Discussion replies wk 7

1. When assessing and improving students’ learning outcomes in the critical psychomotor skills of intravenous catheter insertion and wound care, there are two strategies that could be particularly helpful. The first is the Objective Structured Clinical Examination (OSCE), which involves observing and evaluating students’ performance in a simulated clinical environment (Cidoncha et al., 2023). For instance, students can be presented with a simulated patient who needs an IV catheter insertion or wound care, and their performance can be evaluated based on specific criteria such as equipment preparation, hand hygiene, and technique. This type of assessment can provide an opportunity for feedback and help identify areas where students need improvement (Cidoncha et al., 2023).

Another strategy that can be useful is peer evaluation. This involves having students work in pairs to practice IV catheter insertion or wound care and provide feedback to each other on their technique, communication, and overall performance. Peer evaluation can help students develop critical thinking skills, communication skills, and provide an opportunity for constructive feedback and improvement (Maas et al., 2014). It can also help create a supportive learning environment where students can learn from each other and receive feedback in a non-judgmental and constructive manner (Maas et al., 2014).

2. Revisit the two essential psychomotor skills that you selected for your discussion posting during week 6. What are two strategies you might use to assess the student’s learning outcomes and improve learning? 

The essential psychomotor skills I posted during week 6 were insulin administration and safe patient transferring techniques. The two strategies that I will use to assess students’ learning outcome will be knowledge test and skills check-off test.

For insulin administration students will be tested on medication knowledge about insulin such as reading prescribers’ insulin order, insulin dose calculations, pharmacological purpose of insulin use, types of insulins and mechanism of actions, mode of storage, types of syringes used to administer insulin, how to read insulin syringe calibration, acceptable body site for insulin administration. The second strategy to evaluate learning outcome will be skills check off test. Each Student will be watched as he/she select the correct insulin order, select the correct insulin syringe, read an insulin order aloud, draw up the right insulin dose, select the right site of the body to administer the dose, select the right degree of angle to administer the dose, and administer the dose appropriately.

To evaluate student learning outcome on safe patient transfer techniques. Students will be tested on the knowledge of why it is important to follow safe patients’ transfer techniques, the risks of not following safe patient transfer techniques, and the harm that could result if proper patient transfer techniques are not followed. The second method is to evaluate students’ learning outcome by performing skills check off test. Each student will be monitored as he/she transfers a patient from bed to chair and from chair to bed. Each Student will be tested on maintaining proper body position when transferring a patient, maintaining adequate length and angle of transferring devices, and implementing safety mechanism of locking transferring devices before moving the patient.

3. In the first scenario, the student expressed his frustration and dissatisfaction with his grade by being disrespectful and raising his voice to the professor. Unfortunately, the professor responded in an unprofessional manner by treating the student like a child instead of an adult. Rather than acknowledging the student’s effort, the instructor dismissed it and belittled the student. Furthermore, he failed to provide an explanation to the student regarding the grading system and did not offer any suggestions for improvement. As a result, the situation escalated, and the student’s behavior became even more irrational. In contrast, the instructor in the second scenario showed a different approach, where the professor calmly managed the student’s aggressive behavior by acknowledging the student’s frustration and explaining the grading process. By separating personal feelings and focusing on the grading process, the professor diffused the situation and created a safe environment for the student to understand his grade.

           Instructors can use various strategies to de-escalate situations with frustrated students, such as staying calm, showing respect, and teaching self-regulation skills. Instructors can also prevent potential conflicts by being transparent about the grading process, acknowledging students’ concerns, and separating their personal feelings from the situation at hand. By doing so, they can create a safe and inclusive learning environment where students feel heard and supported (Kathleen Strickland-Cohen et al., 2022). Additionally, providing support and accommodations to academically frustrated students can increase their academic confidence and reduce their frustration (Kathleen Strickland-Cohen et al., 2022). Lastly, positive communication, finding common ground, and listening can also help create a win-win situation for both the instructor and student (Kathleen Strickland-Cohen et al., 2022). If a similar situation occurs, an instructor can advise the student to take a break, then discuss and review their work. By going over the rubric and providing support, instructors can help students increase their academic confidence and overcome their frustration with schoolwork.

4. After watching the video on grade dispute between the instructor and the student it was apparent that the student is obviously upset with grade he obtained, and the instructor did a poor job of communicating with the student. As an instructor you should not talk down to them as if they were a child. The instructor was easily irritated by the student making his frustration known after he put in his maximum effort into the assignment. A better approach would have been to be empathetic and go over the paper with the student and explain the evaluation process. The student will then understand the evaluation process and knowing the reasoning for obtaining the score he received on the assignment. When a student approaches an instructor frustrated with a grade he/she received, as an instructor you can go over the grading requirements and explain the evaluation process. By the instructor answering in a demeaning manner, he opened the door for a bigger argument and the student will now bring up the complaint to a higher level such as the dean or administration of the institution.

           As an instructor it is important to understand students work differently and not all will show the same level of work. There is a great difference between efforts and results, some students may work extremely hard and put maximum effort, yet their work is still poor. Others put in little effort and their work is excellent. As an instructor I would have an open-door policy to discuss student’s work and grades received. It is important to separate personal feelings when grading and explaining a student’s grade on a certain assignment. Transparency is essential, to reduce grade grievances in the class and let the student know exactly where they did not fulfill the requirements of the assignment and give feedback of what could have been done differently. By working together as instructor and student the course objectives can be met and the goal of making the student succeed can be attained.

5. The purpose of informed consent is to notify the patient of the potential risks, benefits, and alternatives to a procedure. During the process of obtaining consent, expectations are laid out and the patient’s questions are answered. The elements of an informed consent form include the nature of the patient’s illness; the name, purpose, risks, success rate, alternatives, and indications of the proposed procedure; and the signatures of the patient, physician, and witnesses along with the date it was signed (Pozgar, 2016, p. 399). Without the inclusion of each of these elements, the consent is no longer considered effective, informed consent. If an element is not adhered to, the physician can either risk harming the patient, not meeting their needs, or even legal repercussions. For example, if risks are not discussed with the patient and the patient experiences what is now considered unexpected consequences, the physician can be held liable. Therefore, all health care professionals should take the initiative to ensure that proper informed consent is obtained, preferably in writing.

6. The elements of informed consent are the following:

The patient has the right to know the potential risks, benefits, and alternatives to proposed procedures.

The patient has the right to control the integrity of their own body.

  • The physician must disclose to the patient sufficient information to enable the patient to evaluate a proposed medical or surgical procedure before submitting to it.
  • The patient must have a full understanding of that to which he or she has consented.
  • The patient must have the competence to give consent.
  • (Pozgar, 2016, p. 397).
  • A clinical example would be if a patient requires amputation of the patient’s right toe and the doctor amputates all toes without the patient consenting to amputation of all toes. The provider is required to inform the patient of other alternatives to save the entire foot and state in the consent of proposed procedures. The patient may have not agreed to have the remainder of the toes amputated and because of that issue, this issue put the patient at risk for a blood clot in which it did arise, causing decreased circulation to the upper leg, causing tissue to become necrotic and now requiring amputation of above the knee. Now this patient is a diabetic and the healing process would be prolonged. This would be detrimental to the patient and would lead to a good malpractice and negligent lawsuit against the provider for violating the informed consent element guidelines.

7. In order to reinforce ethical practice of nurses who care for chronically ill patients, the interprofessional team should be involved as well. Nurses encounter ethical conflicts when providing care for patients, such as limits on the patient’s autonomy. Furthermore, patients may not receive adequate support upon discharge to cover their needs, so the team comprised of physicians, social workers, specialists, and therapists should all work together to facilitate ethical practices when caring for patients that are critically ill (Coronado-Vazquez et al., 2020).

A patient right that may not be fully implemented is the right to distributive justice, or all patients are treated fairly and equally. Health disparities that are based on socioeconomic status or race indicate the presence of bias in health care; the ethical principle of justice, as well as the patient’s right to be treated equivalent to others, are sometimes overlooked (Olejarczyk & Young, 2022). Individuals with lower income, education, or occupational standing have worse health status (morbidity) and increased mortality rates than those who have higher income. Furthermore, disparities may be perpetuated on three distinct levels: institutionalized policies and practices, individual racial discrimination and biases, and individual cognitive processes (Fiscella & Williams, 2004). In order to reduce health disparities and justice, the registered nurse can promote healthier lifestyle behaviors, providing resources for patients and support for issues, and uphold health programs that are culturally sensitive and tailored to specific languages, if needed. Furthermore, nurses can facilitate health screenings and health education (Thornton et al., 2017).

8. Nursing homes are care for elderly patients with chronic illness like hypertension, diabetes, dementia, and many others. On average, the patient in the nursing home is aged 65yrs and older, women accounting for 67% of the patients in this setting (Mason et al., 2015).

Nurses have an obligation of respecting patient’s rights no matter what kind of healthcare setting they are practicing. Nursing homes have patients with dementia and Alzheimer’s, nurses tend to think that they can perform some procedures on these patients without asking for their consent. An example is forcing a patient to take medication when he or she doesn’t want to take it. The ANA describes the right to self-determination as moral and legal, it gives the patients a right to determine if care or treatment should be done on them (Butts & Rich 2016). This right is sometimes ignored by nursing home nurses due to the nature of patients they take care of. 

Strategies that can be used to help support the right to self-determination is to always explain to the patient what kind of treatment to be done, make sure the patient understands, give him or her time to process the information, and then respect the decision he or she takes. According to Butts & Rich (2016), nurses are obligated to understand the legal rights of patients, they then ensure to protect, preserve, and support them, making sure the patient understands the information given.

Nurses can assist in in the protection of patient’s rights by making sure they explain all treatments accurately and involving them in making their own decisions regarding their care. the process of supporting the autonomy of the patient includes respecting their decisions and making sure to understand their cultural beliefs (Butts & Rich 2016). 

One paragraph for each reply and one credible source for each 

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Discussion replies wk 7

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of a medical procedure or treatment. This includes understanding the nature of their illness or condition, as well as the purpose, risks, success rate, and indications of the proposed procedure. It is important for the patient to be informed about any potential alternative treatments or procedures available to them. Additionally, the patient’s understanding and agreement to proceed with the procedure or treatment should be documented through their signature, along with the signatures of the physician and any witnesses. The date of consent should also be recorded for reference (Pozgar, 2016, p. 399). These elements are crucial in ensuring that the patient is fully aware of the implications of their medical decisions and that their autonomy and rights are respected throughout the process.

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