Students maintained and submitted weekly reflective narratives throughout the course to explore the personal knowledge and skills gained throughout this course. This assignment combines those entries into one course-long reflective journal that integrates leadership and inquiry into current practice as it applies to the Professional Capstone and Practicum course.

This final submission should also outline what students have discovered about their professional practice, personal strengths and weaknesses that surfaced during the process, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and, finally, how the student met the competencies aligned to this course.

The final journal should address a variable combination of the following, while incorporating your specific clinical practice experiences:

1) New practice approaches

2) Interprofessional collaboration

3) Health care delivery and clinical systems

4) Ethical considerations in health care

5) Practices of culturally sensitive care

6) Ensuring the integrity of human dignity in the care of all patients

7) Population health concerns

8) The role of technology in improving health care outcomes

9) Health policy

10) Leadership and economic models

11) Health disparities

While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

RN to BSN

2.3: Understand and value the processes of critical thinking, ethical reasoning, and decision making.

4.1: Utilize patient care technology and information management systems.

4.3: Promote interprofessional collaborative communication with health care teams to provide safe and effective care.

5.3: Provide culturally sensitive care.

5.4: Preserve the integrity and human dignity in the care of all patients.

Benchmark – Professional Capstone and Practicum Reflective Journal

Student’s Name

Institutional Affiliation

Course

Instructor’s Name

Date

 

 

Benchmark – Professional Capstone and Practicum Reflective Journal

New practice approaches

The primary topic for this practicum experience was new practice approaches. Healthcare professionals adopt evidence-based practice (EBP) approaches to improve care delivery and patient outcomes (Patelarou et al., 2017). The delivery of safe and high-quality patient care is of the utmost importance for all regulatory agencies. It has an impact on clinical decision-makers who encourage health care providers to incorporate evidence-based practices (EBPs) to provide high-quality clinical care. New practices are evidence-based practices supported by recent research or clinical observations (Patelarou et al., 2017). The evidence-based practice integrates epidemiology, statistics, and research methodology into health care.

These new practice approaches, which are evidence-based practice allow nurses to understand and treat chronic and acute diseases and have better patient outcomes. Evidence-based practice helps nurses determine an effective course of action and involves forming a clinical question to identify a problem, gathering the best evidence, analyzing the evidence, applying the evidence to clinical practice, and assessing the results (Patelarou et al., 2017). Providing an organization of baseline information on new practice approaches permits the development of educational initiatives and changes to enhance EBP incorporation into daily practice.  To apply and maintain new practice approaches, staff education must happen at all levels. Staff education increased awareness of professionals regarding how to apply the new practice approaches as well as their importance in improving care.  Practices, beliefs, and skills of staff related to these approaches may affect the success of initiatives to implement EBP (Patelarou et al., 2017). Therefore, new practice approaches are usually implemented or developed with the sole purpose of improving care delivery and patient outcomes.

Interprofessional collaboration

The practicum experience for this week was very interesting. The primary objective for this week’s practicum was Interprofessional collaboration. It aimed at assessing or enhancing my working relationship, as a nurse, with the rest of the healthcare team, including doctors, pharmacists, clinicians, fellow nurses, and others (Tang et al., 2018). I knew from the beginning that this week’s practicum experience would provide me with vast skills in interprofessional collaboration. I worked with many interdisciplinary individuals to manage the care of various patients (Tang et al., 2018). For example, I worked with the infection control department where I could help them go through a few reports regarding hospital-acquired infections (HAIs). It was noticed that cases of HAIs are gradually increasing and the department was trying to find out the cause and possible interventions.

During the practicum, I also managed to work with the rehabilitation (physiotherapy and occupational therapy) department. One of the patients being treated with a physiotherapist was a female recovering from a stroke. The therapist could prescribe aid and appliances to help her gain mobility. Besides, I worked in the general care of patients where I was involved in a team with doctors, pharmacists, and other nurses to care for various patients (Tang et al., 2018). For example, I was part of a team selected to treat a diabetic patient admitted due to severely elevated glucose levels. The team included a medical doctor, a clinician, a pharmacist, and other nurses (Tang et al., 2018). It was a moment of interaction and learning at the same time. I gained the necessary interprofessional collaboration skills needed to improve patient outcomes.

 

 

Health care delivery and clinical systems

In week three, the primary practicum objective was to learn about health care delivery and clinical systems. Healthcare delivery is the provision of healthcare services to a patient. The hospital has established several clinical systems to improve care delivery (Islam et al., 2018). During week 3 practicum experience, I had the opportunity to learn about a few of these clinical information systems and it enabled me to gain significant knowledge in this area. for example, I learned about electronic medical records. It is the physician specialist system with the highest adoption rates of 76 percent in internal medicine and pediatrics. Patient’s medical data are safely stored in electronic medical records (EMRs) (Islam et al., 2018). Doctors use EMRs to enter patient’s details, such as their name, age, address, and sex to details of every aspect of care given by the hospital.

Another clinical system I learned about is the computerized provider order entry system (CPOE). It is an essential component of ambulatory and inpatient clinical information systems. It allows a physician to prescribe electronically, communicate with various departments, such as pharmacy, laboratory, radiology, intensive care unit (Islam et al., 2018). These systems are designed to alert doctors on potential drug-drug interactions and allergies. In the cardiology department, I came across a cardiovascular information system that helps in monitoring, management, evaluation, and policy development related to cardiac diseases. It Integrates all cardiology requests, procedures, images, and reports. When this system is linked to EMRS or electronic health records, physicians can share information and extract images and reports from any computer inside and outside of the hospital through a portal (Islam et al., 2018). Therefore, the week three practicum was very informative and educative

 

Ethical considerations in health care

The week 4 practicum topic was ethical considerations in health care. The week four objective was to learn about ethics in healthcare, including how to deal with specific ethical situations. Ethical values are essential for any healthcare provider (Haddad & Geiger, 2020). The hospital provides a copy of the summary of the American Nurses Association Code of Ethics for Nurses to every nurse within the facility. Ethics is a serious issue within the facility, everyone is expected to adhere to ethical principles.

During the practicum experience, I came across an ethical situation where the patient refused C-section, even though her life was in danger and the baby could not come out naturally. Healthcare providers did not know what to do. Even after she was explained the risks associated with her decision and the benefits of a C-section for her case, she still refused. She said that she would rather die than go through cesarean delivery. The doctors had to call her husband who later talked to her and she agreed. She successfully underwent Cesarean delivery and has a bouncing baby boy.

I could relate this incident to the principles of autonomy, beneficence, and non-maleficence, that I had learnt at school. The scenario affirmed what I had learned in the classroom that nurses must respect patient’s autonomy and at the same time respect beneficence and non-maleficence (Haddad & Geiger, 2020). I also learned that nurses practice with compassion and respect for the inherent dignity, worth, and unique attributes of every person. I also learned several issues regarding ethics that have not been mentioned here. Therefore, I can conclude that week four practicum was enjoyable and successful.

 

Practices of culturally sensitive care

This week’s practicum experience was also very educative and informative. The primary objective for this week’s practicum was culturally sensitive care. I intended to learn and practice how to culturally sensitive care to improve patient outcomes. Practices of culturally sensitive care are one area of nursing education that nurses are taught and advised to be given keen attention to (Valizadeh et al., 2017). At school, I learned that providing culturally sensitive care is an important component of patient-centered care. Nurses must strive to enhance their ability to provide patient-centered care by reflecting on how their and the patient’s culture, values, and beliefs impact the nurse-patient relationship.

During the practicum experience, I encountered many patients of diverse cultural values. I was able to listen to, understand, and respect patients’ opinions, values, needs, and ethnocultural beliefs. I ensured that I do not dispute any cultural beliefs but educate the patients respectfully regarding some cultural beliefs that might seem harmful to medical care and the patient’s overall outcome (Valizadeh et al., 2017). Before beginning to care for the patient, I ensure that he/she understands English. In cases where the patient does not understand English, a translator may be provided to ensure communication is complete. In some cases, I asked patients what their culture says about their illnesses to find the best approaches for them. Some patients asked that their spiritual leaders be allowed to pray for them and their requests were allowed (Valizadeh et al., 2017). These are some of the practices of culturally sensitive care that I observed during the practicum experience.

 

 

Ensuring the integrity of human dignity in the care of all patients

The main topic of this practicum experience was, ensuring the integrity of human dignity in the care of all patients. Human dignity in healthcare care is a crucial concept on clinical ethics that has various definitions in the existing literature. has been emphasized throughout history by philosophical schools and various religions (Kadivar et al., 2018). During the practicum experience, we took into consideration a few factors related to human dignity in relation to patient care. For example, I showed respect to patients’ preferences and choices regarding their health care (Parandeh et al., 2016). I listened to their preferences and advised them accordingly, but not forcing them on what to select.

Another way I practiced showing dignity to patients is by involving them in decisions relating to their care. Making decisions about one’s health without involving or explaining to them why such changes happen is harmful to a person’s dignity (Kadivar et al., 2018). Therefore, it is crucial to involve them in all decisions that affect their care. I also addressed these people properly, with respect and compassion. Respect is the most important element of human dignity. There is no dignity where respect is absent.

Patients’ privacy is another most important dimension of human dignity. Healing environments are one of the places where privacy may be threatened. This aspect of human dignity was taken into considerations (Parandeh et al., 2016). I ensured that no medical or any other information from the patient landed in the eyes or ears of unauthorized people. Therefore, the week 6 practicum experience was very interesting.

 

 

Population health concerns

The topic of this practicum experience was Population health concerns. This topic enabled me to give attention and acknowledge various population health problems within the healthcare setting. Population health consists of incidences of disease in different groups of people. During the week 6 practicum, I encountered several patients experiencing illnesses and issues that are categorized under population health concerns. For example, I met three patients with heart disease and one with stroke. Both heart disease and stroke are the leading cause of death in the United States (Li et al. 2020). About 610, 00 people die from the illnesses.

Another population health concern I identified is HIV/AIDS. I encountered a patient who was admitted for HIV after defaulting from taking medications. It is one of the worst experiences a patient can ever have. She experienced the normal symptoms of the disease, but severe ones. As a healthcare professional, I educated the patient about the importance of medication adherence (Rivier University, 2021). I also taught her ways to ensure she does not infect her children and other family members.

During the practicum, I participated in a two-day campaign and outreach towards the prevention of substance and alcohol abuse in the nearby community. Approximately 16.8 percent of adults aged 18 years and above smoke in the US (Rivier University, 2021). I managed to educate community members regarding the impact of tobacco, illicit drugs, and alcohol on human health. The CDC recommends increasing the price of tobacco products, establishing statewide smoke-free policies to protect nonsmokers from secondhand smoke, and sustaining tobacco control program funding (Rivier University, 2021). However, these recommendations have not been achieved.

The role of technology in improving health care outcomes

Week 7 practicum experience was amazing, just like the previous ones. The primary objective for the week 7 practicum was to learn about the role of technology in improving health care outcomes. Technology is an integral part of medicine in today’s world. Having the right technology can help improve efficiency, quality, and reduce the cost of care (Alotaibi & Federico, 2017). During the practicum experience, I realized that the hospital has embraced technology as one way of improving patient outcomes and quality of care. I was able to learn the functions of various technology in healthcare.

The hospital has invested in health information technology to enhance communication and care coordination. An electronic health record is used within the organization to enhance coordination between departments. It has an integrated alarm reminder to remind care providers about appointments and the correct time of medication administration (Alotaibi & Federico, 2017). It also has clinical decision support (CDS) to prevent medication errors and enhance patient outcomes. Apart from the information technology, the hospital has smart pumps, which are intravenous infusion pumps that are equipped with medication error-prevention software. This software alerts the operator when the infusion set is set outside of pre-configured safety limits. The hospital also employed telemedicine technology to enable treatment and follow-up services at home or work (Alotaibi & Federico, 2017). Every patient in long-term care or those with chronic illnesses is registered with a patient portal where they can learn and access their medical information. Therefore, the week 7 practicum experience was educative.

Health policy

Week 8 practicum experience was also interesting and very educative. The primary objective for the week 8 practicum is health policy. During the week 8 practicum, I came across several healthcare policies as well as organizational policies that the healthcare providers are expected to adhere to. According to Campos & Reich (2019), health sector reforms happen through the implementation of healthcare policy. It requires a change in individual behavior to ensure these policies are applied. Implementation often entails consensus building, conflict management, and power bargaining among stakeholders located in different corners of the policy environment.

In the hospital, healthcare providers are required to adhere to different federal laws such as HIPAA privacy laws. Healthcare professionals are required to keep patient information confidential unless the law requires otherwise. It is well known that the commitment and competence of leaders to a policy profoundly affect its adoption and implementation (Campos & Reich, 2019). The hospital leaders also follow the state regulations related to recruitment and quality care provision. For instance, only licensed individuals with the required experience are recruited. The hospital also observes the nurse-to-patient ratio rules.

The organizational policies to improve health are also in place. For example, all staff must report in time before the start of the next shift. Members must report prior if they will not attend to their shifts so that proper arrangements are made early. Proper handwashing and hygiene are emphasized. All pregnant patients must be screened for syphilis and HIV (Campos & Reich, 2019). All these regulations are reinforced by the healthcare facility. there are several other policies not mentioned. Therefore, the week 8 practicum was informative.

 

Leadership and economic models

The primary objective of the week 9 practicum experience is leadership and economic models. Nurses need to have strong leadership abilities as well as economic skills to promote quality patient care and safety (Murray, 2017). With these skills, nurses can easily excel in cooperation, interdisciplinary collaboration, and the provision of safe care. In the hospital, healthcare providers who have great leadership, as well as economic model skills, are advocates of their patients and co-workers. As leaders, they understand all the organization’s rules and procedures (Murray, 2017). Effective leadership abilities need an understanding of the organization’s rules and procedures, as well as the ability to initiate and implement new evidence-based policies in their organizations.

One thing I realized in this practicum experience is that economics is part and parcel of healthcare. An economic model is a simplified description of reality, designed to yield hypotheses about economic behavior that can be tested (Sturmberg & Bircher, 2019). Different economists will make different judgments about what is needed to explain their interpretations of reality. Leaders implement economic models that have been deemed competent in the development and the success of the healthcare system. Economic models evaluate market variables such as the prices, demand, and competition within the market industry (Sturmberg & Bircher, 2019). It is about improving client satisfaction, organizational structure, and quality of care to attract more clients.

Health disparities

The primary topic of this week’s practicum experience was health disparities. Health disparities are preventable differences in the burden of disease, violence, injuries, and opportunities to achieve optimal health that are experienced by socially disadvantaged populations (CDC, 2020). Despite significant progress in research, policy, and practice, disparities in youth health risk behaviors persist. Populations are often defined by factors such as gender, education, income, race or ethnicity, geographical location, and sexual orientation.

I learned, during the practicum experience, that health disparities are directly related to the historical and current unequal distribution of social, political, economic, and environmental resources (CDC, 2020). Some of the factors contributing to health disparities include poverty, environmental threats, inadequate access to health care, individual and behavioral factors, and educational inequalities. Dropping out of school is associated with multiple social and healthcare problems (CDC, 2020). During the practicum experience, I realized that most individuals with less education were more likely to experience various illnesses such as diabetes, intentional and unintentional injuries, and substance abuse than individuals with more education.

The National Cancer Institute highlights disparities in mortality based on educational background: Less-educated individuals from any race are more likely to die from colorectal cancer before 65. Causes of disparities in diseases, such as asthma and diabetes, include systemic inequities based on race or ethnicity (CDC, 2020). For example, Black and Hispanic populations are more likely to have asthma than other U.S. residents. To be more specific, Puerto Ricans have the highest rates of asthma prevalence compared to any other racial group in the United States (CDC, 2020). In another example of health disparities, American Indians/Alaska Natives have the highest rates of diagnosed diabetes, according to the Centers for Disease Control and Prevention (CDC).

References

Alotaibi, Y. K., & Federico, F. (2017). The impact of health information technology on patient safety. Saudi medical journal, 38(12), 1173. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5787626/

Campos, P. A., & Reich, M. R. (2019). Political analysis for health policy implementation. Health Systems & Reform, 5(3), 224-235. https://doi.org/10.1080/23288604.2019.1625251

CDC. (2020). Health Disparities Among Youth. https://www.cdc.gov/healthyyouth/disparities/index.htm

Haddad, M., L., & Geiger, R. (2020). Nursing Ethical Considerations. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK526054/

Islam, M. M., Poly, T. N., & Li, Y. C. J. (2018). Recent advancement of clinical information systems: Opportunities and challenges. Yearbook of medical informatics, 27(01), 083-090. https://www.thieme-connect.com/products/ejournals/html/10.1055/s-0038-1667075

Kadivar, M., Mardani-Hamooleh, M., & Kouhnavard, M. (2018). Concept analysis of human dignity in patient care: Rodgers’ evolutionary approach. Journal of medical ethics and history of medicine, 11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6150922/

Li, J. P., Haq, A. U., Din, S. U., Khan, J., Khan, A., & Saboor, A. (2020). Heart disease identification method using machine learning classification in e-healthcare. IEEE Access, 8, 107562-107582.  https://doi.org/10.1109/ACCESS.2020.3001149

Murray, E. (2017). Nursing leadership and management: for patient safety and quality care. FA Davis.

Parandeh, A., Khaghanizade, M., Mohammadi, E., & Mokhtari-Nouri, J. (2016). Nurses’ human dignity in education and practice: An integrated literature review. Iranian journal of nursing and midwifery research, 21(1), 1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4776553/

Patelarou, A. E., Kyriakoulis, K. G., Stamou, A. A., Laliotis, A., Sifaki-Pistolla, D., Matalliotakis, M., … & Patelarou, E. (2017). Approaches to teach evidence-based practice among health professionals: an overview of the existing evidence. Advances in Medical Education and Practice, 8, 455. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5508813/

Rivier University. (2021). Top 10 Public Health Challenges. https://www.rivier.edu/academics/online/resources/program-resources/top-10-public-health-challenges/

Sturmberg, J. P., & Bircher, J. (2019). Better and fulfilling healthcare at lower costs: The need to manage health systems as complex adaptive systems. F1000Research, 8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6900806/

Tang, C. J., Zhou, W. T., Chan, S. W. C., & Liaw, S. Y. (2018). Interprofessional collaboration between junior doctors and nurses in the general ward setting: A qualitative exploratory study. Journal of nursing management, 26(1), 11-18. https://doi.org/10.1111/jonm.12503