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Nursing care model essay
Nursing care model essay
Nursing care model essay
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The publication from the institute of medicine has garnered much interest since its publication in 2010 focusing on the future of nursing and the implementation of this with in the nursing community. The nursing profession has over 3 million members and is the largest segment of the nation’s health care workforce. Working on the front lines of patient care, nurses can play a vital role in helping realize the objectives set forth in the 2010 IOM (Institute of Medicine). One of the recommendations is that of a nurse residency program for new nurses or nurses transitioning into new clinical practice areas. The area I work in is home health and this is a growth area the need for a residency program cannot be over stated home health is not the …show more content…
Also referred to as Lewin’s Force Field Analysis, the theory incorporates three separate stages known as unfreezing, moving and, freezing or refreezing (Bozak, 2003). The intention of the model is to identify factors that can impede change from occurring; influences that resist change sometimes called restraining or ‘static forces’ and forces that promote or drive change, referred to as ‘driving forces’. When health care organizations fully understand what behaviors drive or oppose change, then work to strengthen the positive driving forces, change can occur successfully (Bozak, …show more content…
Implementing a nurse residency program will require sustained effort from various teams, some of which include; information technology (IT), pharmacy, clinical information services (CIS), nursing, program managers, clinical nurse educators and administrators. A project of this magnitude will affect all of these departments in different ways, so planning an effective roll out with the assistance and inclusion of all participants is imperative. Bozak (2003) recommended actively involving the field nurse that will be the preceptors, to create a feeling of ownership of the success of the project. Some areas to consider at this facility are implementation timelines, reliability of the equipment, educational training needs, effects on workflow, organizational culture and leadership (Spetz, Burgess & Phibbs, 2012). It is also important to have a project leader to oversee and monitor a project with a direct line to senior management to address any issues quickly.
Refreezing Stage
In this final stage of Lewin’s theory, the process of freezing or refreezing the changed practice occurs and leads to a time of “stability and evaluation” (Bozak, 2003, p. 84). Ongoing support of the nurses on the frontline and technology support to all stakeholders should continue until the change is deemed complete and the residence program becomes one of the corner stones of the nursing
The IOM report had four key messages needed for advancing the future of nursing. “Nurses should practice to the full extent of their education and training; achieve higher levels of education and training through an improved education system that promotes seamless academic progression; be full partners, with physicians and other health care professionals, …and; effective workforce planning and policy making require better data collection and an improved information infrastructure” (Institute of Medicine, 2011). The report also included eight recommendations needed to facilitate the necessary changes to in the nursing profession so meet to demands of the healthcare reform.
There is a shortage of all health care professions throughout the United States. One shortage in particular that society should be very concerned about is the shortage of Registered Nurses. Registered Nurses make up the single largest healthcare profession in the United States. A registered nurse is a vital healthcare professional that has earned a two or four year degree and has the upper-most responsibility in providing direct patient care and staff management in a hospital or other treatment facilities (Registered Nurse (RN) Degree and Career Overview., 2009). This shortage issue is imperative because RN's affect everyone sometime in their lifetime. Nurses serve groups, families and individuals to foster health and prevent disease.
The nurses would perform as per their training, access the direct reimbursement for services offered thus more would be able to access care. The change would see more nurses take up leadership roles and participate in decision making. Being at the center of practice, the nurse would be the best placed to identify and effectively implement innovations on patient-centered care. Once implemented, the nurse residency programs would access funding harness the transition from training to practice.
Nurse Residency Programs are one way to make nursing practice safer for the patient and to keep nurses from leaving the practice. The Affordable Care Act will increase the number of patients receiving medical care over the next several years. We, as a nation, will need adequate numbers of nurses to fill the void. Many hospitals and universities are constructing nurse residency programs to meet that need. The designation of these programs is to increase knowledge, confidence and job satisfaction of new graduate nurses in their first year of practice. The AACN and University HealthSystem Consortium support the concept of nursing residencies. In 2004, an outline for nurse residency programs became available through their joint effort. Currently, 30 states are currently using the model successfully. The funding for nursing residencies is an area that needs addressing, federal funding for nursing education should include nursing residencies ("Nurse Residency Program," 2012). The purpose of this paper is to describe how this issue can move into a “policy window” using John Kingdon’s Policy Stream Model.
The recommendations called for increased opportunities for nurses to be leaders, manager, and executives in the various settings that they are employed. In addition, there was a push for more interdisciplinary collaboration during training as well as in the various levels of professional interactions (IOM, 2011). In practice these recommendations suggest more diverse performance measures, pooling of interdisciplinary funds, organizations supporting nurses in leadership, and encouraging nurses to work with information technology and medical device developers and manufacturers on new products.
Zerwekh, J., Claborn, J. (2006). Nursing today: Transitions and trends (pp. 343-346). St. Louis, Missouri:
Current literature continues to reiterate the indicators of a major shortage of registered nurses (RNs) in the United States. The total RN population has been increasing since 1980, which means that we have more RNs in this country than ever before (Nursing Shortage). Even though the RN population is increasing, it is growing at a much slower rate then when compared to the rate of growth of the U.S. population (Nursing Shortage). We are seeing less skilled nurses “at a time of an increasingly aging population with complex care needs and an increasingly complex technological care environment” (Mion). According to recent data from the Bureau of Labor Statistics and the Department of Health and Human Services, it is estimated that “more than a million new and replacement nurses will be needed over the next decade” (Diagnosis: Critical).
A model is a simplified representation of the structure and content of a phenomenon or system that describes or explains the complex relationships between concepts within the system and integrates elements of theory and practice (Creek et al 1993).
With my academic, professional and volunteer experience, I have reached a point in my career where I am fully equipped to enter the advanced curriculum of the Doctor of Nursing practice, Family Nurse Practitioner program. Working in the nursing profession for the past three years has shown me that there is an increasing need for research to improve health care delivery and access to vulnerable populations. It is rewarding to be a nurse; however there are limitations in my current scope of practice that prevents me to go beyond my job requirements. Through advanced education, my aim is to provide quality patient-family
Implementing care plans within legal, ethical, and regulatory parameters is a competency that all registered nurses but abide by. As stated before as a baccalaureate nurse you must include not only patients and their families but also the community and population (The Texas Board of Nursing, 2011). Following the nursing process the next competency include evaluate the results of the implementations that have occurred. Once again the biggest difference between the two degree plans is baccalaureate nurses will also include the community and population as well as the patient and their family (The Texas Board of Nursing, 2011). Education is a vital piece of nursing and must be completed at every possible opportunity. Educated patients and their families on promoting health and marinating health is a very important concept. Expanding this education to the community and population is a vital step in helping reduce risk for our patients (The Texas Board of Nursing, 2011). The last competency is the nurse’s role in coordinating human information and material management resources for patients and their families as well as the expansion to include communities and populations as ones transition to a baccalaureate nurse (The Texas Board of Nursing, 2011).
There has been a drastic cut in both the Medicare and Medicaid reimbursement rates. According to Robert (2012), “cuts of more than $360 billion to Medicare and Medicaid will be made over the next 10 years. The focus of nursing needs to emphasize more on wellness care and prevention rather than acute care” (McNeal, G., 2012). Nursing practice will need to shift more towards community and population focused nursing. Baccalaureate prepared nurses are provided with a curriculum that includes both community health and leadership skills that are not included in the associate program. By encouraging associate’s degree nurses to obtain a bachelor’s degree in nursing, an increase in the awareness of the needs of the community and population may be seen. The IOM report has outlined the anticipated obstacles that healthcare will face if changes are not made. By allowing nurses to provide care within their full scope of practice, quality care may be provided at an affordable cost to the population. The use of advanced practice nurses in primary care may provide quality, access, and cost efficient healthcare to high-risk populations and possibly decrease hospital admission rates, thus lowering the overall cost of healthcare. If nurses partner with doctors and other healthcare providers, it may improve healthcare by providing seamless transitions (Institute of Medicine,
The nursing process is one of the most fundamental yet crucial aspects of the nursing profession. It guides patient care in a manner that creates an effective, safe, and health promoting process. The purpose and focus of this assessment paper is to detail the core aspects of the nursing process and creating nursing diagnoses for patients in a formal paper. The nursing process allows nurses to identify a patient’s health status, their current health problems, and also identify any potential health risks the patient may have. The nursing process is a broad assessment tool that can be applied to every patient but results in an individualized care plan tailored to the most important needs of the patient. The nurse can then implement this outcome oriented care plan and then evaluate and modify it to fit the patient’s progress (Taylor, C. R., Lillis, C., LeMone, P., & Lynn, P., 2011). The nursing process prioritizes care, creates safety checks so that essential assessments are not missing, and creates an organized routine, allowing nurses to be both efficient and responsible.
At the end of the project there was a renewed sense of empowerment as a nurse. With the introduction of a hands-on implementation of EBP the nurses honed in on several different skills. Critical thinking was sharpened, change was implemented without rebuttal, nurses could speak up and be heard, and their self-confidence was bolstered in their area of expertise.
Being a registered nurse affords one the option of working in many diverse healthcare settings. In any practice setting the climate of health care change is evident. There are diverse entities involved in the implementation and recommendation of these practice changes. These are led by the Robert Wood Johnson Foundation (RWJF), the Institute of Medicine (IOM), nursing campaign for action initiatives, as well as individual state-based action coalitions. Nurses need to be prepared and cognizant of the transformations occurring in health care settings as well as the plans that put them at the forefront of the future.
From the literature I learned about the importance of driving the nursing profession towards the community health-care system. There is currently a need for revitalization of the primary health care system as stated in this document. There is a need to change some of the focus of education and training in new nurses in an effort to respond to the health care demands of today and the future, since many students are not going into this field. In addition, nurses already working in community health should begin focusing on current prevention and promotion aspects of health. I plan to apply these ideas in my own nursing practice to this rotation.