EPSLO 6:. Engage in the spirit of inquiry to propose solutions that support nursing excellence.

In your Journal summarize personal and professional achievements and accomplishments that you have completed throughout the baccalaureate nursing program at EC that refer to EPSLO 6: Engage in the spirit of inquiry to propose solutions that support nursing excellence.

Attach a minimum of at least two examples of your work that supports EPSLO 6 noted above. Save your Journal entry as your Self-Appraisal for each module in your word document. The professor will request that you submit your journal entries for informal feedback at the end of each module. A Title page of this assignment with a summary of accomplishments (no more than 2 pages in length) is required with attached files as supportive evidence for each EPSLO. A minimum of one or two examples is required to support each EPSLO.



M7A1: Final -Personal Holistic Stress Management Plan

Rose Safaro

Excelsior College

Part 1:

The word stress elicits visions of something that is conflicting, uncomfortable, and even perhaps dangerous in the minds of many people. We say and hear things like, “I’m stressed out”, “That was stressful”, “You’re stressing me out” etc. Stress is a word that is thrown around quite frequently without anyone really thinking too much as to what the word means. Indeed, we think more about stress based on how it makes us feel. But..what is stress and stressors and how do these two things relate to the nursing work environment? Most importantly, how do we manage stress?

Stress and Stressors Defined

According to Seaward (2018), stress has a multiplicity of meanings as it applies to culture and the meaning of the human condition. For example, stress for Eastern cultures (India etc.) consider stress the absence of inner peace while Western cultures look at stress as being out of emotional control (Seaward, 2018). In the writer’s opinion, both of these definitions or conceptions regarding stress are synonymous because when you have inner peace you have more emotional control in your responses to your perception of and reactions to situations that may deemed to be stressful.

Seaward (2018) goes on to provide a definition of stress which comes from the Holistic medicine community,, “Stress is the inability to cope with a perceived (real or imagined) threat to one’s mental, physical, emotional, and spiritual well-being, which results in a series of physiological responses and adaptations” (p.5). Stressors are circumstances, situations, and stimulus that are perceived as a threat (Seaward, 2018). it is important to emphasize, that because what may be deemed to be a stressor is based on perception, they will vary from individual to individual. To understand how stressors work, physiology of stress or the stress response must be understood.

On a physiological level, in the body the stress response is mediated by the hypothalamic-adrenal-pituitary axis (HPA-axis). When the body perceives stress, the sympathetic nervous system and HPA-axis activates the “fight or



Patient Falls Reduction QI

Rose Safaro

M8A1 Scholarly Paper

NUR 456

Nurses, regardless of professional level or designation, will be called on to lead, formally or informally during the course of their careers. Leadership from nurses from the healthcare community is an expectation formally and informally.. According to Adeniran (2013), the Institutes of Medicine’s report The Future of Nursing: Leading Change, Advancing Health released in 2010 emphasized the need for development of leadership programs that results in nurses having the ability to be leaders or change, and advance health and health care through the creation of innovative initiatives that provide opportunities for education and professional growth.

In the scenario provided for this assignment, a Bachelor’s prepared nurse has been asked by the Director of Surgical Services to lead a quality improvement (QI) project to reduce the number of falls with injuries within this division of the organization. It has been determined that the surgical division has a rate of 5.0 falls per 1,000 patient days in the first quarter of this year with three of these falls resulting in serious injuries. According to the Agency for Healthcare Research and Quality AHRQ (2019), falls occur at a rate of 3–5 per 1000 bed-days according to epidemological studies. In addition, the AHRQ (2019) estimates that 700,000 to 1 million hospitalized patients fall each year in the United States. Based on this data, the falls which are occurring in surgical division are in sync with the data obtained from epidemiological studies. The Bachelor’s prepared nurse will assemble an interdisciplinary team to address the problem using the Plan Do Study Act quality improvement model to address this problem.

Long Term Impact of Patient Falls

According to Sentinel Events Alert (2015), “Falls with serious injury are consistently among the Top 10 sentinel events reported to The Joint Commission’s Sentinel Event database*, which has 465 reports of falls with injuries since 2009, with the majority of these falls occurring in hospital”. Depending on the age and physical condition, the long term impact of patient falls can range from head injuries, to hip fractures as well as temporary damages to other bones and areas of the body (Centers for Disease Control and Prevention, (CDC), 2018). Long term impacts of patient falls can result in head trauma, permanent damage to bones or other body systems and even death (Bouldin et al., 2013; CDC, 2018). Th