Practice Dimension/ Ethics/ Resource Utilization: Ms. Cabral applies the nursing process to systems or processes at the unit/team/work group level to improve care. She is the primary nurse for five of our chronic dialysis patients promoting safe high quality care. She involves the patient and their families in monthly interdisciplinary care plan meetings to promote self-efficacy and quality of life. She continually evaluates the patient 's health status. The effectiveness of her patient 's plan of care is reevaluated on a regular basis and changes are made for continuous improvements. Ms. Cabral’s primary patients have maintained 100% dialysis adequacy over the last year. She is also actively involved as a member of the unit’s …show more content…
Cabral is well respected by staff, patients, and families and is respectful of others as well. She makes appropriate referrals to other disciplines to promote continuity and Veteran centered care. Ms. Cabral developed a monthly note template with pertinent nursing diagnosis, interventions and patient goals that are now being used exclusively by staff. She provides nursing care that is environmentally safe and healthy and does so with good infection control practice. Under her leadership there have been 0 incidences of blood stream infections or transmission. Ms. Cabral is 100% compliant with the use of safety devices for patients with catheters being tracked on a daily basis as part of the unit’s safety program. Ms. Cabral is the coordinator of the Anemia Management program which consistently has outcomes above the national benchmark. With the loss of the electronic documentation system, Ms. Cabral developed a new patient flowsheet which she is continually updating to fulfill the documentation needs of the Veterans treatment. Ms. Cabral supports and enhances patient self-determination and follows the ANA code of ethics for nurses. She helps support the patient’s wishes when determining end of life care. She serves as a resource for patients, families and staff in addressing ethical issues and directs them appropriately to the palliative care team and or Medical Center Chaplin. Professional Development/ Educational/ …show more content…
Cabral acquires knowledge and skills to maintain expertise in her area of practice. She attended the annual network meeting and shared new changes in clinical practice. It was an opportunity to network with other nurses in the field to share best practices. She actively participates in educational activities to improve clinical knowledge and enhance role performance. Ms. Cabral is an active member of NPSB. She collaborates with others to evaluate the RN’s dimensions of nursing practice to determine eligibility or not for promotion. She has been helpful in providing guidance to her co-workers in proficiency writing. Renee has trained, and is now competent in providing Continuous Ambulatory Peritoneal dialysis/Ambulatory Peritoneal Dialysis to the Veterans. She took part in the Baxter training seminars and work closely with the Baxter educator, and PD coordinator. She rotates on-call with other colleagues to provide hemodialysis and peritoneal treatments in the event of an emergency during off hours. Ms. Cabral has the responsibility of evaluating the unit performance as measured against the Joint Commission standards on a quarterly basis and takes action to correct any deficits that may be found. Ensuring compliance keeps the unit continuously ready for inspection. The visit by the Joint Commission consultant resulted in a deficiency free survey. Collaboration/
Objective One During my clinical day three, I demonstrated entry-level competence in professional nursing practice in caring for patients with multiple and/or complex unmet human needs. I addressed safety needs, safety in medication administration, effective communication, and surveillance for my patients. First, I addressed safety needs my ensuring the appropriate safety measures were implemented for the patients. Some of the safety measures included, wearing non-skid socks, wearing a yellow armband which indicated fall risk, keeping the bed in lowest position, two side rails up, bed locked, and the call light within reach.
VA nurses assess, provides nursing diagnoses, plans, implements, and evaluates (ADPIE) care based on maturational focused components. Undertakes accountability for the management of care concentrated on the patient’s process through the range of care, patient and family education, patient self-management, and accompanying circumstances that influence the patient’s satisfaction. The VA nurse considers all attributes of the individual, including age and stages of life, presence of health, race and culture, values, and prior experiences. Administers medications and procedures per policies and procedures. The VA nurse effects patient care outcomes by collaborating with members of the interdisciplinary team.
My knowledge in the Doctor of Nursing Practice (DNP) continues to expand as I progress through the DNP program. The knowledge I have attained while in the study of the DNP I and DNP II is priceless. For example, recognizing stakeholders and utilizing networking has helped me to progress on my DNP project (Gokenbach, 2012). I also have a better understanding as well as the purpose of a DNP project. My mentors have been great in directing me in remaining on the right track.
When a patient is at the end of life it is very important to value the patients self dignity and their decisions at the mere end of their lives. The end of life care is to relieve the weight of the patient 's shoulders physically and mentally. I approve of end of life caring. Basic end of life care is summarized by improving the care of quality of life and dignity of the ill person. The important themes to good ethics of end of life care is a combination of human rights,respect,dignified care,and privacy.
Dorothea Orem’s SCDNT appears to be consistent with current nursing standards. Over 400 nursing articles were noted during a literature search by Biggs (as cited in Smith & Parker, 2015). According to McEwen and Wills (2104), SCDNT has been used to formalize care for inpatients and ambulatory care, as well as in community based programs, mother-baby and community nursing. While the use of SCDNT in current nursing practice is a strength, it bears noting that Biggs (as cited in Smith & Parker, 2015) observed an area of weakness that SCDNT has not always resulted in further development of nursing practice.
Dr. Jean Watson’s theory of care addressed the nurse to patient ration, according to the method “nursing is positioned with caring of the sick, prevention of sickness, restoration of health and promotion of health. This process includes the process of assessment, plan, intervention, and evaluation. On the review, the nurse observes, identifies, review problem(s) and forms a care plan that will be used in appropriate nursing care. When the nurse to patient ratio is low, the nurse will not be able to perform this assessment. This will result in a reduction of patients’ outcomes, medical errors, frequent re-admissions, patient deaths.
Medical equipment and supplies are also provided to the patient when needed, most often in the home setting, as when they are in assisted living or long term care setting equipment is provided by that facility. The HPCG staff also help to provide the patient and family with guidance in making end of life decisions such as creating a living will and healthcare directives. Counseling services are provided to the patient and the
To guarantee that the nurses were well aware of their duties and what is expected of them, their roles had to be clarified (Benner et al., 2009). This is the moment whereby the Robert Wood Johnson Foundation collaborated with the Institute of Medicine of which the latter came to release The Future of Nursing: Leading Change, Advancing
Each morning patients came in for assessment and the treatment team developed or altered existing treatment protocols. I longed to be part of this team, working to stabilize each patient so they could return home to pursue their goals. The nurses stood out to me as the team members at ground zero in the unit, working directly with patients, and advocating for them in meetings. As a Nurse Practitioner, I will provide this same standard of holistic care to my patients, taking into consideration their biological, social, psychological and cultural needs while developing and implementing treatment decisions.
I am responsible for coordinating setting up modules for different complex nursing procedures for nurses reviews, informing nurses of upcoming educational conferences and posting articles pertaining to critical-care evidence based practice. I strongly believe that The George Washington University will afford me the opportunity to enhance my career goals and leadership
As Betty 's Chronic Kidney Disease (CKD) has progressed to stage 5, she is mainly concerned about the progressive symptoms she has been experiencing and the emotional wellbeing of Alan and her family not being able to cope when she passes away. Betty was described as "not clinically depressed" and is completely aware of her diagnosis. At this advanced stage of kidney disease, the kidneys have lost their function to remove waste and fluids from the body, toxin build up and regulating blood pressure (stage 5 of chronic kidney disease, 2016). In addition, Betty has been concerned about her hypertension, odeomeous legs, dyspnoea (shortness of breath), pruritus (itching), nausea and lethargy.
The guidelines set by the NP’s Core competencies involves educational programs for nurse practitioner and are referred to as essentials behaviors for all NPs (The National Organization of Nurse Practitioner, ([NONPF],2017). As a future NP, this course has echoed the importance to critically examine information given by finding evidence to support and manage care for the individual or the population, which I will apply to my practice. This, in turn, will offer better treatment plan and optimize better patient outcome. Using the differential diagnosis to pinpoint the best possible diagnosis for individuals has helped me to use critical thinking about my patient and to find the appropriate plan of care.
Nurses are critical for promoting health in the society. The profession is highly flexible, since they specialize in diverse operations in the medical field. Registered nurses, for instance, are responsible for the administration of medicine and inoculations to patients (American Nurses ' Association, 2000). Additionally, these professionals observe, record, and enlighten doctors of any changes in a patient’s health. Nurses interpret and evaluate diagnostic examinations to determine an individual’s condition, as well as making the necessary adjustments in patient treatment plans on their health progress.
Lenore will adhere and abide by the laws/statutes/regulations and policies as set forth by the Criminal History Record Information Processing (CHRIP) Bureau, General Manual (GM), Crime Records Service (CRS) guidelines and the Standard Operating Procedure (SOP) manual. She will continue to update the SOP with any new and/or changing procedures in a efficient and timely manner. Lenore received certification of completion for the following: CJIS Security Awareness, Records Management, and Security Awareness Training
One of updated police was: Acceptance and admission of dialysis patients to outpatient’s settings. These changes was recommended by Department of Health (DOH) and action had to be taken immediately. The Medical director and the senior director of hemodialysis, and infection control staff had 24 hours to develop new policies and update others policies. They researched The Centers for disease control and prevention (CDC) recommendations, hospital policies, and infection control DOH recommendations. When new procedures were developed, the manager and director of the hemodialysis units started to educate the nursing staff and nephrologist.