Overview On Evidence Based Nursing Nursing Essay

Overview On Evidence Based Nursing Nursing Essay According to Olade (2004), nursing practice using observed phenomena and evidences is an example of education which refers to formalized experiences designed to enlarge the knowledge or skills of nursing educators or practitioners. Through experiences and evidences, the ability to learn actual clinical practice and the orientation in health care protocols and policies in handling patients needs will be achieved. This method is also termed as Evidence-based practice. Evidence-based practice involves a combination of many disciplines, including aspects of multidisciplinary sciences to promote the restoration and maintenance of health in our clients (Davies, 2005). Much literature has been published on this topic in recent years, an evolving subject and concept for specific practices that promote more effective, safer and more efficient ways of caring (Drenkard Cohen, 2004). Maintaining and improving high satisfaction and job retention among nurses is an important area to discover (Ebe ll, 2008). To achieve this, we need a workforce to continually strive for excellence, be responsible and flexible enough, have the confidence to face the challenges, and inspire everyone with a shared vision. These are strengths needed by nursing staff to motivate others health care provider to fulfill their potential and achieve goals (Littlefield, 2005). Researches, studies and articles were utilized and analyzed in gathering the necessary information needed. Clinical education, skills and practices are the key concepts used in this paper. Challenges Possession of knowledge and competency in performing skills and interventions which can be acquired in hands on training is essential in practicing the profession especially in the medical-surgical unit where I supervise. As a nursing professional, tangible skills and knowledge in a hospital setting is very important in managing clients and supervising clients (Burns Foley, 2005). Evidences were identified through thorough assessment and research. The challenges discussed below were identified through gathering of recent information in my Medical-Surgical unit and data that focuses on this subject. Communicating effectively at all levels is a common barrier in the implementation of change among health care in various settings (Kleinman, 2004). As a member of the hospital workforce, a nurse must have the capability to communicate effectively in a non-judgmental way and stimulate other colleagues to think critically. They must also arouse enthusiasm and develop quick thinking and imagination. Moreover, they must also demonstrate resourcefulness and professionalism with infinite patience, understanding, confidence and perseverance are also challenges (Bryar et al, 200). According to Kleinman (2004), health care professionals are striving constantly to improve and develop the standards of care. Meeting the challenges require health care providers to be effective leaders who foster a culture and develop partnerships that embraces innovation (Salsberg, 2008). Organizational culture and leadership style result to staff satisfaction, increased productivity, improved patient care well-functioning teams (Drenkard Cohen, 2004). Getting health information about new knowledge is also a critical case or situation, but we have to look at how to make the system on healthcare execute its purpose better for certain facility so that the provided care is more efficient, accessible and effective (Pravikoff et al., 2005). Recent studies have reported gaps between nursing practice and researches (Brancato 2006) and identified different challenges that prevent the evidence to clinical practice to translate into clinical settings (Olade 2004). These challenges in applying evidence-based practice in nursing have been consistent across researches. One challenge is that, in the generation and development of new medical and nursing knowledge, the resistance of profession has often been incorporated with the new ways of practice (Young, 2004). The study suggests that much recent practices are based frequently on tradition, experience and intuition, rather than validation of science (Pravikoff et al., 2005, Egerod Hansen 2005). Furthermore, the growing numbers of nurse studies and researches designed to develop and improve nursing practice at the staff nurse level cannot make nurses improve their skills, research knowledge and understanding. They frequently lack nurses formal training such as scientific inquiries (Fink et al. 2005, Melnyk 2005, Melnyk et al. 2004, Pravikoff et al. 2005, Olade 2004). Institutional challenges to Evidenced-based Practice have also been identified. Moreover, challenges according to Melnyk (2005) were also found such as difficulty gaining support financially for the programs and trainings that ensure the effectiveness of skills, practice, leadership and integration of the program with existing practice of care through trainings and seminars and sustainable momentum during the shift of culture. Study also revealed that these challenges are not limited to those who implement the program (Young, 2004). In general, the main role of nurses is focused on providing effective, quality care. Hence, more advanced and competent means of preparing nurses to supervise and manage their patient is important (Briggs et al., 2004). These challenges must be addressed properly by the implementation of appropriate approach and programs to increase the knowledge and experience. Skill development for nursing educators must constantly be framed within the context of individualized patients. Nursing educators should make themselves aware of every situation happening in the field and make it a motivational means to improve the profession by proper preparation and education (Welk, 2007). Therefore, the need for implementing evidenced-based approach to nursing practice is essential in addressing these issues. Strategies for Implementing an Evidence-based Approach to Nursing Practice The nursing profession enters a new era not knowing what to expect. Yes, patient care is the same everywhere, but they must be comfortable with the environment they are placed in. Adaptation is crucial in the clinical arena (Kleinman (2004). Evidenced-based practice and clinical experience may become a highly useful and effective strategy in clinical practice. The nurse becomes less apprehensive about the clinical environment and becomes more client-focused, therefore increasing the effectiveness of care. This also provides the nurse an opportunity for role modeling as the client and family maintains and develops standards of practice and competent care in a familiar environment (Foster, 2007). In implementing an evidenced-based approach to nursing practice, nursing professionals must learn the ability to have excellent learning and communication skills, exhibit organizational and leadership ability (Salsberg, 2008). The particular problem which is the main issue of the study conducted by Rosswurm and Larrabee (2005) which suggests that the ability of nurses to perform their responsibilities and duties by exhibiting clinical skills and professional abilities are important. Nurses must possess good assessment skills and have good insight and judgment skills in order to anticipate or interpret the needs of the client in health care practice (Hewson, 2006). This evidenced-based model can be used to accommodate change process for the observed facts and laws that can be related to a particular aspect of nursing practice (Burns Foley, 2005). Communication practices must be addressed to identify and effectively set goals. Communicating effectively at all levels is a common barrier in the implementation of change among health care in various settings (Henderson, 2009). In addition,Littlefield (2005) strongly agrees that effective communication is the major factor in the success of effective learning outcomes for the implementation of new approaches, especially in a multicultural environment. As nurses play a different role at different time periods, communication should be considered in my Medical-Surgical unit in order to maintain the effectiveness and quality for the future improvement. Communication plays an essential role in enhancing clinical learning environment. Hallin Danielson (2009) describe that the role of communication is more concerned with the development of clinical competency by using strategies such as role modeling, feedback and questioning, within a supportive, safe and welcoming manner. For experienced nursing practitioners in hospital settings such as the Medical-Surgical unit, financial support and educational programs should provide resources to maintain theoretical and clinical competence (Hagger McIntyre, 2007). The key to successful client management is communication in caring for patients. Some of the activities being practiced in a hospital setting are the provision of the most current information possible for the nurses and nursing educators using the evidence-based practice and through collaborative approach of health care professionals (Lichtman, 2008). It is also useful to have and possess general skills needed to be competent in educating and training nursing personnel in health facility (Welk, 2007). I can share my ability to have excellent teaching and communication skills, exhibit organizational and leadership ability in my unit. The particular factor which is the main issue in improving the knowledge to perform their responsibilities and duties through exhibiting clinical skills and professional abilities is really important. Nursing practitioners must also support the possession of good assessment skills and have good insight and judgment skills in order to anticipate or interpret the needs of the client in health care practice (Foster, 2007). Lastly, trainings, workshops or programs should be properly planned and outlined to provide information and instruction for nurses in the principles of teaching and learning different skills, pedagogical styles, and valid evaluation techniques. According to Hewson (2006), workshops for nurses would impart knowledge and skills essential for success in the clinical setting. Embracing the knowledge and acquired skills in a familiar environment provides the practitioner with an increased level of confidence in the educational development of nursing professionals (Salsberg, 2008). To properly accommodate the strategies mentioned above, the conceptual model for translating evidence into clinical practice authored by Rosswurm and Larrabee (2005) will be helpful to promote the change process. This model recognized that translation of research into practice requires a solid grounding in change theory, principles of research utilization, and use of standardized nomenclature. The model has the following six phases: 1) assess the need for change in practice, 2) link the problem with interventions and outcomes, 3) synthesize the best evidence, 4) design a change in practice, 5) implement and evaluate the practice, and 6) integrate and maintain the practice change. The model provides a pragmatic, theory-driven framework for empowering clinicians in the process of evidence-based practice. The first phase is assessing the need for change in practice which searches for evidence to support the change. The second phase is linking the problem, interventions, and outcomes by using standardized nursing classification systems and nomenclature to identify the problem, and the desired outcomes .The third phase is synthesizing the best evidence by organizing systematic and critical strategies. The fourth phase is designing the practice change by identifying strategies to explore the original issue further and to implement it into practice. The fifth phase is the implementation and evaluation of change in practice by building and fortifying systems identifying problems, communicating and managing changes. The last phase is integrating and maintaining the change in practice, this step of the model is pending further evaluation and consideration (Rosswurm and Larrabee, 2005). This model is applicable to the subject because of its nature in terms of change process and method. Behavior, skills, competency, personal traits and knowledge can be addressed through the utilization of this model (Lichtman, 2008). Freiburger (2004) suggests that learning style in practice can be changed according to the situation such as when going through a new experience and at different maturation. Towards the end when an individual becomes confident and starts to discover new things by him/herself shows that evidenced-base approach of learning (Young, 2004). Conclusion Knowledge and competitiveness is a product of evidenced-based practice. Experience and effective learning processes are essential in actual clinical practice of the nursing profession. To be an effective nurse, one should begin with the individual appraisal of ones self competency and enhanced education based on practices and trainings taken previously during undergraduate and graduate studies, workshops, trainings, continuing education, and preparation for teaching seminars or modules including the conceptual, academic and clinical orientation (Foster, 2007). Competitiveness is largely based on innate potentials and motivations afforded by the familiarity of a learning environment. Accordingly, the primary responsibility of the nurse to the patient is to give him/her the kind of care the patient condition needs regardless of race, creed, color, nationality or status (Salsberg, 2008). The nurse must also advocate the rights and serve as facilitator of patients well being (Foster, 2007). In doing so, the patients care shall be based on subjective and objective evidence, needs, the physicians order and the ailment, and the involvement of the patient and the family. Evidence-based practice promotes understanding of the differing values held by people in other cultures (Henderson, 2009). For example, it helps the client understand why other people in one culture may regard with approval of their practices of exposing their elderly members to the harmful elements, while people in other cultures may abhor such practice (Henderson, 2009). The strength of this critical thinking and decision-making is its recognition of the relationship between personal values and a choi ce of action. It also equates personal values and wrong action and recognizes limits of personal experience and perspective and it implies that a persons moral judgments are infallible. I believe the richness or intensity of the inculcation of knowledge, positive values and skills of a person is not simply based on the innate capacity of one to evaluate, think, reason and interact in a learning situation. It also equally depends on the quality of the nursing experiences which are either limited by the nurses ability and will to choose or by what is desirable to her which is readily accessible in the environment. Nursing education, concepts and programs for improving the knowledge in health facility should also be provided to maintain theoretical and clinical competence of health setting and facilities. From what I have learned in my own area of practice, the key to successful knowledge development is competent learning and effective communication during the practice to achieve the goal of competency. This will determine the path of being an effective and competent nursing professional.

Benito Cereno

The Razor In â€Å"Moby Dick,† by Herman Melville, he writes about multiple gams between Captain Ahab’s ship, the Pequod, and other ships, yet because of Ahab’s selfishness, these meetings do not last a while unless there is information to be gathered about Moby Dick’s whereabouts. This differs from Melville’s novella, or short story, â€Å"Benito Cereno,† in which Captain Delano’s ship, the Bachelor’s Delight, have a gam with Benito Cereno and his ship, the San Dominick.We see a major difference in how Ahab acts and how Captain Delano acts in their meetings with other ships because of Delano’s willingness to help, but this good trait of his is what makes â€Å"Benito Cereno† such a good story. He continually tosses hints of a slave revolt on San Dominick to the side because of he gives the benefit of the doubt to Benito Cereno. Some of these rebellion hints include the captives, or slaves, being free from chains, and slaves slashing axes together.The biggest hint though is the razor that Babo shaves Benito Cereno. The razor is very important in this novella because it ties the entire story together as well as signifies multiple things such as power and fear. The razor symbolizes power, and even perhaps the balance of powers, because this is the first instance in which Babo, one of the slaves onboard the San Dominick, shows his dominance over Benito Cereno by keeping the razor close to Cereno’s neck and eventually cutting his cheek.When this â€Å"accident† happens, we hear no apology from Babo, only, â€Å"See master- you shook so- here’s Babo’s first blood,† (Melville, p210), which shows that he might have meant to cut Cereno, but also that Babo is willing to make Cereno, and perhaps the rest of his oppressors, bleed more. This is important because Babo draws the first blood and the balance of power is possibly beginning to change through harming Benito Ce reno physically and mentally. Although the razor represents power, it also represents the other side of the coin, being fear.Because Babo holds down Benito Cereno with a razor to his throat, Cereno knows he is in Babo’s full control. This evokes a fear from Cereno, knowing that his life could potentially be at stake, especially since Captain Delano is oblivious to the fact that the San Dominick has been taken over by the captured slaves. Not only do we see fear while the razor is close to Cereno’s throat, but when Babo cuts him, we see him become very frightful of what might happen.Melville writes,† No sword drawn before James the First of England, no assassination in that timid king’s presence, could have produced a more terrified aspect than was now presented by Don Benito,† (Melville, p 210) which shows that Cereno is scared that he might be killed, but yet is still frightened of the little blood of his that Babo spilled. Fear plays a major role i n â€Å"Benito Cereno† because of the fact that Don Benito has already experienced the slave revolt on the San Dominick, and could be killed momentarily if he makes one mistake.The razor keeps him in line during his conversation with Captain Delano because he fears what Babo could do to him if he makes one mistake. The razor not only symbolizes the balance of power as well as evil, but it is also meaningful in â€Å"Benito Cereno† because it ties the entire story together. First off, because the razor symbolizes power, we can relate this to Senegal, the place that Babo and the rest of the slaves are forcing Cereno to sail to for their freedom, back to their rightful home.This place could also be considered weak because of the people that are forced from their homes into the slave trade, and now the balance of powers is shifting. At one point during this journey, Benito Cereno was in full control of the slaves, bringing them to Lima, but now, Babo and the slaves that on ce lost their humanly rights, are now in control over the man who kidnapped them. The razor signifies this changing of power because in that scene we see that Babo is holding it to Cereno’s neck and not vice versa.Just like above, the razor to the neck of Don Benito signifies fear, but can also be connected to Cape Horn, which represents suspicion and lies. Fear and Cape Horn can be connected to one another because not knowing what something, or someone, might be can be frightening. As basic as this may sound, it is true because Cereno fears what Babo might do to him next, after cutting his cheek with the razor.As little as the razor may be, it plays a big role metaphorically and literally. The razor is obviously used by Babo to shave Cereno, and while doing this, Babo cuts Cereno, asserting his control and putting fear into his enemy. The razor completes the story of â€Å"Benito Cereno† because without it, blood would not be spilled, showing the slaves’ newly acquired dominance over their oppressors, which is best shown with a razor to the neck.

This is an informative essay about many tourist...

The Most Popular Tourist Attractions in Europe There are many tourist attractions in Europe and has had a very long history. Many countries such as France, England, Germany, Switzerland, Spain, Italy, and Amsterdam all have these very popular attractions. There is a vast history of tourism around the world, especially in Europe. There are writings of Herodotus, a historian who lived in the fifth century BC. He traveled by sea to Egypt, Persia, Sicily, and Babylon Travel writing is thus an activity with a history that stretches over two thousand years. (Swarbrooke and Horner 12) The steady march of tourism development in Europe was halted by the Dark Ages. With the end of the Roman empire came the end of most tourism for they were the†¦show more content†¦(Devine 402) Another cave in France is the Armand Cave. In 1897, a french potholer, Louis Armand, exploring in the Limestone Hills of the Ce`vennes fifty miles northwest of Montpellier, discovered the deep cavern later named after him. After making his way down a vertical shaft 246 feet deep, he entered a vast chamber, now known as La Grande Salle which measures 330 feet by 180 feet. The floor is covered with what has been described as a forest of stalagmites, formed from the percolation of water through the roof of the cave. The tallest of these is 100 feet high. (Devine 398) One of the most popular places in France is the Eiffel Tower. People come from all over the world just to see this huge tower. It is placed in the middle of Paris. Tourists climb or take an elevator to the top. Another attraction in Paris is Jim Morrisons grave. Many people come to pay tribute to this very influential poet and rock star. England is also a popular place for tourists to go. Buckingham Palace is one of the most famous places in Great Britain. The Queen of England resides here, along with her other royal blood relatives. The Guards are perhaps the most famous at Buckingham Palace, for they never move. Tourists will go up to them, but the guards never even blink. Ragdale Hall was established in the 1970s as a business which offers customers the opportunity to experience health, beauty, and fitness treatments. It has had many alterations made in the last twentyShow MoreRelatedEssay about Summary of History of Graphic Design by Meggs14945 Words   |  60 Pagesfor what would be the first spokenlanguage. - Cuneiform – Wedged shaped writing, created in 3000BC. Started as pictographs. - With the discovery of cuneiform, there was a knowledge explosion, where libraries were organized filling with tablets about religion, mathematics, and history. Writing enabled society to stabilize itself, and laws were created. - Two by-products of the rise of village culture were the ownership of property and the specialization of trades. - Egyptians used hieroglyphicsRead MoreMetz Film Language a Semiotics of the Cinema PDF100902 Words   |  316 PagesPhilosophy. I. Title. PN1995.M4513 1991 791.43 014—dc20 90-46965 C1P The French edition of Christian Metz s Essais sur la signification au cinema, volume 1, was published by Editions Klincksieck in 1971,  © Editions Klincksieck, 1968. ÃŽËœThe paper used in this publication meets the minimum requirements of the American National Standard for Information Sciences-Permanence of Paper for Printed Library Materials, ANSI Z39.48-1992. To George Blin, Profesor at the Collà ¨ge de France, whithout whom none of theseRead MoreMarketing and E-commerce Business65852 Words   |  264 Pagesreproduced, with permission, in this textbook appear on page C-1. Microsoft and/or its respective suppliers make no representations about the suitability of the information contained in the documents and related graphics published as part of the services for any purpose. All such documents and related graphics are provided â€Å"as is† without warranty of any kind. Microsoft and/or its respective suppliers hereby disclaim all warranties and conditions with regard to this information, including all warrantiesRead MoreDeveloping Management Skills404131 Words   |  1617 Pages10/12 Weidemann-Book Credits and acknowledgments borrowed from other sources and reproduced, with permission, in this textbook appear on appropriate page within text. Copyright  © 2011, 2007, 2005, 2002, 1998 Pearson Education, Inc., publishing as Prentice Hall, One Lake Street, Upper Saddle River, New Jersey 07458. All rights reserved. Manufactured in the United States of America. This publication is protected by Copyright, and permission should be obtained from the publisher prior to any prohibited

Influence Of Organizational Culture On Corporate Performance

support the proposition that organizational culture is found to be a filter through which leadership influences various performance outcomes. Human Resource Management Organizational culture affects corporate performance. Corporate culture is a deeply embedded form of social control that influences employee decisions and behavior. Culture is persistent and operates unintentionally. It is an automatic pilot directing employees in ways that are consistent with organizational expectations. Corporate culture assists the sense-making process. It helps employee understand organizational events. Employee can communicate more efficiently and reach higher level of cooperation with each other because they share common mental models of†¦show more content†¦Human Resource requires administrator to compare job titles, skill levels together with the culture of work and remuneration to determine the contributions employees with different jobs and titles make towards accomplishing company objectives. Human resources management considers internal consistency when determining pay rates for employees who do the same work and employees who do different works in accordance with the culture on ground in the organization. The internal consistency depends on how a company is structures reflect the structure and culture of the organization. The pay structure of an organization is its range of pay rates for different jobs and skill levels within the organization (Barney, 1986). Company’s culture factors are social customs, job requirements, employee acceptance, employee knowledge and skills. The social customs of an organization do not determine wages only but the current notion of federally mandated minimum which evolve from the employee demanding a just wage which always go with the remuneration culture of the organization. The organizational culture has a positive relationship with the human resource management. 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