NURS 6331: Screencast Lesson Plan
Lesson Overview
Name:
Screencast Title:
End of Life Interventions: Can they cause more harm than good?
Environment:
(on-site, online, or hybrid)
On-Line
Screencast Goal:
To teach nursing students and nurses that at the end of life IV hydration, tube feeding and forced feeding may not be beneficial to the patient.
Description of Screencast lesson:
This screencast begins with a scenario of a patient at the end of her life. With this patient in mind, the screencast will review whether IV fluids, Tube Feedings and forced feedings are appropriate at the end of life. The screencast will then discuss some interventions that may provide end-of-life comfort.
Learning Objectives
· At the end of this screencast, learners will be able to analyze the use of IV Fluids, Tube Feeding and Forced Feedings at end-of-life
· At the end of this screencast, learners will be able to describe interventions which may not be beneficial at the end-of-life and why
Identify at Least One in Each Area
Pre-Licensure QSEN Competencies
Integrated Processes
Clinical Relationships
1. Patient-centered care FORMCHECKBOX
2. Teamwork and collaboration FORMCHECKBOX
3. Evidence-based practice (EBP) FORMCHECKBOX
4. Quality Improvement (QI) FORMCHECKBOX
5. Safety FORMCHECKBOX
6. Informatics FORMCHECKBOX
1. Nursing process FORMCHECKBOX
2. Caring FORMCHECKBOX
3. Communication and documentation FORMCHECKBOX
4. Teaching/ Learning FORMCHECKBOX
1. Varied sources of data FORMCHECKBOX
2. Similar options FORMCHECKBOX
3. Prioritization FORMCHECKBOX
4. Teaching FORMCHECKBOX
5. Notes: FORMCHECKBOX
______________
Rationale:
Rationale:
Rationale:
Script
Actions on Screen
Audio/Narrative
PowerPoint Slide:
Interventions at the End-Of-Life: Do they cause more harm than good
This screen cast, intended for nursing students and nurses will discuss interventions at the end of life and whether they may be causing more harm than good.
PowerPoint Slide:
Learning Objectives
· Analyze the use of IV Fluids, Tube Feeding and Forced Feedings at end-of-life
· Determine why some interventions are not beneficial at the end-of-life
·
The learning objectives for today’s screencast are to analyze the use of interventions at the end of life such as IV fluids, Tube Feeding, and Forced Feeding. We will determine why these interventions may not always be beneficial to patients and discuss those interventions which may provide comfort at the end-of-life
PowerPoint Slide:
Scenario
· A 97 year old patient at the end of life wants to die and wants to be left alone. Her family wants to do everything in their power to keep her alive as long as they can.
· Picture
An elderly patient (Mrs. Lovely), has reached the end of her life. She is 97 years old, has dementia, congestive heart failure and end stage kidney failure. She has expressed that she is ready to die. She has no desire to eat or drink and no longer wants t.
The goal of this webinar was to help hospice and healthcare professionals understand the ethics and application of artificial nutrition and hydration (ANH) for patients near the end of life.
Overall CommentsHi Khanh,Overall you made a nice start with.docxjacksnathalie
Overall Comments:
Hi Khanh,
Overall you made a nice start with your U03a1 assignment; however, your content still does not address the required objectives. For this assignment you will need to focus the content on Capra Tek's regional sales position, and for objective #1 analyze the KSAs for this position, and for objective #2 you will need to analyze wage trends related to this position as well. Objectives 3 & 4 focus on job description and the job analysis so please carefully review what is required for these two objectives.
Please see my feedback below and be sure to let me know if you have any questions about my comments.
Sincerely,
Dr. Marni Swain
COMPETENCY: Describe how hiring practices support an organization's strategy.
CRITERION: Articulate the components of a job description for a position.
DISTINGUISHED
PROFICIENT
BASIC
NON-PERFORMANCE
Non-Performance
Does not articulate the components of a job description for this position.
Faculty Comments:“
Please see feedback above.
”
COMPETENCY: Assess approaches for recruiting, selecting, and retaining talent.
CRITERION: Identify the knowledge, skills, and abilities required for this position.
DISTINGUISHED
PROFICIENT
BASIC
NON-PERFORMANCE
Non-Performance
Does not identify the knowledge, skills, and abilities required for this position.
Faculty Comments:“
Please see feedback above.
”
COMPETENCY: Explore technology tools that support recruiting and staffing management.
CRITERION: Identify wage information and employment trends for this position in a selected state.
DISTINGUISHED
PROFICIENT
BASIC
NON-PERFORMANCE
Non-Performance
Does not identify wage information and employment trends for this position in a selected state.
Faculty Comments:“
Please see feedback above.
”
COMPETENCY: Analyze the impact of legal and regulatory issues on staffing management.
CRITERION: Explain why a job analysis is a requirement for any recruiting and selecting process.
DISTINGUISHED
PROFICIENT
BASIC
NON-PERFORMANCE
Non-Performance
Does not explain why a job analysis is a requirement for any recruiting and selecting process.
Faculty Comments:“
Please see feedback above.
”
COMPETENCY: Communicate in a manner that is scholarly and professional.
CRITERION: Communicate in a professional manner that is appropriate for the intended audience.
DISTINGUISHED
PROFICIENT
BASIC
NON-PERFORMANCE
Non-Performance
Does not communicate in a professional manner that is appropriate for the intended audience.
Faculty Comments:“
Please see feedback above.
”
Dysphagia .
Dysphagia is a serious problem and contributes to weight loss, malnutrition, dehydration, aspiration pneumonia, and death. Careful assessment of risk factors, observation for signs and symptoms, and collaboration with speech-language pathologists on interventions are essential.
Dysphagia, or difficulty swallowing, is a common problem in older adults. The prevalence of swallowing disorders is 16% to 22% in adults older than 50 years of age, and up to 60% of nursing ho.
Epilepsy is a neurological condition characterized by recurrent seizures. Seizures are brief disturbances in the electrical functions of the brain. The assessment of epilepsy involves stabilizing the patient during a seizure by ensuring their airway, breathing, and circulation. Vital signs should be monitored and the duration of convulsions recorded. Underlying causes should be explored, such as eclampsia in pregnant women. Rectal diazepam can be used to stop prolonged seizures when IV access is not available. Status epilepticus requires management in a health facility with IV antiepileptic medications.
END OF LIFE CARE- all ages deserve quality end of life careSandhya C
End of life care involves supporting patients who are in the last months or years of life. It focuses on comfort rather than cure and can be provided by a team including physicians, nurses, social workers, counselors and others. The goals are to enhance quality of life, maintain function, relieve suffering and allow a natural death with dignity. Nurses play a key role in providing physical, psychosocial and spiritual support to dying patients and their families.
An Ethical Case Study On End Of Life CareAshley Thomas
The document discusses end-of-life care and the ethical issues surrounding decisions to continue or withdraw life-prolonging treatment for patients. It describes a case study involving an elderly woman who suffered two strokes leaving her unable to eat, talk, drink or move on her own. Her family considered three options: placing her in hospice care, continuing forced tube feeding, or withdrawing treatment. The document examines the legal and ethical implications of these decisions, particularly regarding tube feeding for patients with advanced dementia.
The document discusses the benefits, burdens and harms of artificial nutrition and hydration like tube feeding in patients with advanced dementia or who are near the end of life. It finds that tube feeding does not prevent aspiration pneumonia or malnutrition, does not decrease mortality rates, and does not prevent or hasten healing of pressure sores. Tube feeding is also not shown to improve patient comfort or functional status. Instead of tube feeding, the document recommends comfort feeding by hand for patients with advanced dementia.
The document describes a 62-year-old female patient named Pauline who suffered a stroke 10 years ago, resulting in left hemiplegia and chronic pain. She has made adaptations to live independently but has fallen three times in her bathroom in the past two months, exacerbating her pain, exhaustion, depression, and anxiety. Her rehabilitation goals include improving strength, self-care abilities, and quality of life. The team will work to modify her bathroom for safety, address her neuropathic pain, and provide psychological support to help her manage her conditions.
The goal of this webinar was to help hospice and healthcare professionals understand the ethics and application of artificial nutrition and hydration (ANH) for patients near the end of life.
Overall CommentsHi Khanh,Overall you made a nice start with.docxjacksnathalie
Overall Comments:
Hi Khanh,
Overall you made a nice start with your U03a1 assignment; however, your content still does not address the required objectives. For this assignment you will need to focus the content on Capra Tek's regional sales position, and for objective #1 analyze the KSAs for this position, and for objective #2 you will need to analyze wage trends related to this position as well. Objectives 3 & 4 focus on job description and the job analysis so please carefully review what is required for these two objectives.
Please see my feedback below and be sure to let me know if you have any questions about my comments.
Sincerely,
Dr. Marni Swain
COMPETENCY: Describe how hiring practices support an organization's strategy.
CRITERION: Articulate the components of a job description for a position.
DISTINGUISHED
PROFICIENT
BASIC
NON-PERFORMANCE
Non-Performance
Does not articulate the components of a job description for this position.
Faculty Comments:“
Please see feedback above.
”
COMPETENCY: Assess approaches for recruiting, selecting, and retaining talent.
CRITERION: Identify the knowledge, skills, and abilities required for this position.
DISTINGUISHED
PROFICIENT
BASIC
NON-PERFORMANCE
Non-Performance
Does not identify the knowledge, skills, and abilities required for this position.
Faculty Comments:“
Please see feedback above.
”
COMPETENCY: Explore technology tools that support recruiting and staffing management.
CRITERION: Identify wage information and employment trends for this position in a selected state.
DISTINGUISHED
PROFICIENT
BASIC
NON-PERFORMANCE
Non-Performance
Does not identify wage information and employment trends for this position in a selected state.
Faculty Comments:“
Please see feedback above.
”
COMPETENCY: Analyze the impact of legal and regulatory issues on staffing management.
CRITERION: Explain why a job analysis is a requirement for any recruiting and selecting process.
DISTINGUISHED
PROFICIENT
BASIC
NON-PERFORMANCE
Non-Performance
Does not explain why a job analysis is a requirement for any recruiting and selecting process.
Faculty Comments:“
Please see feedback above.
”
COMPETENCY: Communicate in a manner that is scholarly and professional.
CRITERION: Communicate in a professional manner that is appropriate for the intended audience.
DISTINGUISHED
PROFICIENT
BASIC
NON-PERFORMANCE
Non-Performance
Does not communicate in a professional manner that is appropriate for the intended audience.
Faculty Comments:“
Please see feedback above.
”
Dysphagia .
Dysphagia is a serious problem and contributes to weight loss, malnutrition, dehydration, aspiration pneumonia, and death. Careful assessment of risk factors, observation for signs and symptoms, and collaboration with speech-language pathologists on interventions are essential.
Dysphagia, or difficulty swallowing, is a common problem in older adults. The prevalence of swallowing disorders is 16% to 22% in adults older than 50 years of age, and up to 60% of nursing ho.
Epilepsy is a neurological condition characterized by recurrent seizures. Seizures are brief disturbances in the electrical functions of the brain. The assessment of epilepsy involves stabilizing the patient during a seizure by ensuring their airway, breathing, and circulation. Vital signs should be monitored and the duration of convulsions recorded. Underlying causes should be explored, such as eclampsia in pregnant women. Rectal diazepam can be used to stop prolonged seizures when IV access is not available. Status epilepticus requires management in a health facility with IV antiepileptic medications.
END OF LIFE CARE- all ages deserve quality end of life careSandhya C
End of life care involves supporting patients who are in the last months or years of life. It focuses on comfort rather than cure and can be provided by a team including physicians, nurses, social workers, counselors and others. The goals are to enhance quality of life, maintain function, relieve suffering and allow a natural death with dignity. Nurses play a key role in providing physical, psychosocial and spiritual support to dying patients and their families.
An Ethical Case Study On End Of Life CareAshley Thomas
The document discusses end-of-life care and the ethical issues surrounding decisions to continue or withdraw life-prolonging treatment for patients. It describes a case study involving an elderly woman who suffered two strokes leaving her unable to eat, talk, drink or move on her own. Her family considered three options: placing her in hospice care, continuing forced tube feeding, or withdrawing treatment. The document examines the legal and ethical implications of these decisions, particularly regarding tube feeding for patients with advanced dementia.
The document discusses the benefits, burdens and harms of artificial nutrition and hydration like tube feeding in patients with advanced dementia or who are near the end of life. It finds that tube feeding does not prevent aspiration pneumonia or malnutrition, does not decrease mortality rates, and does not prevent or hasten healing of pressure sores. Tube feeding is also not shown to improve patient comfort or functional status. Instead of tube feeding, the document recommends comfort feeding by hand for patients with advanced dementia.
The document describes a 62-year-old female patient named Pauline who suffered a stroke 10 years ago, resulting in left hemiplegia and chronic pain. She has made adaptations to live independently but has fallen three times in her bathroom in the past two months, exacerbating her pain, exhaustion, depression, and anxiety. Her rehabilitation goals include improving strength, self-care abilities, and quality of life. The team will work to modify her bathroom for safety, address her neuropathic pain, and provide psychological support to help her manage her conditions.
The goal of this webinar was to help hospice and healthcare professionals understand the ethics and application of artificial nutrition and hydration (ANH) for patients near the end of life.
This document provides information on caring for terminally ill and dying patients, including:
- Assessing patient needs, maintaining communication, and meeting physical, psychological, and spiritual needs.
- Common signs that a patient is approaching death like changes to breathing, circulation, skin, etc.
- Providing symptomatic relief and care of the body after death like cleaning and positioning the body.
- The importance of advance directives to ensure patient wishes are followed and ease the burden on families.
- Other topics covered include euthanasia, organ donation, medico-legal issues, and post-death unit care.
The document discusses nutrition and hydration in hospice patients. It provides an overview of the ethical considerations and evidence around using artificial nutrition and hydration (ANH) like feeding tubes in hospice and palliative care. While ANH may be appropriate in some cancer patients, the evidence shows it does not prevent aspiration pneumonia, malnutrition or pressure sores in patients with advanced dementia. Feeding tubes also do not improve survival or comfort and may decrease quality of life. The document emphasizes the importance of shared decision making and considering patients' goals of care on an individual basis.
Catherine Horton has worked in health and wellness for over 10 years, producing educational programs and materials. Some of her accomplishments include:
1) Developing a mobile wellness business called WOW that would deliver wellness activities and programs to workplaces.
2) Producing health events and programs for organizations like dance shows, health fairs, and team building activities.
3) Creating educational videos, brochures, and online programs on various health topics to teach people about nutrition, disease prevention, and lifestyle changes.
4) Working with physicians to develop patient education resources and programs around chronic disease management and lifestyle modification.
My Experience With an Eating Disorder & University - City OnTopic - Habiba -...Habiba Khanom
The author has struggled with anorexia for 10 years, including during her time studying at university. Being in and out of hospitals has made studying difficult, as the eating disorder caused low energy and concentration issues. She wants to help others suffering in silence by sharing her story and encouraging them to seek help from support services. With treatment, the author hopes to recover and live without anorexia controlling her life after graduation.
Ethical Issues Regarding Nutrition and Hydration in Advanced IllnessMike Aref
Be able to discuss and clarify “pleasure feeding” with patients and their families
Identify ethical issues with continuing or stopping artificial nutrition and hydration
Understand complications of artificial nutrition and hydration that are not ethically justifiable
Be able to discuss issues of self-dehydration and self-starvation
The document provides a detailed overview of a typical day for an occupational therapist working in an orthopedic hospital setting. It describes the OT's morning preparation by reviewing patient charts. It then outlines meetings with 7-8 patients, assessing their home situations and setting recovery goals. Afternoon duties include seeing more patients, updating charts, collaborating with other professionals, and preparing for the next day. An example patient, a 90-year-old man recovering from knee surgery, is highlighted for his resilience and progress with the OT's help.
Faye Glenn Abdellah was a pioneering nursing theorist and public health scientist. She received her nursing diploma and went on to earn multiple advanced degrees. Abdellah worked to expand the role of nursing beyond disease-centered care to include holistic care of patients, families, and communities. She identified 21 nursing problems that encompass patients' physical, emotional, and social needs. Abdellah's work transformed nursing education and practice to focus on meeting all of patients' needs through comprehensive and client-centered care.
How to Reduce Readmissions by Changing Patient EducationChuck Jones
The challenge is no longer finding the perfect medication but rather convincing the patient to take their medication as prescribed. It's no longer providing discharge instructions but educating the patient so they understand the need to follow through on behavior change to avoid repeating habits that brought them to the hospital in the first place.
This lab report examines the hypothesis that the reagent malonate will inhibit the enzyme succinate
dehydrogenase. Malonate is a competitive inhibitor of succinate that binds similarly to the active site but cannot
be dehydrogenated. The experiment measured absorbance of solutions containing varying concentrations of
malonate and succinate over time. The results supported the hypothesis by showing lower absorbance readings,
indicating less substrate conversion, in solutions with higher malonate concentrations. This demonstrates
malonate's inhibitory effect on the important Krebs cycle reaction of succinate oxidation.
This document provides information on caring for dying patients. It discusses assessing patient needs, communicating with patients and families, and meeting physiological, psychological and spiritual needs. It outlines the stages of dying according to Dr. Kubler-Ross and stages of grief. It describes signs that a patient is approaching death and signs of clinical death. It discusses caring for the patient's body after death, including cleaning and preparing the body for the family. The overall message is the importance of providing dignified, compassionate care and supporting both the patient and their families during the dying process.
This document provides information on caring for dying patients. It discusses assessing patient needs, communicating with patients and families, and meeting physiological, psychological and spiritual needs. It outlines the stages of dying according to Dr. Kubler-Ross and stages of grief. It describes signs that a patient is approaching death and signs of clinical death. It discusses caring for the patient's body after death, including cleaning and preparing the body for the family. The overall message is the importance of providing dignified, compassionate care and supporting patients and families during the dying process.
Based on your course reading assignments and your pending research p.docxcherishwinsland
Based on your course reading assignments and your pending research problem, what type of study do you believe you are conducting, and please explain why?
Extra materials:
Descriptive
research
is a study designed to depict the participants in an accurate way. More simply put, descriptive analysis is all about describing people who take part in the survey.
There are three ways a researcher can go about doing a descriptive research project, and they are:
Observational, defined as a method of viewing and recording the participants
Case study, defined as an in-depth study of an individual or group of individuals
Survey, defined as a brief interview or discussion with an individual about a specific topic
Mixed
methods
research
(Extracted from the article below) is the use of quantitative and qualitative methods in a single study or series of studies. It is a new methodology that is increasingly used by health researchers, especially within health services research. There is a growing literature on the theory, design, and critical appraisal of mixed methods research. However, few papers summarize this methodological approach for health practitioners who wish to conduct or critically engage with mixed methods studies.
Article: Using Mixed Methods in Health Research
Meta-Analysis
Meta
-
analysis
is a statistical technique for combining data from multiple studies on a particular topic. A Meta-analysis is an analytical tool for estimating the mean and variance of underlying population effects from a collection of empirical studies addressing ostensibly the same research question. Meta‐analysis has become an increasingly popular and valuable tool in psychological research, and significant review articles typically employ these methods.
Article: Meta-Analysis in Medical Research
Epidemiology
According to the Centers for Disease Control,
Epidemiology
is the method used to find the causes of health outcomes and diseases in populations. In epidemiology, the patient is the community and individuals are viewed collectively. By definition, epidemiology is the study (scientific, systematic, and data-driven) of the distribution (frequency, pattern) and determinants (causes, risk factors) of health-related states and events (not just diseases) in specified populations (neighborhood, school, city, state, country, global).
Article: Epidemiology is a Science of High Importance
Longitudinal Studies
Longitudinal Study, an epidemiologic study that follows a population forward over time, evaluating the effects of one or more variables on a process. If individuals are followed, it is termed a longitudinal cohort study. If classes—e.g., age classes—are studied, it is a longitudinal cross-sectional study. Longitudinal studies are the converse (opposite) of horizontal (parallel) studies.
Article Longitudinal Studies
.
Based on yesterday Assignment (Green Machine)1. Provide a Com.docxcherishwinsland
The document provides instructions for an assignment to analyze competitors in the green machine industry. Students are asked to assess the overall industry strategy, describe each major competitor's current marketing positioning and strategy, and identify the main sources of competitive advantage for each key rival firm.
Based on what youve learned from the material on incidental teachin.docxcherishwinsland
Based on what you've learned from the material on incidental teaching, in a two page (minimum) double spaced paper, describe in detail how you would implement an incidentaI teaching model in a preschool classroom with 10 children. Include: methods of target behavior identification, methods of reinforcement, and expected outcomes as a result of IT implementation.
.
Based on what you have learned related to cybercrime and technol.docxcherishwinsland
Based on what you have learned related to cybercrime and technology, write 2 pages outlining your opinion of what might happen in the future with the emergence of artificial intelligence and/or autonomous vehicles (any kind) and other emerging technologies.
What kind of crimes do you think might be possible?
How might our legal system have to change in order to keep up?
Do we need stricter laws or better technology? or both?
.
Based on what you have learned in this class, write a letter to a fu.docxcherishwinsland
Based on what you have learned in this class, write a letter to a future employer that explains how religion, language, philosophy, material culture, non-material culture, and/or interaction with the environment have shaped the origins and evolution of world civilizations. Please provide at least two concrete examples.
pick on and write about it. 3 pages
.
Based on what you have learned about using unified communication.docxcherishwinsland
Based on what you have learned about using unified communication platforms in a collaborative environment,
create
a 5-slide presentation to a department head or the CEO of a company to convince the audience that this would benefit their business.
Remember to use this format:
Introduction
State the business problem
The current set up
What is Unified Communication Platforms
State how Unified Communication Platforms will help the business
Cite at least two apps that are part of Unified Communication Platforms that is recommended by you
Cost of moving to Unified Communication Platform
Conclusion
Click
the Assignment Files tab to submit your assignment.
.
Based on what you have learned about using cloud-based office pr.docxcherishwinsland
Based on what you have learned about using cloud-based office productivity software,
create
a 5-slide presentation to the department head or CEO to convince him or her that using a cloud-based office productivity suite would benefit the company.
Include
the following in your presentation:
The stated business problem
The current set up
The benefits of moving to the cloud:
The benefits of collaboration
The difference moving to the cloud will be over current practice
Cost of moving to the cloud
Be sure that you also
include
an Introduction and Conclusion slide, along with graphics, Speaker Notes, and a properly formatted APA Reference slide.
Click
the Assignment Files tab to submit your assignment.
.
Based on week 13 reading assignment wh,describe an IT or simil.docxcherishwinsland
Based on week 13 reading assignment wh,
describe an IT or similar business project you have done or are currently doing. In your discussion, provide information on the following:
1. What is that project? Provide complete description.
2. What was the scope, deliverable, and results of the project?
3. What constraints did you experience and how did you handle them?
4. If you had to do the same project again, what changes will you recommend?
Week 13 reading assignment attached
.
Based on the video, how do we make ourselves vulnerable or not so vu.docxcherishwinsland
Based on the video, how do we make ourselves vulnerable or not so vulnerable with decision-making. Sometimes do we try to make the uncertain, certain, by making a decision without the facts and taking into consideration everyone's perspective of the decision at hand? Do we pretend that the other perspective doesn't even exist when we are making decisions?
https://www.ted.com/talks/brene_brown_the_power_of_vulnerability/up-next
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Similar to NURS 6331 Screencast Lesson PlanLesson OverviewNameScr.docx
The goal of this webinar was to help hospice and healthcare professionals understand the ethics and application of artificial nutrition and hydration (ANH) for patients near the end of life.
This document provides information on caring for terminally ill and dying patients, including:
- Assessing patient needs, maintaining communication, and meeting physical, psychological, and spiritual needs.
- Common signs that a patient is approaching death like changes to breathing, circulation, skin, etc.
- Providing symptomatic relief and care of the body after death like cleaning and positioning the body.
- The importance of advance directives to ensure patient wishes are followed and ease the burden on families.
- Other topics covered include euthanasia, organ donation, medico-legal issues, and post-death unit care.
The document discusses nutrition and hydration in hospice patients. It provides an overview of the ethical considerations and evidence around using artificial nutrition and hydration (ANH) like feeding tubes in hospice and palliative care. While ANH may be appropriate in some cancer patients, the evidence shows it does not prevent aspiration pneumonia, malnutrition or pressure sores in patients with advanced dementia. Feeding tubes also do not improve survival or comfort and may decrease quality of life. The document emphasizes the importance of shared decision making and considering patients' goals of care on an individual basis.
Catherine Horton has worked in health and wellness for over 10 years, producing educational programs and materials. Some of her accomplishments include:
1) Developing a mobile wellness business called WOW that would deliver wellness activities and programs to workplaces.
2) Producing health events and programs for organizations like dance shows, health fairs, and team building activities.
3) Creating educational videos, brochures, and online programs on various health topics to teach people about nutrition, disease prevention, and lifestyle changes.
4) Working with physicians to develop patient education resources and programs around chronic disease management and lifestyle modification.
My Experience With an Eating Disorder & University - City OnTopic - Habiba -...Habiba Khanom
The author has struggled with anorexia for 10 years, including during her time studying at university. Being in and out of hospitals has made studying difficult, as the eating disorder caused low energy and concentration issues. She wants to help others suffering in silence by sharing her story and encouraging them to seek help from support services. With treatment, the author hopes to recover and live without anorexia controlling her life after graduation.
Ethical Issues Regarding Nutrition and Hydration in Advanced IllnessMike Aref
Be able to discuss and clarify “pleasure feeding” with patients and their families
Identify ethical issues with continuing or stopping artificial nutrition and hydration
Understand complications of artificial nutrition and hydration that are not ethically justifiable
Be able to discuss issues of self-dehydration and self-starvation
The document provides a detailed overview of a typical day for an occupational therapist working in an orthopedic hospital setting. It describes the OT's morning preparation by reviewing patient charts. It then outlines meetings with 7-8 patients, assessing their home situations and setting recovery goals. Afternoon duties include seeing more patients, updating charts, collaborating with other professionals, and preparing for the next day. An example patient, a 90-year-old man recovering from knee surgery, is highlighted for his resilience and progress with the OT's help.
Faye Glenn Abdellah was a pioneering nursing theorist and public health scientist. She received her nursing diploma and went on to earn multiple advanced degrees. Abdellah worked to expand the role of nursing beyond disease-centered care to include holistic care of patients, families, and communities. She identified 21 nursing problems that encompass patients' physical, emotional, and social needs. Abdellah's work transformed nursing education and practice to focus on meeting all of patients' needs through comprehensive and client-centered care.
How to Reduce Readmissions by Changing Patient EducationChuck Jones
The challenge is no longer finding the perfect medication but rather convincing the patient to take their medication as prescribed. It's no longer providing discharge instructions but educating the patient so they understand the need to follow through on behavior change to avoid repeating habits that brought them to the hospital in the first place.
This lab report examines the hypothesis that the reagent malonate will inhibit the enzyme succinate
dehydrogenase. Malonate is a competitive inhibitor of succinate that binds similarly to the active site but cannot
be dehydrogenated. The experiment measured absorbance of solutions containing varying concentrations of
malonate and succinate over time. The results supported the hypothesis by showing lower absorbance readings,
indicating less substrate conversion, in solutions with higher malonate concentrations. This demonstrates
malonate's inhibitory effect on the important Krebs cycle reaction of succinate oxidation.
This document provides information on caring for dying patients. It discusses assessing patient needs, communicating with patients and families, and meeting physiological, psychological and spiritual needs. It outlines the stages of dying according to Dr. Kubler-Ross and stages of grief. It describes signs that a patient is approaching death and signs of clinical death. It discusses caring for the patient's body after death, including cleaning and preparing the body for the family. The overall message is the importance of providing dignified, compassionate care and supporting both the patient and their families during the dying process.
This document provides information on caring for dying patients. It discusses assessing patient needs, communicating with patients and families, and meeting physiological, psychological and spiritual needs. It outlines the stages of dying according to Dr. Kubler-Ross and stages of grief. It describes signs that a patient is approaching death and signs of clinical death. It discusses caring for the patient's body after death, including cleaning and preparing the body for the family. The overall message is the importance of providing dignified, compassionate care and supporting patients and families during the dying process.
Similar to NURS 6331 Screencast Lesson PlanLesson OverviewNameScr.docx (13)
Based on your course reading assignments and your pending research p.docxcherishwinsland
Based on your course reading assignments and your pending research problem, what type of study do you believe you are conducting, and please explain why?
Extra materials:
Descriptive
research
is a study designed to depict the participants in an accurate way. More simply put, descriptive analysis is all about describing people who take part in the survey.
There are three ways a researcher can go about doing a descriptive research project, and they are:
Observational, defined as a method of viewing and recording the participants
Case study, defined as an in-depth study of an individual or group of individuals
Survey, defined as a brief interview or discussion with an individual about a specific topic
Mixed
methods
research
(Extracted from the article below) is the use of quantitative and qualitative methods in a single study or series of studies. It is a new methodology that is increasingly used by health researchers, especially within health services research. There is a growing literature on the theory, design, and critical appraisal of mixed methods research. However, few papers summarize this methodological approach for health practitioners who wish to conduct or critically engage with mixed methods studies.
Article: Using Mixed Methods in Health Research
Meta-Analysis
Meta
-
analysis
is a statistical technique for combining data from multiple studies on a particular topic. A Meta-analysis is an analytical tool for estimating the mean and variance of underlying population effects from a collection of empirical studies addressing ostensibly the same research question. Meta‐analysis has become an increasingly popular and valuable tool in psychological research, and significant review articles typically employ these methods.
Article: Meta-Analysis in Medical Research
Epidemiology
According to the Centers for Disease Control,
Epidemiology
is the method used to find the causes of health outcomes and diseases in populations. In epidemiology, the patient is the community and individuals are viewed collectively. By definition, epidemiology is the study (scientific, systematic, and data-driven) of the distribution (frequency, pattern) and determinants (causes, risk factors) of health-related states and events (not just diseases) in specified populations (neighborhood, school, city, state, country, global).
Article: Epidemiology is a Science of High Importance
Longitudinal Studies
Longitudinal Study, an epidemiologic study that follows a population forward over time, evaluating the effects of one or more variables on a process. If individuals are followed, it is termed a longitudinal cohort study. If classes—e.g., age classes—are studied, it is a longitudinal cross-sectional study. Longitudinal studies are the converse (opposite) of horizontal (parallel) studies.
Article Longitudinal Studies
.
Based on yesterday Assignment (Green Machine)1. Provide a Com.docxcherishwinsland
The document provides instructions for an assignment to analyze competitors in the green machine industry. Students are asked to assess the overall industry strategy, describe each major competitor's current marketing positioning and strategy, and identify the main sources of competitive advantage for each key rival firm.
Based on what youve learned from the material on incidental teachin.docxcherishwinsland
Based on what you've learned from the material on incidental teaching, in a two page (minimum) double spaced paper, describe in detail how you would implement an incidentaI teaching model in a preschool classroom with 10 children. Include: methods of target behavior identification, methods of reinforcement, and expected outcomes as a result of IT implementation.
.
Based on what you have learned related to cybercrime and technol.docxcherishwinsland
Based on what you have learned related to cybercrime and technology, write 2 pages outlining your opinion of what might happen in the future with the emergence of artificial intelligence and/or autonomous vehicles (any kind) and other emerging technologies.
What kind of crimes do you think might be possible?
How might our legal system have to change in order to keep up?
Do we need stricter laws or better technology? or both?
.
Based on what you have learned in this class, write a letter to a fu.docxcherishwinsland
Based on what you have learned in this class, write a letter to a future employer that explains how religion, language, philosophy, material culture, non-material culture, and/or interaction with the environment have shaped the origins and evolution of world civilizations. Please provide at least two concrete examples.
pick on and write about it. 3 pages
.
Based on what you have learned about using unified communication.docxcherishwinsland
Based on what you have learned about using unified communication platforms in a collaborative environment,
create
a 5-slide presentation to a department head or the CEO of a company to convince the audience that this would benefit their business.
Remember to use this format:
Introduction
State the business problem
The current set up
What is Unified Communication Platforms
State how Unified Communication Platforms will help the business
Cite at least two apps that are part of Unified Communication Platforms that is recommended by you
Cost of moving to Unified Communication Platform
Conclusion
Click
the Assignment Files tab to submit your assignment.
.
Based on what you have learned about using cloud-based office pr.docxcherishwinsland
Based on what you have learned about using cloud-based office productivity software,
create
a 5-slide presentation to the department head or CEO to convince him or her that using a cloud-based office productivity suite would benefit the company.
Include
the following in your presentation:
The stated business problem
The current set up
The benefits of moving to the cloud:
The benefits of collaboration
The difference moving to the cloud will be over current practice
Cost of moving to the cloud
Be sure that you also
include
an Introduction and Conclusion slide, along with graphics, Speaker Notes, and a properly formatted APA Reference slide.
Click
the Assignment Files tab to submit your assignment.
.
Based on week 13 reading assignment wh,describe an IT or simil.docxcherishwinsland
Based on week 13 reading assignment wh,
describe an IT or similar business project you have done or are currently doing. In your discussion, provide information on the following:
1. What is that project? Provide complete description.
2. What was the scope, deliverable, and results of the project?
3. What constraints did you experience and how did you handle them?
4. If you had to do the same project again, what changes will you recommend?
Week 13 reading assignment attached
.
Based on the video, how do we make ourselves vulnerable or not so vu.docxcherishwinsland
Based on the video, how do we make ourselves vulnerable or not so vulnerable with decision-making. Sometimes do we try to make the uncertain, certain, by making a decision without the facts and taking into consideration everyone's perspective of the decision at hand? Do we pretend that the other perspective doesn't even exist when we are making decisions?
https://www.ted.com/talks/brene_brown_the_power_of_vulnerability/up-next
.
Based on the video (specifically Section 1 Understanding the Comm.docxcherishwinsland
Based on the video (specifically Section 1:
Understanding the Communications Plan
) think of a presentation or proposal you have given or observed, or may be giving in the future, and complete a Stakeholder Register (
Stakeholder Register example
). Requirements include a brief synopsis of the presentation or proposal (1 page maximum) and a completed register. You may use whatever format for the register (word document, spreadsheet, etc.) that is convenient
.
Based on the texts by Kafka and Eliot, (writing on one or the other .docxcherishwinsland
Based on the texts by Kafka and Eliot, (writing on one or the other or both), discuss how the writers seem critical of modern culture, as they portray modern man as a self-conscious functionary who fears an acute loss of spirituality and identity, as well as the ability to achieve authenticity and happiness, overcome by the dehumanizing forces of industrialization and capitalism in post-WWI Europe.
- at least 700 words.
- MLA style
.
Based on the texts by Kafka and Eliot, (writing on one or the ot.docxcherishwinsland
Based on the texts by Kafka and Eliot, (writing on one or the other or both), discuss how the writers seem critical of modern culture, as they portray modern man as a self-conscious functionary who fears an acute loss of spirituality and identity, as well as the ability to achieve authenticity and happiness, overcome by the dehumanizing forces of industrialization and capitalism in post-WWI Europe.
.
Based on the techniques discussed for hiding data on a computer, w.docxcherishwinsland
Based on the techniques discussed for hiding data on a computer, which method would you use for the following:
Hiding information from a young family member who uses the same computer
Hiding information from a colleague who is a network administrator
Hiding information from an intelligence agency, such as the CIA
data hiding techniques
: -
1.hide in the properties
2.rename/change extension
3.steganography
4.hash
5.encryption
6.bit shifting
.
Based on the readings, there are specific components that encompass .docxcherishwinsland
Based on the readings, there are specific components that encompass SW-PBIS. Please describe any additional components that you think should also be included in the SW-PBIS plan. State why you think this(these) component(s) should be included.
An initial posting of roughly 150 words is due by January 12th.
.
Based on the readings titled ‘Lost Trust’, ‘Chinese Port Cities’ a.docxcherishwinsland
Based on the readings titled ‘Lost Trust’, ‘Chinese Port Cities’ and ‘Emerging Urban Form of Accra’, identify and describe emerging URBAN spatial patterns in the United States, Shanghai (China) and Accra (Ghana) under globalization.
Instructions. This is a 3-2-paragraph essay and should fit onto one page, 1.5 spacing and 1-inch margins (About 400 words).
Your second paragraph should identify and describe the emerging spatial patterns for the core (USA). This paragraph should be about 100 words.
Your second third paragraph should identify and describe the spatial patterns for the semi-periphery (China). This paragraph should be about 100 words.
Your fourth paragraph should make spatial patterns for the periphery (Ghana). This paragraph should be about 100 words.
Your first paragraph should be a very, very brief introduction (no more than 2 sentences or about 50 words) and the fifth should be a very brief conclusion (no more than two sentences or about 50 words). These make up the 2 in the 3-2- paragraph essay.
By putting these five paragraphs together, you would have written an essay about emerging geographies of urbanization under globalization in the core, semi-periphery and periphery focusing on spatial patterns ONLY.
Rubic_Print_FormatCourse CodeClass CodeAssignment TitleTotal PointsHCA-807HCA-807-O500Contrast of Health Care Structures200.0CriteriaPercentageUnsatisfactory (0.00%)Less Than Satisfactory (73.00%)Satisfactory (82.00%)Good (91.00%)Excellent (100.00%)CommentsPoints EarnedContent70.0%Contrast of Public and Private Structures20.0%A contrast of public and private structures is either missing or not evident to the reader.A contrast of public and private structures is present, but incomplete or inaccurate.A contrast of public and private structures is presented, but is cursory and lacking in depth. The research used for support is outdated.A contrast of public and private structures is thoroughly presented and includes a discussion of all necessary elements. The contrast is moderately well supported though some sources of support are outdated.A contrast of public and private structures is thoroughly presented with rich detail and includes a discussion of all necessary elements. The contrast is well supported with current and/or seminal research.Analysis of Current Viability and Future Sustainability of Each Structure20.0%An analysis of current viability and future sustainability of each structure is either missing or not evident to the reader.An analysis of current viability and future sustainability of each structure is present, but incomplete or inaccurate.An analysis of current viability and future sustainability of each structure is present, but cursory. The research used for support is outdated.An analysis of current viability and future sustainability of each structure is present and thorough. The analysis is moderately well supported though some sources of support are outdated.An analysis of current viability and .
Based on the readings this week, answer the two following questions .docxcherishwinsland
Based on the readings this week, answer the two following questions in 150 words per question:
1. In this weeks' readings the Puerto Rican and Jamaican voice (specifically DJ Kool Herc losing his accent) were omitted from hip hop/rap culture while the Chicano voice was avidly expressed. In your opinion, what factors contributed to this binary of resistance and conformity? In other words, why do you think Chicanos held on to their language and slang, where other ethnic groups did not?
2. In hip hop/rap culture, how important is a name in the quest for identity formation? Use examples from the texts.
.
Based on the readings for the week, discuss your opinion on the need.docxcherishwinsland
Based on the readings for the week, discuss your opinion on the need for variance analysis in either a service provider setting (retail or restaurant), or manufacturing setting.
VanZante, N. (2007, April). Helping students see the "big picture" of variance analysis. Management Accounting Quarterly, 8(3), 39-40, 42-47. Retrieved March 17, 2010, from ProQuest Database.
.
Based on the reading assignment, your experience, and personal r.docxcherishwinsland
Based on the reading assignment, your experience, and personal research, please answer the following questions:
Thoroughly explain what is recovering, data, and validation as it relates to cell phone forensics?
What is evidence contamination as it relates to digital forensics?
List and describe at least two forms of contamination and how they can be avoided
What is the Faraday method?
List and explain three of the strategies associated with Faraday Methods
.
Based on the reading assignment (and in your own words), why are MNE.docxcherishwinsland
Based on the reading assignment (and in your own words), why are MNEs better able to exploit global opportunities (versus purely domestic competitors)?
Your response should be at least
200 words
in length. All sources used, including the textbook, must be referenced; paraphrased and quoted material must have accompanying citations.
[removed] [removed] [removed] [removed]
Moffett, M. H., Stonehill, A. I., & Eiteman, D. K. (2012).
Fundamentals of multinational finance
. (IV ed., pp. 14-14). New York: Pearson.
In-text citation
(Moffett, Stonehill & Eiteman, 2012)
No Wiki, no dictionary.com, please cite all work.
.
Based on the primary documents from chapter 23 of AmericanYawp, plea.docxcherishwinsland
Based on the primary documents from chapter 23 of AmericanYawp, please answer the following questions in a thoughtful, well-written essay of approximately 750 words:
1: What is Herbert Hoover’s fear about the New Deal? What does he mean when he warns that a new deal “would destroy the very foundations of our American system”?2: What was Huey Long’s plan? Would Hoover have approved of it? Why or why not?3: What was FDR’s plan, as outlined in his re-nomination speech? Would Long and Hoover have approved or disapproved of this plan? Why or why not?
Papers should be double-spaced with normal fonts and margins and include an introduction and conclusion
.
Leveraging Generative AI to Drive Nonprofit InnovationTechSoup
In this webinar, participants learned how to utilize Generative AI to streamline operations and elevate member engagement. Amazon Web Service experts provided a customer specific use cases and dived into low/no-code tools that are quick and easy to deploy through Amazon Web Service (AWS.)
A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
How to Manage Your Lost Opportunities in Odoo 17 CRMCeline George
Odoo 17 CRM allows us to track why we lose sales opportunities with "Lost Reasons." This helps analyze our sales process and identify areas for improvement. Here's how to configure lost reasons in Odoo 17 CRM
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
Chapter wise All Notes of First year Basic Civil Engineering.pptxDenish Jangid
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UPRAHUL
This Dissertation explores the particular circumstances of Mirzapur, a region located in the
core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
environment for investigating the changes in vegetation cover dynamics. Our study utilizes
advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
analyze the transformations that have taken place over the course of a decade.
The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
population expansion, and economic progress, the effects on natural ecosystems are becoming
more evident. A crucial element of this impact is the alteration of vegetation cover, which plays a
significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
these activities. As the most crucial natural resource, its utilization by humans results in different
'Land uses,' which are determined by both human activities and the physical characteristics of the
land.
The utilization of land is impacted by human needs and environmental factors. In countries
like India, rapid population growth and the emphasis on extensive resource exploitation can lead
to significant land degradation, adversely affecting the region's land cover.
Therefore, human intervention has significantly influenced land use patterns over many
centuries, evolving its structure over time and space. In the present era, these changes have
accelerated due to factors such as agriculture and urbanization. Information regarding land use and
cover is essential for various planning and management tasks related to the Earth's surface,
providing crucial environmental data for scientific, resource management, policy purposes, and
diverse human activities.
Accurate understanding of land use and cover is imperative for the development planning
of any area. Consequently, a wide range of professionals, including earth system scientists, land
and water managers, and urban planners, are interested in obtaining data on land use and cover
changes, conversion trends, and other related patterns. The spatial dimensions of land use and
cover support policymakers and scientists in making well-informed decisions, as alterations in
these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
This presentation was provided by Steph Pollock of The American Psychological Association’s Journals Program, and Damita Snow, of The American Society of Civil Engineers (ASCE), for the initial session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session One: 'Setting Expectations: a DEIA Primer,' was held June 6, 2024.
How to Setup Warehouse & Location in Odoo 17 InventoryCeline George
In this slide, we'll explore how to set up warehouses and locations in Odoo 17 Inventory. This will help us manage our stock effectively, track inventory levels, and streamline warehouse operations.
How to Fix the Import Error in the Odoo 17Celine George
An import error occurs when a program fails to import a module or library, disrupting its execution. In languages like Python, this issue arises when the specified module cannot be found or accessed, hindering the program's functionality. Resolving import errors is crucial for maintaining smooth software operation and uninterrupted development processes.
Strategies for Effective Upskilling is a presentation by Chinwendu Peace in a Your Skill Boost Masterclass organisation by the Excellence Foundation for South Sudan on 08th and 09th June 2024 from 1 PM to 3 PM on each day.
1. NURS 6331: Screencast Lesson Plan
Lesson Overview
Name:
Screencast Title:
End of Life Interventions: Can they cause more harm than
good?
Environment:
(on-site, online, or hybrid)
On-Line
Screencast Goal:
To teach nursing students and nurses that at the end of life IV
hydration, tube feeding and forced feeding may not be
beneficial to the patient.
Description of Screencast lesson:
This screencast begins with a scenario of a patient at the end of
her life. With this patient in mind, the screencast will review
whether IV fluids, Tube Feedings and forced feedings are
appropriate at the end of life. The screencast will then discuss
some interventions that may provide end-of-life comfort.
Learning Objectives
· At the end of this screencast, learners will be able to analyze
the use of IV Fluids, Tube Feeding and Forced Feedings at end-
of-life
· At the end of this screencast, learners will be able to describe
interventions which may not be beneficial at the end-of-life and
why
Identify at Least One in Each Area
Pre-Licensure QSEN Competencies
Integrated Processes
2. Clinical Relationships
1. Patient-centered care FORMCHECKBOX
2. Teamwork and collaboration FORMCHECKBOX
3. Evidence-based practice (EBP) FORMCHECKBOX
4. Quality Improvement (QI) FORMCHECKBOX
5. Safety FORMCHECKBOX
6. Informatics FORMCHECKBOX
1. Nursing process FORMCHECKBOX
2. Caring FORMCHECKBOX
3. Communication and documentation FORMCHECKBOX
4. Teaching/ Learning FORMCHECKBOX
1. Varied sources of data FORMCHECKBOX
2. Similar options FORMCHECKBOX
3. Prioritization FORMCHECKBOX
4. Teaching FORMCHECKBOX
5. Notes: FORMCHECKBOX
______________
Rationale:
Rationale:
Rationale:
Script
3. Actions on Screen
Audio/Narrative
PowerPoint Slide:
Interventions at the End-Of-Life: Do they cause more harm than
good
This screen cast, intended for nursing students and nurses will
discuss interventions at the end of life and whether they may be
causing more harm than good.
PowerPoint Slide:
Learning Objectives
· Analyze the use of IV Fluids, Tube Feeding and Forced
Feedings at end-of-life
· Determine why some interventions are not beneficial at the
end-of-life
·
The learning objectives for today’s screencast are to analyze the
use of interventions at the end of life such as IV fluids, Tube
Feeding, and Forced Feeding. We will determine why these
interventions may not always be beneficial to patients and
discuss those interventions which may provide comfort at the
end-of-life
PowerPoint Slide:
Scenario
· A 97 year old patient at the end of life wants to die and wants
to be left alone. Her family wants to do everything in their
4. power to keep her alive as long as they can.
· Picture
An elderly patient (Mrs. Lovely), has reached the end of her
life. She is 97 years old, has dementia, congestive heart failure
and end stage kidney failure. She has expressed that she is
ready to die. She has no desire to eat or drink and no longer
wants to take medication. Her family wants her to try IV fluids,
and possibly insert a feeding tube since she is not eating. They
want try to force her to eat when she does not want to. Mrs.
Lovely has an advance health care directive that states she does
not want any interventions at end of life. Let’s keep this patient
in mind as we go through possible interventions.
NOTE: This slide and corresponding narrative were deleted due
to time constraints.
PowerPoint Slide:
As nurses we want to help
· As nurses we are taught non-maleficence: “to do no harm”
· At the end of life are we doing harm by not doing everything
in our power to safe a patient?
· Picture
As nurses, we are taught to do everything we can to help a
patient and keep them alive. At the end of life, if a patient has
made the decision that they are ready to die and they do not
want any interventions, we, as health care practitioners must
learn to respect that and let the patient “just be”
PowerPoint Slide:
5. Commonly Requested Interventions
· At end of life, there are interventions commonly requested
IV Fluids
Tube Feeding
Feeding a patient who does not want to eat
· Picture
As patients are dying, their requests become very few. Family
members and caregivers however, often want to do things to
prolong a patients life. Examples of these life prolonging
measures are IV fluids, Tube Feeding and trying to force a
patient to eat or drink when they no longer have the desire
PowerPoint Slide:
Instead of providing energy and nutrients to the patient, IV
fluid can cause the opposite effect and result in:
·
Swelling
·
Pain
·
Difficulty breathing
The addition of fluids at end of life is sometimes requested by
6. family members so the patient does not get dehydrated.
Research shows that IV fluids at the end of life do not prolong
life or add to quality of life. IV fluids may have the opposite
effect and can cause swelling, pain, dyspnea or even congestive
heart failure. With the addition of these complications, it may
shorten a patient’s life rather than prolong it. If Mrs. Lovely
got IV fluids at this point, it may be difficult to find a vein,
even the insertion could be traumatic. Once the IV is inserted,
the fluid may “third space” or go into areas that the fluid was
not intended for. It could cause Mrs. Lovely great discomfort.
Mrs. Lovely already has congestive heart failure. The fluid may
cause her more harm than good. Are there situations where IV
fluids might be appropriate at the end of life? Think about his
here. Record your thoughts, do some research and be prepared
to discuss this when at our next class.
PowerPoint Slide:
Tube Feeding
· For a person at the end of their life, their body may not have
the strength to process the nutrients of tube feeding.
· Picture
When a person’s body shuts down at end-of-life, they will most
likely not be able to endure the surgery that it takes to insert a
feeding tube and they may not be able to process the nutrients
from a tube feeding. If the patient cannot process the nutrients,
symptoms of bloating and discomfort may occur. This
counteracts the goal of comfort at the end of life. Mrs. Lovely
would not be a candidate for surgery as she has congestive heart
failure and her heart would not withstand the surgery.
PowerPoint Slide:
Feeding at the end-of-life
7. · Losing appetite at the end of life is normal
· Forcing someone to eat when they do not want may take away
from their quality of life
· Eating can add to discomfort, the goal is to provide comfort
· When individuals choose to stop eating or drinking it can be
their way of taking charge of the completion of their life
· Picture
It is hard for family members and caregivers to see their loved
ones lose the desire to eat or drink. You don’t have to force a
person to eat. Going without food and/or water is generally not
painful, and eating can add to discomfort. Loss of appetite is
normal and is a part of dying. Patients may have lost the ability
to swallow, especially if they have dementia. They may have
forgotten how to swallow. Sometimes, giving up food or drink
is the one thing that a person can control in their dying process;
it may be their way of accepting their death. Mrs. Lovely has
refused food for 3 days now and her family is distraught
because they feel they are starving her. How would you explain
to the family that feeding is not beneficial at this point? Make a
video (maximum 3 minutes) with your explanation and upload it
to the blackboard under discussions by day 7.
NOTE: This slide and corresponding narrative were deleted due
to time constraints.
PowerPoint Slide:
Interventions that may provide comfort
· Some interventions may be appropriate for comfort, they
8. include:
Foley Catheter
Suppositories
Paracentesis/Thoracentesis
Antibiotics
There are some interventions that are palliative, may be
appropriate and may provide additional comfort at the end of
life. In my experience, if an individual has discomfort in their
body, it may be keeping them from being at peace and
preventing them from dying. When the patient is comfortable,
they, many times, die after. I had recent scenarios when a
suppository for a patient with a fever who could not longer
swallow, she died as soon as her fever went down. In another
scenario, a patient who was retaining urine, died shortly after a
catheter was inserted and 1000 cc of urine was obtained. For
patients with excess fluid in their lungs or abdomen, if they can
get to an outpatient clinic, it is often beneficial to drain the
fluid so that they can breathe better, it often gives patients a
better quality of life. If a patient has a fever due to infection
either in their lungs or in a wound, antibiotics can relieve the
infection can provide the patient comfort.
Note: This slide was deleted due to time constraints. The
patient’s handouts are available in the reference section.
PowerPoint Slide:
Handouts
IV Hydration
9. ·
Link 1
Tube Feeding and Eating and the end-of-life:
· Link 2
These handouts, although informative to health care providers
are intended for patients to give them an understanding of the
implications of IV Hydration, Tube Feedings and Forced
Feedings at the end-of life.
PowerPoint Slide:
References
Here is a consolidated list of references related to comfort
measures at the end of life. Feel free to use these references as
information for yourselves and your patients as questions come
up about end-of-life interventions
Picture
Here is a picture of my grandmother and my son. She was able
to die at home, with no interventions as she wished. My son and
I were able to visit her 3 months before she died. This picture
captures the essence of my grandmother’s dying journey.
As follow up, please look at the links provided in the reference
section and print out the handouts provided. Be prepared to
come to class to discuss your thoughts on “letting your patient
be” when it is their time and your thoughts on being
comfortable letting a person die when it is their time.
Thank you for listening to this screencast. Feel free to leave any
feedback in the comments when you are submitting your
10. assignments.
Thank you for listening to this screencast. Feel free to leave any
feedback in the comments when you are submitting your
assignments.
Evaluate and Revise
If I were to recreate my Screencast, I would:
Do as I have done and incorporate Feedback from Instructor:
1) Added references and handouts for the audience and their
patients
2) Added pictures
3) Added to the narrative that the patient had an Advance
Health Care directive indicating her wishes
Self Observation:
1) The objective was removed indicating that after the
screencast, students will be able to describe interventions which
may be appropriate for the end of life. This section was
removed from the PowerPoint due to time constraints and
therefore should be removed from the objectives. There is
however, a task in the screencast for the students to research
this topic for class.
11. Rubric for Video: Explaining End of Life Interventions to
Family
Teacher Name: R Garrison
12. Student Name:
________________________________________
CATEGORY
4
3
2
1
Score
Concept
Student has a clear picture of what they are trying to achieve.
Student can describe what they are trying to do and generally
how his/her work will contribute to the knowledge base of the
family of a dying patient.
Student has a fairly clear picture of what they are trying to
achieve. Student can describe what they are trying to do but has
dome trouble describing how his/her work will contribute to the
knowledge base.
Student has a fairly clear picture of what they are trying to
achieve but has difficulty describing it to the audience.
Student does not have a clear picture of what they are trying to
achieve and has difficulty describing the concept to the
audience.
13. Video
Video is complete. Purpose is clearly stated. Student presents at
least 3 reasons why feeding may not be beneficial at the end of
life. Video is quite professional.
Video is mostly complete. Purpose is clearly stated. Student
presents at least 2 reasons why feeding may not be beneficial at
the end of life. Video is somewhat professional.
Video is not complete. Purpose is not stated. Student presents
at least 1 reasons why feeding may not be beneficial at the end
of life. Video is somewhat professional.
Video is not complete. Purpose is not stated. Student presents
at least 1 reasons why feeding may not be beneficial at the end
of life. Video is not professional.
Sound Setup
Video sound is clear with no background noise. All phrases are
well articulated and picked up by the microphone.
Video sound is clear with minimal background noise. All
phrases are well articulated and picked up by the microphone.
Video sound somewhat clear with minimal background noise.
Some phrases are well articulated and picked up by the
microphone.
Video sound unclear with audible background noise. Phrases are
not well articulated and unable to be picked up by the
microphone.
Date Created: Nov 01, 2016 12:55 pm (CDT)
15. a malicious intention.
Bullying is a frequent form of violence in schools and involves
harmful acts that cause psychological, emotional, social or
physical harassment among students. It is often carried out by
the senior students who harass the newly admitted students. The
new students seem naïve and therefore, they are the weakest
ones to bullying. Statistics indicate that there about four million
students who become victims of school bullying annually. The
act of bullying causes adverse effects on students. For example,
it destroys the school environment making it unfriendly and
unbearable for most students (Kwan, Grace and Marko, pg. 47).
Therefore, it requires a collaborative effort and strategies that
would eliminate it especially within the confines of learning.
Negative outcomes of bullying in schools
As pointed out, bullying has many adverse effects that derail the
student’s learning despite the parents’ substantial investment
regarding tuition fees. Some of the negative consequences
established are discussed as follows.
Changing student's personality
During admission that marks a student’s entry in school, there
are often great desires and expectations that they hold and
would want to accomplish in the course of learning. For
example, it is indicated that during admission, most students
seem optimistic and hope to achieve their dreams and also meet
new friends. However, after joining, they meet senior students
who intimidate and threaten them. As a result, their desire and
interest towards school and learning change all of a sudden
(Polanin, Dorothy and Therese, pg. 87). Since some of them are
naïve and face constant intimidation from senior students, their
personality about school gets adversely affected.
Dismal academic performance
When the friendly environment that supports and encourages
learning becomes altered, the concentration for learning is
greatly affected. According to the research, bullying in schools
creates an atmosphere of fear for students and makes everything
16. around to be disgusting. For example, the school set up becomes
like a small prison where a person’s freedom has been curtailed.
Therefore, students are not motivated to study as they struggle
and wonder why they face such kinds of harassments, especially
from their fellow students. As a result, they end up performing
dismally because they cannot concentrate and pay attention due
to fear and lack of motivation.
Increased school drop outs
When a particular environment does provide a good support
system required, the inhabitants tend to move in search of a
better place (Valdebenito, Sara, Maria and Manuel, pg. 339). In
the same way, the research findings indicate that bullying in
schools creates an unfriendly and unbearable place for many
students. Some students have never gone through any
harassment from home and would not adapt or tolerate bullying
anywhere. For example, they have lived not knowing that
stealing exists. As a result, when they cannot tolerate stealing
and beating from other students, they have no other alternative
but quit school. They may not join any other school as they still
suspect there will be bullying.
Low self-esteem
The environment where an individual has been raised has a
significant contribution on his or her self-esteem. By self-
esteem, it refers to how an individual feel about himself or
herself, for example, if a person has a high self-esteem then he
or she will feel a sense of value and importance and behave
confidently (Polanin et al., pg. 204). Therefore, bullying in
schools has been discovered to make some students feel that
they are weak and not liked or appreciated. For example, a
student can force his classmate to clean his or her clothes. As a
result, students who are victims develop a low self-esteem and
lack confidence in what he or she does or says before people.
Dysfunctional families in future
Lastly, every effect in a person’s life leads to subsequent
repercussions. The experience could either make him or her or
destroy his or her next life. For example, bullying in schools
17. creates an unfriendly place for learning, causes harassment and
demotivates a student’s morale. As a result, a student will
change her or his perspective about education, lose confidence
and finally drops out of school. As a result, they join the society
without any clear picture of what they should do. The result is
that; they get married and have their family. The families led by
people who never finished school often will face many
challenges such as fighting and lack of stable finances to
support the basic needs. When an amicable remedy is not found,
then the cycle of dysfunctional families continues. It creates a
cycle of poverty and increases the dependency ratio in the
society.
Suicide
According to the research, some of the adverse effects of
bullying in schools among students are permanent thus cannot
be reversed. For example, bullying makes some students
develop suicidal feelings. It is also a fatal outcome resulting
from bullying in schools. Some individuals exposed to bullying
become distressed, terrified, or depressed (Valdebenito et al.,
pg. 342). They lose a sense of self-worth and have no reason to
live thus they strangle themselves to death. Some of these
students do not have parental support systems to encourage
them.
Positive Effects of Bullying in Schools
Anything that has side effects will also result in some benefits
though the benefits are entirely outweighed by the adverse
consequences. Therefore, apart from the negative impacts
bullying in schools has caused, it can have positive effects in
schools. For example, the act of bullying may enable
individuals to stand up and become bold, voice their concerns or
defend themselves (Polanin, Dorothy and Therese, pg. 221).
This way, it makes victimized students enforce equal rights for
all the students irrespective of their seniority, age and year of
admission. Also, bullying enables some bullies to support their
individual interests and enhance their outlook. Bullies could get
recruited to demanding jobs such as the military to defend the
18. nations against external attacks.
Statistical Data of the Outcomes in Schools
The current statistics indicates that school crime supplement of
deaths among students can be attributed to mental, physical and
emotional torture resulting from school bullies. For example, an
estimated fourteen percent of high school students have
considered suicide as a way avoiding bullying while fifteen
percent has attempted to commit suicide. Additionally,
according to studies conducted by Yale University, victims of
bullying in various schools are about three times more likely to
consider suicide as a way of escaping the issue. The British
survey also has revealed that almost half of suicides among
school students are associated with bullying among students
(Kwan et al., pg. 87). The trend is worrying, and it is high time
that a suitable plan designed to curb the menace in learning
institutions.
Conclusion
Finally, bullying in the schools as highlighted is a big challenge
for students that go through it since it interferes with their self-
esteem and leads to the loss of their confidence and, in extreme
cases it causes suicidal feelings that make some succumb to
death. Also, the long-term effects of bullying in school cause
many individuals to have dysfunctional families. There are more
worrying effects of bullying other than suicide and behavior
change and occur uniquely among the victims. The school
management needs to come up with appropriate disciplinary
measures and actions to curb bullying in schools.
Works Cited
Cornell, Dewey, et al. "Perceived prevalence of teasing and
bullying predicts high school dropout rates." Journal of
Educational Psychology 105.1 (2013): 138.
19. Kwan, Grace Chi En, and Marko M. Skoric. "Facebook
bullying: An extension of battles in school." Computers in
Human Behavior 29.1 (2013): 16-25.
Polanin, Joshua R., Dorothy L. Espelage, and Therese D. Pigott.
"A meta-analysis of school-based bullying prevention programs'
effects on bystander intervention behavior." School Psychology
Review 41.1 (2012): 47.
Valdebenito, Sara, Maria Ttofi, and Manuel Eisner. "Prevalence
rates of drug use among school bullies and victims: A
systematic review and meta-analysis of cross-sectional studies."
Aggression and Violent Behavior 23 (2015): 137-146.