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  • Application of Transformational Leadership in Nursing

    Application of Transformational Leadership in Nursing – Transformational leaders provide their followers with an inspiring mission and vision to give them an identity, rather than just working for self-gain…

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    Any opinions, findings, conclusions, or recommendations expressed in this essay are those of the author and do not necessarily reflect the views of pro-essays.com. This essay should not be treated as an authoritative source of information when forming medical opinions as information may be inaccurate or out-of-date.

    Application of Transformational Leadership in Nursing

    Introduction

    Transformational leadership theory is the process whereby the leaders attends to the needs and motives of their followers so that the interaction advance each to higher levels of morality and motivation (Yoder-Wise, P., 2014, pg. 10). In its most optimal form, it produces positive and valuable change within the followers with the purpose of developing the followers into leaders. When a leader embodies transformational leadership, they enhance the morale, motivation and performance of followers with various techniques.

    These techniques include helping the followers to connect their sense of self and identity to the mission and the collective identity of the organization; inspire followers by being their role model; challenge followers to go above and beyond what is expected of them, and understand their strengths and weakness, so the leader can assign tasks to its followers that can optimize their performance.

    Background

    In 1978 leadership expert, James McGregor Burns developed the first concept of the transforming leadership theory. He created this theory to address the aspects of an organization in which leaders focus on the beliefs, success, needs and values of their employees. According to Burns (1978), “the transforming approach creates significant change in the life of people and organizations.

    It redesigns perceptions and values, and changes expectations and aspirations of employees.” In 1985 Bernard M. Bass extended the work of Burns by explaining transforming leadership, but using the term transformational instead, that the followers of such leaders feel, trust, appreciation, constancy and respect for the leader because of the attributes of the transformational leader willingness to work harder than anticipated.

    Transformational Leadership in Nursing

    Transformational leaders have the following characteristics: model of integrity and fairness, effective communication skills, provides support and recognition, sets clear goals, visionary, encourage others and has high expectations (Yoder-Wise, P., 2015). My current nurse manager, Cathy, is a transformational leader. She allows the Patient Care Coordinators (PCCs) or charge nurses and sometimes the staff to participant in the decision making.

    As one of the PCCs, Cathy lets me make decisions about staffing and I am responsible for scheduling the staff. “She provides constructive criticism, offers information, makes suggestions, and ask questions (Blais & Hayes 2011, p. 167).” Cathy lets me know when I am doing a good job and gives me recommendations on how I can make improvements. She gives us complements and rewards for working an extra day, orienting new staff or mentoring student nurses.

    Cathy “is open and encourage openness, so that real issues are confronted (Blais & Hayes 2011, p. 168).” She respects each individual and “values and uses each staff members’ contribution” (Blais & Hayes 2011, p. 168). She encourages everyone to be a team player because when everyone is working together, there is a higher job satisfaction, less nurse turnover, better patient satisfaction and outcomes.

    She comes to work with a smile on her face, says good morning and how are you doing to everyone. She builds relationships with the staff and gets to know everyone on a personal level. She is straightforward and gives you her honest opinion. Cathy is a good leader and remodel.

    Since I am a member of the leadership team as a PCC of a critical care unit, we must be able to contain cost while ensuring staffing productivity and competency, along with improving patient outcomes. One major area of cost containment where I work is staffing productivity. My hospital uses a predictive model to determine the number of full-time staff each department can have based on the number of patient that were seen that month from the previous year.

    I work in an eight beds intensive care unit and our staffing grid is the following: eight or seven patients – four nurses and one patient care tech. (PCT); six patients – three nurses and a PCT, five patients – three nurses and a PCT, unless we are tight on man-hours then we can only have two nurses and no PCT, however if there is a patient(s) that needs behavioral observation (sitter), then we can have that extra person; four patients – two nurses, unless patient(s) need a sitter, then we can have an extra person; three patients – two nurses and no PCT; two patients – two nurses and no PCT and one patient – one nurse and no PCT.

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    Application of Transformational Leadership in Nursing
    Application of Transformational Leadership in Nursing

    When we have an odd number of patients, we tend to go over in man-hours, so we must follow our staffing grid to ensure that we don’t have to answer to administration.

    As a nurse manager, you educate, encourage and support staff through the changes to come within health care. It’s the nurse manager role to ensure that all staff is maintaining the current acceptable level of care. Along with maintaining adequate staff for patient safety, while controlling the budget.

    One of my responsibilities is to help motivate the staff to buy into different policies and procedures changes. We recently had our blood culture collection policy changed and I had to educate all the staff about the new changes.

    One of my biggest attributes is that I am a visionary leader because I can envision the potential reality, think outside of the box and I have innovative ideas. I can come up with new ideas and new ways of looking at situations. I am a big thinker and I dream even bigger. The critical care unit that I work in has eight beds, so relatively small, and it is on the third floor.

    We will be expanding, which means more beds, however, I requested through my manager for the unit to move down to the first floor because it makes more sense for us to be down there, close to the ER, OR and radiology, but I was told that was not going to happen. That was just one of the many ideas that I had.

    As health care continues to transform, hospitals should work to improve current practices for the future. “Whether you are a leader, a follower, or a manager, being able to visualize in your mind what the ideal future is becomes a critical strategy” (Yoder-Wise 569).

    The Wise Forecast Model would be useful because it allows us to be proactive in preparing for the future instead of being passive and reacting to the changes as they happen. There are three steps:

    1. Learn widely,

    2. Think wildly, and

    3. Act wisely.

    Learn widely means to extend your knowledge beyond your own clinical role and area. Think wildly means to think outside of the box, dream big, and know that we are only limited by our imagination. Act wisely is bringing thoughts and/or ideas back down to reality and doing what is possible with the resources that is available (pg. 570).

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    Conclusion

    Transformational leaders provide their followers with an inspiring mission and vision to give them an identity, rather than just working for self-gain. The followers are motivated and transformed through their leaders’ charisma, encouragement and individual consideration. These leaders encourage their followers to think of new and unique ways to challenge the status quo and to adjust the environment to support them being successful.

    References

    Blais, K. K., & Hayes, J. S. (2011).Professional nursing practice: Concepts and perspectives (6th ed.) [Vital Source Bookshelf]. Retrieved from https://online.vitalsource.com

    Burns, J.M. (1978) ‘Leadership,’ New York: Harper and Row.

    Yoder-Wise, P. (2015). Leading and Managing in Nursing. (6th ed.). United States: Elsevier Health Sciences.

    Related FAQs

    1. What does it mean to be a transformational nurse leader?

    What Does It Mean to Be a Transformational Nurse Leader? Transformational leaders are leaders who employ a distinct management style. The style is just as the title suggests – the leader seeks to transform a workplace to promote success.

    2. What is transformational leadership style?

    The style is just as the title suggests – the leader seeks to transform a workplace to promote success. In other words, the leader goes above and beyond daily operations, motivates staff, and sets goals for the workplace. Transformational leaders should: Nurse leaders can also demonstrate this style of leadership.

    3. What are the four components of transformational leadership in nursing?

    This article focuses on transformational leadership and its application to nursing through the four components of transformational leadership. These are: idealised influence; inspirational motivation; intellectual stimulation; and individual consideration. Rebel Leadership: Commitment and Charisma in the Revolutionary Process.

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    Application of Transformational Leadership in Nursing
    Application of Transformational Leadership in Nursing

    4. What are the approaches to leadership in Nursing Practice?

    There are several approaches to leadership that are applicable in nursing practice. Transformational leadership is an approach that focuses on the attributes and behaviours of the leader required to empower and motivate team members.

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  • What are the Social Determinants of Health

    This article covers a sample essay about What are the Social Determinants of Health. This essay outlines the effect of housing on health of the community. Improving the housing condition is primary prevention through upstream actions.

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    Disclaimer: This is a sample essay written by a student and not one of our professional nursing writers. It is meant to be used as just an example to other students.

    Any opinions, findings, conclusions, or recommendations expressed in this essay are those of the author and do not necessarily reflect the views of pro-essays.com. This essay should not be treated as an authoritative source of information when forming medical opinions as information may be inaccurate or out-of-date.

    What are the Social Determinants of Health?

    Introduction

    The Social determinants of health (SDOH) are a group of factors that impact health and wellbeing of an individual. Child development is influenced by various aspects starting from birth, biology, genetic characteristics, gender, culture and family values.

    The Family provides adequate support systems by various means such as socioeconomic resources, ideal family environment and effective parenting skills. A community’s health and social development depends on healthy living and health services available to them (McMurray & Clendon, 2011). The health burden of disease and causes of major health inequalities arises from the environment in which an individual is born, raised, grown and worked. Theses factors are referred to as SDOH.

    SDOH consist of a number of structural conditions. The model representing cascade of bubble demonstrates how SDOH are interrelated to each other. It is observed that if there are any political or environmental changes, all structural determinants are affected (Wilcox, 2007 as cited in McMurray & Clendon, 2011).

    Primary health care (PHC) is aimed to create healthy communities. PHC approach is best described by multi-level health promotion model. Primary prevention is attained through upstream actions which are aimed to promote and maintain health. This is achieved through providing a healthy environment, health services and education for healthy living.

    Secondary prevention/midstream actions are providing treatment for illness and further prevention of disability. Tertiary or downstream actions are basically rehabilitation services or educating the community to cope with disability conditions (McMurray & Clendon, 2011). This essay outlines the effect of housing on health of the community. Improving the housing condition is primary prevention through upstream actions.

    To improve health and reduce inequalities, a coordinated approach is required to address SDOH which has direct effects on structural determinants. House designs should be made by taking into account health and well being. The infrastructure planning for housing designs which should include insulation, ventilation, sewage system, public spaces as well as community’s participation in their health development project should be encouraged.

    The health of an individual, families and the community can be improved by well designed, insulated houses and community health services. (WHO, 2011; Chapman & Bierre, 2008).

    The US Centres for Disease Control and Prevention also emphasised on approach to promote health by improving housing and living conditions. The visits to emergency and stay in hospital with serious acute medical illness is shorter with improved living conditions as opposed to those who lives in poor housing (Thomson, Thomas & Petticrew, 2009; Sadowski, Kee, VanderWeele & Buchanan, 2009).

    The research study has indicated that people migrated to better housing has improved health outcomes and are also exposed to less substance abuse, violence and less neighbourhood problems as compared to their original living conditions. Government generated social and health policies directly affect the quality of life and living conditions of the community, and also the economical status of the family significantly influence an individual’s health.

    A co-ordinated action is required from the Policy makers, health service providers and leaders from various sectors to utilise their knowledge to enhance better living conditions bringing the best population health outcomes (Williams, Costa, Odunlami & Mohammad, 2012).

    The importance of living and working conditions, indoor environment, safe neighbourhood, healthy lifestyles in general and respiratory health in particular is a major concern these days. The predominant factors increasing the risk of asthma and respiratory problems are moisture damage in the house and bacterial growth.

    The studies have shown a close association between mould, dampness and asthma in children. Damp houses resulting in mould and microbial growth are the predisposing factor resulting in wheezing in adults and infants. In a survey carried in NZ homes reported 35 % of moulds clearly visible in the living area or bedrooms. NZ has been reportedly having higher asthma rates in the world, which is contributed by poor living conditions.

    Damp and cold houses support the bacterial growth, providing favourable media for mould, bacteria and dust mites. Young children spend more time at home as compared to adults, There is a significant effect of damp houses on respiratory system, thus the incident rate of bronchitis and wheezing illness is more common in children. It is suggested, if people will be provided with better housing and insulation, respiratory symptoms will reduce by 33% (Keall, Crane, Baker, Wickens, Chapman & Cunningham, 2012).

    It has always been stated that population of health is largely impacted by quality of housing where they live. If people living in substandard housing or poor living conditions could be provided with better housing, insulation and ventilation, It could potentially prevent ill health. There was a cluster randomised trial for housing, insulation and health study of insulating houses of communities with low socioeconomic status.

    A Community based approach is effective mean of improving health rather than an individual focused e.g. Insulating houses are more effective than providing people with more clothes. Older aged, infants and children spend more time in houses, thus they have to bear the physiological stress due to their weaker immune system. This research also reports an association of cold, damp houses likely to get bacterial and mould growth, eventually causing respiratory problems.

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    Social Determinants of Health
    Social Determinants of Health

    Several international report highlight poor insulation, damp, cold and mouldy houses leading to poor health. People with insulated houses and better living conditions were less likely to be admitted to acute wards with pulmonary and obstructive airway diseases. The results interpreted in studies of the insulated housing affecting health were significant with improved outcome measures, except for the use of medical facilities.

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    This study was conducted in uninsulated old houses with cold and dampness, where at least one member has respiratory problems, Increased warmth and decreased humidity brought improved health conditions. Population living in well designed and insulated houses reported significantly less cold and dampness however People in insulated houses also reported that their houses felt significantly less damp and mouldy, however this study does not determine essential determinants involved.

    Although this study greatly emphasise the effect of living in cold and damp houses resulting in pulmonary conditions such as asthma, cough and wheezing (Chapman et al., 2007).

    A study conducted by Kearns, Smith and Abbott on Pacific population showed substandard living conditions as compared to Maori and European population. Pacific people are at a great risk of developing asthma, cold and flu (as cited in Butler, Williams, Tukuuitonga & Peterson, 2003).

    Studies have reported a close relationship between cold, damp houses and respiratory diseases. Researchers also highlighted the association of poor housing with mental health and maternal health. Statistical analysis showed cold/damp houses a potential risk factor for asthma and postnatal depression. The pathophysiology of the respiratory symptoms is triggered by an allergic reaction to fungi or dust mites (Butler, Williams, Tukuuitonga & Peterson, 2003).

    A major British cohort study has reported an evidence of poor living/housing conditions are growing over the life, of course, and can impose serious health effects on an individual and family.

    Thus, interventions to improve housing could measure better effects. Providing insulation for houses for the community with low economic conditions is a cost effective intervention to promote health and well being. It should be widely accepted by the community for their own health, policy makers and leaders to make strategy for healthy measures (Chapman et al., 2007).

    Conclusion

    The health of the community is greatly influenced by SDOH more than medical care. As above stated, quality of life is significantly affected by the society and the environment in which they live and work. The burden of disease and ill health can be reduced by improving the housing environment. Medical care and accessing physician is not affordable to all, however better housing conditions can effectively reduce the financial burden on the health sector. Hence, the individual and the community should be encouraged to participate in health programmes for the promotion of their health and wellness.

    Reference List

    Butler, S., Williams, M., Tukuionga, C., & Paterson, J. (2003). Problems with damp housing among pacific families in New Zealand. The New Zealand Medical Journal, 116 (1177), 1-8. Retrieved from https://researchspace.auckland.ac.nz/bitstream/handle/2292/4653/12861308.pdf?sequence=1

    Chapman, P. H., & Bierre, S. (2008). Reducing health inequalities by improving housing. In Dew, K., & Matheson, A. (Eds.), Understanding health inequalities in Aotearoa New Zealand (pp. 161-173). Dunedin, New Zealand: Otago University Press.

    Chapman, P. H., Matheson, A., Crane, J., Viggers, H., Cunningham, M., Blakely, T.,…Davie, G. (2007). Effect of insulating existing houses on health inequality: cluster randomised study in the community. BioMedical Journal. doi: 10.1136/bmj.39070.573032.80

    Keall, M. D., Crane, J., Baker, M. G., Wicken, K., Chapman, P. H., & Cunningham (2012). A measure for quantifying the impact of housing quality on respiratory health: a cross sectional study. Environmental Health, 11 (33), 1-8. Retrieved from http://www.biomedcentral.com/content/pdf/1476-069X-11-33.pdf

    McMurray, A., & Clendon, J. (2011). Community health and wellness: Primary health care in practice (4th ed.). Sydney, Australia: Elsevier.

    Sadowski, L, S., Kee, R. A., VanderWeele, T. J., & Buchanan, D. (2009). Effects of a housing and case management program on emergency department visits and hospitalizations among chronically ill homeless adults: A randomized trial. Journal of American Medical Association, 301 (17), 1771-1777. doi: 10011/jama.2009.561

    Thomson, H., Thomas, S., Sellstrom, E., Petticrew, M. 92009). The health impacts of housing improvement: A systematic review of intervention studies from 1887 to 2007. American Journal of Public Health, 99(3), 681-691. doi: 10.2105/AJPH.2008.143909.

    Willimas, D. R., Costa, M. V., Odunlami, A. O. & Mohammed, S. A. (2008). Moving upstream: How interventions that address the social determinants of health can improve health and reduce disparities. Journal Public Health Manag Pract, 14, S8-17. doi: 10.1097/01.PHH.0000338382.36695.42

    World Health Organization. (2011). Closing the gap: Policy into practice on social determinants of health: discussion paper. Retrieved from https://extranet.who.int/iris/restricted/bitstream/10665/44731/1/9789241502405_eng.pdf

    Related FAQs

    1. What are social determinants of health (SDOH)?

    Conditions in the places where people live, learn, work, and play affect a wide range of health risks and outcomes. These conditions are known as social determinants of health (SDOH). are conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of life-risks and outcomes.

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    Social Determinants of Health
    Social Determinants of Health

    2. How does income affect social determinants of Health?

    Income can affect many aspects of health and in turn, have a knock-on effect on other social determinants. For example, a parent’s income may influence a child’s early development and educational opportunities, which in turn can affect a child’s employment opportunities and their income.

    3. What is the importance of social factors in our health?

    They influence the opportunities available to us to practice healthy behaviors, enhancing or limiting our ability to live healthy lives.

    4. Is there a social gradient in determinants of Health?

    There is a social gradient across many of these determinants that contribute to health with poorer individuals experiencing worse health outcomes than people who are better off.

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  • What is Gordon’s Functional Health Patterns Framework

    This article covers a sample nursing essay that discusses what Gordon’s Functional Health Patterns Framework is.

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    Disclaimer: This is a sample essay written by a student and not one of our professional nursing writers. It is meant to be used as just an example to other students.

    Any opinions, findings, conclusions, or recommendations expressed in this essay are those of the author and do not necessarily reflect the views of pro-essays.com. This essay should not be treated as an authoritative source of information when forming medical opinions as information may be inaccurate or out-of-date.

    What is Gordon’s Functional Health Patterns Framework

    Frameworks are used to accurately gage a patients health. They are a systematic way of collecting objective and subjective data to establish a plan of care for the patient. Health care professionals must continually observe the patient’s subjective and objective data in order to recognise any changes in the patient’s health so that they can act upon them to achieve the best possible outcome for the patient’s wellbeing.

    Gordon’s functional health patterns framework was developed by Marjorie Gordon. It provides a sequence of recurring behaviour from eleven different aspects (Luxford, 2012). These include; health perception and management pattern, nutritional-metabolic pattern, elimination pattern, activity-exercise pattern, sleep-rest pattern, cognitive-perceptual pattern, self-perception/self-concept pattern, role-relationship pattern, sexuality-reproductive pattern, coping/stress-tolerance pattern and value/belief pattern (Gordon, as cited in Luxford, 2012, pp. 225-226).

    The patient’s health is believed to be influenced by biological, developmental, cultural, social and spiritual factors. Because Gordon’s functional health patterns framework considers each of these factors, it will provide health care professionals utilising it with a comprehensive assessment of the patient’s health (Fulton & Baird, 2010).

    Dorothea Orem (as cited in Broadbent, 2012, pp. 47-48) developed a nursing framework based on three related concepts. self-care, self-care deficit and nursing systems. Self-care theory consists of four concepts. The first of these concepts are self-care, which refers to those activities the patient should perform without assistance that promotes wellbeing, for example, intake of air, food and water, elimination process, balance between activity and rest, balance between solitude and social interaction, hazard prevention and promotion of normality within social groups.

    The second concept is self-care agency, which refers to the patient’s ability to carry out self-care activities and whether or not they require assistance. The third concept is self-care requisites, which refers to the actions taken to provide self-care. Finally, therapeutic self-care demand, which refers to all the activities required to meet existing self-care requisites (Orem, as cited in Broadbent, 2012, pp. 47-48). Self-care deficit comes into play when self-care agency is not able to meet the self-care demand.

    This means that if the patient is unable to perform any activity of daily living they will not meet the requirements that are essential for them to survive, hence, a health care professional must assist them. The self-care deficit indicates that nursing is required to assist the patient and suggests five different nursing systems that can be used depending on the patient’s ability (Orem, as cited in Broadbent, 2012, pp. 47-48).

    Health care professionals should provide care that is considerate of and reactive to unique patient preferences, needs and values. They must ensure that patient values guide all clinical decisions (Krumholz, 2010). To successfully achieve this, when conducting a health assessment it is imperative that health care professionals make professional, ethical and legal considerations.

    Health care professionals must be mindful of the patient’s comfort and not assume that they are aware of what the health care professional is doing nor assume that the patient is consensual. Kerridge, Lowe & Stewart (2009) stipulate that upholding the patient’s right to autonomy is relevant to a health care professional legally, ethically and professionally. It means that before each procedure the health care professional must ask the patient if they consent to the having the procedure performed on them.

    The patient can give consent by verbal, written or implied communication. The patient’s right to autonomy must be respected at all times (Kerridge et al., 2009). It is the patient’s legal right to choose what happens to them, even if the patient refuses to have lifesaving medication or procedures performed on them that results in their further ill health or even death (Eburn, 2010).

    For both professional and ethical reasons health care professionals must adhere to a code of conduct at all times. Due to the patient’s probable vulnerability, health care professionals have a specific duty to conform to extremely high ethical standards both in their professional and private lives (Johnstone, 2012). Saunders (2012) explains that health care professionals must only perform duties that dwell within their scope of practice. If they do not adhere to this policy they would be failing to uphold ethical standards and also breaking the law.

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    Gordon's Functional Health Patterns Framework
    Gordon’s Functional Health Patterns Framework

    This could lead to the health care professional losing their job and or legal action being taken against them. In order for the health care professionals to maintain professionalism and uphold ethical and legal standards they must consider their scope of practice before performing any duties (Saunders, 2012).There are ethical considerations that health care professionals must be mindful of when documenting a patient’s information.

    For instance, to be conscious of who will be reading the notes, use official abbreviations and clear language, be specific, objective and protect privacy at all times. Breeching professional, ethical or legal responsibilities could lead to ramifications that are detrimental to the health care professional’s career, health care institution’s reputation and patient’s health (Jeffries, Johnson, Nicholls & Lad, 2012).

    Gordon’s functional health patterns framework is a common and excellent way to build a picture of the patient’s health (Newfield, Hinz, Scott-Tilley, Sridaromont & Maramba, 2007). It can be utilised for patients of all ages and in all areas of health speciality. Health is dynamic and ever changing and Gordon’s functional health patterns framework caters for this. Unlike other frameworks, Gordon’s uncovers patterns of both function and dysfunction (Gordon, as cited in Luxford, 2012).

    It considers the patient’s health from eleven specific aspects providing a broad range of information for health care providers to notice emerging patterns. The titles of the patterns are self-explanatory hence, they are easy to use (Newfield et al., 2007). These eleven categories provide a systematic and standardized approach to data collection and enable the health care professional to determine many aspects of health.

    Related Content: [Solved] Functional Health Patterns Community Assessment Guide

    Though it has few weaknesses, like most other frameworks, the data collected for Gordon’s functional health patterns framework is based on much subjective data. This means that some data collected can be manipulated by the patient in order to depict an inaccurate assessment of the patient’s health. For this reason is must be used alongside the objective data such as the patient’s vital signs and physical examination in order to ensure an accurate health assessment.

    While Orem’s self-care framework appears to be a useful resource for health care professionals to use, Gordon’s functional health patterns framework proves to have strengths that far outweigh its weaknesses. One can understand why it is so commonly used within health care institutions.

    Related FAQs

    1. What is Gordon’s functional health patterns?

    The patient’s health is believed to be influenced by biological, developmental, cultural, social and spiritual factors. Because Gordon’s functional health patterns framework considers each of these factors, it will provide health care professionals utilising it with a comprehensive assessment of the patient’s health (Fulton & Baird, 2010).

    2. What is Gordon’s model of Health?

    Unlike other frameworks, Gordon’s uncovers patterns of both function and dysfunction (Gordon, as cited in Luxford, 2012). It considers the patient’s health from eleven specific aspects providing a broad range of information for health care providers to notice emerging patterns.

    As you continue, customnursingassignments.com has the top and most qualified writers to help with any of your assignments. All you need to do is place an order with us. (Gordon’s Functional Health Patterns Framework)

    Gordon's Functional Health Patterns Framework
    Gordon’s Functional Health Patterns Framework

    3. What is the functional health pattern assessment based on?

    The following Functional Health Pattern assessment is based on a 65 year old Scottish woman who lives independently with her husband in their home at Happy Valley. The purpose of the interview was explained in addition to an outline of the types of questions which would be asked during the interview.

    4. How many functional health patterns are covered by open ended questions?

    By the use of family focused open ended questions, 11 functional health patterns were covered. The health patterns were values and health perception, nutrition, sleep and rest, elimination, activities and exercise, cognitive, sensory-perception, self-perception, role relationship

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  • Pathology and Treatments of Streptococcal Pharyngitis

    This article covers a sample essay about the Pathology and Treatments of Streptococcal Pharyngitis. Streptococcal pharyngitis is the inflammation of the pharynx and presentation of white pus spots on the throat caused by the bacterium streptococcus pyogenes….

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    Disclaimer: This is a sample essay written by a student and not one of our professional nursing writers. It is meant to be used as just an example to other students.

    Any opinions, findings, conclusions, or recommendations expressed in this essay are those of the author and do not necessarily reflect the views of pro-essays.com. This essay should not be treated as an authoritative source of information when forming medical opinions as information may be inaccurate or out-of-date.

    Pathology and Treatments of Streptococcal Pharyngitis

    A: Causative Agent

    Streptococcal pharyngitis is the inflammation of the pharynx and presentation of white pus spots on the throat caused by the bacterium streptococcus pyogenes. Streptococcus pyogenes is a gram-positive cocci shaped bacterium that arranges in chains. Gram-positive cocci contain a thick peptidoglycan wall that encloses the inner plasma membrane and sits between the membrane and capsule.

    Unlike gram-negative bacteria, gram-positive bacteria do not contain more than one cell membrane. Streptococcus pyogenes are facultative anaerobes, which allows the bacteria to grow in anaerobic conditions. Facultative anaerobes are able to use oxygen when present to grow rapidly, which explains how S. pyogenes grows so effectively in the throat where oxygen is readily available.

    B: History

     The organism Streptococci was first founded in 1874 by Theodor Billroth. He discovered this organism through cases of wound infections and erysipelas. Louis Pasteur was the first to introduce this organism into history in 1879 through his discovery of isolating the microorganisms from the uterus and blood of women with puerperal fever.

    Friedrich Rosenbach received credit for naming the organism Streptococcus Pyogenes in 1884. One of the treatments called Penicillin was not established to be an effective treatment until 1940. In 1928 Alexander Fleming was the first person to be credited with the discovery of Penicillin through his founding of Penicillium fungus.

    However, Penicillin was not actually isolated to where it could be used as an effective treatment for diseases until 1939 by Howard Florey and Ernst Chain. Throughout decades this treatment continues to be the best option to treat streptococcal pharyngitis. With newer advances in technology led to more knowledge of the disease and the best treatment options to cure this disease.

    C: Epidemiology

     Streptococcal pharyngitis is prevalent worldwide. Although, there are more cases of strep throat found in low income regions. There are thousands of people worldwide who are currently infected with strep throat. Colder temperatures can tend to influence the outbreak of the disease.

    This is why strep throat is a very common disease to be infected with during this time of year. Based on the CDC there are 11,000 to 13,000 cases of streptococcal pharyngitis that arise every year in the United States alone (Centers for Disease Control and Prevention 2018). Each year 20-30% of strep throat cases are found in children and 5-15% of cases are found in adults (Centers for Disease Control and Prevention 2018).

    There are more than 18 million cases of streptococcal pharyngitis found worldwide each year (World Health Organization 2009). According to the CDC the mortality rate for strep throat is approximately 1,100 to 1,600 people die each year in the U.S. (Centers for Disease Control and Prevention 2018). Globally the mortality rate is approximately 500,000 people die each year (World Health Organization 2009).

    This disease is transmitted through direct contact with an infected person’s saliva or nasal fluids. These fluids are transmitted through airborne droplets by the infected person sneezing or coughing. It can also be transmitted by an infected person touching an item that will be touched by several people such as a doorknob.

    A person will then be able to pick up the disease by touching the doorknob and transmitting it to either there mouth, nose, or eyes. Strep throat tends to spread more rapidly in crowded areas such as schools, dorms, daycare centers, military training facilities, and workplaces. Humans are the main reservoir of the disease. Asymptomatic Group A Streptococcus carriers are another reservoir of this disease. Children are most commonly infected with the disease.

    D. Pathology

    Streptococcus pyogenes can affect multiple systems, although in the case of pharyngitis S. pyogenes invades the epithelial cells of the pharynx and tonsils causing inflammation. Due to the body fighting off the infection, the tonsils and surrounding lymph nodes become swollen and white pus spots appear on the tonsils, back of the throat, and tongue. The accumulation of pus in the throat can cause a foul-smell to patients’ breath signaling there is an infection.

    S. Pyogenes contains many virulence factors to aid in their invasion including: M proteins, exotoxins, hydrolytic enzymes, and a capsule around the cell wall. M proteins embedded in the cell wall aid the pathogen in adhering to host cells upon entry. Along with the M proteins, a hyaluronic capsule surrounds the microbe which also aids in adherence and prevents phagocytosis from the immune system.

    The capsule appears sticky causing incoming macrophages be unable to properly engulf the bacteria. The major cause of damage occurs from enzymes and exotoxins released from the pathogen. Streptococcus pyogenes releases an exotoxin that degrades surrounding tissue and causes an excess release of cytokines from surrounding T cells. This excess of cytokines, or a superantigen, causes an increase in inflammation around the infected area. Hydrolytic enzymes are another mechanism that S. pyogenes uses to damage host cells.

    These enzymes include C5a peptidase, streptolysin, and streptokinase. C5a peptidase is an enzyme that blocks the immune system’s complement cascade by cleaving C5 rendering it useless. Streptolysins O & S cause surrounding host cells and red blood cells to lyse and kill phagocytes. Lastly, the enzyme streptokinase is used to lyse blood clots which aid in the spread of bacteria to other tissue in the host.

    When a host is infected with streptococcus pyogenes, the host will not exhibit symptoms for 2-5 days while the pathogen incubates. After 2 or so days, the rapid onset of a sore throat, swollen lymph nodes, fever, and malaise will set in. Vomiting in young children is common, although not as common in adults.

    When showing signs of the infection, the patient should consult a doctor to start treatment and take proper precautions to prevent transmission to others. If the infection is treated, symptoms will resolve within 7-10 days. Although if left untreated, S. pyogenes can cause two major immune-mediated sequelae.

    A sequelae is a condition that presents after a previous disease has subsided. Streptococcal pharyngitis, if untreated, can lead to acute rheumatic fever and scarlet fever. Acute rheumatic fever appears within 2-4 weeks after the initial sore throat and is caused by a cross-reaction between the pathogen’s M proteins and the host’s heart muscle.

    This immunological cross-reaction causes the host to exhibit a fever, painful joints, and unregulated body movements. S. pyogenes’ other sequelae is scarlet fever. Scarlet fever occurs when streptococcus pyogenes has been infected with a phage. When a phage infects S. pyogenes, it begins to produce a erythrogenic toxin that causes a sandpaper-like rash to develop on the cheeks and chest along with a high fever.

    E. Response and Treatment

    The immune system takes action when fighting off strep throat. Inflammation of the throat and fever are key factors. CD4 T cells are directed against the M proteins of the streptococcus pyogenes bacteria. The body’s T cells secrete cytokines to guide that class switch recombination. Th17 cells protect against the GAS bacteria.

    IgG1 and IgG3 are responsible for the body’s humoral response and are developed over time, therefore adults are much less susceptible to this infection than children. Once exposed to the GAS bacteria, the body produces antibodies which have a protective capacity against infection. The B memory cells developed within the body help to fight of future infection of the same strain of bacteria. Vaccine development is currently focusing on antibody development more than the T cell immunity to encompass more the one strain.

    Treatment of the disease will shorten the duration of symptoms, reduce the chance of transmission between people in close contact, and prevent further complications. Clinicians should treat patients who test positive for streptococcus pyogenes (Strep Group A) through a throat culture test or rapid diagnostic throat test, in order to reduce the risk of serious sequelae.

    Penicillin is the first choice of treatment for the bacteria, however cephalexin and vancomycin can be used if the patient is allergic to the penicillin family. Both of these antibiotics are taken for a span of 10 days to completely eradicate the bacteria. The body could potentially fight off the infection without treatment, however antibiotic treatment is important to prevent possible life-threatening sequelae.

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             In order to prevent the spread of the infection, proper hygiene and respiratory etiquette should be practiced. Washing hands after coughing or sneezing and before handling food will help stop the spread of bacteria.  Respiratory etiquette means covering your nose or mouth when coughing or sneezing and not coming into close-contact with sick individuals.

    Normally, after twenty-four hours of antibiotic therapy, the individual is no longer at risk of transmitting the bacteria. They should stay at home for one entire day after starting the medication and until their fever is gone to further limit other’s exposure to possible illness.

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    Pathology and Treatments of Streptococcal Pharyngitis
    Pathology and Treatments of Streptococcal Pharyngitis

    Infectious Disease Fact Sheet

    Group Members: Kourtney Mathis, Savannah Ross, Hannah Stewart

    Name of DiseaseStreptococcal Pharyngitis
    Name of Causative AgentStreptococcus Pyogenes
    Type of MicrobeBacterium
       If Bacterial:
          Gram-reactionGram-positive
          Cell Shape/Arrangementcocci, chains
    Epidemiology
       Geographic PrevalenceWorldwide
       Average Rates of Infection11,000 to 13,000 cases each year in the U.S., 18 million cases worldwide, 20 – 30% in children, 5 – 15% in adults
       Reservoir(s)Humans (primarily children), (asymptomatic) Group A Streptococcus carriers
       Mode(s) of TransmissionRespiratory dropletsDirect contactNasal or saliva droplets from an infected person
    Pathology
       Major Virulence FactorsExotoxins (superantigens), M proteins, capsule, streptolysins O/S, streptokinase, hyaluronidase, C5a peptidase
       Major tissues/organs affectedEpithelial cells in pharynx, tonsils
       Major Signs/SymptomsPain, redness/inflammation of throat/lymph nodes, fever, vomiting in children
       Sequelae?Acute Rheumatic FeverScarlet Fever
       Latency?2-5 days
    Main Treatment Methods
       Pharmacological TreatmentsPenicillin, Vancomycin, Cephalexin
       Typical Length of Treatment7-10 days
       Prophylactic MeasuresAvoid direct contact with sick individualsProper hygiene/hand washing and respiratory etiquette

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    Works Cited

    • Mortensen, Rasmus, et al. “Adaptive Immunity against Streptococcus Pyogenes in Adults Involves Increased IFN-γ and IgG3 Responses Compared with Children.” The Journal of Immunology, American Association of Immunologists, 15 Aug. 2015, www.jimmunol.org/content/195/4/1657.
    • “Group A Streptococcal (GAS) Disease.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 1 Nov. 2018, https://www.cdc.gov/groupastrep/diseases-hcp/strep-throat.html.
    • Costello, Anne Marie. “Group A Streptotoccus.” Austin Community College – Start Here. Get There., www.austincc.edu/microbio/2704y/gas.htm.
    • Efstratiou, Androulla. “Epidemiology of Streptococcus Pyogenes.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 3 Apr. 2017, www.ncbi.nlm.nih.gov/books/NBK343616/.
    • “Strep Throat.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 28 Sept. 2018, www.mayoclinic.org/diseases-conditions/strep-throat/symptoms-causes/syc-20350338.
    • Ferretti, Joseph. “History of Streptococcal Research.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 10 Feb. 2016, www.ncbi.nlm.nih.gov/books/NBK333430/.

    Related FAQs

    1. What is Streptococcus pharyngitis?

    Streptococcal pharyngitis, also known as strep throat, or Bacterial tonsillitis is an infection of the back of the throat including the tonsils caused by group A streptococcus (GAS). Common symptoms include fever, sore throat, red tonsils ( tonsilitis ), and enlarged lymph nodes in the neck.

    2. When did penicillin become an effective treatment for streptococcal pharyngitis?

    However, Penicillin was not actually isolated to where it could be used as an effective treatment for diseases until 1939 by Howard Florey and Ernst Chain. Throughout decades this treatment continues to be the best option to treat streptococcal pharyngitis.

    3. What are the treatment options for acute streptococcal pharyngitis in children?

    “Short-term late-generation antibiotics versus longer term penicillin for acute streptococcal pharyngitis in children”. Cochrane Database of Systematic Reviews (8): CD004872. doi: 10.1002/14651858.CD004872.pub3.

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    Pathology and Treatments of Streptococcal Pharyngitis
    Pathology and Treatments of Streptococcal Pharyngitis

    4. What is the prognosis of untreated streptococcal pharyngitis?

    Untreated streptococcal pharyngitis usually resolves within a few days. Treatment with antibiotics shortens the duration of the acute illness by about 16 hours. The primary reason for treatment with antibiotics is to reduce the risk of complications such as rheumatic fever and retropharyngeal abscesses.

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  • What is Community in Community Health Nursing

    This article discusses What is Community in Community Health Nursing. A community may be defined in many different ways. Community care can also be defined differentially, maybe in relation to a fundamental philosophy, may in terms of imposed limitations and definitions of community delineation….

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    What is Community in Community Health Nursing

    Give a definition of what a community is – it is not solely geography, but includes factors of culture, ethnicity, age, etc. Consider principles of community care and critically discuss how a PHN in Ireland could ensure that care provided in her particular community is both inclusive and comprehensive.

    Introduction

    A community may be defined in many different ways. Community care can also be defined differentially, maybe in relation to a fundamental philosophy, may in terms of imposed limitations and definitions of community delineation.

    Discussion

    One definition of;community’ is “A social group of any size whose members reside in a specific locality, share government, and often have a common cultural and historical heritage” (http://www.sustainablemeasures.com/Training/Indicators/Cmmunty.html). This notion of community identifies the key elements of community in relation to healthcare that concern healthcare service providers and policy makers. Communities can be defined in terms of their location, but it is not enough to delineate communities in terms of specific areas, because communities are not simply collections of people who are in close proximity with each other by happenstance (Webb, 1986).

    Communities occur because of features which bring people together, often because of need, such as family support, or because of common interest, such as healthcare support groups. However, not all groups which share a common interest are communities (Trevilion, 1993). Location and purpose seem to be aspects of community, sharing not only common interest but common activities and common purposes, common concerns and common needs (Sines et al, 2005).

    Culture, ethnicity, age, gender, sexuality, all of these can be characteristics which define a community, but they could also be different elements of identities and needs within a particular community. For example, it is possible to talk of traveller community health, traveller women’s health, gay men’s health, and the like, and thus we are referring to communities which may exist within geographical communities, or despite geographical boundaries (McMurray, 2003).

    Within the United Kingdom, issues surrounding community health and wellbeing have concerned healthcare providers, particularly in defining distinct communities or sectors of communities, in order to identify health needs and develop and mobilise services in order to meet those needs (Lewis, 1999).

    However, these needs and the communities focused on have been traditionally limited to government-defined communities or definitions of who belongs to what community (Lewis, 1999). More recently, the re-orientation of UK healthcare services towards a more patient-centred model has led to the upsurge of service user involvement in design, development and evaluation of services (Pickar et al, 2002; Simpson et al, 2006; Tait and Lester, 2005; Telford and Faulkner, 2004; Humphreys, 2005).

    Related Content: Community Health Nursing

    This could be viewed as a means of breaking down the traditional hierarchical barriers between ‘the community’ or communities being served by healthcare providers, and the providers themselves (Telford and Faulkner, 2004). Addressing community needs can be informal, local, or national and formal, and seems to form part of governance strategies in the UK and Ireland (DoHC, 2001).

    Such strategies also now seem to focus not only on the service user information role, through gathering feedback and through service user involvement (Poulton, 1997), but also the need for greater collaboration, within and between healthcare and community/ social care/ voluntary sector agencies (Cumberledge, 1986; Fisher et al, 1999). These are all very good ideals, but in order to make user involvement and collaborative approaches work, information needs to be applied to practice, and practice needs to be changed for the better. This requires staff at some level to enforce these changes.

    It might be that the Public Health Nursing role within the Irish community healthcare context could be viewed as one of the loci for the enforcement of community-oriented healthcare provision. However, more information is needed on how this ‘enforcement’ of change could be achieved through this role. For example, collaborative care planning, needs assessment and care provision has existed for decades (see for example, Webb, 1986), but this kind of joined up working is still not a reality of practice, with failings in communication and challenges of interprofessional working still dogging the footsteps of primary healthcare providers (Poulton and West, 1999).

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    What is Community in Community Health Nursing
    What is Community in Community Health Nursing

    If healthcare providers cannot work well with each other, they set a poor example for joined up working with community-focused or community-derived groups, as well as individuals who identify themselves as belonging to certain communities.

    Community services within the Irish context cover both health services –primary, secondary and tertiary – and social care services, all of which are supposed to meet the needs of the individual and the community. However, provision and suitability of services can vary by location. Because of the diverse nature of communities, it might be difficult to provide services which meet all community needs in any given location.

    This would suggest a need for flexibility of care provision, and again underlines the need for good inter-professional, inter-disciplinary, and inter-agency working. Public Health Nurses are accustomed to working with multiple professions and agencies, but there is a need to re-evaluate concepts of diversity in relation to the communities which occur within their sphere of practice.

    Conclusion

    Community is a term which encompasses many aspects of social life. Healthcare services which have a community focus would have to be very flexible, adaptable, and even creative, because of the increasingly diverse nature of communities. This diversity emerges not only from social changes, some of which are driven by economic, media and technological changes, but also by new understandings of communities and their inherent components, differences and similarities. Community focused models of service design and provision are those which would involve service users in design, planning, governance and evaluation of services, but such involvement must be representative of the increasing diversity of the communities concerned.

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    Public health nurses are in a good position to access and support all sectors of the community within the Irish context, and to support service users to provide input into all levels of health and social care provision, even into healthcare professional education. However, understanding communities is an ongoing issue and services must be designed to reflect the true needs of each community. As such, they must be responsive rather than prescriptive.

    References

    Cumberlege, J. (1986) Collaboration. London: Centre for Advancement of Interprofessional Education

    Department of Health and Children (2001) Primary Care: a New Direction. Available from: http://www.dohc.ie/publications/pdf/primcare.pdf?direct=1 Accessed 10-11-08.

    Fisher, B., Neve, H. & Zoe, H. (1999) “Community development, user involvement and primary health care: community development has much to offer primary care groups.” British Medical Journal 318 (7186) 749-750.

    Humphreys, C. (2005) Service user involvement in social work education: a case example. Social Work Education 24 (7) 797-803.

    Lewis, J. (1999) The concepts of community care and primary care in the UK: the 1960s to the 1990s Health and Social Care in the Community 7 (5) 333-341.

    McMurray, A. (2003) Community Health and Wellness – A Sociological Approach. 2nd Ed. Elsevier, Australia

    Pickar, S., Marshall, M., Rogers, A. et al (2002) “User involvement in clinical governance.” Health Expectations 5 187-198.

    Poulton, B.C. (1997) Consumer feedback and determining satisfaction with services. IN: Mason, C. (ed) Achieving Quality in Community Health Care Nursing London: Macmillan Press.

    Poulton, B. and West, M. (1999) The Determinants of Effectiveness in Primary Health Care Teams. Journal of Interprofessional Care, 13:1

    Simpson, E.L, Barkham, M, Gilbody, S. and House, A. (2006) Involving service users as researchers for the evaluation of adult statutory mental health services. The Cochrane Library 3

    Sines, D., Appleby, F. and Frost, M. (2005) Community Health Care Nursing 3rd Ed. Bath: Blackwell Publishing.

    Tait, L. & Lester, H. (2005) “Encouraging user involvement in mental health services.” Advances in Psychiatric Treatement 11 168-175.

    Telford, R. and Faulkner, A. (2004) Learning about service user involvement in mental health research. Journal of Mental Health 13 (6) 549-559.

    Trevillion, S. (1993) Care in the Community – a Networking Approach to Community Partnership. London: Longman

    Van Teijlingen, E.R., Hundley, V., Rennie, A.M. et al (2003) Maternity satisfaction studies and their limitations, Birth 30 (2) 75-82.

    Webb, A. (1986) Collaboration in Planning a pre-requisite of Community Care. In Webb, A. and Sistow, G. Eds. Planning Needs and Scarcity. Essays on Personal Social Services. London: Allen and Unwin

    Related FAQs

    1. What is the difference between a community health nurse and public health?

    Community health (CH) nurses provide health services, preventive care, intervention and health education to communities or populations. In the past, public health nurses worked for the government or the public health department. Their role has since expanded.

    2. How do I become a community health nurse?

    When compared with some registered nursing roles, becoming a community health nurse typically requires some additional training and educational experience. A community health nurse needs to have a strong background in nursing as well as an understanding of social science and public policy.

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    What is Community in Community Health Nursing
    What is Community in Community Health Nursing

    3. What is community diversity in public health nursing?

    Public Health Nurses are accustomed to working with multiple professions and agencies, but there is a need to re-evaluate concepts of diversity in relation to the communities which occur within their sphere of practice. Community is a term which encompasses many aspects of social life.

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