REFLECTIVE JOURNAL

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Professional Capstone and Practicum Reflective Journal

Week 1 : New Practice Approaches

I am almost completing my BSN degree, and this is a significant milestone in my personal and professional development as a nurse. Working as a full-time nurse, this journey has been difficult yet bearable. Taking this course has given me a new perspective on the world around me. The first week of the Capstone class was a whirlwind of work on the Individual Success Plan, as students attempted to evaluate all assignments. It seemed like every time I thought I was done, I had to go back over it all again because I had missed something. It was also difficult to make certain that all of the competencies for self-assessment were plugged incorrectly.

As a nurse, my mentor is someone I look up to, and I’m grateful to work alongside him at my current job. My mentor signed off on my pre-conference form without a second thought. First, I went over my Success Plan for the next ten weeks. Afterwards, he signed the plan and gave it back to me. When we met in person, we had a productive discussion regarding my Capstone subject suggestions. As a result of his advice, I whittled it down to just three ideas for my research.

As a nurse, I believe we must advocate for the finest possible care and support the nursing community in providing it in the safest manner possible for our patients (Wojnar, & Whelan, 2017). Novel practice methods are new solutions utilized to improve the quality of care or the level of expertise in the healthcare field. Now that I’ve spoken with my mentor, I realize that not all health care facilities employ the same treatment approach for every problem. To improve catheter-associated urinary tract infections at this facility, I plan to use nursing procedures and bundles. Foley catheters are better maintained and used in my facility because of a nurse-driven procedure. Even on my unit or throughout the facility, I’ve seen other new practice techniques in studies that may adopt a good nurse-driven protocol or bundle (Perfetto, 2019. ). As a class, we could share and work on several research resources for this subject, thanks to the initial discussion questions this week. I’m eager to see what the upcoming week’s goals bring to the table.

References

Perfetto, L. M. (2019). Preparing the nurse of the future: Emergent themes in online RN-BSN education. Nursing education perspectives, 40(1), 18-24.

Wojnar, D. M., & Whelan, E. M. (2017). Preparing nursing students for enhanced roles in primary care: The current state of prelicensure and RN-to-BSN education. Nursing Outlook, 65(2), 222-232.

Week 2 : Interprofessional Collaboration

Learning represents a process through which an individual acquires the necessary skills essential for problem-solving on a daily basis and acquires the skills necessary to perform their duties at work. Through the course, learners develop different skills and knowledge that help them prepare for their professional duties. I have developed the skills that make me a competent and all-around healthcare professional throughout the course. The article will discuss how an individual can develop interprofessional collaboration through the course.

Interprofessional collaboration represents the act of Multiple health practitioners from diverse professional areas working together with patients, families, caregivers, and localities to achieve the most outstanding quality care. It is predicated on the premise that when practitioners incorporate one other’s perspectives and feedback, they are more likely to give higher-quality services than if they worked alone or with other individuals of the same medical professional background (Tang et al., 2018). This week’s course has taught us the essential elements that frms the basis or promote interprofessional collaboration. For example, through the course, we have learned that interprofessional collaboration is promoted through sharing knowledge, experience and insight, encouraging open communication, and recorgnition and reward; the knowledge is essential as it will ensure an individual understands what is required of them, for interprofessional collaborations (Labrague et al., 2018). Again, the course taught us the importance of Interprofessional collaboration, such as the providence of a room for learning and improving quality; the knowledge ensures that every nurse strives to be competent through adopting interprofessional collaborations.

References

Labrague, L. J., McEnroe–Petitte, D. M., Fronda, D. C., & Obeidat, A. A. (2018). Interprofessional simulation in the undergraduate nursing program: An integrative review. Nurse Education Today, 67, 46-55. Retrieved from

https://www.sciencedirect.com/science/article/abs/pii/S0260691718301850

Tang, C. J., Zhou, W. T., Chan, S. W. C., & Liaw, S. Y. (2018). Interprofessional collaboration between junior doctors and nurses in the general ward setting: A qualitative exploratory study. Journal of nursing management, 26(1), 11-18. Retrieved from

https://onlinelibrary.wiley.com/doi/full/10.1111/jonm.12503

WEEK 3 : Health care delivery and clinical systems

Healthcare delivery and clinical systems are critical to ensuring that patients have access to care in order to meet their medical needs. To guarantee that patients receive the best possible care, a diverse range of stakeholders must be included in healthcare delivery and clinical systems. These various components must collaborate to ensure that care delivery is not disrupted. As a result, healthcare delivery and clinical systems must be able to provide patients with the care they require whenever they require it, at reasonable prices that do not discourage them from seeking it (Li et al., 2020). This guarantees that patients receive care that fulfills established quality standards and that their safety is of the first importance. This includes prescriptions and services, as well as a new health care center. If a patient’s prescription cannot be filled due to a lack of coordination among the various players involved in the process, their life may be jeopardized.

Practicum nurses are required to contact a variety of patients by text or phone to inquire on their dose progress and whether they require any assistance. This strategy meets the demands of patients while continuously monitoring prescriptions for any abnormalities. The patient is better treated because there is a means to lodge grievances and receive professional care while being at home (Weinfurt et al., 2017). When healthcare delivery is simplified, all departments have access to relevant and up-to-date information about a patient, ensuring that patients receive the best possible care. This strategy has improved healthcare delivery and clinical processes as compared to the previous model, , which concentrated primarily on a patient’s recovery through prescription and management at the institution. There is a significant shortage of knowledge and diagnosis when it comes to patient therapy. As a result, patients were given the incorrect medication or misdiagnosed.

Current healthcare delivery and clinical systems have adopted technology that has enhanced the outcomes of several treatment elements, including patient satisfaction and safety, as well as provider satisfaction. Clinical systems are continually being updated to match the demands of today’s patients, and the most important stage in developing a treatment plan, diagnosis or sample testing, may now be performed in a matter of minutes. Because of technology developments, the frequency with which healthcare delivery systems are altered has increased. Patient education and preventative care are two of the most important components in today’s healthcare environment. Patients who seek treatment in a medical facility must have their health concerns thoroughly examined, as well as any contributing variables identified, to help them avoid contracting the same ailment or infection again. Citizens are better able as a result of these initiatives to make informed decisions about their own health and lifestyles. This capstone change project will educate and counsel children aged 3-9 about the necessity of handwashing in order to prevent covid-19 transmission (Temesgen et al., 2020). Covid-19 transmission can be avoided if children from all socioeconomic situations are regularly educated and sensitized to the disease.

References

Li, R. C., Asch, S. M., & Shah, N. H. (2020). Developing a delivery science for artificial intelligence in healthcare. NPJ digital medicine, 3(1), 1-3. https://www.nature.com/articles/s41746-020-00318-y

Temesgen, Z. M., DeSimone, D. C., Mahmood, M., Libertin, C. R., Palraj, B. R. V., & Berbari, E. F. (2020, September). Health care after the COVID-19 pandemic and the influence of telemedicine. In Mayo Clinic Proceedings (Vol. 95, No. 9, pp. S66-S68). Elsevier. https://www.mayoclinicproceedings.org/article/S0025-6196(20)30789-8/abstract

Weinfurt, K. P., Hernandez, A. F., Coronado, G. D., DeBar, L. L., Dember, L. M., Green, B. B., … & Curtis, L. H. (2017). Pragmatic clinical trials embedded in healthcare systems: generalizable lessons from the NIH Collaboratory. BMC medical research methodology, 17(1), 1-10. https://bmcmedresmethodol.biomedcentral.com/articles/10.1186/s12874-017-0420-7

Week 4: Ethical considerations in health care and Practices of culturally sensitive care

In the healthcare sector, the need for ethical consideration and cultural sensitivity is mandated to ensure that the healthcare industry’s goal is attained. In other words, the proliferation of optimal community health is the role of healthcare workers. The value of the two aforementioned attributes was experienced during the practicum as all nurses were required to enforce ethical considerations and cultural neutrality. The meeting held before every shift identified that it was a mandate to enforce the practice. The value of ethical consideration is affirmed by Ellis (2020), who identifies it as universal norms of conduct that guide determining what actions, intentions, and reasons are appreciated. In other words, taking into consideration the needs of the patient and the best approach to offering care. . With every nurse undergoing training, the value of ethics in practice is enforced, thereby creating a conducive environment for the patient whereby they are respected.

On the other hand, cultural neutrality or consideration is a critical factor that was enforced during the practicum. Healthcare workers now provide care to a growing number of culturally and linguistically diverse patients worldwide (Ellis, 2020). The rise in globalization has resulted in the demand for more culturally neutral approaches to offering care. The notion is supported by Beagan (2018), who states that cultural competence is critical in offering quality care and education to patients and community members. The consideration addresses the variation in educational systems, cultural approach to events, and consent (Beagan, 2018).

Overall, the practicum experience demonstrated how technology could be exploited in addressing the attributes. Through technology such as EHR (electronic health records), the efficacy of the strategies in enforcing ethical consideration and cultural neutrality are evaluated. The patient-centric approach allows for data to be collected on how the care process and quality can be improved. The current exploitation of leadership in enforcing ethics and cultural neutrality is effective, however, exploiting technology offers a better approach.

References

Beagan, B. (2018). A Critique of Cultural Competence: Assumptions, Limitations, and Alternatives. Cultural Competence In Applied Psychology, 123-138. https://doi.org/10.1007/978-3-319-78997-2_6

Ellis, P. (2020). Understanding ethics for nursing students (3rd ed.).‎ Learning Matters.

Week 5 : Ensuring the integrity of human dignity in the care of all patients

Human dignity is defined as the respect shown to the sufferer for the sake of humanity. Dignity includes a patient’s feeling of self-worth and self-respect, as well as support for physical and psychological integrity empower the patient. The intervention chosen for the catheter care bundle is intended to reduce the likelihood of central line infections in patients. The project requires continuous communication and involvement with the patients in order to protect their dignity. According to the professionalism code, nurses and other healthcare personnel must educate their patients and obtain their permission before giving any care or testing. Notifying caregivers before beginning a project is critical to preserving a patient’s sense of self-worth and self-respect (Igai, 2020). As a human being, the patient deserves to be treated with dignity and cared for by a nurse who treats him or her as such. It is critical for nurses to execute their jobs to instill the value displayed to patients as the standard at the facility. Everyone in the hospital, as well as the rest of society, should adhere to a basic human decency standard.

Being truthful and forthright with the patient is an example of integrity. Integrity entails being truthful with your patients and keeping them up to date on the status of any projects in which you are participating. Patients should remove all non-essential catheters from their bodies and clean the catheter site with a chlorhexidine solution every day. They should also wash their hands with an alcohol-based solution on a regular basis. Academics believe that it is critical to enlighten patients and explain in detail why new procedures are necessary for their safety (Kadivar et al., 2018). As a result, honesty is essential in order to treat the patient with respect and dignity.

References

Igai, Y. (2020). Concept analysis of dignity‐centered care for people with chronic progressive disease. Japan Journal of Nursing Science, 17(2), e12302. https://onlinelibrary.wiley.com/doi/abs/10.1111/jjns.12302

Kadivar, M., Mardani-Hamooleh, M., & Kouhnavard, M. (2018). Concept analysis of human dignity in patient care: Rodgers’ evolutionary approach. Journal of medical ethics and history of medicine, 11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6150922/

Week 6 : Population health concerns

From this course, I have gained a deeper understanding of the various health concerns of communities. As I reflect on population health concerns this week, I have learned that environmental factors are among the main determinants of the health of a community. Social factors such as food security also greatly impact population health. I also realized that major population health concerns are related to nutrition, substance abuse, and cardiovascular diseases, among others (Craig et al, 2018).

Due to the many factors involved in population health, defining population health concerns is not easy. These health concerns are unique to different people around the world. Different communities are affected by different health concerns differently. Cultural practices and behaviors of a certain community play an important role in determining the health concerns of that community (Craig et al, 2018). For example, obesity is brought about by a culture of unhealthy eating and poor physical activity.

Healthcare professionals, especially nurses, have an important role in addressing population health concerns. They educate the public on identifying and addressing factors associated with population health concerns so that they can take care of their health (Stanhope & Lancaster, 2019). Social determinants of health have always been central in nursing practice. Nursing institutions have identified the critical role of social determinants of health in enhancing healthcare. In social determinants of health, people from the lower social class who have challenges in affording proper treatment are more affected by the population health concerns in their community (Stanhope & Lancaster, 2019).

References

Craig, P., Di Ruggiero, E., Frolich, K. L., Mykhalovskiy, E., White, M., Campbell, R., … & Poland, B. (2018). Taking account of context in population health intervention research: guidance for producers, users and funders of research. Retrieved from http://www.storre.stir.ac.uk/handle/1893/27205

Stanhope, M., & Lancaster, J. (2019). Public health nursing e-book: Population-centered health care in the community. Elsevier Health Sciences. Retrieved from https://books.google.com/books?hl=en&lr=&id=ct3WDwAAQBAJ&oi=fnd&pg=PP1&dq=addressing+population+health+concerns+in+nursing&ots=eI_IxgV9Mk&sig=oqrIalPkN7LaUlyXYuSrD1mBn48

Week 7 :The role of technology in improving healthcare outcomes

This course has taught me that technology has continued to impact healthcare in various ways. As I reflect on the role of technology in improving healthcare outcomes, I have learned that the use of electronic health records is one way that the quality of care has been improved. Technology has made it easier for healthcare providers to manage patient care better by facilitating the sharing of health information.

Technology has led to improved communication between the healthcare staff. Improved communication enhances collaboration, thus creating an environment of teamwork that is critical for the effective delivery of services (Aceto et al, 2018). I specifically considered the role of technology in fall prevention programs and discovered that new resources and additional support staff would be required. Therefore, although technology is critical in enhancing healthcare, we must be ready for the extra cost of this implementation.

As a nurse, I believe the healthcare sector cannot be efficient without technology. Evidence-based practice and patient-centered care have been made possible by the availability of technology. Nurses can now monitor patients’ progress even after they have been discharged (Aceto et al, 2018). However, technology is rapidly changing, which presents both technical and economic challenges to healthcare. New technologies make existing ones obsolete, thus requiring total replacement, which can be expensive (Mackey et al, 2019). Healthcare staff also has to be continuously trained on how to use technology effectively. This means that technology in healthcare is helpful but also expensive for a healthcare facility (Mackey et al, 2019).

References

Aceto, G., Persico, V., & Pescapé, A. (2018). The role of Information and Communication Technologies in healthcare: taxonomies, perspectives, and challenges. Journal of Network and Computer Applications, 107, 125-154. Retrieved from https://www.sciencedirect.com/science/article/pii/S1084804518300456

Mackey, T. K., Kuo, T. T., Gummadi, B., Clauson, K. A., Church, G., Grishin, D., … & Palombini, M. (2019). ‘Fit-for-purpose?’–challenges and opportunities for applications of blockchain technology in the future of healthcare. BMC medicine, 17(1), 1-17. Retrieved from https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-019-1296-7

Week 8 : Health Policy

According to WHO (World Health Organization), a health policy is defined as the choices, strategies, and activities performed by society to accomplish specified health care goals (Anders, 2020). They have a significant impact on the overall health care environment, including both patients and practitioners. Nurses or nurse practitioners substantially influence the development, implementation, and evaluation of health policies in their regions (Anders, 2020). Thus, as identified by Turale and Kunaviktikul (2019), healthcare policies are a collection of basic concepts and objectives that guide delivery and healthcare access. Considering nursing staff work at the forefront of healthcare, it is frequently their responsibility to convert complex healthcare policies and practices to patient encounters.

Nurses spend most of their time connecting with and comprehending patients (Turale & Kunaviktikul, 2019). As such, nurses have an excellent sense of what works and what does not. They can communicate accomplishments and constraints to politicians, who can fine-tune health policy. It was experienced first hand as before, and after every shift, the current nursing staff is debriefed on their shift experience. It was later identified that it was to ensure the facility could meet its community objectives. Additionally, the information is used to increase the efficacy of healthcare delivery which is beneficial for the medical staff. The experience demonstrated the need to be aware of personal surroundings and interactions to improve service delivery. Finally, it also demonstrated the need for effective interaction amongst nurses.

References

Anders, R. (2020). Engaging nurses in health policy in the era of COVID‐19. Nursing Forum, 56(1), 89-94. https://doi.org/10.1111/nuf.12514

Turale, S., & Kunaviktikul, W. (2019). The contribution of nurses to health policy and advocacy requires leaders to provide training and mentorship. International Nursing Review, 66(3), 302-304. https://doi.org/10.1111/inr.12550

WEEK 9 :Leadership And Economic Models

Organizational success is contingent upon effective management and leadership approaches enforced. Thus, leadership in the health service contributes to improving care quality, patient satisfaction, and staff engagement by establishing a clear vision, empowering employees, and enhancing the work environment (Nicola et al., 2020). The term leadership also refers to economic frameworks recognized as capable of developing and sustaining the healthcare system. Economic models entail analyzing market variables such as pricing, volume, and competitors within a particular sector (Nicola et al., 2020). The supply-demand model aided in developing the future and comprehension of healthcare necessities. Health executives, for example, are affected by the concept of upgrading organizational structure and clinical procedures to attract customers and ensure patient happiness (Edwards et al., 2018). The identified role of leadership and influence of economic models was experienced during the practicum identified the various leadership attributes that are needed to ensure the smooth flow of duties.

Additionally, it identified personal weaknesses relating to economics, and it was a personal conception that economics was not part of the nursing practice. However, contrary to personal assumptions, it was identified that leadership and economic models are fundamental in the effective operation of a healthcare facility. By assessing internal and external settings, it is possible to employ various economic models that would ensure patient safety, sufficient workflow, and revenue generation to secure the facility’s financial aspect.

References

Edwards, N., Erler, C., & Kirkpatrick, J. (2018). The Impact of the Role of Doctor of Nursing PracticeNurses on Healthcare and Leadership. Medical Research Archives, 6(4). https://doi.org/10.18103/mra.v6i4.1734.

Nicola, M., Sohrabi, C., Mathew, G., Kerwan, A., Al-Jabir, A., & Griffin, M. et al. (2020). Health policy and leadership models during the COVID-19 pandemic: A review. International Journal Of Surgery, 81, 122-129. https://doi.org/10.1016/j.ijsu.2020.07.026

WEEK 10 : Health disparities

This course has equipped me with an understanding of the various health disparities in society. As I reflect on health disparities this week, I have learned that health disparities arise as a result of many factors. These include socioeconomic status, age, gender, geographical location, and ethnicity (Alvidrez et al, 2019). Some diseases affect women more than they do men. A person’s financial situation determines whether they can afford healthcare services when they need to. Health disparities are health inequalities since they result from a lack of equity in certain areas (Alvidrez et al, 2019). Reflecting on health disparities, I have learned that these disparities directly affect nurses during their practice.

Healthcare professionals have an important role in addressing health disparities. There are various ways that nurses can address these disparities. One such way is advocating for the creation of health centers to provide affordable healthcare services to patients who cannot afford these services from already existing facilities (Brown et al, 2019). Educating patients on diseases that affect either gender will help them know how they can protect themselves from such diseases (Brown et al, 2019). Reflecting on this week’s topic has made me realize how evidence-based practice can address health disparities. Healthcare should be equally accessible to all, and addressing health disparities is the first step to ensuring that this is achieved.

References

Alvidrez, J., Castille, D., Laude-Sharp, M., Rosario, A., & Tabor, D. (2019). The national institute on minority health and health disparities research framework. American Journal of Public Health, 109(S1), S16-S20. Retrieved from https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2018.304883

Brown, A. F., Ma, G. X., Miranda, J., Eng, E., Castille, D., Brockie, T., … & Trinh-Shevrin, C. (2019). Structural interventions to reduce and eliminate health disparities. American journal of public health, 109(S1), S72-S78. Retrieved from https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2018.304844