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Nosocomial Infections and Hand Hygiene
Kampf and colleagues (2009) assert that the regular use of hand sanitizers has a better antimicrobial effect than regular hand washing and they suggest that this practice -- in conjunction with improved availability of sanitizers, regular compliance education, reminders, and monitoring -- is best practice for hospital hand hygiene in the prevention of nosocomial infections. This recommendation is based on a review of the literature, which included studies forming the evidence-based foundation for the 2006 orld Health Organization (HO) hand hygiene recommendations, together with more recent recommendations by several authoritative bodies, including: (1) the Commission for Hospital Hygiene and Prevention of Infection, Robert Koch Institute (RKI), (2) the Association of the Scientific Medical Societies in Germany (AMF), (3) HO's final recommendation, and (4) the Centers for Disease Control and Prevention (CDC) (Kampf, Loffler, & Gastmeier, 2009, p. 649).
Apart from the reference list for the…
Within the healthcare environment, Kampf and colleagues (2009) recommend that clinicians rely on alcohol-based hand rubs to minimize the transfer of pathogens from patient to clinician to patient. When combined with gloves and proper environmental hygiene the incidence of preventable nosocomial infections should thus be almost eliminated.
Kampf, G., Loffler, H., & Gastmeier, P. (2009). Hand hygiene for the prevention of nosocomial infections. Deutsches Arzteblatt International, 106(40), 649-655.
Tan Jr, A. K., & Jeffrey Olivo, B. S. (2015). Assessing healthcare associated infections and hand hygiene perceptions amongst healthcare professionals. International Journal of Caring Sciences, 8(1), 108.
1. Describe how the researcher addresses the following four areas in the selected journal article (Introduction, Literature Review, Methodology and Data Analysis:
The purpose of the study is to support the World Health Organization hand hygiene campaign against healthcare associated infections (HAIs). The study aims to conduct an assessment of the perception towards hand hygiene amid healthcare professionals within the hospital. In particular, the study seeks to ascertain perceptions on HAIs and hand hygiene. The literature review conducted by the researcher was not quite extensive. Nonetheless, the previous research studies included by the author demonstrate that the execution of the hand hygiene strategy recommended by WHO is practicable, viable and sustainable across a wide range of different settings in various nations and…
Nursing-Sensitive Quality Indicators
Nurse Sensitive Quality Indicators
Nursing-Sensitive Quality Indicator: Standard Technique Hand Washing
eports of incidences of superbug infections in hospitals and highly infectious diseases in underdeveloped countries heightens the importance of standard sanitation techniques. Moreover, increasingly reimbursement rates for hospitals are tied to achievement of specific patient care outcomes, a change that has made healthcare quality more important for all stakeholders. Standard technique in hand washing, skin preparation, and wound dressing is core to quality patient care, yet the literature and the media point to an increasingly pervasive degradation in this area (Szilagy, 2013). Standard sanitation technique is definitely a nursing-sensitive quality indicator as nurses are universally engaged in these processes and procedures in some capacity.
The literature indicates that improper hand hygiene of clinicians is one of the major contributors to healthcare-associated infections (HAIs), and that 7.1% of admissions to the hospital in developed countries involve HAIs.…
Bargellini, A., Borella, P., Ferri, P., Ferranti, G., & Marchesi, I. (2012, July-September). Hand hygiene of medical and nursing students during clinical rotations: a pilot study on knowledge, attitudes and impact on bacterial contamination. Assistenza infermieristica e ricerca [Nursing and Research], 31(3), 123-130. DOI: 10.1702/1176.13038. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23164964
Farquhar, M. (n.d.). Patient safety and quality: An evidence-based handbook for nurses, Chapter 45. AHRQ Quality Indicators. Retreived from http://archive.ahrq.gov/professionals/clinicians-providers/resources/nursing/resources/nurseshdbk/FarquharM_IS.pdf
Maas M., Johnson, M., & Moorehead, S. (1996). Classifying nursing-sensitive patient outcomes. Journal of Nursing Scholarship, 28(4), 295 -- 301.
Malik, H.R. (Ed.). (2008). A Manual: "My Five Moments for Hand Hygiene" Concept. WHO (World Health Organization). Retrieved from http://www.who.int/gpsc/tools/Manual_5_moments_Pakistan.pdf
Non-Compliance of Hand Hygiene in Healthcare Setting
Hand hygiene is once of the fundamental areas that are often ignored and not well covered in inspections or standardizations, yet it is on area that almost all patients can be affected by or infected through within the healthcare facilities. Though there are recommended hand hygiene practices within the healthcare institutions and in particular the sensitive sections or departments like the obstetrics section, there has been a lot of non-compliance, total negligence of these practices or in most cases use of the wrong detergents to clean hands hence passing infections to the patients.
According to CDC (2013), in their study conducted in General Hospital of Vienna, the rates of mortality among mothers who gave birth in the hospital went down when the staff in the hospital used antiseptic agents as compared to when they used plain soap. CDC also notes that in…
BC Patient Safety & Quality Council, (2013). Hand Hygiene: Hour Challenge. Retrieved December 7, 2013 from http://bcpsqc.ca/clinical-improvement/hand-hygiene/
CDC (2013). Hand Hygiene in Healthcare Settings. Retrieved December 7, 2013 from www.cdc.gov/handhygiene/download/hand_hygiene_core.ppt?
The revised PICOT statement for this proposal is: For hospital patients (P), how does the use of a visual cue to stimulate hand hygiene compliance (I) compared to no visual cue usage to stimulate compliance (C) affect hospital acquired infection (O) during their hospital stay while the patient hand hygiene protocol implementation process is ongoing (T)?
The quantitative study by Doyle et al. (2017) focused on testing whether co-washing could be accepted by patients as a concept to help reduce the risk of infection among hospital patients. The researchers used the survey method to see if patients embraced the concept. Doyle et al. (2017) found that the overwhelming majority of patients approved of co-washing. The findings of the study could be applied in nursing practice in a number of ways. First, co-washing could be adopted by nurses whenever they are treating patients in order to…
Chenoweth, C., & Saint, S. (2013). Preventing Catheter-Associated Urinary Tract Infections in the Intensive Care Unit. Critical Care Clinics, 29(1), 19-32.
Doyle, G. A., Xiang, J., Zaman, H., Neiman-Hart, H., Maroon, M., Arghami, E., ... & King, D. E. (2017). Patient attitudes and participation in hand co-washing in an outpatient clinic before and after a prompt. The Annals of Family Medicine, 15(2), 155-157.
Ford, E. W., Boyer, B. T., Menachemi, N., & Huerta, T. R. (2014). Increasing hand washing compliance with a simple visual cue. American journal of public health, 104(10), 1851-1856.
Fox, C., Wavra, T., Drake, D. A., Mulligan, D., Bennett, Y. P., Nelson, C., ... & Bader, M. K. (2015). Use of a patient hand hygiene protocol to reduce hospital-acquired infections and improve nurses’ hand washing. American Journal of Critical Care, 24(3), 216-224.
Srigley, J. A., Furness, C. D., & Gardam, M. (2016). Interventions to improve patient hand hygiene: a systematic review. Journal of Hospital Infection, 94(1), 23-29.
Wilde, M. et al. (2015). Self-management intervention for long-term indwelling urinary catheter users. Nursing Research, 64(1), 24-34.
Guideline Evaluation According to Agree II
Guideline In Question: WHO Guidelines on Hand Hygiene in Health Care. Geneva: WHO, 2009.
DOMAIN 1. SCOPE AND PURPOSE
The overall objective(s) of the guideline is (are) specifically described.
Strongly Disagree 12 3 4 5 6 7 Strongly Agree
Comments: Numerous sources and studies have demonstrated the importance of cleanliness of the hands, and that when hand hygiene is complete, patient outcomes are more positive and surgeries are safer. (Grol et al., 2003) (Sax et al., 2007) (O’Boyle, 2001)
2. The health question(s) covered by the guideline is (are) specifically described.
Strongly Disagree 2 3 4 5 6 7 Strongly Agree
This guideline could be more specific in detailing all specific health questions this pertains to, though perhaps their lack of specificity was directly connected to the fact that hand hygiene impacts nearly every health condition.
3. The population (patients, public, etc.) to…
Grol, R., & Grimshaw, J. (2003). From best evidence to best practice: effective implementation of change in patients\\\\' care. The lancet, 362(9391), 1225-1230.
O\\\\'boyle, C. A., Henly, S. J., & Larson, E. (2001). Understanding adherence to hand hygiene recommendations: the theory of planned behavior. American journal of infection control, 29(6), 352-360.
Pittet, D., Allegranzi, B., Boyce, J., & World Health Organization World Alliance for Patient Safety First Global Patient Safety Challenge Core Group of Experts. (2009). The World Health Organization guidelines on hand hygiene in health care and their consensus recommendations. Infection Control & Hospital Epidemiology, 30(7), 611-622.
Sax, H., Allegranzi, B., Uckay, I., Larson, E., Boyce, J., & Pittet, D. (2007). ‘My five moments for hand hygiene’: a user-centred design approach to understand, train, monitor and report hand hygiene. Journal of Hospital Infection, 67(1), 9-21.
Doris examined the claim that hand hygiene education and individual feedback on hand hygiene frequency and method enhances hand hygiene frequency and improves nurses’ methodology scores of hand hygiene as stated by Chun et al. (2014). The evaluation entailed using the criteria for examining statistical research to determine whether statistical evidence support the claim. Through the critical appraisal process for statistical analysis by Cohn et al. (2009), Doris demonstrated that the research by Chun et al. (2014) has statistical evidence to support the claim. During the critical appraisal process, Doris examined whether the study met each of the various components in the…[…… parts of this paper are missing, click here to view or download the entire document ]…of the statistical analysis to show how evidence support the claim. In addition, Doris examined evidence relating to hand hygiene frequency when nurses came into contact with MRSA isolated patients. As a result,…
These are questions dealing with attitude and are the most important questions when doing qualitative social science research to gauge relationships among events. In addition to construction questions about attitudes, it is important to have the questions drafted in the correct format (Nachmias, 2008).
The Quantitative methodologies will be the statistical tests designed for the overall model to incorporate the information provided through one, two or all of the Qualitative data analysis methodologies. The tests used to determine the relationship between these "qualitative" factors and increases in Infection rates, will be the Chi-Square, Student's T-Test, ANOVA (to test for variations among the data), the construction of a Linear Regression Model and the calculation of the Pearson Correlation Coefficient, otherwise known as "R-Squared" (Nachmias, 2008).
These tests will be utilized in conjunction with a predetermined level of significance, or alpha. Since these tests will all be measuring the means and relationships…
Barrett, R. & Randle, J. (2008). Hand hygiene practices: nursing students' perceptions. Journal of Clinical Nursing, 17(14), 1851-1857.
Beggs, C.; Noakes, C.; Shepherd, S.; Kerr, K.; Sleigh, P. & Banfield, K. (2006). The influence of nurse cohorting on hand hygiene effectiveness. American Journal of Infection Control, 34, 10, 621-626.
Larson, E.; Quiros, D. & Lin, S. (2007). Dissemination of the CDC's Hand Hygiene Guideline and impact on infection rates. American Journal of Infection Control, 35(10), 666-675.
Roberts, C.; Roberts, J. & Roberts, R.J. (2009). Investigation into the effect of an alcohol-based hand product on infection rate in a nursing home setting. Journal of Infection Prevention, 10(4), 138-142.
handed to ten coffee dinkes visiting Panea Bead on a Satuday moning to analyze the habits of this paticula population.
Please ate the quality of Panea Bead coffee in the scale of 10 (whee 1 is unacceptable low quality and 10 is pleasantly high quality)
Please ate the hygiene of the Panea Bead in the scale of 10 (1 stands fo extemely dity and 10 is high standads of hygiene.
Please ate the Panea cews appoach to the customes in the scale of 10 (1 is extemely unfiendly and 10 is pleasantly fiendly)
Please compae the impotance of following items to be pesented at the Coffee stand in the ank of 10 (whee 10 is vey impotant to have and 1 is not impotant).
Half and Half Milk
Low Cal Suga
What should be pesented at the…
references varied; however, muffins and cookies were slightly more preferred (see Table 3).
Overall results of the study showed that the customers were satisfied with the quality of Panera Bread products and services. In addition the ranking questions showed the expectations from the coffee stand and the bakery. Further analysis and questions are granted to understand the quantity satisfaction and its relation to quality satisfaction.
Hygiene in Medical Settings
My message will be on hand hygiene for everyone that comes to the hospital.
Hand hygiene for hospital guests is just as important as it is for hospital personnel. Everyday interactions and activities can lead to exposure to a variety of bacteria that can create illness. In a hospital setting, this means that guests with good intentions towards loved ones can inadvertently make an illness worse or introduce new germs into clinically sanitized environments. Bacteria and other illness causing agents are often picked up from external environments and surfaces and then transported through body parts such as the nose, throat, skin, and hair. Because the hands are one of the most active parts of the body, we also carry germs between our fingers and underneath fingernails. Therefore, it becomes important that everyone wash their hands properly and frequently to decrease the transmission of bacteria and other…
Kuo, C.C. (2011). What's your hand hygiene?. AAOS Now, 5(10), 17-18.
Smith, S.S. (2009). A review of hand-washing techniques in primary care and community settings. Journal of Clinical Nursing, 18(6), 786-790. doi:10.1111/j.1365-2702.2008.02546.x.
Naturally, any problem that results in 1.7 instances of illness and 100,000 preventable deaths is automatically extremely clinically significant. What makes this topic especially clinically significant is that nosocomial infections are largely a function of behaviors that violate established principles of standard hygiene and antisepsis in clinical settings. If the information can be used to publicize the importance of reducing hospital acquired infections and to increase healthcare worker compliance with antiseptic protocols, it could greatly improve the safety and quality of the American healthcare system.
Primary Barriers to Hand Washing Compliance
The main barriers reported in connection with the low rate of hand washing compliance in U.S. hospitals include ignorance, laziness, habit, and convenience. Ignorance comes into play when healthcare providers fail to consider how vulnerable hospitalized patients are to infection and how easily bacterial infections can be caused by hand-to-hand or hand-to surface contamination. Laziness is an issue because…
Caglar S; Yildiz S; Savaser S. (2010). Observation results of hand-washing by health-care workers in a neonatal intensive care unit. International Journal of Nursing Practice, 16(2), 132-137.
In this article the authors wanted to determine whether healthcare professionals were washing their hands and if they were doing so effectively. The researchers observed 344 incidents in which hand washing was warranted and found that nurses were 63% compliant and physicians were 53% compliant. However, when it came to making sure that the job was done thoroughly, physicians were able to do a better job than nurses at a 24% to 13% rate of success. Since hand washing has been proven to be the most effective and simplest method for preventing infection, it is imperative that healthcare professionals perform it as often as needed and thoroughly.
amos M.M., Schrader, ., Trujillo, ., Blea, M., & Greenberg, C. (2011). School nurse inspections improve…
Researchers are trying different techniques to increase the incidence of compliance with hand washing guidelines and in this study they used social pressure. Initially, compliance with hand washing regulations was deemed to be significantly below expected standard within the nursing staff. To hopefully combat this, researchers told the staff that they were going to weigh the soap dispenser bags to see if people were actually using them or not. The object of the study was to determine if this type of pressure would induce the staff into better compliance with hand washing regulations. The researchers found that this type of behavioral technique is very effective.
15. Parish, C. (2008). Patient campaigner calls for TV cameras to check hand-washing. Nursing Standard, 22(38), 6.
The author of the article looked at the compliance records of staff and whether patients and visitors used infection controls. The campaigner, Roger Goss, said that because MRSA and other similar healthcare-acquired infections were becoming more dangerous that staff and visitors needed to be monitored more closely to prevent spread. The man advocated that close-circuit televisions be used to determine compliance with regulations, and he encouraged staff to be fired and visitors not welcomed if they did not comply. The warning here to nurses is that people are watching whether they wash their hands properly, and they are ready to have them terminated if they do not.
ationalism Politics Impacts Public's View
Web Article eview
The principle best-practice strategy elucidated within Louis DePaola's article entitled "Infection control in the dental office" is for practitioners to adhere to sanitary and hygiene mandates as noted within a pair of documents produced by the Centers for Disease Control. The first document is the Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care (which was published in 2011), and the companion Infection Prevention Checklist for Outpatient Settings: Minimum Expectations for Safe Care. These documents have a number of specific measures for those working in dental offices to follow to reduce the incidence of healthcare associated infections (HAI).
In addition to denoting several of the key guidelines for practitioners to adhere to in order to ensure safety and reduce the rate of infection transmission, the author also reinforces several key facets of this literature that apply to dental office…
DePaola, L. (2012). "Infection control in the dental office." http://static.ow.ly/. Retrieved from http://static.ow.ly/docs/RICDE%20Infection%20Control%20in%20the%20Dental%20Office,%20Standards%20of%20Care%202012%20(CE%20Article%20PDF)_Mcl.pdf
Describe theory rationale selecting theory. 2. Discuss theory works support proposed solution. 3. Explain incorporate theory project.
Self-efficacy theory and the promotion of hand-washing
According to the Centers for Disease Control, hand-washing is one of the most important ways in which to curtail the spread of a wide range of infections and bacteria. Hand-washing can reduce the risks of contracting the common cold, influenza, and other viruses (Wash your hands, 2012, CDC). It can also lessen the chances that bacteria such as E.coli and salmonella will be transmitted from the preparer of food to the diner, or that contaminants from raw poultry and other meats will be spread to fruits, vegetables, and other components of the meal. Hands should be washed thoroughly after preparing food, using the toilet, dealing with animals or children, or handling garbage. But many people fail to take this simple step.
Hand-washing is one…
Cherry, Kendra. (2012). Self-efficacy. About.com. Retrieved:
Wash your hands. (2012). Centers for Disease Control (CDC). Retrieved:
Nurse Lit eview
TYPE OF ESEACH STUDY - Quantitative or qualitative
Descriptive, correlational, experimental, quasi-experimental, phenomenological, grounded theory ethnographic, historical
SAMPLE METHOD & SAMPLE SIZE
Knoll, Lautenschlager & Lipp (2009). British Journal of Nursing.
Impact of workload on hygiene practices.
trials of nursing staff.
Enforcing hygiene practices has practical healing benefits for nurses.
Souweine, B. et al. (2009). Intensive Care Medical Journal.
Compared hygiene practices. Hand rubbing vs. hand washing.
person nursing staff.
Workers completed self report questionnaires.
Hand rubbing with alcohol is preferred to handwashing in some instances.
Creedon, S. (2006). International Journal of Nursing Technologies and Classifications.
Observe health worker compliance in handwashing guidelines.
73 doctors and nurses in an Irish ICU.
Knowledge of handwashing guidelines can lead to positive outcomes.
Allen, L. et al. (2014). Nevada Nformation.
Compared hand washing with hand sanitizer.
Allen, L., & et al. . (2014). Professionalism in Nursing. Nevada RNFormation, 18(1).
Creedon, S.A. (2005). Healthcare workers' hand decontamination practices: compliance with recommended guidelines. Journal of advanced nursing, 51(3), 208-216.
Evans, M.W., Breshears, J., Campbell, A., Husbands, C., & Rupert, R. (2007). Assessment and risk reduction of infectious pathogens on chiropractic treatment tables. Chiropractic & osteopathy, 15(1), 8.
Knoll, M., Lautenschlaeger, C., & Borneff-Lipp, M. (2010). The impact of workload on hygiene compliance in nursing. British Journal of Nursing, 19(16), S18-S22.
Clinical Governance and Auditing
Throughout this paper, an attempt has been made to demonstrate an understanding of the procedure of Clinical Audit (CA). The focus of this CA is the high risk area of patient safety, and with regard to how this is linked to patient safety, hand hygiene has been selected. The findings and the recommendations that follow combined with the CA tool and the selection criteria will be outlined in form of a Clinical Audit. For the purposes of improving clinical practice, CAs forms an integral aspect of clinical governance. It is indeed notable that CAs encapsulates practice which through analysis can result to quality enhancement, particularly for the patients. Various definitions of the term which are invariably the same and which tend towards verbosity exist, but a terse and precise definition is given by Coffey (2009) who puts forth that a CA is a systematic evaluation of…
Hart T. (2013).Promoting hand hygiene in clinical practice. Nursing Times; 109: 38, 14-15.
Tollefson, J. (2011). Clinical skills for enrolled/division 2 nurses. South Melbourne, Vic, Cengage Learning.
Scott, H.R., Blyth, K.G., & Jones, J.B. (2009).Davidson's Foundations of Clinical Practice. London, Elsevier Health Sciences UK..
Wilson, J. (2006). Infection control in clinical practice. Edinburgh, Elsevier, Baillie're Tindall.
Nurse Implementation Plan
It is important to understand that plans do not simply manifest themselves into existence and a specific implementation effort is needed to ensure that the evidence presented in research efforts can be used to practical ends. Although the solution appears to be clear and succinct, putting into this plan into action requires a plan of its own. To do this effectively, Lewin's model of change theory can assist in describing "how" this plan will be put into action and significantly complement "what" needs to be done in order to realize success.
The plan itself is simple and revolves around and addresses Lewin's trinity of components in his change Model. Lewin essentially proposed that change occurs in three distinct stages where an old idea is "unfrozen," then processed and eventually "refrozen." This simple model of understanding the mental processes apply both at a collective level and…
Jansson, I. et al. (2010). Factors and Conditions that Influence the Implementation of Standardized Nursing Care Plans. The Open Nursing Journal, 10 Oct 2010. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3024554/
Jeanes, A. (2009). Improving hand hygiene compliance. Nursing Times, 18 Feb 2009. Retrieved from http://www.nursingtimes.net/Journals/2012/10/04/g/p/i/030218Improving-hand-hygiene-compliance.pdf
Knutsen, R. (2013). Nurses, Hand Hygiene and Infection Control. Advanced Health Care Network, 6 Feb 2013. Retrieved from http://nursing.advanceweb.com/Features/Articles/Nurses-Hand-Hygiene-Infection-Control.aspx
Foreign key fields (i.e. The key that represents the value of a primary key in a related table) may exist in the case of CLEBSI speciment: date of diagnosis, date and time of specimen (where latter may replicate). Under 'Patient', CLEBSI line is a foreign key, too.
V. Atomic-level data
Atomic data would be the most reducible element of information (without elaboration). So for instance for hand hygiene it would be Chlorhexidine Skin Antisepsis Antimicrobial Dressing Placement
VI. Schemas of the database will be:
Patient with the attributes of name, age, medical record number (MN), diagnosis, central line; Central line with the attributes of medical record number, date of insertion, insertion site, date of removal, line days, inserting provider, the components Central Line Bundle compliance, antimicrobial dressing placement; and CLABSI infections with attributes of MN, date of diagnosis, date and time of specimen, organism detected. Central Line Bundle compliance will…
CDC (2010) Central Line-Associated Bloodstream Infection (CLABSI) Event. Retrieved April 1, 2011 from www.cdc.gov/nhsn/PDFs/pscManual/4PSC_CLABScurrent.pdf
Databasics: A Database Dictionary. Retrieved April 1, 2011 from: http://www.geekgirls.com/database_dictionary.htm
Institute for Healthcare Improvement. (n.d.). Implement the central line bundle. Retrieved March 21, 2011, from http://www.ihi.org/IHI/Topics/CriticalCare/IntensiveCare/Changes/ImplementtheCentralLineBundle.htm
Moodle. Database Fields. Retrieved April 1, 2011 from http://docs.moodle.org/en/Database_fields#Field_name_and_description
For its versatility in eluding new antibiotics, it can be life-threatening. One of these "superbugs" is VRE, which is transmissible by direct hand contact or through surfaces and equipment by anyone, including the health care worker (Capriotti, 2007). VRE has recently spread to the community and the health care sector.
New antibiotics continue to be synthesized to cope with the rapid mutation of the VRE bacteria, but the organisms continue to overtake the drugs (Akins & Haase, 2005). A study conducted on a series of VRE outbreaks in Germany revealed that an estimate of 1 million Euros could be saved with adequate prevention and control of the infection. The use of newer antibiotics is not as cost-effective as prevention. These antibiotics have to be administered with precision and require complementary hygienic precautions on the part of the health care worker. The rising incidence of and serious threats posed by the…
Akins, R.L. And Haase, K.K. (2005). Gram-positive resistance: pathogens, implications and treatment options. Pharmacotherapy: Pharmacotherapy Publications. Retrieved on September 15, 2009 from http://www.medscape.com/viewarticle/507658
Capriotti, T. (2007). Resistant "Superbugs" create need for novel antibiotics.
Dermatology Nursing: Medscape. Retrieved on September 15, 2009 from http://www.medscape.com/viewarticle/554935
Department of Health (2006). Fact sheet. New York State Department. Retrieved on September 15, 2009 from http://www.health.stats.ny.us/diseases/communicable/v_r_e/docs/facts_sheet.pdf
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…
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.
The current study aims to examine the effect of the lack of supervision and detachment between administration and low-level supervisors and beat officers and how this leads to low morale and motivation. Imperatively, low level of morale and motivation results in low productivity, which might give rise to absenteeism and poor watch, adversely affecting the society through increased level of crime. A questionnaire will be designed to achieve the purpose of this research study and will be distributed to selected beat officers working in different police precincts. The number of questionnaires analyzed will be to different police precincts. Data collected will be analyzed through SPSS using both descriptive statistics, correlation and regression data.
Organizations endeavor to have more productive personnel, who are deemed the most significant resources and a determining factor for success. Low levels of productivity can be linked to poor employee morale and motivation. The…
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…
General Information About MRSA in the Community. (n.d.). Retrieved February 21, 2015, from http://www.cdc.gov/mrsa/community/index.html
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
he Neuman Model is appropriate for senior care.
Studies necessary with other models.
Penrod, et.al.; Reframing Person Centered Care for Persons with Dementia
Research and heory for Nursing Practice
Lit. Review, discussion
Research shows individual personhood approach has positive effects on care.
Biomedical and psychological models must be merged for persons with dementia.
Further study using different integration modeling.
Rajapaksa and Rothstein; Factors hat Influence the Decisions of Men and Women Nurses to Leave Nursing.
Qualitative, some quantitative analysis
For men, compensation largest barrier to remaining in nursing; for women dissatisfaction with career goals
Barriers to entry in profession for men and still social stigma
It is possible for hospitals and care centers to develop program to retain more nurses
Needs more demographic and psychographic variation.
Gillespie and Peterson; Helping Novice Nurses Make Effective Clinical Decisions
Their Experiences With a Refugee Population." Journal of Nursing Education.
Watson, J. (2008). "Social Justice and Human Caring." Creative Nursing. 14 (2): 54+.
As to catheter straps, if fastened too tightly they can act as tourniquets, cutting off the needed flow of blood and presenting. And at least theoretically, use of straps brings about a risk of increasing the complications such as "…deep vein thrombosis and pulmonary embolism" in those patients with "impaired lower extremity circulation" (Billington 504). Research presented in this article shows that the problem of infection due to poorly attached catheters can be reduced significantly through the use of a product called "Bard StatLock" -- which, the authors insist, is an effective stabilization device because it allows movement (through a swivel clip), because it is a "sterile latex-free, tug-resistant product" (Billington 504). An article in the journal RN, incidentally, states that treating "hemodialysis catheter-related bacteremia" can cost a hospital up to $45,000.
ashing "Bloody Hands": An article in the Australian Nursing Journal asserts, "…hand hygiene is the single most effective…
Aziz, a.M., Ashton, H., Pagett, a., Mathieson, K., Jones, S., & Mullin, B. (2009).
Sharps management in hospital: an audit of equipment, practice and awareness.
British Journal of Nursing, 18(2), 92-98.
Billington, a., Crane, C., Jownally, S., Kirkwood, L., & Roodhouse, a. (2008).
deaths in childbirth were a major problem for the medical community (Ey). The most significant cause for the large number of women dying during this process was the occurrence of puerperal sepsis which was more commonly known as childbed fever. A variety of theories were offered to explain this phenomena but some dated theories surrounding the causes of diseases such as malaria and typhoid made progress toward reaching a cure for childbed fever more difficult. The prevailing thought was that both diseases were caused through contact with water and this fact, added to the lack of indoor plumbing, caused doubt to be raised when Hungarian born Ignaz Phillip Semmelweis first suggested his germ theory and its relationship to childbed fever.
Semmelweis, before Lister introduced his germ killing theory, began insisting that the failure to properly wash one's hands between procedures was the cause of infections and, therefore, the reason why…
Biddle, C. "Semmelweis revisited: hand hygiene and nosocomial disease transmission in the anesthesia workstation." AANA Journal (2009): 229-237.
Carter, K. Codell. Childbed Fever: A Scientific Biography of Igna Semmelweis (Revised Edition). Piscataway, NJ: Transaction Publishers, 2005.
Cork, D.P. "Remembering Semmelweis: hand hygiene and its importance on today's clinical practice." American Surgeon (2011): 123-125.
Ey, Bridson. "Iatrogenic epidemics of puerperal fever in the 18th and 19th centuries." British Journal of Biomedical Science (1996): 134-139.
Refinement of a Nursing Concern into an Evidence-based Practice Proposal Using the Research Process
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…
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…
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
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,…
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
Clean Water Crisis
Every human being on earth necessitates at least 20 to 50 liters of clean, safe water on an everyday basis for the purposes of drinking, cooking, and basically maintaining themselves to be clean. However, there is a significant need for clean water in countries. In the contemporary setting, statistics indicate that 1 in 9 individuals lack accessibility to clean and safe water (Water.org). There are 844 million people across the globe that are presently living without access to clean water. This lack of clean water has resulted in a health crisis as it causes diseases. Notably, access to safe water leads to poor sanitation, which consequently adds to deteriorated health and increases the spread of infectious diseases. The inference of this is that it results in increased child and mortality rates. Statistics further indicate that every 2 minutes in the present day, a child does because…
What are Bacteria and Viruses?
The most palpable variance between bacteria and viruses is their size. Whereas both bacteria and viruses are too tiny to notice with the naked eye, most bacteria are about one micrometer in length and can be perceived with a good optical microscope. On the other hand, viruses are smaller than the wavelength of visible light, which implies that they can be solely perceived by using an electron microscope (Nursing Times, 2006). Infection, every so often the initial phase, takes place when bacteria, viruses or other microbes that cause disease enter the human body and start to proliferate. Disease comes about and ensues when the cells in the human body are damaged, as a result of the infection, and signs and symptoms of a disease appear.
Bacterial and viral infections are contaminations caused by bacteria and viruses. Bacteria release toxins into the blood stream whereas…
What are Bacteria and Viruses?
The most basic difference between bacteria and viruses is their size. Whereas both bacteria and viruses are too tiny to notice with the naked eye, most bacteria are about one micrometer in length and can be perceived with a good optical microscope. On the other hand, viruses are smaller than the wavelength of visible light, which suggests that they can only be perceived by using an electron microscope (Nursing Times, 2006). Infection, every so often the initial phase, takes place when bacteria, viruses or other microbes that cause disease enter the human body and start to multiply. Disease comes about and ensues when the cells in the human body are damaged, as a result of the infection, and signs and symptoms of a disease appear.
Bacterial and viral infections are contaminations caused by bacteria and viruses. Bacteria release poisons known as toxins into the…
Theory vs. Practice
When it comes to working in any sort of organization or corporation, one of the obvious chasms that becomes clear here is the relationship between theory and what is practiced in a small business setting. To truly look at and assess that paradigm, the author of this report has interviewed an owner/manager at a small business to discuss what they do to make things work, what is suggested in theory and scholarly literature and how those frameworks and lessons do or do not work for their particular situation. The author of this report will personally be making a comparison and contrast between what is asserted within the literature and compare it to the feedback and personal experience narrative of the owner/manager. A common refrain seen in the blogosphere and elsewhere is that there is a disconnect between what is suggested in the minds of theorists and within…
When it comes to working in any sort of organization or corporation, one of the obvious chasms that becomes clear here is the relationship between theory and what is practiced in a small business setting. To truly look at and assess that paradigm, the author of this report has interviewed an owner/manager at a small business to discuss what they do to make things work, what is suggested in theory and scholarly literature and how those frameworks and lessons do or do not work for their particular situation. The author of this report will personally be making a comparison and contrast between what is asserted within the literature and compare it to the feedback and personal experience narrative of the owner/manager. A common refrain seen in the blogosphere and elsewhere is that there is a disconnect between what is suggested in the minds of theorists and within the so-called ivory…
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.…
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
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…
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.
The Importance of Patient Identifiers
Adverse events as a consequence of medical treatment are now recognized to be a significant source of morbidity and mortality around the world (World Health Organization [WHO], 2005). Somewhere between 3 and 5% of all hospital admissions in the United States result in an adverse event, and in 1999 it was estimated that the majority of the 44,000 to 98,000 deaths caused annually by medical mistakes could have been prevented (reviewed by Leape, 2000, and WHO, 2005).
The sources of adverse events can be divided into clinical practice, defective or poorly maintained products, improper procedures, or an organizational system. The World Health Organization (2005) concluded that systemic failures are the primary source of adverse events, and can be attributed to a particular organization's patient care strategy, culture, attitudes toward managing quality of care and risk prevention, and the ability to learn from mistakes.…
Resources. When taught in-house, hospital PHI guidelines will be included as course material. A formal 2-hour lecture will be presented, followed by a specified period for home study of the course material. A 1-hour supervised exam will then be administered to test the student's comprehension of the HIPAA Privacy and Security Rules, and the significance of PSQIA.
Association of Surgical Technologists. (2006). Recommended Standards of Practice for Patient Identification. Retrieved March 16, 2011 from http://www.ast.org/pdf/Standards_of_Practice/RSOP_Patient_Identification.pdf
Brady, Anne-Marie, Malone, Anne-Marie, and Fleming, Sandra. (2009). A literature review of the individual and systems factors that contribute to medication errors in nursing practice. Journal of Nursing Management, 17, 679-697.
Brady, Anne-Marie, Redmond, Richard, Curtis, Elizabeth, Fleming, Sandra, Keenan, Paul, Malone, Anne-Marie et al. (2009). Adverse events in health care: a literature review. Journal of Nursing Management, 17, 155-164.
New Sepsis Guidelines and Nurses: Factors, Compliance and Consideration
Introduction to Sepsis
Sepsis refers to the body’s dangerous reaction to an existing infection. Sepsis is extremely serious and if not treated swiftly with appropriate action it can lead to fast tissue and organ damage and death. The medical community has long been focused on getting better control of sepsis, as it is a damaging and debilitating condition that contributes to a host of preventable deaths. In fact, sepsis is one of the primary reasons for death in the number of hospitalized patients and is the cause of 20% of all admissions to intensive care units. (Ferrer et al., 2008). This data clearly indicates that sepsis is an aggravated problem that experts need to have better protocol for and preventative measures to counteract. In America, the rate of death from sepsis is one of the highest rates in the world with…
Research Proposal for Catheter Associated Urinary Tract Infections
Catheter Associated Urinary Tract Infections (CAUTI) affects timely reimbursement and prolongs patient stays in the healthcare facility. Many hospitals strive for ways to reduce CAUTIs and take specific medical measures to aid patients in recovery from the same and avoid recurrence of the cases of CAUTIs. These deliberate measures ensure so they can have better patient outcomes and improve patient care. This also improves the reimbursement received from insurance providers.
The research seeks to investigate the effect of frequent CAUTI education, among the in-hospital patients with indwelling urinary catheter, conducted over six months.
Background and Significance of the Problem
It is common medical knowledge that urinary catheters have the potential to cause urinary tract infections, known as catheter-associated urinary tract infections (CAUTIs). Indwelling catheters are a part of many plans of care, specifically for emergent and critical care patients within…
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…
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.
Lowering the Nurse/Patient atio: A simple Step for Improving Care
Nursing is far from a static profession or discipline, and is in fact in a constant state of progression and change. Not all of these changes are necessarily for the better; increased healthcare demands, decreased abilities to pay for many patients and institutions, and a host of other factors can contribute to negative changes in the nursing work environment. When such factors arise it becomes all the more important for effective nursing researchers and practitioners to identify and advocate positive changes to the practice and the profession of nursing that can help combat the negative factors and ensure a consistent quality of care. In the current era of an ongoing shortage of nurses n the face of increasing demand and the approaching depletion of available nurses due to the aging population of nurses themselves, addressing the nurse-to-patient ratio…
Adomat, R., Dip, P. & Hewison, A. (2004). Assessing patient category/dependence systems for determining the nurse/patient ratio in ICU and HDU: a review of approaches. Journal of Nursing Management 12(5): 299-308.
Hassan, Z., Pryor, E., Autrey, P. & Turner, J. (2009). Hand Hygiene Compliance and Nurse-Patient Ratio Using Videotaping and Self Report. Infectious Diseases in Clinical Practice 17(4): 243-7.
Kane, R., Shamliyan, T., Mueller, C., Duval, S. & Wilt, T. (2007). The Association of Registered Nurse Staffing Levels and Patient Outcomes: Systematic Review and Meta-Analysis. Medical Care 45(12): 1195-204.
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.
Several patients in (Hospital Name) have come in complaining of cardiac related health problems. Some have had issues with cardiothoracic…
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.
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…
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.
Being that it is an operation that is being conducted in an industrial area, and in an industry that dealt with compressed gas, it is critical that all the safety measures are taken into account in a categorical and safe manner in the bid to re-enter the after the terrible hurricane. For instance there are various experts who are present and I would recommend that their individual expertise be put to use in the recovery process. First, the entire employees' body must be informed of the extent of the damage and the seriousness of the problem at hand and instructed not to venture into any area within the firm without the clearance and subsequent communication through a central communications office that they have to be informed of. I would also suggest to the Incident Commander to have a formal written process for the recovery of the firm. This…
Biophica Inc., (2011). The "Chlorinated" Water Issue and the Water Ionization Alternative using
Colloidal Copper or Colloidal Silver Nanocrystal Ionization. Retrieved October 19, 2011 from http://www.biophysica.com/chlorine.html
Healthy Working Lives, (2010). Personal Protective Equipment (PPE). Retrieved October 19,
2011 from http://www.healthyworkinglives.com/advice/minimising-workplace-risks/ppe.aspx
nurses play a very important role in the emotional, spiritual, and physical care of the patient with different illness. When it comes to nursing homes, nurses are responsible for the well-being of the individuals there. Even though majority of the persons there are not critically there, they still depend on nurses for their care both medically and emotionally.
Sanghine (2013) reported that two nursing home nurses managed to turn off the alarms of nineteen patients at night so they would not be disturbed during their sleep. They were caught when the care home manager checked up on them in the middle of the night. IT was reported that elderly patients in ages 75 to 100 were not able to call for help. Not only that, they also reported ill treatment to the persons only because they preferred their own comfort and sleep before their duty at the nursing home.
Baldwin, P., Dodd, M., & Wrate, R. (1997). Young doctors' health -- I. How do working conditions affect attitudes, health and performance?. Social Science & Medicine, 45(1), 35 -- 40.
Bates, D., Boyle, D., V, er Vliet, M., Schneider, J., & Leape, L. (1995). Relationship between medication errors and adverse drug events. Journal Of General Internal Medicine, 10(4), 199 -- 205.
Chaudhury, H., Mahmood, A., & Valente, M. (2009). The effect of environmental design on reducing nursing errors and increasing efficiency in acute care settings a review and analysis of the literature. Environment And Behavior, 41(6), 755 -- 786.
Hughes, R., & Rogers, A. (2008). The effects of fatigue and sleepiness on nurse performance and patient safety. Agency For Healthcare Research And Quality (U.S.).
Instrumentation needed for the research study will be relatively minimal and straightforward; necessary equipment for a standard checkup to determine cardiovascular health and other basic signs of chronic disease as well as scrapers, swabs, and vials for the collection of bacterial samples will be needed. It is possible that culturing of the bacterial samples will be desired, in which case additional instruments and controlled environment equipment will also be needed for the full completion of the study. In order to assess the exclusionary criteria related to weight, a standard scale and height ruler will need to be utilized along with caliper measurements to determine body mass index. Other than this and the instruments necessary for recording and analyzing the data collected using these instruments, it is not expected that any other resources will be necessary for this research study.
ollowing initial measurements to determine suitability for inclusion in…
Following these general examinations and the more extensive examinations of cardiovascular health, specifically identified areas in participants' mouths will be variously swabbed or scraped to obtain bacteria samples, and levels of bacteria in these areas and in the mouth as a whole will be measured using a variety of techniques. If necessary, the bacteria collected through this direct methodology will be cultured in an appropriate lab setting using standard equipment, with twenty-four hours being sufficient time for the culture to grow to be identifiable in most instances. Examination of bacteria types, growth patterns in the mouth, and correlation with cardiovascular disease will be identifiable with the data collected via these methods, enabling appropriate analysis and a determination of correlation.
The latest available version of SPSS software operated by an experienced statistician, under the observation and supervision of the lead researcher, will be utilized to analyze the raw data collected in this study. Specifically, regression analyses will be utilized in order to determine the correlation, if any, that exists between the existence of certain types or levels of bacteria in the mouth or in certain areas of the mouth and cardiovascular disease. The Mann-Whitney test will also be used to determine which if any variables are statistically different between the participant group with cardiovascular disease and those without. Again, this is in keeping with similarly designed studies already successfully completed (Johansson et al. 2008).
Washing and Use of Testosterone:
The Action of Hand Soap Bacteria:
Hand washing is an important practice for body hygiene because of its seeming effectiveness in preventing the transmission of bacteria. Actually, it is believed that hand washing helps to lessen the risk of bacterial infection through removing and destroying bacterial cells. Generally, the use of hand soap while complying with the good washing practices help an individual to destroy bacteria in the hands, which in turn decreases the spread of diseases or illnesses. The need to wash hands using hand soap is attributed to the accumulation of bacteria on the surface of a person's hands because of numerous opportunities brought by day-to-day activities. For instance, a person encounters bacteria every time he/she touches another individual, touches raw meat, and handles money. The bacteria can get into the individual's hands and under his/her fingernails and spread if he/she touches any…
Angkadjaja, S. (2012). What Makes Antibacterial Soap Antibacterial? Retrieved from Illumin
University of Southern California website: http://illumin.usc.edu/printer/68/what-makes-antibacterial-soap-antibacterial/
Singer, N. (2006, August 10). Does Testosterone Build A Better Athlete? The New York Times.
Retrieved December 4, 2013, from http://www.nytimes.com/2006/08/10/fashion/10Fitness.html?pagewanted=all&_r=0
Life and Death: The Life Support Dilemma by Kenneth E. Schemmer M.D
Kenneth Schemmer in his thorough, thought provoking book brings to life the controversial subject of the life support issue. For years, many all over the country have pondered, "What if a person were in some kind of an accident and the physicians told them that they were not going to make it?" And all that he or she could do is just lie there in extreme pain waiting for their life to the end. Or even worse case scenario what if they happened to end up completely brain dead? These debated questions are taken on by Dr. Schemmer in making his point that life support decisions may not necessarily be the decision of the family, the doctor or the patient but by a higher being that gives life and takes life. Schemmer uses these controversial questions in his…
Court backs right to die | terminally ill have right to refuse medical life support. (1984, Dec 28). The San Diego Union, pp. A.1-1.
Ackerman, T. (2005, Mar 27). Life support battle shifts / A decade ago, patients families had to press for 'right to die. Houston Chronicle, pp. 1-B.1.
Allen, P. (2000, Oct 07). Right to die upheld despite new euro law, doctors can end life support rules judge. Daily Mail, pp. 33-33.
Dolan, M. (2001, Aug 10). Justices deal setback to right-to-die movement; health: State court bans removal of life support from conscious patients whose wishes are not clear. Los Angeles Times, pp. A.1-A.1.
Such equipment should be adequate to ensure personnel are protected from chemical exposure to the eyes, skin, and respiratory tract. PPE may be upgraded or downgraded by the site industrial hygienist, HSM, or qualified Site Safety Officer based upon site conditions and air monitoring results (Levin, et al., 2002)
Work practice and administrative controls
Administrative controls or work practice controls are changes in work procedures such as written safety policies, rules, supervision, schedules, and training with the aim of reducing the interval, frequency, and sternness of exposure to hazardous chemicals or situations. Workers who handle hazardous chemicals in the workplace should be familiar with the administrative controls required fewer than 29 CF 1910.1200, and the OSHA Hazard Communication Standard. This controls are perhaps most important, because they impact your people directly. On the one hand, they are the simplest, since all it takes is education. On the other hand, education…
Annual report on 9/11 health (September, 2009). Retrieved on March 20, 2010 from http://www.nyc.gov/html/fdny/pdf/2009_wtc_medical_working_group_annual_report.pdf
Burright, D. et al., (1999). Evaluation guidelines for air sampling methods utilizing chromatographic analysis. OSHA Salt Lake Technical Center, U.S. Department of Labor: Salt Lake City, UT.
Harris, J.S., (ed.) (1997). Occupational medicine practice guidelines: Evaluation and management of common health problems and functional recovery in workers. The American College of Occupational and Environmental Medicine. Beverly, Mass.: OEM Press.
Levin, S. et al.,. (2002). Health effects of World Trade Center site workers. America Journal of Industrial Medicine 42:545 -- 547.
Washing Procedures in a Dental Office
One of the challenges of teaching a lesson plan founded upon "Standard D2.1: Know how to evaluate potential causes and methods of transmitting infections and how to apply standard precautionary guidelines" according to CTE Standards: California Career and Technical Education Standards (232) is that the lesson plan must simultaneously be informative yet also teach critical skills to students. It must balance the need to convey practical information but not solely consist of lectures: a purely academic understanding of the topic will not necessarily affect student behaviors in the field. To impress upon students the importance of proper hygiene, I would first give an overview of healthcare-related infections to students. I would show photographs of what infections look like, both on the human body and also in microbial form. This would be a profound visual stimulus to students about the consequences that infections can render.…
DePaola, L. (2012). "Infection control in the dental office." Retrieved from: http://www.richmondinstitute.com/article/infection-control/infection-control-in-the-dental-office
Hand-washing procedure. (2013). Lesson Plan.
Standard D2.1. (2013). CTE Standards: California Career and Technical Education Standards. Retrieved from: http://www.cde.ca.gov/ci/ct/sf/documents/ctestandards.pdf
Flandes-Stepans, M., Wilhelm, S.L., & Dolence, K. (2006). Smoking Hygiene: Reducing Infant Exposue to Tobacco. Biological eseach fo Nusing, 8(2), 104-114.
Consideing the title of the wok, one would believe that the poblem statement would explain ways to educe infant exposue; when in fact the aticle commences by explaining the lage monetay buden that smoking elated issues has bought about in the medical field. The aticle then begins to explain the coelation that exists between the smoking patten of the mothe and the level of exposue to Envionmental Tobacco Smoke (ETS). Finally, it is explained that a stong coelation has been made between beastfeeding and educed ETS; howeve it is also stated that in fact a child is moe likely to have elevated levels & symptoms associated with ETS if the beastfeeding mothe is a smoke. It is also stated that thee is a distinct coelation between the smoking patten…
references utilized in this article there could have been more useful information provided from these sources. In addition, considering the fact of the redundancy of this research compared to the previous research it would have been an improvement to look at another alternative to decreasing ETS. Though the title of the research would lead one to believe that this will in fact be about ways to decrease ETS, this is not what is truly portrayed in the research in the beginning. The reader is given information as to how much money ETS is costing medically due to health issues and infant related deaths, but very little discusses the impact that breast feeding has. It appears in the beginning that the researchers want to prove that children should be breastfeed and that mothers should not smoke because the infants that are breastfed are protected from the health problems associated with ETS. However little information is given neither in the intro nor in the review of literature to show what impact there really is for a child that is breastfed by a mother that does not smoke, in relationship to ETS from second hand sources i.e. cars, malls etc. Another weakness, which I have already discussed several times through this critique, is the sample size. This was a rather small sample and the ways in which the control and test group were handled may not have been the best methods possible. Ultimately, this research left me wondering why one would want to conduct research to confirm the already obvious, while offering no additional information to the resolution or problem at hand.
Flanders-Stepans, M., Wilhelm, S.L., & Dolence, K. (2006). Smoking Hygiene: Reducing Infant Exposure to Tobacco. Biological research for Nursing, 8(2), 104-114.
air traffic has continued to increase and it now constitutes a considerable proportion of the travelling public. The amount of long-hour flights has increased significantly. Based on the International Civil Aviation authority, air traffic can be anticipated to double amid till 2020. Airline travel, especially over longer distances, makes air travelers vulnerable to numerous facets that will impact their health and well-being. Particularly, the speed with which influenza spreads and mutates, via transportation routes, is the reason why the influenza pandemic is considered to be a huge threat to the human population. Pandemic is a term, which is used for a virus or microbe when it spreads over a large area, in severe cases even the whole world and large number of people start getting affecting by it (CDC, 2009).
In the past 300 years, there have been ten significant influenza pandemics outbreaks that have taken place in this world.…
Airports Council International (2009) Airport preparedness guidelines for outbreaks of communicable disease. Available at: http://www.airports.org/aci/aci/file/ACI_Priorities/Health/Airport%20preparedness%20guidelines.pdf (Accessed: 28 November 2011)
Bouma, G.D. (2002) The research process. 4th edn. Melbourne: Oxford University Press.
Brigantic, R., Delp, W., Gadgil A., Kulesz, J., Lee, R., Malone, J.D. (2009) U.S. airport entry screening in response to pandemic influenza: Modeling and analysis. Available at: http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B7578-4W2M6SG1&_user=10843&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000000150&_version=1&_urlVersion=0&_userid=10843&md5=44685b11dd53d74a8ef85a4f03e185f2 (Accessed: 28 November 2011)
Bush, George W. (2003a). Homeland security presidential directive -- 5: Management of domestic incidents. Available at: http://www.whitehouse.gov/news/releases/2003/02/20030228-9.html (Accessed: 28 November 2011)
4) Wheelworks offers a few different forms of financial compensation. They pay wages that they describe as "the highest possible." This meets the safety needs of their employees, which is key in the retail business. It was stated that many of the employees have good educations, so if they could not meet their safety needs at Wheelworks, they would be forced to do so elsewhere.
Wheelworks does not offer commission. This is good practice, since their staff are more motivated by higher-level needs such as achievement and competition. Commission is insufficient and does not support Wheelworks' attempt to differentiate themselves with their high level of customer service. There are also profit sharing plans, which motivate the employees but also foster teamwork. This is also true of the seasonal bonuses. These also reinforce the belonging needs. In this way, these types of incentives reinforce the higher order needs, while de-emphasizing the…
1. The dilemma of Obesity
Mokdad et al., (1999) in his study found that the issue of unhealthy weight, overweight and obesity are perhaps one of the rising concerns for the Americans in the 21st century as more and more U.S. citizens become vulnerable to the circumstantial risks and dangers of the phenomenon (Mokdad et al., 1999). It is usually the body mass indexes (BMI) that indicate whether a person is actually overweight or not. The National Health and Nutrition Examination Survey (NHANES) carried out a study for the years 1999 to 2002 using the BMI phenomenon and concluded that about 65% of U.S. citizens in the adulthood years were categorized under the overweight group because of their BMI (Division of Nutrition and Physical Activity, National Center for Chronic Disease Prevention and Health Promotion, 2005).
To understand the phenomenon of obesity and its rise, it's important to understand…
Adam Drewnowski and S.E. Specter (2004), Poverty and Obesity: The Role of Energy Density and Energy Costs, American Journal of Clinical Nutrition 79, no. 1: 6-16.
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Following the story and the demonstration, the use of a song to reinforce the steps to proper brushing would assure that the students learn and remember each step. If the music is set to a song they are already familiar with, the chance of learning and remember are increased as the student will make a positive connection.
Finally, a kinestic activity should take place. This could be by having the student draw a picture of him/her doing proper technique or by having the students role-play proper techniques with a partner.
When teaching a group of five-year-old students, it is important to have a wide variety of activities that reach all styles and types of learning. The activities should not be too long and should be taught using vocabulary and language that they identify with and clearly understand. Therefore, the Multiple Intelligence learning theory would be best in this…
Fluoridation: A Public Health Debate
Fluoridation (the adding of fluoride to water) has been a hotly debated health issue for over half a century. Some advocate fluoridation by citing the many oral benefits available through the process, heralding the betterment of public hygiene that has been achieved from the procedure's inception. Detractors, on the other hand, point out the possible side effects from the abuse of fluoridation, the health problems being experienced around the globe by countries with fluoridated water, and the indelible rights of man. Because the decision to fluoridate drinking water or not affects so many of the worlds population it is definitely a worthy topic to sink ones teeth into.
The concept of fluoridation began in the early 20th century by a Colorado Springs, Colorado dentist named Frederick McKay. Upon moving to the area from the East Coast, McKay noticed that several of his patients "exhibited strange…
http://www.ada.org -- retrieved February 18, 2002
http://www.cdc.gov/nccdphp/oh/fl-info.htm -- retrieved February 18, 2002
http://www.nidcr.nih.gov -- retrieved February 18, 2002
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Drawing from Maslow's hierarchy of needs, Shank's old boss failed to fulfill the needs of both esteem and belonging. Belonging is related to making sure employees are comfortable and feel that they are part of the team or group. Although esteem is making employees feel a sense of accomplishment. Shank has described the former boss as being non-motivating, having no relationship with employees and having told employees that they are just a number in the organization. During the tenure of the former boss, motivating employees was not a prime factor. The former boss ran the company on the bottom line of getting things done, making profit, efficiently and effectively. If things were not done in the right manner, the boss would replace the employees. Since the boss is operating at a twofold level of the Maslow's hierarchy of needs (security and physiology), its top priority must be to motivate…
Health Technology Advocacy
The greatly expanded possibilities that are allowed by technology in today's world, has provided a tool for professionals in the health care industry to greatly expand their effectiveness and efficiency. The internet and all the sub-technologies that have spawned from this development are central in any application of modern day communication technology.
Specifically, the use of social media, via smartphone technology can be used to combat the greatest threat to collective health. The extraordinary lack of preventative health measures are at the root cause of the exploding costs and energies dedicated to health care in today's confusing and complex approaches to taking care of both our minds and bodies. While some attention is paid to diet, exercise and hygiene, mental hygiene is often ignored as a preventative measure to good behavior, good choices, which leads to good health.
The constant bombardment of information thorough social media through…
Galer-Unti, R. (2010). Advocacy 2.0: Advocating in the digital age. Health Promotion Practice, 11(6), 784 -- 787.
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Maslow's Hierarchy of Needs is perhaps the most commonly known theory of motivation, which is likely due to the broad applicability of the theory. Maslow developed his hierarchy of needs as part of his research on human potential and a component of positive psychology he termed self-actualization (Maslow, 1943; 1954). Maslow believed that human motivation is heightened when people seek fulfillment through personal growth and discovery. Self-actualized people are fully engaged with their potential, in an ongoing, lifelong effort to create meaning in their lives through highly personalized, positive endeavor (Maslow, 1962).
Doubtless, employers would enjoy not having to be concerned with motivating their employees if, in fact, their employees would "self-actualize" through their work. Indeed, some people do experience self-actualization when they are engaged in their paid employment. But, perhaps more often than not, people who become self-actualized are able to spend time either playing or laboring…
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Both women suffer hard and endure their pain gracefully. Wang Ya-Ming cries but does not feel sorry for herself. Her tears are like a symbolic means of self-purification. She stood "with her back to the classroom," and did not make a habit of crying (3). Her inner strength is evident in her self-composure. Wang Ya-Ming is stalwart and self-contained. She studies hard and for the most part ignores and quietly endures the taunting and teasing. At one point in the story, the narrator notices that her chin was "tilted slightly higher than usual, as through she were calmed by a feeling of repose and a sense of contentment," (3). When she is forced to sleep on a hard bench outside of the dorm bedroom, she comments, "Sleep is sleep no matter where you lie down, so what's the difference," (5). In a similar way, Hsiang Lin's Wife demonstrates remarkable strength…
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…
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