Catheter Essays (Examples)

Quality Evidence From ickard, C.M., et al. (2012)

The objective of this study is to critically appraise quality evidence in the work of ichard, et al. (2012) which focuses on routine vs. clinically indicated replacement of peripheral intravenous catheters: A andomized Controlled Equivalence Trial. The focus of the critique will be on the methodology, results, implications for clinical practice and further research.

Schultz et al. (2010) reports that randomized controlled trials "when they are appropriate designed, conducted, and reported, represent the gold standard in evaluating health care interventions." (p.1) However, the absence of methodological rigor results in biased results in randomized trials. In order for a trial to be accurately assessed, there must be clear and transparent information presented in the study's methodology and findings. Due to the absence of adequacy in the reporting of studies, the Consolidated Standards of eporting Trials (CONSOT) was developed in 1996 and revised in…

References

Rikard, CM, et al. (2012) Routine vs. clinically indicated replacement of peripheral intravenous catheters: a randomized controlled equivalence trial. The Lancet. Vol. 380. 22 Sept. 2012.

Schulz, KF et al. (2010) CONSORT 2010 Statement: Updated Guidelines For Reporting Parallel Group Randomized Trials. Open Medicine 2010;4(1);E60.

Evidence-Based Solution to educing Incidence

The goal of this assignment is to increase my ability to appraise and synthesize evidence to provide experience a logical argument in support of a proposal for practice change, and to provide experience in designing a detailed implementation and evaluation plan for my project. I need to discuss my project plan with you.

An evidence-based solution to reducing incidence of hospital acquired infections through indwelling medical devices

Hospital-acquired or nosocomial infections are the fourth leading cause of disease in developed countries. The increased insertion and implanting of prosthetic or indwelling medical devices is a leading cause of these infections since the introduction of a foreign body significantly reduces the body's immunity and decreases the number of bacteria needed to produce an infection. Prosthetic or indwelling medical devices such as urethral catheters, suprapublic catheter, nasogastric tubes, hemodialysis catheters, central venous catheters, and tracheostomy tubes are associated…

References

Chambless, J.D., Hunt, S.M., & Stewart, P.S. (2006). A three-dimensional computer model of four hypothetical mechanisms protecting biofilms from antimicrobials. Appl Environ Microbiol, 72(3), 2005-2013. doi: 10.1128/aem.72.3.2005-2013.2006

Chu, V.H., Crosslin, D.R., Friedman, J.Y., Reed, S.D., Cabell, C.H., Griffiths, R.I., . . . Fowler, V.G., Jr. (2005). Staphylococcus aureus bacteremia in patients with prosthetic devices: costs and outcomes. Am J. Med, 118(12), 1416. doi: 10.1016/j.amjmed.2005.06.011

Cookson, S.T., Ihrig, M., O'Mara, E.M., Denny, M., Volk, H., Banerjee, S.N., . . . Jarvis, W.R. (1998). Increased bloodstream infection rates in surgical patients associated with variation from recommended use and care following implementation of a needleless device. Infect Control Hosp Epidemiol, 19(1), 23-27.

Digiovine, B., Chenoweth, C., Watts, C., & Higgins, M. (1999). The attributable mortality and costs of primary nosocomial bloodstream infections in the intensive care unit. Am J. Respir Crit Care Med, 160(3), 976-981. doi: 10.1164/ajrccm.160.3.9808145

Urinary tract infections (UTIs) are typically the most prevailing healthcare-associated infection (HAI) in acute care facilities in the U.S. The Centers for Disease Control and Prevention (CDC) has estimated that up to 150,000 hospital-onset, symptomatic catheter-associated UTIs (CAUTIs) occurred in 2013, resulting in as much as $161 million in excess direct medical costs (Kuntz, 2010, p. 319). Current research examines the reason for such a high occurrence of infection. oughly 75% of healthcare-associated UTIs are connected to improper use of indwelling urinary catheters, to which up to a quarter of hospitalized patients are exposed. Adult ICUs have the highest exposure rate for catheter use and reveal over 95% of UTIs related to catheter use.

In the last twenty years, various strategies have been implemented to aid in reducing the risk of CAUTI in healthcare settings. One of which includes identifying proper times to use catheters and proper care and insertion…

References

Deron, D.C., Edwards, J.R., Srinivasan, A., Fridkin, S.K., & Gould, C.V. (2011). Trends in Catheter-Associated Urinary Tract Infections in Adult Intensive Care Units -- United States, 1990 -- 2007. Infection Control and Hospital Epidemiology, 32(8), 748-756.

Flynn, M.B., Martins, S.A., Burns, S., Philbricks, D., & Rauen, C. (2013). Putting Evidence Into Nursing Practice: Four Traditional Practices Not Supported by the Evidence. Critical Care Nurse, 23(2), 37. Retrieved from  http://www.aacn.org/wd/Cetests/media/C1322.pdf 

Goeschel, C.A., Cosgrove, S.E., Romig, M., & Berenholtz, S.M. (2011). Prevention of Central Line -- Associated Bloodstream Infections: A Journey Toward Eliminating Preventable Harm. Current Infectious Disease Reports, 13(4), 343-349.

Kuntz, G. (2010). Guideline for Prevention of Catheter-Associated Urinary Tract Infections 2009. Infection Control and Hospital Epidemiology, 31(4), 319-326.

hanging Blood Transfusion Policy and Practice" by atherine Stupnyckyj, RN, Sheryl Smolarek, BSN, RN, ON, olleen Reeves, BSN, RN, ON, Judith McKeith, BSN, RN, MSRN, and Morris Magnan (December 2014), American Journal of Nursing, 114(12), 50-59

What is the problem that the research is addressing?

hallenging, the "that's the way we've always done it" mindset and citing the dearth of scientific evidence in support of using 20-gauge or larger catheters for blood transfusions, Stupnyckyj et al. (2014) systematically analyzed existing guidelines and consulted with experts to identify optimal catheter gauge sizes for blood transfusions. In sum, the authors cite a paucity of timely and relevant research concerning the use of…

Citing the need for individualized and patient-centered care as well the ongoing heavy demand for regular blood transfusions for many patients, the evidence-based study by Stupnyckyj et al. (2014) evaluated the efficacy of using catheter gauges that were smaller than the 20-gauge or larger sizes previously recommended by the American Association of Blood Banks and the Infusion Nurses Society.

Describe the recommendation for nursing practice.

Although they do not provide specific guidelines concerning the size of catheters that should be used in any given situation, the authors conclude that there is a lack of evidence to support the use of 20-gauge catheters and recommend that depending on patients' age, conditions, and size of available veins, registered nurses should carefully evaluate the potential for using smaller gauge catheters than 20-gauge for blood transfusions.

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.

pressure? How respo

There was a time when I was under extreme duress to get to work on time. Although I can look back on the situation fondly now and apply the lessons learned, back then it could have had serious negative ramifications for my career. I had recently moved and was beginning a new nursing position. I was supposed to fly in on the Friday before I started the following Monday, but I missed the flight and had to catch the next one. By the time I arrived, I barely had a chance to get a full night's rest in my own bed, let alone plot the route from my new residence to my job. I remember feeling so pressured as I drove around the downtown streets which all looked alike since I had just moved. At the time, the last thing I wanted to do was start a…

The conclusion according to Ludwig, et al. (2001) is that "the flat-panel detector has diagnostic performance superior to that of conventional screen-film storage-phosphor radiography for detecting shall artificial osseous lesions at clinical exposure settings. With the flat-panel detector, exposure may be reduced by a sum of 50% in order to gain satisfactory

In the study entitled: "Performance of a Flat-Panel Detector in Detecting Artificial one Lesions: Comparison with Conventional Screen-Film and Storage-Phosphor Radiography" which was written by Karl Ludwig, M.D. et al. states that the case study was done with the express purpose of comparing a "large-area direct-readout flat-panel detector system with a convention screen-film system and storage-phosphor system" for the detection of "small artificial osseous lesions simulating osteolytic disease" and in the assessment of diagnostic performance as the exposure dose decreases over time. The results stated in the study were that: "ROC analysis showed A) Values of 0.820 (speed…

Bibliography

Cohen MD, Katz BP, Kalasinski LA, White SJ, Smith JA, Long B. Digital Imaging with a photostimulable phosphor in the chest of newborns. Radiology 1991; 181:829-832.

Yamamuro, M (1995) Cardiac Functional Analysis with Multi-Detector Row CT and Segmental Reconstruction Algorithm: Comparison with Echocardiography, SPECT, and MR Imaging. Radiology. 2005 Feb;234(2):381-90.Kyoto University Graduate School of Medicine, Japan.

Don Steven M.D., et al. (1999) Computed Radiography vs. Screen-Film Radiography: Detection of Pulmonary Edema in a Rabbit Model That Stimulates Neonatal Pulmonary Infiltrates. Mallinckrodt Institute of Technology, St. Louis Children's Hospital, Washington University of Medicine. 1999 Jan 25

Ludwig, Karl et al. (2001) Performance of a Flat-Panel Detector in Detecting Artificial Bone Lesions: Comparison with Conventional Screen-Film and Storage-Phosphor Radiography 2001 Dec 16 Online available at  http://radiology.rsnajnls.org/cgi/content/abstract/222/2/453?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&searchid=1106962551056_13136&stored_search=&FIRSTINDEX=0&minscore=5000&journalcode=radiology .

At the same time, it also needs to be mentioned that one has to take a decision based on the consideration that whether the person has any individual choice of his/her own in the matter. One of the main reasons for developing such an attitude may be because of depression in the minds of the patient. This matter needs to be raised and decided by the doctor and medicines prescribed accordingly to the need. These medicines have to be given by force, to the patient, if necessary, if he is unwilling to take them. At the same time, one may also understand that when medicines are being forced down a patient's throat, the effects and situation of the mind of the patient makes the medicine to be less effective, unless otherwise it is a medicine which has enough direct physical action. All the developmental effects are being slowed down by…

References

Burgio, Kathryn L; Locher, Julie L; Goode, Patricia S; Michael, Hardin, J; McDowell, B. Joan;

Dombrowski, Marianne; Candib, Dorothy. (16 December, 1998) "Behavioral vs. Drug Treatment for Urge Urinary Incontinence in Older Women" JAMA. Vol: 280; No: 23. Retrieved at  http://jama.ama-assn.org/cgi/content/abstract/280/23/1995?ijkey=a2a0bc880a62c67942c75cc0e54e42e29540ce3c&keytype2=tf_ipsecshaAccessed  18 September, 2005

Curry, M. A; Perrin, N; Wall, E. (1998) "Effects of abuse on maternal complications and birth weight in adult and adolescent women" Obstetrics & Gynecology. Vol: 92; pp: 530-534. Retrieved at  http://www.greenjournal.org/cgi/content/abstract/92/4/530?ijkey=d09f32f9fa411fa987cece30aea39728bd3107d3&keytype2=tf_ipsecshaAccessed  20 September, 2005

Ernst, Edzard; Rand, Julia I; Stevinson, Clare. (1998) "Complementary Therapies for Depression" Arch Gen Psychiatry. Vol: 55; pp: 1026-1032. Retrieved at  http://archpsyc.ama-assn.org/cgi/content/abstract/55/11/1026?ijkey=4aefcb2b211b2daf78065877dca0b571d0e42275&keytype2=tf_ipsecshaAccessed  20 September, 2005

Translation Evidence Into Nursing Health Care Practice. Chapter 6, "Translation Evidence Leadership" Article: Bakke, C.K. (2010). Clinical cost effectiveness guidelines prevent intravascular catheter-related infections patients' hemodialysis.

Briefly summarize your selected issue and propose new evidence-based practice strategies.

Pressure ulcers, commonly known as bedsores, are frequently observed in otherwise healthy bed-ridden patients in nursing homes. To promote wellness amongst this patient population, it has been suggested that regular turning and positioning of the patients by caregivers should be used to reduce their occurrence. Turning and positioning has long been used amongst healthcare practitioners for a variety of bed-ridden patients, usually at regimented intervals spanning 4-2 hours (Thomas 2001). Based upon the previous research conducted upon this population, the suggested shortened interval is 1-11/2 hours for repositioning of the patient (Thomas 2001).

Q2. Describe the theoretical basis for your strategies.

The theoretical basis for this initiative lies in the idea that passive…

References

Bluestein, D. & Javaheri, A. (2008). Pressure ulcers: Prevention, evaluation, and management.

American Family Physician, 78(10):1186-1194. Retrieved from:

 http://www.aafp.org/afp/2008/1115/p1186.html 

Krapil, L.A. & Gray, M. (2008). Does regular repositioning prevent pressure ulcers?

Nursing

Define the Problem

Today, there is a serious problem within the nursing field. There is a huge shortage of nurses in general, but an even greater shortage of nurses with higher levels of education. This ultimately means there are less capable nursing staff that can take on specialty and leadership roles. Unfortunately, "without a more educated nursing workforce, the nation's health will be further at risk" (Tri-Council of Nursing, 2010). Without greater numbers of RNs with advanced degrees, there is only so much the available nursing population can contribute within the field of healthcare. It is clear that "nurses with advanced education are needed in large numbers to serve as teachers, scientists, primary care givers, specialists, and leaders throughout the healthcare delivery system" (Tri-Council of Nursing, 2010). Currently, there is a huge shortage of more advanced nursing specialists and practitioners. s the nation's healthcare demands continue to grow and…

A survey of the existing research that provides statistics to show how alarming the problem is becoming, but also to provide foundation for the most potentially successful solutions. The projected numbers of needed advanced nursing specialists, as well as the goals for future benchmarks, all need to be documented within the context of this research in order to show how dire the problem is and create a foundation for potential solutions. The research was carefully surveyed and thus, data was collected through comprehensive means. The ideal target / benchmark uncovered in this search was that 80% of nursing staff should hold baccalaureate degrees (Pecci, 2013). This research also helps focus in on the most lucrative proposed solutions as a way to promote them within actual practice. It needs to uncover solid alternatives that can help increase the number of advanced practice nurses in this country in a practical and feasible manner. Essentially, the data collection is a survey of prior research, and can be done independently. This means I will personally scour the published resources from academic and scholarly sources, as well as from professional nursing organizations.

Analyze

A number of alarming statistics were uncovered in this comprehensive search of the research. If the situation continues as it is today, by 2025, there will be a shortage of 260,000 nurses in this country (American Nurses Association, 2010). Only about 50% of RNs working today have a baccalaureate degree, with only 13.2% holding a master degree or higher (American Nurses Association, 2010). Even more alarming, the enrollment growth of entry-level baccalaureate nursing programs from 2008 to 2009 was only 3.5%

One possible explanation for the differences observed in the studies could be that the strengths of the chlorhexidine solution were different. It could also be that over time more effective techniques have been developed in the application of the solution, as the results do appear to improve over time.

There are limitations to the methodology of the study which are centered on the use of secondary data for analysis. The use of secondary data allows a wider range of data to be gathered from across the U.S. than would be practical from primary data collection which is the reason for the choice in this study. However this puts the control of several variables beyond the researcher. The results of the techniques may have been affected by the application of different individuals, departments and hospitals, all of whom may vary techniques and other factors influencing the success of these techniques. The…

References

Adams, D., Quavum, M., Worthington, T., Lambert, P., & Elliott, T. (2005). Evaluation of a 2% chlorhexidine gluconate in 70% isopropyl alcohol skin disinfectant. Journal of Hospital Infections, 61 (4), 287-290.

Brungs, S., & Render, M. (2006). Using Evidence-Based Practice to Reduce Central line Infections. Clinical Journal of Oncology Nursing, 10 (6), 723-725.

CDC. (2002). Guidelines for Prevention of Intravascular Catheter-Related Infections. Morbidity and Mortality Weekly Report; Recommendations and Reports, 51 (RR-10), 1-34.

CDC Mission. (n.d.). Retrieved February 6, 2006, from CDC Web site:  http://www.cdc.gov/about/mission.htm

Methicillin-esistant Staphylococci (MSA), most common Healthcare Associated Infections

The PICOT question to be discussed is: For adult patients using catheters, does the use of sterilization practices reduce the future risk of health associated infections like MSA compared with standard procedure in one week?

The answer is yes.

The support given to answer the question will be based on peer-reviewed journals and scientific literature. A summary of the evidence will be availed in a chart plus a conclusion that summarizes evidence used will also be given.

Methicillin-resistant Staphylococcus aureus (MSA) bacteria is resistant to several antibiotics. A significant proportion of MSA infections in the community are on the skin. It results in alarming infections of the bloodstream, surgical site infections and pneumonia in health facilities. Studies have revealed that one person in every three individuals have staph in the nose - most of the time they don't show any illnesses (General…

References"

1)

General Information About MRSA in the Community. (n.d.). Retrieved February 21, 2015, from  http://www.cdc.gov/mrsa/community/index.html 

2)

Sydnor, E., & Perl, T. (2011). Hospital Epidemiology and Infection Control in Acute-Care Settings. Clinical Microbiology Reviews,24(1), 141-173. Retrieved February 21, 2015, from  http://cmr.asm.org/content/24/1/141.full

Nursing

(a) provides an account of your observations on the management of peripheral intravascular devices from your clinical practicum in NMIH202;

Clinical practicum NM1H202 introduces nurses to the management of peripheral devices via scholarly inquiry and clinical practice. The practicum includes a thorough training in handling, inserting, replacing, and dressing peripheral intravascular devices including peripheral venous catheters. Because the primary risk associated with peripheral intravascular devices is infection, proper management of the devices is crucial. Bloodstream infections can cause patient casualties, leading not just to humanitarian disasters but also financial ones as well.

Hand washing vigilance is a primary part of the introduction to peripheral intravascular device management. While it may seem like an abundance of common sense, hand washing and aseptic techniques themselves depend on continued knowledge acquisition and training. Nurses must stay abreast of latest products and tools that promote hygiene in relation to the management of peripheral…

References

Bregenzer, T., Conen, D., Sakmann, P., & Widmer, A.F. (1998). Is Routine Replacement of Peripheral Intravenous Catheters Necessary? Arch Intern Med. 1998;158:151-156.

Crnich, C.J . & Maki, D.G. (2002). The Promise of Novel Technology for the Prevention of Intravascular Device -- Related Bloodstream Infection. I. Pathogenesis and Short-Term Devices. Clin Infect Dis. (2002) 34 (9): 1232-1242

Crnich, C.J. & Maki, D.G. (n.d.). The role of intravascular devices in sepsis. Current Infectious Disease Reports 3(6): 496-506.

Elliot, T.S.J. (1988). Intravascular device infections. Journal of Medical Microbiology 27(1988): 161-167.

The major challenge is how to keep track of any inserted urinary catheter in a patient.  It has been shown that most times physicians and nurses will forget about a urinary catheter, and this is one of the major causes of infections in patients.  Therefore, there should be a strategy in place for monitoring any urinary catheter that has been inserted in a patient and ensuring that it is removed when it is no longer needed.  Removal of unnecessary catheters ensures that HAIs associated with the catheter is prevented.  Another challenge is the time it takes to recognize that a catheter is in place and the physician determines it is no longer needed and issues a removal order.  This might take hours or days.  According to (Meddings et al., 2014) any delay in removing a catheter increases the patient's risk of infections and catheter-associated complications.
Maintaining awareness of any urinary…

speaker notes IN-DEPTH ANALYSIS include DISCUSSION OF YOU DECISIONS specific topics. We restate article. • Analyze critique a qualitative nursing research article (attached) a nursing research journal published past 5 years.

Nursing research: Qualitative critique

Wilde, M.H., Brasch, J & Zhang Y. (2011) A qualitative descriptive study of self-management issues in people with long-term intermittent urinary catheters. Journal of Advanced Nursing 67(6), 1254 -- 1263. doi: 10.1111/j.1365-2648.2010.

The central purpose of the article "A qualitative descriptive study of self-management issues in people with long-term intermittent urinary catheters" is to chronicle the lives of people who use urinary catheters (Wilde, Brasch, & Zhang 2011). The article can be characterized as qualitative because it attempts to explore a particular phenomenon and shed light upon patient's experiences without the use of a formal experimental group and a control group Many patients strive to engage in effective self-management regarding their use of catheters. Little…

References

Advantages and disadvantages of qualitative research. (n.d). UWA. Retrieved:

http://hive.library.uwa.edu.au/hive/hive.cgi/zip/218293/html/pop_advdis.html

Berkwits, Michael & Inui, Thomas S. Inui. (1998). Making use of qualitative research techniques.

J Gen Intern Med, 13(3): 195 -- 199. Retrieved:

Refinement of a Nursing Concern into an Evidence-based Practice Proposal Using the Research Process

Overview

Research is mainly used to generate new knowledge or for the validation of existing knowledge based on a theory. Evidenced-based practice (EBP) is the translation of evidence and applying the evidence to clinical decision-making. Most of the evidence used in EBP stems from research. However, EBP will go beyond the use of research and it will include clinical expertise together with patient preference and values. EBP will make use of the evidence developed or knowledge discovered using research to determine the best evidence that can be used or implemented in clinical practice. Research and EBP go hand in hand in that while one will generate new knowledge, the other will make practical use of the knowledge and make use of the knowledge by implementing it into clinical practice. EBP is supported by research since any…

Management Theory and Associated Urinary Tract Infections

Infection of the urinary tract constitutes a great share of all infections acquired in hospitals (Klevens, Edwards, & ichards, 2007); of these, most cases are of CAUTI or catheter-associated urinary tract infection, which is "reasonably preventable," according to the CMS (Centers for Medicare and Medicaid Services). CMS doesn't reimburse medical facilities for this disease any more. Of the best strategies to reduce CAUTI is ensuring never to employ urinary catheters unless one perceives an appropriate symptom.

Several research works, some even dating back many decades, can be found, of ways to decrease or prevent the development of CAUTI. Over the years, a few of the recommendations have reformed; for instance, at one time, routine catheter irrigation was recommended; however, presently, the medical profession deems it as a practice that must be avoided. Therefore, it is imperative for healthcare organizations to make sure their…

References

Barnard, C.I. (1952). Leadership and the law. New York University Law Review, 27(1), 112-116

Fanning, M., & Oakes, D. (2006). A tool for quantifying organizational support for evidence-based practice change. Journal of Nursing Care Quality, 21(2), 110-113.

IHCI. (2011). How-to guide: Prevent catheter-associated urinary tract infections. Cambrige, MA. Retrieved from  http://www.mnreducinghais.org/documents/CAUTI_How_to_Guide.pdf 

Klevens, R. M., Edwards, J. R., & Richards, C. L. (2007). Estimating health care-associated infections and deaths in U.S. hospitals, 2002. Public Health Rep, 122(2), 160-166.

Howeve, befoe giving the medicine, anesthesiologist caefully examines the condition of the pegnant woman to whom anesthesia is to be given. Epidual anesthesia duing labo and nomal delivey does not cause unconsciousness; thus, patients do not lose thei psychological aletness (Halpen and Douglas 2008).

Dissetation Pat

Accoding to (Oebaugh 2011), epidual anesthesia is commonly administeed by injecting the medicine in the lumba egion of the back, specifically in the epidual egion. The detailed pocedue egading the administation of epidual anesthesia has aleady been discussed in the pevious section of the pape. Howeve, the anesthetic dug injected in the epidual space inteupts the passage of neve impulses that oiginate in epoductive ogans and tavel though neves to lowe spine and then to bain. This hindes the feeling of sensation/pain that is poduced in the lowe pats of the body.

The degee of insensitivity induced depends on few factos that include the…

Heart

The basic work of the heart is to pump blood to the entire body. It performs two types of functions, electrical and mechanical. The electrical function of the heart is the periodic contraction that is triggered by the pacemaker. The pacemaker generates the pumping effect throughout the heart. This pumping action commonly known as action potential is carried in an electrical conduction system. The mechanical function is the fluidic movement of blood; the heart is a pump. The heart's anatomical features include; ventricle, which is the pump, heart valves; that allow blood to flow one way and the atria, which includes the four chambers of the heart. The heart is susceptible to disease and as a result if unable to pump blood can lead to failure in other body organs.

Treated Heart Conditions

Cardiology is generally a field of medicine focusing on diagnosis and treatment of the heart. Discussed…

Reference

American Medical Association. (2011). CPT Professional Edition. Chicago: American Medical

Association.

Fishbein, M.C. (2012). Heart Transplant. Retrieved February 27, 2012, from www.medicinenet.com:  http://www.medicinenet.com/heart_transplant/page2.htm 

Heartmart. (2007). Commonly Performed Heart Procedures - Fixing Broken Hearts. Retrieved February 27, 2012, from www.heartmart.com: http://www.heartmart.com/heart-health/heart-procedures/

Nurse burnout is a common occurrence. This can exacerbate an ongoing problem that is seen in hospitals, nosocomial infections. Nosocomial infections remain prevalent for patients with extended hospital stays like those in intensive care units. An infection that starts roughly 48 hours after admission, those in intensive care units (ICUs) experience a continued rate of infection leading to increase length of stay, mortality, and morbidity. The number of patients that develop a nosocomial infection are from 7 to 10% internationally (Dasgupta, Das, Hazra, & Chawan, 2015). As such, hospitals have decided to classify nosocomial infection sites based on clinical and biological criteria.

esearch has led to the discovery of several bacterial strains that involve the formation of nosocomial or hospital acquired infections. "The agents that are usually involved in hospital-acquired infections include Streptococcus spp., Acinetobacter spp., enterococci, Pseudomonas aeruginosa, coagulase-negative staphylococci, Staphylococcus aureus, Bacillus cereus, Legionella and Enterobacteriaceae family members,…

References

CDC. (n.d.). HAI Data and Statistics. Retrieved from  https://www.cdc.gov/hai/surveillance/ 

Cheng, C., Bartram, T., Karimi, L., & Leggat, S. (2016). Transformational leadership and social identity as predictors of team climate, perceived quality of care, burnout and turnover intention among nurses. Personnel Review, 45(6), 1200-1216. doi:10.1108/pr-05-2015-0118

Cimiotti, J. P., Aiken, L. H., Sloane, D. M., & Wu, E. S. (2012). Nurse staffing, burnout, and health care -- associated infection. American Journal of Infection Control, 40(6), 486-490. doi:10.1016/j.ajic.2012.02.029

Dasgupta, S., Das, S., Hazra, A., & Chawan, N. (2015). Nosocomial infections in the intensive care unit: Incidence, risk factors, outcome and associated pathogens in a public tertiary teaching hospital of Eastern India. Indian Journal of Critical Care Medicine, 19(1), 14. doi:10.4103/0972-5229.148633

Webster et al. 2007) is effective because it clearly identifies the purpose and nature of the study in the trial itself. The CONSOT criteria specifically state that the randomized nature of the trial must be indicated in the title, which is evident in the case of the present study. andomized trials are necessary for health care studies because they help to maintain the homogeneity of the samples (Jadad & Enkin, 2007). It also eliminates selection bias (Piantadosi, 2005). Hence, it may be said that the title is effective because it states that the study was based on a randomized trial.

It is necessary for an effective abstract to have a structured summary of the research design, methods, results, and conclusion. The abstract provides a concise, clear and well-structured summary for the reader. The information has been organized separately to facilitate comprehension. The abstract describes the background, objective, design, setting, participants,…

References

Jadad, A.R., & Enkin, M.W. (2008). Randomized controlled trials. (2nd ed., p. 5). Blackwell Publishing.

Kirch, W. (2008). Encyclopedia of public health. (p. 414). Springer Science.

Kumar, R. (2008). Research methodology. (p. 25). APH Publishing Corporation.

Osborn, C.E. (2006). Statistical applications for health information management. (2nd ed., p. 261). Jones & Bartlett.

Policy Change

The Center for Disease Control (CDC) endorsed the policy of replacing peripheral intravenous catheters (PIVC) within 48 hours following insertion in order to prevent and decrease local catheter infections. The institution that this author is employed at also made a policy to establish such a procedure based on the CDC's actions. However, there is a large body of empirical research that indicates that the length of the time that the PIVC remains in a patient does not appear to be a major factor that results and infections and/or phlebitis. Thus, this policy of changing the PIVC with 48 hours may be unnecessary.

For instance Zarate, Mandleco, Wilshaw, and avert (2008) studied emergency room trauma patients who received a PIVC. The mean number of days before there were indications of phlebitis in these patients was 3.14 days with the range of 1 to 6 days. Phlebitis rates did not…

References

Lee, W.L., Chen, H.L., Tsai, T.Y., Lai, I.C., Chang, W.C., Huang, C.H., & Fang, C.T.

(2009). Risk factors for peripheral intravenous catheter infection in hospitalized patients:

A prospective study of 3165 patients. American Journal of Infection Control, 37, 683

Lee, W.L., Liao, S.F., Huang, C.H., & Fang, C.T. (2010). Soft tissue infections related to peripheral intravenous catheters in hospitalized patients: A case control study. Journal of Hospital Infection, 76, 124 -- 129.

nursing -- caring, empathy and ethics. The author (Lachman, 2012) uses numerous examples, each of which show the positive impacts of caring. Along with examples of ethical decisions that must be made, and with theories on caring and empathy put forward by scholars, the paper examines morality, competence, and the "reciprocal" relationships between nurses and their patients. That is, caring for a patient is reciprocal because if the needs of the patient are met, there is reciprocity -- the giving of care and the receiving and acknowledgement of that care giving.

Summary of Key Points

On page 113 Lachman references several leading theorists and scholars that have provided important research and results on nursing ethics and the caring concepts alluded to in the Introduction. Dr. Jean atson has a caring theory (112) that has three main components: a) carative factors; b) the "transpersonal caring relationship"; and c) the "caring occasion/caring…

Works Cited

French, Peter. (1999). The development of evidence-based nursing. Journal of Advanced

Nursing, 29(1), 72-78.

Lachman, Vicki D. (2012). Applying the Ethics of Care to Your Nursing Practice. Ethics, Law,

and Policy, 21(2), 112-115.

ACIST CVi Angiographic Imaging System

The ACIST CVi is an angiographic imaging system used to diagnose diseases and treat over 15 million patients globally. The ACIST CVi is able to simplify a contrast injection using all procedure ranging from small injections for a coronary artery to peripheral vasculature and a large volume injection for ventricles, which consequently enhance efficiency, safety, image quality, and control. The CVi system assists in improving procedural efficiency and image quality. Moreover, the system minimizes a radiation exposure as well as reducing the patient contrast dose. The CVi system also helps in reducing time to carry out imaging procedure, which is beneficial to both healthcare professionals and patients. (Ferebee, & Scoville, 2009).

Objective of this paper is to investigate the ACIST CVi imaging system and its benefits for the Invasive Cardiac Catheterization.

Benefits of the ACIST CVi imaging system for the Invasive Cardiac

The ACIST CVi…

Reference

Business Wire (2015). ACIST Medical Systems Announces the ACIST CVi product introduction at the TCT: The ACIST CVi - Trust Experience. Rely on Innovation. ACIST Medical Systems, Minneapolis.

Ferebee, D. & Scoville, G.S. (2009). Adoption of new contrast injection method: Impact on costs, patient length-of-stay, and physician and staff satisfaction. ACIST Medical Systems, Inc.

Chahoud, G. Khoukaz, S. El-Shafei, A. et al. (2001). Randomized comparison of coronary angiography using 4F catheters: 4F manual versus "ACISTed" power injection technique. Catheterization and Cardiovascular Interventions. 2001;53(2):221-224.

National Institutes of Health (2012). Explore Cardiac Catheterization. Department of Health and Human Services.

Keeping Patients Very Healthy
The foremost challenge regarding HAI Catheter Associated Urinary Tract Infections (CAUTI) is that they are fairly prevalent. In fact, CAUTI is the most commonly occurring HAI and is directly responsible for a third of HAIs among patients in hospital settings (Iowa Department of Public Health). The challenge, then, is in agreeing to the emphasis placed on CAUTI within the organization, and taking adequate risk management measures to prevent this condition from occurring.
Still, the very nature of this challenge presents opportunities for the aforementioned organization to engage in preventative action to preclude the occurrence of CAUTI as much as possible. Specifically, this organization should implement a number of strategies to help CAUTI from affecting patients in clinical environments. These strategies are readily stratified into two components: early prevention, necessary, and post procedure.
Early prevention strategies are centered on the notion that the organization should acknowledge the…

Treatment to Patients

The main objective of providing treatment to patients is to relieve symptoms along with decreasing the progression of the disease as well as the mortality or morbidity. However, in some cases, this objective is not fully achieved, especially in the case of the patients who are admitted to the ICU with some serious and almost always a terminal stage of the disease. For example, when old patients are admitted in the ICU, their immunity is extremely low and this is the perfect time for the opportunistic infections to make matters worse for these patients. There are many infections that are specifically associated with patients admitted in the hospitals. Pseudomonas Aurigeonosa is a micro-organism that is well documented to cause bacterial pneumonia and bacteremia in the patients who are terminally ill and are receiving treatment in the hospital setting. Since most of the patients in the ICU are…

Bibliography:

Beekmann, SE;Diekema, DJ; Chapin, KC;Doern, GV (2003) Effects of rapid detection of bloodstream infections on length of hospitalization and hospital charges.J ClinMicrobiol, 41:3119-3125.

Boussekey, N, Leroy, O, Georges, H, Devos, P, d'Escrivan, T, Guery, B (2005).Diagnostic and prognostic values of admission procalcitonin levels in community-acquired pneumonia in an intensive care unit.Infection, 33:257-263.

Charles, PE, Dalle, F, Aho, S, Quenot, JP, Doise, JM, Aube, H, Olsson, NO, Blettery, B: Serum procalcitonin measurement contribution to the early diagnosis of candidemia in critically ill patients. Intensive Care Med, 32:1577-1583.

Digiovine, B; Chenoweth, C; Watts, C; Higgins, M (1999)The attributable mortality and costs of primary nosocomial bloodstream infections in the intensive care unit. Am J. RespirCrit Care Med, 160:976-981.

Furthermore, one of the pillars of collaborative care that will need to be firmly established is the fostering of clear dialogue and a means for strong communication within the care management planning. For instance, there needs to be a clear decision and communication of all tests ordered and when the test results will be available. One of the most important aspects of this collaborative care will be the nursing interventions which can have significant impact on the patient's health and stabilization (Allen, 2010). In fact, strategic nursing care can even minimize readmission rates of Margaret and other patients with comparable conditions (Chen et al., 2012).

Prioritize the Nursing Care Needs of Margaret

The prioritization of nursing interventions is essential, and the way in which a nurse determines this priority is going to be something unique and distinct. "Trials reviewed demonstrated a beneficial impact of nursing interventions for secondary prevention in…

References

Adler, H.M. (n.d.). Toward a biopsychosocial understanding of the patient -- physician relationship: An emerging dialogue. (2007). J Gen Intern Med,22(2), 280 -- 285.

Afilala, J. (n.d.). Frailty in patients with cardiovascular disease: Why, when, and how to measure. (2011). Curr Cardiovasc Risk Rep, 5(5), 467 -- 472.

Allen, J.K. (2010). Randomized trials of nursing interventions for secondary prevention in patients with coronary artery disease and heart failure: Systematic review.

Journal of Cardiovascular Nursing,25(3), 207-220.

Angiography;, Types Categories, , Signs & Symptoms, Treatment, Imaging Modality

Angiography

An angiography involves the use of water-soluble X-ray contrast media by injecting it into blood streams in arteries or veins with the purpose of imaging blood vessels. The process is meant to observe normal or pathological conditions of the vessel organization. By seeing the lumen of blood vessels and organs, an angiography can provide information concerning conditions like luminal narrowing and aneurismal widening. Vessel access is essential and serious complications can appear if the substance is unable to pervade the veins and arteries, but this is rare and unlikely to occur. hile these are some of the conditions that are frequently detected through an angiography, it can also play an important role in analyzing sources of bleeding, tumors, and diverse malformations in veins and arteries.

The discovery of X-rays led to some of the first experiments with angiographies as…

Works cited:

Ford-Martin, P.A. (2002). Angiography. Retrieved November 14, 2013, from  http://www.healthline.com/galecontent/angiography#1 

Osborne, A.G. (1999). Diagnostic Cerebral Angiography. Lippincott Williams & Wilkins.

Snellen, H.A., Dunning, A.J., & Arntzenius, A.C. (1981). History and perspectives of cardiology: catherization, angiography, surgery, and concepts of circular control. Leiden University Press.

Thomas, A.M.K. & Banerjee, A.K. (2013). The History of Radiology. Oxford University Press.

In addition to the physical discomfort he suffered, he was terribly embarrassed about his situation and it began to dominate his life. Adult diapers only exacerbated his loss of self-esteem and internal catheters presented too great a risk of recurring urinary tract infections.

With the benefit of access to the necessary materials from my father's practice as a cardiovascular surgeon, I began experimenting with a design for an external catheter that might increase my grandfather's independence and confidence but without presenting the same types of health risks as an internal catheter. The entire process from conceptual design to a practical and usable prototype took months, but eventually, we were able to construct a wearable external catheter fashioned mainly from components of an oxygen mask, a standard hospital urination drainage bag, and lengths of two-centimeter tracheal intubation tubes. Once we produced a reliable design, the benefits were immediate, because my grandfather…

In addition, it is not apparent whether the injections may relieve pain, but for those without surgical lesions the injections may delay requisite surgery and result to permanent neurological deficits. It is evident that some risks associated with infectious epidural steroid injections result to fatal meningitis, but those performing epidural do not make pregnant women opting for epidural aware. I feel that such risks are matters of life and death and women must know them before considering epidurals. In addition, there are common risks of these injections. They include; increased neurological deterioration, paralysis, and quadriplegia Epstein (2013, p. 74-93).

All these researches provide information on the risks of epidurals in different aspects. The epidural procedure may also affect the child. The drugs administered to the mother directly enter the child. The levels may be as high as those of the mother may, and because of the immature liver of the…

References

Akbas, Mert and Akcan, a Baris, "Epidural analgesia and lactation," Eurasian Journal of Medicine 43, (2010): 45-49.

Wilson, M. J, MacArthur, C, and Shennan, a. "Catheterization in labor with high dose vs. mobile Epidural analgesia: a randomized controlled trial." British Journal of Anesthesia 102, no. 2 (2009): 97-103.

Epstein, Nancy, "The risks of epidural and transforominal steroid injections in the spine: commentary and a comprehensive review of literature," Surgical Neurology International 4, (2013): 74-93.

Gwen Lewis, "Epidurals and child cancer," Journal of Childbirth and Medical Research, (2010): 30.

(Torpy, 2007)

Some of the symptoms of ventilator assisted pneumonia may be the onset of fever, a higher white blood cell count, and a new or changing lung infiltrate that may be visible on a normal chest x-ray. Cultures taken as samples from the patient's airways may show the presence of microorganisms or bacteria and fungi that would eventually cause the dreaded ventilator assisted pneumonia in the patient. JAMA states that these risk factors may be eliminated to a large extent if the nurses and medical practitioners were to follow certain simple but essential steps in preventing the onset of the symptoms of pneumonia. First and foremost, the nurse must maintain a high degree of hygiene; he must wash his hands both before and after coming into contact with any patient, and second, he must try to keep the bed elevated to a 30 degree head up position, so that…

References

Druding, Mary. C. (1997, Aug) "Re-examining the practice of normal saline installation prior to suctioning" Medical Surgery Nursing, Retrieved 8 October, 2007 at  http://findarticles.com/p/articles/mi_m0FSS/is_n4_v6/ai_n18607505 

Medscape. (2007) "Should Normal Saline be Used When Suctioning the Endotracheal Tube of the Neonate?" Retrieved 8 October, 2007 at  http://www.medscape.com/viewarticle/552862 

Schwenker, Ferrin, M; Gift, a.G. (1998) "A survey of endotracheal suctioning with installation of normal saline" American Journal of Critical Care, vol. 7, no. 4, pp: 255-260.

Torpy, Janet M. (2007, Apr) "Ventilator assisted pneumonia" the Journal of the American

(Schleder, 2003)

Elevating heads of beds for patients on mechanical ventilation

Along with the recommendations for removal of plaque, there is also a guideline made by CDC that for proper treatment to "elevate at an angle of 30 to 45 degrees the head of the bed of a patient at high risk for aspiration." The benefits elevation of the head of the bed is on the theory that then gravity will reduce the possibilities of regurgitation that exists in an overly distended stomach. The recommendation by CDC also clearly states that the patients should not be lying flat unless there is some clinical need for that. At the same time, some medical authorities feel that this is likely to make the patients uncomfortable, though the recommendation is from CDC. This makes them reduce the angle of laying the patients bed at a lower angle than the angle specified by CDC.…

References

Afessa, Bekele. (May, 2004) "From pro and con debate to evidence-based practice: ventilator- associated pneumonia" CHEST. Retrieved at  http://www.findarticles.com/p/articles/mi_m0984/is_5_125/ai_n6094553 . Accessed on 20 July, 2005

Caffery, Lisa. "Preventing Ventilator associated Pneumonia" Retrieved from www.genesisheart.com/clinical_staff/ventilator_pneumonia.pdf+elevating+patient's+beds+for+ventilator+acquired+pneumonia&hl=en"  http://www.genesisheart.com/clinical_staff/ventilator_pneumonia.pdf . Accessed on 20 July, 2005

Chulay, Marianne. (1 March, 2005) "VAP Prevention: The latest guidelines" Retrieved at http://rnweb.com/rnweb/article/articleDetail.jsp?id=149672Accessed on 20 July, 2005

Geyer, Sherree. "Breathing easy" Retrieved from www.matmanmag.com/matmanmag/jsp/articledisplay.jsp?dcrpath=AHA/PubsNewsArticleGen/data/0407MMH_FEA_Cover_Story&domain=MATMANMAG

Disseminating Evidence

Strategies for Dissemination

The key stakeholders in the implementation of the PICO project include patients, their families, health care team members including physicians, hospital administrators, insurers, suppliers, and investors ("Who are the Stakeholders in Health Care"). A broad and diverse group of stakeholders like this one requires a complex and multifaceted approach to project dissemination.

Different dissemination strategies will be used for different stakeholders. For patients and their families, the dissemination strategy will consist of the distribution of educational materials and access to educational resources. The educational resources will help patients to be empowered, so that they can ask questions related to their catheterization. Knowing what questions to ask, and what the answers mean, will help patients and their loved ones make responsible health care choices. For example, the study will show patients that they do not have to keep the catheter in, just because the nurse has…

References

"Who are the Stakeholders in Healthcare" (2005). Retrieved online:  http://patientsafetyed.duhs.duke.edu/module_a/introduction/stakeholders.html

Psuedomonas Aeruginosa

Pseudomonas aeruginosa

Epidemiology

The Gram-negative, motile, rod-shaped bacterium Pseudomonas aeruginosa is an opportunistic killer that takes advantage of people suffering from medical problems (Van Delden and Iglewski, 1998).For this reason, P. aeruginosa is one of the most common nosocomial infection that occurs in hospitals. P. aeruginosa is responsible for causing 16% of pneumonia cases, 12% of urinary tract infections, 10% of bloodstream infections, and 8% of surgical infections due to hospital care. Patients who are immune-compromised are also susceptible to P. aeruginosa infections, such as patients undergoing chemotherapy, suffering from HIV / AIDS, recovering in burn units, and suffering from cystic fibrosis. With death rates ranging from 30 to 60% for these patients, P. aeruginosa is considered to be a significant threat to patient health.

Ecology

P. aeruginosa can switch between a free-swimming planktonic form and colonies enclosed within slime-protected biofilms attached to surfaces (Baltch and Smith, 1994,…

References

Baltch, A.L. And Smith, R.P. (Eds.). (1994). Pseudomonoas aeruginosa Infections and Treatment. New York, NY: Marcel Dekker, Inc.

Botzenhart, Konrad and Doring, Gerd. (1993). Ecology and Epidemiology of Pseudomonas aeruginosa. In M. Campa, M. Bendinelli, H. Friedman (Eds.), Pseudomonas aeruginosa as an Opportunistic Pathogen (pp. 1-18). New York, NY: Plenum Press.

Hawkey, Peter M. And Kerr, Kevin G. (2004). Laboratory investigation of health care-associated infection. In P. Hawkey and D. Lewis (Eds.), Medical Bacteriology: A Practical Approach (pp. 331-354). Oxford, UK: Oxford University Press.

Hurley, Matthew N., Camara, Miguel, and Smyth, Alan R. (2012). Novel approaches to the treatment of Pseudomonas aeruginosa infections in cystic fibrosis. European Respiratory Journal, published online ahead of print, 1-19. Retrieved 23 July 2012 from  http://erj.ersjournals.com/content/early/2012/06/27/09031936.00042012.long .

Compendium to Research in Cardiology and elemetry

Cotiga, D., et al. (2007). Acute Conversion of Persistent Atrial Fibrillation During Dofetilide Initiation. Pacing & Clinical Electrophysiology, 30(12), 1527-1530. doi:10.1111/j.1540-8159.2007.00902.x.

he researchers look at the role of Dofetilide (D) as "a highly selective blocker of the rapid component of the delayed rectifier potassium current;" approved for the treatment of atrial fibrillation (AF). he study is a replication of clinical trials that concluded in a satisfactory safety/efficacy profile in patients with left ventricle (LV) dysfunction or heart failure. he participants to the investigation all received at least 6 dosing intervals D. while admitted in the elemetry unit. Seventy seven percent (77%) of the patients converted to sinus rhythm (SR) after the first 2.2 ± 1.2 doses. Findings to the investigation revealed that: 1) D. had an unusually high pharmacological conversion rate; 2) demonstrated response with incremental dosage; and 3) correlated with a high…

The stent-based antenna can be used in monitoring of blood pressure from a minimally invasive device inserted for tracking the pulmonary artery in diagnostic and early warning system for cardiac health. In cardiac diagnostics, the foremost challenge in using a like device is the wireless transfer of data and power from within the blood vessel to external devices; whilst maintaining unrestricted blood flow through the artery.

Paoletti, R., Suess, T., Lesko, M., Feroli, A., Kennel, J., Mahler, J., et al. (2007). Using bar-code technology and medication observation methodology for safer medication administration. American Journal of Health-System Pharmacy, 64(5), 536-543. doi:10.2146/ajhp060140.

A three (3) inpatient nursing unit study on the implementation of a multidisciplinary approach to systematically decrease medication errors through the use of observation methodology and the deployment of electronic medication administration records (EMARs) and bar-coded-medication administration (BCMA) is discussed. Testing of two (2) intervention groups: 1) 20-bed cardiac control group in the telemetry unit; 2) a 36-bed medical-surgical unit. Testing was conducted utilizing a direct observation technique for data collection, the measurement of medication errors used the observation process was conducted in two (2) phases: 1) reimplementation; and 2) postimplementation. In the first phase of the study evaluating the medication administration process associated with a manual five (5) day medication administration record (MAR), a total of 188 errors were reported. During the second phase of the study, evaluation of the MAR process using EMAR and BCMA technology implemented under direct-observation. Accuracy rate in reporting before BCMA concluded at (86.5%); after BCMA, the rate rose to (97%). A (54%) reduction of errors to the MAR was observed following implementation the group's approach to medication safety.

Testicular Embolism

Special Procedure requiring Special Sensitivity on the part of the Radiology Department and Attending Physicians

Testicular patients dying through ignorance," proclaimed a 2002 article in Life Extension Daily News. Researchers from Nijmegen's University Medical Center St. Radboud warned that a treatment delay of more than three months for testicular carcinoma was associated with a "significantly decreased" five-year survival rate. The most commonly cited reason for this critical diagnostic delay was not monetary issues. Instead, the delay was often due to patients fear and embarrassment of the condition and the location of the condition in the body. (Health Media Ltd., 2002) One way to prevent the spread of testicular carcinoma is speedy detection and treatment. Patients must conduct self-examinations on a regular basis, of course, and take responsibility for their own health. However, after detection has been made of a suspicious testicular mass, the next step often is the…

Works Cited

Cavallaro, John F. Testicular Cancer Survivor Stories. Web page last altered 2002. Accessed on July 28, 2003 at TCSS.  http://tcrc.acor.org/stories/johnc.html .

Conscious Sedation," FAQs about Vascular Procedures, 2003. Fletcher Health Care. Accessed on July 28, 2003 at http://www.fahc.org/Radiology/vascular_proc.html#sedation

Testicular Patients dying through ignorance." Health Media Ltd. May 9, 2002 Life Extension Daily News. Accessed on July 28, 2003 at  http://www.lef.org/newsarchive/disease/2002/05/09/eng-healthmedia/eng-healthmedia_200850_27_9615709930658.html 

What Happens During the Procedure?" Fletcher Health Care. Accessed on July 28, 2003 at http://www.fahc.org/Radiology/vascular_proc.html

The terms “goals” and “objectives” are used interchangeably but in fact, they do connote different things. Particularly in the context of teaching and learning, it is important to differentiate between goals and objectives. Goals refer to broad end results, whereas objectives tend to be more specific (Norman, 2017). Thus, a learner may have a goal of improving patient care, with the learning objectives being to reduce medical errors by fifty percent. Another key difference between goals and objectives is that the latter can and should be framed in measurable or quantitative ways. Goals do not need to be measurable and can in fact be personal or even emotional in nature, whereas objectives do need to be concrete. For example, a goal might be to master the new informatics system, and the specific learning objectives would be to input three hundred new data points into a particular information management system.
Using…

North Mountain Medical is a super sniff facility as they specialized in high acuity level patient. The patient structure is respiratory, with staff trained in tracheostomy care and ventilator management. In house hemodialysis, in house physical therapy. This facility has been in operation since 2004. Patients in this facility do not self-diagnose. Patient diagnoses are from Medical doctors and Nurse Practitioners that work on site. Patient in the facility are cared for by interdisciplinary team. Certified nursing assistants that care for patient will normally report a Change in patient’s condition to the nurse. Nurse completes an assessment and report changes immediately to the doctor. In the event of an emergency patients are send to emergency room for further evaluation and treatment. Health is a right in this facility. Yes, most of the patient’s life style has impacted the health of the patient. Noncompliance with medication regimen and diet changes. Patients…

Finally, if the nurse and others concede that her ideas regarding policy change are successful and needed in the medical profession and that other medical professions would benefit from the implementation of these changes to their activities and systems, the nurse can then proceed to implementation of her plan. This she can do by communication with legislators by e-mail, phone, or letter (or in person, if she wishes); by attending forums or other official meetings with political candidates; by working in political campaigns; and by involving herself in similar activities. This would provide the nurse with networking opportunities and enable her to find a platform for and to share her ideas.

An example of just such a successful attempt was that achieved by nurses in 31 organizations (such as the Academy of Medical-urgical Nurses, the American Nurses Association, and the American Organization of Nurse Executives) who, in 2008, pushed for…

Source

Anderson, L. (Tuesday, February 22, 2011). The Role of Nurses in Politics and Health Policy, Nurse Together.com. Retrieved on February 22, 2011 from:

 http://www.nursetogether.com/tabid/102/itemid/543/the-Role-of-Nurses-in-Politics-and-Health-Policy.aspx

Moreover, the specific cause of transmission are the low compliance rates of hospital personnel with basic antiseptic protocols such as simple hand washing. Surprisingly, the worst offenders were those with the highest degree of formal training: namely physicians and registered nurses. In some studies, compliance rates among hospital personnel were only between fifteen and thirty percent. Finally, empirical studies have also concluded that compliance rates are lowest in high-volume institutions and among understaffed medical units.

Solution

The solution is rather obviously quite simple. Among the most important aspects of reducing hospital-acquired nosocomial hospital infections is increasing the rates of hand washing among hospital personnel. Naturally, the more direct patient contact individual personnel have, the more important adherence to strict hand-washing policy is. Since physicians and nurses routinely care for many patients during a typical shift, it is crucial for them to become the most compliant rather than the least compliant…

References

Sheridan-Leos, Norma. "Oncology care setting design and planning Part II: Designing healthcare settings to prevent fungal infections and improve handwashing."

Clinical Journal of Oncology Nursing (June 1, 2008).

Full Text of Article Below

This is the second in a two-part series on designing healthcare settings to improve patient safety. Part I addressed concepts of error theory and evidence-based practice as they relate to planning safe care environments (Sheridan-Leos, 2008). Part II describes the design and planning of oncology care settings to prevent fungal infections and improve provider handwashing.

Third, lack of attention to evidence-based practice can lead to inconsistent delivery of care services.

Evidence-based practice relates to almost every aspect of health care at every stage of a client's relationship with the institution. For example, evidence-based practice informs the types of questions asked during the diagnostic procedures and might even impact the diagnosis itself (Bennett & Bennett, 2000). Evidence-based practice impacts the methods by which infections are prevented (Cantrell, 2009). Evidence-based practices impact the extent to which nurses are empowered to make sound, safe, and effective decisions (Scott & Pollock 2008). Evidence-based practice has the potential to transform the structure of a health care organization like MMH. This is because evidence-based practice changes the hierarchical structure in the organization due to the increased responsibility of nurses for conducting their own research. Alternatively, evidence-based practice can be an extension of organizational change. Health care organizations reducing the hierarchical nature…

References

Artinian, B.M., West, K.S., & Conger, M.M. (2011). The Artinian Intersystem Model. New York: Springer.

Bennett, S. & Bennett, J. (2000). The process of evidence-based practice in occupational therapy: Informing clinical decisions. Australian Occupational Therapy Journal (2000), 47, 171-180.

Burns, N. & Grove, S.K. (2009). The Practice of Nursing Research. St. Louis, MO: Saunders.

Cantrell, S. (2009). Performing under pressure: Caring for decubitus ulcers. Healthcare Purchasing News. Aug 2009.

In fact, nursing staff should have access to mobile technologies that allow for decisions to be made instantaneously at the bedside. For example, a PDA would allow nurses to access the literature directly from the bedside without leaving the patient's care. This would help integrate the caring aspects of nursing with the more objective aspects of evidence-based practice.

3) Discuss methods and specific plan to revise an unsuccessful project solution

If the project is unsuccessful, it could be because of insufficient opportunities for application. It may be better to implement the proposed solution in specific departments in which a large number of preventable errors had been tabulated. In this way, more dramatic changes to nursing practice might have been observed. It might also be helpful to survey the various departments in the healthcare institution and discover the specific areas of concern. Then, researchers can target these areas and encourage mentors…

sound rationale(s) for each component of the primary survey that the egistered Nurse will undertake.

The geriatric male patient was admitted to the Emergency Department under triage supervision. Primary survey assessment (Considine, 2011) determines the patient's immediate physical condition pertinent to life or death. These include the patient's Airway, Breathing, Circulation, Disability, Discomfort. The patient scores a 14/15, which indicates his eyes are open, appears oriented with succinct and clear verbal responses, and displays exacting and swift motor response and coordination.

Patient respiration is accelerated with shallow yet painful breathes. Lung capacity appears to be compromised, unsure of whether the left or the right is specifically effected but perhaps the onset of pneumonia is the thought. Blood pressure is low, rapid and painful breathing coupled with low blood pressure are symptomatic and are important to monitor for further changes.

Pulse of 90 bpm is somewhat rapid and irregular with 90%…

References

Considine D. (2011) Patient assessment Primary and secondary survey. Deakin University-Northern Health Clinical Partnership

It shows that Bush did not ensure the carrying out of exactly accurate procedures detailed in the 'Help America Vote Act of 2002', and this had the inevitable result of the lack of appropriate funds for the purpose of election reform until it was a mite too late. The Act that ensures the equality of education for all the children of the United States of America was also not implemented appropriately. The 'No Child Left Behind' act was supposed to make sure that all children would enjoy equal opportunities in the field of education irrespective of their social background and status and race and color. This was however not carried out in the fullest sense of the term during the Bush Administration, and this meant that children were in fact left behind, and their civil rights were thus being violated. Another facet of the negative aspects of the Bush administration…

References

Anti-slavery International" Retrieved at http://www.il.proquest.com/research/pd-product-Anti-Slavery-International.shtml. Accessed on 29 November, 2004

Donaldson, Stephen. "The World Wide Web, Virtual Library" Retrieved at http://www.menweb.org/throop/abuse/prisonrape/bell.html. Accessed on 29 November, 2004

GPA Kenyan student Lynched in Alabama" Retrieved at  http://www.colorq.org/HumanRights/article.aspx?d=usa&x=mutheki . Accessed on 29 November, 2004

Human Rights" (2004) Taking it Global. Retrieved at  http://www.takingitglobal.org/themes/hr/ . Accessed on 29 November, 2004

However, what was once a slow journey has recently gathered momentum with the introduction of "more flexible immunosuppression protocols, the ability to individualize surgical options to patient needs, and the dramatic improvement of isolated islet transplantation results." (Allen, p. 3485) esearchers use pancreas transplant options and advanced surgical techniques, but the donor pancreas and surgical complications, as well as the type of immunosuppression affect the outcome of islet transplantation.

The immunosuppressive drugs have significant side effects and long-term effects are still not known. Known side effects of immunosuppressive drugs include mouth sores and gastrointestinal problems, such as stomach upset or diarrhea. Patients also have experienced increased blood cholesterol levels, decreased white blood cell counts, decreased kidney function, and increased susceptibility to bacterial and viral infections. Taking immunosuppressive drugs increases the risk of tumors and cancer as well.

Progress on whole pancreas and beta cell transplantation has been hampered by the…

References

Allen, R.D.M., et al. (January-February 2000). Pancreas and islet transplantation: an unfinished journey. Transplantation Proceedings. Vol. 33. Nov-Dec 2001.

Clark, W.L. (January-February 2000). Beta cell replacement and islet transplantation. Diabetes Self-Management. Vol. 17(1): pp. 52, 54, 56.

Collazo-Clavel, M., ed.. (2001). Mayo Clinic on Managing Diabetes. Rochester, MN: Mayo Clinic.

Faustman, D. (December 2004). Towards a cure for type 1 diabetes (and other autoimmune diseases?). Infocus. 12(4): 1.

The majority of women can return to their normal routine the next day ("In Vitro Fertilization"). In most cases total bed rest is not required unless there is some risk associated with the development of OHSS ("In Vitro Fertilization").

The NIH further explains that women who utilize IVF must take the hormone progesterone for at least two months following the embryo transfer ("In Vitro Fertilization"). The hormone is taken through daily shots or pills. Progesterone is a naturaly produced hormone produced that assists in thickenign the lining of the uterus ("In Vitro Fertilization"). This thickening makes it easier for the embryo to implant to the wall of the uterus. If there is ot enough progesterone the woman will miscarry ("In Vitro Fertilization").

In additon to the risks associated with this type of reproductive technology, IVF is very expensive ("In Vitro Fertilization"). The NIH explains that many states require that insurance…

References

Becker, G. (2000). The Elusive Embryo: How Women and Men Approach New Reproductive Technologies. Berkeley, CA: University of California Press.

Bleiklie, I., Goggin, M.L., & Rothmayr, C. (Eds.). (2003). Comparative Biomedical Policy: Governing Assisted Reproductive Technologies. London: Routledge. Retrieved Burfoot, a. (Ed.). (1999). Encyclopedia of Reproductive Technologies. Boulder, CO: Westview Press.

In Vitro Fertilization. National Institutes of Health. Retrieved March 18 at  http://www.nlm.nih.gov/medlineplus/ency/article/007279.htm 

Sloan, G.A. (1993). Postponing Parenthood: The Effect of Age on Reproductive Potential. New York: Insight Books.