What should the culture and environment of safety look like when preparing and administering medications. Please include Refrences
Education of medical errors and safer practice in giving medications also needs to be created for a healthier setting in instructing nurses concerning medication errors prevention. Here’s a comprehensive overview of what such a culture and environment should look like, supported by references
1. Standard Operating Procedures and Measures
Clear Guidelines: Adopt and follow rational practices in compounding, dispensing, administering, and recording of drugs prescribed in the hospital. This involves the compliance to what is called the “Five Rights” of medication administration: the right patient, the right drug, the right dose, the right route and the right time.
Regular Updates: Debate and revise the protocols frequent to reflect the best quality proof.
Reference: ISMP. (2023). The Five Medication Rights. Retrieved from ISMP.
2. Use of Technology
Electronic Health Records (EHRs) and Computerized Physician Order Entry (CPOE): Make use of EHRs and CPOE systems in order to minimize the possibility of errors, which stem from illegibility, misinterpretation, and drug interactions. These systems can give timely notification and cut the possibility of human mistakes.
Barcoding Systems: Barcoding of medications should also be used to ensure that right medications are given to the right patient.
Reference: Bates, David W, Gawande, A A Fundamental Review of the Evidence on Error Prevention and Reporting. Optimizing safety with the help of information technology. New Engl J Med 348:2526–2534, doi:10. 1056/NEJMoa041502 doi:10. 1056/NEJMsa020847.
Reference: Tam, V. H. & Green, S. M. (2015) Effects of barcoding of medicines on medication safety. American Journal of Health-System Pharmacy, 72(10), 834-840. doi:10. 2146/ajhp140630.
3. Structures of open communication and reporting
Non-Punitive Environment: Encourage staff reporting medication errors and near miss incidences without any repercussions of being penalized or demoted. Promote discussions to enable people to advance knowledge of why errors occur.
Error Reporting Systems: Develop a properly coordinated and well functioning reporting and analysis system for medication errors and near miss occurrences.
Reference: Reason, J. (2000). Human error: A review in a critical sense. Cambridge University Press.
Reference: ISMP. (2020). Error Reporting and Learning. Retrieved from ISMP.
4. Education and Training
Ongoing Education: Update the staff for medication safety issues such as new drugs, technology and other safety measures frequently.
Competency Assessments: Organise regular competency checks that enrollees are well-equipped and knowledgeable in the handling of medications and prevention of medication-related errors.
Reference: C. P. Friedman & E. S. Berner( 2005). Promoting education and certification programs in the teaching of safety aspects in using technology specifically in the health-care field. Johns Hopkins University, School of Information Sciences and Technology / International Journal of Medical Informatics, 38(3), 165-171. doi:10. 1016/j. jbi. 2004. 12. 002.
5. Environment and Workspace Design
Safe Workspace Design: Take responsibility for the fact that the places where preparations for administering medication and administering them are well-ordered, clean and quiet. Design spaces in a way that will reduce the chances of making cross contaminations and mixing of concepts.
Accessible Resources: Make it easy for students to find resources they need for medications, as well as protocols and emergency equipment.
Reference: Carayon, Paim & Wetterneck, T. B (2011). Human factors and ergonomics in healthcare: Structure, content and possible further developments. 2008, in the edited volume Advances in Patient Safety and Medical Liability (Volume 3, pp. 189–204). Agency for Healthcare Research and Quality.
6. Patient Involvement
Patient Education: Involving patients in their medication schedule which involves the explanation of the medication to the patients with the intention to inform them about the reason why it’s being prescribed, how it is to be taken, and any possible side effects.
Verification: Remind patients to cross-check their current medications and report to the health providers if they realize they are taking the wrong ones or are suspect of them.
Reference: Our project implies a better utilisation and understanding of the Institute for Healthcare Improvement. (2014). Involving patient in their treatment. Retrieved from IHI.
7. Leadership and Accountability
Leadership Support: It is also important that the leaders in a given organization remain very supportive, and be ready to encourage individuals in embracing safety practices. They should set good practices, as well as extend some support or crusade for safer use of medication.
Accountability: Promote identifiable staff members for specific aspects of medication administration and safety.
Reference: Wears, R. L. , & Hollnagel, E. (2015, July). Resilient Health Care: Sustainability of the health care systems. CRC Press.
Conclusion
An organisational safety and culture of medication preparation and administration incorporate organisational protocol putting into use smart technology, excellent communication, education, safe environment physical design, patients’ involvement, leadership with accountability. All of these work in harmony to minimize potential medication mistakes and improve the safety of patients.
References:
D W Bates, and A A Gawande, “The Forgotten Science of Software,” Communicating, Education June 2003. Safety enhancement with the help of information technologies. New EnglJ Med, 348, 2526–2534.
Carayon P and Wetterneck T B. Human factors and ergonomics in healthcare: Categorising information and its implications for the past, present and future. High reliability and patient safety organizations in Johnston: vol. 3 of Advances in patient safety and medical liability, pp. 189-204. Agency for Healthcare Research and Quality < (n. d. ). second opinion-resources for health care professionals and patients.
Friedman CP, Berner ES. Fifteen years of evaluating health information technology: A review of the literature on IT adoption. International Journal of Medical Informatics, 2005; 74: 275–94. It is a method of raising the competency of healthcare professionals in the correct usage of technologies. J Biomed Inform. 2005 Jun;38(3):165-71.
Institute for Healthcare Improvement. (2014). Promoting patients’ involvement in the health care process. Retrieved from IHI.
Society for the Promotion of Rational Use of Drugs. (2020). Error Reporting and Learning. Retrieved from ISMP.
Tam, V. H. , & Green, S. M. The Basics of Medication Administration. In M. H. Henriksen, M. S. Peterson, & E. S. Norris (Eds. ), Physician Assistant Education Review. Effect of barcoding on medication administration. American Journal of Health-System Pharmacy 72(10), 834-840.
Reason, J. (2000). Human error: A scholarly analysis. Cambridge University Press.
Wears, R. L. & Hollnagel, E. (2015). Resilient Health Care: Addressing the vulnerability and the capability of health care systems to adapt and cope with marketing shocks. CRC Press.
Describe the roles of the nurse for the ADN program
In an ADN program, nurses adopt multiple important roles which include; faculty and staff whereby they work hand in hand to provide education and clinical practice that will prepare the students for entry level nursing practice. Here’s a detailed description of these roles:
1. Clinical Instructor
Role: Since it is clinical training, let them practice and supervise them in the clinical environments.
Responsibilities:
Teach Practical Skills: Direct learners in clinical performance of nursing skills like assessment of the client, administering of medication and care planning.
Evaluate Performance: Evaluate and give constructive comments on the students’ clinic performance in aspects such as critical thinking, skills execution, and professional demeanour.
Mentor and Support: Provide counseling to assist the students in their clinical practice and provide them with lessons on clinical setting and how to manage it.
2. Classroom Educator
Role: Provide instruction of the theory and foster the academic achievement of the students.
Responsibilities:
Develop Curriculum: Develop and carry out course material that will fit the educational competencies of the program and the nursing profession.
Facilitate Learning: Teach using power-point, group discussions, teachings games and simulations to improve on the student’s knowledge on issues related to nursing.
Assess Learning: Produce tests, quizzes, and assignments through which one can determine how much the students have understood.
3. Academic Advisor
Role: Offer consultation with students on their academic and career paths.
Responsibilities:
Academic Planning: Assist students with the selection of their courses, their timetable, and the overall movement through an ADN program.
Career Counseling: Give information on employment prospective, a particular field of nursing, and higher education.
Support Services: Enroll students into areas where they receive help such as tutoring or counseling in case they require it.
4. Preceptor
Role: Supervise nursing students while they are doing their clinical practice in particular clinical areas.
Responsibilities:
Role Modeling: Show the professionalism in performing nursing actions, clinical reasoning and patient care interventions.
Provide Feedback: Provide amazing feedback to students on their performance and professional achievements.
Support Learning: Support learners to apply knowledge in practice particularly in business organizations within and outside the host countries.
5. Evaluator
Role: Monitor and confirm the levels of achievement of performance competencies and nursing practice standards by students.
Responsibilities:
Assess Competencies: Assess students’ performance of the assessments, knowledge of theories and guardian attitudes to benchmarks.
Provide Feedback: Be as detailed as possible and do not hesitate to criticize but in a most constructive manner possible so that students can know where to improve and if they are meeting all program requirements.
Maintain Records: Document student assessments, achievements and, learning progress of a course or program.
6. Curriculum Developer
Role: Participate in the implementation of the curriculum and also assist in the modification of the same.
Responsibilities:
Update Content: Make sure that the content of a course is up to date with the newer evidence and strength based strategies in healthcare.
Incorporate Feedback: Apply the feedback that has been given by the students and the experiences dentified in clinical practice to improve the curriculum.
Collaborate: Collaborate with other teachers and interested parties in order to plan a curriculum that is in harmony with educational objectives and with the requirements of an accreditation body.
7. Role Model and Leader
Role: Display professionally acceptable behavior and leadership that students can practice in their day to day interactions.
Responsibilities:
Demonstrate Professionalism: Promote and exhibit ethically responsible behaviours, communication, and patient advocacy practices.
Encourage Leadership: Encourage students into assuming leadership roles and take more responsibilities in their practice.
Promote Lifelong Learning: This should be supported by the fact that the process of learning does not stop even after one is employed.
Conclusion
The faculty involves several duties which are essential to the students in the ADN program which include the following: In their capacity of clinicians, classroom educators, academic advisors, preceptors, evaluators, curriculum developers, and role-models, they make sure that the students acquire the needed skills, knowledge, and competencies that will enable them to become competent and professional nurses. All these roles combined help in the achievement of the mission of the ADN program to produce graduates who are effective and compassionate nurses.
References:
American Assembly for Collegiate Nursing Education (AACNE). (2021). The Essentials: Advanced nursing practice as well as professional curated nursing education comprises of five core competency. Retrieved from AACN
Association for Nurses in Professional, Administrative and Scientific Fields (ANPAS). (2019). These are the identified core competencies of the nurse educators with task statements; Retrieved from NLN
Identify three factors that leads to errors in documentation related to medication administration. Please include References
Medical documentation is vital in assessment, planning, intervention, and evaluation of the patient care and administration of medication and therefore if done incorrectly it could lead to major harm to the patient. Here are three factors that often lead to errors in this area:
1. Incomplete or Inaccurate Information
Description: Documentation inaccuracies are usually experienced when the information that has been documented is either partial or wrong. These may comprise of what dosage of the given drug, when it is supposed to be administered, or the patients’ response to the medication.
Impact: Lack of documentation creates confusion on the side of the care giver as to when the medication was given, whether it has been already given, whether a certain medication was given at all and when it was given and even the dosage that was administered.
Reference:
Kohn, L. T. , Corrigan, J. M. , & Donaldson, M. S. (2000). Crosstrial analyses of the to err is human study. Archives of Internal Medicine, 160, 1449-1459 To Err Is Human: Creating a Healthier Health System. National Academy Press. This paper explains the role of poor and poor documentation processes as causes of medication errors and recommend on how the gaps can be closed.
2. Pervasive Absence of Standard Operating Procedures, and Flawed Protocols
Description: Lack of conformity to the set documentation procedures and standards contribute to errors. Cohort members reported variation in written formats or electronic systems for documentation of medication administration among various nurses or other staff.
Impact: Failure in the standardization can results to misunderstandings, complications and mistakes in regards to medication. The protocols of documentation are strictly followed to maintain uniformity and quality of the work done.
Reference:
ISMP or Institute for Safe Medication Practices. (2016). Safe and Unsafe Forms of Electronic Communication of Medication Information:Adopted by the International Society of Managed Pharmacy. ISMP. The guidelines also touch on the issue of documentation systems so as to minimize inconsistency and improve on the level of flow of information.
3. Insufficient practice and problems regarding the applying of the framework
Description: These occur due to poor teaching of the providers on the right methods of documentation or challenges in the implementation of EHRs. For instance, users can enter wrong information into an EHR or might not be conversant with the documentation system used.
Impact: Lack of training, misimplementation, and lack of technology can result in wrong documentation that may result in giving wrong medication and harm patient safety.
Reference:
Bates, D. W. , Gawande, A. A. (2003). Reducing Risk with information Technology. NEJM, 348(25), June 26, 2003, 2526-2534. Due to advanced continually improving information technology, training and system design arose as critical success factors in elimination of documentation errors.
Summary
Potential errors in medication administration documentation include: inadequate information, no uniformity in the process and compliance to protocols, and insufficient staff training or technologic problems. These reasons need to be managed better through more effective utilisation of better practice, protocols, and training of the health personnel to make medication documentation a more reliable source for patient safety.
References:
Kohn, L. T. , Corrigan, J. M. , & Donaldson, M. S. to present for the committee on quality of health care in America ISBN 0-87553-144-X. To Err Is Human: Health System = A Safer Health System. National Academy Press.
ISMP, Institute for Safe Medication Practice. (2016). In an effort to develop a systematic framework for the analysis of risks related to safe ISMP guidelines for the electronic communication of medication information have been established. ISMP.
Bates, David W, and Atul A. Gawande. 2003. Safety of patients has been considered to have benefited from information technology through the following ways; Circulation The New England Journal of Medicine 348. 25 2526-2534
What can I do to prevent medication errors? please include references
Medication errors are hazardous to patients’ lives and health, which is why it is important to prevent them. Here are strategies to prevent medication errors, supported by references:
1. Specific and explicit policies and procedures should be followed a well as ensure that they are strictly complied with.
Action: Adhere to attached standard operational procedures when prescribing, dispensed, and administering of medications.
Example: Update to protocols that are currently in effective practice, for instance ‘Five Rights’ – patient, drug, dose, route and time.
Reference: ISMP. (2023). Safe Medication Administration deals with the Five Rights of Medication Administration. Retrieved from ISMP
2. Implement Electronic Health Records and Computerized physician order entry
Action: Promoting EHRs and CPOE systems to minimize mistakes due to poor handwriting, wrong interpretation as well as interactions between different drugs.
Example: With EHRs the physician is able to receive real time alerts on drug interactions and allergies hence increasing prescription accuracy.
Reference: Bates, D. W. Gawande, A. A. (2003). How can information seek to enhance safety? N Engl J Med 1993; 348; 2526-2534. doi:10. 1056/NEJMsa020847
3. Always attend to Staff Training and Education Meetings
Action: Ensure enforcement for updates and staff education for safe medication practices, innovations, medicines, and systems.
Example: Organise seminars on medication safety, correct use of medicine and potential side effects.
Reference: Carnegie F. P. , and Berner, E. S. (2005). Promoting technical competency of the receivers in the utilisation of technology in the provision of health services. Journal of Biomedical Informatics, 164–171 vol. 38 no. 3. doi:10. 1016/j. jbi. 2004. 12. 002
4. Implement Medication Reconciliation Processes
Action: Medication Reconciliation: Should be performed for patients : when they are admitted, when they are discharged, or when they are transferred from one care setting to another.
Example: Review and compare the prescribed medications of different patients in order to avoid leaving out some drugs, using similar ones in combination when it should not be done and giving wrong doses of the same drugs.
Reference: Forster, A. J. , Clark, H. D. , & Diemert, D. J. (2004). The medication reconciliation process: Its ministry and consequences. J of Quality in Clinical Practice Vol 24, No: 3 May, 2014 , pp 166-170. doi:10. 1111/j. 1440-172X. 2004. 00353. x
5. Ensure That the Company Cultivates a Safe Environment
Action: Encourage the staff so that they can report any mistakes or any near-miss incidents that occurred in the organization without being dismissed or punished.
Example: Put in place a zero tolerance discipline policy on errors that do not penalize the employees while having constant safety check-ups.
Reference: Reason, J. (2000). Human error: This might mean writing a ‘critical’ appraisal – although the assistance offered by Google is questionable, its significance cannot be denied. Cambridge University Press.
6. Patients should be made to participate and be active players in the process of their treatment.
Action: Provide information to the patients regarding medications, uses, dosage and any negative outcomes associated with it.
Example: Remind the patient to ask questions and double check their medications each time they are seen.
Reference: Organization For Healthcare Quality Improvement. (2014). Interactive patient care. Retrieved from IHI
7. Practice Regularity Check and appraisals
Action: Schedule periodic assessments of state policies and guidelines in medication administration and analyze reported errors for trends and issues.
Example: Carry forward audit findings to improve policies and make specific recommendations that will help in staff training.
Reference: Lammers E. M. , & O’Leary, K. J, (2014) The use of audits to enhance the practices in the administration of medication. Journal of Nursing Care Quality vol. 29/no. 4 pp. 331-338. doi:10. 1097/NCQ. 0000000000000063
8. Utilize Medication Barcoding Systems
Action: Use barcodes in administration of drugs to minimize on mistakes that may arise in identification of the individual medicines.
Example: How do you ensure proper dosage and correct the right medications to the right patients; you should use bar coding of the medications with the patient wrist band.
Reference: Tam, V. H. , & Green, S. M. (2015) Effect of barcoding implementation on medication rationality. American Journal of Health-System Pharmacy 72, 834-840. doi:10. 2146/ajhp140630
Conclusion
Medication errors prevention entails the use of technology, strict compliance with the recommended procedures, continued education of both new and existing staff as well as creating consciousness. That is why, the considered tactics help to decrease the risk of medication errors and enhance the patients’ outcomes and safety.
References:
We are grateful to David W Bates and Atul A Gawande for providing their thoughts on improving patient safety in this article published in 2003. Using IT for increasing the degree of safety. NEJM, 348, 2526–2534.
Forster, A. J. , Clark, H. D. , & Diemert, D. J. The guts and gore of the general surgery shelf examination. Academic Medicine, 79(10), 948-951. The medication reconciliation process: That which it comprises and the consequences which are associated with it. Journal of Quality in Clinical Practice, vol 24, no. 3, pp. 166–170.
C. P. Friedman and E. S. Berner, “Web Enabled Change in Health Care Delivery and Training, in Yearbook of Medical Informatics 2005: Biomedical and Health Informatics,” edited by H. E. A. Brandt (Springer-Verlag, 2005), 191–198. Educators in the use of technology for new medical practitioners and other health workers. Sami S, Horton M, Colliton J, & Tarczy-Hornoch P. (2005) Task allocation in distributed medical image analysis. Journal of Biomedical Informatics, 38(3), 165-171.
Institute for Healthcare Improvement. (2014). Dias 181- patient satisfaction in health care: engaging patients in their care. Retrieved from IHI
Safe Medication Practices of Institute. (2023). Five Medication Rights Information to be communicated by staff and received by consumers. Retrieved from ISMP
Lammers, Jonathan M , & O’Leary, Kathleen J. Medication Administration Time Audit- enhancing practices among nurses for administration of medicines. Therefore, the findings of the present study in the Journal of Nursing Care Quality, 29(4), 331–338 support nursing professionals’ previous experiences.
Reason, J. (2000). Human error: A review of the literature – with a focus on critiques. Cambridge University Press.
Tam, V. H. , & Green, S. M. (2015). 'Extensions to the State Space Model’, Journal of Business and Economic Statistics, 33(3), 356-371. The use of barcoding on medication safety. American Journal of Health-System Pharmacy: Vol. 72, No. 10, pp. 834-840.
A 46-year-old woman is experiencing fatigue and weight gain despite decreased food intake
Her hair is thinning and her skin is very dry. She reports that she has had mild swelling in her legs. She also reports feeling irritable and depressed. Laboratory tests reveal a low serum T4 level and an elevated serum TSH level. What is the likely diagnosis and what information can the nurse provide to the patient about her condition?
From the reported symptoms and laboratory analysis results, one can frankly diagnose that the 46-year-old woman is likely to have hypothyroidism. This is a condition where a person’s thyroid gland does not produce sufficient levels of thyroxin (T4) while at the same time the pituitary gland produces high levels of thyroid stimulating hormone (TSH) due to its effort to compel the thyroid gland into producing the required hormones.
Diagnosis
Hypothyroidism: The low serum T4 means that the thyroid hormone production is low and the high serum TSH implies that the pituitary gland is stimulating the production of thyroid hormones, however, there is a poor response from the thyroid gland.
Patient Education
Understanding Hypothyroidism
Definition: Hypothyroidism is defined as the lack or deficiency of thyroid hormones which are important in the body sensing and metabolisms processes.
Symptoms: Some of the symptoms include tiredness, overweight, dryness of skin and hair loss, anxiety, high rigidity and symptoms that may affect the legs. These symptoms arise because of the slow metabolic rate and decrease in body activities because of decreased thyroid hormones.
Treatment
Medication: The first-line therapy for hypothyroidism is hormone replacement therapy with levothyroxine; it has the active ingredient sodium L-tyrosine and serves as T4 hormone. It can reduce the dosage of steroids required, overcome symptoms and regulate hormone content.
Dosage and Monitoring: The medication should be taken as it was prescribed and there should be follow up appointments to check on the thyroid hormone levels and change dosage in case of needed.
Lifestyle and Dietary Considerations
Diet: However, there are no foods that should be avoided due to hypothyroidism, but a better diet should be taken for the heart. Consumption of certain micronutrients such as Iodine, selenium and Zinc helps in maintaining the thyroid gland.
Regular Exercise: Taking part in regular exercise can assist with coping with gain in weight and in the boost of energy. A person should, therefore, consult a health care provider with a view of coming up with a good exercising plan.
Managing Symptoms
Skin Care: However, to alleviate condition of dry skin appropriate creams or lotion can be used. Another remedy is to drink much water and use a humidifier to maintain skin’s moisture.
Mental Health: Even such symptoms as irritation or depression can be prescribed an appropriate treatment and do not endanger a person’s life. It is always advisable to consult a doctor if the need arises especially a psychiatrist or a psychologist.
Monitoring and Follow-Up
Routine Check-Ups: Periodic blood tests should always be taken to check the functioning of the thyroid gland or presence of hormones at optimal levels. Report any new or changing signs, symptoms or sensations.
Medication Adherence: It important that the patient adheres to their prescriptions in order to be in a healthier state to respond to the hypothyroidism.
Potential Complications
Long-Term Management: If hypothyroidism is left untreated, then it can result in severe conditions like heart disease, cardiovascular disease, high cholesterol and severe mental disorder. This is why the management and monitoring of patients with mental illness are ongoing.
Summary
The patient should be advised that hypothyroidism is a treatable condition if the correct treatment measures and changes of one’s lifestyle are made. This requires constant check up and compliance with prescribed medical regimens in a bid to have the symptoms well controlled.
Controlling seizure activity is paramount in the early stages of traumatic brain injury to avoid hypoxia and aspiration, as well as an elevation of ICP and possible herniation.
If the seizure occurred, the most appropriate anticonvulsant therapy is warranted. What is the most appropriate initial treatment for seizures in this situation?
Seizures are easily managed within the first several days of TBI and preventing them is important to avoid hypoxia, aspiration, increase in ICP and possibility of herniation. These problems can be made worse by the seizures and has been found to have a great effect on the life of patients. The initial treatment for seizures in this context typically involves the following:The initial treatment for seizures in this context typically involves the following:
First Line Management of Seizures in TBI
Benzodiazepines:
Medications: Lorazepam (Ativan) or Midazolam (Versed) are the most commonly used intravenous anaesthetic agents.
Rationale: This class has a rapid onset of action and is useful in the swift management of acute seizures. The devices also have a relatively beneficial safety profile especially when used in the short-term.
Dosage and Administration:
Lorazepam: 4 mg by IV bolus over 2 minutes; may again be given in 10-15 minutes if the seizures continue.
Midazolam: 5-10 mg; IV push; may repeat depending on response and clinical rationale.
Anticonvulsant Therapy:
Once status epilepticus has been controlled with benzodiazepines, the long-term treatment of seizures is done through the use of antiepileptic drugs (AEDs).
Short acting barbiturate or IV valproate is sometimes used in combination with phenytoin (Dilantin) or fosphenytoin (Cerebyx) for status epilepticus treatment.
Dosage and Administration:
Phenytoin: This initial dose is 15-20 mg/kg IV (infra), though this is often administered over 30 minutes.
Fosphenytoin: 15-20 mg PE/kg IV (phenytoin has slower administration rate).
Continuous Monitoring:
Assess the patient for the reappearance of the seizures, the patient’s general health status and complications of medications.
Video EEG monitoring may be necessary in cases when seizures are recurrent or clinically intractable.
Rationale for Initial Treatment
Benzodiazepines are preferred initially as they offer a rapid onset of effect, which is essential as far as the resorber is concerned and focuses on the acute seizures and the elimination of the immediate complications.
Phenytoin or Fosphenytoin is given as first-line in the long-term preventative treatment to reduce any further Seizures specially in clients who have sustained TBI and are at higher risk of developing post-traumatic Seizures.
Follow-Up and Considerations
Re-evaluation: Determination of patient’s neurologic status and response to the treatment should be done more often.
Adjustment: The doses may be changed depending on the seizure frequency, side effects, and tdm especially in drugs such as phenytoin.
Seizures that occur in conferlation with TBI needs to be promptly diagnosed and properly managed to prevent complications that may hinder favourable recovery.
Described six different concepts of leadership
(1) focus of group processes; (2) personality perspective; (3) act or behavior; (4) power relationship; (5) transformational process; and (6) skills perspective (p. 5). Discuss how both the trait and skills approaches may or may not fit within these concepts and why. Provide examples and reflections. Use academic sources from the literature.
1. Focus of Group Processes
Concept Description: Leadership from this viewpoint therefore refers more to the processes and relations within the team. Leaders ensure that there is group cohesiveness, communications as well as working relationships amongst the members of the group.
Trait Approach: The trait approach might fit into this concept in that some traits are inherently positive in a group context (e. g. , sociability, emotional intelligence). It fails, however, to capture how leaders intervene and steer group processes.
Skills Approach: Of all the discussed concepts, the skills approach can be considered most closely aligned with the concept because it emphasises the leader’s capacity to mediate interactions between the members, and regulate group processes. For example, where a leader requires interpersonal skills to strengthen the unity and agreement of the team and to work proficiently to address any disputes that may arise (Northouse 1997/2018).
Example: A leader who is particularly good at dealing with communication and nurturing the team spirit will probably have good skills in the area of group process management, which confirms the skills approach.
2. Personality Perspective
Concept Description: This perspective examines the way in which an individual leader is likely to manage people based on his or hers character.
Trait Approach: The trait approach will be useful here, because it in essence; looks at how certain personality characteristics such as assertiveness, confidence relate to leadership. For example, competencies like emotional stability and openness to experience have been quoted to be associated with leadership (Judge et al. , 2002).
Skills Approach: The skills approach is even less concerned with personality than the behavioural approach; it is more concerned with the competencies a leader acquires. But it crosses with personality when analyzing how effectiveness in specific tasks reflects one’s nature (e. g. , an intuitive individual becomes even better in emotional intelligence).
Example: The trait approach also holds the view that a leader with natural extroverted personality will be more suited to carrier positions that demands high levels of interpersonal communication.
3. Act or Behavior
Concept Description: This concept of leadership is different from the more conventional definition, which is centered on the individual person. It concerns itself with studying particular processes and practices that characterise leadership.
Trait Approach: The trait approach is relevant less here because it concentrates on patterns of behavior not actions that can actually be witnessed. This is missing the perspective of how the leaders themselves work and in this manner, shape their effectiveness.
Skills Approach: For this reason, the skills approach is suitable for this idea because it hinges character on the practical competencies and behaviour of leaders. For instance, students’ problem solving disposition and decision making which are behavioural characteristics are core to the skills approach that Katz (1955) propound.
Example: Thus, the skills which embrace leader’s behavior depend upon are activities that indicate the leader’s actions rather than inherent traits, if the leader is involved in the problem solving and decision making processes.
4. Power Relationship
Concept Description: This perspective focuses on the ways in which power is wielded within an organisation by leaders.
Trait Approach: The above concept brings little understanding into power relations. Despite the specification of certain behavioral variables (e. g. , charisma) that increase the leader’s ability to influence others, it reveals little about the exercise and experience of power.
Skills Approach: Since power dynamics are inevitable in both extreme, the Skills approach can help to ‘decode’ how power is wielded by the leaders and, therefore, how power relations can best be managed. Knowledge sets in negotiation and persuasion come in handy at this stage (Northouse, 2018).
Example: An ordinary leader who applies skills approach in power relations in the process of team decision-making show the feature of negotiation skills.
5. Transformational Process
Concept Description: This perspective is the process through which the leaders motivate the followers to change, and develop commitment towards the vision.
Trait Approach: The trait approach can be used in some extent to fit this concept since vision and enthusiasm for instance are related to transformational leadership. But it does not capture the whole process of change, learning and development.
Skills Approach: The reason the skills approach supports this notion is because it uphelds the competencies that are necessary for fostering and guiding change. Hence, here, the kind of thinking that is called for is strategic thinking, visionary planning (Bass, 1990).
Example: A manager who manages to bring about others to support him or her on the implementation of a large scale change initiative is exercising transformational leadership.
6. Skills Perspective
Concept Description: This perspective is concerned with the actual traits that are required in any leader.
Trait Approach: The trait approach is not as useful to this concept as the skill approach since traits are not skills that can be cultivated.
Skills Approach: This perspective tally with the skills approach which focus on the development of leadership competencies, that is technical, human and concept skills as postulated by Katz (1955).
Example: A skills approach entails efficiency in technical knowledge, interpersonal skills and strategic thinking skills among other competencies in a leader and these skills are very well exemplified by the following leader.
Reflection
The trait approach stands on the belief of certain attributes that one might possess and can impact his or her leadership efficiency, although it does not necessarily explore how such traits can manifest themselves or would develop skills. The skills approach is somewhat more useful in this regard as it is grounded in competency framework, which offer the set of competencies fundamental to leadership. Each of the theories provides significant information, which should be used in conjunction with the other since they study different aspects of leadership and thus complement each other in looking at leadership from its various perspectives.
References:
Bass, B. M. (1990). Bass & Stogdill's Handbook of Leadership: Basic Framework, Empirical Evidence, and Practical Implications. Free Press.
The kind of judge one assigns may play a partial role in the procedure Judge, Bono and other authors: The antecedents and concomitants of job burnout: An integrated model Ilies, R and Gerhardt, M. W (2002). Personality and leadership: A qualitative and quantitative analysis of academic international business research. Applied psychology, they published the article in Journal of Applied Psychology vol. 87, no. 4, pp. 765-780.
Katz, R. L. (1955). Administering for effectiveness Skills of an effective administrator. Harvard Business Review, 33(1), pages 33-42.
Northouse, P. G. (2018). Leadership: Theory and Practice. Sage Publications.
I have a presentation in my nursing class on cultural consideration, it should include 3 learning objectives.
Presentation Title: Culture and Ethnopharmacology
I. Introduction
Opening Statement
In nursing: Cultural competence as a key-value.
A brief on how culture has influenced nursing care provision
Purpose of the Presentation
To consider cultural issues in relation to nursing practice
To improve comprehension of the effects that cultures have on a patient.
II. Learning Objectives
Chapter two is devoted to the discussion of the concept to be understood and, therefore, entitled: Understanding the Concept of Cultural Competence in Nursing.
Cultural competence can be described as set of skills and information apart of recognizing and respecting different cultures, and its role in healthcare.
Examine the features of culture with regard to a particular society (i. e. , culture as a reference to beliefs, values and practices).
Cultural factors that are important to consider while providing patient care should be revealed.
Different cultures shall be understood with reference to their beliefs about health and ways used to enhance it.
Explain about some of the cultural differences or cultural issues nurses meet in their profession
Practical Considerations as Related to Cultural Sensitivity
Know some strategies of communication with patients and other people in general from different cultures.
Discover approaches for implementing cultural factors into patient-oriented plans of treatment
III. Cultural Competence in Nursing
Definition and Importance
Definition of cultural competence
Advantages of integrating cultural competence in the management of patient careEnumerated below are the following:
Dimensions of Culture
Cross cultural comparison of Cultural characteristics (such as race, colour, language, religion, etc)
Some of the cultural practices and beliefs that can affect the health of individuals are as follows:
IV. Tapping Key Cultural Influence that has impact on patient outcomes
Health Beliefs and Practices
How cultural beliefs affect the management of health and choices for care and treatment
Some of the concrete expressions of culture inclusive of health involve the following types of practices including;
Communication Barriers
The use of language and its effect in relation with patients
Accommodation techniques to mitigate communication barriers (e. g. , interpreters, cultural mediators).
Cultural Sensitivity and Respect
Importance of making conspicuous ethic of cultural diversity
Reducing and dealing with cultural prejudices in the sphere of nursing
V. Approaches to the Diverse Patients
Effective Communication Techniques
Developing a good relationship with patients from different origins
Avoiding culturally insensitive language as well as choosing the right body language
Particularly important in the development of care plans with Senegalese clients.
Winning the diverse cultural and individual patient’s preferences and values to formulate care ideologies
Adapting and negotiating with patients and families, for a successful implementation of cultural sensitive interventions
Education and Continuous Learning
Maintenance of cultural competency for cultural diverseness education’s relevance.
Cultural information and cultural development sources
VI. Case Studies and Examples
Case Study 1
An example of a clinical case including patient cultural factors
Review of how cultural aspects impacted on the care delivery and patients’ prognosis
Case Study 2
Another situation with at least one patient of different culture
Comparison of methods that can be employed to overcome cultural concerns
VII. Conclusion
Summary of Key Points
Summary of cultural competence in nursing account.
Precisely, the following strategies can be summarized concerning the care that is culturally sensitive:
Call to Action
Call for further study of culture and cultural difference.
Teaching and learning the role that culture plays, particularly on the experience of the patient.
VIII. Questions and Discussion
Open Floor for Questions
Cherish the floor and let the participants to ask questions, or even to share their vivid experiences.
Discussion Points
Encourage chatter about issues of practical importance for making cultures work in nursing
What will be your nursing considerations for this patient"
Nursing considerations play a very significant role especially when handling patient at 57 years old with stage 4 lung cancer. Here are key nursing considerations:Here are key nursing considerations:
1. Pain Management
Assessment: Conduct pain assessments based on valid instruments at the recommended intervals and of the effectiveness of pain relief.
Medications: Give pain relief, if required, as indicated and observe any side effects such as this one: constipation or the overly sleepy type.
Non-Pharmacological Interventions: Concurrently, apply other approaches like guided imagery, relaxation procedures, and heat or cold treatment to go with pharmacological interventions.
2. Respiratory Management
Monitoring: Check the rate and depth of breathing, oxygen level, and observe for any features of respiratory compromised.
Interventions: Give additional oxygen and respiratory treatment according to prescribed orders. Promote taking a deep breath and making the right posture so as to maximize the functioning of the lungs.
Patient Education: Educate the patient and the family on aspects of what may point towards a lingering respiratory status and when to call for help.
3. Nutritional Support
Assessment: Weigh patients continuously and observe signs of malnutrition or cachexia as well as dietary input.
Interventions: Serve high-energy density, high-protein diets, and pursue, if necessary. Additionally, they share a close collaboration with a dietitian for individual nutritional programs.
Support: Help the patient with food if they are unable and investigate concerning matters like dysphagia or anorexia.
4. Psychosocial and Emotional Support
Assessment: Assess the patient’s psychological status, anxious or/and depressive mood, and coping attitudes.
Support: Advise the patients on matters touching on personal life and also recommend patients to be attended to by a psychiatrist in case of such nature. Organise such services as support groups and spiritual care services.
Family Involvement: Involving the family members in the conversation and offering help to enable them deal with the patients ailment.
5. Patient Education
Disease and Treatment: Regarding disease process, treatment plan, side effects, and management, explain and discuss and incorporate the patient and the family.
Self-Care: Discuss about self management strategies, including home treatments, medication adherence, and signs to go to clinic or hospitals.
6. Advance Care Planning
Discussion: Engage clients in discussing issues to do with the goals of care, treatment preferences and advance directives.
Documentation: Make that the patient’s preference is recorded and transmitted to the members of the health care team.
7. Coordination of Care
Team Collaboration: Collaborate with oncologists, palliative care specialists, social workers, and home health workers to help patients .
Follow-Up: ;Coordinate with the other disciplines in regard to transfer of care and follow-up visits for the patient and the family should be informed on who to expect next.
8. Safety
Fall Prevention: Mention to avoid falls like removing obstruction on the floor all times or using walking aids whenever needed.
Infection Control: Isolate and ensure good personal hygiene and look for any signs of infection since the patient is immunocompromised because of the treatment.
9. Ethical and Cultural Considerations
Respect for Autonomy: Respect the patient’s decision and cultural beliefs on the treatment and the kind of care they wanted at their last moments.
Cultural Sensitivity: Honor religion, culture, and traditions in matters to do with illness, death and caregiving.
10. Documentation
Accurate Records:ensure they keep records of assessments, their intervention, patients’ response, and any changes in respect to their health.
Communication: Regular and effective communication with the healthcare team, in order to have more coherent care plan.
Such aspects guarantee that all aspects of a patient with advanced lung cancer are well addressed hence promoting quality life and enhanced palliative care.
You are nursing a 57 year old man diagnosed with stage 4 lung cancer... Give a detailed plan of care for this patient
The care planning difficulty for the identified client—a 57-year-old man with stage 4 lung cancer—underlines the need to attend to various aspects that are characteristic of the end-of-life period. It is advisable that the plan should have strategies on how to deal with the symptoms that the patient is experiencing, provision of emotional support, and how the care of the patient will be arranged. Here’s a detailed plan of care:
1. Assessment
Physical Assessment: These necessity can include the assessment of vital signs, pain, respiratory status, and other signs and symptoms as may be required.
Psychosocial Assessment: Self- and other-esteemed emotions, coping behaviors, family arrangements, and availability of support.
Functional Assessment: Examine the ability of the patient to perform activities of daily living, transfer, and their total functional capacity.
Nutritional Assessment: Diet, body weight, and any sign of such conditions as malnutrition or cachexia should also be observed.
2. Symptom Management
Pain Management:
Medications: Give pain control medications as required, including strong opioids and other adjuvant agents (e. g. non- morphine opioids, tricyclic antidepressants (TCAs), anti – epileptic drugs).
Non-Pharmacological Interventions: On the side of therapy, relaxation exercises, heat/cold therapy and massage are some of the peripheral remedies in drug administration.
Respiratory Care:
Oxygen Therapy: Ventilate with supplementary oxygen if necessary in order to ensure proper oxygen saturation.
Bronchodilators and Steroids: Give prescribed drugs to reduce dyspnoea and inflammation.
Positioning: Promote positioning that enhance lung expansion and comfort (for example sitting up or semi Fowlers position).
Nausea and Vomiting:
Medications: Ensure that the patient gets the antiemetics as advised by the doctor so as to prevent vomiting.
Dietary Adjustments: Eat small meals often and, never consume foods that would worsen nausea.
Nutritional Support:
Diet: Feed the child with high calorie and protein foods and if necessary you may consult the pediatrician to provide the child with some supplements.
Feeding Assistance: Provide assistance with mealtime and look for the symptoms of dysphagia or any other feeding challenges.
Psychosocial and Emotional Support:
Counseling: Seek help from a therapist for issues to do with anxiety, depression and questions about meaning and existence.
Support Groups: Ensure that cancer patients and their families receive information where they can get support groups.
3. Palliative and End-of-Life Care
Advance Care Planning:
Discuss Goals of Care: Participate in discussions concerning the choice of the treatment plan, the powers of attorney, and the decisions concerning the further treatment if the patient is in a terminal condition.
Document Preferences: Make sure that even if advanced directives executed by the patient were documented appropriately in the past they have been updated in the patient record.
Comfort Measures:
Symptom Control: Palliation is an important part of nursing: ’Comfort and quality of life’ must always take precedence over ‘cure. ’
Spiritual Care: Enable requests for a chaplain or spiritual counseling should the person so wish.
Family Support:
Education: Instruct the family of the patient’s condition, expected degeneration and the measures that they can take.
Emotional Support: Encouraged to provide counseling and support to families relatives of patients with the illness.
4. Coordination of Care
Multidisciplinary Team:
Oncology: Collaborating with oncologists frequently to prescrib e correct cancer therapies and actions.
Palliative Care: Consult with palliative care to improve markers and obtain a holistic approach to the patient’s care.
Social Work: Encourage the participation of social workers to help manage or address some of the client’s mundane matters like money matters and getting around the community.
Care Transitions:
Discharge Planning: Formulate the discharge plan to include who are the persons to attend to the patient in case of transfer to home or hospice and other equipment and home care services.
5. Patient and Family Education
Disease Education: Stage 4 lung cancer, treatment and prognosis.
Medication Management: Teach patient regarding the dosage, proper administration of the drug and possible side effects and how to remedy on them.
Self-Care: Instruct the patient on possible home management of symptoms like the use of pain management interventions and when to seek the medical practitioner.
6. Documentation and Follow-Up
Document Care: Document all carried out assessments, the actions taken to address the situation, the patient’s response to the actions taken and the changes recorded in the patient.
Regular Follow-Up: The patient should visit the doctor or call him periodically in order the doctor to assess the condition of the patient and change the treatment plan if necessary.
The interventions related to this plan of care include the provision of comfort for the patient facing such a serious illness and having multiple symptoms, support of family and caregivers, as well as collaboration of patient’s multiple care providers.
