...this workbook file. There are 16 questions. Type each answer into the space provided below the question. Attach a correctly completed assignment submission sheet and submit to FOSHE office (H block) by the due date and time. Objectives: The purpose of this assessment is for you to demonstrate your understanding of basic elements of the research process by applying concepts about the research process, and learning to read research articles. Instructions: How to answer the questions: You must answer each question using your own words. Do not use quotations as this demonstrates that you can find information but does not demonstrate that you understand a concept. Quoted material will not be counted in the answer that the marker is assigning marks to. Using resources to answer the questions: You are expected to use your prescribed textbook, other up to date research texts and journal articles about research methods and evidence based practice, as well as the 5 key research articles themselves (details below). It is not sufficient to transfer information from the set text (nor from other sources). Lecture notes are not an appropriate reference although they may lead you in the direction of an appropriate published source. Formatting the answers: You will see that there is a table box for you to enter your answer following each question. This box will expand as you type in your answer. Use 1 ½ line spacing (the template is already set at...
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...Nurs 2820 Skin Integrity and Wound Care Student: Navjot Kaur Case Study Dale Gordon has been a client in the ICU for 6 days after developing complications after open heart surgery. He is an 82-year-old African American who is disoriented to place and time. He lives with his daughter Claudia in her home. Claudia and her two brothers visit Mr. Gordon daily since he has been hospitalized. Mr. Gordon has not been eating well since the surgery and has lost 3 pounds. Mr. Gordon has type 2 diabetes and is on oral antihyperglycemic medication. Before he came to the hospital, Mr. Gordon was able to only ambulate for short distances. He has orders to get up in a chair twice a day. Joan, a student nurse, is caring for Mr. Gordon this morning. She has reviewed his medical record and is now ready to start caring for him. 1. Joan assesses Mr. Gordon using the Braden Scale and determines that his score is 12. What does this score indicate about Mr. Gordon’s pressure ulcer risk? Explain what the Braden score is. * Mr. Gordon has a high risk of developing a pressure ulcer because his score is a 12 on the Branden Scale. The lower the score on the Branden Scale (6-23) the higher the risk of developing a pressure ulcer. The Branden Scale is used to determine any limitations with a patient’s sensory perception, activity, nutrition, moisture, and mobility. 2. Joan is assessing Mr. Gordon’s skin and notices that he has a 3 cm blister and a shallow crater on his buttock. Mr. Gordon...
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...instrument specifically designed to aid health care workers evaluate the dangers of pressure sores that a patient faces is called the Braden Scale. After assessment, the victim is categorized depending on six aspects: capability of physical activity, hydration and nutrition status, capacity to alter position, the ability to respond after sensing discomfort related to pressure, shearing or exposure of the skin to friction during locomotion, and skin exposure to moisture. If the overall score is lower it means the risk of pressure sore is higher (Changing Practice, Changing Lives: 10 Landmark Nursing Research Studies, n.d). Prior to this Change, Skin assessment was based on non- formalized risk assessment which varies with each clinical practice. 2. Discuss why the current nursing practice needs to be changed Using non-formalized risk assessment in Predicting pressure ulcer resulted in non-uniformity and personal clinical judgement which varies from one person to another. Using Clinical judgement is more effective where the staffs are experienced and their experience assist in appropriate predictability, but with novice staff, the use of clinical judgment is inappropriate. In a multisite trial, Braden scale was tested by clinics bringing together skilled nursing facilities, Veterans Administration or VA medical centers and hospitals providing tertiary care. Of those who took part, none had experienced pressure sores earlier. Nurses evaluated those who took part in the trial with the...
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...Evidence Based Practice & Pressure Ulcers Matthew Slawter Chamberlain College of Nursing NR451 RN Capstone Course November 2014 Evidence Based Practice & Pressure Ulcers Evidence based practice (EBP) gives nurses a method to use critical appraised data and scientific evidence that is proven to confirm the delivery of quality health care to a patient population. Pressure ulcer prevention continues to be a major and growing concern among todays patients and healthcare providers. This problem is a concern because prevention of pressure ulcers can be accomplished through good skincare techniques and increased education of nurses. The field of nursing along with the healthcare industry can benefit from simply decreased the occurrence of pressure ulcers. The general purpose of this proposal is to determine if the value nurses place on skincare and pressure ulcer prevention can decrease the incidence pressure ulcers. Change Model Overview The John Hopkins Nursing Evidence-Based Practice Process is simply related to the complex challenges organizations and nurses face with the implementation of evidence-based practice and translation. Furthermore, this process provides guidelines for managing the process, structure, and evidence translation among various healthcare settings and outcomes of EBP projects. Nurses should use this process as a guide to facilitate change as it suggest leadership and planning for EBP measurement, identification, evaluation and monitoring...
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...nursing-sensitive indicators could assist the nurses in this case in identifying issues that may interfere with patient care. Nursing-sensitive indicators are determinations used to delineate the excellence of nursing interventions and positive patient outcomes. This is not a new concept. In the 1800’s, Florence Nightingale, a promoter of outcomes, revealed such indicators when she revealed her statistical findings of soldier’s mortality rate associated to environmental conditions during the Crimean War (Fee & Garofalo, 2010). Over the past decades, various studies world-wide have been conducted on the connection of nursing quality indicators and their outcomes. The American Nurses Association (ANA) recognized these studies were an important focus in evidenced-based practice among the nursing profession; and in 1998, they 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...
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...availability of nursing staff, and the education level/certification level of the nursing staff. The process portion of nursing sensitive indicators measures assessments performed by nurses, appropriate nursing interventions and job satisfaction of nurses. (American Nurses Association). Finally, outcomes of nursing care according to the American Nurses Association, measures the quantity and quality of nursing care, for example, prevention of pressure ulcers, prevention of patient falls, and IV infiltration to name a few. Given the scenario in this case, there were several nursing sensitive indicators present that could have been prevented provided that the staff involved received proper training and had a strong foundational understanding of nursing-sensitive indicators. To begin the case of Mr. J, there was no definite explanation of why the restraints were applied. This is an appropriate opportunity for education related to restraint use. Although Mr. J was given pain medication, he obviously knew where he was by being able to answer simple questions when asked. The question then becomes why was restraints applied. Restraints require a physician’s order was there an order? It seems that the staff in this scenario has not been properly trained in regards to restraint use. Restraints are used as a last resort only. While in restraints staff must provide proper patient care and documentation....
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...Intro: What are Pressure Ulcers? Cayuga Medical Center’s Initiative Ideally, in modern medicine patients with wounds are bought to treatment facilities and when they leave they are healthier than when they came in. However, one problem threatens to change this. Pressure Ulcers, which form because of skin pressure reducing blood flow to an area of the body, have a habit of forming in patients with a variety of long-term problems as they are cared for in hospitals and nursing homes. The result of this is that in addition to whatever other problems a patient may have, the ulcer causes the skin and the tissue beneath the skin to die, and if the dead tissue is not quickly removed it can cause additional problems and pain for the patient. There are several factors that put one at risk of pressure ulcers, and these conditions are often difficult or impossible to treat. A typical pressure ulcer patient: suffers from mobility problems, is an older adult, has a spine or brain injury or disease such as multiple sclerosis, has a disease or condition that affect ones mental status, has fragile skin, has urinary incontinence or bowel incontinence or does not get enough nutrition. As most of these conditions are symptoms of old age or mental illness, these people will always be at risk of pressure ulcers, meaning the pressure ulcer prevention is there best chance of living comfortably. Pressure Ulcers can be treated but they are painful and if untreated they can result in death. They are...
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...Low Energy Laser as a Treatment for Refractory Diabetic Leg Ulcers By Wendy Price Wake Forest University Department of Physician Assistant Studies 4/10/2009 I would like to thank everyone at Coy C. Carpenter library help and reference desks. To Ekatrina Zachry who translated the Russian research papers, thank you is the very least I can say for such an excellent job. I would like to tell my girls how proud I am of them and thank them for their patience, pictures, and prayers. You make it all worth the while. I would also like to thank my mother for her support, coming to help with the girls while I have been in school, and her motherly faith in me that never waivers. Most of all I want to thank my husband Clay Price for being an amazing pillar of strength, encouragement, patience, understanding, and love. I know I COULD NOT have done it without you. UA&F Low Energy Laser as a Treatment for Refractory Diabetic Leg and Foot Ulcers ABSTRACT BACKGROUND: Diabetic leg and foot ulcers often lead to immobility, infection, and amputation, cost $7,000 to $40,000 per ulcer, and erode mental health and QOL. Lasers have been effectively utilized in medicine since the 60’s, from various surgical uses to the treatment of diseases. Although low-energy (also called low-power, low-level, and cold) laser therapy for “biostimulation” (or biomodulation) of ulcer healing has been studied extensively, quality data on diabetic wound healing is rare. This review seeks...
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...BSBMED301B: Assignment 1 What you have to do Using the learning resource provided answer the following questions: Question 1 Using your knowledge of word components, give the correct medical term for each of the definitions below. Definition Medical Term 1. rectal hernia Rectocele 2. excision of the stomach Gastrectomy 3. inflammation of the kidney Nephritis 4. enlargement of the liver Hepatomegaly 5. incision to remove a stone Lithotomy 6. fixation of the intestine Enteropexy 7. artificial opening in the colon Colostomy 8. incision into the abdomen Laparotomy 9. absence of one or both testes Anarchism 10. rupture of the uterus Hysterorrhexis 11. excision of the prostate gland Prostatectomy 12. visual examination of the vagina Colposcopy 13. surgical repair of a testicle Orchiopexy 14. discharge of milk Galactorrhea 15. difficult labour or delivery Dystocia 16. suture of the tongue Glossorrhaphy 17. surgical puncture of the abdomen Abdominocentesis 18. pus in the urine Pyuria 19. pertaining to above the kidney Suprarenal 20. narrowing of the urethra Urethral Stricture Question 2 Give the meaning of each of the abbreviations below. Abbreviation Medical Meaning 1. LUQ Left upper quadrant 2. GI Gastrointestinal 3. OGD Oesophago-gastro duedenoscopy 4. CVS Chorionic villus sampling 5. STD Sexually transmitted disease 6. IUD Intrauterine device 7. TURP Transurethral resection of the prostate 8. DRE Digital rectal...
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...Running Head: Older Adults 1 Essential Care of Frail Older Adults Mary Anne V Wheeler Lane Community College Abstract This paper explores the Institute for Healthcare Improvement’s map for the patient process of essential care for the elderly. It summarizes the IHI map and then discusses the specific goals of The Joint Commission (TJC) and how they relate to the IHI map. The paper then continues on to discuss how the standards of TJC are put into effect at McKenzie Willamette hospital to provide the essential care for the older patient. Essential Care of Frail Older Adults Overview On the improvement map from the Institute for Healthcare Improvement’s (IHI) website, the patient process “Essential Care for Frail Older Adults” is outlined. IHI states that the purpose of this process is to “Ensure coordinated, reliable, and safe care for frail older patients as they enter the hospital.” As the title of the map indicates this patient process is related to the care of our older adult patients. The IHI website indicates that it would be moderately challenging to implement this patient process for the following reason “Either it involves multiple units or disciplines OR requires a substantial shift in culture an/or operations, but not both of these.” This patient process will need to be implemented in any medical facility that may treat the frail older adult including medical, surgical and emergency departments of hospitals along with nursing...
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...Hunter Bowen ID#:50241787 Clinical Practicum 3: Microbiology Case Study Number 1: 1. What is the common term for “decubitis ulcer”? * Bedsores or pressure ulcers 2. What does the term “tachycardia” mean? * Abnormally fast resting heart beat, usually at least a 100 beats per minute 3. What does “hypokalemia” mean? * A condition of below normal levels of potassium in serum levels 4. What is the significance of the fact the larger decubitis on the left hip is necrotic and exuding pus? * Necrotic tissue is the ideal place for bacterial growth, which can greatly compromise the healing process for that wound. * Surgical excision of black necrotic tissue may be necessary to reduce infection and smell. Pain in a deep pressure sore is unusual and suggests pus under a necrotic slough, which can be painlessly excised without local anesthetic to release the pus. * Pus contains that person’s dead or dying white blood cells, and the fact that they there are in such abundance leads one to believe that they are indeed fighting an infection. 5. Does the fact numerous pus cells seen on the Gram stain support your conclusion? * Yes, there are many white blood cells (pus cells) to help fight of that person’s infection. 6. What type of white blood cells are “pus cells” usually, especially considering the fact that bacterium were also seen? * Pus is mostly made up of neutrophils 7. What microscopic morphtype...
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...the every 10dB increase in a certain sound indicates that there is ten times increase in the intensity of the sound. A Sound measuring 120dB is very much capable to damage the eardrums. However if the intensity of sound is about 85dB can already be hazardous to the ears if the person is exposed to it continuously. If you are being continuously exposed to such intense sound can bring health problems like damaged eardrums. Source of Noise Pollution: Basically there are 2 major sources for noise pollution, i.e indoor and outdoor sources. Loud music and noise made by some electrical appliance makes the contribution towards the cause of indoor noise pollution and noise from vehicles and industrial machines are under the outdoor source. If past study and statistics is to be believed outdoor source contribute more to this kind of pollution compared to indoor source that is why urban places have higher noise pollution compared to rural places. Effects of noise pollution:If a person is being continuously exposed to high decibel sounds has greater risks of developing health problems. And finally the disorder will lead to acoustic trauma. It can also leads to various psychological problem. The other associated problems of noise pollutions are difficulty in hearing,...
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...Answer the following questions in relation to the information provided in this case study: 1. Define MRSA? Why is it antibiotic resistant? Discuss the complications this organism may have on wound healing and other body systems. Methicillin-resistant Staphylococcus aureus is a bacterium that causes infections in many parts on the body. MRSA is tougher to treat, as it is resistant to most commonly used antibiotics. (Mayo Clinic, 2014) MRSA is normally contracted from person to person through direct contact with a person that has MRSA. This proves to be very complicated when a person with MRSA have a wound, they are often more challenging to treat due to the reduced number of antibiotics accessible to treat them. (Department of Health, 2014) An Antibiotic resistant bacterium is when bacteria is not able to be controlled or killed by antibiotics. This certain bacterium is able to survive through courses of antibiotics and even multiply in the process. 2. What special infection control considerations would you implement for Mr Jones? In your answer include the following – The infection...
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... Staphylococcus is more familiarly known as Staph (pronounced "staff"). Staph-related illness can range from mild and requiring no treatment to severe and potentially fatal. The name Staphylococcus comes from the Greek staphyle, meaning a bunch of grapes, andkokkos, meaning berry, and that is what Staph bacteria look like under the microscope, like a bunch of grapes or little round berries. (In technical terms, these are gram-positive, facultative anaerobic, usually unencapsulated cocci.) Over 30 different types of Staphylococci can infect humans, but most infections are caused byStaphylococcus aureus. Staphylococci can be found normally in the nose and on the skin (and less commonly in other locations) of 25%-30% of healthy adults. In the majority of cases, the bacteria do not cause disease. However, damage to the skin or other injury may allow the bacteria to overcome the natural protective mechanisms of the body, leading to infection. And one of the cures for staphylococcus aureus is vitamin c which is found in malunggay. Called "Malunggay" in the Philippines, "Sajina" in the Indian Subcontinent, and "Moringa" in English, it is a popular tree. Many Asians use the leaves of Malunggay (Sajina) like spinach and also the fruit it produces as a vegetable, like asparagus. Both the leaves and the fruits are very nutritious, which contain many vitamins like Vitamin C and other minerals. For centuries, people in India, Philippines, Malaysia, and Thailand have been eating these leaves as a part...
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...Case Studies Weeks 1-4 Advanced Anatomy and Physiology Name: Robert Mixon Student ID#: 4321101 Case Studies – Instructions: Type your answers IN RED and use your textbook and other resources such as the ones listed below to help you answer the questions. Merck Manual of Diagnosis and Therapy: http://www.merck.com/mmpe/index.html MedlinePlus: Medical Dictionary: http://www.nlm.nih.gov/medlineplus/mplusdictionary.html E-medicine from WebMD: http://emedicine.medscape.com/________________________________________ Case #1: Jim and Jane Magnolia have tried for years to conceive a child, with no success. So instead, they have decided to adopt a child. They have found a beautiful little girl named Emma who has been given up by her mother....
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