Chamberlain College of Nursing - NURSING NR 506Part 2 Portfolio_AP1. This is the complete Portfolio upon Nursing Course (- NURSING NR 506) completion. The document is 66 pages long, includes references and Appendix, and is tutor reviewed.

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Capstone Portfolio Part 2 Ashley N. Peacock NR 661: APN Capstone Practicum March 2020 Table of Contents Exemplars 1 - 10………..………………………………………………... ..…..…….#1-55 References…………………………………….……………………………….….#56-64 Appendix A: Concept Map……………………………………………………….…..#65 Appendix B: Table of Exemplars……………………………………………….…….#66   APN Capstone Portfolio Part 2 The purpose of this APN Capstone Portfolio is to highlight my professional growth and expertise by providing evidence of the knowledge I have learned. This paper will demonstrate how I met Chamberlain University’s program outcomes (PO), the Essentials of Master’s Education (MSN Essentials), and the National Organization of Nurse Practitioner Faculties (NONPF) Core Competencies. I will identify and explain how each of these objectives were met by providing exemplars of my graduate work, reflect on how meeting these objectives have transformed me into a prospective masters-prepared nurse, and how the concepts from your work interrelate. Exemplar 1: NR500 Week 3 Addressing Bias Paper By analyzing and reaffirming our personal biases during the week 3 paper assignment I was able to be better prepared to be a leader with integrity and self-awareness to provide optimal care to all patients. Self-awareness is a process of objective examination of oneself and is one of the important components in nurse-client relationship. Addressing bias is an important step in creating self-awareness. Although experiences can shape our development of a bias mindset; it can be challenging to not permit these bias thoughts to affect how we interact and care for patients. The cognitive exploration of own thoughts, feelings, beliefs, values, behaviors, allows one to understand how they can affect others (Rasheed, 2015). Therefore, it is critical that if any negative attitudes toward any patient strategies be developed to utilize to eliminate them. This paper also allowed me to develop such strategies to use to ensure I am not being bias towards any patient. For example, at the end of each day on the drive home I self-reflect on the care I provided my values, behaviors, feelings, and thoughts of how I would feel if I was the patient so that I could provide better care the following day. This paper also allowed me to reflect on unconscious stereotyping and prejudice contribute to healthcare disparities to advocate for fairness and the elimination of such negative behavior and mindsets. According to Philip, Chadee, and Yearwood (2014), study found that discrimination is still present especially against people diagnosed with HIV/AIDS and at-risk groups. This negative attitude therefore creates barriers to accessing important testing and treatment services. Marques, De Melo, and Dos Santos (2014), study also found several bias and negative attitudes toward obese patient that included: being obese is excessive, it is not healthy; Providing care to the obese is a structural issue; Obese patients are troublesome, they require care, no big deal; Providing care to the obese requires teamwork. These negative views can interfere in the care provided and vital to eliminate as advanced practice nurses. This reflective paper also allowed me to understand, value cultural differences, and the importance of cultural competence. As we move to increasingly diverse society; the U.S. Census Bureau projects that the United States will be a majority-minority nation by 2043, and being cultural competence is vital. Cultural competence training encompasses the needed knowledge about diverse people and their needs, attitudes that recognize and value difference, and flexible skills to provide appropriate and sensitive care to diverse populations (Kools, Chimwaza, & Macha, 2015). Organizations that wish to stay relevant in a society with rapidly changing demographics are learning that organizational cultural competence is the first step in reaching and employing diverse audiences. Cultural competence also enables effective teamwork in cross-cultural communities or programs by giving individuals and organizations the framework for operating in varying cultural contexts. Culturally competent organizations are equipped to work with people who have different backgrounds, attitudes, and worldviews thus building a larger, more powerful organization (Mcmullen-Bushman, 2017). Identify and Explain This exemplar shows evidence that I have met program outcome number #3 engage in lifelong personal and professional growth through reflective practice and appreciation of cultural diversity. By completing the week 3 addressing bias paper I was able to not only reflect on and identify bias thoughts that I may hold or that may be seen in practice to effectively strategize to eliminate them to prevent any hinderance in care to any patient. By reflecting daily on my personal values, beliefs, and attitudes that I may hold to develop steps to ensure that I am not being bias to any patient under my car services. As new graduate advanced practice nurse this is a vital step to be an effective role model, successful career, and business. MSN Essentials III: Quality Improvement and safety was also met through the completing of the reflective paper on addressing bias; I was able to understand the importance of self-awareness, holding bias ideas, and the importance of eliminating such ideas in the healthcare environment through daily self-reflection of my personal interaction with patient and staff members, my values, belief and attitudes. Self-reflection allows the identification of any bias ideas that may hinder care and direct quality improvement methods to promote culturally responsive, safe, timely, effective, efficient, equitable, and patient-centered care therefore meeting this master’s essential (AACN, 2011). NONPF #9 Independent Practice Competencies-develops strategies to prevent one’s own personal biases from interfering with delivery of quality care. Through the completion of week 3 addressing bias paper I was able to self-reflect on my own bias that I may hold and identify biases in the profession environment that could hinder optimal patient-centered care. I was also able to understand the importance cultural competencies, cultural humility, and eliminating bias thoughts in order to promote optimal culturally sensitive patient centered care with partnership of all patients (National Organization of Nurse Practitioner Faculties [NONPF], 2013) Connect The concepts identified in this exemplar are social justice, and cultural humility. Social justice as a concept is defined as a "nursing's professional responsibility to address unjust systems and structures (ANA (2019)." In order to address unjust systems and structures self-awareness is needed to remove any self-bias ideas against any patient that may hinder care. To be socially justice I must also be culturally competent of other’s culture as this nation is moving towards a more diverse society. To provide optimal care for all cultures I must understand different cultures to promote optimal care and change in systems and structures as needed for all when it is unjust and cultural humility is a life-long commitment to always self-reflect and change cultural bias thoughts (Thurman & Pfitzinger-Lippe, 2017). Cultural humility is more important than working to become competent in the cultures of those with whom we work and interact with. Cultural humility is defined as “a lifelong commitment to self-evaluation and critique, to redressing power imbalances and to developing mutually beneficial and non-paternalistic partnerships with communities on behalf of individuals and defined populations.” Cultural competence is a reminder to always aim to know more about communities of all types with which we work or interact. Together with the concept and embodied practice of deep cultural humility, it provides myself and other health professionals with important tools in working with diverse individuals, groups, and communities in today’s complex world. cultural humility, for example, through daily reflection helps me to recognize my own biases and stereotypic beliefs to promote change in my heart, care and the health-care environment (Greene-Moton & Minkler, 2020). Reflect The current healthcare environment is increasing in diversity along with increasing globalization and advancing technologies this can produce complex ethical pressures that can influence nursing practice and care outcome. Master's prepared nurses advanced practice nurse (APN) are charged and equipped to take on leadership roles and affect positive change to promote health and health outcomes. In order to be effective in the advanced practice role, it is important to APNs understand their personal values, beliefs, strengths, weaknesses and most importantly unconscious biases he or she may hold as they affect care. A solid foundation of self-knowledge and awareness is needed to make ethical decision that will affect many different aspects of health, healthcare, and outcomes of a variety of people of different cultural backgrounds. Meeting the above objectives has transformed me as a prospective masters-prepared advanced practice nurse that is not just culturally competent but grounded in cultural humility through daily reflection of the care that I provide. Exemplar 2: NR501-week 7 summary of healthcare concern presentation References AACN. (2011). The essentials of master’s education in nursing. Retrieved from http://www.aacnnursing.org/portals/42/publications/mastersessentials11.pdf ANA (2019). 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Healthcare Quality: A Concept Analysis. Nursing Forum, 52(4), 377. https://chamberlainuniversity.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edb&AN=126171807&site=eds-live&scope=site Andersson, E. K., Willman, A., Sjöström-Strand, A., & Borglin, G. (2015). Registered nurses’ descriptions of caring: a phenomenographic interview study. BMC Nursing, 14(1), 1–10. https://doi.org/10.1186/s12912-015-0067-9 Anxiety and Depression Association of America. (2015). Clinical practice review of OCD. https://doi.org/10.1080/15398285.2015.1035595 Barth, S. K., Kimerling, R. E., Pavao, J., McCutcheon, S. J., Batten, S. V., Dursa, E., Schneiderman, A. I. (2016). Military sexual trauma among recent veterans: Correlates of sexual assault and sexual harassment. American Journal of Preventive Medicine, 50(1), 77–86. doi: https://doi org.chamberlainuniversity.idm.oclc.org/10.1016/j.amepre.2015.06.012 Byers, P. 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M., Berry-Cabán, C. S., Prisock, K., Borsari, B., & Kazemi, D. M. (2018). Evaluations of sexual assault prevention programs in military settings: A synthesis of the research literature. Military Medicine, 183(suppl_1), 421–428. https://doi-org.chamberlainuniversity.idm.oclc.org/10.1093/milmed/usx212 Papathanasiou, I. V., Kleisiaris, C. F., Fradelos, E. C., Kakou, K., & Kourkouta, L. (2014). Critical thinking: the development of an essential skill for nursing students. Acta Informatica Medica: AIM: Journal Of The Society For Medical Informatics Of Bosnia & Herzegovina: Casopis Drustva Za Medicinsku Informatiku Bih, 22(4), 283–286. https://doi.org/10.5455/aim.2014.22.283-286 Peterson, C., DeGue, S., Florence, C., & Lokey, C. N. (2017). Lifetime economic burden of rape among U.S. adults. American Journal of Preventive Medicine, 52(6), 691–701 doi: 10.1016/j.amepre.2016.11.014 Philip, J., Chadee, D., & Yearwood, R. P. (2014). 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Suicide & Life-Threatening Behavior, 44(2), 113–129. https://chamberlainuniversity.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=hpi&AN=HaPI-400106&site=eds-live&scope=site Rafter, A. Hickey, S. Condell, R. Conroy, P. O'Connor, D. Williams, D. (2015). Adverse events in healthcare: learning from mistakes, QJM: An International Journal of Medicine,108(4), 273–277. https://doi.org/10.1093/qjmed/hcu145 Rasheed, S. P. (2015). Self-awareness as a therapeutic tool for nurse/client relationship. International Journal of Caring Sciences, 8(1), 211. Reid, J., Briggs, J., Carlisle, S., Scott, D., & Lewis, C. (2017). Enhancing utility and understanding of evidence based practice through undergraduate nurse education. BMC Nursing, 16, 1–8. https://doi.org/10.1186/S12912-017-0251-1 Santana, M. J., Manalili, K., Jolley, R. J., Zelinsky, S., Quan, H., & Lu, M. (2018). How to practice person‐centred care: A conceptual framework. Health Expectations, 21(2), 429–440. https://doi.org/10.1111/hex.12640 Stanley, D., & Stanley, K. (2018). Clinical leadership and nursing explored: A literature search. Journal of Clinical Nursing (John Wiley & Sons, Inc.), 27(9–10), 1730. https://chamberlainuniversity.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edb&AN=129933115&site=eds-live&scope=site Thurman, W., & Pfitzinger-Lippe, M. (2017). Returning to the Profession’s Roots: Social justice in nursing education for the 21st century. ANS. Advances in Nursing Science, 40(2), 184–193. https://doi.org/10.1097/ANS.0000000000000140 Yedlinsky, N. T., Neff, L. A., & Jordan, K. M. (2019). Care of the military veteran: Selected health issues. American Family Physician, 100(9), 544–551. Retrieved from https://search-ebscohost-com.chamberlainuniversity.idm.oclc.org/login.aspx?direct=true&db=mdc&AN=31674738&site=eds-live&scope=site [Show More]

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