Discussion: Scholarly article review guideline

Capstone Evidence-Based Practice Paper

Stephanie Zepeda

Chamberlain College of Nursing

NR 452 Capstone

Professor White-Williams

November 2021

This study source was downloaded by 100000758613853 from CourseHero.com on 11-10-2022 16:21:00 GMT -06:00

https://www.coursehero.com/file/119678431/Capstone-Evidence-RUA-Nov-2021docx/

2

Introduction

The purpose of this paper is to review previously taken ATI comprehensive assessments

and identify a priority concept topic that is an area of weakness which requires more attention in

preparation for the NCLEX. The priority concept topics include assurance of a safe and effective

care environment which includes management of care and safety and infection control. Health

promotion and maintenance, Preservation of the patient population’s psychosocial integrity and

preservation of the patient population’s physiological integrity. The psychosocial integrity should

include things such as religious and spiritual influences on a patient’s health and promoting

coping and adapting to illnesses. The physiological integrity includes basic care and comfort,

pharmacological and parenteral therapies, reduction of risk potential and physiologic adaptation

(Liu, 2017).

An area of weakness that was identified after reviewing the ATI comprehensive

assessments is preservation of the patient population’s physiological integrity. In this case I

should specifically concentrate on the basic care and comfort, which I scored a 38.5% on Form

A. It includes the nursing care that encourages promotion of comfort as well as encouraging

performance of activities of daily living. Physiological integrity, according to the Ncsbn test

plan, refers to promotion of physical health and wellness by providing both care and comfort

(NCLEX-RN examination, 2019). This should be done by reducing the patient’s risk potential as

well as managing health alterations. The basic care of comfort consists of approximately 6-12%

of the items on the NCLEX according to the Ncsbn test plan (NCLEX-RN examination, 2019).

Importance

This study source was downloaded by 100000758613853 from CourseHero.com on 11-10-2022 16:21:00 GMT -06:00

https://www.coursehero.com/file/119678431/Capstone-Evidence-RUA-Nov-2021docx/

3

Basic care and comfort can be defined as the promotion of comfort throughout the care as

well as promoting independence with activities of daily living. This includes task such as

assessing the patient’s pain level, monitoring nutritional status of the patient and assessing the

patient’s ability to rest/sleep. It is important to the professional practice because these task,

specifically pain management, sleeping/rest, and nutrition all aid in the healing process. As well

as, promoting independence by assessing and intervening as needed with performing activities of

daily living. Activities of daily living includes things such as brushing their teeth, bathing, and

changing. As a nurse it is our duty to ensure that the patient is receiving adequate care to promote

healing as well as independence to be able to care for themselves as best as they can once they

are discharged from your care. Throughout this process consistent education should be occurring

to promote independence. However, the nurse must ensure that the patient is comfortable before

implementing teaching. This includes psychological care and physiological care, such as pain

management, hunger, and mental concerns (Thomas, 2018).

Healthcare Disparities, Inequalities, and Interventions

Despite health care changes that are frequently occurring, such as the emphasis of

Healthy People 2020, whose goal it was to achieve health equity and eliminate any health care

disparities; there continues to be a large gap between the health outcomes of minorities as well as

those with a disability (Makris, 2021). It has been found that this is due to a low probability of

having a high school education therefore having a high unemployment rate or having an annual

income that is less than $15,000 (Makris, 2021). Those with a disability are frequently visiting a

family doctor, however they are more likely to deal with disparities. This is because family

doctors typically lack the knowledge with dealing with those who have a disability. This includes

infrastructure issues and lack of intellectual disability by the physicians (Makris, 2021). Without

This study source was downloaded by 100000758613853 from CourseHero.com on 11-10-2022 16:21:00 GMT -06:00

https://www.coursehero.com/file/119678431/Capstone-Evidence-RUA-Nov-2021docx/

4

knowledge on the patient’s disability medical personnel will not be able to provide proper basic

care or comfort to those who are disabled. Social marketing has been found to be a probable

solution. It focuses on influencing behaviors to encourage delivering a positive interaction

between the health care providers and the disabled patient. A second solution can be to never

make any assumptions about what the patient may want. As medical personnel it is important to

be aware that patients who are disabled have been living with their disease process for years, if

not their entire life, and they are typically the ones who know what is best for their condition

(Makris, 2021).

Legal and Ethical Considerations and Intervention Challenges

Basic care and comfort is a multidimensional task and it is one of the many task that

nurses must accomplish everyday in order to implement proper patient care. This is why as a

medical professional; it is important to have ethical awareness as well as legal considerations

when providing care. There are four main ethical principles that healthcare workers should

follow, it includes beneficence, nonmaleficence, autonomy and justice. For this particular

priority concept, beneficence and nonmaleficence should be taken into consideration.

Nonmaleficence refers to providing care that does not cause harm and Beneficence refers to the

nurse’s actions being “good”, and the nurse should prevent bad situations (Milliken, 2018). For a

legal implication, it is important that the nurse practices per their scope of practice. The nurse

should not perform any interventions or care that is outside their scope of practice. The nurse

should also perform their care at an acceptable standard of care and ensure that it is competent

(Milliken, 2018).

One strategy that can prevent an ethical dilemma can be to ensure that the nurse is

providing ethical care by following all four ethical principles and ensure that you are providing

This study source was downloaded by 100000758613853 from CourseHero.com on 11-10-2022 16:21:00 GMT -06:00

https://www.coursehero.com/file/119678431/Capstone-Evidence-RUA-Nov-2021docx/

5

the best care to your patients. Be aware of your scope of practice by reviewing the American

nurses association and your hospital handbook. If you are not sure about a certain situation speak

to your nurse leaders, managers or charge nurse to seek guidance on appropriate nursing care.

One challenge that we as nurses can encounter in successfully preventing or resolving the

priority concept is family member’s of the patient. There will be times where the family member

may not agree with your patient care or agree with the patient’s decision with their treatment

plan. As a nurse it is important that you educate the family that it is your obligation to care for

the patient based on the patient’s decision as it is their right to Autonomy (Milliken, 2018).

Participants and interdisciplinary approach

The parties that will be involved in implementing basic care and comfort will be based on

the patient’s diagnosis and possible outcomes. Some of these interdisciplinary members can

include physical therapy, occupation therapy and speech therapy. Occupational therapy can aid

with the patient’s activities of daily living. They will begin this by first performing an assessment

to determine their capabilities of performing their activities of daily living. This will then

determine the treatment of plan for the hospitalization stay. Once the patient is preparing for

discharge another assessment will be performed to determine the patients discharge plan. It is

important to include this interdisciplinary member in the patient care to help promote a healthy

outcome for the patient and promote independence throughout hospitalization and after

hospitalization (Busari, 2017).

Quality Improvement

One benefit in implementing basic comfort and care is to provide a healthy recovery

while also encouraging independence. One of the main goals for patients should be to educate

This study source was downloaded by 100000758613853 from CourseHero.com on 11-10-2022 16:21:00 GMT -06:00

https://www.coursehero.com/file/119678431/Capstone-Evidence-RUA-Nov-2021docx/

6

the patients as early as possible to ensure that the patient is educated on their disease process and

what the interventions are and why they are in place. The education is especially important

because we want to prevent rehospitalization from occurring. However, if the patient is not

comfortable, the education process is insignificant and unsuccessful. Therefore, it is important to

ensure that the patient is comfortable. This refers to pain management or mental stability

meaning that the patient is not anxious, depressed or stressed out. Once the patient is

comfortable, then the education process should begin which will help facilitate a healthy

recovery and better management of illnesses. One resource that can be used to help promote

improved patient outcomes is the Agency for Healthcare Research and Quality (AHRQ), which

will help educate health care providers on how to improve health care and how to provide safe,

healthy, quality care to patients (Busari, 2017).

Conclusion

Basic care and comfort is essential for promoting comfort but also encouraging activities

of daily life. It includes things such as pain management, nutritional status, and ability to

rest/sleep. It is essential in promoting healthy healing through nutrition, rest and pain

management. Basic care also includes psychological care which includes mental stability. It will

also include implementing activities of daily living to encourage independence. Independence is

important to ensure that the patient can care for themselves once they are at home (Liu, 2017).

Interdisciplinary care can be implemented as well, such as occupational care to help patients with

any disabilities that they may have that are preventing them from caring for themselves.

Education is also important throughout the patient’s hospitalization as this aids in management of

their illnesses. This should be done from the point of admission up until they are discharged.

However, education should not be performed until the patient is comfortable (Busari, 2017).

This study source was downloaded by 100000758613853 from CourseHero.com on 11-10-2022 16:21:00 GMT -06:00

https://www.coursehero.com/file/119678431/Capstone-Evidence-RUA-Nov-2021docx/

7

This study source was downloaded by 100000758613853 from CourseHero.com on 11-10-2022 16:21:00 GMT -06:00

https://www.coursehero.com/file/119678431/Capstone-Evidence-RUA-Nov-2021docx/

8

References

Busari, J. et. al. (2017). Understanding the impact of interprofessional collaboration on quality of

Care: a case report from a small-scale resource limited health care environment.

Journal of Multidisciplinary healthcare. 10:227-234. doi: 10.2147/JMDH.S140042

Liu, X. and Mills, C. (2017). Assessing the construct congruence of the RN comprehensive

Predictor and NCLEX-RN Test plan. 56(7): 412-419. DOI:10.3928/01484834-20170619-

05.

Makris, A. et. al. (2021). A scoping review of behavior change interventions to decrease health

Care disparities for patients with disabilities in a primary care setting: Can social

Marketing play a role? Sage Journals. 27(1): 48-63. https://doi-

org.chamberlainuniversity.idm.oclc.org/10.1177/1524500421992135

Milliken, A. (2018). Ethical awareness: what it is and why it matters. OJIN. 23(1).

DOI: 10.3912/OJIN.Vol23No01Man01

NCLEX-RN Examination-Test plan for the National Council Licensure Examination for

Registered Nurses. (2019). NCSBN

Thomas, D. et. al. (2018). Perception of caring Among patients and nurses. Sage Journals.

6(3):194-200. https://doi.org/10.1177/2374373518795713

This study source was downloaded by 100000758613853 from CourseHero.com on 11-10-2022 16:21:00 GMT -06:00

https://www.coursehero.com/file/119678431/Capstone-Evidence-RUA-Nov-2021docx/ Powered by TCPDF (www.tcpdf.org)