...N407L OR/PACU Observation Assignment Laquet Henderson NDSU OR/PACU Observation Assignment 1. Introduction On Thursday, the 24th of May, I had the opportunity to visit the operating room at the Sanford hospital. I thought this was going to be atypical day in the OR where everything flows smoothly as if the staff are rehearsing a well-known choreographed dance. Things did not turn out how I imagined them to from the moment I stepped onto the unit. The team I observed appeared disorganized, frazzled, and rushed. Much of the chaos I witnessed boiled down to an error in communication. This all started with the patient failing to inform staff of the medications she was on and came to a head when the surgical techs, physician, and nurse did not understand what the other party in the team was trying to communicate. 2. Patients...
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...Immediate Post Operative Care 2 The following essay will use a systematic approach to critically evaluate the care and treatment delivered to a non-elective paediatric orthopaedic patient within the Post Anaesthetic Care Unit (PACU) by a student Operating Department Practitioner at a local trust hospital. The assessment and management of the patients care will be examined and rationale provided for strategies employed during delivery of individualised patient care. In accordance with Health and Care Professional Council’s standards of conduct, performance and ethics (HCPC, 2012) the confidentiality of the service user will be up held at all times. The service user shall be referred to as “Daisy” to protect her confidentiality. Daisy was received to the PACU after surgical stabilisation of her left fibula and tibia with flexible intramedullary nails following a fall. A specified paediatric bay was utilised enabling the patient to be cared for separately from the adults in the PACU (RCOA, 2013). Anaesthetic and surgical handover was received (RCOA, 2013) which detailed that she was 14 years old with no known allergies. She had no significant medical history. She had a general anaesthetic with 140mfg of Propofol used on induction followed by Sevoflurane as a maintenance agent. 30mg of Atricurium, 4mg Dexamethasone, 4mg Ondansatron, 10mg Morphine and 1g Paracetemol had been administered intraoperatively. 1 litre of Hartmanns solution had been administered during surgery and...
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...HealthCare and Public Health Issues-Nursing Shortage Introduction When we are sick, we will go to the hospital. We want good quality of care but this is a challenge due to the shortage of nurses. Nursing shortage happens all over the world. The problem will get more severe. The population is continually growing, the demand for healthcare workforce increases. For example, while I was working in the operation room over the years, I witnessed an increasing volume of patients entering the hospital. Even though there is this demand, the administration department cut the staff number due to budget reasons. Nursing shortage affects the quality of patient care, increases healthcare staffs' stress, and affects staffs' job satisfaction. The quality of patient Care With advance medical treatment and good living environment, people live longer. In 2020 the demand of nurses is increasing but the supply of nurses is beginning to decrease. As baby boomers’ generation are starting to retire which will reduce the supply of nurses and there are not enough new nurses to fill the gap. With limited nurses, they may do the vital signs improperly, rush of judgment, or giving medication without fully check. A patient can develop an infection or bed sore with not having a nurse every two hours around to turn them. For serious result, patient will die due to not frequently round. A report by Ford stated that 18 mental illness patients commit suicide in a year during observation. Half of those deaths occurred...
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...Children are more susceptible to postoperative airway complication, during the period of extubation, to post anesthesia recovery phase. AT surgery combined with anesthetic implications on swallowing reflex and blood and secretions in the airway places the children at higher risk for adverse airway events during the postoperative period. Any airway complications, regardless of the severity, can lead to morbidity and mortality among children. The airway is the most critical safety issue among children, and any adverse events can result in prolonged recovery time or even inpatient hospitalization. The anesthesia provider and PACU personnel carry a high level of vigilance to minimize airway complication among postoperative children. Anxiety is one of the most challenging aspects of pediatric surgical patients, and apart from behavioral and psychological therapy, midazolam plays an enormous role during the preoperative period. Apparently, midazolam sedation impairs the swallowing reflex under therapeutic doses.10 The cerebral centers have some degree of voluntary control over the laryngeal reflexes during conscious state, resulting in regaining control of respiration after a potential aspiration episode.11 Sedation can cause altered pharyngeal functioning and altered swallowing breathing coordination, leading to an increased risk for aspiration. Midazolam causes a decrease...
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...The Journey into Cultural Care and Diversity in Nursing: A Personal Framework I have had the opportunity to work in many different areas of nursing, and have learned a great deal regarding cultural care and diversity among patients and their families. I have used my past experiences in each different unit and healthcare facility to improve my communication and rapport with my patients and their families to improve the continuity of care. I have been exposed to patients from different countries, cultures, and religions on a daily basis. I believe that it is crucial for the nurse to build a trusting non-judgmental relationship with the patient and their families to show compassion. When caring for patients I listen to their concerns, decrease the stress levels and improve communication and recovery. As a nurse I must take in consideration the culture and religion in which they come from, and care for them appropriately to avoid upset and miscommunication. My goal and focus is to use holistic care to provide the patient with a successful recovery. My personal framework paper will be expressing my own personal journey as a bedside nurse and using my own personal beliefs, values, and philosophies related to caring for culturally diverse patients. Madeleine Leininger’s Cultural Care Diversity and Universality Theory, and the nursing metaparadigm will be discussed, and shown how it is incorporated into my daily nursing practice. Philosophy In McEwen and Wills (2011), Empiricism...
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...WHO Guidelines on Hand Hygiene in Health Care: a Summary First Global Patient Safety Challenge Clean Care is Safer Care a WHO Guidelines on Hand Hygiene in Health Care: a Summary © World Health Organization 2009 WHO/IER/PSP/2009.07 All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: bookorders@who.int). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; e-mail: permissions@who.int). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable...
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...NCSBN ON-LINE REVIEW 1.A client has been hospitalized after an automobile accident. A full leg cast was applied in the emergency room. reason for the nurse to elevate the casted leg is to A) Promote the client's comfort B) Reduce the drying time C) Decrease irritation to the skin D) Improve venous return The most important D: Improve venous return. Elevating the leg both improves venous return and reduces swelling. Client comfort will be improved as well. 2. The nurse is reviewing with a client how to collect a clean catch urine specimen. What is the appropriate sequence to teach the client? A) B) C) D) Clean the meatus, begin voiding, then catch urine stream Void a little, clean the meatus, then collect specimen Clean the meatus, then urinate into container Void continuously and catch some of the urine A: Clean the meatus, begin voiding, then catch urine stream. A clean catch urine is difficult to obtain and requires clear directions. Instructing the client to carefully clean the meatus, then void naturally with a steady stream prevents surface bacteria from contaminating the urine specimen. As starting and stopping flow can be difficult, once the client begins voiding it’s best to just slip the container into the stream. Other responses do not reflect correct technique 3. Following change-of-shift report on an orthopedic unit, which client should the nurse see first? A) B) C) D) 16 year-old who had an open reduction of a fractured wrist 10 hours ago 20 year-old...
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...SITUATION : Arthur, A registered nurse, witnessed an old woman hit by a motorcycle while crossing a train railway. The old woman fell at the railway. Arthur rushed at the scene. 1. As a registered nurse, Arthur knew that the first thing that he will do at the scene is A. Stay with the person, Encourage her to remain still and Immobilize the leg while While waiting for the ambulance. B. Leave the person for a few moments to call for help. C. Reduce the fracture manually. D. Move the person to a safer place. 2. Arthur suspects a hip fracture when he noticed that the old woman’s leg is A. Lengthened, Abducted and Internally Rotated. B. Shortened, Abducted and Externally Rotated. C. Shortened, Adducted and Internally Rotated. D. Shortened, Adducted and Externally Rotated. 3. The old woman complains of pain. John noticed that the knee is reddened, warm to touch and swollen. John interprets that this signs and symptoms are likely related to A. Infection B. Thrombophlebitis C. Inflammation D. Degenerative disease 4. The old woman told John that she has osteoporosis; Arthur knew that all of the following factors would contribute to osteoporosis except A. Hypothyroidism B. End stage renal disease C. Cushing’s Disease D. Taking Furosemide and Phenytoin. 5. Martha, The old woman was now Immobilized and brought to the emergency room. The X-ray shows a fractured femur and pelvis. The ER Nurse would carefully monitor Martha for which of the following...
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...LEAN HOSPITALS “Mark Graban’s book has documented what is now happening in hospitals all across America as we learn to apply the Toyota Production System methodology to healthcare. This book lays out the nuts and bolts of the lean methodology and also describes the more difficult challenges, which have to do with managing change. Graban’s book is full of wins—these are the same type of wins that are happening at ThedaCare every day. I wish I could have read this book six years ago, as it might have prevented some of the mistakes we made in our lean transformation journey.” — John S. Toussaint, MD, President/CEO ThedaCare Center for Healthcare Value “Coupled with a foundation of alignment and accountability, the ideas in this book provide a powerful tool to help hospitals get closer to the goal we want – perfect care.” — Quint Studer, CEO, The Studer Group, author of Results that Last “Mark Graban is the consummate translator of the vernacular of the Toyota Production System into the everyday parlance of healthcare. With each concept and its application, the reader is challenged to consider what is truly possible in the delivery of healthcare if standardized systems borrowed from reliable industries were implemented. Graban provides those trade secrets in an understandable and transparent fashion.” — Richard P. Shannon, MD, Frank Wister Thomas Professor of Medicine, Chairman, Department of Medicine, University of Pennsylvania School of Medicine “There is an...
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...PRELIMINARIES LUPANG HINIRANG Bayang magiliw, Perlas ng Silanganan Alab ng puso, sa dibdib moy buhay Lupang hinirang, duyan ka ng magiting Sa manlulupig, Di ka pasisiil Sa dagat at bundok Sa simoy at sa langit mong bughaw, May dilag ang tula At awit sa paglayang minamahal, Ang kislap ng watawat mo’y Tagumpay na nagniningning Ang bituin at araw niya Kailan pa ma’y di magdidilim Lupa ng araw ng luwalhati’t pagsinta Buhay ay langit sa piling mo Amimg ligaya na pag may mang-aapi Ang mamatay nang dahil Sa’yo. Panatang Makabayan Iniibig ko ang Pilipinas, Aking lupang sinilangan, Tahanan ng aking lahi, Kinukupkop ako at tinutulungan Maging malakas, masipag at marangal. Dahil mahal ko ang Pilipinas, Diringgin ko ang payo Ng aking magulang, Susundin ko ang tuntunin ng paaralan, Tutuparin ko ang tungkulin Ng mamamayang makabayan: Naglilingkod, nag-aaral at nagdarasal Ng buong katapatan Iaalay ko ang aking buhay, Pangarap, pagsisikap Sa bansang Pilipinas Panunumpa sa Watawat ng Pilipinas Ako ay Pilipino. Buong katapatang nanunumpa Sa watawat ng Pilipinas At sa bansang kanyang isinasagisag Na may dangal, katarungan at kalayaan Na ipinakikilos ng sambayanang ...
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...Finance Course: Health Care Finance Readings MBAHC−4 California College for Health Sciences MBA Health Care Program McGraw-Hill/Irwin abc McGraw−Hill Primis ISBN: 0−390−55313−1 Text: Advanced Financial Accounting, Sixth Edition Baker−Lembke−King Harvard Business School Accounting Cases Corporate Finance, Seventh Edition Ross−Westerfield−Jaffe Harvard Business Review General Management Articles Harvard Business School Finance Cases This book was printed on recycled paper. Finance http://www.mhhe.com/primis/online/ Copyright ©2005 by The McGraw−Hill Companies, Inc. All rights reserved. Printed in the United States of America. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without prior written permission of the publisher. This McGraw−Hill Primis text may include materials submitted to McGraw−Hill for publication by the instructor of this course. The instructor is solely responsible for the editorial content of such materials. 111 FINAGEN ISBN: 0−390−55313−1 Finance Contents Ross−Westerfield−Jaffe • Corporate Finance, Seventh Edition I. Overview 1 1 20 34 34 69 97 129 151 151 192 192 214 214 248 1. Introduction to Corporate Finance 2. Accounting Statements and Cash Flow II. Value and Capital Budgeting 4. Net Present Value 5. How to Value Bonds and Stocks 7. Net Present Value and...
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