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Importance of quality improvement in nursing
The purpose of this paper is to discuss, identify, and improve quality improvement issues in nursing practice
Importance of quality improvement in nursing
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Introduction
The purpose of this report is to compare and contrast two different nursing research articles. The report will critique and evaluate two qualitative studies, one being an original research report and the second being a review paper. The scope of comparison and contrast will include research design, theories or conceptual models, how the research was conducted, analysis and reporting of research data, usefulness of the research, and a conclusion.
Selection of Research Interest Area
The first journal article is about advance care planning (ACP) in palliative care. This is of interest due to several clinical experiences and the realization that many families either ignore the patient’s request for end of life (EOL) care or who have no idea of how to plan for EOL care. By reading the research and understanding the methods used, this will allow for insight into how to implement palliative care into clinical practice across different sites. The authors of this original research are Jeanine Blackford PhD, RN, senior lecturer at La Trobe University in Australia, and Annette Street PhD, associate dean of research and professor of cancer and palliative care studies. According to Blackford & Street (2011), this research is important as there are many countries that “report a low percentage of people who have completed an advance care plan” (p. 2022), and ACP is needed upon admission to facilities that offer palliative care. In addition, the purpose of the study is to try and obtain guidance to integrate an ACP model into routine clinical practice in the community. The research question chosen for the analysis of this article is: Is it feasible to implement ACP into routine practice and documentation at multi-site locations in...
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...audited their search results. Agreement on the findings in the studies was obtained through consensus. Houser (2012), states that studies such as this which review multiple studies “compensate for many threats to internal validity” (p. 268). Duggleby et al. (2012), admits that there were limitations as the metasynthesis of the studies included the authors assumptions which is not actual data. In addition, the report admitted that the search results contained findings based on multiple fatal illnesses and the understanding of hope might be different if it had included people with non-fatal illnesses. Houser (2012) would consider this a threat to the internal validity as there is bias involved with the author’s assumptions and the selection of only people with fatal chronic illnesses. There was no indication of any ethical violations in the meta-synthesis review.
Strasser, Judith A., Shirley Damrosch, and Jacquelyn Gaines. Journal of Community Health Nursing. 2. 8. Taylor & Francis, Ltd., 1991. 65-73. Print.
Wiener, Lori, Elizabeth Ballard, Tara Brennan, Haven Battles, Pedro Martinez, and Maryland Pao. 2008. "How I wish to be remembered: the use of an advance care planning document in adolescent and young adult populations." Journal Of Palliative Medicine 11, no. 10: 1309-1313. MEDLINE with Full Text, EBSCOhost (accessed May 26, 2014).
As we get older and delve into the real world, it is important to start thinking about end-of-life care and advance directives. Although it is something no one wants to imagine, there is an absolute necessity for living wills and a power of attorney. Learning about the Patient Self-Determination Act and the different legal basis in where you live is important because it will help people understand why advance care directives are so important. Although there are several barriers in implementing advance care directives, there are also several actions that healthcare professionals can take to overcome these obstacles. These are also important to know about, especially for someone going into the medical field.
Loiselle, C. G., Profetto-McGrath, J., Polit, D. F., Beck C. T., (2007). Canadian essentials of nursing research (2nd ed.) Philadelphia: Lippincott Williams & Wilkins.
Thanks in part to the scientific and technological advances of todays’ society, enhanced medicinal treatment options are helping people battle illnesses and diseases and live longer than ever before. Despite these advances, however, many people with life threatening illnesses have needs and concerns that are unidentified and therefore unmet at the end of life, notes Arnold, Artin, Griffith, Person and Graham (2006, p. 62). They further noted that when these needs and concerns remain unmet, due in part to the failure of providers to correctly evaluate these needs, as well as the patients’ reluctance to discuss them (p. 63, as originally noted by Heaven & Maguire, 1997), a patient’s quality of life may be adversely affected. According to Bosma et al. (2010, p. 84), “Many generalist social work skills regarding counseling, family systems, community resources, and psychosocial assessments are relevant to working with patients and families with terminal illness”, thereby placing social workers in the distinctive position of being able to support and assist clients with end of life decisions and care planning needs. In fact, they further noted that at some point, “most social work practitioners will encounter adults, children, and families who are facing progressive life limiting illness, dying, death, or bereavement” (p. 79).
Hospice focuses on end of life care. When patients are facing terminal illness and have an expected life sentence of days to six months or less of life. Care can take place in different milieu including at home, hospice care center, hospital, and skilled nursing facility. Hospice provides patients and family the tool and resources of how to come to the acceptance of death. The goal of care is to help people who are dying have peace, comfort, and dignity. A team of health care providers and volunteers are responsible for providing care. A primary care doctor and a hospice doctor or medical director will patients care. The patient is allowed to decide who their primary doctor will be while receiving hospice care. It may be a primary care physician or a hospice physician. Nurses provide care at home by vising patient at home or in a hospital setting facility. Nurses are responsible for coordination of the hospice care team. Home health aides provide support for daily and routine care ( dressing, bathing, eating and etc). Spiritual counselors, Chaplains, priests, lay ministers or other spiritual counselors can provide spiritual care and guidance for the entire family. Social workers provide counseling and support. They can also provide referrals to other support systems. Pharmacists provide medication oversight and suggestions regarding the most effective
One of the greatest dangers facing chronic and terminally ill patients is the grey area regarding PAS. In the Netherlands, there are strict criteria for the practice of PAS. Despite such stringencies, the Council on Ethical and Judicial Affairs (1992) found 28% of the PAS cases in the Netherlands did not meet the criteria. The evidence suggests some of the patient’s lives may have ended prematurely or involuntarily. This problem can be addressed via advance directives. These directives would be written by competent individuals explaining their decision to be aided in dying when they are no longer capable of making medical decisions. These interpretations are largely defined by ones morals, understanding of ethics, individual attitudes, religious and cultural values.
Quantitative Research Article Critique This paper is an academic critique of an article written by Lautrette, et al. (2007) titled: “A Communication Strategy and Brochure for Relatives of Patients Dying in the ICU” and accurately reflected the content of the article and the research study itself. The abstract explains the article in more detail, while remaining concise.
The end-of-life nurse’s primary objective is to provide comfort and compassion to patients and their families during an extremely difficult time. They must satisfy all “physical, psychological, social, cultural and spiritual needs” of the patient and their family. (Wu & Volker, 2012) The nurse involves their patient in care planning, as well as educating them about the options available. They must follow the wishes of the patient and their family, as provided in the patient’s advance directive if there is one available. It is i...
Stair, J. (1998). Understanding the Challenges for Hospice: Fundamental for the Future. Oncology Issues [Online]. 13(2): pages 22-25. *http://ehostweb6.Epnet.com: (2000, October 13).
The care of patients at the end of their live should be as humane and respectful to help them cope with the accompanying prognosis of the end of their lives. The reality of this situation is that all too often, the care a patient receives at the end of their life is quite different and generally not performed well. The healthcare system of the United States does not perform well within the scope of providing the patient with by all means a distress and pain free palliative or hospice care plan. To often patients do not have a specific plan implemented on how they wish to have their end of life care carried out for them. End of life decisions are frequently left to the decision of family member's or physicians who may not know what the patient needs are beforehand or is not acting in the patient's best wishes. This places the unenviable task of choosing care for the patient instead of the patient having a carefully written out plan on how to carry out their final days. A strategy that can improve the rate of care that patients receive and improve the healthcare system in general would be to have the patient create a end of life care plan with their primary care physician one to two years prior to when the physician feels that the patient is near the end of their life. This would put the decision making power on the patient and it would improve the quality of care the patient receives when they are at the end of their life. By developing a specific care plan, the patient would be in control of their wishes on how they would like their care to be handled when the time of death nears. We can identify strengths and weakness with this strategy and implement changes to the strategy to improve the overall system of care with...
Polit, D., & Beck, C. (2006). Essentials of nursing research: appraising evidence for nursing practice (7th ed.). Phildelphia: Lippencott Wilkins & Williams.
McIntyre, M. & McDonald, C. (2014). Nursing Philosophies, Theories, Concepts, Frameworks, and Models. In Koizer, B., Erb, G., Breman, A., Snyder, S., Buck, M., Yiu, L., & Stamler, L. (Eds.), Fundamentals of Canadian nursing (3rd ed.). (pp.59-74). Toronto, Canada: Pearson.
THOMAS, K. and LOBO, B., 2011. Advance care planning in end of life care. Oxford: Oxford University Press.
People should make prepared and well planned for the end of life, due to provide a detail plan that can reduce one pressure and have a quality of life in the future. Advance directives is an important plan for clients to have the communication process between the client, family and others different health care services. According to the Compassion and Support video on YouTube, 5 Easy Steps for Advance Care Planning, which help people be more understand themselves and how to solve their problems. The plan gives clients the opportunity to express their own personal care decisions feelings and their wishes since they have a conversation with their family and different social service departments. Through the discussion and listen, their family