Description
NURS 540 Week 6 Discussion 1 Responses
Research question: particularly in the early phases of admission for people with dementia. A thorough investigation of the potential reason causing fall events in this population’s initial three days of access. In the first three days after entry, patients with dementia residing in skilled care facilities are more likely to experience falls due to multiple factors. By identifying these variables, nurse interventions and practices may be created to reduce the risk of falls and enhance patient safety in the critical first few days after admission.
Quantitative test: “Descriptive statistics summarize the sample being studied without drawing any inferences based on probability theory. Even if the primary aim of a study involves inferential statistics, descriptive statistics are still used to give a general summary when we describe the population using tools such as frequency distribution tables, percentages, and other measures of central tendency like the mean,” Kaliyadan & Kulkarni (2019).
Descriptive statistics are appropriate for my research because by doing simple statistical calculations for data about the patient with a history of falls within the first three days of admission, age 65 y/o and above with a diagnosis of dementia with environmental factors, such as determining the mean, median, and standard deviation. This will make it easier to see the general data and any potential patterns or outliers.
For my research study on Hypertension Management with a Digital/Home-based Intervention, data will be analyzed using a longitudinal analysis of covariance method. According to Twisk et al. (2018), longitudinal analysis of covariance can be applied to randomized controlled design examining data from a systolic blood pressure lowering treatment over time. In my study, I will be using a randomized controlled design comparing an intervention group (Group A) and a control group (Group B), and gathering data at 3-months, 6-months, 9-months and 12-months. An advantage of using a longitudinal analysis of covariance method over a repeated measures methods is that with the longitudinal analysis of covariance, an adjustment is made for the baseline differences. When I begin determining my design I considered an ANOVA or t-test method, however with more research I realized these methods would not be suitable. An ANOVA is used to analyze data for three or more groups and a t-test method would be too simple for my research design, as I have longitudinal data at multiple points in time.
NURS 540 Week 6 Discussion 2 Responses
In my study there will be a quantitative portion and qualitative portion to collecting data. In the quantitative portion of the study there will be data collected that reflects whether adding hand washing stations, adding education, and adding hand washing check offs will decrease the amount of hospital acquired infections. In this study the independent variable is the interventions presented to increase the occurrence of proper hand washing. The dependent variable is whether the patients avoid acquiring an infection in the hospital and the rate of participation by employees. The hypothesis is that adding interventions like the ones presented will increase hand hygiene. and decrease hospital acquired infections. The null hypothesis is whether a patient gets an infection despite all precautions be taken.
Research question: In hospitalized patients with acute exacerbation of congestive heart failure, does early administration of intravenous diuretics compared to delayed administration result in shorter hospital stays within a 48-hour timeframe?
Independent variables: Timing of diuretic administration
Dependent variable: Hospital length of stay
Research hypothesis: Patients who receive early administration of intravenous diuretics for acute exacerbation of congestive heart failure will have significantly shorter hospital stays within a 48-hour timeframe compared to patients who receive delayed administration.
Null hypothesis: There is no significant difference in hospital stay length within a 48-hour timeframe between patients who receive early administration of intravenous diuretics and patients who receive delayed administration for acute exacerbation of congestive heart failure.
NURS 535 Week 6 Discussion 1 Responses
Consider some of the challenges that clinical instructors can face.
Nursing education is a blend of theoretical knowledge and clinical practice. Since nurses play a crucial role in healthcare settings, they should be adequately trained for clinical fields through efficient and adequate education (Gaber et al., 2019). From the video, it is clear that an instructor’s job is not easy. The instructor assigns every student a preceptor to guide them in their clinical journal. A set of instructions is also given to the student. These instructions help guide a preceptor on what they should focus on in the clinical setting. In this case, however, the preceptor ignores the student along with the instructions meaning that the student is not given an opportunity to learn. The result is that the instructor is frustrated as it is clear no assistance is given to her in her teaching role.
What strategies can clinical instructors use to overcome the following challenges:
1) Time pressures: Instructors can prioritize learning objectives by identifying the most critical learning objectives for each clinical rotation and focusing on achieving those during the limited time. Additionally, instructors can assign pre-clinical readings to ensure students arrive prepared for clinical.
2) Fewer patients: Instructors can use simulation and skill labs to provide hands-on practice even in situations where there are fewer patients.
3) Shorter hospital stays. Instructors can seek opportunities for clinical rotations in different healthcare facilities to expose patients to various patients and conditions.
4) Limited availability and variety of learning opportunities: Instructors can collaborate with healthcare facilities to expand the range of learning opportunities available to their students.
5) The varied needs and abilities of students. Instructors can develop individualized learning plans for their students based on their needs and abilities. This approach would ensure that every student receives appropriate support and challenges.
There are many issues with the scenario. Students may feel frustrated and cheated by their clinical experience if they are ignored in their rotation for many reasons including time pressure, fewer patients, shorter hospital stays, and limited availability and learning opportunities. Therefore, the faculty need to overcome these challenges to help students actively participate in clinical practice. Here are some strategies that clinical instructors can use in the following situations:
Time pressures: To overcome this obstacle, the instructor needs to set priorities, learning objectives, and create schedules which promote the students’ learning experience. Important clinical activities should be identified and focused on if the time is limited.
Fewer patients and shorter hospital stays: if patients have shorter hospital stays or there are not many patients for students to take care of and learn, the instructor can make up for this situation by case studies and simulations. Case studies can help students explore common real-world problems and management that they may encounter in their future practice. Simulation labs with advanced equipment and learning tools can mimic real-world clinical situations. This allows students to practice their critical thinking and problem-solving skills without relying only on actual patients. Moreover, if possible, the instructor should have students take care of patients at the early stages of hospitalization, so students can have more learning opportunities in case patients have short hospital stays.
Limited availability and variety of learning opportunities: if the clinical rotations do not offer adequate learning opportunities, the instructor can help students to explore more outside resources such as labs, simulations, case studies, online materials, videos, etc. The faculty can reach out to the hospital educators to help students access to training resources that the hospital provides for its employees.
The varied needs and abilities of students: to develop teaching strategies which fit the variety of needs and learning abilities for students, first, the instructor needs to incorporate multiple teaching methods which benefit different learning styles of the students. Each student should be carefully evaluated after their clinical day to develop an individualized learning plan based on their strengths and weaknesses. Moreover, each student should receive honest and supportive feedback on their performance and assistance to maximize their learning abilities.
NURS 535 Week 6 Discussion 2 Responses
The role of a learning resource center has historically been to provide nursing students with the opportunity to observe and practice in a simulated environment. Today’s mostly millennial student population prefers to work in groups and in a collaborative setting. LRCs provide these attributes in a supportive and non-threatening atmosphere (Gaberson, et al., 2014). The LRC is a technologically advanced learning environment where learners gain abilities through visual, auditory, kinesthetic, and tactile modalities. This supports the acquisition of cognitive, affective, and psychomotor skills (Hodson-Carlton, n.d.). Nursing psychomotor skills can be divided into fine, manual, and gross. Fine motor skills used for precise tasks. While manual motor skills are tasks that require manipulation and repetition. Gross motor skills involve large muscle groups and require more movement (Hodson-Carlton, n.d). Fine/manual psychomotor skills such as Peripheral IV starts and gross motor skills such as patient transfer or mobilization are great examples of skills that can be beneficial to master with the help of an LRC resource prior to patient contact. Peripheral IVs can be intimidating to an inexperienced nursing student. Allowing ample time for simulation can provide muscle memory and comfort level prior to the student attempting a PIV start on a live patient. Utilizing simulation can also be helpful with patient mobility and transfers. This not only will improve patient safety but also help the student learn and maintain proper body mechanics ensuring their own safety. Learning resource coordinators oversee the equipment, security, technology, and facilities of the center. They manage appointments and skills labs, provide study rooms or sessions for students, and remain current are technology. Nursing educators can collaborate with LRC coordinators on content, skill acquisition and best methods to ensure that patient safety, evidence-based practice, self-confidence, and intradisciplinary communications are being effectively taught (Hodson-Carlton, n.d.).
Psychomotor skills are crucial in nursing, given our hands-on nature and the numerous procedures we perform. I’d like to address two specific skills: performing BLS/ACLS and conducting clinical exams on patients. The Learning Resource Center (LRC) plays a vital role in preparing nursing students to excel in these competencies. Indeed, knowledge and simulation labs stand out as the most effective resources for achieving this goal.
Concerning BLS/ACLS, as a clinical instructor for this course, I would collaborate with the LRC personnel to create a comprehensive BLS/ACLS algorithm for nursing students. This would enable them to review and familiarize themselves with the algorithm before the courses commence. Additionally, mastering BLS/ACLS requires repetition. Therefore, it is beneficial for students to practice repeatedly with diverse clinical scenarios that involve applying the algorithm. Given that BLS/ACLS heavily relies on teamwork, it’s crucial to have students divide into small groups of 4-5, each assuming a specific role (leader, chest compression, airway, medication). This approach greatly facilitates the learning process. It’s worth noting that many simulation labs now feature manikins capable of assessing the quality of CPR, which adds an extra layer of realism. Lastly, I intend to request the LRC to produce pocket-sized versions of the algorithm, allowing nursing students to carry it in any clinical setting. This way, they will always be prepared to respond to a code-blue situation.
Learning how to conduct thorough physical exams is a pivotal aspect of a nursing career. The LRC can provide valuable clinical information to help students differentiate between normal and abnormal examination findings. Furthermore, simulation labs can enhance the learning experience by offering a variety of resources to familiarize students with different abnormal signs in physical examinations. The role of instructors in this context cannot be overstated, as students tend to emulate the skills and knowledge imparted by their teachers. It’s important to acknowledge that proficiency in clinical examination skills is a gradual process, honed over years of practice. Hence, instructors should offer unwavering support and comprehensive guidance to instill confidence and foundational knowledge in their students before they embark on their clinical journey.
In summary, proficiency in all medical skills requires dedicated practice and repetition. Therefore, the LRC plays a pivotal role in establishing the fundamental knowledge and skills required by nursing students. Through collaboration with the LRC, we can lay a strong groundwork for our students, equipping them to excel in their nursing careers.
