...This paper seeks to find out and elaborate the term Early Warning Scores (EWS) while also showing its vital role in early identification and quick treatment of a patient who is experiencing a fast deterioration of health. There are other diverse scores that are similar to the Early Warning Score (EWS). For example, there is the ‘Modified Early Warning Score’ and the ‘National Early Warning Score’. The above scores have different terms because they use different set of parameters and variables in measurement when compared to the EWS. This paper will focus on the use of EWS consistently and will only refer to measurements that fall under EWS. Literature mainly drawn from national policies and guidelines issued by bodies such as the National Institute of Clinical Excellence (NICE), National Confidential Inquiry into Patient Outcome and Death (NCEPOD), and National Patient Safety Agency (NPSA) reinforce our support of the use and efficacy of EWS. Through the use of literature derived from medical books nursing journal, medical journals, and other medical sources from the internet we will provide evidence on the efficacy and use of EWS. The objective will be to come up with a recommendation on the EWS that is derived from research. The first consideration when discussing critical care is to consider what it comprises of. Critical care is the direct delivery of medical-care to the patients that are acutely ill. While giving critical care it should be understood...
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...CNE V Continuing Nursing Education Objectives and instructions for completing the evaluation and statements of disclosure can be found on page 224. What Is Normal?' Evaluating Vital Signs Dehra Van Kuiken, Myra Martz Huth ital signs (VS) are indicators of physiological functioning and include temperature, respiratory rate, fieart rate (pulse), and blood pressure (BP). Health care professionals measure VS to assess, monitor, evaluate, and document an individual's physiological status or change in condition (Royal College of Nursing, 2011). Depending on the individual's condition, VS are monitored and recorded routinely by policy, tradition, or expert opinion, whether needed or not (Evans, Hodgkinson, & Berry, 2001; Zeitz & McCutcheon, 2006). Five years ago, pédiatrie nurse leaders and evidencebased practice (EBP) experts from children's hospitals across the country voiced concerns about the frequency of VS at a National Summit for Pédiatrie and Adolescent EvidenceBased Practice (Melnyk et al., 2007). This summit resulted in our team formulating a clinical question, searching for the evidence, critically appraising the evidence, and formulating conclusions on normal parameters. Before the question on the frequency of ys could be addressed, two fundamental questions needed exploration, and thus, became the focus of our work. The questions are: • Among pédiatrie patient ages 1 through 5 years, what are "normal" VS parameters? • Among pédiatrie patient ages 1 through 5 years...
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...Compassion Fatigue Compassion is the core value of the caregiver’s work, and that the essence of compassion is what gives nursing its soulfulness, staying power, and healing resources (Bush, 2009). As health care workers overtime caring and helping patients that are suffering or traumatized can have a toll on us, and this can lead to compassion fatigue. Compassion fatigue can suddenly render nurses unable to distinguish between their own emotions and those of their patients (Thompson, 2013). Compassion fatigue can happen to anyone of us, and it should not be ignored. As nurses we have to be aware of the warning signs of compassion fatigue. We can now use proactive measures to deal with this. We spend time providing patient care, but we forget about ourselves. We must take care of ourselves if we want to provide quality patient care. Warning signs of five concepts of compassion fatigue There are five major concepts of compassion fatigue, they are cognitive, emotional, behavioral, spiritual, and somatic (Bush, 2009). All healthcare professionals should be aware of the warning signs. These signs should be used as early signals to see if we are suffering from compassion fatigue or if we are vulnerable. When it comes to compassion fatigue early intervention is key. Each person is different so no one person will have the same warning signs. Warning signs of each concept will discussed below. Concept 1 COGNITIVE Nature of the Problems and their Causes Cognitive relates to...
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...constantly helping people who are sick and suffering .Nursing is a caring profession and people are drawn to the profession because they love to care and to be compassionate .There comes a time during the care giving process that the care we give to the patients become personal and start taking a toll on our physical ,psychological and spiritual health.(Bush, 20090 states that in compassion fatigue not only do the environmental factors of work negatively affect care givers but also the physical demands of the patients such as pain and discomfort and emotional needs such as fear and anxiety..Care givers should be able to recognize the signs of compassion fatigue so that help can seek medical treatment early before the symptoms start to take a severe toll on the care giver’s health. (Gilmore, 2012, p. 20) noted that the things that draw nurses to caring such as providing compassion and support to the patients are the very things that cause nurses to suffer from compassion fatigue .I personally feel that compassion fatigue is when we spend time with the patients ,getting to know them more and during the process we love the patients more to such an extent that their problems become our problems and added with the demands of our families ,the job and the organization we develop compassion fatigue . Warning signs of compassion fatigue Although signs of compassion fatigue may be present many care givers may dismiss these signs and symptoms and attribute them to being related to some...
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...health care assistant. I will use a reflective tool to assist in the reflective cycle using Gibbs (1988) ref – university of cumbria www.cumbria .ac.uk/public /liss/document/skills sat cumbria/reflective cycle) I will ensure that I comply with the Nursing and Midwifery council (NMC) in order to achieve this I will write in first person and all names and locations will be changed to protect identity. Ref (NMC 2015). Description My normal day started at 7.30 I was allocated to work in a bay alongside my colleague within my clinical area. An accurate handover of the clinical information was given in relevance to the patient’s continuity and safety of care. (Adams 2012). (Ref- Adams JM, Osbourne-Mckenzie T Advancing the evidence base for a standardized provider handover structure: using staff nurse description of information to deliver competent care. Journal of continuing Education in nursing 2012;43(6):261-6.) My case study is on a 59-year old lady( Appendix 1)who recently had been discharged after surgery on her left neck of femur fracture. This lady had been readmitted to our clinical area following her discharge due to signs of a UTI, fever and the wound site being very red and inflamed. Pam was showing all the signs and symptoms of a severe infection with a temperature ranging from 38.5 to 40 Celsius, heart rate greater than 90 beats per minute, respiratory rate greater than 20 breaths per minute and a white blood cell count greater than 12,000. These combined symptoms...
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...teenagers that committed suicide (five thousand) is synonymous to the number of people whom the cause of death was cancer or homicide. The number of teenagers, who committed suicide over the years, has outnumbered the number of teenagers who were killed by homicides by at least ratio three to two. That is ridiculous! To some people it sound unbelievable but as we continue to read various articles and continue to expose these occurrences on the internet and newspaper, people will be more aware of this epidemic. This paper is designed to make every person aware of the problem that everyone wants to sweep under the carpet. I want all to realize that teen suicide is indeed an epidemic. In my paper I will define suicide, discuss risk factors, warning signs, prevention measures, and as a healthcare provider, whether you are a nurse or an...
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...in the other hand. (Bush, 2009) Compassion fatigue is caused by empathy. It is a natural consequence from stress resulting from caring for and helping traumatized or suffering people. All health care providers are at major risk for compassion fatigue, and registered nurses are especially at risk because nurses are at the forefront of patient care. Nurses are compassionate and empathetic, it’s the nature of the job description. Nurses are experts at multitasking and putting the needs of others above and beyond their own needs each and every day. It is of the utmost importance that registered nurses understand compassion fatigue and familiarize themselves with the signs and symptoms for themselves and their coworkers so that they can take necessary steps to combat compassion fatigue at the first sign. The core of nursing and being a nurse is compassion. Nurses pride themselves on the extraordinary gift of being compassionate and caring for patients. Nurses see people at their worst and most vulnerable times and assist their patients back to optimal health. Nurses pick you up when you are down and clean you up when you cannot do it for yourself. Nurses provide a caring touch, a smile, and hope where hope is lost. It is not difficult to see that with the world on the shoulders of nurses that they may become fatigued. Health care providers are regular people too. Healthcare providers have families, and issues just like everyone else. Nurses put these things aside when they punch that...
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...Immediate Post Operative Care 2 The following essay will use a systematic approach to critically evaluate the care and treatment delivered to a non-elective paediatric orthopaedic patient within the Post Anaesthetic Care Unit (PACU) by a student Operating Department Practitioner at a local trust hospital. The assessment and management of the patients care will be examined and rationale provided for strategies employed during delivery of individualised patient care. In accordance with Health and Care Professional Council’s standards of conduct, performance and ethics (HCPC, 2012) the confidentiality of the service user will be up held at all times. The service user shall be referred to as “Daisy” to protect her confidentiality. Daisy was received to the PACU after surgical stabilisation of her left fibula and tibia with flexible intramedullary nails following a fall. A specified paediatric bay was utilised enabling the patient to be cared for separately from the adults in the PACU (RCOA, 2013). Anaesthetic and surgical handover was received (RCOA, 2013) which detailed that she was 14 years old with no known allergies. She had no significant medical history. She had a general anaesthetic with 140mfg of Propofol used on induction followed by Sevoflurane as a maintenance agent. 30mg of Atricurium, 4mg Dexamethasone, 4mg Ondansatron, 10mg Morphine and 1g Paracetemol had been administered intraoperatively. 1 litre of Hartmanns solution had been administered during surgery and...
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...Family Health Promotion in Nursing Practice February 22, 2014 Family Health Promotion Health promotion is defined as the science and art of helping people improve their lifestyle to move toward a state of optimal health (Edelman & Mandle, 2010). The World Health Organization (WHO) believes health promotion allows health to be a resource and not the objective of living (WHO, 2012). This paper will review the purpose of health promotion as related to nursing practice, and how nursing roles and responsibilities have evolved in regards to health promotion and implementation on the prevention, management and long term maintenance and rehabilitation on Stroke patients, including preventing education to the public and communities, on a primary, secondary, and tertiary prevention level (Edelman & Mandle, 2010). A stroke is caused by the disruption of the blood supply to the brain, usually related to a blood vessel ruptures or blocked by a clot, as define by World Health Organization. The blockage of oxygen and nutrients to the brain’s tissues can cause permanent damage to the brain tissue. Warning signs of stroke are, sudden weakness or numbness of the face, arm or leg, most often on one side of the body. Other symptoms include: confusion, difficulty speaking or understanding speech; difficulty seeing with one or both eyes; walking, dizziness, loss of balance or coordination; severe headache with no known cause; fainting or unconsciousness. The effects of a stroke...
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...Ectopic Pregnancy: What is it, and how to take care of her physically and emotionally Amanda M Strock Samaritan School of Nursing This paper will cover the topic of ectopic pregnancy, causes, presentation, treatment and care of a patient with an ectopic pregnancy. What is ectopic pregnancy? An ectopic pregnancy is a dangerous pregnancy where the embryo implants in a cavity other than the uterus. This can occur on the ovary, the cervix, in the abdomen or most commonly in the fallopian tube. Between 95% and 98% of ectopic pregnancies develop in the fallopian tube. (McQueen) Ectopic pregnancies are not viable and can cause many complications such as infection, hemorrhage and infertility. In a normal pregnancy the egg is fertilized in the fallopian tube in which it then travels down the fallopian tube to the uterus where it implants and begins its growth. With most ectopic pregnancies, the egg is fertilized normally but then implants to the fallopian tube before reaching the uterus due to a restricted pathway in the fallopian tube. There are many possible causes to ectopic pregnancies and some causes are completely unknown. Research shows that due to the increase in Pelvic Inflammatory Disease there has been an increase in ectopic pregnancies. Other causes or risk factors...
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...equally the most physically and mentally draining job there is. At the end of a twelve hour day, there is often times nothing left for myself or my family. Compassion fatigue is a real challenge that plagues all nurses. No one is invincible. Combining the stresses of life at home with the stresses of simply being a nurse, this fatigue can be severe and debilitating. Knowing how to recognize the warning signs of compassion fatigue and being aware of the potential causes will help one cope. Also knowing what the personal needs of the caregiver are, and coping strategies and resources for combating compassion fatigue will equip the nurse to be successful and to continue to give the best treatment every patient deserves. Signs of Compassion Fatigue All of the sudden this heavy, gray, gloomy feeling starts to weigh on the nurses shoulders. The feeling has slowly been accumulating until it can no longer be carried around. It is called compassion fatigue. Wouldn’t it be nice if you could learn the warning signs and symptoms and head it off at the pass? ‘Some warning signs of compassion fatigue include lack of enjoyment in day-to-day activities, not deriving any joy from things that used to excite you before, difficulty in concentrating on any task, feelings of anxiety and perpetual fear, feelings of irritability triggered by trivial things, isolation from family and friends, detachment from work and life, inability to make big or small decisions, lack of interest in work...
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...Rescue Barbara Combes Breckenridge School of Nursing ITT Technical Institute July 15, 2014 FAILURE TO RESCUE Abstract This paper describes failure to rescue (FTR), according to recent studies. Failure to rescue is discussed in terms of importance to nursing. The paper speculates on how knowing about failure to rescue may help in the nursing course studies and critical thinking skills. FAILURE TO RESCUE Introduction According to a 2007 article in Med Care, use of failure to rescue as an indicator of hospital quality and patient safety has increased over the past decade. Researchers have used different sets of complications and deaths to define this measure. (Silber JH, Romano PS, Rosen AK, Wang Y, Even-Shoshan O, Volpp KG, 2007). This paper gives a description of failure to rescue, discusses the importance to nursing and nursing students, in regards to course studies and critical thinking skills. References for this paper are research studies that used the “original” FTR (using all deaths) description. Description Failure to Rescue is generally defined as the inability to save a hospitalized patient’s life when he/she experiences a complication. A complication is a condition that is not present on admission, such as cardiopulmonary arrest/shock, pneumonia, upper GI bleed, venous thromboembolism (VTE), and sepsis. Failure to rescue does not necessarily imply wrong doing. (Silber, JH, 2007) Importance to Nursing Patients that experience a complication are...
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...RECOGNIZING AND ACTING ON CLINICAL DETERIORATION Introduction Nursing has always been a profession that embraces diversity towards rendering holistic patient care. However, with the constant changes in nursing practice; patient safety has been at risk due to nurse’s competence towards detecting impending patient deterioration that may lead to further complications or even death. It is said that the most important practical lesson that can be given to nurses, is to teach them what to observe (Nightingale 1969). Having the ability to observe and interpret critical situations are the essential key features applied in clinical practice. Effective observation of ward patients is the first step in identifying the deteriorating patient and effectively managing their care (Odell, Victor & Oliver 2009, p. 1993). Studies have shown that poor vital sign recording, lack of knowledge, failure to respond to abnormal signs, lack of knowledge, lack of supervision and failure to report deterioration or seek advice, have all contributed to the suboptimal care of ward patients (Odell, Victor & Oliver, cited in McGloin et al. 1999; McQuilla et al. 1998; Smith & Wood 1998; Hodgetts et al. 2002, p. 1993). With constant observation established, patient safety is implemented and surveillance is then incorporated to be able to identify and prevent possible medical errors and adverse events that may be encountered. The purpose of surveillance is the early identification of risk and the need for intervention and...
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...As stated earlier, sepsis is a worldwide problem. Sepsis strategies/guidelines are imperative to utilize to make a positive outcome. Becker and Dorman share that “sepsis affects more than 1 million patients a year in the United States and even more patients around the globe and is one the leading causes of death,” (2017, para 1 p 807). With these astounding statistics, it is prudent of nursing educators to perform their part in educating the nursing students on life saving strategies against sepsis. Proactive healthcare is one of the ways this author has grown through her discovery as being a leader in healthcare. Prevention to illnesses is preferred than reacting to the severity of illness. Although not all sepsis cases can be prevented,...
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... 1 Concept Paper Atypical Presentation of Illness in Older Adults 2 An atypical presentation of an illness in an older adult can appear as a subtle, nonspecific, or unusual manifestation that is outside the normal range of signs and symptoms for a specific illness. Nursing care of an older adult requires a through assessment of acute, chronic or complex illnesses. Illness in older adults is complicated by numerous medical problems and the physical changes of aging. Identification of an illness can be overlooked simply because symptoms might be reported vaguely. Multiple overlapping factors such as environmental, sociologic, physiologic and psychologic aspects need to be considered in the nursing assessment. It’s essential that nurses recognize atypical presentations of illness in older adults early to help improve patient care. Early detection can reduce the risk of missed diagnoses, death and/or prolonged hospitalization, and reduce rates of co-morbidity from treatable geriatric syndromes (GrayMiceli, 2007). Aging causes physiologic changes to the body. These normal age related changes could be similar to changes seen in the presence of pathological conditions. This causes a problem when normal changes mask early signs of an acute illness. Changes to the musculoskeletal system can affect a patient’s ability to function. Reduced bone mineral density leads to osteoporosis and an increased risk for fall-related fractures (Ebersole, Hess, Touhy, & Jett 2012, p...
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