...data to guide your physical exam. 5. Lab Partners – keep communication and responses clear and truthful. Please wear a bathing suit underneath your uniform. A hospital gown will be provided to you. 6. Proficiency Exam Performance Scores – students will have one opportunity to retest during the session in which the Health Assessment course is taken if total laboratory performance scores fall below 70%. a. Upon faculty recommendation, if a student is still unsuccessful after the initial retest, the student may receive an incomplete “I” for NUR 3069L and retest in the first week of the following semester. b. If a student is still unsuccessful after the second attempt, the student will receive a failing grade for NUR 3069L and must repeat the course. 7. Final Grade – students will receive their final grades in the mail and their final scores posted on Blackboard. Recommended approach 1. Arrive 5 minutes early to familiarize yourself with supplies and equipment and to pose last minute questions. a. You will have 30 minutes to complete your exam (twenty-five minutes for hands on and 5- minutes to review or recap areas that may have been missed). 2. Select your system from the container provided. b. You are allowed 5 minutes to review your notes 3. Select supplies and equipment needed to conduct the exam and prepare exam station. 4. Introduce yourself to your client. 5. Wash your hands...
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...Nail It Then Scale It process is a systematic way to add value to, and organize an individual’s experience with innovation and entrepreneurship. The authors have identified the fallacies associated with the traditional entrepreneurship process which leads entrepreneurs down a dangerous path of trusting their assumptions without validating. The Nail It Then Scale It Process challenges this archaic, risky model. Each step of the process dares the innovator to “get out of the building,” to test assumptions and validate the value of these assumptions. Furr and Ahlstrom designed this process through analyzing the innovative pursuits of successful entrepreneurial individuals, and by observing the habits employed by these entrepreneurs. Nail It Then Scale It leads hopeful entrepreneurs through a 5 part process of nailing a pain, nailing a solution, nailing a go to market strategy, nailing a business model, and ultimately scaling successfully. The old, traditional entrepreneurial model The Nail It Then Scale It entrepreneurial model Nail the Customer Pain Nailing the pain is the initial step which works on validating “good ideas” through letting potential customers, field experts, and experiments determine whether people actually are looking to have their “pains” solved. Products are too often conceived as solutions Nail It Then Scale It: Summary. to pains that don’t actual affect more than the individual who has created the solution. To discover a pain the entrepreneur must...
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...3 Describe how you might respond to difficult questions from individuals and others straightforward language, clear information; careful use of medical terms and abbreviations; showing sensitivity and awareness of individual circumstances; referring to others for advice on appropriate response when question is outside of own area of expertise 4 Outline strategies to manage emotional responses from individuals and others professional approach; prepare for the interaction; request support from colleague if appropriate; allow plenty of time; recognise own responses; focussed on individual and others 5 Explain the importance of sharing appropriate information according to the principles and local policy on confidentiality and data protection know what information can be shared and with whom; confirm with senior staff if unsure; follow given guidelines. Element - 4 Know how to access the range of support services available to individuals and others 1 Identify the range of support services and facilities available to an individual and others •Pastoral services •Other professionals •Citizens advice •Self-help...
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...Push hard and fast, compressing chest at least 2 inches. * Let chest rise completely before pushing down again. * Compress at least 100 times per minute. 3. Stop Only if: * The person starts breathing normally * A trained responder or emergency help takes over * You are too exhausted to continue * There is an automated external defibrillator (AED) to use 4. Use an AED as Soon as One Is Available * Turn on the AED. It will give you step-by-step instructions. * Wipe chest dry. * Attach the pads. * Plug in connector, if needed. * Make sure no one is touching the person. Say "Clear" so that people know to stay back and not touch the person. * Push the "Analyze" button if necessary. * If a shock is advised, push the "Shock" button. * Resume compressions and follow AED prompts. CHOKING * The person is choking. * The person is unconscious. While Waiting for 911 If the Person Is Conscious but Not Able to Breathe or Talk: 1. Give Back Blows * Give up to 5 blows between the shoulder blades with the heel of your hand. 2. If Person Is Still Choking, Do Thrusts...
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...from 1997 to 2009 (Fawzi, 2012, para. 1). By making the Pre-op Total knee Arthroplasty class mandatory patients and their family members will be more educated and prepared for surgery and recovery. During the class patients will be able to ask any questions they may have, learn how to better prepare for surgery and ways to prevent infection during their hospitalization. Physical therapist will also discuss exercises and pain management techniques. By using the John Hopkins evidence based practice model a change can be made in the pre-op process for all total knee replacement patients. Change Model Overview The John Hopkins Nursing Evidence-Based Practice Process is defined as a problem-solving approach to clinical decision-making within a health care organization (Dearholt, & Dang, 2012, p. 4). Nurses often use this model to facilitate change within their organization....
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...Commission are required to conduct a root cause analysis (RCA) in response to any sentinel event such as the one described below. Once the cause is identified and a plan of action established, it is useful to conduct a failure mode and effects analysis (FMEA) to reduce the likelihood that a process would fail. As a member of the healthcare team in the hospital described in this scenario, you have been selected as a member of the team investigating the incident. Scenario: It is 3:30 p.m. on a Thursday and Mr. B, a 67-year-old patient, arrives at the six-room emergency department (ED) of a sixty-bed rural hospital. He has been brought to the hospital by his son and neighbor. At this time, Mr. B is moaning and complaining of severe pain to his (L) leg and hip area. He states he lost his balance and fell after tripping over his dog. Mr. B was admitted to the triage room where his vital signs were B/P 120/80, HR-88 (regular), T-98.6, R-32, and his weight was recorded at 175 pounds. Mr. B. states that he has no known allergies and no previous falls. He states, “My hip area and leg hurt really bad. I have never had anything like this before.” Patient rates pain at ten out of ten on the numerical verbal pain scale. He appears to be in moderate distress. His (L) leg appears shortened with swelling (edema in the calf), ecchymosis, and limited range of motion (ROM). Mr. B’s leg is stabilized and then he is further evaluated and discharged from triage to the emergency department (ED) patient...
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...Difficult People Marvin D. Cofield Jack Welch Management Institute Professor Ardith Bowman JWI 505 Business Communication 10 Feb 2013 Difficult People My topic of choice is on “How to deal with difficult people and their decisions even when they are your boss?” The reason I chose this topic is because I’m quite sure I’m not the only one that has had to deal with someone in upper management that is stubborn and difficult to deal with and the decisions that they make just make no sense whatsoever. This paper follows Munter’s Tell/Sell style of presentation (Munter, Ch 5 pp.86). I will attempt to capture the attention of the audience and show how the topic relates to them. The mental and emotional connection is the level of stress and anxiety most people get from being in the position and how to deal with it. The stress of not being to state the issues to the boss for fear of reprisal. I think this should be an interesting topic to speak on and share my experiences and results. Even if some haven't had the misfortune of ever being in that position, I'm sure just hearing what others have to say on the topic will be beneficial in some way. We have all been there at some point in our lives at one time or another and if you haven’t, consider yourself blessed and very fortunate. Dealing with difficult people. Even if you haven’t been on the job for a real long time, it is very unusual to have not found someone in the workforce that you can consider difficult to deal with...
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...Commission are required to conduct a root cause analysis (RCA) in response to any sentinel event such as the one described below. Once the cause is identified and a plan of action established, it is useful to conduct a failure mode and effects analysis (FMEA) to reduce the likelihood that a process would fail. As a member of the healthcare team in the hospital described in this scenario, you have been selected as a member of the team investigating the incident. Scenario: It is 3:30 p.m. on a Thursday and Mr. B, a 67-year-old patient, arrives at the six-room emergency department (ED) of a sixty-bed rural hospital. He has been brought to the hospital by his son and neighbor. At this time, Mr. B is moaning and complaining of severe pain to his (L) leg and hip area. He states he lost his balance and fell after tripping over his dog. Mr. B was admitted to the triage room where his vital signs were B/P 120/80, HR-88 (regular), T-98.6, R-32, and his weight was recorded at 175 pounds. Mr. B. states that he has no known allergies and no previous falls. He states, “My hip area and leg hurt really bad. I have never had anything like this before.” Patient rates pain at ten out of ten on the numerical verbal pain scale. He appears to be in moderate distress. His (L) leg appears shortened with swelling (edema in the calf), ecchymosis, and limited range of motion (ROM). Mr. B’s leg is stabilized and then he is further evaluated and discharged from triage to the emergency department (ED) patient...
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...directed towards fulfillment of a specific purpose” (p. 54). Wiedenbach believed there were four components to clinical nursing: philosophy, purpose, practice, and art. Wiedenbach felt that the each individual nurse is responsible for identifying their own philosophy based on their own values and life experience. Purpose is the goal the nurse hopes to achieve through the nurse-patient relationship. Wiedenbach believed that nursing was goal-driven. Practice is the actions the nurse takes to help the patient achieve the set goal. Wiedenbach spent much of her time explaining this component of clinical nursing because she felt nursing “is a practice discipline that involves action.” (Wiedenbach, 1970, p. 1057) She further outlined three steps of the nursing...
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...caused by child sexual abuse can have serious and widespread consequences for health and well-being. The purpose of this study was to examine the consequences of childhood sexual abuse for women’s health and well-being. The research methodology was phenomenology. Seven women with a history of childhood sexual abuse were interviewed twice with 1–6 months interval. For all the women, the abuse started when they were between 4 and 5. All of them were repeatedly violated and traumatized ever since then and were even still being victimized at the time of the interviews. The main result of the study is that time does not heal all wounds. All the women described great repressed and silent suffering in all aspects of life, and the abuse is still seriously affecting them and their loved ones. As children, they had learning problems, experienced bullying and had unexplained physical symptoms. In adulthood, they have been suffering multiple physical and psychological symptoms: five of them have fibromyalgia; all of them have been suffering chronic and widespread pain; they have all been dealing with...
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...of 76 ABSTRACT WOMEN’S HIGH HEEL DISCOMFORT ANALYSIS AND SOLUTION Kevin Blakley and Annamarie Kepple Women love high heeled shoes, but this love comes at the cost of comfort. Wearing high heels causes a lot of pain and, in the long term, health complications. This project tries to overcome the problem by ultimately making high heels more comfortable. In order to do this, one must first understand the reasons that high heels are uncomfortable, such as arch angle, heel height, and the changes in walking motion. Once there is a true understanding of the factors that contribute to high heel discomfort, the design stage can begin. The design selected for this project was a wedge heel that contained compressive material. This design would improve user comfort in four different criteria. These criteria were arch angle, compression of the shoe, foot rotation, and ground contact surface area of the heel. After the working prototype was created, it was performance tested in these four criteria against a standard stiletto heel and a standard wedge. The results of the prototype showed a great improvement in all of these criteria, resulting in a more comfortable high heel. However, there were a few areas that this prototype and the production process could be improved upon in the future. First, the prototype weight was a critical design factor,...
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...volatile economy in recent years and with so many businesses competing for the same customers, it is imperative for companies to continually improve their customer service or else risk falling victim to their competitors. This is one reason why many organizations are rethinking how they do business. For years, they have accumulated valuable information as a by-product of production while failing to put it to good use. When a company knows its customers’ buying patterns, interests, and demographics, it provides a distinct competitive advantage. This knowledge has become so critical in recent years that the process of managing information has become an industry of its own. How does a company manage its strategic information assets in today’s rapidly changing business environment? What challenges arise out of that task? Are there any preventive measures that can ease the “growing pains” associated with moving from one information paradigm to the next? No matter how simple or convoluted the current information architecture is, evolving companies’ effective use of information can help them achieve a level of sustainable competitive advantage that can be measured on the bottom line. [pic] Figure 1. The Information Evolution Model and its Five Levels The Information Evolution Model Companies evolve through a number of levels in what SAS calls the Information Evolution Model. This maturity model (see Figure 1) enables an organization to objectively evaluate their use of existing...
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...The Unfortunate Hospital Experience for Mr. B Identification of Events * Mr. B presents to the Emergency Room with complaints of Left hip and leg pain * His son is at the bedside * Dr. T assesses Mr. B determining that he needs to set Mr. B’s hip at the bedside. * Dr. T orders moderate sedation * Mr. B takes oxycodone for chronic pain * Nurse J is assigned to care for Mr. B * Nurse J administers medications per Dr.T’s orders * 5 mg of Diazepam * Dr. T assesses Mr. B’s sedation level. Mr. B needs more sedation * Dr. T orders additional sedation medication * 2mg of Hydromorphone * Nurse J administers additional sedation medication per Dr. T orders * Mr. B is not fully sedated and Dr. T orders a 3rd dose of sedation medication * 5 mg of Diazepam and 2 mg of Hydromorphone * Dr. T assesses Mr. B. * Mr. B is fully sedated for the procedure * Dr. T reduces and sets Mr. B’s left hip * Mr. B’s procedure is completed. He appears comfortable and remains sedated * The Emergency Room receives an emergency dispatch call * Pt. in respiratory distress * Nurse J needs to respond to the call. * Nurse J puts a blood pressure cuff on Mr. B with 5 minute cycles and places the pulse oximeter on Mr. B * Son remains at bedside * Nurse J leaves the room to care for the patient in respiratory distress * Mr. B’s pulse oximeter alarm goes off “...
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...Review Starting Step III opioids for moderate to severe pain in cancer patients: Dose titration: A systematic review Palliative Medicine 25(5) 424–430 ! The Author(s) 2010 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0269216310386280 pmj.sagepub.com ˚ Pal Klepstad Pain and Palliation Research Group, Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Intensive Care, St Olavs University Hospital, Trondheim, Norway Stein Kaasa Pain and Palliation Research Group, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Palliative Care, St Olavs University Hospital, Trondheim, Norway Petter C Borchgrevink Pain and Palliation Research Group, Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Center for Pain and Complex Disorders, St. Olav University Hospital, Trondheim, Norway Abstract The European Association for Palliative Care recommendation for starting morphine for cancer pain is dose titration with immediate release (IR) oral morphine given every 4 h with additionally doses for breakthrough pain. As part of a EU 6th framework programme to revise the guidelines we review the evidence regarding starting treatment and dose ...
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...Running head: PAIN CASE STUDY Case Study: Pain Amit Dhir, Omeid Heidari, Sean Mayer, Ololade Ikuomola & Adam Boyce NR110.542 Physiological/Pathophysiological Basis for Advanced Nursing Practice I 09/29/2015 Johns Hopkins University School of Nursing On our honor, we pledge that we have neither given nor received any unauthorized assistance on this assignment. 1 Running head: PAIN CASE STUDY CASE STUDY Pain Use this document in documenting your response to the Patient Case Questions. CHIEF COMPLAINT “My back is killing me. The pain is mostly sharp and stabbing, and sometimes it’s a dull ache. You’ve got to do something. Those Tramadol pills aren’t cutting it and they’ve bound me up.” “I am not sleeping because of the pain.” MEDICAL HISTORY P.M. is a retired, 81yearold male being seen for a routine health maintenance visit. He has a history of lower back pain, morbid obesity, hypertension, hypothyroid, occipital lobe stroke, bilateral total knee arthroplasty, GERD and sleep apnea. Now reporting pain in feet. He has been a smoker for the past 64 years, reporting 12 ppd. He is accompanied by his wife of 62 years. CURRENT MEDICATIONS Tramadol 50100 mg p.o. Q 12 hrs prn back pain Atenolol 25 mg p.o. Q a.m. Levothyroxine sodium 125 mcg p.o. Q a.m. Clopidogrel 75 mg p.p. Q a.m. Ibuprofen 600 mg ii p.o. prn knee pain Aspirin 650 mg p.o. prn “when I can’t get to sleep” ...
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