JHEBP seeks to educate all nurses regardless
JHEBP seeks to educate all nurses regardless
Currently, XYZ General Hospital experiences a large turnover of nurses. In addition to GNs turnover, the experienced nurses are also leaving the bedside for advanced practice roles. Therefore, there is an increased pressure for GNs to take care the complex patients before they are well trained for the assignments. So the goal is to implement NRP to recruit and retain GNs by providing an intensive and structured training. Moreover, the vision of the hospital is to improve the patient experience through the delivery of high standards of care ("About us," 2015). The stakeholders of XYZ General Hospital are Board of Directors, unit managers, clinical specialists, donors of the hospital foundations, staff, and patients.…
They found the answer in the establishment of a remote monitoring and consultation center. The center was staffed with physicians and nurses who could monitor patients and advise staff at multiple locations. Hospital staffs were initially not pleased with the “oversight”. They felt like others were looking over their shoulder. It only took a couple of successful consultations and catches by the center to convince the staff they were not there to evaluate their performance, but rather to assist them in providing the highest quality of care to their…
High 30-day readmission rates have become problematic for many facilities. The Centers for Medicare & Medicaid Services (CMS) have put emphasis on readmission rate reductions for hospitals (“Readmissions Reduction Program”, n.d.). The stress of high readmission rates weighs heavy on facilities as a result of the Affordable Care Act (ACA) which requires CMS to reduce payments to hospitals with excess admissions (“Readmissions Reduction Program”, n.d.). Incorporating Project Re-Engineered Discharge (RED) as part of the discharge process at a small hospital will impact the facility’s readmission rates. Utilizing an evidence based practice (EBP) model can assist advance practice nurses (APN) in creating a system change. A synthesis of evidence…
There is a significant need to increase the BSN enrollment as the majority of new nurse enrollment is at the associate degree in nursing level (Spencer, 2008, 312). It will be discussed, based on the article; Increasing RN-BSN Enrollments: Facilitating Articulation through Curriculum Reform, author Janine Spencer, RN, EdD, Journal of Continuing Education in Nursing, July 2008, the need for increasing the number of BSN prepared nurses in the workforce and how this may affect the nursing profession as a whole .”Research has shown that patient outcomes can be attributed to higher levels of nursing education” (Spencer, 2008, 312). It is necessary to increase the standard of education required to become a nurse, as well as providing each nurse with all the necessary knowledge and training required in leadership, culture, gerontology, ethics, research, theory based practice, and community health.…
Kathleen, great point about EBP leadership being a shortfall in healthcare, I agree. There are many things that can be done in an organization to help EBP be embraced more readily. Areas that help with implementation of EBP are having the correct education about EBP, mentorship, an EBP culture, and having effective EBP leadership (Melnyk, & Fineout-Overholt, 2015). The implementation process of EBP is affected my multiple factors some of these are beliefs about EBP, understanding of EBP, and support by the organization for EBP. There are multiple areas in this list where my clinic is failing. Kathleen one of the areas that you mentioned was leadership, I too agree that there is a shortfall in this area in my clinic and in healthcare in general.…
The BSN completes their four years of education at the University level training is more focused on patient outcomes and nursing theories. Receiving more theoretical training they are better prepared for management. Also multiple studies show that due to their assessing, critical thinking,communication, leadership, case management, health promotion and their ability to practice across a variety of inpatient and outpatient settings the BSN trained RN has a lower mortality rate and better survival rates for patient resuscitation. (AACN…
I believe a significant practice problem is that many nurses do not see the need to advance their education…
Some concerns of hospitals are surviving in a competitive world. Bringing in the right stakeholders, donators. Also achieving the highest reimbursement from private and state and local insurances. In today’s economy there are many urgent care and private facilities, which patients and consumers along with residents can choose from.…
When discussing utilizing the nurse to their full extent, the IOM report touches on how the nurses are able to practice within different scopes, not based on the extent of the education or their training, however it is based more off of which state the nurse practices in. For example, in some states a nurse practitioner is able to write prescriptions without a supervising physician, and other states do not. This is a clear example of the education or training not determining the extent the nurse practices at, yet the states they are governed by making the decision. With the ever-growing population, it is said in the IOM report that it would be more beneficial to have more nurses at an advanced level in outpatient settings. It is in the best interest of the community in my opinion, which we allow advanced practice nurses or APRNs to practice to their full scope, especially when it comes to primary health care. In Las Vegas it takes 4-6 weeks to get in with most physicians, even as an established patient. With that being said, people are choosing to utilize the ER as their primary care provider because they will get care faster. This leads to overcrowding of the ERs. Additional benefits to allowing nurses to practice to their full extent include improved access to the care of the poor and rural areas, respite and palliative care, care coordination for the chronically ill and elderly, nutrition services, and evaluations that compliment care of other physicians and providers.…
Of course this can fall back on the hospital director’s preference, but with many hospitals heading in the direction of Magnet Status, the charge nurses or leaders of the hospital will need to have their BSN. By having the critical thinking skills, understanding the theories of nurse processes, the promotion of health, and case management training, BSNs will lead the healthcare organizations of tomorrow. “The IOM report makes a strong case to support that advances in science and increasing patient complexity have accelerated our need for nurses with the skill and knowledge to manage a challenging and increasingly diverse health care environment. Unlike Associate Degree programs, BSN curriculum provides content on evidence-based practice, health policy and finance, inter-professional communication and collaboration, systems leadership, disease prevention and population management. This is program content that nurse leaders need to navigate not only today’s health care environment but also the changes anticipated with health reform.” (The Future of Nursing: Leading Change, Advancing Health, IOM,…
The biggest obstacle for nurse practitioners appears to be physicians. According to the report, the majority of physicians feel that replacing physicians or filling voids where there are not enough physicians with nurse practitioners will decrease the quality of care that patients receive. Another obstacle for Nurse practitioner is getting reimbursement from insurance companies. Nurse practitioners receive approximately 80 percent reimbursement when compared to a physician, and some insurance companies do not recognize nurse practitioners, so they have to have a physician to work with them. These NP’s receive an hourly wage rather than a direct payment from insurance providers. The IOM report will change my practice by allowing me to feel as if I have a little more power in helping guide my patients care; it also empowers nurses to make more suggestions concerning care to physicians and will hopefully make physicians value the advice of the Nurses and help them realize what valuable resource nurses are. Fundamental to any patient safety culture is the work environment in which the nurse practices (Creasia, page 412). With the IOM report increasing moral of the nursing workforce turnover rates should decline, thus increasing patient…
This will allow the employee to feel like they have received a good overview of the job duties and expectations. Building relationships with nursing schools and formulating a nurse resident program would allow nurses in the program to be monitored throughout their clinical experience assessing their clinical performance, implementing new hire support programs allowing the employee to have a non- supervisor “ buddy ” to come to and speak freely without intimidation or repercussions (John Commins, Health Leaders Media, February 7,…
(2013) Evidence-based practice models for organizational change: overview and practical applications. Journal of Advanced Nursing, 69(5), 1197–1209. doi: 10.1111/j.1365-2648.2012.06122.x…
It can be a big task for leadership to get everyone on board. Why is it that people resist change? The main reason could include uncertainty, habit, concern about personal loss, and the belief that change is not in the organization's best interest. Change replaces the known with uncertainty. Having to learn new methods, some senior nurses may fear that they will be unable to do what is needed and may develop negative attitudes toward the change or perform poorly while using the new technology.…
Since I quit my job at Miami Children’s Hospital, a lot had changed. When I graduated eight years ago, nurses where in such high demand, that with an ASN degree there where so many open doors to choose from. My personal goal was always to re-enter a pediatric hospital. Now after being in home health and hospice care for the past 6 years, I have found it extremely difficult to get back into the hospital setting, without having a BSN. More Hospitals are seeking Magnet status, and therefore most facilities in my area prefer BSN or higher to even work as a bedside nurse.…