I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 100-120 WORDS

Potential barriers to my EBP project continuing desired results include resistance from staff and waning commitment from staff (Pexton, n.d.). Early mobility of ICU patients involves a lot of work from nurses such as additional assessment and physical demands of mobilizing patients, so I could see how after the initial push the results may decrease. To overcome this, education could be ongoing along with encouragement of staff to express their concerns. Allowing staff to communicate regarding the implementation may bring up points that were not thought of or planned out, leading to improved processes. Waning commitment is another barrier that may reduce the desired outcome of early mobility in the ICU. Many nurses, including myself, feel that we are always given more tasks and asked to do more with less. This may lead to reduced compliance as the program continues. This barrier may be overcome by implementing a communication plan that reaches all ICU staff members and focuses on the positives and “wins” of the project (Pexton, n.d.). Positive feedback from me regarding increased positive patient outcomes due to early mobility would keep the staff motivated and hopefully continue the desired results.  For EBP practices to continue, management also needs to facilitate a culture of improvement and support. Managers and leaders can do this by supporting communication, encouraging staff participations, and establishing priorities (HCPro, 2008). Through education, communication, and management support my EBP project of early mobility of ICU patients could show continued positive results.

References

HCPro. (2008). Nurse managers’ role in evidence-based practice. Retrieved from HCPro:

http://www.hcpro.com/NRS-208146-3238/Nurse-managers-role-in-evidencebased-practice.html

Pexton, C. (n.d.). Overcoming the barriers to change in healthcare system. Retrieved from Six sigma:

Multigenerational nursing

Please, respond to the following discussion by using one reference from peer-reviewed Nursing Journal not older than 5 years.

Some of the challenges of having different generations in the workplace include a difference in education, particularly vocational training, and a difference in communication style. As current practices are studied and re-evaluated, traditional practices may be replaced by those that are more recently researched and are evidence-based. Veteran nurses may believe it is a waste of resources to change a practice that has been in place for so long and, in their view, has yielded adequate results.  Similarly, younger generations may readily dismiss suggestions and viewpoints from veteran nurses in favor of the new practices learned in school without considering that years of clinical experience can be just as valuable. This disconnect between nurses of differing generations may be rooted in a difference of communication style. For example, Baby Boomer nurses were trained to only voice their opinions when asked, whereas Millennial nurses’ were taught to speak up any time they have a problem with, or idea for, new practices; this difference in communication may lead the Baby Boomer nurse to regard the Millennial nurse as impertinent and disrespectful of authority instead of realizing that new nurse is actually trying to improve the patient experience (Phillips, 2016, p.198).

In my experience, some veteran workers can be set in their ways to a fault, even if there is clear evidence that practices they are accustomed to are simply not the best practices anymore. This is not to say that middle-aged or younger workers cannot share this attribute, however the veteran workers sometimes use their field experience as a rationale to ignore current research findings and continue using practices they deem appropriate. Also, as an employee that is frequently on the team that rolls out new technology and equipment, I feel that veteran workers take more time to warm up to change and can be somewhat hostile to a younger person, such as myself, training them.

As far as accommodations, we have certain older employees that will not perform job-necessary duties because of back issues, knee issues, or other medical issues in the same vein. As a result, these employees rarely get assigned total care patients, making the younger staff resentful because they feel they, literally, do all the heavy lifting while these older employees are routinely assigned the less acute patients. To a certain extent, allowances should be made for older workers, including nurses. After a lifetime of caring for patients, it is reasonable to deduce that the joints, particularly knees and back, can be irreparably damaged from repeated use. However, in my opinion if an employee is unable to perform the duties required of their job title, they should be doing a different job. It is not fair that one group of nurses consistently gets less acute patients, thereby doing half the work, but still receiving the same benefits as those nurses that pick up the slack. A potential solution would be for the nurses with physical limitations to shift to a position that utilizes their experience but is less physically demanding; such positions include resource nurse, case manager, or patient care coordinator. If this were fiscally feasible, the unit would be able to retain the wealth of knowledge provided by these seasoned nurses and still have room to hire new nurses that can help distribute the patient loads more equitably.

            Life expectancy in the United States has increased over the past few decades and older people are generally healthier than their predecessors, however the incidence of chronic conditions has also increased in this time frame (Tabloski, 2014, p.8). This indicates that there are more people to care for and these patients are more likely to have multiple comorbidities. This trend has the potential to put an enormous strain, economically and physically, on an already overburdened health care system and nurses, particularly bedside nurses, will bear the brunt of this (Tabloski, 2014, p.13). It is important that nurses engage in primary and secondary prevention with this population, including education related to diet, exercise, and proper medication utilization (Tabloski, 2014, p.13). By encouraging older patients to take an active role in preservation of function and overall health, nurses empower these patients to help decrease their risk for chronic conditions, like hypertension, and injury (Tabloski, 2014, p.13). Also, nurses must be educated on specific attributes of the older population, such as increased sensitivity to certain medications, decreased sensory perception, and increased susceptibility to mental health issues, such as depression, that may affect their physical health or motivation to maintain a healthy lifestyle.le

I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT…BETWEEN 100-120 WORDS

Within the Grand Canyon University (GCU) Library there are multiple resources available to access scholarly journal articles. In the field of nursing and health sciences two scholarly databases include CINAHL Complete and OVID Nursing Essential Collection (Grand Canyon University [GCU], n.d.). CINAHL Complete is a database geared towards nurses and other health care providers and covers nursing specialties, nutrition, and speech language pathology. It contains the full text for more than 1,300 journal titles, many of which are peer reviewed (GCU, n.d.). OVID Nursing Essential Collection contains 112 full text journal titles along with Lippincott, Williams, & Wilkins Nursing & Health Professions Premier Collection which provides access to 64 journal titles (GCU Library, n.d.). Within the GCU Library these are the two scholarly databases I use the most. These databases are better to use than an internet search or Google Scholar because they contain articles that are often from peer reviewed journals that can be trusted. Journal articles found through these databases include an author or authors, dated material which allows for a search of current information, and most contain facts backed by evidence that is cited and often contain statistical data (Grand Canyon University [GCU] Library, n.d.). Information from website searches may be biased, out of date, or lack concrete evidence to back up claims or opinions. By using information from one of the GCU Library scholarly databases I can be sure that the information I am using is trustworthy.

References

Grand Canyon University Library. (n.d.). Evaluating web sites tutorial transcript. Retrieved from Grand Canyon University Library: http://lc.gcumedia.com/mediaElements/evaluating-websites-tutorial/v2.1/documents/transcript.pdf

Grand Canyon University. (n.d.). Journal atabases- Nursing and health sciences. Retrieved from Grand Canyon University Library:

http://library.gcu.edu/Database/Subject?subject=Nursing_And_Health_Sciences

Nurse Practitioners (NPs) obtain their licenses through independence in healthcare sectors for nurses with specialist in provision of healthcare services. The main role of Nurse Practitioners are obtaining assessment, diagnosing, treatment and management of acute and chronic illness.  Besides, they are tasked with responsibility of giving orders, conducting, supervising and interpretation of laboratory tests (Kellams & Maye, 2017). In general, Nurse practitioners are usually experts in health promotion and prevention of diseases. For the case of a Nurse practitioner who is licensed, they have roles in coordinating activities of health care with other health care professionals. When licensed, they provide services as researchers, advocates to patients and a team of consultants. However, responsibility of Nurse Practitioners are involved in healthcare provisions for families, groups or even relatives. 

Expectations of a nurse in giving health services calls for accountability in all duties they undertake. In accountability, it is the role of nurses to deal with code of conduct, issuance of certificates at national levels, reviews on work progress among colleagues and evaluation of outcome from nurses as a profession. 

NP role is giving commitment to work and meet patients as they enter to healthcare centers. Nurses have mandate of showing and practicing healthcare science to all patients. Nurse Practitioners are responsible for all healthcare issues pertaining patients while at healthcare centers. Nurses take responsibilities and are involved at local national and international levels while making decision pertaining service provision to different stakeholders. Moreover, nurses provide professional assessment for collogues in development of their professionalism and actively participate in activities related to medication. According to Kellams and Maye, (2017), it is clear that Nurse Practitioners have been providing quality healthcare services. 

References

Comprehensive Drug Abuse Prevention and Control Act of 1970. Retrieved on March 10, 2019 fromhttps://en.wikipedia.org/wiki/

Comprehensive_Drug_Abuse_ Prevention_and_Control_Act_of_1970

Kellams, J. R., & Maye, J. P. (2017). The last state to grant nurse practitioners DEA licensure: An education improvement initiative on the Florida prescription drug monitoring program. Journal of addictions nursing, 28(3), 135-142. doi: 10.1097/JAN.0000000000000177

I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 100-120 WORDS

This evidence based practice (EBP) project involves implementing ventilator associated pneumonia (VAP) care bundles at least eighty percent of the time in order to reduce the incidents of VAP. Dependent variables are variables that are not changed or manipulated (Helmenstine, 2017). In this EBP, the dependent variable that would be collected will be the incidents of VAP in patients that are mechanically ventilated longer than 48 hours and do not receive at least 80 percent compliance with VAP bundles. This will be the baseline to compare the effectiveness of the VAP bundles. The independent variable is the variable that is changed or manipulated (Helmenstine, 2017). The independent variable that will be collected is the number of patients that develop VAP after having been mechanically ventilated longer than 48 hours and received at least 80 percent compliance with VAP bundle care. Comparing these two variables will show the effectiveness of VAP bundles. This method of evaluation poses a problem because it relies heavily on the nurses and other staff members to accurately document when interventions are or are not carried out. Time constraints and heavy workloads can cause nurses to miss interventions or simply forget to chart them. One way to overcome this challenge is to give every ventilated patient a paper checklist that can be passed along with the SBAR during change of shift. It provides both a reminder and a record of the interventions that were completed, making collecting the information easier. The charge nurse will then take that check list and ensure that the data is plotted on the unit goals board so that everyone can see the progress being made as well as when the unit is lacking.

Helmenstine, T. (2017, August). Understand the Difference Between Independent and Dependent Variables. Retrieved January 17, 2018, from https://www.thoughtco.com/i-ndpendent-and-dependent-variables-differences-606115