Nursing Pamphlet

Orders Instructions

writer may create the title based topic chosen
Instructions: in order to influence policy, you have to understand how a bill is started, moves through the legislative system, and final enacted. in this assignment, you will trace a piece of legislation from introduction to how it impacts health care or nursing practice. develop the assignment as if it will be used during a presentation at a conference or poster presentation. step 1: identify a bill that relates to health care, a social issue, or nursing practice. step 2: develop a poster presentation, infographic, faq document, or pamphlet which outlines how a bill is introduced and passed by including answers the following questions: state the legislation. who introduced/sponsored the bill? why did the person introduce it? where was it introduced? who helped to draft the legislation? was nursing involved? which committees were involved? was it authorized? was it appropriated? did it make it out of committee? was it enacted? what is the impact on health care or nursing practice? cite any sources in 7th ed. apa format.
Focus: create faq document, or pamphlet for this assignment
Structure: answer all questions listed in instructions
Important notes: create faq document, or pamphlet for this assignment

H.R. 434: Prevention Mental Health and Substance Use Crises During Emergencies Act

H.R. 434: Prevention Mental Health and Substance Use Crises During Emergencies Act

David Trone sponsored the bill as the primary sponsors and Steve Womack as the original cosponsors. The bill was introduced to the 117th congress on January 21st of 2021, in its first stage of the bill processes (, 2021). The bill was purposely “directed to the secretary of health and human services to develop a task force to strategize on the prevention of mental health and the rampant substance abuse during public health emergencies, among other purposes” (, 2021). 

David Trone is a representative of Maryland’s congressional district. Inspired by the pandemic emergency and wide felt impacts towards citizens, he, therefore, raised the question of mental health and substance use, which are potential outcomes of the detrimental impacts associated with a crisis associated with public health, additionally, following the 31st 2020 declaration of the secretary of health and human services on the spread of COVID-19 and the subsequent argument of mental health and substances abuse during the COVID-19 pandemic. 

According to Trone, if the situation is not contained, it will be dire for the following vulnerable groups facing a serious significant risk of burnouts and PTSD (post-traumatic stress disorder) (, 2021). They include; all categories of health care workers, COVID-19 patients, and the many individuals who have lost their loved ones to the Pandemic. After it was introduced in the house, it was referred to the Committee on Energy and Commerce, where the committee will be tasked with the responsibility of ensuring accountability and relevance of the bill. It, therefore, gives the house a detailed issue associated with the bill for the house to vote on it. 

Following the recent outbreak of the pandemic and its impacts, which is on a nationwide basis, the bill is therefore appropriate in dealing with the speculated rise in mental health and drug abuse. The bill will reduce mortality rates associated with stress and drugs significantly to health care practices, especially in these unprecedented times. 

References (2021). H.R. 434 — 117th Congress: Preventing Mental Health and Substance Use Crises During Emergencies Act. Retrieved from 

Palliative and End-of-Life Care Across the Continuum

Telehealth in Pediatric Palliative Care

When addressing chronic illnesses, technological innovation enables the health providers, patients and their care givers to enjoy an automated program to address health conditions. The invention of telehealth was timely as the health experts are aware that chronic diseases come with psychological stress to the patient, the family, and the caregivers. Telehealth reduces the physical and emotional strain of on-site visits by allowing pediatric patients to consult remotely and make payments where necessary. Telehealth is an innovation that assists palliative care to improve the quality of life and to reduce suffering among people with serious illness (Danielle et al.,2020) Consequently, Modern palliative care innovations embrace telehealth to allow physicians and patients to consult on different health matters while away from the hospital. Telehealth is an innovation that has been activated by technology to enhance palliative care through remote care giving techniques. Telehealth further improves the communication patterns by providing instant responses and this enhances medical consultations and quality care (Danielle et al., 2020). Evidently, telehealth has provided dynamic medical solutions that make treatment of pediatric conditions easier and more effective. The palliative care innovation indicates effectiveness in the health sector that indicates the government’s ability to increase the life expectancy of its citizens. The palliative care system is created to provide detailed info on the progress of patients and allows responses by the health providers in charge. Telehealth is an innovation of palliative care that has revolutionized healthcare in the country, and it has empowered stakeholders to address palliative care and other issues with minimal limitation. Some issues have emerged from the use of telehealth in Australia and experts are engaging in-depth research to increase the preparedness of the stakeholders

Palliative Population who will benefit from telehealth

Improvement plans for palliative care are structured to address the needs of a specific segment in the market. Telehealth intends to help more pediatric patients by providing unlimited consultation and medical intervention for speedier recovery. Pediatric palliative care (PPC) holistically addresses cases of children with serious illnesses by providing an active remedy for physical and emotional complications. Australia has a dependency on children as the pioneers of the future generations and the health system lays emphasis on pediatric palliative care through dynamic therapy. Controlling pain and reducing the symptoms of diseases in children ensures that the PPC is successful in enhancing the quality of life (Lindsay et al., 2020). The innovative structures will create new possibilities that will ensure that pediatric palliative patients have access quality healthcare services that are timely. PPC further reaffirms parents and family members by reducing the patient’s suffering and introduces grief management through counseling. Telehealth is designed to lengthen the life expectancy of Australian children and to enhance productivity in the society (Meaghann et al., 2020). The preparedness in the healthcare system guarantees a highly-qualified regime that is competent and reliable. Incidentally, preservation of human life is a major concern in healthcare, and targeting the needs of the children will enhance their future (Wu et al.,2020). Providing pediatric palliative care using telehealth is a privilege as the program streamlines communication and enhances its contribution to wellness. Implementation of telehealth has enabled different health organs to work cohesively to educate parents on PPC therapies. Digital apps are synonymous with telehealth as they are an avenue for enhancement of digital performance. Effective communication among the stakeholders has introduced value to telehealth and promotes quality medical and technological intervention.

Factors that Contribute to Barriers in the Implementation of telehealth

Several factors cause barriers to telehealth and the factors require the parties in charge to come up with dynamic solutions. Firstly, telehealth had faced management issues as some health outlets have not received telehealth supplies and they lack materials to implement this innovation. Further, telehealth has failed to achieve substantial results in the provision of effective health services to its beneficiaries. Access to telehealth is limited in rural Australia, and this denies diabetes patients in these areas from enjoying a streamlined healthcare program. Where telehealth is actively operational, the health organs have failed to create enough awareness to the communities and this makes the innovation less effective. Provision of education on the health benefits of telehealth in rural areas and can increase the effectiveness of the innovation. Telehealth is designed to reduce on-site visits and cut down the expense of running physical clinics for palliative patients. The implementation plans should include proper mobilization of teams to broaden communication patterns and to provide remedies to existing barriers. Another factor that limits telehealth is poor skills and resources. Pediatric care innovation is a necessity in the global health arena as Australia is facing poor staffing, lack of skills and unsynchronized payment structures. The present Corona Virus pandemic has posed serious challenges to the world’s preparedness on disease management (Lindsay et al., 2020). The statistics on Corona Virus patients and deaths reveals the need for upgraded programs that will elevate telehealth for pediatric care. Implementation of telehealth faces numerous challenges due to varying health policies and ineffective distribution channels (Steindal et al., 2020). The structures involved in implementing telehealth techniques are subject to the current healthcare goals and leadership patterns on the ground (Holmen, Riiser & Winger, 2020). The presence of payment barriers hinders home care givers from coordinating effectively with health providers remotely. The new palliative care program must include effective payment plans that are streamlined with hospital policies to ensure flawless palliative care plans from home. Palliative care is provided in hospital and at home, and this calls for an organized structure to coordinate the treatment patterns and other issues related to the illness. The innovations further seek to introduce new staffing methods and training for officers in other specialties such as cancer to ensure overall effectiveness. The coordination in different health departments has challenged attempts by telehealth to provide high-quality care in medical facilities and at home (Steindal et al., 2020). Telehealth requires medical practitioners from various departments such as cancer, diabetes, tuberculosis, asthma, and others have to apply common goals to ensure that they provide ideal palliative care to their patients without interruptions. Addressing the issues of staffing and training is a management issue that calls for coordination of all stakeholders in healthcare and consideration of their needs. The care givers must familiarize themselves with the creative models for telehealth by working together with community health providers to assist those with advanced health complications. 

How Telehealth Impact Palliative Patients

Telehealth has a variety of impacts to palliative patients and they vary according to the usage and familiarity to the system. Telehealth thrives on reliable internet access to enable palliative patients and their caregivers to conduct medical procedures. The efficiency that telehealth has introduced to patients is unequaled as it has enabled remote access to consultation and other important services related to palliative care. Telehealth has empowered wellness through a timely and highly effective system. Telehealth thrives on factual evidence regarding patients with terminal illness as they are prone to stress and depression (Back et al., 2009). Patients with serious diseases endure physical complications that may worsen their health conditions. Telehealth further reckon that providing care to terminally-ill patients calls for understanding and resilience to form reliable support systems for the pediatric patients. Technological advancement is another benefit of palliative care innovation to individuals. Telehealth elevates technology and its ability to provide excellent healthcare services without on-site visits (Weaver et al., 2021). Telehealth has impacted pediatric patients positively as it has increased their familiarity with computer programs. Telehealth is synonymous with IT, and the innovation has presented benefits such as computer education and data retrieval skills (Holmen, Riiser & Winger, 2020). The caregivers and patients are empowered to interact with the health providers regularly about all the concerns about the existing medical conditions (Lindsay et al., 2020). The reduced on-site visits reduce the cost of movement for the patients and their caregivers (Holmen, Riiser & Winger, 2020). Accessing the program remotely gives the parties confidence in the innovation and its ability to promote wellness (Meaghann et al., 2020). The effectiveness of telehealth indicates the society’s readiness to accommodate health concepts that are beneficial and highly innovative. Another benefit of telehealth is that compatible areas have gone through thorough installations and infrastructure to support the innovation (Watts et al., 2021). These developments pave the way for higher designs that use similar mechanisms to increase service delivery. Telehealth in rural areas has updated the infrastructure and the lifestyles of the people living in rural Australia. The government has worked tirelessly towards the provision of excellent palliative care through communication and access to essential services. Thus, telehealth has promoted vigorous community education programs that enable the community members to familiarize themselves with available health infrastructure and realities that will improve their lives.


The benefits of telehealth are numerous being that patients can now develop a connection to their social circles for a speedier recovery. Telehealth further encourage caregivers to facilitate social interactions to reduce loneliness and to counter-act their health conditions. The human body responds to poor care by developing the illness and telehealth resolves these issues by providing instant medical care to address shock stress and emergencies. Patients with serious diseases require newly defined strategies like telehealth to address their growing social and physical needs. Further, palliative care innovations seek to control stress among patients by encouraging positive social behavior among invalids to fight infections.


Danielle Noreika, J. Brian Cassel, Jennifer A. Hicks, Elizabeth K. Burpee, Kim Twisdale, Janet H. Bull,(2020). Bridging the Gap: Telehealth Applications in Palliative Care (P20),Journal of Pain and Symptom Management, 59(2)., 402-403,ISSN 0885-3924,

Elana Evan, Anand Sandesara, Kathryn Olivia Mock,Pediatric.(2019). Palliative Telehealth Care from Hospital to Hospital: A Pilot Project (QI653),

Harmony S. E. James, A. C. Smith, E. E. Thomas, C. L. Snoswell, L. J. Caffery & H. M. Haydon (2021) Exploring paramedics’ intention to use a specialist palliative care telehealth service, Progress in Palliative Care, 29:2, 106-113, DOI: 10.1080/09699260.2020.1852657

Holmen, H., Riiser, K., & Winger, A. (2020). Home-Based Pediatric Palliative Care and Electronic Health: Systematic Mixed Methods Review. Journal of medical Internet research22(2), e16248.

Journal of Pain and Symptom Management, 59(2) 528,  ISSN 0885-3924, 

Journal of Pain and Symptom Management,56(1)7-14,ISSN 0885-3924,

Lindsay Bonsignore, Nicholas Bloom, Karen Steinhauser, Reginald Nichols, Todd Allen, Martha Twaddle, Janet Bull, (2020). Evaluating the Feasibility and Acceptability of a Telehealth Program in a Rural Palliative Care Population: TapCloud for Palliative Care,

Meaghann S. Weaver, Marie L. Neumann, Hema Navaneethan, Jacob E. Robinson, Pamela S. Hinds (2020). Human Touch via Touchscreen: Rural Nurses' Experiential Perspectives on Telehealth Use in Pediatric Hospice Care, Journal of Pain and Symptom Management, 60(5)1027-1033, ISSN 0885-3924,

Steindal, S. A., Nes, A., Godskesen, T. E., Dihle, A., Lind, S., Winger, A., & Klarare, A. (2020). Patients' Experiences of Telehealth in Palliative Home Care: Scoping Review. Journal of medical Internet research22(5), e16218.

Watts, KA, Malone, E, Dionne‐Odom, JN, et al. Can you hear me now?: Improving palliative care access through telehealth. Res Nurs Health. 2021; 44: 226– 237.

Weaver, MS, Shostrom, VK, Neumann, ML, Robinson, JE, Hinds, PS, Homestead together: Pediatric palliative care telehealth support for rural children with cancer during home‐based end‐of‐life care. Pediatr Blood Cancer. 2021; 68:e28921.

Wu, Y. R., Chou, T. J., Wang, Y. J., Tsai, J. S., Cheng, S. Y., Yao, C. A., Peng, J. K., Hu, W. Y., Chiu, T. Y., & Huang, H. L. (2020). Smartphone-Enabled, Telehealth-Based Family Conferences in Palliative Care During the COVID-19 Pandemic: Pilot Observational Study. JMIR mHealth and uHealth8(10), e22069.

Benchmark - Capstone Change Project Objectives

Review your problem or issue and the cultural assessment. Consider how the findings connect to your topic and intervention for your capstone change project. Write a list of three to five objectives for your proposed intervention. Below each objective, provide a one or two sentence rationale.

After writing your objectives, provide a rationale for how your proposed project and objectives advocate for autonomy and social justice for individuals and diverse populations.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to LopesWrite.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:


1.5:  Advocate for autonomy and social justice for individuals and diverse populations.


Project Change Objectives

  1. The execution of the project will help to increase awareness of patient safety measures, as evidenced by nurses being able to make sure that patients understand their treatment.

Nurses will be offered education and understand proper patient safety responsibilities and make sure that all patients are informed about their own care to prevent errors. Nurses will be asking patients to recall and restate what they have learned. Evidence shows that regular use of this strategy supports patient safety initiatives.

  1. The implementation of this project will aid inpatient nursing staff to closely track and monitor the early indicators of stress among coronary artery patients as evidenced by the ability of the healthcare providers to use monitoring technology to verify that they are always following the right procedures for the right patient and that they are keeping on top of each need of the patient.

Inpatient nurses will be given education on how to track and monitor stress indications for continued use of technology such as barcode system that verify patient medication, which ensures that the hospital is already taking measures to enhance patient safety.

  1. The implementation of this project will provide nurses with quality education on patient safety measures as evidenced by reduction in medical errors and improve safety culture and quality of service delivered to patients.

The quality of nursing education cannot be separated from patient safety. Existing evidence indicates that the introduction of patient safety should be part of nursing education at all levels of the healthcare system. 

After implementing this project, patients will experience increased quality care outcomes, incorporating a reduction in medical errors, therefore, experiencing a decrease in the incidences of deaths and disabilities. Achieving these project objectives will directly impact all patients, irrespective of their cultural backgrounds, because all patients are at risk for medical errors, deaths, and disabilities when there are no proper patient safety measures. It is essential to ensure the role of stress in coronary artery patients is addressed, along with including the patient in the decision to conduct an educational process with pre-stress test intervention to ensure patient autonomy (Noble, 2019). If the patient develops complications, their hospital length of stay may be increased, directly impacting their capability to attain wellness and recovery. As a result, it is vital to increase patient safety to reduce medical errors and disabilities, which affects patients from all backgrounds (Noble, 2019). Therefore, patient safety care should always be practiced to ensure safety outcomes are achieved while the patient's autonomy is maintained.


Noble, S. M. (2019). The Relationship Between White Racial Identity, Multicultural Competence and Social Justice Advocacy Competence Among White Licensed and Certified School Counselors (Doctoral dissertation, University of Akron).

Assignment: Academic Success and Professional Development Plan Part 1

Part 2: A Plan for Social Change


Explain how you would advocate for the incorporation of a global perspective or lens into your local practice and role as a nurse leader.

In my nursing experience, I have realized that being a nurse leader is a valuable experience. As a nurse leader, one needs to listen and incorporate the opinions and recommendations of other people when making critical care decisions (Lewenson & Truglio-Londrigan, 2016). One to incorporate a global perspective into the current practice is to start an international nurse forum on best practices in an outpatient care setting.  Occasionally, I often encounter many patients in my current organization, either being over-treated or under treatment for their medical conditions. Therefore, developing this forum will provide a greater perspective on patients seeking healthcare services at the outpatient care facilities. Moreover, this forum would be more successful because it will sustain consistency throughout. It is impossible to determine the times I have cared for patients at one facility versus another, and they keep on wondering why didn’t they were not treated in the same way they were treated last time or wondering how come our facility treats them differently from another outpatient facility. 

Explain how the incorporation of a global perspective or lens might impact your local practice and role as a nurse leader.

Incorporation of a global perspective would enable me to become an expert in planning for the care of all my patients.  It will give me more knowledge to add to the practice because better health outcomes are achieved when everyone has something better to bring to the table, and the more information, the better the care. As a nurse leader, I will be more open-minded and willing to accept to try new things that may yield the best health outcomes for my patients. Besides, the global perspective would impact my practice in that the care provided at my facility will be peer-reviewed and consistent with healthcare standards across the globe. 

Explain how the incorporation of a global perspective or lens into your local practice as a nurse leader represents and contributes to social change. Be specific and provide examples.

As a local nurse leader, incorporation of a global perspective can promote social change by promoting cultural competence. Besides, incorporating a global perspective will ensure that I get informed by other nurse leaders worldwide, thus allowing me to provide care without cultural biases or stereotypes.  Notably, in most cases, we often think that we know a lot about a culture on the ground of what we see on TV, but that is not always the case. Therefore, the best way to bring social change with a global perspective is to provide care while being sensitive to other people irrespective of their cultural, racial, ethnic, or sexual orientation and aware of the healthcare disparities amongst different racial groups (Bell et al., 2015). 


Bell, D., Holliday, R., Ormond, M., & Mainil, T. (2015). Transnational healthcare, cross-border perspectives. Social science & medicine124, 284-289.

Lewenson, S. B., & Truglio-Londrigan, M. (2016). Practicing primary health care in nursing: Caring for populations. Jones & Bartlett Publishers.

Clinical Issue: Nursing Fatigue/ Burnout and shift length


Nursing Burnout and Shift Length


The clinical nursing practice issue selected was nursing burnout and shift length. Based on experiences of individual practice it is important to find out how extended hours affect care of patients and the overall performance of the registered nurse due to burnout. This is because most nurses based on my experience working at the critical care ward often complain about the scheduling practices as the hospital. The other challenging aspect is that one can find nurses who are willing to work for even more than the recommended 12 hour shift. Unfortunately these nurses would also result to cases of patient dissatisfaction. Also nurses that work up to 10 hour shifts or longer often experience job dissatisfaction and burnout than nurses who work for 8 hours (Dall’Ora et al., 2020).  The main motivation however is the extra hour’s allowances, shortages of staff and irregular deployment to wards and nurse to nurse shift agreements.  In most cases it is difficult to say whether the administration of shifts is responsible for burnout or this could be impacted by other factors. In most cases, extended shifts usually undermine the wellbeing of nurses which can lead to expensive job turnover or impact on the level of patient care (Dall’Ora et al., 2020). This issue is thus important as there is need to review policies related to working hours for nurses just like there are for resident physicians.  It is important to encourage a culture that adheres to days off, promotion to leadership or supervisory roles and vacation time. Other factors such as sleep management, avoidance of nurse to nurse shift scheduling is also a common factor to burnout and should be investigated.

Evidence Based Review

An article search was done using the Walden University library data bases such as NCBI, PubMed, Cochrane and CINAHL to establish the most relevant articles about nursing fatigue and shifts and how this impacted on the clinical practice and patient care.  The keywords included; ‘Burnout’, ‘nursing fatigue’ and ‘nursing shifts’ The articles have been summarized in the following matrix

Matrix Worksheet Template 


Evidence-Based Project, Part 1: An Introduction to Clinical Inquiry and Part 2: Research Methodologies


Full citation of the selected article

Article #1

Article #2

Article #3

Article #4

Dall’Ora, C., Ball, J., Reinius, M., & Griffiths, P. (2020). Burnout in nursing: a theoretical review. Human Resources for Health volume, 18(41).

Hunsaker, S., Hsiu-Chin Chen, H., Maughan, D., & Heaston, S. (2015). Factors that influence the development of compassion fatigue, burnout, and compassion satisfaction in emergency department nurse. Nurse Scholarship, 47(2), and 186-94.

Son, Y., Lee, E., & Ko, Y. (2019). Association of Working Hours and Patient Safety Competencies with Adverse Nurse Outcomes: A Cross-Sectional Study. Int Journal Environment Res Public Health, 16(21), 4083.

Hwang, J. (2015). What are hospital nurses' strengths and weaknesses in patient safety competence? Findings from three Korean hospitals. International Journal for Quality care: Journal of International Society for quality in Healthcare, 27(3), 232-8.

Why you chose this article and/or how it relates to the clinical issue of interest (include a brief explanation of the ethics of research related to your clinical issue of interest)

Article was chosen because there is a lot of impact related to burnout when the nurses moves from an 8 hour shift to a longer shift of 10 -12 hours, which affects delivery of care, will contribute to burnout and negligence.  The ethical aspect of the article is that the study main concentrated on practicing nurses for which patient confidentiality is observed

Article is chosen it assesses the prevalence of burnout and factors leading to it where it is important to find out whether shift allocations has to do with it. Ethical aspects have were considered in the study where issue of confidentiality was important especially in regard to discussing patient care.

Article is important as it looks at the environmental factors related to the performance of nurses. The article is important as it explores other factors apart from shift which could impact on burnout rates in healthcare.  Ethical aspects if the study is that it demystifies factors associated with burnout which may not only be based on shift schedules. 

Article is important as it looks factors impacting nursing competencies of which shift scheduling is a factor. Ethical aspect of the study is that it does not involve patient subjects in the study. 

Brief description of the aims of the research of each peer-reviewed article

The article aims at providing a summary or studies looking at the relationships between burnout and other variables   to determine the main cause of burnout and consequences. 

Article aims at demystifying issues related to burnout and patient care. 

Article aims at looking at the association between the working hours of hospital nurses and competencies in regard to patient safety and outcomes. 

The aim of the article is examining the hospital nurse safety competence and how this is related to safe working environment. 

Brief description of the research methodology used Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.

Qualitative method was used. 

Quantitative study was used 

Quantitative study was used in the article

Quantitative methodology was used. 

A brief description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.

The advantages of this is that it allows for further updated information regarding the topic. Article is reliable since it makes use of evidence based information. 

The strength is important as it increases reliability of the study.

The strength is important as it increases reliability of the study with the use of primary sources.

The strengths of this methodology is that the study was able to reach out to huge number of nurses in different practice environment. Which makes information reliable. 

General Notes/Comments

Article relates to the clinical practice issue

Article relates to the clinical practice issue

Article relates to the clinical practice issue

Article relates to the clinical practice issue



Dall’Ora, C., Ball, J., Reinius, M., & Griffiths, P. (2020). Burnout in nursing: a theoretical review. Human Resources for Health volume, 18(41).

Hunsaker, S., Hsiu-Chin Chen, H., Maughan, D., & Heaston, S. (2015). Factors that influence the development of compassion fatigue, burnout, and compassion satisfaction in emergency department nurse. Nurse Scholarship, 47(2), and 186-94.

Hwang, J. (2015). What are hospital nurses' strengths and weaknesses in patient safety competence? Findings from three Korean hospitals. International Journal for Quality care: Journal of International Society for quality in Healthcare, 27(3), 232-8.

Son, Y., Lee, E., & Ko, Y. (2019). Association of Working Hours and Patient Safety Competencies with Adverse Nurse Outcomes: A Cross-Sectional Study. Int Journal Environment Res Public Health, 16(21), 4083.


Oral Presentation Nursing Theorist- Margaret Newman


  • In this assignment, we are going to focus on theorist Margaret Newman, her background, social history, her theory, and the impact the theory had in the field of Nursing and its application in different settings. 

  • Margaret Newman was born in 1933 in Memphis Tennessee. She was raised in a Christian family since she was brought up in a Baptist Church where her mother had a job as a secretary (Endo, 2017).  It was through this Christian background that she joined the military service. 

  • During the missionary service, Newman realized that she could not only help people spiritually, but she also had to take care of their health status. It was at this time that she decided to pursue a nursing course, after being inspired by a nursing student, where she took the path herself to ensure that she would later help other people’s physical needs (Endo, 2017).  After receiving the news that her mother was ill, Newman returned home to discover that her mother was suffering from a chronic condition known as the Amyotrophic lateral sclerosis.  At this point, she became the primary caregiver of her mother, after realizing that being diagnosed with a chronic condition does not mean that one remains unhealthy.  She was convinced that her mother would experience healthiness despite being diagnosed with the condition.  She was also able to formulate her mother's condition by confining her but not defining her with the condition (Macharia, 2015)

  • The experience motivated her to go back to school and study nursing so she could help others like her mother.  

  • In 1971 Newman received a doctorate from New York University. She also taught at the New York University up to 1977 and in the fall of 1977, she was able to accept the position of the profession in charge of graduate studies in nursing practice at the Penn state university (Macharia, 2015)

  • In 1984, she also began working as a nurse theorist with the University of Minnesota where she later retired from the teaching practice in 1996 (Macharia, 2015)

Social events and theorist background factors that influenced theory development

  • A trained and professional nurse, Newman was able to become a fellow with the American Academy of Nursing.  
  • Apart from this, she has been honored as an outstanding alumna with New York University and the University of Tennessee. 
  • During her time in practice she was also awarded the distinguished scholar in Nursing Award from the New York University, the Founders Award for the Excellence in Nursing research which was given in Theta Tau International. She was also given the E. Louise Grant Award for the Nursing excellence from the University of Minnesota. 

Theory Model / Components


  • Margaret Newman was known for coming up with the theory of health expanding consciousness. 
  • The theory was inspired by Roger’s theory of unitary human beings, which was based on the assumption of how people interact with their environment as the basis of the consciousness being, which is also a pattern that evolves from the relationship between an individual and the environment. 
  • The basic idea behind the theory of Expanding consciousness was as a result of an invitation Margaret was given to speak at a nursing conference back in 1978 (Pharris & Endo, 2007). Apart from Rogers the theory was also influence by Bentov’s concept regarding the evolution of consciousness, Bohm’s theory of Implicate, and Young's theory of process. 
  • Based on this theory of expanding consciousness each individual in each situation, regardless of how hopeless, or disorder it may look, is a part of the whole process to expand their consciousness.  
  • The process entails becoming more aware of the self, and finding more meaning to life, including reaching new connectedness and dimension with other people of the world. 
  • Based on her theory, there are six assumptions;
  • First is the idea that health is about conditions described illness or in medical language pathology. 
  • The individual pathological conditions are often viewed as the manifestation of the total pattern if the single patient. 
  • Also, the pattern of a particular patient which later manifests itself as a pathology will exist before the functional or structural change. 
  • When this pathology is by itself removed, it does not alter the pattern of the individual patient (Pharris & Endo, 2007).  
  • Meaning that if becoming ill is the one way the pattern of the individual will manifest itself, then it means it becomes the purpose of health for the individual. 
  • Thus, health is all about an expansion of consciousness.



Use of theory in nursing science and advanced nursing practice



  • The theory is an application to nursing science and advances nursing practice due to the fact it puts more emphasis on the continued form of care outside the clinical setting.  It looks at different activities that support the improvement of the health of the individual which can be carried out of the healthcare setting and care centers.   
  • The theory calls for the need to empower and support patients socially through home-based care as it can help in the reduction of the workload among the healthcare providers and reduced the economic burden of the healthcare centers in poor regions. 
  • There are various concepts in the theory that are intrinsic factors requiring nursing intervention like the concept of time and movement (Pharris & Endo, 2007).  Ambulation, motion range, breathing, and coughing being parameters that are used in nursing practice.  The theory can thus be very much applied among patients that are diagnosed with chronic conditions like HIV/AIDS, diabetes, cancer among others. 
  • The theory is important since it is usually very depressing for a patient when they realize that they have been diagnosed with a chronic condition. This will impact in their family, and as individuals, they are going to face spiritual, emotional, and social stress which will affect their response to treatment, there will changes in lifestyle, home and their roles will be disrupted as well as being stigmatized (Endo, 2004)
  • The individual patients also face challenges through the changes in their self-image, own mortality, sexuality, and reproductive capacity.
  • Nurses must make use of this theory to help patients diagnosed with chronic conditions like cancer to know that they are still the same person each day and that they are precious and the life they live is for the present moment.  Nurses are required to use the theory in fighting stigma and apply the theory philosophy that being sick does not always mean one is unhealthy. 
  • Based on the theory, it is important to appreciate that one can be healthy and whole even after they have been diagnosed with a condition or with no condition. 
  • Health does not always mean the opposite of sickness but it will mean a manifestation of the two. 
  • In the past people would hide a chronic illness from their social circles after being diagnosed due to fear, however, the modern nursing practice has proven that they can help through assisting these patients to expand in their consciousness around their condition (Endo, 2004)


Concluding remarks


  • In conclusion, thus, the theory guides nurses to assist their patients towards a pattern of recognition and ensure they understand new possibilities for action and that there is still space for health.  The nurse should assist their patients and ensure they realize they have the power inside then to raise their consciousness level. 
  • Since the theory, people can now come out and disclose their health status, while elderly people in-home nursing care will also have a strong human connection between each other, their family, and their careers. 


  • The theory has also made it easier to administer drugs and establish a good nursing care plan, where the patient and the nurse collaborate to agree on the concepts towards their health. 


Endo, E. (2004). Nursing praxis within Margaret Newman’s theory of health as expanding consciousness. Nursing Science Quarterly, 17(2), 110-115.

Endo, E. (2017). Margaret Newman's theory of health as expanding consciousness and a nursing intervention from a unitary perspective. Asia-Pacific Journal of Oncology Nursing, 4(1), 50.

Macharia, K. S. (2015). Applying Margaret Newman’s theory of health as expanding consciousness to psychosocial nursing care of HIV infected patients in Kenya. American Journal of Nursing Science, 4(2), 6.

Pharris, M. D., & Endo, E. (2007). Flying free: The evolving nature of nursing practice guided by the theory of health as expanding consciousness. Nursing Science Quarterly, 20(2), 136-140.


NSG6101 Nursing Research Methods

PICOT Statement – Diabetes 2 Barriers


Evidence Based Practice is usually accessible for different geriatric patients with diabetes 2; however this practice is often not realized in most hospital and a number of health institutions can grow. A lot of studies concentrate on information to realize the issues that call for more training in nursing care for people living with diabetes 2 which is meant to promote the wellbeing of patients. In addition there is also few studies does in regard to how issues are addressed (Abbatecola, Paolisso, & Sinclair, 2015). This means that there can be more positive results when it comes to address the barriers of diabetes 2 care for geriatric patients when evidence based training for nurses is put in to care practice.  This has often proved to be a challenge for many and call for different techniques in meeting the needs of the top authority in hospitals, the specialists and changing the view of the society regarding people living with diabetes 2. 

PICOT Question

When it comes to the geriatric adult patients with diabetes 2, clinical staff, organisational mission statement and goals are at stake. How does it incorporate the use of evidence based practice to enhance the patient’s experience living with type 2 diabetes? 

Also Read: Pico Questions and Examples



In assessing the implementation of evidence based practice, this activity worked with geriatric patients of ages 40-80  that already have a clinical diagnosis  of Diabetes 2 that are yet to receive self-management education in the past year. All the non-geriatric patients were also excluded. 


The activity worked with about 30 patients that have diabetes 2. All the interventions were evidence based and included the following: 

  1. Ensuring that all forms of care is centered towards the wellness of the patient. It is important that all nurses in the line of care learn to practice recommendations whether they are evidence based or are based on the opinion of the charge nurse. This is because all of them are intended to ensure that there is an overall approach to continuum of care for geriatric patients living with diabetes 2  (Migdal & Abrahamson, 2016).  The art and science of medicine will thus come in when the clinician is also experiencing recommendations for treatment especially for patients that may not have been able to meet the criteria for eligibility for the studies that all the treatment guidelines have been based (Nyambuya, Dludla, & Nkambule, 2018).  
  2. Evidence Based Practice interventions will consider other illnesses that individual patients might be treating like asthma, blood pressure or cancer.  This is because type 2 diabetic patients were often seen to increase in the risk of other illnesses like the cardiovascular disease, meaning when the nurse has a patient centered approach, this will entail coming up with a comprehensive plan that can reduce the risk for cardiovascular disease by also addressing the blood pressure and the control of lipids, cessation and smoking prevention, management of weight, health lifestyle choices and physical activities (Migdal & Abrahamson, 2016). 
  3. Intervention will look at the issue of treatment and care for the diabetes 2 patient across the whole lifespan. Since an increasing population of patients living with type 2 diabetes are adults. This means that there they may have transformed from Type 1 as they grow older, a stage life for which there is need to call for more evidence required for any clinical trial or lead the required therapy.  All the changes in demography means that there is a lot of challenges  when it comes to the practice of high quality care for geriatric patient with diabetes 2, which calls for the need to improve the coordination required among the clinical teams as the patients grow from various lifespan stages. 
  4.  As part of intervention there was the issue of becoming advocates for evidence based practice for patients living with diabetes 2. Among the interventions include providing an active support and engagement for which they will require in advancing the policy cause. Advocacy is important and will be required in improving the lives of patients especially those with other chronic diseases. With the fact that there is the growing number of people with type 2 diabetes who are not able to perform several physical activities, while others are overcome by social lifestyle like smoking, the nurse will be a very important person in educating and encouraging the patient to address and change most of the societal determinants at the main cause of the problem (Migdal & Abrahamson, 2016).  Within the community healthcare setting for nursing clinical practice, there will be standard evidence based guidelines  and recommendation for practice  that can be used in identification of various issues to be looked in to and more research to be done (Onofrei & Smith, 2019). The intervention would also mean that the nurse educates the patients about their choices for healthy lifestyle management of the disease like taking medications the right way and in time and prevention other diabetic related complications (Komkova, Brandt, Hansen Pedersen, Emneus, & Sortsø, 2018). 


For all the 30 participants, there was a supervised exercise for evidence based practice which included diet, exercise, and management of medication among other factors that provided an active development for the geriatric patients with type 2 diabetes. Evidence based approaches were used as the control factors for the group for a period of 3 months. By use of this strategy, it is evidence that there could be prolonged life and increased activities among geriatric individuals with diabetes 2. 


Evidence based Practice interventions can help increase the lifespan of geriatric patient with diabetes 2.  The risk however will increase with various Protease Inhibitors and nucleoside reverse transcriptase inhibitor, meaning when the management of insulin is put in to practice, then diabetes 2 can be contained and the patient is able to live with it for a long time.  In most cases in a community hospital setting, nurse for patients with diabetes 2 lack evidence based training which means that provision of care is often compromised in regard to the social, cultural and economic aspects of the patients, however, when EBP is implemented, that the continuum of care is well documented. 


These outcomes will be measured weekly to determine the use of Evidence Based practice in countering barriers for geriatric patients with diabetes 2. 


Abbatecola, A., Paolisso, G., & Sinclair, A. (2015). Treating Diabetes Mellitus in Older and Oldest Old Patients. Current Pharmaceutical Design, 21(13), 1665-1671. Doi:10.2174/1381612821666150130120747

Awoyemi, A., Trøseid, M., Solheim, S., Arnesen, H., & Seljeflot, I. (2018). Metabolic endotoxemia as related to metabolic syndrome in an elderly male population at high cardiovascular risk. Atherosclerosis, 275, e55-e56. doi:10.1016/j.atherosclerosis.2018.06.149

GUO, M., & XU, Y. (2018). SGLT2 Inhibitors and Stroke Risk in Patients with Type 2 Diabetes—A Systematic Review and Meta-analysis. Diabetes, 67(Supplement 1), 165-OR. Doi: 10.2337/db18-165-or

Komkova, A., Brandt, C. J., Hansen Pedersen, D., Emneus, M., & Sortsø, C. (2018). Electronic Health Lifestyle Coaching Among Diabetes Patients in a Real-Life Municipality Setting: Observational Study (Preprint). doi:10.2196/preprints.12140

Migdal, A. L., & Abrahamson, M. J. (2016). Treating Type 2 Diabetes Mellitus. Principles of Diabetes Mellitus, 1-24. Doi: 10.1007/978-3-319-20797-1_44-1

Nyambuya, T. M., Dludla, P. V., & Nkambule, B. B. (2018). T cell activation and cardiovascular risk in type 2 diabetes mellitus: a protocol for a systematic review and meta-analysis. Systematic Reviews, 7(1). Doi: 10.1186/s13643-018-0835-1

Onofrei, L., & Smith, A. G. (2019). Advocacy for patients with neuropathic pain. Advocacy in Neurology, 347-360. doi:10.1093/med/9780198796039.003.0030

Rodriguez-Saldana, J. (2019). Clinical Practice Guidelines, Evidence-Based Medicine, and Diabetes. The Diabetes Textbook, 333-355. Doi: 10.1007/978-3-030-11815-0_21


Discover our
Nursing Writing Service
McAfee SECURE sites help keep you safe from identity theft, credit card fraud, spyware, spam, viruses and online scams Prices from

Undergraduate 2:2 • 1000 words • 7 day delivery

Order now

Delivered on-time or your money back

Reviews Premium  Writing Service (336 Reviews)
Rated 5 / 5

Our Exclusive Features

What's included
with your writing order
275 words per page
Free revisions
Free amendment request
References/works cited page
Free table of content
Money back guarantee
1-on-1 chat with your writer.
Free 24/7 customer support
Free cover page
Free delivery