Nurses are well positioned for reforming health care in ways that promote a healthier public and reduce healthcare cost. Discuss the role nurse plays in COVID vaccination mandate, telemedicine, and prescription drug pricing as advocates in the healthcare system.

The discussion must address the topic.

Rationale must be provided

May use examples from your nursing practice

150 words minimum (excluding the reference)

Minimum of two references in APA format within the last five years published

Please replies with 200 words each one

1. In the present discussion, I analyzed a quantitative research that can result in conclusions that can influence the nursing field to improve clinical practice and patient outcomes.
    The nursing research article I chose is named “The Proportion of Medication Error Reporting and Associated Factors among Nurses: A Cross-sectional Study”. I chose this research, as handling, preparing, and providing medications is one of the most important tasks that Nurses have in everyday practice. Medication error consequences can vary from zero consequences at all to causing death to a patient. Many research studies state that about 5% of the medication errors have fatal consequences,  but about 50% of the total cases are preventable, so it is crucial to analyze and understand which are the main errors happening, which factors are influencing those errors to happen, which are the most common consequences, and lastly, it is also important to determine what’s the reporting rate, why are many medication error cases not being reported, which factors are influencing the fact of not reporting and what can be done to enhance the nursing personnel to report medication errors to help to analyze the problematic and, in consequence, to improve quality healthcare and patient outcomes. This quantitative study was developed in several countries, counting with a total universe of 597 professional nurses, who were interviewed by answering questionnaires, including variables related with factors that have been described as the most common medication errors, establishing a comparison with a previous pilot study. Although quantitative data results can vary from a hospital or from a country to another, this research concluded that the medication error report proportion was of 57.4%. Among the factors that influenced reporting medication errors, the research concluded some data that replicate in a similar way compared to studies from other countries. Factors as female professionals, married and experienced nurses resulted in the professionals that mostly report medication errors. In addition, the article shows a consistent percentage of 69.8% as the percentage of professional nurses that consider that medication errors should be reported. However, the article also points that the factors that lead in non reporting medication errors were mainly seen in female nurses who had fear of the reaction of other nurses, supervisor or even their manager.
     In conclusion the research article recommends that the health authorities should identify and address the medication errors and enhance the nursing professionals to report these cases to improve patient safety and outcomes. In addition, it is encouraged that the health care facilities should create a more supportive and trustable environment to the professionals to decrease their fear to report. In consequence, this would allow the Nurses to report the cases with the goal of improving patients safety and improve patients outcomes. 

2. In a captivating qualitative research study, nursing students were evaluated for their holistic nursing clinical experiences in medical-surgical clinics. Holistic care is not a new concept in nursing. In fact, many nursing educational institutes have successfully incorporated holistic care into their curriculum. Holistic care involves a multifaceted approach in patient-centered care by considering the physiological, psychological, psychosocial dimensions of an individual’s overall health. These several factors must be balanced within the body in order to achieve optimal health conditions and prevent disease. The nurse’s role in holistic medicine is to formulate care plan interventions that address the various dimensions of holistic care that is tailored to the patient’s needs (Kaya et. al, 2022). 

      The researchers gathered 20 nursing students to undergo three semi-structured focus group interviews that encouraged participants to share their clinical experiences during their time in nursing school. After the answers to the open-ended questions were collected, a thematic analysis of identifying themes and subthemes were laid out into a coding tree. The research data demonstrated several themes and subthemes related to the participants’ experience of holistic nursing clinical practices. Many participants conveyed a lack of knowledge about holistic care and effective communication with patients (Kaya et. al, 2022). Several student nurses admitted to maintaining focus on well-being and upholding an emotional barrier with patients, specifically those with terminal illnesses. This lack of knowledge and emotional disconnect can impede the delivery of holistic care. In addition, the research findings also noted the effects experienced by nurses especially when caring for patients in the stages of illness. Nurses often bear the burden of their patients, which can impact their own wellbeing (Kaya et. al, 2022). While it might be challenging for them to discuss with their families the difficulties they encounter while providing care, stress management and therapeutic communication is a skill that is honed after repetitive practice in similar circumstances. The nursing students believed that holistic care involved a team-based approach including healthcare professionals from various disciplines to deliver effective care. It was determined that although there is constant communication and sharing of information among healthcare providers, it can impede the assessment of patients from a holistic perspective (Kaya et. al, 2022). 

      The holistic care framework guides nurses to look at patients beyond just their physical health, but also include their psychosocial, cultural, and spiritual needs. Addressing and treating  these aspects can significantly impact the quality of care delivered and may even prevent recurrent hospitalizations. There were several obstacles to providing holistic care such as an emphasis on physical wellbeing, a lack of role model nurses, inadequate knowledge, limited understanding of teamwork across disciplines, and a shortage of nursing staff and difficulties related to the curriculum (Kaya et. al, 2022). These challenges hindered the assessment of patients by restricting the amount of time that should be dedicated to personalized care. The implications of these research findings provides insight into the concept of care that is a core philosophy of nursing. Future research can consider these findings to develop courses that emphasize on holistic care and provide appropriate interventions. As a result, this can enhance the learning experiences of nursing students and evolve learning habits of newer nursing generations to deliver high-quality care. 

Hospitals have noises that are buzzing day and night. Emergency Rooms, ICU’s and monitored patient floors to mention a few, have high rates of noise saturation. The most common attribution to the noise is alarms. Alarms are designed to alert staff of a change or potential change in patient status (Hebda et al., 2019). Often, the alarm going off is false or has no patient threat. This is due to parameters not being set, patches not sticking, or positioning of a sensor. This can cause alarm fatigue, “The desensitization of a clinician to an alarm stimulus that results from sensory overload causing the response of an alarm to be delayed or missed” (West et al., 2014).

The result of alarm fatigue can lead to harmful patient situations. For example, if a nurse on a busy med-surg floor has several patients on beds with alarms, patients with IV pumps infusing and on telemetry monitoring, the alarm noise from all the devices could cause the nurse to tone out some of the sounds. If one of her patient’s bed alarms continues to go off repeatedly and every time she enters the patient’s room, finds the patient in bed, she determines the sensor is set to sensitive for the patient. But if the sensor is not reset, and the alarm continues to go off, the nurse may start to ignore the alarm. The last time the alarm sounds, the patient does get out of bed and falls, injuring his hip. This can turn into a legal issue as the safety measure was in place to protect the patient from harm, but due to a failure to change the bed setting, and the nurse’s desensitization of the alarm, the patient had a poor outcome. There is an ethical responsibility for the nurse to assess the injured patient, report the fall to appropriate change according to hospital policy and discuss the incident with the patient or family members. According to Kadivar et al., (2017), that despite measures put into place in the health care setting, there are still numerous threats posed to patient safety.

Evidence suggests that alarm fatigue is a patient safety and quality concern. As health care delivery becomes more digitalized, it is increasingly important to develop a safety culture to address alarm fatigue. The research suggests establishing safe alarm management and response processes. The use of multilevel sharing practices and prevention strategies is also a way to collaborate with multidisciplinary teams on strategies for reduction in alarm fatigue (Winter et al., 2021). By decreasing the number of false alarms with use of proper management, nurses can better care for patients needs without disruptions. Thus, reduce potential missed or ignored alarms resulting in poor patient outcomes.

References:

Kadivar, M., ManooKian, A., Asgharican., & Zarvani, A. (2017). Ethical and legal aspects of patient's safety: A clinical case report.
Journal of Medical Ethics and History of Medicine,
10, 15.

Winters, B., Slota, J., & Bilimoria, K. (2021). Safety Culture as a Patient Safety Practice for Alarm Fatigue.
Journal of the American Medical Association,
326(12), 1207-1208.

https://doi.org/chamberlainuniversity.idm.oclc.org/10.1001/jama.2021.8316

Links to an external site.

Hebda, T., Hunter, K., & Czar, P. (2018). Handbook of Informatics for Nurses & Healthcare Professionals (6th ed.). Pearson Learning Solutions.

https://ambassadored.vitalsource.com/books/9781323903148

Links to an external site.

West, P., Abbott, P., & Probst, P. (2014). Alarm fatigue: A concept analysis.
Online Journal of Nursing Informatics,
18(2), 1.

Reply

Your assigned article for critique is

Avsar, P., Budri, A., Patton, D., Walsh, S., & Moore, Z. (2022).  Developing algorithm based on activity and mobility for pressure ulcer  risk among older adult residents: Implications for evidence‐based  practice. Worldviews on Evidence-Based Nursing, 19, 112–120. https://doi.org/10.1111/wvn.12545

This is article

  If you haven’t already, print the RAC  #2 questions and the article.  Open your book to chapter 9, 10, or 11  and place it on your left, put the RAC 2 questions in the middle of your  desk, and put the article on your right. 

• You’ll need your book for the questions that specifically refer to Grove and Gray 2019 in the question stem and  to look up key words in the question stem that you don’t remember from  your reading, like sampling method, power analysis, and acceptance rate.
• The content for the article-specific RAC questions this week will be  found in the Methods, Results, and Discussion sections of the article.
• This is a book Understanding nursing research  Grove, S., & Gray, J. (2019). Understanding nursing research (7th ed). Elsevier. 

Literature Review/Synthesis

Once you have thoroughly learned your studies (this is where the Table of Evidence you did previously will help you!), you need to communicate to your readers the level and quality of literature that was reviewed. The synthesis is a description of the entire body of literature that you have reviewed that supports your EBP project.  

Literature Synthesis = (100 points)

Purpose/Objective of this assignment is to:

1. Provide a 


synthesis and analysis

 of previously selected articles through a systematic review.

2. Evaluate the findings, identifying gaps in knowledge and implications for future research.

Assignment requirements: Students will utilize the articles selected to write a 

6 to 7 page
 review of the literature on the selected topic. Additional research articles may be included if necessary. (
Note that this is the first section of a two-section paper. (A 4 – 5-page paper discussing the clinical implications of the literature review findings on nursing practice will follow this literature review. See Assignment – Clinical Project: Clinical Implications Paper.) Include a background section.

1. Articles will be reviewed in an integrated manner. Summarize and provide a detailed synthesis of the information from all of your studies as it relates to the topic of interest.

2.

Must provide a synthesis and critical analysis of research designs, methodologies, sampling, independent and dependent variables, research findings, threats to reliability and validity. Discussion to include trends, areas of commonalities and differences in approaches.

3. Discuss outcomes and findings

4. All information must be cited and referenced appropriately.

5. Paper will utilize all appropriate APA 7th Ed guidelines for intro, conclusion, citations, references, document organization, formatting, academic language, and grammar. 
First person is not appropriate in this paper.

Topic: In mechanically ventilated patients in the ICU (P), does an oral care protocol using chlorhexidine mouthwash (I) compared to routine oral care (C) reduce the incidence of ventilator-associated pneumonia (O) over six months (T)?