i already chose a paper

Description

Pick one of the following topics and find a scholarly nursing journal article (published within the last five years) that discusses this nursing topic. The topics are

  • ? safety;
  • ? delegation;
  • ? prioritization; and
  • ? caring.After you find a scholarly nursing journal article using the Chamberlain library resources, you will complete a one-two page summary and reflection on the article. The paper should be completed in APA format and include the following.
  • ? A cover page (not included in the page number requirement)
  • ? A reference page (not included in the page number requirement)
  • ? One direct quote from one of your references, appropriately cited in the body of your paper
  • ? One indirect quote (or paraphrased reference) appropriately cited in the body of your paper
  • ? Citations and references in APA format
  • www.Nursing2015.com January l Nursing2015 l 55

    THIS IS THE PAPER I CHOSE.MAMMAMAART/iSTOCK

    Having Trouble Meeting Your Deadline?

    Get your assignment on i already chose a paper completed on time. avoid delay and – ORDER NOW

    Safety Alert:
    IN 2012, 27,380 U.S. healthcare
    workers were injured in nonfatal
    workplace injuries. According to the
    Bureau of Labor Statistics, healthcare
    facilities with more than 1,000 employees
    have an average of 5.5 nonfatal
    injuries annually.1 Between 2009 and
    2011, eight RNs were fatally injured
    at work.2 (See Startling statistics.)
    Many nurses are routinely exposed
    to violent behavior such as shouting,
    cursing, spitting, biting, pulling,
    pushing, scratching, threats to themselves
    and their loved ones, and actual
    physical assaults with hands, fists,
    weapons, or objects within the assailant’s
    reach.3 All too often, nurses fail
    to report these episodes of violence
    because they erroneously consider it
    to be “part of the job.” Consequently,
    managers and administrators may be
    unaware of the extent of risk to nurses
    and fail to initiate corrective action.
    For their personal safety and the
    protection of patients, visitors, and
    other staff, nurses must recognize
    signs of behavior escalating toward
    violence. This article discusses how
    to recognize signs of escalating behavior
    and what to do to defuse the
    situation effectively and safely.
    Violence: Getting
    down to basics
    Violence is the intentional act of aggression,
    verbal abuse, threatening
    behavior, and/or physical assault. The
    intended goal is to threaten, control,
    coerce, intimidate, humiliate, silence,
    ostracize, demean, or otherwise emotionally
    or physically injure the victim.
    3,4 The focus of this article is
    threatened or actual physical violence
    within healthcare facilities.
    Although anyone can be a victim
    of violence, people in certain
    healthcare positions, such as clinical
    nurses and unlicensed assistive personnel,
    may be routinely exposed to
    acts of violence. Nursing personnel
    who work in the ED, ICU, and psychiatric
    or long-term care units are
    most at risk for experiencing routine
    episodes of violence on the job
    Protecting yourself and
    others from violence
    By Charlotte Davis, BSN, RN, CCRN;
    Denise Landon, BSN, RN, CMSC; and Kandie Brothers, MSN, RN, CNL
    Copyright © 2015 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
    www.Nursing2015.com January l Nursing2015 l 57
    from patients, family members, or
    visitors.3 Patient substance abuse
    and cognitive impairment can increase
    the risk of violence for staff.
    Identifying levels of stress
    The Veterans Administration Health
    Care 2014 Prevention and Management
    of Disruptive Behavior
    (PMDB) program teaches that potentially
    violent behavior escalates
    through four levels of stress: normal,
    moderate, severe, and panic
    level.3,4 In some circumstances, a
    person can transition rapidly from a
    normal stress level to panic level.
    This potential requires nurses to
    refine their escalation assessment
    skills and to develop a plan with
    the employer and coworkers to
    safely manage the perpetrator’s escalating
    behavior and ensure everyone’s
    safety. See Four levels of stress:
    Assessment and intervention for
    warning signs and interventions
    appropriate for each stress level.
    When confronted with signs of
    moderate escalation, avoid arguing
    with the agitated patient or visitor.
    Raising your voice to match the tone
    and volume of the other person’s
    voice can trigger escalation to a
    higher stress level and increase the
    likelihood of physical violence. If the
    person seems to perceive you as a
    threat, remove yourself from the situation.
    If you can safely do so, introduce
    a neutral party to speak with
    the person and try to deescalate the
    behavior.
    If a patient’s family or visitor becomes
    disruptive in the patient’s
    room, consider asking the person to
    step outside the room or press the
    call light to signal the need for assistance,
    depending on the situation.
    Don’t remain in the room with the
    hostile individual because of the risk
    of physical injury.
    Follow facility safety policies and
    procedures if the person’s behavior
    continues to escalate. For example,
    most facility policies include a provision
    for notifying security or a house
    supervisor or management team
    member immediately; that designated
    person may then call law enforcement
    if needed. Nurses should
    program their healthcare facility’s
    security office and 911 into their cell
    phone speed dial.
    Consider developing a code word,
    such as “purple,” that signifies a need
    for assistance because of an escalating
    situation. All staff members
    should be educated on what the
    code word is and what actions to
    take in response.
    If you’re isolated and in imminent
    danger, find alternative ways
    to draw attention to the location,
    such as activating a panic button,
    yelling for assistance, and pulling a
    fire alarm or accessing an automated
    external defibrillator (AED).
    When accessed, some AEDs activate
    an alarm to locate the emergency.
    Check to see if this is an option
    where you work.
    Report and document all incidents
    of potential or actual violence according
    to facility policy. This information
    will help managers and administrators
    take action to maintain the culture
    of safety that staff, patients, and
    staff are entitled to.
    Minimizing risks:
    Watch for weapons
    Some healthcare facilities allow
    staff to review and itemize a patient’s
    personal possessions upon
    admission. If permitted to itemize
    possessions by facility policy, the
    nurse can look for obvious and potential
    weapons at this time. Guns,
    stun guns, knives, and other items
    that could be used to penetrate the
    skin should be confiscated and
    locked in a secure location until
    the patient’s discharge per your
    facility’s policy.
    Be aware that some innocentlooking
    items can be used as weapons;
    for example:
    • a cane can be modified to make a
    sword with a potentially long, lethal
    blade.
    Gestures such as shaking
    a fist and prolonged
    staring signal escalating,
    potentially violent
    behavior.
    Startling statistics
    Results of the Emergency Nurses Association’s 2011 Emergency Department Violence
    Surveillance Study revealed that almost 70% of respondents had been physically
    threatened, 52% had been physically assaulted, and 40% had been involved
    in a violent situation at their job in which a weapon was utilized. Of those routinely
    exposed to physical violence, about 17% experienced the behavior more than four
    times a week. Nurses failed to report physical violence in 66% of these cases because
    they believed that violence was just “part of the job.”6
    Failure to file a timely formal incident report may allow the perpetrator to victimize
    others and place the nurse at risk for uncompensated medical treatment for any
    injuries suffered during the violent incident. Underreporting also can prevent the
    facility’s administrative and safety and quality management teams from recognizing
    and addressing the presence and severity of staff members’ routine exposure to violence.
    Employers may be cited by the Occupational Safety and Health Administration
    if they fail to ”prevent or abate a recognized violence hazard in the workplace.”7
    Copyright © 2015 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
    58 l Nursing2015 l January www.Nursing2015.com
    • both flashlights and cell phones
    can be modified to make a gun or
    stun gun.5
    Nurses should be suspicious if
    an object seems heavier than it
    should be or shows signs of alteration,
    such as screws or reinforcement
    at joints, and contact the
    security team to have the item
    inspected.
    A nurse confronted with an escalating
    person who’s armed with any
    type of weapon should immediately
    evacuate the area and retreat to a safe
    place, then notify hospital security
    and/or call 911. The nurse should
    never try to intervene with someone
    armed with a weapon.
    Besides obvious weapons, many
    items found within a healthcare facility
    can be used as a weapon because
    of convenience and proximity.
    These include telephone cords, holepunch
    devices, examination lamps,
    plants, electrical devices, pens,
    tables, and chairs. When the nurse
    observes escalating behavior, he or
    she should begin to calmly remove
    these items out of sight or away
    from the person’s reach, if this can
    be done safely.
    Many items nurses wear or carry
    are also potential weapons; for example,
    a stethoscope, pen, eyeglasses,
    dangling jewelry, and lanyards.
    Even lanyards with breakaway
    clasps can be used to strangle a
    nurse if the aggressor grasps the
    breakaway clasp.
    During periods of panic-level escalation,
    nurses with long hair should
    put their hair up in a ponytail, twist
    their hair into a bun, or tuck long
    hair underneath the back of their
    shirt. An agitated person can grasp
    loose long hair and use it to control
    the nurse’s head, resulting in a whiplash
    injury, blunt force trauma to the
    head, or even strangulation.
    Control the environment
    By managing the environment, nurses
    can help defuse potentially dangerous
    behavior or minimize the
    consequences. Following these
    guidelines can help prevent escalation
    of aggressive behavior and minimize
    the risk of injury.
    • Pay attention to early signs of escalation
    and intervene at the lowest
    level of stress. (See Making “GAINS”
    against escalating behavior.)
    • Remove unnecessary staff, patients,
    and visitors to minimize the “audience.”
    Some aggressors will calm
    down without an audience.
    • Remove any excess furniture,
    plants, and decorative items that
    could be used as a weapon or thrown.
    • Decrease the noise level and other
    environmental stimuli in patient-care
    areas. Increased environmental stimuli
    and high noise levels can trigger
    anxiety attacks and posttraumatic
    stress disorder exacerbations.3,4
    • Reduce overcrowding in waiting
    areas if possible. Offer patients, staff,
    and visitors the option to take a
    break in a quiet area, such as a chapel,
    outside sitting area, or a less
    crowded waiting room.
    • Don’t multitask when you’re assisting
    patients, staff, and visitors who
    are exhibiting signs of moderate or
    severe stress. Give them your full attention.
    Multitasking may give them
    the impression that you’re not fully
    invested in solving their problem.
    • Pay attention to gut feelings! Immediately
    leave any situation if you
    feel uncomfortable or unsafe.
    Nurses should take advantage of
    any training that their employers
    Four levels of stress: Assessment and intervention3
    Stress level Signs and symptoms Interventions
    Normal • heart rate (HR), 60-80 bpm
    • keen perceptual field (awareness of
    surroundings)
    • able to think clearly and process
    information
    Provide good customer service. Offer assistance or provide
    information in a professional, respectful, and timely manner.
    The nurse may be able to prevent escalation simply by
    communicating the current or anticipated plan of care to
    the patient/family.
    Moderate • HR, 81-100 bpm
    • perceptual field narrows
    • altered thinking
    Verbal intervention: redirect the person, indicating the behavior
    isn’t acceptable
    Severe • HR near or above 100 bpm
    • difficulty processing information
    • task oriented or tunnel vision
    • complex motor skills deteriorate
    • perceptual field very limited
    Set limits. Provide clear one- or two-step directions. Avoid
    multistep directions because the person can’t process this
    information with a limited perceptual field.
    Panic • HR over 100 bpm
    • can’t process information or problem-solve
    • irrational; a danger to self and others
    • gross motor skills, such as strength-based
    actions (walking, running, hitting, or throwing
    objects) are at their highest performance
    Gain attention of coworkers and avoid becoming isolated
    with this person. Locate an exit door and begin moving toward
    the door as you speak. If that’s not possible, yell loudly
    for help, call hospital security or 911, and activate the speaker
    feature on your phone. Consider chemical or physical
    restraints per facility policy if all other efforts have failed.
    Copyright © 2015 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
    www.Nursing2015.com January l Nursing2015 l 59
    offer, such as Crisis Prevention and
    Intervention training, the Veterans
    Administration’s PMDB program,
    and self-defense classes that
    teach hands-on techniques to
    minimize the risk of injury to
    self or others during potentially
    violent situations.
    Help reduce the risk of violence
    by assisting people who appear
    lost, answering questions, and
    conveying your commitment to
    helping to resolve their problems.
    Avoid making comments such as
    “that’s not my job,” which can
    escalate an agitated person’s stress
    level. Like patient and staff safety,
    customer service is everyone’s
    business. ?
    REFERENCES
    1. United States Department of Labor. Bureau of
    Labor Statistics. Economic News Release. 2012.
    http://www.bls.gov/news.release/osh.t03.htm.
    2. American Nurses Association. Workplace
    Violence. 2014. http://www.nursingworld.org/
    workplaceviolence.
    3. Bullard, D. Prevention and management of
    disruptive behavior. Veterans Administration
    Healthcare System {Conference}. Nashville,
    Tennessee. 2014.
    4. Williams J. Improvised weapons and other
    safety concerns. Los Angeles County Sherriff’s
    Department. 2013. https://info.publicintelligence.
    net/LA-DisguisedWeapons.pdf.
    5. NANDA Nursing Interventions. 2013.
    http://nanda-nursinginterventions.blogspot.
    com/2012/03/levels-of-anxiety-mild-moderateand.
    html.
    6. Emergency Nurses Association. Emergency
    Department Violence Surveillance Survey. 2011.
    http://www.ena.org/practice-research/research/
    Documents/ENAEDVSReportNovember2011.pdf.
    7. Occupational Safety and Health Administration.
    OSHA fact sheet: workplace violence. https://www.
    osha.gov/OshDoc/data_General_Facts/factsheetworkplace-
    violence.pdf.
    Charlotte Davis is a CCU/CVICU staff nurse at Heritage
    Medical Center in Shelbyville, Tenn., and Alvin C.
    York VA Medical Center in Murfreesboro, Tenn.
    Denise Landon is an MICU staff nurse at Olin Teague
    Veterans Medical Center in Temple, Tex. Kandie
    Brothers is nursing clinical faculty/prevention and
    management of disruptive behavior coordinator at
    the Department of Veterans Affairs Medical Center in
    Nashville, Tenn.
    The authors have disclosed that they have no financial
    relationships related to this article.
    DOI-10.1097/01.NURSE.0000454955.88149.e4
    Making “GAINS”
    against escalating
    behavior3
    Both verbal and nonverbal indicators
    signal escalating, potentially violent
    behavior, as suggested by the GAINS
    mnemonic:
    Gestures of anger, such as shaking
    a fist, prolonged staring, slamming a
    door, throwing objects
    Acting suspicious, anxious, fearful,
    or hostile toward staff
    Incongruent behavior that doesn’t
    match the words; for example, a person
    stating that he or she is “fine”
    while pacing and becoming increasingly
    agitated
    Noticeable signs and symptoms
    of stress, such as diaphoresis, flared
    nares, jugular vein distension, and
    elevated heart rate and BP
    Systematically pacing, tapping feet,
    shaking knees, sighing, running fingers
    through the hair repeatedly, rubbing
    the forehead.
    Copyright © 2015 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.

References:

Nursing Standards

Nursing and Midwifery Board of Australia. (2018). Code of conduct for midwives. https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx

Clinical Guidelines

Guideline Adaption Committee. (2016). Clinical practice guidelines and principles of care for people with dementia. NHMRC Partnership Centre for Dealing with Cognitive and Related Function Decline in Older People. https://cdpc.sydney.edu.au/wp-content/uploads/2019/06/CDPC-Dementia-Guidelines_WEB.pdf

Living Guideline

Stroke Foundation. (2022). Australian and New Zealand living clinical guidelines for stroke management – chapter 1 of 8: Pre-hospital care. https://app.magicapp.org/#/guideline/NnV76E

Evidence-based practice

BMJ Best Practice

Goldfarb, S., & Josephson, M. (2020). Cystic fibrosis. BMJ Best Practice. https://bestpractice.bmj.com/

Schub, T., & Cabrera, G. (2018). Bites: Head lice [Evidence-based care sheet]. Cinahl Information Systems. https://www.ebscohost.com

Beyea, S. C., & Slattery, M. J. (2006). Evidence-based practice in nursing: A guide to successful implementation. http://www.hcmarketplace.com/supplemental/3737_browse.pdf

JBI: Evidence summary

Swe, K. K. (2022). Blood glucose levels: Self-monitoring [Evidence summary]. JBI EBP Database. https://jbi.global

JBI: Best practice information sheet

Bellman, S. (2022). Experiences of living with juvenile idiopathic arthritis [Best practice information sheet]. JBI EBP Database, 24(1), 1-4.

Cochrane Database of Systematic Reviews

Srijithesh, P. R., Aghoram, R., Goel, A., & Dhanya, J. (2019). Positional therapy for obstructive sleep apnoea. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD010990.pub2

Drug Information

Codeine. (2023, January). In Australian medicines handbook. Retrieved February 2, 2023, from https://amhonline.amh.net.au

Colorado State University. (2011). Why assign WID tasks? http://wac.colostate.edu/intro/com6a1.cfm

 

Dartmouth Writing Program. (2005). Writing in the social sciences. http://www.dartmouth.edu/~writing/materials/student/soc_sciences/write.shtml

Rutherford, M. (2008). Standardized nursing language: What does it mean for nursing practice? [Abstract]. Online Journal of Issues in Nursing, 13(1). http://ojin.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/Health-IT/StandardizedNursingLanguage.html

Wagner, D. (n.d.). Why writing matters in nursing. https://www.svsu.edu/nursing/programs/bsn/programrequirements/whywritingmatters/

Writing in nursing: Examples. (n.d.). http://www.technorhetoric.net/7.2/sectionone/inman/examples.html

Perth Children’s Hospital. (2022, April). Appendicitis [Emergency Department Guidelines]. Child and Adolescent Health Service. https://www.pch.health.wa.gov.au/For-health-professionals/Emergency-Department-Guidelines/Appendicitis

Department of Health. (n.d.). Who is being active in Western Australia? https://ww2.health.wa.gov.au/Articles/U_Z/Who-is-being-active-in-Western-Australia

Donaldson, L. (Ed.). (2017, May 1). Healthier, fairer, safer: The global health journey 2007-2017. World Health Organisation. https://www.who.int/publications/i/item/9789241512367

NCBI Bookshelf

Rodriguez Ziccardi, M., Goyal, G., & Maani, C. V. (2020, August 10). Atrial flutter. In Statpearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK540985/

Royal Perth Hospital. (2016). Procedural management: Pre and post (24-48 hours) NPS. Canvas. https://courses.ecu.edu.au

 

 

Explanation & Answer

Our website has a team of professional writers who can help you write any of your homework. They will write your papers from scratch. We also have a team of editors just to make sure all papers are of HIGH QUALITY & PLAGIARISM FREE. To make an Order you only need to click Order Now and we will direct you to our Order Page at Litessays. Then fill Our Order Form with all your assignment instructions. Select your deadline and pay for your paper. You will get it few hours before your set deadline.

Fill in all the assignment paper details that are required in the order form with the standard information being the page count, deadline, academic level and type of paper. It is advisable to have this information at hand so that you can quickly fill in the necessary information needed in the form for the essay writer to be immediately assigned to your writing project. Make payment for the custom essay order to enable us to assign a suitable writer to your order. Payments are made through Paypal on a secured billing page. Finally, sit back and relax.

Do you need an answer to this or any other questions?

Similar Posts