...ACUTE CARE ASSIGNMENT Introduction For this assignment I have chosen to use a patient on a Medical Rehab Ward that became acutely unwell very suddenly and was eventually diagnosed with Urinary Sepsis before being transferred to an Acute Medical Ward for further treatment. The purpose of this assignment is to show how I as the nurse, managed the situation in the assessing of the patient from the onset of their symptoms using the Airway, Breathing, Circulation, Disability framework. The planning and implementing of the care required and evalutaing constantly to ensure that the care provided is working and how I communicated with the relevent medical staff using the ISBAR tool of communication. The timeframe is over a 36 hour period from onset of symptoms to transfer. I will begin by giving a definition of Sepsis, discuss the ABCDE method of assessment and a brief background as to why the patient is in hospital as well as a brief past medical history. Sepsis, a potentially life-threatening complication of a localised infection, can rapidly lead to acute deterioration risking multi-organ failure and death. (Dellinger et al 2008) Sepsis is quite common and it is therefor imperative that every nurse on every ward be aware of the signs and symptoms of Sepsis and the appropriate measures to take to manage it should their patient become Spetic. Having an effective and proven assessment tool such as the ABCDE approach can help assess, treat and therefore improve the outcome for...
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...Larry Fitzgerald, the vice president for business development and finance for the University of Virginia Health Systems, is preparing a proposal to the U. Va. board members to construct a new long-term acute care (LTAC) facility. An LTAC is designed for patients whom require hospital stays of 25 days or more. Recently the U. Va. had been facing capacity issues with an inadequate number of beds. The hospital would gain an additional 25 bed days per patient transferred to the LTAC, thus increasing revenues from patient’s insurance and increasing patient care. Fitzgerald’s previous proposal for the LTAC facility in 1999 was declined by the board. Although recent regulation put a halt to new construction of LTAC facilities beginning in January 2007, Fitzgerald was determined to convince the board of the value the investment would provide. The board required certain restrictions with new capital investments. First, a 5.0% profit margin as the minimum on new investments,...
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...This week I felt much more nervous than I have in previous weeks, due to the fact that I haven’t been in the acute care setting since December. Fortunately, on my first day back, I was able to take on a client who was of least acuity on the team. Although I normally prefer a challenge, I am happy that I was able to ease back into the fast paced environment of an acute care floor. It was also very helpful to have a RN on my team who was engaged in my learning, through consistently checking in on me, involving me when necessary, and offering opportunities for me to observe her skills, that are not yet within my scope of practice. By the end of my second day back on the surgical floor, I was able to reassure myself of my abilities as a student nurse and put all my worries and doubt to rest. The process of morning rapport, priority checks, vitals and head to toe assessments began to feel more natural and I was quickly reminded of how little I needed to worry about coming back into the acute care setting. I was able to use my growing knowledge in regards to caring for the surgical client as I...
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...Dykes PC1, Carroll DL, Hurley A, Lipsitz S, Benoit A, Chang F, Meltzer S, Tsurikova R, Zuyov L, Middleton B. Fall prevention in acute care hospitals: a randomized trial PubMed.gov 2010 Quantitative Cluster randomized study 4 urban United States hospitals in units that received typical care (4 units and 5104 patients) or the intervention of a fall prevention tool kit (4 units and 5160 patients). Patient fall rates in US hospitals was the focus of study. The primary outcome was patient falls per 1000 patient-days, adjusted for site and patient care unit. A secondary outcome was fall-related injuries to patients in these units. Number of patients that experienced a fall differed between the control (n = 87) and the intervention (n = 67) with...
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...in this case I'm referring to an acute hospital setting. As a child I was taught to believe that it was rude to laugh or speak loudly and disrespectful to make eye contact with elders. Crying was perceived as weak and insecure. Emotions such as pride in academia were revered. I developed a true sense of self-awareness and self-motivation in order to maintain that pride as well as to receive the praise from my family. However I lacked social skills which I attributed to my childhood beliefs. I entered the United States in 1994 and rapidly assimilated with American culture. The most difficult change was to establish eye contact with others, followed by accepting failure and being able to cry. Years of college and constant social exposure has allowed me to gain insight on my own personality as well as to expand on my social skills. The fundamental nature of effective communication is based on emotions. On a personal level I was fortunate to have been given opportunities for introspection, which I believe instilled within me immense emotional intelligence. As a working professional I am able to utilize those attributes to create a productive working environment as well as to alleviate the emotional and physical pain and suffering of my patients. I am faced on a daily basis with patients who are frustrated and angry with the world because of their inability to communicate and provide self care secondary to a debilitating, chronic or acute disease. I am at times angered...
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...Chronic Illness “Chronic illness is the irreversible presence, accumulation, or latency of disease states or impairments that involve the total human environment for supportive care and self-care, maintenance of function and prevention of further disability: (Lubkin, 1995, p.8) Principles Related to Chronic Illness / Trajectory o Duration- lasts for extended period, six months or longer. o Incidence- common in older adults but impacts all ages. o Predictability- one chronic condition impacts 85% of persons 65 years of age and older. The most common are visual impairment, diabetes, heart disease, deafness and hearing impairment, arthritis, Alzheimer’s, osteoporosis, hip fractures, urinary incontinence, stroke, Parkinson’s disease and depression o Shape- multiple health problems with protracted, unpredictable course. Management during the acute phase is usually in the hospital, other phases are usually managed at home. Implications of Chronicity: 1. Managing chronic illness involves more than managing medical problems. Adaptation to illness/disability is a continuous process. 2. Chronic conditions can pass through many different phases over the course of the disease – There can be stable & unstable periods, flare-ups & remission. 3. Keeping chronic conditions under control requires persistent adherence to therapeutic regimens. 4. One chronic disease can lead to other chronic conditions – Diabetes can lead to Neurologic & circulatory changes. 5. Chronic illness...
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...Research proposal An investigation into nursing skills in recognising clinical deterioration of patients in acute care setting in Saudi Arabia Introduction Acute care nurses are expected to demonstrate skills with regards to early detection of deterioration in patients and seek for emergency support. This is indispensable for delivering safe patient care, and thereby to save lives (Cioffi 2009). Nevertheless, ensuring patient safety in acute care setting is still a challenge in the healthcare system in Saudi Arabia (Aldossary, While & Barriball 2008; Almalki, FitzGerald & Clark 2011). Till date, no systematic approach has been undertaken to ensure that acute care nurses are aware of the emergence of new knowledge as well as technological advances that are necessary for early identification (Aldossary, While & Barriball 2008; Al-Ahmadi 2009; Almalki, FitzGerald & Clark 2011). Early identification with patients who are in need of emergency care can prevent cardiac arrest and lessen morbidity and mortality (Cioffi 2009). This study aims to obtain an in-depth understanding of the current level of competence of acute care nurses in Saudi Arabia in terms of their knowledge, skills and attitudes. The findings will be used to develop an integrative model that can provide acute care nurses with effective education and training so that they can be prepared more effectively to identify clinical deterioration at early stages. Literature review According to Grossman & Wheeler...
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...Ethnographic research: oral interview 4-5 pages double spaced An ethnography is a long term investigation of a group (often a culture) that is based on immersion in and, optimally, participation in that group. Ethnography provides a detailed exploration of group activity and may include the collection of historical information and in-person interviews of members of the group. It is an approach which employs multiple methodologies to arrive at a theoretically comprehensive understanding of a group or culture. Ethnography attempts to explain the web of interdependence of group behaviors and interactions. In this assignment, you will interview a disabled or chronically ill person and make observations about the person based on your understanding of what it means to be a member of this social category. Remember that disability and chronic illness include both visible and invisible elements, and that there is great variation in age, class, ethnicity, and gender identity. You may also interview the parent of a child with a disability as long as the parent can speak on behalf of the child’s social experience or experience in society. You will use your knowledge of course concepts related to disability identity and group belonging. The interview can take place in person or, if absolutely necessary, over Skype, but not on the phone. It is important that you read facial expressions and have a sense of the respondent’s non-verbal communication. You should find out as much as you can...
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...Addiction as a Chronic Illness Donnell Parker PS370-01 Health Psychology January 17, 2012 Chronic illness refers to conditions that have the following conditions: The condition involves some disability; it is caused by mostly nonreversible pathological change; and it requires training and motivation on the part of the patient to care for himself or herself. The onset of chronic illness can be sudden or gradual, but one characteristic common to all chronic illnesses is that the patient cannot fully return to the pre-illness state of health (Friedman 2002). Some examples of chronic illnesses are AIDS, various forms of cancer, epilepsy and asthma. Addiction is a condition that results when a person ingests a substance (alcohol, cocaine, nicotine) or engages in an activity (gambling) that can be pleasurable but the continued use of which becomes compulsive and interferes with ordinary life responsibilities, such as work or relationships, even health. Users may not be aware that their behavior is out of control and causing problems for themselves and others (Iliff 2012). Addictions are another form of chronic illnesses. Addictions are characterized by relapses in thinking or a return to substance abuse. Relapse is now seen as the rule rather than the exception in addiction recovery. And it is no longer viewed as a catastrophe but as an opportunity for learning more and better strategies for overcoming urges and for identifying the moods and...
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...I will be looking at the effects of acute and chronic illness on society, particularly in Britain, and the differences between public and private healthcare in their treatment of these problems. Great Britain has a relatively high level of public expenditure on healthcare as a percentage of its GDP. In terms of its healthcare structure it is one of the most public systems as it has a National Health Service, thus offering free healthcare to all residents. The system differs greatly from the more market driven and private healthcare structure of the US. Because of the provision of free healthcare, the vast majority of people in Britain use public healthcare as opposed to the expensive private alternative. However, this does not mean that public healthcare in the UK is superior to other countries as the government struggles constantly with the cost of maintaining the NHS. This leads to a number of cost cutting initiatives, rationing and an inability to purchase the most expensive and advanced medical equipment. The British government also suffers with such problems as bed blocking as hospitals are over subscribed with patients, which leads to increased waiting times for ill people. These problems occur far less in private healthcare sector in the UK, which is of a high level, but it is difficult for the majority to afford. An acute illness is one, which begins and progresses rapidly such as a cold or flu. The person is fine one moment and in urgent need of medical help...
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...An Introduction to Guasha(yuan dynasty) Gua means “to scrape” and Sha means “red skin rash” (in other words, the result of the Gua).So The essence of Guasha is the scraping of the back and other areas to release blocked Qi (energy) and to cure other illnesses. When is Gua Sha used? Gua Sha is used whenever a patient has pain whether associated with an acute or chronic disorder. It can resolve musculo skeletal pain, Gua Sha is used to treat as well as prevent common cold, flu, bronchitis, asthma, as well as any chronic disorder involving pain, congestion of Qi and Blood. Where is Gua Sha applied? Sha is raised primarily at the surface of the body: the back, neck, shoulders, buttocks, and limbs. On occasion, Gua Sha is applied at the chest and abdomen. How is Gua Sha applied? Doctors their patients to find areas that feel tight. They then rub them with a spoon or similar tool until they turn red. “Essentially, you are scraping the restriction in their skin,” What kind of instrument is used to Gua Sha? A soupspoon, coin, or slice of water buffalo horn is used in Asia. I have found that a simple metal cap with a rounded lip works best and is by far more comfortable to the patient. What does the type of Sha indicate? The color of the Sha is both diagnostic and prognostic. Very 1.light colored Sha can indicate Deficiency of Blood. 2.If the Sha is purple or black, the Blood stasis is long-standing. 3.If brown, the Blood may be dry. 4.Dark red...
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...According to Carroll (2007), laboratory evaluation are done in assessing and evaluating acute pancreatitis. She mentioned that initially many biological markers such as amylase and lipase levels, complete blood count with differential metabolic panel, urinalysis and triglyceride levels were being used. However recent studies have found other potential means of concluding the severity and prognosis of pancreatitis. Such promising markers include the use of trypsinogens and pancreatic protease which are used in the auto digestive process of acute pancreatitis. Additional markers that are now being investigated include trypsinogen activation peptide, C-reactive protein, procalcitonin, phosphalipase A2 and the cytokines; interleukin 6 and...
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...April 05, 2012 May 24, 2012 July 04, 2012 ABSTRACT The stem bark of Khaya senegalensis A. Juss (Meliaceae) is used traditionally in the treatment of malaria, intestinal worms, diarrhea, dysentery and venereal diseases. Despite the claim as an effective antidiarrheal remedy in both humans and animals, there is scarcity of documented scientific information of specific in vivo antidiarrheal test using extracts of this plant. The number of wet feces and the distance travelled by activated charcoal meal in rats orally given 300, 600 and 1200 mg/kg doses of aqueous and ethanolic extracts of the stem bark of K. senegalensis were evaluated in the castor oil induced diarrhea and gastrointestinal motility studies. The phytochemical constituents and acute toxicity test of the extracts were also tested using standard methods. Both extracts dose-dependently (P0.05) distance travelled by charcoal in the gastrointestinal motility test. The extracts were apparently safe at 2000 mg/kg body weight per os. Cardiac glycosides and flavonoids were present in both extracts, while tannins were present only in the ethanolic extract. The aqueous and ethanolic stem bark extracts of K....
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...it is inherently inaccurate. United States government should ban animal experimentation for cosmetic products because it is torturous, unethical, and destroys uncounted animal lives. While thousands of animals are killed every year in the United States in product tests, there is no law that requires these tests to be done. Many large and small companies have announced moratoriums or an outright end to product tests. However, there are still a few companies that refuse to end the practice. This is surprising because most scientists have come to the conclusion that animal testing is totally inadequate for protecting humans from harmful products . Hence, this article will examine: 1) treatment of animals in the research 2) care and use of animals 3) alternative to animal testing Testing on live animals began as early as the 17th...
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...WHAT DO YOU UNDERSTAND BY STRESS? DISCUSS THE CAUSES OF STRESS FROM THE INDIVIDUAL GROUP AND ORGANISATIONAL POINT OF VIEW INTRODUCTION Stress is a universal element experienced by employees (Individuals and groups) around the globe. Stress has become a major problem which has had negative impact on individuals, groups and organizations. Employers today are critically analyzing the stress management issues that contribute to lower job performance of employees originating from dissatisfaction and high labor ultimately affecting organizational goals and objectives. A mainstream group of employees articulated that their organizations did not care for its employees and sometimes employees do not like to work with their organizations indicating high levels of stress among them and majority were between of 26-35yrs. Misfits with organizations, no part in decision making, were reported the main cause of stress as well as well no control over work environment, personality traits, lack of relaxation along with ambiguous rules affect employees performance (Meneze 2005). Better managed employees are more cooperative and serve as assets for an organization and when their stress is ignored by the employer the result are increased absenteeism, cost, low productivity, low motivation and usually legal financial damages (The office of Radiation, Chemical and Biological Safety, 1999) Stress is basically a mental strain from the internal or external stimulus that refrain a person...
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