The Importance Of Evidence-Based Practice, Patient Care Management, And Holistic Care Essay For Nurses.

Incorporating Evidence Based Research in Nursing Practice

1. Consider the NMBA Standards for Practice for Enrolled Nurses. List the three Domains and summarise in your own words how these would manifest in practice.

2. Review the NMBA Code of Professional Conduct for Nurses and summarise what it is, and why you think it is important for nurses to adhere to the code.

3. Review the NMBA Code of Ethics for Nurses in Australia. Summarise the content and purpose of this document, and write down some ideas about how it will affect your nursing practice.

4. Review the NMBA Nursing Practice Decision Flowchart and summarise how this will impact on your nursing practice.

5. What do nurses do? Why do you want to be a nurse? What is the Scope of Practice Framework and how does this impact on your understanding of what Nurses do?

6. What do you believe the role of an Enrolled Nurse is in a health care team? How does this differ to the role of a Registered Nurse?

7. What other health care professionals might be part of a health care team?

8. What is the role and position of non-western approaches to health care in Australia? (e.g. are these integrated into western health care approaches? Who, where, what, when, why and how do people access non-western health care approaches? Who pays for this care?)

9. Define the following terms:
a) Functional Care
b) Primary Nursing
c) Case Management
d) Multi-Disciplinary Care

10. How would you define Health?

11. How would you define Illness?

12. Briefly note the differences and links between Primary and Tertiary care.

13. What audit and accreditation requirements might you be asked to participate in as a nurse?

14. What are the purposes of nursing theories and conceptual frameworks?

15. What factors have affected the changing role and function of the nurse?

16. What characteristics are said to make nursing a profession rather than a job?

17. What role to ANMAC, AHPRA and NMBA have in nurse education?

18. What is the impact of a sub-standard health care system on a population of a country?

19. What is the Chronic Care Model and what are the key components?

20. What are the key challenges that will affect the health care systems over the coming decades?

21. Define the term integrated care and why this is important?

22. What are the different funding responsibilities of the Australian commonwealth and state and territory governments in relation to health services?

23. What is e-health, and why is this as an essential component to the health care system?

24. Identify at least three (3) key challenges that will affect the health workforce in the next 10 years?

1. The competency standard of the NMBA nursing practice normally focuses on three domains:-

• Professional and ethical practice
• Critical thinking and analysis
• Management of care.

These three domains are important for an RN to incorporate in to her nursing practice. This can be accomplished by undertaking evidence based research approach to analyze the condition of the patient critically, management of the care by careful assessment of the patient and providing a holistic care of approach towards every patient (Willis et al. 2016).

2. The NMBA codes of conduct involve (Ossenberg et al.2015):

• Legal compliance, which ensures that all the nurses should adhere to the federal obligations and norms under the federal laws.
• Practicing of safe, woman- centered and culturally safe nursing- This can be done by assisting the women in taking health care decisions, taking care of her baby and imparting education to her family.
• Practicing with professional integrity- It is important for a nurse to commit to respect, honesty, compassion to the patient. A nurse should also help her peers for developing a skilled work force.
• Health and well being of the patient- Nurse will be able to promote safe and equal health to the patient.

Nurses should abide by this framework to provide an appropriate care to the patient and to flourish in her professional practice.

3. The NMBA codes of ethics in Australia can be summarized as follows-

Nurses should be able to provide quality nursing to all the population of the society irrespective of the socio-economic status and the diversified culture. Nurses are responsible for providing information to the patient and his family and should be able to maintain integrity and dignity of the patient. A nurse would be able to value the social, economical and environmental well being of a community (Wills et al. 2016).

The NMBA standard will act as a reference point for the nurses to develop the skills of determining and upholding the human rights to give a dignified and safe care (Levett-Jones and Bourgeois 2015).

4. The NMBA practice decision flowchart  involves integration, lawful authorization and professional consensus, risk management , organizational support, preparation and experience, education, competence, accountability and confidence. The flowchart will help the nurse to identify the benefit or the needs of the client, help to select the appropriate person for the activity, helps to evaluate whether proper care is being promoted to the patient (Ossenberg et al.2015).

5. Nurses take care of the physical, mental and spiritual well being of the patient and helps in giving a skilled, dignified, holistic and culturally safe care to the patient.

Nurses go in frontline with the doctors nowadays to provide care to the patients. They are the one to attend a patient first and provide the first line of care. Caring has always been a noble work and encourages me to devote myself to the wellbeing of the people.

The scope of practice frame work would help the nurses to take decisions regarding care for the patients.

6. An enrolled nurse helps a patient with the activities of the daily life, provide medication, other nursing care responsibilities, assess the changes in the patient and report the conditions to the registered nurse (Jacob et al.2012) .

NMBA Codes of Ethics in Australia

Registered nurses on the other hand are on a higher pedestal as compared to the registered nurse as per the qualifications. A registered nurse generally supervises an enrolled nurse (Jacob et al.2012).

7. A multidisciplinary health care team involves:-

A doctor or a General practitioner, Enrolled and registered nurses, health care educators, Physician assistants, pharmacists, dentists, technicians, therapists, spiritual support providers, community health workers (McCrae 2012).

8. Non-western form of traditional medicine is generally practiced by the aboriginals of Australia as they did not believe in the westernized concept of medical treatment. This is primarily cased due to the negative past between the White Australians and the aboriginals. Furthermore Chinese tribal medicines are also found to be practiced in Australia. There are traditional healers who use bush medicines and acupuncture to heal diseases. In general there are no policies on traditional medicines; however the National Medicines Policy includes complementary health care products (Adams et al. 2012). The Therapeutic goods administration of Australia is responsible for the funding and the regulation of traditional medicines. The Australian Health Practitioner Regulation Agency maintains four national health practitioner boards containing TM/CAM practitioners (Wills et al. 2016)..

Define:-

9 a) Functional Care- This type of nursing is mainly task and activity oriented, with the help of the auxiliary health workers having skills in various fields

b) Primary Nursing- this is a mode of nursing which emphasizes on the continuity of responsibility and care by a multidisciplinary team for a group of patients residing in the hospital (Shim and Rust 2013).

c) Case Management- Case management refers to the overseeing of the patient's long term care plans, such as patient having chronic medical conditions.

d) Multi-Disciplinary Care- This type of care occurs when a range of professionals having different complementary skills work together to provide a comprehensive care to the patient (McCrae 2012).

10. Health- According to WHO, health can be defined as a state of physical, emotional , spiritual and social well being of a person and is not only confined to absence of any diseases (Wills et al. 2016).

11. Illness- Illness refers to the poor state of body, mind and spirit. Illness can be referred as the reaction of the body against a particular disease.

12. Differences between primary and tertiary care:-

• Primary care is the general care provided by the physician or the doctor. This generally involves minor health care issues (Shim and Rust 2013).
• Tertiary care generally focuses on a particular disease and involves consultative and specialized care such as Cardiac problems, diabetic problems (Shim and Rust 2013).

Both the types of care requires especially skilled work force and caters to the general well being of the patient.

13. The nurse have to be accreditated by the Australian Nursing and the Midwifery accreditation council. (ANMAC).

NMBA Practice Decision Flowchart for Nurses

The different accreditation of standards required in nursing can be stated as- Governance, development of a curriculum framework, a level 9 masters degree and having a sufficient professional practice, student assessment, and quality and risk management (Wills et al. 2016).

14. Nursing theories and conceptual frame work gives a way to organize the thinking of the nurses by adopting a decision making frame work for a quality nursing. A conceptual framework on the other hand helps in the development of theories.

Nursing theories and conceptual framework provides rationale for predictions about the relationships among the different variables of a research study (Ossenberg et al.2015).

15. The factors that drives the changes in roles of the nurses are -

• Globalization and complexity of diseases.
• Growing rates of chronic conditions such as diabetes and heart diseases.
• New health care technologies require skilled nurses other than the conventional ones.
• Nurses often help to confront the growing costs related to health care.
• Prevalence of online technologies demands for nurses that are technically strong.
• Cultural unrest throughout the world requires nurses that would be able to provide a culturally safe care.

16. The characteristics of a nursing profession involves- Excellent communication, Critical thinking, Patience, adaptability, attentiveness, dignity and integrity (Salmella et al.2012).

A nurse should not remain confined to the conventional standards and should step beyond her comfort zone for providing a safe care to the patient. The profession of nursing ensures a compassionate care for the community instead of thinking about her own benefit (Britt et al.2013).

17. ANMAC protects type health and the safety of the Australian community by setting up a high quality standard of nursing practice, assessment an training (Willis et al.2016). The NMBA and the AHPRA registers the nurses, develops standards and codes for nursing, handle all the notifications, grievances, disciplinary hearings and approve the standards of accreditation. The key role of these organizations is to protect the Australian community. The standards are important as they provide guidance to the clinical practice and helps in promoting clinical competency (Nursing and Council, 2012)

18. Substandard health system can impose serious effect on the population health. Sub-standard health problems such as delay in diagnosis, use of poor quality of medicines, lack of proper infrastructure, lack of proper aged care facilities can bring higher rates of mortality and occurrence of sentinel events in the country. Repeated hospital readmissions will affect the healthcare costs. Furthermore, it will also affect the community health as a poor health system makes each and every individual vulnerable to diseases (Ziebland and Wyke 2012).

19. Chronic care model is a framework created for the management of chronic diseases in a vulnerable population. Chronic care can provide evidence based strategies for the interaction between the patient and a proactive practice team (Gee et al.2015).

• the key components of a chronic care model are-
• Self management support
• Design of the delivery system
• Decision support
• Systems of clinical information
• Health care organization

20. The health care problems that the world will face in a decade are (Britt et al.2013):-

• Rising health care costs.
• The disparities in health care
• Increasing older population
• The uninsured population of people
• New technologies
• Reemergence of viral infections
• Threat of bio-terrorism
• Increase in life style diseases

Registered Nurses vs. Enrolled Nurses

21. Integrated care- The mind and the body regulate each other and hence there is a relation between the physical and the mental health. Integrated care provides a combination of both primary health care and mental health care in one setting (Valentijn et al.2013)

Integrated care helps the patient by blending the expertise of physical, mental health, substance use and the primary care clinicians along with the feedbacks provided by the patient and their caregivers. It provides a multidisciplinary approach where general health and mental health care problems are addressed.

22. The federal government is the main taxation authority. The Medicare funding system, PBS, MBS (Medical benefit schedule) are funded by the federal government (Willis et al.2016).

The public hospitals are funded by the local government.

Funding for aged care, child care is funded by the local council.

23. e- health refers to the application of latest online technologies in all aspects of health care involving collection of data, documentation, sharing and dissemination of patient information, e- monitoring, application of smart e- health cards. Its main aim is to digitizing the entire health care system (Fatehi and Wootton 2012).

Online methods are found to be more effective in sharing and updating patient records. Nowadays patient doctor interaction can also be facilitated via video conferencing. E- Health will be able to strengthen the client-therapist interaction and will be able to maintain transparency in the system. E- Health will also save time and will reduce human errors (Wilkowska and Ziefle 2012).

24. The health work force will be largely influenced by a wide range of factors such as the increasing levels of wealth and income, change in the disease profiles, growth of new technologies, changing priorities of the public health, increase in the chronic diseases, the policy drivers, aging population and market imbalance between demand and supply. One of the major problems is that an increasing number of health work forces had been reaching the age of the retirement (Britt et al.2013). Again with the feminization of the work force is also associated with lower average hours per worker.  

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Different Accreditation of Standards Required in Nursing

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