The field of nursing has changed over time. In a 750-1,000 word paper, discuss nursing practice today by addressing the following:

1. Explain how nursing practice has changed over time and how this evolution has changed the scope of practice and the approach to treating the individual.

2. Compare and contrast the differentiated practice competencies between an associate and baccalaureate education in nursing. Explain how scope of practice changes between an associate and baccalaureate nurse.

3. Identify a patient care situation and describe how nursing care, or approaches to decision making, differ between the BSN prepared nurse and the ADN nurse.

4. Discuss the significance of applying evidence based practice to nursing care and explain how the academic preparation of the RNBSN nurse supports its application.

5. Discuss how nurses today communicate and collaborate with interdisciplinary teams and how this supports safer and more effective patient outcomes.

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The nursing care delivery model used at my current employer is the case management model. According to Marquis and Huston (2017) and Cudney (2018), case managers provide care coordination, cost-effective care recommendations, education, and collaboration through the identification of available resources internally and externally (community) between patients, families, and providers. There are many facets of case management, all advocating for a patient’s optimal health, across the continuum of care (Kelly, Doucet, & Luke, 2019).  That said, working in an integrated care delivery system comprised of several Magnet Level facilities, shared governance is present and successful within the overall organization. In the insurance division where I currently work, we have not implemented a full shared governance structural model to date. We have a strong healthy work culture where our boots on the ground staff highly influence decisions regarding practice, safety, quality improvement, and research. The use of a shared governance model has been related to increased staff empowerment, high job satisfaction, increased retention rates, and improved patient outcomes (Allen-Gilliam et al., 2016). I would utilize the case management model and the shared governance model at St. Louis Medical Center (SLMC) because combined, these models have proven improved patient outcomes while delivering cost-effective care to populations (Allen-Gilliam et al., 2016; Kelly et al., 2019).  

The main function of a nurse case manager (NCM) within a case management model is interprofessional collaboration to improve care coordination, patient and provider satisfaction, and patient outcomes. To foster interprofessional collaboration across care teams I would facilitate relationships among various stakeholders through purposeful strategy meetings to communicate common goals of delivering high quality care to patients while leveraging the unique skillsets of various team members. Through these interactions, relationship form and knowledge are shared to come to a place of agreement to carry out impactful outcomes. Permitting and promoting a constant flow of communication for both internal and external stakeholders will increase trust and collaboration among the organization.

This model supports the person-centred nursing (PCN) framework by McCormack and McCance because the PCN Framework is based on relationships. Forming and fostering healthful relationships between patients, their loved ones, and providers and showing respect promotes holistic nursing care and improved quality outcomes (McCormack & McCance, 2017).  Implementing this model promotes holistic nursing, provides individualized patient care, empowers shared decision making, and ultimately impacts quality patient care outcomes (Fessele, Yendro, & Mallory, 2014).  Most often this model is referred to direct patient care however, the concepts in this model are relatable to nurse leadership roles as person-centered nursing results in positive outcomes for nurses, staff, teams, and organizations (McCormack & McCance, 2017).

Thanks,

Ashley

Allen-Gilliam, J., Kring, D., Graham, R., Freeman, K., Swain, S., Faircloth, G., & Jenkinson, B. (2016). The impact of shared governance over time in a small community hospital. The Journal of Nursing Administration, 46(5), 257-264. doi:10.1097/NNA.0000000000000340

Cudney, A. E. (2018). Letter to the Editor. Consider Case Management Models in Nursing…Fishman, G. Attending registered nurses: Evolving role perceptions in clinical care teams. Nursing Economic$. 2018:36(1);12-17,22. Nursing Economic$, 36(5), 206–251

Fessele, K., Yendro, S., & Mallory, G. (2014). Setting the bar: Developing quality measures and education programs to define evidence-based, patient-centered, high-quality care. Clinical Journal of Oncology Nursing, 18, 7-11. https://doi-org.chamberlainuniversity.idm.oclc.org/10.1097

Kelly, K. J., Doucet, S., & Luke, A. (2019). Exploring the roles, functions, and background of patient navigators and case managers: A scoping review. International Journal of Nursing Studies, 98, 27–47. doi:10.1016/j.ijnurstu.2019.05.016

McCormack, B., & McCance, T. (2017). Person-centered practice in nursing and health care. Theory and practice (2nd ed.). Oxford: Wiley Blackwell.

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minimum of 250 words

Two nurses make a medication error: One causes an adverse event with a patient and the other does not. Should the nurses be disciplined, and, if so, should they be disciplined the same way? Why or why not? How would this be addressed in a just culture?

 Please watch this short clip and answer following questions:

According to the Centers for Disease Control and Prevention, heart disease is the leading cause of death for Americans. Science has determined that the following modifiable factors contribute to heart disease:

• Smoking
• Obesity
• High blood pressure
• High cholesterol levels
• Sedentary life styles
• Uncontrolled diabetes
• Poor food choices

Directions: Watch the video. Once you have watched the video, please discuss the following with your classmates:

1. If the public is aware of the modifiable risk factors for heart disease, why is heart disease still so prevalent?
2. Describe two ways that nurses could motivate healthy lifestyle choices in their patients and community?
3. Do nurses have a responsibility to be role models of healthy life choices?
4. Of the seven factors from the video, which have you improved upon in your own life during the past year?

Watch VideoAmerican Heart Association’s Life Simple 7- Simple Factors that Impact Health and Quality of LifeDuration: 3:51
User: n/a – Added: 6/1/14