...Agent Policy Paper Risk Management is defined as policies and procedures put in place to enhance infection control, patient safety, and quality of service. In healthcare there is always the risk of something getting out of hand and hurting a patient or even the staff of the facility. My facility is a Nursing Home/ Long-Term Care Facility about 2/3 of the residents are just elderly people suffering from ailing health, dementia, or Alzheimer’s. The other 1/3 is post-op recovery patients that need some where to recover before they head home; the average recovery time is 6-8 weeks. My facility has no one person dedicated to Risk Management. The closest we have is an Infection Control Nurse who is responsible for ensuring that no outbreaks of any sort happen and if it does happen it is her responsibility to ensure that the outbreak is contained as well. The Infection Control Nurse is also tasked with administering and keeping updated all records of TB tests. Upon asking her, I was informed that the current standards and policies were given to us during our initial employee orientation. My role as a Respiratory Therapist it falls to me to assist all the new patients as they come into our facility to determine their respiratory needs. Also in case of any code situation, it is the responsibility of the on-duty RT to take charge and stabilize the patient until Emergency Medical Services arrives and then transfer custody of the patient to EMS to deliver them to Emergency Department...
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...HUMIDIFICATION Claudine Billau The formation of a tracheostomy significantly alters the patient’s respiratory physiology. In bypassing the upper respiratory tract, the patient is more susceptible to changes in humidity and there is a consequential change in the function of the respiratory mucosa. Understanding these changes is fundamental to managing these patients effectively (see Chapter 1, Anatomy and Physiology of the Respiratory Tract). NORMAL MECHANISM OF HUMIDIFICATION The upper respiratory system: the nose, pharynx, larynx and the trachea (Fig. 1), normally provides an effective system for conditioning inspired gases. As well as acting as a filter for foreign particles and microbes, the upper airway also warms and humidifies inspired gases so that the gas travelling beyond the carina enters the lower airways and the alveoli at body temperature and fully saturated with water vapour.1 As inspired air enters the upper airway and passes over the nasal turbinates and conchae, gas flow becomes turbulent. This leads to an increase in the number of gas molecules coming into contact with the nasal mucosa. The nasal mucosa is highly vascular and is kept moist by a combination of secretions from mucous glands and direct transudation of fluid through cell walls.1,2 The secreted mucus is hydroscopic and its viscosity varies depending on its glycoprotein content.2,3 The turbulent gas flow results in an increasing efficiency in the warming and conditioning of inspired...
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...Laboratory biosafety manual Third edition World Health Organization Geneva 2004 WHO Library Cataloguing-in-Publication Data World Health Organization. Laboratory biosafety manual. – 3rd ed. 1.Containment of biohazards - methods 2.Laboratories - standards 3.Laboratory infection - prevention and control 4.Manuals I.Title. ISBN 92 4 154650 6 (LC/NLM classification: QY 25) WHO/CDS/CSR/LYO/2004.11 This publication was supported by Grant/Cooperative Agreement Number U50/CCU012445-08 from the Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC. © World Health Organization 2004 All rights reserved. Publications of the World Health Organization can be obtained from Marketing and Dissemination, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel: +41 22 791 2476; fax: +41 22 791 4857; email: bookorders@who.int). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to Publications, at the above address (fax: +41 22 791 4806; email: 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...
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...introduce yourself: Hi, my name is _, I’m a third year nursing student, and I will be administering your medication. “Are you _?” Check bracelet. “And when is your birthday?” Okay perfect. * Room safety checks. Is the oxygen pump working? * Explain procedure. Any questions? * I’m going to pre procedure assess. Wash hands and put on gloves. Respiratory assessment. I’m observing the patient and he seems comfortable at rest, he isn’t breathless, not cyanosed, his chest is symmetrical, no obvious use of accessory muscles. “I’m now going to listen to your lungs”; ausultate 12 lung fields. Say that there is mild wheezing, but it isn’t laboured. Time for medication! * Take resp rate, falls between 12-16 breaths/min. (adult) 3-6 yrs is 22-34 and 6-12 yrs is 18-30. Take O2 sat, over 92% is good. 3. Procedure: Make sure mask fits snugly over the mouth, nose and chin – check for firm seal. Put med in the canister, make sure the green thing is inside. Hook it up to the mask. Attach tube to oxygen pump. Turn it up to ~ 6 L/min. Have it steam before putting on face. Takes about 15 mins to administer. Make sure to knock on the canister to eliminate condensation bubbles, to deliver the maximum amount of the medication. 4. Wait about 10 minutes before reassessing the respiratory system. 5. Document NG tube med admin lab exam 1. Read doc order. Gather equipment & medication (2 syringes, 1 x 30 cc for flush, 1 x 10 cc for med, sterile water, basin) 2. Check...
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...Carvalho & Jillian Smythe March 21, 2014 Clinical Case Study Assignment 2014 The purpose of this paper is to utilize the data collected in the Gordon’s Functional Health Patterns Assessment Tool (Appendix A). After data collection, it will be analyzed and a priority nursing diagnosis will be used to make a care plan (Appendix B). Patient X is an 82 year old male, who presented to the emergency department from his home at Extendicare York with a fever of 38.9 degrees Celsius, a blood pressure of 75/40 mm Hg, blood glucose level of 3.7, diaphoretic and a three day history of diarrhea, nausea and generalized weakness. The admitting diagnosis for this 82 year old male was Pneumonia. Pneumonia is an acute inflammation of the lower respiratory tract due to an infectious agent that impairs gas exchange due to alveolar edema and congestion (Thiem, Heppner, & Pientka, 2011). There are many factors that predispose individuals to pneumonia; however, in the case of this patient the predisposing factors are age and the presence of chronic diseases. The patient’s complete history and demographics can be found in Appendix A. The classic clinical manifestations of pneumonia consist of a temperature above 38 degrees Celsius, diaphoresis, cough, and shortness of breath, chest pain, tachycardia, purulent sputum, fatigue, nausea, vomiting, and diarrhea (Thiem, Heppner, & Pientka, 2011). Physical examination will show signs of percussion dullness over the affected area, diminished...
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...airn Air Pollution and Health in Kuwait Student’s Name Professor’s Name Submission Date Introduction Kuwait is a relatively successful country in the Middle East. It has a rich history though with both the positive and the negative sides alike. Every time the name Kuwait is mentioned, one may not fail to think of its natural endowments in terms of oil. Though this is a common case to most of the Middle East countries, Kuwait stands out as one of the four oil-rich countries and the fourth largest exporter of oil among the Oil Producing and Exporting Countries (OPEC) with petroleum accounting to a sizeable percentage of its annual Gross Domestic Product. Most of its populace directly or indirectly depend on the oil and its products for their daily lives. To the international community, the country has attracted friends and enemies alike and that explains part of its history which every citizen of this country would like to forget and never remember. This was the 1990 incident where the Iraqi troops set its valuable oil wells on fire hence converting millions of its oil and natural endowments to dangerous smokes which would later turn back to haunt its own population. During this time, most leaders had their words for Kuwait, most of which were negative and pessimistic. However, one iron lady, Mrs.Sara Akbar stood out and defended the future of Kuwait (Peter Aldous). Despite the drawback which almost pulled the country to its knees...
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...He a lt h 0 2 2 Fire 1 Re a c t iv it y 0 P e rs o n a l P ro t e c t io n 1 E Material Safety Data Sheet Citric acid MSDS Section 1: Chemical Product and Company Identification Product Name: Citric acid Contact Information: Catalog Codes: SLC5449, SLC2665, SLC4453, SLC1660, SLC3451 CAS#: 77-92-9 Sciencelab.com, Inc. 14025 Smith Rd. Houston, Texas 77396 RTECS: GE7350000 US Sales: 1-800-901-7247 International Sales: 1-281-441-4400 TSCA: TSCA 8(b) inventory: Citric acid Order Online: ScienceLab.com CHEMTREC (24HR Emergency Telephone), call: 1-800-424-9300 CI#: Not available. Synonym: 2-Hydroxy-1,2,3-propanetricarboxylic acid Chemical Name: Citric Acid International CHEMTREC, call: 1-703-527-3887 For non-emergency assistance, call: 1-281-441-4400 Chemical Formula: C6H8O7 Section 2: Composition and Information on Ingredients Composition: Name CAS # % by Weight Citric acid 77-92-9 100 Toxicological Data on Ingredients: Citric acid: ORAL (LD50): Acute: 5040 mg/kg [Mouse]. 3000 mg/kg [Rat]. Section 3: Hazards Identification Potential Acute Health Effects: Hazardous in case of eye contact (irritant), of inhalation (lung irritant). Slightly hazardous in case of skin contact (irritant, sensitizer), of ingestion. The amount of tissue damage depends on length of contact. Eye contact can result in corneal damage or blindness. Skin contact can produce inflammation and blistering. Severe...
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...Section 1 Biological Safety Chapter 3 Standard Laboratory Practice and Technique STANDARD LABORATORY PRACTICE AND TECHNIQUE Biohazard Warning Signage A sign incorporating the universal biohazard symbol must be posted at the entrance to the laboratory when infectious agents are present. Biosafety Level 1: The sign may include the name of the agent (s) in use, and the name and phone number of the laboratory supervisor or other responsible personnel. Biosafety Level 2: Posted information must include the name of the agent (s), laboratory’s biosafety level, supervisor’s name (or other responsible personnel), telephone number, and required procedures for entering and exiting the laboratory. Biosafety Level 3: Posted information must include the name of the agent (s), laboratory’s biosafety level, supervisor’s name (or other responsible personnel), telephone number(s), and required procedures for entering and exiting the laboratory. Personal Protective Equipment Once a biological hazard has been identified, the supervisor and employee must agree on the appropriate personal protective equipment (PPE) to be worn as the primary barrier of protection. PPE may include, but is not limited to face protection, lab coats and gowns, respirators, and shoe-covers/booties. Supervisory personnel are responsible for the initial demonstration and periodic follow-up of proper use. Appropriate PPE should be donned before handling potentially hazardous biological materials and removed immediately and...
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...for five days with the local fire departments battling to contain it. Initially, it was believed to be easily containable but with the early advent of the windy season, the fire continues to burn out of control. Community officials urge citizens that they are not in any immediate danger for evacuation but will issue alerts if they feel the fires may shift course towards the community. Public health officials are urging residents, especially those with chronic heart and lung disease, to remain inside unless absolutely necessary, due to the smoke, haze, and irritants. The local hospital is seeing an influx of patients to the emergency department as well as the units being filled with patients that are having worsening of their respiratory illnesses. The increase in patients is so bad that the staff on the nursing floor is overwhelmed and staff morale is extremely low. The emergency department...
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...surgical procedure of the complete removal of the tonsils and its capsule and often accompanied by removal of adenoids in the presence of sleep disorder breathing. Problem statement: Oral secretions and blood in the oropharynx can cause local irritation or aspiration in patients, who are recovering from anesthesia following adenotonsillectomy (AT) surgery. Gravity plays a significant role in the mobilization of oral and nasal fluids into the lower respiratory tract. Usually, excessive airway secretions among pediatric patient may lead to hypoxemia, hypercarbia, airway...
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...ischaemia. 오류! 책갈피가 정의되어 있지 않습니다. 3. Administer medications- Morphin (normally 2.5-5mg) & anginine 600mcg (given every five minutes; maximum 3 tablets in order to relieve/prevent pain & ischemia to decrease anxiety & cardiac workload. 오류! 책갈피가 정의되어 있지 않습니다. 4. 12-lead ECG & monitor in order to check hypotension & bradycardia, which may lead to hypoperfusion. 오류! 책갈피가 정의되어 있지 않습니다. Ineffective tissue perfusion 오류! 책갈피가 정의되어 있지 않습니다. 1. Monitor vital signs (Hourly) and saturation oxygen to determine baseline and ongoing change. 오류! 책갈피가 정의되어 있지 않습니다. 2. Administer oxygen by Hudson’s mask (6-10L/min) and monitor the effectiveness to increase oxygenation of myocardial tissue and prevent further ischaemia. 오류! 책갈피가 정의되어 있지 않습니다. 3. Monitor respiratory status for sysptoms of heart failure to maintain appropriate levels of oxygenation & Observe for signs of pulmonary oedema. 오류! 책갈피가 정의되어 있지 않습니다. CORONARY ANGIOGRAM 5 Nursing responsibilities and rationale pre angiogram 5 CORONARY ARTERY BYPASS GRAFT 6 Definition (3marks) 6 ANTICOAGULANT THERAPY 7 Nursing Responsibilities 7 APTT. (3marks) 7 WOUND MANAGEMENT 8 DISCUSS MOIST WOUND –HEALING ENVIRONMENT 8 DEFINE 5 DIFFERENT TYPES OF EXUDATES 9 NEUROVASCULAR...
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...SAFETY DATA SHEET 3/4" SUPPORT MATERIAL F89393 Version 1.0 Revision Date 11/03/2012 Print Date 02/20/2013 SECTION 1. PRODUCT AND COMPANY IDENTIFICATION Product name : 3/4" SUPPORT MATERIAL MSDS Number : F89393 Product Use Description : Ceramic Material Company : UOP LLC 25 E. Algonquin Road Des Plaines, IL 60017-5017 USA +1-847-391-2000 +1-847-391-2953 Medical (PROSAR): 1-800-498-5701 or +1-651-523-0309 Transportation (CHEMTREC): 1-800-424-9300 or +1-703-527-3887 (24 hours/day, 7 days/week) Telephone Telefax In case of emergency call : : : : : SECTION 2. HAZARDS IDENTIFICATION Emergency Overview Form Color Odor Hazard Summary : Balls, pellets or tower packing : off-white : none : Repeated or prolonged exposure may irritate eyes, skin and respiratory system. Repeated and prolonged inhalation of crystalline silica in the form of quartz from occupational sources may cause cancer. Potential Health Effects Skin : Prolonged skin contact may cause skin irritation. Page 1 / 16 SAFETY DATA SHEET 3/4" SUPPORT MATERIAL F89393 Version 1.0 Revision Date 11/03/2012 Print Date 02/20/2013 Eyes Ingestion Inhalation : Repeated or prolonged exposure may cause eye irritation. : The product is considered to have a low order of oral toxicity. : Exposure to dust particles generated from this material may cause irritation of the respiratory tract. Repeated and prolonged inhalation of crystalline silica in the form of quartz from occupational sources...
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...Chapter 1 Nursing Images throughout History 1) The angle of mercy 2) The handmaiden 3) The battle-ax 4) The naughty nurse 5) The military image A. Nurses on the battlefield * Hospitalers – specialized soldiers who at the end of battle returned to the outposts to care for the sick and injured * Army nursing service – organize nurses and hospitals and coordinate supplies for the soldiers during the Civil War * Clara Barton a. Provided care in tents set up close to the fighting b. Did not discriminate c. Establishment of the American Red Cross * Harriet Tubman – helped slaves escape to freedom on the underground railroad * Walt Whitman – a poet * Louisa May Alcott – an author * Dorothea Dix – union’s superintendent of female nurses during the Civil War B. Nurses fighting diseases * Florence Nightingale d. Epidemiology – the study of the distribution and origins of disease e. Air, light, nutrition, and adequate ventilation and space assist the patient to recuperate * Lillian Wald & Mary Brewster f. Founded the Henry Street Settlement in NY to improve the health and social conditions of poor immigrants g. Improve health and prevent illness by promoting safe drinking water, adequate sewage facilities, and proper sanitation Florence Nightingale (1820-1910) ...
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...gru NURSES RESPOSIBILITY | Instruct patient to take acamprosate exactlyas prescribed, even if a relapse occurs,and to seek help for a relapse.•Warn patient that acamprosate won’treduce symptoms of alcohol withdrawal ifrelapse occurs followed by cessation.• Urge caregivers to monitor patient for evidenceof depression (lack of appetite orinterest in life, fatigue, excessive sleeping,difficulty concentrating) or suicidal tendenciesbecause a small number ofpatients taking acamprosate have attemptedsuicide.• Advise patient to use caution when performinghazardous activities until adverseCNS effects of drug are known. | SIDE EFFECTS | Adverse ReactionsCNS: Abnormal thinking, amnesia, anxiety,asthenia, chills, depression, dizziness,headache, insomnia, paresthesia, somnolence,suicidal ideation, syncope, tremorCV: Chest pain, hypertension, palpitations,peripheral edema, vasodilationEENT: Abnormal vision, dry mouth,pharyngitis, rhinitis, taste perversionGI: Abdominal pain, anorexia, constipation,diarrhea, flatulence, increased appetite,indigestion, nausea, vomitingGU: Acute renal failure, decreased libido,impotenceHEME: Leukopenia, lymphocytosis, thrombocytopeniaMS: Arthralgia, back pain, myalgiaRESP: Bronchitis, cough, dyspneaSKIN: Diaphoresis, pruritus, rash | INDICATION | To maintain abstinence from alcohol foralcohol-dependent patients who areabstinent at the start of treatment CONTRAINDICATIONHypersensitivity to acamprosate or its com- ponents, severe hepatic (Child-Pugh...
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...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 Territorio, Università Degli Studi Dell'Insubria, Varese, Italy. Robert M Kacmarek, PhD RRT FAARC Respiratory Care Services, Massachusetts General Hospital, Boston, Massachusetts. Paolo Pelosi, MD + Author Affiliations Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Sezione Anestesia e Rianimazione 2) Next Section Abstract BACKGROUND: Heat and moisture...
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