...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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...et.al, 2011) Lilly Walden describes herself as an active, athletic, and healthy woman. In her mid-forties she continues to run 2–3 miles 5 days per week. Lilly is married with three children and is employed by the local school district as a speech therapist. Lilly describes herself as health-conscious. Her diet is balanced, and she is a nonsmoker and drinks wine on rare social occasions. Lilly has a history of asthma, triggered by environmental changes, and it typically requires antibiotic therapy for bronchial infections 2–3 times per year. This presentation will review the following: 1. Priority care needs of the patient at the center of the case study 2. Priority care needs of the family care providers 3. The disruption that this acute illness has caused for the patient, family members, and clinical microsystem 4. The experiential features of acuity 5. The elements that the clinical microsystem 6. Potential barriers to providing care 7. The communication strategies that were used in the delivery of care 8. Well-defined (but flexible) roles within the clinical microsystem 9. Potential strategies for unexpected changes 10. The Deployment Flowchart Priority care needs of the patient require the organization to take good care of the patient in a timely manner to find the cause of the pain being experienced. The patient’s pain has to be kept at minimum, have direct communication with the patient and their family and try to find the cause of the pain in a timely...
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...of Medicine, New York, New York; 2Division of Pulmonary and Critical Care Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina; 3Department of Geriatrics and Palliative Medicine, Mount Sinai School of Medicine, New York, New York; 4Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of North Carolina, Chapel Hill, School of Medicine, Chapel Hill, North Carolina Correspondence and requests for reprints should be addressed to Judith E. Nelson, M.D., J.D., Box 1232, Mount Sinai School of Medicine, 1 Gustave Levy Place, New York, NY 10029. E-mail: Judith.nelson@mssm.edu Next SectionAbstract Although advances in intensive care have enabled more patients to survive an acute critical illness, they also have created a large and growing population of chronically critically ill patients with prolonged dependence on mechanical ventilation and other intensive care therapies. Chronic critical illness is a devastating condition: mortality exceeds that for most malignancies, and functional dependence persists for most survivors. Costs of treating the chronically critically ill in the United States already exceed $20 billion and are increasing. In this article, we describe the constellation of clinical features that characterize chronic critical illness. We discuss the outcomes of this condition including ventilator liberation, mortality, and physical and cognitive function, noting that comparisons among cohorts are complicated...
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...Introduction It is well known that people suffering from chronic diseases have major impact in the healthcare delivery systems, including the elderly population over the age of 65. With the advances in technology combined with the aging population, more people are living longer with chronic diseases. Longer life expectancies count for higher costs in healthcare for the treatment, management and prevention of further complications arising from chronic diseases. The third most common chronic disease of the older adults is Parkinson’s disease. It is a debilitating disease affecting a person’s motor ability, causing tremors, rigidity, akinesia or slow movement, and postural instability. According to the National Institutes of Health, about 500, 000 individuals in the United States suffer from Parkinson’s Disease, and it is estimated that males are more often affected than females. Parkinson’s disease has a large economic impact and directly affects medical costs, as well as the affecting the person financially, such as lost wages and decreased productivity. According to a recent interview with a client suffering from PD over the course of ten years, the disability directly impacted his personal life, financial status, and family members. The next discussion talks about how the patient learned about his disease and the personal impact it created at the beginning of the disease process until the peak onset later in his life. How the patient learned about his disease During the...
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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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...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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...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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...co-ordination and relationships between the agencies that provide community care. Community Care Assessments/ Placements in appropriate setting would be able to be completed in time. This would prevent blocking of beds and allow the patient to be in their own home or a residential home setting. If a planned approach to the resourcing of community care was made. This would allow key decisions to be made and how future needs should be resourced. If there was more flexibility in budgets to facilitate greater innovation and creativity in response to need. There should be a degree of ring-faced especially for new finance with clear guidance to how it is spent.. There should be no permanent decisions made about a person's future care in an acute hospital setting. Assessments done in these settings can lead to the clients proper needs not been met and they could be placed in a unsuitable setting. If hospital staff had access to budgets for services for people with less complex needs, e.g., home helps ,this would not delay them in hospital and would free up beds so hospital duties could be carried...
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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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...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 affects the whole family 6. People with chronic conditions & their families must assume major responsibility...
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...Name: XXXX English 26 Amada Professor Short essay #2 "My name " by XXXXXXX Name is one of beauty thing that people calling each other. In Vietnam , my name has been written by XXXXX because of Vietnamese culture . Frist name will come first , then middle name and last name. “Huy” has no meaning if it stand alone, but when it come with " Hoang " which is my younger sister name ,it gently means splendid victory .My parents gave us that name on purpose . If that are 2 worlds come together will become a full meaning .They expect us always stick together in any problems or any happiness in our life like those worlds has to stick together .Therefore , even before she was born ,she had been named " Hoàng". Notice I put the acute accent on the "A" , giving a full meaning "Victory" in Vietnamese language .The complete word is “XXXXX “ ." Minh" in the middle make my name stronger meaning , it looks like a superman always doing good on everything. At US, they did not pronounce my name right. My friend which is Mexican, she always call me like "Chuy ,Chuy " .Then they named "Chuy" such as "trees" such as my new Mexican name. I was so happy to have a new name. It is so funny name but I love the way that they are calling me. My name is short and very simple. It makes me proud of the meaning inside the name and also give me more spirit that I have to be “victorious “on everything I have to do I am so proud of my name. I wont change my name for anyone else because that is the thing...
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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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...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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...Psychology Core Concepts, which I used as my primary source for this speech, stated that everyone suffers from stress to a greater or lesser degree throughout their lives and people cope with it in different ways, some positive some negative. E. Importance to Audience: By the end of my speech, each of you will have new knowledge about the stress we face on a daily basis. D. Thesis/Preview Statement: Stress is caused by many things in one’s immediate environment. Today, I am going to outline the three basic categories of stress: acute stress, episodic acute stress, and chronic stress. My goal is to inform you, so you can become more knowledgeable about characteristics of stress, its symptoms, duration, and treatment approaches. II. Body A. Acute stress is the most common stress. 1. Acute stress, also known as “Alarm stage,” is both thrilling and exciting. In the chapter where the author discusses physiological responses to stress, he defines acute stress as “A temporary state of arousal, caused by a stressor, with a distinct onset and limited duration” (Zimbardo, Johnson, & McCann, 2009, p. 631). a. Causes includes traumatic events: death, the threat of death to oneself or others, the threat of serious injury to oneself or others, a threat to the physical integrity to oneself or to others; feeling of intense fear,...
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