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Grand Canyon Nursing Professional Capstone and Practicum Reflective Journal

Grand Canyon University

Question Description

Students are required to maintain weekly reflective narratives throughout the course to combine into one course-long reflective journal that integrates leadership and inquiry into current practice as it applies to the Professional Capstone and Practicum course.

In your journal, you will reflect on the personal knowledge and skills gained throughout this course. The journal should address a variable combination of the following, depending on your specific practice immersion clinical experiences:

  1. New practice approaches
  2. Intraprofessional collaboration
  3. Health care delivery and clinical systems
  4. Ethical considerations in health care
  5. Population health concerns
  6. The role of technology in improving health care outcomes
  7. Health policy
  8. Leadership and economic models
  9. Health disparities

Students will outline what they have discovered about their professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and finally, how the student met the competencies aligned to this course.

While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines,

MY EBP PROJECT IS ATTACHED FOR REFERENCE, ALSO FIND THE ATTACHED RUBRIC.

Unformatted Attachment Preview

HEALTH 0 Research Proposal Name Instructor Institutional Affiliation Date HEALTH 1 DETERMINING WHETHER ELECTIVE LABOUR INDUCTION IN PREGNANT WOMEN INCREASES THE TENDENCY OF UNPLANNED CESAREAN SECTIONS Background If there is anything that makes women more special than men, then it must be their ability to carry a fetus in their womb for approximately nine months and then eventually give birth. That is the reason we all respect our mothers. We assume that they gave us life, regardless of the fact that our fathers also played a prominent role in the process. However, women have had to carry the burden that comes with the process of giving birth. Many women have died in the process, some have even had lifelong complications such as secondary subfertility, and others have undergone puerperal psychosis. Am mentioning all these things so that we appreciate the role of women and the risks involved. This research proposal is mainly about the relationship between elective labor induction and cesarean section in expectant women. Does inducing labor in a pregnant woman at term increase the probability of having a cesarean section done on her? This is an issue which has been highly debated. When labor is induced, it merely means that the process is not physiological and that both the mother and the fetus are not yet ready. Inducing labor forces the fetus to come out unprepared and might experience some complications, either short term or long term. Physiologically, during the third trimester of pregnancy, the fetus’s lungs mature, and the fetus rotates in the womb into an appropriate position and presentation. The fetus might not have time to undergo all these slow natural processes that occur before birth when labor is induced. The topic of cesarean section and labor induction has been controversial with some previous studies showing contradicting results. Some studies show that labor induction reduces cesarean section rates whereas others show no HEALTH 2 relationship at all. My hypothesis suggests that labor induction increases the risk of a cesarean delivery method. Problem Statement The rate at which cesarean sections are being done in our hospitals and most countries has been on the rise. The increase in cesarean sections also coincides with an increase in labor induction (Danilack, V. A., et al. 2016). Induction is the leading cause of the rise in cesarean sections, then it interventions should be made towards that regard. Meaning reduction of labor induction will consequently reduce cesarean section rates. The rationale of this study is to follow up the events that happen after labor induction focusing more keenly on cesarean sections done after that. This will enable us to weigh the risks and benefits associated with labor induction. It will also us to see the gaps both in the personnel and patient education on labor induction and cesarean section. Purpose of the Change Proposal Women who have undergone cesarean section during their first delivery have a more than eighty percent probability of having cesarean sections in their subsequent pregnancies. This means that avoiding unplanned cesarean sections, in the first pregnancy, will significantly reduce the overall cases of cesarean sections. This study aims to prove that labor induction is a predisposing factor to cesarean sections in pregnant women. After that, interventions will be done towards the methods in which labor is being induced if it is unavoidable. Training of nurses will also be done for proper assessment of pregnant women, for example, techniques for cervical examination and interpretation of partographs. Cesarean section has a lot of disadvantages which are avoidable. The shortcoming of the cesarean section includes post-partum hemorrhage, delayed recovery after giving birth, septic wounds and peritonitis amongst many others. HEALTH 3 PICOT Population/problem The study population for this research proposal is pregnant women who have had a cesarean section. We will then follow up if there were previous attempts to induce them into labor. The study problem is whether labor induction increases the risk of having a cesarean section done. Indicator/Intervention Nurses are enlightened on ways of conducting cervical examination properly on expectant women. The knowledge will help to prevent recommendation of labor induction for patients with no significant reason. Comparison / Control Our control study will be the number of women who underwent cesarean section without being induced into labor. We will compare this number with that of women who underwent cesarean section after being induced into labor. Outcomes The expectation is that the number of unplanned cesarean sections after labor induction goes down after the interventions have been done. Therefore the incidence of cesarean section is expected to go down in the local health center. Time Frame The estimated period of study is about six months. HEALTH 4 Question Does elective labor induction at term increase the incidence of an unplanned cesarean section in pregnant women as compared to spontaneous vertex delivery? Literature Search Strategy Employed My literature search involved mainly primary sources such as journals and articles are written on labor induction and cesarean section. It also included medical textbooks especially those of obstetrics and gynecology focusing even on reproductive physiology. Getting these articles also involved searching online on sites such as google scholar. Most articles and journals also were about previous topics that had been done. A significant majority range between the years 2013 and 2017. It is important to note that all the literature were written in the English language. Evaluation of Literature It would be essential to appreciate the previous works that have been done by researchers on the topic of labor induction and cesarean sections (Kawakita, T., & Bowers, K. 2018). It is a matter of concern that the number of cesarean sections is on the rise, both in developed and developing countries, according to previous research. The risks of labor induction have also been evaluated to some extent. Some researchers argue that labor induction actually reduces the rate of cesarean sections. However, they lacked evidence and facts to support this hypothesis. From previous research, I was able to conclude that elective labor induction poses the great risk both to the infant and to the pregnant woman. Neonatal complications such as neonatal sepsis have been proven in pregnancies where artificial rupture of membranes was done. This was the case even when sterile techniques were used. My current proposal is that labor induction increase cesarean section rates. Previous research has not looked into this matter deep enough. HEALTH 5 Applicable Change/Nursing Theory Utilized Since induced labor is not a physiological process, it changes a previously normal pregnancy into a high-risk category. This predisposes the mother to complications such as an insufficient power to push the baby out or shoulder dystocia. This eventually leads to emergency cesarean sections. Implementation Plan/Outcome Implementation involves, proper training of nurses and midwives on late pregnancy and stages of labor, proper cervical examination and indications and risks of labor induction. Patients will also be appropriately educated during antenatal clinics towards this regard. The expected outcome is that the labor will only be induced when necessary and after proper clinical evaluation. Potential Barriers Few challenges are expected in this mission. Lack of sufficient trained personnel is a big problem in most health facilities. Most pregnant women are also ignorant and do not attend all their antenatal clinics. Inaccurate from the records might also be very misleading giving out the wrong impression. However, all these challenges can be avoided by taking data from the correct sample population. Recruitment of more trained nurses will also be helpful. For this research to be successful, teamwork and cooperation are required from both the patients and the hospital staff. Reducing cesarean section rate is our primary aim. This will reduce maternal and neonatal complications. A healthy reproductive life is satisfying. HEALTH 6 References Danilack, V. A., Triche, E. W., Dore, D. D., Muri, J. H., Phipps, M. G., &Savitz, D. A. (2016). Comparing expectant management and spontaneous labor approaches in studying the effect of labor induction on cesarean delivery. Annals of epidemiology, 26(6), 405-411. Kawakita, T., & Bowers, K. (2018). Maternal and Neonatal Outcomes of Induction of Labor Compared with Planned Cesarean Delivery in Women with Preeclampsia at 34 Weeks' Gestation or Longer. American journal of Perinatology, 35(01), 095-102. Packard, R. E., &Mackeen, A. D. (2015, October). Labor induction in the patient with preterm premature rupture of membranes. In Seminars in perinatology (Vol. 39, No. 6, pp. 495500). Elsevier. Walker, K. F., Bugg, G. J., Macpherson, M., McCormick, C., Grace, N., Wildsmith, C., ...& Thornton, J. G. (2016). Randomized trial of labor induction in women 35 years of age or older. New England Journal of Medicine, 374(9), 813-822. 2 1 3 5 Less Than 4 Unsatisfactory 0Satisfactory Excellent 90Satisfactory Good 80-89% 71% 76-79% 100% 72-75% 89.00% 0.00% 79.00% 100.00% 75.00% 100.0 %Content 10.0 %New New practice New practice New practice New practice New practice Practice approaches are approaches are approaches are approaches are approaches are Approaches not present. present, but present. Some present and present, incomplete or minor details complete. The complete, and otherwise or elements are submission incorporates lacking in missing but the provides the additional required detail. omission(s) do basic relevant details not impede information and critical understanding. required. thinking to engage the reader. 10.0 Intraprofession Intraprofession Intraprofession Intraprofession Intraprofession %Intraprofession al al al al al al Collaboration collaboration collaboration collaboration collaboration collaboration (4.3) information is information is information is information is information is not present. present, but present. Some present and present, incomplete or minor details complete. The complete, and otherwise or elements are submission incorporates lacking in missing but the provides the additional required detail. omission(s) do basic relevant details not impede information and critical understanding. required. thinking to engage the reader. 10.0 %Health Health care Health care Health care Health care Health care Care Delivery delivery and delivery and delivery and delivery and delivery and And Clinical clinical clinical clinical clinical clinical Systems (4.1) systems systems systems systems systems information is information is information is information is information is not present. present, but present. Some present and present, incomplete or minor details complete. The complete, and otherwise or elements are submission incorporates lacking in missing but the provides the additional required detail. omission(s) do basic relevant details not impede information and critical understanding. required. thinking to engage the reader. 10.0 %Ethical Ethical Considerations In considerations Health Care (5.4) in health care information is not present. Ethical Ethical Ethical considerations considerations considerations in health care in health care in health care information is information is information is present, but present. Some present and incomplete or minor details complete. The otherwise or elements are submission lacking in missing but the provides the required detail. omission(s) do basic not impede information understanding. required. Ethical considerations in health care information is present, complete, and incorporates additional relevant details and critical thinking to engage the reader. 10.0 Population Population Population Population Population %Population health health health health health Health Concerns concerns concerns concerns concerns concerns (5.3) information is information is information is information is information is not present. present, but present. Some present and present, incomplete or minor details complete. The complete, and otherwise or elements are submission incorporates lacking in missing but the provides the additional required detail. omission(s) do basic relevant details not impede information and critical understanding. required. thinking to engage the reader. 10.0 %The Role Information on Information on Information on Information on Information on Of Technology In the role of the role of the role of the role of the role of Improving technology in technology in technology in technology in technology in Health Care improving improving improving improving improving Outcomes (4.3) health care health care health care health care health care outcomes is outcomes is outcomes is outcomes is outcomes is not present. present, but present. Some present and present, incomplete or minor details complete. The complete, and otherwise or elements are submission incorporates lacking in missing but the provides the additional required detail. omission(s) do basic relevant details not impede information and critical understanding. required. thinking to engage the reader. 10.0 %Health Health policy Health policy Health policy Health policy Health policy Policy information is information information information information not present. content is content is content is content is present, but present. Some present and present, incomplete or minor details complete. The complete, and otherwise or elements are submission lacking in missing but the provides the required detail. omission(s) do basic not impede information understanding. required. incorporates additional relevant details and critical thinking to engage the reader. 10.0 Information on Information on Information on Information on Information on %Leadership leadership and leadership and leadership and leadership and leadership and And Economic economic economic economic economic economic Models models is not models is models is models is models is present. present, but present. Some present and present, incomplete or minor details complete. The complete, and otherwise or elements are submission incorporates lacking in missing but the provides the additional required detail. omission(s) do basic relevant details not impede information and critical understanding. required. thinking to engage the reader. 10.0 %Health Information on Information on Information on Information on Information on Disparities (1.5) health health health health health disparities is disparities is disparities is disparities is disparities is not present. present, but present with present and present, incomplete or minor complete. The complete, and otherwise elements submission incorporates lacking in missing that do provides the additional required detail. not impede basic relevant details understanding. information and critical required. thinking to engage the reader. 5.0 The piece is The work is The overall The overall The work is %Presentation not neat or not neat and appearance is appearance is well presented organized, and includes minor general, and generally neat, and includes it does not flaws or major elements with a few all required include all omissions of are missing. minor flaws or elements. The required required missing overall elements. elements. elements. appearance is neat and professional. 5.0 %Mechanics Surface errors Frequent and Some Prose is largely Writer is of Writing are pervasive repetitive mechanical free of clearly in (includes spelling, enough that mechanical errors or typos mechanical command of punctuation, they impede errors distract are present, but errors, standard, communicatio the reader. they are not although a few written, grammar, language use) 100 %Total Weightage n of meaning. Inconsistencies overly Inappropriate in language distracting to word choice or choice the reader. sentence (register), Correct construction is sentence sentence used. structure, or structure and word choice audienceare present. appropriate language are used. may be academic present. A English. variety of sentence structures and effective figures of speech are used. ...
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OUTLINE
Introduction
Body
Conclusion
Reference


Running Head: NURSING

1

Professional Capstone and Practicum Reflective Journal
Name:
Course/Number:
Institutional Affiliation:
Instructor:
Date:

NURSING

2
Professional Capstone and Practicum Reflective Journal

An array of complexities mars the work environments that nurses interact within their
practice. Through my educational endeavors and practical experiences, I have been able to
acquire some of the vital skills to maneuver through these complexities. It is through overcoming
these complexities that quality services can be delivered to patients and any other person that is
disadvantaged health wise. My leadership and professional skills have been enhanced through
the various dealings I have had with my patients, fellow practicians and the scholarly interaction
work that is related to nursing practice. There are several other factors in nursing practice that
dictate the quality to serve patients. Most of them are outside of the training expertise that is
acquired in school. They involve collaborative practices, ethical considerations, and other
cooperative works. It is these factors that have helped me sharpen my leadership skills involving
working with groups of both colleagues and vulnerable people. I have a clear grasp of what the
existing healthcare system requires of me as a nurse, and I can work better under very minimal
supervision (Gordon, Lorilla & Lehman, 2012).
New Practice approaches
They say ...

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