follows rules of grammar, usage, and punctuation

· Has a structure that is clear, logical, and easy to follow

· Consistent with APA guidelines for formatting and citation of outside works

Foundations for Professional Practice In Nursing

/in /by

Foundations for Professional Practice In Nursing

Posted on 2nd October 2015 by Mike G in Fast Dissertations Writing Service, Fast College Dissertations, College Term Papers, College Research Papers, Dissertations

What is the impact of culture on your professional practice?
You are required to explore the concepts of culture and professionalism & demonstrate an understanding of culturally responsive and culturally competent practice.Order for a custom written DISSERTATION now and one of our online writers will write your assignment from scratch within your deadline! https://DISSERTATIONshub.com/order/!What We Offer:• On-time delivery guarantee• PhD-level writers• Automatic plagiarism check• 100% money-back guarantee• 100% Privacy and Confidentiality• High Quality custom-written DISSERTATIONs

Importance Of Hand Hygiene Policy

/in /by

1.1 This report outlines how the Stoke on Trent Community Health Service (PCT) developed the Hand Hygiene Policy (2008). In this report there will be an explanation of the history of the guideline, its rationale and the evidence sources that supported its implementation. There will also be a reflective account of using the guideline in practice and how the guideline helps to further develop the student nurse’s learning.

1.2 This policy was located on the PCT website and was easy to access. The ward manager could also obtain a copy on request. Ward policies could be viewed by patients and their families on request also.

2.0 Rationale for the guideline being written

2.1 The Hand Hygiene policy was published by the PCT in November 2008. This policy provides instruction to all trust staff on how to minimize the spread of infection to patients, themselves and others.

2.2 The executive committee, clinical governors, the infection control team, ward department managers as well as all trust staff have the responsibility to ensure the policy is implemented and adhered to. The policy was ratified by the Stoke on Trent trust board in November 2009 and is due to be reviewed in November 2011.

2.3 In the policy it states that the trust will be responsible for delivering an induction for all new employees, as well as providing an ongoing programme of updates for trust staff. The trust will also monitor staff by conducting regular audits on the ward. These will be conducting by the infection prevention and control nurses (IPCN’s). The audits will be undertaken on a random basis. It is also the trusts responsibility to ensure that there adequate, suitable and well maintained hand hygiene facilities and equipment in all areas.

2.4 In 2003, the Department of Health (DH) published the document; Winning Ways: working together to reduce healthcare associated infection in England. In this document it states that hand washing is vitally important in the control of infection. It also states that problems can arise from healthcare professional’s poor knowledge of guidelines and lack of education regarding correct hand washing, as well as inadequate facilities and a lack of time to wash hands correctly. In this document there are seven action areas all relating to identifying and reducing infections in healthcare settings. Action area four in particular refers to hand hygiene practice. It states that all clinical teams must demonstrate high levels of compliance with hand washing and hand disinfection protocols.

2.5 More recently in 2008, the National Patient Safety Agency (NSPA) published The Clean Hands Save Lives Patient Safety Alert. The NSPA believe that improving the hand hygiene of healthcare staff at the point of patient care will significantly reduce healthcare associated infections. The document states that up to eight per cent of inpatients in England at any one time have a healthcare associated infection.

2.6 The World Health Organisation (WHO) have also published the WHO Guidelines on Hand Hygiene in Healthcare settings. Outlined in this publication are the ‘five moments for hand hygiene’ training exercise. Its aim is to educate health care professionals on when and where hand hygiene should be most prevalent these are;

Before patient contact

Before an aseptic technique

After body fluid exposure risk

After patient contact

After contact with patient surroundings

2.7 Alcohol rub can also be used in between patients. In most cases this is the preferred method to use for cleaning non soiled hands because it is more effective, quicker to use, better tolerated by the hands and can be provided at the patient’s point of care (NPSA 2008). However the PCT’s policy states that alcohol hand rub should not be used

When hands are visibly or potentially soiled

The patient is experiencing vomiting and/or diarrhoea

There is direct hand contact with bodily fluids i.e. if gloves have not been worn

The patient has diarrhoeal illness attributed to an infectious cause.

However alcohol rub is ineffective against clostridium difficile spores. Soap and water is the most effective form of hand hygiene in this case.

2.8 The procedure for effective hand decontamination is a six stage technique using soap and water;

Wet hands under running warm water, apply soap then rub hands palm to palm

Rub the back of both hands (right palm over left back and vice versa)

Rub palm to palm interlacing the fingers

Rub the backs of fingers by interlocking the hands

Rub the thumbs (rotational rubbing of right thumb, clasped in left palm, and then vice versa)

Rub palms with fingertips (rotational rubbing of right fingers on left palm, and then vice versa, finish by rinsing hands under running water and dry thoroughly.

How Healthcare Associated Infections (HCAI) affect the NHS

2.9 The World Health Organisation state that HCAI’s affect between 5% to 15% of hospitalized patients and 9% to 37% of intensive care patients. Also figures from the National Audit Office show that HCAI’s are responsible for approximately 5000 deaths a year (2004). This puts a great financial burden on the NHS. The cost of HCAIs to the NHS is high, at around £1 billion per year (Parliamentary Office of Science and Technology 2005). Although research shows that an estimated £150 million could be saved through the implementation of good clinical practice including correct hand washing practice. However there still seems to be an increase in infections such as methicillin-resistant Staphylococcus aureus (MRSA) and clostridium difficile. These infections can be carried on the skin and can spread through a lack of hand hygiene (Bissett 2005). This in turn will increase patients stay in hospitals as well as increasing the need for ‘deep cleaning’ of the wards (Cunningham, Kernohan & Rush 2006). Although Eaton (2005) states that hand washing is more important than cleaner wards in controlling MRSA. Compliance is another issue that is sometimes found within the NHS, some healthcare workers have been shown failing to follow the guidelines, thus not washing hands as they should. Conley et al argue that education and training do not normally lead to a sustained improvement in hand washing (1989). However having the correct equipment such as sinks and alcohol gels in a clear and appropriate place seems to prompt healthcare workers to wash hands more often (Parker 1999).

3.0 Sources of evidence

3.1 The policy was developed using a wide range of materials. Nine different sources were referenced, these included department of health evidence sources, national patient safety agency documents as well as two guidelines, one from the centre for disease control and one from the infection control nurses association. There is also one journal.

3.2 The most recent document that is referenced is the National Patient Safety Agency Clean Hands Save Lives campaign. This was released in September 2008. The oldest source of evidence was the Department of Health 2003 Winning Ways- Working together to reduce Healthcare Associated Infections in England.

3.3

4.0 Experiences of using the guideline

4.0 Whilst on placement, I have encountered many situations which require me to maintain a standard of cleanliness with regards to my hand hygiene. I came to realise that the six stage hand washing technique is the most thorough way to wash my hands. This policy has helped me to identify how the technique should be done and also why using the correct procedure of hand washing helps to prevent healthcare associated infections.

4.1 All staff at my placement followed and adhered to the guidelines that the policy set out. Also when visitors came to the ward, alcohol gel was visible, as well as signs encouraging visitors to make sure their hands were cleansed.

4.2 At my placement staff were also issued with alcohol hand-rub bottles to clip onto their uniforms. I was also given a leaflet on hand washing and the six stage technique to keep as a reference.

5.0 Placement Learning

5.1 Whilst I have been on placement, I have seen numerous infection control nurses on the ward. I have also seen and taken part when audits have been undertaken by the infection control nurse (ICN). These audits are also referenced in the PCT’s policy.

5.2 The infection control nurse (ICN) uses two types on audit. The first is known as the Hand Hygiene Audit Tool. This consists of sixteen checks that must be made when auditing the wards and is mainly about the equipment that is used to maintain hand hygiene. The ICN checks that equipment is available and in good working order. The other audit tool the ICN can use is the Hand Hygiene Observation Tool. This tool is used to identify compliance amongst healthcare professionals.

Safeguarding and Protection in Health and Social Care

/in /by

Safeguarding is aimed at protecting vulnerable children or adults from abuse and neglect in all situations. Safeguarding is the action that is taken to promote the wellbeing of people of all ages and protect them from harm. It means to protect people from abuse and from getting mistreated and preventing harm to children’s health or development, as a child they should never suffer from any mistreatment as they may affect their health and well-being and their future and how they achieve in life and see things in different perspectives and views

The Children Act 2004 determines parental responsibility and motivates partnership with parents. This Act basically reinforces the message that all organisations and communities that work with children have a goal in keeping children safe by using the safeguarding policy. The Children Act provides a legislative that improves a children life. Once turned 18 it is considered as a legal adult which means they are responsible for their actions and decisions. Children’s Hearings and child protection orders, a child is defined as a young person under 16 years of age.

The Care Act 2014 sets out how legally the frame works and for how local authorities the system protects the adults at the risk of abuse and mistreatments because it has been set the tension that many neglects and abuse have occurred during the years and the system has done something about it to protect the adults from suffering, they have made requirements for them to support every adult with the care needed when they sense that abuse is taking apart and that there is a risk of it happening so they need to find out what actions may be needed.


Section 2- protecting individuals

Abuse may take up to many forms for example physical abuse, neglect, emotional abuse and discriminatory abuse. These type of abuses are the 4 most common, to identify Possible Indicators of Physical Abuse they may be Multiple bruising the victim might be trying to hide bruises by wearing unusual type of clothes such as long sleeves and turtle neck tops. Fractures and Burns the individual may give different excuses every time they appear.

Bed sores most often develop on skin that covers bony areas of the body, such as the heels, ankles, hips and tailbone. Bedsores are caused by pressure against the skin that limits blood flow to the skin. Constant pressure on any part of your body can lessen the blood flow to tissues. Fear, when the individual afraid of doing certain things or say, scared to get in trouble, Depression and Unexplained weight loss.

The Possible Indicators of Neglect Are Malnutrition which is lack of proper nutrition, caused by not having enough to eat, not eating enough of the right things, or being unable to use the food that one does eat. When an individual is self-neglecting there are some noticeable indicators such as untreated medical problems, Bed sores and Confusion.

Indicators of Emotional Abuse Are Fear such as scared to admit how they feeling or scared of consequences. Depression as well as if they are constantly overreacting may mean something is wrong. Confusion, the individual can’t tell right from wrong or gets simple things or tasks mixed up. Loss of sleep which can lead into Unexpected or unexplained change in behaviour

Possible indicators of Discriminatory Abuse. This type of Abuse can be experienced as harassment, insults or similar actions due to race, religion, gender, gender identity, age, disability, sexual orientation. The most known indicator in this Abuse is loss in appetite, low self-esteem, deference, unexplained fear, defensiveness, emotional withdrawal, sleep disturbance and self-harming behaviour.

If there is a situation where the carer suspect abuse of an individual but they haven’t actually said anything, there are a number of steps to take. The carer should Continue to talk to the individual, most individual who are being abused find it very difficult to talk about it. By having conversations with the individual creating trust so the individual feels comfortable to communicate. Keeping a diary, this is a good way to keep a note of what the carer thinks are something or any other concerns, it can also help to spot patterns of behaviour. Talking to people who are friends/ family of the individual asking for any unusual behaviour or concerns. Getting other people perspective may help the situation. Be supportive at most times to avoid the individual feel bad about it. Stay close to the alleged victim to provide some sense of physical security.



Training and responsibilities

Whistleblowing is the act of reporting a concern about a risk, wrongdoing at work and in public interest, which is very essential to reporting straight away as soon as seen. Training of staff is crucial to support good practices and procedures and know what to do when there is any problems occurring and how to treat the patients. Carers will have to report to their manager. The manager will decide whether the concerns warrant a referral to another agency such as NSPCC and the police will assess if the individual is at immediate risk of harm or in need. In most cases the individual and family of concern need support. Services will work with the family, not against them. Unless the level of risk requires the courts to get involved immediately, care proceedings will only start after extensive efforts are made to keep the family members with their family by working with them to address any risks. It is a responsibility to take if any concerns are being raised and report immediately or whistleblowing which gives the manager an opportunity to put things right before any risks are taken place.



Section 3 – Safeguarding and self



Carers have a different types of roles about safeguarding. They can be ones that will notice and report it right away as themselves may be vulnerable to harm and abuse. Carers may be involved in situations that require a safeguarding response including witnessing or speaking up about abuse or neglect which can be really tough to report. Carers have to demonstrate the importance of ensuring individuals are treated with dignity and respect when providing health and care services. Facing intentional or unintentional harm from the adult they are trying to support or from professionals or groups they are in contact with unintentionally or intentionally harming or neglecting the adult they care on their own or with others.

They are many risks that increases in relative to abuse of carers themselves for example risk of abuse increases when the carer is isolated and not getting any practical or emotional support from their family, friends, professionals or even paid care staff. Possible situations where abuse of carers is more likely comprise those where the person supported has health and care necessities that exceed the carer’s facility to meet them does not consider the needs of the carer or family members treats the carer with a lack of respect or manners rejects help and support from outside, including breaks refuses to be left alone by day or by night. Control over financial, property and living arrangements involves in abusive, aggressive or frightening behaviours has a history of affluence mistreatment, unusual or offensive behaviours does not understand their actions and their impact on the carer is angry about their situation and pursues to punish others for it has wanted help or support but did not meet thresholds for this.


Section 4 – Professional practice

The main goal of a safeguarding adults is to make sure that through safeguarding arrangements partners act to help and protect adults in its area who meet the criteria set out in the Care Act 2014. These boards promote information sharing between workers and organisations to make sure that the care meets all of the needs of the individual. If a worker has concerns they must share the information with the managers or report to the office and build up a full picture and discuss in detail the individual’s situation. Carers will need to find out from the manager, service users’ needs so they can make arrangements and keep the main goal intact.

Managers make decisions by following what is agreed locally and by their workplace as the threshold, or the point at which something becomes a safeguarding issue. For example, they are short on staff on a busy day shift regardless of to find a replacement, may not be seen as a safeguarding issue in this work placement but in another situation where individuals have specified needs and many other multiple needs, this may be seen as a problem or even a risk to people’s health and wellbeing and a safeguarding concern. If this service user needs assistance a worker from the office should make their way to the services user house and take care of the users’ needs.

Partnership working allows services to be delivered in a joined-up way. This has benefits both strategically, in terms of providing a well-balanced service which shows service users that they are competent in what they are doing also this shows everyone in general that they can be trusted as in for example if someone needs urgent care they know there is plenty of staff to come by and get her needs sorted in time. Through coming together and focusing on a common goal which is keeping service users happy and safe, a shared vision is formed of what partners want to achieve and how they want to achieve it which they will be able to come into a conclusion and achieve as soon as possible. Service users most likely influence the service.


Section 4 – part 2

A breach of confidentiality starts when confidential information is not allowed to be shared by the person who provided it or to whom it relates, putting said person in danger or causing them embarrassment or pain, this may cause serious problem to the person that shared the information. It’s not a breach of confidentiality if the information was provided on the understanding that it would be shared with a limited number of people, or where there was consent to the sharing. Confidential information should only be shared with professional managers in case of concerns to the individual or to someone that has been mention to in the case. if it’s in the public interest for example where not sharing it could be worse than the outcome of doing so. The decision should never be made as an individual, but with the backup of managers, who can provide support, and sometimes ensure protection.

There are three criteria for sharing information without consent, or overriding refusal to give consent which are where there is evidence that an individual is suffering, or is at risk of suffering, significant harm in these cases it is necessary to tell someone professional to insure that the individual is being safeguarded. Where there is reasonable cause to believe that the individual is or may be suffering or at risk of suffering significant harm. To prevent significant harm arising to children and young people or serious harm to adults, including the prevention, detection and prosecution of serious crime.

Confidential information is ‘personal information of a private or sensitive nature’ that is not already lawfully in the public domain or readily available from another public source and has been shared in a relationship where the person giving the information could reasonably expect it would not be shared with others. Staff can be said to have a ‘confidential relationship’ with families. Some families share information about themselves readily and should be consulted about whether this information is confidential or not. Where third parties share information about an individual, staff need to check if that is confidential, both in terms of the subject sharing the information and the person whom the information concerns. Confidential information before sharing the individual should take notice that whatever is been said will be taken into consideration which if there is anything concerning as safeguarding the staff has the right to report it to the head managers to make sure they are safe.


Reference List


Assume the role of a healthcare professional tasked with educating both the newly diagnosed patient (in laymen terms), as well as the patient’s healthcare advocate (medical and technical terms).

/in /by

Assume the role of a healthcare professional tasked with educating both the newly diagnosed patient (in laymen terms), as well as the patient’s healthcare advocate (medical and technical terms).
Instructions:

Choose one cranial nerve injury or disease OR one spinal nerve injury or disease to serve as the focus of the assignment.
Complete research on the selected injury or disease.
Create an educational pamphlet for the patient that includes the following information on the injury or disease in laymen terms:
Anatomy
Physiological processes/pathways
Risk factors
Signs and symptoms
When to call the primary care provider or seek emergency room attention
Current and potential treatments (to include existing clinical trials)
Prevention strategies and measures
Online and community resources for further information and support
Create an educational pamphlet for the patient’s healthcare advocate
As a medical professional, we will often be tasked with presenting a diagnosis to a patient with no educational background or experience within the healthcare profession. In these cases, it is critical to convey this very important and pertinent information to the patient in a way in which they can fully understand the information, i.e., to put the information into laymen terms, as well as making certain the patient is comfortable in seeking additional support and community.
In addition, patients in the above scenario might also choose to seek out the help of a healthcare advocate (a medical professional appropriately trained within the medical field) to help the patient research, organize, understand and communicate and field questions with the physician. Patient healthcare advocates require that the information is conveyed and presented to them as if the physician and/or healthcare professional were speaking to a colleague, i.e., medical and technical terms.