...Hip arthroplasty is the replacement of the hip joint with a prosthesis, and is one of the most common reconstructive operations (Huo et al 2008). Hip arthroplasty may be performed when irreversible damage has occurred to the joint; this damage often causes pain, dysfunction and reduced quality of life. The pre-operative nursing considerations begin with patient education. This should begin at the time the decision is made to have the surgical procedure performed. It is important that the patient understand the preoperative requirements, the surgical procedure, postoperative care and the necessary home/activity modification. The patient should be instructed in self-preparation, including mental and emotion readiness and having a positive attitude about the surgical outcome. There is a great deal of evidence that a patient’s psychological state before the surgery impacts on their recovery afterwards. Studies have shown that patients who report lower levels of general or mental health before surgery have worse physical health outcomes, such as pain levels, after surgery (Long et al, 2005). Like all surgeries, the patient will be assed for their ability to tolerate the procedure and anesthesia. Of particular concern is their cardiovascular and respiratory status, and the presence of any comorbidities. The patient should also be evaluated for the presence of any infection, as it could spread to the hip prosthesis. The teaching of postoperative exercise before surgery allows the...
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...accident prone. In later years Johnson & Johnson explored other opportunities mainly in the over-the-counter medicinal products. Over the years they have been subject to many lawsuits but the one this paper will focus on is the product liability lawsuit on the DePuy ASR hip implant. DePuy is a company that specializes in orthopedic products and was acquired by Johnson & Johnson in 1998. The metal on metal hip replacement DePuy ASR was approved by the FDA for use by surgeons on patients that were in need of a hip replacement in 2005. (Meier, 2010). The DePuy ASR hip replacement should have a life of at least 10 years. The device was being used on patients, soon after the DePuy dividion of Johnson & Johnson started receiving complaints of the device with the largest spike of complaints in 2009. (Meier, 2010). Many of the complaints resulted in the patient having to receive another hip replacement only a few years after receiving their first hip replacement. The reason the DePuy ASR hip implant didn’t last is because the device is metal on metal and can cause metal debris as the hip is used. ‘This can cause damage to muscles and other soft tissues which results in the replacement of the device.’ (Meier, 2010). The device was tested on a few patients who were not aware they were ‘testing’ and the...
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...Introduction: Total hip replacements (THR) happen for a multitude of reasons. Patient’s requiring a THR are in pain within the hip joint from a specific cause. For example, a THR could be done to relieve arthritis pain, repair a break in the bone, or repair the joint from a traumatic injury or disease. The hip joint is a ball and socket joint, made up of the head of the femur (ball) which moves within the acetabulum (socket) in the pelvis (Hasan & Akbar). Functionally, this joint allows movement of the lower body in relation to the trunk in a circumduction motion. At the time of the repair, usually patient’s have decreased function of that lower extremity because of pain. The joint itself does not have nerve endings, but bone does....
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...Case Study hip Fracture NSG/340 Case Study Risk Factors for Hip Fracture Age, sex (women>men), osteoporosis, poor nutrition (decreased in calcium & Vitamin D), smoking, medications (such as cortisone), limited or very little physical activities or brittle bone area all risk factors. Risk Factors for Hip Fracture related to S.P. *Age/Sex (women>men), *smoking, *medication (prednisone), *limited activity. Post-surgical anticoagulation S.P. is receiving Lovenox and Coumadin as thromboprophylaxis, a common practice after surgeries. Lovenox is used to prevent clot formation and will be an injection form, while Coumadin is taken orally, interferes with the synthesis of vitamin K clotting factor. In addition, it is recommended because of increase with coagulation factor. Anticoagulation is continued for approximately 30 days. INR is measured with the use of Coumadin with a goal of 2-3. A (arthroplasty) versus O (open reduction and internal fixation) A is also known as total hip replacement. O is metal pins, screws, rods and plates are used to immobilize the fracture. A is replacement of the entire hip joint with a prosthetic (artificial) joint system. Intraoperative blood salvage a. The blood that is lost from surgery is immediately re-administered to the patient. b. The blood lost from surgery is collected into a cell saver. c. The salvaged blood must be reinfused within 6 hours of collection. Postoperative problems Dislocation of the hip, infection...
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...Definition of biometals A group of chemical elements that are needed in minute quantities for the proper growth, development, and physiology of an organism. The term Biometal refers to the role of metal ions in biology, biochemistry and medicine. The metals copper, zinc, iron and manganese are examples of metals that are essential for the normal functioning of the body. It is also a term used to describe a living machine. Definition of bioceramics An advanced ceramic used to create components suitable for use or replacement in the human body. Biocompatible or osteoinductive (stimulating bone growth) ceramic material, such as hydroxyapatite or some other type of calcium phosphate ceramic, used for reconstructive bone surgery and dental implants. Definition of biosemiconductor The biosemiconductor, together with the drift of charges, ions, and radicals, may be considered as a form of "bioplasma". Bioplasma may be subject to magnetohydrodynamic (MHD) control. The EM fields emitted by trained healers may be considered as coherent, resonant biomagnetic emissions by which a less coherent EM field of the patient is "tuned" to the specific frequency and phase, and through which homeostasis can be "aligned" to induce "healing". Definition of bioelectronics The application of electronic theories and techniques to the problems of biology. The use of biotechnology in electronic devices such as biosensors, molecular electronics, and neuronal interfaces; more speculatively, the use...
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...Thrombosis in Hip Surgery without Pharmacologic Thromboprophylaxis in an Asian Population Kosuke Tsuda MD, Tomio Kawasaki MD, Nobuo Nakamura MD, Hideki Yoshikawa MD, Nobuhiko Sugano MD Received: 8 August 2009 / Accepted: 22 December 2009 / Published online: 8 January 2010 Ó The Association of Bone and Joint Surgeons1 2010 Abstract Background The clinical importance of asymptomatic deep venous thrombosis in elective hip surgery is not clearly known. Questions/purposes We determined the preoperative and postoperative incidences of asymptomatic deep venous thrombosis, identified preoperative factors associated with postoperative deep venous thrombosis or pulmonary embolism, and established its natural course in patients who underwent elective hip surgery without receiving pharmacologic thromboprophylaxis. This work was performed at Osaka University Hospital and Kyowakai Hospital. Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research. K. Tsuda, H. Yoshikawa Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan T. Kawasaki Department of Cardiovascular Surgery, Osaka...
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...Yichen Huang Robert Reich- Globalization 1. Who is Robert Reich? Who has relationship with Ihouse. 2. What are the myths about globalization? Our company against their company The lost of good job (change the competition of the job, technology) Globalization and technology change competition of workforce. We cannot hope to compete with low wage nations around the world. 3. Before China took that place, which country was seen as a threat to US economic eminence? Japan 4. What are the forces that changed the composition of the workforce? Globalization, everything made in everywhere. Somewhere getting job from American, like China. 5. How do the factories built today compared to the factories built in the past as to the creation of high paying jobs? Job carious because insignificant demand. Recently, Customer in US are 70% spending constitute 70% gross profit. If consumer scared and enable to spend, wage continue drop Consumers are not willing to keep the economic going 6. Do businesses have enough money to expand and hire more people to work for them? Why are they not doing so? They don't need tax cut, more money. American have to 2 trillion of cash. They could afford to expand business and create a job, but they don't want to. They don't want to create job without customer. 7. Before the housing bubble burst, what made Americans feel wealthy and able to spend at a level that exceeds their earnings? Government spending 8. How does consumer...
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...Brittany P. Thornton Dr. Aneil Mishra MGMT 4343 02 February 2016 Dane Miller- The Maverick CEO Great leaders are all defined by different attributes, successes, and contributions made to their professions, communities, and stakeholders. The term “Leader” is subjective and varies greatly in the opinions among various individuals. In this paper, Dr. Dane Miller, my selected CEO, will undergo a leadership assessment based on the ROCC of Trust and various other qualities. Biomet Inc. is a medical device manufacturer specializing in reconstructive products for orthopedic surgery and O.R. supplies (Biomet). Dr. Dane A. Miller or “Mr. Biomet”, was the co-founder of the orthopedic company Biomet, Inc. and served as its president and chief executive officer from 1978 to 2006 (Jordan). In the United States, the medical device market remains the largest one in the world with a market size of about $110 billion (Select USA). The ROCC of trust explores the elements that restore, enhance, and build trust amongst individuals. Being a great leader involves fostering strong and enduring relationships so learning to utilize and assess the ROCC of Trust is a useful analytical tool. Using the ROCC of Trust entails being reliable, open, competent, and compassionate. Dane Miller exhibited reliability both for his products and his commitment to the company. In 2006, he was coerced by the company’s board of directors to retire after 28 years of service. Miller said he contemplated riding...
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...catheter in patients with hip fracture Critical Appraisal In this quantitative research article, the authors have dealt with one of the most common clinical problem i.e. clamping of urinary catheter after hip surgery. Hip surgery is very common among the people of old age group especially above 75 years. Further, older women are more susceptible to hip fracture and commonly undergo hip injury (Johansson & Christensson, 2010). Bladder catheterization is a common clinical practice in surgeries. It helpful in monitoring urine output in patients. However, it is also associated with one of the major clinical problems, i.e. operative urinary retention (POUR). It can be defined as the inability of a patient to pass urine in spite of full bladder (Baldini, Bagry, Aprikian, & Carli, 2009). It is has been reported that patient of hip surgery are at higher risk of urinary retention (Balderi & Carli, 2010; Johansson & Christensson, 2010; Singh et al., 2010). In the case of hip replacement the incidence of POUR has been reported to be between 12- 84%. Similarly, in case of hip fracture the prevalence of POUR is 18% to 56% (Borghi et al., 2004; Oishi et al., 1995). The most effective intervention reported till date for reducing the risk of urinary retention is clamping of urinary catheter. The main objective of this paper was to investigate the efficacy of clamping of urinary catheter through randomized controlled trial in patients undergone hip surgery for fracture. Title:...
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...been described in ethical and legal frameworks, and as a philosophical foundation for practice (Negarandeh et al., 2007). Malik (1997) states that “the core condition which demands advocacy action is the vulnerability of a patient, either personal vulnerability due to illness and/or the vulnerability to risks inherent in the institutional processes to which the patient is exposed in the health care system.” As a nurse discharge planner case manager, part of this author’s job is to identify potential barriers to patient care and safe discharge. As a nurse, this author also has the responsibility to speak for those who cannot speak for themselves. A few years ago an 85-year-old woman was admitted to the orthopedic floor with a fractured hip. She had fallen at home trying to stand from her wheelchair. The family noted that she experienced some dementia, and the paid caregiver had...
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...Mandatory Pre-op for Total Knee Replacement The decision to undergo elective knee surgery can be very stressful for many patients. It is important for patients to be well prepared. Total knee arthroplasty has increased by eighty-four percent from 1997 to 2009 (Fawzi, 2012, para. 1). By making the Pre-op Total knee Arthroplasty class mandatory patients and their family members will be more educated and prepared for surgery and recovery. During the class patients will be able to ask any questions they may have, learn how to better prepare for surgery and ways to prevent infection during their hospitalization. Physical therapist will also discuss exercises and pain management techniques. By using the John Hopkins evidence based practice model a change can be made in the pre-op process for all total knee replacement patients. Change Model Overview The John Hopkins Nursing Evidence-Based Practice Process is defined as a problem-solving approach to clinical decision-making within a health care organization (Dearholt, & Dang, 2012, p. 4). Nurses often use this model to facilitate change within their organization....
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...research uses words instead of numbers. This paper is going to analyze the planning and design of a qualitative research paper titled: Patient’s experience of pain and pain relief following hip replacement surgery, published in the Journal of Clinical Nursing on October, 2010. Research questions Although the research question or questions are not clearly labeled in the study, the research questions were as follows: 1) How do patients describe their experience with pain after hip replacement surgery?, 2) How do patients describe their pain relief following hip replacement surgery?, 3) How does pain affect patients after hip replacement surgery? Problem A research problem is “an area of concern in which there is a gap in the knowledge base needed for nursing practice” (Burns & Grove, 2011). In this research, it was identified that many patients undergo hip replacement every year and previous research has focused largely on the long-term effects of pain for these patients but not so much on their subjective, early postoperative pain experience. Purpose A research purpose is “a clear, concise statement of the specific goal or focus of a study” (Burns & Grove, 2011). The purpose of the research study was to describe patients’ experience of pain and pain relief following hip replacement surgery (Joelsson, Olsson, & Jakobson, 2010). Hypothesis A hypothesis is “a formal statement of the...
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...Successful discharge planning is not something that should be initiated when the patient is ready to go home, but should be discussed prior to the surgery being performed if possible. The total hip replacement that Mr. Trosack is recovering from was not a planned surgery so case management should have begun working on this once he was admitted to the floor postoperatively. Healthcare Issues and Their Importance There are numerous healthcare issues that must be considered in discharge planning for Mr. Trosack to ensure that medical, social and functional issues related to his recovery have been evaluated. Safety is a very important healthcare issue that must be addressed prior to discharge. As with most patients over the age of 65, Mr. Trosack is at high risk for a fall for various reasons. 33% of this age group experience one fall per year and commonly involve falling down stairs or steps (Heasley, Buckley, Scally, Twigg, & Elliott, 2005). He lives on the second floor of an apartment building that has no elevator so he must maneuver a long flight of steps to enter or leave his apartment. In addition to this, he has a small apartment that is cluttered with WWII .memorabilia and furniture which increase his chances of tripping and falling. Mr. Trosack has recently been diagnosed with hypertension and noninsulin dependent diabetes which will present another healthcare issue and result in a lifestyle change for him. Previously, he was not taking any prescription medications and...
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...Hip replacement is a kind of surgical procedure in which the damaged portion of the hip joint are removed and replaced with a new artificial parts made of biomaterials. These artificial parts which are used to treat damaged hip are called the prosthesis. Generally, the hip replacement surgery is done to improve the function of damaged hip joint, increase mobility and to relieve pain caused due to damaged hip. [1] Depending on the condition of the patients, hip replacement surgery can be hemi or half replacement or total replacement. There are various reasons behind conducting these surgeries which includes injury or fracture to the hip, wearing down of the joints over time or osteoarthritis and may be due to age-related joint disease which...
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...Analysis of AML Total Hip Replacement BMEN 3311: Biomaterials Professor: Wei Shen Trevor Springer: sprin222@umn.edu Kristen Williams: will3893@umn.edu 1 Background Every year within the United States, over 332,000 people receive a hip replacement1. Hip replacements, arthroplasty, are a medical procedure where diseased parts of the hip joint are removed from the patients and replaced with an artificial hip. The main causes for needing a hip replacement is for the wearing down of the hip joint. This wear down can result from osteoarthritis, rheumatoid arthritis, avascular necrosis, injury, and bone tumors2. DePuy Synthes first introduced a total hip replacement in the 1970s, later introducing the AML Total Hip system in 1983. According to DePuy,...
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