NURS 6512 Week 5 Essay Assignment
Advanced Health Assessment
Assessment is one of the first steps in becoming a nurse. From the time we enter nursing school we are taught to assess. Whether we are formulating a nursing care plan or rendering bedside care to a patient, assessment skills are, in my opinion, one of the most important foundation skills to master in the profession of nursing.
“Assessment is the collection of data about an individual’s health state (Jarvis, 2008)”. This statement seems so simple, but in reality what I learned during the course of the semester was that assessment is not limited to just the physical being, but also includes culture, values, family and support networks, as well as the ability of the patient to care for self.NURS 6512 Week 5 Essay Assignment These factors must be assessed in order to follow a holistic model of care (Jarvis, 2008).
Although this task seemed insurmountable initially, I realized that the way in which I typically assess patients could provide a more holistic approach by integrating some of the techniques I learned in this class. I normally have conversations with my patients while I assess them, and I found that if I asked them about their lives as I went about the physical aspect of the exam, I could learn much about how they were feeling and what support systems they had available to them.
While it is important to take into account the whole picture of the patient when assessing their health, it is paramount to have assessment skills refined to the highest level because in the hospital, the nurse is the only health care professional who is continually available at the bedside (Jarvis, 2008). I find this idea to be true to my practice. As much as I enjoy learning about the people I care for and what makes them “tick”, that information is of little use to me if I am unable to render appropriate care which is based on my initial physical assessment of the patient.
I felt that this class helped to reinforce and strengthen skills I had previously learned, such as heart and lung sounds, and expanded my knowledge of areas I less frequently assessed, like the hair and nails. I found the textbook in this class to be exceptionally useful for my learning, most notably because of the sheer volume of pictures to refer to, and I have kept this text for my collection. I think the skills I learned over the course of the semester will help me when I continue my education because this class touched on areas that I do not normally assess at length while in the surgical setting, such as the eyes and ears. Additionally, I have all my focused exam videos to look back on if I should need them in the future.NURS 6512 Week 5 Essay Assignment
Advanced health assessment (AHA) is required in Masters of Science in Nursing and Doctor of Nursing Practice programs. Finding preceptors for student clinical experiences is becoming more challenging due to recent increases in numbers of schools with competing programs, and productivity requirements for preceptors. Additionally, faculty noted that students were overwhelmingly weak on history taking and differential diagnosis when leaving the AHA course; often, this trend followed students through their population focused courses. With these issues in mind, we decided to look for other ways to provide students with the experience of getting thorough histories, doing physical exams, determining differential diagnoses and coming up with diagnostics. This presentation describes the use of simulation to achieve these goals.
Methods:
I-Human is a subscription website that provides hundreds of cases reflecting multiple populations appropriate for all levels of student learning. We piloted i-Human in our existing course requiring 52 hours of clinical with preceptors to see how the students used the program, their responses and how best to use it as a learning tool. Once we were sure it would achieve our learning goals, we approached the faculty and proposed changing the course from clinical to didactic. The course has about 100 students every semester and at least 10 faculty. Thus, we had plenty of feedback from our pilot to help us make decisions for subsequent courses. We analyzed the student’s individual work on each case, as well as the results from the class as a whole.
Results:
The pilot showed students improved their history taking skills, critical thinking and differential diagnosis skills when using i-Human. We believe this is because the expert who wrote the case provided detailed feedback on all aspects of the “visit” including history taking, physical exam and differential diagnosis. Students were able to write a SOAP note and compare it to that of the expert, enhancing their ability to practice recording patient data. Faculty and students both appreciated the feedback on the cases, which was provided in visual charts and spreadsheet format to pinpoint the student’s strengths and challenges.NURS 6512 Week 5 Essay Assignment
The revised didactic online course requires students to practice their history and physicals on willing family and friends and come to two on campus clinical lab days to refine skills with faculty. They also practice mock OSCEs in a group situation to prepare for day two, when students do an individual OSCE to demonstrate their history and physical skills. During the debrief of the mock OSCEs, students practiced differential diagnosis and presentation skills with faculty. They then submit a SOAP note on the OSCE case to be graded.
Conclusion:
The feasibility of using simulation to replace clinical preceptors was proven to be acceptable to students and faculty. Simulation seems to be superior in some respects, namely, developing thorough history taking and improving critical thinking abilities regarding differential diagnosis. Students were also able to achieve very good OSCE scores despite having had no clinical experience with preceptors.
Nurses are increasingly expanding and extending their practice scope beyond primary registration in every aspect of health care. Currently, nurses are commonly working in a range of settings situated in urban and local communities. They operate in private practices at an advanced level of practice in all areas, such as community health, mental health, sexual health, general practice, ambulatory care clinics, public health departments, hospitals, HMOs, free standing health clinics, school-based health clinics and employee health departments (Scope of practice – framework for nurses and midwives, 2005).NURS 6512 Week 5 Essay Assignment The Royal College of Nursing developed the first formal education and training program for prospective nurse practitioner in the early 1990’s in UK. Then in 2008 initial educational competencies for nurse practitioners was emerged by RCN. It was grounds on disease screening, consultancy skills, chronic disease management, physical examination, health counseling and education plus minor injury management. Moreover, in the same year International Council of Nurses (ICN) has given the broad definition of advance practice nursing, i.e. “An Advanced Practice Nurse/Nurse Practitioner is a registered nurse who has obtained the complex decision making skills, expert knowledge base and clinical proficiency for extended practice, the personality of which are shaped by the country or context in which they are credentialed to practice and for their entry level masters degree is recommended”. Further, according to European Working Time Directive (2009), the work hours for APN is reduced to 48 hours a week, which was earlier 58 hours.
The term expanded clinical practice means nurses taking on liabilities traditionally attributed to physicians, such as clinical diagnosis, assessment and treatment. Such practice also refers to latest interdisciplinary models under which nurses take initiatives, which are aimed towards improving care of patient, such as the transitional care models development or nurse-led clinics. The huge scope of ANP’s may develop a new dynamic in interdisciplinary cooperation particularly among nurses and physicians. Their expanded competencies that enable them for taking on more responsibilities in medical patient care can be seen as an extra value by few physicians. The ANP’s role introduction demands the redefinition of nurse-physicians cooperation in medicinal care in which shaping appropriate mix of skills to attain optimal results.
Health assessment is one of the most essential and challenging aspects facing health care practitioners. From top to bottom, from inside out, your ability to identify a patient’s condition influences that patient’s care. In NU 607 Advanced Health Assessment and Promotion you’ll draw from your previous course knowledge in health assessment, therapeutic communication, and patient teaching to advance your evaluation skills in a variety of health care situations.NURS 6512 Week 5 Essay Assignment
Through case studies and 30 hours of clinical application, you’ll gain real world experience and insights into effective procedures to evaluate both mental and physical conditions. You’ll put your learning into practice as you accurately complete an adult health history, as well as a pediatric health history. You’ll also submit a video of an adult head-to-toe exam, using a Physical Exam Checklist provided by your instructor.
The aim of this subject is to develop advanced health assessment skills in nursing that are relevant to the student’s area of clinical practice.
The subject provides the foundation for the development of health assessment knowledge and skills that are required in order to practice in an advanced practice nursing role.
The subject will explore diagnostic decision making processes taking into consideration factors that impact on health and health assessment outcomes, such as: age, gender, culture, socioeconomic status and life style.
Students will use a client focused approach to health assessment and apply a structured framework to guide health assessment. History taking, general examination skills, diagnostic testing and communication of assessment findings to the health care team and patient (written and verbal) will form the core content of the subject.NURS 6512 Week 5 Essay Assignment
Students will have the option of selecting areas that are relevant to their own area of practice. These topics will include: cardiovascular, respiratory, neurological, cognitive and developmental, abdominal, alimentary and nutritional, genitourinary, musculoskeletal, integument and psycho social assessment.
The subject will provide a number of strategies to assist the students in developing advanced health assessment skills. On campus tutorials and workshops, reading and resource material will be provided to assist students to develop the necessary knowledge and skills for advanced health examination and patient assessment. Students will use clinical mentors in their practice environment to support their learning, in particular the development of specialty assessment skills.
The subject is designed to support students in meeting the ANMC Competency Standards for Nurse Practitioners (2006).
This subject is a mandatory component of the Master of Advanced Nursing Practice Nurse Practitioner pathway.NURS 6512 Week 5 Essay Assignment