WK7&8 Professional Capstone and Practicum Reflective Journal

Running Scholarly Activity Summary New Practice Approaches (Week One) Overview I got the opportunity this week to sit it on a couple of COVID 19 disaster drills. We currently will not be taking COVID patients, but daily we get patients that are transferred from other facilities, and we are a hospital, so if someone shows up with an emergency, we have to treat them or it will be an EMTALA violation. These drills were to make a plan on how we would handle certain situations that we could find ourselves in. Problem • • • Will we treat someone who shows up with COVID-19 symptoms? If so, what will be our plan to minimize risk to other patients and staff How to handle if we have had a patient in house for 3 days and we get a call from transferring hospital that patient is COVID-19 positive Solution • • • If we do have to treat someone, we will first notify staff, halls will be cleared and all doors closed, patient will then be taken outside and will enter through the rear door and taken directly to RM 129 (negative pressure room) will have supplies already ready in anteroom. The staff assigned to this patient will only have contact with this patient If a patient becomes known positive, we will immediately place this patient in isolation room, then notify and check any staff that have cared for patient. Opportunity This is something that I hope to never have to experience again in my lifetime, but it was interesting being involved at that level to see how and why decisions are made. Often on the floor we are told the solutions and protocols, but do not have the opportunity to be a part of the problem and the solution. Things are changing daily and we will adapt, but understand how important it was to get a plan in place. Intra Professional Collaboration (Week Two) It is said, that Intra Professional Collaboration is the bridge to quality healthcare. “To provide proper care and improve patient outcomes, today’s nurses must collaborate effectively with members of the healthcare team from other disciplines” (Jakubowski, Perron, 2018). This week’s practicum helped me understand and experience the importance of this. Our collaboration team meets every Tuesday and consists of a physician, pharmacists, nurse, case manager, respiratory therapist, wound care nurse, physical therapist, and dietician. The discuss each patient and address the progression of care in meeting the plan of care. This allows nurses to play a pivotal role in the expected plan of care for their patients. References Tami L. Jakubowski, T. J. (2018, June 5). WK7&8 Professional Capstone and Practicum Reflective Journal

Interprofessional collaboration improves healthcare. Retrieved from Sigma Global Nursing Excellence : https://www.reflectionsonnursingleadership.org/features/more-features/interprofessionalcollaboration-improves-healthcare Health Care Delivery and Clinical Systems (Week 3) During this week, the focus was on how to deliver care to nursing staff and patients during the COVID-19 pandemic. I was able to sit it on a daily call with corporate regarding the policies they were implementing based on new data. I assisted in constructing new policies regarding screening of employees and our procedure if we had a known positive patient. There are different unique challenges to the healthcare team each day, but with a strong plan in place, and by following policies and procedures we can navigate more clearly. Ethical Considerations in Health Care (Week 4) My mentor invited me to attend grand rounds with the critical care pulmonologist. We have a patient who they are leaning towards binging to an ethics committee. This led to a discussion about ethical practice. Per the American Nurses Association Code of Ethics, nurses are held to ethical principles and ethical practice is integrated into all aspects of care (Ethical Practice, 2020). Two things that we must adhere to stood out to me in this case, beneficence and Nonmaleficence. “Beneficence is doing good and the right thing for the patient and Nonmaleficence is doing no harm, as stated in the historical Hippocratic Oath. Harm can be intentional or unintentional. (Ethical Practice, 2020). We as healthcare professionals have the responsibility to recognize and bring attention to ethical issues that can affect patients or staff. The supervisor at the LTACH walked me through their process and showed me their policies on ethical principles and the process we would go through if we had an ethical concern. Also, the RN to BSN program must educate us on ethics and the importance of nursing care to have long term effects on the nursing profession and practices in regard to ethics. References Ethical Practice: NCLEX-RN. (2020, March 11). Retrieved from Registered Nursing: https://www.registerednursing.org/nclex/ethical-practice/ Population Health Concerns (Week Five) The topic this week of public health concern lead my mentor and I to discuss the COVID19 and its impact on public health. Public Health is the science of protecting and improving the health of people and their communities (Public Health in Action, 2020). A discussion at our facility is the use of face coverings/mas k. We have masks supplied to us, but how do you guide lay people in the community. This led us to the CDC website and we where able to find instructions how to properly wear a cloth mask and instructions on how to construct. We learned, the CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies), especially in areas of significant community-based transmission (Coronavirus Disease 2019, 2020). References Use of Cloth Face Coverings to Help Slow the Spread of COVID-19. (2020, April 13). Retrieved from Center for Disease Control and Prevention: https://www.cdc.gov/coronavirus/2019ncov/prevent-getting-sick/diy-cloth-face-coverings.html The Role of Technology in Improving Health Care Outcomes (Week Six) Health Information Technology (HIT) is vital today in improving communication and improving quality of care and health outcomes. Peoples ideas and behaviors about health are shaped by information, communication and technology (Health Communication, 2020). “Effective use of communication and technology by health care and public health professionals can bring about an age of patient- and public-centered health information and services. By strategically combining health IT tools and effective health communication processes, there is the potential to: • Improve health care quality and safety • Increase the efficiency of health care and public health service delivery • Improve the public health information infrastructure • Support care in the community and at home • Facilitate clinical and consumer decision-making • Build health skills and knowledge” (Health Communication, 2020). The use of HIT will continue to advance healthcare and improve patient outcomes. References Health Communication and Health Information Technology. (2020, May 4). Retrieved from HealthyPeople. gov: https://www.healthypeople.gov/2020/topics-objectives/topic/healthcommunication-and-health-information-technology https://www.healthypeople.gov/2020/topics-objectives/topic/health-communication-and-healthinformation-technology Health Policy (Week Seven) Per the World Health Organization, “Health policy refers to decisions, plans, and actions that are undertaken to achieve specific health care goals within a society” (WHO,nd) This week the challenge we have faced is, in order to send patients to acute care for things like Interventional Radiology procedures and Peg tube placements, they are requiring a COVID test to be done. We are not currently trained to administer this test, but it has to be done or it will delay patient care. Our physicians were getting upset and not understanding if we were a hospital why we couldn’t we do this. We then determined that we needed to move forward with a policy. We needed a plan of action to achieve this goal. We obtained 10 tests with instructions from the acute care facility and all house supervisors were trained how to collect the sample. References Health Policy. (n.d.). Retrieved from World Health Organization: https://www.who.int/topics/health_policy/en/ Leadership and Economic Models (Week Eight) Health Disparities (Week Nine) Week Ten In this last week of the practicum, my capstone project was presented to the management team of the Long-Term Acute facility. A nurse intensity score was presented that took into account not only acuity, but nursing demands. Including the number of medications in a 12 hour shift, task and time oriented procedures, teaching, psychosocial issues including end of life care, personal or family dynamics, and complicated IV medications such as blood or medications requiring hemodynamic monitoring. https://www.myamericannurse.com/practical-steps-applying-acuity-based-staffing/ …