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Abdomen Assessment
Words: 1474 Length: 4 Pages Document Type: Term Paper Paper #: 82019574
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Assessing the Abdomen
Understanding patient history is important when formulating a diagnosis of a patient. In the case of the patient JR, there is a lot of information that is not reported that could be very useful when determining the correct diagnosis for this patient. Some questions still need to be asked to find out what that history is and whether or not the new information would apply to JR’s case and help the nurse understand what is impacting his health more clearly. In this paper, a review of the SOAP will be conducted and a discussion of what physical exams are required in order to make it known what JR’s condition is or what is causing the symptoms that he is experiencing. The paper will also identify five conditions that may be considered a differential diagnosis for what is causing his pain.
Chief Complaint
JR has a chief…

Chanu, O. R., & Raj, V. K. (2018). Acquisition and characterization of bowel sounds using labview software. Biomedical Engineering: Applications, Basis and Communications, 30(02), 1850006.
Dujic, T., Causevic, A., Bego, T., Malenica, M., Velija?Asimi, Z., Pearson, E. R., & Semiz, S. (2016). Organic cation transporter 1 variants and gastrointestinal side effects of metformin in patients with Type 2 diabetes. Diabetic Medicine, 33(4), 511-514.
Lenhart, A., & Chey, W. D. (2017). A systematic review of the effects of polyols on gastrointestinal health and irritable bowel syndrome. Advances in Nutrition, 8(4), 587-596.
Mustafa, M., Menon, J., Muiandy, R. K., Fredie, R., Sein, M. M., & Fariz, A. (2015). Risk factors, diagnosis, and Management of Peptic ulcer disease. J Dent Med Sci, 14, 40-6.

Nursing Woc Et Approach to
Words: 2715 Length: 9 Pages Document Type: Term Paper Paper #: 94732227
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2004: 45).


Many recommend use of minimally invasive techniques including SEPS to treat and address problems related to chronic venous insufficiency (Kalra & Glovisczki, 2002). Multiple studies confirm the safety and efficacy of SEPS when used early, especially resulting from its low complication rates compared with other procedures including the formerly popular Linton procedures (Kalra & Gloiscki, 2002; Lee, et al. 2003; Tenbrook, et al., 2004; Bianchi, et al. 2003).

More randomized clinical trials are necessary however to answer additional questions related to the efficacy of new procedures including SEPS, though this procedures remains important for patients with advanced CVI secondary to PVI or with patients who do not demonstrate other complications including DVT (Kalra & Gloiscki, 2002; Bianchi, et al. 2003).

Wagner-Cox (2005) also notes that it is important for nurses to be considerate, knowledgeable and compassionate toward patients with acute and chronic illnesses, especially when caring for…


Baranoski, S. & Thimsen, K. (2003, Aug). "Oasis Skin and Wound Integumentary

Assessment Items: Applying the WOCN Guidance Document." Home Healthcare Nurse, 21(8): Supplement 3-13.

Baron, H.C., Wayne, M.G., Santiago, C.A. & Grossi, R. (2004, Sep-Oct). Vasc

Endovascular Surg. 38(5): 439-42.

New Practice Approaches Through Policy
Words: 1086 Length: 3 Pages Document Type: Essay Paper #: 34956566
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New Practice Approaches Through Policy

One of the major current concerns in health care is the rapidly aging nature of the populations in Western societies today. This is, in general, attributed to developments in medical science and better information regarding personal health choices and activities. Despite this, however, it is also true that aging seldom brings with it a glowing sense of health. While many people today age better than ever before in human history, the elderly also tend to suffer from an increasing number of conditions, some of which leave them bed bound. Many of these bed bound residents, in addition to their initial conditions, also suffer related ailments such as pressure ulcers. These create not only great physical discomfort and emotional stress, but also great burdens on the health care system in terms of treating such ulcers. For this reason, it is suggested that policies should be created…


Leonard, R. (2001, Spring). Policy Considerations for Nursing Home Quality Improvement. Harvard Health Policy Review 2(1). Retrieved from: 

Mackie, S. And Dunnery, P. (2008). Clinical Policy: Pressure Ulcer Prevention and Care for Adults in Hospital. Retrieved from: 

Niezgoda, J.A. And Mendez-Eastman, S. (2006, Feb.). The Effective Management of Pressure Ulcers. Advances in Skin & Wound Care: The Journal for Prevention and Healing 19(1). Retrieved from: 

Rich, S.E., Margolis, D., Shardell, M., Hawkes, W.G., Miller, R.R., Amr, S., and Baumgarten, M. (2011, Jan.). Frequent manual repositioning and incidence of pressure ulcers among bedbound elderly hip fracture patients. Wound Repair Regen 19(1). Retrieved from:

Pylori the Cause of Peptic
Words: 891 Length: 3 Pages Document Type: Research Paper Paper #: 36894694
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This is hardly used for detection of H. pylori alone but for ruling out the existence of other stomach maladies. It is quite expensive and requires a highly skilled physician.

Stool Antigen Test; this is when the stool is analyzed for detection of any foreign antigens or proteins that are associated with H. pylori infection. The stool is known to be very sensitive and can also be use to assess the infection status after the treatment has commenced. The disadvantage of this method is that it absolutely depends upon the participation and compliance of the patient, it is inconvenient to handle and the results are not immediate.

Urea breath test; it is used to detect the presence of H. pylori bacteria in the stomach. It can also be used to detect whether the treatment has worked, the problem with this test is that it is not always available (WebMD LLC,…


American Academy of Family Physicians (2002). Management of Helicobacter pylori Infection.

Retrieved May 12, 2011 from 

Dennis Lee, (2011). Helicobacter Pylori. Retrieved May 12, 2011 from 

Gastroenterological Society of Australia, (2006). Helicobacter Pylori. Retrieved May 12, 2011

Maggot Debridement Therapy Is Maggot
Words: 2057 Length: 6 Pages Document Type: Literature Review Paper #: 94862551
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Given the frequency of pressure ulcers, the strategies used in mitigating those wounds must be effective. Sherman reports that 61 ulcers in 50 patients got maggot therapy and 84 ulcers in 70 patients did not receive maggot therapy (instead, those wounds received traditional care). The results showed that "eighty percent of maggot-treated wounds were completely debrided" but only 48% of conventionally-treated wounds were "completely debrided" (Sherman, 208).

(Qualitative) Laura Jean van Veen presents a case in the Journal of ound, Ostomy and Continence Nursing; a 59-year-old woman (a Jehovah's itness) was seriously injured in an auto accident in Vancouver. In order to save her legs (her religion did not permit blood transfusions) the family asked for maggot therapy. After applying maggots weekly for 6 weeks, "…the patient [was] now free of infection" and had skin graft surgery (van Veen, 2008, 432).

(Qualitative) Another case study in the Journal of ound,…

Works Cited

Courtenay, M., Churdh, J.D.T., and Ryan, T.J. (2000). Larva therapy in wound management.

Journal of the Royal Society of Medicine, Vol. 93, 72-74.

Fenn-Smith, P. (2008). Case Study: Maggot Debridement Therapy. Wound Practice and Research, 16(4), 169-170.

Paul, Aaron G., Ahmad, Nazi W., Lee, H.L., Ariff, Ashraff M., Saranum, Masri, Naicker,

Management of Osteomyelitis in the Diabetic Patient
Words: 3435 Length: 11 Pages Document Type: Article Paper #: 7686776
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Osteomyelitis in the Diabetic Patient


Osteomyelitis is an infection of the bone or bone marrow which is typically categorized as acute, subacute or chronic.1 It is characteristically defined according to the basis of the causative organism (pyogenic bacteria or mycobacteria) and the route, duration and physical location of the infection site.2 Infection modes usually take one of three forms: direct bone contamination from an open fracture, puncture wound, bone surgery, total joint replacement, or traumatic injury; extension of a soft tissue infection such as a vascular ulcer; or hematogenous (blood borne) spread from other infected areas of the body such as the tonsils, teeth or the upper respiratory system.2(p807) Bacteria such as Staphylococcus aureus, Pseudomonas, Klebsiella, Salmonella, and Escherichia coli are the most common causative agents of the disease, although viruses, parasites and fungi may also lead to the development of osteomyelitis.3



1. Stedman's Medical Dictionary. 27th ed. Baltimore, MD: Lippincott Williams & Wilkins; 2000.

2. Butalia S, Palda V, Sargeant R, Detsky A, Mourad O. Does This Patient With Diabetes Have Osteomyelitis of the Lower Extremity?. JAMA: Journal of The American Medical Association [serial online]. February 20, 2008; 299(7):806-813. Available from: Academic Search Premier, Ipswich, MA. Accessed September 19, 2012.

3. Lavery L, Peters E, Armstrong D, Wendel C, Murdoch D, Lipsky B. Risk factors for developing osteomyelitis in patients with diabetic foot wounds. Diabetes Research & Clinical Practice [serial online]. March 2009; 83(3):347-352. Available from: Academic Search Premier, Ipswich, MA. Accessed September 19, 2012.

4. Turns M. The diabetic foot: an overview of assessment and complications. British Journal of Nursing [serial online]. August 12, 2011;:S19-S25. Available from: Academic Search Premier, Ipswich, MA. Accessed September 19, 2012.

Assessing a Patient with Stomach Pain
Words: 934 Length: 3 Pages Document Type: Essay Paper #: 33926463
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Assessing the Abdomen
The chief complaint of JR is that his “stomach hurts” and he is experiencing diarrhea, from which he has been unable to obtain any relief. His pain in his abdomen started 3 days earlier and he has taken no medication for it. The pain is midrange, though it was very high today when it began. He ate but experienced nausea afterwards. JR is 47, suffers from hypertension, diabetes and had an issue of gastrointestinal bleeding four years ago. He is on a number of medications to address his high blood pressure and diabetes. He has no known drug allergies, no history of colon cancer. His father and mother both had hypertension; his father has type 2 diabetes; his mother suffered from Gastroesophageal reflux disease and high fatty concentration in the blood (hyperlipidemia).
JR occasionally imbibed alcohol. He is overweight at 248 lbs with a 5’10” height. He…

Best Way to Avoid Bedsores
Words: 1043 Length: 3 Pages Document Type: Essay Paper #: 23053657
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Stress Ulcer Prevention

The subject up for study in this report shall be whether stress ulcers in hospital patients induced by being bedridden can be mitigated or even prevented by turning the patient to a new position at least once every two hours. The amount of research on this subject is not pervasive and voluminous. However, some material about the subject does exist. Thus, a conclusion should be possible regarding whether patient-turning is a solution to prevent stress ulcers from forming in the first place. While it may not truly be a fix-all solution, the practice of turning patients at two hour intervals shows some promised based on evidence-based research and results.

Stress ulcers, otherwise commonly referred to as deep tissue injury (DTI) is a pressing and persistent issue in the medical field. This is especially true when speaking of patients that are bedridden for any significant amount of time…


Behrendt, R., Ghaznavi, A.M., Mahan, M., Craft, S., & Siddiqui, A. (2014).



UNIT. American Journal Of Critical Care, 23(2), 127-133.

Practice Issue Evidence-Based Practice EBP Project in
Words: 718 Length: 2 Pages Document Type: Essay Paper #: 52771736
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Practice Issue Evidence-Based Practice (EBP) Project in courses DNP program, asked

The practice issue I have chosen to explore is whether or not q2 hourly turning and positioning actually decreases the incidence of pressure ulcers in the elderly bed bound population in nursing homes. The conception that turning does help to relieve the pressure associated with these types of ulcers has been longstanding. Specifically, there is clinical evidence to indicate the fact that "Unrelieved pressure is a well-known clinical risk factor for ulcer development" (Salcido, 2004, p. 156). As such, the turning of patients at least every two hours has been carried on for quite some time in the nursing population, although there are some salient points of concern that need to be addressed with this issue.

One of the major things that individuals need to be aware of who take on such a practice is the fact that the…


Leeds, L. (2004). Importance of turning q2. Retrieved from 

Salcido, R. (2004). Patient turning schedules, why and how often? Advances in Skin & Wound Care: The Journal for Prevention and Healing. 17(4), 156.

Wound, Ostomy & Continence Nurses Society. (2012). Patient turning and repositioning: current methods & challenges, a WOCN perspective. Retrieved from

Pathophysiology of Gastric Acid Stimulation and Production
Words: 894 Length: 3 Pages Document Type: Essay Paper #: 39310952
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The digestive fluids that are secreted by the stomach glands aimed at breaking down solid food and to kill bacteria in the stomach are referred to as gastric juices. Gastric acid is produced by the gastric parietal cell located on the walls of the stomach. The region where the gastric juices are secreted into the lumen is the most acidic environment in the human body and is known as the secretory canaliculus (Schubert & Peura, 2008). The secretion of the gastric acid into the lumen occurs in response to a variety of messages from the paracrine, hormonal, and neurocrine inputs. Gastrin, produced by the G cells that are located in the pyloric mucosa of the stomach is the primary hormonal stimulation for gastric acid production. There are various inputs that will stimulate the parietal cells in order for them to secrete hydrogen ions that will flow into the gastric lumen,…

Sarah's Condition it Is Often
Words: 1770 Length: 5 Pages Document Type: Case Study Paper #: 93674158
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As a result, children and adolescents are at risk of delays and impairments in cognitive development" (Levy 2009). Such delays are far from inevitable, but they do underline the need to assure that Sarah 'keeps up' with her studies and that reasonable peer-appropriate learning goals may need to be met with the assistance of additional support in some instances.

Although not directly applicable to Sarah, immunizations with live viruses, including chickenpox, MMR (measles, mumps, rubella), and oral polio vaccines are not advised for children with lupus (Lupus, 2009, Children's Hospital of Boston). Sarah's parents may need to watch for is the possibility of symptoms in her sibling: "a form of lupus may occur at some point in about one out of twenty people whose siblings have lupus" and they may need to take this into consideration when contemplating a vaccination program if they ever have another child (Lehman 2002). Sarah's…

Works Cited

Lehman, Thomas J.A. (2002, Fall). Early diagnosis of SLE in childhood. Lupus News.

22.3. Retrieved June 29, 2009 at 

Levy, Deborah, Stacy P. Ardoin, Laura E. Schanberg (2009). Neurocognitive

impairment in children and adolescents with SLE: Cognitive development in healthy children and adolescents. Nat Clin Pract Rheumatol CME. 5(2)

Burnout and Technical College Counselors
Words: 7250 Length: 25 Pages Document Type: Research Proposal Paper #: 98439444
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The assumption here is that ounselor burnout may be heightened as a result of the diversity of students who attend post seondary eduational institutions, and the variety of servies the 2-year postseondary ounselors must provide to these students. This assumption is ongruent with the findings of a study by Wilkerson and Bellini (2006) who advise, "Professional shool ounselors are asked to perform multiple duties as part of their daily work. Some of these duties math the desriptions set forth by national standards for shool ounseling programs, whereas others do not" (p. 440).

Consequently, shool ounselors are required to formulate deisions on a daily basis onerning the best way to perform their jobs (Wilkerson & Bellini). Not surprisingly, many shool ounselors are overwhelmed by these onstantly hanging working onditions and requirements, and a number of ounselors experiene high levels of stress as a result. Beause the onnetion between high levels of…

cited in Angerer, 2003). Unfortunately, it would seem that most helping professionals, including counselors, possess characteristics which predisposed them to this construct. For example, Lambie notes that, "Counselors may have increased susceptibility to burnout because of their training to be empathic which is essential to the formation of a therapeutic relationship. In fact, research has found counselor empathy to account for two thirds of the variance in supporting clients' positive behavioral change" (p. 32). The ability to remain empathic to the plights and challenges typically being experienced by students in community colleges is complicated by the enormous diversity that is increasingly characterizing these institutions, of course, but all helping professionals run the risk of becoming burned out while performing their responsibilities by virtue of their empathic sharing. In this regard, Lambie emphasizes that, "Empathy helps counselors understand the client's experience, but at the same time, a counselor may experience the emotional pain of multiple traumatized clients. Empathy is a double-edged sword; it is simultaneously your greatest asset and a point of real vulnerability; therefore, a fundamental skill of effective counselors, being empathic, may place counselors at high risk for burnout" (p. 33).

Citing the alarming results of a national survey of counselors that indicated that incidence may be almost 40%, Lambie also emphasizes that although all professions involve some degree of stress, counselors and other human service providers are at higher risk of burnout compared to other professionals. For example, this author notes that, "Counseling professionals are often in close contact with people who are in pain and distress. This continuous exposure to others' despair, combined with rare opportunities to share the benefits of clients' successes, heightens counselors' risk for burnout" (Lambie, p. 34). Other authorities confirm the incidence of burnout among educators, and cite even higher rates than the foregoing estimate. For instance, Cheek, Bradley and Lan (2003) report that, "Based on several international studies, approximately 60% to 70% of all teachers repeatedly show symptoms of stress, and a minimum of 30% of all educators show distinct symptoms of burnout" (p. 204). Indeed, a study by Lumsden (1998) determined that overall teacher morale was sufficiently severe that fully 40% of the educators who were surveyed indicated they would not choose teaching again as a career, and far more than half (57%) remained undecided at the time concerning ending their teaching career, were actively making plans to leave teaching, or would opt to leave the teaching field in the event a superior opportunity presented itself.

There are some other qualities that typify school counselors that may predispose them to becoming burned out over the course of time (some quicker than others, of course), but which may reasonably be expected to adversely effect the ability of school counselors to maintain their effectiveness in the workplace. For instance, Lambie concludes that, "Common counselor qualities of being selfless (i.e., putting others first), working long hours, and doing whatever it takes to help a client place them at higher susceptibility to burnout. As a result, counselors may themselves need assistance in dealing with the emotional pressures of their work" (p. 34).

Counselors and Characteristics of Burnout


Professional Platform for Ethics and Leadership
Words: 3277 Length: 10 Pages Document Type: Research Paper Paper #: 28691589
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agrees that ethics is an important part of effective leadership in the field of health care but there is no universally accepted understanding of what constitutes ethical leadership (Milton, 20004). The concept of ethical leadership has been addressed in the literature of a wide variety of fields associated with the health care profession but none have been able to clearly define its terms. The purpose of this paper will be to examine what ethical leadership means to me and how my personal viewpoints and attitudes have been affected by my background and experience.

Primary Influences

Having been raised in an Irish family my Irish heritage is an important aspect in the formation of my ethical viewpoint. Although I have lived in the United States for nearly forty years, I cannot escape the lessons and values that I learned growing up in the Irish countryside. My family lived in an Irish…


Benner, P. (2000). The roles of embodiment, emotion and lifeworld for rationality and agency in nursing practice. Nursing Philosophy, 5-19.

Catanzaro, A.M. (2001). Increasing Nursing Students' Spiritual Sensitivity. Nurse Educator, 221-226.

Fry, S.T. (2002). Ethics in Nursing Practice: A Guide to Ethical Decision Making. Indianapolis, IN: Wiley-Blackwell.

Hussey, T. (1996). Nursing Ethics and Codes of Professional Conduct. Nursing Ethics, 250-258.

EBP Project Will Every Two Hour Turning
Words: 988 Length: 3 Pages Document Type: Essay Paper #: 51075918
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EBP Project: Will Every Two Hour Turning and Positioning Decrease Pressure Ulcers in the Eldery Bed Bound Population in Nursing Homes?

Practicum: Clinical rotations with preceptor; serving patients with acute, chronic and new medical issues.

One of the things I have discovered during my recent experiences with both academic and clinical education and an EBP project is that there are numerous and effective ways of learning, presenting, and communicating. Each method, however, has one critical thing in common -- it must be a two-way path and none are effective unless there is clear communicative understanding on the part of the receipient, patient, family or colleague. Aristotle, for instance, once commented that "For the things we have to learn before we can do them, we learn by doing them." Experiential learning targets certain brain chemicals and allows a more personal approach to the individual's own particular brain chemistry. Because the individual…


Beard, C., (2006). Experiential Learning: A Best Practice Handbook for Educators and Trainers. Kogan Press.

Hyrkas, K., et al. (2010. Leading Innovation and Change. Journal of Nursing Management. 18 (1): 1-3.

Moon, J. (2004). A Handbook of Reflective and Experiential Learning. New York: Routledge.

Tapscott, D. (1998). Growing Up Digital: The Rise of the Next Generation. New York: McGraw Hill.

Placement Practice I Discovered a Great Deal
Words: 3070 Length: 10 Pages Document Type: Essay Paper #: 48332126
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placement practice I discovered a great deal about pressure ulcers that occur following perioperative care. I am normally community based and I treat patients that have been discharged from hospital that have developed pressure ulcers following an operation. During my complementary placement on a short stay ward I was involved in the care of patients through their perioperative period. I was amazed how quickly one patient developed a pressure ulcer. The experience and subsequent investigation produced several facts concerning the reasons why such ulcers develop, how to prevent them from occurring, treatment and the emotional, financial and physical hardships that having these ulcers produce in patients.

To evaluate my experience, I have chosen to use Driscoll's model of reflection. Driscoll's model was chosen because of the simple but reflective manner in which it concentrates on questions that are pertinent to the care of patients. The model is divided into three…

Works Cited

Driscoll's (2000) Model of Reflection - United Kingdom

NHS Quality improvement Scotland, Tissue Viability, Best Practice Statement, march 2009, Prevention and management of pressure ulcers accessed at [accessed on 21/03/2011]

NICE guidelines for pressure ulcer prevention accessed at  [accessed on 15/03/2011]

National Institute for Health and Clinical Excellence, September, 2009 The Prevention and treatment of pressure ulcers, London, Royal College of Nursing,

Nursing Utilization Review Preparation Scientific
Words: 1792 Length: 7 Pages Document Type: Term Paper Paper #: 85081273
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Resources needed include manpower and positional aids mentioned previously in this report. Evaluation of the effectiveness of the change would be accomplished through data collection related to the frequency of pressure ulcer occurrence in patients and nurse compliance in the four hours supine positional rotation of patients. Questionnaires will also be administered to nursing staff in order to gain insight as to their attitudes, behaviors and perceived barriers to pressure ulcer prevention.

Phase V: Transplantation and Application

This study concludes that positional rotations of every four hours has been shown to be the most effective prevention of pressure ulcer formation in older patients in elderly care homes and further that that attitudes, behaviors and perceptions of barriers in the view of staff nurses predicts the effectiveness of the implementation of such a prevention program for pressure ulcer care. (Moore and Price, 2006)

Exact Nature of Practice Implications

____ Change the…


Moore, Z. And Price, P. (2004) Nurses' Attitudes, Behaviors, and Perceived Barriers Towards Pressure Ulcer Prevention Journal of Clinical Nursing 13, 2004.

Vanderwee, K.; Grypdonck, D.; Bacquer, De and Defloor, T. (2006) Effectiveness of Turning with Unequal Time Intervals on the Incidence of Pressure Ulcer lesions. JAN Original Research 10 July 2006.

Nursing: Utilization Review

Healing Wounds Case Study
Words: 6082 Length: 22 Pages Document Type: Term Paper Paper #: 87019295
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MS Case Study Nurse Practice

When patients enter hospitals it is oftentimes they become more ill and sicker due to inappropriate care and professional ignorance. This is due mainly to the amount of hubris involved within the medical profession and a tendency to ignore empirical evidence as practiced to success. This approach underlines the most important aspects of healing and the medical profession itself.

The argument for continued improvement in the treatment of patients is best exemplified in the case of MS. His ill health has led to more problems and the approach by the nurse practitioner and her staff is critical to the ultimate survival of this young child who innocently trusted the advice of both his parents or caretakers that the medical staff would be able to treat him with the care and respect that every patient deserves when being encountered during a medical treatment or hospital stay.…


Arnold, M., & Barbul, A. (2006). Nutrition and wound healing. Plastic and reconstructive surgery, 117(7S), 42S-58S.

Bennett, G., Dealey, C., & Posnett, J. (2004). The cost of pressure ulcers in the UK. Age and ageing, 33(3), 230-235.

Campbell, N.C., Murray, E., Darbyshire, J., Emery, J., Farmer, A., Griffiths, F., ... & Kinmonth, A.L. (2007). Designing and evaluating complex interventions to improve health care. BMJ: British Medical Journal, 334(7591), 455.

Corbett, L.Q. (2012). Wound care nursing: professional issues and opportunities. Advances in Wound Care, 1(5), 189-193.

Art in Critiquing the Study
Words: 1322 Length: 5 Pages Document Type: Term Paper Paper #: 90046817
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This could have been a significant factor, but researchers will never know because the information was never looked at, nor contained in the study. An additional weakness of the study was that the researchers had to rely entirely on information and data derived from hospital reports and patient charts rather than on direct contact with the individuals involved. This could be a considerable weakness to the study, but again it is not known whether it is a weakness or not because the information is not contained therein, which makes it a weakness.

One rationale that an observer might make in regards to the criticism of this particular study and the fact that it only looked at the records of the patients rather than talking to the patients themselves was that the study was only looking for the incidences of pressure ulcers.

The study did not offer specific solutions to the…

Gastrorrhagia as Early as 1500
Words: 2265 Length: 8 Pages Document Type: Case Study Paper #: 37200878
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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…


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: .

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.

Sufficiently Narrow in Scope Without
Words: 1484 Length: 5 Pages Document Type: Term Paper Paper #: 57155111
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c. What types of validity were used? Is the validity adequate?

Multiple trials, yes validity is adequate d. Are the instruments clearly described?

All instruments utilized in the study are clearly described.

e. Is interrater reliability described?

The journal article also does a good job of expressing what aspects do not effect interrater reliability

9. Data collection a. Is the data collection process clearly described?

All process have been clearly described and explained b. Is the training of data collectors clearly described?

This is not a completely accurate yes answer. The article does inform the reader that the data collectors are nurses with x amount of years in the field. However, numbers of years in the field do not insure that the nurses do the same things, in the same ways.

c. Are the data collection methods ethical?

Nothing appears to be un-ethical.

10. Data analysis a. Are data analysis…


Vanderwee, K., Grypdonck, M.H., Bacquer, D.D., & Defloor, T. (2005, March 1). The reliability of two observation methods of nonblanchable erythema, Grade 1 pressure ulcer. Applied Nursing Research, 19, pp.156-162.

Translation Evidence Into Nursing Health Care Practice
Words: 644 Length: 2 Pages Document Type: Essay Paper #: 12668634
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Translation Evidence Into Nursing Health Care Practice. Chapter 6, "Translation Evidence Leadership" Article: Bakke, C.K. (2010). Clinical cost effectiveness guidelines prevent intravascular catheter-related infections patients' hemodialysis.

Briefly summarize your selected issue and propose new evidence-based practice strategies.

Pressure ulcers, commonly known as bedsores, are frequently observed in otherwise healthy bed-ridden patients in nursing homes. To promote wellness amongst this patient population, it has been suggested that regular turning and positioning of the patients by caregivers should be used to reduce their occurrence. Turning and positioning has long been used amongst healthcare practitioners for a variety of bed-ridden patients, usually at regimented intervals spanning 4-2 hours (Thomas 2001). Based upon the previous research conducted upon this population, the suggested shortened interval is 1-11/2 hours for repositioning of the patient (Thomas 2001).

Q2. Describe the theoretical basis for your strategies.

The theoretical basis for this initiative lies in the idea that passive…


Bluestein, D. & Javaheri, A. (2008). Pressure ulcers: Prevention, evaluation, and management.

American Family Physician, 78(10):1186-1194. Retrieved from: 

Krapil, L.A. & Gray, M. (2008). Does regular repositioning prevent pressure ulcers?

Health and Nursing Reduction of Bedsores Through
Words: 1591 Length: 4 Pages Document Type: Capstone Project Paper #: 8156838
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Health and Nursing

eduction of bedsores through implementation of Hospital wide turntable

Does the implementation of a hospital-wide turntable team have a positive impact on the reduction of bedsores?

eduction of Bedsores

A pressure ulcer (PU) or bedsore can be defined as an injury to underlying tissue of the skin that occurs due to pressure or friction. In most cases, the injured tissue sores due to the pressure exerted over a prominent bone. PU has also been defined as areas of necrosis due to tissue compression amid the bony prominence and the extracorporeal surface for a prolonged time period (Gray & Krapfl, 2008). It is therefore apparent from these definitions that exposure to pressure for a lengthy time is the primary cause of bedsores.

To prevent or minimize bedsores therefore, it is imperative upon medical practitioners to put intervention measures in place that will reduce exposure to pressure. The human…


Gorecki, C., Brown, J.M. & Andrea, N.E. (2009) Impact of Pressure Ulcers on Quality of Life in Older Patients: A Systematic Review. Journal of American Geriatrics Society. DOI: 10.1111/j, 1532-5415.

Gray, M & Krapfl, L.A. (2005) Does regular repositioning prevent pressure ulcers? Journal of Wound, Ostomy and Continence Nursing. Vol.35, No.6, 571-577.

Ikechokwu, E.C., Idowu, O.A. & Anekwe, D.E. (2012) Prevalence and Factors Associated With Healing Outcomes of Hospitals-acquired Pressure Ulcers among Patients With Spinal Cord Injury. Journal of Public Health and Epidemiology.Vol. 4(2), p. 44-47.

Kaitani, T., Tokunaga, K., Matsui, N., Sananda, H. (2010) Risk factors related to the development of pressure ulcers in the critical care setting. Journal of Clinical Nursing. Vol.19, 414-421.

Helicobacter Pylori
Words: 1181 Length: 3 Pages Document Type: Term Paper Paper #: 96552566
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Helicobacter Pylori

Helicobacter (genus) pylori (species), commonly known as H. pylori, is a bacterium that causes gastritis of the inner lining of the stomach in humans and is the most common cause of ulcers worldwide (Delaney, Moayyedi and Forman 536). Ingestion of contaminated food and water and person-to-person contact is the most likely means of acquiring H. pylori. Portals for entry are largely oral, as oral-oral and oral-fecal contact are the most common contamination methods. About 30% of the adult population in the United States are infected and is more common in crowded living conditions with poor sanitation (Malcolm et al. 137). Infected individuals typically carry the infection indefinitely unless they are treated with medications to eradicate the bacterium. Other than the human stomach, there appears to be no natural reservoir for this bacterium. One out of every six patients with H. pylori infection will develop ulcers of the duodenum…

Works Cited

Delaney, B., P. Moayyedi, and D. Forman. "Helicobacter Pylori Infection." Clin Evid.10 (2003): 535-48.

Hofman, P., et al. "Pathogenesis of Helicobacter Pylori Infection." Helicobacter 9 Suppl 1 (2004): 15-22.

Malcolm, C.A., et al. "Helicobacter Pylori in Children Is Strongly Associated with Poverty." Scott Med J. 49.4 (2004): 136-8.

McLoughlin, R., et al. "Therapy of Helicobacter Pylori." Helicobacter 9 Suppl 1 (2004): 42-8.

Against All Odds Article
Words: 542 Length: 3 Pages Document Type: Essay Paper #: 89065899
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Against All Odds: Preventing Pressure Ulcers in High-isk Cardiac Surgery Patients

There are three authors of the article reviewed who represent several degrees, including one master's degree, and certifications. The authors are (Cooper, Jones, & Currie, 2015):

Danielle Nicole Cooper, N, BSN, CCN-CSC

Sarah Layton Jones, N, BSN, CCN

Linda Ann Currie, N, MSN, ACNS-BC, CCN-CSC

The Authors have credentials that include Adult Health Nurse Specialist-Board Certified (ACNS-BC) and Critical Care Nurse -- Cardiac Surgery Certificate (CCN-CSC) certificates.

The article is peer reviewed and appears in the Critical Care Nurse journal and was published in October, 2015. The article sites twenty-two different sources, most of which were published within the last five years.

The title of the article includes the phrase "Against All Odds," which honestly seems a bit dramatic. The Virginia Commonwealth University Medical Center (VCUMC) nursing staff implemented preventative measures to decrease rates of all hospital-acquired pressure ulcers,…


Cooper, D., Jones, S., & Currie, L. (2015). Against All Odds: Preventing Pressure Ulcers in High-Risk Cardiac Surgery Patients. American Association of Critical-Care Nurses, 75-82.

Plan for Implementing Hourly Nursing Rounds
Words: 2107 Length: 6 Pages Document Type: Essay Paper #: 25791802
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Hourly nursing rounding is regarded as one of the most suitable means for enhancing patient satisfaction and clinical outcomes. This process can be described as a proactive, systematic nurse-centered evidence-based intervention to predict and deal with the various needs in hospitalized patients. There is sufficient evidence to demonstrate that effective hourly nursing rounding can enhance patient safety, promote team communication, and enhance the capability of staff to offer efficient patient care. Therefore, this approach would be a suitable method to help reduce falls, prevent ulcers, and call light use and result in enhanced patient satisfaction through evidence-based practices. The adoption of this method in the organization to improve patient satisfaction and clinical outcomes would require the development of a comprehensive implementation plan and participation from all key stakeholders.

Method of Obtaining Necessary Approval

The adoption of hourly nursing rounding in the healthcare facility to enhance patient satisfaction and clinical outcomes…


Brosey, L.A. & March, K.S. (2014, September 16). Effectiveness of Structured Hourly Nurse Rounding on Patient Satisfaction and Clinical Outcomes. Journal of Nursing Care Quality, 00(00), 1-7.

Forde, J.C. (2014, April 9). Intentional Rounding: A Review of Literature. Nursing Standard, 38(32), 37-42.

Negarandeh, R., Bahabadi, A.H. & Mamaghani, J.A. (2014, December). Impact of Regular Nursing Rounds on Patient Satisfaction with Nursing Care. Asian Nursing Research, 8(4), 282-285.

Timothy, H. (2015, June 2). Hourly Rounding is an Effective Patient Safety Strategy. Retrieved from American Sentinel University website:

Nursing Annotated Bibliography Nursing Annotated Bibliography Annotated
Words: 1256 Length: 5 Pages Document Type: Annotated Bibliography Paper #: 27408840
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ursing Annotated Bibliography


Annotated Bibliography

Annotated Bibliography

This article categorizes diabetes as an epidemic that can responds well with the adjunctive treatment of HBOT. The authors use two clinical case studies in their literature review of how oxygen plays a part in the healing of lower extremity diabetic ulcers. They argue for the necessity of further study and research into HBOT because of its efficacy and the potential to drastically lower medical costs for diabetic patients, whose numbers continue to increase steadily. There is a very clear focus on the costs of diabetic treatments on a global scale in relation to the number of diabetic patients worldwide, as part of the authors' strategy to advocate the widespread use of HBOT. Charts and color photographs contextualized the text and make the research more concrete in the mind of the reader, especially the photographs of diabetic amputees who have not had…

Neal, M.S. (2001). Benefits of hyperbaric oxygen therapy for diabetic foot lesions. Journal of Wound Care, 10(1), 507 -- 509.

This article provides a quantitative explanation for the presence of lower extremity ulcers and wounds in diabetic patients. The article additional explains how HBOT elevate the presence of circulating stem cells in diabetic patients. Their research aims to prove how HBOT stimulates the vasculogenic stem cell mobilization in the bone marrow of diabetics, which then are used to heal skin wounds. The authors explain their experience with these types of patients and HBOT treatments because at the hospital where they all work, HBOT is standard operating procedure for the qualifying patients in they study. This is another example of a highly statistical article with the presence of charts and graphs, even digital images of blood samples from the participants both in color and in black and white. Images have the potential to bring the reader closer to the content of the text. Their research shows that HBOT increases important agents in diabetics' bone marrow that lead to increased circulation and healing properties.

Thom, MD, PhD, S.R., Milovanova, MD, PhD, T.N., Yang, MD, M., Bhopale, PhD, V.M., Sorokina, E.M., Uzun, MD, G., Malay, D.S., Troiano, M.A., Hardy, MD, K.R., Lambert, MD, D.S., Logue, MD, C.J., & Margolis, MD, PhD, D.J. (2011). Vasculonic stem cell mobilization and wound recruitment in diabetic patients: Increased cell number and intracellular regulatory protein content associated with hyperbaric oxygen therapy. Wound Rep Reg, 19(2011), 149 -- 161.

Moore Z Price P 2004
Words: 548 Length: 2 Pages Document Type: Research Paper Paper #: 40201353
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Bedsore prevention was not given priority in the 'benchmarks' used to grade nursing effectiveness and insufficient care and attention was devoted to ensuring that nurses followed standardized preventative procedures. Nurses themselves cited many perceived barriers to being able to take full precautions, including a lack of time, having to work long shifts and being over-tired, and a lack of emphasis on such routine patient care overall.

An important implication of this study is that nursing knowledge does not automatically translate into effective nursing practice. It also shows that an intellectual awareness of the seriousness of a health problem such as bedsores likewise does not cause a behavioral change unless there are radical changes in the nursing environment as a whole, and implementation must be supported on a holistic level. Overburdened nurses face obstacles that prevent adequate oversight of patients and inhibit the administration routine, essential care, such as the patient…

Work Cited

Moore Z, Price P. (2004). Nurses' attitudes, behaviors and perceived barriers towards pressure ulcer prevention. Journal of Clinical Nursing, 13 (8):942 -- 952.

Retrieved December 17, 2010. doi: 10.1111/j.1365-2702.2004.00972.x.

Dashboard Evaluation for Medical Portal
Words: 1335 Length: 5 Pages Document Type: Essay Paper #: 77178382
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Dashboard Evaluation

Patient Satisfaction Scorecard

This dashboard page reviews and specifies how satisfied patients attending the hospital were, or were not, based on the service they received at the hospital. The data breaks down into specific areas of concern for patients in terms of the service they received.

Measurements provided:

There are 24 categories for patient input as to the quality of service they received. The hospital sent out 1,232 surveys and 954 people (former and presumably present patients) responded to the survey (450 males and 504 females; 250 new patients and 704 returning patients). The ages reflect a very diverse community of patients, including: 19 that were 10 years of age or younger; 57 between 11 and 20; 124 were between 21 and 30 years of age; 219 were between 31 and 40; 172 were between 41-50; 153 were between 51-60; 113 were between 60 and 70; and…

One of the immediate things that nurses and other healthcare professions do when a new patient arrives is to give that person aspirin. This was done 100% of the time in January, 2009. And 87% of the patients received aspirin (prescribed at discharge). Patients with heart trouble were given ACEI or ARB for their left ventricle systolic dysfunction (90% of the patients) and counseling for people who smoke cigarettes was given 67% of the patients in 2009. The list is quite long but of particular interest is influenza vaccination (75% of patients received it), blood cultures were taken for 78% of the patients, and 76% of patients that had undergone colorectal surgery received "immediate postoperative normothermia."

As to the how this hospital's core measures stack up on a national basis, the barometer graph on the lower right side of this dashboard shows that this hospital meets national averages 80% of the time.

Overall Summary: When a hospital goes to the trouble of presenting specific data regarding how it serves its patients -- and this should be required / expected in today's healthcare environment -- any potential or past patient can easily see the thoroughness therein.

Child Counseling
Words: 2053 Length: 5 Pages Document Type: Term Paper Paper #: 2474313
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Child Counseling

The objective of this work is to provide viable research techniques to use in order to help a child and her family. This report represents a summary of Alicia Thomas, a nine-year-old African-American 4th grader with a series of legitimate medical as well as possibly psychosomatic physiological and psychological concerns. The young lady has been specifically diagnosed as having a duodenal ulcer with the inherent gastrointestinal symptoms including vomiting and intermittent pain. The pain has been linked to increased absenteeism from school, four hospitalizations, adverse sleeplessness, nightmare experiences with detail of dismemberment and professed fears of death for herself and for her family members.

The family consisted of eight total children and an intact parental situation but of these members, there has also been a history of mental retardation, depression and one sibling who has since deceased but in life was a main care provider. There is also…


Annunziata, Jane. (n.d.). "Play Therapy With A 6-Year-old With Jane Annunziata, PsyD." Retrieved May 10, 2005, from

College of Agricultural Sciences (1999). Cognitive Development/Play-Overview. College of Agricultural Sciences, Penn State University. Retrieved May 10, 2005, from

Ferguson, E.D. (1989). "Adlerian Therapy: An Introduction." Vancouver, British Columbia, Canada: Adlerian Psychology Association of British Columbia.

Wikopedia. (n.d.). Post-traumatic stress disorder. Retrieved May 10, 2005, from

Diabetic Vascular Disease
Words: 1945 Length: 5 Pages Document Type: Term Paper Paper #: 3201728
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Diabetic Vascular Disease state caused by the deficiency of a chemical in the body called insulin which is a hormone is called Diabetes. There are two forms of diabetes. In the type-one diabetes no insulin is formed and people require insulin injections for existence. This was once thought it would affect only children, but now it can occur at any age. The type2 diabetes is due to the resistance of the body towards the effects of insulin. This also includes insulin which is insufficient. ut in this type there is some amount of insulin produced. In both the types the blood glucose levels is increased. When compared to people without diabetes, people with diabetes are prone to certain problems. These problems occur in the nerves (neuropathy), kidney (nephropathy) and eye (retinopathy). These people are prone to early heart attacks and stroked due to the hardening of the arteries (arteriosclerosis). With…


Diabetes Basics-About Diabetics," Retrieved from on March 3, 2004

Diabetes & Vascular Disease Research" retrieved from Accessed on March 3, 2004

Haptoglobin: A major susceptibility gene for diabetic vascular complications," retrieved from Accessed on March 3, 2004

Pathophysiology of Diabetes" retrieved at Accessed on March 3, 2004

Case Study on Nursing Indicators
Words: 1070 Length: 3 Pages Document Type: Essay Paper #: 57518512
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Organizational Systems and Quality Leadership

Efforts to measure and improve the quality of nursing care provided to patients began with Florence Nightingale, who measured patient outcomes and worked towards the improvement of hospital conditions. ecently, studies linking nurses to patient outcomes have been given significant focus within healthcare. Efforts to measure the indicators of the quality of care dispensed by nurses have led to the phrase "nursing sensitive indicators," which has become a buzzword in healthcare. These are "outcomes from patient care that reflect the nursing care provided" (Kelly, Vottero, & Christie-McAuliffe, 2014). These indicators reflect the structure, nursing care process, and nursing care outcomes (American Nurses Association, 2014). Structural indicators include nursing staff supply, skill level of nurses and certification. The process indicators include patient assessment measures of nursing interventions while outcome indicators include all patient experiences such as falls, pressure ulcers, and readmissions…


American Nurses Association. (2013). Code of Ethics for Nurses with Interpretive Statements. Retrieved 2014, from Nursing World: 

American Nurses Association. (2014). Nursing-Sensitive Indicators. Retrieved 2014, from Nursing World: 

ANA. (2014). ANA Indicator History. Retrieved 2014, from Nursing World:

Geriatric Nursing
Words: 588 Length: 2 Pages Document Type: Research Paper Paper #: 1748724
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Search the U.S. Department of Health and Human Services National Guideline Clearinghouse website at / for a quality guideline that pertains to the area of nursing in which you are interested. Describe the guideline and how the information could be used in a process improvement project. Reference the website.

Quality Guideline: Pressure ulcer prevention. In: Evidence-based geriatric nursing protocols for best practice at

With the elderly segment of the merican population growing more rapidly than any other, there are going to be a number of age-related infirmities that will require informed healthcare services in the future. This quality guideline sets forth best evidence-based practices for the prevention and care of pressure ulcers and skin tears for the clinical specialties of nursing, family practice and geriatrics with intended users including advanced practice nurses and nurses. The stated guideline objectives are to provide a standard of practice protocol for: (a)…

Agency for Healthcare Research and Quality. (2014). CUSP Toolkit. Retrieved May 11, 2014 from

Safety in the workplace is everyone's responsibility and preventing the spread of increasingly resistant infectious agents represents a timely and valuable enterprise. One straightforward method that has been used to good effect to help coordinate the actions of all healthcare practitioners is the Comprehensive Unit-based Safety Program (CUSP) toolkit. This training program for healthcare providers is intended to promote teamwork and improve communication levels in ways that reduce the risk of infection and improve the safety of healthcare delivery systems.

One practice area that the CUSP toolkit can be used to plan a process improvement project in my workplace is through a reduction in patient falls. Currently, patients are allowed to fall up to three times before a fall flag was placed on their bed alerting healthcare providers of the patient's potential fall risk and placing a notice on the electronic and hard-copy medical records to this effect. In some cases, patients have been severely injured (in fact, one patient even died after his surgical wound became infected when it was contaminated by the contents of his colostomy bag that ruptured when he fell on it) before an medical record and fall flag alerts were posted. The current system requires improvement in order to reduce the prevalence of falls in this tertiary healthcare facility. Implementing the principles of the CUSP toolkit would provide a consistent approach to risk management for patients that are at risk of falling during the in-patient stay, including identifying better ways to conduct assessments and the number of falls that should be allowed before an alert is posted.

Nursing Experience After Spending a Semester in
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Nursing Experience

After spending a semester in the Newborn Intensive Care Unit (NICU) as a student nurse in training, I can report that I have learned a great deal about the vital issues and practices that are involved in the intensive care unit for newborns, and about the duties and responsibilities of a nurse in that area of healthcare. Part of my training involved treating wounds and the therapeutic communication that is involved in wound care; also, I became well familiarized with the family centric care that is part and parcel of the NICU.

Family Centered Care at the NICU

hat can be more important for a family that has just been on the emotional roller coaster of giving birth prematurely to a new member of the family than being made to feel welcomed and to be treated with a great deal of professionalism and respect? There are a number…

Works Cited

Auckland District Health Board (2010). Car seats for babies / Information for parents. Retrieved May 2, 2013, from

Auckland District Health Board (2010). Establishing and Maintaining Breast Milk Supply /

Information for parents. Retrieved May 2, 2013, from

Aukland District Health Board (2010). Meconium and Newborn Babies / Information for Parents. Retrieved May 2, 2013, from