...practice of self-care skills, compared to not, demonstrate less compassion fatigue? Definitions for terms marked with * may be found in the Supporting Information section. Target Population for the Recommendation: Nurses working in pediatric intensive care settings who provide direct patient care Recommendation: It is recommended that nurses working in pediatric intensive care settings receive training that includes compassion fatigue awareness, coping strategies, stress management, relaxation techniques and self-care interventions to decrease the level of compassion fatigue experienced in the work environment (Marine, Ruotsalainen, Serra, & Verbeek (2009) [1a]; Gunusen, & Ustun (2010) [2a]; Kravits, McAllister-Black, Grant, & Kirk (2010) [4a]; Meadors & Lamson (2008) [4a]). Discussion/Synthesis of Evidence related to the recommendation: The evidence referred to a variety of concepts related to the manifestation of compassion fatigue, including burnout, emotional exhaustion, and workplace stress. The concepts were all similar in referring to nurses’ limitations in providing a high standard of patient care due to the events, experiences and challenges associated with their job responsibilities. Meadors & Lamson (2008) [4a] discussed evidence specifically focused on compassion fatigue. The researchers reported significantly more negative behaviors and feelings (p = 0.001-0.003) demonstrated by the...
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...Running Head: NEWBORN ASSESSMENT AND CARE PLAN Newborn Assessment and Care Plan Newborn Assessment On 1/29/09, at 0610, 39 week gestational age, 7lb 4.6oz, black male was born to 18 year old mother. Infant born via vaginal delivery with assistance of vacuum extraction, nuchal cord x1 noted. Mother received adequate prenatal care beginning at 8weeks. Prenatal medications included Iron supplements and prenatal vitamins. Prenatal complication included pregnancy induced hypertension. Onset of labor 0647, full dilation 1705, and delivery of infant at 1810. Apgar scores 6/8.Weight 3305gms, length 20 inches, head circumference 12 inches, chest circumference 12 ¾ inches, abdominal girth 12 inches. The infant is alert and active. Anterior fontanel is soft and flat. No oral lesions. Head caput/ molding, elongated with edema, abrasion noted from suction. Color is pink and changing all over (African American.) Skin is warm, dry, and well perfused. No rashes, vesicles, or other lesions noted. Birthmark present on forehead approximately 2cm. Bilirubin test ordered. Lanugo present. Hair pattern is scattered evenly all over, fine texture and moderate amount. Eyes symmetrical and in midline. No discharge present from eyes. Eyes move from left to right and sclera is white. Eyebrows are fine and symmetrical. Nose is patent and midline. Ears present symmetrically. Mouth midline. Gums and tongue pink and moist. Cheeks symmetrical with no lesions. Saliva present. Chin well aligned on face...
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...Sepsis An Overview Health And Social Care Essay ukessays.com /essays/health-and-social-care/sepsis-an-overview-health-and-social-careessay.php Sepsis is an infection of the bloodstream. The infection tends to spread quickly and often is difficult to recognize. One of our roles as a nurse is that of patient advocate, and as such we are closest to the patient, placing us in a key position to identify any subtle changes at their earliest onset and prevent the spread of severe infection. Knowledge of the signs and symptoms of SIRS, sepsis, and septic shock is key to early recognition. Early recognition allows for appropriate treatment to begin sooner, decreasing the likelihood of septic shock and life-threatening organ failure. Once sepsis is diagnosed, early and aggressive treatment can begin, which greatly reduces mortality rates associated with sepsis. sep•sis (ˈsep-səs) n. Sometimes called blood poisoning, sepsis is the body's often deadly response to infection or injury (Merriam-Webster, 2011) Sepsis is a potentially life-threatening condition caused by the immune system's reaction to an infection; it is the leading cause of death in intensive care units (Mayo Clinic Staff, Mayo Clinic 2010). It is defined by the presence of 2 or more SIRS (systemic inflammatory response syndrome) criteria in the setting of a documented or presumed infection (Rivers, McIntyre, Morro, Rivers, 2005 pg 1054). Chemicals that are released into the blood to fight infection trigger widespread inflammation...
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...Risk factors of tachypnea are decreased SPO2, respiratory arrest, severe anxiety, hypovolaemic shock. Nursing interventions for Tachypnea: 1. Assess respiratory quality, rate, depth, effort and pattern. Rationale: Flaring of the nostrils, tachypnea are signs of severe distress that require immediate intervention. 2. Assess for mental status changes. Rationale: Confusion, restlessness can be early signs of cerebral hypoxia. 3. Administer supplemental oxygen Rationale: Early supplemental oxygen is essential in all trauma patients since early mortality is associated with inadequate delivery of oxygenated blood to the brain and vital organs. 4. Position patient in a semi-fowler’s position. Rationale: promotes better lung expansion and improved gas exchange. 5. Assess changes in vital signs Rationale: Tachycardia and hypertension occur with increasing work of breathing. The types of respiratory disease are asthma, allergies, COPD, emphysema, lung cancer, sinusitis. Factors contributing to one having tachypnea are chronic obstructive pulmonary disease, asthma, and or heart attack, stress and...
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...Rule out diagnoses or differential diagnoses are diagnoses that appear to share similar symptoms as the one that is being used for the client. Erika’s diagnosis is PTSD. Differential diagnosis are any other trauma-and-stressor related disorders such as adjustment disorder, and acute stress disorder. Acute stress disorder is differentiated from PTSD due to Acute Stress Disorder has a duration of three days to one month. Anxiety disorders such General Anxiety Disorder, Obsessive Compulsive Disorder (OCD), Agoraphobia, Social Anxiety, and Specific Phobias can appear like some of the avoidant symptoms in PTSD, and the desire for things to be done in a certain order. OCD can appear like PTSD due to the presence of intrusive thoughts, but the thoughts usually are not due to a traumatic event and such is the same with any other anxiety disorder. Major Depression Disorder (MDD) can sometimes be diagnosed along with PTSD as the symptoms of PTSD may cause eventual depression but MDD lacks criterion C and D of PTSD. PTSD can also present like psychotic symptoms so differential diagnosis may be Schizophrenia, Bipolar Disorder, and...
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...INTRODUCTION Rationale of the Study The ship is a unique environment that it is not only a place of work but at the same time a home to seafarers working on board. Working on ships entails seafarers’ absence for a long period away from home. This situation and other conditions on board such as the weather and the crewing arrangement may compound the situation of seafarers aboard ship. This results into various psychological experiences that could lead to psychosocial problems such as stress, alcohol, tobacco and drugs, HIV/Aids, and violence, consequently, affecting their health, well-being and effectiveness in work. Each of these factors is correlated with each other that one problem may either cause another or be the result or effect of another problem. This greatly affects to the cadets/cadetes in the maritime world who are new to this profession Towards this end, the selected students of the NSA 16th batch 4th year cadets conducted this exploratory study to generate information on the sources of stress of RCPO cadets on board ships and the coping mechanisms employed to minimize the impact of stress. This information will then be used to highlight the good practices/strategies in managing stress on board with the end view of boosting the quality of RCPO cadets in the international labour market. Specifically, the study pursued the following objectives: 1. Determine the sources of stress of RCPO cadets; 2. Identify the different manifestations of stress among...
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...THE CHANGE TO DIFFERENT STORES AND THE STRESS IT HAS CAUSED Table of Contents Table of Contents 3 EXECUTIVE SUMMARY 4 1. INTRODUCTION 5 2. EVALUATION OF FACTORS IMPACTING EFFECTIVE IMPLEMENTATION OF CHANGE 5 3. CRITICAL EVALUATION OF CHANGE MANAGEMENT MODELS 8 4. CHANGE MODEL TO USE FOR ORGANISATION 10 5. CONCLUSION AND RECOMMENDATIONS 12 REFERENCES 13 EXECUTIVE SUMMARY The management of change in organisations is important in order to be able to implement change effectively. There are different change management models that can be utilised in implementing change in organisations with the different models having their advantages and disadvantages. Examples are Kotter's eight-step model and the CIPD's stress management model. The recommendations for M&S in Durham to improve the performance of the stores are as follows: Follow the 8-step Kotter model as the framework for change implementation. Involve the employees in the discussion of the changes and define the timing of the process pre- and post-implementation. Communicate to the wider employee group the approach being taken and the involvement of selected employees in the change management. These key recommendations are designed to support an effective implementation of change management. 1. INTRODUCTION This report provides an understanding of the factors impacting effective implementation of change. Marks and Spencer is undergoing a change in one of its...
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...Postpartum Case Study May 26, 2016 Postpartum Case Study Admission Assessment J.B. a 38-year-old female, G5, P3 (SAB 2, L3) admitted on 5/09/16 at 0930 for a scheduled repeat cesarean section. The patient’s chief complaint is minor contractions and concern from previous SAB (Spontaneous Abortions). J.B’s 1st pregnancy ended at 13 weeks with a SAB. 2nd pregnancy ended by C-section at 37 weeks due fetal intolerance. Her 3rd pregnancy ended at 38 weeks with a repeat C-section and her 4th pregnancy ended at 11 weeks with a SAB. Bringing us to this pregnancy number 5. J.B. chose to have a repeat C-section, because her physician recommended it due to a prior C-section. Multiple scars on uterus increase the risk for several serious problems for women and fetus. These risks include: scar rupture, placenta previa, placental abruption, and placenta accrete (Tobah, 2015). A high-risk pregnancy involves at least one of the following; the woman or baby is more likely to become ill or die more than usual. Complications before or after delivery are more likely to occur than usual. High-risk pregnancies must be closely monitored. Some risk factors are present before women become pregnant. These risk factors include certain physical and social characteristics of women, problems that have occurred in previous pregnancies, and certain disorders women already have. In J.B.’s case she had a high-risk pregnancy due to several reasons, she has advanced maternal age > 35, prior miscarriages...
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... ¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬-__________________________________________________________________________________________________________________ IDENTIFIED NURSING DIAGNOSIS SHORT-TERM GOAL INTERVENTIONS NURSING ACTION TAKEN RATIONALE FOR NURSING INTERVENTION EVALUATION OF THE EFFECTIVENESS OF THE SHORT-TERM GOAL I. Health Perception/ Management A. Nursing Diagnosis: Risk for Injury Subjective: Pt states he has lost his pep and stamina. Has shortness of breath with any exertion. Objective: Pt has Rheumatoid Arthritis and uses a walker. A. The pt will not fall during my shift 1. Provide night light 2. Keep patient’s room free of clutter 3. Assist the pt with all transfers and ambulation. If the patient requires multiple pillows for rest or positioning, tape the bottom layer of pillows to prevent dislodging. 1. Safety measures to prevent falling at night (Cox,2007,p.62) 2. Basic safety measures to prevent injury (Cox, 2007, p.62) 3. Assist in preventing suffocation or tripping on pillows. (Cox,2007,p.62) Goal was met. Pt ambulated with one person assist. Gait belt was used and non-skid socks. Identified Nursing Diagnosis Short-term Goal Interventions Nursing Action Taken Rationale for Nursing Intervention Evaluation of the Effectiveness of the Short-term Goal II. Nutrition-Metabolic B. Nursing Diagnosis: Nutrition, Readiness for Enhanced Subjective: Pt states he is having trouble eating because his dentures keep slipping...
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...COPD All respiratory diseases characterized by chronic obstruction to airflow fall under the broad classification of COPD, also known as chronic airflow limitations (CAL). COPD is a condition of chronic dyspnea with expiratory airflow limitation that does not significantly fluctuate. Within that broad category, the primary cause of the obstruction may vary; examples include airway inflammation, mucous plugging, narrowed airway lumina, or airway destruction. The term COPD includes chronic bronchitis and emphysema. Although asthma also involves airway inflammation and periodic narrowing of the airway lumina (hyperreactivity), the condition is the result of individual response to a wide variety of stimuli/triggers and is therefore episodic in nature with fluctuations/exacerbations of symptoms. Asthma: Also known as chronic reactive airway disease, asthma is characterized by reversible inflammation and constriction of bronchial smooth muscle, hypersecretion of mucus, and edema. Precipitating factors include allergens, emotional upheaval, cold weather, exercise, chemicals, medications, and viral infections. Chronic bronchitis: Widespread inflammation of airways with narrowing or blocking of airways, increased production of mucoid sputum, and marked cyanosis. Emphysema: Most severe form of COPD, characterized by recurrent inflammation that damages and eventually destroys alveolar walls to create large blebs or bullae (air spaces) and collapsed bronchioles on expiration (air-trapping)...
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...1. John is exhibiting Cardiogenic Shock because of the given signs and symptoms with and because of patient history of extensive myocardial infarction. Signs and Symptoms Rationale Decreased level of consciousness due to decreased blood flow to the brain Pale because decrease of blood flow Sweating due to sympathetic compensatory response Cool peripherally due to reduction of cardiac output 2. Pathophysiology of Right-sided heart failure and left-sided heart failure. Right-ventricular failure Right-sided heart failure means that the right side of the heart is not pumping blood to the lungs as well as normal. This usually occurs as a result of left-sided heart failure. When the left side of your heart fails, the pressure increases in the...
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...Children, Parents and teachers Topic: Child Obesity Epidemiological Rationale for Topic (statistics related to topic): Most of the children I see in my neighborhood are obese. So teaching them at an early stage is the best idea so that they will grow up know what is right and what is wrong to eat. “In New York City, 1 in 5 kindergarten students, and 1 in 4 Head Start children, is obese”,(NYC Health, 2015, pp 1) Nursing Diagnosis: Readiness for Enhanced Nutritional Metabolic Pattern. 1. Improving the overall eating habits 2. Showing them unhealthy and healthy foods Readiness for Learning: Identify the factors that would indicate the readiness to learn for the target aggregate. Include emotional and experiential readiness to learn. 1. Showing up for the presentation 2. Participating and asking questions about obesity 3. Listening and return demonstrations Learning Theory to Be Utilized: Explain how the theory will be applied. Ask children what foods they prefer eat and why. Then ask parents what foods should be given to their children. Then discuss the impact of unhealthy and healthy foods has on our bodies. The complications of obesity will be discussed. Stress the importance of physical activities. Goal: Healthy People 2020 (HP2020) objective(s) utilized as the goal for the teaching. Include the appropriate objective number and rationale for using the selected HP2020 objective (use at least one objective...
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...following: o Based on the characteristics described in the case study, speculate the other lines of business you think vets would excel in and provide a rationale. I think veterans can excel in lot of different business’ based on their military experience. Veterans have acquire different skills as well as work ethics. Other lines of business could be owning their own, especially in services. For instance a business in mechanics, auto or equipment repair. Construction, truck driving, animal trainers, personal trainers, security, electrical equipment, refrigeration equipment, restaurants and computer based business, to mention a few. Veterans are a source of highly qualified individuals, they posses a wide range of skills and experience that can make them a great fir for a business. Going into the military requires discipline, loyalty and commitment. Which allows them to be proficient in their own business. They posses leadership and responsibility. Like being on time, finish the job, being able to handle stress, pride on what they do and teamwork. They are also capable of working long hours, which is important to start a new business, since they are time consuming. o Besides those discussed in the case, discuss other characteristics that are essential to the success of franchisees and provide a rationale. Other characteristics that are important to the success of a franchise are understanding the business before investing on...
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...What is internal control? Why is internal control important in organizations? Internal controls are processes established by a business or organizations board of directors, management and other personnel to provide reasonable assurance for that businesses objectives in effectiveness and efficiency, reliability of financial reports and compliance with laws and regulations. Internal controls are used to safeguard businesses assets. They help a to establish guidelines within a business and makes sure that everyone within that business follows those guidelines and procedures. Internal controls are important because without them a business would be more susceptible to fraud. Internal controls are used to prevent people from stealing from a business and to make sure all the rules are followed. Feedback: Internal control is a system of policies and procedures designed to help an organization run more efficiently and effectively. Without strong internal control, an organization is much more susceptible to various forms of risk which can compromise its operations and its financial reporting. What are the four basic purposes of internal control? Give an example of each one. The first purpose of internal controls is to safeguard assets. Internal controls should protect your assets such as cash. One internal control that helps with protection of assets is the segregation of duties, another is sequential numbering of checks or locking checks in a safe place. The second purpose is to ensure...
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...become dominant, helping to accommodate increased stress levels. This usually arises when levels of fear and anxiety are aroused (Appelhans & Luecken, 2005). Additionally, during periods of safety and stability, the parasympathetic system is dominant and maintains a lower degree of physiological arousal, helping to decrease heart rate (Appelhans & Luecken, 2005). Often when people are under high amounts of stress, a person’s HRV can fluctuate (Frazen et al., 2011). Additionally, HRV data can be altered when sleep deprivation is involved. Moreover, the autonomic systems are known to have drastic changes when sleep deprivation and stress are associated together (Appelhans & Luecken, 2005). Previous research has shown that the Trier Social Stress Task (TSST) does measure fluctuations in cardiovascular measures. One study conducted by Von Dawans and colleagues (2011) measured 25 healthy individuals using the TSST and looked at the results of each participant’s HRV levels, cortisol levels, and psychosocial stress. Results showed that the TSST did have significant...
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