This document summarizes information from several sources about falls in older adults. It discusses statistics on falls from the CDC, including that one third of adults over 65 fall each year. It reviews assessment tools for evaluating fall risk such as the Berg Balance Scale, Dynamic Gait Index, and Timed Up and Go test. It also summarizes research studies on identifying fall risk factors and developing effective fall screening and prevention programs for older adult patients.
The purpose of this module is to provide comprehensive information about how to assist patients with ambulation, including the proper use of assestive devices and how to transfer a patient safely.
A health assessment is a plan of care that identifies the specific needs of a person and how those needs will be addressed by the healthcare system or skilled nursing facility. Health assessment is the evaluation of the health status by performing a physical exam after taking a health history.
Tepid Sponge Bath lecture and procedure for First Year Level Nursing students during their Return Demonstration. This is taken from a procedure manual good for both students and instructor.
The purpose of this module is to provide comprehensive information about how to assist patients with ambulation, including the proper use of assestive devices and how to transfer a patient safely.
A health assessment is a plan of care that identifies the specific needs of a person and how those needs will be addressed by the healthcare system or skilled nursing facility. Health assessment is the evaluation of the health status by performing a physical exam after taking a health history.
Tepid Sponge Bath lecture and procedure for First Year Level Nursing students during their Return Demonstration. This is taken from a procedure manual good for both students and instructor.
This presentation is a comprehensive & updated presentation that delves deeply into Multiple Sclerosis. It is intended for healthcare professionals and features the Anatomy and Physiology, Common Etiology, a focused review of the disease Pathophysiology, Prevalence & Morbidity, Clinical Manifestations, Diagnostics, Classification & Prognosis, Treatment (Both current and experimental), Nutrition, and Psychosocial issues and resources available to patients. It is very rich in details, diagrams (on every slide), and interactive content when in slide presentation mode. The presentation has also hyperlinks to videos (3 D Patho) and controversial treatments. Finally, it concludes with a Case Study to highlight the clinical application.
Please note that you're welcome to use any slides as long as you reference my post when you do so to maintain the integrity of authorship
If interested in detailed answers, please email: aamirdash@yahoo.com
Thanks, Ahmad
A wonderful and interesting presentation on Multiple Sclerosis! It includes videos, pictures and great insight into the possible cure for MS. I truly hope whoever downloads it enjoys it as much as I do. Blessings!
Running head EVIDENCE-BASED PRACTICES IN NURSING .docxtodd271
Running head: EVIDENCE-BASED PRACTICES IN NURSING 1
EVIDENCE-BASED PRACTICES IN NURSING 6
Evidence-Based Practices in Nursing
Grand Canyon University
Class: NRS- 433V
Applying the four elements of a statement according to PICOT format helps nursing researchers to formulate a question that would be easier to investigate using Evidence based Process (LoBiondo & Haber, 2017). Regarding elderly persons, is implementing a program to prevent fall with normal care reduce the rate of falls in comparison to normal care? This problem statement follows the PICOT format with the exclusion of time as it is not applicable in this case.
P – In regard to elderly persons who falls
I – Program to prevent fall together with normal care
C – Normal care
O – Reduced rate of falls
Literature Review
1. Risk factors for falls among older adults: A review of the literature
Abstract
Falls are one of the major causes of mortality and morbidity in older adults. Every year, an estimated 30–40% of patients over the age of 65 will fall at least once. Falls lead to moderate to severe injuries, fear of falling, loss of independence and death in a third of those patients. The direct costs alone from fall related injuries are a staggering 0.1% of all healthcare expenditures in the United States and up to 1.5% of healthcare costs in European countries. This figure does not include the indirect costs of loss of income both to the patient and caregiver, the intangible losses of mobility, confidence, and functional independence. Numerous studies have attempted to define the risk factors for falls in older adults. The present review provides a summary and update of the relevant literature, summarizing demographic and modifiable risk factors. The major risk factors identified are impaired balance and gait, polypharmacy, and history of previous falls. Other risk factors include advancing age, female gender, visual impairments, cognitive decline especially attention and executive dysfunction, and environmental factors. Recommendations for the clinician to manage falls in older patients are also summarized.
2. The direct costs of fatal and non-fatal falls among older adults — United States
Abstract
This study sought to estimate the incidence, average cost, and total direct medical costs for fatal and non-fatal fall injuries in hospital, ED, and out-patient settings among U.S. adults aged 65 or older in 2012, by sex and age group and to report total direct medical costs for falls inflated to 2015 dollars.
Incidence data came from the 2012 National Vital Statistics System, 2012 Healthcare Cost and Utilization Project-Nationwide Inpatient Sample, 2012 Health Care Utilization Program National Emergency Department Sample, and 2007 Medical Expenditure Panel Survey. Costs for fatal falls were derived from the Centers for Disease Control and Prevention's Web-ba.
· Hospital Readmissions Reduction Program. (2015) Colleen McIlvennan, Zubin Eapen, Larry Allen. Larry. https://www.ahajournals.org/doi/full/10.1161/circulationaha.114.010270 (Links to an external site.)
·
Hospital Readmissions Re
duction Program. (2015) Colleen McIlvennan, Zubin Eapen, Larry Allen.
Larry.
https://www.ahajournals.org/doi/full/10.1161/circulationaha.114.010270
(Links to
an
external site.)
Hospital Readmissions Reduction Program. (2015) Colleen McIlvennan, Zubin Eapen, Larry Allen.
Larry. https://www.ahajournals.org/doi/full/10.1161/circulationaha.114.010270 (Links to an
external site.)
Running Heading - Critical Appraisal 1
2
CRITICAL APPRAISAL
KARANVIR KAUR
Grand Canyon University
NRS-433V
May 24, 2020
Quantitative Studies
Introduction
Fall prevention in nursing and long-term care facilities for older and vulnerable population remains critical issue better health care results for millions of aged people. In this article make a critical appraisal of two quantitative research studies in relation to addressing the PICOT question in the study of falls among adults based on the research critique guidelines.
Backgrounds
In their study, Albert, assessed the quality and importance of using non-randomized study is for principal prevention of fall for older adults. Albert also gave information about the current models in falls prevention Is all depend on the use of both secondary and other strategies that increased risk of falls. This article is most significantly to the nursing practice all the nurses work in the long term and rehabilitation nursing care facilities that deal with the elderly adults who are very highly risk to the falls. Comment by Melissa Reedy: Include the date of the publication in () Comment by Melissa Reedy: Significant
Be sure to either use the writing center of GCU or download Grammarly to help you proof read your papers so that your sentences are complete and flow well.
In this study, Albert identify the lack of research on the effectiveness of these strategies. Through the development of a non-randomized trial in the state of Pennsylvania, the researcher Comment by Melissa Reedy: Identifies
Question for the study was, does a combination of education on falls and screening as well as referrals reduce risk factors for falls among the target population. Comment by Melissa Reedy: No need to capitalize
The second quantitve study by Alvarez how the falls can be reduced by the all the vulnerable and older populat.
Evidence-Based Practices & Nursing
Introduction
Normally, PICOT format is helpful in formulation of questions in an evidenced based clinical practice. PICOT generated questions generally fall under for main categories of clinical practices. These include; therapy, prevention, diagnosis, etiology as well as Prognosis. The essential elements in PICOT questions. The PICOT format is valuable in addressing research questions comprehensively. Five elements are normally addressed including; population, intervention, comparison, outcome and time as well (Riva, Malik, Burnie, Endicott, & Busse, 2012).
Summary of Case Study
The ever increasingly high incidence of breast cancer conditions has posed serious challenges in the nursing profession. Provision of appropriate healthcare to the cancer patients has been lacking leading to adverse effects of the proliferation of cancerous cells which further worsen the conditions of the patients. As primary care, clinicians have the responsibility to stressing providing healthcare services within healthcare facilities as well as monitoring treatment in home based facilities to help manage cancer condition. Most cancer patient need clinicians who practice evidence-based clinical practices (Riva, Malik, Burnie, Endicott, & Busse, 2012).
Research Question
In cancer patients receiving chemotherapy, will they have better white blood cell count monitoring with a follow-up at home versus follow-up at a health care facility during their treatment?
PICOT Format
1) P-Population: Patients aged 18-60 years-old, breast cancer who have not received chemotherapy in the past six months are subjected to the treatment. Patients with other serious health conditions such as heart diseases were excluded in the study. 30 patients, with 15patients stationed at the healthcare facility while the other 15 patients receiving home-based care, are expected to take part in the study.
2) I -Intervention: The patients will receive dosage based on the age, sex and health general body health as well as the stage of cancer cells proliferation in the body. The patients are required take the prescribed drugs at regular intervals. The subjects will be subjected to treatment under the same during the research study.
3) C-Comparison: All the subject regardless of variations in their level of dose requirement will be subjected to the same treatment for the same duration, 3months. Standardized treatment will be given to subjects with no extreme variations in their level of dose requirement and would be used as an active control group. Using this strategy, it will be possible to minimize the non-specific effects due to a group of the patient receiving treatment within the healthcare.
4) O-Outcome: The response in chemotherapy treatments will be check by examining the numbers of defective cancerous cells in the body tissues. The patients will report to the theatre in order to be examined by an oncologist. The results will be recorded i ...
Final ExamSpend up to the next 2 hours to complete the following.docxcharlottej5
Final Exam
Spend up to the next 2 hours to complete the following task, to the best of your ability. This exam is worth 100 points. There is no specific word count requirement.
Topic: Vitamin C - https://vitamincfoundation.org/squares/
Your submission should be in the form of written paragraphs, but you will not be evaluated on the quality of writing beyond the minimum necessary to understand what you are communicating. Your submission does not need to be as structured as the analysis assignments submitted during the semester. You should answer parts 1-5 of the task individually, each in paragraph form. Number each answer to correspond to parts 1-5, and then references at the end.
1. In one paragraph, summarize the product or service and describe what it is supposed to do.
2. In one paragraph, identify and clearly state at least one scientific claim being made about the product or service.
3. Identify and clearly describe at least two sources that are purported to support the claim. Each source should be described in a single paragraph (i.e., two paragraphs total). You must provide references for these sources (as well as any other that you use to complete the other tasks) at the end of your document, in the same format that you have been using throughout the semester.
4. Briefly evaluate the quality of the sources and whether or not the sources appear to support the claim. This section may be anywhere from one to several paragraphs long, as needed.
◦ State whether or not you believe the claim is justified, correct, and/or relevant based on your overall evaluation. This evaluation must take into account the sources you identified and evaluated (in steps 3 and 4).
◦ You may utilize sources that do not support the claim in your overall evaluation (i.e., sources in addition to the two from step 3).
◦ Your evaluation should explicitly consider at least two logical fallacies. These may be fallacies that you believe are present, or ones that could have been an issue but that you determined were not.
5. Based on your review of the product or service, summarize in one paragraph when use of the product or service might be beneficial: who might benefit and under what circumstances.
You are free to draw on prior knowledge, your textbook, and electronic resources, but should indicate when you have done so by using the same referencing methods utilized during the semester.
You may not use other humans. Communication in any form (verbal, physical, or electronic) with another human being during this exam will be considered academic misconduct and result in an automatic grade of zero. The sole exception is if you have an urgent issue that you communicate to an instructor. Your instructors will not provide assistance with this exam or the resources you utilize to complete it.
Your final document should be uploaded to the Assignments link provided through Brightspace. After verifying that the document has successfully uploaded, you are free to lea.
Part 6 Disseminating Results Create a 5-minute, 5- to 6-sli.docxsmile790243
Part 6: Disseminating Results
Create a 5-minute, 5- to 6-slide narrated PowerPoint presentation of your Evidence-Based Project:
· Be sure to incorporate any feedback or changes from your presentation submission in Module 5.
· Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.
Points Range: 81 (81%) - 90 (90%)
The narrated presentation accurately and completely summarizes the evidence-based project. The narrated presentation is professional in nature and thoroughly addresses all components of the evidence-based project.
The narrated presentation accurately and clearly explains in detail how to disseminate the results of the project to an audience, citing specific and relevant examples.
The narrated presentation accurately and clearly provides a justification that details the selection of this dissemination strategy that is fully supported by specific and relevant examples.
The narrated presentation provides a complete, detailed, and specific synthesis of two outside resources related to the dissemination strategy explained. The narrated presentation fully integrates at least two outside resources and two or three course-specific resources that fully support the presentation.
Written Expression and Formatting—Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.
Points Range: 5 (5%) - 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.
Written Expression and Formatting—English Writing Standards:
Correct grammar, mechanics, and proper punctuation.
Points Range: 5 (5%) - 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.
Evidenced Based Change
Leslie Hill
Walden University
Introduction/PurposeChange is inevitable.Health care organizations need change to improve.There are challenges that need to be addressed(Baraka-Johnson et al. 2019).Challenges should be addressed using evidence-based research.These changes enhance professionalism therefore improving quality of care and quality of life.The purpose of this paper is to identify an existing problem in health care and suggest a change idea that would be effective in addressing the problem. The paper also articulates risks associated with the change process, how to distribute the change information and how to implement change successfully.
Organizational CultureThe Organization is a hospice facilityOffers end of life care for pain and symptom managementThe health care providers cu.
18Falls in The Long-Term Care SettingsNayaris ReyeAnastaciaShadelb
1
8
Falls in The Long-Term Care Settings
Nayaris Reyes
Florida National University
June 12, 2021
Brief Literature Review
The elderly in the long-term care facilities are typically predisposed to falling and might fall for various reasons. Some predisposing factors might be related to unsteady balance and gait, poor vision, weak muscles, dementia, and medications. In addition, various medical conditions, including stroke, low blood pressure, brain disorders, and poorly managed epilepsy, might increase older people's risk for falls (Golmakani et al., 2014). Therefore, several studies have been conducted to evaluate the efficacy of multi-factorial interventions on the occurrence of falls in long-term care settings, including psycho-geriatric nursing home patients. Based on the clinical study, it was concluded that various multi-factorial interventions used in preventing falls such as a general medical assessment emphasizing falls, specific fall risk evaluation devices, assessing medication intake, fall history, and mobility, using protective and assistive aids play a significant role in reducing the incidence of falls among the elderly (Ungar et al., 2013). Accordingly, it was evident that fall prevention, usually geared towards psycho-geriatric patients in a long-term care facility, is possible and efficient in minimizing falls among older people.
Other researchers carried out a study in developing a fall prevention program for the aged patients in long-term care entities, especially those at risk of falling, by increasing caregiving expertise or skills and motivating staff members. From the analysis, exercise programs encompassing warm-up, muscle reinforcement, especially in the lower extremities, and proprioceptive neuromuscular expedition are used in increasing motivation and caregiving skills (Donath et al., 2016). Another research conducted to evaluate the statistics of falls among the elderly found out that falls are the leading cause of injury-interrelated visits to emergency facilities in the U.S. They are also the primary etiology of accidental deaths in persons aged 60 and above. From the analysis, falls might be markers of diminishing function and poor health and are significantly attributable to morbidity.
To assess the risk factors related with falls among the older people in the long-term care facilities, it was realized that more than 25% of facility-dwelling older individuals and 60% of nursing home residents fall yearly (Pfortmueller et al., 2014). Various risk factors linked to their falls are medication use, increasing age, sensory deficits, and cognitive impairment. Studies depict that older persons who have fallen must undergo a thorough clinical evaluation (within the facilities) to analyze the preventive strategies further. This will aid in determining and treating the underlying cause of their falls, return them to baseline function, and minimize the likelihood of recurrent falls (Karlsson et al., 20 ...
1.Write an essay discussing the various causes and solutions for aBenitoSumpter862
1.Write an essay discussing the various causes and solutions for a patient’s inability to pay for medications (prescriptions).
Your response should be at least 200 words in length
2. “Front desk syndrome” is a particularly troublesome aspect of patients visiting their healthcare provider. Write an essay describing this phenomena and methods to prevent or decrease its occurrence.
Your response should be at least 200 words in length.
Inmate Manipulation and Boundaries
Nicole Jones, Dionne Russell, Francisco Villegas, Lupe Silva
University of Phoenix
CPSS/430
Dr. Debra McCoy
May 16, 2022
What to Expect from This Presentation
Summary of manipulation scenario
Development of a plan for how to maintain boundaries in this situation
Possible obstacles in setting and maintaining these boundaries
Identifying ethical and legal consequences to not maintaining boundaries in this situation
Manipulation Scenario
Patricia Wilkes works as a correctional officer at Corcoran California state prison. Corcoran is a high security institution that houses some of the most violent male offenders. Patricia has worked at the institution for four years and has encountered two attacks against her from two separate inmates over a year span. Patricia is freshly returned back to work after being off for a week due to her injuries from her latest attack. The attack involved her being pushed down by an inmate, causing a sprain arm. Feeling vulnerable Patricia became friends with an inmate who witnessed the attack and promised to issue protection if she sneaks in contraband for him. She is conflicted but, because she is afraid; she agrees to do it.
How to Maintain Boundaries in this Situation
How to Maintain Boundaries in this Situation (continued)
How to Maintain Boundaries in this Situation (continued)
Possible Obstacles in Setting and Maintaining these Boundaries
Possible Obstacles in Setting and Maintaining these Boundaries (continued)
Possible Obstacles in Setting and Maintaining these Boundaries (continued)
Ethical and Legal Consequences to not Maintaining Boundaries in this Situation
Ethical and Legal Consequences to not Maintaining Boundaries in this Situation (continued)
Ethical and Legal Consequences to not Maintaining Boundaries in this Situation (continued)
Questions
References
HCA 4303, Comparative Health Systems 1
Course Learning Outcomes for Unit I
Upon completion of this unit, students should be able to:
1. Identify and explain how demographics, such as age and race, impact true access to quality care.
Reading Assignment
Chapter 1: Introduction
Chapter 2: Disparities in Health Care: Race and Age Matters
Unit Lesson
Many Americans find it difficult to even comprehend being denied access to medical care. When we are sick,
we want to see a physician, promptly receive a diagnosis, and procure the necessary treatment that will
restore us to our previous level of health. T ...
1.Write an essay discussing the various causes and solutions for aSantosConleyha
1.Write an essay discussing the various causes and solutions for a patient’s inability to pay for medications (prescriptions).
Your response should be at least 200 words in length
2. “Front desk syndrome” is a particularly troublesome aspect of patients visiting their healthcare provider. Write an essay describing this phenomena and methods to prevent or decrease its occurrence.
Your response should be at least 200 words in length.
Inmate Manipulation and Boundaries
Nicole Jones, Dionne Russell, Francisco Villegas, Lupe Silva
University of Phoenix
CPSS/430
Dr. Debra McCoy
May 16, 2022
What to Expect from This Presentation
Summary of manipulation scenario
Development of a plan for how to maintain boundaries in this situation
Possible obstacles in setting and maintaining these boundaries
Identifying ethical and legal consequences to not maintaining boundaries in this situation
Manipulation Scenario
Patricia Wilkes works as a correctional officer at Corcoran California state prison. Corcoran is a high security institution that houses some of the most violent male offenders. Patricia has worked at the institution for four years and has encountered two attacks against her from two separate inmates over a year span. Patricia is freshly returned back to work after being off for a week due to her injuries from her latest attack. The attack involved her being pushed down by an inmate, causing a sprain arm. Feeling vulnerable Patricia became friends with an inmate who witnessed the attack and promised to issue protection if she sneaks in contraband for him. She is conflicted but, because she is afraid; she agrees to do it.
How to Maintain Boundaries in this Situation
How to Maintain Boundaries in this Situation (continued)
How to Maintain Boundaries in this Situation (continued)
Possible Obstacles in Setting and Maintaining these Boundaries
Possible Obstacles in Setting and Maintaining these Boundaries (continued)
Possible Obstacles in Setting and Maintaining these Boundaries (continued)
Ethical and Legal Consequences to not Maintaining Boundaries in this Situation
Ethical and Legal Consequences to not Maintaining Boundaries in this Situation (continued)
Ethical and Legal Consequences to not Maintaining Boundaries in this Situation (continued)
Questions
References
HCA 4303, Comparative Health Systems 1
Course Learning Outcomes for Unit I
Upon completion of this unit, students should be able to:
1. Identify and explain how demographics, such as age and race, impact true access to quality care.
Reading Assignment
Chapter 1: Introduction
Chapter 2: Disparities in Health Care: Race and Age Matters
Unit Lesson
Many Americans find it difficult to even comprehend being denied access to medical care. When we are sick,
we want to see a physician, promptly receive a diagnosis, and procure the necessary treatment that will
restore us to our previous level of health. T ...
Running Head PICOT STATEMENT1PICOT STATEMENT4.docxglendar3
Running Head: PICOT STATEMENT 1
PICOT STATEMENT 4
PICOT statement
Name of the student:
Good start on your PICO question this week. However, I am not clear on what the PICOT question is. What is the specific intervention, comparison, and outcomes you are evaluating? I noted a few corrections and comments in your paper. Be sure to make corrections before including this in the final capstone paper in week 9. Thanks. – Mrs. Guzman
PICOT Sstatement
Patient/Ppopulation
The population that is mostly affected with hypertension are male adults between the ages of 40 and 70 with hypertension, and with different diseases, that shows alteration in lifestyle (attracting routinely in practice and taking in more advantageous and sufficient dinners), appeared differently in relation to patients who use solution to treat/manage their high blood pressure, assist to manage their heartbeat and lessen the threat of making cardiovascular sicknesses in their recovery time inside a half year. The period will be adequately long to make a sick be able not to encounter the evil impacts of high blood pressure and to in like manner diminish the threats that the general population will customarily experience (Dua, et.al, 2014). Comment by Melanie Guzman: Meaning is not clear Comment by Melanie Guzman: This is vague Comment by Melanie Guzman: 5 authors: Put all last names inn first citation, then et al. in subsequent citations
Intervention Comment by Melanie Guzman: Headings bolded
The essential strategy for mediation for sick with high blood pressure it is with no vulnerability to place them under medicine so that they can be restored. That is the most secure way as it will impact the patient to have the ability to manage themselves to the extent how they to think, what they eat and even the activities that they endeavor to take an interest in. The age of the patients will in like manner suggest that the sick are given arrangement that can oversee them in the most useful means and which they can recognize with everything taken into account. The medicine that can be provided for this circumstance is one that can diminish the brutality of a prescription. The nursing intercession for sick with high blood pressure is evaluating the migraine torments that sick is encountering and checking the obscured vision in like clockwork until the point when it leaves. Another nursing mediation is for an attendant to teach a sick on how they counsel with their specialist before the medicine is ceased (Dua, et.al, 2014). Comment by Melanie Guzman: This is not clear. What is the identified problem? PICOT statement? What evidenced-based interventions related to that problem are you proposing? Comment by Melanie Guzman: What interventions are being doing to prevent high blood pressure? Is evaluation of migraine a major issue with HTN? Comment by Melanie Guzman:
Comparison Comment by Melanie Guzman: What are you specifically comparing in your PICOT statement?
The first c.
Running Head PICOT STATEMENT1PICOT STATEMENT4.docxtodd581
Running Head: PICOT STATEMENT 1
PICOT STATEMENT 4
PICOT statement
Name of the student:
Good start on your PICO question this week. However, I am not clear on what the PICOT question is. What is the specific intervention, comparison, and outcomes you are evaluating? I noted a few corrections and comments in your paper. Be sure to make corrections before including this in the final capstone paper in week 9. Thanks. – Mrs. Guzman
PICOT Sstatement
Patient/Ppopulation
The population that is mostly affected with hypertension are male adults between the ages of 40 and 70 with hypertension, and with different diseases, that shows alteration in lifestyle (attracting routinely in practice and taking in more advantageous and sufficient dinners), appeared differently in relation to patients who use solution to treat/manage their high blood pressure, assist to manage their heartbeat and lessen the threat of making cardiovascular sicknesses in their recovery time inside a half year. The period will be adequately long to make a sick be able not to encounter the evil impacts of high blood pressure and to in like manner diminish the threats that the general population will customarily experience (Dua, et.al, 2014). Comment by Melanie Guzman: Meaning is not clear Comment by Melanie Guzman: This is vague Comment by Melanie Guzman: 5 authors: Put all last names inn first citation, then et al. in subsequent citations
Intervention Comment by Melanie Guzman: Headings bolded
The essential strategy for mediation for sick with high blood pressure it is with no vulnerability to place them under medicine so that they can be restored. That is the most secure way as it will impact the patient to have the ability to manage themselves to the extent how they to think, what they eat and even the activities that they endeavor to take an interest in. The age of the patients will in like manner suggest that the sick are given arrangement that can oversee them in the most useful means and which they can recognize with everything taken into account. The medicine that can be provided for this circumstance is one that can diminish the brutality of a prescription. The nursing intercession for sick with high blood pressure is evaluating the migraine torments that sick is encountering and checking the obscured vision in like clockwork until the point when it leaves. Another nursing mediation is for an attendant to teach a sick on how they counsel with their specialist before the medicine is ceased (Dua, et.al, 2014). Comment by Melanie Guzman: This is not clear. What is the identified problem? PICOT statement? What evidenced-based interventions related to that problem are you proposing? Comment by Melanie Guzman: What interventions are being doing to prevent high blood pressure? Is evaluation of migraine a major issue with HTN? Comment by Melanie Guzman:
Comparison Comment by Melanie Guzman: What are you specifically comparing in your PICOT statement?
The first c.
PEER RESPONSES FOR Patient Outcomes and Sustainable ChangeQUES.docxpauline234567
PEER RESPONSES FOR Patient Outcomes and Sustainable Change
QUESTION: Reflecting on the "IHI Module PS 101: Introduction to Patient Safety," summarize why it is essential to improve patient safety. Use one of the articles from this week's topic Resources and describe the framework or theory that was used to improve the patient outcome. What outcome measures were identified and how did they align with the improvement project? Explain how the authors learned from the error or unintended events to ensure patient safety. Provide supporting evidence.
Dr. Mary Sizemore
Thank you for your response. You provided some good information regarding the quality of care and patient safety. In my practice, many facilities work to improve patient outcomes through the use of electronic health records to reduce errors with medication prescribing. Consider ordering a new medication for a patient. What are some measures you can take as a provider to reduce possible errors with the process?
Kristen Williams
Dec 2, 2022, 12:11 PM
The Institute for Healthcare Improvement (IHI) Module PS 101: Introduction to Patient Safety provides the structural foundation of the vital role patient safety has in a healthcare institution. High reliability was a central theme of the module. A culture of safety is when the employees share a central belief that a healthcare organization supports root cause analysis in patient care (Leape, 2021). It is a significant theme that humans have a predisposition to error, and it is vital to create systems and a safety culture to have a safe environment for patients. It is crucial to develop systems to track and analyze errors as they occur to improve future outcomes by creating safer systems.
When people interact with a healthcare system, they are often at their most valuable state. The number of people dying from medical errors in 2018 was equivalent to a daily jumbo crash (Leape, 2021). Our society would not stand for one plane crash a day, yet often a place whose purpose is to heal hurts. Although humans are prone to error, it is essential to create policies, procedures, and phycological safety to increase safety when people seek healthcare. A facility that commits to embedding safety into policy and procedures and a culture of phycological safety are often referred to as a high-reliability organization (HRO).
Education and empowerment of staff are essential components of building physical safety. Haley & Fritz (2019) used a framework of education and empowerment to improve the rate of urinary tract infections (UTI) in a long-term care (LTC) facility. Haley & Fritz (2019) assessed that evidenced-based signs and symptoms were not consistently utilized in obtaining urine samples to diagnose UTIs. A culture of safety examination showed improvement that could be made. Education and empowerment were done to improve the signs and symptoms used to initiate obtaining a urine sample (Haley & Fritz, 2019). Phycological safety is a vital found.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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2. Who?
According to CDC and Prevention:
One third of people 65 and older fall each year.
Less than half of those who fell talked to their
healthcare provider about it.
1 out of 5 falls causes a serious injury such as a
head trauma or fracture.
(see handout #1)
4. Evaluations are Needed
Nonfatal, >65 years
Falls
Overexertion
Struck by or against
Cut/pierced
Natrual/environmental
Motorvehicle traffic
occupant
Other unspecified
5. Falls Related to Animals
Falls are the leading cause of nonfatal injuries in the
United States. In 2006, nearly 8 million persons were
treated in emergency departments (EDs) for fall injuries.
An estimated average of 86,629 fall injuries each year
were associated with cats and dogs, for an average annual
injury rate of 29.7 per 100,000 population.
CDC-MMWR. Nonfatal Fall-Related Injuries Associated with Dogs and Cats – United States,
2001-2006. Information retrieved from:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5811a1.htm
6. Why?
Falls among older adults, unlike other ages tend to occur from
multifactorial etiology such as acute and chronic illness, and
medications. Because the rate of falling increases proportionally
with increased number of pre-existing conditions and risk factors,
fall risk assessment is a useful guideline for practitioners.
• Discover the underlying etiology of why a fall occurred
• Follow up with a comprehensive post-fall assessment.
Fall risk assessment and post-fall assessment are two interrelated,
but distinct approaches to fall evaluation, both recommended by
national professional organizations.
(see handout #2
7. Communication
The goal in therapy is the suggestion to the aging adult to
stay active and maintain as much of their previous lifestyle
as possible; however, modification will be required to
prevent a fall injury secondary to the patients inability to
recognize their own declining cognitive state.
Communication is important too. Therefore, the next
handout available provides information to help that
communication process happen between the healthcare
provider and the patient.
(see handout #3)
8. Barbara Fischer – Declining Cognition and
Falls: Role of Risky Performance of Everyday
Mobility Activities
- Fischer’s team examined 245 individuals with a mean
age of 79 years of age that still lived independently in their
own homes.
- There were a total of 500 individuals selected for the
study; they were divided in half (controlled group and an
intervention group).
- They used tools such as interviewing and in-home
assessment data to determine if the individuals were a fall
risk while performing mobility-related activities of daily
living.
-This research data was collected over a one year span.
9. Screening and Assessment
The examining tests that were performed during the
examination included a Depression Scale, Rhomberg
Test, relative balance, Modified clinical test of
sensory interaction, and a balance portion of the Berg
Balance Scale, Tinetti Performance-Oriented
Mobility Assessment-gait test, Dynamic Gait Index,
and a Timed "Up & Go" test with and without a
cognitive task.
10. Martina Mancini Studied Relevance
An in-depth look into the basic balance system was
performed by Mancini (2010, June). The research of
Mancini et. al. discusses the basic balance system of
maintenance of postural alignment in all positions,
activation of voluntary movement when transitioning
between postures, and reactive time when an external
force is applied.
11. Relevance
The primary reasons for a clinical evaluation of balance
are:
1) does a balance problem exists;
2) determining the underlying cause of the
balance issue.
Mancini (2010, June) provided a research document that is
a quick reference table providing a brief look at common
balance tests that are used in the clinical setting already.
(see handout #4)
12. Which is the Bestest tool?
This research article identifies a common complaint that
Physical Therapists have when testing a patients' balance.
The patient clearly needs continued balance therapy to be
safe, however, they "ceiling" out on the basic balance
tests.
This makes it difficult for a therapist to validate to the
doctor or insurance company that continued care is
needed. Without incurring the expensive cost of
purchasing a Posturography for advanced testing, Mancini
et. al. developed the BESTest balance test. There is a short
and long version to the test.
(see handouts 5 & 6)
13. Functional, Affordable, Valid,
Reliable, and Sensitive
The ceiling affect was depicted in a study performed
by Leddy (2011, January) where she evaluated the
reliability, validity, sensitivity, and specificity for
identifying individuals with Parkinsons Disease who
fall.
14. Continued….
Leddy et. al. tested the Berg (BBS), Functional Gait
(FGA), and the BESTest on 80 individuals with
Parkinsons Disease (PD).
- The study concluded that the FGA and FGA were
the most reliable and indicated the most validity for
assessing patients with PD.
- The study indicated that PD comes in all stages and
degrees of progression and is no different than most
with any kind of balance/proprioception issues.
- The study determine that these two specific tests can
validate the need for early intervention with a patient
that is a risk for falls, however, is in early stages of
PD
15. Integrating Fall Prevention into the
Practice
As a team of healthcare professionals, we all work
together and assess our patients for improvement,
gains, and losses. However, we can also help reduce
falls by screening the older population for previous
falls or balance problems.
The handout provided next will provide helpful ways
to integrate this system into the clinic setting.
(see handout #7)
16. Fall Risk Assessment &
Interventions
The next handout is a simple graph that helps identify when it
would be an appropriate time to intergrade additional risk
assessment tools, such as the “BESTest Test” and the “Cognitive
Questionnaire Screening Tool.”
(see handout #8)
17. Conclusion
Ask about falls
Ask how often
Ask if walking is difficult
Patients that have
suffered multiple falls
within a year should have
a fall risk assessment
performed
Patients suffering from
a single fall in the last
year should be assessed
for gait and balance.
If the patient performs
poorly on the gait test,
they should have a fall
risk assessment.
For a full list see handout #9
18. References
Abigail L. Leddy, B. E. (2011, January). Functional Gait Assessment and Balance Evaluation System Test:
Reliability, Validity, Sensitivity, and Specificity, for Identifying Individuals With Parkinson Disease Who Fall.
Journal of the American Physical Therapy Association, pp. Vol 91, No. 1, pgs. 102-113.
Anne Shumway-Cook, M. B. (1997, August). Predicting the Probability for Falls in Community-Dwelling
Older Adults. Physical Therapy, Journal of the American Physical Therapy Association, pp. Vol. 77 No. 8 pgs.
812-819.
Barbara L. Fischer, C. E. (2014, March). Declining Cognition and Falls: Role of Risky Performance of
Everyday Mobility Activities. Journal of the American Physical Therapy Association, pp. Vol. 94, No. 3, pgs
355-362.
Centers for Disease Control and Prevention. National Center for Injury Prevention and Control (2014).
www.cdc.gov/injury/STEADI
Diane M. Wrisley, M. L. (2003, October). Reliability of the Dynamic Gait index in People with Vestibular
Disorders. Physical Medicine and Rehabilitation, pp. Vol. 84, Issue 10, pgs. 1528-1533.
Horak, M. M. (2010, June). The relevance of clinical balance assessment tools to differentiate balance deficits.
NIH Public Access. Eur J Phys Rehabil Med., pp. vol 46 No. 2: pgs 239-248.
Sara B. Vyrostek, J. L. (2004, September). Surveillance for Fatal and Nonfatal Injuries - United States, ,2001.
Morbidity and Mortality Weekly Report - Surveillance Summaries -MMWR, pp. Vol. 53/ SS-7 1-57.
Steffen T, Seney M. Test-retest Reliability and minimal detectable change on balance and ambulation tests, the
36-item short-form health survey, and the unified Parkinsons disease rating scale in people with parkinsonism
[erratum in Phys Ther. 2010;90:462]. Phys Ther. 2008;88:733-746