+1 862 207 3288 End-of-Life Education for Patients and Families
Problem statement:
Patients and families often lack the knowledge necessary to make informed decisions regarding end-of-life issues.
Intensive Care Unit (ICU) clinicians may have invalid assumptions regarding a patient’s wishes, due to insufficient supportive initiatives and
protocols within the hospital facility addressing this issue; and as a result, patients may suffer unnecessarily in association with
unwelcomed interventions and loss of dignity (Cook & Rocker, 2014).
Plan:
An educational guide on end-of-life decision making will be developed in the form of a power point presentation and an educational
brochure that clinicians in the intensive care unit (ICU) can implement and use as a tool to help guide patients and families in making end-
of-life decisions regarding advance directives, living wills, healthcare proxy/surrogate, resuscitation, withdrawal of care, and allowing natural
death with palliative measures.
Goal:
Upon completion and implementation of the end-of-life educational brochure and power point presentation education, patients and
family members in the ICU will express their end-of-life option of care as evidenced by 90% participation in the initiation of an advance
directive.
Objectives:
1. Synthesize knowledge from liberal arts and sciences and nursing science to understand global persperctives, stimulate critical
thinking, and use of current technologies.
A. Exhibit critical thinking through analysis and synthesis of liberal arts and sciences and nursing science from learned
objectives, journal articles, and personal clinical experiences as a first step in the first two weeks.
B. Utilize present-day technologies in organizing an educational brochure for patients and families in the form of a
power point presentation during the following five weeks.
2. Make sound decisions in the use of patient information and healthcare technology to design, coordinate, manage, and
evaluate nursing care for individuals, families, and populations.
A. Demonstrate a clear understanding of what is meant by ann advance directive, living will, healthcare proxy/
surrogate, resucitation, withdrawal of care, and allowing natural death with palliative measures at the
project completion in the patient and family brochure by week five.
B. Research and select appropriate tools to evaluate the brochure for clarity, readability, and appropriateness
by week six.
3. Demonstrate clinical excellence in the provision of caring, compassionate, and culturally appropriate patient centered care to
people in a variety of settings.
A. Utilize a patient-centered approach in explaining the difference between curative and palliative treatment by week four.
B. Present information that is both culturally and spiritually appropriate in a caring and compassionate way by week six.
4. Communicate, collaborate, and negotiate effectively to improve patient healthcare outcomes.
A. Communicate and collaborate with preceptor bi-weekly until project completion.
B. Seek multi-disciplinary sources in providing a balanced approach to end-of-life care by week two.
5. Exihibit professional values and behaviors as outlined by a professional code of ethics, professional standards, and legal
statues.
A. Review by week two and adhere to Patient Rights Act, Nursing Code of Ethics, and the Nurse Practice Act.
B. Research by week two and align with legal issues in end of life decisions.
6. Promote healthy lifestyles through health promotion, risk reduction, and disease prevention education for individuals and
populations.
A. Provide patient-focused education relevant to end-of-life issues such as palliative care and pain management by
project completion.
B. Develop brochure that outlines palliative care plan which demonstrates positive outcomes by week six.
7. Incorporate evidence-based knowledge and theory into nursing practice.
A. Summarize current evidence-based research data to support brochure content by week six.
B. Conduct and incorporate a literature review of end-of-life issues by week three.
8. Demonstrate leadership and collaboration within interdisciplinary healthcare partners and professional political, and/or
regulatory organizations to support change in healthcare.
A. Advocate for implementation of the most current palliative measures as it relates to all end-of-life decisions by
attending institutional NPC (Nurse Practice Council) as scheduled for week five.
B. Collaborate with professional organizations to promote patient-focused agenda (e.g. HPNA Hospice and Palliative
Nurses Association http://hpna.advanceingexpertcare.org/) by week five to six.
9. Allocate and manage resources to ensure patient safety and high quality healthcare.
A. Promote healthcare delivery services that endorse good stewardship of hospital resource throughout project.
B. Collaborate with case management and unit educator to streamline delivery of care thereby promoting cost
containment by week four to week five.
10. Engage in life-long learning and scholarly inquiry to continue professional career development.
A. Continue self-directed learning through research and application of evidence-based practice and knowledge
throughout project.
B. Inquire about personal growth an development opportunities in place of employment by project completion.
Reference:
Cook, D., Rocker, G. (2014). Dying with dignity in the intensive care unit. New England Journal of Medicine. Retrieved from:
http://www.nejm.org/doi/full/10.1056/NEJMra1208795
Title: Creating Awareness of PrEP indication in Clients
Problem Statement: HIV is an ongoing epidemic worldwide. About 1.2 million people in the United States were living with HIV at the end of 2012 and of those people about 12.8% do not know they are infected (Basics). About 50,000 people get infected with HIV each year and to date, an estimated 658,507 people diagnosed with AIDS in the United States have died (Basics). With no cure or vaccine available, prevention is key to reduce these staggering numbers. As of July 16, 2012; Truvada PrEP (pre-exposure prophylaxis) is the first FDA approved drug for preventative use against contracting HIV in high risk individuals. Taking PrEP everyday can reduce your risk of getting HIV by up to 92% (PrEP). Choices Health Center is a gynecological office with a target clientele of women and teens. Practitioners here are finding a lack of awareness of PrEP among high risk groups decreases the initiation of conversation and or truthfulness regarding risk potential therefore leading to failure of recognition of indications of utilizing PrEP.
The Plan: To develop and implement an informative poster to display in the waiting room for clientele to observe and read while waiting for their appointments. A questionnaire will be made for health care practitioners to include in their intake of the patients health history that will screen for high risk behaviors and open the door for further conversation and assessment if needed.
Goal: Upon completion of displaying the poster in the waiting room and implementing the high risk behavior screening the high risk patients will recognize their potential benefits of utilizing PrEP as evidenced by at least 90% of patients will be screened for PrEP indication.
Objectives: Upon completion of NUR456 Professional Practice Project, I will be able to complete the following objectives as evidenced by documentation in discussion boards, clinical evaluations, and feedback from preceptor, fellow students, and faculty:
1. Synthesize knowledge from liberal arts and sciences and nursing science to understand global perspectives, stimulate critical thinking, and use current technologies
a.) Organize materials and information from learned objectives, journal articles, interviews in the first two weeks.
b.) Identify high risk behaviors using analysis of research, critical thinking in the following five weeks.
2. Make sound decisions in the use of patient information and healthcare technology to design, coordinate, manage, and evaluate nursing care for individuals, families, and populations.
a.) Evaluate current methods of patient’s health history intake forms by week three.
b.)Demonstrate a clear understanding of high risk behavior in patients by week three.
3. Demonstrate clinical excellence to provide caring, compassionate, and culturally appropriate patient-centered care to people in a variety of settings.
a.) Examine verbiage used in the high risk behavior screening to ensure it is culturally appropriate and patient centered by week four.
b.)Record in professional journal observations of patient response to the poster and high risk behavior screening in week six.
4. Communicate, collaborate, and negotiate effectively to improve patient healthcare outcomes.
a.)Collaborate with my preceptor who is the owner and nurse practitioner on development of high risk behavior screening by week four.
b.)Communicate high risk behaviors to the patients through the poster displayed in the waiting room by week five.
5. Exhibit professional values and behaviors as outlined by a professional code of ethics, professional standards, and legal statues.
a.)Review and adhere to guidelines set out by the Nurse Practice act and Nursing Code of Ethics by week two.
b.)Apply HIPPA laws throughout the project process.
6. Promote healthy lifestyles through health promotion, risk reduction, and disease prevention education for individuals and populations.
a.)Discuss with preceptor how she is currently evaluating patients for high risk HIV behaviors by week three.
b.)Identify high risk behaviors on display poster by week four.
7. Incorporate evidence based knowledge and theory into nursing practice.
a.)Conduct and incorporate a literature review of PrEP indications by week three.
b.)Expand knowledge on HIV and Prep medication by reading six current healthcare articles by week three.
8. Demonstrate leadership and collaboration within interdisciplinary healthcare partners and professional, political, and / or regulatory organizations to support change in healthcare.
a.)Lead an educational discussion group on HIV and PrEP with staff by week four.
b.)Collaborate with staff to include the high risk behavior screening as part of their regular intake forms for all patients by week five.
9. Allocate and manage resources to ensure patient safety and high quality healthcare.
a.)Collaborate with preceptor/owner to ensure proper use of resources for high risk behavior screenings for each patient by week four.
10. Engage in life-long learning and scholarly inquiry to continue professional career development.
a.)Examine the role of the women’s health / gynecological nurse throughout the course of the project.
b.)Continue personal growth and development through self- directed learning throughout the project.
References:
Basic Statistics. (2015, September 14). Retrieved October 24, 2015, from <http://www.cdc.gov/hiv/statistics/basics.html
DeNoon, D. (2012, July 16). FDA Approved First Drug For HIV Prevention. Retrieved October 22, 2015, from http://www.webmd.com/hiv-aids/news/20120716/fda-approves-first-drug-for-hiv-prevention
Jefferson, E. (2012, July 16). FDA Approved First Drug For Reducing The Risk Of Sexually Acquired HIV
Infection. Retrieved October 23, 2015, from http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm312210.htm
PrEP. (2015, June 25). Retrieved October 22, 2015, from http://www.cdc.gov/hiv/basics/prep.html
Truvada for PrEP Medication Assistance Program. (n.d.). Retrieved October 24, 2015, from >http://www.gilead.com/responsibility/us-patient-access/truvada for prep medication assistance program
