Reflective Journal 2: Professional Capstone And Practicum

Reflective Journal 2 professional Capstone and Practicum

Reflective Journal . 2 Professional Capstone and Practicum Reflective Journal Week 1: New Practice Approaches New practice approach in nursing is a specific way to improve patient care, safety, comfort and outcome. Sepsis protocol is performance improvement program, based on best practice, that is being championed by nurses through application of clinical knowledge and prompt action in response to patient’s clinical changes to improve outcome. According to McCaffery, Onikoyi, Rodrigopulle, Syed & Jones, (2016), “certain populations are at a greater risk for sepsis and need to be closely monitored. Pediatrics, the elderly, and those with comorbidities may have decreased capacity to fight infection compared to the general population. These populations may need more specific criteria when assessing for sepsis. By creating an easy to use sepsis screening tool, all nurses and healthcare staff should be adequately equipped to evaluate, diagnose and treat septic patients, decreasing the overall mortality rate of septic shock”. “Although changes in protocols for sepsis screening by nurses are sometimes met with resistance, nurse driven implementation of sepsis protocols have shown to be highly effective in early identification and treatment of septic patients within the one -hour goal”, (McCaffery, Onikoyi, Rodrigopulle, Syed & Jones, 2016) Reflecting on this in this week, has helped me to deliver care promptly hence preventing septic shock and other complications of sepsis.

Purposeful hourly rounding is a new practice approach that helps the nurse meet the patient’s needs. It is also useful as it is helpful in reducing the patient’s stress and anxiety. Moreover, another best practice is giving bedside shift reports in which case patients are given the opportunity to be part of the discussion is a good way to allow the patients to understand their care better and ask fewer questions afterwards. Reflecting on the importance of purposeful Hourly rounds, I recalled a number of times it has helped Rounding hourly, I have been able to catch falls on time. Week 2: Intraprofessional Collaboration I learnt a lot during this week especially where it has to do with relating with other professional in team work approach for the betterment of the sick.

Working with other health care team members meticulously has helped in brushing communicating abilities to ensure continuity of care and efficient consequence of patient care. An interdisciplinary meeting is held every Tuesday and there, each professional discipline bring up problems holding patients discharge and suggest ways to escalate removing the problem and discharging the patient home. The meeting is basically to ensure prolonged hospital stay and avoid unnecessary costs to both the patients and the facility Within this second week, my assigned patients were those with central lines, ports and urinary catheters. I utilized the opportunity to develop interest on preventing hospital acquired infection.

I participated in observing patients for clinical manifestation of infection and ensured aseptic protocols are practiced and maintained. Most importantly, I was able to collaborate with the different healthcare givers within my unit to escalate delays in providing care. Week Three and Four Health Care Delivery and Clinical Systems/ Ethical Consideration in Healthcare These weeks respectively were the most intense filled with learning and more skill acquisition. I was assigned to shadow the rapid response team who also perform the role of the central line team for the hospital by my preceptor. One of her reasons is to learn how to integrate effectively what I have learnt in class room into the clinical setting.

Shadowing them help me to understand how to communicate effectively with both the patients and the staff by application of evidence-based practice to help detect ongoing illness that needs prompt attention. This is in respect to specific role of the rapid response team during the code sepsis protocol. However, it is imperative that the patients are taken care of in a manner that will reflect professionalism and high standard of care. Thus, the staff in the clinical area are anticipated to be proficient in delivery of healthcare services that will enhance patient’s wellbeing. Though, I observed that for patients to access healthcare delivery, they must be covered by insurance, if not might there might be limitation to care the patients might receive, in other words there could be complications due to delays.

The department of Health and Public in an effort to ensure health care to all provides Medicaid to approved individuals meeting certain criteria, that way affordability of health care to all is ensured. Regarding ethical consideration in health care they should. According to Reynolds, (n.d) [“Healthcare workers have a legal and ethical responsibility to protect the patients they care for. When these responsibilities are ignored, patients suffer. Additionally, healthcare workers can be held responsible for these behaviors. Ethical behavior or responsibility is doing the right thing for the patient. Many healthcare professions have codes of ethics to which practitioners are expected to adhere. For example, the nursing Code of Ethics is a lengthy document that covers ethical expectations in detail. Some examples of unethical behaviors include fraud and neglect.” I also learn while shadowing to do right by the patient and avoid any cases of negligent, to be a patient’s advocate and to protect the well being of the patients. Week 6: Population Health Concerns At the 6th week, I took time to note the predominate health concern of the populace within the community where the facility is located. I observed that most of the patients are either obese, hypertensive, diabetic or diagnosed with cancer. These common health issues give them a lot of concern. Health education during discharge is one way I observed the nurses empower the patients on how to effectively take care of themselves at home, in order to limit the complications associated with their illness. Home instructions on medications and other measures necessary to improve their health are part of the strategies employed by the nurses. For the homeless amongst them, the social worker and clinical nurse manager work hand in hand to provide them with help they need while their health care needs are also taken care of. Week 7: The role of technology in improving health care outcomes According to Agency for Healthcare Research and Quality, (n.d) (AHRQ), health IT makes it possible for health care providers to better manage patient care through the secure use and sharing of health information. By developing secure and private electronic health records for most Americans and making health information available electronically when and where it is needed, health IT can improve the quality of care, even as it makes health care more cost effective. I find this truthful because within this week, with the use of IT, several health emergencies were caught on time and addressed promptly, to save patients life and reduce cost of care. Week 8: Health Policy According to World Health Organization (n.d) (WHO), “Health policy refers to decisions, plans, and actions that are undertaken to achieve specific health care goals within a society. An explicit health policy can achieve several things: it defines a vision for the future which in turn helps to establish targets and points of reference for the short and medium term. It outlines priorities and the expected roles of different groups; and it builds consensus and informs people”. There are a lot of health policy the hospital follows to ensure that health care needs of the members of the community are met. For instance, the hospital launched a policy about smoking cessation and offer a lot incentive to patients that are willing to partake in the program, that way the goal of the hospital is to reduce the rate of lung cancer amongst the populace. Week 9: Leadership and Economic Models This week I was opportune to shadow my unit manager, on the instruction of my mentor. Working alongside with her the whole week exposed me to leadership qualities that will enable me ease into the role of a leader. I realized how she uses her position to budget and manage the resources given to her without lacking in anything needed for patient care. I attended important management meetings with her where policies and strategies are discussed to better handle the resources assigned to each unit. Also, the hospital shifting towards magnet recognition program, I was afforded the opportunity to learn forces of magnetism, mentorship programs available and lot more. Week 10: Health Disparities In this week, I also was very fortunate to learn how health disparity is being tackled in the hospital. According to Ubri & Artiga, (2016), “Hispanics, Blacks, American Indians/Alaska Natives, and low-income individuals are more likely to be uninsured relative to Whites and those with higher incomes. Low-income individuals and people of color also face increased barriers to accessing care, receive poorer quality care, and experience worse health outcomes”. Looking at this premise, it seems to be a fact because majority of people coming to the facility are underinsured, uninsured and poor. Most time, they end up coming with complications because they cannot timely access health care due to coverage. The hospital has financial counsellors, social care workers and case mangers working together with government agencies in ensuring policies governing these class of people are lenient. References Health Information Technology Integration | Agency for Healthcare Research & Quality. (n.d.). Retrieved from McCaffery, M., Onikoyi, O., Rodrigopulle, D., Syed, A., & Jones, S. (n.d.). Sepsis-Review of Screening for Sepsis by Nursing, Nurse Driven Sepsis Protocols and Development of Sepsis Hospital Policy/Protocols. Retrieved from Reynolds, V. (n.d.). Ethical & Legal Responsibilities of Healthcare Workers | Study.com. Retrieved from Ubri, P., & Artiga, S. (2017). Disparities in Health and Health Care: Five Key Questions and Answers. Retrieved from

Paper For Above instruction

The comprehensive learning experiences documented in this reflective journal span ten weeks of immersion in various facets of nursing and healthcare management. Each week highlights critical aspects that collectively enhance a nurse practitioner's competence, ethical grounding, and leadership skills, ultimately contributing to improved patient outcomes and system efficiency.

Week 1 centered on implementing new practice approaches, notably the sepsis protocol, emphasizing the importance of early identification and prompt action to reduce septic shock mortality. The introduction of a sepsis screening tool exemplifies how nurses can champion performance improvement initiatives, especially for high-risk populations such as pediatrics, the elderly, and those with comorbidities. Reflecting on this reinforced my commitment to timely clinical responses, ensuring rapid diagnosis and treatment, which are crucial in sepsis management. Furthermore, purposeful hourly rounding emerged as a pivotal practice to meet patient needs efficiently, reduce stress, and prevent adverse events like falls. Bedside shift reports also foster patient engagement and understanding, improving care continuity and patient satisfaction.

Week 2 highlighted the significance of intraprofessional collaboration. Regular interdisciplinary meetings facilitate problem-solving regarding patient discharges, resource allocation, and infection prevention. Working with patients with central lines, ports, and urinary catheters increased my focus on preventing hospital-acquired infections through aseptic techniques and timely escalation of care delays. This collaborative environment underscored the critical role of effective communication among healthcare providers in ensuring seamless patient care.

The subsequent weeks deepened my understanding of healthcare delivery, ethics, and the integration of evidence-based practices. Shadowing the rapid response team enhanced my ability to recognize clinical deterioration swiftly and communicate effectively with team members. Ethical responsibilities, including advocating for patients and practicing integrity, were conscientiously emphasized, aligning with the nursing Code of Ethics. Observations during clinical rotations also highlighted disparities in healthcare access, especially concerning insurance coverage. Patients without adequate coverage face delays or limitations in care, underscoring the importance of ethical and equitable healthcare practices.

Further exploration into population health concerns revealed prevalent chronic diseases such as obesity, hypertension, diabetes, and cancer within the community. Nurses play a vital role in health education at discharge, empowering patients to manage their conditions and reduce potential complications. Additionally, collaboration with social workers ensures that vulnerable populations, including the homeless, receive necessary support, illustrating the holistic nature of healthcare management.

The integration of health information technology (IT) was underscored as a transformative tool for improving health outcomes. Implementation of electronic health records, as per the Agency for Healthcare Research and Quality, has facilitated real-time data access, prompt intervention, and cost efficiency. This technological advancement is critical for contemporary healthcare systems aiming for high-quality, patient-centered care.

Throughout these weeks, healthcare policies—such as smoking cessation initiatives—demonstrated how strategic planning and community-oriented policies can influence public health outcomes positively. The role of leadership extended beyond clinical settings to resource management, leadership qualities, and institutional accreditation processes like Magnet recognition. Observing the hospital leadership’s focus on resource allocation, staff mentorship, and policy development enriched my understanding of effective healthcare administration.

Finally, addressing health disparities reinforced the importance of equitable care. The hospital’s concerted efforts, including the work of social workers and case managers, aim to mitigate barriers faced by underserved populations. These experiences underscore the necessity of cultural competence and social awareness in healthcare delivery, ensuring all patients receive appropriate and timely care.

References

• Agency for Healthcare Research and Quality. (n.d.). Health Information Technology Integration. Retrieved from https://www.ahrq.gov
• McCaffery, M., Onikoyi, O., Rodrigopulle, D., Syed, A., & Jones, S. (n.d.). Sepsis-Review of Screening for Sepsis by Nursing, Nurse Driven Sepsis Protocols and Development of Sepsis Hospital Policy/Protocols. Retrieved from
• Reynolds, V. (n.d.). Ethical & Legal Responsibilities of Healthcare Workers. Study.com. Retrieved from https://study.com
• Ubri, P., & Artiga, S. (2017). Disparities in Health and Health Care: Five Key Questions and Answers. Retrieved from https://kff.org
• World Health Organization. (n.d.). Health Policy. Retrieved from https://www.who.int
• Additional scholarly references to support concepts discussed in the paper.