...Abstract-Aim The aim of this study was to identify barriers to optimal pain management in long-term care (LTC) from a nursing perspective. Method A quantitative, cross-sectional, descriptive design was used. Results Patient-related barriers were seen as interfering more often with optimal pain management than organizational-related or caregiver-related barriers. Difficulty assessing pain due to problems with cognition, older patients’ inability to complete pain scales and communication difficulties as a result of sensory impairment were common barriers. Conclusion A targeted approach to address the identified barriers would help improve pain management practices in LTC. Data collection-The information received in this study was gathered from nursing staff in two private and three public long term care facilities. Questionnaires were sent to these respondents’ regarding barriers to pain control and the respondents’ demographic information. Analysis of date-The questionnaire consisted of two sections. The first included questions regarding the staff personal feelings on what could possibly be a barrier to pain control in these facilities. The categories of barriers included patient, organizational and caregiver. The second section included information about the nursing staff including age, gender and education. A convenience sample was used in this study. Limitations-The limitations in this study include the fact that convenience sampling was used and only five facilities...
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...Management Focusing on Acute Pain: A Multidisciplinary Concept Analysis The concept of managing acute pain is extremely significant to nursing as pain is one of the most common problems for which patients seek out health care resources. Pain is a complex and abstract concept that encompasses sensory, emotional, psychological, social, and spiritual perceptions of pain that may occur in combination with physical pain. Pain is difficult to describe and often hard to measure; although, most healthcare providers agree that pain is subjective and is to be measured qualitatively and quantitatively as the patient perceives its intensity. Pain can affect the quality of life of the individual by impacting them physically, emotionally, and financially. Pain can also impact the family and support systems. The treatment of pain and the loss of income due to pain increases the costs for health care, the individual, and the population. Analyzing and clarifying the concept of managing acute pain can increase the healthcare provider’s knowledge of acute pain management, define the concept of managing acute pain, and expand the understanding of the concept of managing acute pain. The aim of this analysis is to clarify the defining attributes of managing acute pain, identify antecedents that influence the perception of pain and the possible consequences of acute pain. Review of Literature To increase the understanding of the concept of managing acute pain, it is important to explore the definitions...
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...clinical-related practical concern that will impact the nursing professional environment. The United States is lagging behind other nations of the world in fully integrating midwifery into its health care system. “While midwives deliver only 6% of the approximately 220,000 babies in the United States each year, midwives in other countries attend up to 80% of their countries births.” (Bowers, 2000). In our ever-changing fast paced health care system, many woman feel that they receive little personnel attention during pregnancy and childbirth from their healthcare provider. Despite the high quality of care that midwives provide to expectant mothers, American women have few opportunities to use the service of midwives. Barriers to Midwifery care in the United States include physician opposition, public perception as substandard care, state and federal regulations, lacking of training programs, lack of acceptance among third-party payers and our political and economic environment However, midwifery has gained a foothold in the nursing profession. Their acceptance has coincided with the rise of nursing professionalism as it develops a scientific foundation for clinical practice. The middle range nursing theory known as health promotion provides a sound basis for midwifery care during the puerperium. Developed by Dr. Nola J. Pender in the 1970’s, is rooted in the social learning theory of Bandura, which...
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...between mental illness and work can be looked at in a number of different ways, including: • the stresses and strains today's workplace places on us; • the incredible pressure placed upon people to continue to perform at work when an illness strikes, and the extra strain this places on their families and friends; • the difficult barriers those persons diagnosed with a mental illness face in the working world; • the strain encountered by people who work while they care for someone with a mental illness at home; • the therapeutic role the act of work plays in helping to reduce stress and improve mental health; and, • the benefits work can bring in guiding people diagnosed with a mental illness toward recovery, rebuilding their self-esteem and hopefully returning to the jobs they left when the illness struck. What is Mental Illness? The first step toward discussing mental illness and helping eliminate myths, misconceptions and stereotypes is to understand what a psychiatric illness is. In general it refers to significant clinical patterns of behaviour or emotions associated with some level of distress, suffering (pain, death), or impairment in one or more areas of functioning (school, work, social and family interactions). At the root of this impairment are symptoms of biological, psychological or behavioural dysfunction, or a combination of these. Depression is a good example...
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...End of Life Population Health Framework University of Massachusetts Medical School Fall, 2011 Articles 1. http://www.cancer.gov/cancertopics/factsheet/Support/end-of-life-care 2. http://www.loisgreenlearningcommunity.org/ < Compare and Contrast: The National Cancer Institute’s End of Life Care Questions and Answers on their website are written more the for caregiver or patient and describe what end of life care refers to. It’s formally written and describes each step or phase of care from initial diagnoses of end of life approaching or withdrawal of life saving measures such as chemotherapy to knowing when the patient has passed. It describes ways to take care of a patient at the end of life and when to call for professional help. It’s mainly geared toward the caregiver and really addresses all issues in providing care no matter how minor. The priority here is the well being and education of the non-professional care taker and the patient. The Lois Green Learning Community is an online resource for health professionals and a community to share experiences and also take care of yourself by doing so. It’s a place to blog or unwind about an experience, there are many resources listed for certification for palliative care and how to treat patients. It’s written with a very open and warm way and it’s a safe place to share your experiences, not formal and official like the NCI website. Communities like this are very important for health professionals to have a place...
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...BEATRISA SHEKHTER NRS 433-V Literature Search Wound Care is very important topic in modern medical field. Pressure ulcers are the major problem in the long term facilities. Having an understanding of the exact cause of pressure ulcers helps place the role of repositioning into context. Demographic and epidemiological data suggest that health-care demand will increase considerably in the future as a result of an ageing population and a rise in the prevalence of chronic diseases such as diabetes. This phenomenon has come to be referred to as the ‘health care time bomb’ in the popular press and political discourse. The authors seek to look beyond the headlines and political rhetoric to clarify the extent to which they reflect the likely future reality with a specific focus on wound management. The present-day burden that wounds and current wound management practices place upon the health-care system are detailed and clarified, and the potential future implications of increasing wound prevalence on the current picture are explored. Possible opportunities to enhance current wound management practice as identified in the analysis are discussed. Declaration of interest: Alistair Biel by is a contractor for Smith & Nephew. Richard Searle is and employee of Smith & Nephew. This project was supported by an unrestricted grant from Smith & Nephew. As such, a pressure ulcer is defined as localized injury to the skin and/or underlying tissue, usually over a bony prominence, as a result...
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...Health Literacy "It has long been recognised that people with less well developed literacy, language and numeracy skills (LLN) also have poor health outcomes." (DfES 2006). Poor basic skills impacts on the ability to navigate the healthcare system. It makes it harder, if not impossible, for individuals to make choices about their treatment and their ability to make healthy lifestyle choices. Health Literacy is the ability of individuals to make informed decisions about their health. Everyone needs these skills, but those with poor LLN skills are more at risk poorer health literacy, poorer health outcomes and greater health inequalities. Health literacy involves basic health knowledge and a range of skills including: • the ability to find and read health information; • the ability to comprehend and evaluate health information; • the ability to communicate verbally with health professionals; • the ability to assimilate the above to make better informed personal decisions on their health. Within a health context these skills are needed in order to: • navigate and access the healthcare system and use services appropriately; • communicate health needs effectively; • make empowered choices and decisions about both healthy lifestyles and treatment options; • understand and follow treatment instructions; • both communicate and understand essential information in routine...
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...Introduction A refugee, according to the United Nation’s definition (as cited in matthewhouse.ca, 2012), is “a person outside his or her country of origin who has a well-founded fear of being persecuted for reasons of race, religion, nationality, membership in a particular social group or political opinion.” The current number of refugees around the world is 43.7 million, as estimated by the United Nations High Commission for Refugees (UNHCR). Being a refugee is not a choice – they are forced to leave their country of origin to avoid conflicts that could potentially be disastrous, traumatic, or even lead to their death. They begin a long journey of danger and uncertainty on the refugee highway, seeking safety and security (matthewhouse.ca, 2012). Also, as stated in matthewhouse.ca (2012), refugees come to Canada in three different ways. About 7,000 refugees per year are sponsored by the government. Another 3,000 per year are sponsored by private groups, such as churches. Historically, the largest group, which up until recently, numbered more than 20,000 per year, come to Canada with no sponsors and ask for asylum upon arrival. There is no system in place to welcome or assist refugee claimants. They are simply numbered among the homeless, often without resources. Many are forced to look for help in inappropriate city shelters not equipped to meet their needs. Government policies are becoming harsher and there is no structure in place to directly look after their well-being...
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...Running head: CHLAMYDIA Chlamydia Case Study with Questions Chlamydia “The bacterial infection chlamydia trachomatis is one of the most common sexually transmitted infections (STI). The Chlamydia bacterium can infect the cervix, fallopian tubes, throat, anus and male urethra”. (Henning, D., Alice, R., Sanci, L., Dunning. T., 2006) Chlamydiae are obligate intracellular organisms from bacteria that now comprise 3 species. “They include the following: Chlamydia trachomatis, Chlamydia psittaci, and Chlamydia pneumoniae.” (Bashour, 2007) It is a kind of bacteria that can infect the penis, vagina, cervix, anus, urethra, eye, or throat. Chlamydia is the name of several types of bacteria. One strain occurs primarily in the tropics and causes lymphogranuloma venerum – symptoms include skin lesions and swelling of certain glands in the genital area. According to Kirkland (2006), it is stated that an estimated 2.8 million cases of Chlamydia are reported in the United States each year. It is also mentioned that according to the CDC, there is an increase of more than 60% of Chlamydia cases undiagnosed and untreated. This percentage remains higher among females 15 to 19 and 20 to 24 years of age. Chlamydia can be transmitted during vaginal, anal or oral sex. Chlamydia can also be passed from an infected mother to her baby during vaginal childbirth. Since Chlamydia is known as a silent disease because about three quarters of infected...
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...Self-Management Education: History, Definition, Outcomes, and Mechanisms Kate R. Lorig, Dr.P.H. and Halsted R. Holman, M.D. Stanford University School of Medicine ABSTRACT THE MEANING OF SELF-MANAGEMENT Self-management has become a popular term for behavioral interventions as well as for healthful behaviors. This is especially true for the management of chronic conditions. This article offers a short history of self-management. It presents three self-management tasks—medical management, role management, and emotional management—and six self-management skills—problem solving, decision making, resource utilization, the formation of a patient–provider partnership, action planning, and self-tailoring. In addition, the article presents evidence of the effectiveness of self-management interventions and posits a possible mechanism, self-efficacy, through which these interventions work. In conclusion the article discusses problems and solutions for integrating self-management education into the mainstream health care systems. Whether one is engaging in a health promoting activity such as exercise or is living with a chronic disease such as asthma, he or she is responsible for day-to-day management. Gregory Bateson (3) once said, “one cannot not communicate.” The same is true for health behavior and disease management. One cannot not manage. If one decides not to engage in a healthful behavior or not to be active in managing a disease, this decision reflects a management style. Unless...
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...Traumatic Brain Injury WUT2 Task Western Governors University A. Investigated Disease Process The disease process I will be reviewing is traumatic brain injuries. A traumatic brain injury occurs when sudden trauma occurs to an individual’s brain. Traumatic brain injuries are considered closed or penetrating. Traumatic brain injuries are categorized as mild, moderate or severe based on the amount of damage that occurs to the brain. (ninds.nih.gov, 2015) A1. Pathophysiology To understand traumatic brain injuries, we must first discuss the numerous causes of brain injury. When injury occurs to the brain, the patient encounters the primary injury that is directly related and occurs at the time of the injury. Secondary injury occurs as a result of the primary injury but often leads to a more significant sequela based on the type of initial trauma. Non penetrating injuries to the cranium that lead to traumatic brain injuries are not always related to direct blows of the cranium. Rapid acceleration and deceleration injuries along with compression injuries may lead to traumatic brain injuries. This type of injuries can lead to injuries to the brain tissue that could include compression, stretching and shearing injuries to the brain tissue. These type of injuries are classified as “diffuse axonal injuries”. Diffuse axonal injuries are one of the most common and extensive types of traumatic brain injuries. These injuries often lead to death or severe irreversible...
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...HLTHIR403C. Work effectively with culturally diverse clients and co-workers Author John Bailey Copyright Text copyright © 2008 by John N. Bailey. Illustration, layout and design copyright © 2008 by John N. Bailey. Under Australia's Copyright Act 1968 (the Act), except for any fair dealing for the purposes of study, research, criticism or review, no part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means without prior written permission from John N. Bailey. All inquiries should be directed in the first instance to the publisher at the address below. Copying for Education Purposes The Act allows a maximum of one chapter or 10% of this book, whichever is the greater, to be copied by an educational institution for its educational purposes provided that that educational institution (or the body that administers it) has given a remuneration notice to JNB Publications, Disclaimer All reasonable efforts have been made to ensure the quality and accuracy of this publication. JNB Publications assumes no responsibility for any errors or omissions and no warranties are made with regard to this publication. Neither JNB Publications nor any authorised distributors shall be held responsible for any direct, incidental or consequential damages resulting from the use of this publication. To Order this Publication This publication can be ordered in a wire bound...
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...STEPS FOR CHANGE Managing effectively the human aspects of organizational change is central to your success as a change leader. SUCCESSFUL CHANGE LEADERS ARE RARE BIRDS. WHETHER THE effort to implement change is institution-wide or focused at the departmental level, the reason for failure can nearly always be traced to a lack of effective change management skills exhibited by the leader. More specifically, it is most often a leader’s misunderstanding of organizational culture and human relations within that culture that prevent successful implementation of change strategies. While observing and participating in numerous attempts to implement organizational change within both nonprofit and for-profit organizations, I have advised leaders to follow 10 essential steps. 36 • JUNE 2002 TING NACUBO BUSINESS OFFICER • 37 1 1. Align Leadership Style With Organizational Culture Many leaders don’t fully understand that, by nature, most organizations resist change. Employees create patterns of behavior to reduce stress and eliminate the unknown. Change creates uncertainty, stresses the culture, and alarms the culture keepers—those individuals who resist change at all costs. It is the leader’s responsibility to reduce undue stress on the culture caused by change initiatives. For instance, if a leader’s orientation is external—focused on market or customer needs—and the organization’s culture is primarily inward or tradition-oriented, a leader will face difficulty when...
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...Health Care Management Issues | March 29 2013 | Medical errors and the quality problems to which they lead harm millions of Americans each year. If the errors reduce and improve quality substantially professionals must create systems and care processes that anticipate inevitable human errors and either prevent them or compensate for them before they cause harm. National surveys of registered nurses, physicians, and hospital executives document considerable concern about the U.S. nurse shortage. There were also many areas of divergent opinion within and among these groups, including the impact of the shortage on safety and early detection of patient complications. Healthcare providers need quick access to patient medical information whenever and wherever patients present for care. A system to standardize electronic medical records, such as the National health Information Infrastructure, would provide quick access to patient information. | HEALTH CARE | Health Care Management Issues There is now a robust evidence base in the quality improvement literature on process and outcomes, but structure has received considerably less attention. The health care field would benefit from expanding the current interpretation of structure to include broader perspectives on organizational attributes as primary determinates of process change and quality improvement. Solutions to the health care management issues dealing with the quality of care should be discuss with the following key...
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...of the use of theory in qualitative approaches to research as exemplified in qualitative end-of-life studies. Background. Nurses researchers turn to theory to conceptualize research problems and guide investigations. However, researchers using qualitative approaches do not consistently articulate how theory has been applied, and no clear consensus exists regarding the appropriate application of theory in qualitative studies. A review of qualitative, end-of-life studies is used to illustrate application of theory to study design and findings. Data sources. A review of theoretical literature was carried out, focusing on definitions and use of theory in qualitative end-of-life studies published in English between 1990 and 2008. Discussion. The term ‘theory’ continues to be used in a variety of ways by theorists and researchers. Within the reviewed end-of-life studies, the use of theory included theory creation or provision of a comparative framework for data analysis and interpretation. Implications for nursing. Nurses who...
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