...PROFESSIONALS: WEANING Accountability of Nursing Professionals: Weaning from Mechanical Ventilation Samantha Madrid Grand Canyon University Abstract This paper will discuss the weaning of patients off of a mechanical ventilator. It will look at the problems associated with prolonged intubation vs. premature extubation, and what healthcare professionals can do to assess a patients readiness to begin the weaning process. A patient care scenario will be given and an explanation of how nursing practice can evolve with the knowledge from this study will be shown. The accountability of the nursing professional in regards to mechanical ventilation will be visited as well. Accountability of Nursing Professionals: Weaning from Mechanical Ventilation “Mechanical ventilation refers to the use of life-support technology to perform the work of breathing for patients who are unable to do so on their own.” This is the definition of mechanical ventilation according to Cook, Meade, and Guyatt (2000). They performed a study to determine the optimal time to wean a patient off of mechanical ventilation. When weaning a patient you have to find the right time to extubate. Prolonged mechanical ventilation can lead to nosocomial pneumonia, cardiac associated morbidity, and possible death. However, extubating a patient too soon may result in having to reintubate which can result in the same illnesses as prolonged intubation. “Research to date suggests that the best answer to ‘when to start weaning’ is...
Words: 1884 - Pages: 8
...common nosocomial infection in Critical Care units. VAP is linked with high mortality rates, increased hospital stays, longer mechanical ventilation and increased costs to hospitals and patients (Rosa, Hernandez, Carillo, Fernandez, & Valles, 2012). Patients who have an endotracheal tube (ETT) with mechanical ventilation are more likely to develop VAP. These patients have a poor cough reflex due to a decreased level of consciousness and diminished movement of the respiratory tract mucocila, leading to the inability to clear secretions. These contaminated secretions will then sit on top of the ETT cuff and eventually leak down and invade the lungs. Also aiding as a reservoir for microbes is a biofilm that can form on the ETT and enter the lungs causing infection (Mietto, Pinciroli, Patel, & Berra, 2013). Nurses are responsible for applying pharmacological and non-pharmacological measures to help prevent VAP which poses a very difficult challenge. Nurses must research and incorporate the use of evidence-based practice into their daily care of patients on mechanical ventilation (Sedwick, Lance-Smith, & Nardi, 2012). This paper will look closely at the evidence-based research and protocols implemented which best prevent ventilator-associated pneumonia. To help prevent further complications and improve outcomes in patients on mechanical ventilation, a standard of care was created by the Institute for Health Care Improvement (IHI) in 2004 called the Ventilator Bundle. These...
Words: 2122 - Pages: 9
...SOLUTIONS (ADES)” Chennai. THE FOLLOWING PROJECTS WERE HANDLED: * Apollo Tyres Ltd – Factory, Oragadam Chennai, India * Columbia Washing Plant Ltd, Bavanipur, Bangladesh * Thillagar Hotel, Chennai, India * Remi Holdings Ltd, Ademzee EPZ, Bangladesh * Nokia Solutions Networks, Oragadam Chennai, India * Emami Paper Mills Pvt Ltd, Balasore, India AREA OF EXPERTISE: * HVAC schematic design * Fresh air and ventilation calculation with reference to ASHRAE 62.1 * Cooling load calculation with the help of “Hourly Analysis Program (HAP)” * MEP coordination * Green building ratings and documentation * Maintenance and commissioning * Energy simulation with reference ASHRAE 90 * Basic electrical load calculation in a building INDOOR ENVIRONMENTAL QUALITY Indoor environmental quality (IEQ) refers to the quality of a building's environment in relation to the health and wellbeing of those who occupy space within it. IEQ is determined by many factors, including lighting, air quality, and damp conditions. FACTORS AFFECTING INDOOR AIR QUALITY Source: there is a source of contamination or discomfort indoors, outdoors, or within the mechanical systems of the building. HVAC: the HVAC system is not able to control existing air contaminants and ensure thermal comfort Distribution: one or more pollutant pathways connect the pollutant source to the occupants and a driving force exists to move pollutants along the pathway. Occupants: building occupants are present...
Words: 2169 - Pages: 9
...Design Directions and Trends in Portable Ventilators What This Means for the Ventilator-Dependent Individual Twyman, Rod 12/17/2011 Abstract Service, operator, and web site literature on portable ventilators were studied for design “trending” through an examination of the listed specifications and features. If a trend were ascertained, it could provide an assessment tool for ventilator-dependent individuals and their caregivers when surveying the market for a suitable ventilator. An analysis of the results suggested that the portable ventilator market is driven toward developing units of a lighter and smaller chassis, and fewer required service hours. Advances in medical care may separate from or keep pace with advances in certain forms of medical equipment technology. Therefore, a review of what appears to be the interpretive value of current medical trends will require ongoing reexamination. 1 Table of Contents Abstract…………………………………………………………………………………………..1 Introduction…………………………………………………………………………………...3, 4 Methods/Materials………………………………………………………………………………4 Results……………………………………………………………………………………………4 LP10 Volume Ventilator………………………………………………………………...5 Purpose/Use…………………………………………………………………………...5 Specifications………………………………………………………………………….5 Notable Feature(s).…….………………………………………………………………6 Achieva PSO2 Ventilator………………………………………………………………...6 Purpose/Use…………………………………………………………………………...6 Specifications………………………………………………………………………….6 Notable Feature(s).……….……………………………………………………………7...
Words: 2580 - Pages: 11
...Available online http://ccforum.com/content/12/2/R36 Research Vol 12 No 2 Open Access Detecting myocardial infarction in critical illness using screening troponin measurements and ECG recordings Wendy Lim1, Paula Holinski1, PJ Devereaux1,2, Andrea Tkaczyk2, Ellen McDonald2, France Clarke2, Ismael Qushmaq3, Irene Terrenato4, Holger Schunemann2,4, Mark Crowther1 and Deborah Cook1,2 1Department 2Department of Medicine, McMaster University, Canada of Clinical Epidemiology and Biostatistics, McMaster University, Canada 3Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia 4Department of Epidemiology, Italian National Cancer Institute Regina Elena, Rome, Italy Corresponding author: Deborah Cook, debcook@mcmaster.ca Received: 6 Dec 2007 Revisions received: 22 Jan 2008 Accepted: 4 Mar 2008 Published: 4 Mar 2008 Critical Care 2008, 12:R36 (doi:10.1186/cc6815) This article is online at: http://ccforum.com/content/12/2/R36 © 2008 Lim et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Introduction To use screening cardiac troponin (cTn) measurements and electrocardiograms (ECGs) to determine the incidence of elevated cTn and of myocardial infarction (MI) in patients...
Words: 2698 - Pages: 11
...Joseph1, Sujatha Sistla1, Tarun Kumar Dutta2, Ashok Shankar Badhe3, Desdemona Rasitha1, Subhash Chandra Parija1 1. Department of Microbiology, 2. Department of Medicine, 3. Department of Anaesthesiology and Critical Care Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry - 605006, India RESEARCH Please cite this paper as: Joseph NM, Sistla S, Dutta TK, Badhe AS, Rasitha D, Parija SC. Outcome of ventilatorassociated pneumonia: impact of appropriate therapy and other factors. AMJ 2012, 5, 2, 135-140. http//dx.doi.org/10.4066/AMJ.2012.1004. Corresponding Author: Dr. Noyal Mariya Joseph, Assistant Professor, Department of Microbiology, Mahatma Gandhi Medical College and Research Institute, Pillaiyarkuppam, Pondicherry – 607 402 (India) Email: noyaljoseph@yahoo.com Please use these fonts and font sizes only. Abstract inappropriate therapy (defined as lack of coverage of one or all the significant VAP pathogens) were at significantly high risk for death (Relative risk, 2.00; 95% confidence interval, 1.14 to 3.52; P 0.0008). A delay of > 2 days in administering the first dose of appropriate antibiotic therapy significantly prolonged the duration of ventilation (P < 0.0001). Infection by multi-drug resistant pathogens, polymicrobial infection and time of onset of VAP did not have significant impact on the outcome of VAP. Conclusion Early administration of appropriate antibiotic therapy, based on the antibiogram of the VAP pathogens identified...
Words: 3905 - Pages: 16
...innovation and long-term growth. They manufacture and sell medical devices and supplies, diagnostic imaging equipment and pharmaceuticals. Tyco Healthcare separated from Tyco International In June 2007 to form Covidien. Tyco healthcare was to operate the business by acquiring venerable brands such as Kendall, Mallinckrodt and Auto suture. Since separating, they have focused on developing innovative medical solutions for better patient outcomes and on creating value through clinical leadership and excellence. As part of our pursuit of excellence, we are committed to fostering innovation. In addition to acquiring companies with superior products, they have created innovative new products through their own increasingly substantial investments in research and development (R&D). Covidien has launched 60 new products in 2008 and 2009, compared with fewer than 20 in 2005 and 2006, this were the last two years of Tyco healthcare before it become Covidien. Competition – Covidien is engaged in the development, manufacture, and sale of healthcare products, including pharmaceuticals and medical supplies, for use in clinical and home settings. One of Covidien’s main competitors in the healthcare equipment and supplies industry is Baxter International (BAX). Other competitors in the healthcare sector include: C.R. Bard (BCR), and Becton, Dickinson (BDX) Direct Competitor Comparison | COV | BDX | BCR | JNJ | Industry | Market Cap: | 27.04B | 15.15B | 8.26B | 197.90B | 182...
Words: 891 - Pages: 4
...This paper analyzes the Building Management System for a property. All buildings have some form of mechanical and electrical services in order to provide the facilities necessary for maintaining a comfortable working environment. These services have to be controlled by some means to ensure comfort conditions. Basics controls take the form of manual switching, time clocks or temperature switches. Here if Building Management System is introduced, we are able to get a comfortable working environment in an efficient way. Building Management Systems (BMS) comprises a massive variety of technologies, across commercial, industrial, institutional and domestic buildings, including energy management systems and building controls. (Gary Mills 2004-2009) A Building Management System (BMS) is a computer-based control system installed in buildings that controls and monitors the building’s mechanical and electrical equipment such as ventilation, lighting, power systems, fire systems, and security systems. Manual work consumes time and energy and there are always chances of human errors. Technology and new systems are always changing with time and therefore it is very important for any property to keep up to date with the new technology and system. A BMS plays a vital role in any hotel or any business property. (Native Systems 2011) Building Management Systems (BMS) are computer based systems which control and monitor building services automatically. These services include heating, air conditioning...
Words: 1849 - Pages: 8
...major contributors for greenhouse gases. Hence, with the intention of reducing the energy usage which reduces the environmental pollution energy efficient measures have been introduced. The goal of these measures is to decrease the energy use of the building substantially and provide the building's energy needs with on-site renewable energy supply like Photovoltaics. This results in a concept called Net zero energy buildings or Zero Energy Buildings. Zero energy building (ZEB) is a building with zero energy consumption i.e., it consumes only the amount of energy generated by the renewable power on the building site. NZEBs produce zero carbon emissions annually as various renewable energy technologies are deployed on the building site. This paper addresses the energy efficient measures that can be implemented to cut down the power consumption. The energy efficient features implemented in ZEBs for energy savings is justified with a case study. I. INTRODUCTION The environmental effects that Carbon dioxide (CO2) emissions across countries at different levels of development received global attention on what has been done to mitigate these emissions. The continued growth of global emissions of carbon dioxide due to energy consumption and their adverse effects on global warming forces the world to save the environment from further damage. As per EPA in 2011, the combustion of fuels to electrify the homes, buildings and industry in U.S. accounted to 38%...
Words: 4748 - Pages: 19
...Title: differences in competencies between nurses prepared at the associate-degree level versus the baccalaureate-degree level. Patient Care Scenario Barbara Doherty Grand Canyon University: NRS-430-O102 September 21, 2014 Differences in competencies between nurses prepared at the associate-degree level versus the baccalaureate-degree level. Patient Care Scenario “BSN- prepared nurse have a positive impact on lowering mortality rate.” (Tourangeau et. al. , 2007 p.6). As the health care industry is constantly evolving at a fast pace, education is with no doubt one of the most influential aspect that nurses have to conquer to be able to give the best patient care. This paper will argue with solid evidence-based research the differences in educational preparation between a Baccalaureate degree nurse, BSN, and an associate degree nurse, ADN. Different approaches in decision making and patient care will be explained, using a clinical situation, amongst a BSN nurse and ADN nurse showing that BSN nurses make better decisions concerning patient care. Associate Degree Nursing and Baccalaureate Degree Nursing There are three possibilities to become a registered nurse and those are: a 3- year diploma, a 3-year associate degree, which is the equivalent of an ADN degree, and a 4-year baccalaureate degree which is the equivalent of a BSN degree. The ADN program was created by Mildred Montag due to scarcity on nurses. Mildred created a new type of nurse as she explained it...
Words: 1414 - Pages: 6
...Definition of electromechanical 1. : of, relating to, or being a mechanical process or device actuated or controlled electrically;especially : being a transducer for converting electrical energy to mechanical energy Telecommunication is – according to Article 1.3 of the International Telecommunication Union's (ITU) Radio Regulations (RR) – defined as "Any transmission, emission or reception of signs, signals, writings, images and sounds or intelligence of any nature by wire, radio, optical or other electromagnetic systems." This definition is also identical to that contained in the Annex to the Constitution and Convention of the International Telecommunication Union (Geneva, 1992). Telecommunication occurs when the exchange of information between two or more entities (communication) includes the use of technology. Communication technology uses channels to transmit information (as electrical signals), either over a physical medium (such as signal cables), or in the form of electromagnetic waves.[1][2][3][4][5][6] The word is often used in its plural form, telecommunications, because it involves many different technologies. Early means of communicating over a distance included visual signals, such as beacons, smoke signals, semaphore telegraphs, signal flags, and optical heliographs.[7] Other examples of pre-modern long-distance communication included audio messages such as codeddrumbeats, lung-blown horns, and loud whistles. Modern technologies for long-distance communication...
Words: 7653 - Pages: 31
...Laboratory should be conducive to learning so that students are encouraged to study. It is a room where the students have the basic knowledge in theoretical aspects before they ought to gain knowledge outside. So, the study is focus on the development of a modernized laboratory equipped with automatic controls. Before laboratory is just a room with equipment, many lights, and switches. They are using manual switching of the facilities inside a laboratory room which is done manually. The turning on and off the equipment gave waste time and energy. The conceptualization of a modern laboratory gave the students an edge in modern technology as well as application. The common problems encountered in a laboratory room are poor illumination and ventilation. In laboratories and classrooms effectively and efficiently required illumination level and proper...
Words: 15414 - Pages: 62
...Matt Fowler RES 297 11/12/13 Evidence Based Medicine Research Assignment 1) In Vitro Evaluation of Heat and Moisture Exchangers Designed for Spontaneously Breathing Tracheostomized Patients Claudia Brusasco, MD⇑ Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Sezione Anestesia e Rianimazione Francesco Corradi, MD PhD Dipartimento Cardio-Nefro-Polmonare, Sezione Terapia Intensiva Cardiochirurgica, Azienda Ospedaliero Universitaria di Parma, Italy. Maria Vargas, MD Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Sezione Anestesia e Rianimazione Dipartimento di Anestesia e Terapia Intensiva, Università di Napoli Federico II, Napoli, Italy. Margherita Bona, MD Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Sezione Anestesia e Rianimazione Federica Bruno, MD Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Sezione Anestesia e Rianimazione Maria Marsili, MD Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Sezione Anestesia e Rianimazione Francesca Simonassi, MD Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Sezione Anestesia e Rianimazione Gregorio Santori, MD Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Università Degli Studi di Genova, Istituto di Ricovero e Cura a Carattere Scientifico, Azienda Ospedaliera Universitaria San Martino, Genova, Italy. Paolo Severgnini, MD Dipartimento Scienza ed Alta Tecnologia, Sezione Ambiente Salute Sicurezza...
Words: 4847 - Pages: 20
...Evidence Based Analysis Paper The Impact of Advance Care Planning on End of Life in Elderly Patients Amber Frederick April 9, 2013 College of Saint Elizabeth Professor Marranca Many patients do not have advanced directives and often enter the hospital where various medical care is received and sometimes unwanted. This is because many patients are not given the opportunity to plan ahead and choose the care they would want. In order to improve patient satisfaction, reduce family burden and decrease health care cost, advance care planning is suggested. Health care providers play a major role in facilitating discussions and planning for patients’ medical future. All too often patients come into the ER in some type of distress and are often resuscitated or intubated by medical personnel in order to save their lives. When patients are extubated and coherent, they become upset because those resuscitation efforts were not wanted by the patient. Other times, family sees their family member on mechanical ventilation and is disheartened because they know their loved ones didn’t want to be in that situation. These patients may have terminal illnesses and resuscitative efforts only prolong their suffering and impede their comfort. There is a way to educate patients and families about their different options and it starts with the Primary Care Provider (PCP). PCP’s are able to help their patients with advanced care planning. This is a process “whereby a patient, in consultation...
Words: 669 - Pages: 3
... Nutrition affects every part of our daily lives. We eat nutritional foods to stay healthy and live active lives. We also eat nutritiously to regain our lives after an accident or surgery. This paper highlights the importance of nutrition after surgery. Nutrition plays an important role in the reducing the risk of infection and wound healing after surgery. Understanding how nutrition can benefit as well as hurt recovery after surgery when caring for all patients. Malnutrition as a result of critical illness has been defined as ‘acute disease or injury-related malnutrition’, which is associated with severe, acute inflammation. During periods of critical illness, the inflammatory response elevates energy expenditure and nitrogen excretion that is only partially attenuated by the provision of nutritional support. Contributing to this weight loss is inadequate nutritional intake with ICU patients only receiving 60–80% of their prescribed energy and protein requirements.( JCN, 2014) These suboptimal intakes result from delays in initiating feeding and feed interruptions due to nausea, vomiting, abdominal distension, large gastric aspirates, tube displacement, investigations and prolonged fasting for procedures. Oral diet following extubation from mechanical ventilation has also been shown to be inadequate. Peterson assessed the oral intake of 50 patients for the first seven days after extubation and found that mean energy and protein intake was <50% of estimated...
Words: 519 - Pages: 3
