...The aim of this essay is to examine and reflect upon a case study regarding a patient, by focusing on a clinical decision that was made by the author. This particular case study is based around the clinical decision making process of a patient being admitted to hospital for a surgical procedure. A description of the clinical decision making process related to the case study will be addressed; other factors that influenced this process will also be analyzed. Finally, the author will reflect on the decision made using the Gibbs Reflective Cycle. All aspects of this essay will be analyzed and supported by current literature related to the topic. Clinical decision-making is an important skill for all nurses to have, as they are more likely to have a positive impact on patient outcomes (Furze, Nelson, O’Hare, Ortner, Threlkeld & Jensen, 2013). Clinical reasoning can be defined as a “ complex cognitive process that uses both formal and informal thinking strategies to gather and analyze patient information, evaluate the significance of this information and weight alternative options” (Lavote, Pepin & Boyer, 2013, p36). The clinical reasoning cycle is a multi-staged process that nurses and professionals use to “collect cues, process information, come to an understanding of a patient problem or situation, plan and implement interventions, evaluate outcomes, reflect and learn from the process” (Levett-Jones et al, 2010, p516). This eight-stage process may...
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...the flow problem. (Kirkbride, Floyd, Tate, & Wendler, 2012). The nurses I work with would understand the condition admitting many patients on our floor. As a transformational leader, motivating the floor nurses would be easy as they would understand the need for mobile nurses. Before addressing the idea with the clinical...
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...Delegation is a vital skill in Nursing and it is by entrusting a task to another less senior staff. The cycle follows from the sister nurse to the staff nurse going to the health care assistants. In this way nurses can provide a quality of practice and care to the patients (NMC Code of Conduct, 2010). The nurse who is allocated in the specific bay is accountable to advocate for her patient if needed. Alongside with nurse is the healthcare assistant who provides personal care, nutritional care, record keeping such as vital signs. The registered nurse will be focusing on medication which should be done carefully to avoid drug errors while, the health care assistants attend to the personal care and maintaining the cleanliness in the specific bay....
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...accessory muscles, cyanosis, retraction of intercostal spaces - wheezing Predominant on expiration Emphasema - irreversible damage to alveoli, increase airway resistnece - enlargement of air sacs , on expiration - hyperinflated lungs - altered breathing - barrel chest, use of accessort muscles, tripod position, SOB - decreased breath sounds Pleural friction rub - inflammation of the pleura - pain Pneumothorax - free air in the pleural space of the lung causes a collapse - inspection: unqual chest expansion, tachynopnea, cyanosis, bulging in inerspaces - palpation: tracheal shift, unequal chest expansion, tachycardia, decrease B - no sound The clinical reasoning cycle - way of thinking that allows the nurse to make clinical judgements - has a positive impact in the patient normal steps are - patient situation, collect cues, process information, identify issues, establish goals, action, evaluate goals, reflect Patient context: within their context of care Cues: what already know, what new information is needed and recall what is needed Process information: - normal/abnormal - relevant and irrevant information - cluster cues - infer - match - predict a potential outcome indentify problems: synthesis the facts and inferences to make a definitive diagnosis about the patient and define the most urgent issue or problem for the patient establish goals: what you want to happen take action: select a course of...
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...Disorder Specific Cognitive Behaviour Therapy Interventions – WHM-M-030 Introduction The purpose of the paper is to discuss the current theory and empirical literature for using a transdiagnostic approach in cognitive behaviour therapy and it’s relevance in current practice. I will discuss the theory and evidence for using a transdiagnostic approach and highlight the main processes. A discussion on the strengths and limitations of the approach will conclude the first part of the paper. The second part will be a review of personal clinical work discussing the transdiagnostic process and its hypothesised effectiveness. To conclude the author will provide a personal reflection. There has been a long widely accepted claim for the effectiveness of CBT with prolific amount of evidence for it’s effectiveness for Depression, Anxiety and Mood disorders (Roth & Fongy, 1995) Models such as cognitive therapy for depression (Beck, Rush, Shaw, & Emery, 1979), panic disorder (Clark, 1986,), posttraumatic stress disorder (Clark & Ehlers, 2004); and obsessive-compulsive disorder (Salkovskis, 1989) have led to disorder-specific interventions for treating common mental health problems. The benefits of devising a model on specific disorders is the high degree of research and comparable data involved; from that the therapist will be highly trained in the use of the model to deliver the approach for each disorder (Salkovskis 2002). Disorder specific models are seen to be easily delivered...
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...How do dreams differ in people with schizophrenia to from those without the disorder? Kristin Staub Brookfield High School Dreaming is a vital part in sleeping, yet in some individuals it interferes in their waking state. For example, schizophrenics have hallucinatory images while they’re not sleeping causing some psychologists to speculate why this happens. People without the disorder and other people with other disorders have been found to dream while they’re in REM sleep which is a major mental process that allows people to dream. The following articles, “Sleep Fantasy in Normal and Schizophrenic Persons,” “An Extension of Freud and Jung’s Theory of Relation of Dream States to Schizophrenia,” “The Neurochemistry of Waking and Sleeping Mental Activity: The Disinhibition-Dopamine Hypothesis,” “Dream Content of Schizophrenics, Nonschizophrenic Mentally Ill, and community Control Adolescents,” “Sleep Disturbance in Schizophrenia” “Rorschach Responses Subsequent to REM Deprivation in Schizophrenic and Nonschizophrenic Patients,” attempt to explain the problem statement: How do dreams differ in people with schizophrenia to those without the disorder, through REM sleep in normal individuals and schizophrenics. Dream content will also be investigated to answer the problem statement and certain sleep habits. In addition Jung’s and Freud’s theory attempt to explain how dreaming is connected with schizophrenia in their conscious state rather than in their sleeping state through...
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...In this essay I will analyse in reference to the case study, how psychological theory informs our understanding of mental health disorders. I have chosen the following two theories to analyse, Psychodynamic and Cognitive. I will also evaluate how certain therapies such as Cognitive Behavioural Therapy (CBT) and Psychotherapy may help or change a depressed person’s behaviour. Depression is a potentially disabling illness that affects many, but is understood by few. Suffers often do not recognise the nature of this terrible illness until they are so devastated that they can no longer help themselves. (Ainsworth 2000). According to Houpt 2010, Jamie is clearly showing signs of depression. Jamie is exhausted and his schoolwork is falling behind. He has fallen asleep in class and states that he feels depressed and anxious. He also feels a great sense of loss and his eating behaviour has changed drastically. Houpt states that depression reduces, depresses and slows a person’s functional level. It slows mental and bodily activities. Therefore a slowed mind is unable to process and respond to all incoming data. Adolescent depression is a mental and emotional disorder affecting adolescents and teens. More commonly referred to as teenage depression, adolescent depression is not medically different from adult depression and can affect a teen’s personal, school, work, social and family life therefore leading to social isolation. Empfield and Bakalar, 2013). A psychodynamic...
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...surgeries to the implementation of ICD-10 and the electronic health record. Progression is not only inevitable for the healthcare industry, but also for society as a whole. This results in increased workflow to ensure continuum of care is being met. A major concern that the health information management (HIM) industry is facing is inaccurate clinical documentation which contributes to coding errors. This causes increased claims rejection which can affect a facility’s revenue. As part of the ICD-10 transition, there is an expectation of high standards in processing medical records while enduring the massive amount of workload that comes along with thousands...
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...EDUCATION Critical thinking and analysis: a model for written assignments Sharon L Edwards W hat is critical analysis? In the author’s personal experience this question has been answered by the following statement: ‘It is being critical of the literature.’ However, this does not answer the question. A literature search also failed to provide any information on critical analysis. The justification for developing a model for critical analysis, however, was not solely the lack of available literature. Other reasons included: to provide a definition of the terms; and to help both educationalists and students interpret the concepts involved. Nurse educationalists and nursing students lack a clear understanding of the critical processes and this could severely diminish the profession’s ability to articulate issues that are imperative to the advancement of nursing practice in the future. This article recommends a model of critical analysis that can be used by students and educationalists. It suggests that critical thinking and analysis are interrelated and complementary, but not synonymous. It gives examples of the model’s components in order to clarify their meaning. The model will hopefully give students a premise on which to base their assignments, and nurse educationalists will be able to incorporate it into their teaching practice. It will also provide an element of reality to critical analysis which will prevent it from becoming so abstract and idealistic as to render...
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...project manager for the purpose of this paper). Stakeholders are individuals who represent specific interest groups served by the outcomes and performance of a project or program. Project managers are accountable for the end-to-end management of their projects, including performance and expectation management of individuals who may be outside their direct control. Project managers must give due consideration to the people issues surrounding projects and recognise that the appropriate involvement and management of stakeholders is almost always a critical success factor. Project managers should therefore have a formal stakeholder management process that is appropriate for the circumstances of the project. The Stakeholder Management Cycle Stakeholder...
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...has been espoused as a valuable method of promoting reflective practice in nursing and it can be used as a tool in developing curriculum content’ (p770). The Reflective Cycle of Gibb’s (1988) (appendix 1) will be used as a framework to conduct this assignment. My reasoning for choosing Gibb’s can be explained by [anon] (2006) ‘Gibb’s reflective cycle is fairly straight forward and encourages a clear description of the situation, analysis of feelings, evaluation of the experience, and analysis to make sense of the experience’. The assignment will also be organised into sections based on the reflective cycle. Pseudonyms will be used to maintain anonymity and confidentiality in accordance with clause five of the NMC (2004). The critical incident which I have chosen is an inappropriate assessment and application of mouth care in a pre-operative patient. ‘Oral assessment is required in planning effective care, and that the incidence of oral complications was reduced by the frequency of care’ Ginsberg (1961) cited by Mallett, J and Dougherty, L (2000 p361). I have chosen this as I found that mouth care is a valuable skill to perform on a NBM patient, and the appropriate assessment will reduce a patient’s discomfort. The managerial concepts I have chosen will appropriately explain my reasoning for implementation of this into practice. A full account of my critical incident can be found in appendix 2. Naylor (2004) cited by Mullins, L (2005) states...
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...Xochitl Jacques - Smith Hypothesis Testing/ Psychological Reasons for Depression PSY315 Statistical Reasoning Amber Lupo July 6, 2015 Psychological Reasons for Depression The number of people diagnosed with depression will be different because of either biological or psychological conditions. This hypothesis testing will include a two-tailed test with the alternative hypothesis testing as there will be a difference in either biological or psychological causes, and the null would be both cause depression equally with no difference. Our hypothesis testing will be from a survey of people with biological conditions diagnosed with depression. Our method of research is through survey studies because this will provide data that cannot be observed directly and does not allow conclusions. Biological Depression Depression is quite common and attributed as a mental disorder. Biological reasons for depression are varied leaving much research to be done to discover the true cause though there has been much headway in the knowledge of brain function. Through this research, more causes and therefore more cures have been uncovered, making it a more manageable...
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...Analysis of Newspaper Research Report Sandra Nelson HCS/438 10/24.2011 Dr. Jill Wiseberg Analysis of Newspaper Research Report This paper will give an analysis of statistical study involving the eating disorders of teens. Eating disorders are more widespread in teens than formally thought, and has had a devastating effect on their lives, a study for the Archives of General Psychiatry revealed the widespread disorder and behaviors in 10,123 teenagers between the age of 13and 18. The study disclosed that out of the 10,123, about 0.3% had anorexia, 0.9% developed bulimia, and 1.6% practiced binge eating disorders. Nearly all teen with social impairment have anorexia as an eating disorders and theses impairment affect their social and family relationship (Park, 2011). What statistical procedures are used in the study? The population chosen was teens from 13 to 18 years, the 10,123 were chosen from the National Co-morbidity Survey Replication Adolescent Supplement. This would be a subset of the population, this element was possible chosen based on the particular study, and this is not a representation of the entire population, in this article the researcher used the empirical method for gathering data. The sampling method is difficult to differentiate, is it systematic or convenience sampling? the advantages of systematic is that it can eliminate other source of bias, the disadvantage would be that bias can be introduce where patterns used for samples coincides with patterns...
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...(2012) estimates that of prescriptions written 20-30% are never even filled. For those suffering from severe mental illness the issue arises when adherence stops and symptoms take control of their daily lives, putting them at increased risk for substance abuse, assaultive behavior and lower quality of life. Despite continued evidence supporting the efficacy of psychiatric medications in improving symptoms only about half of those receiving medication treatment take it as prescribed. Even worse, in a recent randomized clinical-trial studying anti-psychotic for effectiveness it was reported that 74% of those prescribed medication discontinued use after 18 months (Roe, Goldblatt, Baloush-Klienman, Swarbrick & Davidson, 2009). But for many patients more medication means additional side effects, less freedom and change in their view of themselves. Professionals taking care of these individuals in acute care or long-term settings are left wondering how this vicious cycle can be stopped. In order to further comprehend why individuals suffering from serious mental illness make the decision to discontinue their medication researchers developed a study based on the interview of seven participants with the diagnosis of either Schizophrenia Spectrum Disorder or Bipolar...
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...organizations a good example would be the development of ITaas of EMC and VMware technologies the mission of VMware is to enhance availability of critical applications that would deliver enhanced patient care distribution and cut cost. The Munson Healthcare has chain of eight hospitals and located in Hopkin, Mass chutes and five clinical in northern Michigan has implemented EMC to transform the IT infrastructure to create innovative IT service. Their own creation of health exchange enables the possibility m for healthcare providers to achieve great levels of patient care through a safe information exchange. The IT organization of Munson felt a need to upsurge reliability and agility, while enlarging its role as a provider of IT –as-a-Service that are capable of providing HIE and EMR capabilities to numerous developing hospitals and physician practices testing centers such as laboratories that are either inside or outside the network (PR,2012) Functions and Capabilities Munson Healthcare use virtual storage to accomplish high availability and shared access of resources within all their facilities. ITaas provides” MediTech EMR applications and e-Clinical Works electronic practice management , and McKennon Hospital information system (HIS) The healthcare providers ‘s private cloud also supports Microsoft Exchange and Microsoft SQL Server applications, Cerner, and Siemens Syngo Dynamics picture archiving and communication system (PAC).” (PR,2012). ITaas delivers in reason able...
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