... * Asthma is a multifactorial, chronic inflammatory disease of the airways. The knowledge that asthma is an inflammatory disorder has become a core fundamental in the definition of asthma. (coughing, wheezing, and shortness of breath.) * The prevalence of asthma among children changes with increasing age. As an example, boys have higher current asthma prevalence, compared with girls throughout most of childhood. * From 1980 through the mid-1990s, the asthma hospitalization rate steadily increased in children under 17 years of age. * Trend analysis identified an annual 2.9% increase from 1980 through 1991, but there has been no statistically significant trend after 1991. * Overall non asthma hospitalizations for children has decreased over that period, whereas the asthma hospitalization rate remained level. * In 2006 there were 21 asthma-related hospitalizations per 10,000 children, for a total of 155,000 hospitalizations; this represented approximately 5.6% of all hospitalizations among children in 2006. * Trend analysis found that, while asthma related mortality increased 3.2% per year from 1980 through 1996, a reversal thereafter led to an average decrease of 3.9% per year from 1996 through 2005. * In 2005 there were 2.3 asthma-related deaths per million children, for a total of 167 deaths. * Asthma creates a substantial burden for the estimated 9.6 million children, their families, caretakers, schools, families’ employers, and the healthcare...
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...Alise E. Jenkins May 24th, 2015 HCA-515 Health Care Models Analysis Hypothetical Case (basic details only): The patient is 72 year old female who smokes. She complains of extreme fluid retention in lower two limbs and lower abdomen. Breathing is difficult and she is only able to sleep while sitting erect in a reclining chair. Patient has underlying conditions: Obesity, Coronary Artery disease, Edema, Hypertensions, Dyslipidemia, Ischemia, and hx of quadruple Coronary Artery Bypass Graft. Current dx: Heart Failure Medical Model: A number of tests would be performed to analyze the extent of damage of the heart. An electrocardiogram would be one of the first tests performed to check the electrical activity of the heart and detect any type of ischemia (AHA, 2015). The tests would include X-Rays CT, and MRI scans. Also “Angiography that would allow imaging of the blood vessels” (AHA, 2015). Essentially it is creating a map of the heart. Ultrasound evaluations, echocardiograms, would also help define the amount of damage to the heart. Treatments for heart failure can vary due to underlying causes. However in most cases drugs are used to aid the symptoms. These drugs can include “beta-blockers, ACE inhibitors, and also a diuretic to help rid the body of excess fluid buildup” (CDC, 2015). Mechanical devices can be implemented into the heart too. These devices include pacemakers and defibrillators. These two mechanisms help improve...
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...Reducing Rehospitalizations in Skilled Nursing Facilities Increases the Quality of Care Residents Receive and Decreases Unnecessary Health Care Cost Nurses have the power to increase positive patient outcomes by implementing changes in their practice based on the evidence found in the nursing literature. Utilizing evidence-based practice (EBP) increases nurses job satisfaction, increases communication across the interdisciplinary team, enables nurses to 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...
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...With the near elimination of chicken pox due to the vaccine, older adults have waning immunity and this has possibly led to an increase in herpes zoster. It’s possible that decreasing antibody levels in older adults who are no longer getting exposed to cases in children are allowing more cases of zoster to occur. There is also available a varicella zoster vaccine to reduce the risk of zoster in the at risk generation. So forgive us if we take the time to point out when further evidence comes to light that vaccines are effective public health measures. Despite this, vaccine opponents have continued to argue that vaccines are not safe or effective. Meanwhile the big picture is dramatically clear – vaccine introduction lines up nicely with plummeting disease incidence. Or they confuse death rates with incidence rates (death rates can decline just by improvements in medical care – this does not mean that the spread of the disease was...
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...counteract by savings ensuing from reduction in readmission rates to the hospital. To prevent exacerbation focus more on results with education, suitable cure and systematic follow ups. Due to hospitalization deterioration in client status particularly in the senior can be attributed. Since occurrences of readmissions are higher the burden on health care system and the quality of life have a pessimistic influence on expense improvement efforts. Quality of care improvements can reduce the duration of the stay in the hospital and that avoid repeated readmissions (Denisco, S. M., & Barker, A. M., 2012). Aspects causing readmission can be taken care efficiently over the course of reforming care that can evade exacerbation of the disease. As an alternative to address the cause of the exacerbation, clients should be treated suitably by altering medications, training on dosage instructions and observance and changes in life style. Also follow up with the primary care should be stressed by provider of the care before releasing from hospital to avert preventable hospitalization. An effective release is planned towards the patient’s psychosocial well being (Pearson et al, 2004). To improve the health and wellness, the approach of care delivered should be included into body, mind and soul. Based on the wellbeing requirements education can increase consciousness and self esteem thus rising capability for self-care and decreasing repeated admissions to the hospital. Well-timed...
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...Management of Diabetes in Adults Age 65 and Older: An Evolving Concept Analysis Yaounde Ross University of Texas at Arlington College of Nursing In partial fulfillment of the requirements of N5327 Analysis of Theories in Nursing Ronda Mintz-Binder, RN, MN, DNP June 4, 2012 Management of Diabetes in Adults Age 65 and Older: An Evolving Concept Analysis Managing chronic illnesses like diabetes is becoming progressively essential in high-risk groups. The concept of managing diabetes in persons 65 and older, carry much responsibility by those who provide care and those receiving care. With marvel surrounding the first set of baby boomers who turned age 65 in January of 2011; it became evident that this country would embark upon its greatest challenge yet in managing the care of older adults. With this in mind, the management of chronic illnesses like diabetes and its associated complications is expected to become even more complex and difficult, with the realization that much is to be considered in preparation to care for this age group. In this analysis using the term management, as it relates to the older adult, implies direct guidance to treatment that is both accessible and practical. Review of Literature To better understand management of diabetes as a concept in adults age 65 and older, a review of disciplines is necessary to offer clarity in obtaining a greater sense of knowledge of the burden this disease places on the patient. In examining this concept...
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...The government should take action on determining how many psychiatric beds are necessary. This will help the hospitals concentrate on helping the “special needs” population by trying to reduce the waiting time for a bed. One important strategy that can be used is trying to use programs that will reduce hospitalization rates. The evidence-based practices that are being used are the Assisted Outpatient Treatment, Assertive Community Treatment, and the Sequential Intercept Model. All these programs are similar. The Assertive Community Treatment is a program that consist of a team of medicals that can assist the patients from where they live. Focusing more on these evidence based programs can reduce emergency room visits and psychiatric hospitalization. Lastly, there should be a reform for medicaid from the government for the population of “mentally ill” in prisons and jails. The medicaid should cover the expenses for inmates that financially qualify. However, Congress should direct and fund certain agencies. This would be beneficial for getting more beds instead of reducing beds as we see this is the challenge we are facing now a...
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...Numerous researched have been performed to study the best evidence based practice to prevent falls among the older adults during hospitalization. Healthcare providers have a greater responsibility to practice and use the research interventions in older adults to achieve the best evidence based practice by reducing the fall rates among the older populations. Siegrist et al., (2016) reviewed “the effects of a targeted complex exercise intervention to prevent falls among the older populations”. Exercise programs benefit the older adults by decreasing the risk of falling and it can improve the fall risk factors such as muscle limitation, balance and gait abnormalities. The study by Siegrist et al. (2016) found effectual multifactorial fall prevention...
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...Running head: HOW IMPORTANT IS COLON PREPARATION FOR COLONOSCOPY? 1 How Important is Colon Preparation for Colonoscopy? Wendi McDonough Western Governor’s University HOW IMPORTANT IS COLON PREPARATION FOR COLONOSCOPY? 2 How Important is Colon Preparation for Colonoscopy? Gastroenterologists perform screening colonoscopy to exam the colon for precancerous polyps, with the intent of removing them before they have a chance to develop into colon cancer (Cohen, Kastenberg, Mount, & Safdi, 2009), (Lichtenstein, 2009), (Nguyen & Wieland, 2010). Physicians prescribe bowel preparations prior to colonoscopy to cleanse the colon of stool. Colonoscopy has a number of primary risks involved. These include complications from anesthesia, side effects from preparation, perforation, missing a lesion, and being unable to complete the exam (Hendry, Jenkins, & Diament, 2007). Complications that arise because of poor preparation include increased complexity of the exam, decreased detection of colonic lesions, and increased healthcare spending (Roberts-Thomson & Teo, 2009), (Athreya, Owen, Wong, Douglas, & Newstead, 2011), (Nguyen & Wieland, 2010). The most important function of the colon is to absorb sodium, water, and some fats from the food we eat (Adamcewicz, Bearelly, Porat & Friedenberg, 2011). Complications arise from colon cleansing for a number of reasons. The patient may experience a suboptimal exam with multiple possible complications from poor preparation. These include...
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...Value Compass Healthcare advancements will only transpire when the measurement of outcomes is linked to processes and systems supporting the results. Creating a way to measure quality-related outcomes and costs is essential to successful healthcare management. The value compass is a way to focus the direction of an organization using four main points: clinical outcomes, satisfaction, quality, and costs. The value compass provides clarify for the performance improvement efforts and helps members of the healthcare team reach the department’s goals. The value compass that I have submitted is focused on the Pediatric Critical Care environment. Medical/Clinical Outcomes Pediatric ICU patients are uniquely predisposed to a myriad of risks/problems that the adult population does not encounter. Therefore, safeguards need to be in place to assure satisfactory outcomes. Introducing an Asthma Care Process Model (ACPM) will provide a systematic approach to treating this prevalent disease. It focuses on increasing preventative care and reducing exacerbations and hospital admissions, which will increase patient wellness and therefore outcomes. The pediatric population does not always have the same clinical findings as adults when they are in septic shock and therefore are not always given timely, appropriate treatment. Introducing pediatric shock guidelines for fluid resuscitation and antibiotic administration should help to improve morbidity and mortality...
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...Outcomes Measurement and Data Management Project: Hospital Readmissions Charmein Garner and Celeste Thomas Loyola University New Orleans Outcomes Management Project Defined Issue or Problem of Interest The selected problem of interest is hospital readmissions after being discharged from hospitals/medical facilities. Several patients enter the hospital and soon after discharge are catapulted back into the seemingly revolving doors of the hospital. Readmission rates affect all areas of healthcare. Center for Medicare and Medicaid (CMS) has targeted readmissions as a guideline of poor quality of care. Engaging patients during their inpatient admission as they transition to alternate levels of care may reduce readmission by 50% (Service, 2008). The intent of this proposed paper is to take a look at hospital readmissions rates in correlation with the patient being elderly and having a diagnosis of heart failure and assess what can be done to positively change these statistics, which increase the quality of care we as healthcare professionals provide to our patients. A Rationale for Selecting the Issue or Problem of Interest Hospital readmissions can occur throughout the patient’s transition through the healthcare system. Many times readmissions occur among those who are frail and have chronic conditions. Readmissions account for approximate 18% of Medicare patients, of this 13%, are suspected to be avoidable and are directly linked to poor quality. Quality is...
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...Property Values Business Development Transportation Times and Costs Environmental Indicators Air Quality Indexes (AQI) Carbon Monoxide Concentration Trends Ozone Concentration Trends Health Indicators Asthma Rates Traffic Fatalities Results and Conclusion II. Executive Summary This paper serves as an addendum to the previously existing Transit Oriented Development in the Triangle Region report compiled by the Triangle J Council of Governments. It analyzes the impacts of light rail transit in regions that are comparable to the Triangle Region (as defined by the region surrounding Duke to NC State to UNC). This study focuses on the effects of Vehicle Miles Traveled (VMT) as a result of light rail implementation. Additionally, we examine how light rail impacts the following sub-categories: environment, economic, and health indices. These indices shape our assessment of whether or not light rail is a worthwhile investment in the Triangle Region. In order to enable politicians to make the best decisions regarding light rail, we provide a comprehensive analysis of peer corridors that are similar to the Triangle Region. Based on population growth projections for the Triangle Region, we find it necessary to offset the corresponding increases in traffic rates and the detrimental health effects that are associated with this growth of automobile usage. We found that building a light rail transit system generates additional tax revenues from increased property values and...
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...Philippine Christian University Mary Johnston College of Nursing 415 Morga St. Tondo, Manila A Case Study on Acute Pancreatitis Secondary to Cholelithiasis Submitted by: Abad, Edryan Calara, Sharika Loradel Casul Mark Jury Corpuz, Trisha Dela Cruz, Marjori Gamboa, Jonalyn Lebico, Elmarie Lopez, Anica Tapawan, Ansherina Tuazon, Serleen March 09, 2012 Acknowledgement We would like to thank the following to the development of this case study. Mrs. Edna Oraye-Imperial, Dean, PCU – Mary Johnston College of Nursing, for her support and for allowing us to have our related learning experiences in the clinical area that hone our knowledge skills and attitude to be a competent, caring, Christian nurses. Ms. Ma. Lourdes Galima, Clinical Instructor, for continually guiding and supporting us throughout our duty at the Surgery ward, for helping us in enhancing and improving our skills in the area. For the patience that she showed us despite of our attitude and mistakes. Ms. Loreto Vicarme, School Librarian, for allowing us to utilize the library books and references for our case study. To the staff nurses on duty at the Surgery Intensive Care Unit and Ward of Mary Johnston Hospital for the support and providing us with enough information about the routines in the area which we were able to apply. To our fellow group members for their continuous support and sharing their knowledge and experiences for polishing this case study...
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...Respiratory Disease Paper - Pneumonia Ranacia Alford HCS/245 October 16, 2014 Heather Walzel Respiratory Disease Paper – Pneumonia Introduction Pneumonia, by terminological definition, is an infection of the lungs. It can be caused by bacteria, viruses, and other microbial organisms that invade the body. Pneumonia has the potential to be an advantageous disease in that it can attack when the body is infected by another microbial, such as a upper respiratory infection (Kid’s Health, 2011). Pneumonia can also be contracted by inhaling a liquid or chemical into the lungs (National Institutes of Health [NIH], 2014). Pneumonia may affect anyone from children to adults. This disease can be prevented and treated. Disease Prevention Type Pneumonia falls under more than one prevention type category. Primary prevention of pneumonia in the form of vaccines is an effective method among children and the elderly. The infant vaccine series of the pneumococcal vaccine, Prevnar, has been incorporated into the Centers for Disease Control and Prevention’s recommended immunizations for infants between ages two months and eighteen months (Centers for Disease Control and Prevention [CDC], 2014). Other vaccines also contribute to prevention including Hib, Flu, and Pertussis (CDC, 2014). Because they're at higher risk for serious complications, infants born prematurely may be given treatments that temporarily protect against RSV, which can lead to pneumonia in younger kids (Kid’s Health,...
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...Congestive Heart Failure Introduction Everyone loses pumping ability in their heart as they age. The serious case of heart failure develops when other health conditions cause the heart to work harder or become damaged due to increased stress. Heart failure is usually a chronic disease. It gradually tends to become worse. By the time someone is diagnosed with it, the heart has most likely begun to lose pumping capacity for quits some time. Nearly five million Americans are living with heart failure and 550,000 new cases are diagnosed each year. This paper will discuss what heart failure is, and what nursing interventions may be of help to patients who suffer from this disease. My grandmother was recently diagnosed with congestive heart failure. By interviewing her and performing a brief assessment, I hope to recognize a few nursing diagnoses and some interventions that may make her disease more bearable. Heart failure can involve the right side of the heart, the left side, or both. Heart failure usually affects the left side first. Each side of the heart is made up of two chambers the atrium and the ventricle. If either of these chambers loses their ability to keep up with the amount of blood flow then heart failure occurs. Custom writing service can write essays on Congestive Heart Failure Left - sided failure involves the left (lower) ventricle. The left ventricle pumps oxygenated blood to the rest of the body. This chamber is the largest and is...
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