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NURS FPX 6080 Assessment 2 Reflection on Nursing Core Student name Capella University NURS- FPX6080 Professor Name Submission Date NURS FPX 6080 Assessment 2 Reflection on Nursing Core The profession of nursing demonstrates professional and personal values, including ethics, integrity, compassion, advocacy, and social justice for patients. This assessment is for identifying and distinguishing professional identity, as well as comparing my values with those of distinguished and international nursing professional organizations and their ethical principles and missions. The strategies used to mentor, provide peer feedback, and assess team members for professional development and accountability will also be explored. Personal and Professional Practices in the Context of Nursing’s Core Values The concept of professional identity is strong in the care a nurse is committed to, which includes providing whole person, patient-centred and equitable care. My role as a nurse professional identity is the concept of my expertise in my clinical practice, ethical responsibility, and commitment to learning. The research is based on the values which are fundamental to Nursing – Authenticity, Altruism, Inclusiveness, Compassion, Courage, Humility, Advocacy, Caring, Autonomy, Humanity, and Social Justice, which are relevant to my professional and clinical practice. These are the values that I have in my interactions with patients, fellow healthcare professionals, and the rest of the Healthcare family. My ethics in practice are based on being honest with my client and ensuring that my actions are within the ethical bounds. From the way I will go the extra mile to meet the needs of the patient, even though it is at the expense of my own time, it’s clear that I’m willing. I do this by giving justice to all the patients irrespective of their color, origin, and gender. As I make my assessment of the patients’ needs and make an attempt to meet them, their emotional and physical care is the core of my practice. It is definitely a sign of courage because when I talk up phrases for my patient, the patient can say negative things, but I wouldn’t do it that way. And humility is to recognize my own strengths and weaknesses, to recognize the setbacks I face, and get help when I need it. My passion is to advocate for those in need and for social justice, which is why I want to work towards a policy that will improve the healthcare of vulnerable groups and address health inequality. Working with the principle of diversity, equity, and inclusion, I actively and consciously work towards the elimination of prejudice and respect all my peers and patients. For example, concerning cultural Diversity, I ensure that the creation of suitable care plans is appropriate and dependent on the patient’s needs. Furthermore, I have a positive attitude towards diversity in my working environment; for example, I would like to plan on diversity training: Cultural sensitivity. These values will be part of my everyday life in my practice and a healthcare system that puts the well-being of all at the forefront. Professional Organizations Reflecting Personal Nursing Values and Identity My own values and nursing identity are best represented by professional organizations like Sigma Theta Tau, International Honor Society of Nursing, and the American Association of Nurse Practitioners (AANP). My dedication to lifelong learning, caring for a healthier population, and pressing for health justice worldwide aligns with Sigma’s vision to include nursing in the overall picture for a healthier world. I also agree that AANP is dedicated to supporting NP’s to provide quality care, and this is one of my beliefs as well, that advocacy and leadership are necessary in nursing. These groups and others are providing better access to information like research journals, continuing education, and networks to enhance my practice. For instance, Sigma’s conferences and webinars are a great way to add to my evidence-based practice, and AANP has policy updates to keep me up to date with legislative changes impacting nurse practitioners. A few of the organisations to which I belong keep me abreast of the profession’s progress and also assist in the development of the profession. Modeling Ethical Behaviors in Nursing Practice and Leadership Ethics are an intrinsic part of the nursing profession, and are essential in patient care when providing integrity and trustworthiness. Beneficence, nonmaleficence, autonomy, and justice are the norms that I uphold in my practice to ensure ethical practice. I make sure that I have a good knowledge of the available treatment options, and that the patients make their choices – irrespective of what I have thought is best for them. I keep the patient’s confidence, and I assert the rights of patients – often their voice is drowned out. If I see something that doesn’t seem to be ethical, I believe that we should go into the situation right away and give it a positive response. The person in question and their family member(s) should have an open discussion; education and understanding (not blame) should be the focus, as shown by Šimsíková. If there is an ongoing behavior pattern, I would talk with a supervisor and/or ethics committee; the safety of the patient will always come to the forefront of my mind. The world I envision where I’m in pledges that ethical practice is the norm and creates an accountable culture, an open culture. Mentoring Others in Professional Growth and Accountability The opportunity to mentor other nurses is an excellent way to contribute to nursing, grow professionally, and be held accountable. For instance, when I had an experience of mentoring, I had someone to whom I went and taught a student nurse on their clinical rotation. I guided them, gave them guidance, and helped them with their clinical skills (when they were bad), and gave them moral support when they had to have it. Not only did the student benefit from this mentorship, but our care team also benefited from increased teamwork/collaboration skills! The mentoring relationship was a win-win, and both the mentee and the Care team were able to benefit from the process. The mentee improved their

NURS FPX 6080 Assessment 3 Person-Centered Self-Care Management Interview and Video Presentation Student name Capella University NURS- FPX6080 Professor Name Submission Date Person-Centered Self-Care Management Interview and Video Presentation Chronic disease management needs to be patient-centered, enabling the patient to be responsible for his/her own health. The latter is a technique called motivational interviewing.” The focus will be on using motivational interviewing techniques to assist in developing a client’s ability to self-care and manage a client with hypertension. As well as this assessment, exploring strategies for building empathetic relationships, having sensitive conversations, and determining the adequacy of resources to provide equitable and inclusive care is explored. This allows the client to be more involved in their care and the care they receive, and thus improve their outcomes. Identified Client The identified client is a 58-year-old male named Mr. James H, and has been diagnosed as suffering from Hypertension for the past three years. He has problems with self-care, particularly with taking antihypertensive medication, and has a sodium-restricted diet. His blood pressure hasn’t reached normal levels (120/80 mmHg), and it is an average measurement of 150/95 mmHg. He expresses concern about the possible future problems that can arise from a background of high blood pressure, but admits to irregularly taking his medicine a few times a week and being questioned on his need to make steady improvements in his diet. He can use a home blood pressure monitor that can be linked to a mobile follow-up app, a reminder app for his medication, and follow-up at home through telehealth to help him adhere to and manage his blood pressure. Strategies to promote and foster caring relationships Building and sustaining healthy relationships is a key part of achieving the best health outcomes, particularly for clients who have chronic diseases, such as hypertension. I engaged Mr. James H using some of the motivational interviewing techniques, open-ended questioning, reflective listening, affirmations, and summarizing to build trust and rapport and demonstrate empathy. These approaches created an environment that was non-judgmental, and the clients there were respected and valued, and the patient engagement and adherence to treatment were increased. I listened to Mr. James’ concerns about taking medication and his dietary concerns, showing him I understood, reducing resistance, and establishing a partnership. We created (SMART) goals with him that he was ready to achieve, and this helped us to increase shared decision-making. MI increases the likelihood of clients’ own motivation when it comes to sustaining the behaviour change when compared to directive approaches, as shown by evidence. In addition, the incorporation of technology – such as a home blood pressure monitor and medication reminders apps, for instance – follows the professional guidelines of prioritizing approaches that are focused on the patient and supporting self-management. I used a combination of caring communication with evidence-based strategies to set up a relationship of trust and functional systems in order to achieve positive outcomes for Mr. James’ hypertension. Strategies for Facilitating Difficult Conversations and Disclosure of Sensitive Information Helping to facilitate difficult conversations and disclosure of private information can be a combination of honesty, empathy, and respect to maintain the therapeutic relationship. Effective strategies include using simple and easy-to-understand language, listening attentively, talking quietly, and talking about the client, giving them a chance to talk through their problems without being interrupted. One model that is recommended as an evidence-based approach to giving bad news in an empathetic manner is the setting, perception, invitation, knowledge, emotions, strategy (SPIKES) model. The parts of the model I used in my interview with Mr. James H included creating a non-judgmental environment, establishing confidentiality, and asking Mr. James H about his experience of managing his hypertension. I gave him relief from his irritations through the prescription of antihypertensive drugs and guided him towards an understanding of the potential health risk of failing to take his antihypertensive medications. Reflective listening and affirmation worked very effectively in that it helped to encourage honesty without defensiveness. These communication methods support patient-centered communication, reduce anxiety, and increase compliance with patient self-care. I was able to build a safe, respectful relationship with Mr. James that was also empathetic to his needs and was able to speak about his inconsistencies in self-management, using evidence-based counseling. The approach has been adopted to engage patients to address challenging, but necessary, health-related difficulties. Strategies that Promote Self-Care Management Educational, behaviour support, and technology are some of the successful methods for self-care management. Goal setting, motivational interviewing, and using self-monitoring technologies such as home blood pressure monitors and mobile health apps are used for hypertensive clients. Special literacy-level adapted education is essential as it will enable the person to make a choice/decision about the information (Cao et al, 2022). Besides, there are reminders and systematic follow-ups that reinforce taking medications and making lifestyle changes. Multicomponent interventions with self-monitoring and communications with patients have been shown to have a significant effect in reducing blood pressure. They also promote equitable and inclusive health services if they are adapted to the client’s particular culture, socio-economic status, and needs. For example, making use of technology that is available on the client’s device ensures that it is inclusive, and culturally relevant dietary guidance is relevant and sustainable. MI builds up respect for the client’s autonomy and for his or her point of view, which avoids paternalism. Incorporating patient involvement in the decision-making process and tailoring interventions to the readiness to change of individual patients can help reduce health disparities and ensure interventions are accessible, relevant, and effective for a variety of patients. In sum, these comprehensive therapies promote trust and improve self-care results. Current and emerging technologies to support self-care management Creating client-centric health management solutions that incorporate current and future technologies will provide them with the necessary tools to help them achieve better health results and increased compliance. One of the key approaches in the case of Mr. James is for him to have a home blood pressure monitor that is connected to a mobile app that he

NURS FPX 6016 Assessment 3 Data Analysis and Quality Improvement Initiative Proposal Student name Capella University NURS- FPX6016 Professor Name Submission Date Quality Improvement Initiative Evaluation Hi, I am Emily. The presentation will explore how Hamilton Medical Center has performed on safety with regard to harmful events and introduce a quality improvement (QI) initiative to minimize risks. Objectives Safety in the hospital is paramount to safeguard patients, improve the quality of care, and win the trust of the healthcare system. Keeping hospitals safe and secure is critical to ensure patients are not harmed and lose faith, but it is an ongoing battle in the healthcare industry to prevent harm in hospitals. The presentation includes an analysis of the safety performance at Hamilton Medical Center and proposes a QI plan to reduce risk. Gaps are closed through the use of data analysis, teamwork, and effective strategies. It additionally has communication tools to maintain the team engaged. The study demonstrates the impressive results that can be achieved with the use of QI plans and teamwork to enhance patient safety. Data Analysis and Healthcare Issue Identification According to Hamilton Medical Center’s Leapfrog Hospital Safety Grade, there is an alarming pattern when it comes to the number of harmful events experienced at the hospital. The hospital’s score is 1.15 compared with an average of 1.01, and the highest-performing of the hospitals scored 0.55. This suggests that more patients are suffering from avoidable patient harm, which could be infections, falls, or medication errors. The numbers indicate Hamilton Medical Center is not the worst (2.74), but it could do better to keep up with or beat national standards. Although the Leapfrog data is reliable and it is known to report in the same way, further internal data (such as incident reports, patient surveys, etc.) could be used to get a deeper look. This data can be used to analyze in an organized manner by comparing it with the best-in-class hospitals or assessing it over a period of time. Quality improvement (QI) metrics, including infection rates, readmissions, and adverse events, all facilitate quality improvement. As indicated by the current trend, the percentage of time that Hamilton Medical Center is either “Satisfactory” or “Not Satisfactory” is somewhat random, but the trend for the center is slightly above average. Outcome indicators such as patient harm rates and evidence-based practice/process indicators are important. But there is limited information on specific types of harm (for example, CLABSI or CAUTI), which makes it difficult to make targeted interventions. If there are variations (or it is not possible to be sure of process stability), then a root cause analysis has to be carried out. Quality of Data Hamilton Medical Center’s ability to depend on the data collection is dependent upon the accuracy and completeness of the data collected. The Leapfrog data provides important information, but does not provide specific information on the types of harm, such as CLABSI and CAUTI. This confines the capacity to make particular interventions. But data that is readily available within the organization (including data from incident reports and/or patient surveys) can offer a broader picture of patient safety concerns. To maximize the quality of data collected and make meaningful improvements, tracking and benchmarking against the best-in-class hospitals is vital. There is a need for process stability; although standardized reporting gives consistency, there will be variations in process stability, which need to be addressed with Root Cause Analysis. Data matters – it should be accurate and detailed to help us tell what we don’t know and what we’ll need to do to solve the problem. Quality Improvement Initiative Proposal To achieve harm reduction, Hamilton Medical Center should start a formal QI quality improvement program to address harmful events. Interventions will be tested using the plan-do-study-act (PDSA) model, which will be done in an iterative manner. The benchmark is the best hospital (0.55), and this should be the target. Many of these programs (current programs) may have simple safety measures, but they are not comprehensive because no one is monitoring any of the actions in real time, and there is no staff engagement involved. Focus is on decreasing hospital-acquired infections (HAI), falls, and medication errors. Best practices, such as checklists, employee training, and anticipatory algorithms, can help improve results. There are government initiatives, such as the Centers for Medicare & Medicaid Services (CMS) Hospital-Acquired Conditions Reduction Program and the Joint Commission standards, to which this initiative relates. These benchmarks can be used to identify areas of compliance and noncompliance when compared to Hamilton. Resistance to change, resource constraints, and data integration and management are among the challenges. Involving end-users in the solution design will help with the buy-in. Knowledge Gaps Knowledge gaps – what is the awareness on whether, due to staffing issues, inefficient processes, or any other factor, it is causing a harmful event? The effect these factors have on patient safety is unknown. There is a need for more information regarding near-misses to see and understand patterns and risks. Alder also indicates that staff compliance with safety measures is also needed. But in the end, the overall data will be used to enhance strategies and fine-tune interventions effectively. Assumptions There are a number of underlying assumptions that form the basis of the success of any improvement initiative. One assumption is that leadership will be proactive in fostering change, offering guidance, resources, and support for the smooth implementation of the change. Also, it’s assumed staff are willing to try new things and willing to change their processes for optimal gain. It is also assumed that accurate data tracking is in place; it is important to have reliable data to track progress and pinpoint changes to be made. The conclusions of this plan are based on these assumptions, which also help in determining the plan’s feasibility. If any of these assumptions aren’t correct, the initiative could have a lot of obstacles to overcome. Strategies for Collaboration For a successful quality improvement process, it is important that communication is effective.

NURS FPX 6016 Assessment 1 Adverse Event or Near-Miss Analysis Student name Capella University NURS- FPX6016 Professor Name Submission Date Adverse Event or Near-Miss Analysis Analyzing an adverse Event or Near-Miss is critical in the medical field. A close call incident could have harmed a patient, but did not because of a timely intervention or a lucky break. It means recognizing and comprehending situations where patient safety is almost in jeopardy. Adverse event – an event in which harm is actually suffered by the patient as a result of medical care or treatment. While such incidents are not harmful, they do give insight into possible failure by the person, communication, or technology. Near misses are analysed for the purpose of identifying hidden risks, assessing their potential impact on the patient, families, and those working in the healthcare setting, and creating specific plans for improved safety. In the end, this is a process of reflection that improves patient care, as mistakes from the past are avoided. Case Scenario An insulin infusion pump for a patient accidentally went off, and a nurse heard the alarm. The nurse made a quick evaluation and determined that no problem existed. However, with multiple patients and time constraints, the nurse did not have the time to communicate the problem to the on-call physician or to communicate with the pharmacy. Several hours later, it was discovered that instead of giving the proper insulin dose, an overdose had been given. Impact and Analysis of Adverse Events To study the impact on different stakeholder’s analysis of adverse events was checked. Studies found that alarms of insulin infusions did not answer. Patient was at risk due to wrong infusion of insulin. Causing the error must be stressful and upsetting situation. The incident could be stressing to patient and family. This may focus attention on the care itself, which could be a source of concern that might last for years, depending on whether the injury actually occurred at the time of the care or not. This may impact their attitudes towards the hospital and towards their interactions with it going forward. The impact the incident has had on the inter-professional team is that a sense of urgency and urgent action has arisen – in this case, communication protocols and procedures may need to be tweaked quickly. Less than a month later, internal checks and external regulators began to enquire about the hospital’s improved and stricter oversight and safety evaluation. If it is made public, it may ultimately affect the reputation of the facility and lead to important changes in policy, training, and patient safety. Responsibilities The responsibilities and duties of the interprofessional team are known. As soon as possible, the nurse should contact the pharmacy staff and the on-call physician and make sure that the issue is remedied before it becomes an overdose of medication. The doctor then assesses the issue and makes the necessary adjustments. The Pharmacy staff should have been notified to confirm and change the infusion rate if a discrepancy was detected. Preventive Measures A number of steps were taken to prevent further incidents, such as procedures for handling equipment alarms. Staff was also directed to inform appropriate team members immediately and to communicate with the Doctor and Pharmacist as soon as possible so appropriate action may be taken. Periodic training for healthcare workers was put in place, including communication skills, alarm recognition, alarm response, and routine equipment checks, and advanced alarm systems with real-time notifications were purchased to help improve patient safety. The incident caused a profound impact on different stakeholders and changed work practices to predominantly focus on the importance of collaboration, timely communication, and accountability. Equipment was routinely inspected and new systems for reporting alarm-associated events were introduced. The practices are embedded in improvement and safety practices, thereby lowering future risks and promoting a culture of continuous improvement. Assumptions It is agreed that a large part of the near miss is due to poor communication. These kinds of events could be prevented better in the future, since future protocols and teamwork should have more focus on teamwork. In addition, it is also assumed that the previous systems and procedures were not able to properly address the issue, thereby showing the necessity of the changes. Such improvements should be targeted at improving patient safety systems and modernizing communication methods. Root Cause Analysis of Adverse Events An investigation of the incident at Lakeside Regional Medical Center finds a number of missed steps that may have led to their oversight. The nurse who responded did not adhere to the insulin infusion pump warning of a problem with the rate. The nurse’s pump check was inconclusive (no problem); however, the nurse failed to inform the doctor and/or the pharmacy of the alarm problems, thus delaying the action necessary to correct the actual potential problem. This failure to communicate only exacerbated the problem and eventually led to the near overdose. The nurse failed to note the alarm as per standard operating procedures for equipment alarms. This example showed one of the major issues with adherence, communication and lack of escalation and documentation, which in turn had a significant impact on patient safety. Inter-professional Communication Here, though, there were still some vital things that were less than highlighted. Poor communication was thought to be due to the nurse’s high workload and the number of patients he/she cared for. Lack of awareness of alarm significance and improper adherence were also factors. Improving communication is important in preventing similar incidents. When alarms are activated, immediate notifications of physicians and even of the pharmacy personnel can result in quicker and more effective action taken, minimizing risk. Must have clear escalation procedures and ensure that all staff is aware of and are following them. This near-miss event was preventable due to key contributing factors when it came to escalation and response to the alarm. Future damage will require better infusion management systems, training and auto-notifications of alarms. Knowledge Gaps It is important to note

NURS FPX 6026 Assessment 4 Personal Goals and DEI Reflection Student name Capella University NURS- FPX6026 Professor Name Submission Date What are some of your personal goals for personal, professional, and leadership development that you will achieve in the practicum experience?  My overall personal goal, in general, is to learn more about myself: I would like to have a reflective practice that would enable me to learn more about my strengths and weaknesses, and the way I respond to complex clinical scenarios. As an educator of nursing, I would attempt to make a certain step in the direction of synthesizing the principles of the so-called evidence-based nursing practice with the reality that I can observe with my own eyes on a daily basis on all that could be referred to as the element of the phenomenon of population health and the provision of more personalized care, and streamline my professional skills as a critical reader to condense the findings of marker research to the care planning. I would also wish to lose perfectionist characteristics both at the workplace and as a team. I would discuss my leadership qualities, including communication and decision-making skills, which can possibly empower me to lead groups of patients and deliver quality care campaigns. To this, I would add a little formality exposure to social determinants of health, care advocacy, and culturally competent interventions. I will be aware of a harmonious development of personal cognition, scientific knowledge, and professional behavior at the end of the practicum that will help me to be a more productive, people-oriented, and fair-minded advanced practice nurse. Consider your impressions regarding the principles of DEI and implicit bias. What are the ways in which these principles influence your activities and choices in your assigned field? What is the effect of implicit bias on our professional and leadership maturity?          The values (diversity, equity, and inclusion) would not only be beneficial to me but would also help me provide fair, respectful, and patient-centric care to any person, regardless of the type of background that he or she has. To me, cultural sensitivity and equity in care provision would mean that there must be diversity and equity so that the otherwise equally culturally provisioned care would be achieved. My work experience is costing me the realization that I need to reverse the stereotypes and protect the vulnerable group. This would mean that the decision-making process would be influenced by an implicit form of prejudice, although the motive might not be purposeful, which would create a care delivery gap. This would assist me in removing the degree of prejudice to reach a definitive judgment, and a participative approach to leadership to establish a culture of trust, collaboration, and respect. What steps can you take to further incorporate DEI principles into your practicum experience? The factors that will be utilized in the integration of the concepts of DEI in my practice will incorporate such aspects as inclusiveness, cultural sensitivity, and the treatment of all clients as equals, as these are the most crucial aspects of my practice. I will also make sure that I attend cultural competency trainings, especially in the area of the social determinants of health, so that I can have a clue of the various needs of the clients. Encountering the preceptor, mentor, and client to seek feedback will also assist me in developing new facets of my practice, thus giving me a chance to establish an inclusive environment. I will also strive to make sure that I pass through the process of lifelong self-reflections and journalization to keep track of the application of the principles of DEI. It is based on this fact that I would lean towards the establishment of a care setting, which is founded on the notion of respect, equity, and cultural sensitivity. Consider a recent interaction with a client. How did you incorporate DEI principles into this interaction? What could you have done differently to better promote DEI? I applied the concepts of DEI in my recent opportunity to speak with a client whose background and, consequently, a native language is of low-income and the client is not fluent in English because, in this way, he can get my message, and I have addressed the client, and I have asked a professional translator to help the client to feel that he can be heard and respected. My care plan also applies the cultural beliefs of the client up to the level of health, and this has also assisted in creating trust in the client to the extent that he develops an interest in the care of the client. Nevertheless, I also understood that I would have done a more thorough cultural analysis to be informed more about the social forces behind the choice of the client, which is related to health. I feel that with practice, I will be able to grow the capability of being able to further expound my skills by taking open-ended questions, feedback evocation, and using the appropriate resources to ensure I am in a position to cover the customers holistically and equally. How can you leverage your specialization courses to help you prepare for your MSN capstone project? The courses, which are relevant to my specialization, have assisted me in developing a fine background on how to prepare my MSN capstone project. The evidence-based practice courses have assisted me in acquiring a critical thinking strategy in addressing clinical issues and the implications of the research to clinical issues. The awareness of how I would manage the data and use technology has enhanced my skills in the informatics courses to a level that would make me competent in analyzing trends that can alter the eventual outcome of patient care. The policy and leadership courses have assisted me in increasing my knowledge to the extent that I will make sure everyone gets equal attention, ethical decision-making, healthcare, and the necessity to subject every individual to equal treatment. Such competencies will be required of me