...conclusions concerning personal learning outcomes. The term ‘critical’ introduces a further dimension to analysis, in that judgements are made about the strengths and weaknesses of the different parts, as well as of the whole, Burns (2000). Reflection follows on from this by encouraging the analysis of clinical practice, this in turn, helps the healthcare professional to develop his/her knowledge and to acquire a deeper level of understanding about the complexities of nursing practice. Boud et al (1985) suggests that this type of learning contributes to the development of clinical competence. The critical incident is taken from my recent clinical practice within the Endoscopy Unit. I will be reflecting upon and critically analysing gaining informed consent prior to the patient’s emergency Endoscopy and when to act within patient’s best interests. My rational for the chosen clinical incident is because of the impact it had on me. I realised I was not fully informed on the process of obtaining informed...
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...Running head: COMMUNITY HEALTH NURSING ASSESSMENT Community Health Nursing Assessment Alison C. Jessup Saint Joseph’s College COMMUNITY HEALTH NURSING ASSESSMENT Abstract COMMUNITY HEALTH NURSING ASSESSMENT Prior to becoming a nurse five years ago I didn’t really give much thought to the community that surrounded me. I independently went about my daily life without really considering my neighbors or municipality and I certainly wasn’t geared towards thinking about how I can give back to the community. It wasn’t until I began working in a local hospital that I started to contemplate the community and those I serve not only within the confines of the brick and mortar but far beyond. I initially started to become involved in the Jordan Hospital community and today I currently participate in various committees such as our Unit Based Council, Service Excellence, Meditech 6.0 Computer Implementation and our Stroke Resource Team. Exposure to various teambuilding opportunities has enhanced my relationship with senior leadership and also allowed me to be a voice for staff nurses and implement positive change. A particular area that I saw the greatest opportunity for change with the most impact to patient care and safety was with our stroke team. It is not unusual to have patients admitted to my floor with a diagnosis of Cerebral Vascular Accident or Transient Ischemic Attacks. Rarely do we see the inpatient stroke victim, but it does happen. The first inpatient stroke...
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... Management of Peptic Ulcer Bleeding Dr. Carmen Ka-man NG MBBS, MRCP, FHKCP, FHKAM(Medicine) Associate Consultant, Department of Medicine and Geriatrics, Princess Margaret Hospital Dr. Carmen Ka-man NG This article has been selected by the Editorial Board of the Hong Kong Medical Diary for participants in the CME programme of the Medical Council of Hong Kong (MCHK) to complete the following self-assessment questions in order to be awarded one CME credit under the programme upon returning the completed answer sheet to the Federation Secretariat on or before 30 November 2009. Upper gastrointestinal bleeding (GIB) is defined as haemorrhage proximal to the ligament of Treitz. Peptic ulcer bleeding accounts for 60% of the cases.1 Despite advances in endoscopic treatment and pharmacotherapy, the mortality of upper GIB remains unchanged. In-hospital mortality was found to be 7.1% in 3220 patients admitted for bleeding peptic ulcers from 1993 to 2003 to a teaching hospital in Hong Kong.2 History taking and physical examination help to define the underlying cause. It should be followed by a detailed haemodynamic assessment. Resting tachycardia (pulse 100/min), hypotension (sBP 6 favours platelet aggregation, clot formation and inhibition of fibrinolysis.3 The effect of preemptive PPI before endoscopy was studied. Daneshmend had conducted a randomised study in 1147 unselected patients presenting with upper gastrointestinal bleeding. 578 patients were given omeprazole (bolus...
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...Case Study Three CC: Jose Santa Cruz (JS) is a 68 y/o Native American male and retired construction worker. JS no longer works at this time, except to watch his grandchildren occasionally. ID: 68 y/o Native American Male, retired construction worker. CC: Rt knee pain x many years; epigastric burning with food x 2 weeks with dark stools. HPI: Pt c/o previous history rt knee pain for many years. He also c/o epigastric burning over past 2 weeks, and newly noted dark stools with no other prior history. Onset of rt knee pain approximately 7-8 years ago and increasing at this time. Epigastric burning onset is described as 2 weeks ago with dark stools noticed over past couple days. The location of his knee pain is centered over knee joint. Epigastric pain is focused in the mid to rt upper abd per Pt. Characteristics of his rt knee pain include occasional sharpness with an ongoing ache. His epigastric pain is characterized as burning which occasionally wakes him at night. He describes his stools over the past 1-2 days as dark-black in color, but not tarry in texture. JS denotes aggravating knee pain with movement especially getting up and down, or any activities which put pressure on his knee. He states his epigastric burning is aggravated by certain foods, especially high spice foods. His stools are recently dark- no aggravating of the color change noted. Relief of rt knee pain has been attempted with Advil 800mg po tid without good pain control. JS has also tried...
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...on ORGANIZATIONAL STUDY done at NIMS HOSPITAL Submitted in partial fulfillment of the requirements for the award of the Degree of Master of Business Administration University of Kerala By ANOOP G.P Under the guidance of Ms. AMBILI ASHOK Faculty Lmcst, trivandrum DEPARTMENT OF MANAGEMENT STUDIES LOURDES MATHA COLLEGE OF SCIENCE & TECHNOLOGY LOURDES HILLS, KUTTICHAL P.O, THIRUVANANTHAPURAM-695574 2010-2012 DEPARTMENT OF MANAGEMENT STUDIES LOURDES MATHA COLLEGE OF SCIENCE AND TECHNOLOGY KUTTICHAL, THIRUVANANTHAPURAM – 695574 CERTIFICATE This is to certify that this report titled A Report On Organizational Study done at NIMS HOSPITAL., NEYYATTINKARA, submitted by ANOOP G.P is a bonafide record of the done by him during the year 2011 under my guidance in partial fulfillment of the requirements for the award of Degree of Master of Business Administration of University of Kerala. Ms. Ambili Ashok Prof.B.AjayKumar. Faculty Guide Head of the Department DECLARATION. I ANOOP.GP hereby...
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...potential for harm from fire, and smoke (TJC, 2013). A review of documentation showed appropriate ILSM was not initiated during 3 construction projects this put employees and patients at risk. Education of fire safety equipment should have been completed before the project. The gift shop did not have the required 18 inch clearance from the sprinklers. All sprinklers must have at least 18 inches below and around of clearance for The Joint Commission standards. Review of department documentation shows that the master alarm panel for medical gasses was not tested annually per policy. This is a policy written by the hospital that is not being met. They are to follow the policies that they set for themselves. The Fire Drill History Report showed that the fire drill process is not adequate and does not meet standards. Quarterly fire drills are to be conducted as regulated by the Life Safety Code (TJC, 2013). Clutter was found in the hallways of 3E, 4E, OR and telemetry this could restrict people from leaving the floor safely in case of fire or smoke. Accreditations function of Nursing Leadership it was discovered that Nurses on 3E were not documenting in a timely manner. When questioned they responded that they were “too busy”. Resulting in overtime and low morale on the unit causing discussion about staffing, staffing patterns and nurse to patient ratio. This is all established in a guideline for delivery of nursing care, treatment, and services (TJC, 3013). Accreditation function of...
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...From www.bloodjournal.org by guest on March 10, 2015. For personal use only. How I treat How I treat enteropathy-associated T-cell lymphoma Antonio Di Sabatino,1 Federico Biagi,1 Paolo G. Gobbi,1 and Gino R. Corazza1 1First Department of Medicine, Centro per lo Studio e la Cura della Malattia Celiaca, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico S. Matteo, University of Pavia, Pavia, Italy Enteropathy-associated T-cell lymphoma (EATL) is a complication of celiac disease (CD). This tumor derives from the neoplastic transformation of aberrant intraepithelial T lymphocytes emerging in celiac patients unresponsive to a gluten-free diet. Poor adherence to a gluten-free diet, HLA-DQ2 homozygosity, and late diagnosis of CD are recognized as risk factors for malignant evolution of CD. Recurrence of diarrhea, unexplained weight loss, abdominal pain, fever, and night sweating should alert physicians to this complication. The suspicion of EATL should lead to an extensive diagnostic workup in which magnetic resonance enteroclysis, positron emission tomography scan, and histologic identification of lesions represent the best options. Treatment includes high-dose chemotherapy preceded by surgical resection and followed by autologous stem cell transplantation, although biologic therapies seem to be promising. Strict adherence to a gluten-free diet remains the only way to prevent EATL. (Blood. 2012;119(11): 2458-2468) Introduction Celiac disease (CD) is a chronic...
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...difference is called lead time. If earlier treatment results in a cure, then there is no bias. If the person eventually dies of the disease, then the increased survival time from diagnosis to death may have been only apparent, a bias, since life may not have been extended. In screening, length bias is the detection of more indolent cancers or cancers which may never have surfaced in life, which when added to clinically aggressive cancers, increases the percentages of early cases and increases overall survival percentages. In screening, a decrease in the rate (not percentage) of cases of advanced disease is one of the best predictors of a future decrease in...
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...Admission At the Admitting Department, the patient will be required to provide personal information and sign consent forms before being taken to the hospital unit or ward. If the individual is critically ill, then, this information is usually obtained from a family member. Specialist clinics Specialist clinics provide planned, non-admitted services for people who need the focus of an acute setting to ensure the best outcomes. Specialist clinics provide an interface between primary care services and acute inpatient services, with access to: • medical, nursing, midwifery and allied health professionals for assessment, diagnosis and treatment • ongoing specialist management of chronic and complex conditions in collaboration with community providers...
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...February 08, 2012 S. M. Saief Uddin Ahmed Lecturer, Department of Business Administration, Sylhet International University Dear Mr. Saief: Here is the report based on the comparison of the price charged by different medical diagnostic centres in Sylhet, which you asked us to conduct on January 2012. On our study of 10 private medical diagnostic centres of Sylhet, of different categories revealed significant differences on three areas: priced charged, availability of services in the diagnostic centres, the use of colour or black and white images to make a report. We appreciate your choosing ‘Peter Drucker’ for this assignment. If you have any queries or need assistance in implementing our recommendation, please contact us. Sincerely yours, Kaniz Fatima Choudhury, Group Leader, Peter Drucker. TABLE OF CONTENTS EXECUTIVE SUMMARY ……………………………. 05 1. INTRODUCTION ………………………………….. 06 Incidentals of Authorization and Submittal Objective of the Study Use of Observational Techniques A preview of the presentation 2. THE DIAGNOSTIC CENTRES ……………………. 07 3. COMPARISON BETWEEN THE PRICES ……….. 11 4. CONCLUSION …………………………………… 13 5. BIBLIOGRAPHY …………………………………… 13 EXECUTIVE SUMMARY The pricing strategy of the different diagnostic centres reveals that a few organisations are charging a high price compared to the service provided, while others charge...
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...AFT Task 4: Periodic Performance Review Accreditation Audit Case Introduction The accreditation process is designed to assist healthcare establishment to identify and enhance the patient’s safety and the quality of service delivery. This paper presents a review of the readiness Nightingale Community Hospital for accreditation audit. The paper comprises of a periodic performance review of the establishment. The review has focus of several priority areas. These areas include; assessment and care; quality improvement; patient safety, and staffing effectiveness. Trend within the hospital indicates the Nightingale has made significant progress towards fulfilling the standards of the Joint Review Commission. However, the trends in staffing effectiveness are limiting the organization’s compliance. Periodic Performance Review (PPR) The PPR is based on data collected in the Joint Commission Survey. The survey utilized the priority focus methodology to evaluate the compliance of Nightingale Community Hospital. The priority focus process is a methodology that makes use of data to establish priority areas for reviewing compliance. This process has utilized of both external and internal data to evaluate the compliance of Nightingale Community Hospital. This methodology identified several priority areas. These include; assessment and care services; quality improvement activities, and patient safety. This paper evaluates Nightingale’s compliance in these three priority areas. Compliance...
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...PathWay Business PlanKeval Shah | | * Executive Summary Business Overview PathWay is an innovative new start-up that has been formed with the intention of pioneering a new direction of pathology reporting which is faster and more accessible to healthcare professionals. The company has a great potential for growth and opportunity in the current evolving healthcare setting where digitalisation has become a key priority in the quest to improving healthcare outcomes for patients. Market Overview The importance of technology and information technology (IT) systems in meeting the challenges placed on the health care system is becoming increasingly apparent. The NHS is currently driving a technological revolution with the vision of becoming paperless by 2018. As a result, there is an increase in demand for SME’s like PathWay to contribute to increasing efficiency and working systems in the NHS by providing technological solutions. Our aim is to launch our product one hospital at a time, beginning with UCLH. PathWay will address the problems faced in monitoring patient’s results in a busy healthcare setting. It will improve efficacy and resolve dependability on having to log on at selected terminals to receive patient results. As a result, it will allow healthcare professionals to provide immediate and timely care to patients at risk. This concept will be of great benefit not only to the product users, but also to patients as it improves healthcare outcomes by improving...
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...CHAPTER# 1 INTRODUCTION 1.1 Rationale of the Study: The research has been conducted to assess the level of satisfaction that the patients are receiving from the ICDDR, B hospital sector. This study is conducted in consideration of the ICDDR, B’s successful implementation and continuous process of providing special care to lowest income people. This study contains graphs and figures and also some suggestions that can be taken by ICDDR, B in order to improve their service in their hospital sector. The Gaps model has been discussed, also the strategy by ICDDR, B has been put forward in this report. Using the data followed by the survey, we will be able to pinpoint the strong points of their service sector and specify the reasons of their success. Moreover, the study shall be a potent tool in providing other hospitals the specific strengths of their services. This study could be used as a benchmark for other hospital who have been struggling to deal with patients in terms of providing appropriate service. 1.2 Background of the Company: 1.3.1 About the Company’s Service Offerings Formation and other relevant information about the company’s operations: The International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B) is an international health research organization located in Dhaka, Bangladesh. Dedicated to saving lives through research and treatment, ICDDR, B addresses some of the most critical health concerns facing the world today, ranging...
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...Running head: ACCREDITATION AUDIT- TASK 4 COMPLAINCE STATUS Joint Commission clearly explained that a Periodic Performance Review is as an assessment tool designed to help in assisting the healthcare organization contributes greatly in the improvement and monitoring performance all through the year. The periodic performance focuses more on the measures that has to do with patients safety and care and at same time given the facility for unremitting standards fulfillment. NCH is 100% compliance with most standards of Joint Commission in the following area; Emergency Management, Human resources, Infection Prevention and Control, Performance Improvement, Right and Responsibilities of the Individuals, Transplant Safety. During the inspection at the facility, the hospital was found to be non- compliant in this listed areas; Environment of Care, Leadership, Life Safety, universal protocol, Medication Management, Medical Staff, National Patient Safety Goals, Nursing, Record of Care, Treatment and Services, and provision of care During the PPR, the hospital was found with an increase cluster in the hallways, it is a fire hazard and a safety issue. The nurses are not familiar with verbal order procedures, using the range of orders that received and the abbreviations that are prohibited in the documents. From the trend, there are areas at which the hospital needs to implement proper education and audit. An action plan needs to be implemented by the administration to address the fallout...
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...Veteran’s Administration Scandal and Business Ethics Case Study August 19, 2014 Abstract This paper will discuss how the Veteran’s Administration first started and how it has evolved over the years to become the entity it is today, serving our nations veterans. I will also discuss how the Veteran’s Administration has been plagued with many scandals throughout its existence, from when it was known as the Veterans Bureau during the early 1920’s and also the many issues that the Veterans Administration has dealt with over the years to include those that were involved and their official capacity in wrong doings. This paper will look at how the Veterans administration has tried to make changes to support the increased number of Veterans after many of our past wars and some of the difficulties veterans from the Vietnam War have faced to receive care and benefits that were exposed to Agent Orange. I will also looked at the many problems veterans have faced over the years to include most recent allegation that the VA has gone through since the earlier part of this year and the changes that has taken place to correct the problem. According to an article written by CNN, during the end of the Revolutionary War Congress was supposed to pay those veterans that were disabled during the war, but the service members individual states were left up to the task, leaving only a few thousand to receive any type of payment pay. Congress establishes the Veterans Bureau which...
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