Date PRE POST PRE POST
n/a n/a
n/a n/a
n/a n/a
n/a n/a
n/a
n/a n/a
Marked
*Notify surgeon/Reg n/a n/a n/a
n/a n/a
n/a n/a n/a
n/a n/a n/a
2400 n/a n/a
2400 n/a n/a
n/a n/a
(circle) Top/Bottom/Partial denture n/a n/a n/a n/a
n/a n/a n/a n/a
n/a n/a
Pre-Operative Antibiotics: n/a n/a
n/a n/a n/a n/a
n/a
Bloods n/a
ECG n/a
n/a
n/a n/a
n/a
UR NUMBER 075486
Chelsea Bassett
Joelle Latham
Lisa Leanard
P
E
R
I-O
P
E
R
A
T
IV
E
C
H
E
C
K
L
IS
T
M
R
7
1
A
Chelsea bassett
Joelle Latham
Lisa Leonard
Signature:
Signature:
Signature:
Post- Operative check performed by:
Xray/Scans:
Patient reception check performed by:
Given and signed
Given and signed
Pre-Operative check performed by:
Medical Certificate
Follow up Appointments
Observations Checked
Discharge SummaryGraduated compression stockings insitu
(Circle) N/A / with Patient / With Doctor
VTE Prevention Anticoagulant
Investigations: FBC updated
Check/Wound/Drain tube
POST OP ONLY
Epidural Test Dose
Post Op Orders
Glasses
Hearing aids
Posthetic devices
Pacemaker insitu:
Seen by technician
Pre Op Prep: Skin Prep (Betadine)
Bariatric: (>120kg) - Notify Theatre
(obtain Hover mat prior to transfer to OT)
Cytotoxic Drugs Within 48 hours
Weight Recorded:
Anaes. Record
Fasting time: Food
Fluid(Document time)
Own teeth:
Pre-medication Ordered
Ordered
IV Therapy IV bung flushed
IV orders written
Clip
Bowel Prep
Identification Labels: Min of 20
Infectious State: Please state:
Theatre notified
History: (circle) Old New
Jewellery: (circle) Taped / Removed
Make-up/Nail Polish: Removed
Underwear: (circle) Disposable / Own
Female Sanitary Products:
NB:Please remove tampons Pad in situ
Personal items with patient:
Contact lenses
Procedure on consent form corresponds with
Theatre List
* Do not allow pt to leave holding bay
Side and site of surgery:
Not Marked
Allergies:
Wrist band
Patient Identifcation (check against
Notify surgeon/registrar Not completed
Consent form:
Admission form: Wrist band
Leg band
Patient/rep signature
Doctors signature
Comments: (e.g. Alerts, manual handling issues, Infections, Bariatric skin integ.)
PRE AND POST OPERATIVE CHECKLIST YES P NO O Not Applicable N/A
5/03/2018
DOCTOR John Smith
DATE OF BIRTH
ROBERTS
Darren
25 Happy Street
CAIRNS 4860
23/11/1968
SURNAME
FIRST NAME
ADDRESS
SIMULATED HOSPITAL
Name ROBERTS, Darren Lab ID
UR 075486 Request Date 04/03/2018
Age/Sex 50 years, Male Reported Date 05/03/2018
Test Normal Range Result
Na+ mmol/L 139
K+ mmol/L 4.5
CL- mmol/L 100
Bicarb mmol/L 25
Urea mmol/L 3.5
Creatinine mmol/L 65
Glucose mmol/L 5
Ca++ mmol/L 2.5
Mg++ mmol/L 0.78
CRP mg/L 0.2
Serum Fe µmmol/L 20
Transferrin µmmol/L 45
21- 29
3.0 - 8.0
14 - 32
40 - 260
0 - 5
Laboratory Report
2100045678
Biochemistry Results
2.25 - 2.65
.
Placental abruption is when the placenta separates early from the uterus, in other words separates before childbirth. It occurs most commonly around 25 weeks of pregnancy. Symptoms may include vaginal bleeding, lower abdominal pain, and dangerously low blood pressure.
Surgery in Bleeding disorders- A challenging problem to all surgeonsSelvaraj Balasubramani
Surgery in patients with bleeding disorders like hemophilia is a nightmare to any surgeon. They must have an working knowledge of how to deal these patients in this challenging situation.
Placental abruption is when the placenta separates early from the uterus, in other words separates before childbirth. It occurs most commonly around 25 weeks of pregnancy. Symptoms may include vaginal bleeding, lower abdominal pain, and dangerously low blood pressure.
Surgery in Bleeding disorders- A challenging problem to all surgeonsSelvaraj Balasubramani
Surgery in patients with bleeding disorders like hemophilia is a nightmare to any surgeon. They must have an working knowledge of how to deal these patients in this challenging situation.
CASE REPORT ON osteomyelitis.
Osteomyelitis (Femur debridement & Bone cement Spacer with External fixator).
Femur Deridement-
Doctors may recommend a procedure called debridement to remove dead or damaged bone tissue in people with osteomyelitis. During this procedure, the doctor cuts away dead or damaged bone tissue. He or she also washes the wound to remove any dead or loose tissue.
Osteomyelitis: Osteomyelitis is an infection in a bone. Infections can reach a bone by traveling through the bloodstream or spreading from nearby tissue. Infections can also begin in the bone itself if an injury exposes the bone to germs.
Prof. Mridul Panditrao's Peri-operative Management of Jehovah's Witness Patient Prof. Mridul Panditrao
A case report of Emergency Peri-operative Mnagement of a Jehovah's Witness patient.
Because of their peculear religious belief, these patients do not accept Blood and It's products. This can pose serious problems to the Anesthesiologist.
Best Kidney transplant hospital in Uttar Pradesh home
Apollo Hospitals Lucknow is one of the best kidney transplant centres in Lucknow, Uttar Pradesh. The hospital offers comprehensive kidney transplantation services and has a dedicated team of transplant surgeons, nephrologists, and other specialists who work together to provide the best care for patients. The hospital is equipped with advanced medical technology, including state-of-the-art operating rooms, intensive care units, and dialysis facilities.
The hospital has a well-established transplantation program and has performed a significant number of kidney transplants with high success rates. The hospital also has a track record of performing complex transplant cases and provides post-transplant care to ensure the best outcomes for patients.
In addition to the technical aspects of transplantation, the hospital also provides psychological and emotional support to patients and their families before, during, and after the transplantation process.
In summary, Apollo Hospitals Lucknow is a notable kidney transplantation center in Lucknow, Uttar Pradesh, known for its experienced team of transplant surgeons and nephrologists, advanced medical technology, high success rates and comprehensive care. It's always important to consult with medical professionals and conduct thorough research when seeking medical treatment.
Case presentation on SLE with Pleural effusion (Soap format)Dr. Sharad Chand
Case presentation on SLE with Pleural effusion ,with typical SOAP format, Pharmaceutical care plan, pharmacist intervention & Critical appraisal of the laboratory datas compared with standard reference values.
Deadline 6 PM Friday September 27, 201310 Project Management Que.docxedwardmarivel
Deadline 6 PM Friday September 27, 2013
10 Project Management Questions with sub-questions under each question. A word document is provided with all questions and directions.
Problem 1
The following data were obtained from a project to create a new portable electronic.
Activity
Duration
Predecessors
A
5 Days
---
B
6 Days
---
C
8 Days
---
D
4 Days
A, B
E
3 Days
C
F
5 Days
D
G
5 Days
E, F
H
9 Days
D
I
12 Days
G
Step 1: Construct a network diagram for the project.
Step 2: Answer the following questions:
a)
What is the Scheduled Completion of the Project?
b)
What is the Critical Path of the Project?
c)
What is the ES for Activity D?
d)
What is the LS for Activity G?
e)
What is the EF for Activity B?
f)
What is the LF for Activity H?
g)
What is the float for Activity I?
Problem 2
The following data were obtained from a project to build a pressure vessel:
Activity
Duration
Predecessors
A
6 weeks
---
B
6 weeks
---
C
5 weeks
B
D
4 weeks
A, C
E
5 weeks
B
F
7 weeks
D, E, G
G
4 weeks
B
H
8 weeks
F
I
5 weeks
G
J
3 week
I
Step 1: Construct a network diagram for the project.
Step 2: Answer the following questions:
a)
Calculate the scheduled completion time.
b)
Identify the critical path
c)
What is the slack time (float) for activity A?
d)
What is the slack time (float) for activity D?
e) What is the slack time (float) for activity E?
f) What is the slack time (float) for activity G?
Problem 3
The following data were obtained from a project to design a new software package:
Activity
Duration
Predecessors
A
5 Days
---
B
8 Days
---
C
6 Days
A
D
4 Days
C, B
E
5 Days
A
F
4 Days
D, E, G
G
4 Days
B, C
H
3 Day
G
Step 1: Construct a network diagram for the project.
Step 2: Answer the following questions:
a)
Calculate the scheduled completion time.
b)
Identify the critical path(s)
c)
What is the slack time (float) for activity B?
d)
What is the slack time (float) for activity D?
e) What is the slack time (float) for activity E?
f) What is the slack time (float) for activity G?
Problem 4
The following data were obtained from an in-house MIS project:
Activity
Duration
Predecessors
A
5 Days
---
B
8 Days
---
C
5 Days
A
D
4 Days
B
E
5 Days
B
F
3 Day
C, D
G
7 Days
C, D
H
6 Days
E, F, G
I
9 Days
E, F
Step 1: Construct a network diagram for the project.
Step 2: Answer the following questions:
a)
Calculate the scheduled completion time.
b)
Identify the critical path
c)
What is the slack time (float) for activity A?
d)
What is the slack time (float) for activity D?
e)
What is the slack time (float) for activity E?
f)
What is the slack time (float) for activity F?
PROBLEM 5
Use the network diagram below and the additional information provided to answer the corresponding questions.
a) Give the crash cost per day per activity.
b) Which activities should be crash.
More Related Content
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CASE REPORT ON osteomyelitis.
Osteomyelitis (Femur debridement & Bone cement Spacer with External fixator).
Femur Deridement-
Doctors may recommend a procedure called debridement to remove dead or damaged bone tissue in people with osteomyelitis. During this procedure, the doctor cuts away dead or damaged bone tissue. He or she also washes the wound to remove any dead or loose tissue.
Osteomyelitis: Osteomyelitis is an infection in a bone. Infections can reach a bone by traveling through the bloodstream or spreading from nearby tissue. Infections can also begin in the bone itself if an injury exposes the bone to germs.
Prof. Mridul Panditrao's Peri-operative Management of Jehovah's Witness Patient Prof. Mridul Panditrao
A case report of Emergency Peri-operative Mnagement of a Jehovah's Witness patient.
Because of their peculear religious belief, these patients do not accept Blood and It's products. This can pose serious problems to the Anesthesiologist.
Best Kidney transplant hospital in Uttar Pradesh home
Apollo Hospitals Lucknow is one of the best kidney transplant centres in Lucknow, Uttar Pradesh. The hospital offers comprehensive kidney transplantation services and has a dedicated team of transplant surgeons, nephrologists, and other specialists who work together to provide the best care for patients. The hospital is equipped with advanced medical technology, including state-of-the-art operating rooms, intensive care units, and dialysis facilities.
The hospital has a well-established transplantation program and has performed a significant number of kidney transplants with high success rates. The hospital also has a track record of performing complex transplant cases and provides post-transplant care to ensure the best outcomes for patients.
In addition to the technical aspects of transplantation, the hospital also provides psychological and emotional support to patients and their families before, during, and after the transplantation process.
In summary, Apollo Hospitals Lucknow is a notable kidney transplantation center in Lucknow, Uttar Pradesh, known for its experienced team of transplant surgeons and nephrologists, advanced medical technology, high success rates and comprehensive care. It's always important to consult with medical professionals and conduct thorough research when seeking medical treatment.
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Deadline 6 PM Friday September 27, 201310 Project Management Que.docxedwardmarivel
Deadline 6 PM Friday September 27, 2013
10 Project Management Questions with sub-questions under each question. A word document is provided with all questions and directions.
Problem 1
The following data were obtained from a project to create a new portable electronic.
Activity
Duration
Predecessors
A
5 Days
---
B
6 Days
---
C
8 Days
---
D
4 Days
A, B
E
3 Days
C
F
5 Days
D
G
5 Days
E, F
H
9 Days
D
I
12 Days
G
Step 1: Construct a network diagram for the project.
Step 2: Answer the following questions:
a)
What is the Scheduled Completion of the Project?
b)
What is the Critical Path of the Project?
c)
What is the ES for Activity D?
d)
What is the LS for Activity G?
e)
What is the EF for Activity B?
f)
What is the LF for Activity H?
g)
What is the float for Activity I?
Problem 2
The following data were obtained from a project to build a pressure vessel:
Activity
Duration
Predecessors
A
6 weeks
---
B
6 weeks
---
C
5 weeks
B
D
4 weeks
A, C
E
5 weeks
B
F
7 weeks
D, E, G
G
4 weeks
B
H
8 weeks
F
I
5 weeks
G
J
3 week
I
Step 1: Construct a network diagram for the project.
Step 2: Answer the following questions:
a)
Calculate the scheduled completion time.
b)
Identify the critical path
c)
What is the slack time (float) for activity A?
d)
What is the slack time (float) for activity D?
e) What is the slack time (float) for activity E?
f) What is the slack time (float) for activity G?
Problem 3
The following data were obtained from a project to design a new software package:
Activity
Duration
Predecessors
A
5 Days
---
B
8 Days
---
C
6 Days
A
D
4 Days
C, B
E
5 Days
A
F
4 Days
D, E, G
G
4 Days
B, C
H
3 Day
G
Step 1: Construct a network diagram for the project.
Step 2: Answer the following questions:
a)
Calculate the scheduled completion time.
b)
Identify the critical path(s)
c)
What is the slack time (float) for activity B?
d)
What is the slack time (float) for activity D?
e) What is the slack time (float) for activity E?
f) What is the slack time (float) for activity G?
Problem 4
The following data were obtained from an in-house MIS project:
Activity
Duration
Predecessors
A
5 Days
---
B
8 Days
---
C
5 Days
A
D
4 Days
B
E
5 Days
B
F
3 Day
C, D
G
7 Days
C, D
H
6 Days
E, F, G
I
9 Days
E, F
Step 1: Construct a network diagram for the project.
Step 2: Answer the following questions:
a)
Calculate the scheduled completion time.
b)
Identify the critical path
c)
What is the slack time (float) for activity A?
d)
What is the slack time (float) for activity D?
e)
What is the slack time (float) for activity E?
f)
What is the slack time (float) for activity F?
PROBLEM 5
Use the network diagram below and the additional information provided to answer the corresponding questions.
a) Give the crash cost per day per activity.
b) Which activities should be crash.
DEADLINE 15 HOURS
6 PAGES
UNDERGRADUATE
COURSEWORK
HARVARD FORMATING
DOUBLE SPACING
INSTRUCTIONS
This assignment seeks to assess your ability to:
• Critically evaluate and discuss the major developments during 2017 in corporate taxation from the perspective of multinational companies and their auditors, governments and other stakeholders.
• Apply appropriate knowledge, analytical techniques and concepts to problems and issues arising from both familiar and unfamiliar situations;
• Think critically, examine problems and issues from a number of perspectives, challenge viewpoints, ideas and concepts and make well-reasoned judgements;
• Present, discuss and defend ideas, concepts and views effectively through formal language.
Background:
In the final weeks of 2017 a leading tax expert suggested that “a whirlwind of international tax changes has swept the globe”. He also went on to say that for companies operating in Europe there is no end in sight to the pace of change. The final recommendations on base erosion and profit shifting (BEPS) from the OECD have been endorsed by the EU. In fact a number of European governments have already implemented large parts of these proposals ahead of schedule.
The third quarter of the year saw the European Commission in the spotlight with its landmark decision that the technology giant Apple must repay no less than €13 billion of taxes to the Irish government. This ruling was based on the view that the favourable tax treatment was effectively state aid and hence the Irish government had broken EU law. At the same time countries across the world continue to compete by reducing the rate of corporate taxes. Many commentators suggest that the UK government will cut the corporate tax rate to 10% if the country fails to negotiate a trade deal with the European Union as part of the Brexit process. In a separate development earlier in the year the government of Hungary announced it would become the tax haven of Central Europe with a plan to reduce corporation tax to a mere 9%.
Required:
You are to write a report for the Board of Directors of a listed global company that has manufacturing and R&D activities across Europe, Asia, Australasia and America. The report should assume that the directors have detailed knowledge of the group activities but are not taxation specialists. However they would be aware of issues relating to corporate governance, transparency and reputational risks.
The report should cover the following aspects:
Evaluate the major developments that occurred in corporate taxation in 2017 and the issues that may arise in the current year.
Discuss the implications for the group in regard to the relationship with its auditors.
Consider how other stakeholders and non-governmental organisations (NGOs) may be affected by changes in the level of corporate taxes and their possible reaction.
The resources below are on Blackboard and provide an introduction to the topic.
“Corpor.
De nada.El gusto es mío.Encantada.Me llamo Pepe.Muy bien, grac.docxedwardmarivel
De nada. El gusto es mío. Encantada. Me llamo Pepe.
Muy bien, gracias. Nada. Nos vemos. Soy de Argentina.
1. ¿Cómo te llamas?
2. ¿Qué hay de nuevo?
3. ¿De dónde eres?
4. Adiós.
5. ¿Cómo está usted?
6. Mucho gusto.
7. Te presento a la señora Díaz.
8. Muchas gracias.
Modelo ¡Hola! Buenos días.
Adiós cómo Chau de eres
es está gusto Hasta Le
mío Muy Soy usted vemos
1. ANA Buenos días, señor González. ¿Cómo (1) (2) ?
SR. GONZÁLEZ (3) bien, gracias. Y tú, ¿(4) estás?
ANA Regular. (5) presento a Antonio.
SR. GONZÁLEZ Mucho (6) , Antonio.
ANTONIO El gusto (7) (8) .
SR. GONZÁLEZ ¿De dónde (9) , Antonio?
ANTONIO (10) (11) México.
ANA (12) luego, señor González.
SR. GONZÁLEZ Nos (13) , Ana.
ANTONIO (14) , señor González.
• • Hasta mañana.
• Nos vemos.
• Buenos días.
• Hasta pronto.
• • ¿Qué tal?
• Regular.
• ¿Qué pasa?
• ¿Cómo estás?
• • Puerto Rico
• Washington
• México
• Estados Unidos
• • Muchas gracias.
• Muy bien, gracias.
• No muy bien.
• Regular.
• • ¿De dónde eres?
• ¿Cómo está usted?
• ¿De dónde es usted?
• ¿Cómo se llama usted?
• • Chau.
• Buenos días.
• Hola.
• ¿Qué tal?
Modelo un papel
unos papeles
1. : unas fotografías
2. : un día
3. : un cuaderno
4. : unos pasajeros
5. : una computadora
6. : unas escuelas
7. : unos videos
8. : un programa
9. : unos autobuses
10. : una palabra
Modelo el señor Díaz
Addresing him: usted
Talking about him: él
1. Don Francisco
Addressing him:
Talking about him:
2. Jimena y Marissa
Addressing them:
Talking about them:
3. Maru y Miguel
Addressing them:
Talking about them:
4. la profesora
Addressing her:
Talking about her:
5. un estudiante
Addressing him:
Talking about him:
6. el director de una escuela
Addressing him:
Talking about him:
7. tres chicas
Addressing them:
Talking about them:
8. un pasajero de autobús
Addressing him:
Talking about him:
9. Juan Carlos y Felipe
Addressing them:
Talking about them:
10. una turista
Addressing her:
Talking about her:
Modelo Ustedes son profesores.
Nosotros somos profesores.
1. Nosotros somos estudiantes.
Ustedes .
2. Usted es de Puerto Rico.
Ella .
3. Nosotros somos conductores.
Ellos .
4. Yo soy turista.
Tú .
5. Ustedes son de México.
Nosotras .
6. Ella es profesora.
Yo .
7. Tú eres de España.
Él .
8. Ellos son pasajeros.
Ellas
Modelo Yo soy Jorge.
1. Hola, me llamo Jorge y de Cuba. Pilar y Nati de España. Pedro, Juan y Paco de México. Todos estudiantes. La señorita Blasco de San Antonio. Ella la profesora. Luis el conductor. Él de Puerto Rico. Ellos de los Estados Unidos. El autobús de la agencia Marazul. Todos pasajeros de la agencia de viajes Marazul. Perdón, ¿de dónde tú, quién ella y de quién las maletas?
Modelo nombre / el pasajero
Es el nombre del pasajero.
.
DDL 24 hours reading the article and writing a 1-page doubl.docxedwardmarivel
DDL:
24 hours
reading the article and writing a
1-page double space
annotated bibliography
including:
1.reference
2.specify the concept you will use
3.explain its significance to the course
4.specify how you'll use it in your project
see the article and project inf below
.
*
DCF valuation methodSuper-normal growth modelApplications: single CF, annuity, perpetuity, uneven CFs, bond, stock, etc.
LECTURE 2 Valuation Basics
(Chapters 4, 6, 7)
*
Amount of cash flows expectedRisk of the cash flows Timing of the cash flow stream
Factors that Determine Value
*
DCF Method: General Formula
Finding PVs is discounting. The discount factor i is determined by the cost of capital invested.
*
10%
Single Cash Flow
100
0
1
2
3
PV = ?
What’s the PV of $100 due in 3 years if i = 10%?
*
Financial Calculator Setup
BGN END
P/Y 1
FORMAT: DEC 4 or larger
*
Financial Calculator
Solution
s
N I/YR PV PMTFV
?
N = 3, I/YR = 10, PMT = 0, FV = 100
CPT, PV
-75.13
/
INPUTS
OUTPUT
*
Spreadsheet
.
DDBA 8307 Week 2 Assignment Exemplar
John Doe[footnoteRef:1] [1: Type your name here]
DDBA 8307-6[footnoteRef:2] [2: Type in DDBA section number (e.g. DDBA 8307 – 6) ]
Dr. Jane Doe[footnoteRef:3] [3: Enter faculty name here.]
1
Scales of Measurement
Type text here. Discuss the implications of “scales of measurement” in quantitative research. Be sure to use a minimum of two citations to support your position(s). Be sure to review the “Scales of Measurement” media from Week 1. This section should be no more than two paragraphs.
Research Question
What are the means, standard deviations, frequencies, and percentages of the Lesson 21 Exercise File variables?
Presentation of Findings
I analyzed data from Lesson 21 Exercise File [footnoteRef:4]. In this section, I present descriptive statistics for the study quantitative and qualitative variables. Appropriate APA tables and figures accompany the analysis[footnoteRef:5]. [4: Insert the appropriate file name. ] [5: The tables and figures from your SPSS output will need to be copied and pasted in the appropriate location.]
Descriptive Statistics[footnoteRef:6] [6: Detailed information can be found in Lesson 20, “Univariate Descriptive Statistics for Qualitative Variables,” and Lesson 21, “Univariate Descriptive Statistics for Quantitative Variables,” in the Green and Salkind text.
]
Descriptive statistics were run for the quantitative and qualitative variables in the Week 1 Assignment data set. Table 1 depicts the means and standard deviations for the quantitative data. Figure 1 depicts a histogram for the GPA variable. Table 2 depicts the frequencies and percentages for the qualitative (categorical) data. Figure 2 depicts a pie chart for the ethnic variable. Appendix 1 depicts the SPSS output.
Table 1[footnoteRef:7] [7: This is an example of an APA-formatted descriptive statistics table. Refer to Sections 5.01-5.19, in the APA Manual for detailed information on APA tables. The descriptive statistics table here includes the appropriate information derived from the SPSS output that is to be pasted as an appendix. Do not split tables across pages. Note: The numbers in the SPSS output presented here are fictitious numbers and do not represent correct numbers in the data set you will use for this application.
]
Means (M) and Standard Deviations (SD) for Study
Quantitative Variables (N = 105)
Variable[footnoteRef:8] [8: You would simply add rows to the table to accommodate the variables you have used in the analysis (i.e., variable 3, variable 4, etc.). Hint: Use the Microsoft Word Table feature.
]
M
SD
GPA
2.78
.76
Final
61.48
7.94
Percent
80.34
12.12
Figure 1. Histogram of GPA distribution.
Table 2[footnoteRef:9] [9: Recall from Lesson 20, “Univariate Descriptive Statistics for Qualitative Variables” (Green & Salkind, 2017), frequencies and percentages are reported for qualitative (nominal) variables. Note: Frequency and percentages are the only c.
DBM380 v14Create a DatabaseDBM380 v14Page 2 of 2Create a D.docxedwardmarivel
DBM/380 v14
Create a Database
DBM/380 v14
Page 2 of 2Create a Database
The following assignment is based on the business scenario for which you created both an entity-relationship diagram and a normalized database design in Week 2.
For this assignment, you will create multiple related tables that match your normalized database design. In other words, you will implement a physical design (an actual, usable database) based on a logical design.
Refer to the linked W3Schools.com articles “SQL CREATE TABLE Statement,” “SQL PRIMARY KEY Constraint,” “SQL FOREIGN KEY Constraint,” and “SQL INSERT INTO Statement” for help in completing this assignment.
Note: In the industry, even the most carefully thought out database designs can contain mistakes. Feel free to correct in your tables any mistakes you notice in your normalized database design. Also, note that in Microsoft® Access®, you follow the steps below to launch the SQL editor:
Figure 1. To create a SQL query in Microsoft® Access®, begin by clicking the CREATE tab.
To Complete This Assignment:
1. Use the CREATE TABLE statement to create each table in your design. Note that a table in a RDMS corresponds to an entity in an entity-relationship diagram. Recommended tables for this assignment are CUSTOMER, ORDER, ORDER_DETAIL, PRODUCT, EMPLOYEE, and STORE.
2. As part of each CREATE TABLE statement, define all of the columns, or fields, that you want each particular table to contain. Give them short, meaningful names and include constraints; that is, describe what type of data each column (field) is allowed to hold and any other constraints, such as size, range, or uniqueness.
3. Note that any field you marked as a unique identifier in your normalized database design is a key field. Key fields must be described as both UNIQUE and NOT NULL, which means a value must exist for each record and that value must be unique across all records.
4. After you have created all six tables, including relationships between the tables as appropriate (matching the primary key in one table to a foreign key in another table), use the INSERT INTO statement to insert 10 records into each of your tables. You will need to make up the data you insert into your tables. For example, to insert one record into the CUSTOMER table, you will need to invent a customer number, a customer name, and so on—one value for each of the fields you defined for the CUSTOMER table—to insert into the table.
5. To ensure that your INSERT INTO statements succeeded in populating your tables, use the SELECT statement described in Ch. 7, “Introduction to Structured Query Language,” in Database Systems: Design, Implementation, and Management.to retrieve the records you inserted. For example, to see all 10 records you inserted into the CUSTOMER table, you might apply the following SQL statement: SELECT * FROM CUSTOMER;
After you have created all six tables and populated ten records in each table, submit to the Assignment Files tab the database containin.
DB3.1 Mexico corruptionDiscuss the connection between pol.docxedwardmarivel
DB3.1: Mexico corruption
Discuss the connection between politics, corruption, and criminal organizations in Mexico. How would you go about separating these? Give examples and be specific. Support your ideas on why you would do these specific measures.
DB3.2: Collapse of Soviet Union
How has the collapse of the Soviet Union fostered pirate capitalism and organized crime? Be specific with your answer and support your answer. Do you think that if the Soviet Union did not collapse pirate capitalism and organized crime would still flourish? Support your opinion.
300 words per post
.
DB2Pepsi Co and Coke American beverage giants, must adhere to th.docxedwardmarivel
DB2
Pepsi Co and Coke American beverage giants, must adhere to the U.S Foreign Corruption Act wherever their businesses may take them. Both companies expanded their U.S businesses to India with differing initial results. Coke came home (initially) and Pepsi Co prospered.
Do your research and explain the socio-cultural barriers faced by these two companies? What in your view were the reasons which negatively impacted Coke and positively touched Pepsi Co?
WEEK 3:
Interactive
: Select one company other than the 2 mentioned above, and share this company’s experience in the United Arab Emirates. Comment on another learner’s company experience in a different location of the world.
WEEK 4:
Interactive
: Comment on a different learner’s company experience in a totally different location from those completed earlier. Do you feel that cultural training is an essential pre-requisite for expatriates in any host country? Why/Why not?
Remember to use APA referencing in the body of your posting.
.
DB1 What Ive observedHave you ever experienced a self-managed .docxedwardmarivel
DB1: What I've observed
Have you ever experienced a self-managed team? If so, describe it. If not, why do you think your organization has not embraced self managed teams?
DB2: Case Analysis
Review the case study at the end of Chapter 8, Frederick W. Smith - FedEx. Answer the five questions below:
1. How do the standards set by Fred Smith for FedEx teams improve organizational performance?
2. What motivates the members of FedEx to remain highly engaged in their teams?
3. Describe the role FedEx managers play in facilitating team effectiveness.
4. What types of teams does FedEx use? Provide evidence from the case to support your answer.
5. Leaders play a critical role in building effective teams. Cite evidence from the case that FedEx managers performed some of these roles in developing effective teams.
Image Source Team:
http://www.freedigitalphotos.net/images/gallery-thumbnails.php?id=50143103253525199427035558
.
DB Response 1I agree with the decision to search the house. Ther.docxedwardmarivel
DB Response 1
I agree with the decision to search the house. There was reasonable suspicion to believe the fugitive could have been in the home. The homeowner not only consented to the search of the house but requested it for her safety. Complacency kills. In this situation, the officer is very regretful in his decision to conduct a complacent search of the home, and luckily nobody was killed.
My department does not have body cameras, but I still conduct business as if somebody is recording me. We live in a generation of surveillance. You never know when there are hidden cameras, a camera on a business you did not notice, or a cell phone recording from the top floor of a building. We hire police officers with high amounts of integrity because the definition of integrity is doing the right thing even when nobody is looking. I would be lying if I said my grandmother would approve of everything I do on the job. I am most guilty of foul language and it is something that I am working on not doing that. However, I can emphatically say I work with integrity and honesty without a doubt.
I think setting limits on tolerable behavior in regards to sexual and general harassment is appropriate; however, there are too many situations to make a policy for every behavior one could find inappropriate. When it comes to using force again every situation is different but there should be a pretty well laid out policy at departments for when and how an officer should use a certain amount of force. Officers should be trained on de-escalation tactics and alternatives to using force. Tactical training should include strategies to create time, space, and distance, to reduce the likelihood that force will be necessary and should occur in realistic conditions appropriate to the department’s location (U.S. Commission On Civil Rights, 2018).
Philippians 2 verses 3 – 8 is a pretty straightforward verse with great leadership lessons. Be humble, put others before yourself, and be a servant leader.
From the very beginning of any interrogation, the accused has constitutional rights not to speak to police and also to have an attorney present. The Eighth Amendment to the Constitution prohibits cruel and unusual punishments placed upon any persons in the U.S. With these rights in mind I will only go as far as the Constitution allows when interrogating this suspect even if the suspect admits where the child is if the admission was coerced that admission could get thrown out of court. I would never compromise the investigation. There are other ways to find the abducted girl through detective work than just interrogating the suspect. The cost of illegal interrogations is documented in the number of lost prosecutions. Literally, thousands of cases across the country have had to be dismissed because prosecutors could not trust that the evidence provided by police officers was legitimate or the officer had lost credibility as a witness in all cases because of his or her wrongdoing (P.
DB Response prompt ZAKChapter 7, Q1.Customers are expecting.docxedwardmarivel
DB Response prompt ZAK
Chapter 7, Q1.
Customers are expecting more from their service providers. Rather than traditionally accepting boilerplate offerings from service providers, customers desire that service providers cater to their requests. Organizations providing services must keep up with the customer’s demand or risk losing business to others who will. Many service providers have been adopting lean principles to accommodate the needs of their customers in successful attempts to decrease waste, increase efficiency, improve customer service and satisfaction (Daft, 2016, p. 275). From online music providers, customers expect music tracks personalized for their tastes. From airlines, customers can expect preflight seat and meal selections. Amazon.com provides custom personalization to a customers’ home pages by placing personally directed advertisements and products which the customer is more likely to order from the company. Amazon book recommendations are personalized to the specific customer and are provided based upon previous books read. With customers expecting customized and catered experiences, companies need to keep up with this demand and embrace mass customization in order to obtain and retain customers.
Chapter 7, Q2.
While many facets of businesses may involve craft technology, it is still important for business schools to teach management. Some businesses which only expect their leaders to gain knowledge and expertise from experience, may be creating a bureaucratic and restricted model for their business. Companies which rely only on internal training for their leaders can miss opportunities from potential leaders coming in from the outside. Business schools which teach management can provide potential leaders with a foundation to draw from. Teaching management can expose students to issues and opportunities experienced by others, not just ones restricted to one specific company. Teaching management from a textbook is just one method of conveying information. Just as one would not necessarily be proficient in piloting a boat from reading a book, a textbook about doing so would provide the student with underlying concepts which could dramatically increase the success of the student when they move to an actual boat. This textbook based training would be further enhanced with some practical experience.
Chapter 8, Q1.
Technology has progressed allowing real time instant messaging and virtual meetings. High level managers can indeed expect technology to allow them to do their jobs with little face-to-face communication, but they should question if that is something they really want to do. There are currently methods available which could be used effectively to communicate with subordinates, employees and stockholders, such as recorded feeds which would be able to reach every associated individual. These however may not provide a sense of personalization from the managers. Leaders in an organization may resort to using tec.
DB Topic of Discussion Information-related CapabilitiesAnalyze .docxedwardmarivel
DB Topic of Discussion: Information-related Capabilities
Analyze 2 of the 14 information-related capabilities and explain how the joint force can use these capabilities to affect the three dimensions of the information environment. Give examples of real-world or life events for the capabilities and how can you use these concepts as a CSM/SGM.
Consumer Brand Metrics Q3 2015
Eater Archetypes:
Brand usage and preferences by consumer segment
The restaurant industry has long relied on demographic factors to
identify and prioritize consumer groups. For example, many
brands currently obsess over attracting Millennials—some
without pausing to consider the variations among consumers
within this demographic cohort. In addition to life stages,
consumer attitudes about health, value, convenience and the
overall role of foodservice in their lives drive significant
differences in preferences and behavior.
With these distinctions in mind, we have updated the Consumer
Brand Metrics (CBM) survey with questions that allow us to
segment consumers into one of seven Eater Archetypes. Each
segment has a distinct psychographic profile, which is outlined in
our recent Consumer Foodservice Landscape. Accordingly, their
patronage of the segments and brands tracked in CBM varies.
This paper explores some differences we can discern after the
initial quarterly results, including the archetypes’ segment usage,
brand patronage and occasion dynamics. Examining CBM data by
Eater Archetype reveals nuances that complement a demographic
profile of a chain’s guests.
By Colleen Rothman, Manager, Consumer Insights
To learn more about the Consumer Brand Metrics program or to sign up for future
Spotlight by Consumer Brand Metrics white papers, please contact Bart Henyan,
Senior Marketing Manager, at [email protected]
Consumer Brand Metrics Q3 2015
Segmenting consumers by psychographic factors, rather than
just demographic characteristics, can lead to a better
understanding of the consumers that matter to your brand and
how to appeal to them.
Key Takeaways
Busy Balancers and Functional Eaters drive usage across
restaurants and convenience stores. Full-service restaurant
(FSR) operators may also consider targeting Foodservice
Hobbyists and Affluent Socializers, as these archetypes
comprise more than a quarter of FSR patrons, on average.
How does foodservice segment usage vary by archetype?
Driven by unique needs and motivations, Eater Archetypes
gravitate to a wide variety of brands. For example,
McDonald’s, Burger King and Whataburger each
disproportionately attract unique archetypes (Habitual
Matures, Bargain Hunters and Functional Eaters,
respectively).
Which chains do each archetype visit most frequently?
Archetypes that patronize the same restaurant may not use
the brand the same way. For example, usage varies by
daypart, with afternoon snacks skewing to Busy Balancers
and late-night meals d.
DB Instructions Each reply must be 250–300 words with a minim.docxedwardmarivel
DB Instructions:
Each reply must be 250–300 words with a minimum of 1 scholarly source. The scholarly source used for your thread and response should be in addition to the class textbooks.
Reference Book: Young, M. (2017). Learning the Art of Helping. Boston, MA: Pearson. ISBN: 9780134165783.
.
DB Defining White Collar CrimeHow would you define white co.docxedwardmarivel
DB: Defining White Collar Crime
How would you define white collar crime? What are the advantages and disadvantages of the various terms, such as “white collar crime,” “crimes of the powerful,” “elite deviance,” etc., used to describe the type of crimes.
300 Word Minimum
.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
4. Chelsea bassett
Joelle Latham
Lisa Leonard
Signature:
Signature:
Signature:
Post- Operative check performed by:
Xray/Scans:
Patient reception check performed by:
Given and signed
Given and signed
Pre-Operative check performed by:
Medical Certificate
Follow up Appointments
Observations Checked
Discharge SummaryGraduated compression stockings insitu
(Circle) N/A / with Patient / With Doctor
VTE Prevention Anticoagulant
5. Investigations: FBC updated
Check/Wound/Drain tube
POST OP ONLY
Epidural Test Dose
Post Op Orders
Glasses
Hearing aids
Posthetic devices
Pacemaker insitu:
Seen by technician
Pre Op Prep: Skin Prep (Betadine)
Bariatric: (>120kg) - Notify Theatre
(obtain Hover mat prior to transfer to OT)
Cytotoxic Drugs Within 48 hours
Weight Recorded:
Anaes. Record
Fasting time: Food
Fluid(Document time)
6. Own teeth:
Pre-medication Ordered
Ordered
IV Therapy IV bung flushed
IV orders written
Clip
Bowel Prep
Identification Labels: Min of 20
Infectious State: Please state:
Theatre notified
History: (circle) Old New
Jewellery: (circle) Taped / Removed
Make-up/Nail Polish: Removed
Underwear: (circle) Disposable / Own
Female Sanitary Products:
NB:Please remove tampons Pad in situ
Personal items with patient:
Contact lenses
7. Procedure on consent form corresponds with
Theatre List
* Do not allow pt to leave holding bay
Side and site of surgery:
Allergies:
Wrist band
Patient Identifcation (check against
Consent form:
Admission form: Wrist band
Leg band
Patient/rep signature
Doctors signature
Comments: (e.g. Alerts, manual handling issues, Infections,
Bariatric skin integ.)
PRE AND POST OPERATIVE CHECKLIST YES P NO O Not
Applicable N/A
5/03/2018
8. DOCTOR John Smith
DATE OF BIRTH
ROBERTS
Darren
25 Happy Street
CAIRNS 4860
23/11/1968
SURNAME
FIRST NAME
ADDRESS
SIMULATED HOSPITAL
Name ROBERTS, Darren Lab ID
UR 075486 Request Date 04/03/2018
Age/Sex 50 years, Male Reported Date 05/03/2018
Test Normal Range Result
Na+ mmol/L 139
K+ mmol/L 4.5
10. 0.7 - 1.1
135 - 145
3.5 - 5.3
95 - 105
50 - 120
3.9 - 6.2
Simulated Hospital
Name ROBERTS, Darren Lab ID
UR 075486 Request Date 04/03/2018
Age/Sex 50 years, Male Reported Date 05/03/2018
Test Normal Range Result
Hb g/L 155
WCC x 10⁹L 4.3
Neutrophils x 10⁹L 2
Lymphocytes x 10⁹L 1.8
Platelets x 10⁹L 300
HCT % 48
12. UR 075486 Request Date 04/03/2018
Age/Sex 50 years, Male Reported Date 05/03/2018
Test Normal Range Result
Total Protein g/L 65
Albumin g/L 42
Globulin g/L 28
Total Bilirubin µmmol/L 9
ALP IU/L 50
ALT IU/L 40 - 50
60 - 80
38 - 55
20 - 32
2 - 20
30 - 120
Laboratory Report
2100045678
LFT
Simulated Hospital
13. RN: Lisa Leonard
Item Number (s)
YES
INFECTION STATUS
CLEAN
Dressings INFECTED
Drain Tubes POTENTIALLY INFECTED
DATE:
Operation Performed:
Post Operative Orders (Please print or write clearly)
- RPAO
- IV therapy as charted
Laprascopic +/- Open Cholecystectomy
Details of Operation (including incision, organs removed and
findings)
URN
SURNAME
GIVEN NAME
14. ADDRESS
DATE OF BIRTH
Reece Latham
5th March 2018
John Smith
Chronic Cholecystitis
75486
ROBERTS
Darren
25 Happy Street
CAIRNS 4860
23/11/1968
John SmithOPERATION REPORT
Simulated Hospital
DOCTOR
Date of Operation:
Surgeon:
Operative Diagnosis:
15. Assistant:
- Pain relief as charted
- Diet and fluids as tolerated once bowel sounds present
- Ambulate as tolerated
Speciman to Pathology
- Dressing to remain intact for 7 days
- Follow up with local GP if any concerns post discharge
SURGEONS SIGNATURE John Smith
Original Copy to remain with Hospital Duplicate Copy for
Surgeons records
REASON
Steri Strips and Gauze
Drug and I.V Therapy - As charted arts
5th March 2018
P
Patient placed on standard operating table in supine surgical
position and sites of compression well
padded. Patient prepared with iodine solution and draped in a
sterile fashion. A paramedian incison
was made approximately 5cm in lenght wiht a #10 blade
scalpel, Next haemostasis was obtained
using electro Bovie cautery. Dissection was carried down
16. transrectus in the midline to the posterior
rectus fascia, which was grasped and the abdomen was entered.
The gallbladder was immediately
visualised and brought into view. It was found to be inflammed,
thickened and filmy adhesions were
present. Adhesions to the gallbladder taken down with sharp
dissection. Contents of gallbladder
were aspirated. Gallbladder disected free from liver bed, placed
into specimen bag and
The peritoneum as well as posterior rectus fascia was
approximated with a running #0 Vicryl
suture and tehn the anterior rectus fascia was clised in
interrupted figure- of-eight #0 Vicryl sutures.
Skin staples were used on the skin and sterile dressings were
applied. The patient was transferred
to recovery in a stable condition.
- VTE precautions as charted
withdrawn through the incision. Prior to closure, peritoneal
cavity examined and showed complete
signs of haemostasis, no bleeding from the gallbladder bed and
no evidence of bowel injury.
Original Copy to remain with Hospital Duplicate Copy for
Surgeons records
O
P
E
18. R
T
�LATROBE
� UNIVERSITY
Simulated Hospital
FLUID BALANCE CHART
PLEASE NOTE
• Urine output <50mls / 4hrs requires MET to be called
• Urine catheters must be measure and recorded minimum 4/24
• All fluid volumes are to be checked, totalled and balanced
minimum 8/24
• Fluid Balance Summary MR 128 to be completed at 2400 hrs
• This chart is to be filed in the medical record
DATE INPUT (mis) HOUR PROG.
INTRAVENOUS/EPIDURAUSUBCUTANEOUS
GASTROINTESTINAL
TOTAL TOTAL
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24 hr 24 hr
total total
URN
SURNAME
20. GIVEN NAMES
ADDRESS
DATE OF BIRTH
SEX
DOCTOR
OUTPUT (mis)
COMMENTS
75486
ROBERTS
Darren
25 Happy Street
CAIRNS 4860
23/11/1968
Male
John Smith
HOUR PROG.
TOTAL TOTAL
PROG.
BALANCE
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Darren Roberts Documentation
Enquiry One - Darren Roberts
Darren Roberts, 50 years admitted for Elective +/- Open
Cholecystectomy
Darren's Story
Darren lives in Cairns where he is the owner/operator of a
diving boat tour company. He has moved to a more sedentary
role over the last few years and misses getting out and working
with the tourists.
Darren has one son, Jake, 15 who lives in Wallan, Victoria with
his mum Lisa, step dad Kevin and his 5-year-old stepsister
22. Ruby.
Jake and Darren have a good relationship, Jake fly’s to Cairns
twice a year during school holidays to stay with his Dad.
Darren’s History
DOB: 23/11/1968
Address: 25 Happy Street Cairns
Smoker: 30 per day for last 20 years
Social Drinker 2 heavy beers a day after work and up to 10 a
day on the weekends - Darren’s favourite saying -It’s 5 o’clock
somewhere’
^BMI -33 H: 1.8m W: 110Kg Waist: 115cm
Darren has a past medical history including, hypertension,
hyperlipidemia, mild depression and GORD. He currently takes
medication for these conditions.
· Hypertension
· Hyperlipidemia
· Mild Depression
· Gastric Oesophageal Reflux
He has experienced two episodes of upper abdominal pain
during the night with associated nausea and vomiting within the
last month.
Medications
Generic name
Trade name
Dose
Atorvastatin
Lipitor
10mg Daily
Atenolol
Noten
50mg Daily
Sertraline
Zoloft
20mg BD
23. Ranitidine
Zantac
150mg daily
Darren does not attend regular check-ups with his GP. He last
had his medicaitons reviewed when he presented to the GP
around 12 months ago with his first presentation of upper
abdominal pain, nausea and vomiting. He was commenced on
Ranitidine at tis time.
In the last month, Darren has had two more severe episodes of
upper abdominal pain with nausea & vomiting. He ignored the
first episode and it settled after 24 hours. However, Darren has
presented to the Emergency Department in Cairns 1/7 ago with
similar symptoms but more severe.
Darren’s diagnosis is mild- severe Cholecystitis. Darren has
been transferred to the surgical ward where he is awaiting an
elective Laparoscopic +/- Open Cholecystectomy. Darren has
had pre- operative blood pathology collected including his
Cholesterol, which is reading high. This is part of Darren’s pre-
operative work up.
Darren Roberts Documentation
Enquiry One - Darren Roberts
Darren Roberts, 50 years admitted for Elective +/- Open
Cholecystectomy
Darren's Story
Darren lives in Cairns where he is the owner/operator of a
diving boat tour company.
He has moved to a more sedentary role over the last few years
and misses getting
out and working with the tourists.
24. Darren has one son, Jake, 15 who lives in Wallan, Victoria with
his mum Lisa, step dad
Kevin and his 5-year-old stepsister Ruby.
Jake and Darren have a good relationship, Jake fly’s to Cairns
twice a year during school
holidays to stay with his Dad.
Darren’s History
DOB: 23/11/1968
Address: 25 Happy Street Cairns
Smoker: 30 per day for last 20 years
Social Drinker 2 heavy beers a day after work and up to 10 a
day on the weekends - Darren’s favourite saying -It’s 5 o’clock
somewhere’
^BMI -33 H: 1.8m W: 110Kg Waist: 115cm
Darren has a past medical history including, hypertension,
hyperlipidemia,
mild depression and GORD. He currently takes medication for
these conditions.
Hypertension
Hyperlipidemia
Mild Depression
Gastric Oesophageal Reflux
He has experienced two episodes of upper abdominal pain
during the night
with associated nausea and vomiting within the last month.
Medications
Generic name
25. Trade name
Dose
Atorvastatin
Lipitor
10mg Daily
Atenolol
Noten
50mg Daily
Sertraline
Zoloft
20mg BD
Ranitidine
Zantac
150mg daily
Darren does not attend regular check-ups with his GP. He last
had his medicaitons
reviewed when he presented to the GP around 12 months ago
with his first presentation
of upper abdominal pain, nausea and vomiting. He was
commenced on Ranitidine at this time.
In the last month, Darren has had two more severe episodes of
upper abdominal pain with
nausea & vomiting. He ignored the first episode and it settled
after 24 hours. However, Darren
has presented to the Emergency Department in Cairns 1/7 ago
with similar symptoms but
more severe.
Darren’s diagnosis is mild- severe Cholecystitis. Darren has
been transferred to the surgical
ward where he is awaiting an elective Laparoscopic +/- Open
Cholecystectomy. Darren has
had pre- operative blood pathology collected including his
Cholesterol, which is reading high.
This is part of Darren’s pre-operative work up.
26. Enquiry Based Learning
This enquiry will introduce the students to the concepts of
managing a patient requiring hospitalisation
and a surgical intervention. It will also explore communication
skills, legal considerations, psychosocial
care and the impact of hospitalization upon the family unit.
This enquiry will require students to use the clinical reasoning
cycle and health assessment skills to plan
pre and post-operative care for Darren.
It is important that you have a good understanding of the
concepts in Darren's story.
If you are unsure of any of the conditions or medicaitons, you
will need to explore these prior to attending your first
workshop.
l
ALCOHOL WITHDRAWAL
ASSESSMENT SCORING TOOL
(CIWA-Ar Scale)
Surname ________________________________
Given Name _____________________________
UR No _____________ DOB ________________
27. Address _________________________________
GP ________________ Sex _________________
Assess and rate each of the following : Refer to reverse for
detailed instruction in use of the CIWA-Ar-Scale
Nause a/vomiting (0 - 7)
0 - no ne; 1 - mild na us e a , no vo miting; 4 - inte rmitte nt
na us e a; 7 - c o ns ta nt na use a , f re quent dry he a ve s &
vo miting
Tr e mors (0— 7)
0 - no tremor; 1 - not visible but can be felt; 4 - moderate w/
arms extended; 7 - severe, even w/arms not extended
Anxie ty (0 - 7)
0 - no ne a t e as e; 1 - mildly a nxio us; 4 - mo de ra te ly
a nxio us o r gua rde d; 7 - e quiva le nt to a c ute pa nic s ta
te
Ag itation (0 - 7)
0 - normal activity; 1 - somewhat normal activity; 4 -
moderately
fidget/restless; 7 - paces or constantly thrashes about
Par oxy smal swe ats (0 - 7)
0 - no s we a ts; 1 - ba re ly pe rc e ptible s we a ting, pa lms
mo is t; 4 - be a ds o f wea rs o bvio us o n f o re he a d; 7 -
dre nc hing s we a t
O r ie ntation (0 - 4)
0 - oriented; 1 - uncertain about date; 2 - disoriented to date by
no more than two days; 3 - disoriented to date by > two days; 4
-
disoriented to place and / or person
28. Tactile Distur bance s (0 - 7)
0 - none; 1 - very mid itch, P&N, numbness; 2 - mild itch, P&N,
burning, numbness; 3 - moderate itch, P&N, burning, numbness;
4 - moderate hallucinations; 6 - extremely serve hallucinations ;
7
- continuous hallucinations
Auditor y Distur bances (0 — 7)
0 - not present; 1 - very mild harshness/ ability to startle; 2 -
mild
harshness, ability to startle; 3 - moderate harshness, ability to
startle; 4 - moderate hallucinations; 5 - serve hallucinations; 6 -
extremely severe hallucinations; 7 - continuous hallucinations
Visual Distur bance s (0 - 7)
0 - not present; 1 - very mild sensitivity; 2 -mild sensitivity; 3 -
moderate sensitivity; 4moderate hallucinations; 5 - severe hallu-
cinations; 6 - extremely severe hallucinations; 7 - continuous
hallucinations
He adache (0 - 7)
0 - not present; 1 - very mild; 2 - mild; 3 - moderate; 4 - moder-
ately severe; 5 - severe; 6 - very severe; 7 - extremely severe
Total CIWA-Ar score:
P R N Med : ( ci rc le one) Dose given (mg):
Diazepam Lorazepam Route:
Time of PRN medication administration:
Assessment of response (CIWA-Ar-score 30-60
minutes after medication administered )
RN Initials
29. Assessment Protocol:
a. Vitals Assessment Now.
b. If initial score ≥ 8 repeat q 1 h × 8 hrs, then if
stable q2h × 8 hrs, then if stable q4h.
c. If initial score < 8 for 72 hrs, d/c assessment. If
score ≥ 8 at any time, go to (b) above.
d. If indicated, (see indications below) administer
prn medication as ordered and record on MAR
and below.
Date
Time
Pulse
RR
O2 Sat
BP
Scale f or Scor ing:
Total Sc or e =
0 - 9: absen t or min imal wi thdr awal
10 - 19: mild to mode r ate wi thd rawal
Mo re than 20: se ver e withd rawal
Indica tio ns for PRN medica tio ns:
a. Total CIWA -AR sco re 8 or h igher if ord ered PRN o nly
(Symptom -tr iggered
30. method)
b. Total CIWS -Ar sco re 15 or highe r if on Sc hedu led
medica ti on (Sch edul ed +
prn method)
Conside r tran sfe r to ICU for any of the fo llow ing: Tota l s
cor e ab o ve 35, q1h
assess, x more tha n 8he s r equi re d, more than 4 mg/hr lor
aze pam × 3hr or 20
mg/hr diaze pam ×3hr req ui red, or r esp. dis tr ess
Roberts
Darren
075486 23/11/1968
25 Happy St, Carins
J. Smith M
5/3/
18
0300
90R
20
96%RA
140/
88
1
0
32. Day 2 10mg 10mg 10mg 10mg
Day 3 5mg 5mg 5mg 10mg
Day 4 5mg 5mg 5mg 10mg
Day 5 5mg - - 5mg
Day 6 5mg - - 5mg
Alcohol Withdrawal Assessment Scoring Guidelines (CIWA -
AR)
Na usea / vomiting - R a te o n sca le 0- 7
0 - No ne
1 - M ild na use a with no vo miting
2 -
3 -
4 - I nte rmitte nt na us ea
5 -
6 -
7 - C o ns ta nt na us ea a nd f re que nt dry he a ve s a nd vo
miting
Tremors - have patient extend arms & spread fingers. Rate on
scale 0
-7
33. 0 - No tremor
1 - Not vis ible, but can be felt fingertip to fingertip
2 -
3 -
4 - Moderate, with patient’s arm extended
5 -
6 -
7 - severe, even w/ arms not extended
Anx iety - R a te o n s ca le 0 - 7
0 - No a nxie ty, pa tie nt a t e as e
1 - M ildly a nxio us
2 -
3 -
4 - Mo de ra te ly a nxio us o r gua rde d, so a nxie ty is inf e
rre d
5 -
6 -
7 - e quiva le nt to a c ute pa nic s ta te s se e n in s e ve re
34. de lirium o r a c ute sc hiz o phre nic re ac tio ns
Ag ita tion - R a te o n s ca le 0 - 7
0 - No rma l a c tivity
1 - So me wha t no rma l a c tivity
2 -
3 -
4 - Mo de ra te ly f idge ty a nd res tle ss
5 -
6 -
7 - P ac es bac k a nd fo rth, o r c o ns ta ntly thra s he s a bo
ut
Tactile disturbances - Ask, “Have you experienced any itching,
pins
& needles sensation, burning or numbness, or a feeling bugs
crawling
on or under your skin?”
0 - None
1 - Very mild itching, pins & needles, burning, or numbness
2 - Mild itching, pins & needles, burning, or numbness
3 - Moderate itching, pins & needles, burning, or numbness
35. 4 - Moderate hallucinations
5 - Severe hallucinations
6 - Extremely severe hallucinations
7 - Continuous hallucinations
P a r ox ysma l Swea ts - Ra te o n sc a le 0 - 7
0 - No s we a ts
1 - Ba re ly pe rc e ptible s wea ting, pa lms mo is t
2 -
3 -
4 - Be a ds o f s wea t o bvio us o n f o re hea d
5 -
6 -
7 - D re nc hing s we a ts
Or ienta tion a nd clouding of sensor ium - As k “W ha t da y
is this ?
W he re a re yo u? W ho a m I ” R a te sc a le 0 - 4
0 - Orie nte d
1 - C a nno t do se ria l a dditio ns o r is unc e rta in a bo ut
da te
36. 2 - D is o rie nte d to da te by no m or e tha n 2 ca le n da r
d a ys
3 - D is o rie nte d to da te by mo r e th a n 2 ca le nd a r d a
ys ?
4 - D is o rie nte d to pla ce a nd / o r pe rso n
Auditory disturbances - Ask, “Are you more aware of sounds
around
you? Are they hars h? Do they startle you? Do you hear
anything that
disturbs you that you know isn’t there?”
0 - Not present
1 - Very mild harshness or ability to startle
2 - Mild harshness or ability to startle
3 - Moderate harshness or ability to startle
4 - Moderate hallucinations
5 - Severe hallucinations
6 - Extremely severe hallucinations
7 - Continuous hallucinations
Visual disturbances - Ask, “Does the light appear to be too
bright? It
37. its colour different than normal? Does it hurt your eyes? Are
you
seeing anything that disturbs you or that you know isn’t there?”
0 - No present
1 - Very mild sens itivity
2 - Mild sensitivity
3 - Moderate sensitivity
4 - Moderate hallucinations
5 - Severe hallucinations
6 - Extremely severe hallucinations
7 - Continuous hallucinations
Headache - Ask, “Does your head feel different than usual?
Does it
feel like there is a band around your head?” So not rate
dizziness or
lightheadedness.
0 - No present
1 - Very mild sens itivity
2 - Mild sensitivity
3 - Moderate sensitivity
38. 4 - Moderate hallucinations
5 - Severe hallucinations
6 - Extremely severe hallucinations
7 - Continuous hallucinations
P ro ce dure :
1. A ss es s a nd ra te ea c h o f the 10 c rite ria of the CI
WA s ca le. Eac h c rite rio n is ra te d o n a sc a le fo rm 0 to
7, e xpec t fo r “Orie nt a tio n a nd c lo uding o f
s e nso rium” whic h is ra te d o n a s ca le f ro m 0 to 4. A
dd up the s co re d fo r a ll te n c rite ria / This is the to ta l
CI WA - Ar s co re fo r th e pa tie nt a t the
time . P ro phylac tic me dic a tio n, s ho uld be s ta rte d fo r
a ny pa tie nt with a to ta l C IW A -A r sc o re of 8 o r grea te
r ( ie . S ta rt o n withdr a wa l me dic a-
tio n) . If s ta rte d o n s c he dule d me dicatio n s ho uld be
give n fo r a to ta l C IW A - A r s co re of 15 o r gre a te r
2. D oc ume nt vita ls a nd CI WA - A r a ss es sme nt o n the
W ithdra wa l As s ess me nt S he e t. Do c ume nt a dminis tra
tio n o f PR N me dic a tio ns o n the as s es s-
me nt s he e t as we ll.
3. The C I WA-A r Sc a le is the mos t se ns itive to o l fo r
as se ss me nt of the pa tie nt e xpe rie nc ing a lc o ho l
withdra wa l. Nurs ing a ss es s me nt i s vita lly
impo rta nt. Ea rly inte rve ntio n f o r C IWA - A r sco re o f
8 o r grea te r pro vides the be s t mea ns to pre ve nt the pro
gres sio n of withdra wa l .
Patient Name: ______________________________________
39. UR Number: _________________ Darren Roberts 075486
URN O75486
SURNAME Roberts
GIVEN NAME Darren
ADDRESS 25 Happy St
Cairns
DATE OF BIRTH 23/11/1968
DOCTOR Smith
4/03/2018
2230
M
R
3
2
4
P
R
O
40. G
R
E
S
S
N
O
T
E
S
PROGRESS NOTES
Including Initial History and Examination
NURSING: O/A: Presented to ED with an acute episode and
recent Hx of upper epigastric pain. P’t
report pain 7/10 radiating across upper abdomen,and has a
positive Murphy's sign. -------------------------
CNS: Pt. is alert and orientated to person place and time, GCS -
15, PEARLA. Morphine 5mg administered
via 18g IVC inserted in L)hand. NVS: CWMS present in all
peripheries, Capillary refill <3sec, and Pedal pulses
present. CVS: HR 99bpm/reg, BP, 155/88, Temp - 37.6, Nil
Chest pain, Base line ECG attended. Resp: RR
26rpm, minimal increase in WOB, pt. able to speak in full
sentences, nil cough or sputum, O2Sats 95% RA,
air entry Equal/Bilateral on auscultation, nil adventitious breath
sounds, GIT: History of N&V for last few
days, nil since admission, Bowel sounds present in all 4
quadrants, Bowels regular and patient continent of
bowels and urine, BGL 3.5mmol, increase pain on gentle
41. palpation consistent with positive Murphy's sign.
Integ: Braden Score - 18, skin intact, slightly warm and moist.
ADLS: Pt. normally attends to all ADLS
independently. Safety: provided with call bell and explained
how and when to use it, Social: No NOK
present, pt.s son lives in Melbourne -pt. is worried about him,
Pt owns his own company and is also
concerned about how this will run without him on site. Declined
pastoral care. MSE: Pt. is anxious regarding
needing to be admitted to hospital
....................................................................................Sally
Grimm RND1
Medical 0300: Bloods, Ultrasound and CT Scan R/V'd by
surgical team and diagnosis of Acute Cholecystitis.
Consent gained by patient for a Cholecystectomy +/- Open
procedure. Patient prepared for transfer to
surgical ward when bed is available. Plan: Theatre at 0800 in
the morning. Anaesthetist will see p’t in the
AM
...............................................................................................
............................................GBrigs RMO
Medical 0315: Documentation from emergency admission is
incomplete, this will be sent to the ward
ASAP
...............................................................................................
..........................................G Brigs RMO
Nursing: Darren transferred to surgical ward @ 0400 hours from
ED. CNS: GCS 15, alert & oriented, Pain
2/10 at rest, 3/10 on movement, CVS: HR90 reg, BP 110/85,
T37.8, nil chest pain, IVC insitu in L) hand,
VTE assessment completed, TED stockings insitu Resp: RR 20,
nil increase in WOB, able to speak in full
sentences, O2Sats 96%RA, GIT: nil N&V, Fasting for procedure
in the morning, Safety: Pt, oriented to ward,
provided with call bell and instructed when and how to use it.
Social: AWS assessment attended, made
42. arrangements for Darren to contact his son and business in the
morning prior to surgery...... Di Symes
RND1.....................................................................................
............................................................................
Nursing:Darren seen by anaethetist at 0700hrs, Consent signed,
Ed documentation has arrived and is in
patients file, Pre-operative checklist completed. Awaiting
tansfer to theatre.............Rachel Mckenzie RND1
Nursing:Patient transferred to theatre @
0740hrs.......................................................Rachel Mckenzie
RND1
5/3/18
0300
5/3/18
0315
5/3/18
0400
5/3/18, 0715hrs
5/3/18, 0740hrs
UR NUMBER UR NUMBER
SURNAME SURNAME
FIRST NAME FIRST NAME
ADDRESS ADDRESS
DATE OF BIRTH DATE OF BIRTH
43. DOCTOR DOCTOR
COMPLEX DISCHARGE SCREEN Discharge date &
destination
Diagnosis:
(medical, surgical, mental health):
GEM o
CNS (nerves, brain), CVS, Resp, GIT, urinary, skin)
DISCHARGE CHECKLIST if no what action was taken or N/A
Valuables Checklist complete P (Check ED Checklist for
Valuables)
Collection of Discharge Medications P Hospital Pharmacy P
Own Medications returned P PREDICTED DISCHARGE
Medical Certificate P Predicted date of discarge: Predicted
destination:
Pre-admission or new services notified P Name: Transport Self
P Family/Carer Taxi Ambulance Other
IV/subcutaneous cannula removed P PRE-ADMISSION
Dressing attended P eg HARP, HNSS, MOW, Home Help, PCA,
44. Case Manager (include details & notify Case Manager Liason)
Post d/c action plan (e.g COPD, asthma) Oxygen ordered
Medical discharge summary complete and P
copy to patient P
Family/Carer notified of discharge P
Check Oxygen & Suction, change if required P
Completed Medication Chart
Medications arranged with Pharmacy 1. ADMISSION HISTORY
Residential in Reach notified of discharge Is this a re -
Transfer letter completed (medical) How many times has patient
been in anyhospital in past 12 months? Nil
Facility notified of discharge time 2. ORIENTATION TO UNIT
Welcome information given and explained P Patients rights &
responsibilities booklist P
Inter-hospital transfer form completed P Telephone location P
Introduction to other patients P Bathroom location
At discharge checked by Nurse: Date: P TV P Discharge time
(10am) explained P Use of Nurse Call
VALUABLES No valuables with patients P 3. SOCIAL /
LIFESTYLE NO YES
45. Aboriginal/Torres Strait Islander P Aboriginal Liaison Services
Hearing Aids P Linguistically Diverse? P
Dentures P Does patient have a case manager? P Notify of
admission, Case Management
Jewellery P Does patient have a support person/carer? P Notify
W
Electrical items P Does patient live alone? P Social Worker (if
Mobile Phone P If no, who with (other than carer)? Name: P
Money and Credit Cards P if yes have arrangements been made?
P
Medications P Does patient drink alcohol daily? P Doctor if
Other Items Does patient smoke? P Complete Smoking
assessment
Completion of Screen by Nurse & Patient / Significant Other
nicotine dependence scale (MR92Q)
46. I am aware that any jewellery or valuables kept on me or in the
ward area, are my responsibility and I understand that Latrobe
Does patient use recreational drugs? P Doctor if possible issues
Simulated Hospital are not accountable for any loss or damage.
I understand that my care plan will be developed from the
Nurse & Patient or significant other must sign. If unable to
sign, state a reason why: Will current home arrangements be an
4. ADVANCE CARE PLANNING NO
Patient Name: Date: Does the patient have an Advance Care
Plan? P
Nurse Name: Date: Enduring Power of Attony (medical
treatment)? P
Enduring Power of Guardianship? P
ROBERTS
Darren
25 Happy Street
CAIRNS 4860
23/11/1968
John Smith
47. if P to any, activate Complex
Discharge Process
Patients returning to Residential Aged Care Facilities also
include the following
Patients transferred to another Health Service also include the
following
Hypertension, Atherosclerosis
Cooperative, compliant and communicating appropriately, No
signs of rashes, skin tears or lesions, chest
Clear on ausculation.
date & sign
Consider complex discharge planning
Referrals/action (P)
Provider details include: Admission notification Discharge
notification
service provided date & sign
07/03/2018 Relatives
04/03/2018
Cholecystitis
Chelsea Bassett
Darren Roberts
48. Chelsea Bassett
04/03/2018
04/03/2018
GENERIC ADULT PATIENT ADMISSION &
DISCHARGE SCREEN
Referrals/action (P)YES
Home DD Cupboard Drug Room
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Describe Items
(Do not tick here, Description must be provided)
Returned
Darren Roberts
49. N/A
N/A
075486 075486
ROBERTS
Darren
25 Happy Street
CAIRNS 4860
23/11/1968
John Smith
Clinicial file
A copy of these orders must be place in the
24 hours if possible
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
(Date & Sign)Home Patient Safe
50. Please Tick Location
N/A
SIMULATED HOSPITAL SIMULATED HOSPITAL
UR NUMBER UR NUMBER
SURNAME SURNAME
FIRST NAME FIRST NAME
ADDRESS ADDRESS
DATE OF BIRTH DATE OF BIRTH
DOCTOR DOCTOR
5. INFECTION CONTROL 13. DEPRESSION
MRSA/VRE Clostridium difficille/Other MRO P Swabs as per
Other Infection/Infectious disease P Infection co
6. MEDICATIONS
Does the patient have any allergies? P 14. ACTIVITIES OF
DAILY LIVING
51. Is patient taking more than 5 medications? P Medication Chart
Does patient use a dosette or webster pack? P If yes, Pharmacy
Does patient understand current medications? P Name of local
Pharmacy:
Is the patient likely to receive blood products this P Details of
any Tra
admission?
Has the patient ever had ablood product P
transfusion?
If yest to the above, has the patient ever had a If Yes, noted on
15. ELIMINATION
9
Is the patient disorientated? P
52. AMTS Score:
10. PAIN /
Does patient experience pain or discomfort? P Pain Service
Describe location, severity & life interference on care plan Date
of next replacement
11. SKIN INTEGRITY
On adm
MOBILITY/FALLS
Braden Screen completed? P Score Occu
If Braden score is ≤ 12 a Comprehensive skin assessment must
12. NUTRITION
Does the patient have any food allergies? P
53. MALNUTRTION SCREENING TOOL
Has the patient los weight No 0 P
recently with out trying? U
require the following items? If needed do they have Do items
need to be Complete MR 118
Yes, 1 - 5kg 1 if 2 or more, refer to dietitian and them? brought
Yes, over 5kg 2 comemnce upon HEHP Diet Yes No Yes No
Family and friends asked Falls prevention
required items in booklet
Non slip footear Date discussed provided
Mobility Aids
ROBERTS
Darren
25 Happy Street
CAIRNS 4860
54. 23/11/1968
John Smith
ROBERTS
Darren
25 Happy Street
P
P
P
If concerns exist regarding safety with mobility or
function, refer to:
Complete Falls Prevention Screen, Assessment &
Strategies (MR118) if patient ≥ 65 years or Falls risk is
identified on ALERT SHEET or Yes to 2 or more of the
mobility & falls questions
P
P
P
P
P
P
55. Is the patient in need of frequent toileting?
NO YES
is the patient bariatric?
Has the patient had unexpected falls within the last 6
months
Does the patient have an unsteady/unsafe gait?
Is the patient agitated/confused/disorientated? (see
section 9)
Does visual impairment impact on everday function such
that the patient is considered unsafe?
Referrals/action (P)
P
P
P
P
P
P
I
56. Have incontinence of urine or faeces? (circle)
Use continence aids? What type?
Suffer from constipation or diarrhoea?
(circle and describe strategies)
Have a Urostomy/Colostomy (circle)
Does the patient have an indwelling catheter or an
intermittent catheter?
Grooming I I Mobility
NO YES Referrals/action (P)
Does the patient have frequency, buring or pain on
voiding?
Showering/Bathing I I Toileting I I
I
Level of Function Pre Morbid Level of Function Pre Morbid
Current
Dressing I I Eating
Current
I
57. NO YES Referrals/action (P)
SCORE Referrals/action (P)
NO YES Referrals/action (P)
18
P
NO YES Referrals/action (P)
NO
NO YES Referrals/action (P)
NO YES Referrals/action (P)
NO YES Referrals/action (P)
if the patient is aged 65 years or older, or P in the yes column
complete Multidisciplinary delirium & cognition scfreen and
stickers
NO YES Referrals/action (P)
Recent mood or energy level changes?
Recent changes in sleep patterns, significant
Yes to weight loss/decrease in section 12
Referrals/action (P)
Key: I = Independent S = Supervision A = Able to assist D =
59. Describe of list facts. Context, objects
or people
This is where we begin Data Collection
Darren is a (50) year old male who is scheduled for an Open
Cholecystecomy.
What else do we know about Darren -context, people and
situation?
Review Current inforamtion (e.g.)
handover reports, patient history,
patient charts, results of
investigations, and nursing/medical
assessments previously undertaken.
Gather new information (e.g.
undertake patient assessment)
Admission obs And pre op assessment
Subjective & Objective: Vitals:
Respiratory Ax:
CVS Ax:
Abdo Ax:
Pathology:
60. Recall knowledge (e.g.
pathophysiology, phsyiology,
pharmacology, epidemiology,
therapuetics, culture, contexct of
care, ethics, law)
Consider pathophysiology of upcoming surgery -what is a
cholecystectomy? What is
the difference between a Laproscopic procedure and an Open
procudere? How will
this impact Darrens recovery? Why?
Consider Darrens history -
what impact will this have on his anaesthetic
risk/recovery/post-operative
complications? What are the issues around
Legal -consent etc
Interpret: analyse data to come to an
understanding of signs or symptoms.
Compare normal vs abnormal
Discriminate: distinguish relevant
from irrelevant information;
61. recognise inconsistencies, narrow
down the information to what is most
important and recognise gaps in ccues
collected.
This is where we begin to Cluster the data, to make sense of it
in this patient context.
Relate: discover new relationships or
patterns; cluster cues together to
identify relationships between them.
Infer: make dedcutions or form
opinions that follow logically by
interpreting subjective and objective
cues; sconsider alternatives and
consequences.
Match: current situation to past
situations or current patient to past
patients [usually an expert thought
process]
Predict: an outcome [usually an
62. expert thought process]
Synthesis: facts and inferences to
make a definitive diagnosis of the
patients problem.
Nursing Daignosis - Can be Auctal or Potential.
The Problem realted to the Aetiology (cause) as evidenced by
the signs & symptoms.
Describe what you want to happen, a
desired outcome and a time frame
Goal for solving the patients problem. Can be short term or
long term -
Needs to be SMART
Select a course of action between the
different alternatives available
These are your Nursing Interventions -how you are going to
achieve the Goal and Solve
the problem.
Evaluate the effectiveness of
ourcomes and actions. Ask: Has the
63. situation improved now?
How has the situation improved and How do we know it has
improved. i.e. -
Evaluations need to be measureable (Vital signs, Pain Score
etc.)
Contemplate what you have learnt
from this process and what you cuold
have done differently.
Reflection
Process Description Darren
Describe of list facts. Context, objects
or people
This is where we begin Data Collection
Darren is a (50) year old male who is scheduled for an Open
Cholecystecomy.
What else do we know about Darren -context, people and
situation?
Review Current inforamtion (e.g.)
64. handover reports, patient history,
patient charts, results of
investigations, and nursing/medical
assessments previously undertaken.
Gather new information (e.g.
undertake patient assessment)
Admission obs And pre op assessment
Subjective & Objective: Vitals:
Respiratory Ax:
CVS Ax:
Abdo Ax:
Pathology:
Recall knowledge (e.g.
pathophysiology, phsyiology,
pharmacology, epidemiology,
therapuetics, culture, contexct of
care, ethics, law)
Consider pathophysiology of upcoming surgery -what is a
cholecystectomy? What is
the difference between a Laproscopic procedure and an Open
65. procudere? How will
this impact Darrens recovery? Why?
Consider Darrens history -
what impact will this have on his anaesthetic
risk/recovery/post-operative
complications? What are the issues around
Legal -consent etc
Interpret: analyse data to come to an
understanding of signs or symptoms.
Compare normal vs abnormal
Discriminate: distinguish relevant
from irrelevant information;
recognise inconsistencies, narrow
down the information to what is most
important and recognise gaps in ccues
collected.
This is where we begin to Cluster the data, to make sense of it
in this patient context.
Relate: discover new relationships or
patterns; cluster cues together to
66. identify relationships between them.
Infer: make dedcutions or form
opinions that follow logically by
interpreting subjective and objective
cues; sconsider alternatives and
consequences.
Match: current situation to past
situations or current patient to past
patients [usually an expert thought
process]
Predict: an outcome [usually an
expert thought process]
Synthesis: facts and inferences to
make a definitive diagnosis of the
patients problem.
Nursing Daignosis - Can be Auctal or Potential.
The Problem realted to the Aetiology (cause) as evidenced by
the signs & symptoms.
Describe what you want to happen, a
67. desired outcome and a time frame
Goal for solving the patients problem. Can be short term or
long term -
Needs to be SMART
Select a course of action between the
different alternatives available
These are your Nursing Interventions -how you are going to
achieve the Goal and Solve
the problem.
Evaluate the effectiveness of
ourcomes and actions. Ask: Has the
situation improved now?
How has the situation improved and How do we know it has
improved. i.e. -
Evaluations need to be measureable (Vital signs, Pain Score
etc.)
Contemplate what you have learnt
from this process and what you cuold
have done differently.
Reflection
68. ASSESSMENT Guidlelines
Assessment 1. Clinical Case Study (1,500 words) 40%
Relevant SILOs:
1. Apply the Australian Nursing and Midwifery Board [ANMB]
Standards of Practice for a Registered Nurse when caring for
individuals and their families,with Cardiovascular, Respiratory
and Endocrine disorders
2. Describe the impact of hospitalisation on individuals and
their families.
3. Provide person-centred care, using the Clinical Reasoning
Cycle to individuals experiencing Cardiovascular, Respiratory
and Endocrine disorders.
Rationale:
The purpose of this assessment task is to assess the student
nurses ability to think critically and apply the clinical reasoning
cycle to plan patient care.
As a Registered Nurse, you will be required to make judgments
and prioritise your patients care multiple times per shift. This
assessment task is designed to develop the sophisticated
thinking abilities that are essential to prioritising, planning and
providing safe and effective patient centred, nursing care.
Task:
In this Clinical Case Study, you will be required to select one
(1) of the nursing problems provided below, discuss its
relevance, then plan and evaluate patient centred, nursing care.
The nursing problems all relate to Darren Roberts’ care in the
69. first 4 hours of his discharge from PARU and return to the ward
following his surgery.
Instructions:
Nursing Problem Statements [choose one (1) for your
discussion]
· Potential for respiratory depression related to anaesthesia and
opioid medications and would be evidenced by respiratory rate
<10Rpm, SpO2<95%on RA and shallow breathing.
· Potential for hypovolemia related to fluid deficit and blood
loss intraoperatively and would be evidenced by Pale, cold and
clammy skin, decreased urine output, BP >90/60 and respiratory
rate > 20Rpm.
· Risk of Nausea and/or Vomiting related to anaesthesia and
opioid medications and would be evidenced by complaints of
nausea and observed or reported vomiting
Required Sections
1. Discuss the importance of the Nursing Problem you have
chosen and why it is a particular risk for Darren in the first 4
hours of his return to the surgical ward.
· Use Darren’s data and documentation from the Enquiry to
inform this discussion; this does not require APA6 referencing.
· Use evidenced based nursing literature to support your
discussion; this does require APA6 referencing.
Approximately 500 words
70. 2. Write one Patient Centred SMART Goal for Darren’s Nursing
Problem that you have selected. Approximately 1 to 2 sentences
3. Provide three (3) relevant Nursing Interventions designed to
achieve the selected SMART Goal.
Discuss each intervention separately and include evidenced
based rationales for the intervention; this does require APA6
referencing. Approximately 600 words (200 for each
intervention)
4. Discuss the evidenced based assessments you would use to
evaluate the effectiveness of implemented nursing
interventions; this does require APA6 referencing.
Approximately 400 words
Format:
· Ensure your name and student ID are clearly marked on your
wish.
· Where you have been asked to ‘discuss’ will be expected to
write in academic fashion. i.e. –not use bullet points, but
paragraphs and sentences.
· Use APA6 referencing throughout –except when using
Darren’s documentation provided on the LMS.
· Reference list in APA6 style to be included.
· Suggested word count for each section is a guide only.
· You are not required to provide either an introduction or a
conclusion.
· You do not have to submit the marking rubric, as we will be
using the Turnitin rubric for feedback.
Hyperlinks: Referencing Tool,Referencing at LaTrobe
General information: (hyperlinks to details in Subject Learning
Guide)
· Academic Integrity/Originality
71. · Submission details/Turnitin
· Extensions
· Penalties
Refer to http://www.latrobe.edu.au/policy/for information
about:
· Extension to Submission Dates
· Late Submission of Assessment Tasks
· Special Consideration
· Academic Integrity
· Academic Progress
· Assessment and Feedback
· Occupational, Health and Safety [OHS]
· Privacy
· Student Charter
· Use of Electronic Mail
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