...Process is aspect of policies and procedures at the facility and Outcomes are determined when greater levels of nursing care and quantity are involved with better patient outcomes (ANA, 2015). Nursing-Sensitive Indicators The scenario paints a picture of multiple areas that should be approved on and addressed by management. The use of restraints, as described by the scenario, indicates a clear lack of knowledge in regards to nursing-sensitive indicators, the use of restraints and subsequent pressure ulcer formation is directly related and reflects on all 3 aspects of the indicators. The American Nurses Association, ANA, recommends that restraints only be used when no other viable options are available and this is also the case with the organization that I am involved with as a RN, Seton Health. While reading the scenario, it did not mention patient behavior that would justify the use of restraints; there is no mention of medical or behavioral interference that could possibly require the need to use restraints. The patient is elderly, has a history of mild dementia and a fractured hip, none of these should require the use of restraints but they all create conditions that place the patient at higher risk of developing secondary injuries due to being confined to a bed. The scenario of a patient with dementia is familiar to me, taking care of these patients can be stressful and place greater pressure of nursing staff and these patients...
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...character the “American Wife” shows similar elements of confinement and restraint as to the cat in the story. The constant obsession for the cat in the story from the wife shows that she thinks of herself as the cat and wants to be freed from this rain. Two Americans are stuck in a hotel where their room is facing the sea, a public garden and a war monument. A rainy day it seems to be there somewhere in Italy and the American wife is looking out the window and she spots a cat under the table that is trying to keep dry from the rain. The American wife begins to express a desire for many things in the story. She tells her husband if she cannot have fun on this trip that she should get anything she wants. She starts to request material goods and the story shows that she requests these things due to the lack of intangible goods such as love and affection. The American wife suddenly becomes obsessed with the idea of saving this random street cat. You can metaphorically say the cat is her and she is trying to save the cat from the rain and in the Americans wife case the rain is the lack of love and affection. But, George (her husband) ignores her desires and treats her as if she was a little girl of no importance what so ever. One can clearly see that the relationship is unhealthy. The wife never speaks out about the restraint George puts on her, but rather feels it. “I want to have a kitty to sit on my lap and purr when I stroke her”. This quote shows the feeling of love and...
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...It also guarantees that the care or treatment given is compliant with the patient's requests and preferences and is legal. explain how personal values and attitudes can influence perceptions of situations and of individuals mental capacity 2.3 Personal values and attitudes can influence perceptions of situations and mental capacity by assuming or biasing based on age, appearance, or disability. An independent carer may incorrectly conclude that an elderly person with physical limitations lacks mental capacity. describe strategies and skills that may be used to maximise individuals capacity to make their own decisions. 2.4 Clear and accessible information, breaking down decisions into smaller components, and determining the best time and atmosphere for decision-making can help people make their own judgements. Listening, patience, and understanding can also assist people express their thoughts. explain their role in identifying when an assessment of capacity may be required 2.5 A care practitioner must be aware of signs that an individual may be unable to make a decision, such as confusion, inconsistency, or difficulty understanding information. If a carer challenges an individual's capacity, they should consult a doctor or a social...
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...established a program for implementing, developing and storing these nursing-sensitive indicators, known as the National Database of Nursing Quality Indicators (NDNQI) (ANA, 2014). The NDNQI serves as a valuable resource for hospitals nationwide at the acute level for administrators and nurses alike to compare various indicators and outcomes with that of other facilities to determine best practices for patients and staff. In the case of Mr. J, it is clear the nurse caring for this patient had little or no knowledge of indicators of restraint prevalence. However, my initial concern after reading this case was why this patient was in restraints to begin with. There is no indication that this patient was causing harm to himself or others. There was no mention of agitation or of pulling of tubes or lines, etc. The case clearly states Mr. J is able to “answer simple questions appropriately”. Mr. J has mild dementia and is able to make his needs known. In my opinion, this...
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...dictionary, Self-control is the restraint of one's emotions, desires, or inclinations. I have come to realize that self-control is something that I must master. Despite prior lessons from my parents and readings in the bible, I still committed an action that was contrary to their teachings. I was not only being ignorant and disobedient towards my parents, but greatest of all, my Lord Jesus Christ. “His divine power has given us everything needed for life and godliness, through the knowledge of him who called us by his own glory and goodness. Thus, he has given us, through these things, his precious and very great promises, so that through them you may escape from the corruption that is in the world because of lust, and may become participants of the divine nature. For this reason, you must make every effort to support your faith with goodness and goodness with knowledge, and knowledge with self-control, and self-control with endurance, and endurance with godliness, and godliness with mutual affection, and mutual affection with love. For if these things are yours and are increasing among you, they keep you from being ineffective and unfruitful in the knowledge of our lord Jesus Christ. For anyone who lacks these things is nearsighted and blind, and is forgetful of the cleansing of past sins.†NRSV 2Peter 1:3-10 Therefore, by not restraining my emotions, to do violence towards another person, I rejected the beliefs instilled in me by the lord. My ill-advised actions led me...
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...USA V. VISA U.S.A. INC., VISA INTERNATIONAL CORP., AND MASTERCARD INTERNATIONAL INCORPORATED In 1998 USA filed a complaint against Visa and MasterCard re their dual governance and exclusionary rules of combinations and conspiracy in restraint of trade. (DOJ, 1998) Essay Plan My motivation for choosing the abovementioned case comes from my interest in the financial services market, its regulations and their implications on consumers. This case is attention-grabbing, not solely due to the remedy, but also due to the implications it has on domestic and international markets. It also gives the opportunity to analyse the controversy of vertical exclusionary restraints (Whinston, 2006). When analysing the Visa-MasterCard case, there are two main ‘economic-schools-of-thought’ to be considered. Chicago School(CS) dismisses vertical exclusionary contracts as an anti-competitive tool. While, Post-Chicago School(PCS) offers an opposing explanation by suggesting different models to rationalise anti-competitive behaviour using vertical restrictions. Both schools build their models under the assumption of first-mover advantage and the monopoly power of an incumbent firm. (Motta, 2004) Using the CS in this case, we could assume that Visa and MasterCard are the combined incumbent on the market, due to their cooperative actions. The banks are the buyers and AmericanExpress is the potential new entrant. It could be assumed that AmericanExpress is a new entrant for the market of issuing...
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...I struggled quite a bit with determining levels of evidence, creating PICO questions, and analyzing articles at the beginning of the semester. In comparison to the material that I had learned in my first semester of nursing school, this seemed much more abstract and caused me a great deal of frustration. However, with determination and the help of my professors, I was able to gain a better understanding of EBP and implement it in my practice. This was evident through the final EBP poster that my clinical group and I created on the topic of sleep in acute care units. We struggled with our final EBP worksheet, finding it difficult to locate articles in the literature, creating a PICO question that did not entirely fit with our topic, and receiving a lower score than we had hoped for overall. However, we were able to learn from our mistakes, correct our errors, and compile our information into a cohesive poster summarizing our findings related to sleep. This was a great achievement for us, and was one that we were very proud...
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...302 Understanding mental capacity and restrictive practice. 1.1 - describe how the main purpose and principles of current mental capacity legislation are reflected in codes of practice and agreed ways of working. The primary aim of mental capacity legislation in the UK is to protect and empower individuals who may lack the capacity to make their own decisions. This legislation ensures that individuals are supported to make decisions for themselves whenever possible, and that any decision made on their behalf is done in their best interest. Principles Reflected in Codes of Practice and Agreed Ways of Working: • Presumption of Capacity: The default assumption is that adults can make their own decisions unless proven otherwise. Support to Make...
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...RECOMMENDATIONS 2 Table of Contents Executive Summary ............................................................................................ 3 Company Overview............................................................................................. 4 Security Vulnerabilities ....................................................................................... 4 Hardware Vulnerability: Unrestrained Components .................................................................. 4 Software Vulnerability: Unsecure Wireless Access Points .......................................................... 6 Recommended Security Solutions ....................................................................... 7 Hardware Solution: Physical Restraints ...................................................................................... 7 Impact: Hardware Solution ..................................................................................................... 8 Budget: Hardware Solution ..................................................................................................... 9 Software Solution: Configuring the Wireless access points for security ................................... 10 Impact: Software Solution..................................................................................................... 11 Budget: Software Solution .................................................................................................... 11 Summary...
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...person. It is generally divided into the following categories : Physical abuse is physical force that results in bodily injury , pain or impairment, restraint. Elderly abuse also called elderly mistreatment senior abuse. It is also a single or repeated act or lack of appropriate action, occurring with any relationship where there is an expection of trust which cause harm or distress to an older person. Thus, it includes harms by people the older person knows or whom they have a relationship, such as a spouse, partner or family member, a friend or neighbor, or people that the older person relies on services. Many forms of elderly abuse are recognized as type of domestic violence or family violence. Several key factors emerge when examining the population of elderly victims of domestic violence. Often abuse of the elderly is compared to child abuse. Victims in this age group are almost invisible in the movement to aid battering victims. How will I play a part in reducing the instance of elderly abuse in my community and work place , once I am a certified nursing assistant by making sure that the facility provides a safe environment. Unexplained bruising including restraints marks, and sudden firing a staff member who may be the indicator that something unusual is happening. I will utilize knowledge, experience prosecute...
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...These nursing sensitive indicators include complications such as urinary tract infection, patient falls, surgical complications, length of hospital stay, restraint prevalence, incidences of failure to rescue, patient satisfaction, pressure ulcers and nursing satisfaction. In the case of Mr. J, the demented rabbi, who as a nurse supervisor I am responsible for, nursing sensitive indicators are crucial in monitoring the level of care and making adjustments so that the patient will recover as quickly as possible. Modern nursing, aided by linear flowcharts uses the Pareto principle that states 80% of process or system problems come from 20% of the possible causal factors (Cherry, 2011). This means that by identifying the key and most obnoxious causal factors and focusing effort on relieving them, the problems can have viable solutions. An example of the need to focus on nursing sensitive indicators is the fact that restraints were used on the patient despite only having mild dementia and no previous incident as well as the restraints causing a pressure ulcer would indicate that the patient isn’t receiving the care he deserves. From these two metrics I would assign a CNA to watch over him periodically and release the restraints during that period and help him sit up to relieve the pressure on the ulcer. The discomfort from the restraints and the pressure ulcer could seriously impede Mr. J’s ability to recover or potentially cause new problems, such as sepsis from the infected wound. ...
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... according to Gonzalez Mexican Latinos is the most populous Spanish speaking country in the world. It has 95 million residents, a high birth rate and desperate poverty (Gonzalez). Also, according to the Suarez and Paez in their book reported that the U.S Census Bureau claims that by the year 2050, a full quarter of U.S population will be of Latino origin in which Mexican American with a larger proportion. Mexican-Americans experience in the United States has been profoundly shaped by positives and negatives circumstances. The struggles with self-identification, economic factor, lack of quality education, discrimination at work and poor housing facility issue were the negative factors that Mexican-Americans battle with in United States. Even though, Mexican- Americans is very rich in history, tradition and culture but poor in education and economic. According to Gonzalez, many of them did not know how to read nor write. They didn’t understand their rights and those of their grandparents. Anybody could tell them that your grandfather lost his hand, sold it, and they couldn’t prove otherwise (Gonzalez 100). As a result of racism and ethnicity...
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...RESTRAINT OF TRADE The doctrine of restraint of trade is a legal device to attempt to hold the balance between two competing factors - an employee’s freedom to take employment as and when he wishes, and an employer’s interest in preserving certain aspects of his business. Both factors are important, and indeed the law will protect the employer if necessary by the implication of the term fidelity in the contract of employment thereby restraining the employee inter alia from divulging confidential information. However, the employer may wish to go further and extract an express promise from the employee: a) Not to disclose certain information, b) Not to place himself in a position in which he may do so, e.g. by not working for a competitor for a certain period of time within a certain area after leaving the employment. It is thus established that an employer can stipulate for protection against having his confidential information passed on to a rival in trade. But experience has show that it is not satisfactory to have simply a covenant against disclosing confidential information. The reason is because it is so difficult to draw the line between information which is confidential and information which is not; and it is very difficult to prove a breach when the information is of such a character that a servant can carry it away in his head. The difficulties are such that the only practicable solution is to take a covenant from the servant by which he is not to go to...
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...In addition to a low availability of housing in high-income areas, the failure to improve on location may be due to families’ lack of information about available housing. Because the program is run by multiple different agencies, some provide more housing search assistance to families than others. If a particular agency decides to ignore the family’s need for housing-search assistance, the HUD is not required to administer sanctions. Their performance review of agencies does not focus on how well the agency achieves beneficial housing placement (Sard & Rice, 2016). Because Section 8 places families under a 60-day time restraint to find housing, they do not have the time to navigate unfamiliar high-opportunity neighborhoods. Instead, in the interest of time, they tend to rely on lists provided at the Public Housing Agency, from a website such as gosection8.com, or from properties whose landlords have advertised their properties as “Section 8 welcome.” Such properties often tend to be high-poverty and racially segregated (Furman Center for Real Estate & Urban Policy, 2008). Increased requirements for rental agencies to provide housing-search counseling may prove beneficial to filling the...
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...Introduction Vehicle crashes are one of the leading cause of death in the United States. As a result of traffic crashes, infant and children are most likely to suffer major injuries or die from fatal crashes. Numerous studies demonstrated that proper use of child restraint devices can help reduce the fatality rate in vehicle crashes. However, only a few number of countries around the world adopted some laws to implement the safety of the young children. Currently in the United States, child safety seats and seat belts law regulations vary by states and they are mainly based on the age, height and weight of the children. Many countries are yet to adopt this law that can potentially save the lives of many infants and children. In my country, I grew up riding in the front seat of the car with no seat belt on which is pretty common things to see in other countries as well. Infant car seat is unheard of to people and airbags doesn’t even work on most cars. Babies are cradle by someone while children will often sit on the lap or small children will be moving around while the car is in motion. It wasn’t until recently that all the cars in my country were fully equipped with working seat belts and mandatory seat belt laws were passed....
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