Introduction: The purpose of this task is to implement knowledge of the nursing profession at the graduate level. You will respond to the following scenario considering the role and responsibilities of the nurse. Scenario: Mr. Miles, a 70yearold patient, was admitted to the hospital for bowel obstruction. Mr. Miles is active and adventurous, and tells his nurse that he does not want to compromise his quality of life. The patient becomes septic and goes into acute renal failure and must decide about dialysis and other lifesaving measures. The patient refuses dialysis and expresses a wish to have an advance directive do not resuscitate (DNR). Healthcare professionals and the patient’s family members express concern regarding this decision. Mr. Miles loses consciousness before he signs a DNR. Requirements: Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. Use the Turnitin Originality Report available in Taskstream as a guide for this measure of originality. Professional Communications is a required aspect to pass this task. Completion of a spell check and grammar check prior to submitting your final work is strongly recommended. You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course. Review the scenario and write a scholarly paper in which you do the following: A. Discuss the evidencedbased practice regarding advance directive DNR. B. Discuss the nurse’s moral responsibility by doing the following: 1. Describe the nurse’s responsibility to the patient in the scenario. a. Discuss a potential moral dilemma that the nurse in the scenario may encounter. Include resolution strategies in your response. 2. Describe the impact of the advance directive DNR on the stakeholders in the scenario. C. Discuss how a provision from the American Nurses Association (ANA) code of ethics should relate to the nurse’s professional practice.
1. Analyze how this provision applies to the scenario. 2. Describe the importance of patient autonomy. Note: The “ANA Code of Ethics” can be accessed at the web link below. D. Discuss the legal implications associated with this case by doing the following: 1. Identify potential legal conflicts among patient, family, nurse, and organization. 2. Discuss how the potential legal conflicts identified in part D1 will affect the nursing role. 3. Discuss potential nursing actions to prevent conflicts identified in part D1 among the organization, the patient, and primary care physician. E. Acknowledge sources, using APAformatted intext citations and references, for content that is quoted, paraphrased, or summarized. Note: For definitions of terms commonly used in the rubric, see the Rubric Terms web link included in the Evaluation Procedures section. Note: When using sources to support ideas and elements in an assessment, the submission MUST include APA formatted intext citations with a corresponding reference list for any direct quotes or paraphrasing. It is not necessary to list sources that were consulted if they have not been quoted or paraphrased in the text of the assessment. Note: No more than a combined total of 30% of a submission can be directly quoted or closely paraphrased from outside sources, even if cited correctly. For tips on using APA style, please refer to the APA Handout web link included in the APA Guidelines section. Professional Communications is a required aspect to pass this task. Completion of a spell check and grammar check prior to submitting your final work is strongly recommended. You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course. Write a paper in which you refer to the attached “MSN Program Conceptual Framework” to do the following: A. Discuss 2–3 model elements from the “MSN Program Conceptual Framework” to show how you will apply the role of “Nurse as Detective.” B. Discuss 2–3 model elements from the “MSN Program Conceptual Framework” to show how you will apply the role of “Nurse as Scientist.” C. Discuss 2–3 model elements from the “MSN Program Conceptual Framework” to show how you will apply the role of “Nurse as Manager of the Healing Environment.” D. Acknowledge sources, using APAformatted intext citations and references, for content that is quoted, paraphrased, or summarized. Note: For definitions of terms commonly used in the rubric, see the Rubric Terms web link included in the Evaluation Procedures section. Note: When using sources to support ideas and elements in an assessment, the submission MUST include APA formatted intext citations with a corresponding reference list for any direct quotes or paraphrasing. It is not necessary to list sources that were consulted if they have not been quoted or paraphrased in the text of the assessment. Note: No more than a combined total of 30% of a submission can be directly quoted or closely paraphrased from outside sources, even if cited correctly. For tips on using APA style, please refer to the APA Handout web link included in the APA Guidelines section. Nursing Programs Conceptual Model BSN MSN Nurse as Detective: The nurse uses clinical imagination coupled with nursing science to detect subtle changes and deviations from expected patterns of being to prevent or control adverse outcomes. Nurse as Detective: The nurse uses clinical imagination coupled with nursing science to judge and determine the consequence of subtle changes and deviations from expected patterns of being to prevent or control adverse outcomes. Nurse as Scientist: The nurse participates in scientific inquiry to inform healthcare decisions; and critiques, disseminates and implements evidence to influence practice. Nurse as Scientist: The nurse uses translational science to influence healthcare decisions; to prescribe and implement best practice and broadly disseminate the findings. Nurse as manager of the Healing Environment: The healing environment is global in nature and includes considerations of healthcare policy, finance and regulations. Acknowledging this, the nurse creates, coordinates, and advocates for a respectful, interdisciplinary environment that promotes optimal wellbeing and affirms the dignity of the human experience Nurse as manager of the Healing Environment: The healing environment is global in nature and includes social, cultural, political and economic influences. Acknowledging this, the nurse, as a member of the interprofessional community, influences public policy and promotes social justice in the human health experience. Operational Definitions of the Concepts in the Model The three concentric circles of Knowing, Doing and Being describe the progressive development of the nurse which begins with Knowing, progresses to Doing and culminates in Being. Knowing refers to the acquision of knowledge, informaon or understanding and extends to the integraon of knowledge of the mind, body, environment, community, self, clients and colleagues. https://kb.wgu.edu/al/12/2/highlight.aspx?cp=12&kbid=2&type=0&tag… 1 of 3 10/23/2013 3:38 PM Doing describes the development of skills and abilies essenal to the pracce of nursing and the provision of care to paents, families and communies. It is the demonstraon of skillful and helpful ways of being with paents and includes tasks and processes nurses use in course of providing care. Being a nurse describes the development of ‘habitus’ or habits of ethical comportment and the use of knowledge, skills and abilies in embodying the complex role and intuion of a paentcentered praconer. Model Elements Compassionate Paentcentered care is the provision of holisc care with respect for values, preferences and needs of the paent, family and community in the journey to well being across the lifespan. Evidence based pracce is integrang “best current evidence with clinical experse and paent/family preferences and values for delivery of opmal healthcare” (QSEN, 2009). Genomics and Genethics includes knowledge about the genec basis of health and illness, the variables that impact the responses to genomic informaon and related ethical issues. Informatics/Technology Informatics is the engineering, storing, organizing and manipulation of data to support the provision of safe, effective quality care. Technology is the continuously changing array of devices and software used for patient care. Leadership/Educaon Leadership is the process of identifying and prioritizing goals to achieve optimal quality outcomes. Education is assessing learning needs and facilitating acquisition of knowledge, skills and abilities. Safety & Quality care minimizes risk of harm to paents, families, communies and providers through analyses of systems’ effecveness and individual performance while connually measuring quality of care in terms of cost, structure, process, and outcomes. Cultural competency is providing care that is acceptable to paents, families and communies from diverse cultural, ethnic and social backgrounds. Communicaon is effecve interacon with paents, families, communies, professional colleagues and other health care team members. Teamwork and collaboraon is effecve engagement with nursing and interprofessional teams to foster open communicaon, mutual respect and shared decision making to achieve quality paent care. Professional/Legal/ Ethical is effecve decisionmaking and reflecon within a framework of social jusce and law, advocacy, and standards of pracce to promote the common good. BSN PROGRAM OUTCOMES MSN PROGRAM OUTCOMES The WGU Bachelor’s Degree in Nursing Program Graduate Will: The WGU Master’s Degree in Nursing Program Graduate Will: 1. Communicate effectively in oral, written, interpersonal and electronic modes. 1. Employ appropriate patient care technologies and information management strategies to lead change and improve quality care outcomes. 2. Use clinical reasoning to provide safe, quality, nursing care based on the best available evidence and ethical principles. 2. Integrates clinical reasoning with organizational, patientcentered, culturally appropriate strategies to plan, deliver, and evaluate evidencebased practice. https://kb.wgu.edu/al/12/2/highlight.aspx?cp=12&kbid=2&type=0&tag… 2 of 3 10/23/2013 3:38 PM 3. Assume accountability for providing and ensuring safe, efficient, quality care congruent with ethical, professional and legal standards. 3. Design innovative nursing practices to impact quality outcomes for individuals, populations, and systems congruent with ethical, professional and legal standards. 4. Synthesize theoretical, clinical and empirical knowledge from nursing, scientific, community and humanistic disciplines within the practice of nursing. Synthesizes theoretical and empirical knowledge drawing from the arts and sciences to understand the human experience as a social advocate, and professional nurse. 4. Assemble scientific findings from nursing, biopsychosocial fields, genetics, public health, and organizational sciences for the continual improvement of nursing care across diverse settings. BSN MSN 5. Provide compassionate, patientcentered care to individuals, families, and communities from a variety of cultures across the lifespan. 5. Utilize applied research outcomes within the practice setting, navigating and integrating care services across healthcare systems. 6. Apply leadership and education skills to engage others in creating and promoting a healing environment for continued selfimprovement. 6. Design organization and leadership systems that promote high quality patientcare delivery and advance lifelong learning. 7. Engage in interprofessional collaboration to improve safety and quality of healthcare. 7. Construct interprofessional teams to communicate, coordinate, collaborate and consult with other health professionals to advance a culture of excellence. 8. Incorporate knowledge of genomics and genethics into the care of patients, families and communities. 8. Integrate scientific knowledge including that from genetics and genethics in the continual improvement of nursing care across diverse settings and populations. 9. Use information technology to communicate, mitigate error and make decisions related to the provision of patient care and support incorporation of nursing knowledge in the development of patient care technology. 9. Provide oversight and guidance in the integration of technology to manage care, identify performance measures and standards that improve quality and safety outcomes. Professional Communications is a required aspect to pass this task. Completion of a spell check and grammar check prior to submitting your final work is strongly recommended. You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course. Respond (suggested length of 5–8 pages) to the requirements below as the chief nursing officer from the scenario.
A. Discuss evidencebased practices for reducing nosocomial infections, including one item from each of the following areas with specific evidence for how the item reduces infections: • products • technology • patient/family • finances • community relations B. Analyze the impact of nosocomial infections on patient care. C. Complete a gap analysis in which you do the following: Note: Refer to the attached “Gap Analysis” template to assist with parts C through C5. 1. Identify major causes that lead to the transmission of nosocomial infections. 2. Discuss the impact of stakeholder roles, responsibilities, and relationships on patient care outcomes. 3. Discuss the roles of infection control and education within the organization in the scenario and how they relate to each other. 4. Describe a strategy to combat the increase of nosocomial infections. 5. Discuss one goal for reducing nosocomial infections for each of the areas from part A1: • products • technology • patient/family • finances • community relations 6. Discuss possible solutions to the gap, anticipating potential challenges and using information from the gap analysis. a. Analyze one solution from part C6 to recommend in combatting nosocomial infections. D. Acknowledge sources, using APAformatted intext citations and references, for content that is quoted, paraphrased, or summarized. Note: For definitions of terms commonly used in the rubric, see the Rubric Terms web link included in the Evaluation Procedures section. Note: When using sources to support ideas and elements in an assessment, the submission MUST include APA formatted intext citations with a corresponding reference list for any direct quotes or paraphrasing. It is not necessary to list sources that were consulted if they have not been quoted or paraphrased in the text of the assessment. Note: No more than a combined total of 30% of a submission can be directly quoted or closely paraphrased from outside sources, even if cited correctly. For tips on using APA style, please refer to the APA Handout web link included in the APA Guidelines section. Best Practice Best Practice Strategy Barriers/Challenges to Best Practice Implementation Will Implement Practice (Yes/No; Why Not?) Stakeholder Roles and Responsibilities to Implement Best Practices