...explore an acute deterioration in the health of an adult I have encountered during a clinical placement, in an acute care setting. The essay will begin with a definition of acute care, followed by the introduction of my patient and predisposing factors. This essay will include an explanation of the significant pathophysiological changes and related clinical manifestations and a critical analysis of the nursing interventions implemented during the acute episode of care, focusing on holistic care, rationale and evidence base. It will then describe the actual deterioration in the patient’s condition, and discuss the nurse’s role in the recognition and assessment of the actual deteriorating condition following the trusts policies. Assessment tools, monitoring, detecting and reporting will be considered. Finally this essay will include a discussion of the importance of multidisciplinary team collaboration in the diagnosis and provision of care during the acute episode, and a discussion on whether the deterioration could have been prevented by identifying any areas of practice which could change in relation to evidence based practice. For the purposes of privacy and confidentiality, in accordance with NMC (2008) code of conduct, the name of the patient will be changed to Peter and the placement area will remain as an acute care setting. According to McFerran (2008) the term “acute” is described as a disease of rapid onset, severe symptoms, and brief duration. Acute Care refers to riding...
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...practitioners are nurses that provide mental health care to anyone in need. They may treat specific mental health disorders, conditions, and even substance abuse conditions. This means that this type of nurse can work anywhere from a hospital, to a mental health facility, and so much more. There are also Family Nurse Practitioners who provide healthcare throughout a person’s lifetime. They usually develop long-lasting relationships and get to know the patient, along with their family. Family Nurse Practitioners are also very similar to Pediatric Nurse Practitioners, which provide care to children and see them from infancy to adulthood. They provide checkups, immunizations, and diagnose and treat acute to chronic illnesses and conditions. Both of these specializations have similar job descriptions, and could work in doctors offices, pediatric clinics, hospitals, and much more. Both also see the patient throughout their life and provide the same types of care and treatment, making them very similar in their field of practice. With the specializations being similar, it would be possible to specialize in one, but go on to work in the other in the near future if desired. Neonatal Nurse Practitioners are another type of nurse with a vast range of options. These nurses provide care for sick and premature babies. They diagnose illnesses and provide treatments, they also assist in delivering babies, depending on the hospital or other settings. If these nurses were to get “bored” or tired of...
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...Running head: REHABILITATION CARE IN A SPECIALIZED SETTING Rehabilitation Care in a Specialized Setting: A Multidisciplinary Concept Analysis Dorota M. Loney University of Texas at Arlington school of Nursing In partial fulfillment of the requirements of N5327 Analysis of Theories in Nursing Rhonda Mintz-Binder, RN, MN, DNP April 29, 2012 Rehabilitation Care in a Specialized Setting: A Multidisciplinary Concept Analysis First we need to understand what Rehabilitation is to be able to focus on its concept analysis. It is a part of the continuum of care as it focuses on increasing a patient’s function for self care and mobility. The need for a rehabilitation care concept in a specialized rehabilitation hospital increases as the length of stay decreases in acute hospitals after surgery or procedures due to the financial burden on insurances, Medicare, Medicaid, and the acute hospitals themselves. No longer do we see in the United States two week long acute hospital stays after major surgeries, strokes or other injuries that affect the activities of daily living (ADL). The hospitals discharge patients back home much sooner than before or transfer them to facilities for further recovery. Unfortunately some of these facilities are long term acute care hospitals or nursing homes where continuing daily therapy is very limited. The fortunate ones get admitted to a specialty hospital called a rehabilitation (rehab) hospital that this paper will focus on. Here, nurses, occupational...
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...The school nurse is much more than going in for a Band-Aid and an ice pack. The school nurse is a well-rounded example of what a pediatric nurse, counselor, teacher and advocate looks like. East Dover Elementary school had a lot of the normal ear-aches and the “my tummy hurts” type of students but also presented with those chronically ill who had diseases like Diabetes and Spina-bifida. Later on we will explore the differences between a School nurse and a Pediatric Acute care Nurse. We will learn about the 3 chronically ill children at East Dover Elementary school. I will also explain how the School nurse is important in ways we don’t usual give them credit for! Early in the day, I was asked to help with taking blood pressure for health checks in the 3rd grade, while the nurses assessed hearing and vision. While practicing all the blood pressures, a little girl walked into the bathroom. The one nurse followed her in and within 2 mins, she was back on her way to class. This is the child who has Spina Bifida. She has no sensation in her lower half and difficulties voiding. The nurse assists her inserting a straight catheter to urinate. The child uses the bathroom 2-3 times a day. The nurses explained that it is such a normal part of their day now, they can tell time by her visits. 3 children specifically stood out in my head from this day in the nurse’s office. One child was a diabetic who needed coverage for his school lunch. The nurse just watches as the child gladly administers...
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...The purpose of this essay is to define the term debate and to explore the educational strategy in the development of knowledge, skills and attitudes required to deliver and manage patient care. The topic was due to financial considerations advancement of acute and critical care should be or not curved. In this essay will summarise the key points made by the proposition and opposition with the support of evidence and will explore the relative strengths and weakness of both arguments. It will also discuss whether this has changed in light of debate. Debate is a formal argumentation between two teams or individuals. It is also an essential tool for developing competencies and maintaining freedom such as, controversial issues without descending to insult, emotional appeals, or personal bias (Garreth, et al, 1996). The key trademark of debate is that it rarely ends in agreement, but rather allows for robust analysis of the question at hand (Sather, 1999). Perhaps this is what French philosopher Joseph Joubert meant when he said. “It is better to debate a question without settling it, than to settle a question without debating it.” Debating may be considered as an educational strategy in the development of knowledge. It allows a person to find out if they have a good understanding and also by answering questions from of the audience. The students will enhance the critical thinking through debating process, however, DeYoung (1990) suggest that debating helps students develop the...
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...CAREER 2 Finding a career within the pharmacy profession holds appeal for many reasons: a strong job market, high pay, work equality, divergent career opportunities and favorable working conditions in a profession that consistently ranks at the top in Gallup’s annual poll of most trusted professions. Careers all across the ever-evolving health care industry have seen consistent growth in demand over the last several years, with no projections for slowing down. Pharmacists can look forward to higher than average employment opportunities. The U.S. Department of Labor, Bureau of Labor Statistics (BLS), projects a 25% growth in demand through 2020. This increase is attributed to an ageing population, advances in medicine, increased number of people with insurance coverage and the expanding role of pharmacists in patient care. Additionally, pharmacy students have the envious distinction of a nearly 100% job placement in their career field within a year of graduation. Another appealing aspect of the profession is pharmacists enjoy a relatively high median salary. In the most recent statistics published by the BLS, the median wage is nearly $115,000 per year. Earning potential is projected to continue to rise due to the predicted high growth in jobs, without a corresponding increase in the number of graduates entering the profession. When it comes to work equality, careers in pharmacy continue to top the charts. With women making up nearly two-thirds of the pharmacy profession,...
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... individuals dying in a hospital setting each year, therefore a large proportion of patients will be receiving some form of care prior to and at death (Blackwell 2010 p.1). Numerous research studies have been carried out by theorists identifying the impact of bereavement on different individuals. The earliest thorough study of grief and loss developed from Freud with his classic paper ‘Mourning and Melancholia’ (Freud 1917 cited in Payne et al 1999). Freud believed that for the bereaved to detach from the deceased one must work through their grief by reviewing memories and thoughts of the deceased (Ellman 2010). Other theorists have recently identified death and the importance of understanding it. 'Death is a natural progression from life. Most nurses will be exposed to the physical and emotional effects of this experience as they care for a dying patient. The nurse is taught how to provide support for the patient and family as they proceed through the stages of grief. Often, however the nurse may not realise his or her own need to grieve'. (Brosche 2003 p. 173). Although nurses try to remain professional whilst at work, once they are home and the uniform is removed , emotions that were kept at bay may begin to surface. The main purpose of this literature review is to identify the effects of patient death on nurses within a hospital setting, to recognise any impacts that this may have on them during work hours or in an outside environment...
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...There are many types of therapists that do different types of work , such as Orthopedic , Wound Care , Pediatric, Cardiopulmonary, Vestibular , Geriatric, Decongestive and Neurological . Each type has different components they work on . Orthopedic therapy is the most commonly available form of physical therapy. This physical therapy treats injuries to the muscles, bones and other tissue in the body. Physical therapists can perform treatments that help with wound care , involves making sure the body is getting enough blood and oxygen to a wound Children have different needs when it comes to physical therapy. Pediatric therapists specialize in treating children of all ages who have problems with movement, strength or coordination. Anyone...
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...FAQ: Advance Practice Nurse Role for Legislators/Government Officials What is a Nurse Practitioner? According to the American Association of Nurse Practitioners (AANP 2016), nurse practitioners (NPs) are licensed, autonomous clinicians focused on managing people’s health conditions and preventing disease. As advanced practice registered nurses (APRNs), NPs often specialize by patient population, including pediatric, adult-gerontological, and women’s health. NPs may also subspecialize in areas such as dermatology, cardiovascular health, and oncology. NPs take health histories and provide complete physical examinations; diagnose and treat many common acute and chronic problems; interpret laboratory results and X-rays; prescribe and manage medications...
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...Emerging Standards of Culturally Competent Care NUR/531 University of Phoenix Emerging Standards of Care: Cultural Competence The current U.S. population exhibits unparalleled sociocultural and ethnic diversity, yet the nursing workforce fails to reflect the current state of the nation’s diversity. According to Clark, Calvillo, Fongwa, Kools, Dela Cruz, Lowe, and Mastel-Smith (2011) non-Hispanic Whites constitute 83.2% of the nursing workforce, although Hispanics, African Americans, American Indians, Asians, and other ethnic groups remain underrepresented. Nursing faces the challenge to meet the health care needs of such a culturally diverse population while promoting diversity in the workforce through educating nurses on cultural sensitivity and competence. Cultural competence in nursing is evolving as the standard of care. Nursing and other health care providers must employ knowledge of various social and cultural influences in the care setting to promote patient-centered care (Mitchell, Fioravanti, Founds, Hoffmann, & Libman, 2010). It is crucial to recognize and appreciate the relevance of diversity in the acute care setting to set standards of culturally competent nursing care, and improve care delivery through meeting and improving these standards. Cultural Competence ...
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...Emerging Standards of Care: Cultural Competence Nur 531 July 29, 2013 Instructor Greg Friensz Emerging Standards of Care: Cultural Competence The current U.S. population exhibits unparalleled sociocultural and ethnic diversity, yet the nursing workforce fails to reflect the current state of the nation’s diversity. According to Clark, Calvillo, Fongwa, Kools, Dela Cruz, Lowe, and Mastel-Smith (2011) non-Hispanic Whites constitute 83.2% of the nursing workforce, although Hispanics, African Americans, American Indians, Asians, and other ethnic groups remain underrepresented. Nursing faces the challenge to meet the health care needs of such a culturally diverse population while promoting diversity in the workforce through educating nurses on cultural sensitivity and competence. Cultural competence in nursing is evolving as the standard of care. Nursing and other health care providers must employ knowledge of various social and cultural influences in the care setting to promote patient-centered care (Mitchell, Fioravanti, Founds, Hoffmann, & Libman, 2010). It is crucial to recognize and appreciate the relevance of diversity in the acute care setting to set standards of culturally competent nursing care, and improve care delivery through meeting and improving these standards. When examining definitions and concepts of cultural competence, it is evident that it not only pertains to race, sex, age, and ethnicity, but encompasses “other inseparable factors of culture...
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...Skyline Medical Center are accredited by American College of Surgeons-Commission on Cancer (ACoS-COC). Also both are acute care hospitals and provide emergency services. How is each hospital's quality data rated? Both have low time waiting before outpatients with chest pain or possible heart attack to get an ECG. 9 minutes for Williamson Medical Center and 7 minutes for TrisStar Skyline Medical center, and both have a great number because national average is7 minutes. Waiting too long may cause patients to have a serious problem on this condition, so it very important for hospital to have low waiting time on this matter. How do they compare in metrics such as mortality or complications? Rate of complications for hip/knee replacement both are same as national average which is 3.0% (Theleapfroggroup, n.d.) According to hospital compare, high complications rates caused by poor quality of care which may cause the hospitals to lose patients or get sued” During or after hip/knee replacement surgery there is a chance that a patient may experience a problem or complication, or may even die. Complications included in this measure are: infection, heart attack, pneumonia, wounds that...
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...Nursing and Bachelor Degree Nursing and to compare competency between the two. Competency is an individual’s actual performance in particular situation, described how well individual integrates knowledge, attitudes, skills and behavior in delivering care according to expectations (Gurvis & Gray, 1995; Nolan, 1998). The nursing profession starts when Florence Nightingale established the Nightingale School for Nursing in 1860 in London (Creasia & Friberg, 2010, p. 4). Since that time nursing profession has grown around the world. In the United States of America only RN’s are legally allowed to offer nursing services. RN’s have to be certified by National Council Licensure after passing the NCLEX exam, the test for minimal technical competency for save entry into nursing practice (Rosseter, 2011, p 4). We have two categories of nurses – Associate Degree Nurses and Bachelor Degree Nurses. Associate Degree nursing program was developed during World War 2 at the time of shortage of nurses prompted by the war. Today Associate degree nursing demands two years of formal education that covers general courses (Orsolini – Hain & Waters, p. 267). ADN can be obtain in Community Colleges. It prepares nurses to work in clinical settings and provides minimal skills needed to become a nurse. This is taught by following the nursing process and providing safe hands on practice. They are not thought about research, not prepared in management and leadership skills They possess minimal...
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...Benchmark Assignment: Evolving Practice of Nursing and Patient Care Delivery Models The Evolution of Nursing Practice To my colleagues, the health care system has begun a decade of transitions that, for the nursing profession, promise to change the practice of nurses, expand current nursing roles and create new ones, and provide many opportunities for nurses to participate in shaping the future delivery system. With the passage of the Affordable Care Act (ACA) in 2010, care delivery and financing systems are undergoing significant transformations that will accelerate in 2014, when major provisions of the legislation are implemented. The purpose of the this letter is to explain how the practice of nursing is expected to shift and to also discuss the concepts of continuum of care, accountable care organizations (ACO’s) medical homes, nurse-managed health care clinics (NMHCs). Under the Accountable Care Organizations, strategies will be developed to align the goals of health care delivery reorganizations, enhance care coordination, and improve patient transitions across the care delivery continuum. Expansion of medical care homes, NMHC’s, and enhanced coverage for preventative care services will help to shift the delivery system's current focus on acute care to a greater emphasis on prevention and treatment of chronic care conditions using health care teams and information technology. Medical homes, sometimes referred to as NHMC’s, are identified as a concept that began in pediatrics...
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...CAREERS What do psychologists do? If you are one of the thousands of new psychology students receiving this issue free, read on as Jon Sutton illustrates some potential career paths ahead of you psychological well-being. It’s demanding work. You would deal with a wide range of psychological difficulties and serious mental illnesses. Clinical psychologists work largely in health and social care settings, including hospitals, health centres, community mental health teams, child and adolescent mental health services, and social services. They usually work as part of a team with, for example, social workers, medical practitioners and other health professionals. Most clinical psychologists work in the NHS, but some work in private practice. Others work as teachers and researchers in universities, adding to the evidence base of the profession. The work is often directly with people, assessing their needs and providing therapy based on psychological theories and research. But as Glenda Wallace (a UK psychologist now working with Otago District health Board in Dunedin, New Zealand) explains, these people can be a great resource themselves: You are face to face with another human being who can bring you richness, and if you are lucky you can give them something back. This is not dismissing our profession, but acknowledging that people are a wonderful resource even without the wealth of theory under their belt that we are supposed to have. A lthough this may be the first step...
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