Abstract
Incredible advancements in nursing service intervention have forged immense reformation of techniques in treating numerous diseases. The overall aim is to improve outcomes and promote efficient nursing care. As such, the American Nurse Credential Center (2008) has developed a model which provides the framework for future nursing practice. Also, it is expected to serve as a guideline for organizations wishing to achieve recognition in the Magnet Hospital program (American Nurse Credential Center, 2008). This exposition encompassing a literature review is a sample of both the components of this model as well as forces linked to its execution process within the context of magnetism (American Nurse Credential Center, 2008). Precisely, the emphasis relates to nursing being part of a system incorporating astute leadership, distinct design along with support structured to encourage exemplary professional practice; application of new strategies, innovations, and improvements that enforce not just desired outcomes, but ones that denote excellent efficient results from skilled specialist (American Nurse Credential Center, 2008).
Nursing: Pediatrics: - Sickle Cell Anemia- Literature Review
Introduction
It is often asked by many professionals in adjacent disciplines; what this new model for American Nurses Credential Center (ANCC) (2008) magnet recognition program really entails and how relevant it is to nursing process intervention in the twenty-first century. Importantly, to reduce repetition related to the forces of magnetism, ANCC has configured 14 forces of Magnetism into 5 components. The focus is measuring nursing intervention outcomes (American Nurse Credential Center, 2008).
These important five components and their accompanying forces of magnetism are; first transformational leadership forged by a vision of enlightenments. Secondly, structural empowerment fueled by strategic planning and implementation procedures. Thirdly, exemplary professional practice forced through the integrity of leading by example. The fourth component is new knowledge and innovation influenced by strong leadership and structure as well as exemplary professionalism and fifthly empirical quality results measuring clinical, workforce, patient, consumer and organizational outcomes applying quantitative research techniques for interpretation (American Nurse Credential Center, 2008).
Clearly, this outlines improvements in the scientific nature of nursing as both a practice and discipline. Gone are the days when nurses made decisions based on intuition or tradition. American Nurses Credential Center (ANCC) (2008) magnet recognition program offers tools tested that are continually upgraded. In the same way as every living thing grows and evolves similarly are outcomes within nursing practice. Hence, its relevance to nursing process intervention in the twenty-first century is realized.
Targeted Population and disease
For the purposes of this literature review research, offering a sample of the five component model of American Nurses Credential Center (ANCC) (2008) magnet recognition program; the target population chosen is pediatrics and the disease condition is sickle cell anemia in children. Also, two articles chosen are entitled, ‘Pediatric Nurse Care for Sickle Cell infants and Children’ from Journal of Nurses and “Nursing Care Plan Sickle Cell disease” an American Nurses’ production.
Importance of study
Sickle cell has always been a concern among physicians and pediatricians since it is a genetic disorder which affects people mainly of African descent characterized by sickle shaping of the red blood cell (American Academy of Pediatrics, 2002). The two articles selected for this literature review research has added to this importance by offering models of care from a nursing perspective as well as organizational. This is consistent with the aim of this project to offer a sample of how the American Nurses Credential Center (ANCC) (2008) magnet recognition program is applied to evaluating outcomes pertaining to particular diseases or populations.
Nursing Intervention
Pediatric Nurse Care for Sickle Cell infants and children’ (2008)
The article, ‘Pediatric Nurse Care for Sickle Cell infants and children’ (2008) discusses a broad spectrum approach towards nursing intervention. It includes carrying out doctor’s orders pertaining to medication administration and management as well as addressing nursing diagnosis derived from nursing process. This is in direct relation to the condition itself (Pediatric Nurse Care, 2008)
Besides, nursing intervention extends to treating complications arising from sickle cell anemia crisis. This includes obtaining a history of past episodes, pain management; pain assessment; physiological assessments such as hemoglobin analysis, blood pressure, mobility during pain; intravenous fluid monitoring, non pharmacological interventions like application of heat to painful joints; evaluation for signs of sepsis and splenic sequestration ( Pediatric Nurse Care, 2008)
Also, monitoring aplastic disorders is another important nursing intervention crucial to the crises experience in children. Journal of Nurses explicitly emphasizes the significance of psycho-social pediatric care in the nursing process. Precisely, they have developed a distinct conceptual model informing such care known as the Health Belief Model. This emanated from the desire to institute a cognitive behavioral approach nursing technique. It addresses ‘anxiety, depression, poor school performance, decreased participation in normal activities of daily living, and poor peer and family relationships’ (Pediatric Nurse Care, 2008)
Nursing Care Plan NPC Sickle Cell Disease( 2011)
The second article review; Nursing Care Plan NPC Sickle Cell (2011) outlines definite nursing intervention techniques for specific stages before and after a sickle cell crisis since this is the most crucial aspect of sickle cell management in pediatrics. Specific nursing intervention strategies pertain towards management of hypoxemia and changes in the condition of the blood precipitated by altitude and decreased plasma volume (Nursing Care Plan, 2011).
Hypoxemia is evaluated and managed primarily through nursing assessment techniques by physical examination. During the first six months infants seldom manifest any symptoms of sickle cell disturbance. As such, parents are educated to observe when they begin, to seek medical advice and treatment. Thereafter, the aim of nursing process from a medical perspective is designing a nursing care plan to intervene during anemia and eminent crises.
Subsequently, education becomes the mode through which dissemination of information to parents concerning the condition is applied. It is focused on preventing a crisis initiated by hypoxemia, poor nutrition, infection, analgesia, dehydration, stress or excessive exercise (Nursing Care Plan, 2011).
Selection of tools and measurement of outcome
Pediatric Nurse Care for Sickle Cell infants and children (2008)
The specific tools identified to evaluate the degree of successful intervention seemed limited to laboratory test and reassessment to evaluate whether temperature was reduced or the hemoglobin was increased after a transfusion or pain reduction was achieved from administering heat to a joint.
Nursing Care Plan NPC Sickle Cell Disease (2011)
In this article the nursing intervention approach is one based on prophylaxes rather than curative. As such, education seems the major nursing intervention to be measured. It would appear that quality of content disseminated about this condition would be the tool utilized to measure the overall outcome.
Is the content designed for parents who have no knowledge of medicine to understand clearly and create their personal priorities regarding the information received for improved care for their children? Obviously, the successful outcome of this intervention is an evaluation of how often this group of children goes into a crisis or remains out of hospital.
Learning outcomes
Pediatric Nurse Care for Sickle Cell infants and children (2008)
Major learning pertaining to empirical quality results measuring clinical, workforce, patient, consumer and organizational outcomes after applying quantitative research techniques for interpretation (American Nurse Credentialing Center, 2008) were derived from studies conducted to evaluate implementation of the Heath Belief Model.
It was discovered after a sample of 24 children were studied to assess how nursing intervention, treatment and the disease itself affects cognitive behavior; that they demonstrated immense levels of anxiety, depression, poor school performance and participation in organizations as well as unusual peer and family relations influenced by lowered self esteem (Pediatric Nurse Care, 2008).
Nursing Care Plan NPC Sickle Cell Disease (2011)
The learning outcomes in this article were non specific, but rather speculations of expectations to be derived from preventative educational teaching techniques. It focused mainly on clients’ learning outcomes. In this case these are parents of children affected by sickle cell.
These outcomes centered on acquiring knowledge and skills to cope with children affected by sickle cell. They were expected to detect when the child is about to enter a crisis and institute measures either to alleviate it or control the effects it would have on the child both physiologically and psychologically.
Limitations of study
Improvement initiative
An improvement initiative could be affected by utilizing empirical quality results to enforce transformational leadership; structural empowerment; exemplary professional practice culminating in new knowledge and innovation.
Pertaining to sickle cell as a pediatric population, research is being conducted daily with an aim of improving management of children with the disease. Already it is known that these children tend to be less integrated in their environment. An improvement initiative is to address this issue from the level of transformational leadership appropriating structural empowerment designed and implemented through exemplary professional practice culminating in the application of new knowledge and innovation.
Desired outcome
With the present situation of sickle cell as a pediatric disorder in the world there should be an international desired outcome pertaining to the well being of children which is not exclusive to United States of America.Statistically, 150,000 children are born in Nigeria every year with SCD; 6,000 in the Middle East; 200 per year in United Kingdom and 1 in every 500 births in the US (Bardakdjian & Wajcman, 2004)
Therefore, the problem is obviously more pronounced among developing and underdeveloped poor nations of the world with people of African decent. Then, the American Nurses Credential Center (ANCC) (2008) magnet recognition program with its components of transformational leadership; structural empowerment; exemplary professional practice; new knowledge and innovation and empirical quality results must immediately consider extending itself towards nations of the world delegated by World Health Origination as being deprived of quality health care in addressing the effects of SCD on a nation’s resources.
Children are the generation of tomorrow. Research conducted in these countries surely would yield alternative empirical quality results. There have always been queries among some political circles regarding research and innovations in the management of sickle cell among Africans.
In some situations it has led to heated arguments pertaining to racial prejudice within the health care delivery system of the world as it pertains to the African Diaspora. As such, the appeal as a desired outcome is for more research towards a cure for SCD in the twenty-first century.
Conclusion
In the foregoing pages of this document the researcher sought to offer a sample of both components of the American Nurses Credential Center (ANCC) (2008) magnet recognition program as well as forces linked to its execution process within the context of magnetism (American Nurse Credential Center, 2008).
Pediatric Nurse Care for Sickle Cell infants and children (2008) and Nursing Care Plan NPC Sickle Cell Disease (2011) were selected in completion of this requirement prior to selecting pediatric Sickle cell population for review.
Pediatric Nurse Care for Sickle Cell infants and children (2008) took a curative approach in addressing nursing process strategies, whereas Nursing Care Plan NPC Sickle Cell Disease (2011) was more conservative adapting prophylactic interventions implied in outcomes. Both articles were limited to the American health care delivery system of SCD.
It is the author’s wish that empirical quality results of the American Nurses Credential Center (ANCC) (2008) magnet recognition five stage component models include other countries which have much higher incidences of the disease within their populations.
References
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Bardakdjian J, Wajcman H (2004). "[Epidemiology of sickle cell anemia]" (in French). Rev Prat
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Nursing Care Plan NCP sickle cell disease (2011).Retrieved on (12th Nov, 2011) from
http://gino-memoirofaschizo.blogspot.com/2010/08/nursing-care-plan-ncp-sickle-cell.html
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