Peer responses NURS 6052
Stephanie Kachin
RE: Discussion – Week 4
COLLAPSE
The clinical area of interest I choose to research is related to medication errors and patient allergies. Medication errors are still a common occurrence I have noticed through my years of nursing. Surprisingly, I feel a decent amount occurs because a nurse administered a patient a medication without verifying their allergy first. The most interesting article I found talks about inquiring if patient allergies need to be incorporated into medication rights with every patient administration. (Martel, M. (2019). As a labor and delivery nurse, widespread practice is the insertion of a foley catheter once the patient gets an epidural. Numerous times I have seen or heard of cases where a patient had a latex allergy but still had a latex Foley catheter inserted instead of a latex-free catheter. Even though latex is not a medication, it is still present in numerous medical supplies we use today; depending on the allergy severity, inserting a catheter with this allergy could have harmful consequences.
My clinical inquiry is related to medication errors and patient allergies. I notice it is common for us nurses to ask a patient’s allergies once just in admission then forget to verify later in the patient’s stay. I have also noticed that sometimes patients are nervous on admission and may fail to mention an allergy right away. Does added nurse verification of patients’ allergies before every medication administration and latex procedure on the inpatient labor floor decrease medication errors compared to not verifying allergies with every medication administration? Will a decrease in medication errors related to patient allergies occur over a one month evaluation period? The first search database in my search is Medline full text. I first typed in medication errors and patient allergies and got no results. When I changed my terms to medication errors and drug allergies, I retrieved 30 articles from the search engine. To make my search more useful, I changed my date range within the past five years and made sure I clicked peer-reviewed articles to narrow my search. My next two research articles I found related to my interest topic came from CINAHL plus full text. For this search, I used medication errors and patient allergies, and 15 articles resulted. The final database I searched was Embase, and my initial search gave me 183 articles. At first, I just used the terms of patient allergies and medication errors. When I clicked my time frame to past five years and peer-reviewed, my selection decreased quite a bit too roughly 25 articles.
In conclusion, a strategy to improve effectiveness in formulating a PICOT question is patience. PICOT questions are essential for developing relevant problems for clinical inquiry.
References
Martel, M. (2019). Should allergy status be included as a medical administration, right? British journal of medication errors and drug allergies. Nursing 28(20), pp1-15.
Kabakov, Anna; Rhodes, Nathaniel; Wenzel, Richard (2019). Discrepancies between patient self-reported and electronic health record documentation of medication allergies and adverse reactions in acute care settings: a room for improvement. Journal of pharmacology technology. 35(4), pp 139-145.
Harig, A; Rybarczyk, A; Benedict, A; Zimmerman, J (2018). Clarification of drug allergy information using a standardized drug allergy quest and interview P&T: a peer-reviewed journal for managed care and formulary management. 43(8), pp 480-504
Pfister, E; Oenem, E., Tevesta, V; Mayor, S.; Dohse, K; Krotesch, U (2018). Drug allergy and potential inappropriate mediation in hospitalized patients. Internal Journal of clinical pharmacy. 40(1) pp 275-276.
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1 day ago
B
rian Mohler
RE: Discussion – Week 4
COLLAPSE
Post a brief description of your clinical issue of interest
Time is of the essence. This statement is of critical importance in the emergency departments (ED). ED overcrowding is a significant worldwide issue. The extended length of stays (LOS) can affect the overall quality of care and be a
significant safety issue for critical patients. According to Chaisirin et al. (2020), ED delays can lead to higher morbidity or mortality among patients. Delays such as waiting for antibiotics for pneumonia or an EKG for a patient with chest
pain can lead to poor outcomes. How to reduce wait times and overall LOS in the ED? This topic has been researched numerous times by health care management, but often the research falls short of the intended expectations.
Describe your search results regarding the number of articles returned on original research and how this changed as you added search terms using your Boolean operators.
In my original search, I used the EBSCO host and chose the CINAHL Plus with Full Text. I typed in “How to reduce wait times in the emergency department” with the Boolean expander highlighted. Unfortunately, this search
yielded no results. Because of this, I went back and unhighlighted the Boolean expander and highlighted the “find any of my search terms.” This produced many more articles. After reviewing information from a webpage from the
Library of Congress (n.d.), I highlighted the Boolean expander again but changed my search terms. I used “reducing emergency department wait times OR length of stay.” This produced much better results. I was able to find eight peer-
reviewed articles for my research.
For my second search, I utilized the Ovid database. I typed in the keywords “reducing emergency department times or length of stay.” This produced favorable results. Ovid found 226 articles matching my search terms.
Unfortunately, though, I could not locate any filters to help narrow my search down. However, I was able to find four high-quality articles for research purposes on my topic.
Finally, explain strategies you might make to increase the rigor and effectiveness of a database search on your PICO(T) question. Be specific and provide examples.
The following strategies to increase the strength of the database searches were identified by Stillwell, Fineout-Overholt, Melnyk, and Williamson (2010):
1. Combining search terms using Boolean connectors such as AND, OR, and NOT. An example was adding “OR” to my search for “reducing emergency department wait times OR length of stay.” This yielded more manageable results.
2. Placing limits to narrow the search can be helpful. I utilized limits for English only and dated peer-reviewed articles only.
3. Choosing keywords from the PICOT question. In my search, I used the keywords “reducing” and “emergency department” in my original search. However, once I added length of stay, my search produced better results.
References
Chaisirin, W., Wongkrajang, P., Thoesam, T., Praphruetkit, N., Nakornchai, T., Riyapan, S….Chakorn, T. (2020). Role of Point-of-Care Testing in Reducing Time to Treatment. The Western Journal of Emergency Medicine, 21(2), 404-410. doi:10.5811/westjem.2019.10.43655
Library of Congress. (n.d.). Search/browse help – Boolean operators and nesting. Retrieved December 21, 2020, from https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html
Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010). Evidence-based practice, step by step: Searching for the evidence. American Journal of Nursing, 110(5), 41-47. doi: 10.1097/01.NAJ.0000372071.24134.7e
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PEER RESPONSES
15 hours ago
C hinyere Nora Ogbonna
RE: Discussion – Week 4
COLLAPSE
Main Discussion – Week 4
Chinyere Nora Ogbonna
Leadership theories and behaviors in any organsation cannot be over-emphasized in the 21 st century. Many authors defined leadership in their own perspective, notably amongst them is Broome & Marshall, (2021): stated that effective leader must impact the workplace in a positive way. This behavioral leadership theory focuses on how leaders behave, in my opinion, these traits can be inborn or acquired from other leaders such as mentors with exceptional qualities. The nurse leader must aspire to learn, observe participate in transactional policy to motivate, inspire, and help make positive change for the improvement of healthcare not just for their organization but for society as a whole (Broome & Marshall, 2021) This usher us to the concept of transformational leadership. The need for leaders who can transform these challenges into future opportunities while remaining steadfast in their vision/purpose are term to be effective wise leaders. Never has this statement been truer than it is in the world of healthcare today. Leadership matters as every life in existence. It matters in every organization, not only for nurses to thrive in their careers but for them to advance effective healthcare for society. The current state and pace of healthcare change continue to create unprecedented challenges for individuals, families, and communities of the nation and the world. Healthcare continues to be the integral part of the society. The profession and society will continue to need expert clinicians (leaders like you and l) to make impact to health care. American Journal of Nursing (2018), (Collins, J. C., & Porras, J. I. (1996).
Major insights to becoming a successful leader is to lead through integrity/ action. Notably, leaders with visions are more respected in my organsation. They are more democratic, helps in enriching the lives of those they serve with compassion, respect, excellence and minding the cultural differences of diverse groups. One of the key behaviors of being an effective leader is trust. Which is the fundamental building block in all relationships around the globe. In healthcare, Empathy and compassion, respect of human dignity is devoted while caring for patient in my community hospital. The Leadership style that motivates and creates a culture that encourages open door policy will allow staff irrespective of their position in the organization to be able to express their view to their immediate manager without fear of negative consequences (Bellot, 2011).In my opinion, this embraces Democratic leadership bedrock. My experience was when the Director of Nursing included Assistant Directors of Nursing, managers and care associates in a weekly Town meeting to carry all along, then provides regular workshop to educate, reinforce and maintain awareness. The Leadership style motivated and created a culture that encourages open door policy which allows staff irrespective of their position in the organization to be able to express their view to their immediate manager without fear of negative consequences (Bellot, 2011).In my opinion, this embraces Again insight I learned is that leadership is not about telling others what to do but instead empowering others to reach their full potential as human beings. A review of my scenario with DON, when l got admission for this current master program, he was so excited, continuously tracking my progress t to reach my goals so as to contribute to my hospital care and policy.
Behavior and Skills of A Leader Highlights/Examples: The organizational climate varies from each community to another, because climate is influenced by the environment which further depends on individual behavior and preconception due to their values which may not be a reflective, We need nurse leaders who can draw from their strength in clinical practice to collaborate with leaders in other disciplines, with policy makers, and with members of the community to create new solutions to the problems facing the globe, to improve quality of life, to transform healthcare systems, and to inspire the next generation of leaders. Broome, M., & Marshall, E. S. (2021).
Reference
Bellot, J. (2011). Defining and assessing organizational culture. Nursing Forum, 46(1), 29–37. Retrieved from the Walden Library databases.
Broome, M., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). New York, NY: Springer.
Collins, J. C., & Porras, J. I. (1996). Building your company’s vision. Harvard Business Review, 74(5), 65–77. Retrieved from the Walden Library databases.
American Journal of Nursing: Volume 118(2), February 2018, p 43-45
Copyright: Copyright 2018 Wolters Kluwer Health, Inc, retrieved 11/30/20.
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35 minutes ago
S haron Woodhouse
RE: Discussion – Week 4
COLLAPSE
Leaders are defined by their ability to create a vision and the ability to inspire others (Laureate,2018) According to Samraakoom (2019), there are three main leadership styles: Autocratic leadership, also known as authoritative leadership. Democratic leadership, also known as participatory leadership, and Transformational leadership.
In autocratic leadership, the leader makes decisions solely, and all decisions are made without the employees’ involvement. Democratic leadership involves the employees in decision making, but the leader makes the ultimate decision. In Democratic leadership, the employee perceives ownership and tends to be motivated and job satisfaction. Transformational leaders are cognizant of the employees’ needs and transform the employees’ minds to understand the needs of the organization to bring about change. Emotional Intelligence is one key attribute of Successful leadership. Emotional Intelligence involves having the ability to manage the effect of emotions and relations with others. (Giltinane (2013)
I have seen where a past manager used the autocratic leadership skill. This leadership skill was needed as the team was very inexperienced. The Impact of this leadership skill was positive as this group was a very amateur group of nurses. They were dependent on strict guidance and were not experienced enough to handle a crisis, however as the groups’ experience became more grounded, some team members developed resentment towards the leadership skill, which eventually led to decreased morale amongst the staff members.
Another leadership skill was demonstrated as Democratic, where the leader of my current position asks for the team’s input before making a significant decision. These decisions are made at the staff meetings or a round table where everyone shares their opinion on how a particular situation should be handled. The Impact of this type of leadership enables the staff to feel empowered and makes us feel as we are a part of the team, building our morale. This leadership type also fostered a good relationship amongst the staff and motivated us to work towards the goal mentioned. Although ultimately, the supervisor makes the decision, there is a collaboration of thoughts in the process of making the decision.
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Reference
Samarakoon, K. (2019). Leadership Styles for Healthcare. International Journal of Scientific and Research Publications (IJSRP), 9(9). doi:10.29322/injury.9.09.2019.p9308
Giltinane, Charlotte Louise. “Leadership Styles and Theories.” Nursing Standard 27, no. 41 (2013): 35-39. doi:10.7748/ns2013.06.27.41.35.e7565
Laureate Education (Producer). (2018). The Leader in You [Video file]. Baltimore, MD: Author..
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