The ability to resolve conflicting patients is also an appreciable quality. esearch is an integral aspect of every subject that requires quality improvement. esearch on Orthopedic nursing is required for overall development in the care and assistance provided to improve health conditions of orthopedic patients. ("Orthopedic Nursing Standards," 2007)
Orthopedic nurses currently require developing their knowledge on relevant issues regarding neuro-muscular and skeletal challenges of a patient and the response of patient to medication and assistance. Various questions may arise in the course of care provided to orthopedic patients. An orthopedic nurse who is very closely monitoring a patient is the best person to assess such challenges and bring a platform for research to find better answers. An orthopedic nurse need to work with the patient to find out the quality improvement required in nursing assistance in terms of managing medication, dealing pain and trauma felt by the patient if…… [Read More]
8). A number of alternative treatment modalities have been used in an effort to avoid these adverse side effects, including various mind-body and therapeutical techniques that may prove efficacious in some orthopedic patients, but many healthcare providers remain unaware or untrained in their use (Lukas, 2004). For instance, one orthopedic nurse reports that, "In today's fast-paced surgical environment, perioperative nurses face many challenges to meet the needs of outpatients in helping to alleviate their pain and anxiety. Most nurses have not been taught non-pharmacologic methods for control of pain and anxiety" (Lukas, 2004 p. 8).
Besides this lack of training in providing adjunct treatment modalities for pain management in the orthopedic patient, there is also a pronounced lack of training concerning efficacious treatment modalities for younger orthopedic patients. For instance, Bennett-Branson and Craig (1999) emphasize that, "Despite advances in pharmacological approaches to pain control, most children who undergo surgery continue…… [Read More]
According to recent research published in the Journal of Shoulder and Elbow Surgery, "Economic evaluation of surgical procedures is necessary in view of more expensive newer techniques emerging in an increasingly cost-conscious health care environment (18).
otator cuff tendon repair has been reported to yield excellent, durable clinical results that are superior to the natural history of the condition. etears after a repair of one tendon occur with variable frequency. They are not synonymous with clinical failure, but they are associated with a poorer clinical outcome than are repairs followed by structural healing. Chronic tendon tears are usually associated with atrophy and fatty infiltration of the rotator cuff muscles. These changes reflect loss of contractile elements and may be responsible for changes in the physiological properties of the remaining musculotendinous units (7). Such changes can be assessed quantitatively with magnetic resonance imaging and correlated with age and gender-matched normal values,…… [Read More]
It is a fact that many of the South American continent's governments (such as Venezuela) are antithetical to a free market. Porter's Five Forces are based upon a model of pure competition. The one country that is closest to this model is Brazil. Therefore, the entry point for this author's marketing strategy must be Brazil. This is the best way to cut through the knot of government. By using Brazil as an entry point, entry can they be gotten to the closed markets that Brazil has relations with (World Bank 2010).
The Five Porter Forces:
By lessening the power of governments to intervene in the economy, we will increase the power of the supplier which is us. The lack of government backed companies in the market will prevent backward integration and reverse engineering of our products because of our advantages of economy of scale. This will increase the…… [Read More]
Medical Care Services
The current delivery of health care services represents one of the most important subjects for discussion both in the Obama Administration as well as the epublican one and the Administrations that preceded the Bush one. egardless of political color, it must be pointed out that the health care system in the United States does not only depend on the ideological orientation, but also on the people and their own beliefs in terms of human action and interaction. It is a clear fact that "Ten years ago, the U.S. healthcare system was declared "broken," and it has not improved. Fixes promised by managed care have not materialized. Premiums are rising. Hassles for patients and physicians abound. Nearly 45 million Americans are uninsured." (Garson, 2000)
One of the most severe problems facing the health care system in the United States is the discussion that is being held between those…… [Read More]
communication style is being used by the following personnel. 1. Rashad attended the team meeting with all the rest. When the topic of role clarification for assistive personnel came up, he stated that he thought part of his role was to anticipate the needs of the patients for toileting and personal hygienic care. Robin, one of the staff RNs in their psychiatric care group home, raised her voice as she firmly stated, "You are only an aide. That is in the RN role. We don't expect you to think, just to do what we tell you to when we tell you." Rashad sat quietly without responding because he needed to keep his job but began his plan on how he'd make Robin pay for her statement. Maybe he wouldn't do anything without being told.
The psychiatric nurse was being aggressive. She was humiliating Rashad and belittling him. What she is…… [Read More]
Market Model Changes
The medtech, or medical technology, industry is a large and intensely competitive industry that produces highly innovative medical devices for hospitals and other healthcare facilities in the effort to save lives and improve health for patients (Research, 2012). It is spread across different segments including, cardiology, oncology, neuro, orthopedic, and aesthetic devices. It relies largely on aging baby boomers, high unmet medical needs, and increased incidence of lifestyle diseases, including cardiovascular disease, diabetes, hypertension, and obesity.
The industry is being challenged by pricing concerns, hospital admissions and procedural volume, uncertainty concerning healthcare reform, Medicare reimbursement issues as agencies are looking for cost reduction measures, and regulatory overhang. There is a rise in patients deferring treatment in elective procedures. "One factor aligning economic and clinical forces: in the U.S., the number of medical practices owned by hospitals grew from 25% in 2005 to 50% in 2008" (practice, 2011).…… [Read More]
Emotional reactions to the onset of injuries as well as a patient's attitude toward the injury itself and the proposed treatment have great impacts on the length of time it will take for the patient to recover (VAN RIJN 2007). Therefore, it is in the medical staff's best interest to maintain the patient in a positive, reinforcing paradigm in order to create an atmosphere of positive goal-orientation so the patient may experience significantly reduced levels of anxiety during post-operative procedures as well as reduced rehabilitation time.
N.A.. (2010). Ligament Injury Recovery. Available: http://www.sportsinjurybulletin.com/archive/ligament-injury.html. Last accessed 17th Nov 2010.
Researchers at the University of Wisconsin, the University of Houston and NASA severed the medically collateral ligaments in the knees of lab rates. Three to seven weeks after the incision mechanical and morphological properties were measured in ligaments, bones and muscles. Ligament testing revealed that there were significant reductions in…… [Read More]
As with many pharmaceutical products manufacturers, the extent of supply chain and quality performance has a direct effect on distribution, profitability and services performance as well (tevenson, 2012).
Beginning with supply chain management, J&J has an intensively level of supplier audits they expect each supplier to pass and also randomly be able to manage as they provide materials, components and subassemblies to the company (Wechsler, 2011). upplier audits form the interlinking process to Quality Management, another strategic operations management initiative in the comp[any as well. J&J also uses these supplier audits to ensure alignment to the Collaborative, Planning, Forecasting & Replenishment (CPFR) processes which are critical to their success in anticipating global demand for products by business unit (Weill, Ross, 2005). upply chain management is the unifying operations management strategy that keeping the entire value chain and quality levels of J&J aligned to corporate objectives and standards (Weill, Ross, 2005)…… [Read More]
Jody Smith: Application of the Moral Model…
Applying Ethical Decision Making Model
"Jody Smith Case Study: Application of Thiroux's Moral Model"
The decision making model that will be applied in this work is the Moral Model (Thiroux 1977) and the case it will be applied to is the Jody Smith case. The reason this model was chosen is because the model lends itself best to a situation, such as Smith's where an impasse has been reached between the patients values and desires and that of family and the health care team. In this case the ethical dilemma is one clearly of informed consent as Smith has been excluded from conversations associated with her prognosis and care and this is contrary to her values and her identity. Without inclusion of this communication standard Smith has very little to go on regarding her prognosis and may be seeing her situation as insurmountable…… [Read More]
He seems to be curious about what kind of options he has in life. He sees his sister enjoying herself very much in her studies and relationships developed at the conservatory and he wants some of those same things for himself. Shawn has shown somewhat of an increased interest in learning to socialize because of his growing interest in girls and romantic relationships. He wants to be evaluated in so far as he has interest in how his social skills and social intelligence stand up to his peers.
Shawn has accepted that he will be evaluated periodically. He does not show overt resistance to his evaluation, and he does not show overt excitement about it, either. He was mostly cooperative with the evaluation team. He expressed that he did not think many of his classmates liked him or even knew who he was. He mentioned that he recently became interested…… [Read More]
When using open reduction of dorsal displaced fractures of the radius to restore congruency and extra-articular anatomy, the authors recommended the use of their double-plating method. This method is reliable in providing stable internal fixation and in allowing early function. It is, however, and as earlier mentioned, a demanding technique, as ot requires careful; attention to detail.
Carter, P.. And PR Stuart. The Sauva-Kapankji Procedure for Post-Traumatic Disorders of the Distal Radio-Ulnar Joint. Journal of one and Joint Surgery: ritish Editorial Society of one and Joint Surgery, September 2000
Only one surgeon performed all the operations on a total of 37 patients for pain on the ulnar side of the wrist and decreased rotation of the forearm. The authors reported that most of the tested patients were better after the operation, although a significant number had some pain. Relief from pain could not be guaranteed and that residual pain associated…… [Read More]
Medical Education on Interdisciplinary Staff Practice
The research question I am addressing is the impact of continuing medical education on interdisciplinary staff practice. Researchers of the past decade produced systematic reviews of continuing medical education (CME) and other strategies intended to improve patient outcomes. The subjects of the reviews included such concepts as audit and feedback, chart-based reminders, clinical practice guidelines, and formal lectures. Defined as interventions to change interdisciplinary staff practice, the effects of those strategies were inconsistent across practitioners, settings, and behaviors. As a result, in the midst of contemporary discussions about quality improvement and the effects of continuing education, there is no singularly effective method for improving interdisciplinary staff performance.
Research Methods/Literature Searches
The literature to be studied will come under the rubric of medical education. Medical education journals such as JAMA, Journal of Continuing Education in the Health Professions, and nursing journals such as the Journal…… [Read More]
The anterior and posterior cruciate ligaments allow for flexion and extension of the knee. Tears of these ligaments are a common result of sudden movements that cause strain. Injury can occur from sudden stops or from trauma to the knee as a result of sports activities. When the tear is severe, surgery is often needed. Rehabilitation and exercises to retain mobility of the joint and to preserver strength prior to surgery. After surgery, the recovery process follows a distinctive set of steps.
Anterior Cruciate Ligament Tears and Repairs
Tears of the anterior and posterior cruciate ligaments are a common knee injury that affect people of all ages and activity levels. The injury can range from minor to severe, depending on the extent of the tearing. Some, but not all require surgery to restore range of motion to affected joint. The injury often requires extensive rehabilitation to regain function. The…… [Read More]
Use tools and equipment that are properly designed to reduce the risk of wrist injury, (Zieve & Eltz 2010)
Workstations, tools and tool handles, and tasks can be redesigned to enable the worker's wrist to maintain a natural position during work, (National Institute of Neurological Disorders and Stroke 2010).
Ergonomic aids, such as split keyboards, keyboard trays, typing pads, and wrist braces, may be used to improve wrist posture during typing, (Zieve & Eltz 2010)
Training and awareness; the encouragement of frequent breaks; yoga classes offered for free at the workplace; job rotation.
Employers can develop programs in ergonomics, the process of adapting workplace conditions and job demands to the capabilities of workers, (National Institute of Neurological Disorders and Stroke 2010)
Nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, and other nonprescription pain relievers, may ease symptoms that have been present for a short time or have been caused by strenuous…… [Read More]
he researcher was able to pull up information on Venous hromboembolism hospitalizations by utilizing ICD-10 (Maynard & Stein, 2010)
he clinical diagnosis of Venous hromboembolism is defective; people that are suffering with signs and symptoms of Venous hromboembolism, just 20% have thrombosis confirmed by diagnostic testing.13Clinical prediction rules have been developed to improve the probability of an accurate diagnosis. he most widely used model classifies patients into a high, moderate, or low probability of deep vein thrombosis (Maynard & Stein, 2010). When joined with research laboratory and radiological imaging tests, this method is superior to the old-style method of executing a diagnostic test in all patients with suspected Venous hromboembolism (Martinez- 2008).
Prognosis, broken down by risk groups
A lot of the Deep Vein hrombosis is occult and most of the time resolves instinctively without there being a problem. he main longstanding illness from Deep Vein hrombosis is PS,…… [Read More]
Globalization and American Health Care
What explains the directionality of flows in health care? Patients, health workers, managerial practices?
Globalization has brought in the information revolution and this has again brought changes in the medical profession and the way health care is being administered. It has also brought in unforeseen problems and expansion of the health care issues and running debates on health care is still strong. The flows of healthcare primarily have to deal with the patient -- how the patient is induced to seek treatment and the process of the treatment and the final discharge and post treatment care. This also involves lot of information exchange, and abiding by insurance contracts, payment options and quality care for the patients. (Phillips, 2005)
The second set is the personnel who include doctors, paramedics and all staff. The flow of work of these sections follows the patient and there are changes…… [Read More]
Nursing Proposal -- Evidence-Based
The utilization of call lights particularly in hospital settings has recently been put under study as a function of various aspects of nursing including shortages, rounds and analyses of patient outcomes. The proper scheduling of nursing rounds may be essential to enhance the capability of nurses to tackle common or ordinary patient issues relative to more dire needs that have to be regarded as the primary/main target for the use of call lights by patients. Besides patients' general well-being and safety while hospitalized, nursing employees are also concerned with how satisfied the patients are. On a rather fundamental level, hospital settings that enable patients to experience peace of mind allow them to heal quicker than those that do not; these patients are highly likely to relay less stressful communications to those around them, and have a higher possibility of clearer perspectives that allow them to distinguish…… [Read More]
clinical cases and examine malpractice perspectives.
Concerns over mounting healthcare expenses have resulted in increased inquiry into medical practices. With the rise of malpractice risk and medical liability to unprecedented levels, the field of medical law has influenced defensive medical practice as healthcare providers endeavor towards liability risk mitigation (Nahed, et.al, 2012).
Elements Needed to Prove Malpractice
Medical malpractice is associated with four fundamental elements, all of which have to be present for forming the base for any claim. For any case of medical malpractice to succeed, an attorney is required to prove all four aspects, which are: duty, causation, damages, and breach (What are the Elements of a Medical Malpractice Claim? n.d.). The first element -- Duty -- implies that health care professionals owe their patients the duty to take reasonable and appropriate action; i.e., the practitioner is accountable for delivering some form of treatment or care…… [Read More]
human resource development within the context of the learning and growth perspective of this approach to strategic management to be employed within university settings. This perspective will draw a strategic management and measurement tool, while also exploring available options, at least options to discuss in an open marketing setting by which to integrate strategy and execution.
This perspective alternates around The Greatbatch Management Team's ability to continue to theoretically improve and create value for its stakeholders, as well as the organization's human resource development in the context of the evolutionary process involving a shift from training to a learning orientation in libraries so as to shoot for optimal advantages and earn percentages for their stakeholders.
Quite simply, the proposition herein stated is to create value for their institution's stakeholders. The impasse belief that companies will not generally generate income through accounting terminology, through intangible assets, and their role in strategy…… [Read More]
Once the written request is received, we will pay within 30 days (PCC.com, no date). If you paid by credit card, we will issue the refund to your card directly. If you paid cash, we will issue you a check.
This policy is ideal for a small generalist office.
The policy should outline the Medical Associates position clearly, so that the patient has an understanding of how billing and collections work from our end. This is important because of medical offices are somewhat unique in this regard compared to other businesses. The multiple means of payment, often for a single bill, necessitate this written explanation for the patient.
The main objective of the financial policy is to effectively communicate the means and methods of payment to the patients. Not only should it clarify the role of the office, but it should also clarify for the patient their role…… [Read More]
Running on pavement that is cantilevered, such as on a road that is designed to 'run off' rainwater, is more apt to be a culprit in developing patellofemoral pain, regardless of the individual's foot type, while running downhill may exacerbate the tendency of an individual to develop IB syndrome. Improper running shoes for the individual's foot type can also exacerbate both conditions -- inflexible new running shoes again heightening the chance of developing IB syndrome (Hunter, Dolan & Davis, 1995, p.31).
Stress fractures are another common orthopedic plague. They are small fractures of the bone that develop over time, again often from overuse activities like running. Medical literature suggests that certain foot types are more apt to develop stress fractures in certain places than other areas of the body. For example, some believe that flat-footedness may actually guard against overuse injuries in certain places. One clinical study of fifty healthy…… [Read More]
Specifically focused on products for each phase of a persons' life, this business segment is the most mainstream in terms of promotional strategies. Skin Care, OTC and Nutritionals have successfully given JNJ a permanent marketing strategy for selling to women in the 25-34 and 25-45 segments, two of the fastest growing demographic markets for these products.
The biggest challenge for JNJ is the ability to quickly develop and launch products across all of their business units. This is the most challenging task internally for the entire company to coordinate on, specifically in the area of pharmaceuticals where Federal Drug Administration (FDA) guidelines and the need for compliance are very high.
The costs of producing a new drug can be well over $800M according to AM esearch (2004). An analysis of each phase of the development of a new drug is shown in the following graphic from PhMA (2005).…… [Read More]
In United States the Congress had passed the Medicare Prescription Drug, Improvement and Modernization Act of 2003 or MMA and with this imposed a stoppage for 18 months on the starting of new physician owned specialty hospitals. At the same time, they also wanted to know the position regarding certain matters of physician owned heart, orthopedic and surgical specialty hospitals through MedPAC. The team visited sites, made legal analysis and met the share owners in these hospitals and finally presented a report to the Congress. It had also gone through the cost reports received from Medicare and inpatient claims of 2002, which was the most recent at that time. This will naturally form the basis of such hospitals being permitted or not. (Physician-owned specialty hospitals)
Findings of MedPAC:
The findings of this committee showed that:-
Physician owned hospitals generally treated patients who had less severe problems…… [Read More]
individual health history and examination of a 61-year-old American male Vietnam veteran, "Mr. John Veteran" using the SBAR approach. Mr. Veteran is married, with two adult children and three grandsons, aged 4, 7 and 12 years by his older daughter who is a registered nurse in an intensive care unit; his younger daughter is a senior in college majoring in business administration (she received a full scholarship to a private college). Mr. Veteran earned his bachelor's degree in organizational leadership at a small midwestern university. Although Mr. Veteran continues to work full time as a paralegal, he advises that he intends to "semi-retire" when he turns 62 years next year and becomes eligible for Social Security payments. Mr. Veteran smokes two packs of cigarettes a day and drinks beer on occasion, but does not take drugs, even for severe pain, because he is worried about becoming addicted to them.
Although…… [Read More]
Facility esearch and Selection
The report describes the facilities, need and services offered in an Ambulatory Care Clinic.
VICTIMS IGHTS MOVEMENT
Health practitioners should expect some very dramatic changes in the area of ambulatory care within the next decade. Driven by different factors, which include double digit improvement in some major outpatient areas, health care managers should expect the trend that began in the 80s to continue. The issue of ambulatory care is now a major issue for health care providers. A lot of health care institutions experienced some growth, spanning double digit in major outpatient sectors and significant changes in some major inpatient services to the modes of outpatient only. Hospitals are expected to adopt a new philosophy and plan of action for system redesign, carrying out a scrutiny of the traditional way of making the needed care available with the aim of surviving in the future. While these…… [Read More]
This became more so with the advancement of molecular iology Tests. Subsequently a group of clinicians met in Ghent elgium and came up with the current diagnostic criteria known as the Ghent Nosology. (De Paepe et al. 1996) Similar to the erlin Nosology the Ghent criteria was based on clinical findings in the various organ systems as well as the nature of family history and relationships, a major criteria was classified as which has a high diagnostic specificity because it was less frequent in other conditions and in the general population. A point of divergence from the erlin Nosology was the conversion of minor criteria in the skeletal system into major criteria. For one to be diagnosed with Marfan's the patient must have a first degree relative diagnosed with the disease in addition two systems must be involved with one having a major sign. In the absence of a family…… [Read More]
" Orthopedic Nursing. 19 (1); 71-82.
1. 1. What data was collected in this study? How was the data analyzed? Data from 24 patients who were admitted for primary hip replacement was collected. Participants were assessed for functional status using standard modification; mobility assessed, as well as general medical issues. Data was analyzed using the 1975 Sickness Impact Profile, a standard explanatory measurement within the field.
7. 2. Summarize the results of the study in your own words -- remember that results are the findings based on analysis of the data. The study found that functional status improved between pre and post-operative states in patients who underwent total hip replacement surgery. This also included basic mobility and movement. No real relationship was established regarding the patient's pain, however.
8. 3. What findings from this study were based on descriptive statistics? List them below.
Patients asked to rate (describe) themselves on…… [Read More]
Visual impairment (including blindness);
9. Multiple disabilities;
12. Autism; and,
13. Traumatic brain injury (Evanciew, 2003).
In order to overcome the current constraints to learning about proper condom use by this wide range of special needs college students who may have individualized constraints to learning, an appropriate approach must be developed that can adequately communicate the importance of the practice as well as the mechanics that are involved. To this end, Evanciew (2003) reports that, "esearch suggests that students with special needs benefit from experiences that involve functional, hands-on learning" (p. 7). Therefore, the approach described further below can help special needs college students learn both the importance of proper condom use as well as the mechanics that are involved in applying them.
The objectives of this initiative are two-fold as follows:
1. To promote a greater understanding of the importance of proper condom use…… [Read More]
Nusing poblem 1: May's pain must be contained so she does not injue heself.
Because childen cannot always expess thei sensations of pain, thei pain may go unnoticed until it becomes sevee and fightening.
Nusing poblem 2: Vomiting and the possibility of choking.
Anxiety and pain can cause childen to vomit, making teatment of pain and administeing pope nutition difficult.
Nusing poblem 3: May is attempting to emove he oxygen mask.
A lack of knowledge on the pat of the child as to why cetain teatments ae administeed can esult in noncompliance.
Nusing poblem 4: The need fo social suppot when May's mothe is not pesent.
The unfamiliaity of the hospital envionment is exacebated by May's lack of paental cae.
Diagnosis 1: Pain management
Outcome: The FLACC: a behavioual scale fo scoing postopeative pain in young childen that can be helpful in detemining how to teat…… [Read More]
Practical esearch Finding Implementation and Experimentation Stage -- Phase I
The experimenter did not set out to determine specifically which of the various contributing factors (or combinations of factors) identified by the empirical research of medial tibial stress syndrome was most responsible for the experimenter's symptoms. However, since the initial attempts to resolve the symptoms incorporated changes to all of the external variables except a change in running surface, the experimenter immediately sought a softer running surface and temporarily abandoned running on any hard surface that magnified instead of minimized the physiological trauma associated with running on harder surfaces.
Because the empirical research also implicated poor running stride mechanics and excessive vertical elevation, the experimenter devoted considerable attention to making the following specific changes to the running stride: (1) shorter strides to minimize travel of the body while neither foot is in contact with the running surface; (2) conscious attempts…… [Read More]
Nurses expressed empathy when I complained of pain or discomfort and promptly advocated for me when the need arose.
While hospitalized in an acute care setting, I feel that because I am a nurse, I did not receive the same degree of scrutiny a non-clinician patients or physician may have been given.
While hospitalized in an acute care setting, I feel that because I am a nurse, I received more consideration than a non-clinician patient may have been given.
While hospitalized in an acute care setting, I feel that because I am a nurse, I received less consideration than a physician may have been given.
I feel that the type, quality, and consistency of care I received while acutely hospitalized did not differ from treatment any other person would have been given.
My experience as a patient contributed to shaping my perception as nurse of the health care environment.
I…… [Read More]
The procedure itself and the hospital stay associated with it is only one small chapter in the patient's life. They will eventually go home and will have many years after the procedure. It is important for the nursing staff to make a positive impact on how they feel about the procedure. The procedure will represent a lasting memory to the patient. If the patient perceives this to be a time of strength and care from nurturing individuals then it will help them to be able to develop the coping mechanisms necessary to learn to live with the after-effects of the procedure.
If the patient sees this as a negative experience, then it could produce unwanted effects such as depression, post-traumatic stress disorder, or other emotional problems that could have an effect on their ability to cope with the life changes. Those that develop appropriate coping mechanisms will be more likely…… [Read More]
(ACS Publication June 2006 A Growing Crisis In Patient Access to Emergency Surgical Care at (http://www.facs.org/ahp/emergcarecrisis.pdf)
Statement of Problem
There is a growing problem in the ability of individuals and communities to receive care, according to the American College of Surgeons, as the changing face of emergency care and medical care in general is putting patients at risk. The ACS and the AMA have both recently conducted professional surveys that indicate that the source of the problem is a lack of specialized surgical providers to cover existing trauma centers and a lack of those same staff members to help to establish new centers of care in areas, with the lowest numbers of provider services. (ACS Publication June 2006 A Growing Crisis In Patient Access to Emergency Surgical Care at (http://www.facs.org/ahp/emergcarecrisis.pdf)
The ACS Publication A Growing Crisis In Patient Access to Emergency Surgical Care stresses that the existing system is not…… [Read More]
Mex Am / Hispanic Am. Hlth Care
Sub- cultural Scholarly Paper: Hispanic-American Health
Due to the rising cost of health care and lack of communication and cultural attitudes towards health many Hispanics are faced with poor health, obesity, and in most cases serious illness. This paper provides insight into health concerns, dilemmas of the subculture, and the specifics revealed in the interview process as relates to the individual, the family and ultimately, the community and the culture's collective society.
Subcultural Scholarly Paper: Hispanic-American Health
The theoretical framework used to evaluate this subculture is Purnell's Model. This is a subculture study of Hispanic-Americans in relation to their lack of knowledge concerning their personal healthcare.
Description of Subculture:
One way to address the challenges of providing health care to differing cultures is through advances in the development of competence among cultural providers in the healthcare field as per the minority which…… [Read More]
In the third trimester of pregnancy, caution must be taken concerning congestive heart failure, hypertension and decreased renal and hepatic function, interstitial nephritis, hyperkalemia, hyponatremia and renal papillary necrosis, anticoagulation abnormalities, leucopenia, granulocytopenia and thrombocytopenia. The use of Celecoxib is aimed primarily at suppressing pain and inflammatory stimuli, but it may contribute to NSAID gastrointestinal toxicity. The lowest possible dose of celecoxib should be prescribed and taken. On the whole, NSAIDs can mask the usual signs of infection, therefore, caution must be taken in the presence of existing controlled infection. The physician should investigate symptoms and signs, which suggest liver dysfunction or abnormal liver lab results.
On September 30, 2004, Merck and Company voluntarily withdrew rofecoxib from the American and world markets because of its association with an increase in cardiovascular incidence (Keldaya 2005). A major Food and Drug Administration study linked the medication to a three-fold rise in the…… [Read More]
Nursing Staff Levels Affect Patient Mortality
Managing unnecessary variability in patient demand to reduce nursing stress and improve patient safety.
Litvak, E., Buerhaus, P.I., Davidoff, F., Long, M.C., McManus, M.L. & Berwick, D.M.
Date of publication: June 2005
Examination of the operational issues affecting health care delivery, including patient driven peaks in demand and effects of nursing shortages or inadequate staffing on clinical outcomes for patients.
esearch question and/or hypothesis:
In this study the researchers propose that increases in adverse clinical outcomes occur when hospital nurse staffing is inadequate. Further the researchers suggest that increases in census rates increase the potential for serious stresses for patients and nurses working in the field. Lastly the researchers suggest that if hospitals reduce unnecessary variability of staff levels in a hospital, the hospital can reduce the probability of negative patient outcomes, improve safety for patients and improve the overall quality of care.
Sample…… [Read More]
Evans, E.G. & Sigurgeirsson, B. (1999, April 17). Double blind, randomised study of continuous terbinafine compared with intermittent itraconazole in treatment of toenail onychomycosis. British Medical Journal, 318, pp. 1031-1036.
Key Points: This study examined the effectiveness of two new medications for the treatment of toenail fungus compared to the current recommended treatment. Both new medicines were found to be more effective.
This was a prospective, randomized, double blind, double dummy, multicenter, parallel group study. The study took place over a period of 72 weeks (about 16-1/2 months) and involved 38 investigators from 35 centres in six different European countries (Finland, Germany, Iceland, Italy, the Netherlands, and the United Kingdom).
bjective: To compare the efficacy and safety of continuous terbinafine with intermittent itraconazole in the treatment of toenail onychomycosis. nychomycosis is among the most common diseases of the nail as well as being among the few curable diseases if the…… [Read More]
Martin Army Medical Center, Fort Benning, Georgia and St. Francis Medical, Columbus Georgia
Because resources are by definition scarce, it is important for tertiary healthcare providers to develop healthcare delivery structures that are efficient and effective. Since every healthcare organization is unique, though, these delivery structures can vary widely in scope and purpose. To gain some fresh insights into the healthcare delivery structures that are used by civilian and military health facilities, this paper provides a comparison of Martin Army Medical Center at Fort Benning, Georgia with St. Francis Medical in Columbus, Georgia, followed by a summary of the research and important findings in the conclusion.
eview and Comparison
Martin Army Medical Center, Fort Benning, Georgia
Health care delivery structure. Opened in 1958, this is a U.S. Department of Defense facility operated by the U.S. Army that offers inpatient, outpatient and emergency services. At present, Martin Army Medical Center 250-bed,…… [Read More]
Bed -Profit Health Care Organization
A detailed organizational chart for your new facility
Each and every department of the hospital is responsible for performing certain type of assigned tasks but still departments are grouped together according to the similarity of tasks. Grouping of the departments also aim to provide health care facility with more efficiency. For this hospital the following are the organizational policies:
Services related to administration; which includes business people who are involved in the running of the business.
Informational services; which includes documentation and processing of information.
Therapeutic service; under which treatment is provided to the customers.
Diagnostic Services; these are the services under which the illness is identified.
Support services; these can also be referred as environmental services, which provide support to the entire hospital.
A mission, vision, and values statement for the new entity
The aim of this Healthcare facility is to provide their people…… [Read More]
Thoracic Manipulation on Patients with Chronic Mechanical Neck Pain: A andomized Controlled Trial
The objective of this work in writing is to critique the study reported in the work of Lau, Chiu, and Lam (2011) entitled "The Effectiveness of Thoracic Manipulation on Patients with Chronic Mechanical neck pain -- A andomized Controlled Trial" reported in the Journal of Manual Therapy.
The aim of the study reported by Lau, Chiu, and Lam is stated to be assessment of the effectiveness of "thoracic manipulation (TM) on patients with chronic neck pain." (2011, p.141) Lifetime prevalence of neck pain is stated at 66.7% and 12-month prevalence at 53.6%. (Lau, Chiu, and Lam, 2011, p.141) Neck pain is expensive to treat in addition to the suffering of the individual and lost work time due to employee absenteeism. (Lau, Chiu, and Lam, 2011, paraphrased)
There is growing evidence, which has demonstrated that manipulation with exercise…… [Read More]
zeros in on healthcare and nursing issues. Can a study have one or more purpose, question, and hypothesis? This paper answers that question through the critique of two scholarly papers; one was published in the peer-reviewed Orthopaedic Nursing and the second one was found in Medical Education.
"Improving Patient Care Through the Use of Research"
In this article the author presents scenarios that address the need for research in nursing care -- that is, the need to solve a problem or find a solution that may save a life or at least ease a patient's suffering. The author uses several questions and several generalized hypothesizes and indeed there are several purposes to this research article. These aspects are needed in the interest of thoroughness. The article point to several approaches to finding appropriate medical answers for nursing questions, but as a rule, an answer cannot be located by simply asking…… [Read More]
Education Project Proposal (Nursing)
This study is intended to educate the patients (within the age group of 8-12) about the post operative treatment approaches and to prepare them to face the situation. As the main audience is the pediatric patients who have gone trough a kidney transplant, we will focus on the recovery issues with respect to this audience. This study will help these patients to learn about the general issues related to recovery of their wounds, the nutrition they are supposed to adopt during the recovery stage and the physical activity that is expected to be maintained by them. This educational activity is important for the patients because a thorough understanding of the recovery process is very important for the patient.
With an understanding of the process the patient will be able to cooperate with the nursing staff and will more actively participate in the process. From this program,…… [Read More]
Arthritic conditions found within the joints of the body: their causes, treatment, current research, and what effect they have on athletic participation.
Types of Arthritis
Causes of Arthritis
Arthritis and Athletic Activities
Arthritis is said to be the number one cause of disability in the United States, with more individuals disabled with arthritis than by both heart disease and strokes (Lewis 2000).
Arthritis is also a disease that is plagued with misunderstanding. The Center for Disease Control warns that it is these misunderstandings that result in the disease doing so much harm (Lewis 2000).
Some of the common misunderstandings involve recognizing that there are different types of arthritis and that arthritis is not only a disease of the aged. Arthritis is also often not taken seriously enough in its early stages, preventing individuals from seeking medical help that could…… [Read More]
Nurses are required to make many immediate decisions in their assigned duties. Unfortunately, in recent years, patient care has often been compromised as a nursing shortage crisis has escalated to epic proportions. Increased patient loads have resulted in often hasty nursing decisions as responsibilities and hours worked have increased. Although precious time must be spread thin to accommodate higher numbers of patients, nurses must exercise their morals through consistency in ethical behaviors. According to Peggy Chinn (1), "Many ethical issues, such as end-of-life decision making, have increased in complexity. Other issues, such as advocacy and choice, have changed in certain respects but are more clearly centrally situated within nursing's ethical domain."
As a result, nurses are held accountable for a variety of decisions in nursing practice and in many instances, a patient's life depends on such decisions to survive. Gastmans (496) states that "Generally, the goal of nursing…… [Read More]
emoval From Tdrl
Medical board forwarded process physical evaluation board. A deliberate act discipline a counselor remove military TDL favoritism opportunity adversary make judgment . What criminal offense committed procedures recommended victim process recovery shown significant growth academy suffers social culturally.
Temporary Disability etired List (TDL)
The Temporary Disability etired List (TDL) is a list containing Army members found unfit for the performance of military duties due to permanent physical disabilities Cross, Ficke, Hsu, Masini, & Wenke, 2011.
The disability is permanent, but is has not stabilized sufficiently, which makes an accurate assessment difficult. The Army member is placed in the TDL until their condition is accurately assessed. Army members suffering from disabilities considered not permanent and likely to change in the course of time are placed in TDL instead of Permanent Disability etirement List. Placing members on the TDL protects the Army and the individuals. The individuals will continue…… [Read More]
End-of-Life Care: Scholarly Nursing Practice Choice
I am an advanced practice registered nurse (APN) board-certified to practice in adult care (ANP-BC). Currently, I am employed as a nurse practitioner (NP) in palliative care within a hospice setting. Accordingly, my scholarly nursing practice is focused on the care of individual patients in need of palliative care, many of whom are in need of end-of-life care.
The phenomenon of interest that I have chosen is end-of-life care. Compared to palliative care, end-of-life care is not provided for patients receiving curative treatments or undergoing a disease process that is life-altering (Petersen, Breakwell, & Callahan, 2014). End-of-life care encompasses the principles of palliative medicine, including a focus on the patient's and family's quality of life, optimal functioning, individual growth, and care planning; however, end-of-life care will also emphasize a patient's dignity during the dying process, comfort through effective pain management, and care of family…… [Read More]
isk Analysis and the Security Survey
The following risk analysis and security survey report will be centered on the hospital as an organization. Vulnerabilities can be classified as crime opportunities, opportunities for breaking rules and regulations, opportunities for profiting and also for loss. By definition, vulnerability can be a gap or a weakness inside a security program that might be exploited by opponents to acquire unlawful access. Vulnerabilities include procedural, human, structural, electronic as well as other elements that offer opportunities to damage assets (Vellani and Owles, 2007).
A vulnerability assessment can be classified as a systematic method utilized to evaluate an organization's security position, assess the efficiency of current security infrastructure, as well as, recognize security limitations. The basic approach of a Vulnerability Assessment (VA) first measures what precise assets require protection. Subsequently, VA recognizes the protection measures previously being used to protect those assets, as well as what…… [Read More]
causes for Medicare and Medicaid patients to be readmitted to hospitals within thirty days of a prior discharge. This is a fairly pervasive and major problem and it is one that demands solutions. As part of this capstone, there will be a number of facets and tools used. There will be a problem description that identifies what the problem is and why it is important. There will be a solution description that broadly asserts what is needed to address and resolve the problem identified. There will be an implementation plan that will lay out how the program will be rolled out to the locations and the people that work therein. There will also be an evaluation plan that will be used to monitor and assess performance so that any deficiencies can be spotted and addressed before they become full-on conflagrations that can sap the performance and outcomes of the project.…… [Read More]
HEALTH -- RESEARCH SITE'S PERSPECTIVE ON FUNDING - ESSAY
As the CRA of a large orthopedic clinic specializing in advanced joint reconstructive techniques for athletes, I occasionally recommend funding streams that might be pursued for research. A principal investigator at the clinic is interested in some promising new research that could lead to an improvement in patient recovery times. The question is whether a federal grant or a research contract from a pharmaceutical company should be pursued as the funding stream for the new research.
As a CRA administering clinical trials for a large orthopedic clinic, I would recommend obtaining a federal grant for the promising new research. The key differences between a federal grant -- or any grant, and a private contract -- or any contract, are in the concept and consequences of default (DeMaio, 2015). A grant is a formalized decision to give fund for research or some…… [Read More]
Organizational esearch and Theory
Change methods are actions that managers undertake to handle change. There are two types, systematic methods and management methods. Management methods are more involving and broader than systematic methods (Al-Haddad & Kotnour, 2015, p. 248). Many writers have come up with various methods of change management, including:
Steps of the Change Models of Kotter and Lewin
a) Kurt Lewin's model has three phases including the unfreezing stage, the actual change and the refreezing stage. Lewin opined that change involves the opinion that there is need for change, acting towards the intended change and making the change a custom. The stages involve the following:
Step 1-Unfreezing: According to Lewin, human beings behave under the influence of a semi-stationary equilibrium that is surrounded by compound forces. Before getting rid of old habits and adopting new ones, there is need to unfreeze/ destabilize the equilibrium. Lewin thought of the…… [Read More]
Ineffective Communication Between Shifts in Acute Care Settings
A recent statistics of the adverse effects arisen from ineffective communication between shifts in acute care setting range from 2.6% to 7.6%, however, Okoniewska, et al. (2015) believes that the adverse effects on in-patients can be between 19% and 23%. (Classen, esar, Griffin. et al. 2011).
The Study aims to discuss the adverse effective arisen from ineffective communication between shifts within acute care settings.
Consequences of not solving the problem
Without implementing the strategies that can enhance effective communication between shifts in an acute healthcare setting, the issue can lead to mortality, readmission, and post-hospital adverse effects. Moreover, poor communication between shifts can lead to medication problems resulting to therapeutic errors. (Okoniewska, et al. 2015). Moreover, lack of intervention to address the problem can lead to medical errors, which can lead to patients' harms. Communication failure has also been identified as…… [Read More]
The NIH (2014) defines robotic surgery as "a method to perform surgery using very small tools attached to a robotic arm", wherein the surgeon operates the robot. Robotic surgery was developed to enable the performance of surgical procedures through smaller cuts than open surgery. The robot is capable of smaller, more precise movements that would be possible with a human arm. It is also much easier for the surgeon to work with the surgical tools than would be possible with, say, an endoscope. The NIH notes that robotic surgery is used for an increasing range of procedures, including coronary artery bypass, cancer excision, gall bladder removal, hip replacement, hysterectomy, kidney transplants and pyloroplasty (NIH, 2014).
The minimal invasiveness of robotic surgery means that there is lower risk to the patient during the course of the surgery, and that the post-surgery healing time is lower, and less risky as…… [Read More]
Nursing theory, research, and practice
Scenario in which theory, research, and practice interact to create good patient outcomes
Imogene King’s theory
Using the Imogene King’s theory to enhance Nurse-Patient Relationship
Enhanced Patient care
narrative explanation of your visual representation following the diagram.
Nursing theories have been developed as a way of trying to explain the fundamental importance of clinical practice (INSCOL, 2014). Even though these theories are used to guide practice, it is true to claim that most of them have not been put to the test as a way of determining whether the proposed nursing actions produce the claimed effects. If nursing asserts itself as the professional practice it is a professional practice environment must be supported and practiced. In order to enhance the outcome of patients and nursing staff then the professional nursing practice must be supported (INSCOL, 2014). There exist several nursing theories…… [Read More]
Greenhalgh and Taylor (1997) describe quantitative research as that which examines one clearly formed question using multiple research methods. In this study the authors utilize the sickness impact profile (SIP), the hip outcome tool, and pain and mobility to test functional status pre- and post-operatively.
3. In this study, the independent variables are pain and mobility. The dependent variable is functional status. The patient's perception of his/her illness depends on his/her level of pain and ability to ambulate. The research hypothesis is that functional status improves post-operatively.
4. The authors talk about the history of hip replacement surgery outcome reporting. The authors state that although hip surgery has been used since 1970 it was not until 1988 that a study by Gartland proposed the need for health based outcome research as opposed to only surgical outcomes. The study indicates that as of 2000 there still was a lack in health…… [Read More]
Shuttling the results from an outside provider, because the health insurance agency will only reimburse outside screening, forces the patient to wait and possibly incurs more costs, if the delays in obtaining diagnostic information worsen the patient's condition. This can ultimately result in more prolonged treatment. Many patients may also be put at risk because of the logistics of being transported to outpatient facilities for essential screening and rehabilitative services, while they are still convalescing.
Being able to conduct all necessary tests in-house results in great efficiency, swifter screening, and improves coordination between the different providers involved in the case. Our hospital has extensive resources for patients, and can provide a wide range of treatment options, particularly in its specializations of cardiac and orthopedic care. And improvements in technology that are keeping extremely sick patients alive for longer periods of time also mean that, quite often, patients require attention from…… [Read More]
Cognitive and Psychomotor Disturbance:
This is the other long-term psychological effect of surgery on children particularly those who undergo heart transplant surgical operations. Similar to the post-hospital distress, cognitive and psychomotor disturbance is usually as a result of extra medical treatments and longer stays in hospital. According to research, patients who undergo complex pediatric surgical operations are likely to exhibit signs of cognitive or psychomotor disturbance (Todaro et al., n.d.). The cognitive and psychomotor disturbance is also as a result of the surgical procedures that a child goes through in the inpatient surgical operations.
However, the effect of cognitive and psychomotor disturbances are not limited to patient who undergo inpatient surgical operations since those who undergo day case surgery are also likely to experience these effects. Nonetheless, as compared to the inpatient surgical operations, the likelihood of these effects are less in day case surgical operations. Poor school attendance and…… [Read More]
Estimates of cost savings from the reduction in film costs as well as through reduced work hours needed for the creation of images and the reading of images by physicians will lead to an average annual cost savings of between five hundred- and seven hundred and fifty-thousand dollars a year, leading to an overall cost benefit of one hundred- to three hundred and fifty-thousand dollars a year compared to traditional film production techniques (Hoffman 2008; ath 2010). A ten percent reduction in costs could be achieved through increasing the competitiveness of a the bidding process amongst companies that produce the technologies necessary for a successful PACS, as well as through reducing the time and personnel involved in training programs. This latter is not especially advisable, however, as indirect costs will likely be created though reductions in the efficacy of the adoption and a reduced improvement in treatment efficiencies and speeds…… [Read More]
esearch eport: Gance-Cleveland (2004)
1) This study sought to explore the characteristics, clinical elements, methods, and benefits of school-based support groups for children of alcoholics (COA). Identification of this information may aid in the intervention process of adolescents who are coping with the addiction of a loved one and could improve long-term outcomes for the adolescent.
2) the author found that the support groups educated on the dangers of drug and alcohol use, improved coping strategies, enhanced resiliency factors, improved relationships, and increased school achievement. Of equal importance where the observed positive changes in behavior and an increased awareness of the effect of addiction on their lives (Gance-Cleveland, 2004). The findings of the current study were consistent with previous literature including the ability of the group process to empower youth and create a sense of awareness that can be correlated to improved decision making and long-term outcomes.
3) This study…… [Read More]
They were zigzagging through the sugar cane field, a truly bizarre scene.
Also in Mendoza, it is a dark and evil scene as Mendoza's body is tied to the back of a donkey but the body kept sliding down under the donkey ("ass"). There is no respect for the dead here in this scene, and to take his bloody, muddy, and wet body to his wife's house, and throw it down in the threshold -- that is profoundly evil. He never had a chance, and now his family has to pay the price. The evil and "horrible grimace" that was on the face of the dead Mendoza must have been a terrible shock to his family and his children. His son (who had found what he thought was a corpse) now saw a real corpse, ironically the person he had seen earlier and mistaken for a corpse -- his own…… [Read More]