mmatlab

Dear what is the link for the practice question from ONS, I believe that I have to pay for the whole course review in order to get the the questions, correct?

Hello again This is my email to contact me [email protected] just send your email to me thus I will send the comptencises as attached file but please be more specific Thank you Mamoon

Hello all, I have finished these competencies that are specific to oncology nurse please if you have any addition or comment it will be very informative. they are the following: Management of Chemotherapy Spills Prevention & Management of Chemotherapy Extravasations Safe Administration of Chemotherapy & Disposal of Contaminated Materials Accessing & Flushing of Port A Cath Mouth Care for patient with Oral Mucositis Nursing Care of Patient receiving I-131 therapy Care of the Central Venous Catheter LANTIS software module (for radiation oncology nurses) Alaris Infusion Pump(for adminster of chemotherapy) And if you need any of these competencies just contact me thank you and my warmest regards Mamoon Oncology clinical Educator

i have checked for the evidence based practice for pateint ratio developing indicators developing indicators for nursing is challenging, but with the current change on nurse to patient ratio, it provides both an opportunity and an imperative for nursing to measure and evaluate nursing's contribution to patient care. indicators serve to foster understanding of a system and how it can be improved, and to monitor performance against agreed standards or benchmarks. crucially, indicators provide a mechanism by which care providers can be accountable for the quality of their nursing services. in most cases the main determinants of outcome are patients themselves, not care inputs, however, three domains of quality measurement that reflects nursing contribution seem to prevail in the current literature: safety, effectiveness of nursing care and compassion. safety refers to adverse effects of care, effectiveness refers to positive benefits and compassion refers to aspects of patient experience such as perceived dignity, respect and quality of communication. to be useful, indicators must be measurable with available data. there must be evidence that the quality or quantity (nursing staffing) of nursing substantially contributes to changes measured by the indicator. in considering nursing-sensitive outcomes and experience, we must identify elements of variation that can be attributed largely to nursing care/ nurse staffing. to do this we must seek evidence of correlation with nursing as well as evidence that this correlation is a plausible consequence of variation in nursing rather than other factors. developments of indicators must build on existing evidence and initiatives for consistency across settings and to ensure that best practice is used. the national quality forum (2003) requires indicators to be scientifically sound: * precise specification of the indicator * reliability and validity of measures and * adequacy of risk adjustment. so nursing indicators must be measurable with available data, coding and recording must be consistent and complete and measures must be valid. if an indicator is to measure and evaluate staffing level and the impact on quality of nursing, it must be attributable to nursing in a number of senses, including: * evidence of sensitivity to nursing * recognition of the phenomenon's importance * recognition as a nursing contribution (owned by nurses and acknowledged by others) * recognition as nurses' responsibility in terms of legitimate authority, self-perception and sphere of practice. what are the evidences? doran (2003) asserts that a wide range of potentially measurable indicators of nursing care quality can be identified from nurse-sensitive outcomes. these outcomes are aspects of patient experience, behaviour or patient outcomes that are determined in whole or part by nursing care received and variations in its quality or quantity. pencheon (2008) reports that among the most widely used indicators are safety measures such as failure to rescue (death among patients with treatable complications), falls, healthcare associated infection and pressure ulcers. there is strong evidence supporting an association between nurse staffing levels and mortality (kazanjian et al, 2005), but mortality is determined by many causes and is not likely to be a useful quality measure for nursing. kane et al. (2007) provide the strongest single source of evidence for a link between nursing and outcomes. this systematic review examines the impact of a general nursing variable, the quantity of nursing care available, and assesses the extent to which nursing influences the indicators. the review included 96 studies linking nurse staffing to patient outcomes. increased rn staffing was associated with lower hospital-related mortality (per additional full-time equivalent nurse per patient day) in: * intensive care units (odds ratio 0.91, 95% confidence interval 0.86-0.96) * surgical units (odds ratio 0.84; 95% confidence interval 0.80-0.89) cardiac arrest (all groups) failure to rescue (surgery) mortality kane (2007) takes a cautious epidemiological approach to interpreting causation. causality is supported by evidence of a 'dose-response relationship' which appears curvilinear as increased staffing at the highest levels yields diminishing returns. the evidence is consistent across study designs (including the use of risk adjustment) and while different designs give some modifications in estimates, overall conclusions are unchanged. evidence supports a temporal association as some studies demonstrate that adverse outcomes occur immediately after periods of low staffing, although there is a lower estimate of effect on failure to rescue in studies assessing this temporal association. there was no consistent association between nurse staffing and patient falls, pressure ulcers or urinary tract infections, outcomes among the indicators most frequently identified. although there is some evidence to support these, their appearance on lists of indicators is clearly more predicated upon a convincing theoretical proposition than the strength of the evidence. of the four most prominent outcome indicators identified (failure to rescue, falls, hcai [pneumonia], pressure ulcers), only failure to rescue and hcai pneumonia are supported by kane's (2007) review. suggestions of indicators to measure the impact of nurse: patient ratio of the range of potential indicators, a number emerge as potential "front-runners". most strongly advocated patient safety indicators safety 1) failure to rescue 2) health care associated infection, 3) pressure ulcers* (process indicators should be used with caution because of potential for gaming and difficulty in linking specific processes and patient outcomes) 4) falls . effectiveness 1) staff satisfaction 2) staff perception of the practice environment compassion 1) experience of care (patient reported) 2) communication (patient reported) * patient experience of compassionate care is an important outcome in its own right and may provide the best measure of the nursing contributions to shared outcome and evaluation of complex processes that are otherwise elusive. doran d. (2003) preface. in: doran d, editor. nursing-sensitive outcomes: state of the science.sudbury / london: jones and bartlett pub.,:vii-ix. kazanjian a, green c, wong j, reid r. (2005) effect of the hospital nursing environmenton patient mortality: a systematic review. j health serv res policy;10:111. kane r, shamliyan t, mueller c, duval s, wilt t. (2007) the association of registered nurse staffing levels and patient outcomes: systematic review and meta- analysis. med care 2007;45(12):1195. national quality forum (2003). a comprehensive framework for hospital care performance evaluation: a consensus report. washington: national quality forum pencheon d. (2008) the good indicators guide: understanding how to use and choose indicators. warwick: nhs institute for innovation and improvement. best regards, mamoon matalb oncology nursing educator ssh, ksa

its too terrible , i have seen this where i am working now, the staff was administering the chemotherapy through grasby pump and the spiking for iv set was done beside patient . now i am new oncology clinical educator and i have checked if there any competency to administer the chemotherapy to follow so i have done new competency to safe handling of chemotherapy reference is ons best regards mamoon matalb oncology nursing educator saad specialist hospital, ksa post edited to remove e-mail address for your protection. feel free to exchange e-mail addresses via the pm system that we have here or if a new member, via the visitor messages. suzanne4