Class 1 Week 7 Term D DQ Response

1

Instructions: Reply to 2 of your peers below.  Must be 250 words or more.

For each thread, students must support their assertions with at least two scholarly citations in addition to the Bible in APA format. Each reply must incorporate at least one scholarly citation(s) in APA format. Any sources cited must have been published within the last five years. Acceptable sources include the textbook, the Bible, and scholarly articles.

Review your classmates’ threads, and respond through considering:

Classmates’ Tread 1.

In my hospital we have quite a few of APNs operating in many different roles and fields.  We have Nurse Educators, Nurse Informatics, NPs, and Nurse Leaders.  My boss for example is the Service Chief or Department Head of the Labor and Delivery Unit. She has her Master’s in Nursing Leadership and is currently working on her Doctorate.  Her role as the Service Chief of the unit includes getting involved and using Evidence-Based Practice (EBP) and Quality Improvement (QI) Projects to see how different interventions can help improve our unit and make it function better.  One of the Quality Improvement Projects that they are currently working on is to place infant formula in our Pyxis medication machine.  By doing this, they can assess if taking them out of the supply room and placing them in the Pyxis will limit the amount of formula used on the unit and improve the promotion of breast milk and keeping the unit “Baby Friendly”.  This Quality Improvement Project will allow the Lactation Consultants to be able to go into the Pyxis machine and search for all the patients that have had formula pulled and see which nurse pulled the formula.  This will allow the Lactation nurses to be able to track down the nurse and find out why the patient received formula and if it was medically indicated, and to also find out which patients require more in-depth lactation focus.  

A recent EBP that is now implemented based off a QI project is the use of glucose gel for babies with low blood sugars.  In the past infants who had low blow sugar were given supplementation of formula on top of breast milk to help bring the blood sugar up.  A QI project was implemented to see if the use of glucose gel would help lower the amount of formula use by babies with low blood sugar.  This project did indeed show that mothers were able to utilize glucose gel in conjunction with breast milk to help increase blood sugars without the use of formula.  This helped to provide mothers with another option for supplementation especially those that really did not want to introduce formula to their babies.  This option was still available for mothers if they desired it, but the QI project showed that when given the option, most preferred the use of the glucose gel because it did not inhibit breastfeeding and bonding between mother and baby.  Evidence also showed that when the gel was used along with breastfeeding, the blood sugar came up and stayed up more than if formula was used on top of breastfeeding.  In most cases, the mothers continued to “top-up” breastfeeding with formula with each feeding, as opposed to the glucose gel that showed that most cases only required one initial dose of glucose gel with breastfeeding and then the sugars stayed up.   An Australian study from 2018 showed similar results that both formula and glucose gel were equally effective in increasing sugars but glucose gel required less doses and promoted breastfeeding and bonding better than the use of formula (Barber et al, 2018).  This EBP is now part of our standard care and provides the parents with options on how they want to improve their baby’s blood sugar levels.  At the end of the day our overall goal is healthy mom and healthy baby.  John 16:21 say, “When a woman is giving birth, she has sorrow because her hour has come, but when she has delivered the baby, she no  longer remembers the anguish, for joy that a human being has been born into the world” (Open Bible, n.d.). 

 

Barber, R., Ekin, A., Sivakumar, P., Howard, K. & O’Sullivan, T. (2018). Glucose Gel as a Potential Alternative Treatment to Infant Formula for Neonatal Hypoglycaemia in Australia. Int J Environment Res Public Health, 15(5), 876. Doi: 10.3390/ijerph15050876  

Open Bible. (n.d.). 100 Bible Verses about Breastfeeding. Retrieved from https://www.openbible.info/topics/breastfeeding

Classmates’ Tread 2.

According to American Nurses Association (ANA), “Advanced Practice Registered Nurses (APRNs) include nurse practitioners, clinical nurse specialists, nurse anesthetists, and nurse midwives, all play a pivotal role in the future of health care. APRNs are often primary care providers and are at the forefront of providing preventive care services to the public. APRNs treat and diagnose illnesses, advise the public on health issues, manage chronic disease, and engage in continuous education to remain ahead of any technological, methodological, or other developments in the field.” According to McEwen & Wills (2019), “Roles for APNs include coordination of care for persons with chronic illnesses in for-profit and not-for-profit health care organizations in which APNs provide an array of direct services to plan members.”

In my current position as a transfer coordinator at Veterans Affairs Medical Center (VAMC), APNS is fortunate to be strongly supported by executive leadership throughout the medical center. APNs are often acknowledged for their work on committees, teaching, mentoring nurses, and conducting research. The Department of Veterans Affairs (VA) is amending its medical regulations to permit full practice authority of three roles of VA APRNs when they are acting within the scope of their VA employment. By allowing the three APRN roles, Certified Nurse Practitioner (CNP), Clinical Nurse Specialist (CNS), or Certified Nurse-Midwife (CNM), throughout the VHA system with a way to achieve full practice authority to provide advanced nursing services to the full extent of their professional competence, VHA furthers its statutory mandate to provide quality health care to our nation's veterans. Certified Registered Nurse Anesthetists (CRNA) will not be included in VA's full practice authority under this final rule (Advanced Practice Registered Nurses, 2016). Standardization of full practice authority to the three APRN roles also aids VA in making the most efficient use of VHA APRN staff capabilities, which increases VA's capacity to provide timely, efficient, and effective primary care services and other services.

APRNs' full practice authority increases veteran access to needed VA health care, particularly in medically underserved areas, and decreases the amount of time veterans spend waiting for patient appointments. In addition, standardizing APRN practice authority enables veterans, their families, and caregivers to understand more readily the health care services that VA APRNs are authorized to provide. This preemptive rule increases access to care and reduces the wait times for VA appointments utilizing the current workforce already in place. (Advanced Practice Registered Nurses, 2016). I have found this to be a great asset, and I have learned a great deal from our APRNs at VA, especially Nurse practitioners (NPs) and wound care nurse specialists. I feel much comfortable after working with These APNs sharing their knowledge with our team. I have worked with several APNs in different settings from community living centers, inpatient, outpatient, and hospice. They have all been willing to collaborate with us nurses, and they seem eager to teach others and are open to learning opportunities themselves. I am preferential to APNs because their nursing background is one of their significant assets, and they always use evidence-based practices for patient care. They have that caring attitude towards the patient and strive to advocate while still providing advanced care.

Advanced Practice Registered Nurses. (2016). Washington: Federal Information & News Dispatch, LLC. Retrieved from ProQuest Central http://ezproxy.liberty.edu/login?qurl=https%3A%2F%2Fwww.proquest.com%2Freports%2Fadvanced-practice-registered-nurses%2Fdocview%2F1848609428%2Fse-2%3Faccountid%3D12085

American Nurses Association. (n.d.). Advanced practice registered nurses (aprn) | american nurses association. ANA. https://www.nursingworld.org/practice-policy/workforce/what-is-nursing/aprn/

McEwen, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.). LWW.