Health & Social Care
Use the case study below to answer the following three questions in essay format and ensure that you support your writing with reference to appropriate academic sources with one reference list:
Ms. Y is a 40-year-old woman who suffered serious, life changing injuries in a motor bike accident which means she is unable to walk and has little ability to move her hands. She is mobile in her powered wheelchair and has adaptations to be able to smoke her cigarettes independently. She was admitted to a residential and nursing home as an emergency when she first left hospital which has accommodation for elderly frail people and people with dementia. Ms. Y has always enjoyed an active social life and likes to go out to pubs and clubs with her friends. She went out on one occasion on her own returning to the home at 2a.m. on a night bus. Since then the home has refused to agree to her going out in the evening unaccompanied. However, they are short staffed and cannot provide evening support for her. The home is also encouraging her very strongly to give up smoking and have not provided an outdoor space where any resident can smoke comfortably and safely.
Question 1: Identify and explain which principles of ethics, dignity and respect have been breached in this case study? 3rd person.
Question 2: With reference to relevant ethical principles; discuss why and how the home could improve their service and their communication? 3rd person.
Question 3: Critically reflect on how this case may have impacted on you if you were a care assistant working at this care home? 1st person.
The client is happy for the information in Q3 to be fabricated, but has provided the following information: “I feel sad. The independence is taken away and the patient has to live with people with dementia”.
The client has been working as a senior care worker over the last 15 years in hospitals and the community. The client works with people with learning disabilities, mental illness and people with physical needs. They are also a care representative, student representative and a walking leader for medical complex needs.
Please use the APIE Model (Assess, planning, implement and Evaluate). Please explain why you are using the framework in the introduction. This is problem-solving process.
Learning Outcomes:
1. Demonstrate an understanding of the ethical and moral concepts pertaining to freedom, rights, responsibilities and the use of power in care.
2. Discuss effective communication and interpersonal skills including compassion, dignity and respect.
3. Examine and reflect upon personally held values and the impact they might have on practise, individual learning and own development.
4. Identify strategies for enhancing dignity and respect accorded to people in a care setting.

 

 
Chapter One: Introduction 3500
Introduction 200
Background of the Project 600
Problem Statement 400
Purpose of the Project 300
Study Objectives
Clinical Question 150
Advancing Scientific Knowledge 300
Significance of the Project 300
Rationale for the Methodology 300
Nature of the Project Design 300
Definition of Terms 200
Assumptions, Limitations and Delimitations 300
Summary and Organization of the Project 200
Chapter Two: Literature Review 8500
2.1 Introduction to Chapter
The study focuses on assessing the effects of nurse residency program on patient safety. This chapter presents in-depth analysis of the existing literature form previously completed researches. The chapter is critical in shaping the direction of this current study by ensuring that the purpose of this study is vindicated by an existing research gap that should be addressed in this study. Furthermore, assessing the existing evidence and the past studies will help reduce the issue of redundancy in research field regarding matters nursing residency program. Redundancy increases the problem of information overload, which further reduces the ability of audience to access and use the available data/information effectively. With a strong literature review, this study will manage to appraise the primary findings collected through the survey tool. Consequently, the researcher will managed to report the findings in respect to what has already been reported. Any conflict or differences noted between this study’s primary findings and what is already reported in the literature will, therefore, be explained, and so will be incongruence instances noted. This way, the research will manage to build and update the existing body of literature. The review of literature is also critical in helping the research fine tune the study topic, objectives, and research questions. Following the insights gained from the process of literature review, the researcher can revise the topic and the research direction to be precise and relevant to meet the existing literature need.
The chapter will start with the introduction section depicting the rationale for having this chapter and then followed by a brief background of the study. This section will then be followed by an account and justification of the theoretical model informing this study. The theories will be described and the link between the model and the current study emphasized. The subsequent section detailed the review of literature which will be followed by a summary of the chapter and affirmation of the research gap supporting the rationale for this study.2.2 Background of the Problem
The driving factors to the inception of nursing residency program included increasing acuity of hospital patients, enhancing understanding of health technology, empowering nurses amid complexities in treatment, improving quality of care, reducing nurse turnover, and improve nurses job satisfaction (Goode et al. 2013). The factors were observed to offer significant challenges to nursing workforce, especially due to lack of a standardize student to clinical nurse transition program. In view of these challenges, the University HealthSystem Consortium (UHC) and the American Association of Colleges of Nursing (AACN) pulled together to develop a model residency program that was targeting those nurses joining the clinical nurse setting. It took Chief Nursing Officers from UHC, the Deans from AACN, and nurse educators two years to develop the curriculum for the nursing residency program and establish the benchmark standards for evaluating those joining the program (Goode et al. 2013). The program was piloted in 2002 in six hospitals, and the feedback supported the implementation of the program. By the year 2012, over 31000 nurses had gone through the program in over 100 hospitals. The vitality of this program is further demonstrated by Hawaii State ratifying the program as a mandatory practice for the nurses practicing within the State’s clinical jurisdiction. The program has expanded to over nursing field including the teaching field.
The nursing residency programs facilitates both formal and informal learning opportunities, especially on matters institutional policies, procedures, and standards that can help them delivery quality and safe patient care (Letourneau & Fater, 2015). The residency program is much more than just job orientation in that the person is much more stationed in the area of specialty, and help the nurse to familiarize with persons and structures needed to execute institutional based routine practices. The residency program enhances the job awareness during the period of transition. Some of the nursing skills and practices cannot be acquired in the learning institutions and require the field experience to develop them. These include cultural diversity, perfecting interpersonal connection, promoting inter-professional collaboration spirit, and confidence to responding to matter on the ground. During the residency program, the novice nurses improves their evidence-based decision making skills, playing patient advocacy, promoting political and policy making skills on matters health and grow the patient-centered approach in care delivery.
Statistics indicate that there is a high nurse turnover during the first two years of recruitment. The hospitals spend a lot in recruiting new nurses in the hospital following these turnover rates. Zinn, Guglielmi, Davis & Moses, 2012, estimated the turnover cost for those graduate nurses leaving the job within the first two years to be in the ranges of $22, 420 to $77,200. This cost increases when considering the addition cost of hiring a new graduate nurse employee which can range from $8000 to $50000. One of the quoted contributing factors increasing nursing attrition rate was pressure at work following much expectations and responsibilities bestowed on the struggling to fit in the program nurse. The residency program was aimed at improving the degree or those retained and build on the nurse’s confidence (Lin, Viscardi & McHugh, 2017). With reduced turnover, and increased nursing competencies, there is high expectation that the delivery of nursing care would improve to offer quality safe nursing care. It is this claim that this paper seeks to ascertain. The dreamers and engineers of nursing residency program had high expectations of what the programs means for the nursing profession going forward.2.3 Theoretical Framework
This subsection focuses on delineating model on which this study is founded, and how the model epitomizes the guiding principles and aspects promoting this study. Models are described as conceptual constructs employed to inspire and represent real processes of things, which may otherwise remain not understood from the general description (Pena 2010). The models also guide the implementation or rolling out of a real program by offering a framework for assessing the progress (Field 2014). The residency program entails a strategy aimed at promoting the capability of nurses to delivery their nursing skills and serves the patient in their best way possible. Therefore, a feasible and effective model should focus along this line where the nurses’ capability is on a progressive improvement. Following an intense search from the literature, one of the best models that the research adopted for this study is the Dreyfus Model of Skill acquisition.2.3.1 Dreyfus Model of Skill Acquisition
The model, which was first proposed in 1980, envisages the progressive but gradual transition and development in competency from a novice nurse who majorly relies on taught rules and procedures to a more competent nurse who employs intuition in decision making (Pena 2010). The model is a five stage phase starting from novice < competent < proficient < expert < master, which can be employed to describe the metamorphosis that a nurse undergoes during the transition from a student nurse to a competent clinical nurse (Field 2014). Each of these stages borrows from the later and the process of skill acquisition should be smooth, otherwise, frustrations due to poor improvement will build-up increasing stress and more likely motivating turnover.
A. The Novice
The novice phase is characterized weak understanding of the field, institutional policies, interpersonal relation, and poor inter-and-intra-professional collaboration (Pena 2010). Much of the decisions made rely on the knowledge of the acquired rules and procedures, which at this stage forms the basis of what should or should not be pursued/implemented (Field 2014). The novice stage is also characterized by decisions and procedures in the practice following the same fashion that denotes routine, rigidity, and poverty of options. In this stage, the practice is about reporting rather than interpreting findings, following the routine instead of executing evidence-based implementation of planned interventions, and waiting for instructions rather than being proactive (Field 2014). Due to the much attention directed on sticking to the rules, the novices are likely to make errors, and report poor productivity. The frustrations adds up and unless the novice learn and graduate to the next phase, the highest probability is quitting, especially when the level of expectation bestowed onto them is pressurizing rather than motivating (Pena 2010).
The novice stage symbolizes the new nurse right from the school while joining the practice field. These nurses are full of spirit to implement the acquired knowledge and execute the skills they may have towards effective patient care. However, the reality on the ground may not be as expected and instead they end-up trying very hard to follow the ideals and stick to the rules, which at times may not be feasible or effective due to the challenges on the ground. Therefore, the nurse if patient will pursue to learn from the experts and masters in the field to improve their approach in responding to the patients demands. Baumberger-Henry, 2012, observes that the high rate of turnover observed among the novice is attributed to poor adapting skills and now allowed room to adapt and adjust themselves in the field.
B. The Competent
This stage follows the novice stage and it is much by significant improvement in the decision making process. The stage is marked by the person demonstrating acquisition of sufficient experience following his/her exposure to some real life cases and having witnessed those above him/her in terms of skills acquisition execute their decisions. This exposure plays a critical role in the “competent’s” decision making process. However, they still lack in enough experience and their decision, though improved by the experience, follow the same patterns of recognition, memory, and analytical reasoning. Their proactive aspect of respond to nursing issues is also weakly developed.
C. The Proficient
D. The Expert
E. The MasterReview of the Literature 6000
– Patient Safety Standards
– Benefits of Residency Program
– For Nursing Profession
– For Nurse and Health Care Staff
– For Patients
– Challenges of Residency Program
– Residency Program and Medical Errors
– Residency and Fall Prevention
– Residency and Quality of Care
– Residency and Effective Communication
– Residency and Staff Competency
– Areas of Focus in FutureSummary 300Chapter Three: Methodology 4500
Introduction 200
Project Methodology 300
Project Design 300
Population and Sample Selection 800
Instrumentation 500
Validity 200
Reliability 200
Data Collection Procedure 300
Data Analysis Procedure 300
Ethical Consideration 800
Limitations 300
Summary 250
References
Bleich, M.R. (2012). In praising of nursing residency programs. American Nurse Today, 7(5).
Goode, C.J., Lynn, M.R., McElroy, D., Bednash, G.D. & Murray, B. (2013). Lessons learned from 10 years of research on a post-baccalaureate nurse residency program. The Journal of Nursing Administration, 00(0); 1 – 7
Baumberger-Henry, M. (2012). Registered nurses’ perceptive on the new graduate working in the emergency department or critical care unit. The Journal of Continuing Education in Nursing, 43(7); 299 – 305
Rhodes, C., Radziwicz, R., Amato, S., Bowden, V., Hazel, C., McClendon, S., Medas, J. & McNett, M. (2013). Registered nurse perceptions after implementation of a nurse residency program. Journal of Nursing Administration, 43(10); 524 – 529
Letourneau, R. & Fater, K. (2015). Nurse residency programs: an integrative review of the literature. Nursing Education Perspectives, 36(2); 96 – 101
Johnson, A., Salisbury, H., Johannsson, M. & Barajas, K. (2013). Emergency nurse residency program evaluation. Journal for Nurses in Professional Development, 29(5); 233 – 237
Wierzbinski-Cross, H., Ward, K. & Baumann, P. (2015). Nurses’ perceptions of nurse residency: identifying barriers to implementation. Journal for Nurses in Professional Development. 31(1); 15 -20
Little, J., Ditmer, D. & Bashaw, M.A. (2013). New graduate nurse residency: a network approach. Journal of Nursing Administration, 43(6); 361 – 366.
Zinn, J., Guglielmi, C.L., Davis, P.P. & Moses, C. (2012). Addressing the nursing shortage: the need for nurse residency programs. Association of Operating Room Nurses, 96(6); 652 – 657
Davis, T.L. (2013). A qualitative study of the effects of employee retention on the organization. Insights to a Changing World Journal, 3(2); 25 -112.
Lin, P.S., Viscardi, M.K. & McHugh, M.D. (2017). Factors influencing job satisfaction of new graduate nurses participating in nurse residency programs: a systematic review. Journal of Continuing Education in Nursing, 45(10); 439 – 452
Hofler, L. (2016). Transition of new graduate nurses to the workforce: challenges and solutions in the changing health care environment. A Journal of Health Policy Analysis and Debate,77(2); 133 – 136
Reinhard, S., Farmer, P., Frantz, R.A., Forneris, L. & Cadmus, A. (2014). Nursing residency programs: transition to practice (part I). Future of Nursing. Retrieved from <https://campaignforaction.org/wp-content/uploads/2016/04/Webinar-summary.pdf>
Redman, P. (2016). Effectiveness of a critical care nurse residency program. Walden Dissertations and Doctoral Studies.
Kim, K.H., Lee, A.Y., Eudey, L., Lounsbury, K. & Wede, P. (2015). New RN residency program to improve clinical competency, confidence, and socialization skills of novice nurses. Journal of Nursing Education and Practice, 5(6); 50 – 62
Welding, N.M. (2011). Creating a nursing residency: decrease turnover and increase clinical competence. Advanced Practice, 20(1); 37 – 40
Taie, M. (2014). Skill acquisition theory and its important concepts in SLA. Theory and Practice in Language Studies, 4(9); 1971 – 1976
American Association of Colleges of Nursing (2017). Vizient/AACN nurse residency program. American Association of Colleges of Nursing. Retrieved from <http://www.aacnnursing.org/Portals/42/AcademicNursing/NRP/Nurse-Residency- Program.pdf>
Svercauski, J. (2015). Effects of transition to practice programs on new nurses’ confidence and RN role transition. ProQuest Dissertations Publishing
Harrison, D.A. (2012). Outcome comparison of an evidence-based nurse residency program to other orientation models. UNF Theses and Dissertations. Paper 40.
Pena, A. (2010). The Dreyfus model of clinical problem-solving skills acquisition: a critical perspective. Medical Education Online,
Field, A. (2014). Understanding the Dreyfus model of skill acquisition to improve ultrasound training for obstetrics and gynaecology trainees. Education and Training, 22(2); 118 -122
Pena, A. (2009). The Dreyfus model of clinical problem-solving skills acquisition: a critical perspective. Medical Education Online, 15. doi: 10.3402/meo.v15i0.4846

 

Public Health Care System
The terms: health care and public health are often used interchangeably. Two such widely used terms are public health and health promotion.
Based on your understanding of the topic, create a report in a Microsoft Word document answering the following questions:
Define the terms public health and health promotion.What are the similarities and differences between the two?What specific health promotion activity was provided in your community during the past one year and what was the beneficial result?How did Healthy People 2020 develop and what is the purpose and goals of this program?Over the years, the public health care system has evolved due to the numerous legislative and regulatory influences. These efforts are being illustrated as legislative and regulatory pressures on the form and function of the delivery system.
Note: Click here to view a link to get a better understanding about the issues affecting the community and nation (Go to Policy and Advocacy > Congress and Federal Agencies > Legislation and Issues).
What current legislation has had the maximum impact on the way health care is provided?What interest group(s) influenced the establishment of this legislation?Mention an interest associated with a health care promotion or wellness program that, according to you, had the greatest impact on the people of the U.S. in the last three years. Provide a description of this program.
The description should include the following details:
What were the activities actually associated with the program?How was it reported in the media?What was it about this program that had an impact on you?What population was involved? Why do you think the specified population was involved in the program?What do you think can be done by society to promote this program?

Most Prevalent Health Issues
Select a program that you would like to develop in your community or city based on one of the six most prevalent serious health problems currently faced by communities today such as poverty, health security, and communicable diseases.
Based on your research, create a 2- to 3-page report in a Microsoft Word document including answers to the following questions:
Identify your chosen problem and why it is a health community concern?Identify how you will assess the need for the program? What type of data will you review?How do you determine the target audience? List any one goal and three objectives. What do you want to achieve when you develop the program? What will be the outcome? What is the purpose of developing goal and objectives?How will you get people in the community involved to gain support for your proposal?What realistic method will be used to market the program in your community? Keep in mind the location, transportation, parking, and type of building.How will you implement the program? What type of “best practice” strategy will you include in your program?What type of feedback will you gather to analyze, if the program was successful? Why accurate feedback is critical to make certain, the program is a success? How will you collect objective data?Provide at least two scholarly resources taken from the South University Online Library to support your efforts and topic.
Support your responses with examples.
Cite any sources in APA format.Complete a modified Gemba Walk.
Prepare for your preliminary walk by completing the following:
Refer back to this week’s Gemba walk presentation.Survey your department or another area of your choosing. Decide upon where you will focus your walk.Research both the setting where you will be doing your walk and explore external resources that will inform your setting.Complete the walk by asking and answering the four W’s outlined in the Gemba Walk Presentation
Utilizing systems thinking concepts produce a 525- to 1,050-word executive summary.
Discuss the four Ws and your findings.Where do you see opportunities to decrease muda (waste) and increase creativity and flow within processes or departments within your organization?Answer the following two questions on separate sheets of paper it’s important that you DO NOT include these answers in your Gemba walk Credit WILL NOT be given if you do so. Title page is not necessary for your answers but can be used
1,) Review and consider the content you covered during Week Two.
Post a 260- to 350-word response to the following questions
Using Trbovich’s article, identify one area in your organization where you think you might be able to incorporate systems thinking.
Provide examples from this week’s readings and external research.Cite at least 2 peer-reviewed, scholarly, or similar references.
Format your citations according to APA guidelines
.
2. ) Read the Gemba Walk Presentation created by Eve Krahe, PhD.
Post a response to the following question
How will you prepare to begin your Gemba Walk?