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Larry O'Dell notes that the increasing outbreaks of MRA in schools can be controlled if certain preventive measures are put in place. It is for example known that gyms and locker rooms are target locations for infections. People taking part in sports such as football and other athletics share equipment. Taking part in these sports often result in cuts and abrasions, which make these persons vulnerable to infection.
A well-known cliche is that knowledge is power. It is therefore very important that college students be aware of MRA, its dangers and the locations where it is most likely to infect. People taking part in sports should for example ensure that shared equipment is thoroughly cleaned before and after use. howers should be routine after each practice session, and any cuts and abrasions should be disinfected immediately. To be safe, serious injuries should be attended to by medical professionals.
Johnson, Alan. Methicillin-resistant Staphylococcus aureus (MRSA) infection. 2007. http://www.netdoctor.co.uk/diseases/facts/mrsa.htm
O'Dell, Larry. Skin infections spreading in many schools. The Associated Press, 2007. http://www.newsday.com/news/local/wire/newyork/ny-bc-ny -- staphoutbreaks1012oct12,0,4383079.story
This may eventually lead to end organ failure and death. MSA / S.aureus are not often found to be the etiology of lung infection except in hospitalized patients who reside in the Intensive Care Units. Often the victim requires ventilation, meaning the bacteria can bypass the humoral and physical defenses of the nose and throat. Endotracheal intubation can also be a method of MSA pneumonia, often fatal in the debilitated patient.
Given the prevalence of MSA within the hospital population, both patient and staff, and given the rate of MSA infection within the general population, it is my hypothesis that it is more likely for patients to be contaminated with MSA in radiological procedures which require the use of multi-patient equipment that goes through rudimentary cleaning, rather than radiographic procedures using multi-use equipment which goes through rigorous cleaning between each patient.
In essence, while a multitude of…
www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&term=%22Jernigan+JA%22%5BAuthor%5DJernigan JA, www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&term=%22Pullen+AL%22%5BAuthor%5DPullen AL, www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&term=%22Flowers+L%22%5BAuthor%5DFlowers L, www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&term=%22Bell+M%22%5BAuthor%5DBell M, www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&term=%22Jarvis+WR%22%5BAuthor%5DJarvis WR
Prevalence of and risk factors for colonization with methicillin-resistant Staphylococcus aureus at the time of hospital admission.
Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Bodenheimer T. The American health care system; the movement for improved quality in health care. N Engl J. Med 1999;340:488-92
One in six patients in intensive care units are colonized or infected with MSA, which signifies not only the prevalence of this health risk, but the impact on the nurses' workload. Antibiotic resistant MSA increases mortality and postoperative stay; the number of death certificates mentioning MSA increased by 19% between 2002 and 2003, and postoperative stays were a mean of 8.5 for those without MSA, and 17.9 days for those with MSA (Fairclough, 2006). Nurses are consequently attending to more patients for longer periods of time and are exposed to greater infectious risk. Hospital administrators must assess the burden on clinical and managerial staff, as well as the economic and financial implications of prolonged treatment for patients.
educing the incidence of MSA requires a comprehensive approach to the infection as no single entity can eradicate the bacteria. Fairclough explains the most obvious and immediate measure that needs to be taken…
Fairclough, S. (2006). Why tackling MRSA needs a comprehensive approach. British Journal of Nursing, 15(2), 72-75.
Henry F. Chambers, professor of medicine at the University of California, San Francisco (www.nfid.org).
Moreover, as for Chambers' article, he contends that "bactericidal activity is not an invariable property of an antibiotic"; that depends on the organism and the conditions under which the organism is growing. In any event, Staphylococcus aureus "is not killed by protein synthesis inhibitors, cholramphinicol and erythromycin," the classic agents known to seek out the ribosome.
hat are the ways for diagnosis of MRSA? The Department of Public Health in Massachusetts (www.mass.gov) says the way health officials go about diagnosing MRSA is first taking a culture from the infected person and taking it to a lab. A small biopsy of the actual skin, or of the pus that is draining from the infection - or, better yet, a culture of a skin lesion "is especially useful in recurrent or persistent cases," the article explains. If a…
Association of Medical Microbiologists. "The facts about MRSA." Retrieved Dec. 6, 2007, at http://www.amm.co.uk.
Centers for Disease Control and Prevention. "Methicilli-Resistant Staphylococcus aureus."
Retrieved Dec. 6, 2007, at http://www.cdc.gov .
Centers for Disease Control and Prevention. "What is CDC doing about MRSA?" Retrieved Dec. 5, 2007 at
est Practice to Isolate MRSA Patients in the Hospital Environment
Methicillin-Resistant Staphylococcus Aureus (MRSA) is an anti-microbial organism of concern in the healthcare field; therefore, preventing and controlling its spread within the healthcare environment is a significance function of the infection control experts. One of the preventive measures is isolation of MRSA patients. However, not all are in agreement with such a practice and this makes our topic of discussion raise the question, "Is isolation of MRSA patients in a hospital environment the best practice?"
This reviews aims to evaluate the evidence for the efficiency of isolation measures in managing the prevalence of Methicilin Resistant Staphylococcus Aureus (MRSA) and infection in the hospital environments.
Review Methods: This review relied on scholarly reviewed journals, and selected articles reporting on MRSA related outcomes and illustrating an isolation practice or policy. The paper did not impose quality restrictions on studies employing separation wards…
Allen, U. (2006). Public health implications of MRSA in Canada. Canadian Medical
Association Journal. 175(2). p. 161-162.
Blumberg, H.M., Ray, S.M., & King, M.D. (2006). Treatment of community-acquired
Methicillin-resistant Staphylococcus aureus infection. Annals of Internal
infection trajectory Methicillin-resistant Staphylococcus aureus (MRSA). The paper introduces the development of the bacterium in its most common iterations. The nature of the infection including symptoms, treatment options which are limited, and efforts from the health community are evaluated. Of particular importance is the portion concerning the differences between the communities-based version and the nosocomial version.
Introduction of Evolutionary History of MRSA
Nature of Infection
Diagnosis, Symptoms & Progression of an MRSA Infection
Rates of MRSA Infections in the U.S.A.
MRSA Treatment Strategies and Regimens: Prevention and Control
Economic Implications of MRSA Infections
Staphylococcus aureus is a bacterium. It usually lives on the skin and nose of human beings without leading to health problems. It becomes a problem when the bacterium causes an infection in the "skin, lungs, or blood" (Zeller 2011, p.1828). Methicillin-resistant Staphylococcus aureus (MRSA) is a staph infection which is resistant to the methicillin family of…
Barnes, B & Sampson, D 2011, 'A literature review on community acquired methicillin-resistant Staphylococcus aureus in the United States: Clinical information for primary care nurse practitioners, Journal of the American Academy of Nurse Practitioners, 23,1, pp. 23-32, Academic Search Premier, EBSCOHost, viewed 10 March 2012.
Boyce, J, Landry, M, Deets, T, & DuPont, HL 1981, ' Epidemiologic studies of an outbreak of nosocomial Methicillin-Resistant Staphylococcus aureus', Infection Control, 2,2, pp.110-116, JSTOR, viewed 10 March 2012.
Carleton, H, Diep, B, Charlebois, E, Sensabaugh, G, F, Perdereau-Remington, F, 2004, 'Community-Adapted methicillin-resistant staphylococcus aureus (MRSA): Population dynamics of an expanding community reservoir of MRSA, The Journal of Infectious Diseases, 190,10, pp. 1730-1738, JSTOR, viewed 10 March 2012.
Centers for Disease Control and Prevention, www.cdc.gov, accessed 10 March, 2012.
Looking more generally at how the spread of resistant bacteria has advanced over the last few years one study traces the historical precedence of antibiotic resistant strains of bacteria. This work offers a plethora of good information about the seriousness of the problem with MSA as well as other less common but equally serious bacterial strains and how antibiotic over-utilization and patient non-compliance has added tot the problem. In Hughes, D. Andersson, D.I. (2001) book length discussion, Antibiotic Development and esistance many questions regarding the natural progression of bacterial resistance from the very beginning of antibiotic therapy is discussed. The work details ways in which individual bacterial diseases have progressed as a result of over-utilization of antibacterial (and especially broad spectrum) antibiotics, to treat non-life threatening infections and even viral infections has exacerbated the ineffective nature of antibiotics. The work traces the history of antibiotics and the assumption by many…
Coello, R. Glynn, J.R. Gasper, C. Picazo, J.J. & Fereres, J. (1997) "Risk factors for developing clinical infection with methicillin-resistant Staphylococcus aureus (MRSA) amongst hospital patients initially only colonized with MRSA" Elsevier Science http://www.sciencedirect.com/scidirimg/clear.gif doi:10.1016/S0195-6701(97)90071-2
Gorak, E.J. Yamada, S.M. & Brown, J.D. (1999) "Community-Acquired Methicillin-Resistant Staphylococcus aureus in Hospitalized Adults and Children without Known Risk Factors" Infectious Disease Society of America 29 (4) 797-800.
Graham, P.L. Lin, S.X. Larson, E.L. (March 2006) "A U.S. Population-Based Survey of Staphylococcus aureus Colonization," Annals of Internal Medicine. 144(5) 318-325.
Hughes, D. Andersson, D.I. (2001) Antibiotic Development and Resistance.
Transference of MSA
The transmission of MSA in hospital settings can be dramatically reduced when certain evidence-based practices and procedures are consistently used. The use of chlorhexidine (CHG) wipes when giving bed baths to patients has been shown to reduce the health care associated infections (HAI). However, other benefits associated with bathing patients may be diminished when CHG wipes are substituted for conventional bathing practices. Patients' overall impressions of the quality of care and attention they receive from nurses are important considerations in the healing processes. It is customary for nurses to use bathing time to assess the status of the patient's skin and to provide therapeutic nursing interventions such human touch and time to listen and communicate.
esearch Plan. The research design entails using qualitative research methods grounded in phenomenology to collect data about patients' perceptions of traditional bed bath vs. A bed bath using chlorhexidine wipes. The…
Dye, J.F., Schatz, I.M., Rosenberg, B.A., Coleman, S.T. (2000, January). Constant comparison method: A kaleidoscope of data. The Qualitative Report, 4(1/2). Retrievedhttp://www.nova.edu/ssss/QR/QR4-1/dye.html
Lincoln, Y.S., & Guba, E.G. (1985). Naturalistic inquiry. Newbury Park, CA: Sage.
Savin-Baden, M. And Major, C. (2013). Qualitative Research: The Essential Guide to Theory and Practice. London and New York: Routledge. ISBN 978-0-415-67478-2.
Lyme Disease and Methicillin-Resistant Staphylococcus Aureus (MRSA)
This text will concern itself with Lyme disease and methicillin-resistant staphylococcus aureus (MRSA). In so doing, it will not only give the description and epidemiology of the concerns, but also the etiology and prevention strategies. Further, diagnosis as well as treatment options and prognosis will be highlighted.
1. Lyme Disease
Description and Etiology
Described as an illness that is often debilitating, Lyme disease, as the Centers for Disease Control and Prevention- CDC (2018) points out, “is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of infected blacklegged ticks.” It is important to note that in addition to the bacterium Borrelia burgdorferi, blacklegged ticks are capable of transmitting what are commonly referred to as coinfections, i.e. a variety of other disease-causing parasites as well as viruses and bacteria. Those living in wooded areas have a high likelihood…
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
hospitals is the spread of MSA (staphylococcus aureus). This pathogen remains a leading cause of hospital-acquired infection. Current 'typing' methods for the genome to identify the pathogen include "phage typing, multi-locus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE)" but these methods "have serious limitations when used to investigate the finer details of infection outbreaks" (Price et al. 2013: 14). This is why the use of whole genome sequencing that allows scientists to create distinctions up to a single nucleotide is useful. Whole genome sequences can be used to classify and characterize genetic differences in a far more refined fashion than previous methods "and additionally provides information about the genetic basis of phenotypic characteristics, including antibiotic susceptibility and virulence" (Price et al. 2013: 14). Local-level awareness of the history of disease transmission allows a more carefully matched protocol for treatment as well as improves tracking. "Combined with epidemiological data, such…
Blot, S.I. (2002 et al.). Outcome and attributable mortality in critically Ill patients with bacteremia involving methicillin-susceptible and methicillin-resistant Staphylococcus aureus. Archives of Internal Medicine, 162(19):2229-35.
Price, J.R. (2013) .Whole genome sequencing in the prevention and control of Staphylococcus aureus infection. Journal of Hospital Infection, 83: 14-21.
A found it interesting that at all the practice sites; they eschewed the use of paper in favor of linen gowns and sheets. When I questioned this practice, I was told that it was done mostly out of a fear of MRSA being spread from patient to patient. I wondered about this, because it would seem to me that the use of disposable linens would definitely reduce the incidence of MRSA and save the cost of laundering the linens. This was definitely a different practice that what I was used to.
All in all I found the sonographers to be a very competent bunch. They appear to be extremely technically proficient and know what they are doing. It also appears that this field is held in high regard by the physicians who will even speak to the sonographer about the results of the scan or consult with them on different…
S. than in any other developed nation, yet the quality of care, even for those who are insured, is mediocre at best (Hawkins, 2007).
Doctors and hospitals often treat patients free of charge, if they do not have health insurance. However, that raises costs for other patients and makes healthcare and insurance even more costly. Most Americans recognize that the country's healthcare system is not sustainable and that without significant reform, it is headed for a complete meltdown.
In the U.S., identity theft is a major concern. Now, that, too, has gone into the medical arena. Medical identity theft is being described as the newest frontier in the ever-evolving crime of identity theft and presents a major opportunity for a wide range of criminals as the healthcare industry evolves into an electronic culture. Yet this environment is not properly protected by present law enforcement agencies and criminal offenses (Latour, 2007,…
Andrews, J. (2006). Where the jobs are: eldercare is already creating more jobs than there are people willing to do them. And the market is just heating up. Here's a look at where some of the greatest demand will be. Assisted Living 4(6) S6-9.
Hawkins, D.(12 February, 2007). Bush's Remedy Isn't a Cure; the President's health-care won't help those who need insurance most or the underinsured who can't afford primary care. Business Week Online
Institute of Medicine (2007). Preventing medication errors. National Academies Press, Washington, D.C.:
Lafferty, L. (2007). Medical identity theft: the future threat of health care fraud is now: lack of Federal Law Enforcement efforts means compliance professionals will have to lead the way. Journal of Health Care Compliance 9 (1) 11-21.
As standard procedure warranted in this case, her obstetrician injected her with varicella zoster specific immunoglobulin. The injection did occur too late, but this is a special case warranting attention and was a prophylactic to protect the baby. A few days later the N developed chickenpox anyway. The reasons why the vaccine did not take could have been the fact that the N had already been exposed, and the situation is referred to as "breakthrough varicella," (National Centre for Immunisation, 2009, p. 3). Breakthrough varicella is a mild form of the infection, and yet is still contagious. Varicella vaccine should not be given to the baby until it is twelve months of age, but it may not be necessary at all due to the potential in vitro exposure to the varicella zoster virus. Infants "should receive no specific treatment or vaccination after exposure to Varicella zoster virus (VZV) but…
Centers for Disease Control and Prevention (2014). Preventing varicella in health care settings. Retrieved online: http://www.cdc.gov /chickenpox/hcp/healthcare-setting.html
Cheprasov, A. (2014). The spread of disease. Retrieved online: http://education-portal.com/academy/lesson/the-spread-of-disease-endemic-epidemic-pandemic.html#lesson
Children, Youth, and Women's Health Service (n.d.). Chickenpox. Retrieved online: http://www.health.wa.gov.au/docreg/Education/Diseases/Communicable/Virus/HP8873_chickenpox.pdf
"Descriptive Epidemiology," (2014). Retrieved online: http://www.med.uottawa.ca/SIM/data/Epidemiology_rates_e.htm
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
Along the way, scholarly resources such as books, peer-reviewed journal articles and reputable websites will be used to create or support the opinions or answers given. The three questions that will be answered will include what basic types of healthcare everyone should have access to and why, a choice from thirteen risk factors that impact infectious disease and a recitation of how nurses can play a part in one or more of the millennium development goals (MDG) set forth for global health. While being too loose and generous with what people are entitled to and/or the depth and breadth of what nurses can truly do is a danger, to suggest that neither is worthy of consideration would be less than wise to assert as true.
Healthcare as a ight
The first essay question asks what types and forms of healthcare should be a given and a right to everyone regardless…
Carlton, E.J., Liang, S., McDowell, J.Z., Huazhong, L., Wei, L., & Remais, J.V. (2012).
Regional disparities in the burden of disease attributable to unsafe water and poor sanitation in China. Bulletin Of The World Health Organization, 90(8), 578-
Clasen, T., Pruss-Ustun, A., Mathers, C.D., Cumming, O., Cairncross, S., & Colford, J.
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,…
The variability in problems faced by the King Edward Hospital NHS Trust during the period in question, instigated a multi-level response in knowledge sharing and inclusion on practice. Kotter's theory relies upon such a method, where strategies are an exercise multi-tiered obligation.
As Kotter points out, the transformation model may not be suitable for organizations that are in pursuit of prompt change, and the series of responsibilities which result from consortium relationships may apply to one or all organizations within the scope of his definition of institutional cultures: 1) Developing Social Construct; 2) Oriented Social Construct; 3) and Pluralistic Social Construct types. Evidence-based practice in healthcare is compatible with Kotter's proposition. Process methodology including the '8-Steps' process in three (3) phases -- 1) Creating Climate for Change, 2) Engaging and Enabling the Organisation, and 3) Implementing and Sustaining the Change -- is illustrated in Figure 1.
Abidi, S.S., 2001. Knowledge management in healthcare: towards 'knowledge-driven' decision-support services. International Journal of Medical Informatics, 63 (1-2), pp. 5-18.
Abidi, .S.S. et al., 2009. Knowledge sharing for pediatric pain management via a Web 2.0 framework. Studies in Health Technology and Informatics, 150, pp. 287-91.
Abidi, S.S. et al., 2004. Knowledge management in pediatric pain: mapping online expert discussions to medical literature. Studies in Health Technology and Informatics, 107 (Pt 1), pp. 3-7.
Austin, M.J., 2008. Knowledge management: implications for human service organizations. Journal of Evidence-Based Social Work, 5 (1-2), pp. 361-89.
University bulletin boards -- particularly those in the business building -- and offices would be my first target. Then I would meet with the on campus television professionals. Every school has closed circuit televisions that run looped information from slides. Who among us hasn't sat in front of one of these sets mindlessly watching the words and pictures go by? Someone would need to take responsibility for maintaining the free advertising on campus. Once a week or once a month a student should do a physical walk through to ensure that signs displaying the web address for the site look fresh and new and that the television advertising is up-to-date. This job would need to be passed on as students graduate out of the program and move into the real world of employment.
Strategy three -- participate in university events
Certainly the incorporation of these first two strategies -- using…
Also cited as threats are those of:
(1) Product manufacturing and marketing risks;
(2) Cost and expense control or unusual events; and (3) Changes in laws and accounting standards. (Pfizer Inc. Report to the United States Securities and Exchange Commission, 2008)
IV. Internal Environment -- Strength and Weaknesses
Stated as strengths of Pfizer Inc. are the following components of its organization:
(1) Written policies and procedures;
(2) a compliance officer and compliance committee;
(3) Effective training and education;
(4) Effective lines of communication;
(5) Internal monitoring and auditing;
(6) Enforcement through discipline pursuant to established guidelines; and (7) Prompt response and corrective action for detected problems.
(Pfizer, Inc., 2009)
Another component that provides strength to Pfizer Inc. is its effective training and education program. As well Pfizer boasts effective lines of communication including an 'open door' policy allowing and encouraging colleagues to "discuss any issues, concerns, problems and suggestions with…
Pfizer Inc. (2009) Center for Responsive Politics. Online available at: http://www.opensecrets.org/orgs/summary.php?id=D
Pfizer Streamlines Operational Processes to Achieve Balanced Excellence (2004) Tradeline 29 Sept 2004. Online available at; http://www.tradelineinc.com/reports/40CF58BA-2B3B-B525-80444AE6588980A1
Corporate Governance FactSheet (2009) Pfizer Inc. Online available at: http://www.pfizer.com/about/corporate_governance/corporate_governance_fact_sheet.jsp
Pfizer's Infectious Disease Commitment and Portfolio (2007) Pfizer, Inc. 18 Sept 2007. Online available at: http://www.pfizer.com/files/investors/presentations/icaac_2007_presentation_071807.pdf
According to this professional, circumcisions that are competently performed under local anaesthesia cause no more pain or harm than an immunisation injection. Furthermore, male circumcision ahs shown benefits such as the reduction of sexually transmitted infections such as the human pailloma virus, chancroid and syphilis. She also cites studies that indicated a reduced risk of HIV infection in males who have been circumcised.
Indeed, there are quite humane ways to circumcise infants with the minimal amount of stress and pain today. Furthermore, cultural and religious reasons for performing the ritual cannot be discarded. Particularly when done under the correct and most humane possible circumstances, cultural practices should not be prohibited.
Having said this, and considering the issue from all viewpoints, however, the fact remains that infant male circumcision is the removal of part of the human body without the consent of its owner, the child. It carries significant risks, especially…
Bering, J. (2010, Apr. 23). Is male circumcision a humanitarian act? Scientific American: Bering in Mind. Retrieved from http://www.scientificamerican.com/blog/post.cfm?id=is-male-circumcision-a-humanitarian-2010-04-23
Hinchley, G. And Patrick, K. (2007, Dec 8). Is Infant Male Circumcision an Abuse of the Rights of the Child? Science Daily. Retrieved from http://www.sciencedaily.com/releases/2007/12/071207120817.htm
Manimale, N. (2010, Mar 15). CDC should not recommend infant male circumcision. The Oracle Online. Retrieved from http://www.usforacle.com/cdc-should-not-recommend-infant-male-circumcision-1.2191240
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.
Based on the results of these assays, S. flexneri can often be identified, although additional kits may be required. The simplest way, however, may be the novel approach through multiplex PCR (mRPC). It is possible to identify Shigella species through mPCR techniques by identifying pathogenicity islands associated with Shigella and S. flexneri.
6. How could you create a corn plant that would express the human protein fibrin? (You need to include techniques, steps, enzymes, etc.)
In order to create a corn plant that would express the human protein fibrin, scientists would first need to incorporate the human fibrin gene within the corn plant genome. The incorporated human gene would require regulation and promoter sequences that would function within the plant cell. Proper splicing sequences would also be required or removal of the introns altogether.
The delivery of transgenes into the corn plant could be accomplished through electroporation into corn protoplasts…
Caring is not simply a demonstration of sympathy and empathy for an individual's particular situation, as focusing on such might impair the ability of the nurse to look at long and short-term health goals that could be uncomfortable but might realistically assist the patient to maintain a better quality of life in the near future. Caring for those who are limited in ability to do so themselves, children, soldiers, the poor and the elderly and this is the historical precedence of nursing in general. The text of this course stresses that the development of nursing, like many other caring professions had a great deal to do with the need to provide professional caring to those who were at risk, and lacking the family and economic connection that was the basis for the maintenance of health in earlier times.
Urbanization, war, immigration and the reduction of the numbers of extended families…
Ethics of Marketing esearch in the Internet Era
Increasingly, management is being taken to be a critical production factor alongside the other factors of production. It therefore follows that the success of a business enterprise is largely hinged on the ability of management to make superior decisions. However, for managers to make effective decisions, they not only need a supportive decision making environment but also a set of tools to enhance their ability to correctly analyze and interpret information so as to advance the agenda of the business in an increasingly competitive marketplace. Marketing research is one such tool.
Marketing esearch as a Management Tool
The relevance of marketing research as a decision making tool for management cannot be overstated. According to Blankenship, Breen and Dutka (1998), marketing research can be taken to be "the systematic design, collection, analysis, and reporting of data and findings relevant to a specific situation…
Blankenship, A.B., Breen, G.E. & Dutka, A.F. (1998). State of the Art Marketing Research. McGraw-Hill Professional.
Boone, L.E. & Kurtz, D.L. (2011). Contemporary Marketing. Cengage Learning.
Evans, A.N., & Rooney, B.J. (2010). Methods in Psychological Research. SAGE
Haugtvedt, C.P., Machleit, K.A. & Yalch, R. (2005). Online Consumer Psychology: Understanding and Influencing Consumer Behavior in the Virtual World. Routledge Keillor, B.D. (2007). Marketing in the 21st Century: Interactive and Multi-Channel Marketing. Greenwood Publishing Group.
Clicking on the links reveals that some of the topics provide more information and information in different formats than others. For example, the Aging Driver topic lists the following clickable PDF files:
Tips for Safe Driving, How to Help the Older Driver, Getting by Without Driving, Am I a Safe Driver?, and Successful Aging Tips.
Other topics, such as Health Disparities, do not provide information directly but only link the user to external resources and other databases. This might discourage many users, especially those unfamiliar with online research hoping to find printable information with a minimum of further searching online. Meanwhile, another topic, Breastfeeding, does provide easily accessible information that includes illustrative diagrams along with the text-based information, as depicted below.
How should I hold my baby while breastfeeding?
You can hold your baby in a number of ways. Your baby shouldn't have to turn his or her head or…
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.
Osteomyelitis in the Diabetic Patient
Management OF OSTEOMYELITIS IN THE DIABETIC PATIENT
Osteomyelitis is an infection of the bone or bone marrow which is typically categorized as acute, subacute or chronic.1 It is characteristically defined according to the basis of the causative organism (pyogenic bacteria or mycobacteria) and the route, duration and physical location of the infection site.2 Infection modes usually take one of three forms: direct bone contamination from an open fracture, puncture wound, bone surgery, total joint replacement, or traumatic injury; extension of a soft tissue infection such as a vascular ulcer; or hematogenous (blood borne) spread from other infected areas of the body such as the tonsils, teeth or the upper respiratory system.2(p807) Bacteria such as Staphylococcus aureus, Pseudomonas, Klebsiella, Salmonella, and Escherichia coli are the most common causative agents of the disease, although viruses, parasites and fungi may also lead to the development of osteomyelitis.3
1. Stedman's Medical Dictionary. 27th ed. Baltimore, MD: Lippincott Williams & Wilkins; 2000.
2. Butalia S, Palda V, Sargeant R, Detsky A, Mourad O. Does This Patient With Diabetes Have Osteomyelitis of the Lower Extremity?. JAMA: Journal of The American Medical Association [serial online]. February 20, 2008; 299(7):806-813. Available from: Academic Search Premier, Ipswich, MA. Accessed September 19, 2012.
3. Lavery L, Peters E, Armstrong D, Wendel C, Murdoch D, Lipsky B. Risk factors for developing osteomyelitis in patients with diabetic foot wounds. Diabetes Research & Clinical Practice [serial online]. March 2009; 83(3):347-352. Available from: Academic Search Premier, Ipswich, MA. Accessed September 19, 2012.
4. Turns M. The diabetic foot: an overview of assessment and complications. British Journal of Nursing [serial online]. August 12, 2011;:S19-S25. Available from: Academic Search Premier, Ipswich, MA. Accessed September 19, 2012.
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.
teaching and learning to patients with dysphagia. The situation involves the researcher's own personal experience teaching a Mom of 16-month-old diagnosis with dysphagia and how to learn how to feed him. This paper discusses the client's background, learning objectives, learning needs, outcomes, teaching strategies, and evaluation of outcomes and provides guidance for a mother facing these same issues.
Infants and children need to consume sufficient amount of nutrients in order to grow. Swallowing difficulties has an effect on dietary intake and affects a child's growth and development. For this reason, it is important to manage dysphagia in pediatrics.
Dysphagia is a disruption in swallowing that compromises safety, efficiency, or adequacy of nutritional intake. Swallowing and breathing share a common space in the pharynx, and problems in either of these processes can affect a child's ability to protect their airway during swallowing and ingestion of fluid or food safely.
Dysphagia and swallowing disorders. Retrieved from http://nursing.advanceweb.com/Regional-Articles/Features/Nurses-Role-With-Dysphagia.aspx .
East, L., Nettles, K., Vansant, A. & Daniels, S. Evaluation of Oropharyngeal Dysphagia With the Videofluoroscopic Swallowing Study. Journal of Radiology Nursing.
Gosa, M. & Coleman, J. Thickened Liquids as a Treatment for Children with Dysphagia and Associated Adverse Effects A systematic Review.
Nurses' Role With Dysphagia. Retrieved from https://consultgeri.org/try-this/general-assessment/issue-20 . Preventing Aspiration in Older Adults with Dysphagia
Sexually Transmitted Diseases and Contact Tracing
MG is a 27-year-old graduate student, recently married, who comes into the student health clinic for a routine pelvic exam and Pap smear. During the course of the exam, the gynecology resident performing the exam obtains the Pap smear, but also obtains cervical cultures for gonorrhea and chlamydia. The examination concludes uneventfully. Several weeks later, MG receives a postcard indicating that the Pap smear was normal, with no evidence of dysplasia, but that the cervical culture for gonorrhea was positive. The card instructs her to come into the clinic to discuss treatment, and that "public health authorities" have been notified for contact tracing, which refers to the identification and diagnosis of sexual partners, as required by law. The young woman is terrified that her husband will be contacted. Is contact tracing ethically justified?
While it is definitely not a good thing that…
Amir-Singh, J., Upshur, R., & Padayatchi, N. (2007). XDR-TB in South Africa: No Time for Denial or Complacency. Plos Med, 4(1), e50. http://dx.doi.org/10.1371/journal.pmed.0040050
Armbruster, B., & Brandea, M. (2007). Contact tracing to control infectious disease: when enough is enough. Health Care Management Science, 10(4), 341. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3428220/
Boskey, E. (2016). Contact tracing really is an important thing to participate in.. About.com Health. Retrieved 20 March 2016, from http://std.about.com/od/prevention/f/contacttracing.htm
McKay, B. (2016). Dangerous TB Patient Detained on U.S. Border. WSJ. Retrieved 20 March 2016, from http://www.wsj.com/articles/SB10001424127887323978104578332461533970412
Current Areas of esearch
Much of the current research on staphylococcus aureus centers on the emergence of antibiotic-resistance strains. In particular, the resistant strain MSA is resistant to methicillin and related drugs. This has created a number of issues for medical practitioners, as staph infections are one of the more common infections that occur in a health setting.
One of the threads of research in this regard concerns the spread of staph infection in the hospital setting. It has long been believed that s. aureus infections were transmitted between patients. Where outbreaks have occurred, the response has generally reflected this view, with patients being segregated, and other similar remedies. ecent research has shown, however, that transmission between patients in the intrahospital setting does not occur nearly as much as previously thought (Long, Beres, Olsen & Musser, 2014). This is an important finding for health care facilities, because it changes…
Haba, E., Bouhdid, S., Solana, N., Marques, A., Espuny, M., Celma, M. & Manresa, A. (2014). Rhamnolipids as emulsifying agents for essential oil formulations:
Antimicrobial effect against Candida albicans and methicillin-resistant
Staphylococcus aureus. International Journal of Pharmaceutics. Vol. 476 (2014) 134-141.
Kriegeskorte, A., Block, D., Drescher, M.., Windmuller, N.,Mellmann, A.,Baum, C., Neumann, C., Lore, N., Bragonzi, A., Liebau, E., Hertel, P., Seggeweiss, J., Becker, K., Proctoer, R., Peters, G., & Kahl, B. (2014). Inactivation of thyA in staphylococcus aureus attenuates virulence and has a strong impact on metabolism and virulence gene expression. mBio. Vol.5(4) 1-15
Many people are familiar with the role that accrediting agencies play when it comes to institutions of higher learning. Whether it be the board of regents for a given state, a more national organization or so forth, these agencies are supposed to be an impartial reviewer and accreditor of whether a school meets certain standards. When it comes to healthcare, the Joint Commission on Accreditation of Healthcare Organizations, often shortened to JCAHO, does much the same thing. Of course, healthcare involves much higher stakes than what are seen in a typical school situation. For this regulatory agency, a number of facets and traits of the JCAHO's structure will be covered including its effect on healthcare, an example of the organization executing its duties, what regulatory authority has when it comes to healthcare and how agencies deal with elements and intentional torts that could risk quality and/or risk when…
Anderson, J. G., Ramanujam, R., Hensel, D. J., & Sirio, C. A. (2010). Reporting trends in a regional medication error data-sharing system. Health Care Management Science, 13(1),
Holloway, E., & Kusy, M. (2011). Systems approach to address incivility and disruptive
behaviors in health-care organizations. Advances In Health Care Management, 10239-
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
Purpose and Overview
Nurse consultation involves the application of change management principles and visionary leadership to the improvement of healthcare organizations. Guided by evidence-based practice and ethical principles of the healthcare profession, nurse consultation is a process involving multilateral communications, quantitative assessments, goal-setting, and strategic change management. Advance practice nurses can collaborate with nurse leaders to identify problems, analyze those problems and their root causes, and identify meaningful and feasible methods of achieving desired changes and measurable outcomes.
The purpose of this consultation is to work with nurse leaders, administrators, and executives to help the local healthcare organization better meet their goals and improve patient satisfaction. Nurse consultation requires the use of multiple, rigorous empirical methods. The data collection processed used in this case include both qualitative methods like interviews and focus groups, as well as quantitative data gathered from HCAHPS scores, patient metrics, and patient surveys. Although the current…
Purpose and Overview
Nurse consultation involves the application of change management principles and visionary leadership to the improvement of healthcare organizations. Guided by evidence-based practice and ethical principles of the healthcare profession, nurse consultation is a process involving multilateral communications, quantitative assessments, goal setting, and strategic change management. Advance practice nurses can collaborate with nurse leaders to identify problems, analyze those problems and their root causes, and identify meaningful and feasible methods of achieving desired changes and measurable outcomes.
The purpose of this consultation is to work with nurse leaders, administrators, and executives to help the local healthcare organization better meet their goals and improve patient satisfaction. Nurse consultation requires the use of multiple, rigorous empirical methods. The data collection processed used in this case include both qualitative methods like interviews and focus groups, as well as quantitative data gathered from HCAHPS scores, patient metrics, and patient surveys. Although the…
Patient’s chief complaint, reason for visit
Ms. Richards arrived complaining that she was experiencing severe anal pain, so much so that using a tissue was also proving impossible. She claimed the pain began a couple of days earlier and has aggravated considerably since.
History of Present Illness
Ms. Richards arrived complaining of anal pain which commenced a couple of days earlier and has aggravated since. With regard to her intimate relationships, Ms. Richards states that though she has a boyfriend, their relationship isn’t serious as the two are also seeing other people. According to internal assessment reports, patient has normal hair distribution, an intact perineum, and intact urethral meatus without any discharge or inflammation. However, patient experiences unbearable pain on vaginal opening palpation, redness, and edema. Further, a mass has been identified on the right, with spontaneous, dark-yellow, smelly secretion with palpation over the Bartholin's glands.
Evaluation and Management Coding (E/M Code)
The patient visited the clinic complaining of pain and redness to the left foot and with a history of diabetes. Following an assessment of the patient’s condition and his clinical history, he was diagnosed with cellulitis in addition to type 2 diabetes. Given the patient’s history of diabetes, he is at high risk of developing MRSA and/or osteomyelitis secondary to skin infection. The treatment and management of this patient’s condition require the use of an appropriate evaluation and management coding (E/M code). An E/M code is an important part of the management of cellulitis in patients with diabetes since it is critical to making the correct diagnosis, which in turn influences the treatment approach (Sullivan, 2018). In essence, giving an appropriate E/M code for the patient’s condition is essential to avoid under or overtreatment with antimicrobials, which remains is a major challenge in the…
Krive et al. (2015, May). The Complexity and Challenges of the ICD-9-CM to ICD-10-CM Transition in Emergency Departments. The American Journal of Emergency Medicine, 33(5), 713-718.
Sullivan, T. (2018, April). Diagnosis and Management of Cellulitis. Clinical Medicine, 18(2), 160-163.
Furthermore, the authors claim that pocket infection rates have decreased in general worldwide and especially in institutions with strict procedural guidelines. Moreover, Lakkireddy et al. (2005) note that many of the infections were superficial, due to surface wounds from the surgery and not from the deep pocket itself. Superficial wounds can be readily prevented via standard hygienic procedures used during the surgical process. Lakkireddy et al. (2005) conclude that Povidone-iodine irrigation does not in itself prevent infections but fail to outline the possible implications of the findings.
Although internally valid, the Lakkireddy et al. (2005) study has significant limitations that prevent generalization. Patients were culled from one institution. Surgical procedures were not standardized and could have varied widely from doctor to doctor. In fact, the Povidone-iodine solutions were not standardized either. Most importantly, the researchers were not able to determine whether a course of prophylactic antibiotics administered prior to implantation…
The authors questioned the role of Povidone-iodine vs. other antiseptics, noting that no detailed survey like the current one had ever been conducted on a large patient population. Furthermore, the authors claim that pocket infection rates have decreased in general worldwide and especially in institutions with strict procedural guidelines. Moreover, Lakkireddy et al. (2005) note that many of the infections were superficial, due to surface wounds from the surgery and not from the deep pocket itself. Superficial wounds can be readily prevented via standard hygienic procedures used during the surgical process. Lakkireddy et al. (2005) conclude that Povidone-iodine irrigation does not in itself prevent infections but fail to outline the possible implications of the findings.
Although internally valid, the Lakkireddy et al. (2005) study has significant limitations that prevent generalization. Patients were culled from one institution. Surgical procedures were not standardized and could have varied widely from doctor to doctor. In fact, the Povidone-iodine solutions were not standardized either. Most importantly, the researchers were not able to determine whether a course of prophylactic antibiotics administered prior to implantation affected the rates of infection. In fact, the antibiotics might have had a major bearing on the rates of infection and could abnegate the results of the current study.
However, Lakkireddy et al. (2005) do draw attention to the need for hygienic, aseptic surgical procedures including the use of topical antiseptics like Povidone-iodine. Especially when devices like PMs and ICDs are being implanted, the potential for infection rises. A more informative study might reveal which patient populations are at the highest risk of developing staph or other infections. Those patients who are the most at risk might benefit the most from prophylactic antibiotics as well as standardized, sterilized surgical procedures.
ESBLs Prevention and Education
Extended spectrum beta-lactamase producers (ESBLs) are antibiotic-resistant bacteria that can colonize internally before spreading and/or present as infections that are very difficult to treat du to the protective nature of the ESBL substance itself (AHS, n.d.; CARA, n.d.). ESBL is capable of breaking down antibiotics and thus protecting the producing bacteria, allowing them to continue to thrive and reproduce despite the administering of traditional treatments. For this reason, prevention of such infections is of paramount importance, yet practices that effectively work towards such prevention are not as widespread as would be desirable (AHS, n.d.; Durham, 2006). The following education plan aims to address identified knowledge needs and so reduce rates of ESBLs infections and their negative effects on patient outcomes.
Knowledge Needs Assessment
Though the nursing staff examined for this education project is well qualified and highly educated, there is a definite lack of knowledge regarding…