Kerry Standley, BSN, RN
East Carolina University
College of Nursing
NURS 6002
NURS 6002
E-Portfolio
Thursday, April 25, 2013
Module 1 - Who Moved My Cheese?
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Collins, J. (2009). Lifelong learning in the 21st century
and beyond. Radiographics, 29(2), 613-622.
doi:10.1148/rg.292085179
Synthesis: This article was very helpful with identifying the personality traits of successful lifelong learners as well as suggested ways to overcome roadblocks to learning. The necessary benefits of lifelong continuing education are also discussed including avoiding complacency with treatments and techniques and staying up to date on new material. Tips for motivating learners and various educational methods discussed including seminars, online or written CME credits, hands on learning labs and secondary specialization certification.
Rating - 3 This article was focused more toward physicians than nurses, but otherwise a good resource.
Synthesis: This article was very helpful with identifying the personality traits of successful lifelong learners as well as suggested ways to overcome roadblocks to learning. The necessary benefits of lifelong continuing education are also discussed including avoiding complacency with treatments and techniques and staying up to date on new material. Tips for motivating learners and various educational methods discussed including seminars, online or written CME credits, hands on learning labs and secondary specialization certification.
Rating - 3 This article was focused more toward physicians than nurses, but otherwise a good resource.
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Johnson, S. (2002). Who moved my cheese? An amazing way to deal with change in your work and
in your life. New York: Putnam.
Synthesis: This book was very interesting as I quickly found myself identifying with one of the characters and labeling other people I knew as well. Seeing how the mice responded to the change in their environment from an outside and still humorous perspective made seeing my own similar behaviors a little less painful. In fact, I found myself predicting how the characters would respond to each new challenge. This book would be very useful for team building activities as well as staff retention material, to help staff members that are having difficulty dealing with major change in the workplace.
Rating - 3 This book was entertaining, but somewhat predictable, might be viewed as childish by some.
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Kirkpatrick, M., Esterhuizen, P. (2013). Globalization: Fusing 21st century, intercultural/global and
global leadership competencies in nursing education [Powerpoint slides]. Retrieved from
www.blackboard.ecu.edu
Synthesis: I found myself quite shocked after reading this Powerpoint, especially as the mother of three teenagers. With a whopping 81% of high school graduates displaying deficiencies in written communication, it is no wonder that many workplace are in shambles. Critical thinking skills are not exclusive to nursing, yet children are not routinely taught such skills in school. Additionally, by incorporating cultural competence into early curriculum, the next generation will hopefully be more culturally sensitive and understanding. With the world becoming a smaller place every day, it is essential that the caregivers of tomorrow understand the world they live in.
Rating - 4 The information regarding how employers see the upcoming job force and the skills that they are lacking was quite eye opening.
global leadership competencies in nursing education [Powerpoint slides]. Retrieved from
www.blackboard.ecu.edu
Synthesis: I found myself quite shocked after reading this Powerpoint, especially as the mother of three teenagers. With a whopping 81% of high school graduates displaying deficiencies in written communication, it is no wonder that many workplace are in shambles. Critical thinking skills are not exclusive to nursing, yet children are not routinely taught such skills in school. Additionally, by incorporating cultural competence into early curriculum, the next generation will hopefully be more culturally sensitive and understanding. With the world becoming a smaller place every day, it is essential that the caregivers of tomorrow understand the world they live in.
Rating - 4 The information regarding how employers see the upcoming job force and the skills that they are lacking was quite eye opening.
_________________________________________________________________________________Kirkpatrick, M. (2013). Self directed (regulated) learning. [Powerpoint slides]. Retrieved from
www.blackboard.ecu.edu
Synthesis: This presentation was a good self assessment tool for gauging the readiness of an independent self directed learner. Even outside the formal learning environment, nurses are expected to continue learning activities as related to daily practice. Nurses must be motivated and disciplined for such an activity to be successful, especially when juggling work and other life obligations.
Rating - 4 This was a very good self assessment tool for people to asses their capability for self directed learning.
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Reflection
This week's readings included an insightful book called Who Moved My Cheese? which uses mice to portray people experiencing change in their lives. These mice, when presented with a change in their routine and lives, each react differently. By helping the reader to identify with their own responses to change, the author gives visualization to how maladaptive behaviors hinder professional growth. The other articles present insight into the traits of a motivated, self directed learner and ways to encourage this to continue.
Module 2 - Systems Theory
Systems Theory
Resources
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AHRQ-Agency for Healthcare Research and Quality. (2009). 10 patient safety tips for hospitals.
AHRQ Publications No.08-POO3. Retrieved from http://www.ahrq.gov/qual/10tips.htm
Synthesis: This is a must read, essential article for any healthcare worker, from administration to bedside caregiver to read as it deals with the most common safety risks faced by patients in a hospital and how workers can help minimize these risks. All caregivers and non caregivers should be keeping the patient's safety at the top of the priority list.
Rating - 4 Contains essential, informative information for all healthcare workers, bedside caregiver or
not.
Jones, B.L. (2002). Systems Theory. [PowerPoint slides]. Jones Health Care Consulting for
the National Consortium on Health Science and Technology Education. Retrieved from
www.blackboard.ecu.edu
Rating - 4 Contains a great deal of essential information in a simple to understand format.
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Joynt, J., & Kimball, B. (2008). Innovative care delivery models: Identifying new models
that effectively leverage nurses. Retrieved from Health Workforce Solutions LLC:
Synthesis: This article is more geared toward advance practice nurses and the roles they play in cost saving measures and leading improvements in patient care, even bringing care beyond the walls of the hospital and into the patient home. A good read for information on new trial models of patient care being investigated and developed.
Rating - 2 Informative, but very little information readily useable for most practicing caregivers.
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Pfeffer, J., Sutton, R.I. (2006). Evidence based management. Harvard Business Review.
1-13. Retrieved from blackboard.ecu.edu
Rating - 2 Information overload, very little relevant medical information.
_________________________________________________________________________________ Reflection:
Systems theory explains the systematic pattern of healthcare services and the feedback loop that reinforces the ongoing activity. By understanding each step of the process, the provider can better understand where processes are breaking down, have failed or are succeeding.
Module 4 - Healthcare Organizations
Healthcare Organizations
Resources
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Global Health Council. (2008). Understanding health systems. Retrieved from
http://issuu.com/globalhealthcouncil/docs/2008_hs_intervention/1
Synthesis: This article explains the WHO defined 6 components needed to establish, strengthen and sustain a healthcare system.
Rating - 3 Good basic information, but addresses the important worldwide challenges in healthcare.
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IOM (Institute of Medicine). (2007). The Learning Healthcare System: Workshop Summary.
Washington, DC: The National Academies Press.
Synthesis: This in depth summary discusses the integration of science, informatics, incentive and culture to create a learning environment that is constantly adapting and adjusting to improve the quality of patient care.
Rating - 4 A great deal of information to read, but a very educational summary.
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IOM (Institute of Medicine). (2011). Patients charting the course: Citizen engagement in the learning
health system: Workshop summary.Washington, DC.The National Academies Press
Synthesis: This in-depth workshop summary describes the methods used to create a learning culture revolving around patient centered care. With several common themes seen in other articles such as culturally tailored interactions, listening to patients without interrupting and providing transparent, trustworthy care.
Rating -4 In-depth with good, detailed information.
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Kirkpatrick, M. (n.d.) People, patient, person, culturally client centered care. [Powerpoint slides].
Retrieved from www.blackboard.ecu.edu
Synthesis: This presentation reinforces the importance of client centered, culturally competent care, also focusing on people, patient centered care.
Rating - 4 Good information with several suggestions for providing CLAS appropriate care.
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Mason, A., & Barton, A. (2013). The emergence of a learning healthcare system. Clinical Nurse
Specialist: The Journal For Advanced Nursing Practice, 27(1), 7-9.
doi:10.1097/NUR.0b013e3182776dcb
Synthesis: A short article describing the use of modern computer based electronic health record technology to capture large amounts of patient data and extrapolate information.
Rating - 3 Short but simple and informative article.
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Shi, L. & Singh, D. (2004). Delivering healthcare in america, a systems approach. Jones & Bartlett
pub.
Synthesis: This article is a single chapter of an entire book dedicated to understanding healthcare in America. Beginning with an in depth background review of the various branches of providers and payers, leading into the obstacles to obtaining healthcare, this article gives the reader a primer in United States healthcare.
Rating - 4 An excellent foundation of US healthcare history.
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Reflection
In order to work in healthcare, you must understand how it works. Providers with limited exposure to other types of patients should review the information on current branches and types of healthcare available, as well as always stay abreast of evolving changes in legislature.
Module 6 - Healthcare Costs and Financial Management
Healthcare Costs and Financial Management
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Resources
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Florida Nurses Association. (2008). Advanced practice nurses: Improving access to healthcare and
containing costs. Retrieved from www.blackboard.ecu.edu
Synthesis: This article explores how advance practice nurses working in the role of physician extender can help expand healthcare services to rural, underserved areas and populations. Additionally, the article explores the current legal barriers in place, some of which are unique to the state of Florida, that prevent Nurse Practitioners from practicing at their full potential. These barriers represent a slow reluctance to update and change legislation to follow current national trends in the role of advance practice nurses.
Rating - 4 Very informative for any nurse planning on a career as a nurse practitioner.
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Institute for Healthcare Improvement. (2009). Increasing efficiency and enhancing value in health care:
Ways to achieve savings in operating costs per year. Retrieved from www.blackboard.ecu.edu
Synthesis: This article discusses several focused areas of cost saving, many of which are focused on patient satisfaction and waste reduction methods. With a strong accounting component prevalent throughout the entire article, this may be of more interest to CFO/CNO as compared to APN or bedside nurse.
Rating - 3 Lots of information, but may be more appropriate for financial leaders in nursing.
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containing costs. Retrieved from www.blackboard.ecu.edu
Synthesis: This article explores how advance practice nurses working in the role of physician extender can help expand healthcare services to rural, underserved areas and populations. Additionally, the article explores the current legal barriers in place, some of which are unique to the state of Florida, that prevent Nurse Practitioners from practicing at their full potential. These barriers represent a slow reluctance to update and change legislation to follow current national trends in the role of advance practice nurses.
Rating - 4 Very informative for any nurse planning on a career as a nurse practitioner.
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Institute for Healthcare Improvement. (2009). Increasing efficiency and enhancing value in health care:
Synthesis: This article discusses several focused areas of cost saving, many of which are focused on patient satisfaction and waste reduction methods. With a strong accounting component prevalent throughout the entire article, this may be of more interest to CFO/CNO as compared to APN or bedside nurse.
Rating - 3 Lots of information, but may be more appropriate for financial leaders in nursing.
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Stanton, M., Rutherford, M. (2002). Reducing costs in the health care system: learning from what has
been done. Agency for Healthcare Research and Quality. Research in Action Issue 9. AHRQ Pub.
No. 02-0046.
Rating - 2 Informative, but material has limited use in acute patient care.
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[Powerpoint slides]. Retrieved from www.blackboard.ecu.edu
Synthesis: This article explores methods of cost control and quality improvement tactics that have been tried within the Henry Ford Health System and discusses the outcomes. Though some of the projects returned a financial improvement, the incentives do not pay for improved quality of care, thus not changing patient outcomes significantly.
Rating - 3 A short, yet interesting read, though large amount of the data is greater than 7 years old.
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World Health Organization. (2010). Health system financing. The path to universal coverage. Retrieved
Synthesis: This article discusses the World Health Organization's stance on universal health coverage and the barriers preventing the implementation of such a plan. The article provides easy to understand information regarding the three main challenges to be overcome by national governments before they can offer equal, universal coverage for all individuals.
Rating - 3 An easy to comprehend article discussing one of the hot topics of both the political platforms.
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Reflection
This week's module focused on healthcare costs and the role advanced practice nurses play in controlling those costs. After reviewing several various resources, a consistent positive relationship between costs and the advance practice nursing became apparent. In the role of physician extenders, APN's provide quality, affordable care to patients who might otherwise not have access to a provider at all. In the role of clinical nurse specialist, advance practice nurses can expertly coordinate care with both patient outcome and financial responsibility in mind.
Module 10 - Cultural Competence Healthcare Literacy
Cultural Competence and Healthcare Literacy
Resources
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Beach, M. (n.d.). The intersection of health literacy, cultural-competency,
and patient-centeredness for quality improvement. [Powerpoint presentation]. Retrieved from
www.blackboard.ecu.edu.
Synthesis: This presentation discusses the concept of patient centered care and how in theory, patient centered care would follow suit and be culturally competent care. Yet, all too often there remains a lack of full cultural understanding. The presentation discusses points to consider when educating staff on providing culturally competent care.
Rating - 3 Good information, but the tiles overlap and are difficult to read.
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Kirkpatrick, M. (n.d.). Health literacy. [Powerpoint presentation]. Retrieved from
https://blackboard.ecu.edu
Synthesis: This presentation discusses the statistics related to low health and language literacy, methods for assessing literacy levels and federal guidelines for providing culturally and linguistically appropriate healthcare services. Additionally, the actions caregivers can take to bridge the language gap are discussed.
Kirkpatrick, M. (n.d.). Health literacy. [Powerpoint presentation]. Retrieved from
https://blackboard.ecu.edu
Synthesis: This presentation discusses the statistics related to low health and language literacy, methods for assessing literacy levels and federal guidelines for providing culturally and linguistically appropriate healthcare services. Additionally, the actions caregivers can take to bridge the language gap are discussed.
Rating - 4 Good review of broad array of literacy issues.
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The Joint Commission.(2007). What did the doctor say?Improving health literacy to protect patient safety. Retrieved from www.blackboard.ecu.edu
Synthesis: This article gives several extensive examples demonstrating where patients can get lost in a sea of confusion from low health literacy, worsened by a healthcare system that often limits patient interactions with their doctor to 15 minutes or less. Methods to increase patient understanding such as using layperson terms and verbal teach back are also discussed.
Rating - 4 Very good article that personalizes the patient point of experience.
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Reflection
Patients cannot be expected to follow instructions if they did not or cannot understand them. Effective communication is essential to all steps of the healthcare process. Providers must utilize any and all necessary tools to ensure that the information they are giving to the patient is understood, as the patient's very life may depend on it.
Module 11 - Cultural Competence and Civility
Photo credit: Impactednurse.com
Cultural Competence and Civility
Resources
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Clark, C. M., & Springer, P. J. (2010). Academic nurse leaders role in fostering civility in nursing
education. Journal of Nursing
Education, 49(6), 319-324.
Synthesis: After reading this article, I was very surprised to discover the degree of hostility in nursing school, not just among the students but involving faculty as well. While any nurse will attest to the overwhelming stress level of nursing school, there remains no excuse for such behaviors. Despite awareness of the trend, the incidents of incivility are still on the rise. Several good techniques for dealing with and preventing such incivility are reviewed and follow up actions are discussed as well.
Rating - 4 All nurses, students and educators should read this and become informed of this shameful, yet escalating trend.
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Ferriss, Abbott L. (2000). ‘‘Civility as a Sociological Concept.’’ Paper presented at the annual
Synthesis: After reading this article, I was very surprised to discover the degree of hostility in nursing school, not just among the students but involving faculty as well. While any nurse will attest to the overwhelming stress level of nursing school, there remains no excuse for such behaviors. Despite awareness of the trend, the incidents of incivility are still on the rise. Several good techniques for dealing with and preventing such incivility are reviewed and follow up actions are discussed as well.
Rating - 4 All nurses, students and educators should read this and become informed of this shameful, yet escalating trend.
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Ferriss, Abbott L. (2000). ‘‘Civility as a Sociological Concept.’’ Paper presented at the annual
meeting of the Mid-South Sociological
Association, Knoxville, TN
Synthesis: This article utilizes survey questions to assess if civility is on the decline among general members of society. After reviewing 3 decades of information, the author concludes that there was a small but measurable decrease in civility over the last 30 years.
Rating - 2 An interesting survey and data collection method, but information is purely subjective.
Synthesis: This article utilizes survey questions to assess if civility is on the decline among general members of society. After reviewing 3 decades of information, the author concludes that there was a small but measurable decrease in civility over the last 30 years.
Rating - 2 An interesting survey and data collection method, but information is purely subjective.
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Joint Commission (2008). Behaviors that undermine a culture of safety. Retrieved from http://www.jointcommission.org/assets/1/18/SEA_40.PDF
Synthesis: When Joint Commission releases a statement on disruptive behavior in healthcare, it cannot be ignored. This article discusses several ways incivility and disruptive behavior puts patients safety at risk and decreases employee satisfaction. Additionally, methods for addressing and countering such behaviors are discussed with reminders that retaliation for reporting bullying behavior is considered a form of incivility.
Rating - 4 A must read for all, should be mandatory in nursing school and new employee training.
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Stokowski, L. (2010). A matter of respect and dignity: Bullying in the nursing profession.
Retrieved from http://www.medscape.com/viewarticle/729474_1
Synthesis: Bullying in nursing can take many forms, from overt aggressive behavior such as verbal altercations down to subtle, passive aggressive actions such as ignoring an employee or hiding/hoarding supplies. Both forms are similarly destructive to employee morale and retention. This article discusses the role leadership holds and their obligation to counsel individuals who engage in such behaviors as well as set clear rules that such actions will not be tolerated and will be dealt with accordingly.
Rating - 4 Another must read for all levels of healthcare providers, not just nurses.
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Reflection
This module was very profound for me as I have all too often seen firsthand episodes of bullying and incivility among healthcare workers. Such behavior is very detrimental to the morale of staff members and can lead to increased employee turnover, poor teamwork within the unit and increased absenteeism. In fact, I can personally relate to one nurse who utilized such behaviors to intimidate new nurses into doing extra work she would have otherwise have had to do. While I knew that my hospital had a disruptive behavior policy in place, I had no idea it originated from a Joint Commission position statement. I also did not realize that bullying occurred in nursing school to the degree that it does. I was very fortunate to have not experienced that firsthand, but after reading the material I decided to make a point of speaking with other nurses and many had horrible stories about just such behavior in nursing school. One nurse said she even went as far as to transfer to another program because she simply could not tolerate it. While I had always heard the phrase "Nurses eat their young" I had no idea it began at such an early place in careers. Since this module, I have made it a point to monitor how new employees and students are treated in our office as it really opened my eyes to how some healthcare workers are treated.
Fenway Modules
Fenway Institute Modules
Resources
The Fenway Institute. (2012). The national LGBT health education center learning modules. Retrieved
from http://www.lgbthealtheducation.org/training/learning-modules/
Synthesis
After reading the Fenway Modules, I learned several things that I have since incorporated into my daily practice. As my oldest daughter is gay, I have always considered myself an open minded and accepting individual and healthcare worker. Yet, I realized that my interview techniques might not come off quite as good as I had perceived them to be. For example, historically, I had been asking closed ended questions such as "Are you married?"instead of more LGBT sensitive questions such as "Are you in a relationship with someone?"
Additionally, I had never heard of co-parent adoption before reading the modules. Thanks to a dear friend, I was always aware of some of the challenges LGBT parents face, but I had no idea that some states prohibited adoption, but yet would allow fostering.
Finally, the most important thing I took away from the modules was how easily an individual's HIPPA could be violated with a simple ICD-9 code. I had never thought about how easily a parent can access a teenager's medical information via insurance carriers. This point seems to stress the need for more confidential, anonymous clinics where young people can go for any reasons without fear of backlash from parents who are not open to their identity.
Reflection
As society evolves, so must those caring for members of society. While openly racial discrimination would never be tolerated today, unfortunately similar discrimination against LGBT individuals is often tolerated and viewed as humorous. This behavior cannot be tolerated and it is the responsibility of all healthcare workers to monitor and report any such behavior while teaching the next generation to reach for greater acceptance.
Additionally, I had never heard of co-parent adoption before reading the modules. Thanks to a dear friend, I was always aware of some of the challenges LGBT parents face, but I had no idea that some states prohibited adoption, but yet would allow fostering.
Finally, the most important thing I took away from the modules was how easily an individual's HIPPA could be violated with a simple ICD-9 code. I had never thought about how easily a parent can access a teenager's medical information via insurance carriers. This point seems to stress the need for more confidential, anonymous clinics where young people can go for any reasons without fear of backlash from parents who are not open to their identity.
Reflection
As society evolves, so must those caring for members of society. While openly racial discrimination would never be tolerated today, unfortunately similar discrimination against LGBT individuals is often tolerated and viewed as humorous. This behavior cannot be tolerated and it is the responsibility of all healthcare workers to monitor and report any such behavior while teaching the next generation to reach for greater acceptance.
Appendix - Certificates
Certificates of Completion
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| Cartoon credit: Bill Watterson |
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