Category: Nursing

Research Process

The investigators created an exhaustive search methodology that was useful in the identification of articles from specific databases. They collected data on a variety of qualitative and quantitative studies published from 2005 to 2015 (Tölli et al., 2017). The sources of information included PubMed, PsycInfo, Scopus, Cochrane, and CINAHL. The researchers evaluated 1057 papers and excluded those that did not meet specific outlined criteria such as inadequacies in data collection, poorly described interventions, and solutions not implemented by nursing staff.

Study Type

The investigators developed a systematic quantitative review that does not include a meta-analysis because the interventions, measurements, and study designs under investigation were diverse.

Purpose

The researchers aimed to identify current information regarding the impact of training interventions on the management of challenging patients in nursing practice.

Research Questions

The studys principal objective was to answer three critical questions relating to patient behavior. First, it intended to identify the training interventions that managers use to improve the nursing staffs competence when managing challenging behavior. Secondly, the researchers sought to assess the types of measurements that have been employed in the evaluation of the nursing teams abilities when handling difficult patients. Finally, they purposed to classify the specific effects training sessions had on the nurses capacity to deal with taxing clients, the rate of violent incidents, and the use of restraints. The research results add to the body of evidence that guides the prioritization of patient safety in a variety of clinical contexts.

Reference

Tölli, S., Partanen, P., Kontio, R., & Häggman-Laitila, A. (2017). A quantitative systematic review of the effects of training interventions on enhancing the competence of nursing staff in managing challenging patient behavior. Journal of Advanced Nursing, 73(12), 28172831. 

A summary of the key messages of the IOM report

The US has a chance to transform its healthcare system and nurses, perhaps the largest workforce in the healthcare system, have critical roles to play in the transformation process. In this regard, the IOM focuses on fundamental issues to overcome barriers that limit nurses participation in the rapidly evolving healthcare system. It is vital to overcome these barriers to ensure that nurses can offer effective leadership and promote health. First, the IOM report proposes further nurse education and seamless academic progression (Institute of Medicine, 2010, p. 2). Second, the IOM report requires that nurses should practice to the fullest extent of their education and training (Institute of Medicine, 2010, p. 2). Third, The IOM report supports effective nurse leadership in the healthcare system to lead change and advance service provision. Finally, nurse should have effective workforce planning, data collection for policymaking and enhanced information systems.

The role of the Robert Wood Johnson Foundation Initiative and the American Association of Retired Persons on the Future of Nursing, Campaign for Action and the State Based Action Coalitions

The Robert Wood Johnson Foundation (RWJF) worked in collaboration with the IOM to conduct a study as a part of a major initiative on the Future of Nursing. Generally, the RWJF focused on producing a report to transform the future of nursing. The ad hoc committee reviewed the ability of current nurse workforce to meet healthcare demands, developed several national recommendations for consideration in reforms and addressed nurse shortage and nurse education system. The committee wants to ensure changes across all levels of healthcare policy implementation and promotes innovative intervention models in nursing. In all these processes, the RWJF must identify critical roles of nurses in formulating and executing a more efficient and resourceful healthcare system in the US. These may include reviewing nurse roles, expanding nursing education system, evaluating innovative systems, and attracting and retaining talented nurses across various departments.

The American Association of Retired Persons (AARP) collaborated with the RWJF to implement the recommendations of the report. As a result, these organizations launched a major initiative known as the Campaign for Action (Swartz, 2012, p. 159). Within the first year of the Campaign for Action, various nursing agencies have worked together to gather and analyze data related to nursing, states have formed their own coalitions, funding has been increased, and the RWJF continues to work with other stakeholders to create, review and disseminate information for the implementation of the IOM recommendations.

Action Coalitions are responsible for facilitating the implementation of the Future of Nursing. These coalitions aim for long-term, sustainable implementation of the IOM at local, state and federal levels (Swartz, 2012, p. 159). In collaboration with the RWJF and other related stakeholders, Action Coalitions have embarked on ambitious plans to develop and implement specific sets of regional agendas and campaigns to facilitate the implementation of the IOM recommendations.

The importance of the IOM FON report related to the nursing workforce

The importance of the IOM FON can be identified in the major highlighted areas that concern nursing workforce. First, nursing workforce should specialize in specific areas, develop their skills, knowledge and focus on continued training to enhance the quality of care. Hence, they need to progress academically from diplomas to doctorate for nursing practice (DNP). Second, nurses have continued to encounter regulatory and institutional challenges as they seek for further training, education and practice. For example, advanced practice registered nurses (APRNs) have attained higher qualifications but cannot practices in some areas because of such barriers (Fitzgerald, Kantrowitz-Gordon, Katz, & Hirsch, 2012, p. 2). The IOM recommends that nurses should practice to the fullest according to their qualifications and training. Third, as previously mentioned, IOM wants nursing workforce to practice to their fullest based on training and qualifications. This would solve cases of nursing shortage witnessed in the country (American Association of Colleges of Nursing, 2014, pp. 1-6). Fourth, the IOM FON insists on nurse leadership and therefore requires nurses to participate in decision-making processes, advocacy and healthcare reforms (Ferguson-Paré, 2003, p. 35). Finally, the IOM FON requires nurses to plan and rely on data to enhance effective decision-making.

The intent of the Future of Nursing Campaign for Action

The major intent of the Campaign for Action is to facilitate the implementation of the IOM report recommendations across all states. For instance, the Campaign for Action works with various stakeholders to ensure that they incorporate the IOM recommendations into their strategic plans and programs continuously. It encourages healthcare stakeholders to gather and analyze nursing workforce data across all states to reflect the actual nursing workforce situation in the US. The Campaign for Action has encouraged the formation of coalitions at state levels to enhance change. In the State of Florida, for instance, it facilitates the transformation of community colleges to offer degree programs for nurses. The Campaign for Action also advocates for changes through political leaders and policymakers. For instance, it has ensured that fiscal budgets account for the implementation of the IOM recommendations as witnessed in 2012 (Swartz, 2012, p. 159). It also coordinates research agendas across all states to ensure that stakeholders produce, collect, analyze and provide information necessary to facilitate the implementation of the recommendations. Overall, the Campaign for Action exploits any available opportunities to promote the Future of Nursing based on the IOM recommendations.

The rationale of state-based action coalitions

The state-based Action Coalitions were formed to drive the Future of Nursing agendas. Action Coalitions strive to ensure that long-term sustainable goals of the IOM recommendations are implemented at the local, state and regional levels (Swartz, 2012, p. 159). With a diverse composition of stakeholders from different sectors, the Action Coalitions aim to identify and adopt best practices, identify the need for research, make follow-ups on lessons learned and recognize best replicable models for other states (Swartz, 2012, p. 159).

The Action Coalitions work with other stakeholders to ensure that they identify local situations, develop and implement unique sets of priorities and campaigns by considering such unique conditions at local, state and regional levels.

One state-based action coalition and two initiatives

The Florida Action Coalition is responsible for facilitating the implementation of the IOM recommendations in the State of Florida. The state has distinctive healthcare issues and therefore it collaborates with various providers to develop novel remedies by ensuring nurses participation. Hence, it has significant achievements with the Action Coalition. Its initiatives covered here are education and diversity.

Florida requires nurses to have high quality education in order to be able to deliver high quality care in complex healthcare settings. Currently, nurses possess BSN or higher qualification in Florida. The Florida Action Coalition strives to ensure higher levels of training and education for nurses. It has focused on enhanced, seamless education for nurses, eliminating education barriers and transforming colleges to offer nursing degree programs. Florida has developed an education model for the region based on IOM report.

The state has a diverse population with different healthcare needs, and nurses strive to meet these unique needs. Hence, its nursing employees reflect diversity and Florida works with inputs from diversity stakeholders to ensure inclusion.

References

American Association of Colleges of Nursing. (2014). Nursing Shortage Fact Sheet. Web.

Ferguson-Paré, M. (2003). Administration: What Is Leadership in Nursing Administration? Nursing Leadership, 16(1), 35-37.

Fitzgerald, C., Kantrowitz-Gordon, I., Katz, J., & Hirsch, A. (2012). Advanced Practice Nursing Education: Challenges and Strategies. Nursing Research and Practice, 2012(2012), 1-8.

Institute of Medicine. (2010). The Future of Nursing: Leading Change, Advancing Health. Web.

Swartz, M. K. (2012). Update on the Future of Nursing: Campaign for Action. Journal of Pediatric Health Care, 26(3), 159-160.

The rash with which the patient presented to the healthcare facility has not spread to any other part of the body apart from the face, thus, external exposure to some allergen or infection was likely the trigger for the conditions appearance. Both teaching and nursing plans for each nursing diagnosis formulated for the patient are expected to include two dimensions of the problem: the internal and the external. The nursing diagnoses are the following:

• Nursing Diagnosis 1: A potential comfort alteration related to pain in the joints or the peripheral nerve inflammation or dysfunction related to systemic lupus erythematosus that is evidenced by erythematous plaques, fatigue, and muscle pain.
• Nursing Diagnosis 2: The risk of internal infection as associated with the inadequate primary defences, which is broken skin, as evidenced by high body temperature (fever).
• Nursing Diagnosis 3: Impaired tissue integrity associated with the rash that is related to the exposure to nature after spending a week hiking and camping in the Appalachians. The development of the rash is evidenced by the fact that going outdoors makes the rash worse (increased itchiness and painfulness) is indicative of the rash being triggered by the external environment.

For Nursing Diagnosis 1, the patient should ensure the following of positive choices in diet and exercising to manage pain in the joints. It is recommended to eat a diet rich in fruit, vegetables, as well as lean protein to prevent vitamin deficiency. Regular and mild exercising will manage the joint paint as well as release pressure from the nerves. The patient should be taught to recognize the early signs of nerve inflammation and make healthy choices to manage the condition under the supervision of a healthcare provider.

For Nursing Diagnosis 2, it is recommended to monitor the redness, swelling, increased pain as well as the appearance of discharge from the lesions (Vera, 2016). Monitoring the signs is necessary because of the patient exhibiting fever, which is one of the first signs of infection. In case if the temperature does not decrease and the mentioned signs of the infection keep appearing, the patient needs to present to the health care provider immediately for antibiotic care. The teaching plan of the patient should involve learning how to identify the primary signs of infection. The patient should learn to make connections between the external symptoms that present on the skin as well as inadequate responses, such as fever, in order to make relevant decisions for further diagnosis and intervention.

For Nursing Diagnosis 3, the nursing care plan should focus on avoiding external irritants and heal the impaired tissue integrity steadily and with minimum invasion. It is recommended that the patient stays indoors for at least a week and prevents the exposure to sunlight. The application of chemical creams, serums, and ointments should be avoided to ensure that the irritation does not get worse. The patient should present to the dermatologist for further testing and prescription of medicated creams that could soothe the skin. The teaching aspect of the plan should involve educating the patient on the risks of being exposed to nature in unknown areas (Midtbust, Dyregrov, & Djup, 2018). The patient may be allergic to the plants in the Appalachians, which is why it is important to be aware of the effects that the exposure to nature may have on ones skin integrity.

References

Midtbust, L., Dyregrov, A., & Djup, H. W. (2018). Communicating with children and adolescents about the risk of natural disasters. European Journal of Psychotraumatology, 9(sup2), 1429771.

Vera, M. (2016). Risk for infection. Web.

Being a nurse means that one must be prepared to face numerous challenges (Kelly, 2006) and be ready with an appropriate strategy to address the emerging issues (Kelly, 2006a). Personally, I have encountered a range of situations, in which the outcomes hinged on my competence and skills. However, by far the greatest challenge that a nurse may face is the necessity to be an efficient change agent (Newhouse, 2007).

In my clinical practice setting, it was crucial to reconsider the hand-off communication process within the nursing setting of the hospital and to improve the communication process by introducing the elements of new media into the context of the setting. In other words, new forms of media were supposed to be utilized in order to transfer information. I was among the few people, who were assigned with the task of administering the new tool to the rest of the nursing staff.

It should be noted that the process of the new tools installation and the application of the newly acquired skills to practice took much more time than planned. Even though most of the staff members were quite used to utilizing the modern media tools in their everyday life, using the online interface created for the staff to store and share the information con the patients and the tasks to complete was rather complicated for most of the staff.

With the introduction of the evidence-based practice model (Grant, Colello, Riehle, & Dende, 2010), however, a range of changes occurred. It was rather impressive to see people acquiring new skills so easily after the new tools were shown in practice. More to the point, the evidence-based model has shown once again that the gap between theory and practice is admittedly big, especially in the hospital setting; however, by developing reflective skills with the help of regular training, one can help bridge this gap, thus, making the transgression from theory to practice possible.

It would be wrong to claim that the evidence-based model is a silver bullet that can be used in any situation when the nursing staff is introduced to a new experience. However, in the case of adopting new hands-off communication principles, the model served its purpose well. Not only did the staff finally realize the numerous benefits of the new media tools, but also learned to use them rather quickly after the new media tools were included in the set of equipment used for the hands-off communication.

In a retrospect, the process of installing new media tools as the means for hands-off communication between the nurses, and the following evidence-based training of the necessary skills, were rather long. Instead of taking a month, as it had been planned prior to the experiment, the rearrangement of the nursing strategies and the steps that needed to be taken to acquire the records on the patients and the following training of the staff took three months. The results turned out to be quite impressive, though. Since recently, information leakage has been reduced by half, and data loss no longer occurs in the hospital setting.

The experience described above shows that to sustain changes at any level, responsiveness among the staff and their readiness for cooperation is crucial (Baur, 2011). In addition, a clear and concise plan of actions to be taken is required (Ferrara, 2010). With the key goals and objectives in mind, one can carry out the transformation of the nursing setting on any level, starting from the organizational one to the policy level.

Reference List

Baur, C. (2011). Calling the nation to act: Implementing the national action plan to improve health literacy. Nursing Outlook, 59(2), 6369.

Ferrara, L. R. (2010). Integrating evidence-based practice with educational theory in clinical practice for nurse practitioners: Bridging the theory-practice gap. Research & Theory for Nursing Practice, 24(4), 213216.

Grant, B., Colello, S., Riehle, M., & Dende, D. (2010). An evaluation of the nursing practice environment and successful change management using the new generation Magnet Model. Journal of Nursing Management, 18(3), 326331.

Kelly, D. L. (2006). Improving processes and implementing improvements. Applying quality management in healthcare: A systems approach. Washington, DC: AUPHA.

Kelly, D. L. (2006a). Measuring process and system performance. Applying quality management in healthcare: A systems approach. Washington, DC: AUPHA.

Newhouse, R. P. (2007). Creating infrastructure supportive of evidence-based nursing practice: Leadership strategies. Worldviews on Evidence-Based Nursing, 4(1), 2129.

The efforts to advance the quality of modern healthcare have led to the development of relevant tools that are being continually improved (Centers for Medicare & Medicaid Services, 2014; Stukenborg, 2011). For example, the Quality Indicators (QI) proposed by Agency for Healthcare Research and Quality (n.d.) include four groups of QIs, and one of them was chosen to discuss it at length in the present paper.

Inpatient Quality Indicator 16  Heart Failure Mortality Rate

The Inpatient Quality Indicator 16 (IQI 16) belongs to the Inpatient Quality Indicators group that has been introduced in 2002 to measure the in-hospital quality of service based on the easily accessible data such as hospitalization and mortality rates or procedures utilization and volume. IQI 16 is concerned with heart failure mortality rate. Like many other QIs, it has been introduced since there are noticeable variations in the performance of different institutions with respect to it, which indicates that some of them may be providing better-quality healthcare (Agency for Healthcare Research and Quality, 2015). The Agency for Healthcare Research and Quality (2015) has developed the IQIs together with University of California, Stanford University Evidence-based Practice Center, and the University of California. Nowadays, free software with benchmark data and guides for their measurement are offered.

The Potential of IQI 16

IQI 16 is directly concerned with public health although its impact on the wellbeing of patients and their families is relatively indirect: it can be used to measure the performance of a healthcare institution and detect issues and difficulties with respect to heart failure-related activates. In other words, it can be regarded as a tool for improvement of an institutions performance with respect to one of the vital indicators of public health. Naturally, IQI 16 is incapable of providing definite information on the quality of healthcare, but it can track the performance and indicate issues if it is used properly (Agency for Healthcare Research and Quality, 2015).

The Data Available on IQI 16 and the Leaderships Goal for Improvement

Heart failure is an exception among cardiac disorders as it is resistant to the overall tendency of public health and healthcare improvement. In particular, there is an increase in the prevalence of heart failure while the prolongations in survival remain dissatisfactory (Braunwald, 2013). The issue is being researched, new approaches to therapy are being proposed, and given the varied performance of different institutions, it can be concluded that the IQI 16 is of significant importance for healthcare. However, as it has been pointed out by Glance, Osler, Mukamel, and Dick (2008), IQI 16 needs to be used properly. At the same time, as demonstrated by Ma, Shang, and Bott (2015), the role of nurses and especially nursing leadership and collaboration in healthcare quality improvement is vital. Therefore, it is logical to employ supportive leadership to empower nurses with the goal of improving healthcare with respect to heart failure by properly using IQI 16.

The Proposal of IQI 16 Solution

The research carried out by Glance et al. (2008) indicated that the present-on-admission indicator is capable of significantly biasing the results of IQI 16 assessment. Several years later, Stukenborg (2011) studied the use of present on admission diagnoses as a means of improving the quality of assessment and concluded that it was a viable strategy. However, the author also indicated that the addition of the information was capable of only improving IQI 16, not perfecting it. According to Stukenborg (2011), modern QIs allow the use of present on admission information, which means that nurses are provided with the means of improving IQI 16 data, but training may be required to ensure success. Therefore, it can be concluded that nurse training and leadership can be employed to improve IQI 16 (and other QIs) application, and nurses should be encouraged to participate in the training, use, and feedback on the tool. The feedback of nurses can be used to detect issues in the indicators use, which is of particular value to the continuous quality improvement in healthcare.

References

Agency for Healthcare Research and Quality. (2015). Inpatient Quality Indicators. Web.

Agency for Healthcare Research and Quality. (n.d.). AHRQuality indicators. Web.

Braunwald, E. (2013). Heart failure. Journal of The American College Of Cardiology: Heart Failure, 1(1), 1-20. Web.

Centers for Medicare & Medicaid Services. (2014). 2014 clinical quality measures. Web.

Glance, L., Osler, T., Mukamel, D., & Dick, A. (2008). Impact of the present-on-admission indicator on hospital quality measurement. Medical Care, 46(2), 112-119. Web.

Ma, C., Shang, J., & Bott, M. J. (2015). Linking unit collaboration and nursing leadership to nurse outcomes and quality of care. Journal of Nursing Administration, 45(9), 435442. Web.

Stukenborg, G. (2011). Hospital mortality risk adjustment for heart failure patients using present on admission diagnoses. Medical Care, 49(8), 744-751. Web.

Introduction

Nursing involves a variety of responsibilities, that are crucial to help patients heal. While caring about the registrants, it is important to stay alert; thus, no mistake is overlooked. Prevention of possible medication errors or reporting already committed ones is an ethical duty of any nurse, since such inaccuracy might lead to morbidity or mortality of patients. Therefore, this paper will be dedicated to the analysis of bibliography on the topic of medication errors and patients safety.

In order to conduct a proper research, I will address the recommended method by identifying the elements of the topic and then defining them (Socratic problem-solving approach, n.d.). As a practical nurse, I focus on providing high-quality care in order to satisfy the patients and maintain their trust in the healthcare system. That is why, solving the issue of occurring medication errors is important to me. Unfortunately, in my experience there were several cases of medication inaccuracy, when the diseased were getting wrong drug dosages. Although, these situations were of minor negative impact to the patients, they increased my awareness of this problem and motivated me to delve into it.

Identifying Academic Peer-Reviewed Journal Articles

For the search of the relevant articles, I resorted to the Summon Advanced Search tool, that helped me to filter information in Capella University Librarys collection. The clarification was made possible by using keywords such as medication errors, ethics, patients safety and quality improvement. In order to specify my search, I chose nursing as the discipline, and journal article as the content type. Additionally, I ticked the box near filters peer-reviewed and full text online and selected the 5 years option of publication date; thus, I can easily access the recent scholarly articles.

Assessing Credibility and Relevance of Information Sources

To make sure that the sources I chose were reliable, I checked that they fulfilled a requirement of being no older than 5 years and were published in scholarly journals. Moreover, I personally checked that the authors of the selected articles are credible professionals in the field of nursing or medicine. Furthermore, I ensured that the texts had the information about medication errors and patients safety, required for my research.

Annotated Bibliography

Athanasakis, E. (2021). Registered nurses experiences of medication errorsAn original research protocol: Methodology, methods, and ethics. The Canadian Journal of Nursing Research, 53(2), 171183. Web.

The purpose of the given article is presenting a research protocol on inquiry of nurses experiences of medication errors, along with interpretative phenomenological analysis and relevant methodological and ethical deliberations of the author. The research goal was achieved through collecting data of corresponding nurses experiences, analyzing it and conducting a literature review that contained English language reports published since 1990 until February 2019. The sources originated from such acknowledged databases as PubMed, British Nursing Index, Cumulative Index to Allied Health Literature, Science Direct, and Wiley Online Library. Moreover, the paper incorporated the authors personal methodological and ethical considerations. The presented results of the research included the considerations of methodological and ethical aspects of how nurses dealt with medical errors, that could be used by fellow investigators. This article raised and addressed the question of hardships, that can be encountered in analyzing medical errors cases.

Dirik, H. F., Samur, M., Seren Intepeler, S., & Hewison, A. (2019). Nurses identification and reporting of medication errors. Journal of Clinical Nursing, 28, 931 938. Web.

The examined article was targeted at researching involvement of the hospital nurses in the spotting and reporting of medication errors in Turkey. The authors conducted a survey among 135 nurses, who had to examine 18 sample cases of medication errors occurrences and state their opinion on how they would report them. The obtained results were analyzed via chi-square and Fishers exact methods. The research is concluded with the statement that according to statistics, nurses have the ability to identify medication errors, however, mostly, they are resistant to report them to the administration. Therefore, the mediation errors are more likely to be reported by the physicians. The reviewed article is fitting for my research, since it provides practical evidence of how widespread the issue of ignoring the reporting of medication errors among nurses is. In addition, it mentions the importance of establishing a commonly agreed definition of medical error, thus, the patients safety can be increased.

Jang, S. J., Lee, H., & Son, Y. J. (2021). Perceptions of patient safety culture and medication error reporting among early- and mid-career female nurses in South Korea. International journal of environmental research and public health, 18(9), 4853. Web.

The following article is dedicated to identifying the link between nurses professional experience and their likelihood of reporting a medication error along with their understanding of patients safety culture. The authors conducted the research on the base of cross-sectional, secondary data analysis design. The respondents were early and mid-career nurses, who were surveyed in accordance to Korean Hospital Survey on Patient Safety Culture and single-item self-report measure on disclosing medication errors. Subsequently, there was a conclusion that early-career nurses with a high level of patients safety culture tended to report medication errors 2.4 times more often compared to those with lower levels of patients safety culture. However, despite the age of the nurse, the overall tendency of reporting medication errors was low. Therefore, the rationale for including this paper in my research is its contribution to the discovery of the factors behind the possible poor quality of patients safety provided by nurses.

Strube-Lahmann, S., Müller-Werdan, U., Klingelhöfer-Noe, J., Suhr, R., & Lahmann, N. A. (2022). Patient safety in home care: A multicenter cross-sectional study about medication errors and medication management of nurses. Pharmacology research & perspectives, 10(3), e00953. Web.

In this article, the issue of medication errors occurring at home care facilities was raised. The authors aimed to discover the frequency and the reasons of such cases, since that field of research was still mostly unsearched. In order to achieve the goal of the study, the authors examined almost 500 trained nurses, who worked for different home care services. The data collected through investigation was analyzed via a multiple logistic regression model. As a result, the authors found out that possible influence sources of medication errors were insufficient quality management or absence of regular nurses trainings. Additionally, the study found no correlation between the amount of medication error reports and such nurses characteristics as their professional experience, number of clients per shift and type of work. Therefore, in order to improve patients safety, the proper and regular trainings along with strict management measures should be applied. This paper is relevant to my research, since it provides information about medication errors, made by out-patients nurses and their attitude towards reporting them.

Conclusion

The conducted examination of the scholarly journal articles allowed me to improve my knowledge of medication errors and patients safety, which are essential topics in nursing. More specifically, thanks to the studied papers, I became more aware of the reasons that lead to occurrence of medication errors. Additionally, I found out that the research of medication errors elements might be limited. I also learned that there is a widespread practice of nurses silencing medication inaccuracy both in in-patient and out-patient facilities. All of this information will help me in my future study of the topic.

References

Athanasakis, E. (2021). Registered nurses experiences of medication errorsAn original research protocol: Methodology, methods, and ethics. The Canadian Journal of Nursing Research, 53(2), 171183. Web.

Dirik, H. F., Samur, M., Seren Intepeler, S., & Hewison, A. (2019). Nurses identification and reporting of medication errors. Journal of Clinical Nursing, 28, 931 938. Web.

Jang, S. J., Lee, H., & Son, Y. J. (2021). Perceptions of patient safety culture and medication error reporting among early- and mid-career female nurses in South Korea. International Journal of Environmental Research and Public Health, 18(9), 4853. Web.

Socratic problem-solving approach. (n.d.). Capella University. Web.

Strube-Lahmann, S., Müller-Werdan, U., Klingelhöfer-Noe, J., Suhr, R., & Lahmann, N. A. (2022). Patient safety in home care: A multicenter cross-sectional study about medication errors and medication management of nurses. Pharmacology Research & Perspectives, 10(3), e00953. Web.

Nursing is a field in medicine that entails learning and practicing how to take good care of patients under treatment. Professionals trained in nursing can at times treat patients in the absence of doctors. Learning nursing takes three to four years depending on the level. It is during the study and practice of nursing that one realizes the strong relationship between nursing courses and other fields.

Visiting museums looks isolated and irrelevant to nursing students and tutors. However, taking a closer look at the two reveals the strong relationship that exists between them. In museums, there are old preserved animals that can be used in the study of the anatomy course of nursing. The various parts of the animals can easily be taught during the museum visits. Methods of administering treatment to both animals and human beings can also be elaborated at the museums using the preserved bodies of the animals. Equally, people working at museums use the knowledge of nursing when carrying out the preservation of the animals (Judd, 2009).

Reflective journalism aids both the learning and practicing of nursing. It is through journals and magazines that new diseases discovered in different parts of the world are explained. The nurses and doctors who come across unique treatment cases get to communicate with their colleagues using reflective journals. Skills in an immunization course can be learned from journals, and thus serious nurses gain a lot from the periodical journals on nursing issues.

Reflective journalism also depends so much on nursing and other fields. Journalists have to look for stories to write about. Nurses and other people taking nursing courses give them articles on the various aspects and discoveries in the field (Donahue, 2010).

Music just like journalism is also a very strong means of communication. Those taking up nursing courses can compose songs on new ideas, drugs, or treatment methods that they come across. Those studying nursing or practicing nursing courses listen to these songs and pick up the message. For example, one could write a song to elaborate a certain procedure in the sanitation and health care course. Hence, it is evident that both nursing and music depend on each other (Donahue, 2010).

Geographical tours and hiking activities may also seem like a waste of time to many people in the nursing profession. We understand that the drugs used to treat most illnesses are obtained from trees. It is during manufacturing that chemicals are extracted from the trees are mixed in the right proportions under the right conditions to come up with the drugs. Geographical tours give those taking pharmaceutical courses a chance to understand and see the various plants, the chemicals they produce, and their usefulness in treating patients. They also get to identify poisonous plants and advise their patients accordingly whenever they are affected (Judd, 2009).

Sporting activities are also important to those in the nursing profession. The sporting activities should be organized regularly to help them refresh their minds and be ready to grasp new concepts. Apart from jogging up their memories they also get to learn a lot during these activities. For instance, administration of first aid to injured patients is mostly practiced during these activities and student nurses get to put the theoretical knowledge learned on the first aid course in class into practice.

In conclusion, it is clear from this short analysis that nursing can neither be learned nor practiced in isolation. The same applies to other fields of study. The fields are so interrelated that one cannot learn without understanding the other.

References

Donahue, M. (2010). Nursing, The Finest Art: An Illustrated History. London, UK: McGraw Hill.

Judd, D. (2009). A History of American Nursing: Trends and Eras. New York, NY: Prentice Hall.

Napa County has unmet health needs. About 13 percent lack medical insurance and pay cash. In addition, not all members of the community have Medicare or Medi-cal. Only 4% of the community is healthy while others are in low-income category. There are environmental risks from Lake Berryessa since more than 60 people have drowned in it. Children and elderly are prone to health risks. There are wild animals in the area, which pose health risks to the community. Pollution from pesticide is a concern for many residents. Air pollution has increased in the past few years, but water remains safe.

Hot, dry summer conditions pose threats of fire while some places have limited water. Wells and private water are expensive. The place has the feared poisonous oak and other poisonous plants.

Residential units could be health hazards in Napa County. There are fears of carbon monoxide poisoning, lead-based paints, faulty gas lines, and deviations from building codes. However, Napa has well maintained housing units with safe sidewalks and effective responses from authorities. All homeowners and developers observe building codes. There is public awareness about lead-based paints, which are common in pre-1978 homes. Hence, most families understand how to manage cases of lead poisoning.

The County has no waste disposal problems, but the demand for waste management has increased. There are low cases of residential fire in Napa County, but the responses have been immediate from the fire department. Any residential homes, which are five miles away, are under high alerts of fire. Swimming pools are safe to residents and vulnerable people.

Disasters are likely to have negative impacts on children and the elderly at Napa County. Any disaster could result in psychological trauma among children and disruption of care to senior citizens and children who have special health needs.

The racial composition of Napa County could lead to response challenges in case of a disaster. For instance, whites would rely on external assistance. On the other hand, Hispanics have close family ties and live together. Hence, they can manage a disaster as a team. Language barriers could also be a threat to effective response during a disaster. In case of illegal immigrants, they may decide not to seek for help to avoid detection. A disaster could also negatively affect low-income households, which may lack adequate supplies during emergencies. Still, most Hispanics in the area have high rates of poor health than Caucasians.

Low flooding and threats of fire are common in the entire County. However, these are not major concerns compared to risks from a potential earthquake due to the geographical nature of the County. The entire California could experience an earthquake and many residents of Napa County could sustain injuries or deaths from falling objects, debris, furniture, auto accidents, fire, or even from toxic chemicals. Injuries may include dislocations, fractures, wound infections, head, and brain injuries (Napa County, 2010). California has prepared its residents adequately for any potential earthquakes or other emergencies.

A disaster is likely to have severe impacts on low-income Hispanic communities and other immigrant agricultural workers. This part of the community is prone to health risks due to poverty, infectious diseases, traumatic injuries, sun stress, and exposure to chemicals, musculo-skeletal disorder, and lack of health care access among other risk factors.

A disaster may also cause an outbreak of communicable diseases, which are classified as person-to-person, food borne, and waterborne communicable diseases. Displacement of populations can cause strain on available, limited resources, such as water, shelter, sanitation facilities, and other supplies. Conditions common in most disaster zones could facilitate the spread of diarrheal diseases, hepatitis, and leptospirosis. These diseases and bacteria are associated with water contamination after disasters. In addition, overcrowding could lead to the spread of missiles, acute respiratory infections, and meningitis, as well as tetanus and fungal infections.

Any disaster that takes place during cold seasons may aggravate respiratory conditions in the community. The situation can also affect the existing pregnancies.

Napa County is a well-prepared community for any disaster. Both public and private stakeholders conduct public awareness about disaster preparedness. In the past few years, responses for three disasters caused by fire, earthquake, and the flood have been effective. The County has coordinators to assist with any emergency needs during disasters.

Most disasters have occurred unexpectedly in the community. Hence, it is difficult to ascertain the communitys responses to warning. Nevertheless, past responses to emergencies have been effective.

There are possibilities that poor responses to disasters could occur in Napa County due to challenges in communications and transportation. Communities living in far places may not receive immediate help during emergencies. Moreover, language barriers and age could also affect responses to disasters. Still, mental health conditions could hamper responses to disasters. Overall, Napa County has an organized disaster management program, including plans for handling effects of disasters.

Napa County is culturally conservative. The community tends to respect old age and aging. The community associates old age with diseases, but health promotions and support centers for the elderly are common in Napa. Gender does not play a significant role in health care provisions. No known genetic conditions affect the community, but physiological health conditions associated with heart disease, obesity, diabetes, asthma, most cancers, liver disease, and cirrhosis and effects resulting from alcoholism are common.

Stress is common in the community due to high costs of living, a lack of health care insurance, under insurance, substance abuse in teenagers, and inadequate resources. Overall, Napa community cultural perspectives promote good community health and coping mechanisms through public education.

Interpretation of data collected

Napa community has a population size of 139,045, which consists of 49,179 households. There are 31,002 children aged below 17 years as per 2013, which represents 23% of the entire population. People aged over 65 years account for 16% of the population. This exceeds the California state percentage of 12.1%. The majorities in Napa County are mainly whites (55%) and Hispanic (33%). The rest of the populations (12%) consist of other races, such as Asian, African-American, Native Indian and others. The high rates of poverty are rampant among Hispanic (58%) and whites (40%) while the rest of the populations account for insignificant rates. The percentage of children below poverty line is 12.8% while 12% of the households are below the poverty line. More than 26% of the residents are living below 200% of the Federal poverty line (FPL).

The Community Health Status Indicator (CHSI) for Napa County covers some specific areas in the study (National Institutes of Health, 2010). The leading causes of death in Napa County include heart diseases, cancer, and stroke (Napa County, 2010). The most affected are whites and Hispanics. Most cases of these deaths relate to risk factors like smoking, high blood pressure, high blood cholesterol, binge drinking, obesity, or lack of physical activities. Most deaths are common among male senior citizens.

Relative Health Importance remains close to the countys health importance. For instance, Napa County has the highest number of elderly in California (Napa County, 2010). As a result, there are many community homes for the elderly. A three-year trend analysis of coronary heart conditions showed that Napa performed better than the state of California (Napa County, 2010).

Vulnerable populations consist of children, the elderly and pregnant women. Cases of emergencies could worsen their conditions in the community because they become prone to health related challenges. However, Napa County has adequate disaster response and mitigating strategies for all members of the community.

Environmental health measure and community safety are critical for Napa County. Water remains safe, but air pollution has increased in the past few years. Wild animals and poisonous plants, as well as lead-based paints used in pre-1978 homes and potential disasters are threats to community health.

Generally, access to health care in the community is good. There are facilities to cater for old persons. However, there are uninsured community members (13%) and others who pay for their own medical bills. Poverty in some parts of the community, especially among the vulnerable Hispanic community hinders access to health care.

The communitys cultural aspects do not restrict seeking treatment. Moreover, public awareness and education have reduced cases of stigma.

There is a slight increment in cases of mental health in Napa County. About 6.49% have mental health problems. From this number, 10.9% adults are below the FPL while 10% children are also below the FPL. The community does not discriminate individuals based on their mental status because of public awareness and education.

A community genogram

A short interpretation of the genogram

• All white boxes are health indicators assessed
• Yellow boxes are potential health risks to the community
• Red boxes show factors that have caused deaths to the community
• Green boxes show community safety, level of preparedness, and best practices

A community diagnosis

Napa County has unmet health needs, specifically under population factors and demographic characteristics. Poverty and lack of health insurance continue to affect some members of the Napa community. This creates health care access disparities in the community (World Health Organization, 2001). Moreover, vulnerable populations, especially mentally ill and the elderly, have increased in the community. As a result, health services should focus on such vulnerable groups. There is a need to improve the community health on major causes of deaths and health risk factors associated with deaths. Behavior-related health issues and potential disasters pose serious health challenges to the community. Napa community should continue with public education and awareness campaigns, which have positive health outcomes in the community.

References

Napa County. (2010). Leading Causes of Death: Stroke Fact Sheet. Web.

National Institutes of Health. (2010). Community Health Status Indicators (CHSI) Transcript. Web.

World Health Organization. (2001). Community health needs assessment.

Introduction

Nursing homes have been one of the most critical places the older generation tends to spend the rest of their lives. During this developmental stage, care is given to people who need a certain level of medical attention that cannot be fulfilled through home care settings. In the US, we have about 16,000 nursing home care across the country where older adults receive various treatments and care. A nursing home can be described as where people who are not critically ill and cannot be cured at home utilize these places. As the aging population increases, nursing homes cannot keep up with the demand for elderly care.

Quality healthcare among elongates life among the older patients. Quality of life is a combination of several tasks that include creating a sense of purpose, staying in mental motion, recognizing and treating depression symptoms. Nursing science will keep expanding the scientific evidence foundation for better clinical care and life quality for our older population. Nurses offer preventative care in primary-care offices and society and protracted care in care facilities and assisted living communities for older persons.

Hypothesis

As the aging population increases, nursing homes cannot keep up with the demand for elderly care

Research Methodology

The waterfall methodology, a conventional approach to project management, will be used by me. Tasks and phases are accomplished in a sequential order, and each step of the project must be finished before moving on to the next. Because everything is planned out at the start, there is a lot of space for mistake if assumptions do not meet reality. Qualitative methods, which use observation rather than narrative numerical data, are increasingly being utilized in healthcare settings. They are seen to reach parts of the population that other methods cannot, and they are now considered part of the main methods in healthcare research (Masiero & Carraro, 2018). Qualitative research is a broad research tradition investigating human feelings and experiences. It is a strategy for understanding the significance of emotional characteristics in the natural environment of human collecting.

The project observes HIPAA regulations protects health-care coverage for employees and their dependents who change or lose their employment. It restricts the authority of new health plans to reject coverage based on a pre-existing sickness. On the other hand, OSHA guarantees employees safety and health by setting and implementing standards and providing training, outreach, information, and support.

Participants

I am planning to use is interviews with residents that are receiving care from nursing homes. I will use the in-person surveys by narrowing specific in their day-to-day dealings with residents and families in the nursing homes. Interviews would be conducted with Nurses 6, Social workers, 6, and Residents 8

Materials

I plan to use some tools needed for the survey, including a skilled workforce where trained personnel will be interviewing the participants through questionnaires and interacting with them face to face. Transportation and office supplies to the volunteers.

Measurements

I plan to use interval and ratio in determining the study from various data collected on the research study. The target population used in this study is people 65 years and older, and the current population census on the population of the healthcare team.

Old Age

Old age is defined by physiological deterioration as the bodys normal functioning continues to deteriorate. It leads to impaired eyesight, hearing, movement, diminished memory, inability to consume and digest food effectively, and inability to manage physiological functions, including continence, as well as chronic illnesses (Stefanacci, 2022). Below is a table detailing the predicted changes that will occur with old age.

Table 1:Body Changes in old age

The purpose of ensuring a good aging process is for caregivers to be aware of age-related changes, which allows them to assess possible dangers and make educated decisions about care (Stefanacci, 2022). Recognizing that an individuals cultural and social background might influence specific challenges is critical. According to Stefanacci (2022), the most prevalent difficulties among the aged include failing health, financial hurdles, abuse, social marginalization, dependency, retirement, poverty, and systemic discrimination of the old. Formal social assistance through social laws in countries and informal social care through frequent encounters with family are two important ways to offer care to the elderly.

Research Variables

What is assessed in a research experiment or study is referred to as the dependent variable. In a study investigation or experiment, the independent variable refers to what the researcher changes in the experiment or study. The dependent variable is affected by the independent variable. Independent variables are psychological distress and Social support, while dependent variables are the aging population, health conditions, quality of care, high cost, and staffing.

Gerontological Nurses

In the United States, nursing homes and inpatient rooms in health facilities offer structured healthcare for older people. A trained nurses primary responsibility is to care for patients. Nurses work in both the public and commercial sectors, as well as in non-profit organizations. Nurses serve in public service in primary healthcare, social care, and specialist healthcare. Nurses apply practical and theoretical skills to promote and preserve health, cure and prevent illness, and rehabilitate patients while adhering to nursing norms and practices.

Nurses must be able to make professional and ethical decisions. The nine unique characteristics of nurse competence are client-centeredness, professionalism, ethics in nursing, entrepreneurship and leadership, evidence-based treatment and decision-making, teaching and education, health promotion, and functional capacity (Stefanacci, 2022). The objective of gerontological nurses is to give therapy, lessen or alleviate suffering in old patients, and assist the well-being of the old under challenging conditions.

The relationship between patients and nurses is critical for the psychological well-being of the elderly. Moreover, gerontological nurses enhance elderly trust, dialogic engagement, and confidence, all of which are seen as critical components in the elderlys life quality. Nursing older adults is a highly skilled occupation that necessitates the development of specialized competencies that enable nurses to fulfill the demands of patients who may have sensory and cognitive deficits as well as significant degrees of physical reliance.

Role of Nursing Homes in elderly care

A nursing home is an alternate place to live for elderly individuals who require support with their everyday tasks. In contrast to the ambiance of a healthcare facility, several institutions provide living accommodations with a home-like atmosphere. Residents at a nursing facility felt much safer than they did in their own houses (Stefanacci, 2022). They were scared that anything would occur to the elderly, and they would be unable to obtain help at a critical time.

Residents at nursing homes contact employees the majority of the time. Thus those interactions must be meaningful. Nursing facilities with additional resources can assist their employees, resulting in better resident-staff interactions. The interaction with doctors and nurses is critical since it has a favorable impact on the well-being of residents. According to Stefanacci (2022). Residents felt more at ease in nursing homes where the person genuinely cared about them.

Challenges in Nursing Homes

Nursing homes aim to help increase the elderlys quality of life. Even though nursing homes help the elderly and aim to enhance their standard of living, it is unquestionable that institutional care in the shape of a nursing home environment does provide certain obstacles. Elderly persons are at risk of abuse and neglect. They are vulnerable to maltreatment from family members, fellow senior people, and, most importantly, caregivers who provide direct care. Frail elderly persons and patients with cognitive disabilities rely heavily on their caretakers, thus vulnerable to exploitation.

Theoretical Framework

The World Health Organization (WHO) defines lifes quality as how a person evaluates their situation in life in connection to their objectives, aspirations, standards, and concerns in the context of the value systems where they live. It is a broad phrase that encompasses psychological and physical health, psychological condition, independent degree, social interactions, personal values, and how an individual interacts with their surroundings.

Strengths

The instruments were created cross-culturally and are accessible in more than 20 languages. Most medical evaluations are performed by health personnel and laboratories; the instruments, on the other hand, focus primarily on the patients perspective of the ailment (Masiero & Carraro, 2018). For example, in the case of diabetes, the devices will not only assess how well individuals with diabetes operate but also how content they are with their functionality and the consequences of the therapy.

Objectives of the Study

This research aimed to examine the factors influencing life quality in nursing facilities for the elderly. The research material on nursing home life quality was evaluated to accomplish this purpose. Literature on what the older people thought was essential for them at the nursing facility was also examined.

The following questions were created in order to fulfill the studys goal:

1. What variables influence the quality of life for seniors in nursing care homes?
2. What nursing home attributes are significant to the elderly?

The following questions were created in order to fulfill the studys goal:

1. What variables influence the quality of life for seniors in nursing care homes?
2. What nursing home attributes are significant to the elderly?

Discussion

The study aims to identify the elements influencing the senior populations quality of life. According to the findings, more family members are considering placing their elderly relatives in nursing facilities. As people age, their cognition deteriorates, they get feeble, and they require more specialized care (Bouchard, 2021). When the old leave their homes, it is viewed as the end of life since what follows is death, and it is tough for the old to accept this transition in life. As a result, nursing homes must give home-like surroundings and activities relevant to them so that they can continue to live fulfilling lives.

Many aspects linked with old age impact the elderlys quality of life, including changes in health condition, coping, changing roles in life, and the availability of social support (Bell et al., 2020). As a result, nurses must consider the many features of the older person while drafting a care plan. It includes the physical, emotional, social, and spiritual components and personalized services suited to unique older people. The articles share that many older groups were questioned, and the elderlys main worry was being regarded as an individual.

Residents three most critical quality of life characteristics were being treated with respect, having meaningful, successful relationships, and receiving competent nursing care (Bouchard, 2021). Other psychological demands, like respect, choice, and self-determination, also lead to being perceived as healthy. Although the old do not want to be identified by their condition or disease or simply as a task, nurses must consider the elderly as persons with particular preferences and requirements.

When shopping for nursing homes, households look for particular traits. The most obvious impact is personnel and the availability of personal space or private rooms. Although studies have yet to conclude that having more staff leads to a higher quality of life, it is crucial to highlight that the nursing home is understaffed if the number of employees does not surpass a particular threshold. Nurses get the most one-on-one time among the elderly, and this time must be sufficient to satisfy their requirements.

Strengths, Limitations, and Recommendations

According to the study, more people are living longer lives. Thus, research on the issue of quality of life among some of the elderly ought to be ongoing to find additional ways to increase the quality of life. There was sufficient and up-to-date literature for this investigation. Quality of life is a comprehensive notion that includes various aspects, like health, job safety, education, religious views, and the environment. It was difficult to isolate the health-related quality of life since all other aspects intersected with health.

Assisting with everyday duties becomes regular, and dismissing the older person as a duty to be completed is tempting. Nurses may continue to include these concerns in their everyday routines by learning why they are essential to the elderly. Nursing facilities must have adequate employees to guarantee that nurses have enough time to interact with the elderly. It significantly impacts nurse-elderly person interactions whenever nurses are fatigued and burned out.

Conclusion

Although studies have yet to conclude that having more staff leads to a higher quality of life, it is crucial to highlight that the nursing home needs more staff if the number of employees does not surpass a particular threshold. As a result, the nurses cannot spend meaningful time with the elderly. Nurses get the most each time with the elderly, and this time must be sufficient to satisfy their requirements. Nurses roles include guaranteeing they are fully skilled and have specialized competencies to cope with unique senior demands such as cognitive and sensory deficits and high degrees of physical reliance.

References

Bell, S., Patel, N., Patel, N., Sonani, R., Badheka, A., & Forman, D. (2016). Care of older adults. Web.

Bouchard, D. (2021). Exercise and physical activity for older adults. Human Kinetics.

Masiero, S. & Carraro, U. (2018). Rehabilitation medicine for elderly patients. Springer.

Stefanacci, R. (2022). Changes in the Body with Aging. Msdmanuals. Web.

Introduction

The American Association of Colleges of Nursing (2010) indicates that Gerontology nursing is a specialty of nursing practice that is evidence-based. It manages the unique physiological, financial, formative, social, and profound needs of the process of aging (p. 10). It encompasses the application of the knowledge and skills of the body to provide nursing care that ensures that it meets the unique spiritual and biopsychosocial needs of the elderly (NONPF, 2012). Two types of nurse practitioners exist in this field: primary care and acute care nurse practitioners. The elderly population consists of 65-year-old people and above (AACN, 2010). However, the main element differentiating this population from others is their needs related to the process of aging and the stage of development.

The purpose of this essay is to describe the differences between the competencies of the AGACNP and AGPCNP and show how these differences affect practice in specific clinical areas. It will also discuss their differences in terms of education and training, the scope of practice as well as the position of the Arizona Board of Nursing.

The Difference between Adult-Gerontology Acute Care Nurse Practitioner And Adult-Gerontology Primary Care Nurse Practitioner Competencies

How I perceive the differences in competencies and how it affects practice in specific clinical areas

Not much difference exists between ACNPC-AG and FNPC-AG. The little difference that they have ensures that every nursing practitioner works within his/her jurisdiction. It ensures there is no conflict within the working environment. It also ensures that only a qualified nurse attends to patients either in the primary care setting or in the acute care setting (Buppert, 2002).

The Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP) is a Registered Nurse, who is mandated to incorporate exploratory, hypothetical, and contemporary clinical learning to survey actually and oversee wellbeing and also disease state. The fundamental obligation of the AGPCN is to give essential treatment to all adults and elderly age ranges in every aspect beginning from health to sickness.

As per the AACN (2010), adult-gerontology primary care concentrates on giving patient-focused quality care to grown-ups and the elderly population. The AACN also states that AG-Primary Care makes use of evidence in practice so that the quality of care and outcomes can become better. (p. 12).

Education and training

The Gerontology Nurse practitioner deals with advanced practice. The nurse possesses a masters or doctorate from a nurse practitioner program. The practitioner specializes in the care of older adults. They must have passed a National Certification Examination in Adult-Gerontology Primary Care. These nurses must also follow the regulations of the state board of nursing (AACN, 2010 p. 11).

Family Nurse Practitioners (FNPC) Adult-Gerontology is instructed to analyze and oversee intense and chronic diseases, taking a comprehensive approach to deal with the restorative, psychosocial and utilitarian needs of the elderly. The AACN (2010), states that gerontology nurse practitioners train over the health ailment continuum (p. 12).

Scope of Practice and position of the Arizona Board of Nursing

According to the National Organization of Nurse Practitioner Faculties (2012, p. 6), adult-gerontology primary care nurse practice is not based on a particular setting. It mainly deals with the needs of the patient.

The Adult-Gerontology ACNP works within the acute care areas within the hospital. The ACNP-AG primarily deals with patients who have acute and chronic illnesses and those in the ICU (AACN, 2010). The Arizona Board of Nursing explains that a registered nurse practitioner whose work is to provide acute care services is not expected to exceed the points of confinement of the propelled practice claim specialty area.

Example from personal experience

Scenario

My grandfather is an 85-year-old, and he frequently visits his PCNP for the administration of his constant sickness. He states that his COPD has lost control. The COPD he was given together with the salvage nebulizer treatment has been insignificantly powerful. He now needs antibiotics. The oximetry of his heartbeat is 89% on room air. He likewise has shortness of breath and breaths with his lips pressed together. He also has respiratory wheezing and two-sided rales.

His admission note directs that he is admitted to internal medicine, acquire confirmation labs, EKG, and midsection x-ray in ER.

In this situation, the PCNP will admit my grandfather to the doctors facilitys medicinal unit. The affirmation will be either through the emergency department of the hospital, or a direct admit. In the event that the patient sidesteps the emergency department and is admitted specifically to the medicinal/surgical unit of the doctors facility after admission, the ACNP will start treating the patient to settle his condition.

Conclusion

A registered nurse practitioner has competencies in both acute care and primary care. The scope of practice for both the AGACNP and AGPCNP does not have a definite setting. However, it is concerned with the requirements of the patients (AACN, 2010). The nursing practitioners may be equipped with competencies in both primary care and acute care during training. However, these graduates must seek certification in both critical and primary care roles. The certification must also match the type of education that a certified nurse practitioner has concerning these functions.

References

American Association of Colleges of Nursing. (2010). Adult Gerontology Primary Care Nurse Practitioner Competencies. Web.

Buppert, C. (2002). 20 Questions to Ask a Prospective Employer. Web.

NONPF. (2012). Statement on acute care and primary care certified nurse practitioner practice. Web.