...related to Nursing home-acquired pneumonia. Pneumonia care and the nursing home: a qualitative descriptive study of resident and family member perspectives. Soo Chan Carusone,1 Mark Loeb,1,2 and Lynne Lohfeld1,3 1Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada2Department of Pathology and Molecular Medicine, McMaster University, Canada 3Program for Educational Research and Development, McMaster University, Canada Corresponding author. Soo Chan Carusone: chansy@mcmaster.ca; Mark Loeb: loebm@mcmaster.ca; Lynne Lohfeld: lohfeld@mcmaster.ca Received September 19, 2005; Accepted January 23, 2006. Pneumonia is the inflammation of the lung parenchyma, build up fluid in the tissue of the lungs and then this infection spread in to whole body. The causes are mainly by Viruses, Bacteria, often caused by parasites or fungi. Pneumonia is the 5th leading cause of death in elderly. It may be unrecognized due to many factors such as it may be asymptomatic, or may be confused with other medical Pneumonia and other lower respiratory infections occur frequently among older adults residing in long-term care facilities. These infections are the most common reason for why residents are transferred to hospital. Such transfer is not only a frightening experience for these seniors, but may also be associated with multiple risks including decline in functional status, falls, delirium, and acquisition of multi-drug resistant bacteria. A clinical pathway or algorithm...
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...evaluation of clinical practice became a prominent focus during the second half of the 20th century.1 More recently, attention has been paid to methods of determining which of multiple proven approaches to a healthcare problem works best for which patients.2 Evidence-based practice encompasses implementing the best-known practices into the clinical setting using a scientific approach. It evolved from evidence-based medicine, which was developed in Canada to teach medical students. “Evidence-based medicine has been defined as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.”3, p. 3 The National Quality Forum’s report A National Framework and Preferred Practices for Palliative and Hospice Care Quality is a consensus report that is a first step toward introducing evidence-based measures into palliative practice on a formal, national level.4 The Agency for Healthcare Research and Quality (AHRQ) supports organizations in their efforts to improve the quality and efficiency of healthcare by facilitating the use of evidence-based research findings in clinical practice.5 The nursing discipline has also embraced evidence-based practice over the past 25 years, initially through its support of “research utilization,” the integration of research into nursing curricula, and the education of nurse scientists. Sigma Theta Tau International, the Honor Society of Nursing, considers evidence-based nursing “as an integration...
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...include quoted include bibliography exclude small matches download refresh print mode: 1% match (publications) Kim, S. H., A. Yu, J. H. Jung, Y. J. Lee, and E.-S. Lee. "Incidence and Risk Factors of 30-Day Early and 90-Day Late Morbidity and Mortality of Radical Cystectomy During a 13-Year Follow-up: A Comparative Propensity-score Matched Analysis of Complications Between Neobladder and Ileal Conduit", Japanese Journal of Clinical Oncology, 2014. Calene Roseman NUR / 544 Nursing Research Utilization Project August 18, 2014 Dr. Margarret Colucceillo 2 Nursing Research Utilization Project Proposal Clinical issue: The improvement of morbidity and improved recovery for patients with bladder cancer. Undergoing radical cystectomy with ileal conduit (Castle. & Pruthi,2013) The problem that I identified and needs a solution is the improvement of post-operative outcomes and morbidity for bladder cancer patients undergoing radical cystectomy with ileal conduit (Kim.Yu.Jung.Lee.& Lee.2013)With the aim to discharge patients using fast track and clinical pathways and improve quality of life and morbidity. Radical cystectomy is a serious and extensive surgery not without risk and complications, hence the fact that complications occurs frequently. (Kulkarni. 2011) the standard care for bladder cancer is cystectomy. (Kulkarni.2011) During this major surgery the bladder is removed along with seminal vesicles, the prostate and lymph nodes (Ohio State University, department of surgery,)...
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...Master of Nursing [pic][pic] La Trobe is an internationally recognised university with a strong research and teaching focus. It has over 100 partner universities with student exchange networks across more than 30 countries. The Division of Nursing and Midwifery of La Trobe University in Melbourne, Australia, in cooperation with the Nurses Learning Hub Pte Ltd (NLH), a subsidiary of Singapore Nurses Association (SNA), has delivered the highly successful Bachelor of Nursing (Post-Registration) course for nurses in Singapore for the past 13 years. Now, with its international recognition for quality educational programs and high academic standards, La Trobe University is pleased to offer the Master of Nursing degree in Singapore. Master of Nursing (Professional) Master of Nursing (Research Methods) [pic] The Master of Nursing course at La Trobe University is one of its flagship professional programs, attracting great interest from highly qualified local applicants. The program has been further developed to allow flexible delivery mode enabling LTU to offer the course in Singapore. The aim of this course is to provide students with the knowledge and skills that assists professional development within a nurse’s area of practice. It offers nurses the ability to design a study pathway that meets their career needs. Degree Award This course is equivalent to the Master of Nursing degree conducted by La Trobe University in Australia and students who complete...
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...Standardization of Nursing Protocol for Cardiac Arterial Bypass Patients Abstract Evidence-Based Practice (EBP) is an important factor in determining medical courses of action. Nurses have long used tradition rather than evidence in making decisions about beside care; to convince them to switch practice, it is useful to draw a comparison between the efficacy of these disparate routes. Our study designed a research question based on the PICOT model for the cardiac floors and designed procedures using the Kotter and Cohen’s Model of Change. In order to study the effect discussed in our PICOT question, a web search was conducted and the quality of each pertinent study reviewed. Introduction In the nursing staff of an adult Cardiac Surgical Care unit, how does the buy-in from the staff for Evidence-Based Practice (EBP) changes in a new Coronary Arterial Bypass Graft (CABG) pathway affect the decreases in infection rate among this patient population when compared to the old way of delivering patient care through nursing tradition in a six month time frame? The formation of a guideline for practice in nursing is not a new occurrence; books and manuals have been a reality for many years. However, in the past these resources lacked the evidence for standards of care, which traditionally have been based on professional consensus and tradition. The Joint Commission has recognized processes that can be measured regarding patient outcomes and care in order to meet standards for Medicare...
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...School of Nursing NURS 220 Spring 2016 Vocabulary Homework Assignment – Chapters 10-16 in Taylor et al textbook – Worth 100 points Chapters 10 – 13 due Thursday February 25 Chapters 14 – 16 due Thursday March 3 Please define the following words using your Fundamentals of Nursing textbook and/or a medical dictionary. Please indicate the text and page number you used to obtain each definition. (If you want to make them flashcards you may, just make sure that your name is on them and they are rubber banded together so I can record and return them easily.) Chapter 10 Assess Concept mapping Decision making Dynamic Evaluate Expected outcomes Implement Interpersonal Nursing diagnoses Nursing process Outcome identification Outcome oriented Plan Reflective practice Systematic Cerebral Vascular Accident (CVA) Chapter 11 Cue Data Data base Documentation Emergency assessment Focused assessment Inference Initial assessment Interview Minimum data set Nursing history Objective data Observation Physical assessment Review of systems (ROS) Subjective data Time-lapsed assessment Validation Multiple Sclerosis (MS) Prioritize Factual Accurate Relevant Interpersonal competence Virus Consultation Laboratory study Diagnostic study Chapter 12 Constipation Cancer Actual nursing diagnosis Collaborative problems Data cluster Diagnosing Diagnostic error Health problem Medical diagnoses Possible nursing diagnoses Risk nursing diagnoses ...
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...state. Hypertension is usually diagnosed and treated in the community. As this is largely an asymptomatic disease, particularly in its initial stages, compliance with treatment regimens can be problematic. Successful treatment of HTN relies on the patient establishing an ongoing therapeutic relationship with a trusted and knowledgeable health professional (Casey, 2011). Tools to manage care, such as clinical pathways, practice guidelines, and best practices have increased as the health care insurance industry has put more pressure on health care providers to improve care and provide more cost-effective care. These tools offer health care providers the opportunity to determine the best approaches to clinical problems based on current research and expertise (Finkleman, 2011). Best Practices Best practices are those treatments, procedures, tests, therapies and interventions that have consistently shown, through research and evaluation, superior results, and are then used as benchmarks. Best practices, also called evidence-based practices, include four elements: clinical expertise, research evidence, patient history and assessment data, and patient values and preferences (Finkleman, 2011). Best practice in regard to hypertension begins with the understanding that...
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...WORD COUNT 4399 The assignment will discuss a critical incident from a nursing management perspective, being an admission assessment experienced during placement. It is not a care study. There will be an overview of the nurse-managers responsibilities during the admission assessment and attention drawn to local and government policy. Particular consideration is given to risk assessment, Essence of Care (DoH 2001) in respect of the Waterlow Pressure Damage Assessment (1985), pressure sores, nutritional screening and delegation. Other issues considered will be communication, partnership working, the therapeutic relationship, and the nurse as an agent of change. Findings will be supported by literature. Identifying factors have been changed to respect patient confidentiality. Mary had no previous psychiatric history. She was eighty-four and lived in residential accommodation. She had two adult daughters who were unable to attend Mary’s admission. Prior to admission Mary’s behaviour had changed over several weeks and she had been refusing to get out of bed during the day. During admission she showed occasional signs of confusion but was able to give consent. Physically, Mary was in a wheelchair, had a history of falls, pressure damage, skin flaps. and needed full assistance with mobility. My mentor facilitated her admission assessment. I observed this in preparation of undertaking future ones myself whilst under supervision. From a management perspective my mentor who was the...
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...The Liverpool Care Pathway: Does it improve the quality of dying? The Liverpool Care Pathway (LCP) is an integrated care pathway developed in the late 1990’s (Ellershaw et al, 1997) as a means of transferring best practice in care of the dying, from the hospice environment to other sectors starting in the acute setting. Currently the LCP is a recognised tool used by clinicians in the United Kingdom as well as over twenty countries, to give appropriate care to patients who have reached the last hours or days of their lives. Described to provide comfort to the dying and also address the needs of the carers (Chapman 2009). During this assignment the author will highlight and explain how a data search was conducted, and will analyse the data retrieved, explaining and evaluating the data to build a discussion based on the chosen topic of end of life care, with a focus on the Liverpool Care Pathway. The author will conclude by producing recommendations for practice. Although described above that the Liverpool Care Pathway is an appropriate tool for providing adequate care for patients, it can also be seen as a controversial pathway, being described as a ‘tick box’ approach rather than a humanistic approach (Chapman 2010). It has been referred to by the UK’s Daily Telegraph as ‘sentenced to death on the National Health Service’ (Devlin 2009). The author has a keen interest in palliative care, after researching is interested in enhancing knowledge surrounding the LCP as there are many...
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...Student ID No: 000764715 Programme: BSc (Hons) Nursing (Adult Nursing) Course Title: Patient Pathways of Care in Adult Nursing 1 NURS 1442 Cohort: 9/13 PGT Leader: Debbie Dorsett Submission Date: 25th August 2015 Word Count: 3250 This essay will be exploring a patient pathway in a clinical environment. The pathway to be investigated is the national diabetes pathway from the National Institution for Health and Care Excellence (NICE), which was published in February 2015 (NICE, 2015). I will also exploring local agendas and guidelines that are available from a local trust. I will be exploring one patient in particular, who cannot be named for confidentiality reasons, in accordance with the Nursing and Midwifery Councils (NMC, 2008) the code of conduct governing patient confidentiality, (NMC, 2008). Diabetes is growing in the United Kingdom (UK) at an alarming rate, (Diabetes UK, 2012). In 2010, evidence showed that approximately 3.1 million people in the UK aged over 16 years old have diabetes. By 2030, this figure is estimated to rise to 4.6 million, (National Health Service [NHS], 2014). It is important as an adult nurse, that I understand the pathway of diabetes as individuals with the condition are at risk of developing further health complications (Diabetes UK, 2012). This includes conditions such as heart disease, stroke and blindness (Diabetes UK, 2012a). A pathway is a “foreseen care placed in an appropriate time frame, written and agreed by a multidisciplinary...
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...Change Project Proposal To provide 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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...and the entire population at large in a wide range of healthcare settings. They also constitute the surveillance system for early detection of complications and problems in care and in the best position to initiate actions that will minimize negative outcome for patients.(Aiken et al 2003). For one to become a registered nurse there are three pathways to follow and these are Diploma- a 3year hospital based program, Associate degree- a 2year degree obtainable from community colleges, and Baccalaureate degree program from 4year colleges and universities. All three of these pathways will qualify the nurse to sit for the National Council Licensure Examination (NCLEX). As stated in the journal of American Association of colleges of Nursing (AACN) “The NCLEX-RN is only one indicator of competency and does not measure performance over time or test for all the knowledge and skills developed through BSN program (Rossetter 2012). However, we will focus more on the differences in competencies between nurses prepared at the associate degree level versus baccalaureate degree level in nursing and identify a patient care situation in which nursing care or approaches to decision making may differ based upon educational preparation. The associate degree program (ADN) which was founded by Mildred Montag due to severe shortage of nurses was designed to prepare technical bedside nurses for secondary care settings such as community hospitals and long term...
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...The Great Nursing Debate: Differentiating Competencies between Associate-Degree Level Nurses and Baccalaureate-Degree Level Nurses By: Candace Williams Grand Canyon University: NRS 430V March 13th, 2011 The Great Nursing Debate: Differentiating Competencies between Baccalaureate-Degree Level Nurses and Associate Degree Level Nurses Since the 1960’s, there has been much debate as to what the required entry level education should be for the Registered Nurse (RN). While there are many different levels of education that an RN can obtain, the most common two types of practicing nurses are the Associate-Degree nurse (ADN) and Baccalaureate-Degree nurse (BSN). While both of these types of nurses perform the same bedside patient care, there are several differences in their educational training and competencies. In response to the passage of the Comprehensive Nurse Training Act of 1964, the American Nurses Association (ANA) publicized a position paper calling for the minimum requirement of the entry level nursing be a baccalaureate degree. The ANA began researching nursing education and scope of responsibilities and concerns were raised about the hospital-based diploma programs amidst the growing complexity of the healthcare system. The ANA noted specific changes in nursing practice that included "major theoretical formulations, scientific discoveries, technological innovations, and the development of radical new treatments" (ANA, 1965, p. 107). This paper examines the...
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...essay I will be reflecting on an incident from practice, by drawing on developing knowledge, understanding and the application of professional studies. Reflection offers an opportunity to learn through an experience. This allows us to develop or sustain effective practice (Johns, 2000). I will be using the Gibbs (1988) reflective framework to structure my reflection (see appendix A). I find this framework very easy to follow, and as Clodagn (2003), explains it allows a person to implement alternative actions to an event, if followed. The incident will be described and the influence of key issues relating to ethical theories and decision-making, illness journeys and lay and professional perspectives will be explored. Principles of nursing models will be looked at and their contribution to individual patient care. I will also look at resource management, quality assurance and the role of evidence-based practice. For the purpose of this essay, to maintain confidentiality, the patient will be referred to as Mr Charlie Wood, (NMC code of professional conduct 2002; 5.1). Incident The incident occurred when I was a student on a medical ward. Mr. Wood, age 80 had been admitted to hospital following a stroke. From this he had lost the ability to mobilise and speak effectively. He was a very dependent gentleman and counted on the nurses to undertake all aspects of his care. His wife, whose name has also been changed for confidentiality reasons (NMC 2002), was very dedicated...
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...to licensure of Registered Nurse and nursing career. One of the most widespread pathways to become a registered nurse is Associate Degree in Nursing (ADN) offered in many community colleges as a two-year degree, and Bachelor of Science in Nursing (BSN) degree, which requires a four-year education at colleges and universities. Even though, these educational pathways are considerably diverse in studying period and content, they both lead to eligibility to pass the identical National Council Licensure Examination (NCLEX)-RN in order to acquire RN license. The ADN degree focuses primarily on practical scope and utilizes entry level knowledge and clinical skills in the healthcare setting. In the contrary, the BSN degree offers advance in research, leadership, community health and is planned to aim for a better understanding of the economic, cultural, religious, and social concerns influencing healthcare delivery and patients. Both nursing programs offer classroom guidelines and clinical experience in the real health care settings. Students take numerous courses. Over the last decade, ADN nursing programs help to educate approximately 60% of new nurses, and 36% of these new graduates finished BSN programs (Hood, 2010). Despite of many similarities the ADN nurses are trained typically in structured settings to become a caregiver, educator and counselor for their patients. Individuals who complete the ADN degree obtain entry nursing education and are less trained in community...
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