Post Operative Complications Essays (Examples)

Antiemetic Efficacy of Ipa Inhalation

Post-Operative Nausea and Vomiting

Antiemetic Efficacy of IPA Inhalation in High-isk PONV Patients

Antiemetic Efficacy of IPA Inhalation in High-isk PONV Patients

Post-operative nausea and vomiting (PONV) is considered a significant enough threat to patient health that surgical patients are often treated prophylactically to prevent its occurrence (reviewed by Murphy, Hooper, Sullivan, Clifford, and Apfel, 2006). PONV has been defined as an episode of nausea, vomiting, or retching (non-productive vomiting) that occurs within 24 hours following surgery, which can cause patient distress, post-operative complications, prolonged recovery times, and increase the cost of post-surgical care. The prevalence of PONV for the average surgical patient is estimated to be between 20 and 30%, but high-risk patients may have up to an 80% or higher chance of experiencing this condition. The high variability in PONV risk precludes standard prophylactic treatment, due to the cost and the increased risk…

References

Apfel, Christian C. (2005). PONV: A problem of inhalational anaesthesia? Best Practice & Research Clinical Anaesthesiology, 19(3), 485-500.

Cullen, Karen A., Hall, Margaret J., and Golosinskiy, Aleksandr. (2009). Ambulatory surgery in the United States, 2006. National Health Statistics Reports, 11, 1-28. Retrieved 9 Oct. 2012 from  http://www.cdc.gov/nchs/data/nhsr/nhsr011.pdf .

Hines, S., Steels, E., Chang, A., and Gibbons, K. (2012). Aromatherapy for treatment of postoperative nausea and vomiting (review). Cochrane Database of Systematic Reviews, April 18(4), 1-52. Retrieved 11 Oct. 2012 from  http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007598.pub2/abstract .

Lummis, Sarah C.R. (2012). 5HT3 receptors. Journal of Biological Chemistry, in press, October 4. Retrieved 8 Oct. 2012 from  http://www.jbc.org/cgi/doi/10.1074/jbc.R112.406496 .

Interventions that might be adopted by PACU staff include oxygenation, ventilation, circulation and temperature checks; in addition pulse oximetry might be used during the initial phases of recovery (Tilton, 2003). To further ensure client safety PACU staff will manage the patient's airway and provide oxygen, and record vital signs for communication of overall patient condition to the anesthesiologist (Tilton, 2003).

Other monitoring that might be conducted may include cardiac rhythms and blood pressure (Tilton, 2003). The utilization of such monitoring equipment and procedures will depend on the patient's health both pre and post operative, and the type of procedure the patient has undergone that facilitated use of anesthesia.

Procedures necessary to ensure asepsis include utilization of sterile equipment within the sterile field, which consists primarily of the patient and the surrounding table and equipment (Operating, n.d; Courtenay, 2000). In addition nurses are required to keep hands gloved and should be…

References

Courtenay, M. (2000). Advanced nursing skills: Principles and practice. London:

London Greenwich Medical Limited.

Evans, T. "Origin of the Word Anesthesia." Anesthesia Nursing and Medicine. December 17, 2001. Retrieved February 15, 2005:

 http://www.anesthesia-nursing.com/anesth.html .

It was noted that factors affecting the removal of third molars vary from country to country depending on the stakeholders (Esposito, 2005).

In this section, we discussed the origins of third molars, as well as the different types of impaction that can occur. The effects of the type of impaction were found to be a factor in the ease if removal and the complications that may occur. Understanding types of impactions and the affect that they can have on the potential for complications is an important step in preventing complications before and after surgery. The following section will discuss the surgical procedures for removal of mandibular impactions.

Surgical Extraction of Impacted Mandibular Third Molars

Surgical extraction of third molars is performed for a number of reasons. They are sometimes performed to prevent surgery in older patients, although this reasoning is questionable (Valiati, Ibrahim, & Poli, et al., 2009). It can…

References

Al-Asfour, a. (2009). Postoperative Infection After Surgical Removal of Impacted Mandibular

Third Molars: An Analysis of 110 Consecutive Procedures. Med Princ Pract 18:48-52.

Bernard, G. & Mintz, V. (2003), Evidence-based means of avoiding Lingual Nerve Injury

following Mandibular Third Molar Extractions. Brazilian Journal of Oral Science. 2 (5):

Tonsil Problems

Surgery is a traumatic and often dangerous event. While tonsillectomies are somewhat common in the history of surgical procedures, it is necessary to investigate the problems of Amy as listed in the case study following a post operative procedure in which her tonsils were removed. In order to determine the patient's pathophysiology it is necessary to identify the problematic or typical physiological processes that are occurring with the patient.

The first step in discussing this problem should identify any problems or situations that are out of the normal set of circumstances for a tonsillectomy. Most of these types of surgeries are simple and require little to no healing time and prescriptions to finish the process. Here in Amy's case however, there seems to be a definite problem. The main problems deals with the patient's mental state and her fear of not healing. This fear has no doubt complicated…

References

Audit, N.P.T., & van der Meulen, J. (2004). Tonsillectomy technique as a risk factor for postoperative haemorrhage. The Lancet, 364(9435), 697-702.

Aukburg, S.J., Ketikidis, P.H., Kitz, D.S., Mavrides, T.G., & Matschinsky, B.B. (1989, November). Automation of physiologic data presentation and alarms in the post anesthesia care unit. In Proceedings of the Annual Symposium on Computer Application in Medical Care (p. 580). American Medical Informatics Association.

Berry, J.G., Blaine, K., Rogers, J., McBride, S., Schor, E., Birmingham, J., ... & Feudtner, C. (2014). A framework of pediatric hospital discharge care informed by legislation, research, and practice. JAMA pediatrics, 168(10), 955-962.

Brar, M.S. (2009). Airway management in a bleeding adult following tonsillectomy: a case report. AANA J, 77(6), 428-430.

(Sussman and Bates-Jensen, 2007)

Assessment data is reported to enable the clear communication among clinicians about the wound and in making the provision for "continuity in the plan of care" as well as allowing for "evaluation of treatment modalities." (Sussman and Bates-Jensen, 2007) Wounds that are classified as red, yellow and black are those that require examination of deep tissue involvement. (Sussman and Bates-Jensen, 2007) The wound must be monitored during the healing process since monitoring provides the means of "checking the wound on a regular and frequent basis for "signs and symptoms that should trigger a full reassessment, such as increased wound exudate or bruising of the adjacent or periwound skin. Included in monitoring is the "gross evaluation for signs and symptoms of wound complications, such as erthema (change in color) or periwound skin and pus, which is indicative of infection." (Sussman and Bates-Jensen, 2007) Included as well should…

References

Aseptic Technique (2008) Aseptic Technique. Section G. NHS Foundation Trust. Online available at:  http://www.cht.nhs.uk/fileadmin/departments/infection_control/policies/Section_G_-_Aseptic_Technique_Issue_2.pdf 

Burney, R.E. et al. (1997) Core Outcomes Measures for Inguinal Hernia Repair. Journal of the American College of Surgeons. Vol. 185, Issue 6. Online available at:  http://www.journalacs.org/article/S1072-7515%2897%2900108-7/abstract 

Issues in Wound Care: Appropriate Use of Dressings. Report from a Wound Academy Expert Forum. Sponsored by the Molnlycke Health Care Wound Academy. September 2007. Online available at:  http://www.molnlycke.com/Global/Wound_Care_Products/UK/Wound%20Academy/IssuesAppropriateusefinalSept07.pdf 

Khan, Y. And Fitzgerald, P. And Walton, M. (1997) Assessment of the postoperative visit after routine inguinal hernia repair: A prospective randomized trial. Journal of Pediatric Surgery. Vol. 32, Issue 6. June 1997. Online available at:  http://www.jpedsurg.org/article/S0022-3468%2897%2990644-8/abstract

However, proper treatment may restore fertility. During pregnancy, existing fibroids may grow at a greater pace due to the increased blood flow and estrogen levels but they usually return to their original size after delivery.

Pelvic Inflammatory Disease

Definition & Cause: Pelvic inflammatory disease (PID) is a general term for infection of the lining of the uterus, the fallopian tubes. It is a very common disease and in the United States alone, nearly 1 million women develop PID each year and more than 100,000 women become infertile as a result of PID (NAID Fact sheet, 2005). It is caused in a majority of cases through sexually transmitted diseases such as Chlamydia and gonorrhea but PID-causing bacteria may also cause infection through other means such as during childbirth, abortion, or IUD insertion.

Complications: PID can damage the fallopian tubes, ovaries, uterus, and cervix, leading to chronic pelvic pain and serious damage…

References

Carson-DeWitt, R., and Odle, T.G. (2006). "Infertility.." The Gale Encyclopedia of Medicine. Third Edition. Jacqueline L. Longe, Editor. 5 vols. Farmington Hills, MI: Thomson Gale, 2006.

Frequently Asked Questions About Infertility." (2006). American Society of Reproductive Medicine. Retrieved on November 6, 2006 at  http://www.asrm.org/Patients/faqs.html 

General Infertility FAQ." (2006). The InterNational Council on Infertility Information Dissemination (INCIID). Retrieved on November 6, 2006 at  http://www.inciid.org/faq.php?cat=infertility101&id=1 

Mallari, B. (2001). "Polycystic Ovarian Syndrome." 3 RX.com. Retrieved on November 6, 2006 at  http://www.3-rx.com/polycystic-ovarian-syndrome/default.php

Benson, H.; Dusek, J.A.; and Sherwood, J.B. "Study of the Therapeutic Effects of Intercessory Prayer (STEP) in Cardiac Bypass Patients: a Multicenter

Randomized Trial of Uncertainty and Certainty of Receiving Intercessory

Prayer." American Heart Journal. Vol. 151 (2005): 934-42. Reported by Carey,

in "Long-Awaited Medical Study Questions the Power of Prayer" The New

York Times, (March 31, 2006). Retrieved March 12, 2011 from:

http://www.nytimes.com/2006/03/31/health/31pray.html

Intercessory prayer in medicine is the use of prayer to divine powers to assist and benefit the welfare of patients in clinical circumstances. Various studies have produced conflicting results with some purporting to demonstrate a benefit toward positive clinical outcomes and other concluding that the act of praying for medical patients is useless. This study sought to examine the issue empirically through a formal quantitative analysis designed to compare the medical outcomes of surgery patients who received intercessory prayer and those who did not.

Statistical Procedures…

In this case, that power dynamic was only exacerbated by the fact that the entire MSICU nursing team had never received training in management of the type of clinical issues presented and by the fact that they were excluded from any consultation in connection with a post-operative management plan.

Therefore, it is recommended that the institution immediately implement a policy of "see something, say something" according to which all members of healthcare teams are encouraged to speak up irrespective of power differentials. Furthermore, that protocol must include a statement of policy insulating any member of a healthcare team who does voice a legitimate concern in good faith from any retaliation or other negative response that could conceivably deter such diligence. Finally, the record of this case also indicates the immediate need for protocols requiring all members of the healthcare team to identify themselves to other members of the team, especially…

References

Bosk, Charles L. (2003). Forgive and Remember: Managing Medical Failure.

Gawande, Atul. (2008). Better: A Surgeon's Notes on Performance.

Groopman, Jerome. (2008). How Doctors Think.

Timmermans, Stefan. (2003). The Gold Standard: The Challenge of Evidence-Based

NICE Standards

NICE Compliance Standards eview

NICE has developed a set of guidelines and standards to help minimize the risk of VTE and ensure healthcare protocols are in place to educate patients about the risks of VTE. The purpose of this literature review is to examine a tool to access a Hospital Trust compliance with the National Institute of Clinical Excellence (NICE) published standards on Venous thromboembolism (VTE) prevention. The tool will have the capability to monitor, report, and disseminate relevant information.

National Institute for Clinical Excellence

The National Institute for Health and Clinical Excellence, or NICE, is an institution whose goals including providing clinical quality guidelines and standards to help manage a nationwide database. The purpose of this database includes help improve total healthcare at multiple levels, including at the cardiovascular, vascular, mental, neurological at other levels of health (NICE, 2011). The goals of NICE include prevention of disease,…

References:

Department of Health (DH). (2010 March). "Venous Thromboembolism (VTE) Risk

Assessment." Department of Health. Retrieved July 23, 2011: Publications PolicyAndGuidance

NHS Evidence. (2011). NHS Evidence: Evidence in Health and Social Care. NHS Evidence,

Retrieved July 23, 2011:  http://www.evidence.nhs.uk/

Aortic dissection is a disease of the wall of the aorta in which the aortic blood bursts into the muscular layer of the great artery, thus forming a blood filled channel along the planes of the muscularis layer. This false lumen can re-rupture back into the true lumen, through a second distal intimal tear, creating a biluminal or double barrelled aorta. Due to weakened walls, there is threat of rupture into the surrounding tissue with fatal consequences. (Boon, , Colledge, Walker, & Hunter, 2010)

The pathophysiology behind the condition is often a spontaneous or iatrogenic tear in the intima. However, in about five to ten percent of patients, these tears are absent. An intimal tear can occur anywhere along the aorta, although a vast majority of tears are found within ten centimeters of the aortic valve. The dissection may extend towards the heart, affecting the coronary arteries, or it may…

REFERENCES:

Duranki. (n.d.). Type an aortic dissection - the silent killer. Retrieved from  http://duranki.hubpages.com/hub/Beware-High-Blood-Pressure-It-will-Kill-You  -- You-Wont-See-It-Coming

Erbel, R., Alfonso, F., Boileau, C., & Dirsch, O. (2001). Diagnosis and management of aortic dissection*.European Heart Journal, 22(18), 1642-1681. Retrieved from  http://www.escardio.org/guidelines-surveys/esc-guidelines/GuidelinesDocuments/guidelines-aortic-dissection-FT.pdf 

Multum, C. (2012, Feburary 12). Morphine injection. Retrieved from  http://www.drugs.com/pro/morphine-injection.html 

Nicholas A. Boon, Nicki R. Colledge, Brian R. Walker, John A.A. Hunter.(2010). Davidson's Principles and Practice of Medicine . India, Elsevier.

Failure Mode and Effects Analysis (FMEA)

Description of FMEA

As applied to the healthcare industry, "Failure Modes and Effects Analysis" (FMEA) is a proactive process for assessing risks of patient injury by anticipating possible system failures and prioritizing them (Davis, Riley, Gurses, Miller, & Hansen, 2008, p. 1). Rather than reviewing a past incident of failure, FMEA teams focus on processes and ask, "How could these systems fail?" (Davis, Riley, Gurses, Miller, & Hansen, 2008, p. 1). Originally developed in 1949 by the U.S. Military (V. Bulletin Solutions, Inc., 2011) and then adopted by the business world, FMEA consists of 2 types of analysis:

Process FMEA, which assumes that the product works and examines the process for possible defects and their possible effects;

b. Design FMEA, which assumes that the process works and examines the product for possible defects and their possible effects (Reiling, Knutzen, & Stoecklein, 2003).

FMEA's Usefulness…

Works Cited

Davis, S., Riley, W., Gurses, A.P., Miller, K., & Hansen, H. (2008). Failure Modes and Effects Analysis Based on In Situ Simulations: A Methodology to Improve Understanding of Risks and Failures. Retrieved from Agency for Healthcare Research and Quality:  http://www.ahrq.gov/downloads/pub/advances2/vol3/Advances-Davis_60.pdf 

HealthLeaders Media. (2010, May 7). Joint Commission Updates: Sentinel Events Statistics. Retrieved from Health Leaders Media Web site: http://www.healthleadersmedia.com/content/QUA-250699/Joint-Commission-Updates-Sentinel-Event-Statistics##

Joint Commission on Accreditation of Healthcare Organizations. (2001, July 1). Revisions to Joint Commission Standards in Support of Patient Safety and Medical/Health Care Error Reduction: Effective July 1, 2001. Retrieved from JCAHO Web site:  http://www.dcha.org/JCAHORevision.htm 

Reiling, J.G., Knutzen, B.L., & Stoecklein, M. (2003, August). Healthcare: FEMA - The Cure for Medical Errors. Retrieved from American Society for Quality Web site:  http://asq.org/pub/qualityprogress/past/0803/qp0803reiling.pdf

References

Boulton, Martha (2005) Exploring alexithymia, depression, and binge eating in self-reported eating disorders in women. Perspectives in Psychiatric Care

Dahm, Lori (2005) Obesity update: are we getting any thinner?(Special Report)

Private Label Buyer

Merrick, Joav (2005) Psychosomatic reasons for chronic pains.(Editorial)

Southern Medical Journal

____(2006) Obese people may be more sensitive to pain.(NEWS Breaks)(Brief article) Nutrition oday

PORER, LAWRENCE C. WAMPLER, RICHARD S (2000) Adjustment to Rapid Weight Loss. Families, Systems & Health

Rubin, Jay J. (2005) Psychosomatic pain: new insights and management strategies.(CME opic: Psychosomatic Pain) Southern Medical Journal

ucker, Miriam E. (2005) Depression tied to poor adherence to cardiac Rx: results of two studies show that use of aspirin and [beta]-blockers was lower in depressed patients.(Psychosomatic Medicine) Clinical Psychiatry News

MEHODOLOGY

his study will seek to determine whether or not obese post operative patients have a higher incidence of psychosomatic disorders and illnesses than non-obese post op…

The need for this study is evident. The cost factor of psychosomatic illnesses may be reduced if it can be determined whether or not the obese patient population has a higher incidence of psychosomatic illness in post op. If it does then future steps can be taken to better prepare the obese patient population for surgery to reduce the incidence of post op psychometric illness.

REFERENCE

Tucker, Miriam E. (2005) Depression tied to poor adherence to cardiac Rx: results of two studies show that use of aspirin and [beta]-blockers was lower in depressed patients.(Psychosomatic Medicine) Clinical Psychiatry News

Spinal vs. General Anesthesia

The outcome of patients after undergoing transurethral resection of the prostate is examined under varying clinical situations to assess whether spinal anesthesia is associated with greater likelihood of positive outcome. Also examined in great detail are the potential for increased morbidity and mortality based on whether patients underwent general or spinal anesthesia during surgery. A large body of evidence indicates that there is no statistically significant difference between patient outcomes regardless of choice of anesthetic technique. This paper concludes that patients should be well educated and informed so they may make the choice most appropriate to their personal situation and comfort level preferences. An equal number of adverse side effects are associated with each anesthetic technique; as such patients should choose the technique that will result in the greatest post-operative satisfaction. The implications for practice suggest that physicians and anesthetists have an obligation to educate and…

Bibliography

Dobson, PM., Caldicott, LD., Gerrish, SP., Cole, JR., & Channer, KS. Changes in haemodynamic variables during transurethral resection of the prostate: comparison of general and spinal anaesthesia. British Journal of Anaesthesia. Mar; 72 (3): 267-71

Edwards, ND., Callaghan, LC., White T., & Reilly, CS. (1995). Perioperative myocardial ischaemia in patnets undergoing transurethral surgery: a pilot study comparing general with spinal anaesthesia. British Journal of Anaesthesia. Apr; 74 (4): 368-72

Gravenstein, D. (1997). Transurethral resection of the prostate syndrome: a review of the pathophysiology and management. Anesthesia Analg. Feb; 84 (2): 438-36

Hosking, MP., Lobdell, CM., Warner, MA., Offord, KP., & Melton LJ. 3rd. (1989).Anaesthesia for patients over 90 years of age. Outcomes after regional and general anaesthetic techniques for two common surgical procedures. Anaesthesia. Aug; 44 (8): 697-8

Mrs. Mansfield is being handed over to care from the operating theatre nurse. We would require an update chart information. She has had an ovary removal (bilateral salpingo-oophrectomy) and is currently on an IV infusion of .8% Normal Saline. In order to continue her care, we would need previous vitals, lab work, and any details on her condition. We know she has a bellovac drain insitu and a PCA along with O2 via nasal prongs. We would need the orders on the PCA and the physician's assessment of pain medications. There would likely be instructions on wound draining, as well as potential additional fluids and/or blood transfusion information (part of vitals in chart). Post-operative care instructions would be mandatory -- including diet, hourly rounding instructions and additional materials to assist with her post-operative care condition (Fogel & Woods, 2008 p. 428).

Q2 -- esearch shows that unrelieved pain has a…

REFERENCES

Beattie, S. (2008, June 1). Beside Emergency: Wound dehiscence. Retrieved from Bedside Emergency: Wound dehiscence: http://www.modernmedicine.com/modern-medicine/news/bedside-emergency-wound-dehiscence

Chumbley, G., et al. (2004). Pre-Operative information and patient-controlled analgeisa. Anaesthesia, 59(4), 354-8.

Common Postoperative Complications. (2013, April). Patient.co.uk. Retrieved from patient.co.uk:  http://www.patient.co.uk/doctor/common-postoperative-complications 

Doctor QA.com. (2009, April). Compression Socks. Retrieved from doctorqa.com:  http://www.doctorqa.com/vein/procedures/compression-socks

Music and Pain

The use of music in relation to relaxation and pain control is universal in application. Many cultures use music, tones, chanting, drums, or other forms of biofeedback to treat patients in acute pain, women in labor, recovery, and now, most recently, in pre- and post-operative care. In fact, the therapeutic value of music has been recognized as vital and powerful since Ancient Times; archaeological evidence shows flutes carved from bone in pictures of physicians healing patients, Greek physicians used music and vibration to heal, aid in digestion and induce sleep; the Early Egyptians used musical incantations to help with the healing process; and certainly, numerous native tribes use singing and chanting as part of their healing rituals (Nilsson, 2008).

Further, most postoperative patients have pain, despite the use of analgesia. Nurses are constantly trying to be more effective in delivering pain medication. One study showed that patients…

WORKS CITED

Ghetti, C. (2011). Active music engagement with emotional-approach coping to improve well being in liver and kidney translplant recipients. Journal of Music Therapy. 48 (4): 463-85.

Good, M., et.al. (2010). Supplementing Relaxation and Music for Pain After Surgery. Nursing Research. 59 (4): 259-69.

Goodwin C.J. (2010). Research in Psychology: Methods and Design. New York: John

 http://www.experiment-resources.com/scientific-control-group.html

More times than not, a patient will argue that he did not understand what the physician stated to him; even amidst documented proof the medical professional and the patient did engage in an informed conversation. "The fact that a meeting took place does not necessarily mean that there was a meeting of the minds" (Informed consent…, 2010, ¶ 5). This issue leads some health care providers to assert that informed consent forms possess little value, particularly when a legal battle ensues and the professional cannot prove the patient did, in fact, understand the informed consent process.

Currently, lawyers routinely challenge informed consent forms in courtrooms throughout the United States (U.S.). "The model consent forms incorporate substantial details of anesthesia techniques, risks and other elements of 'informed consent', so that a strong presumption is established on its face" (Informed consent…, 2010, ¶ 7). During the informed consent process, to help inoculate…

REFERENCES

Anaesth, B.J. (2009). Perioperative visual loss: What do we know, what can we do? Department

of Anesthesia and Critical Care. University of Chicago. Retrieved January 25, 2010 from  http://bja.oxfordjournals.org/cgi/content/short/103/suppl_1/i31 

Booth, B. (2008). Informed consent at the heart of New York lawsuit. Retrieved January 26,

2010 from  http://www.ama-assn.org/amednews/2008/03/10/prca0310.htm

bmj.com/cgi/content/full/325/7369/887

Pfizer, 'NEW FRAGMIN INDICATION FIGHTS SECOND LEADING CAUSE of DEATH in CANCER PATIENTS, CANCER-ASSOCIATED THROMOSIS', retrieved feb 29th 2008, from, http://www.pfizer.ca/english/newsroom/press%20releases/default.asp?s=1&releaseID=160

Dirix LY,

Salgado R,

Weytjens R,

Colpaert C,

enoy I,

Huget P, van Dam P,

Prove a,

Lemmens J,

Vermeulen P. (2002), 'Plasma fibrin D-dimer levels correlate with tumor volume, progression rate and survival in patients with metastatic reast Cancer', ritish Journal of Cancer, http://www.ncbi.nlm.nih.gov/pubmed/11875705

John a Heit, (Sep 2005), "Cancer and Venous Thromboembolism: Scope of the Problem', Cancer Control, Vol! 2, Supplement 1.

Diana M. eck, (Oct 2006), 'Venous Thromboembolism: Prophylaxis: Implications for Medical Surgical Nurses,"

MEDSURG Nursing -- October 2006 -- Vol. 15/No. 5, Available online at, http://www.medsurgnursing.net/ceonline/2008/article10282288.pdf

Race, Tara Kay SN, RN, CCRN; Collier, Paul E. MD, (July-Sep 2007), 'The Hidden Risk of Deep Vein Thrombosis -- the Need for Risk Factor Assessment: Case Reviews.', Critical Care Nursing Quarterly, 30(3):245-254

Susan egelman MD, 'Venous Thromboembolism',…

Bibliography

MF Scully (2005), 'Clinical Guide Cancer and Thrombosis', retrieved Feb 28th 2008, at http://www.tigc.org/pdf/cancervte05.pdf

Alexander G. Turpie, (2002) 'ABC of Antithrombotic Therapy', British Medical Journal, available at  http://www.bmj.com/cgi/content/full/325/7369/887 

Pfizer, 'NEW FRAGMIN INDICATION FIGHTS SECOND LEADING CAUSE of DEATH in CANCER PATIENTS, CANCER-ASSOCIATED THROMBOSIS', retrieved feb 29th 2008, from,  http://www.pfizer.ca/english/newsroom/press%20releases/default.asp?s=1&releaseID=160 

Dirix LY,

Cardiac Stress Response: The Use of Anesthetic Technique to Promote Positive Outcome; Analyzing the Pros and Cons of Technique

Cardiac surgery by nature elicits a powerful stress response resulting from activation of stress hormones including epinephrine, norpinephine and cortisol hormones among others. Surgical trauma and blood loss may contribute to this stress response. Some surgeons have suggested that cardio pulmonary bypass surgery in and of itself activates an inflammatory response that results in a stress reaction.

The role of the anesthesiologist in cardiac surgery is to as much extent as possible, to reduce the stress response that results form cardiac surgery. Stress response can be mitigated by a variety of anesthetic technique, including use of opioids and epidural anesthesia. These ideas are explored in greater detail below.

Cardiac Stress Response: The Use of Anesthetic Technique to Promote Positive Outcome; Analyzing the Pros and Cons of Technique

INTRODUCTION stress response may…

Bibliography

Cook, Richard I. "Adapting to New Technology in the Operating Room." Human Factors, Vol. 38, 1996.

Cook, R.I., Woods, D.D., Howie, M.B., Horrow, J.C. & Gaba, D.M. (1992). "Unintentional delivery of vasoactive drugs with an electromechanical infusion device." Journal of Cardiothoracic and Vascular Anesthesia, 6, 238-244.

Cuschieri, R.J., Morran, C.G., Howie, J.C., & McArdle, C.S. (1985). "Postoperative pain a dpulmonary complications: comparison of three analgesic regimens." British Journal of Surgery, 72, 495-499.

Glaser, J., Kiecolt-Glaser, MacCallum P., Marucha, P., & Page, G. "Psychological Influences on Surgical Recovery: Perspectives from Psychoneuroimmunology." American Psychologists, Vol. 53, 1998.

Alcoholic Liver Disease

CAUSES AND IMPACT

Causes, Incidence, Risk Factors, Impact

Alcohol use has been linked with liver disease mortality and increased social and economic costs (NCI, 2014; ruha et al., 2009). Most recent statistics say that disorders in alcohol consumption afflict millions of people worldwide. The incidence has been increasing along with increasing alcohol consumption. Alcohol liver disease takes the form of acute alcoholic hepatitis and chronic liver disease, such as steatosis, steatohepatitis, fibrosis and cirrhosis. Seriousness and prognosis depend on the amount consumed, the pattern of drinking and the length of time of consumption, the presence of liver inflammation, diet and nutritional and genetic disposition. While steatosis is virtually benign, morbidity and mortality are both high in liver cirrhosis. Survival rate for advanced cirrhosis is 1 to 2 years and 50% mortality risk for those with severe acute alcoholic hepatitis have as much as 50% mortality (NCI, 2014).…

BIBLIOGRAPHY

Bruha, R., et al. (2009). Alcoholic liver disease. Vol. 110 # 3m Prague Medical Report:

PubMed Central. Retrieved on April 6, 2014 from  http://www.ncbi.nlm.nih.gov/pubmed/19655694 

EASL (2012). EASL clinical practical guidelines: management of alcoholic liver disease. Vol. 51 # 1, Journal of Hepatology: European Association for the Study of the liver. Retrieved on April 6, 2014 from  http://www.easl.eu/assets/application/files/5e1b5512fb2cabb_file.pdf 

Frazier, T.H. (2011). Treatment of alcoholic liver disease. Vol. 4 # 1, Therapeutic

The brain while expanding pushes the skull outward in the same perpendicular to the closed structure. This will be marked by the occurrence of 'papilledema' 'pseudoproptosis' as also 'optic atrophy.' (39) This results in the orbital socket being smaller and the eyes getting 'protoposed'. The intercranial pressure is bound to be high. The symptoms in such cases will be optic atrophy, head ache and papilledema. Or in the case of 'Crouzon's disease' where occurs a marked hooked nose and a frontal lobe which makes the disease also called the parrot head disease. Surgery in both these types of situations become mandatory as the result of the cranial pressure could result in death. (39)

egarding the facial surgery discussions always centre on perfecting features and cosmetic changes. The debate must rather be on the goals of the surgery and the overall benefits that can accrue to the patient in terms of…

References

1. Buncke HJ. Facial Paralysis - Reanimation. California Pacific Medical Center. [online]. 2007 [cited 2008 Feb 16]. Available from: URL:

 http://www.cpmc.org/advanced/microsurg/procedures/facial-animation.html 

2. Sataloff J, ThayerSataloff R. Occupational Hearing Loss. CRC Press. 2006.

Kim JYS, Bienstock a, Ketch L. Facial Nerve Paralysis, Dynamic Reconstruction. [online]. 2007 [cited 2008 Feb 16]. Available from: URL:

People die each year of cardiac related health problems. Some die of heart attacks and others of congestive heart failure and so forth. This research proposal highlights five peer reviewed journal articles that show how to improve, step-by-step, the infrastructure of a hospital cardiac program. Quantitative data from the studies along with in-hospital data will reveal the need for quality improvement as well as how successful certain methods are when implemented among specific populations. Information was gathered through the search engine Google Scholar and PubMed. All articles are less than four years old and reveal ways to not just improve the safety and care of patient's but also how to improve surgical outcomes and enhance IT infrastructure, all of which are essential to running a great hospital cardiac program.

Introduction

Several patients in (Hospital Name) have come in complaining of cardiac related health problems. Some have had issues with cardiothoracic…

References

Elliott, M.J. (2012). The role of information in ensuring quality and patient safety. Progress in Pediatric Cardiology, 33(1), 5-10. Retrieved from  http://www.sciencedirect.com/science/article/pii/S1058981311000853 

Grace, S.L., Poirier, P., Norris, C.M., Oakes, G.H., Somanader, D.S., & Suskin, N. (2014). Pan-Canadian Development of Cardiac Rehabilitation and Secondary Prevention Quality Indicators Endorsed by the Canadian Association of Cardiac Rehabilitation. Canadian Journal of Cardiology, 30(8), 945-948. Retrieved from  http://www.sciencedirect.com/science/article/pii/S0828282X14002335 

Guillamondegui, O.D., Gunter, O.L., Hines, L., Martin, B.J., Gibson, W., Clarke, C., Cecil, W.T. (2012). Using the National Surgical Quality Improvement Program and the Tennessee Surgical Quality Collaborative to Improve Surgical Outcomes. Journal of the American College of Surgeons, 214(4), 709-714. Retrieved from  http://www.sciencedirect.com/science/article/pii/S1072751511013287 

IEEE Conference on Software Engineering Education and Training, & IEEE Computer Society. (2011). Educating software engineers of the future: Software quality research through problem-based learning. In CSEE&T 2011: Proceedings (pp. 91-100). Los Alamitos, California: IEEE.

Improving Surgical Outcomes Using the Perioperative Dialogue Model

The estimated $8.5 to $17 billion lost to surgical errors in 1999 was not primarily due to individual incompetence, but to the failure of perioperative systems to operate seamlessly (reviewed by Plasters, Seagull, and Xiao, 2003). The successful management of an operating-room depends heavily on effective communications, but in the absence of a foolproof system for keeping abreast of changes in patient status or surgery schedules, miscommunication is not as rare as it should be.

An important component of the perioperative surgical team is the duties performed by the perioperative nurse (PN), who typically functions as a patient advocate before and during surgery (reviewed by Lee, Kerridge, Chui, Chiu, and Gin, 2011). In Sweden, surgical nursing care has begun to emphasize the importance of a perioperative dialogue between the patient and the PN (eviewed by Lindwall and von Post, 2008). Under the…

References

Kehlet, Henrik and Wilmore, Douglas W. (2002). Multimodal strategies to improve surgical outcome. American Journal of Surgery, 183, 630-641.

Lee, Anna, Kerridge, Ross K., Chui, Po Tong, Chiu, Chun Hung, and Gin, Tony. (2011). Perioperative systems as a quality model of perioperative medicine and surgical care. Health Policy, 102, 214-222.

Lindwall, Lillemor and von Post, Irene. (2009). Continuity created by nurses in the perioperative dialogue -- a literature review. Scandinavian Journal of Caring Sciences, 23, 395-401.

Plasters, Cheryl L., Seagull, F. Jacob, and Xiao, Yan. (2003). Coordination challenges in operating-room management: An in-depth field study. AMIA Annual Symposium Proceedings, 524-528.

Temporomandibular Joint Surgery: A Comparison

Between Arthrocentesis And Arthroscopic Approaches

Background and Historical Perspective:

Temporomandibular Syndrome is a somewhat general descriptive term comprising several distinct pathologies, all related to the various structures of the temporomandibular joint. TMJ symptomatology ranges from general myofascial discomfort which can often be addressed by conservative (non-invasive) approaches to profoundly pathological interarticular mechanical malfunctions requiring extensive surgical repairs.

In general, the vast majority of TMJ symptoms are temporary in duration and resolve either spontaneously, or with conservative treatment consisting of rest, anti- inflammatory agents, muscle relaxants, physical therapy, dental devices and/or bite adjustments, behavior modification and external application of thermal compresses.

A comprehensive evaluation is essential to accurate diagnosis, particularly since stress management problems and repressed aggression sometimes manifest as myofascial pain.

Surgical intervention should therefore always be considered as a last resort and limited to intracapsular pathology associated with significant pain and mechanical malfunction. Where…

9. Sanders B: Arthroscopic management of internal derangements of the temporomandibular joint. Oral Maxillofacial Surgical Clinic North America 1994; 6:259-269

10. Sanders B: Arthroscopic management of internal derangements of the temporomandibular joint. Oral Maxillofacial Surgical Clinic North America 1994; 6:259-269

11. Kuwahara T, Bessette RW, Maruyama T (1994). A retrospective study on the clinical results of temporomandibular joint surgery. Cranio 12:179-183

However, recently, anesthesiologists have suggest a low to mid thoracic epidural combined with adequate general anesthesia. This anesthetic technique will allow for adequate inter-operative monitoring. After the operation, the anesthesiologist must continue to monitor the patient for either hypertension, hypotension and hypoglycemia. The presence of either of these conditions may alter the course of the medication given to the patient once the patient is removed from the anesthesia.

Respiratory System

Neurofibroma can cause systemic problems within the various components of the Respiratory System. As has already been presented, Neurofibromas can cause partial blockages within upper parts of the trachea. However, Neurofibromas can also pose challenges or the anesthesiologist when dealing with nasal, sinus or maxilofacial cavities with Neurofibromas present within. One example of how devastatingly complex the Neurofibroma can become is seen when a benign neurofibroma can cause a superior vena cava compression. Such was the case of a 21-year-old…

Does taking Metoprolol before cardiac surgery reduce the incidence of post-op atrial fibrillation
Abstract
Postoperative atrial fibrillation (POAF) remains a prevalent supraventricular arrhythmia. PoAF has associated effects such as deteriorating hemodynamic, increased risk of stroke and increased probability of death. Beta-blockers have been recommended as effective intervention mechanism of preventing PoAF. Metoprolol is one such beta-blocker that is commonly administered to prevent the incidence of PoAF. The systematic review below entails an analysis of six clinical trials that explore the effectiveness of metoprolol. The analysis identifies reduced hospitalization length, reduced mortality and reduced financial burden as the beneficial impact associated with the administration of prophylactic. The small number of studies reviewed limits the validity of the conclusion warranting future large sample size research.
Introduction
Annually, approximately 750,000 cardiac surgery are performed globally with postoperative atrial fibrillation (PoAF) being the prevalent complications (George, et al., 2018). With the increasing proportion of elderly population…

Medical Case Study

Florence (F) is a 43-year-old woman who is two days post-operative, following an appendectomy. She has a history of arthritis, and currently takes 10mg of prednisone daily. She is allergic to penicillin. She weighs 46 kg (101.5 lbs.) and is 168cm tall (5'6"). This puts her slightly underweight for her age and height, at least 18-25 pounds (Height and Weight Chart, 2010). While doing a route in dressing change, nurse notice a yellow discharge emanating from the wound.

Identify and discuss the importance of obtaining information during a nursing admission in relation to post- operative assessment. In modern healthcare, a nurse must first and foremost try to understand and utilize a systematic and synergistic model of data collection and assessment. Human beings are complex creatures, and the more data one has, the easier it will be to ensure that a proper diagnosis is made. A systematic assessment…

REFERENCES

Height and Weight Chart. (2010). HealthCheck Systems. Retrieved from:

 http://www.healthchecksystems.com/heightweightchart.htm 

Prednisone and Other Corticosteroids: Balance the Risks and Benefits. (2011). The Mayo

Clinic. Retrieved from:  http://www.mayoclinic.com/health/steroids/HQ01431

Stated to be barriers in the current environment and responsible for the reporting that is inadequate in relation to medical errors are:

Lack of a common understanding about errors among health care professionals

Physicians generally think of errors as individual that resulted from patient morbidity or mortality.

Physicians report errors in medical records that have in turn been ignored by researchers.

Interestingly errors in medication occur in almost 1 of every 5 doses provided to patients in hospitals. It was stated by Kaushal, et al., (2001) that "the rate of medication errors per 100 admission was 55 in pediatric inpatients. Using their figure, we estimated that the sensitivity of using a keyword search on explicit error reports to detect medication errors in inpatients is about 0.7%. They also reported the 37.4% of medication errors were caused by wrong dose or frequency, which is not far away from our result of…

Bibliography

Discussion Paper on Adverse Event and Error Reporting In Healthcare: Institute for Safe Medication Practices Jan 24, 2000

Patient Safety/Medical Errors Online at the Premiere Inc. page located at:  http://www.premierinc.com/all/safety/resources/patient_safety/downloads/patient_safety_policy_position_2001.doc 

Medstat / Shortell, S. Assessing the Impact of Continuous Quality Improvement on Clinical Practice: What It Will Take to Accelerate Progress.

Health Policy Monitor (2001) A Publication of the Council of State Governments Vol. 6, No. 1 Winter/Spring 2001 PO18-0101

For a fifty-seven-year-old man with a fairly unremarkable past medical history, surgery was recommended. Also, performing the surgery could have a positive impact upon his diverticulosis, urinary hesitation, Gerd, BPH (benign prostrate hyperplasia, or enlarged prostate) and mild anemia. A surgery to correct the inguinal hernia had been successfully performed in 1998 without incident, as did the patient's other surgeries, including his varicose vein stripping done in 1987 and eye surgery in 1995.

During an inguinal hernia repair procedure, first, the surgeon makes an incision and separates the muscle and tissues to expose the hernia sac. The sac is cut open and the contents are replaced into the abdomen, the neck of the hernia sac is tied, and the muscles and tissues are sutured. During a laparoscopic procedure the procedure is performed through tiny incisions, using an instrument with a camera attached and a video monitor to guide the repair.…

Works Cited

Culvert, Lee L. (2004). "Inguinal Hernia Repair." Gale Encyclopedia of Surgery.

General Anesthesia Information." (2007). Surgery. Retrieved 15 Sept 2007 at  http://www.justbreastimplants.com/surgery/general_anesthesia.htm 

Goverman, Jeremy (23 Jan 2006). "Hernia" Medline Encyclopedia Online. Retrieved 15 Sept 2007 at  http://www.nlm.nih.gov/medlineplus/ency/article/000960.htm 

R'os, J. Rodr'guez, P. Munitiz, D. Alcaraz, P. Perez, Flores. (Sept 2001)."Parrilla using a prosthesis." Hernia. 5(3): 1265-4906 (Print) 1248-9204 (Online). http://www.springerlink.com/content/a04wbnfjp82v60t2/

Endovascular Laser and Microphlebectomy for Treatment of Varicose Vein

Venous insufficiency is a condition that affects hundreds and thousands of individuals each year, particularly women. Venous insufficiency often results in varicose veins, phlebitis and similar physiological conditions. In general these abnormalities are thought to result from a combination of gender and heredity among other things. Historically treatment for venous insufficiencies involved very aggressive and invasive surgery which stripped veins; this process resulted in a removal of the offending veins. Often the recovery time was in excess of two weeks, with patients often only minimally mobile.

Advances in technology and procedure however have resulted in a new minimally invasive procedure that combines the use of endovascular laser surgery and microphlebectomy to remove varicosities that occur below the knee (Pearce, 2003). The use of endovascular laser is limited primarily to the greater and minor saphenous veins, which are often implicated in venous…

Bibliography/References

Aetna. "Varicose Veins." Aetna. {Online} Retrieved April 11, 2004, Available: http://www.aetna.com/cpb/data/CPBA0050.html

Anwar, S, Shrivastava, V, Welch M, al-Khaffaf H. Subfascial endoscopic perforator surgery: A review. Hosp Med. 2003; 64(8): 479-483

Arnoldi CC. The aetiology of primary varicose veins. Dan Med Bull 1957; 4: 102-107.

Belcaro, G., Nicolaides, AN, Ricci A, et. al. Foam scleropathy, surgery, sclerotherapy and combined treatment for varicose veins: A 10-year, prospective, randomized, controlled trial (VEDICO Trial). Angiology. 2003; 54 (3): 307-315

Sampling method -117 patients with primary breast cancer; all who had same-day surgery as part of their treatment.

Appropriateness of sample -- Appropriate for circumstances under consideration.

Results (when applicable: credibility, transferability, dependability, & conformability)

Study found significant differences between the control and experimental group in terms of post-surgery mood, confusion, tension, and home management.

Ethical considerations -- All ethical considerations; privacy, etc. followed- professional study.

Relative strengths of each publication -- Peer reviewed strong work and sense of issues surrounding pain, fatigue and emotional disturbances after surgery.

Relative weaknesses of each publication -- Larger sample than previous study, but still limited in scope, demographics, psychographics and geographic extrapolation.

Application of each article in nursing practices -- Using any intervention that helps patient's after a traumatic surgery is helpful; especially if that patient can ventilate their emotions, angst, and stages of healing. Short-term telephone intervention using the AFSMI technique proves…

Yarbo, C., Wujcik, D., Holmes-Gobel, B. (2010). Cancer Nursing: Principles and Practices.

Philadelphia, PA: Jones and Bartlett Learning.

5 | Page

" Orthopedic Nursing. 19 (1); 71-82.

1. 1. What data was collected in this study? How was the data analyzed? Data from 24 patients who were admitted for primary hip replacement was collected. Participants were assessed for functional status using standard modification; mobility assessed, as well as general medical issues. Data was analyzed using the 1975 Sickness Impact Profile, a standard explanatory measurement within the field.

7. 2. Summarize the results of the study in your own words -- remember that results are the findings based on analysis of the data. The study found that functional status improved between pre and post-operative states in patients who underwent total hip replacement surgery. This also included basic mobility and movement. No real relationship was established regarding the patient's pain, however.

8. 3. What findings from this study were based on descriptive statistics? List them below.

Patients asked to rate (describe) themselves on…

Medical Care Services

The current delivery of health care services represents one of the most important subjects for discussion both in the Obama Administration as well as the epublican one and the Administrations that preceded the Bush one. egardless of political color, it must be pointed out that the health care system in the United States does not only depend on the ideological orientation, but also on the people and their own beliefs in terms of human action and interaction. It is a clear fact that "Ten years ago, the U.S. healthcare system was declared "broken," and it has not improved. Fixes promised by managed care have not materialized. Premiums are rising. Hassles for patients and physicians abound. Nearly 45 million Americans are uninsured." (Garson, 2000)

One of the most severe problems facing the health care system in the United States is the discussion that is being held between those…

References

Garson, Arthur. "Current Perspective. The U.S. Healthcare System 2010. Problems, Principles, and Potential Solutions" 2000. Available at  http://circ.ahajournals.org/content/101/16/2015.full#sec-7 

ImpediMed. "Pre-emptive vs. Reactive Models of Care: Pre-emptive Care Model Prospectively Managing Lymphedema in Breast Cancer Patients" 2012. Available at  http://www.impedimed.com/knowledge-center/health-insurance-providers/pre-emptive-versus-reactive-models-of-care.htm 

Yale School of Medicine. "The PA Profession." 2013. Available at  http://medicine.yale.edu/pa/profession/index.aspx

Education Project Proposal (Nursing)

This study is intended to educate the patients (within the age group of 8-12) about the post operative treatment approaches and to prepare them to face the situation. As the main audience is the pediatric patients who have gone trough a kidney transplant, we will focus on the recovery issues with respect to this audience. This study will help these patients to learn about the general issues related to recovery of their wounds, the nutrition they are supposed to adopt during the recovery stage and the physical activity that is expected to be maintained by them. This educational activity is important for the patients because a thorough understanding of the recovery process is very important for the patient.

With an understanding of the process the patient will be able to cooperate with the nursing staff and will more actively participate in the process. From this program,…

References

Barbara A. Nilsen: Week by Week: Plans for Observing and Recording Young Children: Delmar Learning, January 1997

Evelyn A. Petersen: Practical Guide to Early Childhood Planning, Methods and Materials, A: The What, Why and How of Lesson Plans: Allyn & Bacon, November 1995

Linda M. Bambara & Tim Knoster: Designing Positive Behavior Support Plans: Amer Assn Mental Retardation: January 1998

Barbara Stevens Barnum: Teaching Nursing in the Era of Managed Care: Springer Publication Company, March 1999

Barriers and Facilitators

Effectiveness, Barriers and Facilitators of Using Computerized Charting in the Operating oom

The world is surging ahead with technological boom which is leaving its indelible imprints on almost all the facets of human life. Healthcare is also one of the significant sectors in which medical technology is advancing to provide better diagnostic techniques, examining facilities, and treatment procedures. These technological developments mainly encompass the equipments used in diagnosis and treatment, medical services offered by the healthcare sector, knowledge regarding different branches of biology and medicine, and so forth. However, the growing usage of information technology holds a prime position amongst all (Lorenzi, 2005).

Computerized systems in healthcare are gaining immense limelight in the current epoch; however, it has considerably assisted in provision of improved and efficient surgical services to patients in operating rooms. Computerized information system, specifically the one used for the purpose of administering surgeries, largely…

References

Lorenzi, N.M. (2005). Transforming health care through information. Second Edition. USA: Springer.

Maurer, P.R. (2013). They Do Well Who Do Good. Second Edition. USA: Trafford Publishing.

Nelson, R. & Staggers, N. (2013). Health Informatics: An Interprofessional Approach. USA: Elsevier Health Sciences.

Vacanti et al. (2011). Essential Clinical Anesthesia. First Edition. USA: Cambridge University Press.

The dependent variable was a measure of stress by virtue of physiological responses. Those variables were perfectly chosen for the study topic.

Hypothesis

The hypothesis was that exposure to music during the immediate pre-operative period would correspond to a reduction in stress in the experimental group as compared with the control group. This hypothesis is perfectly appropriate and capable of empirical testing for substantiation or non-substantiation.

Sampling, Research Design, and Data Collection Methods

The sample size was very small and acknowledged as an inherent limitation of the study. Other limitations included the use only of subjects scheduled for minor arthroscopic surgery and the fact that subjects could have changed their responses to please the researchers. The research design and collection methods were appropriate in that they utilized and collected objective physiological data that are generally relevant to stress. However, that design presumed that (1) the specific data collected necessarily corresponded…

For candidates not considered good prospects for conventional LASIK because of extreme nearsightedness and who are leery of the long recovery period of PRK, phakic intraocular lenses can be implanted. "In these cases, a phakic intraocular lens may be used. This lens is implanted inside the eye and can effectively treat nearsightedness up to -20 diopters" (Randleman & Payne 2010, p.4). Intracorneal rings (thin plastic segments) implanted into the peripheral cornea to flatten the cornea can be used for individuals wary of the side effects of the surgery. hile visual recovery is less predictable with the intracorneal rings, the procedure has the advantage of being reversible. However, it is only able to correct up to -3 diopters of myopia (Randleman & Payne 2010, p.4).

Because it is not considered necessary surgery, and because the conditions it is designed to treat can be corrective with less expensive glasses and contacts, most…

Works Cited

Boyles, S. "LASIK Surgery: Safer than contacts?" WebMD. 2006. May 15, 2010.

 http://www.webmd.com/eye-health/news/20061010/lasik-surgery-safer-than-contacts 

Cloud, Daniel. "Perfect vision is helping." 'The New York Times. June 6, 2006.

May 15, 2010.  http://www.nytimes.com/2006/06/20/us/20eye.html?fta=y

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.…

As with any other type of surgery, whether considered minimally invasive or major surgery complications can arise. Under the supervision of the physician, the nurse will be responsible for most of the perioperative care of the patient. As a result, the nurse must be aware of any and all complications that may arise and must also know how to assist the patient with treatment and management of these medical issues. Some of the common complications that transapical aortic valve implantation patients experience and how they should be treated are as follows:

Allergic reaction to contrast material -- Patients should always be screened for allergies beforehand, but if an allergic reaction should occur, the nurse should administer steroids, antihistamines and other airway protection measures.

Infection -- Prescreening should always take place before the procedure. A complete history of the patient's health should be documented along with a dental infections or conditions.…

Bibliography

McRae, Marion E., Rodger, Marnie, and Barbara A. Bailey. (2009). Transcatheter and transapical aortic valve replacement. Critical Care Nurse, 29(1), 22-37.

Walther, Thomas et. al, (2009). Transapical aortic valve implantation: Step-by-step. The Annals of Thoracic Surgery, 87, 276-283.

A newer and easy test is the OSOM Vlue, which mixes a swabbed specimen from the vagina with a reagent. The test yields sialidase activity or presence in the vaginal fluid in 10 minutes. Sialidase is produced by V pathogens (Mashburn).

pH Level

The most reliable criterion for detecting V is a pH>4.5 (Mashburn, 2007). A normal pH should, therefore, rule out V. A pH >4.5 can also indicate trichomoniasis or muco-purulent cervicitis. Vaginal inflammation more strongly suggests trichomonas or muco-purulent cervicitis, in turn associated with gonorrhea or chlamydial trachomatis (Mashburn).

The patient's pH level is 6, indicating V.

Wet Smears

These are an inexpensive and relatively easy screening procedure for the most common sexually transmitted diseases, such as V (Iglesias, Alderman & Fox, 2000). The practitioner should be appropriately trained and experienced in using this procedure. Hence, the proper protocol and quality control are needed to insure accurate diagnosis.…

BIBLIOGRAPHY

Alfonsi, G.A.; Cshlay, J., and Parker, S. (2004). What is the best approach for managing

Recurrent bacterial vaginosis? Journal of Family Practice: Dowden Health Media,

Inc. Retrieved on July 7, 2009 from  http://findarticles.com/p/articles/mi_m0689/is_8_53/ai_n6169486/?tag=content;col1 

Brown, M (2007). Treating a case of bacterial vaginosis -- case study. Health and Republic News: Health Republic. Retrieved on July 12, 2009 from  http://www.healthcarerepublic.com/res/clinical/article/572868/treating-case-bacterial-vaginosis

Hip dysplasia in children [...] nursing care and considerations of the child with congenital or developmental hip dysplasia. Hip dysplasia occurs actually quite commonly in infants and children all over the world. There are some special considerations nurses should use when caring for these patients, including recognizing the early symptoms of hip dysplasia in infants and children, and fully understanding the treatment necessary to help the family cope with the disease. Treating and diagnosing children is often much more difficult than diagnosing and treating older patients who can communicate more effectively, so the nurse must be patient, cognizant, and highly aware of the disease, its indicators, and its treatment.

Hip dysplasia in infants and children used to be known by two terms, developmental dysplasia of the hip (DDH), or congenital dislocation of the hip (CDH). However, today, most professionals refer to the condition as DDH. Hip dysplasia occurs when the…

References

Author not Available. (2004). Developmental hip dysplasia in children. Retrieved from the Drugs.com Web site:  http://www.drugs.com/CG/DEVELOPMENTAL_HIP_DYSPLASIA_IN_CHILDREN.html13  Sept. 2004.

Berant, Moshe. (1999). Developmental dysplasia of the hip: A new approach to incidence. Pediatrics; 1 Jan. 1999.

D'Alessandro, Donna, M.D. And Huth, Lindsay. (2002). DDH (Developmental dysplasia of the hip). Retrieved from the Virtual Children's Hospital Web site:  http://www.vh.org/pediatric/patient/pediatrics/cqqa/ddh.html13  Sept. 2004.

Dietz, Frederick R. (1999). Screening for developmental dysplasia of the hip. American Family Physician; 1 July 1999.

Falls

THE ISSUE OF ACCIDENTAL FALLS

At some point, anyone who had learned how to walk has had the experience of falling down -- it is a universal experience for infants as they gain ambulatory ability. In hospitals, however, the accidental fall is the most reported type of patient safety incident, with elderly patient populations displaying a particular vulnerability (Oliver 2007, p.173). Approximately one-third of adults over the age of sixty-five will experience an accidental fall this year (CDC 2012, n.p.) Fischer (2005) offers some clarification as to how these incidents should be defined -- the simplest basic definition is "a sudden, uncontrolled, unintentional, downward displacement of the body to the ground or other object" (p822). This definition takes into account the unpredictable nature of the incident, and the fact that it frequently involves a certain loss of control on the part of the patient; it also reminds us that…

References

CDC (2012). Adult falls. Web. Accessed at: http:/ / www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.htm

Currie, LM. (2006). Fall and injury prevention. Annual Review of Nursing Research. 24(1):39-74.

Fischer ID; Krauss MJ; Dunagan WC et al. (2005). Patterns and predictors of inpatient falls and fall-related injuries in a large academic hospital. Infection Control and Hospital Epidemiology. 26(10):822-7.

Grubel, F. (1959) Falls: A principal patient incident. Hosp Manage. 88:37-8.

Health Organization Case Study

The mission of Banner Healthcare is to make a difference in the lives of people through excellent patient care. They achieve this by providing leadership for excellence in patient safety and clinical care. Traditionally, healthcare institutions focused on analyzing aggregate performance, questioning causation, monitoring scorecards and identifying gaps. Planning and managing stages at integral to the process of achieving Banner Healthcare's vision. Planning entails the development of standards, rules, and work teams necessary for the work. Concurrent management involves patient-oriented care and coordinated health care. Across the various work teams, care management efforts and the number of people are involved in making clinical improvements across the organization have been gradually increasing.

This occurs regardless of whether they are work groups, system wide teams, strategic initiatives, and special projects. The work is organized under functional teams. Besides the functional teams, initiative work groups and clinical consensus groups…

Reference

Wickramasinghe, N. & Sharma, S.K. (2010). Creating knowledge-based healthcare organizations. Hershey Penns: Idea Group Pub.

That nurse must go deeper than the superficiality of "nursing helps people maintain health (Nursing Philosophy it Matters, 2012).

"The fight against post-operative wound infections has long been undertaken by practitioners. We appreciate that surgical site infections (SSIs) are frequently caused by bacteria commonly found on the skin. Therefore, reducing the number of bacteria on the skin has been a common preoperative practice. Standards and recommended practices from the Association of periOperative egistered Nurses (AON) state preoperative skin preparation of surgical patients should include little or no hair removal, cleansing of the area around the surgical site, and use of an antiseptic agent immediately before the surgical incision" (amsey, 2012).

The clinical implications of this practice might be to shave or clip the hair before surgery but there is no evidence that it does or does not reduce infections. It is done to make sure there are no possible infections…

References

Finkelstein, D.K. (2012, November 28). Surgical Shaving.

Ramsey, C.A. (2012). Preoperative Measures to Prevent Surgical Site Infections. Retrieved November 28, 2012, from Preoperative Measures to Prevent Surgical Site Infections

Shaving the Surgical Area. (n.d.). Retrieved November 28, 2012, from http://micro-reversals.com/shaving-the-scrotum/

Tanner J, N.P. (2011). No evidence that routine preoperative hair removal reduces surgical site infection. Retrieved November 28, 2012, from  http://summaries.cochrane.org/CD004122/no-evidence-that-routine-preoperative-hair-removal-reduces-surgical-site-infection

In addition to the key point that intubating is an unnecessary and undesirable step in the handling of a pyeloplasty, Sarin et al. reveal something which may be seen as a serious obstacle in the face of what can ultimately be a problematic health concern. There is a strength in the study's design where the support of its hypothesis is concerned, with the comparison of control and experimental groups serving almost as secondary to the aim of simply establishing the absence of need for the process of intubating. Still, there is a weakness in the study's failure to obtain numerically comparable sample groups. With only four subjects of the 24 being intubating, the resultant 75% infection rate here may not tell the full story.

Still, the study's value to the nursing profession is quite clear, denoting that where they pyeloplasty is concerned, the practicing nurse may diminish the threat of…

According to the 2006 article by Sarin et al., traditional perspective and procedure on how best to accommodate the post-operative needs of infants suffering from pelviureteric junction obstruction is being shown to have flaws. Particularly, the article highlights the fact that, in cases where this obstruction to the drainage of renal fluid may exist, the traditional use of intubating or stent drainage of said fluid following the necessary pyeloplasty procedure is not only unneeded but also can diminish recovery opportunity. In a study which ultimately featured the experiences of 24 infants undergoing pyeloplasty procedures, Sarin would find that a significant set of evidence exists to indicate that intubated patients will undergo a longer recovery period and will likewise be more vulnerable to the onset of possible urinary tract infection or kidney infection.

In addition to the key point that intubating is an unnecessary and undesirable step in the handling of a pyeloplasty, Sarin et al. reveal something which may be seen as a serious obstacle in the face of what can ultimately be a problematic health concern. There is a strength in the study's design where the support of its hypothesis is concerned, with the comparison of control and experimental groups serving almost as secondary to the aim of simply establishing the absence of need for the process of intubating. Still, there is a weakness in the study's failure to obtain numerically comparable sample groups. With only four subjects of the 24 being intubating, the resultant 75% infection rate here may not tell the full story.

Still, the study's value to the nursing profession is quite clear, denoting that where they pyeloplasty is concerned, the practicing nurse may diminish the threat of complication or infection by foregoing the intubating drainage process.

The first reference to the practice of acupuncture is found in the 4,700-year-old Yellow Emperor's Classic of Internal Medicine, the oldest medical textbook in the world, which was itself a chronicle of much earlier practices to treat circulation, pulse, and heart-related conditions (Singer, 2007). Acupuncturists can use as many as nine types of needles today, though only six are commonly used. These needles vary in length, width of shaft, and shape of head (Singer, 2007).

Preclinical studies have documented acupuncture's effects, but they have not been able to fully explain how acupuncture works within the framework of the estern system of medicine that is commonly practiced in the United States, as estern medicine does not believe in the concept of energy blockage or ying and yang. Various theories as to acupuncture's efficacy have been proposed, including the theory that it stimulates pain-killing endorphins, encourages the release of neurotransmitters that promote…

Works Cited

Acupuncture." (2007). NIH/NCAM Official Website. Page last modified 7 Aug 2007.

NCCAM, National Institutes of Health. Retrieved 7 Sept 2007 at http://nccam.nih.gov/health/acupuncture/

National Institutes of Health and the National Center for Complementary and Alternative

Medicine. (2007). Official Webpage. Retrieved 7 Sept 2007 at http://nccam.nih.gov/

Learning Objectives:

In support of the Terminal Objective, several key learning objectives will drive the content and curriculum for nurses undergoing the present training course. Primary among them, the training course is designed to create a standardized set of behaviors amongst nurses that conform with existing and evolving best practices in the perioperative care of CABG patients. This means that course content and design will be geared toward achieving procedural and professional consistency amongst attending nurses where preoperative, intraoperative and postoperative care are concerned.

An additional learning objective is to ensure that outgoing students are informed in the ethical and personal dimensions of the profession. Coronary surgical procedures are inherently serious in nature as are the heart and circulatory conditions that typically require such procedures. Therefore, it is of critical importance that nurses are trained in the proper bedside manner to approach patients, families and extended support systems with potentially…

Works Cited:

Aroesty, J.M. (2010). Patient information: Recovery after coronary artery bypass graft surgery (CABG). Up To Date, 19(2).

Cleveland Clinic (CC). (2011). Diseases and Conditions. my.ClevelandClinic.org.

Kulick, D. & Shiel, W.C. (2011). Coronary Artery Bypass Graft Surgery. MedicineNet.com.

National Heart Lung and Blood Institute (NHLBI). (2010). What is Coronary Artery Bypass Grafting. National Institute of Health.

Plastic Surgery

Teen Plastic Surgery: A Controversial Medical Practice

According to the American Society of Plastic Surgeons, in 2007, more than 87,000 teenagers had cosmetic surgery; and that number has grown exponentially since. Although aesthetic cosmetic surgery is popular amongst United States teens, physicians and plastic surgeons worry that such invasive surgery on teens' still growing bodies can be dangerous. Other developed countries, including Germany and Australia, are considering banning all but medically necessary plastic surgery for anyone under the age of 18. However, the question remains, if such a measure were taken like that in the United States for minors stem the tide of teenagers going under the knife? This paper will address the controversy associated with teenagers and aesthetic cosmetic surgery in the United States, and the business of plastic surgery for teens, from a legal, ethical, and social responsibility standpoint.

Introduction

In a country, and dare say…

References

Ali, K., & Lam, T. (2008). Teens under the knife: Is plastic surgery too dangerous for teens? Current Events, 108(1), 7-14.

American Society for Aesthetic Plastic Surgery (2003). National totals for cosmetic procedures. Cosmetic Surgery National Data Bank.

www.surgery.org/download/2003-stats.pdf:10. Accessed 25 July, 2011.

Bourdieu, P 1977, Outline of a Theory of practice, Cambridge University Press, Cambridge.

Military Application of Tranexamic Acid in Trauma Emergency esuscitation

This is an article that reviews military use of tranexamic acid in cases of resuscitation in the instance of a trauma emergency.

Scular disturbance with concomitant bleeding is one of the main death causes in military and civilian trauma. Experience from Afghanistan and Iraq wars has caused developments in resuscitation of hemorrhage victims, with the use of optimum blood component ratio identification (Morrison, et.al, 2012). The new approaches involved balanced and early delivery of packed BCs (red blood cells), FFP (fresh frozen plasma), cryoprecipitate and platelets to restore clotting factor 6 and circulating volume. Notwithstanding these developments, the usefulness of a treatment to reduce hemorrhagic shock related mortality is yet to be established.

The Problem

As a result of wars in Iraq and Afghanistan, there has been a need to find advances towards revitalization for hemorrhagic shock. Optimal blood ratio components…

References

Additional Information

Morrison, J., Dubose, J., Rasmussen, T., & Midwinter, M. (2012). Military Application of Tranexamic Acid in Trauma Emergency Resuscitation (MATTERs) Study. Achieves of Surgery, 147(2). Retrieved, from http://118.139.163.84:8088/2161431/Article_2.pdf

Fault: An Alternative to the Current Tort-Based System in England and Wales

The United Kingdom

statistics regarding claims

THE NATIONAL HEALTH SYSTEM

OBSTACLES TO DUE PROCESS

THE CASE FOR REFORM

THE REGULATORY ENVIRONMENT

THE RISING COST OF LITIGATION

LORD WOOLF'S REFORMS

MORE COST CONTROLS

THE UNITED STATES

PAUL'S PULLOUT

THE INSURANCE INDUSTRY

TORT REFORM IN AMERICA

FLEEING PHYSICIANS

STATISTICS FOR ERROR, INJURY AND DEATH

THE CALL FOR REFORM IN 2003: A FAMILIAR REFRAIN

THE UNITED STATES SITUATION, IN SUMMARY

NEW ZEALAND CASE STUDIES

THE SWEDISH SCHEME

COMPARISON: WHICH SYSTEM IS BETTER?

FIRST: UNDERLYING DIFFERENCES

TALKING TORT: AMERICAN PECULIARITIES

AMERICANS CONSIDER NO-FAULT

BRITAIN CONSIDERS NO-FAULT

CONCLUSION

Works Cited

Appendix A THE UNITED KINGDOM

INTRODUCTION

At issue is the economic effectiveness of tort law in the common law legal system of England and Wales, as applied to medical and clinical negligence and malpractice cases. In response to economic concerns and a continual…

Accounting Information for Decision Making

Corporate Confirming on Water isk (Feb 2010) indicates that the Global Confirming Initiative (GI) G3 Guidelines' five water-related indications (total withdrawal volume by source, ponds considerably impacted by distributions, percentage and total amount of water recycled and used again, total water discharge by quality and destination, and identification water physiques and related habitats impacted by discharges) make the perfect beginning point for assessing and confirming water risks. Within this section, we'll briefly discuss the relevance of all these standards (Power, 2010).

Total water withdrawal by source

Confirming the entire amount of water withdrawn by source adds for knowledge of the general scale of possible influences and threats connected using the company's water use. The entire volume withdrawn offers an indication from the organization's proper size and significance as a user of water and offers to set up a baseline figure for other information relevant to…

References

Task 1:

GRI, (Global Reporting Initiative). (2006) Sustainability Reporting Guidelines. Version 3.0, Accessed on September 27, 2012 from: www.globalreporting.org/NR/rdonlyres/ED9E9B36-AB54-4DE1-BFF2-5F735235CA44/0/G3_GuidelinesENU.pdf

Power, G. Paddling Upstream - Approaches to Corporate Water Reporting. Business and the Environment, 21. 6 (Jun 2010): 1-3.

Task 2:

Routine Shaving of the Surgical Site

Select a preoperative procedure (e.g., routine shaving of the surgical site) that you would commonly find on a surgical floor.

Describe the process or procedure you have chosen and why you think it needs change.

The process which I have chosen for surgical floor is routine shaving of the surgical site and I think it needs change because patients going through surgery are required to remove hair from the site of the cut. This is considered to reduce the chance of the surgical site becoming infected (National Collaborating Centre for omen's and Children's Health, 2008). Shaving, clipping the hair and using a cream which dissolves the hair are some of the different methods available to remove hair. And these are important because clinically, care plans offer a way to plan and communicate appropriate patient care.

A2. Based on your initial investigation of the situation,…

Works Cited

Collins, A.S. (n.d.). Preventing Health Care - Associated Infections. Retrieved October 30, 2012, from National Center for Biotechnology:  http://www.ncbi.nlm.nih.gov/books/NBK2683/ 

Graham, I.D., RN, J.L., Harrison, M.B., Straus, S.E., Tetroe, J., RN, W.C., et al. (2006). Lost in knowledge translation: Time for a map? Journal of Continuing Education in the Health Professions, 13-24.

Green, L.A., & Seifert, C.M. (2005). Translation of Reserch into Practice: Why we can't "Just Do It." PubMed, 541-545.

National Collaborating Centre for Women's and Children's Health. (2008, October). Surgical Site Infection: Prevention and Treatment of Surgical Site Infection. Retrieved October 29, 2012, from Nice.org.uk:  http://www.nice.org.uk/nicemedia/pdf/CG74FullGuideline.pdf

Pedagogic Model for Teaching of Technology to Special Education Students

Almost thirty years ago, the American federal government passed an act mandating the availability of a free and appropriate public education for all handicapped children. In 1990, this act was updated and reformed as the Individuals with Disabilities Education Act, which itself was reformed in 1997. At each step, the goal was to make education more equitable and more accessible to those with special educational needs. During the last presidential term, the "No Child Left Behind" Act attempted to assure that individuals with disabilities were increasingly mainstreamed and assured of high educational results. All of these legislative mandates were aimed at insuring that children with disabilities were not defrauded of the public education which has become the birthright of all American children. The latest reforms to IDEA, for example, provided sweeping reforms which not only expanded the classification of special…

ECMO

Extracorporeal Membrane Oxygenation is a procedure that allows for the oxygenation of a patient through the use of an external machine. Oxygen is required in order to keep a body healthy and alive. The definition of oxygenation is the amount of oxygen in the bloodstream of a patient. If the oxygen level drops below 90% a condition called hypoxemia occurs. Hypoxemia can be very serious and if not addressed within a short period of time can be fatal. Hypoxemia is diagnosed through cyanosis (the skin turning blue). Patients being treated with the EMCO procedure are usually longer-term patients (3-10 days) as compared to the short-term patients who receive a standard cadriopulmonary bypass which is a support that usually only lasts for a number of hours (not days).

Purpose

According to odriguez-Cruz et al. The purpose of the ECMO is "to allow time for intrinsic recovery of the lungs and…

References

Adhikari, N.K.; Burns, K.E.; Friedrich, J.O.; Granton, J.O.; Cook, D.J.; Meade, M.O.; (2007). Effect of nitric oxide on oxygenation and mortality in acute lung injury: systemic review and meta analysis, BMJ; Vol. 334, pp. 779.

Bastin, A.J. & Firmin, R.; (2011) Extracorporeal membrane oxygenation for severe acute respiratory for failure in adults: NICE guideance, Heart, Vol. 97, Issue 20, pp. 1701-1703

Berryman, S.; (2010) Extracorporeal membrane oxygenation in a Scottish intensive care unit, Nursing in Critical Care, Vol. 15, Issue 5, pp 262 -- 268

Brower, R.G. & Krishnan, J.A.; (2000) High frequency ventilation for acute lung injury or acute respiratory distress syndrome, Chest; Vol. 118, pp. 795 -- 807.

The lack of action over Rwanda should be the defining scandal of the presidency ill Clinton. Yet in the slew of articles on the Clinton years that followed Clinton's departure from power, there was barely a mention of the genocide."

The UN, pressured by the ritish and the U.S., and others, refused to use the word "genocide" during the event, or afterward when it issued its official statement of condemnation of the genocide in Rwanda.

Since that time, ill Clinton has said that Rwanda is one of his regrets of his presidency, but that he lacked the information to "fully grasp what was going on in Rwanda."

Reports to the UN and its member states, as reported by William Ferroggiaro (1995), online at http://www.gwu.edu/~nsarchiv/NSAE/NSAE119/index.htm, were based on reports via the Freedom of Information Act (FOIA), said that there was a "probability" of certain individuals and groups being responsible for certain…

Bibliography

Anderson, D.L. The Columbia Guide to the Vietnam War. Columbia University Press, New York, 2002. p. 232.

Brahimi. L, Report of the Panel on United Nations Peace Operations (2000), found at  http://www.un.org /' target='_blank' REL='NOFOLLOW'>

Economic Motivators for Employers on Employment ates for People With Disabilities in Atlanta

Qualitative esearch

Quantitative esearch

Definition of Disability

Statistics for Individuals with Disabilities

Effects Of ADA On Persons With Disabilities

Economic Motivators for Employers Hiring People with Disabilities

Factors Affecting Economic Motivators for Employers

Lack of Information and Knowledge egarding Economic Motivators

Misconception about Individuals with Disabilities

Inaccessible Hiring Strategies

Conflicts with Existing Programs

Lack of Appropriate Planning and Difficulties in implementations Economic Incentive Programs

Unemployment Among People with Disabilities

Summary

Conclusion

CHAPTE III: METHODOLOGY

Introduction

Qualitative esearch

Quantitative esearch

esearch Design

Variables

Selection of Participants

Complete description of the esearch Participants

Type of Sampling

Instrumentation 52

eliability 54

Validity 55

Appropriateness/rationale for use in the study 55

Ethical Consideration 56

Data Analysis 57

Qualitative esearch Analysis 57

Quantitative esearch Analysis 59

The esearcher's ole 60

Credibility 60

Dependability 60

Transferability 60

Conformability 61

Conclusion 61

CHAPTE IV:…

REFERENCES

Andrew, D. P. S., Pedersen, P. M., & McEvoy, C. D. (2011). Research Methods and Design In Sport Management. Champaign, IL: Human Kinetics.

Arthur, S., A. Corden, A. Green, J. Lewis, J. Loumidis, R. Sainsbury, B. Stafford, P. Thornton, & R. Walker, R .(1999). New Deal for disabled people: Early implementation, Research Report No 106, (UK) Department of Work and Pensions, Corporate Document Services, Leeds.

Ashworth, K., Hartfree, Y & Stephenson, A. (2001). Well, enough to work? Research Report No. 145, (UK) Department of Work and Pensions, Corporate Document Services, Leeds.

Baker, M. & Tippin, D. (2003). More than just another obstacle: Health, Domestic Purposes Beneficiaries, and the transition to paid work, paper presented at the Social Policy, Research and Evaluation conference Connecting Policy, Research and Practice, 29-30 April, Wellington.

Economic Motivators for Employers on Employment ates for People With Disabilities in Atlanta

Qualitative esearch

Quantitative esearch

Definition of Disability

Statistics for Individuals with Disabilities

Effects Of ADA On Persons With Disabilities

Economic Motivators for Employers Hiring People with Disabilities

Factors Affecting Economic Motivators for Employers

Lack of Information and Knowledge egarding Economic Motivators

Misconception about Individuals with Disabilities

Inaccessible Hiring Strategies

Conflicts with Existing Programs

Lack of Appropriate Planning and Difficulties in implementations Economic Incentive Programs

Unemployment Among People with Disabilities

Summary

Conclusion

CHAPTE III: METHODOLOGY

Introduction

Qualitative esearch

Quantitative esearch

esearch Design

Variables

Selection of Participants

Complete description of the esearch Participants

Type of Sampling

Instrumentation 50

eliability 52

Validity 53

Appropriateness/rationale for use in the study 53

Ethical Consideration 54

Data Analysis 55

Qualitative esearch Analysis 55

Quantitative esearch Analysis 57

The esearcher's ole 58

Credibility 58

Dependability 58

Transferability 58

Conformability 59

Conclusion 59

CHAPTE IV:…

REFERENCES

Andrew, D. P. S., Pedersen, P. M., & McEvoy, C. D. (2011). Research Methods and Design In Sport Management. Champaign, IL: Human Kinetics.

Arthur, S., A. Corden, A. Green, J. Lewis, J. Loumidis, R. Sainsbury, B. Stafford, P. Thornton, & R. Walker, R .(1999). New Deal for disabled people: Early implementation, Research Report No 106, (UK) Department of Work and Pensions, Corporate Document Services, Leeds.

Ashworth, K., Hartfree, Y & Stephenson, A. (2001). Well, enough to work? Research Report No. 145, (UK) Department of Work and Pensions, Corporate Document Services, Leeds.

Baker, M. & Tippin, D. (2003). More than just another obstacle: Health, Domestic Purposes Beneficiaries, and the transition to paid work, paper presented at the Social Policy, Research and Evaluation conference Connecting Policy, Research and Practice, 29-30 April, Wellington.

It is not unusual to see cochlear implant users experience improvement for several years after the surgery. Children often improve at a slower pace than adults. A lot of training is needed after implantation to help the child use their new hearing. Most are able to distinguish loud, medium and soft sounds without problem. People have reported that they can perceive different types of sounds, such as footsteps, slamming doors, sounds of engines, ringing of the telephones, barking of dogs, whistling of the tea kettle, rustling of leaves, and the sound of a light switch being switched on and off. There are many patients that report being able to understand speech without having to read lips. Many people can make telephone calls and understand familiar voices over the telephone. Some can even make normal telephone calls and understand an unfamiliar caller on the other end. Not all people who have…

Works Cited

Cochlear Implants. (2007). Retrieved July 6, 2009, from NIDCD Web site:

 http://www.nidcd.nih.gov/health/hearing/coch.asp 

Cochlear Implants. (2009). Retrieved July 6, 2009, from FDA Web site:

 http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProstheti

Figure 2: "Information System for Geography" (GIS)

2. The Map View: A GIS consists of a set of intelligent maps and other views depicting features and feature relationships on the earth's surface. Students can use GIS to support their queries, make analyses, and edit information. ith GIS, they can create maps of underlying geographic information and utilize the maps as "windows into the database," as noted by figures (3 & 4).

Figure 3 & 4: Intelligent Maps (GIS)

3. The Model View:

GIS is "a set of information transformation tools that derive new geographic datasets from existing datasets." (GIS) Students can use these geoprocessing functions to retrieve information from existing datasets. The GIS then applies analytic functions, and writes results into new derived datasets.

Figure 5: Example of a Derived Dataset (GIS)

hen students combine data and apply some analytic rules, they can create a model that helps answer questions…

Works Cited www.questia.com/PM.qst?a=o&d=5015493029

Alibrandi, Marsha, and Herschel M. Sarnoff. "Using GIS to Answer the 'Why's' of 'Where' in Social Studies." Social Education 70.3 (2006): 138+. Questia. 20 Mar. 2008  http://www.questia.com/PM.qst?a=o&d=5015493029 .

A www.questia.com/PM.qst?a=o&d=5000637589

Andrienko, Natalia, et al. "Testing the Usability of Interactive Maps in CommonGIS." Cartography and Geographic Information Science 29.4 (2002): 325+. Questia. 20 Mar. 2008  http://www.questia.com/PM.qst?a=o&d=5000637589 .

Environmental Program Takes Aim at Weeds: Townsend K-12 School District 1 / Montana." School Administrator Apr. 2007: 12. Questia. 20 Mar. 2008  http://www.questia.com/PM.qst?a=o&d=5020644157 .

2003, p. 247).

The use of NSAID has been associated with increased risks of gastrointestinal bleeding in unselected patients, approximately five-fold for musculoskeletal pain and two fold for secondary prevention of cardiovascular disease with low-dose aspirin (Clinical Guideline 17: Dyspepsia 2004). Therefore, depending on the level of pain management required, a simple analgesic that can be used for pain management is paracetamol; this preparation does not cause bleeding of the stomach and it has been found to be highly effective in relieving mild to moderate pain; furthermore, it can be purchased without a prescription from chemists and supermarkets (Henderson & Wood 2000).

Discussion of Health Education Advice Required.

The U.K. Department of Health recommends the following educational advice and support for people suffering from gastrointestinal bleeding:

Patients and their relatives should be offered as much information as they want. GPs should ask what they would like to know, and give…

Bibliography

Barve, S., Hill, D., Marsano, L.L., Mcclain, C.J., & Mendez, C. (2003). "Diagnosis and Treatment of Alcoholic Liver Disease and Its Complications." Alcohol Research & Health 27(3):247.

Dyspepsia: Management of dyspepsia in adults in primary care. NICE Clinical Guideline 17. [Online]. Available:  http://www.nice.org.uk/guidance/CG17/niceguidance/word/English .

Garcia, N., Jr., & Sanyal, a.J. (2001). "Portal hypertension." Clinics in Liver Disease, 5(2):509- 540.

Govoni, R., Mann, R.E., & Smart, R.G. (2003). "The Epidemiology of Alcoholic Liver Disease." Alcohol Research & Health 27(3):209.