Introduction
The aim of carrying out the study was to evaluate the risks of falling in hospitalized patients. In addition, the study wanted to describe the risks of falling based on the personal attributes of the individual patients. The research started in Portugal in 2013 and completed in January 2014. Specifically, it was carried out to examine the above phenomenon at the medicine department of the Médio Ave Hospital Centre (CHMA) in Portugal.
At the time of writing the article, Sandra Cruz, Barbara Lamas and Luis Carvalho were working at the Escola Superior de Enfarmagen do Porto while Pedro Barboa was working at the Centro Hospitalar de Sao Joao (Cruz, Carvalho, Lamas & Barbosa, 2014). In addition, the academic qualifications and backgrounds of the researchers provide evidence that they are justified to carry out an empirical study in the nursing field. Sandra Cruz holds both a PhD and a Master’s in administration degrees from different universities in Portugal. Pedro Barbosa is a registered nurse and a holder of a Master’s degree in clinical nursing. Luis Carvalho holds a PhD degree in education sciences from the University of Santiago in Spain while Barbara Lamas has a Master’s degree in clinical supervision nursing from the Nursing School of Porto, Portugal.
Identification of the problem/hypothesis
The study was based on the issue of patient safety, especially the hospitalized individuals. According to the researchers, the risks of patient’s falls is a major health issue in hospitals because it shows the degree of patient care provided at the specific healthcare facility (Hall, Doran & Pink, 2004). In particular, the researchers considered the high probability of falling in the elderly patients. According to Cruz, Carvalho, Lamas & Barbosa (2014), nurses have the responsibility of working with the patients in order to understand the risks of falling and the personal attributes that may contribute to the probability of falling while hospitalized. The study wanted to address the problem of lack of adequate understanding of the aspects that should be included in the clinical supervision model in the field of nursing. These issues are important in promoting safety and quality of the nursing care relayed to the risks of falls among the hospitalized patients.
In addition, the researchers identified the research hypothesis that the study was trying to describe (Cruz, Carvalho, Lamas & Barbosa, 2014). The researchers argued that there was a link between the sex of a patient and the risk of falling (Cruz, Carvalho, Lamas & Barbosa, 2014). The third hypothesis stated that the differences between the conducted evaluation and the documented findings in records during patient admission were significant (Cruz, Carvalho, Lamas & Barbosa, 2014). The fourth hypothesis stated the role and knowledge of nurses in preventing falls and the number of falls recorded in a hospital setting (Cruz, Carvalho, Lamas & Barbosa, 2014).
The nature of the study
The study used a quantitative approach, where statistical inferences played a significant role in testing the hypotheses as well as describing the issue. In addition, the researchers used an exploratory and descriptive study to characterize the risks of falling in hospitalized patients and the knowledge of nurses in preventing and mitigating the risks of falling.
Sample size and the population of the study
The researches gathered a number of patients who had been hospitalized for at least 24 hours with no history of readmissions. Thus, the total study population (N) included 132 persons. The mean age was 72.5 years while the standard deviation was about 13 years. Most of the patients were males (n=79, 59%) while all the rest were identified as females.
Results of the study
Multiple procedures were used for the collection of data, including the application of questionnaires to assess the risk of fall. From these statistics, the researchers found that more than 16% of the patients were not under the risk of falling while about 48% were under “low” risk of falling (Cruz, Carvalho, Lamas & Barbosa, 2014). In addition, about 34% were classified as “under high risk of falling” (Cruz, Carvalho, Lamas & Barbosa, 2014). Therefore, it was concluded that the existence of non-conformities was realized in the implementation of the protocol (Laschinger & Leiter, 2006). The researchers concluded by recommending a number of contributions to the clinical supervision in order to reduce the risks of falling. It was also shown that nurses should play the biggest role in reducing risks of falling among the hospitalized patients (Rubenstein, Josephson & Osterweil, 2006).
Reflection
The article shows that the risk of falling is a major problem in hospitals, despite the fact that the issue seems to be ignored in empirical studies. An in-depth analysis of the study states that the problem should be mitigated, especially because the results of falling are detrimental. The article examines a major health problem, which means that it is relevant to the clinical practice.
References
Cruz, S., Carvalho, L., Lamas, B., & Barbosa, P. (2014). Improving Quality in the Patients‟ Risk of Fall Evaluation through Clinical Supervision. International Journal of Information and Education Technology, 4(6), 526- 530.
Hall, L. M., Doran, D., & Pink, G. H. (2004). Nurse staffing models, nursing hours, and patient safety outcomes. Journal of Nursing Administration, 34(1), 41-45.
Laschinger, H. K. S., & Leiter, M. P. (2006). The impact of nursing work environments on patient safety outcomes: The mediating role of burnout engagement. Journal of Nursing Administration, 36(5), 259-267.
Rubenstein, L. Z., Josephson, K. R., & Osterweil, D. (2006). Falls and fall prevention in the nursing home. Clinics in geriatric medicine, 12(4), 881.
Rubenstein, L. Z., Josephson, K. R., & Robbins, A. S. (1994). Falls in the nursing home. Annals of internal medicine, 121(6), 442-451.
HR Management Skill Set In Health Care
It is necessary to note that an HR manager is expected to have an outstanding knowledge of the industry, and some aspects are incredibly valued by employers. The first skill set that should be highlighted is focused on compensation and benefits. Demands of healthcare professionals are always increasing, and one should be capable of offering packages that would attract new employees, and ensure that valuable specialists remain loyal. The second skill set focuses on recruitment and hiring. A manager must analyze available data to determine which individuals have potential. The role of communication skills also should not be overlooked, and it is imperative to collect as much information as possible during the interview. The third dimension is devoted to employee evaluation. One should develop evaluation strategies that would fit a particular healthcare facility, and it should help to increase productivity levels (Vermeeren et al., 2014).
Health care professionals that understand that their performance is measured are much more motivated. It is also beneficial to measure work engagement levels and determine the ways in which they may be improved (Shantz, Alfes, & Arevshatian, 2016). A manager should also utilize such techniques as training needs analysis and others to determine knowledge gaps that should be addressed. Lifelong learning is a core part of the modern healthcare industry, and a supervisor should provide employees with numerous opportunities that would help them to enhance their skills and get access to new information. A skill set of an individual determined to become an outstanding professional in this area should be quite diverse. Such aspects as conflict solving and change management can be crucial. Also, one should be capable of multitasking because one has a set of responsibilities, and it may be necessary to change priorities based on the situation.
It is important to understand that the vision of an organization is rather vague most of the time, and can be altered. However, its realization is a primary goal, and it is reasonable to involve every employee in the process. On the other hand, the mission is precise most of the time, and it is focused on the steps that would help to improve an organization in the long-term. Therefore, it is possible to set priorities, and an HR manager may develop the plans focused on the utilization of resources. One should ensure that employees are aware of the goals of the organization, and are determined to achieve them in the future (Cryts, 2016). A broad range of methods may be utilized in such cases. The mission and vision are quite different nowadays because the industry had to go through numerous changes, and much more attention is devoted to the needs of patients and the number of positive outcomes. Furthermore, these aspects became vital for every health care facility, and their strategies had to be modified. The most attention should be devoted to evidence-based practice because it helps to reduce unnecessary expenses, and resources can be used much more efficiently (Melnyk, 2014). It is understandable that registered nurses have a broad range of responsibilities, but both vision and mission should guide an HR manager, and affect his or her decision-making process. It is possible to state that they both are essential and help employees to get a better understanding of the organization’s direction. Overall, mission and vision should be well-developed to ensure that some of the complications that may occur are acknowledged, and numerous internal and external factors are taken into account.
References
Cryts, A. (2016). The changing face of healthcare leadership. Managed Healthcare Executive, 26(1), 29-32.
Melnyk, B. M. (2014). Evidence‐based practice as mission critical for healthcare quality and safety: A disconnect for many nurse executives. Worldviews on Evidence-Based Nursing, 11(3), 145-146.
Shantz, A., Alfes, K., & Arevshatian, L. (2016). HRM in Healthcare: the role of work engagement. Personnel Review, 45(2), 274-295.
Vermeeren, B., Steijn, B., Tummers, L., Lankhaar, M., Poerstamper, R., & Van Beek, S. (2014). HRM and its effect on employee, organizational and financial outcomes in health care organizations. Human Resources for Health, 12(1), 1-9.
The Most Important Advanced Practice Roles In Nursing
Introduction
Nursing is one of the essential healthcare careers that offer a wide variety of services to patients who are in need. This speciality has grown from the traditional support role for other health practitioners to one that is universally respected. This growth has also led to improvement in training where most nurses receive specialised education as opposed to the traditional practice of learning by apprenticeship. Advances in medicine and healthcare have led to the emergence of special advance practice roles for nurses. This research paper presents an overview of some of the most important advanced practice roles in nursing, especially those that are found in the master of the nursing curriculum. The paper examines and reviews the roles played by these specialists. However, it focuses mainly on the personal scope of practice, core competencies, certification requirements, and legal aspects of practice for that specific role. It also identifies the environment or population that is targeted after completion of the course. In addition, it will also discuss the future personal leadership role and participation in professional organisations.
Advanced Practice Roles in Nursing
There are several advanced practice roles in nursing. Examples of such roles include the nurse practitioner, nurse educator, nurse informaticist, and nurse administrator (Dowling, Beauchesne, Farrelly, & Murphy, 2013). Each of these core advanced practice roles in nursing is tailor-made for a particular function and purpose. These roles also work in support of each other. Therefore, they are complementary. The existence of these sophisticated rehearsal roles in nursing was necessitated by the increased demand for healthcare services, the improvement in healthcare as a profession, and the development of complex challenges for which special customised solutions were necessary.
Individuals who are trained on the different superior practice positions in nursing require special skills to perform these roles. A nurse practitioner is registered after completing graduate education in a recognised institution of higher learning. This individual is responsible for the provision of primary care to patients (Lowe, Plummer, O’Brien, & Boyd, 2012). On the other hand, a nurse educator is an individual who works in a clinical setting as a mentor and instructor for junior nurses along with those who go through training in other nursing roles. These nurses use their skills and experience to ensure that the profession is safeguarded.
Nursing informatics is another example of advanced roles in nursing. It integrates nursing science with other sciences such as information science and computer science (Dowling, Beauchesne, Farrelly, & Murphy, 2013). This role ensures that nursing incorporates information science in the management of patients and the communication of data and information as well as knowledge in their places of work. A nurse administrator, as the term suggests, is an individual with nursing training, skills, and experience such that he or she can make administrative decisions (Lowe, Plummer, O’Brien, & Boyd, 2012). A nurse administrator makes financial decisions, policies, and issues that relate to staff administration. These highly developed roles in nursing are crucial since each has a special contribution in the effective management of patients.
Comparison and Contrasts
All the aforementioned different roles have similarities and differences. This section compares and contrasts these roles. The main similarity between these roles is the training that the individuals have to get so that they can perform the roles. All these roles are performed after special training from recognised nursing institutions where nurses are taught the basic requirements for each of the roles. The comparison and contrasts between these roles can be made based on clinical practice, primary care, education, administration, and research.
A nurse practitioner has a graduate education from a recognised higher institution. He or she is required to offer primary care to patients as the basic training for most of the nurses. It is among the oldest advanced roles in nursing. According to Lowe, Plummer, O’Brien, and Boyd (2012), most individuals who perform different roles were initially nursing practitioners before progressing to these roles. These individuals are not primarily tasked with administration. They may carry out research work in relation to their areas of work. A nurse educator has the basic training as a nursing practitioner, with most regions around the world requiring all educators to have this training. The nurse educator has education on the primary care of patients. He or she is expected to dispatch this training to other junior nurses and/or nursing students. These individuals often have a wide experience in nursing. They conduct research on a number of areas.
A nurse informaticist integrates the practice of nursing to other sciences such as information science. Although these nurses are not in regular practice, most of them are required to perform their nursing duties as they perform these advanced roles. Their research is also mainly in the areas of information science and its application in nursing. Unlike most of the other nurses who play different nursing roles, nurse administrator is tasked with administrative duties in areas where nursing care is relevant. These individuals are mostly not practicing nursing. They prefer performing their administrative duties only. Most of the nurse administrators also conduct studies that are relevant to administration and its relation to nursing care.
Selected Advanced Practice Role
Each of the above advanced practice roles in nursing is important to the field of nursing. Different individuals who are interested in nursing prefer different advanced roles. The personal advanced role played in nursing is family nurse practitioner. This position is part of the nursing practitioner role that is selected by many other students that are interested in nursing. Family nurse practitioner is a sub-speciality of nursing practitioner course. He or she has the main aim of providing primary care to patients at the level of the family (Lowe, Plummer, O’Brien, & Boyd, 2012). This speciality is a personal choice based on the future interests in nursing care and the provision of services to families that are in need.
Regulatory and Legal Requirements
Just like most other professions, the nursing practice is subject to rules and regulations that operate in the state and territory of practice. There are many regulatory and legal requirements in the nursing practice, especially in the state within which the personal training of family nurse practitioner will be applicable. The state of interest is Minnesota, which has different rules and regulations pertaining to the nursing profession. In this state together with other states in the US, nurse practitioners are allowed to prescribe medications for patients. This requirement follows the federal legislative directive that is applicable to the other states in the US such as Minnesota.
Another regulatory and legal requirement that is applicable to this state in nursing practice is the recognition of third party reimbursement for certified nursing practitioners (Dowling, Beauchesne, Farrelly, & Murphy, 2013). The state of Minnesota requires nurse practitioners to have collaborative profession agreements with licensed physicians (Dowling, Beauchesne, Farrelly, & Murphy, 2013). This requirement has been lauded as crucial in the establishment of standard practices in nursing. This state is performing better as compared to other states in relation to nursing care (Gardner, Chang, Duffield, & Doubrovsky, 2013).
Professional Organisations
Professional organisations allow effective practice in any career and occupation. Nursing practice requires one to be a member of a professional organisation. This demand is intended to protect the profession, advocate for better practice and delivery of services, and improve the welfare of the respective members. Many professional organisations are present for membership in this area. One of these organisations is the body that is responsible for the welfare of nursing practitioners in the state of Minnesota. In addition, a federal body is responsible for the welfare of these health practitioners on the national front. The presence of these professional bodies ensures that the human resource in this area is effectively managed, and that the practices that they undertake are within the law.
Required Competencies
For one to be a nurse practitioner in any speciality, he or she must demonstrate several competencies. The most basic of these competencies is the ability to offer quality care to patients who are in need of it. The profession is made up of people who have been trained to carry out basic nursing care. For nurses to be good at this practice, they should be adequately prepared to manage the patients according to the latest methods that have been demonstrated to have the best effects and results. Nursing practitioners also need to be hands-on in terms of the ability to offer care as desired by their patients. In most cases where nurses are called upon to play the role of practitioners, there is a need for compassion, caring spirit, hard work, and empathy. These requirements are the core competencies for one to qualify as a nurse practitioner, in addition to the role played in the institutions of practice.
Predicting Work Organisation and Setting, Population, and Colleagues
The predicted work organisation will be according to the individual characteristics. The expectation is that the organisations will provide the basic facilities that are required in the practice of nursing. The environment will also be conducive for this exercise. The setting should facilitate the practice of nursing since the individuals have the basic training in the same. The population that the learnt skills will be practiced in is also important to consider. This population is expected to have a basic respect for the profession. It should also have the basic skills that are required in the interaction with nursing practitioners. According to Shiu, Lee, and Chau (2012), the population within which individuals operate in is important since it determines the general outlook that they have their motivation and desire to practice. Colleagues are also important at the workplace. Future colleagues will also be hardworking, skilled, and experienced.
Leadership Attributes of the Advanced Practice Role
Leadership contributes to the success of any career. The leadership skills that are available to an individual determine his or her success. The advanced practice role focused above is one of the areas that require demonstration of leadership skills. According to Shiu, Lee, and Chau (2012), a leader should control and influence people and environment around them. The leadership attributes of the advanced practice role discussed above include the provision of motivation to the training nurses, teaching nurses that are in the process of learning, and carrying out of studies that are aimed at improving the advanced role. In nurse practice, leadership skills are important in that they enable the individuals to direct the activity of others for better results. It is from this advanced nursing role that the other roles can be advanced.
Leadership Style
The leadership style of an individual may be determined through a number of ways. According to Shiu, Lee, and Chau (2012), the assessment of leadership styles may be done through tests that are administered to the individuals under discussion. The internet is a significant source of leadership styles. Anybody can participate in tests that are aimed at evaluating his or her leadership style. In one of the tests that were taken over the internet, the leadership style that emerged is a laissez-faire one. In this style of leadership, leaders delegate activities to their juniors, with some allowing the staff members below them to make independent decisions. Although this method of leadership promotes independence, some leaders have challenges with the management of this group of individuals.
Leadership Attributes
Some of the leadership attributes that are currently present include patience and free will. Honesty, professionalism, and competence are some of the other values and attributes that are present. These aspects will be crucial in the future survival of the profession. The other leadership attribute is patience, which is an important part of any leader. Leadership is a crucial part of any institution or profession. Only professions with good leaders are able to succeed. Despite the above leadership attributes being present, other leadership qualities are important to develop over the next few years.
The attributes that are needed over the next few years in the nursing practice include persistence and professionalism. The observation is that these attributes have been lacking, and hence the need to acquire them. The acquisition of these attributes will contribute significantly to the betterment of this profession and other subspecialties within it. The attributes that are needed can be attained and evaluated in several ways. One of the ways is the utilisation of the existing frameworks and policies. The second way in which the missing attributes may be evaluated and observed is through the utilisation of a second party, which entails asking for the assistance of other people who have an idea of the necessary changes.
Health Policy and the Advanced Practice Role
The advanced practice roles are important in the health of the citizens and the economy as a whole. The US government along with other global governments have embarked on the creation of a health policy to safeguard this industry. Nurse practitioners are affected by the health policy in a number of ways, including the determination of the environment in which they work, the conditions of their work, and the manner in which they are supposed to act at their places of work. An example of a relevant health policy is the one that pertains to the payment of healthcare. Many projects have been formulated in an attempt to finance healthcare. These projects are important to the nursing advanced practice roles.
Current Policy
The current policy framework has been realized after many years of trial and error. The health policy in is favourable for the advanced professions in nursing. It facilitates their work in a safe and steady political, social, and economic environment. The current policy environment facilitates the transfer of knowledge between individuals. Besides, it recognises health as a significant pillar of the economy. Most of the policies that have been implemented over the past century are meant to streamline the heath sector. The above roles are some of the candidates for this streamlining. The United States government is one of the governments that have engaged on a campaign to popularise the available services in healthcare (Shiu, Lee, & Chau, 2012). The act of popularising the issues of health has made the advanced roles of nursing more popular than it had been observed a few years ago.
Necessary Change
Despite the success of most of the above programmes, there is a need to implement changes based on the need that is present on the ground and the level of care that is necessary for the respective health facility. Some of the advanced nursing roles have attracted more people than others, thus leading to overcrowding in the particular advanced area. Some of the ways that can be used to ensure that more of the other advanced roles in nursing are attractive include the provision of better remuneration, motivation, and the presence of better working terms. The other area where change is necessary is the training for the different advanced nursing roles. Training needs to be conducted in institutions that are recognised by professional bodies, with the appropriate standardisation protocols being followed to ensure that graduates are well prepared for their future roles.
There is a need to change the attitude of students and professionals in the various advanced nursing practices. There have been complaints from practitioners and other nursing staff about discrimination from other cadres of health practitioners (Shiu, Lee, & Chau, 2012). There is also duplication of roles between some of the advanced nursing roles. This situation makes it difficult for individuals to perform their duties effectively. The process of implementing the above changes is multidisciplinary, with all the different levels of staff being involved. The process of bringing about change needs to be guided by the objectives that originate from the desired results. The key players in this change process include legislators, the policymakers, healthcare professionals, and nurses. The community is also a major player in any health policy change since it is the source of the involved clients.
The personal roles that may be played in an attempt to influence policy change include advocating for a change and being part of it. Despite the personal training as a family nurse practitioner, it is important to recognise the importance of other advanced nursing roles. This plan will go a long way in reducing the perceived differences between the different nursing roles. A personal contribution is needed in policymaking through conducting research that may be used to guide any anticipated policy change. It is possible to predict the effect on health care quality if the change in policy is implemented. One of the expected results is an improvement in the quality of care that is provided by the nursing staff. The other effect is that there will be increased respect for this profession, thus leading to the improved self-esteem of the individuals within it. There is also a possibility of improving the general health of the nation through the policy intervention.
Reference List
Dowling, M., Beauchesne, M., Farrelly, F., & Murphy, K. (2013). Advanced practice nursing: A concept analysis. International Journal Of Nursing Practice, 19(2), 131-140.
Gardner, G., Chang, M., Duffield, C., & Doubrovsky, A. (2013). Delineating the practice profile of advanced practice nursing: a cross-sectional survey using the modified strong model of advanced practice. Journal Of Advanced Nursing, 69(9), 1931-1942.
Lowe, G., Plummer, V., O’Brien, A., & Boyd, L. (2012). Time to clarify – the value of advanced practice nursing roles in health care. Journal Of Advanced Nursing, 68(3), 677-685.
Shiu, Y., Lee, F., & Chau, C. (2012). Exploring the scope of expanding advanced nursing practice in nurse-led clinics: a multiple-case study. Journal Of Advanced Nursing, 68(8), 1780-1792.