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As a neonatal intensive care nurse, I need to be aware of special considerations when working with my patients. Pain in neonates may have serious consequences for the development of the child, especially with regards to the serious risk of neurodevelopmental impairment (American Academy of Pediatrics, 2006). Long-term pain could be indicators of serious issues. Because of this, "the prevention of pain in neonates should be the goal of all caregivers, because repeated painful exposures have the potential for deleterious consequences," (American Academy of Pediatrics, 2006, p. 2231).
Barriers to optimal pain management begins with the fact that neonates cannot verbalize their pain, and therefore, depend on the astute observation and wisdom of others around them to recognize, assess, and manage pain (The oyal Children's Hospital Melbourne, 2015). Not all nurses may be familiar with the gamut of signs that indicate the presence of pain, especially those that are…
American Academy of Pediatrics (2006). Prevention and management of pain in the neonate. Pediatrics 118(5): 2231-2241.
The Royal Children's Hospital Melbourne (2015). Neonatal pain assessment. Retrieved online: http://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Neonatal_Pain_Assessment/
Pain Management in Post-Operative Patients
Pain suffered patients undergoing surgery. The severity pain vary patient. It nurse caring patient postoperative phase manages patient's pain. Questions arise pain assessment, nurses estimation mismanagement patient pain, modes administration medical orders pain management suitable.
Pain Management in Post-Operative Patients
Effective pain control in post-operative patients is essential in ensuring patient's quick recovery, earlier mobilization and lower cost and higher patient satisfaction. The immune system of patients who have undergone surgery is suppressed owing to the surgery. The suppression is proportionate to the level of invasion by the surgery thereby, necessitating proportionate pain management measures. For effective post-operative pain management, consider the patient's physics, physiology, age and type of surgery (Vadivelu et al., 2010).
Tissue damage in surgical procedures is inevitable and results in pain to patients depending on their age, sex, and the degree of invasion by the surgery. Inadequacy of pain relief yields…
BUVANENDRAN, A., KROIN, J.S., DELLA VALLE, C.J. & KARI M. 2010. Perioperative oral pregabalin reduces chronic pain after total knee arthroplasty: a prospective, randomized, controlled trial. . Anesth Analg., 110, 199-207.
B-Y-KYILMAZ, F.E. 2010. Postoperative pain characteristics in Turkish orthopaedic patients. Pain Management Nursing, 11, 76-84.
ELVIR-LAZO, O.L. & WHITE, P.F. 2010. Postoperative pain management after ambulatory surgery: role of multimodal analgesia. Anesthesiol Clin, 28, 217-224.
HILL, C.W.L. & JONES, G.R. 2007. Strategic Management: An Intergrated Approach, Stamford, Houghton Mifflin Harcourt Publishing Company.
Oregon State Board
Treatment Method for Pain Management
Treatment Method for Pain Management
Treatment Method for Pain Management
Education equirement by Oregon State Board of Nursing (OSBN)
The Oregon State Board of Nursing (OSBN) is responsible for checking and monitoring the education requirements of the registered nurses. There is a standard pain management requirement for every licensed health care provider in the state of Oregon regarding pain management. It has been made mandatory to complete seven hours of pain management. Out of which one hour should be of course offered by Oregon Pain Management Commission. This course is available online.
Selected Method for Pain Management
The method of pain management selected for discussion here in the paper is Acupuncture. This treatment has been used in various parts of Asia for centuries and has had some popularity in the world recently. While some are skeptical to this treatment, there…
Hopwood V, Lewith G. (2003). Acupuncture trials and methodological considerations. Clinical Acupuncture Oriental Medicine, 3:192 -- 9.
Kaptchuk, Ted J. (2002). The placebo effect in alternative medicine: can the performance of a healing ritual have clinical significance? Ann Intern Med. 136(11):817 -- 825.
MacPherson H, White A, Cummings M, et al. (2002). Standards for reporting interventions in controlled trials of acupuncture: the STRICTA recommendations. Clinical Acupuncture Oriental Med, 3:6 -- 9.
Schnyer RN, Allen JJ. (2002). Bridging the gap in complementary and alternative medicine research: manualization as a means of promoting standardization and flexibility of treatment in clinical trials of acupuncture. Journal of Alternative Complement Medicine; 8:623 -- 34.
Moreover, fully three-quarters of the surveyed nurses reported that the lack of adequate assessment of cancer pain was a significant barrier to effective pain management, and almost as many (72%) reported a lack of clinician knowledge as representing yet another significant barrier to effective pain management (Vorthern and ard 1992). Given the complexity of the pain experience, helping caregivers provide appropriate levels of pain management is particularly challenging. Many caregivers may be reluctant to provide adequate levels of opioids for pain management in the home based on fears of addiction, levels of tolerance, potential side effects of the drugs and whether increased opioid treatment reflecting disease progression (Aranda et al. 2003). Although the sample used in their study was relatively small (n=75), Aranda et al. (2003) conclude that, "The increasing role of the family in managing the patient's pain in the home environment and a recognition that family beliefs and…
Aranda, S. Yatesp, Edwards H., Skerman, K. And McCarthy, a. (2004). "Barriers to effective cancer pain management: a survey of Australian family caregivers."
European Journal of Cancer Care 13: 336 -- 343.
Baker, Kylie. (2005). "Recent advances in the neurophysiology of chronic pain."
Emergency Medicine Australasia 17: 65-72.
Findings showed that medication was the most common treatment, followed by physiotherapy and no treatment. The majority preferred physiotherapy and no surgery was the third most popular choice. Their preferences and choices evolved from previous experience. They did not perceive their pain as severe enough to require surgery. (Mitchell & Hurley).
A revised regimen for Sid consists of 10 parts. These are a record of his general medical history for a total and comprehensive picture; the use of the four assessment tools mentioned earlier in this paper; his complete and updated pain history; instruction on chronic pain, opioids and opiate therapy; information about non-pharmacological treatment options for chronic pain; continuation of interrupted physiotherapy treatment sessions; conduct of training on self-management and pain control; warning about the risks of smoking; counseling on depression; matching preferences with evidence-based guidelines recommended for chronic pain; and hiring caregivers for himself and his wife.
Benedict, D.G. (2008). Walking the tightrope: chronic pain and substance abuse.
4 (8) Journal for Nurse Practitioner Elsevier Science, Inc. Retrieved on October
:5, 2010 from http://www.medscape.com/viewarticle/581261
Brevik, H., et al. (2008). Assessment of pain. 101 (1) British Journal of Anaesthesia:
Hospice caregivers have moral obligations to the patient and the patient's caregivers. The author clarifies that in the hospice, the patient's family members are, in fact, the primary caregivers under the situation. The best that nurses can do is to use strategies, which will incorporate family members into delivering the best palliative care possible. Failure to achieve the best results can create much moral anguish and sense of failure in nurses. Nevertheless, nurses who resort to this step should be convinced that they do what is right and worthy of praise.
Summary and Conclusion
Managing the pain experience of hospitalized children, cancer patients in home care or older adults in community dwelling is the responsibility of health care professionals. The nurse is a mainstay and front liner in the health care team in all settings.Therefore, it is her primary responsibility to know and perform the most and the best she…
Kirk, T.W. (2007). Managing pain, managing ethics. 8 (1):25-34. Pain Management
Nursing: Elsevier Science, Inc. Retrieved on April 15, 2009 from http://www.medscape.com/viewarticle/557072
Kortesluoma, R.L, Nikkonen, M., and Serlo, W ( 2008). "You just have to make the pain go away" -- children's experiences of pain. 9 (4); 143-9. Pain Management
Nursing: Elsevier Science, Inc. Retrieved on April 15, 2009 from http://www.medscape.com/viewarticle/585567
(Levin & Feldman, 2006, p. 298)
Open Ended Questions
1. Please list and elaborate on any specific concerns about pharmacological pain management that I can help you with?
2. Please list and elaborate on any specific questions about complimentary options for pain management that you have after briefly looking at the material I have offered you?
3. Can I define any terminology that you have about non-pharmacological pain management techniques, just make a list for me and we will talk about it tomorrow prior to discharge?
This internet assessment assignment deserves a grade of a, as the plan clearly responds tot the needs of the patient and caregiver with special attention to the willingness and aptitude of the patient herself to explore the topic, while still wishing to stay inside the confines of effective and evidence-based treatments. The comparison of materials to nursing text book as well as…
Alternative Medicine Foundation: Pain Management: An Alternative and Complementary Medicine Resource Guide at http://www.amfoundation.org/pain.htm
Cancer Treatment Centers of America: Pain Management at http://www.cancercenter.com/complementary-alternative-medicine/pain-management.cfm
Levin, R.F. & Feldman, H.R. (Eds.). (2006). Teaching Evidence-Based Practice in Nursing: A Guide for Academic and Clinical Settings. New York: Springer.
Menefee, L.A. PhD; Monti, D.A. MD (Nov 2005) Nonpharmacologic and Complementary
The study observed that post training pain documented by physicians and nurses increased from 61% and 76% to 78% and 85% respectively. Also noticeable was the increase in dosage of analgesia from 40% to 63% and of morphine from 10% to 17% while intravenous morphine dosage increased from 2.45 to 4.6 mg. The visual analogue scale score, which is an indicator of pain, also showed a marked reduction from 2. 9 cm to 2.1 cm post training suggesting a significant improvement in pain management and patient satisfaction. This cohort study clearly showed that pain management in the ED can be considerably improved by providing appropriate training for the ED staff and by implementing pain management guidelines for the ED.
Addictive Personality and Psuedo Addiction
One of the major issues revolving around pain care medication is the possibility of abuse. While in most cases patients are under treated there is also…
1) James Ducharme, MDCM, FRCP, DABEM, 'The Future of Pain Management in Emergency Medicine', Emerg Med Clin N. Am 23 (2005) 467-475
2) Liesl A. Curtis, MD, FACEP & Todd D. Morrell, MD, 'Pain Management in the Emergency Department' Emergency Medicine Practice, 2006, Vol 8, No 7
3) Linda L. Lawrence, MD, FACEP, 'Legal Issues in Pain Management: Striking the Balance', Emerg Med Clin N. Am 23 (2005) 573-584
4) Walter Allen Fink Jr., DO, FAAEM, FACEP, 'The Pathophysiology of Acute Pain', Emerg Med Clin N. Am 23 (2005) 277-284
Within a nursing home there are many elderly people who have come to get care from the facilities. Most of the elderly people are suffering from chronic illnesses and due to these conditions they experience a lot of pain and discomfort. The pain and discomfort has a lot of negative impact on the lives of the elderly in the nursing home. These impacts are particularly felt on an individuals well being and on their communication. It makes the patients feel very uncomfortable and they are not at peace. All the time an individual is restless trying to find a way to relieve their pain and discomfort. A person experiencing pain and discomfort is also not active. They can not carry out any activity since their body is not in a position to do anything as a result of the pain and discomfort (Severson, 2012).Their bodies do not function…
Scott, J., Baluch, A., Kaye, A. (2010).Pain Management in the elderly population. Retrieved May 12, 2013 from http://www.ncbi.nlm.nih.gov /pmc/articles/PMC3096211/' target='_blank' REL='NOFOLLOW'>
The better the pain management is in any case, regardless of age, the more likely a patient is to recover fully and in comfort and not feel afraid when injury or illness occur. From a clinical nursing perspective this is essential to the development of a more holistic level of treatment. Future research should attempt to analyze real time occurrence of treatment as a way to adapt pain assessment tools to younger children and also improve the qualitative and quantitative data on this issue.
Alexander J, Manno M. (2003) Underuse of Analgesia in Very Young Pediatric Patients
With Isolated Painful Injuries. Annals of Emergency Medicine.41:617 -622.
Campbell, C.S. (1988). Pain Perception in Infants. The Hastings Center eport, 18(2), 3-12.
Chan, L. ussel, T.J. oback N. (1998) Parental Perception of the Adequacy of Pain Control in Their Child After Discharge from the Emergency Department. Pediatric Emergency Care, 14, 251-253.
Alexander J, Manno M. (2003) Underuse of Analgesia in Very Young Pediatric Patients
With Isolated Painful Injuries. Annals of Emergency Medicine.41:617 -622.
Campbell, C.S. (1988). Pain Perception in Infants. The Hastings Center Report, 18(2), 3-12.
Chan, L. Russel, T.J. Roback N. (1998) Parental Perception of the Adequacy of Pain Control in Their Child After Discharge from the Emergency Department. Pediatric Emergency Care, 14, 251-253.
Pain Management: Ethical Issues
The most ethical way to approach the pain management. Explanation.
It is acceptable as long as the patient understands the risks
Successful pain relief, particularly during patients' end-of-life (EOL) phase, is a key ethical duty based on the values of patient autonomy, non-maleficence, beneficence, and, chiefly, the double effect concept. Pain management's practical groundwork starts with comprehensive evaluation, which integrates "WILDA" (i.e., Words, Intensity of pain, Location, Duration, and alleviating / aggravating factors) and takes into account overall pain elements: i.e., physical, spiritual, emotional and social pain. Opioids represent pain management's pharmacologic necessity in case of life-limiting disease, and must be administered or prescribed depending on pain severity, taking into consideration the psychological and functional significance of pain intensity. A number of misunderstandings act as obstacles to successful pain management. These misunderstandings include: the notion that opioid tolerance or dependence constitutes a form of…
Fine, R. L. (2007). Ethical and practical issues with opioids in life-limiting illness. Proc (Bayl Univ Med Cent), 20(1), 5-12.
In reviewing this study, we do not know the exact parameters and methods of the way that the studies were done before this leading one to view the results with some further questions.
The results of this particular study include that "institutional models, clinical pathways and consultation services are three alternative models for the integration of care processes in cancer pain management" (rink-Huis, van Achterberg & Schoonhoven, 2000). The pain consultation service, that the researchers believed was the foundation of the pain management care regimen, was in fact a "stand-alone model that was integrated into the clinical pathway" and not the care regimen itself (rink-Huis, van Achterberg & Schoonhoven, 2000). It seems that the results also include those patients most benefit from a pain management process that involves components of all three models- the institutional, clinical and consultation. In evaluating the patients progress though, a standardized set of measures must…
Brink-Huis, A., van Achterberg, T., & Schoonhoven, L. (200). Pain management: a review of organisation models with integrated processes for the management of pain in adult cancer patients. Journal of Clinical Nursing, 17, 1986-2000.
The Campbell Collaboration. 2011. What is a systematic review?. Retrieved from http://www.campbellcollaboration.org/what_is_a_systematic_review/index.php
Provider Education for Chronic Pain Management
Today, the Department of Veterans Affairs (VA) is the largest healthcare provider in the United States and one of the largest in the world. In fact, fully half of the physicians in the United States receive their training at a VA healthcare facility. This paper provides a description and explanation of the complex health care system to provide a framework for enhancing VA medical support staff knowledge of chronic pain management via a monthly "pain management" newsletter designed to improve pain management outcomes for veterans. In addition, an examination of the various levels of interprofessional team that would be required for the optimal operation of the multidisciplinary pain management delivery system and supporting rationale for each level is followed by a discussion concerning the core abilities required for each team member of the interprofessional pain management team, including suggestions for role responsibilities of each…
Boschert, S. (2009, February). Many health workers need to bone up on pain management.
Clinical Psychiatry News, 32(2), 82.
Clark, M.E. & Norton, C. (2009). Interdisciplinary pain team training program. Tampa:
Chronic Rehabilitation Program.
Pain Management Assessment
WHAT it TAKES
ecause moderate to severe postoperative pain is a common experience among patients, pain management is an essential part of nursing care (Yuceer, 2011). Nurses must evaluate the pain, teach the patient appropriate strategies in dealing with it, implement a treatment plan and monitor the results, educate the patient's family on it and record the outcomes of pain management. It is thus clear that the nurse's effective approach to pain management is of primary importance in reducing patient pain and discomfort after surgery. Studies, however, suggest that nurses' current inadequate management of patients' postoperative pain relates to her level of training and preparedness (Yuceer).
This study aims at assessing the results of a continuous quality improvement program on acute pain management of surgical patients by nurses. It will answer these questions: 1. What is this quality improvement program and how does it improve present pain…
Carlson, C.L. (2009). Use of three evidence-based postoperative pain assessment practices by registered nurses. Vol. 10 # 4, Pain Management Nursing: Medscape.
Retrieved on April 11, 2014 from http://www.medscape.com/viewarticle/715639
Guardini, I.., et al. (2008). The effectiveness of continuing education in postoperative pain management: results from a follow-up study. Vol. 39 # 6, Journal of Continuing
Education in Nursing: PubMed Central. Retrieved on April 11, 2014 from http://www.ncbi.nlm.nih.gov /pubmed/18557287' target='_blank' REL='NOFOLLOW'>
This is because every person has a different pain management need. Therefore, there is a need to have a bio-psycho-social-spiritual approach to the management of chronic pain. The four components of the experience of pain by the patient are as follows. The first component is the physical sensation that is felt. Second are the automatic thoughts that come as a result of the gross pain being experienced. Third are the uncomfortable emotional reactions that the patient has to deal with from the pain. Fourth are the self-defeating behaviors that are as a result of the thinking and the feelings of the patient. This is the approach that is in use in Sierra Tucson Hospital in Tucson, Arizona Merskey, 1994()
Studies have indicated that as the patient continues to experience the pain and as the pain becomes chronic, the mood of the patient is grossly affected and their motivation toward the…
Crombie, I.K., Davies, H.T.O., & Macrae, W.A. (1994). Entering the Loop: Assessing the Contribution of Pain Clinics in Northern Britain. Quality of Life Research, 3, S35-S38.
Dusek, J.A., Finch, M., Plotnikoff, G., & Knutson, L. (2009). Best Practices in Integrative Medicine: Inpatient Pain Management Minneapolis, Minnesota: The Bravewell Collaborative.
Fordyce, W.E. (1994). Pain and Suffering: What Is the Unit? Quality of Life Research, 3, S51-S56.
Jason, E.O., Klapow, J.C., & Casebeer, L. (2000). Evaluating the Relationship between Pain Presentation and Health-Related Quality of Life in Outpatients with Metastatic or Recurrent Neoplastic Disease. Quality of Life Research, 9(7), 855-863.
adiologic Procedure Pain Management
The author of this report is asked to identify and explore a given concept. The concept that shall be explored is pain management during procedures like biopsies, angioplasties and angiograms. This concept was selected by the author of this report because it is closely related to the interests and studies of the author. The attributes of the policy will be described by the author. The author has also done a literature view pertaining to the subject at hand and the author will also apply the concept to future habits and tactics that will be used when the author is practicing medicine. The value of these concepts and the associated traits will be enumerated to close out this report.
easons for Interest
The use of radiologic procedures to prevent, treat and detect disease is invaluable in the current medical sphere. Just as one example, doctors and nurses…
Aktoz, T., Kaplan, M., Turan, U., Memis, D., Atakan, I., & Inci, O. (2010). 'Multimodal'
approach to management of prostate biopsy pain and effects on sexual function:
efficacy of levobupivacaine adjuvant to diclofenac sodium - a prospective randomized trial. Andrologia, 42(1), 35-40. doi:10.1111/j.1439-
Butler, L., Symons, B., Henderson, S., Shortliffe, L., & Spiegel, D. (2005). Hypnosis reduces distress and duration of an invasive medical procedure for children.
Christensen, a., & Jacobsen, N.S. (1996). Studying the effectiveness of psychotherapy: How well can clinical trials do the job? American Psychologist, 51(10), 1032.
Authors emphasized that pain sufferers should not limit themselves to one approach, but should rather seek to identify a broad range of therapies that may result in appreciable gains for the healthcare consumer.
Craig, K.D., & Hadjistavropoulos, . (Eds.). Pain: Psychological perspectives. Mahwah, NJ: Lawrence Erlbaum Associates, 2004.
Authors emphasized the continuing risk of unnecessary or undermanaged pain because of an inadequate knowledge base, underdeveloped assessment procedures, and inadequate pain management.
Gersten, R., Schiller, E.P., & Vaughn, S. (2000). Contemporary special education research: Syntheses of the knowledge base on critical instructional issues. Mahwah, NJ: Lawrence Erlbaum Associates.
Authors noted that the introduced of computer-assisted statistical analytical tools has contributed greatly to the conduct of meta-analyses in recent years.
Greenhalgh, S. (2001). Under the medical gaze: Facts…
The second leg of triangulated methodology will consist of a meta-analysis of recent clinical studies involving the use of natural healing methodologies in general and their use in pain management regimens in particular. This approach is congruent with Gersten, Schiller and Vaughn (2000), who advise that, "The meta-analyst is seeking to determine whether a particular finding is robust across different sets of assumptions. If the answer is 'yes,' then greater confidence can be placed in the conclusion. The specific techniques used in any meta-analysis will differ somewhat depending on the characteristics of the data set and the questions asked by the research synthesist" (p. 275).
The final leg of the triangulated methodology will consist of a convenience sample online survey of pain sufferers to determine their use of natural healing methodologies for pain management purposes, and to assess their level of awareness and education concerning their alternative approaches. This research methodology is congruent with a number of social researchers who recommend triangulation to garner as much insight and background into an issue under investigation as possible (Jonasssen, 2004). A three-part anonymous survey will be posted on pain management forums such as "Pain Management Forum" available at http://ehealthforum.com/health/pain_management.html and "MedHelp Pain Management Forum" available at http://www.medhelp.org/forums/Pain-Management-Support/www.board.html . with the goal of collecting at least 200 completed surveys in time for inclusion in the final study. This first part of the survey will collect various demographic data from the pain suffering respondents such as medical condition and length of time the pain has been experienced. The second part of the survey will consist of a series of Likert-scaled questions ranging from "strongly agree" to "strongly disagree" concerning various alternative medicine approaches to pain management. The final section of the survey will consist of an open-ended comment section where respondents will be requested to provide their personal experiences, insights and views concerning mainstream medicine and natural healing methodologies as they pertain to pain management regimens.
The results of the proposed study can be used to provide a best practices guide for both mainstream clinicians as well as healthcare consumers concerning alternative approaches to pain management today. The conclusions of the study will be presented in the concluding chapter, together with a summary of the findings and recommendations for healthcare consumers and mainstream healthcare providers.
Nurses and Pain Management
Pain management has always been a critical goal of health care workers. Strategies for improved pain management guidelines have been in place since the early 1990s, with the aim of allowing clinicians to improve pain management. However, research shows that patients in all age groups continue to experience needless pain, despite the guidelines and treatment availabilities.
This paper examines the pain management strategies that could be employed by nurses towards alleviating pain in a variety of patients.
The first part of this paper examines the background and reviews the current literature regarding pain management. The next part then examines the key pain management issues, including the concern regarding addiction, a clinician's ethical responsibilities towards patients and legal culpability.
The next section examines the pros and cons of establishing pain management standards.
The paper then examines these proposed guidelines from a nursing viewpoint, in line with the…
ANA House of Delegates. 2001. "Code of Ethics for Nurses With Interpretive Statements." available at http://www.nursingworld.org/ethics/chcode.htm
Chaska, NL. 2001. "Avoiding the fatal 'By-pass operation' in facilitating accountability." NL Chaska, ed. The Nursing Profession Tomorrow and Beyond. Thousand Oaks: Sage Publications.
Collaboration and independent practice: Ongoing issues for nursing." 1998. Nursing Trends and Issues (column), Nursing World 3(5). Available at http://www.nursingworld.org/readroom/nti9805nti.htm .
Emmanuel, Linda. 1995. "Structured deliberation to improve decision making for the seriously ill." Special Supplement, The Hastings Center Report, 25:6: S. 15.
Acute Pain Management: A Brief Overview
Course Number, Section, and Title
(Example: NUS 4000 Section 04, esearch and Scholarship for Evidence-Based Practice)
(enter the date submitted to Instructor)
CHANGE IN PACTICE
Acute pain management is a difficult task to manage in most hospitals and other medical facilities. Patients may exhibit opioid addiction behaviors and some medications meant to alleviate acute pain may (in the end) increase pain. The purpose of this assignment is to highlight current ways hospitals and other medical facilities deal with needs of acute pain patients.
Acute pain management has become a growing problem in the modern world. Patients with acute pain have become used to certain medications and some have shown opioid addiction leading to accidental deaths and prescription abuse. Modern practices have included interviewing techniques as well as physical assessment to help competently evaluate and manage patients that complain of acute pain.
Emergency rooms, a…
Ahern, T., Herring, A., Anderson, E., Madia, V., Fahimi, J., & Frazee, B. (2015). The first 500: initial experience with widespread use of low-dose ketamine for acute pain management in the ED. The American Journal Of Emergency Medicine, 33(2), 197-201. doi:10.1016/j.ajem.2014.11.010
CV, P., & ER, V. (2015). Improving acute pain management in emergency medicine. Hospital Practice, 43(1), 36.
Lyons, P., Rivosecchi, R., Nery, J., & Kane-Gill, S. (2015). Fentanyl-Induced Hyperalgesia in Acute Pain Management. Journal Of Pain & Palliative Care Pharmacotherapy, 29(2), 153-160. doi:10.3109/15360288.2015.1035835
Paschkis, Z., & Potter, M. (2015). CE: Acute Pain Management for Inpatients with Opioid Use Disorder. AJN, American Journal Of Nursing, 1. doi:10.1097/01.naj.0000471243.30951.92
Johnson & Potter’s (n.d.) case study “Walking the Tightrope” demonstrates how different ethical obligations like patient autonomy, beneficence, and non-maleficence often conflict during delivery of care. Pain management is especially difficult, given the problematic side effects and potential for abuse of some pain management interventions. The patient in the case in question has been described as a “complainer,” but there is no indication of dementia (Johnson & Potter, n.d.). Therefore, there should be no reason to allow the family members to continue in their overbearing manner preventing the patient from making her own decisions regarding pain relief. The case illustrates the doctor, the sister, and the brother making decisions on the patient’s behalf, clearly impinging on her autonomy.
The disparate voices are also pulling in opposite directions, leading to a piecemeal and haphazard approach to pain management that could cause further complications and even medication errors. This would also open…
Johnson, L. & Potter, R. (n.d.). Walking the tightrope. Center for Practical Bioethics. http://practicalbioethics.org/case-studies-walking-the-tightrope
Maumus, M. (2015). Bioethics in practice. The Ochsner Journal 15(2): 124-126.
Smebye, K.L., Kirkevold, M. & Engedal, K. (2016). Ethical dilemmas concerning autonomy when persons with dementia wish to live at home: a qualitative, hermeneutic study. BMC Health Services Research 16(2016): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4717656/
Situation of Focus
The opioid epidemic in America has arisen in part as a result of over-prescription of drugs to patients (Brummett et al., 2017). While patients have a right to expect pain relief, the tendency among health care providers to prescribe opioid therapy to opioid naïve patients at an unnecessarily high dosage can have detrimental effects and risks, such as long-term addiction of the patient (Harbaugh et al., 2018), sleep apnea and even depression (Rowsell et al., 2016). Nurses and doctors should be careful, therefore, to use opioid therapy at the lowest doses for effective pain relief, with the goal being pain management at a tolerable level rather than for opioids like oxycodone to be prescribed at high levels so that the patient can experience zero pain.
The problem is that some patients may expect to be given a strong prescription that will effectively take all their…
Brummett, C. M., Waljee, J. F., Goesling, J., Moser, S., Lin, P., Englesbe, M. J., ... & Nallamothu, B. K. (2017). New persistent opioid use after minor and major surgical procedures in US adults. JAMA surgery, 152(6), e170504-e170504.
Harbaugh, C. M., Lee, J. S., Hu, H. M., McCabe, S. E., Voepel-Lewis, T., Englesbe, M.J., ... & Waljee, J. F. (2018). Persistent opioid use among pediatric patients after surgery. Pediatrics, 141(1), e20172439.
Leininger, M. (2008). Transcultural nursing: Its importance in nursing practice. Journal of cultural diversity, 15(1), 37-43.
Lenz, E. R., Suppe, F., Gift, A. G., Pugh, L. C., & Miligan, R. A. (1995). Collaborative development of middle-range nursing theories: Toward a theory of unpleasant symptoms. Advances in Nursing Science, 17(3), 1-13.
Rowsell, L., Wong, K., Yee, B., Eckert, D. J., Somogyi, A., Duffin, J., ... & Wang, D. (2016). Identifying obstructive sleep apnea patients vulnerable to opioid-induced respiratory depression-a randomized double-blind placebo-controlled crossover trial. Am J Respir Crit Care Med, 193, A4321.
Volkow, N. D., & McLellan, A. T. (2016). Opioid abuse in chronic pain—misconceptions and mitigation strategies. New England Journal of Medicine, 374(13), 1253-1263.
Wagner, J. M., & Dahnke, M. D. (2015). Nursing ethics and disaster triage: applying utilitarian ethical theory. Journal of Emergency Nursing, 41(4), 300-306.
The Benefits and Dangers of Hydrocodone
Today, the United States is suffering from a veritable epidemic of prescription drug abuse, including both legitimate and illicit uses of these otherwise legal drugs including most especially the analgesic hydrocodone. The purpose of this paper is to review the literature to provide a description of the origin of hydrocodone, the effects of the drug on the human body and how it is typically introduced into the body. In addition, a discussion concerning slang references for hydrocodone and its current street costs is followed by current usage statistics, a description of applicable laws and a physical description of hydrocodone. Finally, the paper presents a summary of the literature review and key findings about the research concerning hydrocodone in the conclusion.
Origin of hydrocodone
Although the prescription abuse epidemic that is sweeping the country is relatively recent in origins, the origin of semisynthetic hydrocodone dates…
Fiscella, K. & Gibson, B. (2018, May/June). Management techniques for opioid-dependent inmates. American Jails, 32(2), 8.
Hydrocodone drug slang/code words. (2018). Clinical Pain Advisor. Retrieved from https://www.clinicalpainadvisor.com/dea-drug-slang-code-words/hydrocodone-drug-slangcode-words/article/678817/.
Hydrocodone overview. (2018). MedlinePlus. Retrieved from https://medlineplus. gov/druginfo/meds/a614045.html,
Hydrocodone reclassification. (2014). American Medical Association Wire. Retrieved from https://wire.ama-assn.org/delivering-care/6-things-you-need-know-about-hydrocodone-reclassification.
Kavilanz, P. (2018, June 1). Prescription drugs worth millions to dealers. CNN Money. Retrieved from http://money.cnn.com/2011/06/01/news/economy/prescription_drug_ abuse/index.htm.
The history of hydrocodone. (2018). Forever Recovery. Retrieved from http://aforever recovery.com/drug-addiction/painkiller/the-history-of-hydrocodone/.
Villa, L. (2018). The serious side effects of shooting hydrocodone. Rehabs. Retrieved from https://luxury.rehabs.com/iv-drug-use/shooting-hydrocodone-lortab-or-vicodin/.
Alternatives to Pain Medication
Given the growing concerns over opioid addictions in recent years and the potential for tolerance, clinicians continue to search for efficacious alternatives to convention pain medications (Moore & Anderson, 2016). Fortunately, a number of alternatives to conventional pan medication are readily available, including cannabis, yoga, hypnosis, mind-body meditation, therapeutic touch, herbal remedies, acupuncture, biofeedback, massage therapy, homeopathic practices (Tan & Craine, 2007) and aromatherapy (Esposito & Bystrek, 2014). To learn more about these alternatives, this paper provides an initial reference list of ten relevant peer-reviewed and scholarly sources concerning pain medication alternatives, followed by a description of clinical guidelines and an implementation plan for these alternatives. A discussion concerning the manner in which the implementation of the intervention should be tested is followed by an assessment of potential barriers and strategies intended to gain cooperation from individuals who will be implementing the change. Finally, a timeline…
Clinical practice guidelines. (2016). U.S. National Center for Complementary and Integrative Health. Retrieved from https://nccih.nih.gov/health/providers/clinicalpractice.htm .
Levin, R. F. & Feldman, H. R. (2006). Teaching evidence-based practice in nursing: A guide for academic and clinical settings. New York: Springer Publishing Company.
Moore, B. A. & Anderson, D. (2016, Janury). Stepped care model for pain management and quality of pain care in long-term opioid therapy. Journal of Rehabilitation Research & Development, 53(1), 137-141.
Pain management guidelines. (2016). U.S. Agency for Healthcare Research and Quality. Retrieved from https://www.guideline.gov/summaries/summary/9744 ?.
fuse the content of the third chapter from the class text and a selected article. The salient and primary point to be taken from the chapter reading is concept analysis and frameworks. The important point from the article that will be focused on is aggression in the emergency department. To be certain, the emergency department of any hospital or other medical institution is a place where the presence of aggression can emerge in some instances. While some may say that concept analysis and frameworks are just a lot of navel-gazing, this is far from the truth so long as the practice is taken serious and is done as needed.
As explained by the class text, it is important to have proper concept development and research because there is a common language that must exist. To use a simpler example, three widgets to one person should always be three widgets to…
Bresler, S., & Gaskell, M. (2015). Risk assessment for patient perpetrated violence: Analysis of three assaults against healthcare workers. Work, 51(1), 73-77.
McEwen, M., & Wills, E. (2011). Theoretical basis for nursing. Philadelphia: Wolters
Kluwer/Lippincott Williams & Wilkins.
The Improve Phase of the DMAIC process is also essential for managing the piloting and testing of the Six Sigma solutions discovered. It is also essential during the new product development process for measuring and quantifying the unique value proposition of the product or service being produced as well. The final phase, Control, is essential in both a Six Sigma and new product introduction process as well (Pestorius, 2007).
The DMAIC process aligns very well to the new product development and introduction process and is used extensively for that purpose in applying Six Sigma to marketing. Six Sigma can change an entire company's culture and make the many processes synchronized and in unison in making new product introductions more profitable and capable of gaining market share as a result.
Brian Cocolicchio (2007). Sales and Marketing the Six Sigma Way. Quality Progress, 40(9), 79. Link: http://www.sixsigmaselling.com/six_sigma_selling/2006/07/about_sales_and.html
Fundin, a.P., &…
Brian Cocolicchio (2007). Sales and Marketing the Six Sigma Way. Quality Progress, 40(9), 79. Link: http://www.sixsigmaselling.com/six_sigma_selling/2006/07/about_sales_and.html
Fundin, a.P., & Cronemyr, P. (2003). Use customer feedback to choose six sigma projects. ASQ Six Sigma Forum Magazine, 3(1), 17-21. Retrieved from http://asq.org/sixsigma/2005/03/use-customer-feedback-to-choose-six-sigma-projects-en.pdf
Hasan, M., & Kerr, R.M. (2003). The relationship between total quality management practices and organisational performance in service organisations. TQM Journal, 15(4), 286-286.
It is not that managers do not see the benefit in conflict that they eschew it; it is that conflict is high-risk and can have significant negative externalities, some of which linger with the organization for a long time. Managers are less enthusiastic about conflict because they are taking into account a longer time frame and the totality of externalities, which makes their views a reflection of better information and therefore more accurate than the views of academic researchers.
Recommendations. Carefully manage conflict -- do not use it wantonly. Conflict does not always create positive outcomes sufficient to outweigh the negative ones that are certain to accrue. Take steps to ensure that the conflict is task-focused and not personal. This will limit the amount of damage that accrues from conflict. Create conflict only when necessary -- large scale conflict for small scale problems is dangerous. Conflict is a powerful tool…
Vazquez, E. (2008). Managing conflict across generations in the workplace. Massachusetts Institute of Technology. Retrieved May 30, 2010 from http://dspace.mit.edu/bitstream/handle/1721.1/50103/462996891.pdf?sequence=1
Rahim, M. (2001,a). Managing conflict in organizations. Westport, CT: Quorum Books.
Cohen, C., Birkin, S., Cohen, M., Garfield, M. & Webb, H. (2006). Managing conflict during an organizational acquisition. Conflict Resolution Quarterly. Vol. 23 (3) 317-331.
Rahim, M. (2001, b) Towards a theory of managing organizational conflict. The International Journal of Conflict Management. Vol. 13 (3) 206-235.
Giving them the opportunity to participate in the product launch decisions from a marketing standpoint also highlighted an embarrassing point for marketing, and that was engineering often understood the competition and its true functionality better than anyone in marketing. The reason is that the engineers had taken great pride in working on their product features they were responsible for to make them the best in the industry, and it was clear some had taken great pains to make a statement in their work. Creating shared ownership of product outcomes strengthens morale of technical professionals and infuses an entire development team with more accountability (Voss, 1993) and willingness to internalize a strong commitment to the success of the product (Kochanski, Ledford, 2001).
The risk of recommending this strategy would be that the more dominant engineers would overrule marketing and turn the entire marketing strategy into more of a features discussion than…
David Baccarini, Geoff Salm, & Peter ED Love. (2004). Management of risks in information technology projects. Industrial Management + Data Systems, 104(3/4), 286-295.
Jain, S.. (2008). DECISION SCIENCES: A Story of Excellence at Hewlett-Packard. OR-MS Today, 35(2), 20
James Kochanski & Gerald Ledford. (2001). "How to keep me" -- retaining technical professionals. Research Technology Management, 44(3), 31-38.
Li, Y., & Zhu, K.. (2009). Information acquisition in new product introduction. European Journal of Operational Research, 198(2), 618.
Management of Immunocompromised Patients
In beginning I writer specific nursing assignment. The Question: 2000 Words While clinical placement asked prepare a single room an admission. The patient requiring admission isolation room immunocompromised.
Immunocompromised patients usually require isolation in order to prevent them from becoming infected with infections from other patients which is known as protective isolation. For the immunocompromised patients, their immune system is unable to fight the infectious diseases. There are many diseases or conditions that lead to immunodeficiency in patients.
One is AIDS (acquired immunodeficiency syndrome). The pathophysiology of AIDS starts when the person's CD4+ T cell count begins to decrease as the disease kills these cells. This is HIV-induced cell lysis where the virus enters the CD4+ cells where it inserts its genetic information to the cell nucleus thus taking over the cell and replicating itself. The virus then mutates extremely rapidly thus making it more and…
Agusti, C., & Torres, A. (2009). Pulmonary Infection in the Immunocompromised Patient: Strategies for Management. New York: John Wiley & Sons.
Bodey, G.P. (2010). Managing Infections in the Immunocompromised Patient. Clinical Infectious Diseases, 40(Supplement 4), S239. doi: 10.1086/427328
Glauser, M.P., & Pizzo, P.A. (2009). Management of Infections in Immunocompromised Patients New York: Elsevier Health Sciences.
Hayden, R.T. (2008). Diagnostic Microbiology of the Immunocompromised Host. Washington, DC: ASM Press.
Innovation in its simplest form can be termed as something new or newly introduced into the market. Innovation in the business field is quite necessary since it forms the backbone of a company's growth and that of the economy as a whole. Innovation is the success of every business and must be managed effectively and efficiently (Limerick, 2002).
The ever changing technology and instant global communication have made it easier for companies to find answers to some problems they encounter and more so come up with innovations to improve on the current ones. Companies are also faced with pressures arising from global competition and by this; most of them are seeking the need to manage their innovations. Companies are nowadays attracting and managing innovations by having rewards or prizes for individuals within the company who manages to come up with brilliant and innovative concepts. This will give the…
AFUAH, A. 2003. Innovation Management: Strategies, Implementation, and Profits, New York and Oxford, Oxford University Press.
ALEXY, O. & REITZIG, M. 2012. Managing the business risks of open innovation. McKinsey Quarterly, 17-21.
BROWN & HELEN 2008. Knowledge and innovation: a comparative study of the U.S.A., the UK, and Japan London Routledge.
DANNEELS, E. 2002. The Dynamics of Product Innovation and Firm Competences. Strategic Management Journal, 23, 1095-1121.
In fact I sincerely wanted to help them find positions where they could excel. The lack of trust on their part and the acute resistance to change was so strong that structuring for integration to the point of even defining what conditions needed to be changed to overcome shortcomings and design a new position for them was not possible. As trust was not present and despite my best attempts to earn it through being genuinely concerned about them, all attempts were seen more as patronizing and less about attempting to help them. On the occasion that they did ask for pay increases, I told them they would need to get their cumulative customer satisfaction scores up and also call volumes. Not interested in the position or excelling at it, these employees refused to improve and when let go, saw it as very personal given my continual efforts to help them…
Alexander, Kenneth O. "Worker Ownership and Participation in the Context of Social Change: Progress Is Slow and Difficult, but it Need Not Wait upon Massive Redistribution of Wealth. " the American Journal of Economics and Sociology 44.3 (1985): 337. ABI/INFORM Global. ProQuest. 25 Oct. 2008
Timothy Bartram, Gian Casimir. "The relationship between leadership and follower in-role performance and satisfaction with the leader:the mediating effects of empowerment and trust in the leader. " Leadership & Organization Development Journal 28.1 (2007): 4-19. ABI/INFORM Global. ProQuest. 24 Oct. 2008
Douglas Brownlie, Paul Hewer, Beverly Wagner, Gran Svensson. "Management theory and practice: bridging the gap through multidisciplinary lenses. " European Business Review 20.6 (2008): 461-470. ABI/INFORM Global. ProQuest. 24 Oct. 2008
Huei-Fang Chen, Yi-Ching Chen. "The Impact of Work Redesign and Psychological Empowerment on Organizational Commitment in a Changing Environment: An Example From Taiwan's State-Owned Enterprises. " Public Personnel Management 37.3 (2008): 279-302. ABI/INFORM Global. ProQuest 27 Oct. 2008
Management of Stress and Tension
Goals-- What do you wish to complete?
The answer to attain a postgraduate degree can develop into a very long journey. For me, the contending aspects of time and financial resources constantly appeared to present problems and control the situation. In truth, it would be considerably much easier to provide every single argument present against returning to institution at this time. One can say that numerous considerable life-changing occasions experienced just recently would be cause or motive enough to put off the commencement of the Master's of Business Administration (MBA) program. Concerns associated with household loss and task modification can be made use of as proof in support of delay. Financial pressures can likewise exist yet an additional motive that the moment in time, endeavor, and cost needed for an MBA would not be a required use of resources. Nonetheless, regardless of every one of…
Center for Applications of Psychological Type, Inc.. (2011). What are archetypes. Retrieved from http://www.capt.org/discover-your-archetypes/about-archetypes.htm
Cohen, B. (2001, April 21). Average Salary for First Year Accountants. Retrieved from eHow Money: http://www.ehow.com/info_8271661_average-salary-firstyear-accountants.html
Curtis, J. (2009). Life change stress test. WebMD. Retrieved from http://www.webmd.com/hw-popup/life-change-stress-test
Hansen, R.S. (n.d.). The Master of Business Administration: Is the MBA Worth the Time, Effort, and Cost? Retrieved from Quint Careers: http://www.quintcareers.com/MBA_degree.html
The most recent trajectory for China's economy has been notable for its absence of emphasis on heavy industry. Mao's original plans focused on heavy industry the major driver of Chinese economic growth. Deng, too, had wanted to build out China's capacity in steel and heavy manufacturing industries. In recent years, service industries and light manufacturing have taken a more prominent role in the Chinese economy. The sense is that during the first years of the reforms, it was essential for China to build out its industrial capacity. Having done that, the only role left is to leverage the heavy industry infrastructure in order to help build out the fledgling service industry.
It was the heavy industry that facilitated productivity growth in China in the past couple of decades. Productivity has contributed 13.5% of China's economic growth since the early 1930s (u, 2003). Substantial improvements in infrastructure and technology were able…
BBC: China's Economic Reform website. (2005). Retrieved May 1, 2009 from http://news.bbc.co.uk/nol/shared/spl/hi/pop_ups/quick_guides/05/asia_pac_china0s_economic_reform/html/1.stm
GDP figures from the International Monetary Fund. (2009) Retrieved May 2, 2009 from http://www.imf.org/external/pubs/ft/weo/2009/01/weodata/weorept.aspx?sy=2008&ey=2008
History Learning Site. (n.d.) Retrieved May 1, 2009 from http://www.historylearningsite.co.uk/china_five_year_plan.htm
Harms, William. (1996). China's Great Leap Forward. University of Chicago Chronicle. Retrieved May 1, 2009 from http://chronicle.uchicago.edu/960314/china.shtml
"Contention for shared resources significantly impedes the efficient operation of multicore processors" (Fedorova, 2009). The authors of "Managing Contention for Shared Resources on Multicore Processors" (Fedorova, 2009) found that shared cache contention as well as prefetching hardware and memory interconnects were all responsible for performance degradation. After implementing a pain, sensitivity and intensity, model to test applications, the authors discovered that high miss rate applications must be kept apart and not co-scheduled on the same domain (memory). Therefore, the management of how the applications were scheduled by the scheduler would mitigate the performance degradation of the cache lines and the applications on the processors.
The authors built a prototype scheduler, called Distributed Intensity Online (DIO) that distributes intensive (high latest level cache (LLC) miss rates) after measuring online miss rates of the application. With the execution of eight different workloads for testing, the DIO improved workload performance by…
Arteaga, D. e. (n.d.). Cooperative Virtual Machine Scheduling on Multi-core Multi-threading Systems -- A Feasibility Study. Retrieved from Florida International University: http://visa.cs.fiu.edu/...i/tiki-download_file.php?field=25
Fedorova, A.B. (2009). Managing Contention for Shared Resources on Multicore Processors. Vancouver, Canada: Simon Frazier University.
Xu, C.C. (2010, Mar). Cache Contention and Application Performance Prediction for Multi-core Systems. Retrieved from University of Michigan: http://web.eecs.umich.edu/!zmao/Papers/xu10mar.pdf
Zhoa, Q. e. (2011, Mar). Dynamic Cache Contention Detection in Multi-threaded Applications. Retrieved from Massachusetts Institute of Technology: http://groups.csail.mit.edu/commit/papers/2011/zhao-vee11-cache-contention.pdf
" (Kotler and Lee 2005, p.3). Since this study was published, the contributions have steadily increased making CS an integral part of every major company today.
A report by Price Water Cooper House in 2010 shows that the CS initiatives and reporting has increased despite the sagging economy and this points to a positive change in the mindset of the management of companies. "PWC explains that such reports have become critical to a company's credibility, transparency and endurance." (Business & the Environment 2010, p.5). The reduced role of the Government in business circles is only going to further increase this trend because companies feel they have an obligation to the society at large and they want to make this country a better place for living. All this is done out of their own interest and initiative rather than any force by any external institution. Also, many companies understand the significance…
Associated Press. 2011, February 25. State and Local Budget Cuts are slowing the U.S. Economy. Fox News. [Online] Available at: http://www.foxnews.com/us/2011/02/25/government-budget-cuts-pose-threat-recovery / [Accessed 27 March 2011]
No Author. 2011. Political Conditions. United States Country Review. 1(5). pp29-258.
Kotler, Philip; Lee, Nancy. 2005. Corporate Social Responsibility: Doing the most good for your company and your cause. New York: John Wiley and Sons.
BSD Global. 2011. Corporate Social Responsibility. International Institute for Sustainable Development. [Online]. Available at: http://www.iisd.org/business/issues/sr.aspx [Accessed 27 March 2011]
For instance, doctors usually tend to show the real situation through their facial expressions.
According to Smith,
There are no occurring contradictions as signs of body expressions or gestures are understandable to the family members"
This kind of example only demonstrates the success of using nonverbal communication. In the case we mentioned, the emotional pain showed by a physician is almost equivalent to telling the real truth to the patient's family about the patient's health condition. Here, the flow of information gathered from a nonverbal form is effective because despite of lack of speech, the sender is able to deliver the message that he wants to convey.
The book of Smith (1966) reiterates that the symbols exist in nonverbal communication. Symbols are sometimes used in hospitals to deliver information about a patient. Symbols such as medical symbols cannot be understood by a layman unless they are explained to him by…
Cherry, Colin. On Human Communication. (Chicago: Encyclopedia Britannica, Inc. 1966).
Gordon, G.N. The Languages of Communication. (NY: Harper & Row, 1969).
Pierce, J.R. Symbols, Signals and Noise. (McGraw-Hill Book Co., 1961)
Rosen, George. The Encyclopedia Ameicana. (CT: Grolier, Inc., 1972).
According to the text by Sanders (2011), the Venturi Mask is likely to be the most appropriate assistive device in this process. Sanders indicates that this particular apparatus is "advised for patients who rely on hypoxic respiratory drive. This includes, for example, patients with COPD. The main benefit of the Venturi Mask is that it allows precise regulation of the FiO2. It also permits the paramedic to titrate oxygen for the patient with COPD so as not to exceed the patient's hypoxic drive while allowing enrichment of supplemental oxygen." (Sanders, p. 422)
In addition the Venturi Mask which can help to normalize pulmonary activity, the patient is also experiencing a productive cough with thick yellow sputum. The presence of excessive mucus is also likely contributing to Mr. Hay's airway blockages. This would be an appropriate place to use the Yankeur sucker in order to help remove fluids that might be…
Australian Nursing and Midwifery Council. (2006). National competency standards for the midwife. Retrieved from: http://www.nursingmidwiferyboard.gov.au/Codes-and-Guidelines.aspx#competencystandards
Ambulance Victoria. (2012). Ambulance Victoria clinical practice guidelines for ambulance and MICA paramedics. Retrieved from: http://www.ambulance.vic.gov.au/Paramedics/Qualified-Paramedic-Training/Clinical-Practice-Guidelines.html .
Courtney, M. (2005). Evidence for nursing practice. Marrickville NSW: Livingstone Churchill Elsevier. Page 19 of 24.
Johnson, R. & Taylor, W. (2010). Skills for midwifery practice (3rd ed.). Edinburgh: Elsevier.
Combining these two methods is one effective strategy in mitigating pain in children (Cohen).
Additional strategies that involve both the patient and family are evident, particularly when dealing with chronic pain. Children sometimes internalize pain, believing that they must restrict their activity, particularly when parents worry and hesitate to allow them to be active. Parents see play as worsening of the situation or a relapse, contributing to an overprotectivness. This, in turn, reflects on the self-image of the child. In any case, experts recommend that parents not react in a negative way -- either by thinking the child is faking pain or becoming so overprotective that the child is a virtual prisoner. Instead, the psychological strategy should be to set realistic and evolving strategies so that there is not a continue pessimism regarding future health outcomes. This, for adolescents, is critical since there is also a self-esteem issue that goes…
The Handbook of Chronic Pain. (2007). New York: Nova Science Publishers.
Handbook of Pediatric Chronic Pain. (2011). New York: Springer.
Carter, B., & Threlkeld, M. (2012). Psychosocial perspectives in the treatment of pediatric chronic pain. Pediatric Rheumatology, 10(15), 1-11. Retrieved January 2013, from Pediatric Rheumatology: http://www.ped-rheum.com/content/pdf/1546-0096-10-15.pdf
Christie, D., & Wilson, C. (2005). CBT in Pediatric and Adolescent Health. Developmental Neurorehabilitation, 8(4), 241-47.
suffer anymore: Access to pain treatment as a human right, Human ights Watch author Diederick Lohman discusses the issue of pain management as a human rights issue. Lohman addresses the fact that it has long been established that pain relieving drugs, particularly narcotics, are an essential element of healthcare. In fact, he points out that in 1961, the world community adopted the 1961 Single Convention on Narcotic Drugs, which instructed countries to make pain relieving medications available to people (Lohman, 2009). However, the reality is that, even now the majority of the world's people lack access to pain-relieving medication. This is particularly true in low and middle income countries. Moreover, the lack of access impacts patients at all levels, even those whose conditions are terminal, so that they literally die in pain.
In the article, Lohman cites an extraordinary amount of facts and figures to back up his assertion that…
Brennan, F., Carr, D., and Cousins, M. (2007). Pain management: A fundamental human right.
Anesthesia & Analgesia, 105(1), 205-221.
Lohman, D. (2009). "Please do not make us suffer any more:" Access to pain treatment as a human right. New York: Human Rights Watch.
Purdue Pharma LP (2012). Ethics & Pain. Retrieved February 5, 2013 from In the Face of Pain
Chronic musculoskeletal pain necessitates the maintenance of good extensibility in order for normal functioning to be enhanced. This enhancement results in improvements in strength, endurance, fitness, and psychological well-being (Law et al., 2009). Programs promoting the improvement of movement for people with chronic musculoskeletal pain usually include stretching components. Stretching helps to improve functioning through improved range of motion within joints, and therefore muscle extensibility (Law et al., 2009).
The study by Law et al. (2009) emphasized the importance of tolerance and extensibility for individuals with chronic musculoskeletal pain. The purpose of the study, which was clearly outlined in the report, was to explore whether stretch affects either or both of these factors. The researchers hypothesized that individuals with chronic musculoskeletal pain may respond to stretch differently than individuals who do not experience chronic pain. Further to this suggestion, the researchers suggest that individuals with chronic musculoskeletal pain may show…
Law, R.Y., Harvey, L.A., Nicholas, M.K., Tonkin, L., De Sousa, M., Finniss, D.G. (2009). Stretch exercises increase tolerance to stretch in patieints with chronic musculoskeletal pain: a randomized controlled trial. Physical Therapy, 89(10), 1016-26.
The changes in the age demographic of the U.S. As well as the need to reduce overall spending in health care are significant reasons why advanced practice and specialty provision practitioner's skill sets and demands have changed. It is for this reason as well as for patient efficacy that such a subspecialty should be offered at a postgraduate level to AAs. These advanced practice alternative providers can be successfully and efficiently trained to provide services at a significantly lower rate, creating a potential opportunity for more people to receive advanced pain management care in a broader setting. This could only improve outcomes for chronic pain sufferers and broaden the scope of opportunity for AAs and possibly other advanced practice alternative providers. As need continues to rise alternatives must be sought within the system to provide care to patients who will likely need pain management service in growing numbers in…
American Board of Pain Medicine Website. Retrieved February, 21, 2008 at http://www.abpm.org/
Bandlow, D. (1995). M.D. Monopoly: How Nurses Can Help Relieve Spiraling Health-Care Costs. Policy Review, (74), 89.
Block, a.R., Kremer, E.F., & Fernandez, E. (Eds.). (1999). Handbook of Pain Syndromes: Biopsychosocial Perspectives. Mahwah, NJ: Lawrence Erlbaum Associates.
Block, a.R. (1996). Presurgical Psychological Screening in Chronic Pain Syndromes: A Guide for the Behavioral Health Practitioner. Mahwah, NJ: Lawrence Erlbaum Associates.
Perception of Pain
Uses of Pain in nursing
Definitions of Pain from Dictionaries
Uses of Pain in psychology
Antecedents and Consequences
CONCEPT ANALYSIS OF PECEPTION OF PAIN
The aim of this paper is to increase the understanding of the perception of pain. The researcher purpose to clarify describe the characteristics of pain and recognize antecedents that effect the idea of pain and the likely outcomes of pain by utilizing Avant's and Walker (2005) theory of study. Also, a model case shows how pain is connected to these serious characteristics contrary case and a borderline case are shown to distinguish the perception of pain from other notions. Empirical referents show the current point-of-view of the perception of pain. (Akyol & Salmond, 2009)
Concept Analysis of Characteristics of Pain
The goal of this paper is to expand the understanding of the concept of…
Akyol, O., Karayurt, O., & Salmond, S. (2009). Experiences of pain and satisfaction with pain management in patients undergoing total knee replacement. Orthopedic Nursing, 28(2), 79-85.
Chan, S., Hadjistavropoulos, T., Carleton, R.N., & Hadjistavropoulos, H. (2012). Predicting adjustment to chronic pain in older adults. Canadian Journal of Behavioral Science, 44(3), 192-199.
Eggermont, L.H.P., Bean, J.F., Guralnik, J.M., & Leveille, S.G. (2009). Comparing pain severity vs. pain location in the MOBILIZE Boston study: Chronic pain and lower extremity function*. The Journals of Gerontology, 64A (7), 763-70.
Gelinas, C., Fortier, M., Viens, C., Fillion, L., & Puntillo, K. (2004). PAIN ASSESSMENT AND Management IN CRITICALLY ILL INTUBATED PATIENTS: A RETROSPECTIVE STUDY. American Journal of Critical Care, 13(2), 126-35.
43). The pain assessment guidelines set forth in this article will have an immediate effect on my first encounter with a patient, particularly if that patient is a chronic pain sufferer or end-of life patient. The sixth defined responsibility in the INPA is also of particular importance in regards to the information contained in this article; this is the responsibility to "evaluate with the patient/client the status of the goal achievement as a basis for reassessment" (INPA, 2007, p. 43). The evaluation of pain and the assessment of necessary and reasonable care in end-of-life patients is a complex task, as this article points out, so the implications of this article's information on this task of the registered nurse are huge.
Its affects on the practical nurse are similar, though heightened. Many of the basic responsibilities of the registered nurse and the practical nurse are the same; for instance, the language…
Indiana Code and Indiana Administrative Code. (2007). Indiana nurse practice act.
Sherman, D., Matzo, M., Pace, J. & R. Virani. (2004). "Learning pain assessment and management: A goal of the end-of-life nursing education consortium." The journal of continuing education in nursing, 35 (3), pp. 107-120.
Mindfulness Meditation Training on Experimentally Induced Pain" by Zeidan et al., (2010), published in the Journal of Pain, presents the results of research to investigate
The research addresses a gap in the research examining the benefit of meditation in attenuating pain symptoms. The research problem is clearly articulated, with the title clearly stating the content of the paper and the introduction expressing and justifying the issue. Past research has demonstrated that meditation programs, such as mindfulness-based stress reduction (MBS) programs have been correlated with positive health outcomes, including pain attenuation. The most common form of program is the MBS. In the context of pain management the eight-week length of the program renders it difficult for some patients, such as suffers of chronic pain, as they may not have the ability, or the time, required to complete the course. The research undertaken by Zeidan et al. (2010) addresses this problem, implementing…
Zeidan, Fadel, Gordon, Nakia S., Merchant, Junaid, Goolkasian, Paula, (2010), The Effects of Brief Mindfulness Meditation Training on Experimentally Induced Pain, The Journal of Pain, 11(3), 199-209
Also, when this option is not used, the number and nature of other types of pain management methods will be investigated. The sample size will be in the range of 100 patients in addition to their primary care-giving family members, which might range between 100 and 200.
A power analysis will be done to determine the divergence of choices from the ones that are expected. In cases where pain management in hospitals have been relatively effective, it is expected that fewer patients and families would opt for sedation, for example, whereas those who remained with their families for as long as possible before the end stage, as well as those for whom pain medication has stopped functioning adequately, are expected to more readily choose this form of pain management.
End-of-life care is a very emotional stage in the lives of both sufferers and their families. Ethical research will be ensured…
Claessens, P., & Broeckaert, B. (2011). Palliative Sedation, Not Slow Euthanasia: A Prospective, Longitudinal Study of Sedation in Flemish Palliative Care Units. Journal of Pain and Symptom Management, Vol. 41, No. 1, 14-24.
Given, B.A. (2001). Family Support in Advanced Cancer, Vol. 54, No. 4. CA - A Cancer Journal for Clinicians, 213-31.
Kahn, D.L., & Steeves, R.H. (1996). An Understanding of Suffering Grounded in Clinical Practice and Research. In B.R. Ferrell, Suffering (pp. 3-28). Sudbury, MA: Jones and Bartlett.
Pain and Suffering
Pain is an abstract and complex topic, which is influenced by a serious of psychological and environmental variables. We all have experienced pain although at varying intensities. Since the psychological factors play a great role in influencing how we perceive pain, therefore, it renders pain a highly subjective experience. esearchers have tried to differentiate between physical and mental pain (Campbell & Edwards 2012). In this essay, I describe physical pain from mental pain. I also show how various people respond to pain, contrast two different responses to pain. I also highlight how Asian culture compares with Hispanic culture in responding to pain.
Describe physical pain from mental or soul pain.
The two major types of pain can be classified as physical and mental. Since physical and mental pains are subjective, complex phenomenon, defining them seems to be a challenge. The International Association for the Study of Pain…
Campbell C. M & Edwards, R. R. (2012). Ethnic Differences in Pain and Pain Management. Pain Management. Vol. 2(3): 219 -- 230.
Edwards RR, Moric M, Husfeldt B, Buvanendran A, & Ivankovich O. (2005). Ethnic Similarities and Differences in the Chronic Pain Experience: A Comparison of African-American, Hispanic, and White Patients. Pain Medicine. Vol. 6(1):88-98.
Mrs. Margaret Foley's Culturally Congruent, Personalized Nursing Care Plan
Case Scenario Overview
Mrs. Margaret Foley (Maggie) is a 46-year-old Aboriginal female has had an emergency open cholecystectomy. Although the case does not specifically indicate why the laparoscopic surgery was changed to an open procedure, this is common whenever the surgeon has trouble accessing the gallbladder for any reason such as a patient's smaller frame. Furthermore, this has several implications for the length of her stay and her care plan. There are also factors that indicate that Maggie will benefit from a nursing care plan that is attunded to her cultural needs due to the fact that multiple previous misunderstandings were mentioned in her case history. For instance, the case indicates that Maggie "felt uncomfortable" with the medical jargon used which was essentially incomprehensible to her and likely led her to not follow the care plan that was recommended for her.…
Building Linkages Between Nursing Care and Improved Patient Outcomes: The ole of Health Information Technology
Health IT (HIT) is capable of transforming care quality and establishing connections between patient outcomes and nursing care. This article will examine the application of health IT and nursing-sensitive measures/indicators (NSIs) for improving care quality and establishing connections between better patient outcomes and nursing care. NSIs refer to measures reflecting nursing care process, structure, and outcomes. NSIs of outcome denote caregiver or patient measurement approaches sensitive to nurse care. While a number of advocates deliberate over the perceived advantages of health IT, an honest consideration of practical experiences with real HIT systems, together with the drawbacks and obstacles associated with poorly-constructed systems, is not addressed. Ultimately, the aim must be improvements to quality, added convenience, and growth of efficiency, rather than mere creation of wired health facilities. Nursing informatics as a practice specialty is having…
Balas, M. C., Rice, M., Chaperon, C., Smith, H., Disbot, M., & Fuchs, B. (2012). Management of delirium in critically ill older adults. Critical Care Nurse, 32(4), 15-26. doi: 10.4037/ccn2012480
Council of Economic Advisors (2009). The economic case for health care reform. Washington, D.C.
Chapter 3 (n.d) HEALTHCARE ENVIRONMENT: INNOVATION, TECHNOLOGY, AND LEGAL ISSUES IN NURSING. Retrieved 19 April 2016 from http://www.nursecredentialing.org/documents/certification/reviewmanuals/nurseexecchapter.aspx
Dykes, P., & Collins, S. (2013). Building linkages between nursing care and improved patient outcomes: The role of health information technology. OJIN: The Online Journal of Issues in Nursing, 18(3).
Pfizer can be included in the larger industrial sector of biotechnology and pharmaceuticals, although a great part of its revenues come from the pharmaceutical products for which it is renowned. The pharmaceutical companies have specialized in a vast category of drugs, from simple, aspirin- type drugs, to more complex ones, including drugs that inhibit or activate individual molecules in different selected environments. They also produce vitamins and livestock food supplements.
The pharmaceutical industry in the United States (and worldwide for that matter) is considered to be one of the most profitable and continuously booming. It is estimated that globally, over $300 billion worth of drugs are sold. A simple explanation for this high degree of profitability is, of course, the high demand of the sector: no matter what happens, drugs and medicine continue to be one of the necessities of people. Additionally, this demand seems to be on a constant…
Merck's profit margin was 13.6%, while Pfizer scored 34.8%, almost three times as much! This means either that Pfizer is selling at higher prices than Merck (it may be the case that Pfizer provides more specialized drugs that sell at a higher price) or that Pfizer has lower costs (I doubt that this is the main cause here. In general, the main costs in the pharmaceutical industry come from research and developed. As is the case here, it is very probable that these two companies are spending more or less the same amount on R& D. In order to remain competitive).
The return on total assets ratio, obtained by dividing the net income after tax to the total asset value, showed a score of 1.9% in Pfizer's case and of 14.8% in Merck's case, while the ROE (return on equity) amounted for 40.37% in Merck's case and 3.57% on Pfizer's case. The differences, as we can see, are extremely high. I could explain the first indicator, the ROI, with the very high value of total assets for Pfizer in 2003 (this almost doubled from 2002), which made the company less profitable that year, but the difference in ROE is enormous. It does not necessarily reflect a low profit in Pfizer's case (this seems comparable), but a very high value of equity. However, the analysis is even more complicated when we look at the P/E ratio, where the differences are staggering: Pfizer has a reported P/E of 136.92, while Merck has one of only 16.75, with the industrial average somewhere at 28.72. The closest to Pfizer in this case is Bayer, with 96.01.
The conclusions that we can draw from this analysis are somewhat ambiguous. We have had a look at several financial indicators and in many of them, Pfizer has scored lower scores than its competitor Merck. This is mainly the case of the asset management ratio and the profitability ratio. However, one of the most important indicators, the P/E, that shows us the perspective of a company, showed extremely high values for Pfizer, compared to all other companies and to the industrial average. Seeing that many indicators were influenced by the unstable value of the total assets, due to current acquisitions and mergers, investing in Pfizer may be advisable given the fact that a long-term growth is expected in the industry, as well as for the company (see again the P/E).
Pilot Study of elationships Among Pain Characteristics
Mood Disturbances, and Acculturation in a Community
Sample of Chinese-American Patients With Cancer
Edrington, J., Sun, A., Wong, C., Dodd, M., Padilla, G., Paul, S., & Miaskowski, C.
This study is a pilot study to determine how level of acculturation and mood affect the intensity and functional aspects of pain in Chinese-American cancer patients. The purpose of the study is to determine if the pain perception of Chinese-American cancer patients is consistent with some past research on other ethnic groups (particularly Hispanic and African-Americans) that find that the level of acculturation is negatively related to the patients' self-reported pain intensity and the relief from pain associated with cancer. The researchers use the definition of acculturation as the process by which immigrants take on or embrace values, beliefs, customs, norms, and the lifestyle of the mainstream culture. Thus the Americanized the group is the…
Bates, M.S., Edwards, W.T., & Anderson, K.O. (1993). Ethnocultural influences on variation in chronic pain perception. Pain, 52, 101-112.
Edrington, J., Sun, A., Wong, C., Dodd, M., Padilla, G., Paul, S., & Miaskowski, C. (2010). A pilot study of relationships among pain characteristics, mood disturbances, and acculturation in a community sample of Chinese-American patients with cancer. Oncology Nursing Forum, 37 (2), 172-181.
Gregory, R.J. (2011). Psychological Testing: History, Principles, and Applications (Sixth Edition). Boston: Allyn & Bacon.
Koyama, T., McHaffie, J.G., Laurienti, P.J., & Coghill, R.C. (2005). The subjective experience of pain: Where expectations become reality. Proceedings of the National Academy of Sciences, 102, 12950-12955.
The objective of the study is to carry out the analysis on chapter 8 and 9 of the book titled "Project Management, the Managerial Process." (Larson, & Gray, 2010 p.iv). The chapter 8 of the book discusses the strategy the project manager could schedule resources and costs. On the other hand, the chapter 9 carries out analysis on the strategy to reduce project duration.
Larson, & Gray, (2010) discusses in their book that the project manager often faces challenges in developing an appropriate project scheduling and the chapter discusses the strategy that the project manager could employ to develop a project's resource schedule. Within an organization, there are often more projects than available resources, thus, the priority is to select projects that could contribute to organizational efficiencies. Faced with the project's constraints, it is critical to schedule resources to make a realistic judgment from the available resources and…
Larson, E.W. & Gray, C.F. (2011). Project Management - The managerial process (5th Edition), New York, The McGraw-Hill/Irwin.
Sloninsky, J. (2011). Innovations in Project Controls: Integrating Cost and Schedule. University of Texas. Dallas.
feature of the contemporary workplace is the convergence of, and collision among, traditional and new talents from four different time zones: the Greatest Generation of World War II in the 40s and the 50s; the aby oomers born between 1946 and 1964; Generation X individuals born between 1964 and 1976; and Generation Y individuals born between 1976 and 1995. With different orientations and meeting in common grounds, the problem is how to set them together to produce their generational best without sacrificing corporate objectives and hurting anyone's rights or point-of-view. In other words, how to manage the generations' wide differences in the workplace without tilting the balance towards any particular side or sector.
Let us take a good look at these generations in the labor market. The Greatest Generation on top of the ladder consists of those born before 1946 are the brave souls of World War II who very…
Gawel. Richard. Survey Shatters Workplace Stereotypes. Electronic Design:
Penton Media, Inc., 1999
Gomolski, Barbara. Managing Age Diversity in the Workplace. Computerworld, 2001
3. Martin, Carolyn. Managing the Generation Mix. Top Echelon Network, Inc.:
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.
This could make it easier for everyone to deal with critical challenges and prevent the situation from becoming worse. (Medina, 2006) (Leddy, 1998)
However, because the son is engaging a confrontational attitude, means that these issues are becoming very complicated based upon the way he is acting. These elements are showing how new tactics must be utilized that will exercise health care professionals' power and control over the situation. The defining variables for this component are the primary caregiver does not want to cooperate and understand what is happening. This supports the answer to the assessment question by illustrating what options they have available, in dealing with these kinds of challenges over the long-term. (Medina, 2006) (Leddy, 1998)
egulation and Conflict
The basic regulations allow the caregiver to make decision concerning the treatment options the patient is receiving. According to the AAPS, the patient and the caregiver have a number…
Patient's Bill of Rights. (2013). AAPS. Retrieved from: http://www.aapsonline.org/patients/billrts.htm
Cohen, E. (2005). Nursing Case Management. St. Louis, MO: Mosby.
Leddy, S. (1998). Conceptual Basis of Professional Nursing. Philadelphia, PA: Lippencott.
Levine, C. (2004). The Cultures of Care Giving. Baltimore, MD: John Hopkins University Press.
Evaluation of Decision to Close and Closure Process
It seems as though FBPS was trying to fulfill the more popular of the Six PESTEL factors, technology. The launch of its International Baccalaureate Programs seemed promising; however, it came at the worst possible economic time. The US economic recession of 2005 took toll on not only the FBPS campuses but other reputable schools surrounding it. This indication quickly started impacting the FBPS organization. The closure of several schools and the announcement of others not continuing with certain academics.
The fact that only two campuses would remain open—the Richmond and the North Richmond campuses—rankled parents, and the fact that news of the closing of the Staunton campus school came after the enrollment deadline at other neighboring schools was a shock that parents simply were not inclined to accept. The FBPS assured parents that the closures were not the result of finances—but Moody’s…
management of fatigue in patients on peritoneal dialysis and respond to the following critique questions. Do not provide simply yes or no answers to the questions. Provide examples to support your responses. Submit the assignment through the assignment link in Moodle
Identify the study design. Identify the specific type of quasi-experimental design used in the study.
The quasi-experimental design of this research was to implement exercise interventions within a patient population undergoing continuous ambulatory peritoneal dialysis. There was no random sampling because of the very small population that met the inclusion criteria. The independent variable was the level of exercise, while the dependent variable was the reported measures of fatigue experienced by the participants. These measurements were then statistically analyzed using
For the specific design, what are the threats to internal validity? What are the threats to external validity?
There were threats to validity based on the individuals who participated…
The problems at the work place were detected over a long period of time and are a part of the history of development. The development of technology was very rapid which must also have brought in the needed changes in the workplace functions and norms. Unfortunately the basic structure of health protection came to be discussed only in the beginning of 1960s. The occupational medicine became a separate field of study since then and the occupational health service was born. The motto which the service wanted to achieve was an ergonomic system that could fit the job and the worker and simultaneously identify and eliminate health hazards. (Wilkinson, 50) There were many statues passed that created safety at the workplace. The greatest step in this regard was the OSHA regulations.
The OSHA act of 1970 was the single piece of legislation that gave an impetus to the work…
N.A. Comparative table of pain distribution. ( http://www.aans.org/education/journal/neurosurgical/may98/4-5-p1/8204f3.GIF )
Charlton, Samuel G; O'brien, Thomas G. Handbook of Human Factors Testing and Evaluation. Lawrence Erlbaum Associates. Mahwah, NJ. 2002.
Harrington, Lisa. H. The Safety Zone. http://www.inboundlogistics.com/articles/features/0506_feature01.shtml
Chronic Illness: Coronary Heart Disease
Outline of Coronary Heart Disease
The Coronary Heart Disease (CHD) has been on the increase of late across the globe and this disease, alongside stroke have been the top causes of death in many countries like Australia (Baker Heart and Diabetes Institute, 2017). There have been cases of people succumbing to complications occasioned by the CHD hence the need for any medic or clinician to fully furnish themselves with the CHD and the causes and effects as well as how it can be managed.
CHD is a disuse characterized by the development of a waxy substance called plaque building up in the inner walls of the coronary arteries. These are the arteries responsible for supplying oxygen-rich blood to the heart muscles. The buildup of plaque on the inner walls of the arteries results into atherosclerosis and this takes many years to pile up to harmful…
Baker Heart and Diabetes Institute, (2017). Heart disease and stroke are the top two causes of death -- and among the leading causes of disability -- in Australia. Retrieved April 9, 2017 from https://baker.edu.au/health-hub/fact-sheets/cardiovascular-disease?gclid=Cj0KEQjwt6fHBRDtm9O8xPPHq4gBEiQAdxotvNmN_YV05am6ts6wLgbbEPubE3I2Z6wwGSNl0AaycX0aAnFy8P8HAQ
Cleveland Clinic, (2017). Coronary Artery Disease Symptoms. Retrieved April 9, 2017 from https://my.clevelandclinic.org/health/articles/cad-symptoms
Mayo Clinic, (2017). Coronary Heart Disease: Symptoms and Causes. Retrieved April 9, 2017 from http://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/symptoms-causes/dxc-20165314
Southern Cross, (2017). Coronary heart disease - causes, symptoms, prevention. Retrieved April 9, 2017 from https://www.southerncross.co.nz/group/medical-library/coronary-heart-disease-causes-symptoms-prevention
Downsizing and Change Management
In any organization, the only permanent reality is change if the firm wants to thrive and succeed in the global economy. In times of extreme hardships, companies will some times have to make decisions, which are fairly harsh but are immensely important for survival of the firm. Downsizing is one such decision and while it appears unfair to some, it is actually the only way a company can reduce its overall costs, improve productivity, gain a sense of focus and possibly improve its financial health. We-based our downsizing process on Kurt Lewin change management theory and kept it as close to the three stages of change described by Lewin as possible.
At our firm, we needed to make this change because it appeared that in harsh economic times, this would the best option in order to stay afloat. However we had heard so many…
Abrahamson, Eric. Change without Pain, Harvard Business School, Boston 2004.
Chadwick C, HunterL.W. And Walston S.L. 2004 "Effects of Downsizing Practices on the Performance of Hospitals" Strategic Management Journal. iss 25, pg 405 -- 427
Devine, K, Reay, T, Stainton, L, Nakai, R, C, (2003) Downsizing outcomes: Better a Victim than a Survivor? Human Resource Management Vol 42, Iss 2, pg 109
Lewin, Kurt. Field Theory in Social Science. Harper, New York 1951.
" Since this clearly person was not trained to answer questions about governance, I was connected to a "sponsor relations" associate. Speaking to this second person located in the Kansas City main office, I asked how Children International "operates." During our discussion, the customer service associate became passive-aggressive and unwilling to discuss internal matters; clearly the associate had never fielded questions about governance. hile the associate could only "have to get back to me on that," she did not take any interest in the profile of the board. My perception is that the associate felt that the board is a private or almost confidential unit, rather than a publicly transparent, well-regarded entity. The associate was quite sure, however, that the board consisted of the non-indigent.
Children International represents a conventional aid scenario: children are starving in a distant nation, and if only the global north were aware of their pains,…
Salamon, Lester M. The State of Nonprofit America. Brookings Institution Press: Washington, D.C., 2002.
Laughlin, Fredric L., Andringa, Robert C. Good Governance for Nonprofits: Developing Principles and Policies for an Effective Board. American Management Associatioon: New York, 2007.
Creating Organizational Value through the Integration of Information Technology: A Management Perspective
Change Management and the Construction of a eceptive Organization
Transformational and Participative Leadership
A Decentralized Organizational Culture
Effective Utilization of esources
Performance Monitoring Systems
isk Management and Support Strategies
When considering the ever-changing and highly competitive global landscape of business today, firms must stay at the cutting edge of their respective fields in order to sustain profitability in the long-term. With the current exponential growth of technology and the computerization of business and learning, consumers and investors have become much more connected to the businesses they patronize (Kurzweil, 2001). Accordingly, companies are faced with the continuous task of finding new ways to understand and subsequently accommodate the needs of those customers and shareholders, while simultaneously securing lucrative business models and job environments. In doing so, businesses must be able to efficiently integrate and utilize various sources of…
Aladwani, A.M. (2001). Change Management Strategies for Successful ERP Implementation. Business Process Management Journal, 7 (3), 266-275.
Anthony, S. (2010, May). Three Critical Innovation Lessons from Apple. Retrieved July 26, 2011, from http://hbr.org/anthony/2010/05/three_critical_innovation_less.html
Antonelli, C. (2000). Collective Knowledge Communication and Innovation: The Evidence of Technological Districts. Regional Studies, 34 (6), 535-547.
Ashkenas, R., Ulrich, D., Jick, T., & Bossidy, L. (2002). The Boundaryless Organization: Breaking the Chains of Organization Structure. United States: John Wiley and Sons.