Benchmark- professional capstone and practicum reflective journal
Judith Pottinger
The nursing field has transformed in recent years that have helped in the provision of efficient medical care. These changes, therefore, require the nursing staff to be well trained, highly educated, and critical thinkers to enable them to make complex clinical decisions (Salmond & Echevarria, 2017). They should be prepared to work in different health settings, and well rounded to take care of the changing healthcare needs and their scope of practice. This journal entry, therefore, integrates leadership and inquiry into current practice over the last eleven weeks.
Week 1
New Practice Approaches
During the first week of my practicum, I spent time in the Intensive Care Unit after reviewing the course objective with the mentor. My focus was mainly on patients who were suffering from Hospital Acquired Infections, and I realized that there are numerous changes and practices that nurses have integrated to take care of these patients. For instance, the use of technology and the application of evidence-based practices have helped nurses in the handling of HAIs. The organization had adopted the care bundle approach to take care of CAUTI patients, which significantly improved the health outcomes of the patients. Some of the practices included the removal of catheters, aseptic insertion, and optimum use and maintenance of catheters. I learned the application of evidence-based practices, especially in acute care settings, and encouraged the nurse practitioners and nurse leaders to adopt these practices and use empirical studies for guidance. Nursing institutions should also make some changes in their programs to incorporate new approaches and evidence-based practices (Kristensen et al., 2015).
Week 2
Interprofessional Collaboration
Collaboration in healthcare has been cited as a key strategy in reforming the healthcare sector. According to Bosch & Mansell, 2015, interprofessional collaboration improves patient outcomes, optimizes medication dosages, and reduces morbidity and mortality rates in hospitals. In our facility, interprofessional collaboration has increased staff job satisfaction by reducing the workload. I have also collaborated with my mentor and preceptor throughout my project, and this has nurtured by collaboration skills and eased my work. A team filled with members who collaborate and put their egos aside increases their job satisfaction, and the likelihood of success is always high (Jünger, Pestinger, Elsner, Krumm, & Radbruch, 2017). I learned that the new practice approaches not only affected nurses in my unit but also the physicians and other teams in the organization.
Week 3
Health care delivery and clinical systems
Although numerous challenges face the healthcare system in the United States, patient satisfaction is key to the delivery of healthcare services (Bordoloi, 2020). It is a sure measure for the quality of healthcare, and it is the ultimate goal of every healthcare service provider to ensure that patient satisfaction is attained. Coordination can help in ensuring that there is a flow in implementing treatment plans for all population groups. It can be achieved by creating a good communication culture within the organization. All the stakeholders, including insurance firms, should be involved to promote timely decision making and implementation of plans. The integration of agents of change that enhance the quality of healthcare, such as information technology, should be adopted. In week 3, i sought to understand the healthcare system in our organization and realized that following the CMS guidelines is essential in health promotion.
Week 4
Ethical considerations in health care
This week, I learned that ethical issues always arise, and nurses need to reconcile the nursing obligation with their values. Nurses operate in an environment and a culture that takes into considerations all the ethical problems that may arise when offering care (Prince-Paul & Daly, 2015). An ethical culture needs to be embraced, whereby; all the ethical considerations are done during the provision of care. An organization can maintain ethical practices by consulting from ethical experts. Nurses should understand every patient has his or her own set of morals and ethics that need to be considered. Ethics assists nurses in recognizing the healthcare dilemmas, making ethical judgments, and making decisions based on their values but within the laws that govern them. The American Nurses Association (ANA) has developed a code of ethics that regulates and guides nurses within the profession.
Week 5
Practices of culturally sensitive care
The provision of culturally sensitive care is a vital component of patient-centered care (Borrego & Johnson, 2017). Culturally sensitive care has an impact on the nurse-patient relationship, and nurses should always strive to understand the patients’ culture, values, and beliefs. Nurses should also understand the relationship between the patients’ healthcare needs and the cultural background and the bio-psychosocial needs (Borrego & Johnson, 2017). Patient well-being and patients choice is considered the essential values in providing nursing care. Nurses should be able to listen, understand, and respect patients’ values, need opinions, and ethnocultural beliefs. They can support patients and meet their specific health goals by integrating these elements into a care plan
This week, I learned that to provide culturally sensitive care, nurses should create awareness of their colleagues with openness and positivity on the importance of providing more competent cultural care. They should also avoid making assumptions on cultures that they are not familiar with. Assumptions can lead to mistrust and reduce the rapport between the nurse and the patient, therefore, affecting the treatment acceptance. Building trust and rapport and also overcoming the language barrier regardless of the ethnic and racial background is considered as a way of providing culturally sensitive care (Dogan & Schmidt, 2016). Translators can be used to enhance effective communication and educate the patients about procedures and medical practices. Nurses should, therefore, work hard to become aware of cultural differences and providing culturally competent care.
Week 6
Ensuring the integrity of human dignity in the care of all patients
Human dignity is one of the essential rights of every patient, but the healthcare team can easily compromise it. In healthcare, it is more focused on the aspects of autonomy, privacy, and respect for human life. Patients are often exposed and vulnerable; they are asked difficult questions and scrutinized by strangers. Some of these episodes can be frightening to some patients and can easily erode human dignity. There are aspects of staff behavior that can affect dignity in care. These aspects include communication and interactions, providing privacy, autonomy, and essential care (Matiti, 2015).
Interactions and communication are vital aspects of promoting a patient’s dignity. They make patients feel valued, respected, comfortable, and in control. A key element of interactions is to understand the patient and develop a relationship with them (Zirak, Ghafourifard, & Aliafsari Mamaghani, 2017). Even in acute care situations, nurses can inspire patients’ confidence by building a good rapport that makes them feel appreciated. The nurses should obtain informed consent before any physical examination, treatment, and provision of personal care, reflecting on the patients’ right to determine what happens to their body. Dignity is also associated with autonomy among old patients. During my practicum, I learned that nurses should have control over how their destinies unfold. Even the ones who have cognitive impairment have the right to make choices and have their wishes honored (Matiti, 2015). Every nurse has a duty of providing essential care promptly with privacy and confidentiality that promotes human dignity.
Week 7
Population health concerns
Population health is primarily affected by social determinants of health, the conditions where people are born to grow, work, live, and age. Population health nursing roles go beyond sick care to advocacy, health education, community organizing, and political and social reform (DeSalvo, O’Carroll, Koo, Auerbach, & Monroe, 2016). Governments, non-profit organizations, foundation, and the private sector need interprofessional and interagency cooperation to address these social determinants that affect population health. This week I worked with my mentor to gather information on Urinary Tract Infections (UTIs) in two healthcare facilities. I realized that for a country to advance and take care of public health, it must gather enough resources and support from all stakeholders. The public health sector should come up with more sophisticated ways and strategies for implementing healthcare policies that promote public health (DeSalvo, O’Carroll, Koo, Auerbach, & Monroe, 2016).
Week 8
The role of technology in improving health care outcomes
Over recent years, there has been an accelerated adoption of health information technology in many organizations. Technology has presented various opportunities that have improved and transformed the healthcare sector. Commonly used health information systems include Electronic Health Records (EHRs), telehealth, remote monitoring tools, genome sequencing, and wearable technology. These include reduced human errors, improved practice efficiencies, enhanced clinical outcomes, facilitating care coordination, and tracking of data over time (Alotaibi & Federico, 2017).
This week I visited an Emergency Department in one of the healthcare facilities with my mentor, and as I walked around the rooms, I issued a questionnaire that I have created to different staff just to identify the role that technology played in that department. From the responses, it was evident that technology holds great potential in overcoming the multiple barriers to behavioral health screening, interventions, and referrals to treatment in the emergency department (Choo et al., 2012).
Week 9
Health policy
Health policy includes all decisions, plans, and actions undertaken by different stakeholders to achieve specific healthcare goals within the society. Most policies aim at promoting communication between the policymakers and the researchers. These policies have helped healthcare organizations to achieve and attain their community goals faster by defining their objectives, vision, and mission that create a point of reference to their healthcare practices. They provide standardization in daily activities and outline a general plan of action that is used to guide desired outcomes and help in decision-making (Zelmer, 2016). This week I learned that health policies help employees to understand their roles and responsibilities and set the foundation for the delivery of safe and cost-effective quality care. I hope the engagements that I had with different stakeholders during the practicum would improve the quality of healthcare delivery.
Week 10
Leadership and economic models
According to Gobbi, 2017, most patients undergo difficulties in different healthcare facilities due to inadequate staffing. It leads to rationing and missed nursing care that adversely affects the patients’ outcomes. Nurse leaders should be at the forefront in advocating for adequate staffing levels in all healthcare facilities. Strong leadership is required in the realization of the vision of a transformed healthcare system. Nurses should be leaders by design, evaluation, and implementation of evidence-based practices that improve patient outcomes. Leaders should ensure that nurses are well rewarded and protected. Nurse leaders should look at their staffing levels and balance their revenue with expenses but ensure that overtime hours are compensated, and all equipment needed by purses are provided. I learned that the quality of health care delivery is highly dependent on the care given to nurses.
Week 11
Health disparities
Healthcare disparities arise when a particular group of individuals enjoys better healthcare services than others (Chan et al., 2019). They are mainly caused by factors such as differences in the level of education, environmental threats, poverty, and inadequate access to health care, individual, and behavioral factors, among others. These disparities not only affect the groups facing them, but they also limit the overall gains in the quality of healthcare and health for the large population, therefore, leading to unnecessary costs (Chan et al., 2019). Addressing these effects is so vital as the population is becoming more diverse. Although the ACA’s coverage expansions increased the coverage, States and local communities should be actively engaged in reducing the health disparities by focusing on and addressing the social factors that lead to health disparities.
During my practicum, I encountered a group of nurses who were biased towards a patient who was suffering from schizophrenia as they were attending to that patient a public figure that is a well-renown businessman checked-in, and all their attention and focus shifted. I took upon myself to have that patient checked in. I, however, brought this to the attention of the charge nurse and the unit director who promised to take action and educate the staff on the importance of bridging this gap that has adversely affected the most vulnerable population in the society.
References
Alotaibi, Y., & Federico, F. (2017). The impact of health information technology on patient safety. Saudi Medical Journal, 38(12), 1173-1180. https://doi.org/10.15537/smj.2017.12.20631
Bordoloi, S. (2020). Modelling patient satisfaction in healthcare. International Journal of Services and Operations Management, 35(3), 339. https://doi.org/10.1504/ijsom.2020.105375
Borrego, E., & Johnson, R. G. (2017). Cultural competence in health care. Cultural Competence for Public Managers, 253-271. https://doi.org/10.4324/9781315095219-13
Chan, K. S., Parikh, M. A., Thorpe, R. J., & Gaskin, D. J. (2019). Health care disparities in race-ethnic minority communities and populations: Does the availability of health care providers play a role? Journal of Racial and Ethnic Health Disparities. https://doi.org/10.1007/s40615-019-00682-w
Choo, E. K., Ranney, M. L., Aggarwal, N., & Boudreaux, E. D. (2012). A systematic review of emergency department technology-based behavioral health interventions. Academic Emergency Medicine, 19(3), 318-328. https://doi.org/10.1111/j.1553-2712.2012.01299.x
DeSalvo, K. B., O’Carroll, P. W., Koo, D., Auerbach, J. M., & Monroe, J. A. (2016). Public health 3.0: Time for an upgrade. American Journal of Public Health, 106(4), 621-622. https://doi.org/10.2105/ajph.2016.303063
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Zirak, M., Ghafourifard, M., & Aliafsari Mamaghani, E. (2017). Patients’ dignity and its relationship with contextual variables: A cross-sectional study. Journal of Caring Sciences, 6(1), 49-51. https://doi.org/10.15171/jcs.2017.006