The course aims to provide nursing students with advanced knowledge and skills for comprehensive health assessment of adult clients through various teaching methods including lectures, skill demonstrations, hospital attachment, and audiovisual aids. Students will learn techniques for obtaining health histories, performing physical examinations, and making clinical decisions. Upon completing the course, students will be able to conduct full health assessments, recognize normal and abnormal findings, and develop nursing diagnoses and care plans.
Lecture I-IV -for adult nursing care planssuser1af747
This document provides a course syllabus for an Advanced Nursing Health Assessment of Adult course. The 3-credit course is intended for first year adult health nursing students and will cover advanced health assessment techniques, history taking, physical examination skills, and clinical decision making. The course objectives are to enhance students' health assessment knowledge and skills to assess and care for adult clients. The course will be delivered through lectures, skills labs, hospital placements, and assignments. Students will be evaluated based on presentations, skills exams, and a final written exam.
SAAD COLLEGE OF NURSING AND ALLIED HEALTH SCIENCESUNIVERSI.docxrtodd599
SAAD COLLEGE OF NURSING AND ALLIED HEALTH SCIENCES
UNIVERSIY OF ULESTER
Student name: Fatimah Aldawood
ID number: SNC:136193
Cohort: (Year 4 semester 2)
Course Title: BSc (Hons) in Nursing Studies
Module Title: Developing research proposal
Module Code: NUR 585 CRN: 59060
Words Count:
Date:
Lecturer responsible for unit:
List of content:
The content
Pages
Table of content
2
Acknowledgment
3
Abstract
4
Literature review
5-
Significant of the study
Aim, Objectives and Research question
Methodology
Setting
Population
Sampling
Tools for data collection
Robustness of the study
Ethical consideration
Pilot study
Data analysis
Process of data collection
Outcomes
Time scale
Budget
Appendix A: information leaflet
Appendix B: consent forms
Appendix C questionnaire part1
Appendix C: interview questionnaire part2
Reference
Acknowledgement:
First of all, I would like to thank my mother and my sister to their emotional support, they encourage drove me into this level. Then I have to say thanks to my teachers for their good learning to me. Finally, I hope that my research study stimulates nurses to give more and understand the importance of great nursing profession.
The Effective of Nursing Education and Attitude to Improve Knowledge in Palliative Care of Hospital- internationally.
Abstract:
This research going to describe the effect of nursing education and attitude to improve knowledge in palliative care of hospital- internationally. The palliative is medical specialty caring for people with chronic and serous disease. This type of care concentrate on rest of patient from the symptoms and stress diseases. The aims is to improve clarity of life for both the patient and their family. However nursing education and attitude have real affect on patient health, by improve nursing education patient care can improved. Even if the nurse dos not have enough education she can progress himself by continuous learning. "The 2011 Public Opinion Strategies found that most Americans believe that palliative care should be made available to all hospitals "(Center to Advance Palliative Care [CAPC], 2011).
Background: Long work in medical area can affect in the Knowledge and attitude for the nurse it could in bad or good way, So the nurse have to improve himself to achieve the standard of care for patient in Palliative Care. Because of around the world the numbers of patients who`s need palliative care is increased, and the nurse come from the first line of patient care.
Method: A quantitative study will used to explore the determine the knowledge and attitude of Saudi nurse who is provide care for palliative patient.
Data collection:
Data collection is "the process of gathering and measuring information on variables of interest, in an established systematic fashion that enables one to answer stated research questions, test hypotheses, and evaluate outcomes". The data collection compo.
This document provides a detailed overview of the systematic process for developing and validating questionnaires for survey research. It outlines 7 key steps: 1) Set clear aims; 2) Define attributes; 3) Write a plan; 4) Develop and write items; 5) Select items; 6) Assess reliability; and 7) Evaluate validity. The first 4 steps focus on designing the questionnaire, while the last 3 steps deal with validation. Validation involves content validation, cognitive interviews, pilot testing, and psychometric evaluation including factor analysis and reliability testing. Following these steps helps ensure a rigorous and valid questionnaire is developed.
This document provides an overview of the nursing process. It begins by outlining the objectives of understanding the nursing process, its characteristics, benefits, and phases. It then defines the nursing process as a modified scientific method used to assess client needs and develop a care plan. The key phases are described as assessment, nursing diagnosis, planning, implementation, and evaluation. Assessment involves collecting client data, nursing diagnosis identifies responses to health issues, planning develops the care approach, implementation provides care, and evaluation assesses effectiveness. The document explains each phase in further detail.
The document summarizes the career path of a physician assistant. It outlines the history and creation of the PA profession to address physician shortages. PAs work on medical teams under physician supervision, examining, diagnosing, and treating patients while prescribing medication. The career offers high growth potential and salaries averaging $90,000. PAs enjoy investigative, social and hands-on work. Becoming a PA requires a master's degree which usually takes 2 years of full-time study following an undergraduate degree with prerequisite science courses.
The document discusses the career of a physician assistant. It provides a brief history of the profession starting in the 1960s to address a shortage of primary care physicians. The duties of a PA are described, including examining patients, diagnosing illnesses, prescribing medication, and assisting in surgery. Strong projected job growth of 38% by 2022 is explained by an increasing and aging population demanding more healthcare services. The salary range for PAs is outlined, with a median of $90,930 annually. Education requirements including a master's degree from an accredited program are also summarized.
Health Assessment ON ABDOMEN (1) for midwifery students.pptxEndex Tam
This document discusses health assessment and physical examination skills for midwifery students. It covers obtaining a health history, performing a physical examination, and using the nursing process. The key points are:
1) Midwives play an important role in assessment by obtaining a health history and physical exam. This can be done in various healthcare settings.
2) The nursing process is a systematic problem-solving approach used to provide individualized care. It consists of assessment, nursing diagnosis, planning, implementation, and evaluation.
3) Assessment skills include taking a health history through interviewing and using techniques like inspection, palpation, percussion and auscultation for the physical exam.
Master of Science in Nursing
Practicum Experience Plan
The development of a practicum experience plan is significant as I determine my goals and objectives for this course. The practicum experience plan acts as a planned, supervised, and evaluated practice experience guideline during the activities of the course (Demir & Ercan, 2018). The practicum experience plan helps in providing an opportunity for specifying how classroom learning will be applied in the work environment and the planned activities for observing and learning from professionals in the field (Fiedler et al., 2017). The objectives discussed in this practical experience plan are in relation to my self-assessment regarding clinical skills. The purpose of this paper is to discuss three of my individualized practicum learning objectives, planned activities for these objectives, the mode of assessment, and the course outcomes that will be addressed in the process.
Part 2: Individualized Practicum Learning Objectives
Objective 1: To improve my skills and techniques in psychiatrist assessments and evaluations when addressing the health issues of mental health patients by week 10.
Planned Activities: To successfully assess and evaluate a minimum of 80 patients during the practicum for the purpose of enhancing my knowledge about the efficient skills and techniques to be used for similar patients.
Mode of Assessment: A documentation of at least 80 patient encounters in meditrek.
PRAC Course Outcome(s) Addressed:
· Assess psychiatric-mental health advanced practice nursing skills for strengths and opportunities.
Objective 2: To improve my ability in identifying the correct diagnosis and prioritizing the differential list by week 10.
Planned Activities: I will observe my preceptor conduct at least 1 psychiatric assessment and use the information to develop the correct diagnosis and prioritize the differential list. I will then independently conduct 3 comprehensive psychiatric assessments and utilize the information in developing the correct diagnosis and correctly prioritizing the differential list.
Mode of Assessment: A documentation of at least 3 independent comprehensive psychiatric assessments with correct diagnoses and correct prioritized differential lists in meditrek (Goolsby & Grubbs, 2018).
PRAC Course Outcome(s) Addressed:
· Apply advanced practice nursing assessment and diagnosis skills in mental health settings.
· Formulate differential diagnoses for patients across the lifespan
Objective 3: To enhance my ability to identify the correct assessment tool or scale utilized in diagnosis by week 10.
Planned Activities: I will consult my preceptor about the appropriate tools used in various diagnoses. I will also obtain evidence-based research information about the various tools/scales and their appropriate use in diagnosis (McGuiness et al., 2019). I will independently identify correctly at least 3 assessment tools or scales that aide in spec ...
Lecture I-IV -for adult nursing care planssuser1af747
This document provides a course syllabus for an Advanced Nursing Health Assessment of Adult course. The 3-credit course is intended for first year adult health nursing students and will cover advanced health assessment techniques, history taking, physical examination skills, and clinical decision making. The course objectives are to enhance students' health assessment knowledge and skills to assess and care for adult clients. The course will be delivered through lectures, skills labs, hospital placements, and assignments. Students will be evaluated based on presentations, skills exams, and a final written exam.
SAAD COLLEGE OF NURSING AND ALLIED HEALTH SCIENCESUNIVERSI.docxrtodd599
SAAD COLLEGE OF NURSING AND ALLIED HEALTH SCIENCES
UNIVERSIY OF ULESTER
Student name: Fatimah Aldawood
ID number: SNC:136193
Cohort: (Year 4 semester 2)
Course Title: BSc (Hons) in Nursing Studies
Module Title: Developing research proposal
Module Code: NUR 585 CRN: 59060
Words Count:
Date:
Lecturer responsible for unit:
List of content:
The content
Pages
Table of content
2
Acknowledgment
3
Abstract
4
Literature review
5-
Significant of the study
Aim, Objectives and Research question
Methodology
Setting
Population
Sampling
Tools for data collection
Robustness of the study
Ethical consideration
Pilot study
Data analysis
Process of data collection
Outcomes
Time scale
Budget
Appendix A: information leaflet
Appendix B: consent forms
Appendix C questionnaire part1
Appendix C: interview questionnaire part2
Reference
Acknowledgement:
First of all, I would like to thank my mother and my sister to their emotional support, they encourage drove me into this level. Then I have to say thanks to my teachers for their good learning to me. Finally, I hope that my research study stimulates nurses to give more and understand the importance of great nursing profession.
The Effective of Nursing Education and Attitude to Improve Knowledge in Palliative Care of Hospital- internationally.
Abstract:
This research going to describe the effect of nursing education and attitude to improve knowledge in palliative care of hospital- internationally. The palliative is medical specialty caring for people with chronic and serous disease. This type of care concentrate on rest of patient from the symptoms and stress diseases. The aims is to improve clarity of life for both the patient and their family. However nursing education and attitude have real affect on patient health, by improve nursing education patient care can improved. Even if the nurse dos not have enough education she can progress himself by continuous learning. "The 2011 Public Opinion Strategies found that most Americans believe that palliative care should be made available to all hospitals "(Center to Advance Palliative Care [CAPC], 2011).
Background: Long work in medical area can affect in the Knowledge and attitude for the nurse it could in bad or good way, So the nurse have to improve himself to achieve the standard of care for patient in Palliative Care. Because of around the world the numbers of patients who`s need palliative care is increased, and the nurse come from the first line of patient care.
Method: A quantitative study will used to explore the determine the knowledge and attitude of Saudi nurse who is provide care for palliative patient.
Data collection:
Data collection is "the process of gathering and measuring information on variables of interest, in an established systematic fashion that enables one to answer stated research questions, test hypotheses, and evaluate outcomes". The data collection compo.
This document provides a detailed overview of the systematic process for developing and validating questionnaires for survey research. It outlines 7 key steps: 1) Set clear aims; 2) Define attributes; 3) Write a plan; 4) Develop and write items; 5) Select items; 6) Assess reliability; and 7) Evaluate validity. The first 4 steps focus on designing the questionnaire, while the last 3 steps deal with validation. Validation involves content validation, cognitive interviews, pilot testing, and psychometric evaluation including factor analysis and reliability testing. Following these steps helps ensure a rigorous and valid questionnaire is developed.
This document provides an overview of the nursing process. It begins by outlining the objectives of understanding the nursing process, its characteristics, benefits, and phases. It then defines the nursing process as a modified scientific method used to assess client needs and develop a care plan. The key phases are described as assessment, nursing diagnosis, planning, implementation, and evaluation. Assessment involves collecting client data, nursing diagnosis identifies responses to health issues, planning develops the care approach, implementation provides care, and evaluation assesses effectiveness. The document explains each phase in further detail.
The document summarizes the career path of a physician assistant. It outlines the history and creation of the PA profession to address physician shortages. PAs work on medical teams under physician supervision, examining, diagnosing, and treating patients while prescribing medication. The career offers high growth potential and salaries averaging $90,000. PAs enjoy investigative, social and hands-on work. Becoming a PA requires a master's degree which usually takes 2 years of full-time study following an undergraduate degree with prerequisite science courses.
The document discusses the career of a physician assistant. It provides a brief history of the profession starting in the 1960s to address a shortage of primary care physicians. The duties of a PA are described, including examining patients, diagnosing illnesses, prescribing medication, and assisting in surgery. Strong projected job growth of 38% by 2022 is explained by an increasing and aging population demanding more healthcare services. The salary range for PAs is outlined, with a median of $90,930 annually. Education requirements including a master's degree from an accredited program are also summarized.
Health Assessment ON ABDOMEN (1) for midwifery students.pptxEndex Tam
This document discusses health assessment and physical examination skills for midwifery students. It covers obtaining a health history, performing a physical examination, and using the nursing process. The key points are:
1) Midwives play an important role in assessment by obtaining a health history and physical exam. This can be done in various healthcare settings.
2) The nursing process is a systematic problem-solving approach used to provide individualized care. It consists of assessment, nursing diagnosis, planning, implementation, and evaluation.
3) Assessment skills include taking a health history through interviewing and using techniques like inspection, palpation, percussion and auscultation for the physical exam.
Master of Science in Nursing
Practicum Experience Plan
The development of a practicum experience plan is significant as I determine my goals and objectives for this course. The practicum experience plan acts as a planned, supervised, and evaluated practice experience guideline during the activities of the course (Demir & Ercan, 2018). The practicum experience plan helps in providing an opportunity for specifying how classroom learning will be applied in the work environment and the planned activities for observing and learning from professionals in the field (Fiedler et al., 2017). The objectives discussed in this practical experience plan are in relation to my self-assessment regarding clinical skills. The purpose of this paper is to discuss three of my individualized practicum learning objectives, planned activities for these objectives, the mode of assessment, and the course outcomes that will be addressed in the process.
Part 2: Individualized Practicum Learning Objectives
Objective 1: To improve my skills and techniques in psychiatrist assessments and evaluations when addressing the health issues of mental health patients by week 10.
Planned Activities: To successfully assess and evaluate a minimum of 80 patients during the practicum for the purpose of enhancing my knowledge about the efficient skills and techniques to be used for similar patients.
Mode of Assessment: A documentation of at least 80 patient encounters in meditrek.
PRAC Course Outcome(s) Addressed:
· Assess psychiatric-mental health advanced practice nursing skills for strengths and opportunities.
Objective 2: To improve my ability in identifying the correct diagnosis and prioritizing the differential list by week 10.
Planned Activities: I will observe my preceptor conduct at least 1 psychiatric assessment and use the information to develop the correct diagnosis and prioritize the differential list. I will then independently conduct 3 comprehensive psychiatric assessments and utilize the information in developing the correct diagnosis and correctly prioritizing the differential list.
Mode of Assessment: A documentation of at least 3 independent comprehensive psychiatric assessments with correct diagnoses and correct prioritized differential lists in meditrek (Goolsby & Grubbs, 2018).
PRAC Course Outcome(s) Addressed:
· Apply advanced practice nursing assessment and diagnosis skills in mental health settings.
· Formulate differential diagnoses for patients across the lifespan
Objective 3: To enhance my ability to identify the correct assessment tool or scale utilized in diagnosis by week 10.
Planned Activities: I will consult my preceptor about the appropriate tools used in various diagnoses. I will also obtain evidence-based research information about the various tools/scales and their appropriate use in diagnosis (McGuiness et al., 2019). I will independently identify correctly at least 3 assessment tools or scales that aide in spec ...
Master of Science in Nursing
Practicum Experience Plan
The development of a practicum experience plan is significant as I determine my goals and objectives for this course. The practicum experience plan acts as a planned, supervised, and evaluated practice experience guideline during the activities of the course (Demir & Ercan, 2018). The practicum experience plan helps in providing an opportunity for specifying how classroom learning will be applied in the work environment and the planned activities for observing and learning from professionals in the field (Fiedler et al., 2017). The objectives discussed in this practical experience plan are in relation to my self-assessment regarding clinical skills. The purpose of this paper is to discuss three of my individualized practicum learning objectives, planned activities for these objectives, the mode of assessment, and the course outcomes that will be addressed in the process.
Part 2: Individualized Practicum Learning Objectives
Objective 1: To improve my skills and techniques in psychiatrist assessments and evaluations when addressing the health issues of mental health patients by week 10.
Planned Activities: To successfully assess and evaluate a minimum of 80 patients during the practicum for the purpose of enhancing my knowledge about the efficient skills and techniques to be used for similar patients.
Mode of Assessment: A documentation of at least 80 patient encounters in meditrek.
PRAC Course Outcome(s) Addressed:
· Assess psychiatric-mental health advanced practice nursing skills for strengths and opportunities.
Objective 2: To improve my ability in identifying the correct diagnosis and prioritizing the differential list by week 10.
Planned Activities: I will observe my preceptor conduct at least 1 psychiatric assessment and use the information to develop the correct diagnosis and prioritize the differential list. I will then independently conduct 3 comprehensive psychiatric assessments and utilize the information in developing the correct diagnosis and correctly prioritizing the differential list.
Mode of Assessment: A documentation of at least 3 independent comprehensive psychiatric assessments with correct diagnoses and correct prioritized differential lists in meditrek (Goolsby & Grubbs, 2018).
PRAC Course Outcome(s) Addressed:
· Apply advanced practice nursing assessment and diagnosis skills in mental health settings.
· Formulate differential diagnoses for patients across the lifespan
Objective 3: To enhance my ability to identify the correct assessment tool or scale utilized in diagnosis by week 10.
Planned Activities: I will consult my preceptor about the appropriate tools used in various diagnoses. I will also obtain evidence-based research information about the various tools/scales and their appropriate use in diagnosis (McGuiness et al., 2019). I will independently identify correctly at least 3 assessment tools or scales that aide in spec ...
Running head: PROFESSIONAL GOALS 1
PROFESSIONAL GOALS 2
Professional Goals
Janeika Barnes
Walden University
NURS 6565 Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings
Professor: Amy Hamlin
March 3,2018
Professional Goals
Short-term goals and their impact
The short-term goals that I will set include; becoming a certified board member, choosing the patient population to serve as well as evaluating potential employers carefully. Becoming a certified board member will help me become more confident as a nursing practitioner, as well as boost my marketability in the competitive industry. In an effort to ensure that I become a certified board member in record time, I will undertake to apply for the exams before I leave RN and ensure that I am able to sit for them within three or four months after application.
The selection of the patient population encompasses the finding of the perfect position from which I will be able to grow and I will thus have to decide on a specific population that I will serve such as cardiac or the old age people. This will help ensure I am able to easily network within that given specialty area. The third goal that I will set is critical evaluation of the potential employers in which I will undertake to ask about job expectations, such as work hours, patients to be served as well as growth opportunities such as training programs. This will help ensure I land an employer that offers growth opportunities as well as an enabling environment to hone my skills as a nursing practitioner (Masters, 2017).
Long-term Goals and Their Impact
These goals include; get my name out there, engaging in research as well as advancing my qualifications. In an effort to increase my marketability, I will ensure that I stay in touch with the various individuals that I completed my practice with and who are likely to help with recommendations in the event I decide to advance career-wise. I will also ensure that I engage other nursing practitioners who are in the field whether older or even younger and who might help in giving advice as well as recommending career opportunities that might help in my growth. The engagement in research will help advance my understanding of contemporary issues and nursing topics while also giving me the chance to increase my marketability (Masters, 2017). This will add more value on my portfolio and thus increases my chances of advancing in the field. Academic qualifications will play a crucial role in ensuring I continuously hone my skills as well as improve my employability standings; it will also help me improve my leadership skills thus prepare me for a role as a nursing leader.
Strategic Plan
In an effort to ensure that I am able to achieve these goals I will set in place a strategic plan that will address the short-term as well as the long-term goals. In an effort to ensure that I mee ...
The document discusses the nursing process and its five steps: assessment, nursing diagnosis, planning, implementation, and evaluation. It explains that the nursing process is used to organize and deliver nursing care by integrating critical thinking. The nursing process allows nurses to identify diagnoses and treat human responses to health and illness. It is a dynamic and continuous process that can be modified as a client's needs change.
The document discusses the nursing process and how it is used to organize nursing care. The nursing process includes 5 steps - assessment, nursing diagnosis, planning, implementation, and evaluation. It allows the nurse to systematically collect and analyze data, identify issues and priorities, plan care, implement interventions, and evaluate outcomes. The assessment step involves collecting both subjective and objective data from various sources to develop a comprehensive understanding of the patient's health issues and needs. Various techniques are used during the interview process to gather this assessment data in an organized manner. The nursing process promotes individualized, evidence-based care tailored to the unique needs of each patient.
evidence based practice that hlps in you reasarch and ease you in reaseach practice. in this presentation many things are given which you learn n your research article.
This document outlines a plan for developing a needs assessment related to clinical pathways for ED admissions for intractable pain and social admissions. It includes reviewing strategies to overcome organizational barriers, identifying legal and ethical considerations, finalizing a theoretical needs assessment plan, and beginning an annotated bibliography with 6 sources related to the needs assessment topic.
This document provides an overview of nursing health assessment. It discusses the four main types of health assessments nurses perform: comprehensive, interval, problem-focused, and those for special populations. It also outlines the key components of a health history and physical exam, including the chief complaint, present health status using PQRST, past health history, lifestyle, psychosocial status, family history, and review of systems. The document reviews the main assessment techniques of inspection, auscultation, palpation, and percussion and provides examples of their use during a physical exam.
This document summarizes a scoping review that examined factors influencing the clinical decision-making processes used by mental health nurses to provide provisional diagnoses. The review identified two main themes: 1) clinical decision-making in mental health nursing and 2) diagnostic practice in nursing. It was found that clinician, environmental, and patient factors all influence clinical decision-making. Mental health nurses rely heavily on tacit knowledge when making clinical decisions due to limited understanding of their diagnostic processes. The review calls for further research on diagnostic practice in mental health nursing to develop frameworks that can help nurses make better clinical decisions and provisional diagnoses.
Name olubunmi salako date 1262021identification of scenariojack60216
This document provides an annotated bibliography by Olubunmi Salako for a leadership and management in nursing course. It summarizes four sources that discuss various aspects of patient education, nursing standards, and healthcare policy. The sources examine how competency-based nursing curriculum and educational interventions can improve compliance with nursing standards. They also discuss how health policies and addressing social determinants can help reduce public health problems and disparities. The annotations provide details on the authors and relevance of each source to topics like patient education, nursing practice standards, and using policy to influence health outcomes.
Critical Research Appraisal AssignmentNUR501 PhilosophiMargenePurnell14
Critical Research Appraisal Assignment
NUR501: Philosophical & Theoretical, Evidence-Based Research
Dr. Corzo-Sanchez
June 24, 2022
Critical Research Appraisal Assignment
Nursing research uncovers new knowledge to help build the foundation of clinical practice. Research can help prevent diseases and disabilities, help manage symptoms, establish new treatment plans and improve nursing skills. This is why nurses need to be able to participate in and analyze research, as this can bring positive outcomes to their careers and the health of their patients. There are two different types of research, quantitative and qualitative, that provide information and data. For this assignment, I chose one qualitative research that focuses on the stress and burnout experienced by nursing professionals and one quantitative analysis that explores nurses’ knowledge regarding hand hygiene. Each study will be evaluated thoroughly and analyzed.
Qualitative Research
The definition of qualitative research can be challenging. Qualitative research involves collecting and analyzing non-numerical data to understand concepts, opinions, or experiences (Morgan et al., 2021). This form of research explores deeper insights into real-world problems in an emergent and holistic way. Qualitative data can be collected using various methods such as interviews, focus groups, observations, and documentation analysis (Hoover, 2021). Qualitative research has been used in nursing for many years, but it was not the first method used in nursing. Before quantitative research, philosophical methods such as hermeneutics and phenomenology were the only options for professional inquiry (Butts & Rich, 2017). However, it was changed to qualitative research because its ways were incompatible with science. There are three major approaches to qualitative research, (1) ethnography, based on anthropology, (2) phenomenology, drawn from philosophy; and (3) grounded theory, drawn from sociology (Morgan et al., 2021). The use of qualitative studies is common due to its many strengths, such as providing multiple methods of data collection, more detailed information, and how it can refine and strengthen quantitative research. However, some of the limitations of this form of research are difficulty analyzing and collecting data while being more time-consuming.
Evaluating and Analyzing a Selected Qualitative Study
For the example of the qualitative study, I chose Luis M. Dos Santos's study, which focused on the effects of stress, burnout, and low self-efficacy in nursing professionals. The quantitative research aimed to understand and explore how social and environmental factors influence nursing professionals’ self-efficacy. In the study, the Social Cognitive Theory was used to define how each subject was affected based on their thoughts, behaviors, feeling, and personal beliefs (Dos Santos, 2020). For this research study, the phenomenological approach and analysis were used thought the survey to collec ...
nursing process Presentation by gedion ed1.pptxGEDIONZERIHUN1
This module is designed to equip trainees with appropriate knowledge, Attitude and skills required to undertake nursing assessment, diagnosis, planning, implementation and evaluation of patient care.
The nursing process is a framework that organizes nursing care through five steps: assessment, nursing diagnosis, planning, implementation, and evaluation. It provides an orderly and systematic method for planning and delivering nursing care centered around the client. The assessment step involves comprehensively gathering both subjective and objective data on the client's health, needs, and situation through various sources like interviews, examinations, and records.
The TAP project is developing a program at UCSF to facilitate the transition of adolescent patients with chronic health needs from pediatric to adult care. This includes resident training in transitional care competencies and a transition handbook for patients to teach self-management skills.
The IPR project at the Medical College of Georgia will initiate patient- and family-centered rounds on adult medical and surgical units, initially evaluating one team for satisfaction, costs, efficiency and quality/safety.
The Resident Performance project at Carilion Clinic intends to adapt an evaluation tool for patients to assess resident performance on ACGME competencies, comparing feedback and coaching to attending-only feedback.
Dynamic Learning Online has been providing online continuing education for healthcare professionals for over 10 years. It offers over 100 courses across various clinical and professional topics that are accredited by several national organizations. The courses provide affordable, convenient, and interactive learning opportunities to help healthcare professionals meet licensing requirements and stay up to date in their fields. This document specifically describes a 10-part differential diagnosis course series that helps physical therapists accurately diagnose conditions and determine when a medical referral is needed.
The document summarizes key topics covered in a Professional Capstone and Practicum course, as reflected in a student's journal. The journal addresses new practice approaches learned, including evidence-based practice and intraprofessional collaboration. It also discusses healthcare delivery systems, ethics, population health, the role of technology, health policy, leadership models, and health disparities. The student reflects on strengthening their cultural competence and how the course helped them meet competencies.
This document discusses the challenges of assessing the thorax, lungs, cardiovascular, and peripheral vascular systems due to their complex interrelated structures and functions. It notes that less experienced nurses like the author may provide inaccurate information when evaluating these systems. Age differences can also impact findings interpretation. Additionally, pediatric patients cannot always supply clarifying information during exams. The author advocates collaborating with experienced nurses to accurately interpret exam findings like breath sounds. Patient factors like occupation may further aid interpretation.
This document discusses nutrition for critically ill patients. It outlines nutritional risk assessment tools, energy and protein needs, and enteral feeding protocols. For the case, it recommends starting enteral nutrition as soon as hemodynamically stable, with a calorie target of 25-30 kcal/kg ideal body weight per day, or 1250-1500 kcal for a 50kg man. Locally available formulas like Plumpy'Nut and Mumbai formula are options for enteral feeding in the ICU.
This document provides an overview of sedation, analgesia, and delirium management in the intensive care unit (ICU). It discusses pain in critically ill patients, common painful procedures, and tools for pain assessment. It covers pharmacological and non-pharmacological approaches to pain management, including regional analgesia, opioid analgesics like fentanyl and morphine, and non-opioid options. The document also addresses goals of sedation in the ICU, scales for sedation monitoring, benzodiazepines, dexmedetomidine, propofol and their properties and adverse effects. Finally, it briefly discusses delirium and its management.
Master of Science in Nursing
Practicum Experience Plan
The development of a practicum experience plan is significant as I determine my goals and objectives for this course. The practicum experience plan acts as a planned, supervised, and evaluated practice experience guideline during the activities of the course (Demir & Ercan, 2018). The practicum experience plan helps in providing an opportunity for specifying how classroom learning will be applied in the work environment and the planned activities for observing and learning from professionals in the field (Fiedler et al., 2017). The objectives discussed in this practical experience plan are in relation to my self-assessment regarding clinical skills. The purpose of this paper is to discuss three of my individualized practicum learning objectives, planned activities for these objectives, the mode of assessment, and the course outcomes that will be addressed in the process.
Part 2: Individualized Practicum Learning Objectives
Objective 1: To improve my skills and techniques in psychiatrist assessments and evaluations when addressing the health issues of mental health patients by week 10.
Planned Activities: To successfully assess and evaluate a minimum of 80 patients during the practicum for the purpose of enhancing my knowledge about the efficient skills and techniques to be used for similar patients.
Mode of Assessment: A documentation of at least 80 patient encounters in meditrek.
PRAC Course Outcome(s) Addressed:
· Assess psychiatric-mental health advanced practice nursing skills for strengths and opportunities.
Objective 2: To improve my ability in identifying the correct diagnosis and prioritizing the differential list by week 10.
Planned Activities: I will observe my preceptor conduct at least 1 psychiatric assessment and use the information to develop the correct diagnosis and prioritize the differential list. I will then independently conduct 3 comprehensive psychiatric assessments and utilize the information in developing the correct diagnosis and correctly prioritizing the differential list.
Mode of Assessment: A documentation of at least 3 independent comprehensive psychiatric assessments with correct diagnoses and correct prioritized differential lists in meditrek (Goolsby & Grubbs, 2018).
PRAC Course Outcome(s) Addressed:
· Apply advanced practice nursing assessment and diagnosis skills in mental health settings.
· Formulate differential diagnoses for patients across the lifespan
Objective 3: To enhance my ability to identify the correct assessment tool or scale utilized in diagnosis by week 10.
Planned Activities: I will consult my preceptor about the appropriate tools used in various diagnoses. I will also obtain evidence-based research information about the various tools/scales and their appropriate use in diagnosis (McGuiness et al., 2019). I will independently identify correctly at least 3 assessment tools or scales that aide in spec ...
Running head: PROFESSIONAL GOALS 1
PROFESSIONAL GOALS 2
Professional Goals
Janeika Barnes
Walden University
NURS 6565 Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings
Professor: Amy Hamlin
March 3,2018
Professional Goals
Short-term goals and their impact
The short-term goals that I will set include; becoming a certified board member, choosing the patient population to serve as well as evaluating potential employers carefully. Becoming a certified board member will help me become more confident as a nursing practitioner, as well as boost my marketability in the competitive industry. In an effort to ensure that I become a certified board member in record time, I will undertake to apply for the exams before I leave RN and ensure that I am able to sit for them within three or four months after application.
The selection of the patient population encompasses the finding of the perfect position from which I will be able to grow and I will thus have to decide on a specific population that I will serve such as cardiac or the old age people. This will help ensure I am able to easily network within that given specialty area. The third goal that I will set is critical evaluation of the potential employers in which I will undertake to ask about job expectations, such as work hours, patients to be served as well as growth opportunities such as training programs. This will help ensure I land an employer that offers growth opportunities as well as an enabling environment to hone my skills as a nursing practitioner (Masters, 2017).
Long-term Goals and Their Impact
These goals include; get my name out there, engaging in research as well as advancing my qualifications. In an effort to increase my marketability, I will ensure that I stay in touch with the various individuals that I completed my practice with and who are likely to help with recommendations in the event I decide to advance career-wise. I will also ensure that I engage other nursing practitioners who are in the field whether older or even younger and who might help in giving advice as well as recommending career opportunities that might help in my growth. The engagement in research will help advance my understanding of contemporary issues and nursing topics while also giving me the chance to increase my marketability (Masters, 2017). This will add more value on my portfolio and thus increases my chances of advancing in the field. Academic qualifications will play a crucial role in ensuring I continuously hone my skills as well as improve my employability standings; it will also help me improve my leadership skills thus prepare me for a role as a nursing leader.
Strategic Plan
In an effort to ensure that I am able to achieve these goals I will set in place a strategic plan that will address the short-term as well as the long-term goals. In an effort to ensure that I mee ...
The document discusses the nursing process and its five steps: assessment, nursing diagnosis, planning, implementation, and evaluation. It explains that the nursing process is used to organize and deliver nursing care by integrating critical thinking. The nursing process allows nurses to identify diagnoses and treat human responses to health and illness. It is a dynamic and continuous process that can be modified as a client's needs change.
The document discusses the nursing process and how it is used to organize nursing care. The nursing process includes 5 steps - assessment, nursing diagnosis, planning, implementation, and evaluation. It allows the nurse to systematically collect and analyze data, identify issues and priorities, plan care, implement interventions, and evaluate outcomes. The assessment step involves collecting both subjective and objective data from various sources to develop a comprehensive understanding of the patient's health issues and needs. Various techniques are used during the interview process to gather this assessment data in an organized manner. The nursing process promotes individualized, evidence-based care tailored to the unique needs of each patient.
evidence based practice that hlps in you reasarch and ease you in reaseach practice. in this presentation many things are given which you learn n your research article.
This document outlines a plan for developing a needs assessment related to clinical pathways for ED admissions for intractable pain and social admissions. It includes reviewing strategies to overcome organizational barriers, identifying legal and ethical considerations, finalizing a theoretical needs assessment plan, and beginning an annotated bibliography with 6 sources related to the needs assessment topic.
This document provides an overview of nursing health assessment. It discusses the four main types of health assessments nurses perform: comprehensive, interval, problem-focused, and those for special populations. It also outlines the key components of a health history and physical exam, including the chief complaint, present health status using PQRST, past health history, lifestyle, psychosocial status, family history, and review of systems. The document reviews the main assessment techniques of inspection, auscultation, palpation, and percussion and provides examples of their use during a physical exam.
This document summarizes a scoping review that examined factors influencing the clinical decision-making processes used by mental health nurses to provide provisional diagnoses. The review identified two main themes: 1) clinical decision-making in mental health nursing and 2) diagnostic practice in nursing. It was found that clinician, environmental, and patient factors all influence clinical decision-making. Mental health nurses rely heavily on tacit knowledge when making clinical decisions due to limited understanding of their diagnostic processes. The review calls for further research on diagnostic practice in mental health nursing to develop frameworks that can help nurses make better clinical decisions and provisional diagnoses.
Name olubunmi salako date 1262021identification of scenariojack60216
This document provides an annotated bibliography by Olubunmi Salako for a leadership and management in nursing course. It summarizes four sources that discuss various aspects of patient education, nursing standards, and healthcare policy. The sources examine how competency-based nursing curriculum and educational interventions can improve compliance with nursing standards. They also discuss how health policies and addressing social determinants can help reduce public health problems and disparities. The annotations provide details on the authors and relevance of each source to topics like patient education, nursing practice standards, and using policy to influence health outcomes.
Critical Research Appraisal AssignmentNUR501 PhilosophiMargenePurnell14
Critical Research Appraisal Assignment
NUR501: Philosophical & Theoretical, Evidence-Based Research
Dr. Corzo-Sanchez
June 24, 2022
Critical Research Appraisal Assignment
Nursing research uncovers new knowledge to help build the foundation of clinical practice. Research can help prevent diseases and disabilities, help manage symptoms, establish new treatment plans and improve nursing skills. This is why nurses need to be able to participate in and analyze research, as this can bring positive outcomes to their careers and the health of their patients. There are two different types of research, quantitative and qualitative, that provide information and data. For this assignment, I chose one qualitative research that focuses on the stress and burnout experienced by nursing professionals and one quantitative analysis that explores nurses’ knowledge regarding hand hygiene. Each study will be evaluated thoroughly and analyzed.
Qualitative Research
The definition of qualitative research can be challenging. Qualitative research involves collecting and analyzing non-numerical data to understand concepts, opinions, or experiences (Morgan et al., 2021). This form of research explores deeper insights into real-world problems in an emergent and holistic way. Qualitative data can be collected using various methods such as interviews, focus groups, observations, and documentation analysis (Hoover, 2021). Qualitative research has been used in nursing for many years, but it was not the first method used in nursing. Before quantitative research, philosophical methods such as hermeneutics and phenomenology were the only options for professional inquiry (Butts & Rich, 2017). However, it was changed to qualitative research because its ways were incompatible with science. There are three major approaches to qualitative research, (1) ethnography, based on anthropology, (2) phenomenology, drawn from philosophy; and (3) grounded theory, drawn from sociology (Morgan et al., 2021). The use of qualitative studies is common due to its many strengths, such as providing multiple methods of data collection, more detailed information, and how it can refine and strengthen quantitative research. However, some of the limitations of this form of research are difficulty analyzing and collecting data while being more time-consuming.
Evaluating and Analyzing a Selected Qualitative Study
For the example of the qualitative study, I chose Luis M. Dos Santos's study, which focused on the effects of stress, burnout, and low self-efficacy in nursing professionals. The quantitative research aimed to understand and explore how social and environmental factors influence nursing professionals’ self-efficacy. In the study, the Social Cognitive Theory was used to define how each subject was affected based on their thoughts, behaviors, feeling, and personal beliefs (Dos Santos, 2020). For this research study, the phenomenological approach and analysis were used thought the survey to collec ...
nursing process Presentation by gedion ed1.pptxGEDIONZERIHUN1
This module is designed to equip trainees with appropriate knowledge, Attitude and skills required to undertake nursing assessment, diagnosis, planning, implementation and evaluation of patient care.
The nursing process is a framework that organizes nursing care through five steps: assessment, nursing diagnosis, planning, implementation, and evaluation. It provides an orderly and systematic method for planning and delivering nursing care centered around the client. The assessment step involves comprehensively gathering both subjective and objective data on the client's health, needs, and situation through various sources like interviews, examinations, and records.
The TAP project is developing a program at UCSF to facilitate the transition of adolescent patients with chronic health needs from pediatric to adult care. This includes resident training in transitional care competencies and a transition handbook for patients to teach self-management skills.
The IPR project at the Medical College of Georgia will initiate patient- and family-centered rounds on adult medical and surgical units, initially evaluating one team for satisfaction, costs, efficiency and quality/safety.
The Resident Performance project at Carilion Clinic intends to adapt an evaluation tool for patients to assess resident performance on ACGME competencies, comparing feedback and coaching to attending-only feedback.
Dynamic Learning Online has been providing online continuing education for healthcare professionals for over 10 years. It offers over 100 courses across various clinical and professional topics that are accredited by several national organizations. The courses provide affordable, convenient, and interactive learning opportunities to help healthcare professionals meet licensing requirements and stay up to date in their fields. This document specifically describes a 10-part differential diagnosis course series that helps physical therapists accurately diagnose conditions and determine when a medical referral is needed.
The document summarizes key topics covered in a Professional Capstone and Practicum course, as reflected in a student's journal. The journal addresses new practice approaches learned, including evidence-based practice and intraprofessional collaboration. It also discusses healthcare delivery systems, ethics, population health, the role of technology, health policy, leadership models, and health disparities. The student reflects on strengthening their cultural competence and how the course helped them meet competencies.
This document discusses the challenges of assessing the thorax, lungs, cardiovascular, and peripheral vascular systems due to their complex interrelated structures and functions. It notes that less experienced nurses like the author may provide inaccurate information when evaluating these systems. Age differences can also impact findings interpretation. Additionally, pediatric patients cannot always supply clarifying information during exams. The author advocates collaborating with experienced nurses to accurately interpret exam findings like breath sounds. Patient factors like occupation may further aid interpretation.
Similar to 1A.Lecture I-IV - ppt Tade note.pptx (20)
This document discusses nutrition for critically ill patients. It outlines nutritional risk assessment tools, energy and protein needs, and enteral feeding protocols. For the case, it recommends starting enteral nutrition as soon as hemodynamically stable, with a calorie target of 25-30 kcal/kg ideal body weight per day, or 1250-1500 kcal for a 50kg man. Locally available formulas like Plumpy'Nut and Mumbai formula are options for enteral feeding in the ICU.
This document provides an overview of sedation, analgesia, and delirium management in the intensive care unit (ICU). It discusses pain in critically ill patients, common painful procedures, and tools for pain assessment. It covers pharmacological and non-pharmacological approaches to pain management, including regional analgesia, opioid analgesics like fentanyl and morphine, and non-opioid options. The document also addresses goals of sedation in the ICU, scales for sedation monitoring, benzodiazepines, dexmedetomidine, propofol and their properties and adverse effects. Finally, it briefly discusses delirium and its management.
This document discusses vasoactive agents used to treat shock. It outlines different types of shock including septic, cardiogenic, and hypovolemic shock. It describes the autonomic nervous system and types of adrenergic receptors. Various vasopressors and inotropes are presented including norepinephrine, dopamine, epinephrine, vasopressin, and phenylephrine. Their mechanisms, dosages, and indications for treating shock are provided. Maintaining adequate perfusion and tissue oxygen delivery is critical for treatment.
This document provides an overview of fluid management for a patient admitted to the ICU. It discusses fluid types, their components and uses. It describes how to assess a patient's fluid status and calculate fluid requirements. The document outlines fluid monitoring, electrolyte disorders like hyponatremia and hypernatremia, and their management. It emphasizes the importance of maintaining fluid balance and addressing imbalances to support organ function.
A 29-year old male with no previous medical history was admitted to the ICU after a car crash with multiple trauma requiring laparotomy. He is intubated, sedated and on noradrenaline with low blood pressure and heart rate. A feeding tube was inserted into his jejunum. The discussion points are about when to start nutrition, what the energy target should be, and how to manage hypoglycemia. The document discusses the risks and benefits of early enteral nutrition in the ICU, optimal routes, timing and formulations of feeding as well as monitoring for complications. It also covers indications for parenteral nutrition and management of hypoglycemia.
Electrolytes like sodium, potassium, calcium, and magnesium are important minerals in the body that regulate functions like nerve impulses, muscle contraction, and fluid balance. Sodium is the main cation in extracellular fluid and helps maintain fluid balance and nerve transmission. Potassium is mainly intracellular and regulates muscle contraction and acid-base balance. Common electrolyte imbalances include hyponatremia (low sodium), hypernatremia (high sodium), hypokalemia (low potassium), and hyperkalemia (high potassium). Their causes, clinical effects, and management strategies are discussed.
Critically ill patients are susceptible to short- and long-term complications. Implementing proven best practices through checklists, bundles, and interdisciplinary rounds can help prevent these complications. A bundle is a set of evidence-based interventions that improve patient outcomes more than any single intervention alone, such as the ABCDEF bundle which is shown to reduce ICU length of stay, delirium, and mortality.
This document discusses various clinical syndromes related to COVID-19 including:
- Mild to severe pneumonia characterized by cough and respiratory symptoms. Severe pneumonia can progress to ARDS.
- ARDS is identified by acute hypoxemic respiratory failure, bilateral lung opacities, and onset within one week of a known clinical insult or infection.
- Sepsis is defined as a dysregulated immune response to infection leading to life-threatening organ dysfunction. Septic shock involves circulatory and metabolic abnormalities requiring vasopressors.
This document describes the case of a 35-year-old obese woman presenting with fever, myalgia, fatigue, cough, shortness of breath, and respiratory distress who is suspected of having COVID-19 or another respiratory infection. Upon initial examination, she requires high-flow oxygen and has diffuse crackles on lung exam and bilateral infiltrates on chest x-ray. She deteriorates clinically and requires intubation and mechanical ventilation. Over the following days, her condition gradually improves with treatment but she initially fails attempts at breathing trials due to anxiety and high respiratory rate and volume. After diuresis to correct fluid balance and a subsequent successful breathing trial, she demonstrates readiness for extubation.
This document discusses the principles of documentation in the ICU. It outlines what should be documented, including assessments, clinical problems, communications, medications, plans of care, and special considerations. Documentation is important for communication among healthcare professionals, and has several uses like ensuring quality care, credentialing, addressing legal issues, and supporting research. The principles of documentation include producing high quality, accurate records in a timely manner according to policies and protecting patient privacy and confidentiality. Entries should be authenticated, dated, and use standard terminology. Documentation provides evidence for appropriate decision making and care.
7-Dead body management in a covid patient.pptxMesfinShifara
Dead body management of COVID-19 patients should follow standard infection prevention and control practices. The major steps are: 1) preparing the body in the patient room while preventing exposure to fluids, 2) transferring the body wrapped in cloth to the morgue, 3) cleaning and disinfecting surfaces, 4) burial following physical distancing with PPE-wearing burial teams, and 5) cleaning equipment and practicing hand hygiene before returning home. Proper cleaning, disinfection, PPE use, and minimizing contact with fluids are essential throughout the process.
This document discusses various oxygen delivery devices and airway management techniques. It describes nasal prongs, simple face masks, and non-rebreather masks, and how they can provide different fractions of inspired oxygen (FiO2). It also outlines techniques for using face masks, as well as other simple airway maneuvers like positioning and oral/nasal airways. Finally, it discusses criteria for considering intubation in a patient, including objective criteria based on blood gases and ventilation, as well as subjective criteria like decreasing mental status or signs of respiratory failure.
This document discusses mechanical ventilation, including its definition, indications, goals, settings, modes, parameters, monitoring, and criteria for extubation. Mechanical ventilation uses machines to assist or replace spontaneous breathing. Common indications include inadequate ventilation or oxygenation. Goals are to achieve adequate oxygenation and carbon dioxide removal while solving ventilatory problems. Ventilator settings include variables like trigger, control, and cycling that determine breath initiation and delivery. Common modes described are A/C, SIMV, PCV, and PSV. Parameters like tidal volume, respiratory rate, and pressures are adjusted based on patient factors. Monitoring involves vital signs, ventilation assessment, and equipment checks. Extubation criteria focus on spontaneous breathing trials and respiratory parameters
This document discusses Gastroesophageal Reflux Disease (GERD). It defines GERD as a condition that occurs when stomach contents reflux into the esophagus, leading to troublesome symptoms. Common symptoms of GERD include heartburn, indigestion, belching, hiccups, and regurgitation of bitter acid into the mouth. The document then discusses treatments for GERD, including lifestyle modifications, medications like H2 blockers, proton pump inhibitors, and prokinetics, as well as surgical options. It provides details on the mechanisms of different drug classes used to treat GERD and manage its symptoms.
This document provides information on chemotherapeutic drugs and antimicrobial mechanisms of action and resistance. It begins by outlining the learning objectives which are to describe the principles of chemotherapy, mechanisms of antimicrobial drug action and resistance, specific drug classes and their effects. It then discusses the basic principles of chemotherapy and antimicrobials before explaining various mechanisms of antimicrobial action and how selective toxicity is achieved. The document closes by discussing antimicrobial resistance and complications of drug therapy.
This document discusses various diseases of the liver including hepatic failure, cirrhosis, hepatitis, tumors, and inborn errors. It describes the clinical features and morphological alterations that can cause liver failure such as massive hepatic necrosis from viruses, drugs, or chronic liver disease. Cirrhosis is characterized by fibrosis and regeneration of hepatocytes into parenchymal nodules. Portal hypertension is a consequence of cirrhosis and can result in ascites, portosystemic shunts, splenomegaly, and hepatic encephalopathy. Viral hepatitis includes hepatitis A, B, C, D, and E which are transmitted through various routes and can cause acute or chronic disease. Alcoholic liver disease encompasses hepatic ste
This document discusses diarrhea, including its causes, symptoms, diagnosis and treatment. It notes that diarrhea is caused by viruses, bacteria, parasites and other factors. The most common infectious causes in children are rotavirus and Giardia. Diarrhea can lead to dehydration, electrolyte imbalances and other complications if not properly treated. Treatment involves oral rehydration with fluids like ORS, continued feeding and monitoring for dehydration. Preventive measures include breastfeeding, safe water/sanitation, handwashing and vaccination.
This document discusses neonatal jaundice (hyperbilirubinemia) in newborns. It begins by explaining that jaundice is caused by elevated bilirubin levels, which is a normal occurrence in many newborns due to immature liver function and the breakdown of red blood cells. The document then covers the assessment, types (physiological vs pathological), risk factors, causes, investigations and management of neonatal jaundice. Key points include that physiological jaundice is common in the first week of life but requires treatment if bilirubin levels rise too quickly or become too high. Treatment options discussed are phototherapy and exchange transfusion.
Disorder of fluid and electrolytes.pptxMesfinShifara
This document provides guidelines for initial electrolyte management in infants receiving intravenous fluids, with a focus on sodium, potassium, calcium, and disorders related to abnormalities in these electrolytes. It recommends:
- Daily electrolyte measurements for infants receiving only IV fluids, especially very preterm infants under 750g.
- Starting calcium supplementation on the first day for high-risk infants.
- Not adding sodium or potassium to IV fluids for the first few days until levels begin to fall.
- Maintaining sodium at 2-4 mEq/kg/day and potassium at 1-3 mEq/kg/day once supplementation begins.
- Carefully managing abnormalities like hyponatremia, hypernatremia
Congenital pneumonia is a lung infection that is present at birth. It occurs when an infant contracts a pneumonia-causing pathogen while in the mother's womb. Symptoms may include fast breathing, fever, poor feeding, and cough.
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LGBTQ+ Adults: Unique Opportunities and Inclusive Approaches to CareVITASAuthor
This webinar helps clinicians understand the unique healthcare needs of the LGBTQ+ community, primarily in relation to end-of-life care. Topics include social and cultural background and challenges, healthcare disparities, advanced care planning, and strategies for reaching the community and improving quality of care.
MBC Support Group for Black Women – Insights in Genetic Testing.pdfbkling
Christina Spears, breast cancer genetic counselor at the Ohio State University Comprehensive Cancer Center, joined us for the MBC Support Group for Black Women to discuss the importance of genetic testing in communities of color and answer pressing questions.
PET CT beginners Guide covers some of the underrepresented topics in PET CTMiadAlsulami
This lecture briefly covers some of the underrepresented topics in Molecular imaging with cases , such as:
- Primary pleural tumors and pleural metastases.
- Distinguishing between MPM and Talc Pleurodesis.
- Urological tumors.
- The role of FDG PET in NET.
Can coffee help me lose weight? Yes, 25,422 users in the USA use it for that ...nirahealhty
The South Beach Coffee Java Diet is a variation of the popular South Beach Diet, which was developed by cardiologist Dr. Arthur Agatston. The original South Beach Diet focuses on consuming lean proteins, healthy fats, and low-glycemic index carbohydrates. The South Beach Coffee Java Diet adds the element of coffee, specifically caffeine, to enhance weight loss and improve energy levels.
Let's Talk About It: Breast Cancer (What is Mindset and Does it Really Matter?)bkling
Your mindset is the way you make sense of the world around you. This lens influences the way you think, the way you feel, and how you might behave in certain situations. Let's talk about mindset myths that can get us into trouble and ways to cultivate a mindset to support your cancer survivorship in authentic ways. Let’s Talk About It!
Healthy Eating Habits:
Understanding Nutrition Labels: Teaches how to read and interpret food labels, focusing on serving sizes, calorie intake, and nutrients to limit or include.
Tips for Healthy Eating: Offers practical advice such as incorporating a variety of foods, practicing moderation, staying hydrated, and eating mindfully.
Benefits of Regular Exercise:
Physical Benefits: Discusses how exercise aids in weight management, muscle and bone health, cardiovascular health, and flexibility.
Mental Benefits: Explains the psychological advantages, including stress reduction, improved mood, and better sleep.
Tips for Staying Active:
Encourages consistency, variety in exercises, setting realistic goals, and finding enjoyable activities to maintain motivation.
Maintaining a Balanced Lifestyle:
Integrating Nutrition and Exercise: Suggests meal planning and incorporating physical activity into daily routines.
Monitoring Progress: Recommends tracking food intake and exercise, regular health check-ups, and provides tips for achieving balance, such as getting sufficient sleep, managing stress, and staying socially active.
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Application to conduct study on research title 'Awareness and knowledge of oral cancer and precancer among dental outpatient in Klinik Pergigian Merlimau, Melaka'
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Hypertension and it's role of physiotherapy in it.Vishal kr Thakur
This particular slides consist of- what is hypertension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is summary of hypertension -
Hypertension, also known as high blood pressure, is a serious medical condition that occurs when blood pressure in the body's arteries is consistently too high. Blood pressure is the force of blood pushing against the walls of blood vessels as the heart pumps it. Hypertension can increase the risk of heart disease, brain disease, kidney disease, and premature death.
This particular slides consist of- what is hypotension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is the summary of hypotension:
Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
1. Advanced Nursing Health Assessment of
Adult
For 1st Year Adult Health Nursing Students
By: Tadele K (Ass’t Professor)
Email: kinati2010@gmail.com
Salale University, CHS, Department of Nursing, June, 2023! 1
2. Course Syllabus
Course Code: GNUR5023
Course Credit: 3 Cr.Hr
Course type: Nursing specialty course
Program - MSc in Adult Health Nursing
Placement: Year I, Semester II
Enrollment: Regular
Course Delivery: Block
Salale University, CHS, Department of Nursing, June, 2023! 2
3. Course Description
This health assessment course has been designed to provide
advanced level knowledge and psychomotor skills necessary for
assessing the health status of adult clients/patients.
Students are grounded in the theoretical perspectives, empirical
documentation, and practice skills necessary for advanced
communication (i.e., clinical interviewing, focused and
comprehensive history taking), biopsychosocial and physical
assessment, critical diagnostic reasoning, and clinical decision
making.
Students acquire the required advanced knowledge and skills within
a case based, problem focused learning framework that integrates
theoretical, empirical, and experience based practical knowledge.
Salale University, CHS, Department of Nursing, June, 2023! 3
4. Course Objectives
On successful Completion of this course, students will be able to:
Describe advanced health assessment techniques in nursing
practice
Demonstrate techniques of physical examination, and health
screening
Organize comprehensive history of patients based on Gordon’s
approach and medical Human response pattern approach
Distinguish the difference between normal and abnormal
findings of body structures
Compare critical reasoning approaches to advanced health
assessment and patient-centered care.
Compile and report a comprehensive database, physical
examination, laboratory and diagnostic study results.
Practice Orem’s Self care theory
Salale University, CHS, Department of Nursing, June, 2023! 4
5. Course contents
Introduction to health assessment
Health history and physical examination
Approaches of Health Assessment in Nursing
Nutritional assessment
Assessment of integumentary system (Skin, Hair and Nails)
Assessment of Head, Eye, Ear, Nose and Throat (HEENT)
Salale University, CHS, Department of Nursing, June, 2023! 5
6. Course contents
Assessment of Neck, lymphoglandular system
Assessment of the respiratory system
Assessment of the cardiovascular system
Assessment of the renal system
Assessment of breast and axilla
Assessment of gastrointestinal system
Assessment of the reproductive system
Assessment of the musculoskeletal system
Assessment of the neurologic system
Salale University, CHS, Department of Nursing, June, 2023! 6
7. Teaching/Learning
Strategies
Lecture, presentation
Demonstration /skill
lab/
Hospital attachment
Audio visual
Reading
assignment....and
Experience sharing
Teaching
aids/materials/
Lap top
LCD
Different forms/
formats/
White board
Parker
Textbooks
Salale University, CHS, Department of Nursing, June, 2023! 7
8. Evaluation
Individual Presentation (30%)
Skill lab /demonstration exam/ (30%)
Final written examination (40%)
Salale University, CHS, Department of Nursing, June, 2023! 8
9. References
Bickley, L.S. (2012). Bates' pocket guide to
physical examination and history taking. 5th Ed.
Lippincott, Williams & Wilkins
Patricia M (2007). Nursing Health Assessment, 2nd
Ed.
Salale University, CHS, Department of Nursing, June, 2023! 9
11. Brainstorming
Health Defined …?
The absence of disease concept?
The WHO definition?
Dunn’s level of wellness?
The adaptation model? (internal/external factors)
The freedom from pain model?
Holism? (mind, body, spirit)
Salale University, CHS, Department of Nursing, June, 2023! 11
12. Holistic Principles of Health
All state of health and disease have a psychological component
Every person presents a complex but, unique interaction of body, mind
and spirit
The primary responsibility for health lies not with a health care provider,
but with one’s self
Individuals need to be in control of and regulate their destiny
Holistic health care providers must determine to what extent the
atmosphere of dependency is created within the context of helping
roles
Holistic health concept believers take the position that illness is not bad
Positive wellness and not just the absence of disease is the goal of
holistic health
Practitioners of holism must come to know themselves as human beings
before prompting optimal health in others
Salale University, CHS, Department of Nursing, June, 2023! 12
13. Hence, Health is defined as … ?
It is a state of physical, mental, social,
spiritual, emotional and economical well
being not merely the absence of disease or
infirmity. (Terris M., 1978)
Salale University, CHS, Department of Nursing, June, 2023! 13
14. Nursing Defined?
Florence Nightingale ?
Virginia Henderson ?
ANA?
Salale University, CHS, Department of Nursing, June, 2023! 14
15. Nursing Defined?
“The unique function of the nurse is to assist
the individual, sick or well, in the
performance of those activities contributing to
health, its recovery, or to a peaceful death that
the client would perform unaided if he had the
necessary strength, will, or knowledge. And to
do this in such a way as to help the client gain
independence as rapidly as possible.”
Virginia H.
Salale University, CHS, Department of Nursing, June, 2023! 15
16. Nursing Defined?
“Nursing is the protection, promotion, and
optimisation of health and abilities,
prevention of illness and injury, alleviation of
suffering through the diagnosis and treatment
of human response, and advocacy in the care
of the populations.” ANA
Salale University, CHS, Department of Nursing, June, 2023! 16
18. Overview of Nursing process
Definition:
It is a systematic problem solving process that guides all
nursing actions.
Purpose:
To help the nurse provide goal directed, Client -
centered care
Salale University, CHS, Department of Nursing, June, 2023! 18
19. ♣ Components of Nursing process
1.Assessment:
Systematic and continuous collection of client data
The nurse carefully examine the client’s body parts to
determine any abnormalities
Document of relevant data
Salale University, CHS, Department of Nursing, June, 2023! 19
20. Types of Assessments {4}
1.Initial comprehensive assessment (admission assessment,
Triage) is performed when the client enters a health care
services.
The purposes are to evaluate the client’s health status, to
identify functional health patterns that are problematic,
and to provide an in-depth, comprehensive database,
which is critical for evaluating changes in the client’s
health status in subsequent assessments.
Vital signs, patients statement …
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21. Types of Assessments
2.Focused assessment: Collects data about a problem that
has already been identified.
This type of assessment has a narrower scope and a
shorter time frame than the initial assessment.
In focus assessments, nurse determine whether the
problems still exists and whether the status of the
problem has changed (i.e. improved, worsened, or
resolved).
This assessment also includes the appraisal of any new,
overlooked, or misdiagnosed problems.
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22. Types of Assessments
3.Emergency assessment: It takes place in life-
threatening situations in which the preservation of life is
the top priority.
Time is of the essence rapid identification of and
intervention for the client’s health problems.
Often the client’s difficulties involve airway, breathing
and circulatory problems (the ABCs).
Abrupt changes in self-concept (suicidal thoughts) or
roles or relationships (social conflict leading to violent
acts) can also initiate an emergency.
Once the ABCs are stabilized, the emergency assessment
may turn into an initial or focused assessment,
depending on the situation.
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23. Types of Assessments
4.Time-lapsed assessment or Ongoing assessment:
It takes place after the initial assessment to evaluate any
changes in the clients functional health.
Nurses perform time-lapsed reassessment when
substantial periods of time have elapsed between
assessments (e.g. periodic output patient clinic visits,
home health visits, health and development screenings).
During the time-lapsed assessment, the current status of
the patient is compared to the previous baseline during
and prior to treatment
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24. Types of the Data
Subjective (Patients
description )
Objective (measureable and
observable)
Sources the Data
Primary – Patient
Secondary- others sources
Salale University, CHS, Department of Nursing, June, 2023! 24
25. Methods of Assessment
Observation
Interview
Health history
Symptom analysis
Physical examination
Laboratory and diagnostic data
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26. Components of Nursing process
2.Diagnosis:
Compare clinical findings with normal and abnormal
variation and development events
Interpret data
Validate diagnoses
Document diagnoses
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27. Components of Nursing process
Diagnosis: 3 activities in Diagnosing includes:-
Data Analysis
Problem Identification
Formulation of Nursing Diagnosis
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28. Components of Nursing process
Diagnosis: components = PES/PE
Components of a nursing diagnosis: PES or PE
Problem -P
Etiology - E
Defining characteristics (sign/ symptoms ) -S
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29. Components of Nursing process
Diagnosis: Types:-
1.Actual nursing diagnosis
2.Risk nursing diagnosis
3.Possible nursing diagnosis
4.Wellness nursing diagnosis
5.Syndrome nursing diagnosis
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30. Components of Nursing process
1.Actual Nursing Diagnosis:
A client problem that is present at the time of the nursing
assessment.
It is based on the presence of signs and symptoms.
Patient problem + Etiology + symptoms
Examples:
Imbalanced Nutrition less than body requirements r/t decreased
appetite as manifested by decrease body weight
Ineffective airway clearance r/t to viscous secretions as
manifested by productive cough
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31. Components of Nursing process
2.Possible nursing diagnosis:
One in which evidence about a health problem is
incomplete or unclear therefore requires more data to
support or reject it; or the causative factors are unknown
but a problem is only considered possible to occur.
Problem + etiology
Examples:
Possible low self-esteem r/t loss job
Possible altered thought processes r/t unfamiliar
surroundings
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32. Components of Nursing process
3.Risk Nursing diagnosis:
is a clinical judgment that a problem does not exist, therefore no S/S
are present, but the presence of risk factors indicate that a problem is
only likely to develop unless nurse intervene or do something about it.
No subjective or objective cues are present therefore the factors that
cause the client to be more vulnerable to the problem is the etiology of
a risk nursing diagnosis.
Problem + risk factors
Examples:
Risk for infection r/t compromised immune system
Risk for injury r/t decreased vision after cataract surgery.
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33. Components of Nursing process
4.Wellness nursing diagnosis
Clinical judgment about an individual, family and
community in transition from a specific level of wellness
to a higher level of wellness
E.g. Knowledge deficit regarding breast feeding RT first
time birth.
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34. Components of Nursing process
5.Syndrome nursing diagnosis
Comprises of a cluster of problems
Eg:
Rape trauma syndrome
Disuse syndrome.
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35. Components of Nursing process
3.Outcome identification
Identify expected outcomes
Individualize to the person
Culturally appropriate
Realistic and measurable
Include a timeline
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36. Components of Nursing process
4.Planning
Establish priorities
Develop outcomes
Set timelines for outcomes
Identify interventions
Integrate evidence-based trends and research
Document plan of care
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37. Components of Nursing process
5.Implementation
Implement in a safe and timely manner
Use evidence-based interventions
Collaborate with colleagues
Use community resources
Coordinate care delivery
Provide health teaching and health promotion
Document implementation and any modification
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38. Components of Nursing process
6.Evaluation
Progress toward outcomes
Conduct systemic, ongoing, criterion-based evaluation
Include patient and significant others
Use ongoing assessment to revise diagnoses,
outcomes, plan
Disseminate results to patients and family
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39. Components of Nursing process
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40. Explanatory Model
Formulated by Kleinman
ls a set of questions care providers can ask during an
assessment which provides insight into what is most
important for the client in terms of their health,
illness, and care.
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41. Explanatory Model
What do you call your problem? What name do you give it?
What do you think has caused it?
Why did it start when it did?
What does your sickness do to your body? How does it
work inside you?
How severe is it? Will it get better soon or take longer
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42. Explanatory Model
What do you fear most about your sickness?
What are the chief problems your sickness has caused for
you (personally, family, work, etc.)?
What kind of treatment do you think you should receive?
What are the most important results you hope to receive
from the Treatment?
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43. Nursing Documentation
Is the record of nursing care that is planned and delivered to individual
clients by qualified nurses or other caregivers under the direction of a
qualified nurse.
It contains information in accordance with the steps of the nursing
process.
It is the principal clinical information source to meet legal and
professional requirements, care nurses' knowledge of nursing
documentation, and is one of the most significant components in nursing
care.
Quality nursing documentation plays a vital role in the delivery of quality
nursing care services through supporting better communication between
different care team members to facilitate continuity of care and safety of
the clients.
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44. Contents of Nursing Documentation
Admission form
Is a fundamental record which documents a client's status,
reasons why the client is being admitted, and the initial
instructions for that client's care and is completed by a nurse
when a client is admitted.
Nursing care plan
Is a clinical document recording the nursing process, which is a
systematic method of planning and providing care to clients.
Progress note
Is the record of nursing actions and observations in the nursing
care process which nurses to monitor and control the course of
nursing care.
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46. What Is Critical Thinking?
Is a combination of:
Reasoned thinking
Openness to alternatives
Ability to reflect
A desire to seek truth
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47. What is Critical Thinking?
“…reasonable reflective thinking that is focused on deciding
what to believe or do” (Ennis, 2000)
Process through which nurses analyze and make sense of situ
ations in order to make sound clinical decisions.
“the art of thinking about your thinking while you are thin
king in order to make your thinking better…” (Paul, 1988)
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48. Components of Critical Thinking
A. Skills:
Cognitive (intellectual) activities and processes
used in problem solving and decision making.
Gather information
Identify problems
Recognize gaps in own knowledge
Listening, reading
Organizing information
visualizing, exploring, evaluating credibility
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49. Components of Critical Thinking
B.Attitudes: Attitudes are like feelings and traits of mind
Independent thinking
Intellectual curiosity
Intellectual humility
Intellectual empathy
Intellectual courage
Intellectual perseverance
Fairmindedness
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50. Critical Thinking….
Critical Thinkers Ask Questions.
Inquiring Minds WANT to KNOW!
What am I taking for granted?
Did I explore all points of view?
Do I understand the question?
What information do I need?
Do I need to report anything?
What complications should I anticipate?
Which is my highest priority?
Are there ethical or cultural issues I should consider?
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51. Why Is Critical Thinking Important for Nurses ?
Nurses deal with complex situations
Our clients are unique
Nurses apply knowledge to provide holistic care
Nursing is an applied discipline
Nursing uses knowledge from other fields
Nursing is fast paced /stepped/
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52. Five Major Categories of Critical Thinking
1.Contextual awareness
2.Inquiry /review/
3.Considering alternatives
4.Examining assumptions
5.Reflecting critically
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53. The Four Critical Thinking Skills
Reading
Listening
Observing
Analyzing
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54. 1.To Improve Critical Reading
Highlight the main ideas as you read.
Join a study group and see if your main idea is the same as fellow
group member’s.
Dialogue with yourself to identify the main idea of your reading.
Try to state the main idea in your own words
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55. 2.To Improve Critical Listening
Restate the points made in a discussion with others to
see if you understand them.
Focus on what a speaker is saying and listen for key point
While listening, make note of anything you find
confusing, and ask about it later.
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56. 3.To Improve Critical Observing
Remove any restrictions in your mind
Eliminate or decrease any distraction
Ask yourself if you understand the most important points?
Create new ways of looking at situations
Always look from outside the situation
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57. 4.Improve Critical Analyzing
Maintain clear and accurate logic
Take all details into consideration
Use systematic and scientifically based process
Use both cognitive and psychomotor skills
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58. Barriers to Creative Thinking
Resistance to change, rigid mindset, practice guided by tradition,
habit, routines
Stereotypical perceptions of clients
Fear of making mistakes
Unwillingness to take risks or look for alternative strategies
Decision making without sufficient data or supported by rationale
Failure to evaluate effectiveness of nursing actions
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59. Critical Thinking and Creativity
Critical thinkers = creative thinkers
Question the status quo.
Search for new and practical strategies for improvement.
Group think: a major block to creativity
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60. How Is the Nursing Process Related to Critical Thinking?
Nursing process is a problem -
solving process that uses many individual critical thinking skills
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62. Decision Making
Think about your choice of specialty….. What influenced
you?
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63. Decision Making
Decision making in nursing is a complex process that may
be defined as a series of decisions, including obtaining
subjective and objective data in relation to a patient
situation and the evaluation of that data to implement
actions to achieve a desired outcome (Lauri et al.,2001).
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64. Decision Making …
DECIDE: a model of the decision-making process steps
D = define the problem
E = establish the criteria
C = consider all the alternatives
I = identify the best alternative
D = develop and implement a plan of action
E = evaluate and monitor the solution and feedback when
necessary
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65. Decision making models in Nursing
1. Rational Model
Consists of a structured four-step sequence:
identifying the problem
generating alternative solutions
selecting a solution
implementing and evaluating the solution
65
Salale University, CHS, Department of Nursing, June, 2023!
66. Decision making models in Nursing
Techniques used in rational model of decision-making are:
SWOT analysis
Pareto analysis (the 80/20 rule/ the vital few and the trivial
many)(80% of a project’s benefit can be achieved by doing 20% of
the work or 80% of problems can be traced to 20% of the causes)
Decision trees (listing all possibilities, branching's ,..)
Management by Objectives (objective based)
66
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67. Decision making models in Nursing
2. Simon’s Normative Model
This model based on premise that decision making is not rational
The model state that decision making is characterized by:
Limited information processing
Use of rules of thumb or shortcuts
Satisfying
67
Salale University, CHS, Department of Nursing, June, 2023!
68. Decision making models in Nursing
3. Group Decision Making Model
Groups can accumulate more knowledge and facts
Groups have a broader perspective and consider more alternative
solutions
Individuals who participate in decisions are more satisfied with the
decision and are more likely to support it
68
Salale University, CHS, Department of Nursing, June, 2023!
69. Decision making models in Nursing
4. Clinical Decision Making Model:
Information-processing model that uses a scientific hypothetic-deductive,
quantitative approach,
The intuitive-humanistic model that focuses on intuition and how the
knowledge gained from nursing experience enriches the clinical decision
making process and
The clinical-decision model that uses both hypothetico-deductive and
pattern recognition.
Critical pathways are used as a technique in clinical decision making.
69
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71. The Health History Taking
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72. The Health History Taking
o It is the systematic collection of subjective and objective data
that is used for determining a client’s functional health
pattern status for the purpose of nursing diagnosis.
o It is also a chronological and detailed health record of a client.
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73. Purposes of History Taking
To elicit information regarding all of the variables that
may affect the client’s health experience and status.
Guides on which body parts or systems to focus during
physical examination.
To establish a trusting relationship between the nurse and
the patient.
Develops understanding about the patient.
Serves as a background material related to the
development of the present symptoms.
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74. Phases of History Taking
1.Introductory phase: introduction of self and explains
the purposes of the interview to the patient.
An explanation of note taking, confidentiality, Comfort
and privacy
2.Working phase: This is the actual data collection phase.
3.Summary and closure phase: The nurse summarizes
information obtained form the patient during the working
phase and validates problems and goals with the patient.
Possible plans to resolve the problems are identified and
discussed with the patient.
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75. Techniques of Effective History Taking
Great the patient according to the norm and culture then call
according to his/her title and name, and give undivided
attention.
Keep comfort (for patient with pain) and privacy
Never be in a hurry even when you are in a limited time.
Design questions appropriately /avoid leading questions/
Facilitation: you can use posture, actions, or words that
encourages the patient to say more but do not specify the
topic.
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76. Techniques of Effective History Taking
Reflection: This is the repetition of the patient’s words to
encourage him/her to give you more details.
Clarification: when the patient’s words are ambiguous or
associations are not clear, you must ask for clarifications.
Empathetic response: this is the recognition of feelings such
as embarrassment, shame suffering and responding to
patients in a way that shows understanding and acceptance.
Confrontation: If you observe clues of anger, anxiety, or
depression.
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77. Cultural Variations & History Taking
Cultural variations in communication and self-disclosure
styles seriously affect the information obtained.
The nurse should be aware of possible variations in the
communication styles of self and patient.
When misunderstanding or difficulty in communicating is
evident, the nurse should seek help.
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78. Ethical Considerations & History Taking
The patient has a full right to know why you are collecting the
information.
The individual patient/ client is fully informed about the process of
data collection and the decision of the patient is freely made.
Following the interview the nurse selectively records information
that is pertinent to the health status of the patient.
When data collection is completed and the data recorded, the
written record is maintained in a secure place and made available
only to those health professionals directly involved in the care of
the patient.
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80. Physical Examination
Reviewing of the whole system…
Indications:
Routine screening
Eligibility prerequisite for health insurance, military
service, job, sports, school,…
Admission to a hospital or long term care facility
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81. Things to Do Before Starting PE
Think /Organize/
Consider Environment
Accommodate special needs (cultural sensitivity)
Equipment - clean surface & clean equipment
Room - quiet, warm & well lighted
Maintain privacy
Observe & Listen
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82. Components of Physical Examination
Inspection
Palpation
Percussion
Auscultation
Note: there is 5th skill known as olfaction
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83. 1.Inspection
“the use of the senses of vision and hearing to observe the normal
condition or any deviations from normal of various body parts.”
The nurse inspects or looks body parts to detect normal
characteristics or significant physical sings.
Inspection helps to know normal characteristics before trying to
distinguish abnormal findings in different ages.
The quality of an inspection depends on the nurse's willingness to
spend time doing a thorough job.
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84. Inspection
Use vision and hearing
Always first
Look for symmetry
Use good lighting
Use good exposure
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85. Principles of Accurate Inspection
Good lightening either day light or artificial light is suitable.
Expose body parts being observed only.
Look before touching.
Warm room for examination of the client “not cold not hot".
Observe for color, size, location, texture, symmetry and sounds.
Compare each area inspected with the opposite side of body if
possible.
Use pen light to inspect body cavities.
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86. 2.Palpation
Touch & feel with hands to determine:
Texture – use fingertips (roughness, smoothness).
Temperature – use back of hand (warm, hot, cold).
Moisture (dry, wet, or moist).
Organ location and size
Consistency of structure (solid, fluid, filled)
Slow and systematic
Light to deep
Light palpation (tenderness)
Deep palpation (abdominal organs/masses)
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87. Principles of Accurate Palpation
Examiner finger nails should be short
Use sensitive part of the hand
Light Palpation precedes deep palpation
Tender area are palpated last
Tell client to take slow deep breath to enhance muscle relaxation.
Examine condition of the abdominal organs
Depressed areas must be approximately “2cm”
Assess turgor of skin measured by lightly grasping the body part with
finger tips.
Bimanual palpation used to assess organs deep in the abdomen by using two
hands, one on each side of body part or organs being felt
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89. 3.Percussion
Tap a portion of the body to elicit tenderness that varies with the
density of underlying structures.
Percussion denotes location, size and density of underlying structures,
percussion requires dexterity.
Methods of percussion:
Direct method: involving striking the body surface directly with one or
two fingers. Elicits pain/tenderness/
Indirect method: performed by placing the middle finger of the
examiner’s non dominant hand “pleximeter hand” firmly against the
body surface with palm and fingers remaining off the skin, and the tip
of the middle finger of the dominant hand “plexor” strikes the base of
the distal joint of the pleximeter. Use a quick & sharp stroke
Elicits sounds
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91. 5 Percussion Sounds Produced in Different
Body Regions
1. Resonant – normal lung
2. Hyper resonant: it’s a louder and lower pitched than resonant
sounds. Normally heard in children and very thin adults , and
abnormally in emphysema
3. Tympany : A hollow drum-like sound produced when a gas-
containing cavity is tapped sharply. Tympany is heard if the chest
contains free air (pneumothorax) or the abdomen is distended
with gas air filled (stomach)
4. Dull or thud like sounds are normally heard over dense areas such
as the heart or liver. Dullness replaces resonance when fluid
replaces air-containing lung tissues, such as occurs with
pneumonia, pleural effusions, or tumors
5. Flat: shown in no air areas such as thigh muscle, bone and tumor
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92. Auscultation
“To listen for various breath, heart, and bowel sounds”
Direct or immediate auscultation is accomplished by the unassisted
ear that is without amplifying device.
This form of auscultation often involves the application of the ear
directly to a body surface where the sound is most prominent.
Mediate auscultation: the use of sound augmentation device such as a
stethoscope in the detection of body sounds.
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93. Auscultation
Listening to body sounds
Movement of air (lungs)
Blood flow (heart)
Fluid & gas movement (bowels)
Remember the sound changes in
the abdomen…
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94. Olfaction
Another skill that used during assessment, certain alteration is body
function create characteristic body odors, smelling can detect
abnormalities that unrecognized by other means.
Assessment of characteristic odors:
Alcohol odor from oral cavity means ingestion of alcohol
Ammonia from urine means urinary tract infection
Body odor from skin, particularly in areas where body parts rub together
Halitosis from oral cavity means poor dental and oral hygiene, gum disease.
Sweat, fruity ketones from oral cavity may be from diabetic acidosis.
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95. Variations for physical assessment of the
geriatric client
Remember: normal variation related to aging may be observed in all parts of the p/exm.
Dividing the physical assessment into parts in order to avoid fatigue in the older
client.
Provide room with comfortable temperature and no drafts.
Allow sufficient time for client to respond to directions.
If possible assess the elderly clients in a setting where they have an opportunity to
perform normal activities of daily living in order to determine the client’s optimum
potential.
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96. Steps of Physical Examination
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98. Approaches of Health Assessment in Nursing
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99. Approaches of Health Assessment in Nursing
The functional health assessment approach (Gordon’s approach)
The medical approach (Body Systems Model)
Orem’s approach to self-care assessment
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102. 1.Health Perception-Health Management
Pattern
Determine how the client perceives and manages his or
her health.
Compliance with current and past nursing and, medical
recommendations.
The client's ability to perceive the relationship between
activities of daily living and health.
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103. Health Perception-Health Management
Pattern
Client's Perception of Health: Describe your health.
Client's Perception of Illness: Describe your illness or current health
problem.
Health Management and Habits: Tell me what you do when you have
a health problem.
Compliance with Prescribed Medications and Treatments: Have you
been able to take your prescribed medications? If not, what caused
your inability to do so?
Subjective and Objective data
Different types of Dx
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104. 2.Nutritional-Metabolic Pattern
Assessing the client's nutritional-metabolic pattern is to
determine the client's dietary habits and metabolic
needs.
The conditions of hair, skin, nails, teeth and mucous
membranes are assessed.
Subjective and objective data
Different types of Dx
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105. 3.Elimination Pattern
Adequacy of the client's bowel and bladder
The client's bowel and urinary habits
Bowel or urinary problems
Use of urinary or bowel elimination devices
Subjective and Objective data
Habits, frequencies, sounds ….
Different types of Dx
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106. 4.Activity- Exercise Pattern
Activities of daily living, including routines of exercise, leisure, and
recreation.
Activities necessary for personal hygiene, cooking, shopping, eating,
maintaining the home, and working.
An assessment is made of any factors that affect or interfere with the
client's routine activities of daily living.
Subjective and Objective data
Different types of Dx
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107. 5.Sexuality- Reproduction Pattern
Consider female and male separately
Identify both subjective and objective data
Different types of Dx
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108. 6.Sleep- Rest Pattern
Mention all subjective and Objective data
i.e. sleep habits, special problems, sleep aids…
Different types of Dx
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109. 7.Sensory - Perceptual Pattern
Pain Assessment
Special Aids
Identify all subjective and objective data
Different types of Dx
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110. 8.Cognitive Pattern
Ability to Understand
Ability to Communicate
Ability to Remember
Ability to Make Decision
Mental status examination
Different types of Dx
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111. 9.Role- Relationship Pattern
Roles and responsibility at work, home, social …
Observe family members
Different types of Dx
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112. 10.Coping Stress Tolerance Pattern
Perception of Stress and Problems in Life
Coping Methods and Support Systems
Different types of Dx
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113. 11.Value-Belief Pattern
Values, Goals, and Philosophical Beliefs
Are there certain health practices or restrictions that are
important for you to follow while you are ill or
hospitalized? Explain.
Observe religious practices, Bible , clergy,….
Different types of Dx
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114. The Medical Approach (Body Systems Model)
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115. The Medical Approach (Body Systems Model)
1. Biographic Data
Full name
Address and telephone
numbers
Birth date and birth
place
Sex
Religion and race
Marital status
Social security number
Occupation (usual and
present)
Source of referral
Usual source of
healthcare
Source and reliability of
information
Date of interview
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116. 2. Chief Complaint / CC/
The main reason for:
Health care visits
Hospitalization
With duration
Salale University, CHS, Department of Nursing, June, 2023! 116
117. 3. History of Present Illness
Gathering information relevant to the chief complaint, and the client's
problem, including essential and relevant data, and self medical treatment.
Components:
Client's summary and usual health
Investigation of symptoms: "onset, date, gradual or sudden, duration,
frequency, location, quality, and alleviating or aggravating factors"
Negative information
Relevant family information
Disability "affected the client's total life"
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118. Symptom Analysis (P Q R S T)
a. Provocative or Palliative
First occurrence :
What were you doing when you first experienced or noticed the
symptom?
What to trigger it ? stress? Position?, activity?
What seems to cause it or make it worse? For a psychological
symptom.
What relieves the symptom : change diet? Change position ? Take
medication ? Being active?
Aggravation: what makes the symptom worse?
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119. Symptom Analysis (P Q R S T)
b. Quality Or Quantity
QUALITY:
How would you describe the symptom- how it feels, looks, or sounds?
QUANTITY:
How much are you experiencing now?
Is it so much that it prevents you from performing any activity?
Salale University, CHS, Department of Nursing, June, 2023! 119
120. Symptom Analysis (P Q R S T)
C. Region Or Radiation
Region :
Where does the symptom occur?
Radiation :
Does it travel down your back or arm, up your neck or down your legs?
Salale University, CHS, Department of Nursing, June, 2023! 120
121. Symptom Analysis (P Q R S T)
d. Severity scale
Severity
How bad is symptom at its worst?
Course
Does the symptom seem to be getting better, getting worse?
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122. Symptom Analysis (P Q R S T)
e. Timing
Onset :
On what date did the symptom first occur
Type of onset :
How did the symptom start sudden? Gradually?
Frequency :
How often do you experience the symptom ; hourly ? Daily ? Weekly?
monthly
Duration :
How long does an episode of the symptom last
Salale University, CHS, Department of Nursing, June, 2023! 122
123. 4. Past Health History
Purpose: to identify all major past health problems of the
client.
This includes:
Childhood illness e.g. history of rheumatic fever.
History of accidents and disabling injuries
History of hospitalization (time of admission, date, admitting
complaint, discharge diagnosis and follow up care
History of operations "how and why this done“
History of immunizations and allergies
Physical examinations and diagnostic tests
Salale University, CHS, Department of Nursing, June, 2023! 123
124. 5. Family History
Purpose: to learn about the general health of the client's blood
relatives, spouse, and children and to identify any illness of
environmental genetic, or familiar nature that might have implications
for the client's health problems.
Family history of communicable diseases.
Heredity factors associated with causes of some diseases.
Strong family history of certain problems.
Health of family members "maternal, parents, siblings, aunts,
uncles…etc.".
Cause of death of the family members "immediate and extended family".
Salale University, CHS, Department of Nursing, June, 2023! 124
125. 6. Environmental History
Purpose:
To gather information about surroundings of the client",
including physical, psychological, social environment, and
presence of hazards, pollutants and safety measures.“
Salale University, CHS, Department of Nursing, June, 2023! 125
126. 7. Current Health Information
The purpose is to record major current health related information.
Allergies: environmental, ingestion, drug, other.
Habits "alcohol, tobacco, drug, caffeine"
Medications taken regularly "by doctor or self prescription
Exercise patterns
Sleep patterns (daily routine)
The pattern life (sedentary or active)
Salale University, CHS, Department of Nursing, June, 2023! 126
127. 8. Psychosocial History
Includes:
How client and his family cope with disease or stress,
and how they responses to illness and health.
You can assess if there is psychological or social problem
and if it affects general health of the client.
Salale University, CHS, Department of Nursing, June, 2023! 127
128. 9. Review of Systems (ROS)
Collection of data about the past and the present of each of the
client systems.
Review of the client’s physical, sociologic, and psychological
health status may identify hidden problems and provides an
opportunity to indicate client strength and disabilities
Salale University, CHS, Department of Nursing, June, 2023! 128
129. 9. Review of Systems includes:
General review of skin, hair, head, face, eyes, ears, nose, sinuses,
mouth, throat, neck nodes and breasts.
Assessment of respiratory system
Assessment of Cardiovascular system
Assessment of gastrointestinal system.
Assessment of urinary system
Assessment of genital system
Assessment of extremities and musculoskeletal system
Assessment of endocrine system
Salale University, CHS, Department of Nursing, June, 2023! 129
130. Orem's Approach of History Taking
130
Salale University, CHS, Department of Nursing, June, 2023!
131. Dorothea Orem (Biography, 1914-2007)
Born in 1914 in Baltimore, US
Earned her diploma at Providence Hospital –Washington, DC,1930
1939 – BSN Ed., and 1945 – MSN Ed., at Catholic University of
America
She worked as a staff nurse, private duty nurse, nurse educator
and administrator and nurse consultant.
Received honorary Doctor of Science degree in 1976.
Theory was first published in Nursing: Concepts of Practice in
1971, second in 1980, in 1995, and 2001.
131
Salale University, CHS, Department of Nursing, June, 2023!
132. Orem’s theories
1. Theory of self care
2. Theory of self care deficit
3. Theory of nursing system
132
Salale University, CHS, Department of Nursing, June, 2023!
133. 1. Theory of Self-Care
According to this theory, self-care is a learned behavior and a
deliberate action in response to a need.
Why and how people care for themselves
133
Salale University, CHS, Department of Nursing, June, 2023!
134. 1. Theory of Self-Care (concepts)
Self-care
Self-care agency
Self-care requisites
Therapeutic self-care demand
134
Salale University, CHS, Department of Nursing, June, 2023!
139. Therapeutic self care demand
139
Salale University, CHS, Department of Nursing, June, 2023!
140. 2. Theory of Self-Care Deficit
This theory purports that nursing care is needed when people are
affected by limitations that do not allow them to meet their self-
care needs.
Why people can be helped through nursing
The relationship between the nurse and the client is established
when a self-care deficit is present.
Self-care deficits, not medical diagnosis, determine the need for
nursing care.
According to Orem, the only legitimate need for nursing care is when
a self-care deficit exists.
140
Salale University, CHS, Department of Nursing, June, 2023!
141. 2. Theory of Self-Care Deficit
“The condition that validates the existence of a requirement for
nursing in an adult is the health associated absence of the
ability to maintain continuously the amount and quality of
therapeutic self-care in sustaining life and health, in
recovering from disease or injury, or in coping with their
effects.”
141
Salale University, CHS, Department of Nursing, June, 2023!
142. 2. Theory of Self-Care Deficit
Nurses meet the self care needs through:
Acting or doing for another
Guiding
Providing physical or psychological support
Providing and maintaining an environment that supports
personal development
Teaching
142
Salale University, CHS, Department of Nursing, June, 2023!
143. 3. Theory of Nursing Systems
This is the unifying theory that “subsumes the theory of self-care
deficit which subsumes the theory of self-care” (Orem, 1991, p. 66).
The Theory of Nursing Systems attempts to answer the question
“What do nurses do?”
This was the original question that prompted the development of
Orem’s theory.
Describes and explains relationships that must be made and
maintained for nursing to be produced
143
Salale University, CHS, Department of Nursing, June, 2023!
144. 3. Theory of Nursing Systems
The nurse determines whether or not there is a legitimate need for
nursing care.
Is a person able to meet self-care needs?
Does a deficit exist?
If a deficit exists, then the nurse plans care that identifies what is
to be done by whom: the nurse, the client, or other (family or
significant other).
Collectively, the actions of all these people are called the nursing
system.
144
Salale University, CHS, Department of Nursing, June, 2023!
145. 3. Theory of Nursing Systems
This describes:
How the patient’s self care needs will be met by the nurse, the
patient, or both
Nursing responsibilities
Roles of the nurse and patient
Rationales for the nurse-patient relationship
Types of actions needed to meet the patient’s demands
Orem identified three types of nursing systems:___>
145
Salale University, CHS, Department of Nursing, June, 2023!
146. 3. Theory of Nursing Systems
1.Wholly compensatory nursing system, the nurse supports and
protects the client, compensates for the client’s inability to care
for self, and attempts to provide care for the client. E.g. Post
anesthetic pts
146
Salale University, CHS, Department of Nursing, June, 2023!
147. 3. Theory of Nursing Systems
2.Partly compensatory nursing system, both the nurse
and client perform care measures. E.g. Ambulating the
pts /selective activities/
147
Salale University, CHS, Department of Nursing, June, 2023!
148. 3. Theory of Nursing Systems
3.Supportive-educative nursing system, the nurse’s actions are to
help clients develop their own self-care abilities through knowledge,
support, and encouragement. E.g. Educating about insulin self
administration
148
Salale University, CHS, Department of Nursing, June, 2023!
149. Orem’s General Theory of Nursing
149
Salale University, CHS, Department of Nursing, June, 2023!
150. 3. Theory of Nursing Systems
150
Salale University, CHS, Department of Nursing, June, 2023!
151. Orem’s Nursing Process
Consists of 3 steps:
Step 1: determine why a patient needs care
Step 2: design a nursing system & plan the delivery of care
Step 3: management of nursing systems - planning,
initiating, & controlling nursing actions
151
Salale University, CHS, Department of Nursing, June, 2023!
152. Application of Orem’s theory
Practice
Used as a bases for different clinical practices, e.g.
diabetes self care
Education
Bases for different curriculums
Research
Used a conceptual framework for different researches
152
Salale University, CHS, Department of Nursing, June, 2023!
153. ‘’The bridge between knowledge and skill is practice.
The bridge between skill and mastery is time’’ Jim
Bouchard
Thank You!
Salale University, CHS, Department of Nursing, June, 2023! 153
154. The ways to mastery ……
1st Attention
2nd Acquisition
3rd Ascension
Salale University, CHS, Department of Nursing, June, 2023! 154