Sam Abraham

Fall prevention conceptual framework.

Falls can have lasting psychological and physical consequences, particularly fractures and slow-healing processes, and patients may also lose confidence in walking. Injuries from falls lead to functional decline, institutionalization, higher health care costs, and decreased quality of life. The process related to the problem of patient falls in the hospital, using the nursing model developed by the theorist, Ida Jean Orlando, is explained in this article. The useful tool that provides guidance to marketers in this endeavor is Maslows hierarchy of needs. During acute illness, individuals are greatly in need of satisfying their physiological needs. If these needs are not met, patients leave the hospital lacking a positive experience. Initial fall risk assessment is critical to plan intervention and individualize care plan. Interventions depend on the severity of fall risk factors.

Technological trends in health care: electronic health record.

The most relevant technological trend affecting health care organizations and physician services is the electronic health record (EHR). Billions of dollars from the federal government stimulus bill are available for investment toward EHR. Based on the government directives, it is evident EHR has to be a high-priority technological intervention in health care organizations. Addressed in the following pages are the effects of the EHR trend on financial and human resources; analysis of advantages and disadvantages of EHR; action steps involved in implementing EHR, and a timeline for implementation. Medical facilities that do not meet the timetable for using EHR will likely experience reduction of Medicare payments. This article also identifies the strengths, weaknesses, opportunities, and threats of the EHR and steps to be taken by hospitals and physician medical groups to receive stimulus payment.

Night Shift Work and Its Health Effects on Nurses

The purpose of this research was to study night shift work and its health effects on nurses. This was a quantitative study using descriptive design; it also incorporated three qualitative open-ended questions to complement the study. The data were collected using Survey Monkey, with an Internet-based confidential data collection tool. The population of relevance to this study was nurses employed in hospital settings in the United States. E-mail addresses and Facebook were used to recruit participants. Results indicated that there is an increased risk of sleep deprivation, family stressors, and mood changes because of working the night shift. Rotating shifts were mentioned as a major concern for night shift nurses. Respondents agreed that complaints about fatigue and fatigue-related illnesses in night shift workers were ignored. There was also a general perception among nurses working the night shift that sleep deprivation leads to negative health consequences including obesity; however, they were not as high a concern as rotating shifts or fatigue.

A Correlational Study of Spiritual Well-being and Depression in the Adult Cancer Patient

Depression in adult cancer patients has been widely studied, along with spiritual effects of traumatic events and even spiritual growth after a diagnosis of cancer. There has been limited research determining a direct correlation between spiritual well-being and depression in adult cancer patients. The purpose of this research study was to examine the relationship between spiritual well-being and depression in adult cancer patients. This was a descriptive correlational study using 59 patients older than 18 years from an outpatient cancer center. The researchers hypothesized that patients with a low spiritual well-being score would be more likely to have a high depressive symptom score, thus providing support for a correlation between cancer patient’s spiritual well-being and risk of depression. Implications of this study lead to evidence for better screening processes for cancer patients regarding spiritual well-being.

Increasing Registered Nurse Retention Using Mentors in Critical Care Services.

Recruiting and training 1 newly hired registered nurse can cost thousands of dollars. With a high percentage of these newly hired nurses leaving their first place of employment within their first year, the financial implications may be enormous. It is imperative that health care facilities invest in recruiting and retention programs that retain high-quality nurses. Mentorship programs in retaining and easing the transition to practice for new graduate nurses, re-entry nurses, and nurses new to a specialty area are critical in nurse retention. Discussion in this study includes the effect of implementing a mentor program into the critical care services area of a 325-bed not-for-profit community hospital in northern Indiana. Based on this study, nurses with a mentor were retained at a 25% higher rate than those not mentored. Implementation of a mentor program reduced the training cost to the facility and increased retention and morale.

Managing Patient Falls in Psychiatric Inpatient Units: Part 1

Patient falls in the hospital psychiatric inpatient units are more frequent than in the medical-surgical units. The purpose of this study was to explore psychiatric unit directors’ perceptions of the factors that contribute to patient falls in the State of Michigan. A quantitative online questionnaire was sent to the directors of psychiatric units in Michigan. Two research questions (RQs) guided the study: (a) What are psychiatric unit directors’ perceptions of the possible intrinsic factors that contribute to patient falls in the psychiatric inpatient units, and (b) what are psychiatric unit directors’ perceptions of the possible extrinsic factors that contribute to patient falls in the psychiatric inpatient units? In comparing the results, 6 of the 7 factors with the highest mean levels of agreement were intrinsic factors. In the current study, patient gait (mean, 4.65) ranked first, history of falls (mean, 4.52) second, and multiple medications (mean, 4.50) third as fall-risk factors. The need for the involvement of the team members (mean, 4.55) in preventing falls was the most highly rated factor among the extrinsic factors. Educating unit team members in assisting with fall prevention is a critical consideration for leaders.

Acquisition and allocation of human, financial, and physical resources in the health care system.

Based on the current financial status and forthcoming changes in the health care system, governing boards give chief executive officers the responsibility to manage human, financial, and physical resources. The role and degree of involvement of chief executive officers in managing resources-the resource allocation process, retention and recruitment, technology adaptation, reimbursement, and expansion of the outpatient program-are illustrated in this article. A new strategy for diverting resources to tap into the outpatient market is the appropriate direction to choose during days when the economy is down and people are not seeking inpatient treatment as in the past. Reimbursement in the future will depend on customer satisfaction scores; therefore, a dedicated and loyal staff is the most important resource for any service organization.

Walking on Eggshells: Addressing Nursing Students' Fear of the Psychiatric Clinical Setting

The current article discusses the feelings of nursing students as they enter their psychiatric rotation. Most nursing students are apprehensive of the psychiatric clinical setting. After more than 25 years of teaching, observing, and listening to remarks from students, the current researchers have discovered two major situations nursing students fear most about the psychiatric clinical setting: handling an assaultive patient and communication. Students have heard stories from the media and come with preconceived ideas about the psychiatric setting. Orientation and training in these two areas before the start of psychiatric clinical rotation is key in preparing students for this experience. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].

Nurses’ Perspectives on Patient and Visitor Violence: A Qualitative Study

The profession of nursing is at high risk for work-related threats and violence from patients and visitors. The purpose of this study was to investigate nurses’ perspectives on patient and visitor violence. In this research study, a qualitative, phenomenological design was used. The study question was, “What are your lived experiences as a nurse with patient and visitor violence?” This study included what nurses have personally experienced and how they handled violent situations while performing their job. A total of 19 registered nurses were interviewed. Open-ended questions and follow-up probes evoked responses. Sequential interviews were conducted until all concepts were repeated multiple times without new themes emerging. Four common themes emerged were violence (punching, kicking, tackling, pinching, and spitting) , long-term consequences of violence, need for education and training for violence, and the need for support from the organization. Taylor’s cognitive adaptation adjustments to threatening events theory helped guide the study.

Appearance of Nurses and Perceived Professionalism

Background: After completing a literature review on the topic of appearance and professionalism a knowledge gap was identified, relating to how individuals perceive professionalism based on appearance. First impressions are how patients form opinions of their nurses. Professionalism is influenced by many variables, such as hair, make-up, uniform, behavior, and image. Purpose: The purpose of this study was to explore perceptions of a nurse’s appearance and projected professionalism. Method: A total of 120 students volunteered to participate in the study. The research question was: “How do college students perceive the professional appearance of the nurse?” This was a quantitative, cross-sectional, non-experimental study with a descriptive design. A qualitative question was also asked to complement the quantitative data. The survey contained 3 demographic questions and 18 items based on the participant’s perception of the perceived professionalism using the given images. The data collected were analyzed using descriptive statistics. Orem’s theory of self-care was used to guide this study. Results: The results confirmed the complex nature of the nursing image. Participants perceived a nurse who took extra time to improve appearance to be professional, trustworthy and least lazy. A not so prepared nurse was perceived to lack confidence and also to be less compassionate.