Our Nursing Papers Samples/Examples

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Introduction

If not all, most people usually carry a notebook or a notepad to take notes either at school, at work, in meetings or while undertaking personal projects. The Microsoft office OneNote unlike a notebook or notepad is a program which can allow different people to view and share notes at the same time electronically irregardless of their geographical location. The OneNote is the only method  capturing and gathering information that enables you to capture information and ideas electronically. It also allows to insert files from the web and saves data entered in a form that is easily retrievable with the right file name. 

The Microsoft office OneNote is mostly used with the Personal Digital Assistant(PDA).  The PDA is a hand held computer which can synchronize data with the larger computers. The OneNote is used with the PDA because of their portability nature. OneNote's are affordable components that if well used can have immense benefits to the nurses. Implementation of a more customized OneNote in nursing will offer solutions to most challenges that are facing the health care sector as well as the health care administrators. 

Abstract 

The following paper defines and explains the use of the Microsoft One-Note® in a Cloud Computing Environment as a Problem Solving tool in the nursing sector. It explains how the OneNote can be used to maximize production easeing operation, minimize deployment costs and to make the tasks of nursing care generally easier (Kimura et al, 2003). It also analyzes how the Microsoft  One-Note® is used in collaboration with the PDA to make the nursing career more exciting than a task. The paper also outlines the problem statement, hypothesis and the expected outcomes of the study.  In conclusion, the paper expounds the benefits and the implications of the study leaving room for further research. 

Literature review 

The functionality health care workers is one of the most threatened sector of economic development in the United States. The nursing sector is a working environment just like any other and is bound to experience organizational and working setbacks. The shortage of IT knowledge in health care in this clouded computing era is a major problem facing the nursing sector. Knowledge of IT is very essential in the collecting, analysis and presentation of data in this time we are living. Lack of this knowledge has contributed to human resource related challenges such as burnout amongst health care administrators and prolonged problem solving processes in the whole health care system. Technological challenges are a very significant issue in health care. 

Computer technology provides a solution to, if not all the most crucial challenges in the health care system. Information technology has the ability to offer relevant up to date information needed to support clinical decisions. The potential for computers to improve the work-flow in health care organizations is enormous as they provide a way for linking up to date research findings with clinical care (Kuziemsky, Laul and Leung, 2005,  pp335-342). 

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Problem statement

In establishing quality improvement, people intensive processes, time management and cost are among the difficult and thorny realities. Needs assessment will be a necessary systematic process so as to identify the learning needs of nurses in using the Microsoft One-Note® . The nursing process has a model for steps that can be followed in planning a budget, this include first, assessing the needs to be covered in the budget (Marquis and Houston, 2008).

The learning needs will be assessed here. The needs should be considered in terms of labor, operating expenses and equipment. In identifying the learning needs, the nurses performance analysis will be the method of choice. It will be based on the assumption that there is already a system which identifies problems in the organization by investigating multiple causes for poor performance. Staff competencies will be a component of the performance analysis. 

Hypothesis/ questions

The method of determining nursing learning needs will be based on McGregor’s framework of developing staff competencies which starts with developing a list of standards and skills (Russell, Swansburg and Swansburg, 1995). The learning needs will then be ascertained through interviews, verbal feedback, observations and unit quality assurance findings (Russell, Swansburg and Swansburg, 1995). Once learning needs have been identified the educational programs will be set up with skills achievement and knowledge tests being conducted to assess the achievement of the standards by the nurses. 

The learning outcomes will be measured using pre-tests and post-tests and spot checks for skills. For those nurses who may not meet the mastery level (mastery level for skills is put at 100% and for knowledge at 80%) remedial studying will be done which will be followed by retesting. 

The unit is a 28 bed step-down cardiac unit, where all aspects of preoperative and post-operative care are performed for patients.

The patients are received in the unit to recover post cardiac catheterization, post coronary artery bypass grafting and after angioplasty stent placement. The patients generally require acute care. The nurses work extensively with the patients and families while maintaining a fruitful nurse-client relationship. The nurses also have a role of working with physicians and other disciplines to ensure high quality care is provided to all the patients. The staff population is 25 RNS, 20LPNs and 25 UAPs. In every shift there are 4RNs, 2LPNs and 4UAPs. All the staff work 12 hour shifts. 

The numbers of the staff above are all considerations in making plans for their learning needs. The method of addressing their learning needs may be expensive hence certain cost containment measures will be considered. These include using readings and video taped material for the remedial topics as well as using data from quality management audits to provide insight on learning needs. The problem- centered approach has been used in identifying learning needs because it serves as a motivator to the adult learner who will want to see a real-world answer to problems they may have (Russell, Swansburg and Swansburg, 1995).

This will be valuable in motivating the nurses and will also sever the purpose of improving the quality of care. When quality of care has improved it often results in reduced costs as less is spent on managing hospital acquired infections, managing patients who may have fallen or may have developed pressure sores or other hospital associated problems that may result from poor quality care. 

Purpose of the study and expected outcomes.

The study was carried to determine the use of the Microsoft OneNote in nursing and the entire health care. After thorough analysis, the following were expected to be the best possible outcomes of the above study:

  1. The use of the  Microsoft OneNote in nursing will aid in the gathering, storing and managing of information and notes in an efficient manner. This information includes pictures , texts, both video/ audio records and digital capturing in one location. This will help in making more organized and informed decisions.
  2. It will help in providing back up information. Information stored in the computer is considered more safer than information saved as hard copy. 
  3. Enable easy retrieval of information. Using the  Microsoft OneNote makes access of information very easy as long as you have the right file name.
  4. Fosters team work. The sharing of information in groups makes people feeling appreciated hence promotes group works in organizations. It also allows groups at different geographical locations to look, share and even make changes on information at the same time. 
  5. Makes information hard to duplicate. The Office OneNote 2007 helps you to keep on track of information to avoid duplicating ideas in meetings and briefings. 
  6. Helps in organizing information just the way you want it be. Helps in choosing your own way. It also provides room to add hyper links. 
  7. Also helps in choosing the priorities from the less priorities. You can customize the note tags as per your needs to enable easy access of information and data.
  8. Will help in increasing productivity in meetings. It offers the nurses with the advantage of accessing all the information released in the meetings making them to become more productive. It ensures that all members have the same understanding of information in meetings since all members are on the same page. 
  9. Will help increase speed of performance and prevent time wastage. 
  10. Will help in the improvement of the production level in and away from the office. Synchronizing the windows in your computer with your mobile phone will guarantee access of information in the PC anytime anywhere.

Significance of Microsoft office OneNote's in nursing

If well implemented in the nursing care, the Microsoft office OneNote will help reduce the time nurses spend on paperwork significantly. This leaves the nurses with more time to give nursing care to a patient which translates to better patient outcomes. The OneNote is aimed at giving the nurse access to schedules, medical references, patients’ charts and to fill and submit nursing forms any time any place. 

The OneNote also has the benefit of being a ready reference for any doubts that may arise while delivering patient care as well as the capability to decrease prescription errors (Pochciol and Warren, 2009). The nurses are also more likely to practice evidence based care due to access to a computer (Pochciol and Warren, 2009). This is because the information needed for practice is easily accessible on the OneNote. 

The OneNote if used with a PDA synchronizes data with larger computers for import and export of data. It has the option of accessibility in terms of storage of information in password protected databases which is important to ensure the security of patient information. The ability to recognize one’s handwriting is a unique safety precaution as it means that it is not possible for someone to steal the nurse’s identity and gain access to confidential information in the system. The password allows one to store information in an encrypted style making it even more secure. Through integration with other systems such as drug management, ordering, blood transfusion management it is possible to confirm that the drug and patient match thus preventing administration of the wrong drug. This contributes to patient safety in a significant way. 

With respect to safety, research has also shown that OneNote technology is effective in the enhancement of critical thinking and it also reinforces the necessary core knowledge for practice (Kupier, 2008). Kupier (2008) also points out that dependence on memory is unreliable and unsafe; hence by providing the nurse with a store of information, the nurse’s practice will be safer due to the ability to counter check when in doubt. 

Use of the OneNote has the potential to increase patient outcome as it means nurses have a greater access to information. With a OneNote the nurse is able to find information more quickly and thus clear any doubts that may arise during patient care. This means that the potential for errors in giving treatment is reduced. This also adds to the nurse’s confidence in giving nursing care. The overall effect will be better patient outcomes in the unit. 

In addition to reducing errors, the OneNote also gives the nurse more time to interact directly with the patient especially by reducing the time spent on documentation and searching for copies of documents. The OneNote is also able to offer a comprehensive report on crucial information about patient contraindications, interactions, compatibility with other drugs and prescribing indications. The nurse is thus able to provide more holistic care to the patient which again improves patient outcomes. The portability of the OneNote makes it appropriate for use at the patient’s bedside and can even provide a means for which health education to the patient can be done. 

The role of the OneNote in nursing education is valuable especially with the potential it has for continuing nurse education. The OneNote has been used in undergraduate nursing courses both in the classroom and for practical experience. Students have reported major improvements in their understanding of core material as well as a feeling of being better prepared in the practical area as it is easier to interact with their clinical instructors via the OneNotes. The OneNote can be used in the same way for the already qualified nurse for continued medical education through its ability to access the Internet and also its capacity to store information from various journal articles.

OneNote incorporation into the nursing unit: questions for consideration

Before making the decision to incorporate OneNotes in the nursing unit some of the things to be considered include the desirable capabilities of the OneNote. Several characteristics are key in this consideration; these include the type of operating system (Pocket PC versus Palm OS), cost, memory, size, and battery life. The Palm OS is less expensive, lighter and smaller. 

Both devises have software programs available for them but the Palm OS has a wider range of software (George and Davidson, 2005). The Palm OS has also released a OneNote that has the capability to save programs even when the battery drains completely. The Pocket PCs have more memory (RAM of about 64-128 MB) than the Palm OS. They however require more RAM to operate similar programs. Their screens are larger and they generally have more peripheral features (video players, voice recording, MP3 players). 

The cost of the program ranges from $20 to $200 depending on the features present on the OneNote. The OneNotes will mainly be used to access information about patients and as a reference tool for nurses, thus features such as a telephone, MP3 player will not be necessary. However a long battery life, wireless capability may be desirable to assist in meeting the needs of the nurses. Size is another important consideration for ease of use. The nurses will be using the OneNotes at the patient’s bedside thus an easily portable device will be more appropriate for the nursing unit as opposed to a larger device. 

The size will be moderate however to ensure that the screen is clear enough for use by the nurses. Most OneNotes now come with a memory card that can be used as extra memory. This may be the more cost-effective option, in place of buying Pocket PC which is more expensive yet requires more memory to run the same programs as the Palm OS (George and Davidson, 2005). Battery life is very important to the nurses because if the battery runs short, the usefulness of the OneNote is reduced. Palm OS devices generally have a longer battery life than Pocket PC devises. 

With all the considerations mentioned, the Palm OS device seems the better choice for the nursing unit as it more cost-effective and is more likely to meet the needs of the nurses in the unit. Software programs for the OneNote that will support evidence-based nursing care will be the programs of choice. These include clinical reference software, calculation programs, patient tracking and management and nursing procedure programs among others. This will however be the main ones in the OneNote's. 

To integrate the OneNote technology into the nursing unit, the team leaders of the nurses will have some experience with the OneNote's prior to introduction to the rest of the nurses. They will then teach the other nurses how to use them. Support for nursing staff will include training and frequent brown bag sessions. For newly employed nursing staff intense training will also be necessary. 

Managing the limitations of the OneNote

One of the major barriers to integration of OneNote;s into nursing practice is the short technological life and cost of these programs. Consideration of the benefits of the OneNote however makes these barriers manageable. In addition technology is constantly progressing such that the OneNote's currently being manufactured have longer life cycles and are generally reducing in cost.

The fact that information may be lost if the OneNote is not upgraded frequently is a limitation to use of the OneNote but this is hardly sufficient to completely reject the OneNote for use in improving patient care. The OneNote is generally easy to use and has a user friendly interface thus most of the nurses are likely to adapt well to its use in the unit. It is however expected that there may be some trepidation especially due to a lack of technology preparedness. 

Conclusion

To facilitate the adoption of OneNote's in the unit, financial support will be necessary as well as changes in the organizational set up and social acceptance of the OneNote. Cost effectiveness will be achieved by settling on a products with the features that meet the units objectives. To reduce on cost, high end specifications will not be necessary. Since the use of the OneNote is not entirely new to health care, these changes are not very radical and it should be easy for the nurses and other health care professionals to adapt to. In areas where the use of OneNote's has been implemented nurses have been noted to have a good understanding of the OneNote technology thus social acceptance should be an issue easy to manage. 

The rationale for use of OneNote's in the nursing unit is based on the very real possibility that the OneNote will add value to the nursing care given to the patient. The use of OneNote's will have substantial effect on efficiency, data accessibility and clinical education in the unit and is also likely to manage some of the challenges that come with shortage of nursing staff.  The main goal of health care is to have a positive patient outcome as far as is possible; the use of the OneNote in the nursing unit will go a long way in achieving this.

References

Aiken, L. Sean, C. Sloane, S. (2002). Hospital nurse staffing and patient mortality, Nurse burnout and job dissatisfaction.  The Journal of the American Medical Association, 288(16): 1987-1993

Kuziemsky, C. Laul, F. and Leung, R. (2005). A review on diffusion of 

personal digital assistants in health care, journal of medical systems, 29(4): 335-342

Chantelle, G. Khaled, E. & Beng, C. (2006). Who’s using PDAs? Estimates of PDA 

use by health care providers: A systematic review of surveys, Journal of medical I internet research, 8(2):7  

Huber, D.  (2006). Leadership and nursing care management. USA: Elsevier health 

sciences.

Garret, B. and Klein G. (2008). Value of wireless personal digital assistants for practice: perception of advanced practice nurses, Journal of Clinical Nursing, vol 17, iss16, pp2146-2154

Gamel W. (2009) Historical perception as a complementary framework: for 

understanding the usability of mobile computers, Cognition, technology & work, 12(3): 205-217

Kimura, E. Onozaki, Y. Shizui, Y. and Masato, O. (2003). Development of Nursing Care Support System using PDA with wireless and barcode reader, AMIA Annu Symp Proc. 2003; 2003:894

Kupier, R. (2008). Use of personal digital assistant to support clinical reasoning in undergraduate baccalaureate nursing students. Computers, Informatics, Nursing, 26(2), 90-98. 

Marquis, L. and Huston, J. (2008). Leadership Roles and Management Functions in Nursing: Theory and Application, Lippincott Williams and Wilkins

Rusell, C. Swansburg, L. and Swansburg, C. (1995). Nursing staff development: a component of human resource development, Jones and Bartlett Learning

Pochciol, J., & Warren, J. (2009). An information technology infrastructure to enable evidence-based nursing practice. Nursing Administration Quarterly, 33(4), 317-324. Retrieved from CINAHL database

Self-Assessment of Leadership, Collaboration, and Ethics

Leadership has earned heated debates on what makes an individual a better candidate for the position. Various qualities are explored to define the kind of leadership and determine the individual's excellence or failures. Self-control and self-awareness are necessary to keep leaders on their toes and help them know how they need to react to specific issues in their careers. Self-reflection is critical to allow the awareness and control abilities to be reviewed and enhanced desirably. Leaders need commitment and dedication to effectively carry out their obligations. Excellent leaders need a culture of learning and continuous growth and development to foster new skills and experiences. The Western Medical Enterprise Questionnaire reveals critical issues that earned the response as presented in this assessment section. The response explores the leadership attributes, behaviors, and approaches that promote collaboration and the use of specific codes to address ethical issues.

Section I:  Leadership and Collaboration Experience

I recently worked at John Hopkins Hospital as a registered nurse and was required to lead a group of nurses in the emergency room (ER). The team's shared vision was to ensure the patients have safe and quality care from the nursing department. The vision was fostered by the nursing objective to always work to assure patients of safe and quality care delivery. My time at the hospital experienced significant challenges following the outbreak of coronavirus. The work mode had to change, and the team was forced to adapt to new work dynamics. I used a transformational leadership approach to manage the team and drive them towards the main objectives. Transformational leadership is where leaders work with their teams to identify the need for change, create a vision, and guide them to execute the reforms (Nicola et al., 2018). The pandemic introduced various hospital measures, and the teams needed to change to meet the new work guidelines defined by the World Health Organization and other health agencies. The facility stakeholders appreciated my approach to leading the team as I worked to ensure they are all aware of the need for the new measures and stay motivated to work and maintain quality care.

The assertive communication approach has been my best mode of communication with the team members. The model includes active listening, open to feedback from the teams, and setting clear expectations. During this period, these factors were imperative where nurses are exposed to the virus infection and the riskiest profession. I listened to every concern the team members raised, asked for their opinion and input on specific issues, and informed them of what the emergency room expected from them. The assertive communication approach helped manage the team and efficiently implement the desired principles and objectives (Real & Pilny, 2017). The most appropriate decision was to involve the team members in finding a solution to our department's issues. I will uphold this tradition as it helped develop better working guidelines and principles and a source of motivation for the team. On the same aspect, behavioral decision-making seemed appropriate, especially when using the transformational leadership style. The approach helps note the team's poor behaviors and use the best appropriate approach to ensure the issue is countered. The behavior approach to decision-making empowers the team members, creates a feeling of value, and enhances the communication within the department.

The approach to improve collaboration, motivation, and team engagement is teleconferencing. The aspect of social distancing as recommended by the health stakeholders applies to prevent the spread of the virus. The approach allows the team members to listen to each other actively and observe the nonverbal cues and emotional connection (Karis, Wildman & Mané, 2016). It allows the collaboration between the team members to be enhanced and engagement among the remote individuals.

Section II:  Ethics Experience

Ethical issues are more challenging in the healthcare sector. Ethical dilemma for nurses is more sensitive and involves the emotional ability of the leaders. Such issues involve putting the nurses and their leaders in a position where they are torn between following their professional code and their employer or religious obligations. John Hopkins expects the employees to uphold integrity, compassion, innovation and maintain safe and quality care management. Such expectations influence the employees to hold themselves and their patients to the most rigorous possible ethical deeds without compromising their work principles.

Sometime in the past, I encountered a case where a family wanted to impose their religious beliefs on their son not to undergo treatment at the hospital. The patient was a minor, and it was appropriate for the parents to intervene in the decision making. However, he was not in agreement with his parents' decision to forgo the treatment on a religious basis. As a nurse, it was an ethical dilemma on whether to listen to the parents or uphold the minor's decision. In response, I exercised the autonomy principle of ethical decision making in the healthcare setting. I acted on the basis that each person had the right to make their choice. The principle makes the basis for informed consent in the relationship between the patient and the physician (Donnelly & MacEntee, 2016). I ignored the fact that the patient was a minor and took note of his choice to treat the religious background.  

The professional nursing code influenced the decision to exercise the patient's interest despite his status as a minor. I recalled taking an each to always make sure every individual receives the best treatment and always gives safe and quality care. My work as a nurse is to ensure my patients are safe and treated, and allowed to live healthy lives (American Nurses Association, 2015). The principle of autonomy and the oath of nursing practice informed my decision to listen to the choice selected by the patient. Although the parents threatened to sue me for the issue, I chose to uphold my obligations as a nurse to make my patient safe and to allow him to decide on his health.

Conclusion

Leadership in the healthcare setting is critical and desires the best attributes, skills, and experiences. The leadership techniques, qualities, and values are significant factors to consider when exercising in the nursing sector. The responsibility to the organization, profession, and followers to embrace ethical deeds is among the key agenda for leaders. Excellent leaders reflect on their actions and behaviors to make necessary reforms and foster accountability in their careers. Leaders desire a learning culture to assure them of the best appropriate results in their teams and achieve goals.

References

American Nurses Association. (2015). Code of ethics for nurses with interpretive     statements. Nursingworld.org. https://www.nursingworld.org/coe-view-only

Donnelly, L., & MacEntee, M. I. (2016). Care perceptions among residents of LTC facilities purporting to offer person-centred care. Canadian Journal on Aging, 35(2), 149-160. doi:http://dx.doi.org/10.1017/S0714980816000167

Karis, D., Wildman, D., & Mané, A. (2016). Improving remote collaboration with video     conferencing and video portals. Human-Computer Interaction, 31(1), 1-    58. https://doi.org/10.1080/07370024.2014.921506

Paolucci, Nicola & Dimas, Isabel & Zappalà, Salvatore & Lourenço, Paulo & Rebelo, Teresa. (2018). Transformational Leadership and Team Effectiveness: The Mediating Role of Affective Team Commitment. Revista de Psicología del Trabajo y de las Organizaciones. 34. 000-000. 10.5093/jwop2018a16.

Real, K., & Pilny, A (2017). Health care teams as agents for change in health and risk messaging. In R. Parrott (Ed.) Encyclopedia of Health and Risk Message Design and Processing. New York: Oxford University Press. doi:10.1093/acrefore/9780190228613.013.517

C228- Community Health Nursing

A. Communicable Disease

The Communicable disease chosen is Ebola.  This is a rare but deadly virus that causes fever, diarrhea, body aches and at time it can also lead to internal bleeding and external bleeding from its victims (CDC, 2019). As the virus continues to spread through the body, the victim’s immune system and organs will be affected. Eventually it will lead to high levels of blood clotting cells drop. This will also motivate the severe uncontrolled bleeding. Several studies indicate that the Ebola virus is known to kill up to 90% of those infected. 

B. Description of the Outbreak

The Ebola virus disease brings one of the most frightening communicable diseases to the mind of many. The virus disease is one of the thing that can be said to be dreamt by many horror writers.  This is because of the symptoms that is associated with the virus, where the victims are bleeding from their eyes, nose and ears, and at an autopsy it is found that the individual has been bleeding in almost all of the necrotic organization. This shows that the Ebola disease is a severe illness which is responsible for the Ebola virus (CDC, 2019). As it is communicable, the virus is highly infectious, very fatal with a guaranteed death rate of about 90% though this can be prevented.  

According to the World Health Organization (WHO, 2019), the first Ebola virus outbreak was recorded in 1976 in Sudan and Zaire, which is currently the Democratic Republic of Congo. Since then, the world continued to witness multiple outbreaks in central part of Africa with the largest incidents occurring between 2000-2001, which involved 425 infected.  The outbreak of the Ebola virus has also occurred in many instances in Uganda, the Democratic republic of Congo, Gabon and South Sudan from 1976, the world has been able to report over 1,500 cases of death (WHO, 2019).  In most cases, the spread of the disease is caused by the close members of the family of the filovirus or Ebolavirus. In this regard five different species of the virus have been recorded which includes Tai Forest Ebolavirus, Bundibugyo Ebolavirus, Zaire Ebolavirus, Sudan Ebola virus and  the Reston Ebola virus. Ebola is also the first outbreak ever recorded in Africa and especially West Africa. By the month of early May 2018, about 236 new cases were reported with around 158 deaths only in guinea. Some of the serious case have also been reported in the neighboring countries like Liberia. As regards the previous outbreaks, the healthcare workers and families of the first victims have often been the main victims due to close contact, in fact the virus has claimed around 16 deaths of healthcare workers.

 

B1. Epidemiological Determinants and Risk factors

According to an article titled ‘ Epidemiology of Ebola virus disease transmission among health care workers in Sierra Leone, May to December 2014: a retrospective descriptive study’ by Olu, O., Kargbo, B., Kamara, S., Wurie, A. H., Amone, J., Ganda, L., … Kasolo, F. (2015); the authors describe the determinants and the risk factors that are associated with the spread of the Ebola virus. From their study, the researcher were able to discover that the Ebola virus is commonly spread by the sick people, since this is a communicable disease. It means that those who are in close contact to the person who has the virus, or contaminated environment are likely to contract the virus. In this regard, some people contracted the virus by being in contact with the sick in funeral homes, while providing care for someone who is sick among other environmental factors (Olu et al., 2015). According to the studies of many of the people who they included in the research, it was reported that they had been in contact with the body of the victim in the hospital. Some of these things also occurred within a period of one month that the patient began to reveal symptoms. Also the other risk associated with the virus is whether the individual had been the primary caregiver of the patient or the infected. As much as there was some cases of which the patient had reported no contact with any sick person, and no evidence of them being in any funerals. There is actually no evidence to show that they had actually not been in these environments at some point, or may have crossed paths with the sick individual and in the process contracted the virus. This study also concluded that when the person is in contact with the body of an individual who is living with the virus, sick from the virus or deceased, is a very important factor in the contraction of the Ebola virus (WHO, 2019).  That is why as was discovered by researcher, health worker are often at high risk situation, and that is why the virus was able to spread to other regions. 

This study concurs with previous reports of the spread from the World health organization, there were 25 new case reported from the laboratory as Ebola Virus disease ( EVD) in the democratic republic of Congo. The newly confirmed cases of the virus have also been reported in Oicha, Beini and Mabalako health zones, Mandima Health Zones (Ituri Province). However, statics also indicate that all transmission and exposure events have been linked to Mabako which is the outbreak epi-centre (Olu et al., 2015). Beyond the outbreak of the Ebola virus disease, the democratic republic of Congo still remain to be in one of the most  complex humanitarian crisis in regard to the concurrent epidemic rocking the region. By 22nd of august 2018, reports indicate that there was a total of 103 new Ebola case of which 76 were confirmed while 27 remained probable. This also included 63 deaths of which 36 were confirmed and 27 probable. All of these case were reported in five health zones that included North Kivu (Butembo, Beni, Oicha, Museinene and Mabalako), the other one include one health zone found in Ituri (Mandima).  There were also other majority case that were reported from Mabalako with the area health zones of about 62 confirmed and 21 probable. By 22nd august 2018, six new cases were pending in the laboratory confirming the Ebola virus disease. Also 88 case and probable ones were reported in regard to age and gender. In this regard, the median age of infections were between groups of 32 years, with 30-39 yeas accounting for about 28% of the cases. Also 50% of all cases were said to be female (WHO, 2019)

B2. Route of Transmission

According to the center for Disease control, the Ebola virus is spread with the uninfected persons comes to direct contact with the individual that has been infected with the virus. This contact also include a deceased person who had the virus, and this is why most people have been reported to have contracted the virus during funeral ceremonies (Olu et al., 2015. The virus is also spread through the contact of human body fluids like semen, saliva, open wounds, sharing of utensils, kissing, mucus membranes like the nose, eyes, vagina and mouth or sneezing. The virus spreads through having a direct contact with blood, and urine among others, from the infected individual. The virus can also be spread when a person has contact with linen soiled by the infected person’s body fluids (WHO, 2019).  This also means that the Ebola virus can easily be eliminated with alcohol based products, heat, calcium hypochlorite (bleaching powder) or sodium hypochlorite (bleach) with appropriate concentrations. 

Other studies have also show that the spread of Ebola is common in the semen of a man, which can linger for a while to the extent that one can transfer the virus from an infected women to the other since the virus can survive in the semen for quite some time, making the disease easy to be passed. With regard to the spread of the virus to other regions, this has mostly been attributed to the family members as well as healthcare workers. According to a study by World health organization, in 2018, there were fourteen reported cases of the spread of Ebola virus among healthcare workers, of these cases thirteen were confirmed by the laboratory, also one healthcare worker sadly died from the virus. In addition, most of the reported healthcare workers are likely to have been infected in the clinic as they exchanged beddings, cared for the sick especially be the declaration of the new outbreak, and not in the Ebola treatment centers. It thus become important for healthcare worker to create partnership with communities to increase awareness of the infection, prevention and control so as to avoid the outbreak (WHO, 2019). It is also important that those at risk of infection are vaccinated. 

B3. Impact of the virus to the community

It is evident that the continued spread of the Ebola virus is going to have a social and economic impact to the community, given the fact that the virus is not so common in the united western countries. In this regard, I feel that there incidence of the virus being reported will lead to a lot of panic from member of the community given the information they have about the deadly virus impact in Africa. With this in mind, it also means that the government will have to order all the social connections including schools, clubs, institutions of higher learning and sporting events to be shut down to prevent the spread. The region reported to have evidence of the virus will also be quarantined. Just recently the United States had some of its schools shut down due to the reported communicable disease known as influenza and norovirus. These are just but some of the illnesses that the country has had to deal with (WHO, 2019). In this regard, I feel that Ebola virus would definitely affect the healthcare institutions around the region, due to the fact that most of these institutions may not be well prepared to deal with the virus, including having a ready space to secure as a quarantine for reported cases. Also the hospitals will need to receive and implement new guidelines including possible quarantine zones before air travel as some of the measures taken to contain the virus in one region in the country.  In this regard, my community will need to adjust their day to day lifestyle until the situation is put under control.  

 

B4. Reporting Protocol

The most instrumental tools for reporting the outbreak of the Ebola virus has been the mainstream media which is the first place that people in my community would rely on for issues of concern. Given that I stay in a peri-urban environment, I make my personal business to always watch health related news affecting my neighborhood. In addition, bad news like the spread  of a virus would spread fast in the region through other tools like the social media pages, word of mount  among other platforms/ however, it is still important to verify information spread through the social media since most of it is based on rumors and is incomplete as it has no facts.  This means that to get the right information regarding a disease outbreak it is best to get it from the center for disease control, which also uses the mainstream media (Television, radio and newspapers) as an outlet for information (WHO, 2019). This information is also spread through newsletters in school, leaflets in public places, especially with advice on prevention. This makes the mainstream media the right instrument for an Ebola outbreak.

B5 Prevention Strategies

In regard to Ebola virus, the first strategy that the community and healthcare institutions can use for preventing the spread would be to introduce an education aspect for patients already infected and their families. The type of education they will be given will be around the risk factors, causes and important of quarantine. The family of the victims will need to be taught on the first thing that they need to do if they believe that they may have contracted the virus, or depict symptoms of the virus. To implement this way, I can suggest adding such information I the discharge summary, where patient are given bulleted advice with subheadings on cause, prevention and treatment for the Ebola virus. This is currently done with other diseases like signs and symptoms of sexual transmitted infections; of which we have been able to educate a lot of young men and women on the treatment and prevention of sexual transmitted infections. 

The second strategy would be to conduct community awareness program about the Ebola virus. This would be instrument for ensuring that panic is contained in case there are reports about the virus, or there is need to quarantine a particular region to contain the spread of the virus or other virus in that case. The best instruments for community awareness strategy will be both the mainstream media and the social media. This will entail having a public announcement at several intervals in popular radio and television stations. Billboards will also be set around the country, including community awareness events to educate people about the virus, prevention and treatment (Olu et al., 2015). There will also be distribution of leaflets with information about the virus which will be very helpful in the long run.  I believe that when the community is provide the right education, they will be well informed to avoid or prevent the spread of the virus. Thus community education and personal responsibility are among the best instruments for ensuring the community is safe from the spread of this deadly virus. 


References

CDC. (2019, March 29). Transmission. Retrieved from https://www.cdc.gov/vhf/ebola/transmission/index.html

Olu, O., Kargbo, B., Kamara, S., Wurie, A. H., Amone, J., Ganda, L., … Kasolo, F. (2015). Epidemiology of Ebola virus disease transmission among health care workers in Sierra Leone, May to December 2014: a retrospective descriptive study. BMC Infectious Diseases, 15(1). doi:10.1186/s12879-015-1166-7

WHO. (2019, April 19). Ebola virus disease ? Democratic Republic of the Congo. Retrieved from https://www.who.int/csr/don/24-august-2018-ebola-drc/en/

 

Qualitative Data Collection & Ethic

Research Critique: Qualitative Studies

Background of Study

Recent data shows that the incidence and prevalence of End-Stage Renal Disease continue to increase and is high among African America population. As a non-reversible kidney damaging illness, hemostasis in patients diagnosed with ESRD can be maintained in two ways. The ways are either through dialysis or a kidney transplant. Moreover, research shows that blacks and African Americans have an increased risk of developing kidney failure. Therefore, this paper critically appraises two qualitative studies that address the PICO question. The two studies include one by Zazzeroni et al. (2017) on “Comparison of Quality of Life in Patients Undergoing Hemodialysis and Peritoneal Dialysis: a Systematic Review and Meta-Analysis” and the second one by Fox et al. (2020) on “Social Support in the Peritoneal Dialysis Experience: A Qualitative Descriptive Study.” These studies will try to address the PICO question which is: “In African Americans with End-Stage Renal Disease (ESRD), how will peritoneal dialysis make for fewer restrictions and less complication than in-centre hemodialysis? This critique will incorporate the study's background, how the articles support PICO question, the methodology used, results of the two studies, and ethical considerations. 

In the first study by Zazzeroni et al. (2017), the authors noted an increase in the survival rate of patients with chronic renal failure dues to substitution treatment prompting an investigation of their quality of life (QoL), which is a key measure of evaluating the outcomes of chronic disease treatment. The authors embarked on determining whether hemodialysis or peritoneal dialysis provided a better QoL. In doing so, the authors aimed at performing a systematic review and meta-analysis of published studies using KDQOL-SF 1.3 and KDQOL-SF 36 in patients with chronic renal failure to determine which hemodialysis or peritoneal dialysis treatments that lead to a higher QoL. In this study, the problem is increased patients suffering from chronic renal failure and determining the QoL in patients with chronic renal failure best between hemodialysis and peritoneal dialysis treatments.

On the other hand, in the study by Fox et al. (2020), the authors noted that individuals with end-stage kidney disease could decide to go for either conservative (palliative) management or kidney replacement therapy. Again, the authors also noted that most patients prefer kidney transplant. Still, due to the limited number of organs available, most patients are forced to seek some form of dialysis treatment. Moreover, the authors also noted that most patients prefer either hemodialysis or peritoneal dialysis, which are both equivalents concerning clinical outcomes, though peritoneal dialysis is less costly to offer. As a result, peritoneal dialysis is often done in the home by patients or support persons. Peritoneal dialysis is associated with self-care burden on patients and families, even though social support for patients receiving peritoneal dialysis is vital for its sustenance. As a result, the objective of the authors was to explore how patients, family members, and nurses view social support among outpatients undergoing peritoneal dialysis clinic..

How do these two articles support the nurse practice issue you chose?

These two articles support the PICO question and will be used to address the elements of the question to gain a deeper understanding of both hemodialysis and peritoneal dialysis. For instance, the study by Zazzeroni et al. (2017) will be used to determine how hemodialysis and peritoneal dialysis can be used to enhance the quality of life among patients with end-stage renal disease, which are the focus of the PICO question. The systematic meta-analysis will reveal which is the best treatment model is better to enhance the quality of life. Similarly, the article by Fox et al. (2020) will support the PICO question by providing more information on how nurses, family members, and nurses view the social support in helping patients diagnosed with kidney disease under peritoneal dialysis recover.

Moreover, the intervention and comparison groups in the study by Zazzeroni et al. (2017) included patients undergoing hemodialysis and peritoneal dialysis treatment, respectively, exactly as the intervention and comparison group in the PICO question. However, the in the study by Fox et al. (2020), the intervention and comparison groups were patients, family members, and home care–assisted PD program nurse as the intervention group while and PD nurses were the comparison group respectively, which is not the case in the PICO question.

Method of Study

In the article by Zazzeroni et al. (2017), the authors used a systematic review and meta-analysis research design in which data was gathered from the articles searched through various databases and articles that compared peritoneal dialysis and hemodialysis therapy for the treatment of patients with chronic renal failure in relation to the QoL were selected. However, Fox et al. (2020) used a qualitative descriptive research design to comprehensively explore the role of social support as perceived by patients receiving PD, their families, and nurses. The two articles used different research design in which the first study by Zazzeroni et al. (2017) used secondary data while the second by Fox et al. (2020) used primary data. More importantly, the advantage of using a systematic review and meta-analysis is that they seek to reduce bias at all stages of the review process. However, limitation of systematic review and meta-analysis is that the setting of tests used, the expected role of the tests, study design characteristics, and participants' demographics are often left unreported. On the other hand, the advantage of qualitative descriptive research design is that it offers the researchers the opportunity to observe the phenomenon in a completely natural and unaltered natural setting. However, one limitation of qualitative descriptive research design is that I can be difficult to replicate results and is prone to researcher bias.

Results of Study

In the study conducted by Zazzeroni et al. (2017), the authors found that only a few of the seven articles found significant differences between hemodialysis and peritoneal dialysis treatments. The study by Wakeel et al. showed a better QoL for peritoneal dialysis patients than in hemodialysis patients. On the contrary, two other studies support that the best QoL is in patients receiving hemodialysis. Another article displayed a significant difference only for satisfaction in relation to care, better in patients on peritoneal dialysis, and for physical health, better in hemodialysis. These findings imply that the quality of life in patients diagnosed with kidney disease is better in patients undergoing peritoneal dialysis.

On the other hand, in the study by Fox et al. (2020), the authors found that four themes are attributed to social support. They included addressing emotional needs and managing emotion (emotional support); peritoneal dialysis tasks and life tasks (instrumental support); accessing information, receiving information, and learning (informational support); and affirmation/external reassurance and self-confidence (appraisal support). The social support needs of both patients and family members also varied and depended on their existing support networks and individual perspectives of support. This study implies that for health care providers to encourage this treatment route, they need to comprehend how to best support patients and their family members. This knowledge will empower clinicians to focus on these four attributes when providing care to patients and their families.

Ethical Considerations

One important ethical issue in conducting research is ensuring that there if is informed consent, especially where human participants are involved in the research. Informed consent means that an individual knowingly, voluntarily and intelligently, and clearly and manifestly, provides consent to participates in research (Ferreira, Buttell, & Cannon, 2018). Informed consent is one of how the autonomy rights of a patient are protected. Moreover, informed consent seeks to include the rights of autonomous persons through self-determination. The other ethical issue in conducting research is that of Respect for anonymity and confidentiality. According to the American Nurses Association, this ethical issue means that the anonymity is protected when the subjects identify can note be linked with personal responses in research (Ferreira, Buttell, & Cannon, 2018).

However, in Zazzeroni et al. (2017), the authors did not address any of the two ethical concerns because the study was based on other studies other human participants. On the other hand, the study by Fox et al. (2020) followed the ethical principles of confidentiality by where the participants transcribed verbatim by a transcriptionist who signed a confidentiality agreement. Again, this study respected the principle of informed consent by ensuring that patients were reminded that they could withdraw their consent at any point during the qualitative data collection.

References

Ferreira, R. J., Buttell, F., & Cannon, C. (2018). Ethical issues in conducting research with children and families affected by disasters. Current psychiatry reports20(6), 1-7.

Fox, D. E., Quinn, R. R., James, M. T., Venturato, L., & King-Shier, K. M. (2020). Social Support in the Peritoneal Dialysis Experience: A Qualitative Descriptive Study. Canadian journal of kidney health and disease7, 2054358120946572. https://doi.org/10.1177/2054358120946572  

Zazzeroni, L., Pasquinelli, G., Nanni, E., Cremonini, V., & Rubbi, I. (2017). Comparison of Quality of Life in Patients Undergoing Hemodialysis and Peritoneal Dialysis: a Systematic Review and Meta-Analysis. Kidney & blood pressure research42(4), 717–727. https://doi.org/10.1159/000484115

 

NURS 6002 Foundations for Graduate Study Sample

Academic Success and Professional Development Success Template

    Involvement of different stakeholders in my MSN program would be vital to promote a successful interprofessional education (IPE) journey. IPE would offer the ability to exchange skills, knowledge, and ideas between different experts. Thus, it will foster a better understanding of how shared values and respect among different healthcare professionals improve the quality of care and patients’ outcomes (Reeves, Pelone, Harrison, Goldman, & Zwarenstein, 2017). Therefore, I identify two academic and professional individuals to join my network for a successful completion of the MSN and promotion of my nursing practice.

Network Member 1

Name: National Association of Pediatric Nurse Practitioners

Title: NAPNP

Organization: National Association of Pediatric Nurse Practitioners

Academic or Professional: Professional

    Reason for The Selection and The Influence:

In the future, I would like to major in pediatric. Therefore, joining NAPNP would be a great platform to network with other professionals pursing pediatric. I would also increase my chances of securing a job faster in my specialty by joining NAPNP.

Network Member 2

Name: David

Title: Walden University Field Experience Officer

Organization: Walden University

Academic or Professional: Academic and Professional

Reason for The Selection and The Influence:

David will be of great importance the moment I will start searching for clinical placements. He will also be invaluable since I will be consulting him whenever am faced with difficult questions regarding my practicums. He has a wide network of friends that I could also link with to advise me on the best places to apply for clinical placements. 

Network Member 3

Name: Stephen Bowler

Title: Tutor

Organization: Walden University

Academic or Professional: Academic 

Reason for The Selection and The Influence:

Bowler is a renowned tutor in the faculty of clinical medicine. He has a wide knowledge in human anatomy. IPE is a vital facet of the modern nursing education (Khanbodaghi, Natto, Forero, & Loo, 2019). Therefore, creating a network with him would increase my chances of performing better in courses related to human anatomy through regular consultations. Besides, I would be borrowing learning resources from him to use in my studies. 

Network Member 4

Name: Charlie Ben 

Title: MSN Student

Organization: Walden University

Academic or Professional: Academic 

Reason for The Selection and The Influence:

I was interested in selecting Ben to join my network because he is ahead of me in the studies. Therefore, he will act as my mentor in the MSN program. Ben will guide me on what MSN students are supposed to do to complete the program successfully. 

To sum up, interprofessional collaboration is vital in nursing. It helps in improving care delivery and patients’ outcomes through the sharing of values and skills. Besides, IPE contribute positively toward successful completion of different healthcare courses such as MSN program.


References

Khanbodaghi, A., Natto, Z. S., Forero, M., & Loo, C. Y. (2019). Effectiveness of interprofessional oral health program for pediatric nurse practitioner students at Northeastern University, United States. BMC oral health19(1), 170. Retrieve January 13, 2021, from https://link.springer.com/article/10.1186/s12903-019-0861-y/

Reeves, S., Pelone, F., Harrison, R., Goldman, J., & Zwarenstein, M. (2017). Interprofessional collaboration to improve professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, (6). Retrieved January 13, 2021, from https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000072.pub3/pdf/CDSR/CD000072/CD000072.pdf/