...Managing Mobility After a Total Knee Replacement November 15, 2011 INTRODUCTION In Kindred Rehabilitation, the patient had a total knee replacement due to osteoarthritis. Osteoarthritis causes degenerative changes, within the joints causing bone stiffening and reactive inflammation. My patient was admitted on 10/21/11 with osteoarthritis and a left total knee replacement. Her PT and INR were a concern because she had developed mild thrombocytopenia which resulted in the elevation and potential bleeding. The physician had to take her off of Lovenox and switch her to an oral anti-coagulant Xarelto at 10mg once daily. During her care I was educated by the interdisciplinary teams managing mobility, safety, and the more modern approaches with a total knee replacement. The purpose of this clinical summary paper is to discuss managing mobility after a total knee replacement. REVIEW OF RELATED LITERATURE In seeking out information on this topic, I used the Amarillo College Library Network and CINAHL database on campus and opened as many articles that I believed would aid in my research. The words I used for searching were: TKR, total knee care, and managing total knee replacement. The contributing factors gave me the articles that related to my patient that I had cared for in clinicals. These searches took me to the information that I was in need of for my paper. Turner’s (2011) primary focus was about care prior to surgery, during, post-operatively...
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...American dream for many people. This dream means one can be their own boss and express their own ideas. Successful entrepreneurs tend to follow multiple steps to achieve their goal is business. These processes include four distinct stages: (1) identify and evaluate the opportunity, (2) develop a business plan, (3) determine what resources are necessary, (4) managing the new business (Hisrich, Micheal, & Shepherd, 2005). It is these four stages that give the entrepreneur a better understanding of the organizational and financial feasibilities of the new business (Barringer & Ireland, 2010). It is the order of these stages, which allow the entrepreneur to determine the best course of action to ensure the success of the new business. This paper will cover the order of the stages and importance of the stages from an individual and corporate perspective. Identify and Evaluate the Opportunity The first stage in the entrepreneurial process is to identify and evaluate the business opportunity. There are four environmental trends: (1) economic, (2) social, (3) technological advances, and (4) political and regulatory changes (Barringer & Ireland, 2010). Understanding these trends is helpful in determining the location of the business and the technology appropriate for the area. First is to understand the economic and social trends in the market place. When the economy is at its best, people are more...
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...of clamping the indwelling urinary catheter in patients with hip fracture Critical Appraisal In this quantitative research article, the authors have dealt with one of the most common clinical problem i.e. clamping of urinary catheter after hip surgery. Hip surgery is very common among the people of old age group especially above 75 years. Further, older women are more susceptible to hip fracture and commonly undergo hip injury (Johansson & Christensson, 2010). Bladder catheterization is a common clinical practice in surgeries. It helpful in monitoring urine output in patients. However, it is also associated with one of the major clinical problems, i.e. operative urinary retention (POUR). It can be defined as the inability of a patient to pass urine in spite of full bladder (Baldini, Bagry, Aprikian, & Carli, 2009). It is has been reported that patient of hip surgery are at higher risk of urinary retention (Balderi & Carli, 2010; Johansson & Christensson, 2010; Singh et al., 2010). In the case of hip replacement the incidence of POUR has been reported to be between 12- 84%. Similarly, in case of hip fracture the prevalence of POUR is 18% to 56% (Borghi et al., 2004; Oishi et al., 1995). The most effective intervention reported till date for reducing the risk of urinary retention is clamping of urinary catheter. The main objective of this paper was to investigate the efficacy of clamping of urinary catheter through randomized controlled trial in patients undergone...
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...have to depend on government assisted help nor would be struggling day to day. I have not been in a situation where I myself needed help, however I do know some people who are truly needed help and received yet, as well as others who honestly did not need the help but did not want to work hard. I am hoping my paper shows both the good and bad of today’s situation with people struggling, and hopefully some readers will have changed opinions on this whether it be good or bad. My Paper is written in APA format. Ending Poverty One Meal at a Time After reading the article “On the Edge of Poverty” by Sheryl Gay Stolberg[->0], it’s realized that it was written from a point of view that shows the many down falls of a situation where a SNAP card is needed yet doesn’t point much at improving it. In many ways it supports the food stamp system, or Supplemental Nutrition Assistance Program (SNAP) as it is currently laid out. Stolberg starts off by phrasing Dustin Rigsby from Tennessee. She goes on to lay out that he is a struggling mechanic who reluctantly accepts food stamps as a way to feed his family of three. It goes on to say that while he is off work due to a knee injury his wife only works part time as a cashier at a local JC Penney. Having more than half the...
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...Medical Tourism Medical Tourism Introduction Medical tourism is the act of traveling to other countries to obtain medical, dental or cosmetic care. Medical tourism is a new term but thousands of years old act. People have been traveling across the continents in search of cures for any imaginable illnesses and making therapeutic trips for health wellness. In ancient Greece, pilgrims and patients came from all over the Mediterranean to the sanctuary of the healing god, Asklepios at Epidaurus, and from the 18th century wealthy Europeans have been traveling to spas from Germany to the Nile. In recent years, medical tourism is becoming more popular with patients seeking treatment for health and well-being purposes abroad. Medical Tourism is also known as Medical Travel, Health Tourism, Surgical Tourism, Health Travel, Treatment Abroad, Surgeries Abroad, and Medical Outsourcing. Medical Tourism Concerns Though many are eager to be the right pieces in the puzzle, many are still struggling to get the right fit. There are a number of concerns and risk factors for patients getting treatment much less seeking them abroad. Some concerns for patients include a consistent quality of care, lack of extensive dialog between the patient and the doctor, lack of post-op follow up, cultural differences and difficulty in obtaining sufficient insurance coverage. In order to mitigate the risk, it’s essential that the patient works with well reputed facilitators. Medical Tourism Accreditation ...
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...My Leadership SMART Goal Leadership development is one of the many pertinent skills that nurses has to master in congruent with the dynamic and fast changing healthcare system, in order to provide an effective and safe patient care. Part of effective leadership is setting a goal that is achievable and realistic for the team or group in order to reach a desired outcome. Using a SMART-formatted goal ensures that the desired outcome is achievable, hence the meaning of SMART goal, Specific, Measurable, Attainable, Realistic, and Time bound. To help with my leadership development in the care of my patients, I will focus my SMART goal on improving my leadership skills in patient education particularly with pain management on post-surgical patients since I take care of a lot of post-surgical patients. This goal is in line with one of the Institute of Medicine’s core competencies for health clinicians that states to provide patient-centered care. I will achieve my goal with some help from a team member at work. Nurses and other health care professionals are expected to provide care that is effective, safe, and patient-centered. One of the core competencies that the Institute of Medicine (IOM) set for healthcare professionals is to provide patient-centered care. Providing a care that is patient-centered focuses on including the patients in their plan of care, recognize, and respect their needs, values and preferences. Open communication with the patients and collaborative care is also...
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...Akshata Makkaru kd7643, HCA 6200-02 April 22, 2015 Important trends in the Hospital Industry The objective of this paper is to discuss certain emerging trends in the hospital industry and their impact on the U. S health care system. The focus will be on Big Data, Re-admissions reduction program, and Tele Health services which have brought significant reforms in the U.S health care system. Big Data in Hospital industry: Large amount of data is produced in the healthcare industry and most of the data is stored in hard copy form. The current trend is towards the digitization of these enormous troves of data. Report says that the data from the U.S. healthcare system alone has reached,150 exabytes in the year 2011. Kaiser Permanente, the California-based health care network which has more than 9 million members is believed to have between 26 and 44 petabytes of potentially rich data from electronic health records, including images and annotations. By definition, big data in healthcare refers to electronic health data sets are so large and complex that they neither possible to manage with traditional software and/or hardware nor can they be easily managed with traditional or common data management tools and methods. Now, most of the patient data is compiled electronically because it is...
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...other organizations providing health-care services. Business and leaders must be well equipped in traditional management knowledge and practices to manage the unique aspects of the health-services industry. The success of the new Health Care Reform depends on the cost, types of coverage and technological advances. Careful elevation and true quality assurance programs will reduce some the nepotism that goes on in our system. This will allow the best person, business, or technology to be used as it is needed. The innovation that has been created over the past ten years have allowed for improvements as well as lowering the mortality rate. Japan system allows for frequent health checks and even house calls are being done electronically. This paper looks at various costs of the Healthcare system, technological alternatives available in the Healthcare system and look at the pros and cons of different options available. History of the United States Healthcare If we compare the quality of health care today with the health care prevailing a century ago, it has dramatically improved and quality of care provided today is far better, but at the same time the health care system has become very complex, confusing and to some extent inefficient in spite of the burgeoning cost of health care. Expectations today have grown rapidly with the advancement in the health care technology. Medical technology, training, technique and facilities have...
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...27 References.......................................................................................................…...30 Abstract Medical tourism, where patients travel overseas for operations, has grown rapidly in the past decade. High costs and long waiting lists at home, new technology and skills in destination countries alongside reduced transport costs and Internet marketing have all played a role. With the best infrastructure and medical facilities, comparable with any of the western countries, accompanied with the most competitive prices, treatment can be done in India at the lowest charges. The research suggests that India represents the most potential as a medical tourism market in the world. This paper seeks to provide a first assessment of this emerging phenomenon and then will examine, using the research, whether medical tourism will be a profitable business venture for Medscape India Inc. in New Delhi, India. Medscape will form an alliance with Apollo Hospitals and will be in operation early...
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...27 References.......................................................................................................…...30 Abstract Medical tourism, where patients travel overseas for operations, has grown rapidly in the past decade. High costs and long waiting lists at home, new technology and skills in destination countries alongside reduced transport costs and Internet marketing have all played a role. With the best infrastructure and medical facilities, comparable with any of the western countries, accompanied with the most competitive prices, treatment can be done in India at the lowest charges. The research suggests that India represents the most potential as a medical tourism market in the world. This paper seeks to provide a first assessment of this emerging phenomenon and then will examine, using the research, whether medical tourism will be a profitable business venture for Medscape India Inc. in New Delhi, India. Medscape will form an alliance with Apollo Hospitals and will be in operation early 2009. Medscape...
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...provide their patients with high-quality care and decreases health care cost. The purpose of this paper is to describe why readmissions from nursing homes (NHs) is a nurse practice problem, nurse practice changes to reduce hospitalizations in NHs, evidence found in the nursing literature that supports the change in nursing practice and how to evaluate the change in practice after implementation of interventions. The Problem Residents in NHs continue to experience potentially avoidable 30-day readmissions to hospitals. Rahman, Foster, Grabowski, Zinn, & Mor (2013) define 30-day readmissions as when the resident is readmitted to the hospital within 30 days of being discharged from the hospital to NHs and avoidable readmissions as conditions that can be managed safely and efficiently in NHs instead of the resident being transferred to the hospital (p. 1901) There are more than 1.6 million Americans living in NHs in the United States and 23.5% of these Americans experience readmission to the hospital within 30 days of discharges and cost more than $17.4 billion per year in unnecessary health care cost (Ouslander & Berenson, 2011, p. 1165). The residents that are at an increased risk of readmission to hospitals from NHs have a diagnosis of congestive heart failure (CHF), pneumonia, myocardial infarction (MI), chronic obstructive pulmonary disease (COPD), or total hip and knee replacements (Kripalani, Theobald,...
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...MBA Consulting Project Customer Loyalty as a Function of Brand Penetration Growth Arguably, generating customer loyalty is a prerequisite for effective ad campaigns. Frederick Reichheld claimed in the 1980s that by increasing customer retention by 5%, profitability would increase from 25% to 85%. Since then, profitability has actually increased 25% to 100%. Subaru used a multi-platform marketing campaign which included online and offline elements as well as a customer relationship management scheme, with personalized direct communications According to Andrew Ehrenberg's "double jeopardy rule", small brands are said to be "doubly jeopardized" because they have fewer buyers who are less loyal to the brand, while large brands tend to "benefit twice" as a result of higher market penetration, increased buying frequency and customer loyalty. Brands looking to increase customer loyalty should focus on increasing penetration, since loyalty follows as a logical consequence of brand penetration ." Consumer loyalty can also be increased by creative marketing campaigns that generate buzz and stimulate word-of-mouth. As opposed to simply looking at attitudinal loyalty, it is important to observe price sensitivity as a measure of consumer commitment to a brand. Multi-media campaigns are an effective way to stimulate market share, thereby increasing brand loyalty. An important part of any marketing mix is the use of television advertising, which repeatedly demonstrates it's superiority...
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...Economic Consequences of Firms’ Depreciation Method Choice: Evidence from Capital Investments Scott B. Jackson* University of South Carolina Xiaotao (Kelvin) Liu Northeastern University Mark Cecchini University of South Carolina May 2009 * Corresponding author: Scott B. Jackson, School of Accounting, Moore School of Business, University of South Carolina, Columbia, SC 29208. E-mail: scott.jackson@moore.sc.edu. Phone: (803) 777-3100. Fax: (803) 777-0712. We gratefully acknowledge the comments of S.P. Kothari (the editor), an anonymous referee, Kin Blackburn, Tom Canace, Marc Caylor, Dutch Fayard, Victoria Glackin, Noah Jackson, Scott Whisenant, and Rich White. Electronic copy available at: http://ssrn.com/abstract=1415976 Economic Consequences of Firms’ Depreciation Method Choice: Evidence from Capital Investments Abstract: This study identifies several interrelated reasons why firms’ depreciation method choice is likely to influence managers’ capital investment decisions. We find that firms that use accelerated depreciation make significantly larger capital investments than firms that use straight-line depreciation. Further, we find that there has been a migration away from accelerated depreciation to straight-line depreciation over the past two decades. Firms that make such accounting changes make smaller capital investments in the post-change periods than in the pre-change periods. These results suggest that a choice made for external financial reporting purposes...
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...London: A National Healthcare Perspective Kaye Leonard Pfeiffer University MHA 776 Dr. James Leist Dr. Gwendolan Swain Abstract This paper provides an overall impression of the United Kingdom’s health service, inception of the National Health Service, challenges the NHS faces regarding financial sustainability, providing effective and efficient care, and the move towards more privatization . Comparisons are made between the National Health Service and heathcare in the United States across multiple sectors that include acute care settings, skilled nursing facilities, primary care providers and regualtions governing nursing practice and the challenges faced by both systems. Table of Contents Introduction 4 Background 4 Impression of the NHS 5 Mr. John Smith Director, Civil Eyes Research 7 Mr. Andrew Cheesbrough, CEO Orders of St. John Care Trust 8 Mr. Robert Creighton, Transition Director and Government Advisor on Public Health 9 Dr. Elizabeth Fellows-Smith. Senior Policy Advisor, Mental Health 10 Dr. Rodney Taylor, Former Medial Director NHS Hospital 12 Professor Simon de Lusignan, Primary Care 12 Mr. Bernell Bussue, Director of London Region,Royal College of Nursing 12 Mr. Paul Holdom, CEO The London Clinic 14 Professor Duncan Empy, Group Medical Director of BMI Healthcare 14 Shirley Kramer, Chief Executive Institute of Healthcare Management 16 Strengths and Weaknesses 16 Summary 17 References...
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...American Healthcare Systems-Research Paper-6th Dec 2013 Medical Tourism By: Mrudula Mynampaty and Swathi Damacherla Introduction “Medical tourism” is the term commonly used to describe people traveling outside their home country avail medical services at lower costs1. Medical tourism is fundamentally different from the traditional model of international medical travel where patients generally journey from less developed nations to major medical centers in highly developed countries for medical treatment that is unavailable in their own communities 2. History The concept of medical tourism has been very pervasive all through the history. The first recorded case of medical tourism describes Greek pilgrims who traveled from the Mediterranean Sea to Epidaurus, a small territory in the Sardonic Gulf. It was said that this small territory was the sanctuary of Asclepius, known as the healing god. Since the 1500s India has enjoyed a rich history of providing yoga instruction as well as Ayurveda healing to patients from around the world. In the 18th and 19th centuries, Europeans and Americans flocked to health spas and sanitariums, sometimes in remote places, in the hope that they would obtain relief from their disabling conditions, such as tuberculosis, gout, bronchitis, or liver diseases 3. What led to Medical Tourism today? The market size for medical tourism is USD 24-40 billion, based on approximately eight million cross-border patients worldwide spending an average of USD 3,000-5...
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