Category: Evidence Based Practice

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Attaining and Protecting Your Professional Nursing

I plan to become licensed in the state of Massachusetts. Currently, Massachusetts is pending to become a nurse licensure compact state but is not currently. The application has been moved to online where a paper license is no longer issued. The application process can be done via paper but requires further steps to obtain and send the application. Massachusetts requires that you graduate from a board approved nursing program, have good character, and have passed the NCLEX. Background checks are also conducted that an individual meets the requirement to become a nurse based on any criminal activity. An individual must not have criminal convictions for a minimum of 5 years and have completed all court ordered stipulations a minimum of 1 year. Fingerprints are not a requirement under the Massachusetts Board of Nursing.

Substance abuse causing nurses to be impaired can be a dangerous thing for the nurse, other nurses, and the patients. Being impaired can correlate with making mistakes that can be life threatening to patients as well as the nurse. It is under legal obligations that a nurse must report other nurses who are impaired by substance abuse. When a nurse is suspected of substance abuse, it is important to conduct a thorough investigation and evaluation. This will look at safety, stability, and provide the person safe transportation to a safe environment. The nurse can be at risk of self-harm as they may experience shame and guilt when they realize what they have been doing. There are various resources available within and external to the organization. If unionized, they can provide support and there should be written policies based on the employer for incidents like these. External resources can look at the Massachusetts Nurses Association Peer Assistance Program, weekly nursing support groups, Massachusetts Substance Abuse Rehabilitative Program, self help groups, and SMART Recovery. If a nurse is found to be impaired, then termination of work may be the disciplinary action. Followed by this, a return-to-work agreement may be required to resume duties per protocol of employer.

In a world that is full of mistakes, it is important to always cover your back and your license when you are a nurse. Malpractice, protecting patient rights, refusing treatment, and abuse are things that  can be seen to cause a nurse to lose their license. As a nurse, you should take the proper measure to ensure that you don’t loose your license. Communication is a key part of protecting yourself and your license. Following protocols, minimize relying on coworkers, ensure social media is private, and always staying focused are keyways to protect yourself. At any moment a slip up can occur and taking the proper measures that are outlined by the employer is key.

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Presenting Change

This project has taught me an immense amount of information on the nursing process and quality control. As a group, we got to identify a current issue within the hospital and collaborate to resolve this issue. When searching for ideas for this project, we collectively agreed on researching the importance of accurate documentation of input and output. Documentation can be a tedious task and consume valuable time that could be used on face-to-face patient care yet, should not be underestimated. Adequate documentation of input and output can play a tremendous role in directing the course of treatment for patients. For example, patients with congestive heart failure tend to gain weight via the accumulation of fluid. This fluid increases the weight of the patient causing them to experience edema. These patients tend to be put on a diuretic which will reduce the amount of fluid within their system. Input and output come into play when determining how much fluid is coming out of the body versus being put in. If a diuretic is used, the patient should experience an increased output. Documentation of this output should be done adequately so that doctors can properly dose their medications and have an accurate representation of the patient’s current condition. Recording a patient’s input is just as important as it can give insight into if a patient is potentially dehydrated or malnourished. This information is vital in keeping the patient safe.

Through this project, we learned more than just what input and output is and how important it is. We also came up with a potential solution and key points to help health care staff to accurately document it. Devices such as an automated urine output device (UOPs) can allow for precise measurements of output from a patient. These devices can help reduce the tedious task of checking the patient’s urinal and allows for accurate handoff when reporting. We discovered other methods that can assist in making sure the health care team accurately documents input and output. This can include increasing the amount of education that is being done via a class online or in person. Classes are an efficient way to educate team members so that they can understand why it is important and how they can do their part in providing accurate documentation. These methods can be implemented to help increase the accuracy of the documentation that is being done.

A lot has been learned through this process and this information can be utilized later on during my practice. Nursing is an ever-changing occupation that requires extensive research and education to be successful. New technology is constantly coming out that can influence proper documentation. This project has taught me the importance of recording what a patient takes in and what they put out. This information can be shared with coworkers while being a nurse which will ultimately provide a positive benefit to the patient. This project has taught me how to collaborate with my peers to achieve a common goal in the health care setting. Quality control will always be a part of health care as we are constantly looking for new and more efficient ways to provide the best care possible. This project required extensive research and critical thinking to interpret and resolve a current issue. With this newly acquired knowledge and skill set, I will be able to further improve my future employer by participating in quality control and evidence-based practice initiatives.

Reflecting on the team process, I am able to see how I performed as a member of the group and how that affected our overall project. I have discovered that I am very effective when it comes to communication. I can help resolve conflict between members by being a mediator. I hold the capability to listen to both sides effectively and be able to help come down to a decision. These qualities can also help me later on when I am practicing as a registered nurse.

Currently, feedback on our dissemination project has yet to be completed. We await the feedback from our clinical instructor and floor personnel.

EBP2-Project-1Download

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Proposing Change

Our project has been very challenging yet interesting as we further discover the importance of maintain and documenting adequate input and output. Tools such as the automated urine output device showed to be helpful in reducing time while providing an accurate urine output. This device could be used throughout health care as the urge to document an accurate urine output increase. The workload for the nurses can be diminished using devices to help with urine output. I was surprised during our research period how difficult it can be to accurately document a patient’s urine output. This could be due to various reasons such as being over worked and fatigued, forgetting to do so, and the patient is not compliant with this process. An easy way to combat this is to document the urine output as soon as it is collected. This is to reduce the documentation errors that can be made when doing so. Education is also a key part we discovered during our research. This is because if the patient and nurse are educated on the importance of urine output, then positive outcomes can come from obtaining and documenting accurate measurements.

This project has made me think of how important it is to trend urine output as it can relate to cardiac and kidney function in a wide variety of populations. There were minimal revisions that we needed to make in our final proposal. We precisely and efficiently described our methods, findings, and evaluating our plan through our use of extensive research.  With this, our project does propose a positive change in the health care industry by strengthening the accuracy of urine output. This use of new devices can happen anywhere and can change the way this process is done in nursing. It will be important to familiarize yourself with these devices and accurately documenting urine output, especially in acute patients.

The process that went into this project was a very well thought out one. We discussed regularly as a group what we wanted to do and how we wanted to execute it. Our team has an immense amount of success through this project. Our research plan set us up with success as we each found an article and went through each one to find the best ones for our project. We went in depth with each article to examine what they testes and the outcomes that came with that. With success comes challenges. Writing out and formulating our thought into a short and precise proposal was challenging. We each had different ideas and thoughts we wanted to include. We had to work through these and formulate the best product that we could. When doing our project, we listened to what each person had to say and tried to incorporate everyone’s views into our project. Communication was the biggest part that allowed us to be successful.

Group-6-Project-Proposal-FINAL-1Download

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Planning Change

This team dissemination project can be completed efficiently and in a timely manner if we all work together. We will have to work on it section by section and in detail in order to receive proper feedback. Communication will be one of the most important things when completing the dissemination project. We currently have a group chat set up to discuss things together. Also, we will be in clinical with each other and have the availability to work on it. Having each person in the group on board and ready to be successful is important. One challenge that can arise is that one group member is not in clinical with us. This challenge can be overcome by proper communication. We all need to be on the same page and ready to adapt. That team member will need to communicate effectively to understand what is going on.

            Conflict within a group project can occur at any point. It is how the group manages that conflict that can determine how successful they are. To minimize this conflict, communication and being flexible is key. Talking through and reasoning with a decision will help reduce conflict as everyone will be on the same page. A group member should not be afraid to go against the majority. This could ultimately help our group by introducing a different point of view. If a group member does not complete work in a timely manner or the work is of poor quality, soothing will be said to correct these issues. It is not personal, rather, trying to push each other to do the best work they can and to care for the project. Ultimately, I believe the group will work together by listening, respecting, and participating to produce the best work that we can. This project will be beneficial as nurse’s work together all the time. They collaborate with other nurses, doctors, therapists, and pharmacists to take care of the patient.

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Influence Paper

Team-Influence-PaperDownload

This team influence paper examines the effects of cannabis on Parkinson’s disease related symptoms. Scholarly studies are analyzed to determine the effect in clinical practice. An exert from the paper is included below.

“Medications, physical therapy, and newly, cannabis, has been reviewed as potential solutions to reduce these symptoms that affect gait, balance, and coordination. The efficacy in clinical practice of cannabis is examined by scholarly sources, as well as, the effects cannabis has on REM sleep behavior disorders in patients with Parkinson’s disease as an alternative form of treatment.”

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Final Reflection

This final project has been very interesting. Going into it, I did not think I would learn so much about the process and my topic. My groupmate and I worked really hard on this project and put everything we had into it. Many challenges presented but through communication and reasoning we were able to resolve it. This project has taught me how to collaborate with others in a way that is not usual. I have never written a paper with another person before but I really enjoyed it. I feel it requires a different set of skills from other collaboration activities. You have to work through every little detail and both agree on it before continuing. This will help me through my career when dealing with similar situations. For a future employer, I would want them to know that I stayed driven and positive during this project. I worked through each assignment diligently and completed it efficiently. From this project, I can contribute to critically appraising articles and help with examining them. I can identify good articles from bad articles by looking over the credentials and reading the article. I can positively contribute to the medical profession by participating in these articles and giving adequate input. Through this team process I was able to identify some of my strengths and weaknesses. I feel like I am strong in designing and articulating words in a way that makes sense and is meaningful. I feel like I need to work on my grammar capabilities as sometimes this was lacking. Over all the team process was very beneficial and provided great cooperation experience.

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Ethical Considerations For EBP

Reviewing the provided resources about nursing and ethics, my opinion has not changed. I understand further that the role of a nurse will entail ethics. This is because patients have a wide view on the practices that they want to participate in. Educating the patient and informing them of recommendations should be a priority of the nurse. With this, it comes down to what the patient feels comfortable doing based on their past experiences or practices. There is a common saying by George Santayana that goes, “Those who do not learn history are doomed to repeat it.” This is the case for ethics in nursing. Understanding what practices have been preformed before will help further the knowledge of the nurse. Taking a deeper dive into these practices can help further progress studies that examine the same variable. A nurse should have a good understanding of the events that have occurred in the past and what lead up to those events. This can help prevent possible complications that could arise. This course specifically has enhanced my knowledge of the relationship between nursing and ethics. This course looks at evidence based practices and how to read, interpret, and explain these articles. It starts with understanding what you are reading. Once you have the ability to interpret results and hold the ability to explain them, the nurse will be able to communicate the results and consider them in their practices. Evidence based practice looks at problem solving in the medical profession while incorporating the patient and family. This should be done with every evidence based article that revolves around care. A nurse should have the capability to participate in these studies once they understand the key concepts of EBP. Contributing can ultimately result in a better experience for the patient by looking at what works and what does not work. This class, along with my ethics class, have delivered home the importance of ethics in nursing. I have the knowledge to examine articles and understand how they can play a role in the care I am providing. In short, the job of the nurse is to provide the most exceptional care keeping in mind the beliefs, values, and morals of the patient.

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Appraisal and Synthesis

Our topic of discussion has been very interesting to use. We have found articles that follow on both sides of for and against the use of cannabis for symptoms related for Parkinson’s disease. This disease has no cure so it is the job of the health care team to explore and find new treatment options that best suites the patient. Our research and analysis of our articles made us really think about ethics and how they can play a role in what treatments work some patients. Some cultures and religions may be against the use of cannabis, but the nurse should always educate patients on the variety of options that they have. Without education, the patient could be left guessing what to do rather than making an informed decision.

This critical appraisal did not change my mind, rather, enforce what I had expected. I knew cannabis could play a role in sleep and muscle tenacity in patient’s who have Parkinson’s disease. I am family with Michael J Fox who is currently sufferings from mild Parkinson’s. We watched videos on him to get a better understanding of how the disease works and affects patients. Our findings still lead us to resort to further research before providing a strong recommendation for or against. This does lead me to follow up on the topic as more research is found out about the efficacy. My teammate and I both agreed with the articles that are pro cannabis as they can be affective. The process of articulating the paper has been a challenge. We both have very expansive minds that can counteract each others views. We debated and both came down to the same consensus. Our writing styles are both different as well but I feel like this can compliment our paper by providing different views intertwined with each other. I feel like our hard work through this process of figuring out our challenges will ultimately benefit us.

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From Inquiry Through Discovery

After thorough development or our PICOT question and retrieving peer edited articles, we found that some revision was needed. We decided to look at a broader age group in which we included anyone receiving the medical marijuana with any age. This helped in finding more article as needed for our paper. In continuation of developing our paper, we looked in depth at each article chosen to compare results and see if they would fit in the scheme of our paper. We want to create a connection between the articles that include the major nursing theory. This was not as easy as it seemed and developed challenges. First was in choosing a theme that correlates with he articles and the scheme of the paper that we want to deliver. This in itself presented a challenge as there was not many theories that we could intertwine into the paper. This made us question some of our sources and we decided to take a look for other sources that could present new information. In doing so, did not completely resolve our issue, rather, gave us more knowledge of our topic and how to discuss it in our paper. With these challenges came success. We were successful in defining what our articles mean and how they relate to each other. With the class activities, we were able to understand what the articles meant and how the information is presented relates to what we need to know. This was not an easy task and required work but we now have a better understanding of what each article is trying to portray. This project has been a challenging one but with determination to succeed, these challenges have been over come so far.

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Planning The Journey

Eric and I plan to be very successful in drafting and writing our team project. We cooperate and listen to each other very well and this will set us up for success. We will be on top of each other throughout this whole project as we live together and can keep each other accountable. If one of us is lacking in our part, we will communicate that and find the most effective compromise to the issue. A benefit we have is that we live together and can do each part together. A down fall is that we both can procrastinate at times but I believe this will not be an issue for this project. This project will benefit my communication with others and increase my ability to problem solve. I look forward to getting after it during this project to show case my abilities.

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