Bloom Research and Response Paper

Larkin and Burton’s abstract preface the Joint Commission’s directive for effective communication among caregivers during handoff to ensure patient safety (Larkin Burton, 2008, p. 360). The case study reviews the lack of handoff practice and its effect on continuum of care provided to â€Å"Ms. C, a 64-year-old woman, presented to the ambulatory surgery center for an open cholecystectomy† (p. 390), and the subsequent workshop utilizing Bloom’s Taxonomy of Education Objectives to educate and change clinical practice among the staff members. From this reader’s vantage Ms. C’s respiratory de-compensation was a result of the nurses’ failure to communicate patients medical history and critical findings during unit-to-unit transfer and shift report, inadequate nurse to patient ratio along with incomplete charting, failure to recognize early signs and symptoms of respiratory compromise, and lack of critical thinking skills. Evidenced by the case study’s assertions, Ms. C required oxygen in the post anesthesia care unit (PACU) but was transferred without it. Second, the PACU nurse did not communicate to the patient’s need for oxygen to the receiving nurse during handoff report. It is unclear if the surgeon wrote vital sign parameters and pulmonary toilet orders, or if there were standard protocols for this post operative unit. Ms. C’s incomplete graphic record indicate she was placed on four liters of oxygen within two hours of her arrival to the unit at 1630; however, fail to adequately trend abnormal vital signs such as low grade temperature and tachycardia (Larkin Burton, 2008, p. 392). The record does not document any nurse-initiated interventions or call to the doctor requesting a chest x-ray or recommending a respiratory therapy consult for breathing treatment and incentive spirometer. On post-op day two Ms. C’s respiratory status declined requiring a non-rebreather mask, rapid response team consult, and a transfer to the intensive care unit for a diagnosis of respiratory distress (p. 392). There were multiply factors that contributed to the above scenario; Larkin and Burton writes that â€Å"after this near-miss, failure to rescue incident† (p. 94) a task force consisting of management, clinical nurse specialist (CNS) and unit educator convened to discuss the event. The task force concluded that the nursing staff members were ineffectual in critically evaluating the patient’s signs and symptoms. The CNS chose a framework that utilized â€Å"Bloom’s Taxonomy of Educational Objectives†, that provided measurable outcomes to the ed ucational activity and enabled the nursing team to optimize their critical skill levels. A workshop to assist staff to navigate through the case study in a realistic manner was implemented (Larkin Burton, 2008, p. 95). The cognitive domain contains six intellectual skills that measure: knowledge, comprehension, application, analysis, synthesis, and evaluation of information received. The affective domain contains five emotional factors: receiving, responding, valuing, organizing, also conceptualizing and characterizing by value concept. It is during this phase that individual buy-in occurs or not. Finally, the psychomotor domain contains five motor skills functions of imitation, manipulation, precision, articulation, and naturalization. The individual learn to adapt his or her movements intuitively to a given situation (Larkin Burton, 2008, p. 395). The key component of continued nursing education is to advance and apply evidenced based practice at the bedside. The use of Bloom’s Taxonomy of Educational Objectives as the framework promote the transfer of evidence based information, in a setting that allow the nurse educators to evaluate and measure the learner’s: cognitive, affective and psychomotor processes. It allows the learner (nurse) to assess his or her level of application within each domain. Both the educator and the nurse can reinforce successes and target learning opportunities to areas of inefficiency. References Blais, K. K. , Hayes, J. S. (2011). Professional Nursing Practice Concepts and Perspective (6th ed. ). Upper Saddle River, NJ: Pearson. Bouchard, G. J. (2011, November). In Full Bloom: Helping Students Grow Using the Taxonomy of Educational Objectives. The Journal of Physican Assistance Education, 22(4), 44-46. Larkin, B. G. , Burton, K. J. (2008, September). Evaluating a Case Study Using Blooms Taxonomy of Education. AORN, 88(3), 390-402.

Stress Essay Example | Topics and Well Written Essays - 250 words - 3

Stress - Essay Example After the re-structuring there is no real motivation to inspire the employees because they fear that they could lose their jobs just like their past colleagues.   Part of the stress suffered by the employees has to do with the rapid transformation that the company has undertaken. This may be unavoidable because the company either has a limited budget or must make the transition by a deadline. This extra work load has required every employee to contribute more to the organization as a whole. Although not a perfect option, one method could be to give a raise to employees who choose to work longer hours. If finances are out of the question, then the company could introduce more work breaks so that employees do not feel tired as much. Another cause of stress can often be job security. The only way to remedy this is to make sure that every employee has a defined set of work responsibilities and no one else is trying to take over their job. Finally, the last cause of stress can be insufficient skills for the job. If an employee is unsure about how to complete their job tasks, then they will likely stress over it. This can be prevented by encouragin g open communication channels between employees and management and transfer employees who do not feel that they are capable of performing their job. Other co-workers can be located or new staff can be hired to help fill the

The economics of Crime Essay Example | Topics and Well Written Essays - 1500 words

The economics of Crime - Essay Example There are two aspects to consider when undertaking a study of the death penalty. The first aspect is whether or not the penalty is effective as a crime preventative measure. The second is whether or not the effectiveness of the prevention, no matter how effective it may or may not be, is worth the immorality of the taking of another’s life. The question relates to whether or not the right of the state to forfeit a life falls within the expectation of moral and ethical behavior that the worldwide community believes is fair and just. In considering the final nature of the death penalty and the lack of truly effective prevention from the threat of the death penalty, the forfeiture of life by the state does not seem to have merit. World wide opinion on the use of the death penalty as an effective tool for the prevention of crime has been diminished over the last two decades. According to Amnesty International (2010), two-thirds of the countries of the world do not have the death penalty and of the 58 remaining countries, most do not use the death penalty although they have it as an option. The United States, an economic and social leader in the world, still uses the death penalty as a punishment for crime. According to the American website Death Penalty Information Center (2010), 2009 saw 52 executions, all but one of which was done through lethal injection. Larry Bill Elliot was executed in the state of Virginia through the use of an electric chair. It has only been in recent history within the United States that the death penalty for juveniles was abolished. A sum total of 228 juvenile offenders were sentenced for life ending measures between the years of 1973 and 2004 with 22 of those ending in executions and 134 received commuted sentences (Lawrence & Hemmens, 2008, p. 34). A United States Supreme Court decision in the case of Roper v Simmons abolished the