NR 351 Transitions in Professional Nursing Week 4 Discussion
NR 351 Transitions in Professional Nursing Week 4 Discussion
NR 351 Transitions in Professional Nursing Week 4 Discussion
“Professional nurses bring a unique perspective and offer valuable skills to enhance health care quality. All health team members must be invested in developing and maintaining a culture of safety and QI” (Hood). Nurses play a vital role in all aspects of care, nurses are the frontline and with that comes huge responsibility. Nursing is probably one of the most stressful occupations and with stress comes the potential for mistakes. No one is without fault but what makes the difference is how that fault is handled, whether it is punitive response or an opportunity to learn. “An important feature of a safe organization is the creation of a “just culture.” A just culture allows frontline employees or personnel to feel comfortable disclosing errors, even one’s own error” (Fondahn, Lane, Vannucci). Even mistakes or near misses should be treated as an opportunity to reflect and learn. We are all imperfect and working in a punitive environment creates stress and the potential for increased errors. Nurses must feel empowered to take responsibility for mistakes and not feel that they will be punished. At my hospital we embrace a “just culture” and use every opportunity to huddle and review what happened, what could have happened, and what could have been done differently.
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I feel that my hospital has the tools in place to create a non-punitive environment. The improvement I would like to see is something in place to help nurses work through the pressure and guilt of needing to be perfect. Any time I have ever made a mistake the guilt I feel and the “beating myself up” is more punitive then any one could impose.
Hood, L. J. (2018). Leddy & Pepper’s professional nursing ninth edition. Philadelphia: Wolters Kluwer.
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Fondahn, E; Lane, M; Vannucci, A (2016). The Washington Manual of Patient Safety and Quality Improvement. Philadelphia: Wolters Kluwer.
Nursing Roles in Quality Improvement
Purpose
This week’s graded discussion topic relates to the following Course Outcome (CO)
CO2: Demonstrate leadership strategies that promote safety and improve quality in nursing practice and increase collaboration with other disciplines when planning patient-centered care within systems-based practice. (PO2)
CO7: Compare and contrast the professional nursing roles for ADN/diploma through PhD/DNP prepared nurses in providing cost-effective, quality healthcare in structured and unstructured systems
The Assignment
Participation: RN-to-BSN
In discussions, you, as a student, will interact with your instructor and classmates to explore topics related to the content of this course. You will be graded for the following.
1. Attendance
Discussions (graded): Discussions are a critical learning experience in the online classroom. Participation in all discussions is required.
2. Guidelines and Rubric for Discussions
PURPOSE: Threaded discussions are designed to promote dialogue between faculty and students, and students and their peers. In the discussions students:
- Demonstrate understanding of concepts for the week
- Integrate scholarly resources
- Engage in meaningful dialogue with classmates
- Express opinions clearly and logically, in a professional manner
Participation Requirement: You are required to post a minimum of three (3) times in each graded discussion. These three (3) posts must be on a minimum of two (2) separate days. You must respond to the initial discussion question by 11:59 p.m. MT on Wednesday.
NR 351 Transitions in Professional Nursing Week 4 Discussion
Participation points: It is expected that you will meet the minimum participation requirement described above. If not:
- You will receive a 10% point deduction in a thread if your response to the initial question is not posted by 11:59 p.m. MT on Wednesday
- You will also receive a 10% point deduction in a thread if you do not post at least three (3) times in each thread on at least two (2) separate days.
3. Threaded Discussion Guiding Principles
The ideas and beliefs underpinning the threaded discussions (TDs) guide students through engaging dialogues as they achieve the desired learning outcomes/competencies associated with their course in a manner that empowers them to organize, integrate, apply and critically appraise their knowledge to their selected field of practice. The use of TDs provides students with opportunities to contribute level-appropriate knowledge and experience to the topic in a safe, caring, and fluid environment that models professional and social interaction. The TD’s ebb and flow is based upon the composition of student and faculty interaction in the quest for relevant scholarship. Participation in the TDs generates opportunities for students to actively engage in the written ideas of others by carefully reading, researching, reflecting, and responding to the contributions of their peers and course faculty. TDs foster the development of members into a community of learners as they share ideas and inquiries, consider perspectives that may be different from their own, and integrate knowledge from other disciplines.
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4. Participation Guidelines
You are required to post a minimum of three (3) times in each graded discussion. These three (3) posts must be on a minimum of two (2) separate days. You must respond to the initial discussion question by 11:59 p.m. MT on Wednesday. Discussions for each week close on Sunday at 11:59 p.m. Mountain Time (MT). To receive credit for a week’s discussion, students may begin posting no earlier than the Sunday immediately before each week opens. For courses with Week 8 graded discussions, the threads will close on Wednesday at 11:59 p.m. MT. All discussion requirements must be met by that deadline.
5. Grading Rubric
Discussion Criteria | A (100%) Outstanding or highest level of performance |
B (87%) Very good or high level of performance |
C (76%) Competent or satisfactory level of performance |
F (0) Poor or failing or unsatisfactory level of performance |
---|---|---|---|---|
Answers the initial graded threaded discussion question(s)/topic(s), demonstrating knowledge and understanding of concepts for the week. 16 points |
Addresses all aspects of the initial discussion question(s) applying experiences, knowledge, and understanding regarding all weekly concepts.
16 points |
Addresses most aspects of the initial discussion question(s) applying experiences, knowledge, and understanding of most of the weekly concepts.
14 points |
Addresses some aspects of the initial discussion question(s) applying experiences, knowledge, and understanding of some of the weekly concepts.
12 points |
Minimally addresses the initial discussion question(s) or does not address the initial question(s).
0 points |
Integrates evidence to support discussion. Sources are credited.* ( APA format not required) 12 points |
Integrates evidence to support your discussion from:
Sources are credited.* 12 points |
Integrates evidence to support discussion from:
Sources are credited.* 10 points |
Integrates evidence to support discussion only from an outside source with no mention of assigned reading or lesson.
Sources are credited.* 9 points |
Does not integrate any evidence.
0 points |
Engages in meaningful dialogue with classmates or instructor before the end of the week. 14 points |
Responds to a classmate and/or instructor’s post furthering the dialogue by providing more information and clarification, thereby adding much depth to the discussion.
14 points |
Responds to a classmate and/or instructor furthering the dialogue by adding some depth to the discussion.
12 points |
Responds to a classmate and/or instructor but does not further the discussion.
10 points |
No response post to another student or instructor.
0 points |
Communicates in a professional manner. 8 points |
Presents information using clear and concise language in an organized manner (minimal errors in English grammar, spelling, syntax, and punctuation).
8 points |
Presents information in an organized manner (few errors in English grammar, spelling, syntax, and punctuation).
7 points |
Presents information using understandable language but is somewhat disorganized (some errors in English grammar, spelling, syntax, and punctuation).
6 points |
Presents information that is not clear, logical, professional or organized to the point that the reader has difficulty understanding the message (numerous errors in English grammar, spelling, syntax, and/or punctuation).
0 points |
PARTICIPATION: Response to initial question: Responds to initial discussion question(s) by Wednesday, 11:59 p.m. M.T. |
0 points lost
Student posts an answer to the initial discussion question(s) by Wednesday, 11:59 p . m. MT. |
-5 points
Student does not post an answer to the initial discussion question(s) by Wednesday, 11:59 p . m. MT. |
||
PARTICIPATION Total posts: Participates in the discussion thread at least three times on at least two different days. |
0 points lost
Posts in the discussion at least three times AND on two different days. |
-5 points
Posts fewer than three times OR does not participate on at least two different days. |
||
NOTES: * Credited means stating where the information came from (specific article, text, or lesson). Examples: Our text discusses…. The information from our lesson states…, Smith (2010) claimed that…, Mary Manners (personal communication, November 17, 2011)…. APA formatting is not required. |
||||
** Assigned readings are those listed on the syllabus or assignments page as required reading. This may include text readings, required articles, or required websites. | ||||
*** Scholarly source – per the APA Guidelines in Doc Sharing, only scholarly sources should be used in assignments. These include peer reviewed publications, government reports, or sources written by a professional or scholar in the field. Wikipedia, Wikis, .com website or blogs should not be used as anyone can add to these. For the discussions, reputable internet sources such as websites by government agencies (URL ends in .gov) and respected organizations (often ends in .org) can be counted as scholarly sources. Outside sources do not include assigned required readings. |
As nurses, we promote safety and improve quality by constantly “analyzing errors and designing system improvements” (Massachusetts Department Of Higher Education Nursing Core Competencies, Revised 2016). My floor is now the COVID-19 quarantine unit of the hospital and we are continually collaborating to improve upon processes aimed to prevent contaminating ourselves, patients who might not actually be infected, or anything outside of our unit. Preventing the contamination of patients involves constantly changing PPE and keeping the unit as clean as possible. Moving people, supplies, and waste, and eating, drinking, and going to the bathroom takes more thought, though. Our donning and doffing area is like a gradient of cleanliness with a tent at the end. On the other side of the tent lies the outside world. I feel like we live on an island where practically everything has to be delivered. But it’s not a Southern Caribbean island where people are happy to bring things and might even stay for lunch, it’s more of a Northern Atlantic island, in the middle of winter, where people do not want to come, usually leave supplies on the coast, and rush home. This is good though, because we want as few people as possible coming ashore.
Then there is the conservation of supplies issue. We are now confronted with the choice of conserving and waiting, or depleting PPE, to leave the area to drink, eat, and use the bathroom. Supplies are already low and according to Palmer (2020) “preparing for a worldwide pandemic, especially when you don’t know how fast it will spread or how serious its consequences will be, is one of the hardest things that healthcare workers do.” But we are really learning how to better cluster care and align the time between patients, when we already have to change PPE, with short breaks. I feel like we are going to come out of this being some of the most efficient nurses ever.
And in addition to improving the effectiveness of our unit, we exemplify adequate training with regard to the provided technology to ensure safety to both healthcare provider and receiver (Massachusetts Department Of Higher Education Nursing Core Competencies, Revised 2016). We have become very skilled at working in airborne precautions and although all hospital staff involved in direct patient care have been extensively trained in it, those who don’t frequently visit our unit need special instruction with our process of moving into and out of the quarantine area. Our solution is to always have a “specialist” appointed to the area to both assist those in need and ensure the area is adequately cleaned and stocked.
In response to the second question, I believe my workplace, promotes a very non-punitive culture of safety, where the cause of the error is more significant than the one who caused it (Barnsteiner, 2011). Earlier in my career, I once started a fentanyl drip too fast and realized it a few hours later. The rate was within the titration parameters, and although the patient was not harmed, it was still a medication error. That evening I reflected upon what had caused the error, identified how I could prevent repeating it, discussed it with my manager, and documented it on our error tracking system. Since I was very open and honest about my mistake, and I do not have a reputation for medication errors, my manager was very understanding and I was not punished because there is a balance in my workplace “between not blaming individuals for errors and not tolerating egregious behavior” Barnsteiner (2011).
References
Barnsteiner, J. (2011). Teaching the culture of safety. Online Journal of Issues in Nursing, 16(3). doi:10.3912/OJIN.Vol16No03Man05
Massachusetts Department of Higher Education Nursing Initiative. (2010). Massachusetts Nurse of the Future Nursing Core Competencies© Registered Nurse. Retrieved from http://www.mass.edu/nahi/documents/NOFRNCompetencies_updated_March2016.pdfLinks to an external site. Palmer, J. (2020). Coronavirus and preparing for the worst. Medical Environment Update, 30(4), 1-4. Retrieved from https://web-a-ebscohost-com.chamberlainuniversity.idm.oclc.org/ehost/pdfviewer/pdfviewer?vid=10&sid=97796d22-d348-4e3f-ae9b-322226ab0e2a%40sessionmgr4007