NUR 4667 NURSING IN GLOBAL HEALTH SYSTEMS MODULE 4: HEALTHCARE ORGANIZATIONS & DELIVERY OF NURSING CARE The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems. American Nurses Association. (2001). Code of ethics for nurses. Silver Spring, MD: ANA MODULE 4 OBJECTIVES At the completion of this module, the student will: Identify the relationship of culture to health, including health beliefs and practices, and health behaviors and behavior change. (EVALUATION: Module 4 quiz) Recognize the impact of environmental issues, including disasters and humanitarian emergencies, on the burden of disease and state of health. (EVALUATION: Module 4 quiz) Develop an innovative nursing care delivery model for a vulnerable population in the United States or a low income country that reflects nurse managed care, collaboration, care across settings, and technology. (EVALUATION: Paper: Innovative Nursing Care Delivery Model) MODULE 4 LEARNING ACTIVITIES 1) READ the following: Chapter 6: Culture and Health Chapter 7: Environment and Health Chapter 15: Natural Disasters and Complex Humanitarian Emergencies RECOMMENDED: Chapters 21 & 22: The nurse in a culturally/spiritually diverse world. In K.K. Blais & J.S. Hayes (2015). Professional nursing practice: Concepts and perspectives (7th ed.). Upper Saddle River, NJ: Prentice Hall. RECOMMENDED: Chapter 13: The nurse as colleague and collaborator. In K.K. Blais & J.S. Hayes (2015). Professional nursing practice: Concepts and perspectives (7th ed.). Upper Saddle River, NJ: Prentice Hall. 2) COMPLETE the [open book] quiz (10 questions) on the above chapters. The quiz will be open during the 48 hours before the due date. See schedule for due date. 3) WRITE a paper (at least 750 words) on a Innovative Nursing Care Delivery Model. Read the two (2) articles below: Norlander, L. (Ed.). (2011). Transformational models of nursing across different care settings. Report: The future of nursing: Leading change, advancing health (Appendix G). Washington, DC: National Academy of Sciences, Institute of Medicine. (CLICK on PDF file:
TRANSFORMATIONAL NURSING MODELS) NOTE: For this assignment, ignore curriculi/nurse education models Hughes, F. (2006). Nurses at the forefront of innovation. International Nursing Review, 53, 94-101. (CLICK on PDF file: NURSING PRACTICE INNOVATIONS) Baccalaureate-prepared nurses are expected to function as managers, educators, collaborators, advocates, and leaders within a variety of settings. These articles describe a variety of innovative or “transformational” models in nurse-managed care across various care settings. For this paper, you will develop an innovative nursing care delivery model for a vulnerable population, care specialty, and setting in the United States OR a low income global country that reflects nurse managed care, collaboration, care across settings, and technology. For your paper, it is easiest to focus on one (1) population, one (1) health issue/disease, and one (1) type of setting within a country. Be specific. If you use a low income country, name your low income country (see list in module 1) and adjust your model to the disease(s) and conditions found within that country. Consider that low income countries will not have access to the same level of facilities, technology related to diagnostics and communication, medications, and the health care professionals found in the U.S. A vulnerable population can include low income children & adults; elderly; homeless; migrants; immigrants; racial & ethnic minorities, people with chronic health or terminal conditions/diseases (or any group at risk for obtaining appropriate health care). A care specialty can include preventative care; primary care; acute care; chronic care; palliative or end-of-life care (including the targeting of any disease or condition that results in a health risk). A setting can include rural or urban community housing and/or clinic; school; specialty unit in a hospital; emergency room; health provider office; armed services facility; rehabilitation facility; hospice facility; ambulatory health care center; client home; nursing home; short term stay housing (or any setting where a vulnerable client/patient population is available for care). a) Content of paper: Title of Paper (top of page 2, centered) Innovative Nursing Care Delivery: [Name of Your Model] PAPER HEADING: Introduction [Level 1] What is your model’s population, setting, care specialty, and your model’s goal(s) and/or purpose(s)? For example, are you targeting a particular group or disease/condition? Choose a name for your model and include it in your paper title. PAPER HEADING: Description of the [Name of Your Model] [Level 2] You are welcome to use your creativity in the model–develop your own or base it on an existing model. For ideas, start with the articles found with the assignment, textbook (Global Health 101) scenarios, or do literature searches on the internet. However, be sure that the model is nurse-led or nurse-managed. Registered nurses have authority to make decisions regarding nursing diagnoses, interventions, and referrals. Registered nurse practitioners have additional authority related to medical diagnoses and interventions (prescriptions). Be sure to include the themes crucial to meeting the challenges of the future: nursemanaged care, collaboration, continuity of care and technology in describing your model. Be aware of cost-effectiveness; you could develop the “Cadillac” of models, but no one would consider implementing it because the cost would be too high. Nurse led and nurse managed health care. [Level 3] How is your model nurse managed? Were nurses instrumental in the development and implementation of your model? Are nurses consulted and/or make decisions re: budget, personnel, and the communication, referral, and evaluation processes? Partnerships and collaboration. [Level 3] What partnerships and collaborations exist for your model? Are they at the professional level (i.e., social workers, nutritionists, community leaders) and/or the organizational level (home health care agencies, public health departments, hospitals)? Continuity of care across settings. [Level 3] What happens when a patient/client moves to a different setting, i.e., home, hospital, hospice, clinic, emergency room, etc. How is communication handled so the patient/family needs are consistently met when moved across settings? Technology. [Level 3] What technology is used? Is it low-technology (basic assessment tools, screening tests) or high-technology (i.e, patient diagnostic, monitoring, and/or data processing systems) or a combination of both?
PAPER HEADING: Development/Implementation Team for the [Name of Your Model] [Level 2] Your team is important to carry out model’s goal(s). Depending on your model and setting, your team may include other registered nurses, nurse practitioners, community workers, nurse assistants, licensed practical nurses, nutritionists, physical therapists, occupational therapists, dentists, social workers, community leaders, psychologists, clergy, administrators, informatics technicians, physicians (if physicians are part of the team, they should function as consultants, not “captain of the ship”). Include your team members and briefly discuss their functions in carrying out the model goal(s)/purposes(s). How would communication and referrals be handled? Again–think about the cost effectiveness–could ancillary staff (nurse assistants, trained community workers) be used just as effectively?
PAPER HEADING: Evaluation of [Name of Your Model]: Outcome Measurement [Level 2] After implementation of the model, what outcomes would you measure and how and when would you measure those outcomes? Be specific on how and when. Would you look at cost comparisons and/or savings? Patient satisfaction? Staff satisfaction? Fewer ER visits and/or re-hospitalizations? Decreased incidence of a particular disease/condition? Increased number of therapies? Increased knowledge of a disease or intervention? b) An example of a nurse-managed model: Below is an idea for a nurse-managed model. Your paper would be organized per the assignment instructions and more detailed regarding the health care delivery (nurse-led, collaboration/partnerships, continuity of care, and technology), and the functions of each of the team members, etc., but this is the start of an idea: Let’s say you are a nurse working in community health and you are aware of three large migrant communities located in the rural areas around Homestead, Florida. The migrant workers who reside in these communities include their families–from infants to elderly. The communities are isolated and lack transportation and the ability to pay for and access local health care facilities. You develop a model named Bus Stop for Health. You obtain funding (donor and/or grant) to refurbish a bus or utilize a refurbished bus already owned by a local health care organization. The bus will include an examination room (with assessment devices, such as BP cuffs, otoscopes, exam tables), supplies for health screenings (i.e., diabetes, cholesterol, pap smears, etc.), and two rooms for consultation. An informatics technician (IT) will establish a computerized (e-tablet) system to input, store, and access data in the field. Smart phones will be used for real time communication. After consultation with and permission from the local community leaders in the migrant communities, the bus is scheduled to drive to and spend 1-2 days/week at each migrant community. The purpose of the bus is to provide primary health care (preventative care, such as immunizations and well child exams), monitor chronic diseases, such as hypertension and diabetes), diagnose and treat minor illnesses, and provide healthrelated education for this population. A referral system will be established for specialty care, such as obstetrics. Some folding chairs and a tarp will be carried in the bus so small covered outdoor or indoor health education sessions can be provided. Regular team members on the bus will consist of a nurse practitioner, registered nurse, and receptionist/translator. Other team members will rotate in and out of the scheduled bus times on a regular basis. For example, you could include a social worker, dentist, and psychologist (describe their specific functions/purposes for this migrant population) as rotating team members. A nurse midwife could also be included in the bus rotation for managing low risk pregnancies. A consultant and referral relationship with a physician or physicians could be established for more complicated health care problems. Commonly prescribed medications can often be obtained through pharmacies at reduced costs or free from donors. Evaluation? Some outcomes looked at could be increased immunization rates, increased knowledge related to common chronic diseases, child safety, etc. (by using pre & post tests), reduced visits to the local ERs for minor illnesses), earlier prenatal care, or other outcomes of interest. You could also use surveys to determine patient and community leader satisfaction with the model. c) In-text citations and a reference list MUST be found in your paper. See the Nursing Student Writing Guidelines Checklist for APA formatting. d) UPLOAD completed paper (file) into the Assignment TURNITIN folder by the due date. e) WRITING EVALUATION: See rubric on Course Content page Paper: Innovative Nursing Care Delivery (750 words min) Innovative Nursing Care Model; Development/Implementation Team for Innovative Nursing Care Model; Evaluation of Model: Outcome Measurement Critical Thinking Skills (15 pts); Content Development (15 pts); Organization (15 pts) References (15 pts); Format (15 pts); Computer/Technology Skills (25 pts)