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Issuing New Guidelines to Prevent Surgical Infections Research Paper

… Surgical Infection

Issuing new guidelines to prevent surgical infections

Surgical site infection prevention clinical practice guidelines have become increasingly important in recent years, given the rise of Methicillin-resistant Staphylococcus aureus (MRSA)-in hospital settings. The purpose of the most recently-issued guidelines by the Surgical Care Improvement Project (SCIP) related to surgical prophylaxis is to ensure safety for the patient and to minimize the risks of the procedure. The specific stated goal of the guidelines is the "identification of evidence-based prevention measures pertaining to SSIs" to give healthcare providers "the knowledge base needed to effectively deliver high-quality, continuity of care among patients" (Smith, Dahlen, Bruemmer, Davis, & Heishman 2013). These guidelines include "nasal swabbing, preoperative skin cleansing, preoperative hair removal, perioperative antibiotic timing, and specific postoperative care…. [read more]


Surgical Procedure Research Paper

… Surgical Procedure

Before a patient undergoes surgery, a nurse removes hair from the surgical site. The rationale behind this practice is that hair may interfere with the opening and closing of the surgical incision and with the use of surgical drapes and dressings, and that it may harbor bacteria that could cause infection of the surgical site (Tanner, Moncaster, & Woodings, 2007, p. 118.)

Shaving is the oldest and most common method used to remove hair from the surgical site prior to surgery (Tanner & Khan, 2008, p. 241). The perioperative nurse uses a sharp blade that is contained in the head of a razor and pulls it over the skin of the patient to remove hair from around the area where the surgical incision…. [read more]


Preventing VRE Thesis

… Preventing VRE

ALL MEASURES to the FULL EXTENT

VRE is a "superbug," a bacterial strain that resists the action of antibiotics. For its versatility, VRE is difficult to treat or is even life-threatening. Prevention is also much more inexpensive and less draining of resources. Hospitals, clinics and offices are strongly encouraged to formulate their own strategies to prevent or reduce the spread of VRE through all possible means. Respective guidelines should be provided for the strict adherence by health care workers, patients and visitors towards the common end.

The enterococci bacteria naturally inhabit the intestinal tract (Department of Health, 2006). Some enterococci strains have become resistant to an antibiotic called Vancomycin. These strains are referred to as Vancomycin-resistant enterococci or VRE. Neither antibiotic-resistant nor non-resistant…. [read more]


Quality and Safety Issues Essay

… com). Preventing adverse drug events is also one of the six aims promoted by the institute of medicine for improving health. "Over 770,000 people are injured or die each year in hospitals from adverse drug events (ADEs),1-3 which may cost up to $5.6 million each year per hospital4,5 depending on hospital size. This estimate does not include ADEs causing admissions, malpractice and litigation costs, or the costs of injuries to patients" (ahrq.com). This quote best summarizes the tremendous cost, in patient lives, health and trust that occur to the health care arena when a drug is adversely prescribed, and how it costs the health care arena significant sums that could be significantly better spent elsewhere.

On a similar note, preventing things like surgical site infections…. [read more]


Infection Control Surgical Site Infections Essay

… Nurses are also responsible to check the instruments in the operating room to make sure that they meet with infection control guidelines.

Surgeons are responsible to always keep the field clear and to examine patients for any obvious signs of infection prior to operating.

The hospital administration is responsible for support of all personnel who are responsible for preventing infection in the hospital.

Procedure

There is always need for improvement to any plan at times because infection is an issue that continues to grow. Therefore, monitoring of infection control procedures will be constant, and if anyone notices a procedure that would better fit a particular situation they are responsible to bring that to the attention of the staff who can affectively make the desired change.…. [read more]


Improving Customer Service Research Paper

… It is also evaluated to check its sense of fairness and that it is not a violation of any of the ethical principles. The last step is then to implement the chosen course of action.

The Team

The team which will lead this improvement in patient satisfaction rate will consist of 8 members. One will be the nurse manager who will be the overall and the "senior leader" for this process. he/she will be involved in supervising all members of staff of the medical-surgical unit to make sure they act in a way which complements the achievement of this desired patient satisfaction rate. The other 7 team members will be staff members of the medical-surgical unit chosen based on their experience in the team and…. [read more]


Ethical Issues Associated With Paying for Unsuccessful Surgeries Thesis

… Ethical Issues in Performing Unnecessary Surgeries

Even before the drastic changes that began evolving in healthcare during the late 1970s and through today, surgeries have always been the focus of scrutiny and intense insurance payer oversight, because unnecessary surgeries can be difficult to detect. The implications of performing unnecessary surgeries is defined as to the ethics involved in the decision to perform this kind of surgery by the description using the word "unnecessary."

Unnecessary surgeries constitute the biggest single reason why health care reform began in the latter part of the twentieth century. The allegation was that hospitals, physicians, and others in the industry failed to police their selves, and treated healthcare reimbursement like a free-for-all. The lack of ethical judgment on the part of…. [read more]


Green Provides Some Clear Guidelines Term Paper

… e. via telephone, email, marketing, direct face-to-face communication, focus groups, interviews, etc. (Perko, Module 4).

Step 6/7: Create messages/Develop promotion programs

- The messages and development programs are created and implemented with the help of professional marketing or advertising companies (Perko, Module 4)

Step 8: Implement communication strategies

- This is done primarily following the internal organizational structure of the hospital (discussed late in question 6 under health communication) (Perko, Module 4)

Step 9/10: Assess Effects/Feedback

- This is a long-term monitoring process of the management whereby statistical, qualitative and quantitative data and facts are collected to ensure the success or failure of a promotion strategy employed (Perko, Module 4)

3. Discuss three examples of health promotion techniques that can effectively achieve environmental change.

Ethical…. [read more]


Addressing the Issue of Medical Errors With Mandatory Reporting Systems and Computer Technology Term Paper

… Healthcare: Addressing the Issue of Medical Errors

Healthcare

Addressing the Issue of Medical Errors with Mandatory

Reporting Systems and Computer Technology

To combat the current crisis of deaths due to preventable medical errors the health care industry and lawmakers have taken two approaches. The first is the implementation of a system of mandatory reporting systems. The solution is to crate an atmosphere in hospitals that fosters less blame, not more, according to the IOM report. A blue-ribbon pane appointed by the IOM argues that the failure to acknowledge and analyze mistakes deprives hospitals of important information that could help prevent similar mistakes in the future. However, many in the healthcare industry argue that mandatory reporting of errors will foster an atmosphere of lawsuits and backlash…. [read more]


Transgender Employment Discrimination Research Paper

… Background and Significance

There are a number of laws, procedures, and constitutional amendments including the 14th Amendment that affect civil rights and employment practices in the American workplace today. Employment anti-discrimination laws began under Title VII of the Civil Rights Act of 1964 which prohibits employment discrimination based on race, color, sex, religion, or national origin. The Equal Pay Act of 1963 (EPA) protects men and women who perform equal work against sex-based wage discrimination. The Age Discrimination Employment Act of 1967 protects workers who are over the age of 40. The American with Disabilities Act of 1990 prohibits discrimination against qualified individuals with disabilities in the private sector. These laws prohibit the following:

hiring and firing; compensation, assignment, or classification of employees; transfer, promotion,…. [read more]


Scleroderma, a Chronic, Systemic Disease That Effects Term Paper

… ¶ … scleroderma, a chronic, systemic disease that effects the lungs, skin, heart, gastrointestinal tract, kidney and musculoskeletal system. The article is a case report on a specific case dealing with achalasia due to scleroderma and multiple left lung hydatid cysts which the practicioners performed a thoracic epidural blockade in combination with general anesthesia with air-oxygen and sevoflurane without neuromuscular blockade and without intravenous opioids.

The surgical procedure involved using an epidural catheter prior to inducting anesthesia. After the surgery, the anesthesia was discontinued and twenty minutes later that patient began spontaneous breathing, responding to painful stimuli and to buck on the tube.

In general, it is found that scleroderma is a connective tissue disease and an autoimmune disorder which causes vascular damage, especially in…. [read more]


Coaching and Development Term Paper

… Coaching and Development

The two scenarios are highlighting the overall challenges that preceptors will face inside a health care facility. To help them adjust with these issues requires examining each situation and understanding the most effective approaches for troubleshooting the different problems. This will be accomplished by focusing on: creating an orientation / development guide for preceptors, developing a set of guidelines for them to follow, creating an incentive program, designing a performance improvement plan and creating a strategy for addressing preceptor's specific educational needs. Together, these elements will highlight the underlying challenges impacting everyone and the way to most effectively deal with them over the long-term.

A brief orientation and development guide for the preceptors.

A preceptor is an individual such as doctor or…. [read more]


Animal Research Is a Necessity Research Paper

… This 1966 law was "a very minimal and in many ways incoherent attempt to regulate animal research," and even though the 1985 amendments "did much to render coherent the ethic for laboratory animals," it remains inadequate (Rollin 2006). Under EU Directive EEC 86/609 of 1986, researchers had to obtain "special authorization on experiments likely to cause severe, prolonged pain to animals," and the EU also banned use of animals in the cosmetics industry in 2009 (DeGrazia 307). In reality today, the "treatment of research animals in the United States is far from cruel" and "every institution in the United States that conducts animal research must establish an Institutional Animal Care and Use Committee" (Gaddy 2009).

On the other extreme of this debate are animal rights…. [read more]


Minor Consent to Medical Treatment Term Paper

… " (Dugas, 1998) This change also allows an unemancipated minor to contract in Louisiana. Looking at the "dollar amounts spent yearly by minors and the large number of minors in the workforce suggest that young persons can and do contract daily. The code itself recognizes that unemancipated minor's contract, and a series of articles deal specifically with this area." (Dugas, 1998)

Thus even unemancipated minor, rather than being unable to contract, in fact has "the sword of contract and the shield of nullity." (Grodin; Glantz, 1994) The provisions of capacity now makes it possible for minors in general terms to enter into contracts and in special circumstances their consent is valid in medical services. The other laws would also follow suit, for example abandonment. Where…. [read more]


Tylenol Cyanide Case Study

… Tylenol Case Analysis: Johnson and Johnson

In the contemporary world, taking responsibility and immediate action in the face of a huge crisis is a requirement for any U.S. corporation if they are to survive and maintain their market position and reputation. These types of organizations are expected to be socially responsible to their employees and the public not only if they are directly involved in a crisis involving their products or services, but also if there is an indirect association. In 1982 Johnson and Johnson was faced with this challenge. They were indirectly involved in a catastrophe which killed seven people because their leading pain killer Tylenol was tampered with and unassuming consumers became the victim of such an atrocity. The way in which Johnson…. [read more]


Chest Pain the Presenting Patient Case Study

… Chest Pain Case Study

The presenting patient in the present case scenario is Mr. Hay, an 82-year-old male with an existing diagnosis of Cardiac Obstructive Pulmonary Disease (COPD). This existing diagnosis will prove relevant in a care plan for Mr. Hay, who has been admitted following a loss of consciousness. Having been discovered by a neighbor after some sustained period of unconsciousness, Mr. Hay would be admitted with an array of treatment issues. The three most pressing would prove to be the patient's Activity Intolerance, his Ineffective Airway Clearance and his Pain management. The discussion here below considers these treatment challenges.

Patient Problem 1: Activity intolerance

In any case where an elderly patient is admitted to the hospital, sedentary conditions can lead to an exacerbation…. [read more]


Patent Law and Genetic Medicine Term Paper

… Human Stem Cell Medical - Legal Implications

How Do Legal Issues in Patent Law Shape Ethical Decision in Human Stem Cell Research?

Patent Law & Genetic Medicine

This work examines the issue of human stem cell research from the view of the medical profession with an eye on funding, the public perspective and legislation historically affecting and futuristically possible in relation to research of the human genome. Specifically this work takes a look a the patenting process and how it is disputable as to whether patenting the human genome is plausible and what consequences might exist in this patents. This work notes the veritable quietness of the legal community at large in relation to this medical research issue and while this document is of the…. [read more]


Death and Dying 'My New Term Paper

… Her experience, which prompted her to write the book Embraced by the Light illustrates that dying is not in itself a bad thing and therefore cutting the feeding tube off of someone who has lost the essence of their human nature might be the morally correct thing to do. The spiritual experiences that are shared by many who have had near-death experiences show that dying can allow the individual to encounter God in ways that living often cannot. Denying individuals the right to die in cases of terminal illness demonstrates a lack of understanding of death as well as an infringement on personal civil liberties.

In his book The Rights of the Dying: A Companion for Life's Final Moments, David Kessler lists several rights that…. [read more]


Guidance for the Safe Entry Case Study

… 3. Work practice controls - we will take steps to be able to deal with the work in a safe and restful manner. For instance, we will work during the day hours using plenty of light. Crew will be well rested and able to communicate in English. We will rest frequently and refresh ourselves with water and food when necessary. Unnecessary people will be asked to leave the premises and not allowed in the first place from entering. All equipment and personnel will be decontaminated after tidying the premises

Workers will also be told to only drink water from safe sources and to not eat food that was exposed to the floodwaters. Also team should not smoke or eat in areas that contain floodwater, debris,…. [read more]


Ethics Behind Stem Cell Research Into New Term Paper

… Ethics Behind Stem Cell Research

Research into new means of curing diseases heretofore untreatable, and research into preventing conditions that damage and destroy life are all dependent upon the discovery that embryonic stem cells promise to hold the answer to many of these problems. Embryonic stem cells were isolated from inner cell masses of mouse blastocysts in the early 1980s. They are present in mammalian organs and tissue holding pluripotent embryonic stem (ES) cells present at the embryo development stage of the blastocysts. In 1998, researchers at the University of Wisconsin and a Johns Hopkins University team announced the first successful isolation and culturing of human ES cells. While donors of healthy oocytes do not donate any part of themselves or their tissues, their tissues…. [read more]


Verification of Nasogastric Tube Term Paper

… A solution that is relatively simple to implement is to elevate the head of the bed to between 30o -- 40o Risk assessment pH testing in place of litmus. In addition a flow chart should be adopted for risk assessment during the insertion process.

Summary

The fact that there are so many methods in current use for verification of NG tube placement is a sign that there is no one perfect method.

All studies are agreement that radiographic technique is the best current solution for verifying tube placement. To overcome the disadvantages of radiography it may be useful to provide non-radiologist physicians with better training in interpreting chest X-rays for confirming placement and also to develop a more portable X ray apparatus. In addition there…. [read more]


Whose Responsibility Is Informed Consent in the Patient at Risk for Postoperative Vision Loss Research Proposal

… Postoperative Vision Loss

Elements of an Informed Consent Form

Patients Who May be Unable to Make Healthcare Decisions

Recommendations for Decreasing POVL

Four Elements of Negligence

Prudent Behaviors in Medical Informed Consent

Cortical Blindness (Vision loss after…, 2009, ¶ 6).

CRAO: Central Retinal Artery Occlusion (Chang & Miller, 2005, Introduction section, ¶ 1).

IGT: Iowa Gambling Task (Northoff, 2006, p. 70).

Ischemic Optic Neuropathy (Vision loss after…, 2009, ¶ 6).

IOP: Intraocular Pressure (Gilbert, 2006, ¶ 4).

MacCAT-T: MacArthur Competence Assessment Tool (Northoff, 2006, p. 70).

NQF: National Quality Forum (Clarke, Johnston & Finley, 2007, p. 395).

OR: Operating Room (Clarke, Johnston & Finley, 2007, p. 396).

POION: Perioperative Ischemic Optic Neuropathy (Chang & Miller, 2005, Introduction section,

¶ 1).

POVL: Perioperative Visual Loss (Gilbert,…. [read more]


Nice Standards Nice Compliance Literature Review

… All of these risk factors pose an additional risk for thrombosis. Complications that may additionally increase the risk for thrombosis may include a recent hip fracture or knee replacement or surgery which may increase immobility (DH, 2010). Factors that may impose an increased bleeding risk may include acquired bleeding disorders, use of certain medications including anticoagulants, acute stroke, thrombocytopenia, uncontrolled hypertension, inherited bleeding disorders including haemophilia, lumbar puncture during a recent epidural or spinal anesthesia, or other procedures that increase the risk of high bleeding (DH, 2010). These factors when combined dramatically increase the risk for VTE.

VTE Prevention and Implementation

Prevention is key to survival. The purpose of NICE is essentially, risk management, which falls in the category of prevention. Education and assessment are…. [read more]


Patient Identifiers the Importance Term Paper

… Non-compliance with existing patient safety guidelines represented 95.2% of all errors found, which suggests the vast majority of errors were preventable.

Misidentification during Medication Administration

During a study observing nurse-patient interactions in three hospitals in England, close to 7% of nurses failed to ask the patient's name when administering medication in an acute mental health care setting (Duxbury et al., 2010). The failure to positively identify the patient before administering medication violated the patient care guidelines set forth by the Nursing Midwifery Council. This was particularly troubling since two nurses made the medication rounds, with one acting as an observer. Medication errors are the most common source of preventable adverse events, and are believed to have led to the deaths of 1200 patients in England…. [read more]


Cross-Sectional Study to Determine Factors Term Paper

… South Africa is being chosen because the scarcity of physicians in some parts of the country means that nurses receive extensive medical training because there may be times when they are the only medically trained person within hundreds of miles. Hasina Subedar, head of the South African Nursing Council, states, "The pitch is 'pack your bag', we'll do the rest. As long as the nurse agrees to work in an American hospital for two years, everything else from green cards for the entire family to airline tickets to apartments are taken care of" (CBS News, January 17, 2003).

One option which has been overlooked by many during this period of "healthcare hysteria" is the cadre of skilled, intelligent and available licensed practical nurses. These nurses…. [read more]


Theatre Nurses Equipped Term Paper

… Communicate approximate length of operation, any requirement and essential resources to the waiting list office, bed management, operating theatre department and/.or theatre scheduler.

Contact all patients failing to attend pre-operative assessment to identify the reason. Act on the reason, following local protocols for the management of DNAs in pre-operative assessment." (NHS, 2005)

Role of Nursing Team in Pre-operative Assessment

Further needed in comprehension is the role of the nursing team. The nursing team performs clinical examination and emergency assessments of all patients in the ER before surgery takes place for the purpose of ensuring that the fitness of patients is provided for to the greatest possible extent. Strategies include, "redistributing cases from emergency to elective theatre schedules, day case emergency surgery, and booking parts of…. [read more]


Tracking Down Problems With Tissue Research Paper

… For this to happen, both tissue banks and end-users need to improve their tissue tracking procedures beyond minimum recommendations. In addition, since donor tissues frequently cross international boundaries a global set of recommendations is needed. Accordingly, the ICCBBA established the IBST 128 standards for the coding and labeling of all biologics of human origin intended for medical use. The wide acceptance of these standards by tissue procurers in over 75 countries will help create an auditable documentation trail; however, these standards do not fully address the sometimes significant and health-threatening delays that have occurred. As Brubaker (2010) notes, the speed of notifications are not being documented during tissue recalls. There is thus an urgent need to conduct studies on notification delays, like the one completed…. [read more]


Atrial Fibrillation as a Post Operative Complication Term Paper

… Atrial Fibrillation as a Post Operative Complication

Atrial Fibrillation and Heart Surgery

Atrial fibrillation represents a serious post-operative complication in many types of heart surgery. Nearly 40% of all patients undergoing coronary and valve surgery experience this side effect (Saltman, 2004). Post operative atrial fibrillation is an enigma that remains refractory to both pharmacologic and nonpharmacologic attempts at prevention (Saltman, 2004). Reducing the incidence of atrial fibrillation (AF) is a serious concern for heart surgeons in all types of heart surgery. The following will explore the mechanisms that trigger AF, risk factors, monitoring procedures, and new treatments aimed at reducing the occurrence of post operative AF.

Mechanism

One of the key reasons for the ineffectiveness of procedures to minimize AF is a lack of understanding…. [read more]


Cardiac Stress Response Term Paper

… al, 1994) or at the "level of the spinal cord" (Koltun, et. al, 1996) significantly reduce "neuroendocrine or immune responses affected by surgery" (Glaser, et. al, 1998). Significantly lower pain scores have been noted among patients who experienced advantages in surgery such as epidural anesthesia, which is typically associated with " a significant reduction in the incidence of postoperative pain and immune outcome, including infections" (Glaser, et. al, 1998; Cuschieri, et. al, 1985). Epidurals have in fact been associated with lower overall pre and post operative pain scores among patients enduring Cardiac surgery, which suggests that use of such anesthesia will ultimately result in a reduced stress response, eliciting a more positive pre and post operative outcome.

The reduction in stress induction during cardiac surgery…. [read more]


Healthcare Delivery Imagine Term Paper

… Each person is likely to react in anger and may request for legal help immediately; consequently, the hospital would have to follow through by showing respect to the individual who had harm caused to him or her. Anyone can become unpredictable, especially since we are all unique in our responses. With this approach, legally, she could take the doctor and facility to court, regardless because of patient's rights. Ethically, the hospital did the right thing, despite the fellow not; therefore, the choice is up to the person on how to best handle the situation in which damage was done. This would have impacted all the medical staff by means of having better policies and procedures in place by double and triple checking the operative site…. [read more]

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