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A respiratory therapist is someone who literally has the life of her patients in her hands. I have been fortunate this semester in being able to talk with people who chose this career. I even spent some time shadowing them at their job. I have known for a long time that I wanted a career in the health care field. Becoming a respiratory therapist sounded interesting. Now that I have talked with respiratory therapists and seen them at work, I am more certain than ever that this is the right path for me.
A respiratory therapist works under the supervision of an intensive care physician or pulmonary specialist. The job, basically, involves management of the patient's airway during trauma or intensive care. A respiratory therapist sometimes administers anesthesia, and may administer medication or medical gases. Respiratory therapists work in many settings, including hospitals, outpatient clinics, and even in…
Professions of caring career project: Where Am I Going? Part 2 Interview
Why did you decide to work in this field?
My grandmother had asthma, so I have always been acutely aware of the importance of the challenges some people experience with the simple act of breathing.
Did you have another career before you went to school to become a ____? What was it like to change from one career to another?
I did consider becoming a nurse at one point, and I worked in various doctor's offices before going to school to get my B.A. And my licensure in respiratory therapy.
Where did you go to school for this job? What was the hardest part of school for you?
I first got my Associate's degree from a local community college, before moving on to get my Baccalaureate. Then, I had to take my licensure exam to be…
Ely, E.W., et al. (1999). Large-scale implementation of a respiratory therapist-driven protocol for ventilator weaning. Vol 159 American Journal of Respiratory Critical
-(2001). Mechanical ventilator weaning protocols-driven by non-physician health-care professionals. Vol 120 Chest: Clinical Investigation in Critical
Harbrecht, .G., et al. (2009). Improved outcomes with routine respiratory therapist evaluation of non-intensive care unit surgery patients. Vol 54 # 7, Respiratory Care:
Daedalus Enterprises. Retrieved on November 23, 2012 from http://www.upmc.com/careers/pathways/allied-health/respiratory/Documents/ImprovedOutcomes_NICU_Patients.pdf
Hess, D.R.(1998). Professionalism, respiratory care practice and physician acceptance of a respiratory consult service. Vol 43 # 7, Respiratory Care: American Association
of Respiratory Care. Retrieved on November 23, 2012 from http://aarc.org/daz/rcjournal/rcjournal/x.RCJOURNAL.COM02.21.07/content
Kollef, M.H., et al. (2000). The effect of respiratory therapist-initiative treatment protocols on patient outcomes and resource utilization. Vol 117, Chest: Clinical
Investigations in Critical Care. Retrieved on November 23, 2012 from http://journal.publication.chestnet.org
Marelich, G.P., et al. (2000). Protocol weaning of mechanical ventilation…
CRTO (2011). Orders for medical care. Professional Practice Guidelines. College of Respiratory Therapies of Ontario. Retrieved on November 23, 2012 from http://www.crto.on.ca/pdf.PPG/OrdersMC.pdf
Ely, E.W., et al. (1999). Large-scale implementation of a respiratory therapist-driven protocol for ventilator weaning. Vol 159 American Journal of Respiratory Critical
-(2001). Mechanical ventilator weaning protocols-driven by non-physician health-care professionals. Vol 120 Chest: Clinical Investigation in Critical
2008).. This points to the ethical responsibility of nurse educators -- it is not enough to treat the disease, bit one must treat the patient.
Failure to provide the proper level of education to a patient is certainly one way to fail them both ethically and medically, bit the opposite can also be true. That is, it is possible to provide too much care -- what is deemed "medically futile care" -- and this also raises very serious ethical issues in the realm of respiratory illnesses (Sibbald et al. 2007). This particular stuffy found that insufficient communication among the medical team was one of the primary causes for prolonging futile care, which often means increasing and/or prolonging a patient's discomfort without any reasonable expectation of an improvement in their condition (Sibbald et al. 2007).
The ethical choice here, of course, is to end care (with the consent of the patient…
Efraimsson, E.; Hillverik, C. & Ehrenberg, A. (2008). "Effects of COPD self-care management education at a nurse-led primary health care clinic." Scandinavian journal of caring sciences, 22(2), 178-85.
Selecky, P.; Eliasson, A.; Hall, R.; Schneider, R.; Varkey, B. & McCaffree, D. (2005). "Palliative and end-of-life care for patients with cardiopulmonary diseases." Chest 128(5), pp. 3599-610.
shiao, J.; Koh, D.; Lo, L.; Lim, M. & Guo, Y. (2007). "Factors predicting nurses' consideration of leaving their job during the SARS outbreak." Nursing Ethics, 14(1), pp. 5-17.
Sibbald, R.; Downar, J. & Hawryluck, L. (2007). "Perceptions of 'futile care' among caregivers in intensive care units." Canadian medial association journal, 177(10), pp. 1201-8.
In Puerto Rico I was a licensed respiratory therapist. When I moved to America, the license that I held was not valid to allow me to continue that line of work. I deliberated whether or not I wanted to pursue a respiratory care degree so as to return to this profession. It is a demanding activity and requires care and patience. However, as I thought about it and what I loved about it in Puerto Rico, I decided to take up this program here in the States. I feel it was the right decision because as soon as I did I fell right back in love with the profession. So, after being away from it for nearly a decade, I have returned to what I love to do, and I am very happy to be able to do it right here in Florida.
Being able to work in…
For example, Dr. Gutierrez took me around to the different departments and allowed me to meet and talk with Dustin Bowman, one of his patients. He is 23-year-old, was in the U.S. Air Force and just transferred to Haley Hospital about a week ago. He had a Cervical 1 injury, and his left lung was deflated, which completely affected his entire body. He needs a great deal of respiratory care. With this patient and others that Dr. Gutierrez told me about during my observations at the hospital, I clearly came to see how respiratory therapist must know the patient's entire medical condition to fully provide effective treatment.
Respiratory therapists have to be knowledgeable and skillful about cardiopulmonary therapy, but beyond this, they must have the necessary understanding about human physiology, anatomy, and body chemistry to best understand the holistic condition of their patients. For example, to evaluate patients, the respiratory…
In fact it has been proposed that the positive impact observed of PBL on motivation may come from these academically talented individuals rather than the intervention itself (Hwang & Kim, 2006). GPAs and demographic characteristics were not found to be correlated to PBL (Ceconi et al., 2008).
White et al. (2004) found in a study regarding that PBL was not shown to be superior to other learning styles in assisting students to acquire or retain knowledge regarding asthma management. This finding is consistent with the majority of research that has not found greater knowledge acquisition or retention amongst PBL students vs. traditional teaching methods (Albanese, 2000; Beers, 2005; Rogal & Snider, 2008). However, it is not that PBL produces inferior results, most studies have found that there are no significant differences between PBL students and those from traditional curricula on standardized knowledge tests (Beachey, 2007). Beers (2005) points out that…
Many studies have shown that PBL students experience greater motivation toward learning than their traditional counterparts (Hwang & Kim, 2006; Beachey, 2007, Rogal & Snider, 2008). Further PBL has been associated with greater satisfaction in the learning process by physicians than its traditional counterpart (Beachey, 2007; Op't Holt, 2000; Rogal & Snider, 2008). Evaluations of PBL programs have found that not only do students take pleasure in the process, they also believe that they have the capacity to out perform their peers from traditional curricula in clinical settings (Op't Holt, 2005; Kaufman & Mann, 1996). Studies have shown that the teaching method has little bearing on the learning of academically talented students (Hwang & Kim, 2006; Distlehorst, Dawson, Robbs, & Barrows, 2005; Op't Hoyt, 2005). In fact it has been proposed that the positive impact observed of PBL on motivation may come from these academically talented individuals rather than the intervention itself (Hwang & Kim, 2006). GPAs and demographic characteristics were not found to be correlated to PBL (Ceconi et al., 2008).
White et al. (2004) found in a study regarding that PBL was not shown to be superior to other learning styles in assisting students to acquire or retain knowledge regarding asthma management. This finding is consistent with the majority of research that has not found greater knowledge acquisition or retention amongst PBL students vs. traditional teaching methods (Albanese, 2000; Beers, 2005; Rogal & Snider, 2008). However, it is not that PBL produces inferior results, most studies have found that there are no significant differences between PBL students and those from traditional curricula on standardized knowledge tests (Beachey, 2007). Beers (2005) points out that one would expect significant improvement in clinical knowledge and performance in order to advocate for the use of PBL in the classroom due to the extensive resources that are required to utilize PBL curricula.
One would expect that PBL students would be at a significant advantage over their traditional peers due to the clinical application in the classroom (Colliver, 2000). Some
PBL vs. Traditional
Two of the methods of pedagogy that are currently employed in respiratory therapy are Problem-Based Learning and Traditional Teaching. Both instructional methods can provide a strenuous curriculum for the student interested in comprehensive training in the field of respiratory therapy, and each method has its advantages and (of course) its disadvantages. The focus of this study will be to determine which pedagogical methodology provides the most efficient and effective results in a respiratory therapy educational setting.
To accomplish that objective, the study will administer surveys in questionnaire form to students attending two separate schools that offer training in respiratory therapy. The questionnaires will provide a quantifying response to qualitative, and quantitative, information. Each school's pedagogy will represent either problem-based or traditional teaching methods and students from each school will be asked to complete pre and post training questionnaires and surveys. Additionally, students will be tested on their…
Albanese, M.A. & Mitchell, S. (1993) Problem-based learning: A review of literature on its outcomes and implantation issues, Academic Medicine, Vol. 68, Issue 1, pp. 52-81
Ali, M.; Gameel, W.; Sebai, E.; Menom, N.A.; (2010) Effect of problem-based learning on nursing students' approaches to learning and their self-directed learning abilities, International Journal of Academic Research, Vol. 2, Issue 4, pp. 188 -- 195
Allie, S.; Armien, M.N.; Bennie. K.; Burgoyne, N.; Case, J.; Craig, T.; (2007) Learning as acquiring a discursive identity through participation in a community: A theoretical position on improving student learning in tertiary science and engineering programmes, Cape Town, South Africa, accessed at http://www.cree, uct.ac.za., on January 15, 2011
Biggs, J. (2003) Teaching for quality learning at university (2nd ed.), Buckingham: The Society for Research into Higher Education and Open University Press
education at Valencia College, where I am studying to be a respiratory therapist. I want to continue my education, with the hope of attending the University of Central Florida. The University of Central Florida does not offer a Bachelor of Science degree in respiratory therapy, but does offer a wide range of degrees related to the medical field. I intend to pursue a B.S. In Health-Sciences, Pre-Clinical undergraduate degree. I feel that this will give me the educational background I need to place me in a competitive position for graduate or professional training, while exposing me to a wide variety of occupations in the medical field.
The four-year university that I have selected is the University of Central Florida in Orlando, Florida. It is a competitive university with a student body of just under 50,000 (49,900) students (Petersons, 2013). The average in-state tuition rate seems reasonable at $6,247 per academic…
Bureau of Labor Statistics. (2013). Respiratory therapists. Retrieved March 7, 2013 from the Occupational Outlook Handbook website: http://www.bls.gov/ooh/healthcare/respiratory-therapists.htm
Petersons. (2013). University of Central Florida. Retrieved March 7, 2013 from Peterson's website: http://www.petersons.com/college-search/university-of-central-florida-000_10000671.aspx
University of Central Florida. (2013). Health-sciences, pre-clinical. Retrieved March 7, 2013
from University of Central Florida website: http://www2.cohpa.ucf.edu/health.pro/prospective_students.shtml
Some of the major objectives of the strategy include lessening regional alveolar distension, atelectasis, oxygen mediated injury, diaphragm injury, and inflammation. The other approaches that can be used to lessen the injury include using high frequency oscillatory ventilation, positioning, neuromascular blocking agents, fluid therapy, and immunomodulation.
Ventilator Induced Lung Injury is one of the common illnesses that occur among patients with acute lung injury. This disease is mainly attributed to the use of mechanical ventilator to save these patients though there are other risk factors that contribute to the injury.
Dreyfuss, D. & Saumon, G. (1998, January 1). Ventilator-induced Lung Injury -- Lessons from Experimental Studies. American Journal of espiratory and Critical Care Medicine, 157(1), 294-323. etrieved from http://ajrccm.atsjournals.org/content/157/1/294.long
Feng et. al. (2011, July 19). Pediatric Acute espiratory Distress Syndrome Treatment and Management. etrieved September 26, 2012, from http://emedicine.medscape.com/article/803573-treatment
Galvin, S. & Granton, J. (2011, March 3). educing…
Dreyfuss, D. & Saumon, G. (1998, January 1). Ventilator-induced Lung Injury -- Lessons from Experimental Studies. American Journal of Respiratory and Critical Care Medicine, 157(1), 294-323. Retrieved from http://ajrccm.atsjournals.org/content/157/1/294.long
Feng et. al. (2011, July 19). Pediatric Acute Respiratory Distress Syndrome Treatment and Management. Retrieved September 26, 2012, from http://emedicine.medscape.com/article/803573-treatment
Galvin, S. & Granton, J. (2011, March 3). Reducing Ventilator Lung Injury. Retrieved September
26, 2012, from http://respiratory-care-sleep-medicine.advanceweb.com/Features/Articles/Reducing-Ventilator-Induced-Lung-Injury.aspx
Arterial Blood Gas Samples
Instructions for the Sampling of Arterial Blood for Blood Gas Analysis
This document provides the procedure for the drawing of arterial blood from human patients for use in the analysis of blood gasses.
This document is intended to provide proper and safe steps in the procedure used by respiratory therapists, phlebotomists, nurses and doctors for the procurement of human blood from extremity arteries for subsequent analysis of blood gases (Browning 1989).
This document covers recommended clinical practice for the sampling of arterial blood (Bruck1985). Because the nature of this procedure uses human clinical subjects and a biohazardous substance, human blood, significant explanation of safety and best clinical practice are covered in the information. Topics covered include:
Clinical Practice Guidelines
I. Safety Guidelines
Blood is considered a toxic and/or pathogenic substance;…
assist you in one or more of the following areas of your current (or past) job?
espiratory care is a highly technical profession, so critical thinking skills are very useful in being able to troubleshoot equipment, locate and correct technical problems (Mishoe, 2003). Critical thinking is very useful to the respiratory therapy profession because the position requires the evaluation of information for problem solving which is crucial to operating complex equipment and diagnosing unknown problems in patients who often require immediate care to breathe and survive.
Critical thinking in communication is crucial for the respiratory therapist to gather and provide information through verbal and nonverbal communication with nurses, physicians, patients, patients' families, other respiratory therapists, and other clinicians (Mishoe, 2003). Gathering appropriate and sufficient information to analyze, evaluate, and make judgments in clinical practice depends on effective communication (Mishoe, 2003). There is a tremendous amount of skill…
Bureau of Labor Statistics (2009, Dec 17). Occupational Outlook Handbook, 2010-11 Edition: Respiratory Therapists Retrieved from http://www.bls.gov/oco/ocos321.htm
Mishoe, Shelly (2003). Critical Thinking in Respiratory Care Practice: A Qualitative Research Study. Respiratory Care, 48 (5), 500-516.
Attorneys, however, note that the suits are reflective of an increase in negligent doctors, who are hard pressed to serve a larger and more demanding patient load. Medical care is more costly and it is true that doctors fail to establish bedside relationships with their patients. Others point out that problems lie at the door of the insurance industry and management of hospitals (Committee, p. 1).
Because we discovered the problem in time, Mr. Jones was able to apologize and explain to the patients affected concerning the true nature of his outbursts. They did not have to pay for their treatment and none of them brought lawsuits against Mr. Jones or the hospital. We retained Mr. Jones, but advised him to notify the management if it appeared that there might be future outbursts. It is true that hospitals are much more diligent today because of risk management practices. Because of…
Abbott, R.L., Weber, P. And Kelley, B. (2005). Medical professional liability insurance and its relation to medical error and healthcare risk management for the practicing physician. American Journal of Ophthalmology. Vol. 140(6).
Committee to Study Medical Professional Liability and the Dellivery of Obstetrical Care, Institute of Medicine. (1989). Medical Professional Liabilityand the Delivery of Obstetrical Care: Vol I. Washington, D.C.: National Academy Press.
Grol, R. (2001). Improving the quality of medical care: Building bridges among professional pride, payer profit, and patient satisfaction. Journal of the American Medical Association. Vol. 286(20). 28 Nov 2001.
Harris, G. (2006). Senators to unveil new drug safety proposals. The New York Times. 21 Jun 2006. Retrieved January 14, 2008 at http://www.nytimes.com/2006/06/21/health/policy/21fda.html?_r=2&adxnnl=1&oref=slogin&adxnnlx=1200373850-0PNMhVh8RDTFqV4OOSZCpQ .
Gaps occur in various situations. They can be in lesson plans or healthcare. When it comes to the MICU, practice gaps happen. To implement a quality improvement proposal one needs to see what works and how to use it to meet the needs of the proposal. Early Progressive Mobility in a Medical Intensive Care Unit has shown to be helpful in meeting the medical goals of patients. In this proposal, evidence as well as strategies will show how important it is for patients to gain mobility early on in recovery and the problems these kinds of programs face.
The MICU or ICU is for patients who are very ill. When in the ICU, it's been demonstrated patients acquire weakness from the acute onset of neuromuscular/functional impairment caused by unknown factors other than their critically ill condition. This weakness impairs ventialtor wearing and functional mobility. (AACN PEAL, n.d.,…
A framework for diagnosing and classifying int... [Crit Care Med. 2009] - PubMed - NCBI. (n.d.). National Center for Biotechnology Information. Retrieved March 20, 2013, from http://www.ncbi.nlm.nih.gov/pubmed/20046114
AACN PEARL (n.d.). E - Early Exercise and Progressive Mobility Session Notes from NTI 2012 (ABCDE Bundle). American Association of Critical-Care Nurses. Retrieved March 20, 2013, from http://www.aacn.org/wd/nti/nti2012/docs/pearl/early%20exercise%20and%20progressive%20mobility/early-mobility-nti-session-notes.pdf
Armoni, A., & IGI Global. (2002). Effective healthcare information systems. Hershey, Pa: IGI Global (701 E. Chocolate Avenue, Hershey, Pennsylvania, 17033, USA.
Duarte, P. (2012). Mobilization of ventilated patients in the intensive care unit: Patient disposition. Davis, Calif: University of California, Davis.
European Society of Intensive Care Medicine. (2011). Clinical evidence in intensive care. Berlin, Germany: Med.-Wiss. Verl.-Ges.
Garber, J. S., Gross, M., & Slonim, A. D. (2010). Avoiding common nursing errors. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Kotter, J. P. (2012). Leading change. Boston: Harvard Business Review Press.
Lancet. (1975). Screening for disease: A series from the Lancet. London, United Kingdom: The Lancet.
health profession that I am considering is respiratory therapist. Respiratory therapists care for patients who have trouble breathing; for example, from a chronic respiratory disease, such as asthma or emphysema. They also provide emergency care to patients suffering from heart attacks, stroke, drowning, or shock (OOH)
O-Net online lists basic tasks of a RT as the following:
Assess, treat, and care for patients with breathing disorders. Assume primary responsibility for all respiratory care modalities, including the supervision of respiratory therapy technicians. Initiate and conduct therapeutic procedures; maintain patient records; and select, assemble, check, and operate equipment
What we have here then is a combination of patient skills with rigorous attention to order and organization as well as to details. The RT has to be self -- disciplined and enjoy working according to rules. he has to be responsible and able to follow orders. ome administrative and leadership capacity is required…
OOH respiratory-therapists http://www.bls.gov/ooh/healthcare/respiratory-therapists.htm
O-Net.com Summary Report for: 29-1126.00 - Respiratory Therapists
Autobiography of Iviannette Figueroa
In this paper, I will describe my life and how my life experiences have shaped the person that I am today, how they have impacted my dreams, and what I intend to do in the future. In this paper I explore my childhood and how the difficulties that I encountered in that childhood have helped shape the woman I am today. The woman that I am today is a mother, a wife, and a student working towards admission into the respiratory therapist program. Generally, I have worked hard to put a difficult childhood behind me. As a result, I have to acknowledge that an autobiographical paper was very challenging for me. I do not like to think about how my childhood has impacted the woman that I am today. While I am generally self-confident, I realize that the things I like the least about myself are…
Deaux, K. & Snyder, M. (2012). The Oxford handbook of personality and social psychology.
New York: Oxford University Press.
DiCanio, M. (2004). Encyclopedia of violence: Frequent, commonplace, unexpected. Lincoln,
NE: Mystery Writers of America.
ABCDE Bundle in a Medical Intensive Care Unit:
The ABCDE bundle is an important element in the modern critical care setting or a medical intensive care unit. This bundle is a collaborated initiative between several disciplines for the management of patients who are critically ill. The usage of the ABCDE bundle is usually geared towards lessening immobility, oversedation, and the development of delirium, which combine to harm critically ill patients. Notably, the use of this bundle in the intensive care unit requires an understanding the meaning of each of the letters in the bundle in relation to patient care. In addition, the effectiveness of its use requires collaborative initiatives by respiratory therapists, physicians, and other health care professionals.
This bundle involves awakening trials for ventilated patients, which is signified by letter A, spontaneous breathing trials or B, and coordinated efforts between various stakeholders in the care process or C. These…
Balas et. al. (2012, April). Critical Care Nurses' Role in Implementing the "ABCDE Bundle"
Into Practice. Critical Care Nurse, 32(2), 35-47. Retrieved June 21, 2014, from http://www.aacn.org/wd/Cetests/media/C1223.pdf
McGann, E. (2012, June 14). ABCDE Bundle: Improving Outcomes for Ventilated Patients.
Retrieved June 21, 2014, from http://www.medscape.com/viewarticle/765687
Healthcare Quality Management
PDCA Modeling in Healthcare
Psychiatric emergencies in medical settings may be particularly challenging since the staff does not encounter them frequently and may not have experience dealing with behavioral crisis intervention. The purpose of this exercise is to help staff improve understanding and coping with nonmedical emergencies that occur in medical settings using the PDCA cycle.
X is a 41-year-old male admitted to a medical unit with a diagnosis of possible stroke. The patient is ambulatory, 5'10," and 350 lbs. Mr. X presented to the emergency department the day before after apparently losing consciousness at home. The initial CAT scan of his head was negative. It is suspected that Mr. X may be an IV drug user since his urine toxicology screening came back positive for opiates. The medical staff thinks that Mr. X had a seizure prior to admission, but he has shown no abnormal signs…
Bennet, L., & Slavin, L. (2009, April 3). What Every Health Care Manager Needs to Know. Retrieved from Continous Quality Improvement: http://www.cwru.edu/med/epidbio/mphp439/CQI.htm
i Six Sigma. (N.d.). Focus - PDCA. Retrieved from I Six Sigma: http://www.isixsigma.com/dictionary/focus-pdca/
Pestka, E., Hatterberg, D., Larson, L., Zwygart, L., Cox, A., & Cox, D. (2012). Enhancing Safety in Behavioral Emergency Situations. Medsurg Nursing, 335-341.
My Goals For The Next Five Years
Setting goals: SMART
Setting goals is an important part of moving forward in life. Martin Luther King Jr. once said: "If you can't fly then run, if you can't run then walk, if you can't walk then crawl, but whatever you do you have to keep moving forward." Of course, all of us would like to fly forward and reach our goals easily. But often long-term goals take a great deal of work to achieve, and are the cumulation of a series of short-term goals that are undertaken step-by-step. My ultimate personal goal in life is to be a good mother to my son and to financially as well as personally support him on his journey to becoming a pilot while I pay off my house. My long-term academic goal is to complete my major successfully. I am studying to be…
The 2007 film The Bucket List depicts two men who are dying of cancer. They each help each other fulfill their final wishes and dreams. As they do so, they realize that most of the things on their "bucket list" were not material fulfillment but emotional and spiritual fulfillment. For example, they travel around the world together but are not truly happy until they are reconciled with their families. This is exactly how I feel about my own bucket list. I might have some materialistic and fun goals that I would like to achieve, such as learning how to SCUBA dive, and flying in a helicopter. However, the most important things in life for me are my children. Before I die, I want to know that they are all happy in their own way. I would love to see them all happily married with children.
Therefore, I could…
Kail, R.V. & Cavanaugh, J.C. (2007). Human Development. 5th edition. Cengage.
Reiner, R. (2008). The Bucket List [feature film].
As Epstein suggested earlier, there seems to be no downside to this process.
James Colliver (2000) would disagree. He dismisses the assertions that favor the efficacy of PBL; his misgivings parallel Hmelo-Smith's earlier remarks. For instance, Colliver contends that the popularity of PBL is predicated on a kind of mass enthusiasm rather than empirically
based scientific evidence (p.259). Colliver asserts that PBL has not proven valid and lacks confirmation as successful teaching model. His article is largely a condemnation of the assertions that proponents of PBL assert. (He also implicates the cognitive sciences that underscore PBL.)
Colliver believes medical educators must abandon their support of PBL until there is sufficient empirical proof that PBL is, in fact, an effective way to teach people.
After ten years of administering Problem-Based Learning at the University of Missouri's
School of Medicine, Hoffman and her research team sought to examine the overall efficacy of…
patients undergoing mechanical ventilation contract Ventilator Associated Pneumonia (VAP). This acute medical condition always results in increased death rates and associated medical costs among patients. This article reviews several literatures that try to enlighten masses on the diagnosis, medical treatments and VAP prevention methods. In addition, this article outlines recommendations medical practitioners can implement in their daily practices to curb VAP and offers an insight on controversies that usually arise during VAP diagnoses, treatment plans and prevention methodologies. This article defines VAP to be the causative agent of approximately 25 to 54% mortality rates among patients undergoing mechanical ventilation in ICUs. Factors responsible for VAP among patients include patients' population in ICUs, hospital stay durations and antimicrobial treatments. Even though antimicrobial medications are confirmed to reduce VAP casualties, further studies should be undertaken such as the ones outlined in the literatures below to help in early identification and treatment of…
Arroliga, A.C., Pollard, C.L., Wilde, C.D., Pellizzari, S.J., Chebbo, A., Song, J., et al. (2012).
Reduction in the Incidence of Ventilator Associated Pneumonia: A Multidisciplinary
Approach. Respiratory Care, 688-696.
Camargo, L.F., De Marco, F.V., Barbas, C.S., Hoelz, C., Bueno, M.A., Rodrigues Jr., M., et al.
ENEFITS, ARRIERS, CHALLENGES
ackground and Origin
Progressive mobility refers to a series of planned and sequential movements aimed at bringing the patient back to his or her baseline (Vollman, 2010). It consists of positioning and mobility techniques. A meta-analysis of 39 randomized trials was conducted to examine the effect of bed rest on 15 different medical conditions and procedures. Four short-term medical conditions were identified for critically ill patients. ut the major and long-term complication was the reduced quality of life after discharge on account of lost physical functions during their stay at the ICU. Another study conducted among survivors of acute respiratory conditions found that they lost 18% of their body weight and suffered much functional limitations from muscle wasting and fatigue. The more than 5 million who get confined at the ICU must come to terms with both the short- and long-term complications of immobility or prolonged…
Adler, J. And Malone, D. (2012). Early mobilization in the intensive care unit: a systematic review. Vol 23 # 1, Journal of Cardiopulmonary Physical Therapy:
American Physical Therapy Association. Retrieved on March 21, 2013 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3286494
Baker, C. And Mansfield, L. (2008). Physical rehabilitation following critical illness.
Vol. 9 # 2, Journal of the Intensive Care Society: The Intensive Care Society.
Some of the symptoms of ventilator assisted pneumonia may be the onset of fever, a higher white blood cell count, and a new or changing lung infiltrate that may be visible on a normal chest x-ray. Cultures taken as samples from the patient's airways may show the presence of microorganisms or bacteria and fungi that would eventually cause the dreaded ventilator assisted pneumonia in the patient. JAMA states that these risk factors may be eliminated to a large extent if the nurses and medical practitioners were to follow certain simple but essential steps in preventing the onset of the symptoms of pneumonia. First and foremost, the nurse must maintain a high degree of hygiene; he must wash his hands both before and after coming into contact with any patient, and second, he must try to keep the bed elevated to a 30 degree head up position, so that…
Druding, Mary. C. (1997, Aug) "Re-examining the practice of normal saline installation prior to suctioning" Medical Surgery Nursing, Retrieved 8 October, 2007 at http://findarticles.com/p/articles/mi_m0FSS/is_n4_v6/ai_n18607505
Medscape. (2007) "Should Normal Saline be Used When Suctioning the Endotracheal Tube of the Neonate?" Retrieved 8 October, 2007 at http://www.medscape.com/viewarticle/552862
Schwenker, Ferrin, M; Gift, a.G. (1998) "A survey of endotracheal suctioning with installation of normal saline" American Journal of Critical Care, vol. 7, no. 4, pp: 255-260.
Torpy, Janet M. (2007, Apr) "Ventilator assisted pneumonia" the Journal of the American
Of the new consults 23 were transferred to ICU and 43 remained on the wards. The transfer of these patients was greatly facilitated and the inpatient ward staff was greatly satisfied with the interaction with the Outreach Team. edside education, expert resources and better patient-family communication were the most valued features of the team when the in-patient ward staff was surveyed. We noted a tremendous increase in the accessibility of the ICU to the hospital population. We did not, however, notice a decrease in the number of cardiac arrests in the hospital." (Simone, et al., 2007)
It was reported in the work entitled: "Pilot Project at TGH Shows that Critical Care Response Teams Can Significantly Reduce Cardiac and Respiratory Arrests and Hospital Deaths" in 2007 that data gathered between May 2005 and May 2006 "on the impact of the critical care response teams on 342 patients in Toronto General Hospital,…
Smith GB, Poplett N. (2004) Impact of attending a 1-day multi-professional course (ALERT) on the knowledge of acute care in trainee doctors. Resuscitation 2004; 61: 117-122.
Smith, Gary B. And Nolan, Jerry (2002) Medical Emergency Teams and Cardiac Arrests in Hospital: Results May Have Been Due to Education of Ward Staff. BMJ 2002 May 18; 324(7347): 1215.
White RJ, Garrioch MA.(2002) Time to train all doctors to look after seriously ill patients -- CCRiSP and IMPACT. Scot Med J. 2002; 47: 127.
Simone, Carmine, et al. (2007) the Introduction of a Critical Care Rapid Response Team in a Canadian Community Hospital. Critical Care: ICU Organization. 22 Oct. 2007. Online available at: http://meeting.chestpubs.org/cgi/reprint/132/4/445.pdf
Airway Pressure on Cardiovascular Performance
The Influence of Mean Airway Pressure on Cardiovascular Performance
reathing, also known as pulmonary ventilation, is the basic connection between the heart and lungs (Williams & Whitney, 2006). The connection allows air between the lungs and the atmosphere and the exchange of gases between the air and the alveoli in the lungs. ody receptors can detect changes involved in the movement of air and the pressure that accompanies it. These receptors can either increase or decrease breathing rate. They encourage slower breathing when blood pressure rises and faster breathing rate if the blood pressure goes down. Meanwhile, an exchange of gases between body tissues and capillaries is needed to maintain life. It brings in the gases living tissues need for survival. lood carries oxygen molecules when leaving the heart and distributes it throughout the body. Very small capillaries coordinate in the flow and…
Byrd, R.P. And Mosenifar, Z. (2010). Mechanical ventilation. Medscape: WebLLC.
Retrieved on August 18, 2011 from http://emedicine.medscape.com/article/304068-overview
Daoud, E.G. (2007). Airway pressure release ventilation. Vol 2 (4) Annals of Thoracic
Medicine: Pub Med Central. Retrieved on August 12, 2011 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2732103
Compliance to Ventilator Care Bundles on educing Ventilator-Associated Pneumonia
Ventilator-Associated Pneumonia (VAP) is a common infection that is acquired by patients who have used mechanical ventilation in health care facilities. This infection has generated numerous concerns in public health because of its negative impacts on health care. Some of these negative health effects include extended hospital stays, increased costs of health care services, and deaths. Consequently, there have been numerous initiatives in healthcare to address this problem including ventilator care bundles. Existing literature on evidence-based practice for dealing with VAP has shown that compliance with ventilator care bundles is the most suitable clinical intervention (Al-Thaqafy, 2014). For this study, the John Hopkins Nursing Evidence Practice Process will be utilized to facilitate compliance to these bundles in order to reduce VAP. John Hopkins developed an equation that helps administrators quantify probable savings through lessening hospital-acquired infections like VAP (Guterl, 2013). This…
Al-Thaqafy, M. S., El-Saed, A., Arabi, Y. M., & Balkhy, H. H. (2014). Association of Compliance of Ventilator Bundle with Incidence of Ventilator-associated Pneumonia and Ventilator Utilization among Critical Patients Over 4 Years. Annals of Thoracic Medicine, 9(4), 221-226. doi:10.4103/1817-1737.140132
Guterl, G. (2013). Cost Implications of VAP. Retrieved from: http://respiratory-care-sleep-medicine.advanceweb.com/Features/Articles/Cost-Implications-of-VAP.aspx
Lawrence, P., & Fulbrook, P. (2011). The Ventilator Care Bundle and its Impact on Ventilator-associated Pneumonia: A Review of the Evidence. Nursing In Critical Care, 16(5), 222-234. doi:10.1111/j.1478-5153.2010.00430.x
Mukhtar, A., Zaghlol, A., Mansour, R., Hasanin, A., El-Adawy, A., Mohamed, H., & Ali, M. (2014). Reduced Incidence of Methicillin-resistant Staphylococcus Aureus Ventilator-associated Pneumonia in Trauma Patients: A New Insight into the Efficacy of the Ventilator Care Bundle. Trauma, 16(3), 202-206. doi:10.1177/1460408614532622
Spiritual Care Practices
Mitchell, Andrea. (2011), Focusing on mind, body, and spirit while caring for patients and their families. Critical Care Nurse, (31), 69-70.
How did the transport nurse manage the patient's physical needs?
What is so extraordinary about the story of the transport nurse, as related in Mitchell (2011) is the degree to which the nurse, even while dealing with the emotionally-fraught situation of a critically ill patient going to view the body of his dead wife, was able to be mindful of Mr. L's physical needs. For the journey, the patient Mr. L was initially switched to a travel ventilator. However, when he did not tolerate this, the nurse suggested a manual resuscitation bag instead, although the travel ventilator was still brought along during the transport. The transport nurse carefully monitored the patient throughout the visitation. During the ceremony at the chapel where his wife's body was present,…
I believe that my education and my professional experience in management genres, in healthcare -- including working as a nursing assistant and in homecare environments -- and in business have prepared me well for a career in nursing. After reviewing my qualifications and my skill set -- revealing that I have a history of competent, dependable involvement in worthy vocations -- and the extent of my career interests, I believe it will be clear that I am well positioned for a career as a practical nurse.
Reasons that justify my Goal of becoming a Practical Nurse
First of all, I am very familiar with a number of pivotal aspects of medicine and healthcare and have worked extensively in the industry. I have an Associate Degree in Respiratory Therapy (1992) from the California College of Health Sciences through St. Joseph's Hospital in Minot, North Dakota. As a respiratory therapist at…
Planning for Behavioral Emergencies on a Non-Psychiatric Unit
Hospital staffs are trained to deal with minor behavioral problems because they often occur when someone has some type of traumatic injury or occurrence. Especially patients who are confined to an ICU have issues which may cause them to exhibit adverse behavioral issues. Tesar and Stern (1986) list what should be examined as "(1) the presence of delirium or psychosis; (2) the type of ICU setting (e.g., coronary, surgical, respiratory, or medical); (3) a history of psychiatric disorder; (4) a history of central nervous system disorder; and (5) patients' personalities, which affect their reactions to illness and its treatment." Of course, there are many reasons why the staff in the ICU scenario was unprepared for the disruption caused by Mr. X, but by using the FOCUS model (Find a process to improve, Organize a team that…
American Hospital Association. (2007a). Case examples. Behavioral Health Challenges in the General Hospital.
American Hospital Association. (2007b). Recommendations. Behavioral Health Challenges in the General Hospital.
Cooke, M. (2010). The safe management of behavioral health patients in non- behavioral health settings. Alabama Safe Management.
DMHRM. (1997). Management of aggressive behavior. Women and Children's Hospital, Adelaide.
Interdisciplinary Care Providers
CABG or coronary artery bypass graft surgery is advised for individuals suffering from CHD (coronary heart disease), for alleviating symptoms, prolonging lifespan, and improving QOL (quality of life) (Bayoumi, 2015). Improvements in mechanical ventilation-supported cardiac operation patient management continues to be a major focus area for better optimizing clinical results. The FTE (fast-track extubation) theory applied in case of cardiac operation patients is growing in popularity, in a bid to offer more economical and superior-quality healthcare. A large number of research works have established that prompt extubation (i.e., between 6 and 8 hours after surgery) may be a safe step, whilst decreasing admission and resource use expenses (Cheng, Karski & Peniston, 1996). In spite of the aforementioned advantages, prompt extubation is not consistently performed, underscoring the need to adopt a protocolized strategy for decreasing setbacks and variations and linked to weaning mechanical ventilation. Time-guided extubation protocols’ benefits have been…
Furthermore, one of the pillars of collaborative care that will need to be firmly established is the fostering of clear dialogue and a means for strong communication within the care management planning. For instance, there needs to be a clear decision and communication of all tests ordered and when the test results will be available. One of the most important aspects of this collaborative care will be the nursing interventions which can have significant impact on the patient's health and stabilization (Allen, 2010). In fact, strategic nursing care can even minimize readmission rates of Margaret and other patients with comparable conditions (Chen et al., 2012).
Prioritize the Nursing Care Needs of Margaret
The prioritization of nursing interventions is essential, and the way in which a nurse determines this priority is going to be something unique and distinct. "Trials reviewed demonstrated a beneficial impact of nursing interventions for secondary prevention in…
Adler, H.M. (n.d.). Toward a biopsychosocial understanding of the patient -- physician relationship: An emerging dialogue. (2007). J Gen Intern Med,22(2), 280 -- 285.
Afilala, J. (n.d.). Frailty in patients with cardiovascular disease: Why, when, and how to measure. (2011). Curr Cardiovasc Risk Rep, 5(5), 467 -- 472.
Allen, J.K. (2010). Randomized trials of nursing interventions for secondary prevention in patients with coronary artery disease and heart failure: Systematic review.
Journal of Cardiovascular Nursing,25(3), 207-220.
Staff Nurses' Perceptions of the Advantages and Disadvantages of apid esponse Teams
apid esponse Teams (T) are critically important in hospital settings to reduce the failure to resuscitate patients however, there are questions as to the perceptions of nurses concerning Ts.
The significance of this study is the knowledge that will be added to the existing base of knowledge on the perceptions of nurses of Ts.
The work of Heintz and Schreiner (2007) entitled "Improving Patient Safety Through the Use of apid esponse Teams" states in relation to the perceptions of nurses to rapid response teams that staff nurses "… may be fearful that T members will criticize their clinical judgment." In a separate work entitled "apid esponse Teams: educing Codes and aising Morale" it is reported that many hospital nurses like the idea of a apid esponse Team and in fact "an addition to their significant value as a…
Johal, Jagdeep (2008) Staff Nurses' Perceptions of Rapid Response Teams in Acute Care Hospitals. Queens Research & Learning Repository. Retrieved from: http://qspace.library.queensu.ca/handle/1974/1503
Heintz, Anne and Schreiner, Mary Ann (2007) Improving Patient Safety Through the Use of Rapid Response Teams" Dateline. Vol. 6, No. 1. Online available at: http://www.mlmic.com/portal/Files/Dateline/DatelineSpring07_6.pdf
Tee, A., et al. (2008) Bench-to-Bedside Review: The MET Syndrome -- the Challenges of Researching and Adopting Medical Emergency Teams. Critical Care 23 Jan 2008.
Rapid Response Teams: Reducing Codes and Raising Morale. Institute for Healthcare Improvement. Online Retrieved from: http://www.ihi.org/IHI/Topics/CriticalCare/IntensiveCare/ImprovementStories/FSRapidResponseTeamsReducingCodesandRaisingMorale.htm
Human esource Development Initiatives for the Department of Veterans Affairs
As the nation's largest healthcare provider and second-largest federal agency, the Department of Veterans Affairs (VA) is responsible for administering a multi-billion dollar budget in support of the nation's heroic veterans. The VA fulfills its mandate to care for veterans and their families through a nationwide network of medical centers, outpatient facilities, Vet Centers and domiciliaries that provide the entire spectrum of medical, surgical and rehabilitation healthcare services. Given the importance of its mandate and scope of its budget, the VA is well situated to take advantage of a wide range of human resource initiatives that can save money, improve organizational performance and the quality of healthcare provided to the country's veteran population. This study defines five such human resources initiatives and describes how they can be applied to achieve these goals. A summary of the recommendations and their potential…
Anderson, C.H. (1984). Job design: Employee satisfaction and performance in retail stores.
Journal of Small Business Management, 22, 9.
Benevides, A.D. & David, A.A. (2010). Local government wellness programs: A viable option to decrease healthcare costs and improve productivity. Public Personnel Management,
Evidence has been cited suggesting that ECT is particularly efficacious with psychotic depression. Experimental research and reviews of the literature tend to conclude that ECT is either equal or superior to antidepressant medication in the treatment of severe depression. In one study both depressed men and women were helped by ECT, but women tended to improve more with ECT than with imipramine, a tricyclic antidepressant. Men tended to improve more with imipramine. Both men and women improved more with ECT than with phenalzine, a monoamine oxidase inhibitor (MAOI). It has been suggested that MAOIs and serotonin-specific reuptake inhibitors (SSIs) may be less clinically effective than heterocyclic antidepressants for severe depression. Thus, ECT's favorable comparison with imipramine is a strong endorsement.
The side effect of ECT that has received the most attention is memory loss. ECT results in two kinds of memory loss. The first involves quick forgetting of…
Breggin, P.R. (n.d.). Electroshock: Scientific, ethical, and political issues. Retrieved from http://www.sntp.net/ect/breggin1.htm
Electroconvulsive therapy. (2011). Retrieved from http://www.minddisorders.com/Del-
Electroconvulsive therapy (ECT). (2011). Retrieved from http://www.mayoclinic.com/health/electroconvulsive-therapy/MY00129
Marketing Plan for Ford Motors Company
The logic is really very simple -- when a model is supposed to be for women, it has to be designed by women.
It is clear that cars are now being purchased in USA for both men and women, and many times, women have their own cars. This fact had been realized as early as 1956 when there was a model called Dodge La Femme for women to drive and probably that was the reason why it failed. (Women and SUVs) There was a difference in the thinking of men who designed the car and women who were supposed to drive it.
The market for cars among women is large and it had been 20% of the new vehicles during 1984 and this has gone up to 28% in 1990. The decisions are taken by them in 80% of the cases of purchase. (Women…
Concept cars for women. 4 March, 2004. Retrieved from http://english.aljazeera.net/NR/exeres/4B81525E-DCB6-4BBB-8B67-82DAD22E03E4.htm Accessed on 18 July, 2005
Kile, Heather. Women and SUVs. Retrieved from http://fubini.swarthmore.edu/~WS30/HKFinalProject.html Accessed on 18 July, 2005
Ten Cars Women Love. Retrieved from http://cars.msn.co.uk/CarNews/carswomenlove/?MSID=af118d01110c47c484a9a1ae4f5e590b Accessed on 18 July, 2005
Women and minority automobile buyers. Road and Travel Magazine. Retrieved from http://www.roadandtravel.com/businessandcareer/careers/minoritycarbuy.htm
21). Non-training and development-related actions should be required (Schraeder & Jordan, 2011, p. 6) and should include MMPI testing specifically for XX and generally for all RNs. Employee-development actions will include employee seminars and workshops around developing greater awareness, compassion and acceptance of personal accountability. Based on XX's very low score, I anticipate XX's only slight improvement due to imposed consequences for failing to learn proper policy and procedure; however, those gains will be only slight and probably insufficient (Schraeder & Jordan, 2011, p. 9). Given the hospital's very low score and static categorization, its ability to implement the development action plan will probably be signficantly hampered by the hospital's static approach to health care (Silverman, Pogson, & Cober, 2005, pp. 143-4). The collective effect of XX's well-deserved "unaware" categorization and the hospital's "static" categorization will probably result in small, inadequate changes on XX's part over a long period of…
Brocato, R. (2003). Coaching for improvement: An essential role for team leaders and managers. Journal for Quality and Participation, 26(1), 17-22. Retrieved August 11, 2013, from the TUI Library.
Schraeder, M., & Jordan, M. (2011). Managing performance: A practical perspective on managing employee performance. Journal for Quality and Participation, 34(2), 4-10. Retrieved August 11, 2013, from the TUI Library.
Silverman, S.B., Pogson, C.E., & Cober, A.B. (2005). When employees at work don't get it: A model for enhancing individual employee change in response to performance feedback. Academy of Management Executive (1993-2005), 135-147. Retrieved August 11, 2013, from the TUI Library.
Computers Used by Nurses
The area of interest in nursing informatics are nursing information, nursing data and nursing knowledge. The present state of knowledge related to these phenomena proposes four implications for the development of systems to assist nursing. First, research suggests that experience and knowledge is linked to the quality of nursing assessment, diagnosis or clinical inference, and planning of nursing care, and also that knowledge is task-specific Information technology can provide access to a variety of information resources, such as knowledge bases and decision support systems, to enhance the level of knowledge of the nurse decision-maker. Second, organized patient assessment forms with linkages to knowledge bases of diagnoses have the capability to improve the quality of the patient check up and the accuracy of the diagnosis. Third, studies on planning care have demonstrated the complexity of the task when a number of options are potentially appropriate Model-based decision…
Cornell University. 2012. Retrieved from Medical calculators: http://www-users.med.cornell.edu/~spon/picu/calc/medcalc.htm
Evidence-based medicine_BMJ Journals. Evidence_based Medicine for primary care and internal Medicine . 2012
Nursing Informatics for BSN Nursing students. (n.d.). Retrieved from Data Analysis Nursing Informatics: http://www.nursing-informatics.com/kwantlen/nrsg4120.html
Online journal of nursing informatics. (n.d.). Online journal of nursing informatics .
Mock Code Blue taff Assessment
A hospital-based code team should consist of the following medical professionals:
Emergency Department Physician - a board certified emergency physician oversees the code blue process.
Team Coordinator - A registered nurse from the Cardiovascular Medical Intensive Care Unit (CVICU) acts as Team Coordinator. This person is certified in advanced cardiac life support (ACL), and is responsible for the patient's care during a code blue.
Recorder - The recorder is an ACL certified registered nurse from the Cardiovascular Care Center (CVCC). This team member monitors the patient throughout the process and documents the time and details of each action taken.
Medication Nurse - The medication nurse comes from the Neuro Intensive Care Unit and is also ACL certified. This individual establishes an IV and administers medications necessary to restore a patient's vital functions.
Other Professionals - In addition to the core team described above, a pharmacist,…
AHA Guideline Update. 2005. American Hospital Association. 2005. 8 Jan 2012.
SafeWise. 2007. Code Blue Sample Procedures. SafeWise Consulting, LLC.
goal of their ethical calling, physicians, nurses and other health care workers are obliged to treat the sick and potentially infectious patients and, in so doing, they are to take some personal risk (Murray 2003). This was the bottom line of the assessment and stand made by Dr. Henry Masur and his colleagues at the National Institute of Allergy and Infectious Disease (NIAID), particularly during the outbreak of dread global SARS in Canada and Hong Kong last year. They also referred to other epidemics, such as the HIV / AIDS.
Masur emphasized that this primary goal and obligation is voluntary and sets the medical profession apart from other professions, precisely because of the involvement of some personal risk in fulfilling that obligation. esides physicians, medical professionals are nurses, dentists and health workers. Records of the first SARS outbreaks in Toronto and Hong Kong showed that a huge 50% of those…
Katz, Laura L. And Marshall B. Paul. When a Physician May Refuse to Treat a Patient. Physician's News Digest, 2000. http://www.physiciansnews.com/law.202.html
Levin, Aaron. Doctors Willing But Not Ready to Treat Deadly Bio-terror Agents. Health Behavior News Service: Center for the Advancement of Health, 2003. http://www.cfah.org/ubns/news/bioterror09-17-03.cfm
Murray, Terry. Health Care Staff Have a Duty to Treat. The Medical Post: Rogers Media, 2003. http://www.medicalpost.com/mpcontent/article.jsp.jsessionid=NJCJNDCEAGHH?content=20020515_09
Schulman, David I. The Dentist, HIV and the Law: Duty to Treat, Need to Understand. Dental Treatment Consideration, 2000. http://www.hivdent.org/dtcblaa082001.htm
Personal Healthcare Technology
Sunrise Hospital and Medical Center and the Sunrise Children's Hospital
The Sunrise Hospital and Medical Center, which includes the Sunrise Children's Hospital, is an approximately 55-year-old facility located in Southern Nevada; it serves the greater Las Vegas area and the surrounding communities. The Sunrise Health and Medical Center is proud of its quality initiatives to ensure patient safety and comfort, including direct approaches to pharmaceutical safety such as safe medication dosing via smart pump technology, and bar coding on medications. As well, the Sunrise Health and Medical Center does not discriminate with respect to HIV / AIDS or in any manner related to employment, program participation, admission and/or treatment.
Sunrise has been rated as the most popular area hospital for 15 years in patient surveys. As well, Sunrise Health and Medical Center has developed community outreach programs for health education in a variety of areas, often based…
Appari, A., & Johnson, M.E. (2010). Information security and privacy in healthcare: Current state of research. International Journal of Internet and Enterprise Management, 6 (4), 279-314. Retrieved from http://www.ists.dartmouth.edu/library/501.pdf
Ayanian, J.Z., & Weissman, J.S. (2002). Teaching hospitals and quality of care: A review of the literature. The Milbank Quaterly, 80(3), 569-593. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690120/pdf/milq0080-0569.pdf
Baker, J.J., & Baker R.W. (2000). Health care finance: Basic tools for nonfinancial managers. Gaithersburg, MD: Aspen
Byington, R., Keene, R., Masini, D. (2006). The impact of federal and state funding levels on strategic decisions and how those decisions affect patient care. The Internet Journal of Healthcare Administration. (4)2. Retrieved from https://ispub.com/IJHCA/4/2/5827
Mcardie Estate v. Cox case, by providing a case summary, comparison of exclusive professional practice scope and right to health care professionals' title, and protections for healthcare workings abiding by practice standards.
Malpractice and neglect are perhaps the aspects most carefully covered by healthcare policymakers. Healthcare law may be considered distinctive in the legal sphere, as it is one subdivision that affords numerous scholarship approaches a chance to succeed (Jocelyn, et.al, 2002). Healthcare law is an interdisciplinary and dynamic domain, with numerous legal, scientific, economic, social, political and philosophical grounds for its dynamism.
McArdie Estate v. Cox was an appellate court case. Gastroplasty reversal surgery was performed on the deceased patient on 26th June, 1995. Gastroplasty refers to a weight-loss tactic of stapling the stomach; the patient in question had two staple lines across her tummy. She was made aware of the fact that, in view of her…
Social network mapping is one of the important aspects of an individual’s professional development in his/her career. Creating a social network map is important for professionals in clinical practice because clinical practitioners are increasingly realizing the significance of informal social support in their practice (Tracy & Whittaker, 1990). In essence, analysis of social support resources is necessary in identifying routine practices and assessment that are clinically beneficial. Consequently, several social network mapping techniques have been developed to help an individual assess his/her social and environmental resources (Tracy & Abell, 1994). Social network maps gather information regarding an individual’s social network in terms of size and composition, relationships, and frequency of contacts with others. This paper provides my social network map in relation to my clinical practice. It is divided into three major segments i.e. field work, map creation, and a portfolio.
I am currently working as a registered…
Improvement of Human esource Management in a espiratory Care Center
When individuals play as a team they tend to achieve greater clinical and organizational outcomes in a healthcare institution like the respiratory care center. Clinical and financial improvements have been reported in cases where there has been teamwork between the healthcare team. Whenever there is an organizational breakdown, the departments in any organization can conspire to sabotage each other and this hampers the progress of any care giving institution (Hoff 2004).
Overall patient care is achieved whenever there is total cooperation and teamwork between the workers, this is because each worker works with only one sole aim and that is to meet the needs of the patient. In such a case the main goal is to achieve an improved respiratory care. Teamwork exist in two levels in any respiratory care center, the first instance is when there is cooperation between…
Baker, D.P. (2005). "Medical Team Training Programs in Respiratory Care." In Advances in Patient Safety: From Research to Implementation (Vols. 3).
Gagnon, D.1 (1998) National Consultation on Health Services and Policy Issues: Summary Report. Ottawa: American Health Services Research Foundation.
Hoff, T.L. (2004) "Quality provision of respiratory care." Medical Research and Review 98(1): Vol 3.
Nursing Administration -- Controlling
The FOCUS model requires the nursing administrator to find out what the main problem is, obtain information about this problem, communicate effectively with the nurses and patient, understand the needs of the nurses and the patient, and finally summarize these findings for the patient and nurses Dlugacz, 2009.
In this scenario, the process to be improved is responsiveness and willingness of the nurses to help the patient's situation.
Using the FOCUS model, the nursing leader should identify and clearly define the problem. To do this, they must recognize the role of the patient and the nurses in the situation and prioritize the potential improvements in the process Kreitner, 2008.
They also need to draft this problem statement in a clear way. The problem statement for this scenario is that the nurses feel inadequate in responding to the situation where the patient needs…
Dlugacz, Y.D. (2009). Value-Based Health Care: Linking Finance and Quality. New York: Wiley.
Kleespies, P.M., & Association, A.P. (2009). Behavioral Emergencies: An Evidence-Based Resource for Evaluating and Managing Risk of Suicide, Violence, and Victimization. Washington, D.C., DC: American Psychological Association.
Kreitner, R. (2008). Management. Mason, OH: Houghton Mifflin Company.
Zun, L.S., Chepenik, L.G., & Mallory, M.N.S. (2013). Behavioral Emergencies for the Emergency Physician. Cambridge, United Kingdom: Cambridge University Press.
In an acute care setting, such Veterans Affairs, this objective is executed by educating patients about how to maintain a healthy diet and lifestyle after the leave the facility, while in a long-term care setting-such as Cobble Hill-this objective is executed on a daily basis by providing nutritious meals for elderly residents. And finally, in an ambulatory, out-patient care setting-such as Atlantic -- the clinical nutritionist works to support patients in maintaining a diet that addresses their personal healthcare needs, while still living independently within a larger community. Perhaps the most significant similarity between facilities is the notion of nutrition as merely one component of a comprehensive care program; hence the necessity of a clinical nutritional to work in conjunction with a full medical, administrative, and social support staff. The apparent goal of such an approach is to promote multiple aspects of health and well-being among patients, regardless setting or…
Cite Health. (2010). Long Island College Hospital. Retrieved December 19, 2010 from http://citehealth.com/dialysis-centers/new-york/cities/brooklyn/long-island-college-hospital
Cobble Hill Health Center. (2010). Resident Services. Retrieved December 19, 2010 from http://www.cobblehill.org/services
United States Department of Veterans Affairs. (2010). Patient Information. Retrieved December,
19, 2010 from http://www.brooklyn.va.gov/patients/index.asp
Healing Touch Annotated Bib
Bardia, A., et.al. (2006). Efficacy of Complementary and Alternative Medicine Therapies in elieving Cancer Pain: A Systematic eview. Journal of Clinical Oncology. 24 (34): 457-64.
Anecdotal evidence abounds regarding the use of complementary and alternative medicine therapies when dealing with issues of pain. One of the clear issues is that there is a lack of rigorous and well-developed scholarly literature on the subject. In this study, 18 trials were reviewed totaling 1,499 patients. Seven trials reported significant benefits using CAM, seven reported intermediate or short-term benefits, and four studies reported no benefits. The researchers conclude that there are a number of variables and a number of types of CAM, all which require more methodologically sound studies in order to determine actual efficacy of individual interventions.
Jones, T., Glover, L. (2012). Exploring the Psychological Processes Underlying Touch:
Lessons From the Alexander Technique. Clinical Psychology and Psychotherapy. EPub:…
Bardia, A., et.al. (2006). Efficacy of Complementary and Alternative Medicine Therapies in Relieving Cancer Pain: A Systematic Review. Journal of Clinical Oncology. 24 (34): 457-64.
Jones, T., Glover, L. (2012). Exploring the Psychological Processes Underlying Touch:
Lessons From the Alexander Technique. Clinical Psychology and Psychotherapy. EPub: doi 10.1002/cpp.1824.
Kelly, A., et.al. (2004). Therapeutic Touch, Quiet Time, and Dialogue: Perceptions of Women With Breast Cancer. Oncology Nursing Forum. 31 (3): 625-31.
Even in areas where there is little to no technology, there are always health care initiatives that can be implemented in order to engender proper health.
The lack of familiarity with the landscape can be addressed through cultural immersion. Nurses need to integrate within the culture that they treat, familiarizing themselves with the common maladies and understanding the environmental factors that cause them. Nurses need to become part of the community, and if they show that they are committed to the local landscape, they will be more likely to engender commitment from the native population as well.
One strategy for advocating health care at the global level is for nurses to immerse themselves in communities in the developing world. After living amongst the native people, nurses would acquire a first-hand perspective of the health issues facing the people, and by having to respond to the environmental pressures themselves, they would…
Chen, P.W. (2012, July 26). What we can learn from third-world health care. The New York Times. Retrieved from http://well.blogs.nytimes.com/2012/07/26/what-we-can-learn-from-third-world-health-care/
Peters, DH, et al. (2008). Poverty and access to health care in developing countries. Annals of the New York Academy of Sciences, 1136, 161-171
Review of Related Literature
This chapter provides a review of the literature concerning hypnosis, Eastern Meditation, Chi Kung, and Nei Kung and how these methods are used to treat various ailments and improve physical and mental functioning. A summary of the review concludes the chapter.
In his study, "Cognitive Hypnotherapy in the Management of Pain," Dowd (2001) reports that, "Several theories have een proposed to account for the effect of hypnosis. State theories assume that the hypnotic trance is qualitatively different from all other human experiences. From this perspective, trance capacity is supposedly a fairly stale trait that exhiits sustantial individual differences. Nonstate theories, often referred to as social learning, social psychological or cognitive-ehavioral theories of hypnosis propose that hypnotic phenomena are related to social and psychological characteristics such as hope, motivation, expectancy, elief in the therapist, desire to please the therapist, a positive initial…
bibliography. (2010). http://science.jrank.org / pages/7857/Meditation-Eastern.html.
Many religious traditions have practices that could possibly be labeled meditation. In Judaism, Christianity, and Islam, these practices are usually associated with prayer, contemplation, or recitation of sacred texts. In the religious traditions of the Native Americans, Australian aboriginals, Siberian peoples, and many others, what could be identified as meditation techniques are incorporated within the larger rubric of shamanism. It is, however, in the religions of Asia that meditation has been most developed as a religious method.
Meditation has played an important role in the ancient yogic traditions of Hinduism and also in more recent Hindu-based new religious movements such as Maharishi Mahesh Yogi's Transcendental Meditation program. But it is most especially in the monastic or "elite" forms of the various traditions of Buddhism (Theravada, Tibetan/Vajrayana, and Ch'an/Zen) that meditation techniques have taken center stage and have been developed to the highest degree of sophistication and complexity.
Short-Term Effects of Meditation vs. Relaxation on Cognitive Functioning. Contributors: Gillian King - author, Jeffrey Coney - author. Journal Title: Journal of Transpersonal Psychology. Volume: 38. Issue: 2. Publication Year: 2006. Page Number: 200+.
Authors cite the lack of relevant studies concerning the effect, if any, of meditation on short-term improvements in cognitive performance. The results of this study clearly showed that meditation, per se, does not produce a short-term improvement in cognitive performance compared to other relaxation techniques.
Healthcare Administration Mission Viejo Executive Summary
Over the last several years, the healthcare delivery environment has been continually evolving. This is because consumers are demanding efficient ways for receiving a variety of services. That is focused on reducing costs and enhancing quality. The result is that the entire system is continually changing to keep up with them. In the case of Golden Age Hospital (GAH), they are reaching a crossroads with rising number of seniors locally and nationally. This is in response to the rising demographic and many local facilities feeling overwhelmed. The new location can be utilized as an integrated business model that will achieve these larger objectives. In the long-term, this will make them more competitive and able to respond to changes in the way industry is operating. Those who are able to do this will see their employee turnover rates decrease and they can enhance the care…
Community Profile. (2014). City of Aliso Viejo. Retrieved from: http://www.cityofalisoviejo.com/wp-content/uploads/ApdxC_Community_Profile.pdf
Mission Viejo, California. (2015). U.S. Census. Retrieved from: http://quickfacts.census.gov/qfd/states/06/0648256.html
Rising Demand for Long-Term Care. (2014). CBO. Retrieved from: http://www.cbo.gov/publication/44363
Cuellara, A. (2006). Strategic integration of hospitals and physicians. Journal of Health Economics, 25 (1), 1-28.
The most frequent symptom is difficulty in walking or gait ataxia (Unicorn Self-Help Committee 2000), which spreads slowly to the arms and the trunk. Foot deformities, such as clubfoot, flexion of the toes or foot inversion are other early signs. In time, muscles weaken and waste, especially the muscles in the feet, lower legs and hands and, at this time, deformities s begin to show. Other symptoms are the loss of tendon reflexes especially in the knees and ankles, the gradual disappearance of sensation in the extremities, dysarthria or slowness of speech or slurring, easy fatigue, rapid and involuntary movements of the eyes, scoliosis, chest pain, shortness of breath, palpitations, heart enlargement, myocardial fibrosis, tachycardia, heart block and heart failure. Studies showed that about 20% of FA patients also develop carbohydrate intolerance and 10%, of diabetes mellitus, while others lose their hearing or eyesight.
In most cases, the patient gets…
Adler, Tina. Single Gene Causes Ataxia, Cancer Risk - Ataxia-Telangiectasia Mutated Gene Causes Fetal Disorder or Increased Risk of Cancer. Science News: Science Service, Inc., 1995. http://www.findarticles.com/p/articles/mi_m1200/is_n25_v147/ai_7142442
Barrett, Julia. Ataxia-Telangiectasia. Gale Encyclopedia of Medicine, Gale Research, 1999. http://www.findarticles.com/p/articles/mi_g2601/ai_2601000157
Bird, Thomas D. Hereditary Ataxia Overview. Gene Reviews: National Human Genome Research Institute, 2005. http://www.geneclinics.org/profiles/ataxia/details.html
Robinson, Richard. Friedreich's Ataxia. Gale Encyclopedia of Medicine: Gale Research, 1999. http://www.findarticles.com/p/articles/mi_g2601/is_0005/ai_2601000562
Elevating heads of beds for patients on mechanical ventilation
Along with the recommendations for removal of plaque, there is also a guideline made by CDC that for proper treatment to "elevate at an angle of 30 to 45 degrees the head of the bed of a patient at high risk for aspiration." The benefits elevation of the head of the bed is on the theory that then gravity will reduce the possibilities of regurgitation that exists in an overly distended stomach. The recommendation by CDC also clearly states that the patients should not be lying flat unless there is some clinical need for that. At the same time, some medical authorities feel that this is likely to make the patients uncomfortable, though the recommendation is from CDC. This makes them reduce the angle of laying the patients bed at a lower angle than the angle specified by CDC.…
Afessa, Bekele. (May, 2004) "From pro and con debate to evidence-based practice: ventilator- associated pneumonia" CHEST. Retrieved at http://www.findarticles.com/p/articles/mi_m0984/is_5_125/ai_n6094553 . Accessed on 20 July, 2005
Caffery, Lisa. "Preventing Ventilator associated Pneumonia" Retrieved from www.genesisheart.com/clinical_staff/ventilator_pneumonia.pdf+elevating+patient's+beds+for+ventilator+acquired+pneumonia&hl=en" http://www.genesisheart.com/clinical_staff/ventilator_pneumonia.pdf . Accessed on 20 July, 2005
Chulay, Marianne. (1 March, 2005) "VAP Prevention: The latest guidelines" Retrieved at http://rnweb.com/rnweb/article/articleDetail.jsp?id=149672Accessed on 20 July, 2005
Geyer, Sherree. "Breathing easy" Retrieved from www.matmanmag.com/matmanmag/jsp/articledisplay.jsp?dcrpath=AHA/PubsNewsArticleGen/data/0407MMH_FEA_Cover_Story&domain=MATMANMAG
The study found that computer charting was well accepted by therapists. "Charge capture was reduced from a four-step manual process to a single-step computer documentation of the procedure. Computer charting was more complete and informative. Productivity increased 18%, although it remains unclear to what degree the computer was responsible." (Andrews, 1985)
In conclusion, the study determined that computer charting streamlined the process of documentation and allowed more beneficial use of clinical information. (Andrews, 1985)
In other words, the study fell in line with the later Cunningham study in that they both noted that computer involvement in various stages of health care provision via computer charting truly benefits the health care provider and the patient. In addition, it streamlines costs and eliminates costly errors.
College health systems benefit especially from computer charting, according to Carol Mulvihill, R.N.,C., CQ Editor and Director of Health Services, University of Pittsburgh at radford.…
Andrews, RD, et al. 1985. Computer charting: an evaluation of a respiratory care computer system. Respir Care. 1985 Aug;30(8):695-707.
Cunningham, S, et al. 1996. Comparison of nurse and computer charting of physiological variables in an intensive care unit. Int J. Clin Monit Comput. 1996 Nov;13(4):235-41.
Medinotes: 2005. Charting Plus. www.medinotes.com
Mulvihill, Carol. 1997. Advantages of computerized charting in college health. University of Pittsburgh: CQ.
he most common progressive chronic lung situations that would require the rehabilitation include interstitial lung disease, chest wall disease, bronchiectasis, and pre and post thoracic surgery. he fourth category of patients to offered pulmonary rehabilitation is those with recent exacerbation of COPD requiring hospitalization, without the anticipated recovery path, and whose functional baseline has changed significantly ("Service Specification," 2012).
Chronic lung diseases have developed to become one of the most common respiratory illnesses across the country. As the diseases have become one of the major reasons for hospitalizations of patients, they usually affect individuals at the age of 35 years and above despite of the fact that these individuals are usually not diagnosed until they are 50 years and above. he growth and rapid increase of chronic diseases is attributed to the tendency of many people with the disease not to get medical assistance. While the conditions continue…
The most common progressive respiratory disease is the Chronic Obstructive Pulmonary Disease (COPD), which is a name that is also used to refer to a collection of lung diseases ("Introduction," 2012). The other common chronic lung diseases include emphysema, chronic bronchitis, chest wall disease, interstitial lung disease, chronic asthma, and obstructive airways disease. These chronic lung diseases usually involve a combination of three major factors i.e. airway diseases, lung circulation diseases, and lung tissue diseases. As the name suggests, the airway diseases affect the airways or tubes that transport oxygen and other gases to and from the lungs. In contrast, the lung tissues diseases affect the lung tissue structure through inflammation or scarring of the tissue. Lung circulation diseases affect the blood vessels in the lungs through scarring, clotting, or inflammation of these vessels. As a result, these diseases contribute to difficulties of the lungs to receive oxygen and release carbon dioxide. The severity of chronic lung diseases is basically dependent on the combination of these three conditions. However, most of the chronic lung diseases are attributed to the narrowing or blockage of the airways. For instance, emphysema, COPD, and chronic bronchitis are conditions that inhibit the ability of the tubes or airways to carry oxygen and other gases to and from the lungs. Generally, patients with chronic lung diseases such as COPD always have difficulties breathing because of airflow obstruction or narrowing of the airways.
As previously mentioned, these diseases account for a huge number of hospital emergency room visits and hospitalizations, although they are largely preventable. Despite being preventable, these diseases have become some of the major causes of death and key factors in the ever-increasing huge human and economic burden because of the tendency of patients to ignore their symptoms ('Emergency Department Support Fund Application," n.d). The major symptoms of these diseases include rising breathlessness, frequent chest infections, and constant cough with phlegm ("Introduction," 2012). The tendency to ignore these symptoms contributes to the many incidents of recidivism to acute care facilities.
The main cause of chronic lung diseases, especially chronic obstructive pulmonary disease is smoking. An individual enhances the risk of developing these diseases when he/she smokes more and for long periods of time. Smoking results in scarring that increases the risk of chronic lung diseases, through irritating or inflaming the lungs. The inflammation in turn results in permanent lung changes over many years. During this period, the walls of the tubes or airways thicken as more mucus is generated. In addition to making the lungs lose their normal elasticity, the damage or harm to the delicate walls of the air sacs in the lungs results in the development of emphysema. Moreover, the smaller airways or tubes become narrowed or scarred. The combination of these permanent changes to the lungs contributes to symptoms of cough, breathlessness, and phlegm linked to chronic obstructive pulmonary
In addition, small frequent feeds, and a large amount of fluid is provided to maintain the nutritional needs of the patient and prevent dehydration. The r suctioning of secretions proves necessary in preventing aspiration of secretions. The loss of voluntary muscle's activity increases the risks of accumulation of secretions hence, the need for regular suctioning. Bulbar involvement often results in communication complications such as dysarthria and muscle paralysis of the muscles of the face, throat, and tongue. As such, it requires the provision of management strategies such as augmentative and alternative communication (AAC) techniques and other forms of speech therapy that improves the communication abilities of patients with ALS. Pseudobulbar effects that often accompany those brought by the frontotemporal lobe degeneration often require the administration of antidepressants. The antidepressants manage mood disorder that presents through disproportionate crying, and inappropriate response to the external stimuli. Maximizing patients' comfort and…
Brettschneider, J., Libon, D.J., Toledo, J.B., Xie, S.X., McCluskey, L., Elman, L., & #8230;
Trojanowski, J.Q. (2012). Microglial activation and TDP-43 pathology correlate with executive dysfunction in amyotrophic lateral sclerosis. Acta Neuropathologica, 123(3),
395 -- 407. doi:10.1007/s00401-011-0932-x
Crespi, C., Cerami, C., Dodich, a., Canessa, N., Arpone, M., Iannaccone, S., & #8230; Cappa, S.F. (2014). Microstructural white matter correlates of emotion recognition impairment in Amyotrophic Lateral Sclerosis. Cortex, 53, 1 -- 8
All these professionals work together in order to establish a
rehabilitation plan that works best for each individual. The component
members of the team are subject to change in accordance with each
individual's needs and requirements. Also, the center holds
The Palm Gardens Center does not use volunteers in its activity. The
reason behind this choice relies on the fact that this center is a for
profit organization. All the individuals employed here are paid. Most of
them work full time, but there are also part time employees.
In management's opinion, it is not a good idea to use volunteers,
because people that are not financially motivated tend to not perform their
tasks as good as they are supposed to. Basically, if one wants something
done properly, the activity in cause must be remunerated in accordance.
The Palm Gardens Center is very involved in the life of the…
1. Mission (2005). The Palm Gardens Center. Retrieved March 25,
2009 from http://www.palmgardenscenter.com/ .
2. Staffing Information (2009). UCompareHealthCare. Retrieved
March 25, 2009 from
3. Palm Gardens Nursing Home, Brooklyn, NY (2009). Hospital Data,
Hospitals and Nursing Homes Profiles. Retrieved March 25, 2009
The authors state: "The amphetamines occasioned dose-related increases in d- amphetamine-appropriate responding, whereas hydromorphone did not. Amphetamines also occasioned dose-related increases in reports of the drug being most like "speed," whereas hydromorphone did not. However, both amphetamines and hydromorphone occasioned dose-related increases in reports of drug liking and in three scales of the ARCI. Thus, some self-report measures were well correlated with responding on the drug-appropriate lever and some were not. Lamb and Henningfield (1994) suggest that self-reports are complexly controlled by both the private event and the subject's history of experience with the drug. Some of the self-reports they observed (e.g., feels like speed) are probably occasioned by a relatively narrow range of stimuli because in the subject's experience with drug administration, these reports have been more selectively reinforced by the verbal community relative to other reports (e.g., drug liking). They also suggest that these results imply…
Budney, Alan J. et al. (2006) Clinical Trial of Abstinence-Based Vouchers and Cognitive-Behavioral Therapy for Cannabis Dependence. Journal of Consulting and Clinical Psychology 2006. Vol.. 74 No. 2. 2006 American Psychological Association.
McRae, a.; Budney, a.; & Brady, K. (2002) Treatment of Marijuana Dependence: A Review of the Literature. Journal of Substance Abuse Treatment 24 (2003)
Pathways of Addiction: Opportunities in Drug Abuse Research (1996) Institute of Medicine (IOM)
Kamon, J; Budney, a. & Stanger, C. (2005)a Contingency Management Intervention for Adolescent Marijuana Abuse and Conduct Problems. Journal of the American Academy of Child & Adolescent Psychiatry. 44(6):513-521, June 2005.
69). Petting a dog lowered blood pressure and respiratory rate -- even if the dog was somebody else's. Pet owners that have heart surgery recover faster and stand a better chance of full recovery. Touching a warm furry animal gives them relief.
Moreover, pet ownership is a predictor of survival after hospitalization for any serious illness (Gunter & Furnham, 1999).
Demello (1999) found that the "mere presence of an animal" could lower blood pressure and that the effect persisted even after the animal was gone. Visual contact with an animal, although it helped, was not as good as touching. Heart rates decreased significantly in a three-minute period of physical contact with the animal (Demello, 1999).
A story in Time magazine (2001) tells how a brain-injured man needed help to get back his sense of balance. Ginger, an Australian shepherd, liked to fetch, so physical therapy for this man was to…
Brodie, S., Biley, F.C., and Shewring, M. (2002). An exploration of the potential risks associated with using pet therapy in healthcare settings. Journal of Clinical Nursing, 11 (4), 444-456.
Demello, L. (1999). The effect of the presence of a companion-animal on physiological changes following the termination of cognitive stressors. Psychology & Health, 14 (5), 859.
Gunter, B. And Furnham, a. (1999). Are pets good for our physical well-being? In Pets and People: The Psychology of Pet Ownership, Chapter 5, 6. London: Wherr Publishing, 66-81/
Hooker, S.D., Freeman, L.H., and Stewart, P. (2002). Pet therapy research: A historical review. Holistic Nursing Practice, 16 (5), 17-23.
In some instances this will mean lying prone on a massage table, or using an ergonomically design massage chair.
Relax your mind and let yourself drift close to a state of sleep and deep relaxation. Try not to talk or move unnecessarily in order to adjust your mind to a new mindset.
Communicate with your masseuse so that they will adjust pressure according to your needs. Become accustomed to their touch and relax under their guidance.
Listen to soothing music or light therapeutic candles to further establish the mood of the session.
These above guidelines will ensure that you have optimize your experience while getting a massage. The most important rule of thumb to remember is to follow the guidance of your massage therapist!
There are some easy steps to follow after a massage that will help you release your muscle strains and extend the lasting benefits of your massage.…
Founded in 1982, the ehabCare Group Inc. is a private company that provides physical and cognitive rehabilitation program management services to approximately 1200 hospitals, skilled nursing facilities, outpatient facilities, and other long-term care facilities in the United States. The company also has a Program Management Services division that provides rehabilitation services and skilled nursing for acute conditions, a Hospital division that primarily functions in rehabilitation hospitals, and an Other Healthcare Services division that provides strategic and financial consulting services. The company's headquarters is in Louisville, Kentucky. Below is a SWOT analysis of the company:
High quality of care.
Licensed therapists / highly skilled workforce.
Large distribution and sales networks. Experienced business units.
Little investments in research and development.
Extremely competitive market.
Patient census subject to issues with the economy.
New products and services.
Price changes in services.
Issues with the economy.
Joynt, K.E., & Jha, A.K. (2012). Thirty-day readmissions -- truth and consequences. New England Journal of Medicine, 366(15), 1366-1369.
Needham, D.M., Dinglas, V.D., Morris, P.E., Jackson, J.C., Hough, C.L., Mendez-Tellez
A., ... & Hopkins, R.O. (2013). Physical and cognitive performance of patients with acute lung injury 1 year after initial trophic vs. full enteral feeding. EDEN trial follow-up. American journal of respiratory and critical care medicine, 188(5), 567-576.
RehabCare (2014). About us. Rehabcare.com. Retrieved on November 19, 2014 from http://www.rehabcare.com/about-us/ .