...------------------------------------------------- Clinical Preparation Worksheet- Information Necessary for Care ------------------------------------------------- ------------------------------------------------- Your Name _ Date of Care_3/17/2014_____ Pt. Initials__M.A.____________ ------------------------------------------------- Pt. age__51_______ Code Status _Full Code______________Braden /SKIN Score __K_____ ------------------------------------------------- Fall Risk- Fall risk with high injury probability __Level 2________________ ------------------------------------------------- ------------------------------------------------- Admitted from: Home/extended care facility? __Home___________________ ------------------------------------------------- ------------------------------------------------- Reason for admission - also called CC or Chief complaint: (This is in the pt.’s words. Ask them why they came to the hospital and record what they say as a direct quote.) ------------------------------------------------- Fell in the shower and became unconscious, tried to call girlfriend but couldn’t move left side ------------------------------------------------- ------------------------------------------------- Admitting Medical Diagnosis/Diagnoses: ------------------------------------------------- Stroke ------------------------------------------------- ------------------------------------------------- Medical and Surgery History:...
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...Organizational Quality Improvement Plan Part 1 HCS/588 June 3, 2013 Organizational Quality Improvement Plan Since the Institute of Medicine’s report “To Err is to Human” enacted in 2000, effort has been made to improve the quality of health care. To implement correctly a quality improvement plan (QIP) the perception of the organization culture and the stakeholder’s culture need to be explored (Centers for Medicare & Medicaid Services, 2013). Quality improvement plan improves quality and efficiency of services to the highest levels rendered. In the United States, for example, consumers have the right to choose, bargain, and express their dissatisfaction or concerns about a product or service. The economy is based on consumerism and the opinion of the consumer is valuable. In the health care arena, consumers have the right to choose the right providers when they looking for medical attention. They have the option to choose the one that can accommodates their needs. This also can create competition in an open market. Competition is very good because it helps competitors to improve the quality of their goods and services. In this paper, a quality improvement plan will be developed for Mary Washington Hospital, the difference between performance measurement and quality improvement will be addressed along with the organization mission and goals. The role of the stakeholders, and which external quality indicators are available will also be discussed in this...
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...NURSING MANAGEMENT OF A STROKE PATIENT INTRODUCTION Stroke is the only largest cause of adult disability which leaves a devastating and lasting effect on people and their families (DoH, 2007a). The government of the United Kingdom had recognized stroke as a health care priority. Several government agencies developed clinical guidelines which are being implemented today in local health care settings (Williams et al, 2010a). This essay will focus on stroke as the cause of impaired mobility and will tackle on the patient-centered rehabilitation care plan along with its evidence-based rationales. Health and social care policies and its effect on the patient’s chosen journey will also be discussed. PATIENT PROFILE This is a case of a 68 year-old, married female who lives in the south of England. Mrs. G was admitted on 12 October 2010 with a presenting complaint of left-sided weakness. Prior to admission, she experienced persistent pain on the back of the head for 2 days, which was unrelieved by Paracetamol intake. On the morning of admission, she collapsed in the bathroom and was found by the husband after 3 hours. She was brought to the hospital via ambulance and upon initial assessment, no shortness of breath, slurred speech, dizziness, palpitation and chest pain were noted. Her vital signs were as follows: blood pressure of 169/59 mmHg, pulse rate of 80 bpm, respiratory rate of 18 breaths per minute, body temperature of 37.5 degrees...
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...oxygenation of the cells and vital organs of the body (Kim 2017, p. 43). While diagnosing the patient the airway and use of oxygen should be applied to prevent hypoxia that can occur due to obstructions and lack of oxygen intake (Kim 2017, p. 43). Additionally, the patient should be ordered isotonic fluids to maintain fluid volume levels in the body, this is due to hypervolemia being a common factor in stroke; during this stage the health care team will be conducting diagnostic assessments to confirm stroke as the diagnosis and to determine the location and severity (Kim 2017, pp. 44-5). Once a stroke is confirmed the physician is able to determine the best treatment regime dependant on the type, location and severity of the stroke; often treated through medication or thrombectomy procedures (Kim 2017, p. 44)....
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...examine the challenges of managing Mr. W. Fountain nursing problem on his immobility condition. Developing a care plan for Mr. W. Fountain to aid his recovery due to stroke; resulting to mobility problem. Although, mobility as a result of stroke will be the main focus of this essay but I will also briefly explain the process of developing an effective care plan. I will be relating it to my anatomy and physiology knowledge and show why dealing with my father’s stroke condition some twenty seven years ago make Mr. W. Fountain condition more personal to me. At this stage, I will like to highlight that the nursing management for Mr. W. Fountain will be based on the use of Roper Logan Tierney model in practice. (2003). I will be applying the nursing process that includes delving into the phases and cycle of nursing assessment, planning, implementing and evaluating (APIE). At the implementation stage, a care plan with appropriate objectives, implementation steps and evaluation strategies will be drawn in ensuring that his care is more focused on his needs. I will also be using a range of assessment tools: such as waterloo score and strip, trips and fall. Dignity and respect of Mr. Fountain will be maintained all through in this essay. In conclusion a copy of care, feedback from the Lecturer and reflective summary will be attached. According to Glasper and Mcewing (2010) Stroke occurs if there is an interruption of blood flow to part of the brain. Without blood to supply oxygen and...
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...Health Promotion Health promotion has become a very important role for the nurse to play in the care of the patient. The United States Public Health Service states “health promotion is the process of advocating health in order to enhance the probability that personal (individual, family, and community), private (professional and business), and public (federal, state, and local government) support of positive health practices will become a societal norm.” (Edelman & Mandle, 2010, p. 16) Health promotion can be identified as primary, secondary or tertiary prevention. With primary prevention of health promotion the focus is on prevention of disease processes. Secondary prevention focuses to identify the disease before the manifestation of symptoms become apparent and the tertiary focus of health promotion is the treatment of the symptoms of the disease process once is has manifested in the patient. (Grand Canyon University, 2011, para. 8- 10) The role of the nurse changes as the prevention focus changes. For example, a group of individuals living along the Texas/Mexico border was identified as being high risk for the development of type 2 diabetes mellitus. The patient population was working class poor without the ability to afford health insurance and clinics with waiting lists so long they were not adequately serving the community. The study showed there was a “demand for health education among the very poor and for participatory programs that meet their needs through...
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...Many consider Virginia Henderson a legend in nursing. Henderson viewed nursing as “doing for others what they would do for themselves if they had the strength, will, and the knowledge; and also that the nurse helps the patient to carry out the plan of therapy prescribed by the physician” (Smith, 1989, p. 69). She saw the function of the nurse as helping the patient. Virginia believed a nurse should focus on helping the patient recover and rehabilitate quickly. She saw the practice of a nurse as being different from that of the physician, yet she believed both roles were an integral part of the rehabilitation phase. Henderson also believed the nurse should be independent from the physician and make independent judgments (Henderson, 1966, p. 22). Henderson proposed 14 basic human needs that help focus the nursing care (Alligood & Tomey, 2010, p. 56). She believed these 14 needs would help a patient return to independence. She believed only a dedicated and devoted nurse would help a patient fulfill these needs. According to Henderson, a nurse that helped a patient acquire independence or helped a patient accept their limitations was a successful nurse (Henderson, 1966, p. 23). The diagram below depicts Henderson’s 14 basic human needs. They are divided into four categories: physiological, psychological, social/moral, and sociological. Henderson claimed that the physiological needs are experienced by all human beings and are the most important for survival. If the physiological...
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...high-quality care, nurses must be the coordinator of the care and activities of the multidisciplinary team that is providing care for the patient. Clinical pathways and physician standing orders can be used as a guide for the team in managing stroke patients. They ensure that the appropriate diagnostic tests, therapies and care needs are being included in plan for a patient. Clinical pathways also improve coordination of acute stroke care and discharge planning, decrease hospital care costs, decrease readmission rates, reduce length of hospital stay, and improve patient outcomes by providing a guide to ensure best practice care guidelines are being followed (Summers et al, 2009). Currently, our hospital does not utilize nursing clinical guidelines for patients who suspected or actual stroke. I am proposing that our hospital implement the use of nursing clinical guidelines for the care of possible and actual stroke patients beginning in the Emergency Department and to other nursing units that provide care to stroke patients....
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...discussed within this assignment is a 70 year old male admitted to hospital following a stroke. Pressure ulcer risk assessments and nutritional risk assessments will be discussed within this assignment looking at how they are used in the assessment of an older people with multiple health problems. A stroke occurs when there has been a disturbance or cut off of blood flow within the brain, this disturbance damages or destroys brain cells preventing these cells from doing their job. Damage to the brain causes problems with bodily functions and can also affect mental processes (Stroke Association, 2010). A stroke can cause sudden weakness or paralysis which often only affects one side of the body and is one of the most common symptoms of a stroke. It can also cause swallowing difficulties (dysphagia), speech and language (dysphasia) can be affected also, patient may have difficulty in understanding and basic things such as reading and writing following stroke. Problems with eyesight, perception and interpretation, mental processes, bladder and bowels, mood swings, sensation and pain can all be experienced by an individual following a stroke (NHS Choices, 2008). Strokes are a major health problem within the United Kingdom (Mant et al, 2004). The National Audit Office (2005) states that approximately 110,000 people yearly suffer a stroke and over 900,000 people are living with the effects of stroke in England, many of which whom depend upon others to help them...
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...extractions; and humans can be purged of such feelings and their validities by demolishing the theories that give them life. The cognitive restructuring model is a proven model in addressing behavioral issues concerning stroke victims and adolescents. Team A’s focus will be addressing the perceptions into these interventions. Behavioral changes can be difficult, but for a stroke victim it can be even more challenging due to cognitive deficiencies after a stroke. These changes are not only grueling to accept, but create a challenge due to physical, cognitive and emotional impairments. After a stroke, the ability to return to a consistent routine and activities now depend on the individual’s ability modify behaviors. One of the challenges one may face after a stroke is difficulty relating with others among other behavioral challenges relating to this type of injury. One of the main steps in overcoming this challenge is building a trusting relationship with the stroke victim; this develops throughout the rehabilitation process. Encouraging the patient too understand the benefits of setting goals. This trust is achieved through honesty, caring and regular interaction always trying to achieve realistic expectations. “Other Interventions include developing a plan that the stroke victim is happy with, so that it is more likely to be effective” (White, Seckinger, Doyle, and Strauss, 1997). Take into consideration their weaknesses and strengths, and prioritize their needs. Also reflect on the...
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...INTRODUCTION This essay is all about discharge care planning and will be discussed in two parts, the first part will highlight patient profile, assessment and discharge care planning with evidence based rationale using a framework based on Roper- Logan-Tierney (2000) model of nursing which involve giving nursing care holistically by using 12 activities of living (AL) and also incorporate nursing process to carry out care plan in this essay, which are maintaining a safe environment, communicating, breathing, eating and drinking, eliminating, personal cleansing and dressing, controlling body temperature, walking and playing, mobilising, sleeping expressing sexuality and dying. Also with the above mentioned framework, factors influencing the activities of living which include biological, psychological, socio-cultural, environmental and political economic will be considered. Also demonstration of how discharges are planned and problems identified will be discussed, which will involve members of the multidisciplinary team (MDT) and their roles in the patients care, education and support for family/carers. The second part will explore how recent health service legislation has influenced this care plan and its impact on caring of older people with long term condition. In this essay, issues on professional values according to Nursing and Midwifery Council (NMC) Code of Professional Conduct (2008), which include consent, confidentiality, respect and dignity will be undertaking. For the...
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...Stroke Care at Hilo Medical Center The Care of a New Population of Patients Stroke Care at Hilo Medical Center The incidence of strokes among our population is increasing. According to the American Heart Association “It's the third largest cause of death, ranking behind "diseases of the heart" and all forms of cancer. Stroke is a leading cause of serious, long-term disability in the United States” ("Stroke statistics," 2011). Approximately 15 million people worldwide survive stroke annually (Seneviratne, Mather, and Then, 2009). Hospitals need to be able to care for the increasing number of patients being admitted due to strokes, and Hilo Medical Center is no exception. Currently at Hilo Medical Center, the vast majority of patients that are inflicted by CVA’s, or cardiovascular accidents, are transferred off island to better equipped medical facilities, such as Queen’s Medical Center in Honolulu. In the near future, that some of those practices will change. According to the nurse manager at HMC’s cardiovascular unit, Lisa Marie Nance, 6 beds will be added to the current 11 bed unit to accommodate some these patients. The unit will be changed to accommodate patients that are stable and do not meet criteria to receive thrombolytic therapy. It did seem odd that the hospital would be expanding the unit to care for a limited portion of the stroke patient population. I wanted to know more information regarding HMC’s plans, as well as what steps is needed to care for...
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...use of Cognitive Restructuring in regards to Stroke Victims and Adolescent Interventions. It will also identify questions regarding interventions. It is an in depth look into interventions too help assist the victims suffering from stroke and adolescent issues. The paper includes an introduction, in depth analysis of backgrounds and interventions associated with stroke and adolescent behavior, intervention questions, and the conclusion. Cognitive Restructuring Definition The cognitive restructuring theory holds that your own unrealistic beliefs are directly responsible for generating dysfunctional emotions and their resultant behaviors, like stress, depression, anxiety, and social withdrawal, and that we humans can be rid of such emotions and their effects by dismantling the beliefs that give them life. Thought challenging–also known as cognitive restructuring–is a process in which you challenge the negative thinking patterns that contribute to your anxiety, replacing them with more positive, realistic thoughts. The cognitive restructuring model is a proven model in addressing behavioral issues concerning stroke victims and adolescents. Our focus will be addressing the insights into these interventions. Cognitive Interventions for Stroke Victims As most of us know behavioral changes are difficult. But for a stroke victim it can be even more difficult due to cognitive impairments after a stroke. These changes are not only hard to accept,...
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...Stroke The Causes And Effects Health And Social Care Essay ukessays.com /essays/health-and-social-care/stroke-the-causes-and-effects-health-and-socialcare-essay.php In this assignment I discuss Paul who is a 65 year old male and has suffered a stroke. My aim is to explain what a stroke is, the causes and effects, and give you my understanding of how I as a Health Care Worker can help identify, meet and care for the client's needs following a stroke. For this assignment I will bring together the knowledge I have gained as a health care assistant student to date along with some research also. I have carried out my research using the internet, Irish heart foundation, stroke centre organisation, stroke.ie. My focus as a health care assistant is to explain what care my client should receive after his stroke, identify the assistance needed and give recommendations to meet his rehabilitation, to help him keep abilities and gain back lost abilities and also take care of his needs such as physical, emotional, social and intellectual needs. Introduction "A stroke is caused by an interruption of the blood supply to part of the brain, the term stroke comes from the fact that it usually happens without any warning, 'striking the person from out of the blue" (ihf.com) A stroke can happen to anyone, some people are at higher risk for different reasons such as age and family history. Other risk factors include high blood pressure, smoking, being overweight, diabetes, and high cholesterol. "2...
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...Vascular dementia occurs when the blood flow to the brain is reduced and usually happens from strokes, it also can be caused by a variety of diseases and damages that affects the brain. One of the most common type of vascular dementia is the Multi-infarct dementia which is caused by minor strokes or (which sometimes are called “mini strokes” or silent strokes”) that at times could go unnoticed. Unlike Alzheimer's disease, there are no licensed treatments for vascular dementia (O’Brien and Thomas, 2015) Multi-infarct dementia is more common in older men than women around the ages of 60 to 75 years old. Vascular dementia is really rare in anyone younger than 65. Global, 48.5 million people have dementia, about 70% of that is Alzheimer’s and around 10% are vascular dementia, there are 7.7 million new cases every year. This case study looks further into Vascular Dementia and the people who have them and shows how a great care system and collaboration can help the patient. A case study will be conducted for the patient while using a long term nursing home. Case Description Tania Joseph, female, age 78, was recently checked into a long term nursing home. Tania was healthy until a year ago, which was when Tania was involved in a terrible car accident and had a concussion but after a couple of days was told that she would recover nicely. A couple of days later she had a serious of strokes...
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