PICOT Question Development and Literature Review
The Modeling and Role Modeling Theory of nursing developed by Erickson provides a useful means of analyzing and presenting options for solutions of my research area. The theory is based on the concept that nurses must appropriately use models to guide patients to better health decisions. In the theory, modeling is the process by which the nurse seeks to know and understand the patient's personal model of his or her own world, as well as learns to appreciate its value and significance. Modeling recognizes that each patient has a unique perspective of his or her own world. These perspectives are called models. The nurse uses the process to develop an image and understanding of the patient's world from that patient's unique perspective. Role modeling is the process by which the nurse facilitates and nurtures the individual in attaining, maintaining, and promoting health. It accepts…… [Read More]
PICOT Analysis on Chronic Heart Failure
One may describe heart failure (HF) as a complicated medical condition which may arise due to functional or structural cardiac disorders capable of hindering ventricular capability of ejecting or filling blood. Chronic HF (CHF) represents a serious health issue. Its prevalence in America stands at over 5.8 million, while over 23 million individuals across the globe are affected by this problem. The mortality rate linked to HF is 40% in the initial diagnostic year, which reduces to 10% subsequently. Individuals most impacted by the condition lie in the age group of over 65 years. This age group is associated with rather high healthcare costs and high mortality and morbidity rates. HF patients get admitted to hospitals often and their re-hospitalization rates continually increase. In this paper, peer-reviewed articles will be employed for shedding light on the clinical issue, its diagnosis, patient care and the…… [Read More]
In the United States, The COP (Chronic obstructive pulmonary) disease is one of top serious diseases that places a great burden on patients and healthcare system because it is associated with high rate of outpatients visit, hospitalization and readmission. In the last few decades, the COP has become the top public health issues with over 65 million cases of COP In the U.S., the direct costs of the COP disease is enormous reaching $32.1 billon because of the associated prevalence of the COP disease. The UK is facing similar problem where 1.6% of the population is suffering from the COP disease, and costs burden reaching £800 million yearly with direct costs of hospitalization reaching £800 million per annum, and direct medical costs reaching £625 million. However, the prevalence of the COP disease is likely to rise because of an increase in the ageing population.
The telehealth is an…… [Read More]
Yu et al., 2014
Non-targeted research, quantitative
Kruskal-Wallis H Test
Obstructive sleep apnea correlated with males (but not females) with hypertension
Scheers-Anderson et al., 2015
Secondary esearch/Literature eview
eview of governmental data
9,816 males (4,908 sets of brothers)
Generalized estimation equations and adjusted regression models
No discernible link between gestational weight gain and blood pressure issues, including hypertension
Military draft only applies to men, exams of men decreased in rate over 2000's
Lakshman, Manikath, ahim & Anilakumari, 2014
Quantitative and Cross-Sectional
Data collected from bus drivers (exercise, tobacco use, etc.)
179 bus drivers aged 21 to 60 years old
Statistical analysis (binary logistic regression
Blood pressure tends to increase with age
They did not measure abdominal circumference
Chang et al., 2013
Age-matched case-control study design
ecruited healthy males without hypertension present from local clinic
80 males -- 40 with hypertension and 40 without
Measure of cytokines…… [Read More]
Healthcare Associated Infections for the Nursing Profession
Despite the most rigorous and comprehensive universal precautions, healthcare facilities are still germ-ridden environments that can introduce potentially deadly infections in patients. Hospitals and clinics in particular are notoriously infectious environments, and nosocomial infections due to methicillin-resistant staphylococci (MSA) are increasingly commonplace across the country (Boa & ahube, 2013). For instance, Boa and ahube emphasize that, "Numerous nosocomial MSA outbreaks occur annually due to the widespread prevalence of MSA within hospitals" (p. 50).
Besides the entire array of environmental reservoirs, one potential source of MSA contamination in particular that many healthcare providers encounter on a routine basis are the public access computer keyboards that are used to input patient data and coordinate care (Boa & ahube, 2013). For instance, a study by the University of Toledo examined 24 public access computer keyboards and identified two that were MSA-contaminated (Boa & ahube, 2013). Based…… [Read More]
Diabetes is a chronic and debilitating disease that has long-term consequences for those that become insulin-dependent. One of those long-term consequences is the formation of foot ulcers. Foot ulcers can lead to amputation of an insulin-dependent patient's legs and feet. Amputation is a serious and expensive economic burden on anyone that must endure it. To avoid amputation, foot exams performed by a physician may help provide the kind of preventative care that may lead to a reduced risk for amputation in diabetes mellitus patients.
Foot ulceration develops as a result of trauma, neuropathy, and deformity (Scott, 2013). Foot exams have various components that allow for effective assessment of any potential problems the patient is facing in regards to foot ulceration and amputation. One such component is history of the patient. Another is assessment of peripheral/neuropathic vascular symptoms, possible renal replacement therapy, and impaired vision. Another part of foot examinations is…… [Read More]
Right," Gaffney et al. (2012) examine how nurses respond to workplace bullying. The authors point out that although the consequences of workplace bullying include diminished performance and rises in problems like absenteeism and turnover, there is limited research and limited information about workplace bullying in the healthcare sector. In fact, the purpose of this study is to help administrators improve patient outcomes by reducing workplace bullying or aggression, which reflects a hostile work environment. This is a qualitative study with research questions related to the prevalence and specific manifestations or types of workplace bullying, and also the strategies nurses use to minimize or mitigate workplace bullying. Gaffney et al. (2012) set out to examine what workplace bullying looks like in different scenarios, how workplace bullying is perceived and responded to by both nurses and patients, and how nurses respond to bullying that targets either themselves or colleagues. The research questions…… [Read More]
As Karnik and Kanekar (2012) show, there are many interventions available to health care providers for childhood obesity, which has fast become a "global public health crisis" in the world (p. 1). These interventions include the promotion of family bonding, education, and pharmacology.
The specific aim of this project is to improve outcomes with regard to children's health. By measuring the impact of one intervention against another, primary care providers can better understand which intervention may be more effective in helping to reduce the rate of childhood obesity for their patients.
This study will measure the weight, dietary and physical exercise habits of children and adolescent patients at a primary care facility over the duration of 6 months time. During that time, the patients will be exposed to two separate interventions -- a pharmacological intervention and a health literacy intervention.
The PICOT is as follows:…… [Read More]
PICOT & Literature Review Worksheet
NEC remains a challenge in the nursing world despite the major medical progress made in the medical sector. Given the varying clinical presentation of NEC among infants, clinicians have a challenge in diagnosing the disease at both the earliest and least severe stage of pathogenesis (Mulhall, 1998). To curb this problem, assigning disease severity based on staging criteria for NEC is vital for both the diagnosis and treatment. Therefore, properly educating nurses on Bell Staging; the standard in assigning severity of disease to NEC cases is likely to result in accurate and effective diagnosis.
Educating NICU Nurses
Nurses working in the nation's NICUs lack the basic knowledge in handling infants showing possible signs of NEC infection. Thus, to ensure efficient diagnosis and treatment of NEC, proper education of nurses on the diagnosis methods is necessary (Barnsteiner, 1996). The nurses are educated on Bell's three stages…… [Read More]
Hourly Nurse ounds, Can They Make a Difference?
[Author Name(s), First M. Last, Omit Titles and Degrees]
Pressure ulcers or as some refer to as bed/pressure sores or decubitus ulcers are categorized as localized areas of damaged tissue that is caused by shearing forces and excess pressure usually from maintaining the same position over a long period of time. Pressure ulcers typically happen in people who have nerve damage and/or limited mobility. When the person feels pressure, from sitting or lying on any certain body part, this often results in nutrient and oxygen deprivation to the wound or affected area. Strategies to circumvent this involve repositioning. epositioning consists of moving the person into a different position to give the body the ability to redistribute or remove pressure from the affected area. "Pressure ulcers are distressing events, caused when skin and underlying tissues are placed under pressure sufficient to impair blood…… [Read More]
Sykes -- Picot Agreement
As Iraq lurches deeper into turmoil, Kurdish leaders threaten to break away and declare outright independence, and the militants of the self-styled Islamic State (IS) are reshaping the border between Iraq and Syria, one must look to the history of the region to be able to put these conflicts in full perspective (Muir, 2016). The Sykes -- Picot Agreement was officially signed on May 16, 1916, however the agreement was in the workings for quite some time before it was officially signed. The deal was also known as the Asia Minor Agreement because of the geography that the agreement sought to affect. The Middle East has been a major strategic goal for policy planners and strategist for centuries. An author who published in the Smithsonian summarized the agreement as:
"Even before the final outcome of the Great ar has been determined, Great Britain, France, and Russia…… [Read More]
Suicide rates are remarkably high worldwide and nationally, making suicide one of the leading causes of death (Schwartz-Lifshitz, Zalsman, Giner et al, 2012; Tillman, 2014). Although most suicides do not occur in the hospital setting, psychiatric disorders—especially mood disorders and psychotic disorders—are risk factors that increase the likelihood of a suicidal event (Appleby, 1992; Sarzetto, Delmonte, Seghi, et al, 2017). Suicide not only affects the patient, but reverberates throughout the patient’s family and social circle, also causing distress and potential performance issues among clinical staff (Tillman, 2014).
Therefore, it is important that psychiatric nurses understand how to recognize risk factors, and establish a clinical practice environment that prevents suicide. Minimizing suicidal tendencies requires different types of treatment interventions individually tailored for at-risk patients, as well as implementing best practices for creating a clinical environment that reduces risk. Best practices may also include preparing, teaching, and training nursing staff, especially when…… [Read More]
Weightloss Counseling and Physical Exercise
PHASE II Search Paper
Dana Delatush RN BSN ONC
"I pledge my honor that I have neither given nor received inappropriate aid on this assignment."
Abstract Comment by Patricia: Place the abstract on a separate page for your final search paper
This paper is focused on the literature search related to the PICOT question: Does weight loss counseling and physical exercise improve pain and mobility in obese patients with a BMI >25 suffering from osteoarthritis? To answer this clinical question, six databases were searched including the Cumulative Index of Nursing and Allied health Literature (CINAHL), The Cochrane Library, PubMed/Medline, Google Scholar, PsycInfo®, and ProQuest Nursing and Allied Health Source™. The paper describes the search methodology. Keywords: osteoarthritis, obesity, weight loss counseling, pain, mobility
Introduction to Search Strategy
I will be creating a search strategy to help me clarify what information I need, and…… [Read More]
News Reporting on Crimes, Corruption, and worsening Economic Conditions:
News channels also telecast detailed reports on crimes, corruption, political instability, and worsening conditions of economies. General public, which is already in a miserable condition due to a stressful life further gets into tensions and worries due to such type of information. These reports present a very weird picture of what is happening around the world. All this creates an atmosphere of restlessness, anxiety, and depression among the general public (Kraut & Attewell).
Impacts of Information overload on Investors:
Investing in a particular asset, organization, or industry is such a decision which requires a comprehensive and careful analysis of the relevant facts and figures. Generally, investors look at the industry trends over the last few years in a view to anticipate the attractiveness and potential of their investment. Now-a-days, there are various sources through which they can obtain this information. But…… [Read More]
PICOT Question and its Significance
The PICOT question is: Does mindfulness meditation (I) reduce long-term risk factors and suicidal behaviors (O) among psychiatric patients (P) versus those who do not participate in the meditation programs (C)? This is of great significance to the nursing practice because psychiatric disorders are risk factors that cause an increase in the probability of a suicidal occurrence. As a result, it is imperative for psychiatric nurses to comprehend how to pinpoint such risk factors and institute a clinical practice setting that dissuades suicide. More importantly, nursing practice encompasses the execution of best practices for generating a clinical setting that diminishes risk such as mindfulness meditation.
Summary of Literature Review
The mindfulness meditation theory is deemed to the most prospective one in treating addictive disorder patients. The safety of these models is guaranteed if carried out in the framework of clinical studies. In recent periods, associated…… [Read More]
It does not happen overnight; 3) eflective practice occurs best when learners work with role models; 4) as noted by Fink, instruction needs to be learner-centered, of interest to the learners and long-lasting; 5) the institution in which the nurses learn must be supportive of reflective learning.
The PICOT is a useful format for developing a clinical research question. It helps to answer questions and decrease uncertainty and determine the appropriate choice of action. In this case, the PICOT is the following:
Nursing student population
Provide long-term knowledge to make reflective decisions
Traditional learning situations
eflective practice offers several benefits over traditional learning
Time frame (optional)
Fink, L.D. (2003). Creating significant learning experiences: An integrated approach to designing college courses. San Francisco: Jossey-Bass
Loughran, J. John (2002) "Effective reflective practice: in search of meaning in learning about teaching." Journal of Teacher Education 53(1): 33+.
Osterman, K. (1998) Using…… [Read More]
pursuit of preparing the data analysis for the prior PICOT question that has been detailed in numerous ways, it shall now be described how the data will be analyzed. The analysis that shall be completed has three aspects that will be described in this brief section. They include a detailed description of the intervention that will be tested, a detailed description of the data collection process and the analysis that will be completed for the collected data. While the PICOT question and structure as well as the associated analysis is not terribly complicated, it must be completed in a thorough, diligent and proper way.
First off is the intervention that shall be employed in the experimental group. Of course, there will also be a control group that is not subject to the intervention described below. With that established, the intervention group will be exposed to the following…… [Read More]
Cultural Competency in Nursing
The basic knowledge in nursing or medical studies needs substantial facilitation in order to be effective and appropriate towards addressing the needs and preferences of the patients. Watson notes the need to integrate humanistic aspect into the career or nursing profession. He also believes on the need for the establishment of the caring relationship between the patients and nurses thus demonstration of unconditional acceptance of the patients in any condition. Nurses should integrate holistic and positive treatment with the aim of promoting health through knowledge and interventions thus elimination of interruptions during treatments or 'caring moments'. Modern patients have diverse problems and issues because of the cultural differences, races, and ethnicity thus the need to enhance the operations of the nurses. There is need to ensure that the nurses obtain cultural competencies with the aim of enhancing their ability to address diverse issues and problems faced…… [Read More]
Health and Nursing
eduction of bedsores through implementation of Hospital wide turntable
Does the implementation of a hospital-wide turntable team have a positive impact on the reduction of bedsores?
eduction of Bedsores
A pressure ulcer (PU) or bedsore can be defined as an injury to underlying tissue of the skin that occurs due to pressure or friction. In most cases, the injured tissue sores due to the pressure exerted over a prominent bone. PU has also been defined as areas of necrosis due to tissue compression amid the bony prominence and the extracorporeal surface for a prolonged time period (Gray & Krapfl, 2008). It is therefore apparent from these definitions that exposure to pressure for a lengthy time is the primary cause of bedsores.
To prevent or minimize bedsores therefore, it is imperative upon medical practitioners to put intervention measures in place that will reduce exposure to pressure. The human…… [Read More]
In 2007, it established that about two thirds of Canadians concur that immigration has a very affirmative or rather affirmative influence on Canada. Immigrants' view their choice to come to Canada as affirmative as well. While those coming into the country in 2000 were not pleased about their financial outcomes, the majority of the two thirds who stayed had a fairly affirmative feeling about their choice to come to Canada and to have stayed there (Picot, 2008).
On the whole, immigration for the country of Canada is a good thing. It helps to aid the economy in a very positive way. This can be seen in Canada's decision to increase their immigration efforts during the current recession as opposed to what a lot of other countries have done, which has been to decrease the effort. It has been shown that even those immigrants are often faced with adverse financial circumstances…… [Read More]
The progressive care unit (PCU) is a practice setting in which the researcher’s health care team is often failing to meet quality care objectives according to patient reporting on the hospital consumer assessment of healthcare providers and systems (HCAHPS). Opportunities for growth in quality care based on the HCAHPS of the PCU include topic areas related to patient inclusion as well as communication skills of the members of the healthcare team. Patient perception of quality is that the healthcare team in the PCU is unable to explain the care process in a way that the patient and family members feel comfortable with or that allows them to understand the care that is being provided to them. The researcher has first-hand experience with this challenge in the PCU and has heard first-hand from patients there that the care seems disjointed, that continuity is lacking, and how problematic it is for…… [Read More]
EBP is to facilitate strategy to eradicate short cycle return to second readmission of psychiatric patients on hospital beds. Doing so will assist health care providers in addressing the issue of bed shortage. eduction of readmission rates allows more space to be available for other patients and helps to cut costs as well as bring about better conformity with governmental regulations.
The search process used in this literature review began with searching key words in online databases such as Cochran eview, CINAHL, and other nursing research journal databases. Google Scholar was used as the primary search engine, with filters set to permit results from these particular databases. Key words used included "reducing readmission rates," "readmission psych," "causes of readmission psych hospital," "psych hospital readmission," "reduction of psych readmission," and other combinations of key words identified by relevant articles found after conducting these searches. More than a thousand articles…… [Read More]
Telehealth Strategies to Support Adolescents with Diabetes and CKD
Children and youth who must undergo dialysis because of chronic kidney disease (CKD) are typically provided age appropriate educational materials for self-care. Key objectives of efforts to strengthen self-care education are the maintenance of optimally beneficial diet and, although direct evidence has not yet been shown for children, maintenance of blood pressure that is below the 90th percentile for height, age, and gender ("NIH," 2014). Longitudinal studies may point to strategies that result in earlier detection, and perhaps even enable diabetic kidney disease to be prevented (Lane, 2005). In the interim period, research that identifies enhanced methods for assisting and encouraging children and youth to adhere to their dietary regimens are an important support to utilize ("NIH," 2014).
Guidelines for optimizing the benefits of a customized diet for children and youth with chronic kidney disease have been provided by the National…… [Read More]
Immigration to America
An Introduction and Claim
Over the years, the issue of immigration in America United States has raised complex demographic issues. Elements of population increase and cultural change on the native societies in the United States are evident characteristics of immigration. The social, political, and economic components of immigration cause controversies on issues of employment, settlement patterns, ethnicity, and economic benefits for non-immigrants. The government works on developing social mobility, reducing crime, and controlling voting behavior. This paper intends to outline the negative issues surrounding immigration in the U.S. The United States has fewer immigrants on per capita consideration comparable to half the OECD countries. Policies had developed before 1965 focused on establishing a working formula for limiting naturalization and immigration opportunities for persons without native claim.
The exceptional economic status of America makes it a haven for immigrants (David & Okazaki 887). However, globalization is fast…… [Read More]
According to research, evidence-based practice (EBP) results to greater quality care, enhanced patient outcomes, minimized costs, and more nurse satisfaction when compared to conventional approaches to care. Evidence-based practice is simply a problem-solving approach to healthcare delivery, which incorporates the best evidence from research and patient care records with clinician skill and patient values and likings. The greatest quality of care and best patient outcomes could be gotten when provided in a caring situation and in a supportive educational culture. The aim of this paper is to evaluate a published work founded on evidence-based practice. The other part of the paper contains a summary of the important points in the article, steps in the development and execution of evidence-based practice, and the manner through which this new information could be implemented.
Capnography is still an essential tool in the measurement of invalidated "carbon-dioxide" (CO2). Latest "Advanced-Cardiac-Life-Support" or…… [Read More]
Benchmark-esearch Critique and PICOT statement
This article is a research critique on the paper titled 'Home Telehealth for Patients with Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis' by J. Franek. The research paper under review was published by the Ontario Health Technology Assessment Series.
Although there isn't a direct statement that refers to Problem statement, there is a title that highlights the "Objective of the Analysis." There is an excerpt of the objectives below. The discussion in the objective statement is only centred on the evaluation steps. There is evidence in the literature that the effects of COPD were openly revealed as being core elements of the problem statement in the first place.
"For patients experiencing multiple comorbidities, it is essential to observe routine self-management support. Such support consists of the necessary education to enlighten parents to pick out the symptoms in good time. They will consequently manage their…… [Read More]
Patients in hospitals often complain of pain regardless of the diagnosis. Several activities in a patient's life contribute to pain. Some of the activities include amount of sleep, daily chores and quality of life (Alaloul, Williams, Myers, Jones, & Logdson, 2015). While health care expenses have increased significantly over the years, there have been great improvements in increasing both family and patient involvement in medical care. Hourly care is one of the strategies that have worked well in various healthcare settings. Hourly care has been a success in various areas but using it in urgent pediatric settings hasn't been well documented (Emerson, Chumra, & Walker, 2013). Opportunities still exist to look into pediatric family preferences and perspectives as pertains to the use of whiteboards (Cholli, et al., 2016). Several studies have been done in different setups and this paper references many of them. The research projects include in-patient surveys, quasi-experimental…… [Read More]
Search of Literature for Evidence
One of the most crucial elements towards conducting a high-quality research is conducting an effective and valid search of literature for evidence. The search of literature for evidence is defined as an organized comprehensive search of existing literature published regarding the research issue. A well-organized search of literature is important when conducting a study since it's the most efficient and effective means for locating sound evidence on the research topic. For this study on intensive care delirium, a literature search is crucial towards identifying existing evidence on the topic and identifying gaps in knowledge. The information or insights obtained from the literature search is used to provide guidelines on the research process and how to fill the gaps in knowledge.
In this regard, the researcher conducted a search on electronic databases in order to identify credible sources of data. The researcher conducted the…… [Read More]
Evidence-Based Project Proposal
Graduate Project in Nursing
The incidence of sexually transmitted diseases has been increasing among adolescents in countries around the world, but there remains a dearth of timely and relevant studies concerning salient differences in knowledge level and attitudes between different cultures and ethnic populations. One common factor that has been consistently demonstrated in improving the effectiveness of treatments for sexually transmitted diseases is promoting adherence to treatment regimens, most especially for medications since these are used in all treatments for sexually transmitted diseases. While there have been some studies concerning various strategies for promoting adherence levels to treatment regimens, there remains a lack of studies concerning evidence-based practices that incorporate technological solutions. To this end, the proposed study intends to conduct an experiment using innovative face recognition and motion detection smartphone app to evaluate its effectiveness in promoting adherence to medication regimens among a population of adolescents…… [Read More]
Mentorship in Nursing Leadership and the Effects of Evidence-Based Practice: An Integrated Literature eview
Nursing leadership has been identified as a major contributor to the outcomes of the organization, the nurses, and the patients. Mentoring in nursing leadership has been shown to be critical in the development and sustenance of nursing leadership (Wallen et al., 2010; Stetler et al., 2014). In addition, mentoring in nursing leadership and evidence-based practice (EBP) is an explicit method that is conscientious in the delivery of healthcare services as it incorporates the best evidence from research studies. However, research on the effectiveness of EBP regarding leadership in nursing is limited, as most of the focus has been on institutionalized EBP. This research therefore is an integrated literature review with the aim of establishing and identifying the status and the effects of EBP in nursing leadership.
Background of the Problem
Various studies have reported on the…… [Read More]
Refinement of a Nursing Concern into an Evidence-based Practice Proposal Using the Research Process
Research is mainly used to generate new knowledge or for the validation of existing knowledge based on a theory. Evidenced-based practice (EBP) is the translation of evidence and applying the evidence to clinical decision-making. Most of the evidence used in EBP stems from research. However, EBP will go beyond the use of research and it will include clinical expertise together with patient preference and values. EBP will make use of the evidence developed or knowledge discovered using research to determine the best evidence that can be used or implemented in clinical practice. Research and EBP go hand in hand in that while one will generate new knowledge, the other will make practical use of the knowledge and make use of the knowledge by implementing it into clinical practice. EBP is supported by research since any…… [Read More]
Vietnamese Entrepreneurship (1975-013)
Microbusinesses form a large share of the economy of Vietnam. Owned by self-employed entrepreneurs, they create employment and provide income for millions. Although the density of vendors, boutiques, and other small shops in any Vietnamese city or town is impressive, such activities were banned by authorities until the end of the 1980s.
Communist rulers have long believed that private businesses had no place in the socialist economy. This policy had been implemented in North Vietnam after French colonialism came to an end in 1954. Following the fall of South Vietnam and the reunification of the country in 1975 and 1976, it was also applied to the South. It proved to be a significant failure. In 1979, the government began to realize that its policies were leading the nation toward complete collapse. (Freeman, 1996) A short war with China, ignited by Vietnam's liberation of Cambodia, resulted in economic…… [Read More]
Nursing Proposal -- Evidence-Based
The utilization of call lights particularly in hospital settings has recently been put under study as a function of various aspects of nursing including shortages, rounds and analyses of patient outcomes. The proper scheduling of nursing rounds may be essential to enhance the capability of nurses to tackle common or ordinary patient issues relative to more dire needs that have to be regarded as the primary/main target for the use of call lights by patients. Besides patients' general well-being and safety while hospitalized, nursing employees are also concerned with how satisfied the patients are. On a rather fundamental level, hospital settings that enable patients to experience peace of mind allow them to heal quicker than those that do not; these patients are highly likely to relay less stressful communications to those around them, and have a higher possibility of clearer perspectives that allow them to distinguish…… [Read More]
Describe the background of the problem
Diabetes is considered to be one of most manageable and frequent problems impacting a large number of Americans. As someone becomes older, they are more likely to develop the condition from poor lifestyle choices, diet, the lack of exercise and genetics. According to the Centers for Disease Control (CDC), there are a total of 29 million Americans who are impacted every single year. Out of this, number 17.7 million are between the ages of 40 to 60 years old. In many cases, learning to manage their diabetes and making healthy choices are critical for avoiding other complications. The most notable include: heart disease, stroke, blindness and the loss of limbs. This issue deserves attention as the inability to live with and manage the condition will result in premature death and the inability to function normally on a daily basis. ("National Diabetes Statistics…… [Read More]
Translating an Evidence Into Practice
Among the older adults aged 60 years and above, falls have been identified as a leading cause of fatal injuries and non-fatal injuries. In the United States, nearly 50% of hospitalized adult patients face the risks of falls and nearly 80% of the patients who fall suffer from fatal or non-fatal injuries. (CDC, 2010). When patients fall, the issue can lead to negative health effects that include longer hospital stays, elevated patient's costs, and longer recovery times. An average hospital stay can increase by more than 12.3 days, and consequently increase the cost of hospitalization by 61%. In essence, elder population face the risks of severe head or leg injuries after a fall, and the issue can ultimately increase the risk of head trauma and hip fractures. (CDC, 2010).
Numerous organizations have employed different strategies to prevent falls. Current practice includes bed alarms, adequate light,…… [Read More]
There are a number of medical maladies and conditions that are ravaging a large swath of the populations of countries like the United States. Among them are diabetes, heart disease and hypertension. The last of those three will be the focus of this report. The PICOT question that shall be posed for this report centers on the reactions and perceptions of those men in their 30's or older that are newly diagnosed with high blood pressure. Beyond the gravity of such a revelation, the interventions and changes that could be made to diet, lifestyle or drug intake are all on the table and it is presumably a good idea to gauge what is the most attainable and reachable by the patient in partnership with the medical professionals that help them.
The problem in question is pretty basic. It is the solution that is rather vexing and…… [Read More]
But it was the British who would have the greatest impact on the decline of the Ottoman Turkish Empire. Gaining control of Egypt during the Napoleonic Wars, Britain administered Egypt as an independent province of the Ottoman Empire. However, it was World War One that gave Great Britain the opportunity to directly expand into the Ottoman Empire. The Ottomans allied themselves with the Central Powers, enemies of France, ussia, and, most importantly, Great Britain. By first fomenting a revolution among the Arabs, the British were able to destabilize the Turks in the Middle East, which then led to the conquest of Palestine and Syria. While the British had promised their Arab Allies independence, the Sykes-Picot agreement actually split the Middle East into four "mandates," and "recognized long-standing French claims to Syria." (Cleveland, 2009, p 164) Three of the four "mandates" were controlled by the British, one by the French,…… [Read More]
Thus, while the term "Arab" is useful for describing a particular group of people with a shared language, culture, and history, one cannot readily assume that all Arabs subscribe to a pan-Arabist ideology, especially in light of the often overlapping "Muslim world," which many Arabs would identify themselves a part of (above and beyond any shared connection due to their Arab heritage). In reality, a shared linguistic and cultural background is really the only thing that unites Arabs, but because the world's largely white, Christian reigning powers have for so long actively disenfranchised and brutalized the Arab world, either through direct action or proxies, this shared linguistic and cultural background has been the only unifying feature which allows for any resistance. In many ways, one may see the emerging democratic movements of the Arab Spring as the successful replacement of both pan-Arabism and pan-Islamism, because the desire for…… [Read More]
World War I and its Effect on the Middle East
The Europeans who had already colonized much of the area with post-World War I now spread further into the Middle East claiming further portions such as Arabia, Iraq, yria, Libya, and Palestine. The Constantinople Agreement followed by many more including the ykes Picot agreement over and again implemented covert agreements regarding lands that would go to each of the Allies. After the war, France received Lebanon and yria (
) even though yria herself preferred an American mandate (2), and Britain received land that included Palestine, Israel, Transjordan, and Iraq (3). The indigenous people themselves were never consulted regarding whom they wished to control them, and colonization, consequently, prompted Arabic nationalism.
Nationalism was, furthermore, created by the fact that the peace settlements imposed by the Allies after World War I broke up nation states and created others, confusing many who,…… [Read More]
Middle East/Gulf region has a complex history and has experienced a series of important events both during and in the years following Muhammad's influence in the territory. hile Muhammad's ruling played an important role in shaping thinking in the region, his legacy was actually more important, taking into account that it practically influenced people in taking on certain attitudes and in expressing great interest in wanting to promote Islamic thought.
The Arab Caliphate greatly expanded the Islamic Empire and turned it into one of the greatest in all of history. It lasted from 632 until 1513 and it involved a series of leaderships: the Rashidun period, the Umayyad period, and the Abbassid period. These three dynasties kept Arabs together and provided them with a sense of unity and cultural identity. Introducing Arab as an official language further contributed to making individuals in the Middle East feel as if they were…… [Read More]
Methicillin-esistant Staphylococci (MSA), most common Healthcare Associated Infections
The PICOT question to be discussed is: For adult patients using catheters, does the use of sterilization practices reduce the future risk of health associated infections like MSA compared with standard procedure in one week?
The answer is yes.
The support given to answer the question will be based on peer-reviewed journals and scientific literature. A summary of the evidence will be availed in a chart plus a conclusion that summarizes evidence used will also be given.
Methicillin-resistant Staphylococcus aureus (MSA) bacteria is resistant to several antibiotics. A significant proportion of MSA infections in the community are on the skin. It results in alarming infections of the bloodstream, surgical site infections and pneumonia in health facilities. Studies have revealed that one person in every three individuals have staph in the nose - most of the time they don't show any illnesses (General…… [Read More]
vidence-Based Quality Nursing Practice
As a result of a variety of conditions, hospitalized patients may experience extended times in their hospital bed, unable to ambulate, and forced to rely on call buttons to communicate their needs or anxieties to nurses on duty. Not infrequently, patients who attempt to get out of bed may fall. And patients who cannot get out of bed, or adequately shift their positions in bed, may experience pressure sores as a result of their immobility.
Patients experience a number of emotions in response to these types of situations, any one of which can compel them to use their call button to summon help, or even express their frustration at their helplessness, discomfort, or heightened sense of vulnerability. The use of call bells by patients may occur more frequently than nursing staff consider appropriate, consequently, the probability that responsiveness to nurse call bells will diminish over time…… [Read More]
Intervention for the Improvement of Hypoglycemic Control
Diabetes complication is one of the top health problems in the United States, and the ADA (American Diabetes Association) recommends that people suffering from diabetes should control their hypoglycemic and maintain A1C to < 7% to avoid diabetes complications. To achieve this objective, the "diabetes self-management education (DSME)"(Ni coll, aiser, Campbell, ET AL. 2014 p 207) is an effective tool to enhance hypoglycemic control and improve patients' outcomes. The DSME is an on-going educational process to facilitate the skill, knowledge, and ability of patients to carry out a diabetes self-care. I am a diabetic educator working in the diabetic outpatient clinical setting. My experience has made to understand that patients struggle to manage and control their diabetes after being educated because patients are not allowed to set their goals in order to manage their diabetes. (American Diabetes Association; 2013).
Objective of this paper…… [Read More]
Evidence-Based Practice, or EVB, is a strategy that uses research, quality control measures, and other forms of evaluation data in order to improve practice methods within the healthcare setting.
EVB utilizes innovative clinical research study findings, survey results from both patients and healthcare providers, expert opinions, and quality improvement data to demonstrate a need for change and generate the most potentially successful strategy to improve the quality of care.
The procedures used within any application of EVB practices are guided by a clear mission and vision statement that directly reflect a need for improvement or other problem area.
Teams within the healthcare setting must be willing to search for and use evidence to help facilitate change.
Today, there are more Americans living with and at risk for diabetes than ever before in this nation's history.
Over 29 million Americans deal with diabetes on a daily basis. Many might think…… [Read More]
Iran and Iraq
Analysis of the Impact of Imperialism on Iran and Iraq
The modern nation of Iraq was formed in 1932 when the Kingdom of Iraq gained independence from the United Kingdom. It had been placed under the authority of Great Britain as the British Mandate of Mesopotamia by the League of Nations in 1920. Prior to that, it was part of the Ottoman Empire. This delineates the history of imperialism in Iraq as beginning with the arrival of the Ottomans the 15th century, through independence from the Great Britain. These two stage of imperial rule had several different impacts on modern-day Iraq.
The first is the borders of the current state of Iraq were the direct result of British rule. The Ottomans had administered Iraq differently, with three main provinces. Under Ottoman rule, Baghdad, Mosul and Basra were all provinces within the Ottoman Empire. Iraq was not Iraq…… [Read More]
Hourly Nursing ounding
Nursing rounding is the schedule or process that ensures a member of staff, either the nurse or the nursing assistant visits the patient's room to offer the needed service to the patient. It is common that during the day, each hour this exercise is repeated and during the night, then after every two hours the patients are visited. Studies have shown that hourly rounding significantly decreases call light use and reduces unit noise levels. The practice also increases the satisfaction levels of both the patients and the staff members. The hourly rounding is also seen to increase staff productivity as they feel that they have control over the patient care. The hourly visits are also seen to significantly reduce the pressure sores that patients who are not able to turn on their own would suffer and also decreases falls that would otherwise be rampant if the rounds…… [Read More]
Ineffective Communication Between Shifts in Acute Care Settings
A recent statistics of the adverse effects arisen from ineffective communication between shifts in acute care setting range from 2.6% to 7.6%, however, Okoniewska, et al. (2015) believes that the adverse effects on in-patients can be between 19% and 23%. (Classen, esar, Griffin. et al. 2011).
The Study aims to discuss the adverse effective arisen from ineffective communication between shifts within acute care settings.
Consequences of not solving the problem
Without implementing the strategies that can enhance effective communication between shifts in an acute healthcare setting, the issue can lead to mortality, readmission, and post-hospital adverse effects. Moreover, poor communication between shifts can lead to medication problems resulting to therapeutic errors. (Okoniewska, et al. 2015). Moreover, lack of intervention to address the problem can lead to medical errors, which can lead to patients' harms. Communication failure has also been identified as…… [Read More]
Evidence-Based Practice Project: educing ate of Psychiatric eadmission
The purpose of the evidence-based practice project is to examine ways to eliminate psychiatric readmissions. More specifically, literature is reviewed to examine evidence supporting the effectiveness of care transition interventions in preventing re-hospitalization amongst adult patients with severe mental illness. In this chapter, the search process is first described. Next, the identified literature is summarized and synthesized, clearly evaluating the relevance of the literature to the specified PICOT question.
Literature for the review was searched in CINAHL, PubMed, EBSCO, ProQuest, and Google Scholar databases using the following phrases: psychiatric readmission, re-hospitalization, care transition interventions, transitional care interventions, and reducing readmission in adults with mental illness. Focus was particularly on literature published in English. From the first round of search, it was quite evident that not much scholarly attention has been given to the topic as the search returned less than…… [Read More]
The PICOT question that will be evaluated in this study is, "Does the use of a validated delirium assessment instrument (intervention) improve delirium detection (outcome) among adults in the ICU (population) as compared multicomponent interventions (comparison) within a 6-month period (timeline)?"
Intervention to be Implemented
The intervention that will be implemented in this study is Confusion Assessment Method, which is a validated delirium screening instrument. The intervention will be utilized to examine how it improves the detection of ICU delirium among adults in intensive care units as compared to multicomponent interventions.
Outcomes to be Analyzed
The outcomes that will be analyzed during this study is whether a validated delirium screening instrument enhances the detection of this condition among adults in intensive care units as compared to other methods. As previously indicated, the validated delirium screening instrument that will be implemented is Confusion Assessment Method while the…… [Read More]
ICU Delirium -- Type Of Study
The PICOT question that will be evaluated in this study is, "Does the use of a validated delirium assessment instrument (intervention) improve delirium detection (outcome) among adults in the ICU (population) as compared multicomponent interventions (comparison) within a 6-month period (timeline)?"
The clinical question demonstrates that the study will involve conducting a comparison of the impact of a validated delirium assessment instrument vis-a-vis multicomponent interventions with regards to delirium detection among adults in intensive care units. Therefore, the most suitable way for conducting the comparison is through an experiment. In this regard, this research will be an experimental study in which study participants will be randomly assigned to different intervention groups i.e. the experimental and control groups (esearch Connections, 2016). The research will then observe the participants' response to the interventions to determine the impact of the interventions in enhancing delirium detection…… [Read More]
Diabetes is regarded as one of the most problematic and major health concerns that has become prevalent across the globe. According to Kam et al. (2016), in 2012, diabetes resulted in the deaths of 1.5 million people throughout the world. Given its prevalence and devastating impacts, effective prevention and management of diabetes has become a major issue, especially among high-risk individuals/populations. Based on existing findings in the public health sector, dietary and lifestyle changes have been identified as the most suitable prevention and management techniques of diabetes. This study focuses on examining whether an intervention consisting of a traditional, organic, and all-natural diet of locally grown/produced foods plus exercise is more effective in addressing the body's issues in creating or absorbing insulin than insulin injections. In this regard, the researcher has identified relevant studies that will be synthesized based on their relevance, rigor, and level of evidence in…… [Read More]
Research Proposal for Catheter Associated Urinary Tract Infections
Catheter Associated Urinary Tract Infections (CAUTI) affects timely reimbursement and prolongs patient stays in the healthcare facility. Many hospitals strive for ways to reduce CAUTIs and take specific medical measures to aid patients in recovery from the same and avoid recurrence of the cases of CAUTIs. These deliberate measures ensure so they can have better patient outcomes and improve patient care. This also improves the reimbursement received from insurance providers.
The research seeks to investigate the effect of frequent CAUTI education, among the in-hospital patients with indwelling urinary catheter, conducted over six months.
Background and Significance of the Problem
It is common medical knowledge that urinary catheters have the potential to cause urinary tract infections, known as catheter-associated urinary tract infections (CAUTIs). Indwelling catheters are a part of many plans of care, specifically for emergent and critical care patients within…… [Read More]
Healthcare System Practice Guideline
Introduce an overview of one healthcare system practice guideline
There are numerous areas within health care that demand change in everyday healthcare practice. More often than not, irrespective of the healthcare setting, an inventive group is required to conduct research and facilitate change. There are numerous practices that require change or upgrading. This is facilitated through the establishment and advancement of clinical practice guidelines. The selected healthcare system practice guideline is Management of Diabetes Mellitus in Primary Care (2017). This particular guideline delineates the important decision points in the Management of Diabetes Mellitus (DM) and provides well-outlines and wide-ranging evidence based recommendations assimilating prevailing information and practices for practitioners throughout Department of Defense (DoD) and Veretan Affairs (VA) Health Care Systems. Diabetes mellitus is an illness that is caused either by an absolute or relative deficiency in insulin giving rise to hyperglycemia. Type 1 DM (T1DM)…… [Read More]
psychosocial smoking cessation interventions for coronary heart disease patients effective?
The association with smoking and coronary heart disease (CHD) has been well documented. To prevent further heart attacks, as well as to preserve their life, smokers have been consistently and strongly advised to quit smoking, and associations such as the American Heart Association and American College of Cardiology Task Force have drafted recommendations and reams of advice to assist patients in doing so. Nevertheless, many patients diagnosed with CHD continue to smoke despite the possibility of interventions and programs (many of them free) helping them to stop. Mortality can be reduced by as much as 36% if smokers with CHD determine to stop smoking 3-5 years after diagnosed (Critchley, 2003) aside from which dramatic reductions in cardiac attacks have been discovered when smokers have stopped smoking for as short a time as a year (Quist-Paulsen, & Gallefoss, 2003). The Coronary…… [Read More]
A synthesis of what the studies reveal about the current state of knowledge on the question developed
The mindfulness meditation theory appears to have the potential to treat addictive disorder patients. Zgierska and coworkers (2009) state that such models seem to be safe if implemented within the context of clinical studies. One can find considerable methodological shortcomings in a majority of existing works on the subject. Further, which addiction-diagnosed individuals may derive maximum benefits out of mindfulness meditation isn’t clear. But, of late, related initiatives and practices in the role of complementary clinical aids for treating multiple physical and psychological ailments have grown in popularity. MBCT (mindfulness-based cognitive therapy) and MBSR (mindfulness-based stress reduction) as clinical initiatives have specifically been analyzed, with a sound evidential pool recording their efficacy. Integration of the latter initiative’s aspects and cognitive behavioral therapy and cognitive psychology strategies resulted in the former’s creation. At first,…… [Read More]
Still, the concept of guided imagery tends to stray far from traditional methods of pain management. Pharmaceuticals have long been a major method of treatment for pain, but have resulted in major backlashes in regards to patients becoming addicted, especially in long-term and chronic cases of pain. If guided imagery could be a successful method, it may reduce pain or increase pain tolerance, without the threat of chemical dependence.
There are a number of benefits which are seen in the ongoing discourse today. As such, the expected improvements include things like drops in blood high blood pressure, lower heart rates, and reduction of chronic pain symptoms, lessoning of headache pain, and increasing overall pain tolerance (Cornelius, 2010). In situations were patients going into a major surgery were coached with guided imagery, it was "shown to decrease stress and anxiety before and after surgery," thus helping reduce additional pain issues during…… [Read More]
experts would likely agree with the very general statement that individuals who exercise, or who implement an exercise regime, are much more likely to lose weight and alleviate pain experienced from a variety of diseases and maladies. It would seem that much of the current literature would provide evidence of this hypothesis. This specific study, however, seeks to do more than just ascertain the results from such a general question. This study seeks to determine whether initiating an exercise regime for patients experiencing osteoarthritis can lower the level of the pain they are feeling and increase their mobility through adherence to that regime.
This study will, in essence then, take a two-pronged approach. The first is to determine whether patients with suffering from osteoarthritis can lower the level and incidence of pain they suffer by implementing a basic exercise regime. If so, this study wishes to determine just how much…… [Read More]
This clearly shows that alcohol-based hand-washing, when used regularly and vigorously (e.g. prior to any healthcare procedure by any level of personnel), infection will be reduced.
The Saudi study was a bit more detailed, with protocols varying depending on severity of procedure (surgery, etc.) and the administering of prophylactic antibiotics as part of the regular treatment procedure. Statistical analysis of the samples showed no significant differences between the Betadine Group and the Alcohol-Based Gel Group. However, the total number of infections within both groups were quite small, 20 out of 600 subjects in the trial. This suggests that the conditions at the Saudi hospital were already more sterile, with less than 5% (3.33%) even developing infections; compared to 13.1% in Vietnam. In both cases, demographic differences between patients were not statistically significant in the protocol.
Combining the data from the two studies, however, results in two conclusions: 1) There is…… [Read More]
Medical Conditions -- There are a number of factors that can increase the likelyhood of type-2 diabetes: hypertension, eleveted cholesterol, and a condition called Symdrome X, or metabolic syndrome (combination of obesity, high cholesterol, sedentary lifestyle, stress, and poor diet). Cushing's syndrome, cortisol excess and testosterone deficiency are also associated with the disease. Often, it is a number of co-dependent conditions that seem to give rise to diabetes (Jack & Boseman, 2004).
Genetics -- There is ample evidence that there is a strong inheritable genetic condition in type-2 diabetes. In addition, there is a genetic mutation to the Islet Amyloid Polypeptide gene that results in early onset diabetes (Lee & Hasim, 2001). There is a stronger inheritance pattern for type-2 diabetes with a significant association between family members. Typically, this is excacerbated by cultural and lifestyle factors that, while not inherited, are culturally shared. Gene expression promoted by a diet…… [Read More]