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Discussion  : End of Life initial post.

End-of-Life Care (including advanced directives, palliation) Topics to review:

Article: Nurses roles and responsibilities Providing care and support at end of life. https://www.nursingworld.org/~4af078/globalassets/docs/ana/ethics /endoflife-positionstatement.pdf

choose 1 focal point from each subcategory of practice, education, research and administration and describe how the APRN can provide effective care in end of life management

Using the American nurses association position statement, recommendations for improvement in end of life management focuses on practice, education, research and administration. Listed below are steps that nurses can take to overcome barriers in healthcare practice.

Practice

1. Strive to attain a standard of primary palliative care so that all health care providers have basic knowledge of palliative nursing to improve the care of patients and families.

2. All nurses will have basic skills in recognizing and managing symptoms, including pain, dyspnea, nausea, constipation, and others.

3. Nurses will be comfortable having discussions about death, and will collaborate with the care teams to ensure that patients and families have current and accurate information about the possibility or probability of a patient’s impending death.

4. Encourage patient and family participation in health care decision-making, including the use of advance directives in which both patient preferences and surrogates are identified.

Education

1. Those who practice in secondary or tertiary palliative care will have specialist education and certification.

2. Institutions and schools of nursing will integrate precepts of primary palliative care into curricula.

3. Basic and specialist End-of-Life Nursing Education Consortium (ELNEC) resources will be available.

4. Advocate for additional education in academic programs and work settings related to palliative care, including symptom management, supported decision-making, and end-of-life care, focusing on patients and families.

Research

1. Increase the integration of evidence-based care across the dimensions of end-of-life care.

2. Develop best practices for quality care across the dimensions of end-of-life care, including the physical, psychological, spiritual, and interpersonal.

3. Support the use of evidence-based and ethical care, and support decision-making for care at the end of life.

4. Develop best practices to measure the quality and effectiveness of the counseling and interdisciplinary care patients and families receive regarding end-of-life decision-making and treatments.

5. Support research that examines the relationship of patient and family satisfaction and their utilization of health care resources in end-of-life care choices.

Administration

1. Promote work environments in which the standards for excellent care extend through the patient’s death and into post-death care for families.

2. Encourage facilities and institutions to support the clinical competence and professional development that will help nurses provide excellent, dignified, and compassionate end-of-life care.

3. Work toward a standard of palliative care available to patients and families from the time of diagnosis of a serious illness or an injury.

4. Support the development and integration of palliative care services for all in- and outpatients and their families.

*DUE IN THE NEXT 15HOURS PLEASE!

Being able to articulate your personal worldview can help you formulate a personal philosophy of practice and enhance your influence on patients and the industry. In this assignment, you will have an opportunity to reflect on your current and future practice, and the ways worldview and nursing theory influence that practice.

Draft a 1,000-1,250 word paper in which you:

  1. Describe your personal worldview, including the religious, spiritual, and cultural elements that you think most influence your personal philosophy of practice and attitude towards patient care.
  2. Choose a specific nursing theory that is most in line with your personal philosophy of practice and approach to patient care and discuss the similarities. Explain how the nursing theory reinforces your approach to care.
  3. Include in your explanation a specific example as a nurse of a past or current practice and how your worldview and the nursing theory could assist you in resolving this issue.
  4. Finally, explain how your worldview and the nursing theory will assist you in further developing your future practice.

You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

DUE IN THE NEXT 15HOURS PLEASE!

Being able to articulate your personal worldview can help you formulate a personal philosophy of practice and enhance your influence on patients and the industry. In this assignment, you will have an opportunity to reflect on your current and future practice, and the ways worldview and nursing theory influence that practice.

Draft a 1,000-1,250 word paper in which you:

  1. Describe your personal worldview, including the religious, spiritual, and cultural elements that you think most influence your personal philosophy of practice and attitude towards patient care.
  2. Choose a specific nursing theory that is most in line with your personal philosophy of practice and approach to patient care and discuss the similarities. Explain how the nursing theory reinforces your approach to care.
  3. Include in your explanation a specific example as a nurse of a past or current practice and how your worldview and the nursing theory could assist you in resolving this issue.
  4. Finally, explain how your worldview and the nursing theory will assist you in further developing your future practice.

You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

*DUE IN THE NEXT 15HOURS PLEASE!

Being able to articulate your personal worldview can help you formulate a personal philosophy of practice and enhance your influence on patients and the industry. In this assignment, you will have an opportunity to reflect on your current and future practice, and the ways worldview and nursing theory influence that practice.

Draft a 1,000-1,250 word paper in which you:

  1. Describe your personal worldview, including the religious, spiritual, and cultural elements that you think most influence your personal philosophy of practice and attitude towards patient care.
  2. Choose a specific nursing theory that is most in line with your personal philosophy of practice and approach to patient care and discuss the similarities. Explain how the nursing theory reinforces your approach to care.
  3. Include in your explanation a specific example as a nurse of a past or current practice and how your worldview and the nursing theory could assist you in resolving this issue.
  4. Finally, explain how your worldview and the nursing theory will assist you in further developing your future practice.

You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

Discussion Board  2: End of Life Care.

Choose 1 focal point from each subcategory of practice, education, research and administration and describe how the APRN can provide effective care in end of life management

Using the American nurses association position statement, recommendations for improvement in end of life management focuses on practice, education, research and administration. Listed below are steps that nurses can take to overcome barriers in healthcare practice.

Practice

1. Strive to attain a standard of primary palliative care so that all health care providers have basic knowledge of palliative nursing to improve the care of patients and families.

2. All nurses will have basic skills in recognizing and managing symptoms, including pain, dyspnea, nausea, constipation, and others.

3. Nurses will be comfortable having discussions about death, and will collaborate with the care teams to ensure that patients and families have current and accurate information about the possibility or probability of a patient’s impending death.

4. Encourage patient and family participation in health care decision-making, including the use of advance directives in which both patient preferences and surrogates are identified.

Education

1. Those who practice in secondary or tertiary palliative care will have specialist education and certification.

2. Institutions and schools of nursing will integrate precepts of primary palliative care into curricula.

3. Basic and specialist End-of-Life Nursing Education Consortium (ELNEC) resources will be available.

4. Advocate for additional education in academic programs and work settings related to palliative care, including symptom management, supported decision-making, and end-of-life care, focusing on patients and families.

Research

1. Increase the integration of evidence-based care across the dimensions of end-of-life care.

2. Develop best practices for quality care across the dimensions of end-of-life care, including the physical, psychological, spiritual, and interpersonal.

3. Support the use of evidence-based and ethical care, and support decision-making for care at the end of life.

4. Develop best practices to measure the quality and effectiveness of the counseling and interdisciplinary care patients and families receive regarding end-of-life decision-making and treatments.

5. Support research that examines the relationship of patient and family satisfaction and their utilization of health care resources in end-of-life care choices.

Administration

1. Promote work environments in which the standards for excellent care extend through the patient’s death and into post-death care for families.

2. Encourage facilities and institutions to support the clinical competence and professional development that will help nurses provide excellent, dignified, and compassionate end-of-life care.

3. Work toward a standard of palliative care available to patients and families from the time of diagnosis of a serious illness or an injury.

4. Support the development and integration of palliative care services for all in- and outpatients and their families.

The Clinical Evaluation Tool (CET) lists five core concepts with bulleted illustrations of each concept. Caring, nursing process, comfort & pain, quality & safety, cultural awareness, and health promotion are displayed throughout the CET to demonstrate inclusion of  University’s philosophical framework.

Instructions

The Professional student will complete the CET at midterm and final. For each evaluation period, the student will provide an overall summary statement AND a meaningful, substantive, narrative account under each core concept. This narrative will include specific clinical examples which support the “fully met” or “partially met” concept. The clinical instructor will review the completed CET and provide summary comments and added feedback as necessary. The final electronic document will be retained for the student’s academic file. The CET will be returned to the student for resubmission if it is not completed with sufficient detail.

 

Midterm Evaluation

Date:   Pass/Fail:

Student Summary statement of overall performance, including strengths, areas for improvement, and goals for the remaining weeks:

Student Signature:

————————————————————————————-­­­­———————–

Final Evaluation

Date:  Pass/Fail:

Student Summary statement of overall performance, including strengths, and areas on which to focus for the future:

Student Signature:

Core Concepts

I. Incorporate effective modes of communication with patients and other healthcare providers

The professional role transition student:

· Incorporates personal and professional caring attributes in the delivery of care (caring)

· Displays confidence and evaluates interactions in communicating with faculty, staff, healthcare team members, patients and families (nursing process)

· Demonstrates competence in using a variety of resources to facilitate communication with diverse patient populations, including those with limited English proficiency and health literacy (cultural awareness)

Midterm:

This concept is: (5) fully met ___ (3) partially met ___ (1) not met ___

Student/Instructor comments and supportive evidence:

Final:

This concept is: (5) fully met ___ (3) partially met ___ (1) not met ___

Student/Instructor comments and supportive evidence:

 

II. Assimilate professional behaviors that adhere to standards of practice and legal/ethical codes

The professional role transition student:

· Integrates professional standards of diagnosis, assessment, outcome identification, planning, implementation, and evaluation into delivery of care (caring; nursing process)

· Advocates for effective pain management (comfort & pain)

· Arrives on time and prepared for clinical displaying a professional appearance (quality & safety)

· Integrates professional accountability and follow through (quality & safety)

Midterm:

This concept is: (5) fully met ___ (3) partially met ___ (1) not met ___

Student/Instructor comments and supportive evidence:

Final:

This concept is: (5) fully met ___ (3) partially met ___ (1) not met ___

Student/Instructor comments and supportive evidence:

 

III. Engage in collaborative practices with the healthcare team

The professional role transition student:

· Collaborates with appropriate interdisciplinary team members to plan, deliver, and evaluate care in a timely manner (nursing process)

· Advocates for informed patient participation in care (quality & safety)

· Collaborates with patients and families to achieve mutually agreed upon goals (cultural awareness)

Midterm:

This concept is: (5) fully met ___ (3) partially met ___ (1) not met ___

Student/Instructor comments and supportive evidence:

Final:

This concept is: (5) fully met ___ (3) partially met ___ (1) not met ___

Student/Instructor comments and supportive evidence:

 

IV. Evaluate evidence-based practice (EBP) in guiding professional nursing

The professional role transition student:

· Evaluates use of EBP into own professional practice (nursing process)

· Analyzes and individualizes evidence-based plan of care (quality & safety)

Midterm:

This concept is: (5) fully met ___ (3) partially met ___ (1) not met ___

Student/Instructor comments and supportive evidence:

Final:

This concept is: (5) fully met ___ (3) partially met ___ (1) not met ___

Student/Instructor comments and supportive evidence:

 

V. Incorporate critical thinking in the application of professional nursing

The professional role transition student:

· Integrates the physiology, pathophysiology, pharmacotherapeutic, spiritual, and sociocultural knowledge in designing, implementing, and evaluating patient plan of care (nursing process; comfort & pain)

· Applies technology and information management tools to support safe processes of care (quality & safety)

· Prioritizes patient’s health promotion needs (health promotion)

Midterm:

This concept is: (5) fully met ___ (3) partially met ___ (1) not met ___

Student/Instructor comments and supportive evidence:

Final: 

This concept is: (5) fully met ___ (3) partially met ___ (1) not met ___

Student/Instructor comments and supportive evidence:

  • attachment

    CET.docx

The point of the nursing process is to impose easy to follow steps and critical thinking on the provision of excellent care. This is more of a process then something linear, because everything is situational. Its more of a guidance, so the nurses are organized and can use these steps to get to their goal (Black ,2017.)

Phase 1: Assessment. This is the phase where information about the patients family or community is gathered, such as physiologic, spiritual, environmental, or sociocultural information. There are subjective and objective data that nurses must obtain from patients. Subjective data is when a patient is describing their perceptions, needs, feelings of the problem. Objective data is data collected through examination (Black, 2017.)

Phase 2: Analysis. This is the data-gathering phase which nurses group data to identify the problem. It Is necessary to follow the PES system so that there is a correct diagnosis. This system is split into 3 parts, which is problem, etiology, and symptoms. The nurse can use this data to come up with a diagnosis (Black, 2017.)

Phase 3: Planning. The nurse must identify the patients goals and determine what will reach those goals. Both the patient and the nurse use goals to evaluate the patient’s progress and how far they came from the start (Black, 2017.)  This will also make the patient confident as well when they are near their goal.

Phase 4: Implementation of Planned Interventions. This occurs when nursing orders are carried out. Interventions are included in this phase, such as educating patients and pain management. This step is very important, since you’re developing a blueprint on how to get closer to your goal by holistic help, which is common in the nursing field (Black, 2017.)

Phase 5: Evaluation. This phase is when the problem is solved, and ultimately, to lay out the goal. The patients progress is monitored by the nurse, to see how far they got and if they achieved their goal. The nurse plans out how to get closer to the overall goal, if some things are not met yet (Black, 2017.)

To prepare:

  • Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.
  • By Day 1 of this week, you will be assigned a case study by your Instructor. Note: Please see the “Course Announcements” section of the classroom for your case study assignment.
  • Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient assigned to you.
  • Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
  • Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?
By Day 3 of Week 2

EB is a 68-year-old black female who comes in for follow-up of hypertension. She has glaucoma and her vision has been worsening during the past few years. She lives alone and is prescribed four hypertension medications (Hydralazine 50 mg PO Q8H, Metoprolol XL 200 mg PO Q12H, Lisinopril 40 mg PO daily, and HCTZ 25mg PO daily ). She brings in her medication bottles and she has some medication bottles from the previous year full of medications. She is missing one medication she had been prescribed and says she may have forgotten it at home. Her BP in clinic today is 182/99 with HR of 84.

Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

Discussion # 2 : End of Life i

End-of-Life Care (including advanced directives, palliation) Topics to review: Article: Nurses roles and responsibilities Providing care and support at end of life. https://www.nursingworld.org/~4af078/globalassets/docs/ana/ethics /endoflife-positionstatement.pdf

For your initial post/ threat choose 1 focal point from each subcategory of practice, education, research and administration and describe how the APRN can provide effective care in end of life management

Using the American nurses association position statement, recommendations for improvement in end of life management focuses on practice, education, research and administration. Listed below are steps that nurses can take to overcome barriers in healthcare practice.

Practice

1. Strive to attain a standard of primary palliative care so that all health care providers have basic knowledge of palliative nursing to improve the care of patients and families.

2. All nurses will have basic skills in recognizing and managing symptoms, including pain, dyspnea, nausea, constipation, and others.

3. Nurses will be comfortable having discussions about death, and will collaborate with the care teams to ensure that patients and families have current and accurate information about the possibility or probability of a patient’s impending death.

4. Encourage patient and family participation in health care decision-making, including the use of advance directives in which both patient preferences and surrogates are identified.

Education

1. Those who practice in secondary or tertiary palliative care will have specialist education and certification.

2. Institutions and schools of nursing will integrate precepts of primary palliative care into curricula.

3. Basic and specialist End-of-Life Nursing Education Consortium (ELNEC) resources will be available.

4. Advocate for additional education in academic programs and work settings related to palliative care, including symptom management, supported decision-making, and end-of-life care, focusing on patients and families.

Research

1. Increase the integration of evidence-based care across the dimensions of end-of-life care.

2. Develop best practices for quality care across the dimensions of end-of-life care, including the physical, psychological, spiritual, and interpersonal.

3. Support the use of evidence-based and ethical care, and support decision-making for care at the end of life.

4. Develop best practices to measure the quality and effectiveness of the counseling and interdisciplinary care patients and families receive regarding end-of-life decision-making and treatments.

5. Support research that examines the relationship of patient and family satisfaction and their utilization of health care resources in end-of-life care choices.

Administration

1. Promote work environments in which the standards for excellent care extend through the patient’s death and into post-death care for families.

2. Encourage facilities and institutions to support the clinical competence and professional development that will help nurses provide excellent, dignified, and compassionate end-of-life care.

3. Work toward a standard of palliative care available to patients and families from the time of diagnosis of a serious illness or an injury.

4. Support the development and integration of palliative care services for all in- and outpatients and their families.