NUR435/445 Discussion questions and peer responses

Discussion Questions Requirements: Main discussion post should be at least 2-3 paragraphs. Two peer responses should be at least 50 words minimum. NUR435 Discussion post: Step 1 Post your response to the discussion board and cite your reference(s) in APA 7th edition. Reflect on the nursing care model used in your organization. Post its name and a description of it by answering the following questions: Step 2 Read other students’ posts and respond to at least two of them and cite your reference(s) in APA 7th edition. Use your personal experience, if it’s relevant, to help support or debate other students’ posts. If differences of opinion occur, debate the issues professionally and provide examples to support your opinions. NUR435 Student Posts: Student #1: The nursing care model we use on my unit is the total patient care model. “Total patient care is a nursing model where one nurse provides total care to a single patient or a group of patients during his/her shift. During that shift, all the patient needs are addressed by the nurse, and in some cases, the nurse issues care until the end of the patient’s medical needs. The nurse will have all the patient data on hand.” (let scale.com, 2021). We previously had CNA’s that would help out with our patient’s but in the last 6 months our management has moved us to total care. This total patient care model is basically is where the nurse manage everything from vitals, meds, communication with doctors, assessments etc. Although none of us wanted this model to happen, one of the biggest positives is that we always know everything that happens with the patient which is super helpful to know if things go wrong or when you give report to the doctors. I thing a negative is it can be really frustrating when things get busy and you have no help. The only exception to our model, is when we are short nurses and the only help we can get in a CNA which we always loves. It feels like a treat! I don’t think this model helps us give the most quality care because things can get so busy and if you have no help we don’t have extra time to spend with the patients to help them but have to run and do small tasks that anyone can do. I would love to spend wayyyy more time with my patients than I get because I have zero help! I think we should get our CNA’s back! It would free up so much time doing small tasks and allow us way more time with our patients providing more quality care. Student #2: At Riverside Methodist Hospital, the nursing care model used on the Labor, and delivery unit is a team nursing model. Generally, RMH receives a high number of deliveries daily, and an effective nursing care model must, therefore, be used to provide the best services to the patients. Typically, the team nursing care model involves a group of people led by an experienced nurse who coordinates the team to provide proper care to the patients (Dickerson & Latina, 2017). In particular, the team comprises Registered Nurses, Nurse Practitioners, midwives and physicians who are usually led by a knowledgeable nurse who serves as the team leader. The team nursing model has numerous benefits that make it one of the best models. This model has remained crucial in my department at Riverside Hospital since it grants team member the opportunity to share and teach other team members vital techniques of handling various emergency cases based on personal experience (Dickerson & Latina, 2017). This model also allows the team members to learn from others as people work in a group with a common goal of providing the best services to the clients. Additionally, this model enables the team leader to monitor team member’s performance as they work. Joint operation enhances the quality of healthcare delivery, and the patients have higher chances of survival (Dickerson & Latina, 2017). The main disadvantage of this model is that it takes time and effort to establish the team concept and procedure to handle a complex health case, but emergency cases require quick decision-making (Organizational Healthcare Structure (n.d.). When the department receives several emergency c-sections at the same time, some exceptions do occur to this model. In situations like this, the leader assigns every team member a patient to take care since the entire team cannot concentrate on one patient and leave the rest. Assigning roles to individual nurses during these times makes this process effective. In my view, the team, nursing care model, used in my organization is effective in helping the nurses provide quality services because it allows them to handle patients with a common goal of providing the best care services to the patients. This model also enables team members to share vital ideas that can be applied to deliver high-quality care to clients. NUR445 Discussion Post Step 1 Recall a situation when you were asked to perform a specific intervention and/or practice idea based on authority or tradition. Describe the intervention or practice. Based on your knowledge of evidence-based practice, does this practice still hold value now? Use an Evidence-Based Guideline or nursing specialty organization Standard of Practice to support your answer. Cite your reference(s) in APA 7th edition. Step 2 Read other students’ posts and respond to at least two of them and cite your reference(s) in APA 7th edition. NUR445 Student Posts: Student#1: It was hard for me to come up with something because I feel like we are really good at following evidence-based practice at my hospital. However one thing I came up with although it is really small it is how often we use alcohol wipes. We use alcohol wipes to wipe down everything, including skin prep. One thing that I recently heard that evidence-based practice supports is the unnecessary wiping skin prepping every injection we give. It has proven that wiping for every injection doesn’t make a difference on whether or not the patient will develop an infection from the injection site. However, I know there are many other things that are much more dangerous things that happen because of tradition and not evidence-based practice. It is so important to always follow EBP rather than tradition especially if it puts the patient in danger. “The inclusion of EBP in nursing provides nurses with the scientific research to make well-founded decisions. Through EBP, nurses can stay updated about new medical protocols for patient care. By searching for documented interventions that fit the profiles of their patients, nurses can increase their patients’ chances for recovery.” (learnonline.ieu.edu, 2018) Student #2: Health care is developing rapidly. Ongoing research is bringing out numerous changes which force us to change the traditional practice we followed till date. EBS is a conscientious use of current best evidence in making decisions. It was hard for me to come up with something because I feel like we are good at following evidence-based practice at my hospital and we use so many different methods. One thing I can think of is infection control hospital acquired infection like unnecessary use of foley catheter on patients. On our unit we use foley for emergencies c-section and scheduled c-section. Laboring mother that gets epidurals get straight catheterized every 2 hours. Removing the foley in a timely manner can prevent the infection rate. EBP shoe high CAUTI rates were identified in the medical units in March 2015(Haytham Taha,2009 HICPAC Guideline for prevention of Catheter-associated urinary tract infection). Compliance with recommended evidence-based infection-prevention practices was a challenge. Urinary catheters are commonly placed for inappropriate indications and healthcare providers are often unaware that their patients have catheters leading to prolonged unnecessary use (Haytham Taha,2009 HICPAC Guideline for prevention of Catheter-associated urinary tract infection). Guidelines for the prevention of CAUTI are appropriate catheter use, aseptic insertion, use of closed drainage systems, proper maintenance, and timely removal of indwelling urinary catheters, as well as the use of established practices such as hand hygiene (Haytham Taha,2009 HICPAC Guideline for prevention of Catheter-associated urinary tract infection). Requirements: Main discussion post should be at least 2-3 paragraphs. Two peer responses should be at least 50 words minimum. What are some advantages and disadvantages of using your specified nursing care model in your organizational structure? Are there any exceptions to following the nursing care model? If yes, describe when those occur and how they are managed. Is it effective? Do you think that the nursing care model used in your organization is effective in assisting nurses to deliver high quality care? Please explain your answer. If it is not effective, please give a suggestion of a nursing care model that would be more beneficial to the organization.

Prof. Angela

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