Want help to write your Essay or Assignments? Click here
Policy Brief
Instructions:
A policy brief is a concise summary of an issue, event, or a problem. There may be supporting documents, but these are used sparingly and selectively; most often they are not submitted with the “brief.” Be aware that while policy briefs are shorter than papers or reports, they are not any less scholarly or rigorous. In fact, some individuals find them harder to write, as decisions have to be made about what content to include and what not to include.
The author has to be concise yet document and substantiate points. So, while the basic write-up of this “brief” is short, one should not underestimate the analysis that underpins it. Assertions have to be supported with logical arguments, data, or expert opinions. Use standard sized margins and a 11 or 12 point font.
Directions
Choose a policy area/issue on the WNA or AANP websites (links provided in Policy Brief Resources folder in Moodle). You are NOT to use the APRN Modernization act as it is serves as the example for the assignment.
Explore and define the problem. Provide data to establish prevalence, importance, or significance of the problem. Try to describe through the lens of an APN.
Conduct a search for possible options to address the problem.
Identify two possible options to address the policy problem, one of which must be a current Bill; seek out organizational positions, and/or interview influential and key interests about the issue.
Compare and contrast the two options in an objective, balanced manner. Consider the benefits and limitations of each, the winners and losers (i.e., stakeholders) for each. Consider costs-benefits.
Based on an objective analysis, determine your solution and why you prefer the option/action you do. Be sure you address issues related to distributional equity.
Write up your recommendation with any provisos, cautions, or limitations. Be sure to identify the alternative that you have not chosen and to discuss why your preferred option is better than that one.
Discuss resources needed to implement.
Want help to write your Essay or Assignments? Click here
Want help to write your Essay or Assignments? Click here
Nursing and patient care delivery methods
Introduction
The evolving practices in patient care delivery system indicate that the nursing profession need to transform in order to meet the healthcare’s demand. The nursing practice is expected to change in its approach to leadership and education so that it can deliver its functions effectively (Nursing’s Social Policy Statement, 2010). In this context, this paper aims at analysing how nursing practice is expected to change. The paper will also discuss the concepts of continuum of care, nurse-manage healthcare clinics (NMHCs) and accountable care organizations (ACO’s) (Perry & Hoffaman, 2010).
The transformations are associated with the Patient Protection and Affordable Care Act of 2010 (PPACA) changes which focuses on provisions that will intertwine cost efficient care with high quality of care. For a long time, the healthcare systems arrangements have been somewhat fragmented, lacking coordination and individual responsibility, which affected the quality of care. The integrated care delivery models aims at improving coordination and quality of healthcare services by allocating resources in the underserved areas.
The law attempts to restore the healthcare system by rewarding quality of services rather than the volume of services delivered. Consequently, the nurses are expected to become adjusted to the reorganized structure as they are the focal point of patient care. They play a huge role in the attainment of objectives for the emerging healthcare delivery methods (Quad Council of Public Health Nursing Organizations, 2011).
Want help to write your Essay or Assignments? Click here
The continuity of care concepts refers to the interaction between a patient and practitioner that goes beyond the clinical encounters. It is defined by two core aspects; a) the focus on individual (patient) context and their health demands, and b) continuity of care i.e. patients care over time- present and future. The restructuring of the USA healthcare system aims at ensuring continuity of care, which entails developing a discharge care plan that will enable smooth transition from acute care to home self-care (Quad Council of Public Health Nursing Organizations, 2011).
This will call for extremely trained nurse practitioners, who are equipped with great nursing skills, competencies and knowledge. Therefore, looking forward to the challenging but exciting roles, nurse educators must ensure that the basic value of nursing is reemphasised. This is a profession that delivers care based on scientific knowledge. They must work in partnership with other disciplines to efficiently meet the healthcare goals (Nursing’s Social Policy Statement, 2010).
Arguably, various factors have converged to transform the healthcare system. Consequently, this affects the responsibilities of a nurse practitioner. The changes in the healthcare system are radical and occurring more rapidly than it used to be in the past. Previously, health care facilities used to be the main avenue for nursing practice. Today, the role has reversed.
This is because patients are in the hospital for the shortest time possible. Only patients under critical conditions stay in the hospitals for the longest time. This calls for nurses who understand and value patient’s demands, and who have the capability to facilitate smooth transitions from healthcare settings to home (Quad Council of Public Health Nursing Organizations, 2011).
Want help to write your Essay or Assignments? Click here
Accountable care organizations (ACO’s) were implemented to ensure that the various healthcare organizations focus on delivering comprehensive care to the patients. It comprises of an association of healthcare providers who join together to ensure a collective accountability to ensure delivery of quality and cost effective care. The ACO has developed pre-defined quality performance indicators to ensure that quality standards of care are maintained.
The National Health Care Workforce commission (NHCWC) facilitates the analysis of the workforce to ensure that only qualified and determined people are permitted to practice. The processes of this commission are steered by nurse educators in conjunction with policy makers with the aim of identifying ways to improve delivery of care. This includes deploying resources in rural areas (Perry & Hoffaman, 2010).
NMHC’s are primary healthcare services at community levels. It is under the leadership of the APN and is very important especially, with the new changed in the healthcare system that aims at providing medical cover to over 30 million people in rural areas. NMHC’s models are well established with the aim of providing health education, disease prevention and health promotion in the underserved areas (Quad Council of Public Health Nursing Organizations, 2011).
Currently, there are 200 NMHCs in 37 states. They currently attend about 2 million patients every year. Most of them are uninsured. If the healthcare systems are restructured, it will facilitate the NMHC’s to operate at its full capacity. If the healthcare reforms are made, the changes are expected to focus more on preventive care in the community. The advancement of technology will improve delivery services. Therefore, nurse practitioners will be expected to be knowledgeable and competent on preventive health and in healthcare technological advancement (Nursing’s Social Policy Statement, 2010).
Want help to write your Essay or Assignments? Click here
Evidently, the restructuring of the healthcare systems will shape the nursing practice. This implies that nurse educators should ensure that nurse student skills, abilities theoretical, practical and technological knowledge are improved. Additionally, the students must be equipped with leadership skills as they are intricate part of these healthcare changes.
This approach will ensure that the new professionals are adequately equipped with skills that will enable them to manage sensitive and ethical dilemmas in a healthcare that have uniform regulated systems. This will help in ensuring that the patient healthcare receives effective care and at a cost effective (Perry & Hoffaman, 2010).
Nurses feedback summaries:
Feedback 1: Stephany is a RN with four years’ experience. She believes that nursing practice is a vocation. It requires one to be enthusiastic to deliver effective care. The practice is dynamic, which requires one to continue researching to learning and understand the futuristic technological advancements that are emerging in this profession. She supports NMHC’s programme arguing that it will help reach many vulnerable population, and simultaneously offer new opportunities which will enable the nurses to cultivate their competencies.
Feedback 2:
Alfred has a 10 years’ experience in nursing profession. He has worked as an APN in both the traditional and current healthcare systems. His commitment to delivering effective care has made him become a nurse educator. He says that nursing practice is a sensitive field and only strong willed survive. He supports the concept of continuum of care arguing it is the only way one is assured that the patient healing is holistic.
He says that during teaching, he ensures that the students understand the benefits of establishing a good interaction with their clients. He says that technological advancement has improved the delivery of care as it helped reduce medical errors. The interoperability in healthcare practice has ensured that nurses can learn evidenced based practice. He states that he happy and confident that nurses are ready to face the future emerging trends in healthcare.
Want help to write your Essay or Assignments? Click here
Feedback 3:
Aria is a passionate RN, who has worked in this field for the last five years. She began her nursing career as clinical assistant nurse and has consistently worked hard. The issue of Accountable Care Organization (ACO’s) is thrilling and has helped improve delivery of care in other healthcare institutions. She says that she has analysed the ACO’s concepts and its intentions. She says that the model supports growth in healthcare system. She also supports NHMC’s arguing that their approaches of preventive care us strategic in ensuring that the community health is protected.
Want help to write your Essay or Assignments? Click here
Therefore, it is evident that nursing professionals act as the controllers of new healthcare system. This healthcare industry comprises of wide range of professionals with diverse knowledge and capabilities. Due to these increased changes in the healthcare industry, the nurses are ultimately responsible for the patient’s outcome. Therefore, the nurses are expected to be very knowledgeable in discussions of the proposed reforms.
The nursing professionals must participate in these policy making meetings. This evolution of collaborative approach is beneficial as it has enabled policy makers to address patient issues foreseen. This facilitates the uniformly regulated healthcare systems to ensure that patients are well taken care of through the implementation of the care plans identified (Quad Council of Public Health Nursing Organizations, 2011).
References
Nursing’s Social Policy Statement (2010). The Essence of the Profession. 2010 Ed., 3rd ed. Silver Spring, Md.: American Nurses Association, 2010. Print.
Quad Council of Public Health Nursing Organizations. (2011). Core competencies for public health nurses. Washington, DC: Quad Council of Public Health Nursing Organizations
Want help to write your Essay or Assignments? Click here
Want help to write your Essay or Assignments? Click here
Case Study on Moral Status of the Fetus
The “Fetal Abnormality” case study case involving a couple, Marco and Jessica in which the latter is found to be pregnant with identified abnormalities in the fetus. The news regarding the fetus brings about conflicting theories concerning the moral status of the fetus. Marco employs the conflict model theory, which is often used in decision making processes. Marco uses this theory when he is reluctant about his wife discovering the news since he believes that Jessica would undergo some level of stress and make the wrong decision in the process.
Maria, on the other hand, employs the dual-concern theory, which is evidenced by the fact that she thinks that the fetus has the moral right to live because it is part of God’s creation (Grand Canyon University, 2015). However, she prays for Jessica when she gets the news because she has already lost hope in the life of the fetus. This propels her to support Jessica and convince her to keep the child.
Want help to write your Essay or Assignments? Click here
Jessica is not sure about the best decision to make since she values life by indicating that, “all life is sacred” (Grand Canyon University, 2015). At this point, she uses the sentience theory by indicating that the child has the right to live. Nonetheless, she also has an obligation to the fetus as a mother, which highlights the use of the relationship theory. This aspect might change her decision due to their financial status.
Marco also uses the sentience theory by stating that he will support the decisions of his wife (Grand Canyon University, 2015). This means that his actions would indeed support the moral status of the fetus. Conversely, the doctor uses the virtue theory by convincing the couple to opt for an abortion since it helps in alienating the burden of raising an abnormal child and suffering from the involved costs. Based on all these theories, the virtue theory is the most effective since the couple has financial problems and an abnormal child would just add onto their challenges.
In this case study, there is conflict between the nurse ethical responsibilities to her patient, legal responsibility to her employer and legal duty to the physician; which exposes the RN to professional risk. This is a challenging situation as there is inadequate guide in resolving such kind of dilemmas. For instance, the nursing standards and law are vague about rights to ethical decisions made by RNs. The code of ethics does not offer legal protection to RN who works as patient advocate (Hunt, 2013).
In this case, the role of the nurse is to remain cultural competent. The RN must respect the patient decision even when the patient’s decision is irrational or wrong. The RN should advise the patient about their clinical opinion without putting pressure on them to accept the RNs advice. While doing so, the RN should be careful not to use words and actions that disrespect the patient values and beliefs (Hinkle & Cheever, 2013).
RNs support to patient decision
The RN can offer support to patient’s decision by (Taylor, Lilis, LeMone, & Lynn, 2011);
Being an active listener
This is important as it helps establish mutual relationship and trust to the RN. It is a way for RN to show their concerns to the patient. The RN should ask the patient about their understanding of the health condition, which will help RN to address any misconceptions.
Explain medication detail
Most of the healthcare medical terms are jargons to ordinary people. It is important to discuss all the details associated with the medication, his risk level and programs which could help with the patient cost management and coping strategies.
Explore alternative approaches
Some of the patients could be comfortable to seek alternative medication such as herbal remedies or traditional healers. The RN must be thoroughly informed about the alternative medication because some of the treatment could be harmful. If considered as an alternative, the nurse can refer the patient to a certified practitioner. In Some cases, religious rituals such as prayers can be integrated into practice.
Example of major religion
An example of a religion that could possibly be holding similar doctrines is Muslim religion. Devout Muslims can reject medication containing alcohol such as those used during the peri-operative procedures, or medications made from pork derivatives. In medical situations which are not of emergency, the RN should educate the patient, but help them preserve their values and believes (Smith, 2013). This includes exploring other beliefs that do not contradict to their beliefs. These small accommodations could pay off the patient emotional well-being. Therefore, to remain culturally competent care, the RN must perform cultural assessment in order to understand their perception of illness and wellness (Kee, Hayes, & McCuistion, 2015).
Hunt, R. (2013). Introduction to community based nursing (5th ed.). Philadelphia, PA: Lippincott, Williams and Wilkins.
Kee, J., Hayes, E., & McCuistion, L. (2015). Pharmacology: A patient-centered nursing process approach (8th ed.). St. Louis, MO: Elsevier.
Taylor, C., Lilis, C., LeMone, P., & Lynn, P. (2011). Fundamentals of nursing: The art and science of nursing care (7th ed.). Philadelphia, PA: Lippincott, Williams and Wilkins.
Smith, L. (2013). Reaching for cultural competence. Nursing, 43(6), 30-38.
Want help to write your Essay or Assignments? Click here
Nursing practice is bounded by various legal obligations. These laws are in accordance with the nursing ethics which guides the nature of conduct of nurses. In Australia, there is a specific nursing code of conduct that each nurse is expected to abide by in their operation. Moreover, the Parliament of Australia enacted a social act that nurses should operate within.
The primary objectives of having to adhere to legal obligations in nursing is to protect all the individuals who are affected by the nursing practice and the nurses themselves. According to Day (2007), nurses often face situations that require quick and critical decision making. In such circumstances, Carryer, et.al, (2013) argues that if a nurse fails to consider the overlaying rules regarding what to do, he or she may end up making a mistake that could be punishable by law.
For instance, the Australian rights of terminally act introduced a law which allows active voluntary euthanasia. However, this may go against the law if a nurse carries out euthanasia with consent from the family members of the sick person and not that of the sick individual. Even though the nursing legal and ethical conduct laws are different, they operate through closely related frameworks. However, nursing legal obligations regarding mental health sometimes crashers with the ethical requirement of the nursing code.
Under my specialty which is mental health, the law has set out directives of when a person can be admitted (Carryer, et.al, 2013). In the requirement, a single medical officer or nurse cannot fully ascertain that one needs to be admitted but it has to be agreed by several health officers. This legal obligations may be good in preventing unwarranted admissions, however, it sometimes contradicts with the nurses’ believe of offering help.
Mental ill individuals might not always know that they are sick, there is need for someone else to point that out. Before that happens, one cannot be treated for mental illness. This becomes problematic in a situation where there is an urgent need to treat a mental ill person yet the legal obligations procedure of ascertaining that the person is ill has not occurred.
These individuals might be involved in self destructive activities of which another person may not point out easily. Therefore, as per Doran, et.al (2015), if the proper procedure for identifying their problems is followed, treatments can be administered when it is too late. My resolution is that I will offer consultative help to the individual first before administering any medication. This way, I will be able to offer help them in advance and yet again still remain within the legal obligations confines of the Australian nursing laws.
References
Lennard-Palmer, L. (2012). The use of simulation for pediatric oncology nursing safety principles: Ensuring competent practice through the use of a mnemonic, chemotherapy road maps and case-based learning. Journal of Pediatric Nursing, 27(3), 283-286.
Carryer, J., Gardner, G., Dunn, S., & Gardner, A. (2013). The capability of nurse practitioners may be diminished by controlling protocols. Australian Health Review, 31(1), 108-15. Retrieved from http://search.proquest.com/docview/231731777?accountid=45049
Doran, Evan, BA, Grad Dip Health Soc Sci, P., Fleming, Jennifer, BA, M.H.A., PhD., Jordens, Christopher, BA, M.P.H., PhD., Stewart, Cameron L, Bec, L.L.B., PhD., Letts, J., M. Bioeth, & Kerridge, Ian H, MPhil(Cantab), F.R.A.C.P., F.R.C.P.A. (2015). Managing ethical issues in patient care and the need for clinical ethics support. Australian Health Review, 39(1), 44-50. Retrieved from http://search.proquest.com/docview/1673832440?accountid=45049
Want help to write your Essay or Assignments? Click here
In their line of duty, perioperative nurses are bound to the duty of confidentiality and ethics. However, in executing their responsibilities, perioperative nurses find themselves in dilemma situations with regards to ethical issues and confidentiality concerns accompanying the sharing of patient’s health information (Ulrich et al., 2010). According to the Nursing and Midwifery Board of Australia (2010), ensuring confidentiality of the health information of a patient I at the core of nurses establishing and maintaining trusting relationships with patients, patient’s families, and other health professionals.
With no assurance regarding the confidentiality of their health information, patients could be hesitant to provide sensitive yet important information regarding their health status/condition that can help in provision of high quality care (Price, 2015). However, perioperative nurses are faced with dilemma in situations where they consider appropriate to share a patient’s confidential health information to his or her family member(s) or caregiver for purposes of ensuring the patient continue to receive quality and safe health care.
The ethical implication of this action is the violation of ethics duty by the nurse as well as the potential loss of trust in the nurse and other health professionals in the institution by the patient or family should it be discovered that such confidential information was shared.
According to the Nursing and Midwifery Board of Australia (2010), patients have an inherent right to autonomy, which allows for their informed consent or the withheld of this consent. The law of informed consent holds that patients have the right to withhold personal information unless it is required by law to provide such information; or make decisions concerning their own treatment (Taylor, 2014).
Thus, perioperative nurses have ethical and legal obligation to respect and protect patient’s right to autonomy by allowing the patients to make their own treatment decisions or not to provide certain personal information deemed confidential. However, nurses may find themselves in a dilemma in situations where protecting and respecting patient’s right to autonomy could result in harm to the patient (Olson & Stokes, 2016).
For instance, in situations such as multiple series of surgery or uneventful incidents, letting the patient make his/ her own treatment decisions or withhold important information to health care practitioners could result in self-harm or harm others altogether.
In such scenarios, the nurse or health professional might be compelled to violate the duty of confidentiality through such means as disclosing important information concerning the patient to the family or deciding on the suitable heath care for the patient through the help of family and other health professionals without patient’s consent. This could result in an ethical break that can have legal implications on the nurse or health professional involved (Simek, 2016).
References
Nursing and Midwifery Board of Australia (2010). Nursing and national competency standards for Registered nurse. Retrieved from: http://www.nursingmidwiferyboard.gov.au
Olson, L., L., & Stokes, F. (2016). The ANA Code of Ethics for Nurses with Interpretive Statements: Resource for Nursing Regulation. Journal of Nursing Regulation, 7(2), 9-20
Price, B. (2015). Respecting patient confidentiality. Nursing Standard, 29(22), 50-57.
Simek, J. (2014). Specifics of nursing ethics. Kontakt, 18(2), 64-68
Taylor, H. (2014) Promoting a patient’s right to autonomy: implications for primary healthcare practitioners. Part 1. Primary Health Care, 24(2), 36-41
Ulrich, C., M., Taylor, C., Soeken, K., O’Donnell, P., Farrar, A., Danis, M. & Grady, C. (2010). Everyday Ethics: Ethical Issues and Stress in Nursing Practice. Journal of Advanced Nursing, 66(11). doi: 10.1111/j.1365-2648.2010.05425.x
Want help to write your Essay or Assignments? Click here
End of life conversations are difficult to initiate to a point where health care practitioners start to actively avoid talking with individuals that are under palliative care. The thought of initiating the conversation fills a clinician with dismay. McRee & Reed (2016) advise that conversations about end of life should be initiated at the time of patient’s admission. Therefore, GPs should monitor the trajectory of patients’ conditions as soon as they have been admitted in hospital.
For instance, they can assess whether the patient is exhibiting a consistent decline instead of improvement or if the patient is complaining of fatigue with the treatment process of frequent hospitalization. These prompts then require a clinician to set up a place and time when those who should be involved can be present.
As a RN nurse, I can promote and support the process of end of life conversations by first asking for permission from the patient to talk about the topic. This is crucial as it assures the patient that I respect and honor his/ her wishes. I can start by a question such as, “I would like us to discuss about how you would like to be cared for in case you become really sick, is that okay with you?”
I will then determine the appropriate time and place where the conversation should be done. During the discussion, I will show empathy and give enough time to the patient and the loved ones for them to absorb what is being said. I will ensure that I am patient in that I do not focus on covering everything at once.
One of the challenges that makes nurses to shun away from end of life conversations is the fear of blame or causing emotional harm to the patient (McRee & Reed, 2016). Similarly, some clinicians spend months or even years with their patients such that they end up developing deeper relationships with the patients, and therefore, it becomes difficult for them to initiate talks about the patient’s death. They treat the patients as their close friends or loved ones, and honestly no one would like to discuss with a beloved one about their death. Dreadful!!! This is how most clinicians describe the thought of initiating the discussion.
Nurses play a central role when it comes to delivering end of life care. Their conversations about end of life should be patient led, honest, gentle, and should not proceed with the conversation in the event that the patient does not want to continue. Therefore, they should be equipped with the right skills, attitude, and knowledge on end of life for them to deliver quality care.
In their line of duty, perioperative nurses are bound to the duty of patient confidentiality and ethics. However, in executing their responsibilities, perioperative nurses find themselves in dilemma situations with regards to ethical issues and patient confidentiality concerns accompanying the sharing of patient’s health information (Ulrich et al., 2010). According to the Nursing and Midwifery Board of Australia (2010), ensuring confidentiality of the health information of a patient is at the core of nurses establishing and maintaining trusting relationships with patients, patient’s families, and other health professionals.
With no assurance regarding the confidentiality of their health information, patients could be hesitant to provide sensitive yet important information regarding their health status/condition that can help in provision of high quality care (Price, 2015). However, perioperative nurses are faced with dilemma in situations where they consider appropriate to share a patient’s confidential health information to his or her family member(s) or caregiver for purposes of ensuring the patient continue to receive quality and safe health care.
The ethical implication of this action is the violation of ethics duty by the nurse as well as the potential loss of trust in the nurse and other health professionals in the institution by the patient or family should it be discovered that such confidential information was shared.
Additionally, in situations where the health condition of the patient deteriorates, health professionals find themselves in a dilemma state with regards to protecting the patient’s privacy whilst addressing the carers’ concerns about the patient’s condition (Price, 2015). For instance, patients that have undergone brain surgery are often mentally and physically unstable because of the nature of the surgery and as such are not in a position to interact with family as well as make important decisions concerning their health information, which could be confidential.
At the same time, the patient’s family members might request to know about the health condition of the patient, being unaware and unfamiliar of the hospital procedure and policies and health care code of ethics regarding the application of confidentiality in their context (Ulrich et al., 2010). In this situation, disclosing the patient’s confidential health information to the family members can be a complex task.
Thus, the nurse must obtain the patient’s permission about the information that can be shared, to who and under what circumstances to minimise possible misunderstanding with family member(s) as well as evade possible legal implications accompanying such (Olson & Stokes, 2016).
According to the Nursing and Midwifery Board of Australia (2010), patients have an inherent right to autonomy, which allows for their informed consent or the withheld of this consent. The law of informed consent holds that patients have the right to withhold personal information unless it is required by law to provide such information; or make decisions concerning their own treatment (Taylor, 2014).
Thus, perioperative nurses have ethical and legal obligation to respect and protect patient’s right to autonomy by allowing the patients to make their own treatment decisions or not to provide certain personal information deemed confidential. However, nurses may find themselves in a dilemma in situations where protecting and respecting patient’s right to autonomy could result in harm to the patient (Olson & Stokes, 2016).
For instance, in situations such as multiple series of surgery or uneventful incidents, letting the patient make his/ her own treatment decisions or withhold important information to health care practitioners could result in self-harm or harm others altogether.
In such scenarios, the nurse or health professional might be compelled to violate the duty of confidentiality through such means as disclosing important information concerning the patient to the family or deciding on the suitable heath care for the patient through the help of family and other health professionals without patient’s consent. This could result in an ethical break that can have legal implications on the nurse or health professional involved (Simek, 2016).
References
Nursing and Midwifery Board of Australia (2010). Nursing and national competency standards for Registered nurse. Retrieved from: http://www.nursingmidwiferyboard.gov.au
Olson, L., L., & Stokes, F. (2016). The ANA Code of Ethics for Nurses with Interpretive Statements: Resource for Nursing Regulation. Journal of Nursing Regulation, 7(2), 9-20
Price, B. (2015). Respecting patient confidentiality. Nursing Standard, 29(22), 50-57.
Simek, J. (2014). Specifics of nursing ethics. Kontakt, 18(2), 64-68
Taylor, H. (2014) Promoting a patient’s right to autonomy: implications for primary healthcare practitioners. Part 1. Primary Health Care, 24(2), 36-41
Ulrich, C., M., Taylor, C., Soeken, K., O’Donnell, P., Farrar, A., Danis, M. & Grady, C. (2010). Everyday Ethics: Ethical Issues and Stress in Nursing Practice. Journal of Advanced Nursing, 66(11). doi: 10.1111/j.1365-2648.2010.05425.x
Want help to write your Essay or Assignments? Click here
Perioperative refers to the practice of surgical procedure where patients experience surgical intervention. Perioperative nurses are tasked with the responsibility of taking care of the patient before, during and after the surgical intervention (Banschbach, 2016). During this time of surgery intervention and care, many safety issues many arise. According to Ford (2012), many safety issues such as emotional, physiological, and socio-cultural safety issues may arise during the pre-operative, intra-operative, and post-operative phases of the surgical intervention because of the negligence of preoperative nurses.
Prior to the surgical procedure, perioperative nurses perform a patient assessment to evaluate the nursing care to be given in the operating room and after the patient returns to the nursing unit, or at home. This involves assessing the social, physical, and emotional needs of a patient. From the information obtained, the perioperative nurse can then predict the suitability of the surgical timing for the patient (Ford, 2012).
However, studies have shown that during this assessment period, perioperative nurses are bound to making social mistakes that result in social safety issues. According to Steelman et al. (2013) perioperative nurses, at the interaction level with the patients, may fail to actively engage the patient’s family members who can furnish important information about the patient that can help in assessing the social and physical needs of the patient and consequently help in determining the care to be provided.
In addition, Robinson (2016) states that sometimes the amount of and length of teaching recommended to a patient by the perioperative nurses is not sufficient enough to prepare the patient psychologically for the surgery type and procedure, leading to psychological safety issue during the intra-operative procedure where the patient can be more anxious and less cooperative.
According to the Nursing and Midwifery Board of Australia (2010), the information from pre-operative assessment helps in determining the surgery site and procedure for a patient. However, incorrect or insufficient information obtained from or about the patient can result in perioperative nurses recommending wrong site surgery for the patient, thereby resulting in physiological safety issue during the surgical intervention (Ford, 2012).
Besides, insufficient or inaccurate information from the pre-operative assessment can result in verification errors, scheduling errors, medication error, and patient time-out errors (from the surgical room and out of hospital) (Steelman & Graling, 2013). Thus, wrong or insufficient pre-operative assessment can be a strong basis for physical, emotional, and social safety issues on the part of the perioperative nurses.
Further, according to the Nursing and Midwifery Board of Australia (2010), the information from the pre-operative assessment can be used in settling professional and legal issues concerning the surgical treatment of the patient as it depicts proof of the medical care provided. According to Steelman & Graling (2013), any documents completed by healthcare practitioners during the pre-operative assessment are legal documents and can be demanded by the court during legal proceedings concerning the health care of a patient.
Thus, the pre-operative assessment should be undertaken with utmost care and keenness especially documentations such as pre-scribed medication, health care, and surgical areas. Ford (2012) adds that pre-operative assessment is part of the professional duty of perioperative nurses to the patients. And as such, accurate assessment and evaluation is a vital part of nursing practice as it forms the basis for efficient and safe care provided to patients.
References
Banschbach, K. S. (2016). Perioperative nurse leaders and their role in patient safety. AORN Journal, 104(2), 161-164
Ford, A. D. (2012). Advocating for perioperative nursing and patient nursing. Perioperative nursing clinics, 7(4), 425-432
Nursing and Midwifery Board of Australia (2010). Nursing and national competency standards for Registered nurse. Retrieved from: http://www.nursingmidwiferyboard.gov.au
Robinson, L. N. (2016). Promoting patient safety with perioperative hand-off communication. Journal of PeriAnesthesia Nursing, 31(3), 245-253
