...lung associationhttp://www.breathing.orgAmerican association for cardiovascular and pulmonary rehabilitationhttp://www.aacvpr.orgThe national Jewish medical and research Centrehttp:www.national jewish.org | The purpose of above resources is to provide information to health care professional information on chronic pulmonary diseases, some treatment options and available links.Chronic obstructive pulmonary disease:Anatomy of the respiratory system consists of two parts: includes upper respiratory tract consists of nose, nasal cavity, sinuses and trachea.The lower respiratory tract consists of bronchi. Bronchioles and alveoli(neighbors, m, &tanehill,.,j 2006)Causes of chronic pulmonary disease:Long term exposure to lung irritants for example smoking, air pollution, chemical fumes, dust (U.S. Department of national lung and blood institute).Statics on COPD diseaseChronic pulmonary disease claims approximately 118, 171 people annually this number increased to 127,000 in 2005, recent studies indicate COPD could be the leading cause of death by the year 2020 in the Unites States of America( American lung association 2004). Men and women are 12-13 times likely to die from chronic pulmonary disease respectively (American lung association.)Diagnostic testingchest examinations using a stethoscope, listen to lungs sounds like a paper being rumbled. Bronchoscopy is a procedure to look into lung passages, placing a probe on middle finger or ear...
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...Change Paper Nursing 427 By Jennefer Grady Table of Contents Introduction………………………………………………………………..3 Lewin’s Theory……………………………………………………………..4 Problem Statement………………………………………………………….5 Proposed Solution…………………………………………………………..6 Moving Forces………………………………………………………………7 Restraining Forces…………………………………………………………...8 Change Integration…………………………………………………………..8 Refreezing Process…………………………………………………………..9 Introduction On patients requiring bipap masks, what is the effect of applying duoderm to bridge of nose compared to not using any barrier to prevent skin breakdown while in the hospital? This paper is about a problem that has been identified in the nursing field and the change process. Patients who need to wear a bipap mask for better oxygenation are having complications with the mask causing a pressure ulcer on the bridge of the nose. This is not only painful to the patient but also increases health cost. This paper is about Lewin’s change theory and how to implement this new change and overcome resistance. It will talk about the freezing, moving and refreezing process, changes that need to be made and how to implement this plan. As well as what is necessary to enforce this change so that it becomes status quo. Lewin’s Theory Kurt Lewin was born in Germany and immigrated to the US in August of 1933, after Hitler came to power. He had originally been involved with schools of behavioral psychology before changing directions and going into research. He is well...
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...which the infection develops (CDC, 2014). HCAP develops during or following a stay in a healthcare facility. In contrast, patients who are diagnosed with CAP have had no contact within a health care setting prior to presenting with the infection (Driver, 2012). Pneumonia may be present as a mild illness but has the potential to be life-threatening. Despite advances in research, pneumonia remains a common illness contributing to the death of young children in developing countries and the elderly population of developed countries throughout the world (Ruuskanen, et al., 2011). In 2010, approximately 50,000 people in the U.S. died after developing the infection (CDC, 2014). From a global perspective, 450 million cases of pneumonia are recorded annually and roughly 4 million of those diagnosed will die from this illness (Ruuskanen, et al., 2011). CAP is the eighth-leading cause of death within the U.S. and is the leading cause of death from infection in the developed world (Brown, et al., 2012). While anyone is susceptible to contracting it, certain risk factors increase the chances of developing the infection. Research confirms that pneumonia is more serious in younger and older populations; people with chronic health problems; and people who have weak immune systems (CDC, 2014). In the U.S., the population older than age 65 account for nearly two thirds of hospitalizations and 90 percent of deaths associated with...
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...rates, increased hospital stays, longer mechanical ventilation and increased costs to hospitals and patients (Rosa, Hernandez, Carillo, Fernandez, & Valles, 2012). Patients who have an endotracheal tube (ETT) with mechanical ventilation are more likely to develop VAP. These patients have a poor cough reflex due to a decreased level of consciousness and diminished movement of the respiratory tract mucocila, leading to the inability to clear secretions. These contaminated secretions will then sit on top of the ETT cuff and eventually leak down and invade the lungs. Also aiding as a reservoir for microbes is a biofilm that can form on the ETT and enter the lungs causing infection (Mietto, Pinciroli, Patel, & Berra, 2013). Nurses are responsible for applying pharmacological and non-pharmacological measures to help prevent VAP which poses a very difficult challenge. Nurses must research and incorporate the use of evidence-based practice into their daily care of patients on mechanical ventilation (Sedwick, Lance-Smith, & Nardi, 2012). This paper will look closely at the evidence-based research and protocols implemented which best prevent ventilator-associated pneumonia. To help prevent further complications and improve outcomes in patients on mechanical ventilation, a standard of care was created by the Institute for Health Care Improvement (IHI) in 2004 called the Ventilator Bundle. These measures were specifically designed to help prevent VAP and other ventilator associated...
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...Grand Canyon University Abstract This paper will discuss the weaning of patients off of a mechanical ventilator. It will look at the problems associated with prolonged intubation vs. premature extubation, and what healthcare professionals can do to assess a patients readiness to begin the weaning process. A patient care scenario will be given and an explanation of how nursing practice can evolve with the knowledge from this study will be shown. The accountability of the nursing professional in regards to mechanical ventilation will be visited as well. Accountability of Nursing Professionals: Weaning from Mechanical Ventilation “Mechanical ventilation refers to the use of life-support technology to perform the work of breathing for patients who are unable to do so on their own.” This is the definition of mechanical ventilation according to Cook, Meade, and Guyatt (2000). They performed a study to determine the optimal time to wean a patient off of mechanical ventilation. When weaning a patient you have to find the right time to extubate. Prolonged mechanical ventilation can lead to nosocomial pneumonia, cardiac associated morbidity, and possible death. However, extubating a patient too soon may result in having to reintubate which can result in the same illnesses as prolonged intubation. “Research to date suggests that the best answer to ‘when to start weaning’ is to develop a protocol implemented by nurses and respiratory therapists that begins testing for the opportunity...
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...goal of this paper is to scrutinize the regrettable sentinel event of Mr. B, a sixty-seven-year-old patient who was admitted to a rural ED with left leg pain that he found unbearable. A root cause analysis will be used to exam the causative factors that led to this unfortunate sentinel event. Then I will identify the errors or hazards in the care of Mr. B. A change theory will then be utilized to establish a useful improvement plan that would hopefully decrease the chances of a repeat of the outcome in the Mr. B scenario. A Failure Modes and Effects Analysis (FMEA) will then be used to project the likelihood that the suggested improvement plan would not fail. In conclusion key roles of the nurses involved in the care in the Mr. B scenario will be discussed. I have completed the RCA considering: causative factors, errors and hazards that had unfortunately lead to the death of the 67 year old patient that was brought to the ED. By performing the RCA we start at the beginning with the causative factors, we list staffing levels, who was there and who was not. The participants during the root cause analysis would be the emergency room physician (Dr. T.), the LPN and RN (Nurse J) the respiratory therapist who was in house but not in the ED at the time of this sentinel event, and the unit secretary. As we read through the scenario we discover that conscious sedation was used for Mr. B. Conscious sedation should never take place without a qualified Respiratory Therapist (RT) present...
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...Effects of Exercise on Diabetes Exercise in the Treatment and Prevention of Diabetes Western Governors University Abstract Article Larose J; Sigal RJ; Khandwala F; Prud'homme D; Boulé NG; Kenny GP. (2011 January). Associations between Physical Fitness and Glucosylated Hemoglobin in Type 2 Diabetes Mellitus. Diabetologia, 54(1), 93-102. Retrieved May 17, 2012, from MEDLINE database. 20953579 Background Information Exercise and physical activity has shown to be a significant factor in the management and treatment of diabetes. What is unknown is how benefits from physical activity directly correlate to glucose control as manifested in low glucosylated hemoglobin (HbA1c) levels in diabetic people. The study aims to prove that the decrease in HbA1c is a result of greater aerobic fitness and strength in patients that are performing aerobic or anaerobic exercise. Secondly, it is related to the changes in strength and aerobic fitness that are performing cardiovascular exercise and resistance training. Review of Literature The purpose of the article is to assess the correlation of reduced HbA1c to physical activity. It is hypothesized that this reduction is related to the changes and increase in aerobic fitness and strength in diabetic people who are engaged in aerobic and anaerobic exercise. The result from the study showed that the link between the changes in glucose control during exercise training is not that high nevertheless; physical activity...
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...qwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmrtyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmrtyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmrtyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmqwertyuiopasdfghjklzxcvbnmrtyuiopasdfghjklzxcvbnmqwer...
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...Family Value Paper Siana Stone NUR 542 March 11, 2013 University of Phoenix Family Value Paper This family value paper individual assignment will discuss the concept of family nursing that has developed into a fundamental aspect of nursing. Research of nursing has shown that individual poor health affects the entire family and not only an individual, plus, the effectiveness of health care is improved when emphasis is placed on family (Harmon & Hansen, 2001). There was no conceptual theoretical framework that was found in family nursing. Friedman, Bowden and Jones (2003), discussed the lack of a complete family nursing theory with their proposal “nurses must draw upon multiple theories to work effectively with families” (p. 62). This particular subject matter will discuss the family system and theories related to the up-and-coming to unite with family nursing. This will also portray stratagem to integrate nursing theories in the practice of family nursing. This includes family work as a system, concept of area of nursing practice, most helpful area in my nursing of practice, chosen concept of family and why is it helpful, theories conducive in the area of my practice and last, the conclusion. Family work as a system Family must first define themselves to have a better understanding on how to work as a family nursing system. In real life family is composed primarily mother, father, single, and married children. Family must have unity to function...
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...A TERM PAPER PRESENTED BY EUGENIA NWOKEFORO ON PROFESSIONAL DEVELOPMENT OF NURSING PROFESSIONALS THE EFFECT OF IOM REPORT 2010 ON THE FUTURE OF NURSING PRACTICE Nursing is a profession which plays vital role in improving the health care system by promoting, protecting and optimizing health and abilities, prevention of illness and injury, alleviating suffering through the diagnosis and treatment of human response and an advocate in care of individuals, families, communities and populations(ANA). INSTITUTION OF MEDICINE (IOM) was founded in 1970. In 2008, The Robert Wood Johnson Foundation(RWJF) and Institution of medicine (IOM) formed a two year committee to respond to the need to assess and transform the nursing profession. Today healthcare faces serious issues like child obesity, influenza(H1N1), HIV-AIDS, IOM is the entity that is advising on how to improve the health care system to meet the increased issue as it pertains to saving life and disease prevention and THE EFFECT OF IOM REPORT ON NURSING EDUCATION Nursing education is a crucial issue according to IOM report, Improved education system is paramount to increase nursing competence ,Advanced nursing degree provide nurses with more knowledge in their area of specialization, improve quality and efficient care for...
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...related by their chemical structure, the way they work or if they are used for the same purpose (Pubmed Health, 2012). A cholinergic stimulant is a class of drugs used to increase activity at acetylcholine synapses and can be further subdivided into two categories; direct and indirect acting cholinergic stimulants. This categorization is based on their mechanisms of action and specificity for clinical use (Ciccone, 2007). Direct-acting cholinergic stimulants increase activity at the acetylcholine synapses by binding directly with the cholinergic receptor on the other hand; indirect-acting cholinergic stimulants put forth the same effect by inhibiting the acetylcholinesterase enzyme situated on the cholinergic synapse. For the purpose of this paper, an analysis of indirect acting cholinergic stimulants will be completed, with focus on Pyridosigmine and Prostigmin and their implications to physical therapy practice. Indirect-Acting Cholinergic Stimulants Indirect-acting cholinergic stimulants are also known as Cholinesterase inhibitors or Anticholinesterase agents. Cholinesterase inhibitors increase activity at cholinergic synapses by preventing the acetylcholinesterase enzyme from breaking down acetylcholine (ACh) after its release from the presynaptic terminal. Cholinesterase inhibitors inhibit acetylcholinesterase thus allowing more acetylcholine to remain at the synapse which results in an increase in cholinergic synaptic transmission (Ciccone, 2007). For circumstances where acetylcholine...
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...2030 based on the high demand but quick turnover from the new grad nurses population and the 2010 Affordable Care Act (Auerbach, et. al., 2013). The Robert Wood Johnson Foundation (RWJF) and the Institute of Medicine (IOM) in 2008, created a two-year initiative response toward the need to assess and transform the nursing profession in response to the 2010 Affordable Care Act legislation which has become one of the largest health care overhauls since the 1965 creation of Medicare and Medicaid. The IOM appointed a committee on the RWJF Initiative on the Future of Nursing at the IOM to produce multiple reports that would make recommendations for an action based blueprint for the future of nursing practice (Institute of Medicine, 2010). This paper will discuss the impact of the IOM report on nursing education, the nurse’s role as a leader, nursing practice with a focus on primary care, and the changes within my own nursing practice based on current recommendations. Nurses in the United States can enter the nursing profession through...
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...Introduction Myasthenia gravis is an autoimmune disease in which antibodies are produced that block or destroy the nicotine acetylcholine receptors at the postsynaptic membrane, causing muscle weakness and fatigue (Pendleton & Schultz-Krohn, 2006). Myasthenia gravis can occur at any age but onset usually occurs at an earlier age in women than in men. In the United States, there are about 14.2 cases of myasthenia gravis per one million people (Pendleton & Schultz-Krohn, 2006). Myasthenia gravis will be discussed in this paper according to the following: etiology, signs and symptoms, pathology and the progression of myasthenia gravis, diagnosis, prognosis, medical interventions, complications and resulting dysfunction of myasthenia gravis. Etiology Romi, Gilhus, and Aarli (2005) point to a genetic predisposition for myasthenia gravis with 30% of patients having mothers with myasthenia gravis or another autoimmune disease (p. 136). Other precipitating factors may include surgery, certain drugs, infection, and disorders of the thymus (Beers & Porter, 2006, p. 1899). Approximately 12% of babies born to mothers with myasthenia gravis display a passing muscle weakness termed “neonatal myasthenia” (Keesy, 2004, p. 485) not considered autoimmune, due to maternal antibodies crossing the placenta. Myasthenia gravis occurs at any age with the peak onset age in males between 50 and 70 years and in females between the teens and the thirties. Both...
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...Research shows that strong communication between patients and their nurses leads to greater patient satisfaction, better outcomes and safety, and lower healthcare costs. When this line of communication is lacking, patients are less likely to seek the needed care, and are more likely to experience differences in the plans of their respective practitioners. Also, it is important to ensure patients are able to provide informed consent for all of their treatments, which can only be accomplished through successful communication. Finally, patients have a strong desire and right to have their wants and opinions made a priority when developing their plan of care (Paget et al.,...
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...Job Analysis Paper Psych 435 February 28, 2011 Nursing Job Analysis A job analysis is a process used to determine and identify the details of a specific job requirement or duties and the significance of these duties for the given job (Spector, 2008). In a job analysis there are also judgments about the data collected on-the-job (Fine & Crinshaw, 1999). It is also important to remember that a job analysis is conducted for the job position and not the person. The data collected for a job analysis comes from current questionnaires or interviews, the specification and description of the job (Spector, 2008). The main purpose of a job analysis is to document and establish the job relatedness of employment procedures such as interviewing, selection, training, compensation, and performance appraisals (Fine & Crinshaw, 1999). In this paper a job analysis will be performed on the position of a registered nurse. It will evaluate different performance appraisal methods, explain a variety of benefit and vulnerability of performance appraisals, and also evaluate the reliability and validity of a job analysis. To become a registered nurse there are some requirements. The student needs t o be a high school graduate or GED equivalent. This would be considered the proper basic training along with the pre-requisites required from the college. Then once these are completed the student can apply for the nursing program in your college and obtain the advanced education, skills, and...
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