Category: Nursing

The connection between the education of BSN-prepared nurses and improved patient outcomes can be explained not only by the advanced writing skills and critical thinking of professionals but also by the long-term effects of their activity. In the first place, they are related to lower readmission rates in the facilities where they work and shorter hospital stays for the people admitted to these hospitals (OBrien et al., 2018). These scores are complemented by the decrease in mortality within 30 days from the moment of admission regardless of the conditions, which are to be treated by these nurses (OBrien et al., 2018). As a result, patient satisfaction is higher, the probability of complications is much lower, and the quality of rendered services is unaffected by any external circumstances (OBrien et al., 2018). Hence, the presence of these specialists in medical facilities is advantageous for all the aspects of their functioning, and the performed operations are more efficient.

In turn, the differences in the patient population are better addressed by BSN nurses in contrast to the outcomes of employees of lower qualifications. The former is characterized by improved cultural competence, which is especially essential in critical situations, such as the provision of end-of-life care. The diversity of their patients does not prevent these workers from considering their desires in a timely manner (Cheshire & Strickland, 2018). Moreover, BSN-prepared nursing personnel possesses better skills in the area of cultural assessment, which allow them to anticipate the needs of people stemming from the traditions of their population group (Cheshire & Strickland, 2018). Thus, the involvement of these specialists in the operations of hospitals contributes to the promotion of an individualized approach to providing healthcare services.

References

Cheshire, M. H., & Strickland, H. P. (2018). Distance learning teaching strategies in registered nurse to baccalaureate nurse programs: Advancing cultural competence of registered nurses in providing end-of-life care. Teaching and Learning in Nursing, 13(3), 153-155. Web.

Geraghty, S., & Oliver, K. (2018). In the shadow of the ivory tower: Experiences of midwives and nurses undertaking PhDs. Nurse Education Today, 65, 36-40. Web.

McCauley, L. A., Broome, M. E., Frazier, L., Hayes, R., Kurth, A., Musil, C. M.,& & Villarruel, A. M. (2020). Doctor of nursing practice (DNP) degree in the United States: Reflecting, readjusting, and getting back on track. Nursing Outlook, 68(4), 494-503. Web.

OBrien, D., Knowlton, M., & Whichello, R. (2018). Attention health care leaders: Literature review deems baccalaureate nurses improve patient outcomes. Nursing Education Perspectives, 39(4), E2-E6. Web.

Introduction

Effective dissemination of evidence-based practices requires the right choice of audience among stakeholders. The main purpose of dissemination is to raise awareness among people involved in the healthcare system in order to change practices and improve overall public health (Melnyk & Fineout-Overholt, 2018). By disseminating the results of the project, more healthcare professionals can be involved in an important process of change. Nurse colleagues will be more motivated to change if they see evidence of its effectiveness.

Approach for Dissemination of Project Results

The most effective method for disseminating project results is an external approach. Since the target audience for a change project is the entire medical community, this method allows all stakeholders to be reached. Using an external distribution method can include speaking at professional nursing organization conventions (Ruoslahti, 2020). To reach a wide audience, it is planned to use communication strategies designed to convince the need for intervention to change practices. The external approach is also suitable for EBP teaching and stakeholder involvement in the process. This result can be achieved because the external approach is broad and reaches the largest possible audience to attract change. In this case, the changes will not remain within the framework of one particular hospital but will continue to improve the healthcare system as a whole.

Maintaining the Spirit of Research

The best motivation for maintaining the spirit of research in a medical institution is to see positive results of work. An effective motivating plan would be to implement changes and involve all healthcare professionals in the process of researching the results (Fernandez et al., 2019). It is necessary to make the results of the intervention visible and accessible so that all stakeholders can see the effectiveness of the project. Improved practice and more positive treatment outcomes will allow professionals to move forward and explore the best strategies to continue improving the healthcare facility.

EBP support

A mentor is needed to support EBP, as change can only be achieved through joint efforts. The main limitation that arises at this stage is related to the workload of senior medical staff. However, this approach is realistic to implement, since all medical staff have a common goal: to improve the health of patients. It is necessary to effectively demonstrate the benefits of supervising nursing projects in order to interest and motivate the mentor. However, the nurse will have to show independence so as not to distract the mentor from the most important goal: caring for patients.

Conclusion

Dissemination of the results of a quality project aimed at improving patient health is one of the most difficult and important parts of improving evidence-based practice. To organize this process, it is most effective to use an external approach, which will allow the changes to be extended to the entire healthcare system, not only to a specific hospital. In order for the dissemination of results to be more successful, it is necessary to acquire a mentor, to whom the nurse needs to convey all the advantages of the change project. The motivation of the staff of a particular hospital is also critical, as this is where the process of improvement will begin. To achieve a motivated attitude, it is necessary to use communication strategies and organize educational lectures. The best communication strategy is to draw on the personal experiences of staff and increase their engagement by providing evidence of concrete improvements in patient health.

References

Fernandez, M. E., Ten Hoor, G. A., Van Lieshout, S., Rodriguez, S. A., Beidas, R. S., Parcel, G., & Kok, G. (2019). Implementation mapping: Using intervention mapping to develop implementation strategies. Frontiers in Public Health, 7(1), 158-172. Web.

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in Nursing & Healthcare: A guide to best practice (4th ed.). Wolters Kluwer.

Ruoslahti, H. (2020). Complexity in project co-creation of knowledge for innovation. Journal of Innovation & Knowledge, 5(4), 228-235. Web.

Problem

In the state of New York, the current problem related to nursing that requires advocacy is the dysfunctionality and inaccessibility of proper healthcare coverage for all citizens. According to Scheinker et al. (2021), current healthcare costs are unrealistic and too high due to the administrative costs and the active involvement of private insurance companies. Currently, the healthcare system is in crisis in terms of health quality and costs of care due to the limited financial opportunities of vulnerable populations to obtain insurance and receive qualitative and timely care. Thus, the affected parties in the context of this problem are the citizens of the state of New York since their well-being, safety, and health are jeopardized. In addition, the actors within the healthcare decision-making sphere and political bodies are affected since they bear significant monetary losses associated with elevated morbidity, treatment, and mortality due to poor health in light of improper preventative care. Thus, the current ramifications of the issue of heightened costs and inaccessibility of health care for New Yorkers are manifested through high costs that lead to limited insurance rates for the population. According to Jackson (n. d.), over 1 million New Yorkers lack health insurance, and 45% of Americans have difficulty paying for their medical expenses (p. 2). If the issue remains unattended, more severe and tragic consequences will follow. Indeed, according to Scheinker et al. (2021), more preventable deaths will follow if New Yorkers do not obtain equal access to quality care without overpaying.

Idea for Addressing Solution

When seeking a solution to the identified problem of inequality and socio-economic disparity in access to healthcare in the state of New York, one might refer to the analysis of the insurance system that involves private insurance companies. According to the New York State Nurses Association (NYSNA) (2019), private insurance companies are beholden to shareholders seeking to maximize profits  not patient care (p. 1). For that matter, high co-payment bills and deductibles impose a significant burden on patients while enriching private insurers (NYSNA, 2019). Thus, having identified the main barrier in the current system, which is the private insurance companies, which serve as a mediator between a patient and a health care provider, the proposed solution addresses the elimination of the mediator and establishment of a single-payer system of universal coverage. The reason why this solution needs legislative advocacy is that the procedure of instilling a single-payer requires a law that would regulate the responsibilities of the involved stakeholders at the state level. Nurses as advocates of patient care can actively support policies to impact the nursing practice positively and motivate other nurses to engage in the political process (Helbig, 2018, para. 18). Therefore, it is imperative to contact members of Congress or local government to promote the legislation because, in this manner, the solution is more likely to be enacted and contribute to the improvement of patients health and care experiences by entering political agenda.

The Issue

The most important piece of evidence supporting the idea is the anticipated improvement for the citizens of New York in terms of financial and health incentives. Indeed, according to NYSNA (2019), the proposed solution will benefit the state by reducing the number of New Yorkers without healthcare and removing financial barriers to accessing care; these improvements would save thousands of lives each year (p. 2). Indeed, in the whole USA, there are an average of 45,000 annual deaths as a result of a lack of health insurance, which might be prevented by means of the proposed legislative solution (Jackson, n. d., p. 1).

While Medicare was intended to be a single-payer system across the US states, it targets only vulnerable populations, leaving the burden on the patients not considered vulnerable. Thus, there are no similar legislations in other states; however, Bryant (2022) presents evidence that the Canadian single-payer Medicare system benefits the patients and healthcare workers at large.

Financial Incentives/Costs

The financial impact of the proposed legislative idea to advocate for the equality and accessibility of health care for all New York state citizens is the most significant implication apart from saved lives and improved well-being. Indeed, given the excessive administrative costs and avoidable overpricing of health care services due to the involvement of private insurance companies, the proposed solution will ease the financial burden on the patients. In particular, the implementation of the solution will yield significant savings for the state. According to Jackson (n. d.), New York Health will have net savings of $11.4 billion by eliminating insurance company profits, reducing administrative costs, and reducing prescription drug costs (p. 2). Moreover, long-term home care, the costs of which are assessed at $31 billion and formerly unpaid, will be replaced by paid home care services (Jackson, n. d.). The savings are projected to be used as funds for supporting a vulnerable population in New York. Indeed, evidence provided by NYSNA (2019) shows that over 90% of New York households would spend less on healthcare under the Act than they do now with savings of $1500  $3000 going back into New Yorkers pockets (p. 2). Thus, these numbers indicate that the implementation of the proposed idea will be beneficial in terms of savings and healthcare coverage funding for the state of New York in general and individual households in particular.

Christian Principles and Nursing Advocacy

Equity and unbiased attitudes are essential for the healthcare setting, which goes in accord with the core principles of a Christian worldview. The virtues of kindness, respect, and equal treatment lie in the foreground of Biblical teachings, which apply to the nursing field. The proposed legislative idea is based on the incentives of promoting equal access to healthcare, especially for those who suffer from inequalities and health disparities. Indeed, the diminished access to timely treatment and the lack of preventative care for those from low socio-economic backgrounds, immigrants, ethnic minorities, and other vulnerable groups are exposed to higher risks in the current system. However, Bible teaches that God does not show favoritism and treats all equally (Romans 2:11). Moreover, one of the verses from the Bible indicates that rich and poor have this in common: the Lord is the Maker of them all (Proverbs 22:2). In the context of the Christian worldview, health is considered as an ultimate value, which is illustrated by the following quote: I pray that you may enjoy good health and that all may go well with you, even as your soul is getting along well (John 1:2). Thus, the proposed legislative idea is based on the Christian principles of promoting equality and advocates for the opportunity for each New Yorker to enjoy a healthy life.

References

Bryant, D. C. (2022). Single-payer health care: Financial implications for a physician. International Journal of Health Services, 52(3), 410-416.

Helbig, J. (2018). Influencing health care through advocacy. In Trends in health care: A nursing perspective, Grand Canyon University. Web.

Jackson, R. (n. d.). What is the New York Health Act? Web.

Liu, J., White, C., Nowak, S., Wilks, A., Ryan, J., & Eibner, C. (2018). An assessment of the New York Health Act: a single-payer option for New York State. RAND. Web.

New York State Nurses Association. (2019). An act to amend the public health law and the state finance law, in relation to enacting the New York Health Act and to establish the New York Health Plan. Web.

Scheinker, D., Richman, B. D., Milstein, A., & Schulman, K. A. (2021). Reducing administrative costs in US health care: Assessing single payer and its alternatives. Health Services Research, 56(4), 615-625.

The number of nurses practicing in the United States has considerably declined over the years. It is estimated that in the next 20 years, there will be a shortage of 400000 practicing nurses in the United States due to the high nurse turnover (Halter et al., 2017). Hospital finds it hard to retain the highly skilled and experienced nurses at their service. This has grave implications for the patient, including poor quality patient care, increased financial cost, and rising malpractice claims. The high nursing turnover is especially a challenge to nurse leaders in keeping the primary care providers at their medical facilities. Therefore, this paper looks at the various ways that nurse leaders can use to attract and retain registered nurses at the organization.

Causes of Nurses Turnover

Numerous studies have been done to determine the potential causal factors for the high nurses turnover, retention, and desire to leave the organization. One of these factors includes job dissatisfaction to nurses due to low salaries, strict supervision, and lack of autonomy in conducting the nursing duties. Nurses feel demotivated when the organization fails to make a pertinent decision affecting their practice inpatient care. Hence, they seek other experiences where their input is valued (Dewanto & Wardhani, 2018).

Furthermore, several researchers have cited burnout secondary to high workload or longer working hours as the other factor associated with a high nurse turnover. Burnout at work has made nurses collaborate with policymakers and legislators to agitate for adopting a standard nurse to patient ratio in all hospitals. A collaborative and supportive work environment is instrumental for ensuring the retaining of expert nurses at an organization.

Strategies to Attract Nurses

Nurse leaders need to create effective plans for recruiting, retaining, and preventing the turnover of nurses. First, nurse leaders should put in place plans to attract new employees to their organization. These strategies include encouraging the student nurses at the undergraduate level to undertake nursing research. Their research interests can also be increased through a clinical placement to work with other nurse researchers. At the undergraduate level, nursing students should be guided in data collection for their dissertations. Second, proper recruitment plans provide for adequate support for new nurses in career planning.

Mentors, preceptors, or coaches should be allocated to novice nurses to help them in their career development and settling at the workplace. Highly skilled and experienced nurses can be used as coaches or mentors for the new job recruits (Moyo, 2019). Mentoring and coaching enable the new nurses to settle at their new jobs hence reducing nursing turnover. Further, these initiatives help promote a sense of collaboration and teamwork for the new nurses to improve their settling into the new institution.

Additionally, a successful recruitment plan needs to be strategic in its recruitment process. The healthcare organization needs to aspire to make an excellent first impression to their probable future employees. An ideal first impression involves captivating advertisements outlining clearly the critical interpersonal and professional requirements for working at the organization. Furthermore, the interview process should be seamless and direct-forward on the questions asked to the interviewees. The interviewing panel should practice professionalism and objectivity during the interview to recruit new nurses.

Encouraging openness in the shortlisting of qualified candidates is imperative in the creation of the recruitment plan. In addition, it is prudent to look above an individuals academic qualifications before offering them an employment vacancy in the organization (Halter et al., 2017). The selection of individuals has to consider the behavioral traits which align with the organizational values. Some characteristics, including honesty, integrity, and hardworking nature, promote an individuals career at the organization hence reducing chances of leaving the institution.

Nurse leaders need to make career development a top priority for junior nurses to take over new nursing profession roles. One of these areas is in nursing education. A rising number of nurse students are being turned down from several American universities due to an inadequate number of tutors. Hence, nurse leaders need to plan to encourage junior nurses to pursue higher nursing education qualifications to take over teaching jobs in nursing education. Bachelors level trained nurses should increase their training to masters level and then to doctorate level to take up teaching positions at the university (Halter et al., 2017).

Consequently, the number of teachers would rise, resulting in more significant students admissions to nursing schools. The long-term implication of this goal is to create a large pool of highly trained nurses who can be employed to care for patients.

Plans for a Continuous Market Supply of Nurses

Changes in the education curricula are needed to produce highly skilled nursing personnel to take up the retiring nurses vacancies. The International Institute of Medicine published a report outlining recommendations for radical changes in the nursing profession to meet the United States of Americas shifting patient demographics. After analysis, these commendations came into play that showed that most of Americas population would be majorly composed of senior personnel in the future (Halter et al., 2017).

In line with this reality check, the recommendations aim to produce highly trained nurses to meet the demands of the elderly population. An increase in the number of expert trained nurses will also meet the shortage in nurses supply. One way to achieve this goal by the IOM includes encouraging the advancement of nursing education by nurse practitioners. Nurse leaders should promote a framework to help those nurses unable to enhance their education by providing affordable loans.

Other aspects of the IOM report suggested the overhaul of the nursing curricula to produce positive nurses able to participate in multidisciplinary teams composed of healthcare experts. The scope of the nursing practice is to be changed to cater to the changing healthcare demands. The new hybrids of nurses are impacted by the knowledge and skills necessary to work in different settings, including nursing homes for the aged. Moreover, highly trained nurses will be able to work independently of the physicians scrutiny, thereby catering to physicians shortage in the country (Halter et al., 2017). The future of nursing report also advocates for the seamless transition of nurses to higher nursing qualifications. The nurses workforce improvements are instrumental in improving nurses job satisfaction, thereby promoting their retention in work.

Legislative Roles of the Nurse Leaders

Furthermore, the caregivers leaders and managers have legislative roles in addressing staffing issues in the profession. A standard nurse to patient ratio is critical in reducing the burnout experienced by nurses following high workload hence reducing nurses turnover. Leaders can adopt the advocacy role by forming political parties to campaign for nurses fair hiring to meet the patient population requirements. Transformational leaders in nursing effectively mentor and support the junior nurses in the hospitals to prepare them to agitate for more staffing (Waddell, Adams, & Fawcett, 2017).

Through supportive supervision and adequate salaries, they empower nurses with the motivation and experience to ensure quality patient care. Nurse leaders and managers can influence healthcare policy changes to improve the retaining of nurses at the hospitals.

Ideas for Retaining Nurses

Nurse leaders can implement many ideas to improve the job satisfaction of junior nurses at work. First, nurses job satisfaction is increased when nurse leaders recognize little contributions done by individuals in inpatient care. A word of affirmation by an employer gives the nurse a sense of accomplishment as they feel valued by the management. The nurse leaders can also collaborate with their staff in the decision-making process to develop new policies affecting patient management. Collaboration also promotes the implementation of the procedures by the nurses as they own the suggested interventions (Halter et al., 2017).

Second, nurse leaders can enhance job satisfaction by practicing active listening of the employees concerns. An organizational culture that encourages speaking up motivates the staff as the managers get to know about the problems faced by their subordinates and plan accordingly to assist in resolving the employees issues. Furthermore, healthcare leaders can motivate employees through rewarding longevity. Policies should be put in place to give tokens of appreciation to highly experienced nursing staff who stay in the organization for a prolonged time.

Implementation of the Plan

Implementing the plan for recruiting and retaining the healthcare professional is an integral component to maintaining a continuous supply of human resources in nursing. Nurse leaders tend to collaborate with the other junior nurses during the implementation step for the plans success. The nurse leaders can institute forums and seminars to enlighten the nurses on the strategies the management is putting in place to address their welfare.

The management can also educate the workforce on the diversity in the composition of the nursing staff. Implementation strategies should result in the generation of interventions tailored according to generational differences (Halter et al., 2017). Effective communication between the unit leaders is needed during the interdisciplinary committee meetings to address staff recruitment and retention plans.

Economic Implications

The implementation of a recruitment and retaining plan in nurse staffing has several economic implications. First, funds are required to mobilize other policymakers and legislators to pass laws on standard staffing ratios. The leaders need nursing unions funds to advocate for the implementation of the plan to reduce nurses turnover. Additional funds are required in providing financial subsidies for nurses who have stayed at the workplace for a long time to discourage them from leaving the organization (Halter et al., 2017). Remuneration of the nursing staff also requires the availability of capital in the hospital. Adequate salaries and allowances of the team are vital in motivating them to achieve the organizations goals.

High nurse turnover is due to high rates of nurses leaving the profession or the low number of qualified nurses available in the job market. The high nursing turnover has considerable negative effects on patient care and the running of the hospital. The provision of care is affected when highly qualified and experienced nurses leave the profession. Nurse leaders are instrumental in the generation of organizational policies for reducing nurses turnover (Squires, Jylhä, Jun, Ensio, & Kinnunen, 2017). The recruitment and retention plans aim to decrease the discomfort that the primary care providers may have during the provision of patient care. Effective collaborations of the leaders with their subordinates are required for the recruitment and retention plans success. Capital is needed for the implementation of the program.

References

Dewanto, A., & Wardhani, V. (2018). Nurse turnover and perceived causes and consequences: a preliminary study at private hospitals in Indonesia. BMC Nursing, 17(2), 17. Web.

Halter, M., Pelone, F., Boiko, O., Beighton, C., Harris, R., Gale, J., & Drennan, V. (2017). Interventions to reduce adult nursing turnover: A systematic review of systematic reviews. The Open Nursing Journal, 11, 108123. Web.

Moyo, M. R. (2019). Adapting the nurse manager role to attract generation X and millennial nurses. The American journal of nursing, 119(3), 11. Web.

Squires, A., Jylhä, V., Jun, J., Ensio, A., & Kinnunen, J. (2017). A scoping review of nursing workforce planning and forecasting research. Journal of Nursing Management, 25(8), 587596. Web.

Waddell, A., Adams, J. M., & Fawcett, J. (2017). Exploring nurse leaders policy participation within the context of a nursing conceptual framework. Policy, Politics & Nursing Practice, 18(4), 195205. Web.

Licensure, accreditation, certification, and education (LACE) are essential in the healthcare sector since they ensure that nurses possess the required knowledge and skills. Every state has specific demands and policies regarding LACE and licensure. This means that all nursing programs have to be approved. These measures support the monitoring and quality of available medical services.

LACE in California

In California, LACE applicants should have a masters degree and be registered practitioners. They should have attended schools that are accredited and recognized by the National League of Nursing (Advanced practice nursing California, n.d). The application process takes several stages to make sure that all demands are fulfilled. Licenses are renewed periodically to promote competence and efficiency.

LACE in Washington

The specifications and considerations for LACE in California and Washington are similar. Specialists are required to undergo an advanced program designed for ARNPs. A masters degree is demanded from potential applications (Advanced registered nurse, n.d.). A national certification examination is needed to get privileges for working in the demanded sphere.

LACE in Illinois

LACE licenses in this state fall into these four categories: certified nurse-midwife (CNM), certified nurse practitioner (CNP), certified clinical nurse specialist (CNS), and certified clinical nurse anesthetist (CRNA). A masters degree and application for Registered Professional Nurse Examination Packet are essential for those who target the LACE license (Advanced practice nursing Illinois, n.d.). Successful candidates get privileges as health workers. The entire process is monitored by the Illinois Center for Nursing.

Similarities

The requirements for LACE in the above states have presented several similarities. Firstly, a masters degree is demanded from all applications. Secondly, an examination process is mandatory. Thirdly, successful professionals will get similar privileges to licensed nurses. Fourthly, the application procedure is the same. Finally, all applicants should possess desirable skills and knowledge.

Differences

Some differences are evident from the above discussion. For instance, there are specific regulatory bodies and centers in such areas. There are placement packages that are unique to specific states. Some peculiarities at the local level impact the LACE program. Applicants will be required to consider different payments or fees.

Strategies to Achieve Continuity

The standardization of procedures and approaches implemented by different state regulatory boards will deliver continuity. Educational standards and APRN consensus models should be streamlined in all regions. The implementation of full-practice authority and improvement of cooperation among regulatory agencies will result in continuous improvement (Polit & Beck, 2017). The regulation of the sphere and introduction of laws will support applicants needs and deliver improved medical outcomes.

Independent Practice

In Florida, independent NP practice is not permitted. This means that NPs are usually supervised by licensed physicians by the Florida Board of Nursing protocol. This agency monitors the practices and responsibilities of NPs. This means that NPs offer primary care and can be delegated by specified authorities.

Opinion on Independent Practice

All states should allow NPs to work independently. This practice will ensure that more patients receive high-quality services. More practitioners will also have a positive perspective and become motivated. They will be willing to identify additional competencies and skills. This development will maximize the health experiences of all populations in the United States.

Conclusion

The above discussion has indicated that there some similarities and differences in LACE considerations. The standardization of the required policies and procedures across all states will streamline the process. The APRN model will deliver positive results and support citizens demands. Independent practice for NPs is essential to improve the quality and effectiveness of the healthcare sector.

References

Advanced practice nurse requirements in California. (n.d.). Web.

Advanced practice nursing Illinois. (n.d.). Web.

Advanced registered nurse practitioner requirements in Washington. (n.d.). Web.

Polit, D., & Beck, C. (2017). Essentials of nursing research: Appraising evidence for nursing practice (9th ed.). New York, NY: LWW.

Theory Description and the Rationale for Selecting the Theory

There are many different nursing theories that aim at explaining the peculiarities of the health care system and the conditions under which people are able to get the required portion of help and assistance from nurses. Unfortunately, the cases of nurses workload are frequent indeed, and it is very important to incorporate the most appropriate theories in order to understand how to solve the problem and succeed in using the necessary solutions. Among a variety of nursing theories, the Neuman system model seems to be a successful decision for the problem under consideration as it focuses on the analysis of human relationship to stress, nurses abilities to react to it properly and prevent it, and explanations of how people should interact with their environment (Snowden, Donnell, & Duffy, 2014). Betty Neuman, the developer of the theory, admits that it is a matter of stabilizing the system through nursing because stability is equated with well-being (Kim & Kollak, 2006, p. 124). It serves as the best rationale for selecting this particular theory for the project as the theory helps to prevent stress invasion that is defined as one of the outcomes of nurses work overload.

Explanations of How the Theory Works to Support the Solution

The Neuman system model is the theory that helps to support the solution offered previously. Nurses, as health care providers, take responsibility for a number of activities. They have to be ready to give appropriate pieces of advice, provide patients with various types of assistance, and improve personal qualities and skills on a regular basis. This is why the chosen theory as a possibility to improve interpersonal and intrapersonal relations should be used. The Neuman system model is designed in the way it can control the interactions of the systems and their respective environments in terms of management of, defense against, and resistance to, stress (Kim & Kollak, 2014, p. 124). As the solution offered in the project is based on the improvements of working conditions of nurses that may cause stress or job dissatisfaction (Carayon & Gurses, 2008), the effectiveness of the chosen theory is evident. Nurses have to comprehend how they can improve their working conditions and stay physically and psychologically stable in order to provide patients with a rationale care. Nurses cannot allow themselves breaking the rules or violating the required norms. Their main task is to become an exemplary worker and promote appropriate doctor-patient relations.

Possible Incorporation of the Theory in the Project

The Neuman theory may be incorporated in the project in several ways. The role of stress is crucial, and nurses should learn how to prevent it. The workload is a serious issue that has to be analyzed and considered in nursing practice. This is why the ideas offered by Neuman, like the identification of external and internal environment, promotion of stability at work, and evaluation of possible stressors, become a solid background for the project. The theory under consideration underlines the fact that the system of each person is unique; this is why it is necessary to search for particular approaches in order to solve a problem. The project aims at analyzing nursing practice from a variety of concerns that lead to workload. The understanding of the uniqueness of the problem can be very helpful to the researcher as well as it proves the necessity to search for interesting approaches of the problem solution.

Reference List

Carayon, P. & Gurses, A.P. (2008). Chapter 30. Nursing workload and patient safetya human factors engineering perspective. In R. G. Hughes (Ed.) Patient safety and quality: An evidence-based handbook for nurses. Rockville, MD: Academic Press.

Kim, H. & Kollak, I. (2006). Nursing theories: Conceptual and philosophical foundations. New York, NY: Springer Publishing Company.

Snowden, A., Donnell, A., & Duffy, T. (2014). Pioneering theories in nursing. London: Andrews UK Limited.

Introduction

The purpose of this paper constitutes several principal aspects. It is essential to overview the principles of research and evidence-based practice. Further, based on the identified nursing concern, it would be appropriate to develop a Population-Intervention-Comparison-Outcome-(Time) (PICOT/PICO) question that will serve as the basis for the development of the MSN project proposal. The identification of the literature research strategy, as well as the application of a theoretical framework, will also be discussed. A comprehensive conclusion will be built upon the findings of the paper.

Overview of the Selected Evidenced-based Practice Project

Before dwelling upon the discussion of the particular nursing concern that will determine the scope of the future MSN project proposal, it is of high importance to observe general aspects related to research and evidence-based practice in nursing. It is possible to state that nursing research is the significant integral part of the evidence-based practice (EBP) (Holloway & Galvin, 2016). Nursing research and EBP are integrated parts of the scientific process that is improving the modern health care system in various ways. Nursing research is a more theoretical part that develops and observes new strategies for improving the patients health.

At the same time, EBP is a practical implementation of the results of theoretical research that tests and refines techniques by providing care for patients. The nursing research contributes to the EBP by retrieving useful information from various scholar studies as well as original research. Regarding the differences between the EBP and nursing research, it could be noted that the EBP covers a larger field of concern (Holloway & Galvin, 2016).

For example, the EBP also includes such aspects as the nursing expertise, principles of decision-making, along with the provision of advanced care. Therefore, it could be concluded that the nursing research is the instrument that ensures that the current EBP is in compliance with the high standards of care and that nurses are informed about the best possible practices.

Accordingly, the contribution of the EBP to professional nursing is evidently positive. As it was identified previously, the EBP represents a holistic framework of various integral components. Each of these components serves as an instrument for the overall improvement of the nursing profession. As nursing strategies are refined and improved according to patients needs, it allows collecting more data case by case, leading to the accumulation of knowledge in specific cases. Accordingly, the significance of the nursing research as the primary contributor of renewing the nursing knowledge is apparent.

Therefore, the scope of the future MSN project proposal should be identified. Since my MSN Program Specialty Track is the family nurse practitioner, it is logical that the practice focus, as well as the overall field of interest of the MSN project proposal, would be largely connected with problems specific for the family nursing practice. Such problems, despite the fact that their magnitude for the overall state of the public health sector might not seem to be crucial, are still highly important for numerous people, who are in need for high-quality care and support from a nursing professional.

Additionally, it is appropriate to state that the EBP has a direct impact on the promotion of change within the practice setting of a nurse practitioner. Therefore, I consider my MSN project proposal to be a significant contribution to the improvement of this area of practice.

Identification of the Nursing Concern to Be Improved

Since the significance of conducting the nursing research as an integral part of the EBP was identified in the previous section, it is possible to dwell upon the discussion of the particular nursing concern that will be the primary scope of the future MSN project. Due to the fact that my nursing role is the family nurse practitioner, it would be appropriate to focus on the problem of self-care of the elderly population. This section aims to provide a strong rationale for the selection of this nursing concern.

The issue of self-care of the elderly is a problem that contains multiple facets. Numerous aspects are covering them, such as the ascertaining of capability for self-care among the patients, educating on the subject and so on (Dorociak, Rupert, Bryant, & Zahniser, 2017). As it is a problem that concerns those with limited capabilities for precise actions, it is essential to find those barriers and work around them, leaving the more difficult tasks to professional care. At the same time, it is crucial to assure the elderly patients that they are still independent and functional people, decreasing their psychological issues regarding their aging. Those actions should provide an improvement in the well-being of senescent people.

First of all, it is possible to state that the selected issue is chosen because it is one of the most frequently occurring problems within the area of family nursing practice. Within my specialty track setting, the lack of self-care skills among elderly patients is highly evident. Since the insufficient level of self-care affects nearly every aspect of the patients life, such as cooking, eating, dressing, using the bathroom, grooming, doing the laundry, and other routine tasks, it could be hardly doubted that the various problems would occur frequently.

Apparently, the primary stakeholders impacted by the identified nursing concern are elderly patients since they are directly affected by the problems related to the lack of self-care skills. The second significant group of stakeholders consists of the elderly patients relatives and significant ones, who often do not have the time or other resources to provide a sufficient amount of care. Additionally, family nurse practitioners could also be mentioned as the involved stakeholders since they are responsible for the health condition of their elderly patients.

Consequences of the selected nursing concern are evidently negative. First of all, it could not be argued that the inability to perform routine tasks, which were mentioned previously, seriously affects the quality of the patients life. Both the psychological and physiological aspects of the inability to independently conduct everyday tasks might lead to the worsening of a patients condition. Regarding psychology, it may incur the feelings of hopelessness and infirmity, which may lead to depression and general damage to an individuals well-being (Liu, Wang, Huang, Cherng, & Wang, 2014).

Moreover, the lack of self-care skills also influences the patients ability to adhere to treatment, follow food restrictions, and communicate with family nurse practitioners on a regular basis, et cetera (Holden, Schubert, & Mickelson, 2015). In overall, the complex of these factors has a vast negative impact on the quality of life of elderly patients.

Primarily, it is argued that even though various health disparities found in elderly patients are determined by genetic factors to a considerable extent, the inability to implement self-care is largely caused by social and environmental factors (Passarino, De Rango, & Montesanto, 2016). Therefore, the proposed solution for the selected nursing concern is to investigate how social and environmental factors impact the life of elderly patients and their ability to implement self-care (Sharoni et al., 2015). Accordingly, the purpose statement of the EBP proposal could be formulated as follows: it is critical to identify to which extent social factors and environment influence the implementation of self-care in elderly patients.

PICOT/PICO Question and Literature Search Process

In the context of the problems specificity, the qualitative approach appears to be a more suitable approach to researching the identified topic. Thus, the PICO question could be formulated in the following way: in elderly patients from 60 to 80 years old (P), does social and environment factors like motivation and family support (I), compared to genetic factors (C), associate more with self-care problems (O)? Accordingly, the expected outcome of the conducted research is the development of a comprehensive understanding of the impact of social and environmental factors on the implementation of self-care among elderly patients (Räsänen, Kanste, Elo, & Kyngäs, 2014).

The purpose of conducting the literature review for the EBP project is to provide evidence for the proposed hypothesis by researching other works in the same field. Additionally, it would be possible to avoid possible repetitions and ensure that the research is original, and its findings are substantial. Other than that, a literature review is a valuable tool to systematize the study and to trace its origins, as well as to track how the researched topic has evolved over the years. After all, previous theories often inspire the improvement of the more recent. This also allows highlighting the contribution of the new work to the scientific field.

As literature research is a vital stage in any research, it should be executed following the correct procedure. Firstly, to conduct the literature review, it is essential to employ databases such as Scopus, SAGE Publications database, and CINAHL, as they provide the access to peer-reviewed, reputable sources on the topic. The primary search terms should include self-care, elderly patients, social factors in self-care problems, environment, and genetic factors. Additional search terms might include behavior and family nurse practice. The Uniformed Nurse Practitioner Association is the organization that is highly relevant for the EBP proposal.

Theoretical Framework

It is also of high importance to identify a theoretical framework that will support the proposed EBP research. Arguably, the most suitable theory for the identified area of concern is the Dorothea Orems self-care deficit nursing theory (Hartweg, 2015). In general, the theory is based on the interaction between the self-care agent (person receiving care)/dependent-care agent (family member/friend providing care) and the nurse (nurse agent) (Hartweg, 2015, p. 109).

It allows researchers to have an overview of nursing practices that could be used by self-care agents or dependent-care agents to practice self-care. It also provides tools to ascertain that the patient can tend to themselves, as well as sets roles for the nursing staff and patients in order to maximize the impact of the self-care and to minimize the risks for the patients health.

However, to properly utilize this theoretical framework, it is necessary to investigate it through the prism of this research. The data provided by it is used to both obtain the necessary tools for research, and to correctly analyze it.

The theory that was chosen for this assignment provided additional insight into the issue, allowing both to conduct the research and to verify the result. In particular, the purpose of this theoretical framework is to ensure that the patient is able to implement self-care. The theory also emphasizes the crucial role of the patient, as the nurse should only provide guidance in the nurse-patient relationships (Hartweg, 2015). Therefore, it would be highly beneficial to apply this theoretical approach to the EBP proposal, as the Orems self-care theory is highly suitable for the identified area of concern.

Conclusion

It could be stated with certainty that the continuous research is one of the most important aspects of the discipline of nursing. Not only it is significant due to its contribution to theoretical aspects of the nursing science, but also it has a vast positive impact on the improvement of the evidence-based practice. Therefore, it is appropriate to state that this paper is an important step toward the implementation of the nursing research.

This essay overviews the principles of conducting the nursing research and its role in the evidence-based practice. As a result, it was concluded that the nursing research is one of the crucial parts of EBP, as it allows the existing knowledge to constantly refresh. In addition to that, it was found that EBP plays a similar role in terms of the practical implementation of theoretical knowledge, as it allows to expanse the sample and to correct any individual issues.

Moreover, the paper identifies a specific area of clinical concern, develops the PICO question that will guide the future EBP project, and also discussed the literature research strategy as well as the application of the theoretical framework. As such, it could be said that this work has achieved all its goals, providing an overview of existing study formats and mechanics and discussing their importance in the scholars research. Thus, it could be concluded that this essay serves as a solid basis for the future development of the research on the identified topic.

References

Dorociak, K. E., Rupert, P. A., Bryant, F. B., & Zahniser, E. (2017). Development of the Professional Self-Care Scale. Journal of Counseling Psychology, 64(3), 325-334.

Hartweg, D. L. (2015). Dorothea Orems self-care deficit nursing theory. In M. C. Smith & M. E. Parker (editors), Nursing theories and nursing practice (4th ed.) (pp. 76-81). F. A. Davis Company.

Holden, R. J., Schubert, C. C., & Mickelson, R. S. (2015). The patient work system: An analysis of self-care performance barriers among elderly heart failure patients and their informal caregivers. Applied Ergonomics, 47, 133-150.

Holloway, I., & Galvin, K. (2016). Qualitative research in nursing and healthcare (4th ed.). Hoboken, NJ: Wiley-Blackwell.

Liu, M. H., Wang, C. H., Huang, Y. Y., Cherng, W. J., & Wang, K. W. (2014). A correlational study of illness knowledge, self-care behaviors, and quality of life in elderly patients with heart failure. The Journal of Nursing Research, 22(2), 136-145.

Passarino, G., De Rango, F., & Montesanto, A. (2016). Human longevity: Genetics or lifestyle? It takes two to tango. Immunity & Ageing, 13. Web.

Räsänen, P. M., Kanste, O., Elo, S., & Kyngäs, H. (2014). Factors associated with the self-care of home-dwelling older people. Journal of Nursing Education and Practice, 4(8), 90-96.

Sharoni, S. A., Shdaifat, E. A., Majid, H. M. A., Shohor, N. A., Ahmad, F., & Zakaria, Z. (2015). Social support and self-care activities among the elderly patients with diabetes in Kelantan. Malaysian Family Physician, 10(1), 34-43.

Introduction

The dissemination of the projects results to improve practice and keep the spirit of inquiry alive is undoubtedly one of the complex tasks for a healthcare professional. However, with a competent approach to planning this goal, achieving the best results and high achievements is possible. This paper aims to justify the choice in favor of specific methods, tactics, strategies, and approaches in demonstrating the project.

Approach

Disseminating the results through a presentation with colleagues is an approach that will be used to share the results of the practice change project. Without any doubt, this method can be used both for teaching EBP and to engage stakeholders in the process. According to Horntvedt (2018), this approach is one of the most effective and productive in the context of interaction between an educator and students. Furthermore, academic processes using this strategy ensure the quality of teaching and contribute to implementing a favorable environment to support the activity and interest of students.

The Best Plan

According to the student, awareness and sharing knowledge are among the best ways to keep the spirit of inquiry alive within an organization. Therefore, this plan increases productivity and enables employees to perform their work efficiently and promptly while gaining easy access to information, resources, and experience (7 Ways to Improve Knowledge, 2022). Thus, this plan is associated with many advantages and positive aspects and is the best choice based on specific goals.

A Possible Solution

Indeed, identifying a mentor to champion EBP is possible and feasible in practice. It is assumed that this approach will be appropriate within the framework of an ordinary working day and in stressful conditions. The EBP Mentor provides adequate assistance and support to nurses using a multifaceted approach to their work. This specialist can maintain a positive attitude and a favorable atmosphere, minimizing stress, fatigue, and burnout.

Conclusion

Summarizing the above, distributing the results through a presentation with colleagues is one of the best ways to demonstrate the project in the best light. Accordingly, supporting the spirit of research in the organization will allow the mutual exchange of knowledge, skills, and awareness maintenance. In addition, attention should be focused on identifying a mentor to champion EBP; this approach can be realistic even in stressful clinical conditions.

References

Horntvedt, M. E. T., Nordsteien, A., Fermann, T., & Severinsson, E. (2018). Strategies for teaching evidence-based practice in nursing education: A thematic literature review. BMC Medical Education, 18(1), 1-11. Web.

7 ways to improve knowledge sharing across your organization. (2022). Starmind. Web.

The job of a chief nursing officer (CNO) involves a variety of duties and responsibilities and requires a number of professional skills, such as leadership, communication, and knowledge. Although much of the CNOs work is done behind the scenes, the value of these professionals in healthcare organizations cannot be overestimated. The major function of a CNO is the supervision of the quality of care within the healthcare facility. However, CNOs also perform another significant role, which is representing nurses interests at board meetings. According to the report prepared by the Institute of Medicine (2010), CNOs reporting skills require improvement since due to their inefficiency in this dimension, nurses interests are hurt. The purpose of the present paper is to explain the three most important areas of CNOs influence on nurses based on research and personal experience.

The major aspect of a CNOs influence on nurses is establishing the coordination of nurses work with the hospital boards interests. In this respect, CNOs need to make sure that every nurse knows the responsibilities and complies with them. What is more, a CNO has to maintain a high level of collaboration among nurses. Research indicates that the lack of such cooperation leads to a decreased quality of nursing services and a reduction in patient satisfaction (Ingwell-Spolan, 2018). Hence, it is the CNOs duty to improve interpersonal relations in the team of nurses. In my previous workplace, there was a problem of communication among nurses from different departments. The CNO dealt with the issue by arranging a series of team-building exercises. As a result, all nurses started to treat their coworkers with greater respect, which considerably enhanced the hospitals work.

The second area of CNOs impact on nurses is arranging a comfortable working schedule, which is one of the prerequisites of any nurses job satisfaction. Martin (2015) reports that the endeavor of some CNOs to evaluate the effect of shift length on their subordinates burnout led to positive outcomes. Specifically, CNOs realized that by suggesting more than one shift option to nurses, they were able to increase nurses dedication and eliminate their fatigue (Martin, 2015). I can refer to a similar case at the hospital where I currently work. When our CNO started to notice that the level of turnover was increasing, she implemented a plan that presupposed a choice of an 8- or a 12-hour shift. Some of the nurses chose the first option, and others opted for the second. The outcome was that nurses noticed their CNOs concern about them and felt inspired to cope with their strenuous work.

The third dimension of CNOs effect on nurses may be reflected in the participation in policy- and decision-making procedures. CNOs have the potential to enhance service delivery since they collaborate with the boards (Cummings, McArdle, McQueen, & White, 2016). CNOs can draw links between the nursing profession and training, which is a beneficial aspect of work. A CNO at the healthcare facility where I once had practice made it possible for nurses to obtain training for free by making some arrangements with the local authorities. I find such actions rather promotional both for nurses and their patients.

To conclude, I would like to assert that CNOs perform crucial functions, and their hard work should be valued. Nurses do much work, but they rarely realize how complicated administrative duties can be. Every team member working for the benefit of patients and communities should be friendly, responsive, and helpful. By pursuing such a goal, hospitals will achieve the best outcomes of their profoundly valuable work.

References

Cummings, J., McArdle, C., McQueen, F., & White, J. (2016). Chief Nursing Officers: The past, present and future of nursing. British Journal of Nursing, 25(9), 500-502.

Ingwell-Spolan, C. (2018). Chief nursing officers views on meeting the needs of the professional nurse: How this can affect patient outcomes. Healthcare, 6(2), 56.

Institute of Medicine. (2010). The future of nursing: Leading change, advancing health. Report recommendations. Washington, DC: The National Academies Press.

Martin, D. M. (2015). Nurse fatigue and shift length: A pilot study. Nursing Economics, 33(2), 81-87.

Abstract

The Essentials prepared by the AACN are a set of documents, the goal of which is to give an idea about the required curriculum and practices for practical training of nursing staff at all levels. In other words, the essentials are unified and standardized guidelines that define all theoretical and practical compliances that nursing staff needs to possess at all stages of training. Even though the theory and methods covered by the Essentials include the most relevant information and techniques, specific chapters of these guidelines need to be a subject of constant review. The paper is dedicated to the study of the Essentials and listing the possible methods to improve them.

Introduction

AACN is a structure that promotes a high quality of academic studies of the nursing staff on all levels  from Baccalaureate to Doctor studies, also featuring Nursing Practice programs. This body is responsible for the implementation of innovation in this area. The so-called Essentials prepared by the AACN are a set of documents, the aim of which is to provide an idea about the required curriculum. Among the others, these documents also cover the competencies, which the graduates of each level are supposed to achieve.

Masters Essentials

This manual defines the core ideas of nursing education at the Masters level. It is an updated version of the older document, which now includes the concepts improving the standards of the current nursing practices (Ferrell, & Virani, 2016). These nine core Essentials at the Masters level, which include background practice, leadership, safety, scholarship, IT, health policy, collaborative measures, clinical prevention, and masters nursing practice (Wang et al., 2018). All these underlying ideas complement each other and form a unique set of developmental aims towards building a strong and solid professional background.

The Essentials from one to five cover the fundamental skills and competencies needed for a nursing specialist, whereas Essentials six and seven supports and emphasizes the jurisdictional and legislative rights of masters level nurses. The remaining Essentials analyses and summarizes a broad spectrum of issues related to population-level features alongside the details of nursing practice at the given level.

According to the authors interpretation, each Essential point recognizes certain masters related property of nursing practice (Wang et al., 2018). For instance, Essential four is designed to make necessary preparations for nurses to be able to handle research projects and work in professional team setups. In addition, Essential two enables nurses to be able to take on managerial roles and monitor nursing practices.

The Fundamentals of the Clinical Resources

This manual covers the core elements of the medical support of the whole range of nursing staff at all levels of academic training. Thus, it includes the spheres of research, graduate and undergraduate levels of education, and medical practice at the faculties. The manual summarizes the factors that promote or limit the possibilities to access proper training in the nursing field. Also, it covers the fundamental learning practices for the students of all levels of medical education. Finally, this document provides the resources helpful in research and practice.

The Challenges of the Implementation of the Essentials

Nursing programs based on the principles of competency, standardized studying, guidelines for training, and the assessment of students performance are required at all levels. The AACN essentials include all these competencies in separate documents for each stage of training.

These competencies might be a subject of expansion, and the goal of the AACN is to make them more explicit in the future. Some topics need to be covered better; for example, the reflection of the required skills linked with disaster practice needs significant improvement (Ferrell, & Virani, 2016). However, the existing standards already identify the development of staff in the nursing field through a well-structured approach based on the principles of consensus building.

The other challenge is that the institutions pursue a different approach to the integration of specific practices into the study process (Murphy, Staffileno, & Carlson, 2015). Thus, it is reasonable to promote coalitions of these institutions to build a common strategy. The further documents presented by the AACN need to include standardized skills and practices.

Despite significant improvement in formulating a national strategy of education that is shown through the essentials of AACN, some of its chapters become outdated extremely fast. This process is linked with the fact that scientific advancements in discovering the reasons and treating certain diseases occur faster than the system can react to them. It leads to a situation where the methods of nursing, as well as theoretical fundamentals provided by the Essentials, become irrelevant.

The improvement of the strategies of AACN can happen by means of encouraging volunteering at professional organizations. Such volunteer professionals are a significant help in many cases (Veenema & Larson, 2016). The idea of nurses taking part in volunteering projects, which might be organized by the government or privately, can help in gaining experience, for example, in cases of disaster.

Conclusion

The Essentials of AACN are the unified and standardized guidelines that define all theoretical and practical compliances that nursing staff needs to possess at all levels of training. Even though the theory and methods covered by the Essentials include the most relevant information and techniques, specific chapters of these guidelines need to be a subject of the constant dynamic review. Thus, while the policy-makers need to address this issue, the institutions that train nursing staff need to follow the Essentials as the ultimate guideline for the education of future professionals.

References

Ferrell, B., & Virani, R. (2016). CARES: AACNs new competencies and recommendations for educating undergraduate nursing students to improve palliative care. Journal of Professional Nursing, 32(5), 327-333.

Murphy, M. P., Staffileno, B.A., & Carlson, E. (2015). Collaboration among DNP- and PhD-prepared nurses: Opportunity to drive positive change. Journal of Professional Nursing, 31(5), 388-394.

Veenema, T.G., & Larson, E. (2016). Nurses as leaders in disaster preparedness and response  A call to action. Journal of Nursing Scholarship, 48(2), 187-200.

Wang, J., Guo, R., Liu, M., Zhang, X., Ren, L., Sun, M., & Tang, S. (2018). Career decision-making self-efficacy and professional commitment among Master nursing students. Western Journal of Nursing Research, 40(3), 327345.