The Healthcare Quality Strategy Nursing Essay

The Healthcare Quality Strategy Nursing Essay This essay will discuss a significant event in relation to the peoples priorities identified within the Healthcare Quality Strategy. It will also discuss my role as a student nurse in relation to a patient who is receiving palliative care. The essay will demonstrate my understanding and views on reflection and the issues surrounding my practice. I have chosen Gibbs (1988) reflective framework as it has a structured format and six steps which follow in order starting with a description of the event and ending with an action plan for future practice. The steps are Description, Feelings, Evaluation, Analysis, Conclusion and Action Plan (Gray, 2007). Reid, (1993) describes reflection as a process of reviewing an experience of practice in order to describe, analyse, evaluate and so inform learning about practice. In May 2010, the Scottish Government introduced the Healthcare Quality Strategy for NHS Scotland, their aim is to deliver the peoples priorities which are: firstly caring and compassionate staff and services, good communication and a clear explanation about conditions and treatments, effective teamwork between clinicians, patients and others, a clean and safe care environment, continuity of care and clinical excellence. Secondly, to bring together the patients priorities as well as the values of everyone working within the NHS Scotland. Thirdly, by applying these three interventions and putting them into practice improvements within priority areas of the Healthcare Quality Strategy will be met (Scottish Government, 2010, p.6). This reflective account will focus on the importance of communication and how it can affect individuals. It will identify if the priority was met in relation to my significant event and it will further clarify its importance (Scottish Government, 2010, p.6). Description Whilst on my Management Placement I met Janet, she is 65 years old and has been admitted to my ward for palliative care. She has end stage bowel cancer and is awaiting a bed at the local hospice. All names have been changed to protect her identity and maintain confidentiality (NMC, 2008). Janets GP has requested that she be admitted onto the ward as she is now confined to bed because of increased pain and a general deterioration of her condition (Dougan and Colquhoun, 2006). Feelings Whilst carrying out my training as a student nurse, I have met a number of palliative patients and I feel that I lack confidence when communicating with these patients and their families at this difficult time. However, whilst on this placement I was able to build up a good rapport with Janet and her family and this allowed me to provide good patient centred care (NMC, 2008). Therefore when dealing with Janet and her family at this difficult time I must treat Janet as an individual (NMC, 2008) and I must provide the best care for my patient and be caring and compassionate always (Scottish Government, 2010, p.6). I was privileged to have the opportunity to be involved in Janets care as well as working within a ward of clinical excellence (Scottish Government, 2010, p.6). Evaluation When caring for palliative patients a holistic approach with continuity of care is extremely important and all nurses have a central role in providing information, care and support (Kennedy and Lockhart, 2007). Excellent communication and good interpersonal skills are paramount when caring for Janet, it is important not only to establish Janets wants and needs but also her families. It is imperative when relaying any information to Janet or her family make sure they understand it, if not explain the information to them again (NMC, 2008). Also when dealing with members of the multi-disciplinary team, effective teamwork is imperative again providing Janet and her family with continuity of care and the clinical excellence they require from all staff. I feel the Quality Strategy aim was achieved, as all staff when looking after Janet dealt with her in a caring and reassuring manner at all times, in turn providing Janet with the best care, whilst she was on the ward (Scottish Government, 2010). Analysis Palliative care helps to improve the quality of life for patients and their families who have to come to terms with the difficulties associated with life threatening illness. It is about identifying the patients needs through accurate assessment, good symptom control and sensitive nursing care (Scottish Partnership for Palliative Care, 2012). When planning Janets care I must take a holistic approach and look at her physical, psychological, social, emotional and environmental needs. This included not only the patient, the hospital and any multi-disciplinary team members but also her husband and any other family members she would like involved (Dougherty and Lister, 2011). As Janets condition could change from day to day her care plan was reviewed on a daily basis and updated accordingly (Dougan and Colquhoun, 2006). Good communication is paramount when dealing with my patient, it is important to listen and support them and make sure any information they have been given, do they understand it, if not explain it to them again (NMC, 2008). It is also important to document any care given to the patient in accordance with the NMC guidance on record keeping (NMC, 2009). In addition to caring for Janet on the ward I was given the opportunity to go to the Hospice and meet with Janets palliative care nurse and also be included in her multi-disciplinary team meeting. This again highlighted the importance of good communication and good record keeping as all team members are aware of Janets circumstances and can pick up her file and know exactly what is happening with Janet at any given moment (Nice, 2004). This meant that when I was communicating with Janet and her family I was more confident and I was able to communicate in a language that they understood (Dunne, 2005). As well as building a trusting relationship between nurse and patient, good communication skills again helps to reduce fear and anxiety at this stressful time (Dunne, 2005). When dealing with patients who are receiving palliative care the peoples priorities are relevant. All nurses must be able to make the patient as comfortable as possible, be aware of their wants and needs and provide a safe and clean environment (Scottish Government, 2010, p.6). On reflection this event has brought further awareness of the level of involvement of staff members from nursing auxiliaries, nurses and consultants. This was shown by the number of multi-disciplinary meetings, assessments, re-assessments, written correspondence and working hours placed into looking after this patient (NMC, 2009). All staff members were committed to providing the correct input and treatment for this patient and to make her last few days as comfortable as possible (Scottish Government, 2008). Conclusion This reflection has demonstrated the difficultly in caring for palliative care patients. It requires a holistic approach to ensure that the patient and their family receive the best possible attention. Nurses have a duty to ensure that the care they deliver is of an acceptable standard (NMC, 2008). While participating in ward rounds I took on board the doctors instructions and carried out and prioritised the care of my patient, therefore making Janets stay in hospital as comfortable as possible. The code provides values, which can be adapted to any setting and as long as these are followed, nurses will be able to carry out their legal and professional duty of care (NMC, 2008). Action Plan Palliative care is a sensitive subject to deal with but I feel that as long as you treat the patient as an individual, listen to their wants and needs, then a positive outcome can be accomplished. Communication and good interpersonal skills are once again highlighted as an essential part of good nursing practice. I must be an effective communicator and be able to provide a high standard of care at all times and this is imperative when dealing with palliative care patients. I must keep my knowledge and skills up to date (NMC, 2008). Identify Steps Through experience of this placement and in relation to my transition from student nurse to staff nurse; the steps to facilitate an improvement and development would be to ensure effective communication with all staff and all members of the multidisciplinary team. This includes accurate record keeping and collection of all relevant information from the patient and their family in order to deliver safe effective patient care. It also promotes a positive nurse patient relationship and offers reassurance at this difficult time (Dunne, 2005). In addition palliative care does not only deal with cancer patients but with patients who have long term chronic illnesses such as multiple sclerosis, heart disease and respiratory problems, therefore palliative care is relevant today and also in the future because we will be caring for an ageing population (Scottish Partnership for Palliative Care, 2012) In conclusion and in relation to The Healthcare Quality Strategy I feel that Janet was looked after in a caring and compassionate manner at all times and the nursing auxiliaries and nurses looking after Janet worked well together putting her first and treating her with respect at all times (Scottish Government, 2010). Conclusion In conclusion and in relation to The Health Quality Strategy and my transition from student to nurse, Bowie (2010) states that positive practice should be highlighted as it allows others to learn from it and provides opportunities to improve the safety of patient care. Reflecting on these events has helped me to identify areas where practice needs improvement and given me a greater insight into my own role as a registered nurse.

The Passing Of Arthur And Excalibur :: essays research papers

John Boorman adapted the †Passing of   Ã‚  Ã‚  Ã‚  Ã‚  Arthur† in the movie â€Å"Excalibur.† Movies are not the only adaptations of Tennyson’s poem but there are several art and music adaptations. Examples of these adaptations include music by Loreena McKennit and paintings by John William Waterhouse, Howard Pyle and Arthur Rackham. In Bela Balazs’s Art Form and Material Balazs states that a good adaptation is a reinterpretation of the original. Boorman uses nature and color to recreate the atmosphere of the original text. These techniques enhance the richness of the movie, provide a more in depth view of Arthur’s life and make the setting more interesting.   Ã‚  Ã‚  Ã‚  Ã‚  Tennyson’s descriptive writing allows the reader to form detailed pictures. The atmosphere Tennyson creates focuses a lot on the beauty of nature. During the scene when Bedivere throws Excalibur in the lake he describes the area with â€Å"zigzag paths, and juts of pointed rock, the shining levels of the lake...the winter moon, long cloud and frost.† He produces an atmosphere of bleakness and despair.   Ã‚  Ã‚  Ã‚  Ã‚  Tennyson concentrates on the image of the winter moon while Bedivere tries to get rid of the Excalibur. This picture makes the reader think that the setting is a winter night. According to Webster’s dictionary, winter symbolizes of coldness, misery or death. Winter is the season when living things die. The moon only comes out during the night. At night people â€Å"rest† from their busy lives and do nothing. Night closely related to winter because both are very dark and bleak times. The lack of light shows the sadness happening to Arthur. As Arthur passes the only light he has comes from the winter moon. The reader gets the feeling that Arthur is heading there. Tennyson chooses dark words and images to create a very desolate and gloomy setting.   Ã‚  Ã‚  Ã‚  Ã‚  Sidney Lumet states in Making Movies â€Å"there are no unimportant decisions in a movie.† Production designers put a lot of effort to recreate the original text. The setting is a very important factor in making a movie. It contributes to much of the style of a movie. Settings reflects many of the directors insights and opinions. There are times where the director goes to great lengths just to form the perfect scene. They leave no detail spared. According to Lumet, a director’s goal is to create a setting so that the audience feels apart of the movie’s world.   Ã‚  Ã‚  Ã‚  Ã‚  When the director needs to find a setting for his/her movie Lumet recommends to â€Å"find places that are closest to what you want to end up with.† If the setting needs to be changed it can change the atmosphere and become expensive too. Art direction

Greatest Gift You Can Give Essay

As I sat and observed the ticking clock, as I saw yet another day come to an end†¦ just like the ones before it had, I understood how precious time is. Here are a couple reasons why I think that; I’ve always believed that the greatest gift we can share with those we love is time. There are some things money just cannot buy, and in the long run our memories are far more valuable than any material goods we receive. There’s a reason why I always believed that the greatest gift we can share with those we love is time because memories have sentimental value that lasts you a lifetime. Having a Lamborghini and enjoying it one your own is only half as rewarding as having someone enjoy it with you. Sharing time with your loved ones, on the other hand, creates lasting memories that will always accompany you. After all, it is all about quality, not the quantity of the time with spend with others. There’s a reason people say money can’t buy happiness or money just cannot buy everything. Time is the greatest gift to give out because you can always make more money, but the people you care about won’t be around forever. Therefore, it is important to make the time for your loved ones. Once a person starts working full-time you can lose yourself in your job and begin living to work instead of working to live. This might result in you becoming rich but you miss out on the time you could’ve spent with the people you truly care about. To prevent this from happening it is crucial to have a balance between work and family life. To be truly happy and to have a fulfilling life you must pay close attention to time you spend accumulating material things and how much you spend with family and friends. â€Å"The greatest gift you can give someone is your time because when you are giving someone your time, you are giving them a portion of your life that you will never get back. † – Anonymous

The Writing Process Part 1 Finding a job in today’s tough job market Essays

The Writing Process Part 1 Finding a job in today’s tough job market Essays The Writing Process Part 1 Finding a job in today’s tough job market Paper The Writing Process Part 1 Finding a job in today’s tough job market Paper The Writing Process Part 1 Finding a job in today’s tough job market It is well known that we are in the midst of an unfathomable economic depression or otherwise the worst economic situation since the period of the great depression. Almost every organizations or companies are announcing daily about reducing employment and the unemployment level is increasing rapidly to the worst level. There is high competition in the job market so it is essential that you use the available tools so that you can achieve the position that you aspire. Now let us take some of the essential key rules of thriving into a job search in the tough job market. However, before I start giving out essential principles of successful job search, I want to present to you how I managed to get my job. When I graduated from the college nearly eight years ago, I bought a newspaper, read through the advertisement job pages and I was ever connected on the network. I kept on like this until one time I received a call from one of the biggest automotive industry. Therefore, you have to know that going through a job search is mentally exhausting. However, you should be patience because it can be sometimes frustrating and leads to rejection especially when you fail to get a job for a long time. It is essential to prepare for a job search just like the way athletes prepare for a competition. You should know that everybody is going though the same process and it is normal but eventually success comes after when you adhere to the following tips, First, use the technology for your own benefit. In the modern world, technology has become a vital tool in that one cannot do without it. Therefore, you should utilize technology as much as possible. It is good to create e-mails and subscribe for job alerts that match with your course criteria. Create blogs on the subject of your expertise area and stay connected to social networks. I am sure that you are aware of the network and even familiar with it because mostly you do research work or course work using the computer or form a group discussion. So do not go outside and forget that computer have completed their college work. It is now that you should understand that you are going to need computers more than ever. Take use of social networking. Make sure that to attend various organizational events where you can be able to meet all kinds of people and try to seek advice on job search from them. Do not get tired and feel discouraged even though they will not attend you positively. You should be patience and understand why you are out their and what you are searching for because it is through hardworking and tolerance that you can be able to achieve your goals. You should bear in mind that the purpose of attending events on different organizations is to be acquainted with the skills and grow in your networking. This will enable you to develop potential skills that will one time help you when being called for an interview (Roebuck and McKenney, 2006). You should prepare fully for an interview. I know everybody will search to get an interview but the interviews are not meant for open positions. In this point, you should now realize that social networking is crucial because you might be interviewed on what you know about the company where you have gone for an interview. Incase you had already attended the company’s events you are then likely to pass your interview. Another thing you should not forget is dressing code when going for an interview. Some people tend to forget that dressing is part of an interview therefore, incase you are interviewed for a manufacturing industry, be in a conservative attires. Part 2 The process I used to draft my message was that first, I had to organize the message by choosing on the essential ideas that can enable me to deliver my message. I started with prewriting my speech whereby I outlined many points. Secondly, I started writing down the crucial ideas on another draft. In addition, I had to revise on my points that can enable me to draw the attention of my audience. Lastly, I revised my points in order to ensure whether my speech met the required value. My audiences are the students who will be graduating because they are the one mostly affected especially when it comes to competition for jobs in today’s job market. However, other audience may include parents and guardians who will accompany them to graduation because they are affected indirectly especially when it comes to helping their children find a job. Others may include honorable guests and lecturers who will be present in graduation day. In addition, business managers and others executive members from different companies or organizations who will be present will be my audience because they have knowledge about the existing job issues in the economy. My audience was displeased because of the high unemployment rates in the economy and the way I expressed my points to them. I used inductive approach by giving examples about the situation that I went through before I got a job. My audience were displeased especially students who realized that getting a job is not easy after they listened to my speech. I outlined the main ideas from the first draft and included the major points in the second draft. This is because I did not want to make long speech that could have ended boring my audience. I used inductive information sequencing approach because this is a constructivist form of passing across the information and it is more student-centered. This is because my speech aims mostly students who are ready to face the challenges of job market. This method is widely used because it is more experimental and it gives practical example that indicates a direction of something. I wrote the second draft because the first draft had many ideas but after proofreading, I had to choose the essential ideas that can benefit my audience. I had to revise on my points to make sure the points are correct and if they are in line with the speech that I was to present. Reference Roebuck, D. B., McKenney, M. A. (2006). Improving business communication skills. Upper Saddle River, N.J: Pearson Prentice Hall.

Comm 307 Study Guide Essays

Comm 307 Study Guide Essays Comm 307 Study Guide Essay Comm 307 Study Guide Essay Comm 307 Midterm Study Guide Types of Hypotheses: ?tentative statement about the relationship between IV DV ?One-tailed ?predicts the specific nature of the relationship or difference ?EX: Females will talk more (higher word count) than males in mixed dyadic dinner conversations ? Two-tailed ?predicts significant relationship or difference, but does not indicate the specific nature of the relationship ?EX: There is a significant difference in the quantity of words used (talkatively) by males females in mixed dyadic dinner conversations ? Null (Ho)? predicts that groups will not vary on DV or that there is not a relationship between 2 variables ? Ho: r=0 H1: r=0 ?H0: male talkatively = female talkatively ?**you are testing the Null hypotheses Types of Research Questions: ?explicit question researchers ask about variables of interest ? Directional ?asks if there is a positive or negative relationship or a specific difference between two or more variables ?EX: Do females use significa ntly more words than males? ?Nondirectional ?when researcher asks if there is no relationship between two or more variables or a significant difference occurs between two or more variables EX: Is there a significant difference between the amount of words (talkatively) females and males? Variables: ?Any entity that can take on different values ?Concrete ?birth order (first born, middle child, baby) ?sex (male or female) ?Abstract ?age (a number that changes) ?level of public speaking anxiety (score) ?Relationships ?correspondence between two variables ?Correlation ?Positive, Negative, No relationship ?Strength and Direction Variables: ?Independent ?variable(s) that is (are) manipulated or changed ?we study the impact on the DV ?Dependent ?variables recorded or measured ?we study changes in DV **RESPONDER! ?Intervening Variables ?variable that intervenes between the independent variable the dependent variable ? Antecedent Variables ?must consider what happened previously ?a study exa mining the impact of conflict (IV) on marital satisfaction (DV) ?possible antecedent variables could potentially impact the results ? Variable Levels ?Nominal ?three rules: ?mutually exclusive ?equivalency ?exhaustive ?examples: ?biological sex (male vs female) ?heart attack (yes vs no) ?Ordinal ?three rules: ?mutually exclusive ?logical ordering of categories (more of something) ?categorical balance ?examples: socio economic status ?(lower, middle, upper) ?education level ?(high school, college, graduate) ? letter grades ?(A, B, C, D, or F) ?Interval ?variable where the values of the categories are classified in a logical order that represents equal distances between the levels within each category ?there is no absolute zero ?examples: ?likert scale ?strongly disagree, disagree, neutral, agree, strongly agree ? semantic differential/bipolar adjective scale ? good/bad, dirty/clean, strong/weak ? guttman or scalogram rarely used in comm research ?to ascertain belief ?Ratio ?variable where the values of the categories are classified in a logical order that represents equal distances between the levels within each category with the presence of an absolute zero ?examples: ?temperature, age, height, weight ?mass, blood pressure, speed, heart rate CALCULATING Mean Median Mode ?most frequently reported score ?Bimodal (2 different modes) ?No Mode Skewness ?positively skewed = tail runs to right of curve ?negatively skewed = tail runs to left of curve Kurtosis ?If Kurtosis is above 0, then distribution is peaked with short, thick tails If Kurtosis is below 0, then distribution is flat and has many cases in the tails Normal Distribution (Bell curve) ?mean, median, mode = same number = bell curve CALCULATING: ?Range ?distance between largest value (Xmax) smallest score (Xmin) ?range = Xmax Xmin ?Sum of Squares ?Variance ?the average distance of the scores for an internal or ration scale from the mean in squared units ?high variance = most of scores are away form the me an ?low variance = most scores are centered closely to the mean ?Standard Deviation ?summary statistic of how scores vary from the mean is expressed in the original units of measurement tells us on avg how far each score differs from the avg score ?why we care: ?for a study we might see a reported: (M=24. 5, SD = 2. 1) ? 68% between 22. 4-26. 6 ?95% between 20. 3-28. 7 Likert Scales ?one likert scale ordinal data ?multiple likert scales interval data ?strongly disagree-strongly agree Semantic Differential Scales ?determines differential/bipolar adjective ?one scale ordinal data ?multiple interval data Reliability ?accuracy that a measure has for producing stable, consistent measurements ?ex: does the watch work effectively? ?Tests for Reliability Test-retest ?same measure/different occasion ?Alternate ?different measure/same phenomenon ?Split-Half ?split to 2 groups/correlate scores ?Cronbach’s Alpha ?statistical test ?interpreting like grades ?a = excellent, b = good, c = r espectable, d =undesirable, f = unacceptable ? . 70 to get published ?Krippendorf’s Alpha ?Ways to improve reliability of an instrument ? item construction ?increase the length of the instrument ?improve the admin of the test Validity: ?degree to which the measuring instrument measures what it is intended to measure ? Types of Validity ?Face (content) Validity ?look at appearance of measure ?Criterion Validity ?look at how accurately new measure can predict well-accepted measures ? Construct Validity ?look at degree survey measures ?Threats to Validity ?Overlapping variables ?Measuring relationship satisfaction but actually measuring life satisfaction ? Interaction of Different Treatments ?intervening variable ?results form multiple treatments not from experiment ?ex: measuring improvement of public speaking in comm majors (its likely that other classes are contributing to success too) ? Interaction of Testing and Treatment ?when participants are sensitive or receptive to future measures of particular variable ? Hypothesis Guessing ?when participants guess what researcher is attempting to measure ? Evaluation Apprehension ?some individuals experience anxiety when they know they are being evaluated ? ex: white coat syndrome ?Experimenter Expectancies ?experimenter unknowingly influence a participants scores on a measure ? ex: accidentally telling the subject to quickly complete their measure (when they are measuring time as a ariable) ? Social Desirability Bias ?when participant changes a response to be seen in a better light ? ex: altering a survey response in case someone links the response to self Conducting Survey Research ?Prepare ?determine your question types (NOIR) ?use common sense putting survey together ?create clear instructions ?design your study ?complete pilot testing as needed ?Disseminate ?interview (face to face, telephone) ?self-administered ?mass a dministration ?mailed administration ?internet administration ?Improving Response Rates ?make survey easy to complete ?keep survey short use SASE (stamps envelopes to return) as needed ?include a good cover letter ?use multiple administration techniques Response Sets, Non-Response Bias Content Analysis ?a summarizing, quantitative analysis of messages ?conducting content analysis ?early stelps: ?theory rationale ?conceptualization ?operationalization ?detailed description ?unit of analysis: ?major phenomenon being analyzed within a study ? next steps: ?coding schemes (defined) ?sampling (determined) ?training pilot reliability Cohen’s kappa Coding Problems ?coding misinterpretations ?coder inattention ?coder fatigue

Nursing research Essay Example | Topics and Well Written Essays - 250 words - 17

Nursing research - Essay Example In line with this, the process of change involved a number of principles as guided by Lewin’s principles of process of planned change. The principle of unfreezing as advocated by Lewin improved the chances of success. In this case, Lewin advocated for proper and efficient planning of the change process in a detailed manner that clarifies and identifies the problem while suggesting the change process (Keele 236). In this case, this principle helped the facility change the thoughts, attitudes, and behavior of the nurses regarding the old and conventional method of bedside handovers. In effect, the new process of change was set to be effective since all nurses were aware of the new method of bedside handover. In addition, the principle of unfreezing, which involves encouraging people on the need for process of change was instrumental in ensuring that the change process was successful (Keele 236). In this case, unfreezing involved building relationships with the nurses who were to implement the planned

Dental Asst Research Paper Example | Topics and Well Written Essays - 250 words

Dental Asst - Research Paper Example ("NYSDA") Salary structure: Compensation amount differs from state to state as per the cost of living and other surrounding factors like year of experience, clinic location, etc. California dental assistant’s annual wage is $35,290, average $ 12.96 per hour and in New York $14.92 per hour. ("Dental Assistant") State board: For California, the state board is Dental board of California ("Dental board of California") while for New York, it is NYS education Department (NYS Edu). Dentist and dental assistants must be licensed by this board to practice in NY State. ("NYSED.GOV") Hygienist: Educational Requirements: To become a dental hygienist in California, the candidate has to undergo 4 or 6 years programme to get bachelor or masters degree respectively from Dental Hygienist College. The classes include Anatomy, Chemistry, Pharmacology, Nutrition, Physiology, Periodontology, Microbiology, Clinical dental hygiene, Sociology, laboratory and clinical training. To qualify for this deg ree, the candidate should have previous high school diploma and good score on college entrance test.