Cardiac Surgery Essays (Examples)

Cardiac Stress Response: The Use of Anesthetic Technique to Promote Positive Outcome; Analyzing the Pros and Cons of Technique

Cardiac surgery by nature elicits a powerful stress response resulting from activation of stress hormones including epinephrine, norpinephine and cortisol hormones among others. Surgical trauma and blood loss may contribute to this stress response. Some surgeons have suggested that cardio pulmonary bypass surgery in and of itself activates an inflammatory response that results in a stress reaction.

The role of the anesthesiologist in cardiac surgery is to as much extent as possible, to reduce the stress response that results form cardiac surgery. Stress response can be mitigated by a variety of anesthetic technique, including use of opioids and epidural anesthesia. These ideas are explored in greater detail below.

Cardiac Stress Response: The Use of Anesthetic Technique to Promote Positive Outcome; Analyzing the Pros and Cons of Technique

INTRODUCTION stress response may…

Bibliography

Cook, Richard I. "Adapting to New Technology in the Operating Room." Human Factors, Vol. 38, 1996.

Cook, R.I., Woods, D.D., Howie, M.B., Horrow, J.C. & Gaba, D.M. (1992). "Unintentional delivery of vasoactive drugs with an electromechanical infusion device." Journal of Cardiothoracic and Vascular Anesthesia, 6, 238-244.

Cuschieri, R.J., Morran, C.G., Howie, J.C., & McArdle, C.S. (1985). "Postoperative pain a dpulmonary complications: comparison of three analgesic regimens." British Journal of Surgery, 72, 495-499.

Glaser, J., Kiecolt-Glaser, MacCallum P., Marucha, P., & Page, G. "Psychological Influences on Surgical Recovery: Perspectives from Psychoneuroimmunology." American Psychologists, Vol. 53, 1998.

To the degree that nurses match their skills with patient's needs, thus is qualified nursing met (AACN, 2006).

From my experience, most surgeons, specifically in the cardiac ward focus on the minutiae of their skill and on saving the patient's life mo matter what. A failed surgery seems to them to cast aspersions on their skills. Dr. Agnihotri is, however, unique in that he places the patients needs first and foremost and ascertains that his assistants and interns do the same.

A case, at one time, for instance, that made ripples around the ward and impressed me intensely involved patient x who, at a great deal of pain and an advanced age with a surgery that seemed to promise only complications, just wanted to expire. Her family, however, endeavored to keep her alive, despite cost, level of pain, frequency, extension, and complications of surgery involved. Dr. Agnihotri focused on the…

References.

American Association of Critical-Care Nurses (AACN). (2006). The AACN Synergy Model for Patient Care. Retrieved April 3, 2011, from  http://www.certcorp.org/certcorp/certcorp.nsf/vwdoc/SynModel ? opendocument

Hardin, S. (2005). Introduction to the AACN Synergy Model for Patient Care. In S.R. Hardin & R. Kaplow (Eds.), Synergy for clinical excellence: The AACN Synergy Model for Patient Care (pp. 3-10). Sudbury, MA: Jones and Bartlett Publishers.

Salmon, M. (2008). Cardiac Care Unit. Heart health Center. Retrieved April 3, 2011, from  http://heartdisease.about.com/lw/Health-Medicine/Conditions-and-diseases/Cardiac-Care-Unit.htm

The "pain" caused to the heart due to tissue damage can be misplaced in the body due to these nerve pathways and connections; heart attacks are often felt in the left arm and elsewhere on that side of the body between the heart and brain.

5)

Diuretics would encourage the elimination of sodium and a lessened fluid retention, easing the pressure in his arteries.

6)

The increased acidity in J.M.'s blood indicates reduced heart functionality and creatine phosphokinase levels are elevated which indicates muscle damage; low-normal lactate dehydrogenase suggest no recent prior infarctions, however, and without further tests this particular measure is not especially edifying.

7)

The drug relaxes blood vessels, allowing easier passage of blood reducing chest pain (which elevates stress and blood pressure) and easing the underlying problem, as well

8)

Aspirin inhibits the collection of platelets at the site of a plaque rupture, preventing a full blockage…

People die each year of cardiac related health problems. Some die of heart attacks and others of congestive heart failure and so forth. This research proposal highlights five peer reviewed journal articles that show how to improve, step-by-step, the infrastructure of a hospital cardiac program. Quantitative data from the studies along with in-hospital data will reveal the need for quality improvement as well as how successful certain methods are when implemented among specific populations. Information was gathered through the search engine Google Scholar and PubMed. All articles are less than four years old and reveal ways to not just improve the safety and care of patient's but also how to improve surgical outcomes and enhance IT infrastructure, all of which are essential to running a great hospital cardiac program.

Introduction

Several patients in (Hospital Name) have come in complaining of cardiac related health problems. Some have had issues with cardiothoracic…

References

Elliott, M.J. (2012). The role of information in ensuring quality and patient safety. Progress in Pediatric Cardiology, 33(1), 5-10. Retrieved from  http://www.sciencedirect.com/science/article/pii/S1058981311000853 

Grace, S.L., Poirier, P., Norris, C.M., Oakes, G.H., Somanader, D.S., & Suskin, N. (2014). Pan-Canadian Development of Cardiac Rehabilitation and Secondary Prevention Quality Indicators Endorsed by the Canadian Association of Cardiac Rehabilitation. Canadian Journal of Cardiology, 30(8), 945-948. Retrieved from  http://www.sciencedirect.com/science/article/pii/S0828282X14002335 

Guillamondegui, O.D., Gunter, O.L., Hines, L., Martin, B.J., Gibson, W., Clarke, C., Cecil, W.T. (2012). Using the National Surgical Quality Improvement Program and the Tennessee Surgical Quality Collaborative to Improve Surgical Outcomes. Journal of the American College of Surgeons, 214(4), 709-714. Retrieved from  http://www.sciencedirect.com/science/article/pii/S1072751511013287 

IEEE Conference on Software Engineering Education and Training, & IEEE Computer Society. (2011). Educating software engineers of the future: Software quality research through problem-based learning. In CSEE&T 2011: Proceedings (pp. 91-100). Los Alamitos, California: IEEE.

Interdisciplinary Care Providers
CABG or coronary artery bypass graft surgery is advised for individuals suffering from CHD (coronary heart disease), for alleviating symptoms, prolonging lifespan, and improving QOL (quality of life) (Bayoumi, 2015). Improvements in mechanical ventilation-supported cardiac operation patient management continues to be a major focus area for better optimizing clinical results. The FTE (fast-track extubation) theory applied in case of cardiac operation patients is growing in popularity, in a bid to offer more economical and superior-quality healthcare. A large number of research works have established that prompt extubation (i.e., between 6 and 8 hours after surgery) may be a safe step, whilst decreasing admission and resource use expenses (Cheng, Karski & Peniston, 1996). In spite of the aforementioned advantages, prompt extubation is not consistently performed, underscoring the need to adopt a protocolized strategy for decreasing setbacks and variations and linked to weaning mechanical ventilation. Time-guided extubation protocols’ benefits have been…

Patient Education Decrease Anxiety Undergoing Invasive Cardiac Procedures

Annotated Bibliography

In this case, one of the main areas of topic is based on the role played by initial patient education on the anxiety of patients undergoing noninvasive cardiovascular surgery. It has been reported that the initial education provided by the nurses to the patient in relation to the noninvasive cardiac surgery helps the patient, as there is a great reduction in stress and level of anxiety in relation to the surgical procedures and the outcomes.

Riegel, B (ed). Journal of Cardiovascular Nursing. Philadelphia, U.S..

The journal is a complete online source for the information needed by the nurses in accordance to the procedures that can be used to reduce anxiety levels in the patients undergoing noninvasive cardiac surgery. These days it is important that the patients be taken into complete confidence by making sure they are aware of the procedures…

This is vital because medical personnel could administer something that causes life threatening symptoms if taken with an anticoagulant.

The final educational area that needs to be covered are the changes that must take place in the daily life of the patient. The patient must be careful not to cut himself or herself, In addition the patient must be careful not to take part in activities that might cause injury as injury can cause the patient to hemorrhage.

GI POBLEMS

Three common GI problems include heartburn, ulcers and irritable bowel syndrome. Each of these conditions can cause stomach upset. Heartburn can be treated with over the counter medications, including Zantac. Ulcers require a specific antibiotic and a stomach acid reducer and IBS is often treated with stomach acid reducers. In addition all three conditions respond favorably to changes in diet.

The medications for heartburn can be purchased over the counter,…

References

Precautions While Using This Medicine  http://www.healthopedia.com/drugs/detailed/anticoagulants/precautions.html# 

What is OxyContin?  http://www.drugfree.org/Portal/Drug_Guide/OxyContin

The procedure itself and the hospital stay associated with it is only one small chapter in the patient's life. They will eventually go home and will have many years after the procedure. It is important for the nursing staff to make a positive impact on how they feel about the procedure. The procedure will represent a lasting memory to the patient. If the patient perceives this to be a time of strength and care from nurturing individuals then it will help them to be able to develop the coping mechanisms necessary to learn to live with the after-effects of the procedure.

If the patient sees this as a negative experience, then it could produce unwanted effects such as depression, post-traumatic stress disorder, or other emotional problems that could have an effect on their ability to cope with the life changes. Those that develop appropriate coping mechanisms will be more likely…

References

Knoll, N., Rieckmann, N., & Schwarzer, R. (2005). Coping as a mediator between personality and stress outcomes: A longitudinal study with cataract surgery patients. European Journal of Personality, 19, 229-247.

Lippke, S., Ziegelmann, J.P., & Schwarzer, R. (2004). Initiation and maintenance of physical exercise: Stage-specific effects of a planning intervention. Research in Sports Medicine, 12, 221-240.

Lippke, S., Ziegelmann, J.P., & Schwarzer, R. (2004). Behavioral intentions and action plans promote physical exercise: A longitudinal study with orthopedic rehabilitation patients. Journal of Sport & Exercise Psychology, 26, 470-483.

Lippke, S., Ziegelmann, J.P., & Schwarzer, R. (2005). Stage-specific adoption and maintenance of physical activity: Testing a three-stage model. Psychology of Sport & Exercise, 6, 585-603.

Congestive Cardiac Failure: Nursing Perspective

Congestive heart failure is a congenital condition that affects millions of American's every year. Heart failure often manifests in a chronic condition for victims of the disease.

There are several nursing interventions important for control and maintenance of the condition. Congestive heart failure can result in serious complications including edema, respiratory disorders and can lead to premature death. Treating congestive heart failure appropriately is critical to a patient's outcome. Perhaps even more critical to a patient's outcome is patient education targeted at prevention and healthy living. Nursing management of the condition depends upon appropriate medical evaluation, medication administration, monitoring and patient education. These ideas are explored in greater detail below.

Congestive heart failure is often congenital in nature. Congestive heart failure usually manifests when the cardiac muscle is old and tired and stops circulating properly. This may result from damage to the heart; alternatively myocarditis…

References

AMA. (2004). "Congestive Heart Failure." American Heart Association, Inc. {Online} Available:  http://www.americanheart.org/presenter.jhtml?identifier=4585 

Adomeit, A; Baur, A; Salfeld, R. (2001). "A New Model for Disease Management." The McKinsey Quarterly.

Antoni, M; Ironson, G; Saab, P; Schneiderman, N. (2001). "HEALTH PSYCHOLOGY: Psychosocial and Biobehavioral Aspects of Chronic Disease Management." Annual Review of Psychology

Arocha, J; Patel, V. (1995). "Novice Diagnostic Reasoning in Medicine: Accounting for Evidence." Journal of the Learning Sciences, Vol. 4

Implantable Cardiac Devices

Heart disease remains one of the leading causes of death in the United States but there are a number of different implantable cardiac devices (ICDs) available today, including pacemakers, defibrillators and cardiac resynchronization devices, that can help people with heart disease or failure go on to lead normal lives by regulating their heart beats through a series of electric shocks. To determine the facts about these devices, this paper provides a review of the literature to explain the respective indications for these devices as well as their differences. Finally, a summary of the research and important findings concerning these implantable cardiac devices are provided in the conclusion.

eview and Discussion

Indications for each of the following: Pacemaker, ICD (defibrillator) & Cardiac esynchronization Devices

Pacemaker. According to Gregoratos et al. (1), this type of ICD is indicated for patients suffering from abnormalities of atrioventricular (AV) conduction which may…

References

1. Gregoratos, G et al. American Heart Association [Internet] ACC/AHA Practice Guidelines 2016 [cited 2016 April 26] Available from  http://circ.ahajournals.org/content/97/13/1325.full .

2. American Heart Association. [Internet] What is a pacemaker. 2016 [cited 2016 April 26] Available from  https://www.heart.org/idc/groups/heart-public/@wcm/@hcm/documents  / downloadable/ucm_300451.pdf.

3. Perry, P ICD -- The Beat Goes On: Experts Call for Expanded Coverage of ICDs, the Most Effective Method to Date for Preventing Sudden Cardiac Death in High-Risk Coronary Patients. The Saturday Evening Post 2004, March-April 276(2): 28-29.

4. Medtronic [Internet] 2012 ACCF/AHA/HRS Guidelines for Implantable Defibrillator and Cardiac Resynchronization Therapy for Cardiac Rhythm Abnormalities. 2012. [cited 2016 April 26] Available from  http://www.medtronic.com/content/dam/medtronic-com-m/mdt/crdm  / documents/2012-accf-aha-hrs-guidelines.pdf.

Maxton, F.J.C., Justin, L. & Gillies, D. (2004). Estimating core temperature in infants and children after cardiac surgery: a comparison of six methods. Journal of Advanced Nursing 45(2): 214-22.

What is the research question? If it is not explicitly written, but is implicit in the article, suggest null and alternative hypotheses.

Which temperature-taking site yields the most accurate readings in babies and young children following cardiac surgery? Temperature is usually measured using the pulmonary artery as a "gold standard." However, the authors hypothesize that because the pulmonary artery cannot be used in the majority of the patients in the target population, other methods can and should be used. In addition to pulmonary artery temperature, the temperatures can be taken at the rectal, bladder, nasopharyngeal, axillary, and tympanic sites.

List the variables used in the study and identify each of them as either independent or dependent variables. Also describe the level…

References

Maxton, F.J.C., Justin, L. & Gillies, D. (2004). Estimating core temperature in infants and children after cardiac surgery: a comparison of six methods. Journal of Advanced Nursing 45(2): 214-22.

internal validity and external validity are important when designing, implementing, and reviewing empirical research. Internal validity refers to the design of the research and its methodology. Issues like sampling, statistical analyses, robustness of the variables, survey instruments, and researcher bias can impact internal validity. With regards to my research question, internal validity is of the utmost importance. The independent variables in this case include two different types of interventions: bloodless cardiac surgeries and blood transfusions. However, it is important to operationalize these two independent variables so that the researchers are clear on what exactly constitutes a bloodless surgery and a blood transfusion. Moreover, issues like hospital setting must be taken into account as a potentially confounding variable. When, where, and how these procedures are implemented can all have a bearing on the internal validity of the research design.

Likewise, the dependent variables are morbidity and mortality in patients. It is…

References

"Internal Validity," (n.d.). Retrieved online:  http://www.indiana.edu/~p1013447/dictionary/int_val.htm 

Osborn, D.R. (n.d.). External validity. Retrieved online: http://cas.bellarmine.edu/Osborn/hypertut_piv/external_validity_is_concerned_w.htm

Shander, A., Moskowitz, D. & Rijhwani, T.S. (2005). The safety and efficacy of 'bloodless' cardiac surgery. Seminars in Cardiothoracic and Vascular Anesthesia 9(1).

Whitson, B.A., Huddleston, S.J., Savik, K. & Shumway, S.J. (2007). Bloodless cardiac surgery is associated with decreased morbidity and mortality. Journal of Cardiac Surgery 22(5): 373-8.

satisfactorily completed all elements of your job description?

Yes __X____ No

Are there areas where you exceeded the standards?

Yes ____X__ No

If yes, describe: areas:

One area in which I feel like I made a positive contribution to the team and exceeded standards was through the education of nursing fundamentals for the OR, SICU and Cath LAB nurses. For example, to provide a framework for education grand rounds instituted and seemed to have a positive effect on the staff in regards to learning. Other areas in which I believe that I exceeded standards would be in the program-patient flow, process improvement, communication, and the hand-off of patient information. There were also service-implemented changes made that including items such as converting from the reprocessing of AV temporary pacing cables to disposable pacing cables which are better suited for reduction in RSSI, adding cost measurements to streamline the use of medical…

greatly distressed to have received a written warning about my conduct at work. I am sending this letter to more fully detail my side of the story.

When I first secured my position 18 months ago, I was given the task of enacting a number of necessary changes as the clinical research coordinator for the cardiac surgery service. I was instructed to implement new processes for patient care and to improve the skill levels of the staff. I have over twenty years of experience in my field and am currently enrolled in a master's program for health care management to further hone my abilities.

I was well aware of the phenomenon of change resistance when I embarked upon my task and given the fact that the needed changes were so intimately related to standard operating procedures at the hospital, some anger and resentment was only natural, despite the fact that…

This is then followed by a discussion and recommendations for future study. The findings offers hope that there could be prevention measures to drastically reduce the likelihood of developing dementia symptoms when health factors are emphasized while risk factors are reduced. This has implications for the drive towards healthy aging that has become an increasing concern in society today.

One potential shortcoming of the article is its nature as a review article. There is therefore a specific lack of practical study to confirm the findings presented by the literature. Nevertheless, the research is highly valuable in terms of creating a premise for future studies of this kind, where practical information can be gathered to confirm the literature outcomes. Ultimately, the article could be the basis of many effective measures to prevent the burden that dementia has become for individuals with the condition and those who are obliged to care for…

Given the projected demographic trends and the actual statistics from the surrounding hospitals considered above, it is obvious that the "business" for open heart surgery is moving into the Cabarrus Memorial Hospital area. In the interim however, the hospital administrators on the Board will have to consider possible alternative strategies before making a "go/no-go" decision on the possible addition of the open heart program. Unfortunately, a helicopter medevac average price is $7,500-$8,000. This will of course vary based upon the medications and supplies used during trip ("How much does," 2011).

First of all, in the opinion of the author, we have identified an access problem for the present CMH area residents to the existing open heart surgery facilities at the surrounding hospitals. As noted in the case study text, driving to Charlotte is a major problem. The immediate issue will be relieving this before an open heart surgery center is…

Works Cited

Heart. (2011). Retrieved from  http://www.cmc-northeast.org/body.cfm?id=51 .

How much does a ride in a medevac helicopter cost? (2011). Retrieved from  http://answers.yahoo.com/question/index?qid=20100329055051AAbYeqW .

Nilsson, J., Algotsson, L., Hoglund, P., Luhrs, C., & Brandt, J. (2006). Comparison of 19 pre-operative risk stratification. European Heart Journal, 27, 867 -- 874.

Swayne, L.E., Duncan, W.H., & Ginter, P.M. (2007). Strategic management of health c are organizations. Malden, MA: Blackwell, MA.

More times than not, a patient will argue that he did not understand what the physician stated to him; even amidst documented proof the medical professional and the patient did engage in an informed conversation. "The fact that a meeting took place does not necessarily mean that there was a meeting of the minds" (Informed consent…, 2010, ¶ 5). This issue leads some health care providers to assert that informed consent forms possess little value, particularly when a legal battle ensues and the professional cannot prove the patient did, in fact, understand the informed consent process.

Currently, lawyers routinely challenge informed consent forms in courtrooms throughout the United States (U.S.). "The model consent forms incorporate substantial details of anesthesia techniques, risks and other elements of 'informed consent', so that a strong presumption is established on its face" (Informed consent…, 2010, ¶ 7). During the informed consent process, to help inoculate…

REFERENCES

Anaesth, B.J. (2009). Perioperative visual loss: What do we know, what can we do? Department

of Anesthesia and Critical Care. University of Chicago. Retrieved January 25, 2010 from  http://bja.oxfordjournals.org/cgi/content/short/103/suppl_1/i31 

Booth, B. (2008). Informed consent at the heart of New York lawsuit. Retrieved January 26,

2010 from  http://www.ama-assn.org/amednews/2008/03/10/prca0310.htm

Apart from that, Chennai has become the eye specialist city and Kerala has become the ayurvedic center for healing. These facilities are being made use of by the non-Indian nations (Connell, 2011).

Huge market at hand

The population is surging, the patterns of diseases are altering, salary levels are rising, clinical needs aren't attended, health issues aren't being attended, demand for quality care is needed at moderate prices and medical tourism is all set to rise. So is the need for modern equipment. In any case, demand for modern equipment is needed in India on a basis of 12%-15% yearly. Many foreign companies commence their initial 500 surgeries in India after getting approval from FDA. Medical services are still shallow by the way. China has 106 doctors while India has 60 doctors per 1000. Australia has 247 doctors per 1000 people. The rural areas suffer a lot from this lack…

References

Connell, J. (2011). Medical Tourism. CABI - Business & Economics.

Dhawan, J (2007). The Changing Face of Indian Economy. Atlantic Publishers & Dist.

Gulati, S., & Taneja, U. (2012). Specialty Hospitals Leveraging Information Systems For Greater Success. Internet Journal of World Health & Societal Politics, 7(2).

Herzlinger, R.E. (2008). Fortis Healthcare. Harvard Business School.

Gurkan, Y., Canatay, H., Agacdiken, a., Ural, E., & Toker, K. (2003). Effects of halothane and sevoflurane on QT dispersion in paediatric patients. Paediatr Anaesth, 13(3), 223-227.

Kerssens, C., Ouchi, T., & Sebel, P.S. (2005). No evidence of memory function during anesthesia with propofol or isoflurane with close control of hypnotic state. Anesthesiology, 102(1), 57-62.

Macario, a., Dexter, F., & Lubarsky, D. (2005). Meta-analysis of trials comparing postoperative recovery after anesthesia with sevoflurane or desflurane. Am J. Health Syst Pharm, 62(1), 63-68.

Marczin, N. (2004). Editorial I: Tiny wonders of tiny impurities of nitrous oxide during anaesthesia. Br J. Anaesth, 93(5), 619-623.

Ng, a. (2005). Sevoflurane sedation in infants - a fine line between sedation and general anesthesia. Paediatr Anaesth, 15(1), 1-2.

Preckel, B., Mullenheim, J., Hoff, J., Obal, D., Heiderhoff, M., Thamer, V., et al. (2004). Haemodynamic changes during halothane, sevoflurane and desflurane anaesthesia in dogs before and after…

References

Desalu, I., Kushimo, O.T., & Odelola, M.A. (2004). Cardiovascular changes during halothane induction in children. Niger Postgrad Med J, 11(3), 173-178.

Gungor, I., Bozkirli, F., Celebi, H., & Gunaydin, B. (2003). Comparison of the effects of neuroleptanesthesia and enflurane or sevoflurane anesthesia on neuromuscular blockade by rocuronium. J Anesth, 17(2), 129-132.

Gurkan, Y., Canatay, H., Agacdiken, a., Ural, E., & Toker, K. (2003). Effects of halothane and sevoflurane on QT dispersion in paediatric patients. Paediatr Anaesth, 13(3), 223-227.

Kerssens, C., Ouchi, T., & Sebel, P.S. (2005). No evidence of memory function during anesthesia with propofol or isoflurane with close control of hypnotic state. Anesthesiology, 102(1), 57-62.

Tetralogy of Fallot: Literature eview

Tetralogy of Fallot is a congenital heart defect associated with systemic cyanosis, accounting for approximately 5 to 6% of all cases of congenital heart disease and is characterized by; ventricular septal defect, aortic override, pulmonary stenosis and right ventricular hypertrophy. It is the most common cause of blue baby syndrome with children diagnosed developing Tet spells. Sudden increases in cyanosis followed by syncope characterize Tet spells and may result in hypoxic brain injury and death. Environmental and genetic disorders are other causes of TOF; always associated with chromosome 22 deletions and DiGeorge syndrome and occurs slightly more often in males than in females. If left untreated, Tetralogy of Fallot rapidly results in progressive right ventricular hypertrophy due to the increased resistance on the right ventricle. This progresses to dilated cardiomyopathy which begins in the right heart chambers often leading to left heart failure. Actuarial survival…

References

Digilio, M.C., Casey, B., Toscano, A., Calabro, R., Pacileo, G., Marasini, M., et al. (2001). Complete Transposition of the Great Arteries: Patterns of Congenital Heart Disease in Familial Precurrence. Journal of the American Heart Association, 2809-2814.

Gelson, E., Gatzoulis, M., Lupton, M., Steer, P., & Johnson, M. (2008). Tetralogy of Fallot: Maternal and Neonatal Outcomes. British Journal of Obstetrics and Gynaecology, 398-402.

Jing-bin, H., Ying-long, L., Pei-wu, S., Xiao-dong, L., Ming, D., & Xiang-ming, F. (2010). Molecular Mechanisms of Congenital Heart Disease. Cardiovascular Pathology, 183-193.

Marshall, J. (2007). Caring for the Child with a Cardiovascular Condition. Maternal-Child Nursing Care, 853-884.

Secondary Career Option Cardiovascular Perfusionist

Second Career Option Cardiovascular Perfusionist

Second Career Option: Cardiovascular Perfusionist

Second Career Option: Cardiovascular Perfusionist

A cardiovascular perfusionist is a specialized health professional who operates the heart-lung machine during cardiac surgery and other surgeries that require cardiopulmonary bypass (Goeckner, Hicks, and Wanzer, 2011, p. 136). The perfusionist is a highly trained member of the cardiothoracic surgical team whose responsibilities center around the support of the physiological and metabolic needs of the cardiac surgical patient so that the cardiac surgeon may operate on a still, unbeating heart (Lackatta, 2002, p. 29). Perfusionists are vital to the completion of such operations, and are vital to the hospitals in which they work as these individuals are often responsible for purchasing equipment and supplies relative to their duties, hiring support technicians and overseeing department management and quality improvement regarding their area of work and expertise. In addition to playing…

References

American Board of Cardiovascular Perfusion. (2011). Recertification. Web. Retrieved

from: http://www.abcp.org/recertification.htm on 9 November 2011.

Goekner, B., Hicks, R. And Wanzer, L. (2011). Perioperative pharmacology: a framework for medication safety. Association of Operating Room Nurses Journal. 93.1: pp. 136. Web. Retrieved from: ProQuest Database.

Lackatta, E. (2002). Age associated cardiovascular changes in health. Heart Failure

ole of Spirituality in the Treatment of Depression

Over the last thirty years, one of the most interesting paradoxes in the study and treatment of depression has been that increased knowledge about the biomedical and genetic causes of the disease has been coupled with a renewed interest in the effect of religion and spirituality on human mental health and well-being. No matter how religion and spirituality are defined -- and many scholars and laypersons see no great distinctions between the two -- there are now hundreds of studies that demonstrate the beneficial effects of religion on both mental and physical health. Indeed, the more firmly held and intrinsic a person's religious convictions are, the more salutary the effect. eligious people are more optimistic, hopeful and trusting, and have more purpose and meaning in life than those with weak or no religious views. All of these qualities are of course lacking…

REFERENCE LIST

Ai, A..L. et al. (2005). "Prayer Coping, Positive Attitudes, and Cardiac Surgery" in Lee, A.V. Coping with Disease. Nova Science Publishers, Inc., pp. 23-64.

Auer, B. And J.A. Ang (2007). Torment of the Soul: Suicidal Depression and Spirituality. AuthorHouse.

Beck, A.T. And B.A. Alford (2009). Depression: Causes and Treatment. University of Pennsylvania Press.

Biebel, D.B. And H.G. Koenig (2010). New Light on Depression: Help, Hope and Answers for the Depressed and Those Who Love Them. Zondervan Publishing House.

Against All Odds: Preventing Pressure Ulcers in High-isk Cardiac Surgery Patients

There are three authors of the article reviewed who represent several degrees, including one master's degree, and certifications. The authors are (Cooper, Jones, & Currie, 2015):

Danielle Nicole Cooper, N, BSN, CCN-CSC

Sarah Layton Jones, N, BSN, CCN

Linda Ann Currie, N, MSN, ACNS-BC, CCN-CSC

The Authors have credentials that include Adult Health Nurse Specialist-Board Certified (ACNS-BC) and Critical Care Nurse -- Cardiac Surgery Certificate (CCN-CSC) certificates.

The article is peer reviewed and appears in the Critical Care Nurse journal and was published in October, 2015. The article sites twenty-two different sources, most of which were published within the last five years.

The title of the article includes the phrase "Against All Odds," which honestly seems a bit dramatic. The Virginia Commonwealth University Medical Center (VCUMC) nursing staff implemented preventative measures to decrease rates of all hospital-acquired pressure ulcers,…

References

Cooper, D., Jones, S., & Currie, L. (2015). Against All Odds: Preventing Pressure Ulcers in High-Risk Cardiac Surgery Patients. American Association of Critical-Care Nurses, 75-82.

Chest Tubes

Nursing -- Chest Tubes

As the field of nursing gains more respect around the world, nursing professionals and nursing students becomes increasingly aware of the high degree of specialized knowledge and practice that are necessary to be a competent or successful nurse. One of the more complex tasks and pieces of equipment will be the focus of this paper, which is chest tubes. There are a few types of chest tubes including wet, dry, and those with Heimlich valves. Chest tubes are used for very specific and delicate types of injuries, mostly to the lungs.

Trauma, disease, or surgery can interrupt the closed negative-pressure system of the lungs, causing the lung to collapse. Air or fluid may leak into the pleural cavity. A chest tube is inserted and a closed chest drainage system is attached to promote drainage of air and fluid. Chest tubes are used after chest…

References:

Advance for Nurses. Troubleshooting Chest Tubes. Available from:  http://nursing.advanceweb.com/Continuing-Education/CE-Articles/Troubleshooting-Chest-Tubes.aspx . 2012 September 23.

Bauman, M. & Handley, C. (2011). Chest tube care: the more you know the easier it gets. Available from:  http://www.americannursetoday.com/article.aspx?id=8256&fid=8172 . 2012 September 23.

Hudson, K. (2012). Chest Trauma: Nursing Care and Management. Available from:  http://dynamicnursingeducation.com/class.php?class_id=33 . 2012 September 23.

Medical Training.com. (2012). Chest Tube Care and Monitoring. Available from:  http://www.medtrng.com/blackboard/chest_tube_care_and_monitoring.htm . 2012 September 23.

Capital Project

esults and acceptability of the item for key stakeholders

Da Vinci is a lucrative product that has immense contributions to the delivery of health services in many health centres globally. The effectiveness of the product lies on its new entry into the modern market. Da Vinci production and use have enlightened the public and hospital fraternities on new approaches of managing surgery operations. The resultant effects that are going to be felt after using the product are more increasing and beneficial than using the old mechanisms. The innate objective of the tool will improve on delivery of surgery services in ways that are more safe, effective, and affordable to the public. Da Vinci was first introduced as a safe way of improving surgery operations in the hospitals. Moreover, the use of the product had not been made public. Now that the machine will be available in many health…

References

Athanasiou, T., Debas, H.T., & Darzi, A. (2009). Key topics in surgical research and methodology. Berlin: Springer.

Bahouth, M.N., Bahouth, M.N., Blum, K., & Simone, S. (2013). Transitioning into hospital-based practice: A guide for nurse practitioners and administrators. New York, NY:

Springer Pub. Co.

Gitman, L.J., & McDaniel, C.D. (2009). The future of business: The essentials. Mason, OH:

Jesus' Teachings, Prayer, & Christian Life

"He (Jesus) Took the Bread. Giving Thanks Broke it. And gave it to his Disciples, saying, 'This is my Body, which is given to you.'" At Elevation time, during Catholic Mass, the priest establishes a mandate for Christian Living. Historically, at the Last Supper, Christ used bread and wine as a supreme metaphor for the rest of our lives. Jesus was in turmoil. He was aware of what was about to befall him -- namely, suffering and death. This was the last major lesson he would teach before his arrest following Judas' betrayal. Eschatologically speaking, the above set the stage for the Christian ministry of the apostles, evangelists and priests. Indeed, every Christian is called to give of him or herself for the Glory of God and the Glory of Mankind. The message at the Last Supper was powerful. People have put themselves through…

Since modern medicine can sustain patients with proper medical follow-up for years, it becomes incumbent on the profession to follow the patients and provide them with the knowledge and tracking to insure that they are observing the procedures and medications which prolong their quality of life. Given hospitals' short-term orientation with the patients, there is a need to bridge patient care before, during and after acute-care visits.

While there are some nursing specialties which can be regarded as solely hospital- or community-based, many of the specialties call for a more holistic notion of patient care. y combining the CNS and NP specialties, this profession has a better chance of assuring better patient outcomes, and a better quality of life for the patient.

ibliography

ennett, .J. (1998). Psychiatric mental health nursing: thriving in a changing environment through outcomes-based measurements. Semin. Nurse Manage., 144-148.

erger, a.M.-F. (1996). Advanced practice roles for nurses…

Bibliography

Bennett, B.J. (1998). Psychiatric mental health nursing: thriving in a changing environment through outcomes-based measurements. Semin. Nurse Manage., 144-148.

Berger, a.M.-F. (1996). Advanced practice roles for nurses in tomorrow's healthcare systems. Clinical Nurse Specialist, 250-255.

Chaska, N.L. (2001). The Nursing Profession Tomorrow and Beyond. Thousand Oaks: Sage.

Cukr, P.L. (1997). The psychiatric clinical nurse specialist/nurse practitioner: an example of a combined role. Arch Psychiatr Nurs, 2-12.

Rossmond Jack for the Position of a First Assistant Surgical Technologist

I write to you in regards to the above applicant, Rossmund Jack. I recommend that you consider him for an entry-level position as a first assistant surgical technologist. Jack has the training, qualifications, and skills needed to effectively and efficiently undertake the role. He also has a strong passion for the field.

Jack will shortly be completing his surgical technologist degree at Mandl School's College of Allied Health; one of the top institutions in New York as far as allied health training is concerned. He has a solid understanding of the practical facets of surgical room procedures, modern surgical equipment, instrument set-ups, sterilisation techniques, patient-care techniques, as well as emergency care during surgery. His knowledge spans across a wide range of surgical disciplines including general surgery, orthopaedic surgery, spinal surgery, cardiac surgery, plastic surgery, thoracic surgery, and vascular surgery.…

Quality Development in Advanced Practice field knowledge in nursing: Proposal on Enhancing the dental health of children suffering Congenital Heart Disease

One of the most prevalent development abnormalities found in children is heart disease, and it occurs in about 8-10 in every 1, 000 births. Dental supervision of children with congenital heart problems calls for special care, due to their increased susceptibility to contagious endocarditis, which is associated with bacteremia caused by persistent dental processes. Additionally, these patients always have developmental enamel abnormalities that raises caries risk, and always have deprived oral health. This latter condition may be said to be due to cardiac health problems, whose care and attention may lead to the under-estimation of oral health and inadequate consideration. Additionally, continual administration of liquid drugs containing sucrose as sweetener may cause caries and gingivitis cases in children (Andersson et al. 2013a). Dental ailment may cause dental extractions in…

References

Andersson, A-C., Elg, M., Perseius, K-I. & Idvall, E. (2013a) Evaluating a questionnaire to measure improvements initiatives in Swedish healthcare. BMC Health Services Research, 13(48)

Andersson, A-C., Idvall, E., Perseius, K-I. & Elg, M. (2013b) Sustainable Outcomes of an Improvement Program: Do Financial Incentives Matter? Total Quality Management & Business Excellence

Balmer, R., Booras, G. & Parsons, J. (2010). The oral health of children considered very high risk for infective endocarditis. Int J Paediatr Dent. 20(3):173-8

Frankl, S.N., Shiere, F.R., Fogels, H.R. (1962). Should the parent remain with the child in the dental operatory? J Dent Child.29:150-163.

1. Subjective
Patient’s chief complaint: A man aged 69 comes to the emergency room with a sharp pain to his chest’s left side, lasting between 30 and 40 mins and then subsiding.
History of present illness: The pain has woken him up thrice in the last 7 days. He claims the pain first started roughly six months ago. Initially, however, the pain used to surface only occasionally, commonly while he was doing gardening. The patient’s past medical history reveals a diagnosis of hypertension twenty-five years back.
Precipitating/alleviating factors: The patient has been smoking a half-cigarette pack daily for the last forty-five years.
Family History: The patient has lost two brothers and his dad to heart disease. The patient does not report any other significant illness history in the family.
Social History: His typical pastimes include sharing a drink with pals and gardening.
Review of Systems: From a physical examination of…

(ACS Publication June 2006 A Growing Crisis In Patient Access to Emergency Surgical Care at (http://www.facs.org/ahp/emergcarecrisis.pdf)

Statement of Problem

There is a growing problem in the ability of individuals and communities to receive care, according to the American College of Surgeons, as the changing face of emergency care and medical care in general is putting patients at risk. The ACS and the AMA have both recently conducted professional surveys that indicate that the source of the problem is a lack of specialized surgical providers to cover existing trauma centers and a lack of those same staff members to help to establish new centers of care in areas, with the lowest numbers of provider services. (ACS Publication June 2006 A Growing Crisis In Patient Access to Emergency Surgical Care at (http://www.facs.org/ahp/emergcarecrisis.pdf)

The ACS Publication A Growing Crisis In Patient Access to Emergency Surgical Care stresses that the existing system is not…

Resources for Health 2006, 4:12 at  http://www.human-resources-health.com/content/4/1/12 

Fishman P.E. MD, Shofer, F.S. PhD, Robey J.L RN, BSN, Zogby, K.E. RN, BSN, Reilly, P.M. MD, Branas, C.C. MS, PhD, Pines, J.M. MD MBA, Hollander, J.E. MD. (October 2006), "The Impact of Trauma Activations on the Care of Emergency Department Patients With Potential Acute Coronary Syndromes" Annals of Emergency Medicine, 48: 4, pp. 347-353

Hofman, Primack, Keusch, & Hrynknow (Jan. 2005), "Addressing the growing burden of trauma and injury in low- and middle-income countries" American Journal of Public Health 95: 1 at  http://hestia.unm.edu.libproxy.unm.edu/search/i0090%2D0036/i00900036/1,1,1,B/l856~b1044007&FF=i00900036&1,1,1,0/startreferer//search/i0090%2D0036/i00900036/1,1,1,B/frameset&FF=i00900036&1,1,/endreferer/ 

Hospital Survey Sheds New Light on Diversions" (July 2004) Emergency Medical Services, at http://hestia.unm.edu/search/temergency+Medical+/temergency+medical/1,25,31,B/l856~b1044565&FF=temergency+medical+services&1,2,1,0

Mock, C.M. & Jurkovich, G.J. (1999) "Trauma System development in the United States," Trauma Quarterly 14:3 pp. 197-209.

Evidenced-Based Pactice (EBP)

The objective of this study is to eview an aticle titled "Evidence-Based Pactice Habits: Tansfoming Reseach into Bedside Pactice" (Rauen, Flynn, Bidges 2009 p 46). The authos point out that nusing pactice in the United States is moe focused on the taditional-based pactice than evidence-based pactice. Many pactices in citical nusing cae ae still continuing despite that the eseaches contadicting the pactices. The study believes that insufficient administative suppot, lack of time, limited access to infomation ae the baies in the clinical-based pactice thee decades ago still exist today. While the benefits of evidence-based pactice ae well undestood, nevetheless, thee is a still a baie in tansfoming the eseach findings into pactice. To eliminate the poblems, the acceditation bodies that evaluate and mandate the EBP (evidence-based pactice) assist in moving the eseach fowad. The authos suggest that it is citical to developing a cultue of inquiy that…

references and research studies to find solutions to the patient's problems suffering from acute respiratory distress, heart failure, cardiac surgery and sepsis. There is also a need to make a research on the studies that discuss the hemodynamic parameters in backrest versus supine elevated position, prone position and lateral position. The authors argue that the evidence-based practice can assist the nursing practitioner to observe the difference between CVP (central venous pressure) and PAP (pulmonary artery pressure) in patients in supine and flat position compared with the position that is more than the spontaneous variability. Thus, the evidence-based research assists in enhancing a greater understanding of the positioning of the patient when monitoring patients" hemodynamic parameters.

Rauen, Flynn, Bridges (2009) further point out that a method nurses can employ in taking accurate measurements of patients hemodynamic parameters is to use the position specific reference in order to correct the hydrostatic pressure. The author believes that nurses can measure the output of the thermodilution cardiac when the bed is elevated by up to 20°. The authors also believe that the application of EBP requires nurses to investigate series of studies about patients in cardiac ICU (intensive care units) and patients in medical-surgical units to assist in obtaining the CVP and PAP of patients' supine, as well as patients with bed head elevation from 0° to 60°.

Conclusion

The EBP is the conscientious use of the available evidence to make effective decisions regarding the patient care. With integration of the clinical evidence and clinical expertise as well as using a sound methodology, nursing practitioners are able to make decisions to improve the patients' healthcare.

Reference

Nursing and eligion Practice

ELIGION AND NUSING PACTICE

Nursing success depends on the ability to put the patient in a state of rest and comfort as much as it is about administering the prescriptions of the doctor. To secure the rest of the patient, nurses need to understand their needs and show respect to their beliefs and values. This requires courteous and open communication with the patient and adopting a patient-centric orientation. Along with other factors, the religious background of the patient makes a lot of difference to their values and expectations. eligious doctrines and practices may differ across religions and denominations such as Jehovah's Witnesses, Muslims, Seventh Day Adventists and Scientologists and may impose restrictions on certain kinds of interaction between nurse and patient or on certain forms of treatment. Moreover, people with a different religious background are not usually aware of such differences. Therefore, it is necessary for…

References

Banja, J.D. (2010). Overriding the Jehovah's Witness patient's refusal of blood: A reply to Cahana, Weibel, and Hurst. Pain Medicine, 10(5), 878-882. doi: 10.1111/j.1526-4637.2009.00648.x.

Charles, C.E., & Daroszewski, E.B. (2012). Culturally competent nursing care of the Muslim patient, Issues in Mental Health Nursing. 33(1), 61-63. doi: 10.3109/01612840.2011.596613.

Cort, M., & Cort, D. (2008). Willingness to participate in organ donation among Black Seventh-Day Adventist college students. Journal of American College Health, 56(6), p. 691-697. Retrieved from EBSCO Academic Search Primer.

Effa-Heap, G. (2009). Blood transfusion: Implications of treating a Jehovah's Witness patient. British journal of nursing, 18(3), 174-177.

CPT Codes

CPT coding is a fact of life in the provision of healthcare today. CPT stands for Current Procedural Terminology, and is a system first developed by the AMA (American Medical Association) in 1966 "to convert widely accepted, uniform descriptions of medical, surgical and diagnostic services rendered by healthcare providers into five-numeric codes" (Medical Coding Experts, p. 1). CPT codes are necessary in order for accurate reimbursement to be obtained for services rendered and procedures performed. Inaccurate coding may result in a loss of reimbursement or, should extra codes be assigned and/or submitted, insurance fraud.

Category one CPT codes are the standard set of codes, and are divided into six sections. These sections are: evaluation and management; anesthesiology; surgery; radiology; pathology and laboratory; and medicine (Medical Coding Experts, p. 4). Each section has a discrete span of numbers that applies to the procedures classified under that section heading. They…

References

American Medical Association. (2012). Chapter One: Introduction to CPT® Coding. Retrieved from  https://catalog.ama-assn.org/MEDIA/ProductCatalog/m2310979/Intro%20to%20CPT%20Coding%20-%20Chapter%201%20Sample%20Pages.pdf 

American Medical Association. (2012). CodeManager: CPT Code/Relative Value Search. Retrieved from  https://ocm.ama-assn.org/OCM/CPTRelativeValueSearch.do 

Medical Coding Experts. CPT Basics. Retrieved from http://www.medicalcodingexperts.com/Flashdemo/CPTbasics.html

Quizlet. (2010). Steps for CPT Coding. Retrieved from  http://quizlet.com/1858882/steps-for-cpt-coding-flash-cards/

In order to truly be judged by his/her peers, a physician in an outlying area like Redding should be periodically visited by others to evaluate outcomes.

It is clear that Tenet's top management failed its ethical responsibilities in two ways: (1) they failed to reinforce the ethical guidelines central to any hospital or medical management group, and (2) they failed to monitor the performance of their institutions to insure that they were ethically compliant.

How Individual's Professional Conduct is Guided or Not Guided by the Code of Ethics.

Individuals in the medical profession take an oath to conduct themselves in an ethical manner. Nurses have a 9-point oath, which is fairly far-reaching. Physicians' oaths are shorter, but no less binding. Since each profession (this includes firemen, lawyers and accountants, not just healthcare professionals) has an important 'self-policing' element, the primary enforcer of ethical conduct is the professional his/herself.

As we…

Bibliography

City Data. (2007). Redding, California. Retrieved August 10, 2007, from City-Data:  http://www.city-data.com/city/Redding-California.html 

Weintraub, a. (2002, November 25). A Scandal-Ridden Tenet Stands by Its Man. Business Week, p. n.p.

Wynne, M. (2003, July). Tenet Healthcare, Scandal in General Hospitals. Retrieved August 10, 2007, from U. Of Washington:  http://www.uow.edu.au/arts/sts/bmartin/dissent/documents/health/tenet2002story.html 

There are about 2 million angioplasties done in the U.S. each year. Given Redding's size, that means that about 1,500 angioplasties per year should be performed in that town. In fact, over 7,000 were performed per year.

Chlorhexidine to Prevent Ventilator-Associated Pneumonia

Ventilator-associated Pneumonia (VAP) is one of the most common infections acquired by patients who've utilized mechanical ventilation in health care facilities. This infection is a major concern because it leads to several deaths, extends hospital stay, and increases the costs of medical care services. The infections are commonly developed when pathogenic bacteria colonize the aero digestive tract. According to Babcock et al. (2004), the prevention of these infections has usually entailed preventing bacteria colonization and the subsequent aspiration of the contaminated secretions to the lower airways. Given the increased incidents of ventilator-association pneumonia, this paper proposes the use of chlorhexidine in preventing it. Chlorhexidine has proven effective in prevention of VAP as shown in baseline data. The implementation of this proposed procedure in patient care will entail various logistics based on approval from organizational leadership.

Methods for Obtaining Necessary Approval and Support

One of the…

References

Babcock, H., Zack, J.E., Garrison, T., Trovillion, E., Jones, M., Fraser, V.J., & Kollef, M.H. (2004). An educational Intervention to Reduce Ventilator-associated Pneumonia in an Integrated Health System. Chest, 125 (6), 2224-2231.

Hoshijima et al. (2013, December). Effects of Oral Hygiene Using Chlorhexidine on Preventing Ventilator-associated Pneumonia in Critical-care Settings: A Meta-analysis of Randomized Controlled Trials. Journal of Dental Sciences, 8(4), 348-357.

Keyt, H., Faverio, P. & Restrepo, M.I. (2014, June). Prevention of Ventilator-associated Pneumonia in the Intensive Care Unit: A Review of the Clinically Relevant Recent Advancements. Indian Journal of Medical Research, 139, 814-821.

Klompas M., Speck, K., Howell M.D., Greene, L.R., & Berenholtz, S.M. (2014). Reappraisal of Routine Oral Care with Chlorohexidine Gluconate for Patients Receiving Mechanical Ventilation: Systematic Review and Meta-analysis. JAMA Internal Medicine, 174 (5), 751-761.

Oral Hygiene Methodology

There is a significant amount of research that shows statistical correlation between oropharyngeal bacterial colonization and the presence bacteria responsible for ventilator associated pneumonia (VAP). Several interventions have been shown as effective in reducing the incidence of VAP, but many have not gained widespread clinical use in a majority of hospitals. esearch does show that the amount of oropharyngeal bacteria present in the mouth and oral cavity has a relationship to the propensity of developing VAP. This is likely due to the lack of appropriate levels of oral hygiene combined with the bacterial colonization of ventilator equipment. We expect that oral and mouth washes regularly administrated that include chlorohexedine will kill bacteria and reduce incidence of VAP infections on ICU patients. The aim of this study will be to survey the efficacy of chlorohexdedine mouth washes in a randomized group of patients who were placed in an…

REFERENCES

Chlebicki, P., & Safdar, N. (2007). Topical chlorhexidine for prevention of ventilator-associated peneumonia: A Meta-analysis. Critical Care Medicine, 35(2), 595-602.

Collard, H., & Saint, S. (2005, June). Prevention of Ventilator Associated Pneumonia. Retrieved from ahrq.gov:  http://archive.ahrq.gov/clinic/ptsafety/pdf/chap17.pdf 

Dodek, P., et al. (2004). Evidence-Based Clinical Practice Guidelines for Prevention of Ventilator-Associated Pneumomia. Annals of Internal Medicine, 141(4), 305-13.

Lansford, T., et al. (2007). Efficacy of a Pneumonia Prevention Protocol in the Reduction of Ventilatory-Associated Pneumonia in Trauma Patients. Liebert Open Access- Surgical Infections. 8 (5): 5505-10.

business plan will help determine effective ways to improve recently reported HCAHPS scores for the organization as a whole. The detailed plan and report shows how educational challenges or delays may play a part in influencing low HCAHPS scores. Shared accountability along with an effective presentation will allow the board to see not only what causes HCAHPS low scores, but how the organization can avoid such low scores. Educational dynamics within any given population may potentially influence the higher occurrence of HCAHPS scores. Educational delays that stem from developmental issues like mental illness or chronic disease and educational delays brought on by financial hardship will be discussed. The strategic plan will also incorporate ideas of shared accountability between personnel, payers, patients, and medical providers.

Educational Delays

Educational delays can exist for several reasons. The most commonly interpreted are physical and mental delays. People with mental health issues like depression and…

Ethical and Legal Issues Depicted in the Movie, John Q?

From beginning to end, "John Q" is a movie full of moral and ethical quandaries. It offers viewers a clear glimpse at private and public entities' obligation to engage in ethically-right routine decision-making for their respective communities. John lacked the required health insurance to cover his son's cardiac surgery expenses. The Hope Memorial Hospital, electing not to play a "Good Samaritan," does not agree to perform the surgery without being assured payment. Thus, John is faced with the moral quandary of accepting fate and readying for the funeral of his son (as suggested by Rebecca Payne, the Hospital's administrator), or somehow procuring the money needed. Given the urgency of his son's case, the second option is rather daunting. Ultimately, John ends up holding emergency room patients and staff members hostage, to ensure his son is catered to (angura, 2011).

Another…

Bibliography

Bangura, G. B.-L. (2011, August 28). ETHICAL ANALYSIS OF "JOHN Q" MOVIE. Retrieved from Bailama Dynasty:  http://bailamadynasty.blogspot.com/2011/08/ethical-analysis-of-john-q-movie.html 

HubPages. (2015, December 26). John Q Analysis: Ethical & Moral Dilemmas. Retrieved from hubpages.com:  http://hubpages.com/entertainment/Morality-and-Ethics-in-John-Q

Marcia Hegstad

The case study of Marcia Hegstad is a good example of critical thinking at work (ubenfeld & Scheffer, 2010, pp. 305-307). In this case study it is evident that she identified a need, fully engaged herself in it, she focused on the questions and was action oriented. She considered this quest a long journey she was willing to purse.

This case study not only presents real life nursing challenges and how to overcome them, but also offers insight on both critical thinking and evidence-based practice. This case study is an ideal model for any nursing student and offers guide to hands on practice. The case study is lesson packed and begins with Hegstad's identification of patients' needs. She realized that "post-cardiac surgery patients to the ICU with deep sternal wound issues" (ubenfeld & Scheffer, 2010, p. 306) and based on this she was concerned and curious to find…

References

Green, C. (2000). Critical thinking in nursing: Case studies across the curriculum. New Jersey: Prentice Hall Health.

Rubenfeld, G.M., & Scheffer, B.K. (2010). Critical Thinking Tactics for Nurses. Sudbury: Jones and Burtlet Publishers.

eligion and health have long been linked, and continue to be so in most cultures around the world. In fact, both mental and physical health problems were once believed to have supernatural or spiritual origins, a belief which persists until this day in spite of empirical evidence showcasing the biological and chemical causes of illnesses (Koenig, 2000). egardless of whether or not religion is a worthwhile social institution, religion, spirituality, and practices like prayer remain central to the lives of most people. eligion can be inextricably linked with personal and cultural identity, and can greatly inform both medical decisions and health practices including lifestyle choices. There is also a notable link between religiosity and a number of health outcomes including morbidity and mortality rates, proven in empirical studies. The literature tends to support a strong connection between prayer and stress relief in particular, as prayer and religion are widely believed…

References

Bearon, L.B. & Koenig, H.G. (1990). Religious cognitions and use of prayer in health and illness. The Gerontologist 30(2): 249-253.

Davis, L.I. & Owens, C. (2013). The impact of religion on health practices. American Association of Colleges of Pharmacy. Retrieved online:  http://www.aacp.org/governance/SIGS/hdcc/Documents/Webinar%20Materials/Impact%20of%20Religion%20Webinar.pdf 

Koenig, H.G. (2000). Religion and medicine I. International Journal of Psychiatry in Medicine 30(4): 385-398.

Koenig, H., King, D. & Carson, V.B. (2012). Handbook of Religion and Health. Oxford University Press.

As a student who had only just completed the first semester of the course, I had no experience with pediatric patients prior to the shadowing task. Thus, the nurse shadowing task was a rather exciting experience for me, exposing me to several new aspects of pediatric care (Burkitt et.al 2001). However, its most heart- rending element was congenital patient care – seeing babies being born with an illness was a rather touching experience.
While a few of my peers were fairly well- informed on the subject of pediatric care, I wasn’t. Most of the information I gleaned and things I saw in the course of my nurse shadowing assignment were new to me. The nurse practitioner I was tasked to shadow provided me with detailed information about appendicitis, which is apparently a widely- occurring pediatric issue and, at times, may take long to diagnose (Gaydos et.al 2005). Further, I gained…

The patient should drink less, participate in more physical activity and should eat a better diet. The blood pressure and cholesterol both need to come down immediately.

Question 6

The patient needs to take the recommendations in question 5 or he likely has a very dim future if his BP and cholesterol is not lowered a lot. Blood pressure should be measured after the patient has rested for at least five minutes. He should be instructed in advance of the appointment what not to eat or drink so that the test result is not improperly influenced (e.g. drinking caffeine).

Question 7

There is no advancement or progression in symptoms but blood pressure is still entirely too high. It needs to drop by at least 30 points to be within a non-hypertension range. Needs to be made clear to patient that while he is feeling fine for now, that will change…

For example, in these procedures it is often difficult to open the patient's mouth wide enough for laryngoscopy and intubation, thus creating the possibility that cardiopulmonary changes may be present and the "probability o lesions in oesophagus, bowel, kindneys, skin and joints." This information would not be known if not for this study and its reported findings.

The study's conclusion is that the use of thoracic epidural anesthesia to sevoflurane based inhalation "may be a suitable technique for thoracic surgery in achalasia due to sclerodermic patients." The reason for this conclusion is that the study found that this procedure "can provide a smooth anesthesia course and a rapid recovery, with hemodynamic stability, and also having pain-free postoperatively." More so, the study found that providing anesthesia without neuromuscular blockade and non-intravenous opioids has "provided a shorter recovery time."

Clearly this specific case study has important and practical implications to the practice…

Bibliography

Erol, Demet Dogan, M.D. (2006): "Thoracic Epidural Blockade in an Elderly with Achalasia Due to Scleroderma for Thoractomy, Esophageal Myotomy and Cystotomy-Capitonnage. The Internet Journal of Anesthesiology. Vol. 11, Number 1.

Learning Objectives:

In support of the Terminal Objective, several key learning objectives will drive the content and curriculum for nurses undergoing the present training course. Primary among them, the training course is designed to create a standardized set of behaviors amongst nurses that conform with existing and evolving best practices in the perioperative care of CABG patients. This means that course content and design will be geared toward achieving procedural and professional consistency amongst attending nurses where preoperative, intraoperative and postoperative care are concerned.

An additional learning objective is to ensure that outgoing students are informed in the ethical and personal dimensions of the profession. Coronary surgical procedures are inherently serious in nature as are the heart and circulatory conditions that typically require such procedures. Therefore, it is of critical importance that nurses are trained in the proper bedside manner to approach patients, families and extended support systems with potentially…

Works Cited:

Aroesty, J.M. (2010). Patient information: Recovery after coronary artery bypass graft surgery (CABG). Up To Date, 19(2).

Cleveland Clinic (CC). (2011). Diseases and Conditions. my.ClevelandClinic.org.

Kulick, D. & Shiel, W.C. (2011). Coronary Artery Bypass Graft Surgery. MedicineNet.com.

National Heart Lung and Blood Institute (NHLBI). (2010). What is Coronary Artery Bypass Grafting. National Institute of Health.

Falls

THE ISSUE OF ACCIDENTAL FALLS

At some point, anyone who had learned how to walk has had the experience of falling down -- it is a universal experience for infants as they gain ambulatory ability. In hospitals, however, the accidental fall is the most reported type of patient safety incident, with elderly patient populations displaying a particular vulnerability (Oliver 2007, p.173). Approximately one-third of adults over the age of sixty-five will experience an accidental fall this year (CDC 2012, n.p.) Fischer (2005) offers some clarification as to how these incidents should be defined -- the simplest basic definition is "a sudden, uncontrolled, unintentional, downward displacement of the body to the ground or other object" (p822). This definition takes into account the unpredictable nature of the incident, and the fact that it frequently involves a certain loss of control on the part of the patient; it also reminds us that…

References

CDC (2012). Adult falls. Web. Accessed at: http:/ / www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.htm

Currie, LM. (2006). Fall and injury prevention. Annual Review of Nursing Research. 24(1):39-74.

Fischer ID; Krauss MJ; Dunagan WC et al. (2005). Patterns and predictors of inpatient falls and fall-related injuries in a large academic hospital. Infection Control and Hospital Epidemiology. 26(10):822-7.

Grubel, F. (1959) Falls: A principal patient incident. Hosp Manage. 88:37-8.

Aortic dissection is a disease of the wall of the aorta in which the aortic blood bursts into the muscular layer of the great artery, thus forming a blood filled channel along the planes of the muscularis layer. This false lumen can re-rupture back into the true lumen, through a second distal intimal tear, creating a biluminal or double barrelled aorta. Due to weakened walls, there is threat of rupture into the surrounding tissue with fatal consequences. (Boon, , Colledge, Walker, & Hunter, 2010)

The pathophysiology behind the condition is often a spontaneous or iatrogenic tear in the intima. However, in about five to ten percent of patients, these tears are absent. An intimal tear can occur anywhere along the aorta, although a vast majority of tears are found within ten centimeters of the aortic valve. The dissection may extend towards the heart, affecting the coronary arteries, or it may…

REFERENCES:

Duranki. (n.d.). Type an aortic dissection - the silent killer. Retrieved from  http://duranki.hubpages.com/hub/Beware-High-Blood-Pressure-It-will-Kill-You  -- You-Wont-See-It-Coming

Erbel, R., Alfonso, F., Boileau, C., & Dirsch, O. (2001). Diagnosis and management of aortic dissection*.European Heart Journal, 22(18), 1642-1681. Retrieved from  http://www.escardio.org/guidelines-surveys/esc-guidelines/GuidelinesDocuments/guidelines-aortic-dissection-FT.pdf 

Multum, C. (2012, Feburary 12). Morphine injection. Retrieved from  http://www.drugs.com/pro/morphine-injection.html 

Nicholas A. Boon, Nicki R. Colledge, Brian R. Walker, John A.A. Hunter.(2010). Davidson's Principles and Practice of Medicine . India, Elsevier.

In year 1799 anesthetic properties of Nitric Oxide were discovered by Humphery Davy (1778-1829) he advised that the by using nitric oxide, pain and shock of the surgical procedure can be negated. Third person who continue with Morton and ells philosophy was Charles T. Jackson. The Fourth man who contributed to anesthetics was Thomas Mortan (Blatner, 2009). In the year 1848 James Simpson used chloroform in obstetric surgery, he used diethyl ether to anesthetize a women with a pelvic deformity for delivery (kodali, 2009) and in year 1853 John Snow did a successful induction of chloroform to her Majesty Queen Victoria at the time of Prince Leopold's Birth and also on Fenny Longfellow who wrote to her poet brother that this use of ether is certainly the greatest blessing of this era (Longfellow, 1956). In the year 1885-illiam Halsted introduced the nerve block. In 1891 Heinrich Quincke demonstrated the process…

WORKS CITED

Bergman, Norman. History of Anesthesia. chua2.fiu.edu.  http://ahahq.org/Bulletin/AHA_GB_1991-10.pdf  .Retrieved from 14th Jan 2013.

Conquering surgical pain: Four men stake their claims. (2012). Massachusetts General

Blatner, Adam. The discovery and invention of Anesthesia. Blatner.com.  http://www.blatner.com/adam/consctransf/historyofmedicine/4-anesthesia/hxanesthes.html . Retrieved on 14th Jan 2013.

Fadden, John. Cultural, Environmental and Genetical influences on drug therapy. Jbpub.com. http://samples.jbpub.com/9780763786076/86076_CH03_FINAL.pdf . Retrieved on 14th Jan 2013.

Pharmaceutical industries have to operate in an environment that is highly competitive and subject to a wide variety of internal and external constraints. In recent times, there has been an increasing trend to reduce the cost of operation while competing with other companies that manufacture products that treat similar afflictions and ailments. The complexities in drug research and development and regulations have created an industry that is subject to intense pressure to perform. The amount of capital investment investments required to get a drug from conception, through clinical trials and into the market is enormous. The already high-strung pharmaceutical industry is increasingly investing greater amounts of resources in search of the next "blockbuster" drug that can help them gain market position and profits. Laws, regulations and patents are important to the industry while spending billions of dollars in ensuring the copyright of their products.

It is the intention of this…

Bibliography

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Ansoff, H.I. (1965). Corporate Strategy. New York, NY: McGraw-Hill.

Ashour, M.F., Obeidat, O., Barakat, H., & Tamimi, A. (2004). UAE Begins Examination of Patent Applications. Tamino.com. Retrieved January 18, 2004, from the World Wide Web:  http://www.tamimi.com/lawupdate/2001-01/intprop.htm 

Bain, J.S. (1954). Economies of scale, concentration, and the condition of entry in twenty manufacturing industries. American Economic Review, 44, 15-36.

In the third trimester of pregnancy, caution must be taken concerning congestive heart failure, hypertension and decreased renal and hepatic function, interstitial nephritis, hyperkalemia, hyponatremia and renal papillary necrosis, anticoagulation abnormalities, leucopenia, granulocytopenia and thrombocytopenia. The use of Celecoxib is aimed primarily at suppressing pain and inflammatory stimuli, but it may contribute to NSAID gastrointestinal toxicity. The lowest possible dose of celecoxib should be prescribed and taken. On the whole, NSAIDs can mask the usual signs of infection, therefore, caution must be taken in the presence of existing controlled infection. The physician should investigate symptoms and signs, which suggest liver dysfunction or abnormal liver lab results.

On September 30, 2004, Merck and Company voluntarily withdrew rofecoxib from the American and world markets because of its association with an increase in cardiovascular incidence (Keldaya 2005). A major Food and Drug Administration study linked the medication to a three-fold rise in the…

Bibliography

Avicena. (2005). Charcot-Marie-Tooth Syndrome. Disease Targets. Avicena Group. http://www.avidenagroup.com/disease_targets/neuromuscular/cmt_php?print=on

Kedlaya, D. (2005). Charcot-Marie=Tooth Syndrome. eMedicine.com, Inc. http://www.emedicine.com/arthoped/topic43.ht

National Center for Biotechnology Information (2005). Charcot-Marie-Tooth Syndrome. Genes and Diseases. U.S. National Library of Medicine.  http://www.ncbi.nlm.nih.gov/books/bv_fcgi?call=bv.view.ShowSection&rid=gnd.section.197 

National Human Genome Researc Institute. (2004). Learning About Charcot-Marie-Tooth Disease. National Institutes of Health.  http://www.genome.gov/11009201

References

Boulton, Martha (2005) Exploring alexithymia, depression, and binge eating in self-reported eating disorders in women. Perspectives in Psychiatric Care

Dahm, Lori (2005) Obesity update: are we getting any thinner?(Special Report)

Private Label Buyer

Merrick, Joav (2005) Psychosomatic reasons for chronic pains.(Editorial)

Southern Medical Journal

____(2006) Obese people may be more sensitive to pain.(NEWS Breaks)(Brief article) Nutrition oday

PORER, LAWRENCE C. WAMPLER, RICHARD S (2000) Adjustment to Rapid Weight Loss. Families, Systems & Health

Rubin, Jay J. (2005) Psychosomatic pain: new insights and management strategies.(CME opic: Psychosomatic Pain) Southern Medical Journal

ucker, Miriam E. (2005) Depression tied to poor adherence to cardiac Rx: results of two studies show that use of aspirin and [beta]-blockers was lower in depressed patients.(Psychosomatic Medicine) Clinical Psychiatry News

MEHODOLOGY

his study will seek to determine whether or not obese post operative patients have a higher incidence of psychosomatic disorders and illnesses than non-obese post op…

The need for this study is evident. The cost factor of psychosomatic illnesses may be reduced if it can be determined whether or not the obese patient population has a higher incidence of psychosomatic illness in post op. If it does then future steps can be taken to better prepare the obese patient population for surgery to reduce the incidence of post op psychometric illness.

REFERENCE

Tucker, Miriam E. (2005) Depression tied to poor adherence to cardiac Rx: results of two studies show that use of aspirin and [beta]-blockers was lower in depressed patients.(Psychosomatic Medicine) Clinical Psychiatry News

Electrocardiogram

Currently there are different types of tests to study the behavior of the heart and monitor it. These tests are extremely important, because let us know in time if the heart is failing or has a problem. And because of that, today we submit to treatment or surgery to correct them when they are still small and manageable, before our life is at risk. The electrocardiogram, ECG or EKG, is one of those tests.

The electrocardiogram (ECG / EKG) is the graph obtained with the electrocardiograph to measure the heart's electrical activity as a continuous graphic tape. It also helps to know the duration of the cardiac cycle. It is the main instrument for cardiac electrophysiology and has a significant role in screening and diagnosis of cardiovascular diseases, metabolic disorders and predisposition to sudden cardiac death (Daja, eljin, eljin, 2001). The ECG has the advantage of being a medical…

References

Alwan M., Dalal S., Mack D.' Kell S.W., Turner B., Leachtenauer J. And Felder R. (2006) 'Impact of Monitoring Technology in Assisted Living: Outcome Pilot', IEEE Trans on Info Tech in Biomed, Vol. 10, No.1,192-198

Daja, N., Reljin, I. And Reljin, B., (2001). Tele-monitoring in cardiology -- ECG transmission by mobile phone, Annals of the Academy of Studenica 4:63-66.

Forkner-Dunn J. (2003) 'Internet-based Patient Self-care: The Next Generation of Health Care Delivery', J Med Internet Res., Vol.5, No. 2:e8

Madias J. (2008). Manual-based Vs Automation-based measurements of the amplitude of QRS complexes and T. wave in patients with edematous states -- clinical implications. J. Of Electrocardiography; 41(1):13-8.

new nurse graduate position.

Like most nursing students, when I was growing up I began to see myself as a caretaker; I always wanted to help people any way that I could. In middle and high school I volunteered at the local hospital from time to get a feel for what nursing would really be like, and this experience only made me want to pursue the career more. Now my dreams are becoming a reality -- I was accepted into a two-year BSN program at UNC, and I have been working as a nursing assistant on the general surgery floor at UNC Hospital since May, 2010. I love my job and can't wait to continue my education and gain more experience.

Please describe a time when you provided exceptional patient care.

One incident from my clinical experiences stands out in my mind as a quintessential example of what nursing is…

reason I selected the University of Alabama at Birmingham School of Nursing for graduate studies in nursing is because I ultimately seek to become a leader in the field of nursing, and there are several facets of this institution that legitimize its "vision to sustain nursing leadership worldwide." In particular, I was attracted to the synthesis of different disciplines and areas of erudition that the UAB School of Nursing emphasizes as part of its graduate education in this field, which include various aspects of management, economics, information technology, marketing and consultation to equip graduates with the necessary skills to perform as leaders within this profession.

It is increasingly necessary for nurses in advanced positions to utilize evidence-based practices as part of their means to fulfilling their responsibilities. The UAB School of Nursing, with its research center providing funded opportunities to counter some of the most pressing health care issues in…

References

Egenes, K.J. (2012). The nursing shortage in the U.S.: a historical perspective. Chart. 110(4), 18-22.

Harper, D.C. (No date). About our school. www.uab.edu. Retrieved from  http://www.uab.edu/nursing/home/about 

Marelli, T.M. (2013). The good, the bad and the ugly in the changing healthcare landscape: the role of nurse practitioners in meeting increasing demand for primary care (the good), CMS and contractor oversight of home health agencies (the bad), and the sad demise of the Medicaid hospice benefit in Louisiana (the ugly). Home Health Care Nurse. 31(3), 121-123.

UAB Nursing. (2013). Nurse practitioner family primary care. www.uab.edu. Retrieved from  http://www.uab.edu/nursing/home/images/stories/info_sa/MSN_Flyer_NP_Family.pdf

Schneck Medical Center

Provide a description of the company, its mission, and values

SMC (Schneck Medical Center) is a nonprofit healthcare organization that provides specialized and primary care services. The center was established in 1911 with a donation of five thousand dollars and a land from Mary Schneck (Jcr, 2007). It was established in memory of the founder's Husband to provide healthcare requirements to people of Jackson County. Initially, the center had a seventeen-bed capacity but it has now developed to ninety five-bed capacity. SMC celebrated its 100th centenary in 2011. This medical center is located in Jackson Country where it provides medical services to people of this area and the surrounding communities. Schneck Medical Center provides a full continuum of primary care services (Jcr, 2007). Particularly the medical center focuses on the health of women, noninvasive cardiac care, bariatric surgery, cancer care and joint replacement. Schneck Medical Center provides…

References

Biller, J. (2008). The interface of neurology & internal medicine. Philadelphia: Wolters Kluwer Health/Lippincott Wiliams & Wilkins.

Cribb, A. (2005). Health and the good society: Setting healthcare ethics in social context. Oxford: Clarendon Press.

Rahman, N., & de Feis, G.L. (2009). Strategic decision-making: models and methods in the face of complexity and time pressure. Journal Of General Management, 35(2), 43-59.

Johnson, K., Uecke, R., & Austin, R.(2006). The essentials of project management. New York: Harvard Business Press.

Nurses are considered the backbone of the medical care-giver community. Good quality patient care centers on having a competent educated nursing labor force. There is a wealth of empirical evidence that has demonstrated Baccalaureate (BSN) nurses are associated with fewer medication errors, lower mortality rates, and greater overall positive patient outcomes than nurses at lower levels of educational achievement. For example, Brady, Malone, and Fleming (2009) performed an extensive literature review and found that BSN nurses made fewer medication errors than their less educated counterparts. Aiken and associates (2003) found a strong link between N education level and patient outcomes. Their findings indicated that for every ten percent increase in the proportion of BSN nurses in a surgical unit there was a four percent decrease in the risk of death to patients. In a large study of nearly 47,000 patients conducted at the University Toronto it was found that hospital…

References

Aiken, L.H., Clarke, S.P., Cheung, R.B., Sloane, D.M., & Silber, J.H. (2003). Educational levels of hospital nurses and surgical patient mortality. Journal of the American Medical Association, 290, 1617-1623.

Brady, A.M., Malone, A.M., & Fleming, S. (2009). A literature review of the individual and systems factors that contribute to medication errors in nursing practice. Journal of Nursing Management, 17(6), 679-697.

Friese, C.R, Lake, E.T., Aiken, L.H., Silber, J.H. & Sochalski, J. (2008). Hospital nurse practice environments and outcomes for surgical oncology patients. Health Services Research, 43(4), 1145-1163.

Profetto-McGrath, J. (2003). The relationship of critical thinking skills and critical thinking dispositions of baccalaureate nursing students. Journal of Advanced Nursing, 43(6), 569- 577.

Veterinary Nursing Anesthesia and Analgesia Case Journal

The objective of this study is to address anesthesia needs in two specific cases with the first being a 12-week-old Jack Russell puppy and the second being a 12-year-old geriatric cat.

12-Week-old Jack Russell Puppy

This 12-week-old Jack Russell Puppy has eaten a babies dummy. This case study will highlight the anesthesia requirements and protocol and highlight the relevance of effect on renal function, speed of recovery, analgesia, emphasis on knowledge and understanding. Even at 12-weeks of age, this puppy is considered a pediatric patient according to the work of Gleed and Seymour (1991). This means that the patient has a higher oxygen requirement that the adult. The tongue of this patient due to his age is large and the airway is small in diameter. As well, there is a lower functional renal capacity in this age patient all of which make the…