...PICO Question Population – Mechanically ventilated intensive care patients. Intervention – Oral care with chlorhexidine. Comparison – Oral care with other chlorhexidine. Outcome – Decreased oropharyngeal pathogen colonization reduces number of VAPs and lowering intubation time, hospital stay, and mortality rate Does the use of chlorhexidine oral care reduce the number of ventilator-acquired pneumonias? More specifically, determine the efficay of chlorhexidine in decontamminating the oral cavity of pathogens in mechanically ventilated intensive care patients based on published scientific literature. Significance of the Problem Pneumonia is the second most common nosocomial infection in the United States and the leading cause of death from nosocomial infections. Critically ill patients are a vulnerable population that is more susceptible to developing nosocomial infections. Ventilator-associated pneumonia (VAP) occurs in patients treated with mechanical ventilation, and is associated with a higher incidence in patients treated with continuous ventilatory support. These patients have 8% to 25% risk of developing VAP, and the risk increases by as much as 1% per ventilator day (CDC, 2015). VAP is considered a serious problem, because it extends hospital stay by 6 days or more, has substantial cost implications of up to $40,000 per patient episode, and is associated with significant morbidity and mortality rates (CDC, 2015). Strategies for the reduction and prevention...
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...For a literature review, is usually in the of single research reports, statistics, texts about specific topics, specialist websites news media and other front line accounts of events .These reports may be by academics and other field researchers such as journalists .Literature can also include audio, film and videotexts scripts, commentaries and credits. Category selection is the Structural dimensions and related analytic categories are selected, which are to be applied to the collected material. Structural dimensions form the major topics of analysis, which are constituted by single analytic categories. And the material evaluation is analysed according to the structural dimensions. This should allow identification of relevant issues and interpretation of results. For the material analysis mentioned above provides a detailed description of the process in the analytic of literature review, while it includes a feedback circle for the collected material resources only such as a circle that might be needed for the overall process. For the material analysis provides a detailed description of the process and the structural dimensions and related analytic categories which allow classification of the reviewed literature can be derived deductively or inductively. In a deductive...
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...1. Full Bibliographic of Reference John P. Meyer and Thomas E. Becker. Employee Commitment and Motivation: A Conceptual Analysis and Integrative Model University of Western Ontario and University of Delaware Chri 2. Introduction The article is about presenting an integrated model about employees' commitment and motivation. According to the article, commitment and motivation are distinguishable, albeit related, concepts. More specifically, it suggest that commitment is one component of motivation and, by integrating theories of commitment and motivation, it gain a better understanding of the two processes themselves and of workplace behavior. This article is conceptual based which is largely based on presenting the reasoning of different theories. Employee Commitment and Motivation: A Conceptual Analysis and Integrative Model uses various theories about motivation and commitment. 3. Brief Summary This article tried to assert commitment is one part of motivation and, by integrating theories of commitment and motivation, For example, because commitment often involves psychological attachment to social foci, incorporating commitment as an independent aspect of motivation should allow enhanced understanding of behaviors that have broader social implications. The article begin its attempt at integration by providing a broad overview of theory and research pertaining to workplace motivation and commitment. Both are complex concepts, and therefore a comprehensive analysis...
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...INTRODUCTION The purpose of this analysis is to review and summarize preferred learning styles that are preferred to learning new strategies and styles. The purpose of this paper is to identify the many different learning styles noted in the “VARK Questionnaire” developed by Neil D. Fleming a teacher from New Zealand. Topics outlined in subsequent paragraphs will delineate the different learning styles and study strategies regarding: aural, multimodal, read/write, and kinesthetic learning strategies. Identification of learning preference through the corresponding link and this analysis will be discussed in comparison to the other learning strategies. Method Personal Learning Report After addressing questions to the VARK report it was noted that one is noted to be one in the majority, as 60% of any population fits the category of Multimodal. What this means is that one may have two or three strong preferences of aural, visual, read/write, and kinesthetic. Various preferences give you choices of two or three styles to use for your learning and interaction with others. It’s often necessary for individuals to use more than one strategy for learning and communicating. The feeling of insecurity is often noted with one strategy, that’s why multimodal individuals tend to utilize the other strategies to incorporate into their learning and communicating process. Context Specific Approach Following the integrative literature review process outlined by Fleming, N.D. & Mills...
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...metabolic control in youth with type 1 diabetes: an integrative review. http://ehis.ebscohost.com.library.gcu.edu:2048/ehost/detail?vid=8&sid=feb187e3-959a-463b-b132-6fdc0a76dfec%40sessionmgr12&hid=5&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY Abstract: guo j., whittemore r. & he g.-p. (2011) The relationship between diabetes self-management and metabolic control in youth with type 1 diabetes: an integrative review. Journal of Advanced Nursing 67(11), 2294-2310. Abstract Aims. The purpose of this integrative review was to describe the relationship between diabetes self-management and metabolic control in youth with type 1 diabetes and to explore factors which affect this relationship. Background. In the past 15 years, research has indicated that youth with type 1 diabetes face considerable self-management challenges and are at increased risk for poor metabolic control. To enhance the development of behavioral interventions for youth with type 1 diabetes, the relationship between diabetes self-management and metabolic control needs to be more clearly elucidated. Data Sources. Research studies that examined the relationship between diabetes self-management and metabolic control in youth with type 1 diabetes were included (n = 18). The electronic databases searched included OVID, MEDLINE (1996 to present), SCOPUS (1996 to January 2010) and PubMed (1996 to January 2010). Review Method. An integrative literature review was carried out using Whittemore's modified framework...
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...Nursing http://jsn.sagepub.com/ Literature Reviews as a Research Strategy Julia Muennich Cowell The Journal of School Nursing 2012 28: 326 DOI: 10.1177/1059840512458666 The online version of this article can be found at: http://jsn.sagepub.com/content/28/5/326 Published by: http://www.sagepublications.com On behalf of: National Association of School Nurses Additional services and information for The Journal of School Nursing can be found at: Email Alerts: http://jsn.sagepub.com/cgi/alerts Subscriptions: http://jsn.sagepub.com/subscriptions Reprints: http://www.sagepub.com/journalsReprints.nav Permissions: http://www.sagepub.com/journalsPermissions.nav >> Version of Record - Sep 25, 2012 What is This? Downloaded from jsn.sagepub.com by guest on August 26, 2013 Editorial The Journal of School Nursing 28(5) 326-327 ª The Author(s) 2012 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/1059840512458666 http://jsn.sagepub.com Literature Reviews as a Research Strategy Literature reviews have long been important strategies to assess the state of the science. As early as 1993, Broome (1993) recommended literature reviews as a strategy to assist in the development of concepts. Many graduate students in nursing and other sciences learn about synthesizing literature throughout their academic programs using a variety of guides including Cooper’s (1998) Synthesizing Research: A Guide for Literature Reviews as a common reference or Fink’s...
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...provide health care opportunities for individuals, families, and communities. The outcomes of our experience with one particular, such partnership have been very positive resulting in increased numbers of baccalaureate-prepared nurses and has generated new models of teaching and learning which have been most favorable for both students and staff. Such partnerships may also significantly affect patient health outcomes. The Scholarship of Integration occurs when nursing interacts with other disciplines to complete analysis of health policy, development of interdisciplinary educational programs and service projects, integrative reviews of the literature, and integrative models or paradigms across disciplines. Scholarship in this context would engage academic and civic Peer-reviewed publications are of research, policy analysis, case studies, integrative reviews of the literature (Peterson & Steven 2013). ...
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...Recently we have seen a significant change in study behavior of today’s Flemish students (Belgium) of higher education. In exam periods, more and more students are looking for social environments to study alongside each other. Public places such as libraries, study landscapes, student restaurants are receiving large groups of students. Looking on the broad research literature related to this phenomenon we found two lines of theorizing and research that describe the same phenomenon, but could not offer us a satisfying explanation. On the one hand recent studies and projects have used thematic pedagogical concepts, such as student-centeredness, active learning, collaborative group work and technological enhancement to drive design for informal learning spaces to provide students with a common area in which to gather, relax, socialize and work together outside classes. The increases use of students studying in these common areas support the success of this redesigning, but not our phenomenon. In Flanders this phenomenon occurs also in old libraries without such innovations. On the other hand, a lot of research focuses on the current generation of students and their relationship to technology. Termed ‘digital natives’ or the ‘Net generation’, these young people are said to have been immersed in technology all their lives, imbuing them with sophisticated technical skills and learning preferences. These characteristics suggest that this Generation would benefit from a more structured...
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...systematic approach has been undertaken to ensure that acute care nurses are aware of the emergence of new knowledge as well as technological advances that are necessary for early identification (Aldossary, While & Barriball 2008; Al-Ahmadi 2009; Almalki, FitzGerald & Clark 2011). Early identification with patients who are in need of emergency care can prevent cardiac arrest and lessen morbidity and mortality (Cioffi 2009). This study aims to obtain an in-depth understanding of the current level of competence of acute care nurses in Saudi Arabia in terms of their knowledge, skills and attitudes. The findings will be used to develop an integrative model that can provide acute care nurses with effective education and training so that they can be prepared more effectively to identify clinical deterioration at early stages. Literature review According to Grossman & Wheeler (1997), nurses need to develop appropriate skills and incisive clinical judgment to avert deterioration nursing, hence to hasten recovery through timely interventions. Expert nurses can predict individual patients’ deterioration even before they show well-known physiological or psychological signs. Essentially, an astute clinical decision comes through the process that comprises of...
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...& Bernstein, 2008). The main resource for the medical needs of almost all elderly disabled people is the Medicare program (Altman & Bernstein, 2008). The Medicare program provides them with access to primary healthcare providers, hospital care, nursing home care, hospice, home health, some medicines, and medically necessary services like durable medical equipment and supplies (Centers for Medicare and Medicaid Services, n.d.). Unfortunately, according to the Medicare National Coverage Determinations Manual (2012) it does not reimburse Complementary and Alternative Medicine services. The author proposes that Complementary and Alternative Medicine should be included in Medicare’s coverage for elderly disabled people as part of an integrative approach to their care. The use of Complementary and Alternative Medicine (CAM) offers the elderly disabled person an additional option in ways to improve their quality of life. Almost half of older adults have a functional limitation and this has a direct relationship with their ability to live independently and in their overall quality of life (Holmes, Powell-Griner, Lethbridge-Cejku, & Heyman, 2009). Studies have shown that despite Medicare’s refusal to cover such services, the prevalence of...
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...Literature Search Paper NUR443 September 19, 2011 Professor Dina Faucher Literature Search Paper Numerous studies have been conducted to prove the relationship of shift work and fatigue and the results noted on medication errors. Two articles were chosen using the University Library, a qualitative research study and a quantitative research study from peer reviewed articles through the use of databases such as EBSCOhost, ProQuest, and Gale Powersearch. To research this topic, the query tool utilizing terminology such as shift work, fatigue, and medication errors was used to narrow the search. The intent of this paper is to identify the difference between research study articles versus plain journal articles, the type of nursing journals, and if the article is peer reviewed. EBSCOhost allows one to narrow the search, by selecting the mode as Boolean search, the source type as Academic Journal, the subjects as errors and patient safety, the publication as Journal of Nursing Management, AORN Journal, and Journal of Nursing Education, and finally the database as CINAHL plus with full text reduced the results to 259 articles. The articles are in order from most relevant to least relevant. Effects of working conditions of intravenous medication errors in Japanese hospital, written by Seki and Yamazaki was the most relevant article posted that encompassed the use of a quantitative research method to support the educational content. According to Burns and Grove (2011) “quantitative...
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...OTASC_2-2_Layout 9/8/05 11:30 am Page 83 Journal of Organisational Transformation and Social Change Volume 2 Number 2 © 2005 Intellect Ltd Article. English Language. doi: 10.1386/jots.2.2.83/1 Towards a generic international human resource management (IHRM) model Jie Shen University of South Australia Abstract Keywords Reflecting the prevailing Western literature and based on an empirical study in Chinese multinational enterprises (MNEs), this study develops an IHRM model and argues that it can be widely applicable. The model indicates that an MNE’s IHRM policies and practices are the interaction of the home HRM system, firmspecific factors and host-contextual factors. The firm-specific and host-contextual factors have a differentiated, changing and concurrent impact on IHRM policies and practices. There is also interplay between IHRM policies and practices. Intervening factors and their impact may vary over time and in different contexts. IHRM IHRM model intervening factors Chinese IHRM multinational enterprises (MNEs) Internationalization and the effective use of international human resources are two major issues facing firms in today’s global economy. As more and more firms operate internationally, there is a clear need to develop an understanding of how to manage human resources that are located outside the domestic environment. An IHRM system is a set of distinct activities, functions and processes that are directed at attracting...
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...This model consists of six different steps designed for guidance and transformation within nursing practice. It allows for integration of principles leading to quality health improvements and developing medical practices. The six steps focus on 1) assessing the need for change in practice, 2) locating the best evidence, 3) critically analyzing the evidence, 4) designing practice change, 5) implementing and evaluating change in practice, and 6) integrating and maintaining change in practice (Melnyk & Fineout-Overholt, 2011). The reviewed literature also utilized three different conceptual models and frameworks for identifying and describing the factors that influenced pediatric patients in developing laryngospasms after receiving an inhalational induction with Sevoflurane and nitrous oxide. These models consisted of the 1) objective movement scale, 2) demographic details table with age, weight, and gender and 3) the Dixon’s up-and-down sequential method. Each model focused on a variety of developing components of physical patient factors such as patient movement, coughing, or laryngospasm during the actual stimulation of intravenous cannulation along with concentrating on the patient’s demographic details of age, weight, and gender. One of the key conceptual variables for the...
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...Medication Adherence Instrument for Patients With Coronary Artery Disease: Development and Psychometric Evaluation Ava-Gaye Shaw Reed Northeastern Hospital School Of Nursing Introduction The adherence with taking medications was found to be at a rate much lower than where the researchers had initially believed. Adherence with taking medications by patients with chronic illnesses was found to be even worse due to the lack of patient-centered, medication-specific and theoretically integrative measurement instruments. The researchers decided to work towards developing a tool that would not only be reliable but also a valid instrument that would measure the various factors that have an effect on the patients and the compliance with taking their medication. This study focused specifically on patients with coronary artery disease. This instrument was developed in two phases. Phase 1 consisted of developing the structure and content of the tool. This was defined by analyzing literature pertaining to medication adherence and interviews with patients. Phase 2 consisted of establishing the psychometric properties of the tool. Exploratory factor analyses, reliability and validity estimations were performed with a sample size of 404 patients from 3 tertiary cardiology referral centers. This phase resulted in a 16-item, three factor solution; Medication Planning Strategies, Health Risk and Health Protection. This helped to create an adherence instrument for patients on pharmacotherapy...
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...be discussing the overview of the major research approaches and my selection of which I believe to be most effective. Research approaches Most leadership literature classify research approaches in to five major categories: the traits approach, the behavior approach, the power-influence approach, the situational approach and the integrative approach (Yukl, 2010). Following is a definition of each: • Trait approach- This approach tries to find physiological, demographic, personality, intellective, task related and social characteristics that identify leader emergence and effectiveness (Trait Theory of Leadership, 2011). • Power-influence approach- This approach attempts to measure effectiveness based on the different ways managers use power and influence to get things done (Leadership Styles , 2011). • Situational approach- This approach emphasizes on contextual factors that affect leadership behaviors (Yukl, 2010). • Integrative approach- Integration is the most commonly used today, which means to use more than one of the previously mentioned approaches (Yukl, 2010). Approach Selection After reviewing the major approaches to researching leadership I believe one style isn’t sufficient to properly measure effectiveness. For this reason, I selected the integrative approach. I base my decision on personal experience since I have had the opportunity of working in different industries and have noticed that those who I perceived...
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