...which the infection develops (CDC, 2014). HCAP develops during or following a stay in a healthcare facility. In contrast, patients who are diagnosed with CAP have had no contact within a health care setting prior to presenting with the infection (Driver, 2012). Pneumonia may be present as a mild illness but has the potential to be life-threatening. Despite advances in research, pneumonia remains a common illness contributing to the death of young children in developing countries and the elderly population of developed countries throughout the world (Ruuskanen, et al., 2011). In 2010, approximately 50,000 people in the U.S. died after developing the infection (CDC, 2014). From a global perspective, 450 million cases of pneumonia are recorded annually and roughly 4 million of those diagnosed will die from this illness (Ruuskanen, et al., 2011). CAP is the eighth-leading cause of death within the U.S. and is the leading cause of death from infection in the developed world (Brown, et al., 2012). While anyone is susceptible to contracting it, certain risk factors increase the chances of developing the infection. Research confirms that pneumonia is more serious in younger and older populations; people with chronic health problems; and people who have weak immune systems (CDC, 2014). In the U.S., the population older than age 65 account for nearly two thirds of hospitalizations and 90 percent of deaths associated with...
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...Qualitative Research Article Critique June Cleaver, RN NUR410: Research in Nursing Boston December 12, 2011 Title of Paper In order to obtain the greatest benefit from research, it is necessary to interpret results accurately. The development and application of critical thinking skills is paramount when reading and evaluating research articles, rather than to take the research as fact. The following paper is a critique of a qualitative research article published in 2007 by Journal of Critical Nursing, titled “The Effects of Different Maternal Positions on Non-Stress Test: An Experimental Study”. Title and Introduction The title “The Effects of Different Maternal Positions on Non-Stress Test: An Experimental Study” (Alus, Okumus, Mete, Guclu, 2007) accurately reflected the content of the article and research study. The abstract remained concise as well as provided more detail to the article. The objectives, background, study design, means of data collection and analysis, results; conclusion, and relevance to clinical practice were all mentioned in a brief paragraph. The importance of the study was clearly stated, obtaining erroneous results from non-stress tests, when, indeed, the fetus is healthy and well oxygenated. The authors further described the supine position showed the least fetal activity, increased maternal back pain as well as maternal shortness of breath. (Alus, Okumus, Mete, & Serkan, 2007). The introduction was informative and included additional...
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...failure. The aim of this study was to examine the incidence of fatigue and distinguish its demographic, clinical and psychological correlates in patients suffering from heart failure. These findings could possibly lead to ways to better treat patients living with HF. Healthcare workers could benefit greatly from the data gathered to better understand the needs of the aforementioned patients and focus their interventions to accommodate their needs. No review of literature is included in this research paper. The study was conducted by six scholars with advanced degrees. Two of the researchers hold PhDs and two other hold DSNc degrees, which are professional level research degrees in Nursing. The Doctor of Philosophy (PhD) in Nursing is considered a more academic degree and prepares those who have attained the it for both research and teaching positions. In this study, a cross-sectional correlation design method was used. This type of research study uses a small group of individuals to represent a whole population. It is often used in making healthcare decisions and imperative that only current information is considered (Last, 2010). In this particular study, 150 patients from a single heart failure center, 73% percent were men and 27% were women. All study subjects were above the age of 18 and had a left ventricular ejection fraction less than 40% that had been documented longer than 6 months. Researchers used 3 tools to help...
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...test (6MWT). Specifically, it reviews indications, details factors that influence results, presents a brief step-by-step protocol, outlines safety measures, describes proper patient preparation and procedures, and offers guidelines for clinical interpretation of results. These recommendations are not intended to limit the use of alternative protocols for research studies. We do not discuss the general topic of clinical exercise testing. As with other American Thoracic Society statements on pulmonary function testing, these guidelines come out of a consensus conference. Drafts were prepared by two members (P.L.E. and R.J.Z.) and were based on a comprehensive Medline literature search from 1970 through 2001, augmented by suggestions from other committee members. Each draft responded to comments from the working committee. The guidelines follow previously published methods as closely as possible and provide a rationale for each specific recommendation. The final recommendations represent a consensus of the committee. The committee recommends that these guidelines be reviewed in five years and in the meantime encourages further research in areas of controversy. BACKGROUND There are several modalities available for the objective evaluation of functional exercise capacity. Some provide a very complete assessment of all systems involved in exercise...
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...CHAPTER I • INTRODUCTION • Asthma is a long-term, inflammatory condition that affects the lung, which results to a difficulty of breathing of a person experiencing it (Morris, 2011). According to the World Health Organization (WHO), approximately 235 million people worldwide are affected by asthma. Asthma is the most common chronic disease in children. According to the Centers for Disease Control and Prevention (CDC) , the number of people with asthma increased by 4.3 million from 2001 to 2009 and that during this time period, asthma rates rose the most (almost 50 percent) in black children. In 2007, asthma was linked to 3,447 deaths in the United States. (Morris, 2011) Severe asthma is a serious health concern that can lead to respiratory failure. Each year in the United States, as many as 470,000 people seek hospital treatment for asthma-related symptoms and the disease causes about 5000 deaths. Despite its prevalence, experts differ in the definition of the disease. Clinical authorities typically favor a broad, comprehensive definition. The National Heart, Lung and Blood Institute, defines asthma as: "A chronic inflammatory disorder of the airways (which causes recurrent episodes of wheezing, breathlessness, chest tightness and coughing, particularly at night or in the early morning) usually associated with widespread but variable airflow obstruction that is often reversible, either spontaneously or with treatment...
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...Difference in Competencies between Associate and Baccalaureate Nurses Introduction The need for competent bedside nurses has drastically increased and so will it be in the near future. The level of basic education that a nurse should have has always been an issue of debate and controversy. Primary focus of this paper will be to point out the difference in competency of nurses educated in an ADN level to those educated in BSN level. Nursing is a profession where skill and knowledge has to work hand in hand to promote and deliver optimum level of care, skill alone acquired by years of experience cannot be an answer for this question .But a combination of expert knowledge, decision making, planning, research and leadership which is an integral part of the basic curriculum of a BSN program is extremely necessary. ADN nurses usually have 2-3 year education in community college setup and are focused to provide individualized care to their patients based on their diagnosis. But on the other hand BSN nurses undergo 4 year degree program where they get more training in the field of science, nursing management research and leadership. .(“When care”,2002,para.20) The more the year of their education the lesser the error in their field of clinical practice and procedure violations. Weather it is a ADN or BSN ,both can get a license to work as RN,provided they pass NCLEXRN.Study suggest that a BSN focuses on psychosocial complexity and therapeutic use of self to know patients...
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...Heart Failure Western Governors University Pathopharmacological Foundations for Advanced Nursing Practice Heart Failure It is estimated that about five million people in the United States are living with heart failure with an overwhelming number of 550,000 newly diagnosed cases each year, costing the nation roughly $32 billion dollars per year (Centers for Disease Control and Prevention, 2016). Heart failure is a complex, pathophysiological condition in which the ventricles of the heart is weakened and unable to pump effectively to meet the body’s needs for nutrients or has lost adequate filling capacity. Clinical presentations of heart failure depends on which ventricles have failed to pump blood adequately; left ventricular failure, also known as congestive heart failure (CHF) is more common than right ventricular failure (McCance & Huether, 2014). The most common symptoms of heart failure are shortness of breath, fatigue, and peripheral edema. HF is not a disease, but rather a manifestation of a diseased heart. Large number of disorders can lead to heart failure, and with the aging population and many surviving primary cardiac events, it is no surprise that the most common reason for hospitalization in patients older than 65 years old is heart failure (McClintock, Mose, & Smith, 2014). Heart failure has become a major public health problem because it is the only cardiac condition that continues to increase in prevalence (McClintock, Mose, & Smith, 2014)...
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...Chapter 1 Nursing Images throughout History 1) The angle of mercy 2) The handmaiden 3) The battle-ax 4) The naughty nurse 5) The military image A. Nurses on the battlefield * Hospitalers – specialized soldiers who at the end of battle returned to the outposts to care for the sick and injured * Army nursing service – organize nurses and hospitals and coordinate supplies for the soldiers during the Civil War * Clara Barton a. Provided care in tents set up close to the fighting b. Did not discriminate c. Establishment of the American Red Cross * Harriet Tubman – helped slaves escape to freedom on the underground railroad * Walt Whitman – a poet * Louisa May Alcott – an author * Dorothea Dix – union’s superintendent of female nurses during the Civil War B. Nurses fighting diseases * Florence Nightingale d. Epidemiology – the study of the distribution and origins of disease e. Air, light, nutrition, and adequate ventilation and space assist the patient to recuperate * Lillian Wald & Mary Brewster f. Founded the Henry Street Settlement in NY to improve the health and social conditions of poor immigrants g. Improve health and prevent illness by promoting safe drinking water, adequate sewage facilities, and proper sanitation Florence Nightingale (1820-1910) ...
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...Atrial Fibrillation And Nursing Considerations As a nurse one must provide holistic care. To better understand aspect of providing holistic nursing care one must have an in-depth understanding of primary body systems and their pathology. This paper will educate the prudent nurses who read it with detailed information about the specific cardiac pathology of atrial fibrillation. Written with a basic understanding of human heart function/structure as a prerequisite, this paper will first discuss key terms one must be familiar with before providing researched information explaining the pathophysiology of atrial fibrillation (AF). Next, it will discuss the etiology, clinical manifestations, common laboratory diagnostics, and interventions. Lastly, this paper continues by providing readers with nursing diagnoses and patient teachings associated with AF. Key Terms As a nurse one must become a scientist of sorts and must be familiar with technical nursing terminology. Atrial fibrillation, or AF, is a cardiac dysrhythmia in which “multiple rapid impulses from many atrial foci depolarize the atria in a totally disorganized manner at a rate of 350 to 600 times per minute” [ (Ignatavicius & Workman, 2010) ]. A dysrhythmia is a disorder of the heartbeat involving a disturbance in cardiac rhythm and an irregular heartbeat; whereas an arrhythmia is basically a fast or irregular heartbeat caused by a disorder in the heart's electrical system. Tachydysrhythmia is an abnormal...
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...Nursing Theory Plan of Care Fintan O’Connell NUR/513 May 23, 2012 Francine McDonald Care Plan for Ronald Issler |Nursing Process |Data and Relevant Information | |1. Breathe normally |Complains of shortness of breath, oxygen saturation 88% on room air, | | |heart rate 58, chest x-ray with bilateral lower lobe infiltrates, | | |history of DVT. | |2. Eat and drink adequately |Height 6 ft., weight 147 pounds. BMI 19.7 (lower range of normal). | | |History of congestive heart failure, takes diuretic. Hemoglobin and | | |hematocrit levels low (HGB 10.4 gm/dl, HCT 29.6%) | |3. Elimination of body wastes |History of congestive heart failure (as noted above), elevated | | |creatinine level of 2.0 mg/dl | |4. Move and maintain posture |Increasing weakness...
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...means of relief are within practitioners’ capabilities to provide care. With careful assessment and a comprehensive plan of care that addresses the various aspects of the patients needs; chronic pain can be controlled in the vast majority of cases. Thus, awareness and provision of basic and specialized interventions can ensure comfort and improve quality of life. However, chronic pain left untreated or undertreated may cause suffering. This will also cause disease-mediated symptoms such as pain, dyspnea, fatigue, and loss of mobility. Needless to say, there are accompanying emotional states such as depression, anxiety, and a sense of uselessness. This paper will explore the under treatment of chronic pain among the elderly, its defining attributes, the use of an analysis model and its relationship to the concept. Identify a nursing theoretical framework used to analyze and resolve the problem. Also, an attempt will be made to identify an evidence based practice and research to support strategies for the resolution of the problem. Problem Under treatment of Chronic Pain in the Elderly However, most often than not, nurses make the assumptions that older patients have high tolerance for pain or are unable to tolerate stronger pain medications. Due to some of these biases and forgetting that the elderly population usually has more comorbidites which contribute to their undertreated chronic pain. Even though about 80% of the elderly population have chronic pain, many healthcare...
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...I. Executive Summary A third-party logistics provider (abbreviated 3PL, or sometimes TPL) is a firm that provides service to its customers of outsourced (or “third party”) logistics services for part, or all of their supply chain management functions. Third party logistics providers typically specialize in integrated operation, warehousing and transportation services that can be scaled and customized to customers’ needs based on market conditions and the demands and delivery service requirements for their products and materials. 3PL is defined as “a firm that provides multiple logistics services for use by customers. Preferably, these services are integrated, or bundled together, by the provider. Among the services 3PLs provide are transportation, warehousing, cross-docking, inventory management, packaging, and freight forwarding.“ Metro Combined Logistics Solutions Inc. is a third party provider of several companies here in the Philippines; one of them is the Johnson and Johnson Philippines Inc. Metro Combined is the third party provider for the management of the raw and packaging materials warehouse for the said company. Our group had our internship in the said warehouse wherein we were assigned to do several warehousing tasks. We were under the supervision of Mr. Engelbert Ranjo, the Assistant General Manager for Metro Combined and Operations Manager for the Johnson and Johnson account. During our internship we have observed that Johnson and Johnson is incurring a lot...
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...Part I As of this date, the best evidenced-based treatment for treating panic disorder, with or without agoraphobia, appears to be a combination of cognitive behavioral therapy and pharmacotherapy. There are numerous studies to support this claim, some of which will be discussed here. There have been a number of comparative studies of psychotherapy, drug treatment, and a combination of both in the treatment of panic disorder and most have indicated that a combination is superior to mono-therapy of either type (Bandelow, Lichte, Rudolf, Wiltink, & Beutel, 2014). There are other methods that are also used, but current research shows that none appear to be as effective as this combination. Anxiety disorders are the most common mental illnesses, although persons suffering from them rarely seek treatment. Specific phobias are the most common type of anxiety disorder followed closely by panic disorder/agoraphobia (PDAG). Anxiety disorders are now thought to originate from an interaction of psychosocial, genetic, and neurobiological factors (Bandelow et al., 2014). Panic disorder (PD) is associated with significant personal, social, and economic costs and ranks among the most expensive psychiatric disorders (White et al., 2013). Merriam-Webster defines panic disorder, panic attack and agoraphobia as...
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...The Role of Motivation in Wellness Coaching and Weight Loss Liberty University Abstract The consequences of the American lifestyle, obesity and its associated comorbidities, on healthcare costs is staggering. Physicians prescribe behavioral changes such as diet and exercise, and hand out information on how to decrease stress. Wellness coaching has an opportunity to address clients holistically in order to achieve the behavioral changes needed to improve people’s lives and embrace their full potential. Motivation, both intrinsic and extrinsic, is a complex construct or force causing people to act and its presence is needed for change to begin as well as sustained. Based on Self-Determination Theory where the combination personality, self-regulation, and autonomy in motivation yield behavior change. Wellness coaches collaborate with clients in the coaching process to motivate client’s to meet their goals, using the coaching experience and accountability teaches the client self-motivation, and coaching the client in motivating others. During the initial screening conversation the coach must determine if the client is a good fit for wellness coaching and if they have any hurts that a counselor needs to address to free the individual to move forward. The coach needs to understand how the client is motivated to ensure goals are S.M.A.R.T with the right mixture of motivation applied through action steps and accountability to meet goals. Motivational interviewing techniques...
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...DANGERS OF SECONDHAND SMOKE ____________________ In Partial Fulfillment Of the Requirements for the Course Communication Arts II ____________________ By Julienne TABLE OF CONTENTS I. INTRODUCTION…………………………………………………………………….. II. NATURE OF SECONDHAND SMOKE…………………………………………….. III. CHEMICAL COMPOSITION OF SECONDHAND SMOKE…………………….... A. Cotinine…………………………………………………………………………... B. Carcinogens………………………………………………………………………. 1. Carbon Monoxide……………………………………………………………… 2. Cyanide……………………………………………………………………….... IV. TYPES OF SECONDHAND SMOKE……………………………………………….. A. Mainstream Smoke………………………………………………………………… B. Sidestream Smoke…………………………………………………………………. C. Thirdhand Smoke………………………………………………………………….. V. EFFECTS OF SECONDHAND SMOKE……………………………………………. A. Cancers…………………………………………………………………………… 1. LungCancer………………………………………………………………….. 2. Breast Cancer ……………………………………………………………….. B. Effects in Cardiovascular System………………………………………………… 1. Coronary Heart Disease……………………………………………………… 2. Stroke…………………………………………………………………………. 3. Other Heart Disease………………………………………………………….. C. Effects in Respiratory System…………………………………………………….. 1. Asthma………………………………………………………………………... 2. Irritation of Respiratory Tract………………………………………………… D. Effects in Neurological System……………………………………………………. 1. Dementia………………………………………………………………………. E. Effects During Pregnancy…………………………………………………………. F. Effects to Children…………………………………………………………………...
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