Running head: LITERATURE REVIEW
LITERATURE REVIEW
Literature Review: Hand washing and Hospital-Associated Infections
Name
Walden University
Course Name
April 3, 2016
Literature Review: Hand washing and Hospital-Associated Infections
Most Hospital associated infections are alleged to be transmitted via the hands of Healthcare providers mainly through direct contact when the medical practitioner’s hands transfer the pathogens between individuals or between an environmental reservoir and an individual (Al-Khawaldeh, Al-Hussami, & Darawad, 2015). The purpose of this study is to find out whether there is sufficient evidence to indicate whether there is need for further research on hand washing with regards to the infections that patients are susceptible to in the case of contaminated contact. The evidence from the various studies and nursing journals were carefully assessed to ensure that salient information regarding the research study area were present and were relevant to the study. The researcher took into consideration the ethical issues that are involved in research. The identities of the sample population were not released at any given time and they gave consent for the use of the information retrieved from them (Newcomb, 2010). Furthermore, most of the information used was from journal articles that allow for others to reference the works and findings of the research and, thus, the researcher could include the research material in the literature review (Fouka & Mantzorou, 2011).
Synthesis on the Current State of Knowledge
Despite the relative simplicity of hand hygiene procedure, the adherence rates to the standard recommendations remain unacceptably low; well below 50% (Bukhari et al., 2011). The reasons for non-compliance with hand washing are low staff to patient ratios, lack of appropriate hand washing equipment, insufficient knowledge about risks and procedures, allergies to some hand washing products, the casual attitude of healthcare practitioners (HCPs) and time factors (Pfoh, Dy, & Engineer, 2013). Patients are likely to suffer infections that arise from inconsistent hygiene practices especially those that are supposed to undergo an operation and have undergone a surgical operation.
The United Stated Department of Infectious Diseases estimated the incidence of hospital-acquired infections by 4.5% and with a 5% fatality in 2014 translating to a huge economic impacts (Al-Khawaldeh et al., 2015). One of the main contradictions is the fact that; despite the numerous hand washing guidelines that have been adopted by a majority of health facilities, the compliance by the health care providers remains low despite the practice being one of the simplest and most effective ways of preventing hospital-acquired infections (Bukhari et al., 2011). Some studies point of knowledge, attitude and practice as the primary factors affecting hand hygiene practices while other researches show that even if the healthcare workers from ...
Running head hand hygiene compliance1hand hygiene compliance8.docxwlynn1
Running head: hand hygiene compliance1
hand hygiene compliance8Hand Hygiene Education Implementation and Nurses Compliance in Reducing Nosocomial Infections
Grand Canyon University NRS-490
March 31, 2019
Background
Hygiene is a very crucial factor in prevention of infection in any health care facility. Also, compliance of handwashing ensures patients safety, aids in the treatment and recovery of hospitalized patients. Hand hygiene is important action performed by healthcare works to prevent transmission of healthcare associated infection (Smiddy, O’Connell & Creedon, 2015). Health care professionals such as doctors, nurses, physical therapist and laboratory technicians, take the responsibility of providing efficient, effective and quality care that will improve the health of their patients.
The purpose of this paper is to discuss the change proposal project components the author has been working on throughout the course. The goal of health care works rendering a quality, effective and efficient care to their patient in the health care setting will be difficult to achieve if the rate handwashing adherence is below expectation. Unclean healthcare environments harbor germs that can cause disease, thereby placing the patient at risk of developing infection instead of recovering from their present health condition. Healthcare providers inability to comply with hand hygiene is one the main reason patient develop hospital acquired infections (HAIs). Healthcare employees have the lives of patient in their hands therefore, hand hygiene should not by any means be neglected or dominated out in any healthcare facility.
Approximately 250 health care specialists in a Metro Detroit facility happened to be watched and assessed directly; prior to the start of the exercise, participants were selected based on their hand washing comprehension and compliance. Partakers expresses that they observed improvement on handwashing practices and that most nurses complied to hand washing guidelines evidenced by some significant reductions in the rate of transmission of HAIs within the healthcare facility. HAIs are the infections a patient acquire during the period of hospitalization. The result of the research showed a huge decrease in the spread of nosocomial infections due to progress of hand hygiene training and nurses’ compliance to handwashing protocols. These infections mostly manifest during or after 48 hours of admission or thirty days after discharge from the hospital or health-care facility. The author of this research study sees HAIs as a dangerous disease with many complications. Because inadequate handwashing practices by healthcare workers are the main cause of spread of hospital acquire infections, it is important to educate staff members on proper hand hygiene, implement plan to encourage hand hygiene compliance in the healthcare settings. Blood-stream, ulcers / surgical wounds, CAUTI and respiratory infections are the most common types of HA.
A Study to Assess the Knowledge and Practices of Hand Hygiene among Nursing S...ijtsrd
Topic A study to assess the Knowledge, And Practice of Hand Hygiene among Nursing Staff in different department of the Hospitals in Uttar Pradesh. Background of the study Health care associated infections persist as amajor problem in health care settings especially Intensive Care Units. Hand hygiene is the most simple and effective method for the prevention of these healthcare associated infections. So, assess the reported hand hygiene practices and observing is very much important to find out gaps, plan remedial measure to reduce HAIs. Hand hygiene practice is still burdened by inadequate compliance, whether in the professional sphere by health professionals or in the non professional sphere by lay population Aims of the study A. To assess the hand hygiene practices among nurses B. To assess the reason for non compliance. Material and method This study was conducted in different department of Fatima hospital. It was an observational, study50 different professional categories nurses were taken for observational study, 50 for assess the reported hand hygiene practices. Questionnaire and observation tool were used for data collection. Result The study revealed that there is a corelation between the knowledge and the practices of hand hygiene among the nurses. The overall observed compliance was 58 50 nurses included in observation study, 308 number of opportunities are given only 180opportunities of hand hygiene being performed . The BSc nurses shows higher compliance rate 93.4 . The GNM nurses show 64 and the ANM show low rate 60 . The reported hand hygiene compliance among Questionnaire given to50 Nurses they were may or may not be included in observation study . Conclusion There were two studies conducted by the investigator. The observational study and reported study. The observational study shows that the overall hand hygiene compliance was58 and the reported study give more than 93.4 of compliance among different categories of nurses. The investigator found that the overall observed hand hygiene compliance among nurses was 58.4 , from that BSC Nurses have performed better. They reported the reason for noncompliance was that they were too busy 64 . Sister Ancy Varghese | Dr. Priyanka Chaudhary | Mrs. Ramanpreet Kaur "A Study to Assess the Knowledge and Practices of Hand Hygiene among Nursing Staff in Different Department of the Hospitals in Uttar Pradesh" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-6 | Issue-1 , December 2021, URL: https://www.ijtsrd.com/papers/ijtsrd47804.pdf Paper URL: https://www.ijtsrd.com/medicine/nursing/47804/a-study-to-assess-the-knowledge-and-practices-of-hand-hygiene-among-nursing-staff-in-different-department-of-the-hospitals-in-uttar-pradesh/sister-ancy-varghese
Running head HAND HYGIENE 1HAND HYGIENE10Monitori.docxjeanettehully
Running head: HAND HYGIENE 1
HAND HYGIENE 10
Monitoring for Hand Hygiene Compliance and its Effectiveness at Preventing Healthcare-Associated Infections
Your Name
July 15, 2019
Monitoring for Hand Hygiene Compliance and its Effectiveness at Preventing Healthcare-Associated Infections
Despite the vast body of evidence that correlates proper hand hygiene practices amongst healthcare providers with a decrease in the incidence of healthcare-acquired infections (HAIs), or infections contracted during admission to a healthcare facility, recommended hand hygiene compliance (HHC) continues to be a challenge (Gupta, Gupta, & Bhaskar, 2018). This paper will explore the issue by providing a brief background, discussing the importance to this author, nurses, and the nursing profession, outlining a related clinical question, highlighting current research on the topic, and talking about how this topic can be implemented in nursing practice, both on an individual level, and on a systems level. This author will then present information on how to translate the importance of this issue to the client population through education.
Introduction, Significance, and Importance of Hand Hygiene
When discussing hand hygiene in healthcare, this author is referring to the rudimentary practice of healthcare providers, including nurses, either washing their hands with soap and water or using an antiseptic hand wash or rub, like an alcohol-based hand sanitizer. Centers for Disease Control and Prevention (CDC) (2018) recommends to clean hands before and after contact with clients, after touching items that are close to the client, before and after wearing gloves, after using the restroom, and before eating. Additionally, antiseptic rubs may not be used if the client has Clostridium difficile (CDC, 2018).
The importance of hand hygiene practices can be traced back to the days of Florence Nightingale, who championed the cause by promoting hand hygiene when nursing soldiers during the Crimean War. Despite this longstanding knowledge, HHC continues to be problematic, and potentially preventable HAIs are still occurring in healthcare today. It is estimated that healthcare providers are only washing their hands 50% of the times they should, which very well could be contributing to the one in 25 patients who acquire a HAI (CDC, 2018). In the United States, about 80,000 people die annually as a result of HAIs (McCalla, Reily, Thomas, & McSpedon-Rai, 2017). This author has cared for many patients who acquired HAIs. It is for these reasons that this author has chosen the topic as it impacts both the individual nurse and the nursing profession.
There are many reported reasons why healthcare providers remain out of compliance with recommended hand hygiene. Some identified by Gupta et al. (2018) include a lack of knowledge by the healthcare provider, hand hygiene products that are difficult to find, or placed in out-of-the-way locations, and emergent situations wh ...
Occupational exposure to blood & body fluids among the nursing staff in a ter...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
C361 TASK 2 2
C361 TASK 2 2
C361 Task 2
WGU
Evidence-Based Practice and Applied Nursing Research
C361
Eve Butler
July 28, 2019
Running head: C361 TASK 2 2
C361 Task 2
A.1 Healthcare problem
Worldwide estimates have shown that greater than 1.4 million patients have acquired nosocomial infections. Adherence to hand hygiene policies are shown to be the most effective way to help prevent these healthcare-associated infections; sadly research shows that healthcare workers have suboptimal compliance with their facilities hand hygiene policies due to lack of education and compliance monitoring. Patients in our healthcare settings are under the assumption that we are doing our best to promote their healing when in fact 7% of them will be subjected to a nosocomial infection with that rate climbing to 10% in developing countries (Finco et al., 2018).
A.2 Significance of the problem
The cost of care that is associated with nosocomial infections is estimated to be over ten billion dollars putting a burden on both patients and health organizations alike. It is estimated that 38% of all infections are caused by cross-contamination due to noncompliance with hand hygiene policies. These infections lead to approximately 99,000 deaths a year in the United States alone (Sickbert-Bennett et al., 2016).
A.3 Current healthcare practices related to the problem
Most healthcare facilities have an educational program that simply teaches how to achieve proper hand hygiene and use the WHO five moments of hand hygiene as their standard. However, this does not educate the healthcare workers on why it is important, nor does it address the far-reaching consequences for noncompliance. Along with the lack of foundational education, most facilities do not monitor for compliance.
A.4 How the problem affects the organization and patients’ cultural background
Inadequate hand hygiene leading to nosocomial infections can affect the organization's cultural background by leading to dissatisfaction in the workplace as staff becomes frustrated by their feelings of inadequacy and helplessness in dealing with patients getting sicker instead of better. The staff may also be feeling stress in the burden of caring for sicker patients. The patient's cultural background may be affected as they may be feeling despair or depression at their inability to get better, and some may feel it is punishment according to their cultural or religious beliefs.
B. Two research evidence sources and two non-research evidence sources considered
In searching for my research evidence sources, I start with the Western Governors University Library online. Once in the library, a boolean phrase was used, which allowed me to search for research articles that contain more than one topic in the same paper. Phrases I used in this search were “nosocomial infections,” “hand hygiene compliance,” and “ hand hygiene education.” With these phrases, thousands of articles were available to peruse.
One of the res.
Running head hand hygiene compliance1hand hygiene compliance8.docxwlynn1
Running head: hand hygiene compliance1
hand hygiene compliance8Hand Hygiene Education Implementation and Nurses Compliance in Reducing Nosocomial Infections
Grand Canyon University NRS-490
March 31, 2019
Background
Hygiene is a very crucial factor in prevention of infection in any health care facility. Also, compliance of handwashing ensures patients safety, aids in the treatment and recovery of hospitalized patients. Hand hygiene is important action performed by healthcare works to prevent transmission of healthcare associated infection (Smiddy, O’Connell & Creedon, 2015). Health care professionals such as doctors, nurses, physical therapist and laboratory technicians, take the responsibility of providing efficient, effective and quality care that will improve the health of their patients.
The purpose of this paper is to discuss the change proposal project components the author has been working on throughout the course. The goal of health care works rendering a quality, effective and efficient care to their patient in the health care setting will be difficult to achieve if the rate handwashing adherence is below expectation. Unclean healthcare environments harbor germs that can cause disease, thereby placing the patient at risk of developing infection instead of recovering from their present health condition. Healthcare providers inability to comply with hand hygiene is one the main reason patient develop hospital acquired infections (HAIs). Healthcare employees have the lives of patient in their hands therefore, hand hygiene should not by any means be neglected or dominated out in any healthcare facility.
Approximately 250 health care specialists in a Metro Detroit facility happened to be watched and assessed directly; prior to the start of the exercise, participants were selected based on their hand washing comprehension and compliance. Partakers expresses that they observed improvement on handwashing practices and that most nurses complied to hand washing guidelines evidenced by some significant reductions in the rate of transmission of HAIs within the healthcare facility. HAIs are the infections a patient acquire during the period of hospitalization. The result of the research showed a huge decrease in the spread of nosocomial infections due to progress of hand hygiene training and nurses’ compliance to handwashing protocols. These infections mostly manifest during or after 48 hours of admission or thirty days after discharge from the hospital or health-care facility. The author of this research study sees HAIs as a dangerous disease with many complications. Because inadequate handwashing practices by healthcare workers are the main cause of spread of hospital acquire infections, it is important to educate staff members on proper hand hygiene, implement plan to encourage hand hygiene compliance in the healthcare settings. Blood-stream, ulcers / surgical wounds, CAUTI and respiratory infections are the most common types of HA.
A Study to Assess the Knowledge and Practices of Hand Hygiene among Nursing S...ijtsrd
Topic A study to assess the Knowledge, And Practice of Hand Hygiene among Nursing Staff in different department of the Hospitals in Uttar Pradesh. Background of the study Health care associated infections persist as amajor problem in health care settings especially Intensive Care Units. Hand hygiene is the most simple and effective method for the prevention of these healthcare associated infections. So, assess the reported hand hygiene practices and observing is very much important to find out gaps, plan remedial measure to reduce HAIs. Hand hygiene practice is still burdened by inadequate compliance, whether in the professional sphere by health professionals or in the non professional sphere by lay population Aims of the study A. To assess the hand hygiene practices among nurses B. To assess the reason for non compliance. Material and method This study was conducted in different department of Fatima hospital. It was an observational, study50 different professional categories nurses were taken for observational study, 50 for assess the reported hand hygiene practices. Questionnaire and observation tool were used for data collection. Result The study revealed that there is a corelation between the knowledge and the practices of hand hygiene among the nurses. The overall observed compliance was 58 50 nurses included in observation study, 308 number of opportunities are given only 180opportunities of hand hygiene being performed . The BSc nurses shows higher compliance rate 93.4 . The GNM nurses show 64 and the ANM show low rate 60 . The reported hand hygiene compliance among Questionnaire given to50 Nurses they were may or may not be included in observation study . Conclusion There were two studies conducted by the investigator. The observational study and reported study. The observational study shows that the overall hand hygiene compliance was58 and the reported study give more than 93.4 of compliance among different categories of nurses. The investigator found that the overall observed hand hygiene compliance among nurses was 58.4 , from that BSC Nurses have performed better. They reported the reason for noncompliance was that they were too busy 64 . Sister Ancy Varghese | Dr. Priyanka Chaudhary | Mrs. Ramanpreet Kaur "A Study to Assess the Knowledge and Practices of Hand Hygiene among Nursing Staff in Different Department of the Hospitals in Uttar Pradesh" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-6 | Issue-1 , December 2021, URL: https://www.ijtsrd.com/papers/ijtsrd47804.pdf Paper URL: https://www.ijtsrd.com/medicine/nursing/47804/a-study-to-assess-the-knowledge-and-practices-of-hand-hygiene-among-nursing-staff-in-different-department-of-the-hospitals-in-uttar-pradesh/sister-ancy-varghese
Running head HAND HYGIENE 1HAND HYGIENE10Monitori.docxjeanettehully
Running head: HAND HYGIENE 1
HAND HYGIENE 10
Monitoring for Hand Hygiene Compliance and its Effectiveness at Preventing Healthcare-Associated Infections
Your Name
July 15, 2019
Monitoring for Hand Hygiene Compliance and its Effectiveness at Preventing Healthcare-Associated Infections
Despite the vast body of evidence that correlates proper hand hygiene practices amongst healthcare providers with a decrease in the incidence of healthcare-acquired infections (HAIs), or infections contracted during admission to a healthcare facility, recommended hand hygiene compliance (HHC) continues to be a challenge (Gupta, Gupta, & Bhaskar, 2018). This paper will explore the issue by providing a brief background, discussing the importance to this author, nurses, and the nursing profession, outlining a related clinical question, highlighting current research on the topic, and talking about how this topic can be implemented in nursing practice, both on an individual level, and on a systems level. This author will then present information on how to translate the importance of this issue to the client population through education.
Introduction, Significance, and Importance of Hand Hygiene
When discussing hand hygiene in healthcare, this author is referring to the rudimentary practice of healthcare providers, including nurses, either washing their hands with soap and water or using an antiseptic hand wash or rub, like an alcohol-based hand sanitizer. Centers for Disease Control and Prevention (CDC) (2018) recommends to clean hands before and after contact with clients, after touching items that are close to the client, before and after wearing gloves, after using the restroom, and before eating. Additionally, antiseptic rubs may not be used if the client has Clostridium difficile (CDC, 2018).
The importance of hand hygiene practices can be traced back to the days of Florence Nightingale, who championed the cause by promoting hand hygiene when nursing soldiers during the Crimean War. Despite this longstanding knowledge, HHC continues to be problematic, and potentially preventable HAIs are still occurring in healthcare today. It is estimated that healthcare providers are only washing their hands 50% of the times they should, which very well could be contributing to the one in 25 patients who acquire a HAI (CDC, 2018). In the United States, about 80,000 people die annually as a result of HAIs (McCalla, Reily, Thomas, & McSpedon-Rai, 2017). This author has cared for many patients who acquired HAIs. It is for these reasons that this author has chosen the topic as it impacts both the individual nurse and the nursing profession.
There are many reported reasons why healthcare providers remain out of compliance with recommended hand hygiene. Some identified by Gupta et al. (2018) include a lack of knowledge by the healthcare provider, hand hygiene products that are difficult to find, or placed in out-of-the-way locations, and emergent situations wh ...
Occupational exposure to blood & body fluids among the nursing staff in a ter...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
C361 TASK 2 2
C361 TASK 2 2
C361 Task 2
WGU
Evidence-Based Practice and Applied Nursing Research
C361
Eve Butler
July 28, 2019
Running head: C361 TASK 2 2
C361 Task 2
A.1 Healthcare problem
Worldwide estimates have shown that greater than 1.4 million patients have acquired nosocomial infections. Adherence to hand hygiene policies are shown to be the most effective way to help prevent these healthcare-associated infections; sadly research shows that healthcare workers have suboptimal compliance with their facilities hand hygiene policies due to lack of education and compliance monitoring. Patients in our healthcare settings are under the assumption that we are doing our best to promote their healing when in fact 7% of them will be subjected to a nosocomial infection with that rate climbing to 10% in developing countries (Finco et al., 2018).
A.2 Significance of the problem
The cost of care that is associated with nosocomial infections is estimated to be over ten billion dollars putting a burden on both patients and health organizations alike. It is estimated that 38% of all infections are caused by cross-contamination due to noncompliance with hand hygiene policies. These infections lead to approximately 99,000 deaths a year in the United States alone (Sickbert-Bennett et al., 2016).
A.3 Current healthcare practices related to the problem
Most healthcare facilities have an educational program that simply teaches how to achieve proper hand hygiene and use the WHO five moments of hand hygiene as their standard. However, this does not educate the healthcare workers on why it is important, nor does it address the far-reaching consequences for noncompliance. Along with the lack of foundational education, most facilities do not monitor for compliance.
A.4 How the problem affects the organization and patients’ cultural background
Inadequate hand hygiene leading to nosocomial infections can affect the organization's cultural background by leading to dissatisfaction in the workplace as staff becomes frustrated by their feelings of inadequacy and helplessness in dealing with patients getting sicker instead of better. The staff may also be feeling stress in the burden of caring for sicker patients. The patient's cultural background may be affected as they may be feeling despair or depression at their inability to get better, and some may feel it is punishment according to their cultural or religious beliefs.
B. Two research evidence sources and two non-research evidence sources considered
In searching for my research evidence sources, I start with the Western Governors University Library online. Once in the library, a boolean phrase was used, which allowed me to search for research articles that contain more than one topic in the same paper. Phrases I used in this search were “nosocomial infections,” “hand hygiene compliance,” and “ hand hygiene education.” With these phrases, thousands of articles were available to peruse.
One of the res.
PRACTICE OF FIVE MOMENTS OF HAND HYGIENE AMONGTHE NURSES IN SELECTED HOSPITAL...AJHSSR Journal
ABSTRACT :A Quantitative Research approach with a Cross sectional descriptive survey design was used in
the study. 100 Nurses from Thumbay University Hospital, Ajman, UAE who met the sampling criteria were
selected. Written consent was taken. A structured questionnaire to elicit the demographic profile, as well as a
modified Self-reported hand hygiene practice scale, was used online to assess the practice of five moments of
hand hygiene.The majority of the nurses 94-99 % of them had moderate to adequate hand hygiene practice
during the five moments of hand hygiene of which 99% before touching the patients, 95 % before carrying out
clean and aseptic procedures, and after body fluid exposure, 96 % after touching patient unit and 94 % after
touching patient surroundings. Overall, 90 % of the nurses had good hand hygiene practice. No significant
association was found between hand hygiene practices among the nurses with their demographic variables.
KEYWORDS: Five moments, Hand Hygiene, Infection, Nurses.
KNOWLEDGE AND PRACTICES AMONG SURGEONS REGARDING CROSS INFECTION CONTROL PROC...Anil Haripriya
The study revealed good knowledge of infection control procedures but there were problems in practices of
sterilization. Most of them did not separate the needle from the syringe prior to disposal therefore needle
prick injuries were common. So more intensive and regular training programs to surgeons must be included
in the plans of quality control in all hospital and regular inspection from the ministry of health guarantees
good infection control practices
Literature Evaluation TableStudent Name Joyce NwakorPIC.docxcroysierkathey
Literature Evaluation Table
Student Name: Joyce Nwakor
PICOT Question: For patients and healthcare workers in the hospital (p) does hand washing protocol (I) compared to an alcohol-based solution (C) reduce hospital-acquired infection (O) within a period of stay in the hospital (T)
Criteria
Article 1
QUANT
Article 2
QUANT
Article 3
QUANT
Article 4
REVIEW
Author, Journal (Peer-Reviewed), and
Permalink or Working Link to Access Article
Daisy, V. T., & Sreedevi, T. R.
Link:
http://eds.a.ebscohost.com.lopes.idm.oclc.org/eds/detail/detail?vid=4&sid=72619044-c224-4bc5-9982-cf6c3953f7d2%40sessionmgr4007&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#AN=110819455&db=ccm
Fox, C., Wavra, T., Drake, D. A., Mulligan, D., Bennett, Y. P., Nelson, C., … Bader, M. K. (2015). Use of a Patient Hand Hygiene Protocol to Reduce Hospital-Acquired Infections and Improve Nurses' Hand Washing. American Journal of Critical Care, 24(3), 216-224. doi:10.4037/ajcc2015898
Knighton, S. (2017). The Use of Instructional Technology to Increase Independent Patient Hand Hygiene Practice of Hospitalized Adults in an Acute Care Setting. Open Forum Infectious Diseases, 4(suppl_1), S411-S412. doi:10.1093/ofid/ofx163.1029
João Manuel Garcia do Nascimento Graveto, Rita Isabel Figueira Rebola, Elisabete Amado Fernandes, & Paulo Jorge dos Santos Costa. Link:
https://doi-org.lopes.idm.oclc.org/10.1590/0034-7167-2017-0239
Article Title and Year Published
Effectiveness of a Multi-Component Educational Intervention on Knowledge and Compliance with Hand Hygiene among Nurses in Neonatal Intensive Care Units. 2015Use of a Patient Hand Hygiene Protocol to Reduce Hospital-Acquired Infections and Improve Nurses' Hand Washing
Published May 2015
The Use of Instructional Technology to Increase Independent Patient Hand Hygiene Practice of Hospitalized Adults in an Acute Care Setting. Open Forum Infectious Diseases.
Published in 2017
Hand hygiene: nurses’ adherence after training.
2018
Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study
The study was aimed to assess the effectiveness of a multi-component educational intervention on the knowledge and compliance with handhygiene guidelines among nurses working in Neonatal Intensive Care Units.
The research investigated the reduction of infections in the hospital through observation of hand hygiene.
What handwashing procedures were performed by the medical personnel before patient contact part 1.
What is the level of effectiveness of training (I) in improving nurses’(P) adherence to hand hygiene(O)?”.
Design (Type of Quantitative, or Type of Qualitative)
A pre-experimental pre-test post-test design was adopted for the study. QUANT
Pre-experimental study design
. QUANT
A quantitative study was done using quasi observational data
Qualitative/ quantitative studies
This is a review
Setting/Sample
This study was conducted in 3 level III NICUs of selected private hospitals in Kerala
Total sample compri ...
CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS2CENTRAL LINE-ASS.docxsleeperharwell
CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS2
CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS2
Central Line-Associated Bloodstream Infections Literature Review
Kerry S. Murphy
Grand Canyon University
Translational Research and Evidence-Based Practice
DNP-820-O501
Dr. Kari Lane
September 26, 2018
Running head: CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS2
Central Line-Associated Bloodstream Infections Literature ReviewComment by Microsoft Office User: The heading of introduction is inferred in APA format
I. Introduction
Central Line-Associated Bloodstream Infection (CLABSIs) in a fatal infection that results from bacteria or viruses entering the bloodstream through the central line. A central line, also known as a central venous catheter, refers to a tube used by doctors to administer medication, fluids or to collect blood from the body of a patient (Deason & Gray, 2018). Central Line-Associated Bloodstream Infection is one of the leading causes of deaths each year in different countries across the globe. Central Line-Associated Bloodstream Infection has been an area of interest for many healthcare researchers representing a diverse body of knowledge about the infection while still expanding on what is already known. The paper is an analysis of articles related to CLABSIs with the major themes of concern to the authors including risk factors, interventions, CLABSIs and Hospital Acquired Infections (HAIs), benefits of the preventive measures and the common symptoms of CLABSIs. Comment by Microsoft Office User: Add a description of how the literature search was completed. Tell the reader how you did your literature search, which databases you searched, how many articles were found, and how you eliminated articles to come to the ones you included here.
II. Questions Posed in the Studies
a. Afonso, Blot, & Blot (2016) seeks to establish how hospital-acquired bloodstream infections can be prevented through the use of chlorhexidine gluconate-impregnated washcloth bathing in intensive care units. In the study by Chidambaram (2015), the question raised is, what associations dental procedure and CVCs have.
b. Kadium, M. (2015) inquired into how the education program for 1 month, based on the
evidence-based guidelines recommended by CDC, will improve registered dialysis nurses’ knowledge regarding CVC maintenance care?
c. CDC and NCBI (2011) raise the research question, how many people have been affected in the USA from 2001-2009?
d. Srinivasan, Wise, Bell, Cardo,Edwards, Fridkin, Jernigan, Kallen, McDonald, & Patel (2011) considers questioning the perception of central line-associated bloodstream infection.
e. Dougherty (2012) questions the potential solutions in reducing incidences of central-line associated bloodstream infections have to be created in line with the clinical setting and careful consideration of the patients and the organizational culture.
f. Lin, Apisarnthanarak, Jaggi, Harrington, Morikane, Thu, Ching, Villanueva.
Running head INFECTION PREVENTION1INFECTION PREVENTION.docxjeanettehully
Running head: INFECTION PREVENTION 1
INFECTION PREVENTION 15
Phase # 2 Infection Prevention
Literature Review
Healthcare acquired infections constitute a major public health issue and it is affecting millions of people on a yearly basis. The approximation from the recent studies is showing more than 5 percent of the hospitalized patients are exposed to nosocomial infections. Many studies further show that the surgical site infections are the common infections associated with nosocomial infections and it is contributing to about 30 percent of all healthcare acquired infections cases.
Study by Ayed et al (2015) shows that healthcare providers are continuously exposed to pathogens which are sometimes severe and lethal. Nurses specifically are more exposed to different infections during the course of providing healthcare services to the patients. This study indicates that it is therefore crucial for nurses to possess sound knowledge as well as strict adherence to the infection control practices. Updating the acquaintance and the practices of nurses through involvement in ongoing in-service educational programs and putting more focus on the role of the current evidence-based practices of infection prevention in the continuous training is important. Provision of the training to the newly recruited nurses regarding the infection control frequently as well as replicating the study through observation checklist is necessary in assessing the level of practice (Imad, Ayed, Faeda, & Lubna, 2015).
Study by Desta et al (2018) reveals that working experience is a stronger predictor of the knowledge in relation to the prevention of the infection. In this study, the goal was to the relationship between the acquaintance, practice and connected aspects of infection prevention among healthcare employees. Education level is a key determinant to the level of experience when it comes to the control or the prevention of infections. According to this study, it is clear that healthcare providers with advanced experience as well as advanced age are significantly linked with the knowledge. This is basically based on the fact that as healthcare providers are getting older, they are more likely to have advance knowledge due to their experiences as well as having worked with their seniors (Desta, Ayenew, Sitotaw, Tegegne, Dires, & Getie, 2018).
Teshager et al (2015) also studies the knowledge, practices, and the related aspects towards the reduction or prevention of the surgical site infections among nurses who were employed in Amhara Regional State Referral healthcare facilities, in the Northwest Ethiopia. This study looked at some of the factors linked with the knowledge of the nurses regarding the preventi ...
Research Appraisal of a Clinical Practice Guidelineemilyparker01
With the advent of new technologies in the health sector, the needs of health care have kept pace with the new technology. A growing patient numbers, growing dimensions of disease and emerging disease, no doubt forcing the health care professionals to run after the development of new drugs and technologies for combat. At the same time, patient safety and quality health care delivery are buzzing priority for every country and every health care organization.
Running head QI ESSAY BLOODSTREAM INFECTION ELIMINATION OR REDUCT.docxtodd581
Running head: QI ESSAY BLOODSTREAM INFECTION ELIMINATION OR REDUCTION 1
QI ESSAY BLOODSTREAM INFECTION ELIMINATION OR REDUCTION 20
QI Essay Bloodstream Infection Elimination or Reduction
Name
College of Affiliation
Date
Contents
Abstract 4
Introduction 4
Literature Review 6
Definition of the Terms 9
Bloodstream infections 9
The evidence-based intervention being implemented: adherence to the CDC recommended practices and infection prevention principles 9
The plan for the implementation 11
The creation of bloodstream infection prevention and control programs 11
The development of the evidence-based guidelines to be implemented for the reduction of the bloodstream infections in hemodialysis patients 11
The introduction of the bloodstream infection control or reduction education to the healthcare workers through using a team and the task-based approaches 12
The surveillance of the bloodstream infections in the hemodialysis process 12
The implementation of the multimodal strategies to help in the improvement of the practices aimed at reducing the bloodstream infections in hemodialysis patients 13
The development of the program to help in the coordination and facilitation of the implementation process of the bloodstream infection prevention activities for the patients on hemodialysis 13
A continuous process of monitoring and auditing of the bloodstream infection elimination approaches and feedback as well as the control activities 14
Workload, bed occupancy, and staffing in the facility 14
The building of the materials, environment, and the equipment needed for the implementation process 15
Ethical Considerations 15
Required Resources 17
Leadership Theory as a guide to the implementation and substance of the proposed change or practice 18
Shared Leadership Theory 19
The change theory to facilitate the implementation process 20
Behavioral change theory 20
Evaluation Procedures 21
Alternative Processes, the plan for sustainability 22
The expected outcome from the implementation of the practice 23
Conclusions 23
References 25
Abstract
Bloodstream infections refer to the infections that occur in the healthcare facilities and they are the new infections that are acquired within the facility. These infections lead to hospitalization, morbidity, and mortality in hemodialysis patients. There are about 30,100 reported incidences of infections in the United States. The bloodstream infections are caused by the equipment being used by the healthcare providers for example the surgical equipment, the environment of the facility, and the healthcare workers or patients who transmit such infection to the other. The paper aimed at discussing the adherence or the practices recommended by the CDC to help in the prevention and reduction of the bloodstream infection in hemodialysis patients. The CDC proposed some interventions to be followed in the reduction of these infections. These included the provision of the feedback, surveillance, audit of the hygi.
Running head QI ESSAY BLOODSTREAM INFECTION ELIMINATION OR REDUCT.docxcheryllwashburn
Running head: QI ESSAY BLOODSTREAM INFECTION ELIMINATION OR REDUCTION 1
QI ESSAY BLOODSTREAM INFECTION ELIMINATION OR REDUCTION 20
QI Essay Bloodstream Infection Elimination or Reduction
Name
College of Affiliation
Date
Contents
Abstract 4
Introduction 4
Literature Review 6
Definition of the Terms 9
Bloodstream infections 9
The evidence-based intervention being implemented: adherence to the CDC recommended practices and infection prevention principles 9
The plan for the implementation 11
The creation of bloodstream infection prevention and control programs 11
The development of the evidence-based guidelines to be implemented for the reduction of the bloodstream infections in hemodialysis patients 11
The introduction of the bloodstream infection control or reduction education to the healthcare workers through using a team and the task-based approaches 12
The surveillance of the bloodstream infections in the hemodialysis process 12
The implementation of the multimodal strategies to help in the improvement of the practices aimed at reducing the bloodstream infections in hemodialysis patients 13
The development of the program to help in the coordination and facilitation of the implementation process of the bloodstream infection prevention activities for the patients on hemodialysis 13
A continuous process of monitoring and auditing of the bloodstream infection elimination approaches and feedback as well as the control activities 14
Workload, bed occupancy, and staffing in the facility 14
The building of the materials, environment, and the equipment needed for the implementation process 15
Ethical Considerations 15
Required Resources 17
Leadership Theory as a guide to the implementation and substance of the proposed change or practice 18
Shared Leadership Theory 19
The change theory to facilitate the implementation process 20
Behavioral change theory 20
Evaluation Procedures 21
Alternative Processes, the plan for sustainability 22
The expected outcome from the implementation of the practice 23
Conclusions 23
References 25
Abstract
Bloodstream infections refer to the infections that occur in the healthcare facilities and they are the new infections that are acquired within the facility. These infections lead to hospitalization, morbidity, and mortality in hemodialysis patients. There are about 30,100 reported incidences of infections in the United States. The bloodstream infections are caused by the equipment being used by the healthcare providers for example the surgical equipment, the environment of the facility, and the healthcare workers or patients who transmit such infection to the other. The paper aimed at discussing the adherence or the practices recommended by the CDC to help in the prevention and reduction of the bloodstream infection in hemodialysis patients. The CDC proposed some interventions to be followed in the reduction of these infections. These included the provision of the feedback, surveillance, audit of the hygi.
SYSTEMS-LEVEL QUALITY IMPROVEMENTFrom Cues to Nudge A Knolisandrai1k
SYSTEMS-LEVEL QUALITY IMPROVEMENT
From Cues to Nudge: A Knowledge-Based Framework
for Surveillance of Healthcare-Associated Infections
Arash Shaban-Nejad1,2 & Hiroshi Mamiya2 & Alexandre Riazanov3 & Alan J. Forster4 &
Christopher J. O. Baker2,5 & Robyn Tamblyn2 & David L. Buckeridge2
Received: 3 June 2015 /Accepted: 30 September 2015 /Published online: 4 November 2015
# Springer Science+Business Media New York 2015
Abstract We propose an integrated semantic web framework
consisting of formal ontologies, web services, a reasoner and a
rule engine that together recommend appropriate level of
patient-care based on the defined semantic rules and guide-
lines. The classification of healthcare-associated infections
within the HAIKU (Hospital Acquired Infections – Knowl-
edge in Use) framework enables hospitals to consistently fol-
low the standards along with their routine clinical practice and
diagnosis coding to improve quality of care and patient safety.
The HAI ontology (HAIO) groups over thousands of codes
into a consistent hierarchy of concepts, along with relation-
ships and axioms to capture knowledge on hospital-associated
infections and complications with focus on the big four types,
surgical site infections (SSIs), catheter-associated urinary tract
infection (CAUTI); hospital-acquired pneumonia, and blood
stream infection. By employing statistical inferencing in our
study we use a set of heuristics to define the rule axioms to
improve the SSI case detection. We also demonstrate how the
occurrence of an SSI is identified using semantic e-triggers.
The e-triggers will be used to improve our risk assessment of
post-operative surgical site infections (SSIs) for patients un-
dergoing certain type of surgeries (e.g., coronary artery bypass
graft surgery (CABG)).
Keywords Ontologies . Knowledge modeling .
Healthcare-associated infections . Surveillance . Semantic
framework . Surgical site infections
Introduction
Healthcare-associated Infections (HAIs) affect millions of
patients around the world, killing hundreds of thousands
and imposing, directly or indirectly, a significant socio-
economic burden on healthcare systems [1]. According
to the Centers for Disease Control (CDC) [2], hospital-
acquired infections in the U.S., where the point preva-
lence of HAIs among hospitalized patients is 4 %, result
in an estimated 1.7 million infections, which lead to as
many as 99,000 deaths and cost up to $45 billion annually
[3, 4]. Similar or higher rates of HAI occur in other coun-
tries as well with an estimated 10.5 % of patients in Ca-
nadian hospitals having an HAI [5]. Clinical assessment
and laboratory testing are generally used to detect and
confirm an infection, identify its origin, and determine
appropriate infection control methods to stop the infection
from spreading within a healthcare institution. Failure to
monitor, and detect HAI in timely manner can delay di-
agnosis, leading to complications (e.g., sepsis), and
allowing an epid ...
Exploring Knowledge, Attitudes and Practices of ICU Health Workers Regarding ...QUESTJOURNAL
Background: Nosocomial Infection is a localized or systemic infection acquired at any health care facility including hospitals by a patient admitted for any reason other than the pathology present during admission. Including an infection acquired in a healthcare facility that manifest 48 hours after the patient's admission or discharge. Objective: Themain aim of this study is toassess the level of knowledge, attitudes and practice of ICU health personnel with regards to the spread of nosocomial infections. Methodology: A cross-sectional and facility based study was conducted from March to November 2016 at King Khalid hospital in Najran, Saudi Arabia. By adopting convenience technique, 50 subjects had been recruited to participate in this study. Results: 62% of respondentswere female. The mean age was 29 years. Concerning educational status, 54% of the participants have Bsc. professionally most of them (48%) were nurses. 60% of the participants have less than three year working experience in ICU.86% of them highlighted that hands must be washed with soap and water or even rubbed with alcohol before contacting with patients. Additionally, the result reveals that employees who had master degree or above displayed higher mean knowledge scores as compared to the other two groups (diploma or less & bachelor) (0.7147 & 4.6656) respectively. High significant statistical differences were found between the three academic groups in relation to sharp devices, personal protective equipment (gloves, gowns &masks), care of intravenous infusion therapy, central line care and urinary catheter care (F=4.594, F=7.982, F=5.539, F=4.471, F=15.310, F=4.345) respectively at p < 0.05. Recommendation & conclusion: Health workers in ICU (King Khalid hospital) showed adequate knowledge and faire attitude regarding universal precautions
REVIEW CENTRAL LINE-ASSOCIATED BLOODSTREAM2REVIEW CENTRAL .docxzmark3
REVIEW: CENTRAL LINE-ASSOCIATED BLOODSTREAM2
REVIEW
CENTRAL LINE-ASSOCIATED BLOODSTREAM2
Central Line-Associated Bloodstream Infections
Grand Canyon University
Translational Research and Evidence-Based Practice
DNP-820-O501
Running head: CENTRAL LINE-ASSOCIATED BLOODSTREAM 2
October 9, 2018
CLABSI Supporting Literature
Central Line-Associated Bloodstream Infection (CLABSIs) in a fatal infection that results from bacteria or viruses entering the bloodstream through the central line. A central line, also known as a central venous catheter (CVC), refers to a tube used by doctors to administer medication, fluids or to collect blood from the body of a patient (Deason & Gray, 2018). Central Line-Associated Bloodstream Infection is one of the leading causes of deaths each year in different countries across the globe. Central Line-Associated Bloodstream Infection has been an area of interest for many healthcare researchers representing a diverse body of knowledge about the infection while still expanding on what is already known. The paper is an analysis of articles related to CLABSIs with the major themes of concern to the authors including risk factors, interventions, CLABSIs and Hospital Acquired Infections (HAIs), benefits of the preventive measures and the common symptoms of CLABSIs. There were 200 articles that were established to talk about the CVCs, CLABSIs, risk factors, intervention, and benefits of preventive measures. Through inclusion and exclusion criteria many journal articles were left out because of being written in other languages rather than English. Therefore, the use of the English language index the Cumulative Index of Nursing and Allied Health Literature (CINAHL) was used to search related journal articles. Other search tools includeThe National Center for Biotechnology Information (NCBI) – PubMed. Studies older than five years were excluded to ensure that the research remained current and up to date. Using real-time cases or conditions helps to improve the quality and validity of the resulted research.
Questions Posed in the Studies
Afonso, Blot, & Blot (2016) seeks to establish how hospital-acquired bloodstream infections can be prevented through the use of chlorhexidine gluconate-impregnated washcloth bathing in intensive care units. In the study by Chidambaram (2015), the question raised is, what associations dental procedure and CVCs have.
Education, Simulated Training, Experience, and Knowledge
Kadium (2015) inquired into how the education program for one month, based on the evidence-based guidelines recommended by CDC, will improve registered dialysis nurses’ knowledge regarding CVC maintenance care? Other researchers that focus on how education, experience, and workshops enhance prevention or reduction of CVC infections include; El-Sol & Badawy, (2017), Leistner, Thürnagel, Schwab, Gastmeier, & Geffers (2013), and Soffle, Hayes, & Smith (2018). Dougherty (2014) questions the potential solutions in reducin.
INTERGRATIVE REVIEW 14
Equipment and Product Safety
Introduction
Equipment, drugs, and medical supplies have significant impact on quality of patient care and they account for high proportion of health care costs. Hospitals should make informed choices about what to procure in order to meet priority health needs and avoid wasting the limited resources (Chu, Maine, & Trelles, 2015). Procurement is an important part of managing equipment and products, and stock control, effective storage, and maintenance are also significant factors in health services. Many firms have produced information about important drugs, however, there is less information available about essential equipment and medical supplies (Weinshel, et al., 2015). This results in procurement of items which are inappropriate because they are incompatible with existing equipment, technically unsuitable, and spare parts are unavailable. Despite this, there is little information available about these aspects of management of equipment and medical supplies.
According to “American Association of Critical-Care Nurses (AACN), there is convincing evidence that unhealthy surgery environment contributes significantly to ineffective care delivery, medical errors, and stress among nurses (Magill, O’Leary, Janelle, & Thompson, 2018). This integrative literature review was executed to find evidence between surgery operation environment and products on patient safety. This paper is intended to be resourceful in management and procurement of equipment and medical products at primary health care level. It includes guiding concepts for care and maintenance, selecting products and equipment, and safe disposal of medical waste.
Purpose of research
The integrative literature review aim at analyzing pieces of research which have been conducted on surgical environment and product and their effect on patient safety and outcome.
Background
Although there are various improvement ongoing, the prevalence of healthcare-associated infections (HAIs) remain a risk and cost within hospitals. Unsafe, inappropriate, and negligent surgical products and equipment affect one in ten patients, on average in the US. Despite the advancement in use of surgical techniques and ergonomic improvements in operating rooms, cases of surgical site infections (SSIs) are high and they cause patient mortality and morbidity. Necessarily, there is increased emphasis on prevention of these infections. The risk of error in operating environment is greater. Some of the environmental and products risks include risk of patient falling and risks of infections. In this light, nurses should promote use of evidence-based care to promote patient safety and improve the quality of care.
Patient safety is an important element in health care. Within the principles of WHO, patient safety is the reduction of risk of harm or injury associated with health care. Hospitals are focused in creating healthy and safe ...
SYSTEMS-LEVEL QUALITY IMPROVEMENTFrom Cues to Nudge A Kno.docxdeanmtaylor1545
SYSTEMS-LEVEL QUALITY IMPROVEMENT
From Cues to Nudge: A Knowledge-Based Framework
for Surveillance of Healthcare-Associated Infections
Arash Shaban-Nejad1,2 & Hiroshi Mamiya2 & Alexandre Riazanov3 & Alan J. Forster4 &
Christopher J. O. Baker2,5 & Robyn Tamblyn2 & David L. Buckeridge2
Received: 3 June 2015 /Accepted: 30 September 2015 /Published online: 4 November 2015
# Springer Science+Business Media New York 2015
Abstract We propose an integrated semantic web framework
consisting of formal ontologies, web services, a reasoner and a
rule engine that together recommend appropriate level of
patient-care based on the defined semantic rules and guide-
lines. The classification of healthcare-associated infections
within the HAIKU (Hospital Acquired Infections – Knowl-
edge in Use) framework enables hospitals to consistently fol-
low the standards along with their routine clinical practice and
diagnosis coding to improve quality of care and patient safety.
The HAI ontology (HAIO) groups over thousands of codes
into a consistent hierarchy of concepts, along with relation-
ships and axioms to capture knowledge on hospital-associated
infections and complications with focus on the big four types,
surgical site infections (SSIs), catheter-associated urinary tract
infection (CAUTI); hospital-acquired pneumonia, and blood
stream infection. By employing statistical inferencing in our
study we use a set of heuristics to define the rule axioms to
improve the SSI case detection. We also demonstrate how the
occurrence of an SSI is identified using semantic e-triggers.
The e-triggers will be used to improve our risk assessment of
post-operative surgical site infections (SSIs) for patients un-
dergoing certain type of surgeries (e.g., coronary artery bypass
graft surgery (CABG)).
Keywords Ontologies . Knowledge modeling .
Healthcare-associated infections . Surveillance . Semantic
framework . Surgical site infections
Introduction
Healthcare-associated Infections (HAIs) affect millions of
patients around the world, killing hundreds of thousands
and imposing, directly or indirectly, a significant socio-
economic burden on healthcare systems [1]. According
to the Centers for Disease Control (CDC) [2], hospital-
acquired infections in the U.S., where the point preva-
lence of HAIs among hospitalized patients is 4 %, result
in an estimated 1.7 million infections, which lead to as
many as 99,000 deaths and cost up to $45 billion annually
[3, 4]. Similar or higher rates of HAI occur in other coun-
tries as well with an estimated 10.5 % of patients in Ca-
nadian hospitals having an HAI [5]. Clinical assessment
and laboratory testing are generally used to detect and
confirm an infection, identify its origin, and determine
appropriate infection control methods to stop the infection
from spreading within a healthcare institution. Failure to
monitor, and detect HAI in timely manner can delay di-
agnosis, leading to complications (e.g., sepsis), and
allowing an epid.
Running head ANALYSIS OF LITERATURE REVIEW 1ANALYSIS OF LITERA.docxhealdkathaleen
Running head: ANALYSIS OF LITERATURE REVIEW 1
ANALYSIS OF LITERATURE REVIEW 7
Literature Review
Atsede Iyasu
NRS-490- 0500- Professional Capstone and Practicum
Grand Canyon University
08/11/2019
Analysis of Literature Review
Introduction
Catheter-associated urinary tract infection (CAUTI) more so in the ICU seems to be an issue that is challenging hospitals and health care centers. Nurses are the healthcare staffs who are responsible for ensuring that patients do not acquire CAUTI in their stay in the ICU (Mody et al., 2015). There are proven techniques and methods identified to be effective at preventing the catheter associated urinary tract infection. One technique that is highly mentioned in the prevention of CAUTI is strict aseptic technique and hand hygiene. The technique can significantly help nurses reduce CAUTI in intensive care units and lessen the health burden of patients in the intensive care unit (Bradley et al., 2018).
In order to confirm whether the above-mentioned technique is effective at preventing CAUTI, a literature review was carried out. The review touched on these method as well as other known methods or techniques for preventing CAUTI. A total of eight studies were reviewed. All the reviewed studies were on publications made between 2014 and 2018. It is important that the studies reviewed are not over five years old. The above was important as it ensured only relevant and up-to-date information established from the review. Comment by Shanna Foley: Great introduction. Be sure your thesis discusses the purpose of the current paper, not the purpose of your change proposal.
A comparison of the research questions
There were three main research questions that were identified in the studies reviewed. The first main research question identified was whether there was an effective scientific method of preventing CAUTI (Purvis et al., 2014). Five of the studies reviewed were interested in answering whether there is a well-known and established medical interventions or scientific interventions that can effectively prevent CAUTI. All the five studies are driven by the hypothesis that CAUTI can be prevented and treated by given medication and it is for the above reason that all the five studies were seeking to confirm whether medical interventions can effectively prevent the infection.
The second main research question was what is the role of hospitals or health centers in the acquiring of CAUTI? According to a publication done in 2017 by Theobald and his colleagues, Hospital conditions are the primary reasons that patients acquire CAUTI. The conditions being mentioned above include; general hospital cleanliness practices and the handling of patients. The third main research question identified was whether the method of administering and removing the catheter was the main reason that patients were acquiring CAUTI. Three of the studies reviewed seemed to run on the hypothesis that the main reason that CAUTIs are acquir ...
Case Study 1 Applying Theory to PracticeSocial scientists hav.docxcowinhelen
Case Study 1: Applying Theory to Practice
Social scientists have proposed a number of theories to explain juvenile delinquency. Each has its own strengths and weaknesses. For this assignment, go to the following Website, located at http://listverse.com/2011/05/14/top-10-young-killers/ and select one of the juvenile case studies.
After reading the case, select one (1) of the psychological theories discussed in Chapter 4 of the text.
Write a two to three (2-3) page paper in which you:
1. Summarize three (3) key aspects of the juvenile case study that you selected.
2. Highlight at least three (3) factors that you believe are important for one to understand the origins of the juvenile’s delinquent behavior.
3. Apply at least two (2) concepts from the theory that you chose from the text that would help explain the juvenile’s behavior.
4. Identify one (1) appropriate strategy geared toward preventing delinquency that is consistent with the theory you chose.
5. Use at least three (3) quality references. Note: Wikipedia and other Websites do not qualify as academic resources.
Discussion-
"The Changing Family System"
Using what you’ve learned this week, respond to the following prompts in your post:
· Explain at least two (2) roles that different parenting styles play in shaping the overall behavior of children. Next, indicate the significant impacts that each role has in contributing to delinquent behavior among juveniles.
· Think about the following question: Should juvenile delinquents be removed from their home and parent(s) and placed in a foster home or group home if the child continues to commit criminal acts after repeated attempts at treatment and confinement? Based on this question, discuss your thoughts on this subject. Provide support for your response.
Discussion-
"Exploring Monopolies and Oligopolies"
Watch this video, Oligopolies and Monopolistic Competition, to help you prepare for this week’s discussion.
Reply to these prompts by using the company for which you currently work, a business with which your familiar, or a dream business you want to start:
· With your selected business in mind, determine if it is competitive, monopolistic competitive, an oligopoly, or pure monopoly. Explain how you drew your conclusion about its market structure.
· How does the business/firm in this industry determine the price it will charge for the products or services it sells?
Discussion-
"Considering Tradeoffs You Make Every Day"
Let's talk about two tradeoffs we face every day: how we spend our time and money.
We can only do two things with income: spend it or save it. Time is the ultimate resource. We can choose to spend time working to earn an income or we can do other things, broadly classified as leisure. Reply to these prompts to start your discussion:
· How does a change in interest rate affect your decision to spend or save? How would a change in the interest rate affect a firm's decision to invest or save?
· How might an increas.
Case Study - Option 3 BarbaraBarbara is a 22 year old woman who h.docxcowinhelen
Case Study - Option 3: Barbara
Barbara is a 22 year old woman who has recently graduated from college with a psychology degree. She is currently working as a waitress at a popular restaurant near campus, and says she has always planned to attend law school. Barbara was born in a New Orleans, Louisiana. Her mother is an African American who is an assistant manager at a grocery store. Her father is Caucasian and works at a department store. Barbara reports that she was a shy, unattractive child, but that in general her early childhood was "pretty happy." Barbara says that during elementary school, she was constantly harassed by classmates about being of mixed race. Still, she says that she felt very close to her family during this period. She now insists that "I am not black or white, I am me."
Barbara is sexually active and engages in sexual activity with different men at least 1 time a week. Barbara indicates that she does not need protection because she is on the pill. She says she is simply too young to settle down. During her junior year of high school, Barbara had her first serious boyfriend, Morris, who was a high school classmate. She describes the relationship as warm and supportive and they became sexually active during her senior year of high school. They broke up soon after the first sexual interaction. In college, Barbara has dated and she acknowledges some bisexual experimentation. Barbara says that she prefers heterosexual relationships, however.
Although Barbara appears to be a natural athlete, she leads a relatively sedentary lifestyle. She does not exercise regularly and indicates that it is just not enjoyable.
Barbara does not like her job at the restaurant, but seems unwilling to look for other employment. She says that she feels "very jittery" whenever she gets ready for work, and she uses any excuse to take days off. She also refuses to associate with fellow employees, and reports getting very anxious when she was given a surprise birthday party. Recently, she has lost interest in cleaning her house and seldom cooks for herself. She also attends less to her personal grooming.
Diagnosis – Social Anxiety Disorder/Minor Depression
DSM-5 – Diagnostic Criteria for Social Anxiety Disorder
1. Fear or anxiety specific to social settings, in which a person feels noticed, observed, or scrutinized.
2. Typically the individual will fear that they will display their anxiety and experience social rejection,
3. Social interaction will consistently provoke distress,
4. Social interactions are either avoided, or painfully and reluctantly endured,
5. The fear and anxiety will be grossly disproportionate to the actual situation,
6. The fear, anxiety or other distress around social situations will persist for six months or longer and
7. Cause personal distress and impairment of functioning in one or more domains, such as interpersonal or occupational functioning,
8. The fear or anxiety cannot be attributed to a medical disorder, s.
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ABSTRACT :A Quantitative Research approach with a Cross sectional descriptive survey design was used in
the study. 100 Nurses from Thumbay University Hospital, Ajman, UAE who met the sampling criteria were
selected. Written consent was taken. A structured questionnaire to elicit the demographic profile, as well as a
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clean and aseptic procedures, and after body fluid exposure, 96 % after touching patient unit and 94 % after
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Literature Evaluation TableStudent Name Joyce NwakorPIC.docxcroysierkathey
Literature Evaluation Table
Student Name: Joyce Nwakor
PICOT Question: For patients and healthcare workers in the hospital (p) does hand washing protocol (I) compared to an alcohol-based solution (C) reduce hospital-acquired infection (O) within a period of stay in the hospital (T)
Criteria
Article 1
QUANT
Article 2
QUANT
Article 3
QUANT
Article 4
REVIEW
Author, Journal (Peer-Reviewed), and
Permalink or Working Link to Access Article
Daisy, V. T., & Sreedevi, T. R.
Link:
http://eds.a.ebscohost.com.lopes.idm.oclc.org/eds/detail/detail?vid=4&sid=72619044-c224-4bc5-9982-cf6c3953f7d2%40sessionmgr4007&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#AN=110819455&db=ccm
Fox, C., Wavra, T., Drake, D. A., Mulligan, D., Bennett, Y. P., Nelson, C., … Bader, M. K. (2015). Use of a Patient Hand Hygiene Protocol to Reduce Hospital-Acquired Infections and Improve Nurses' Hand Washing. American Journal of Critical Care, 24(3), 216-224. doi:10.4037/ajcc2015898
Knighton, S. (2017). The Use of Instructional Technology to Increase Independent Patient Hand Hygiene Practice of Hospitalized Adults in an Acute Care Setting. Open Forum Infectious Diseases, 4(suppl_1), S411-S412. doi:10.1093/ofid/ofx163.1029
João Manuel Garcia do Nascimento Graveto, Rita Isabel Figueira Rebola, Elisabete Amado Fernandes, & Paulo Jorge dos Santos Costa. Link:
https://doi-org.lopes.idm.oclc.org/10.1590/0034-7167-2017-0239
Article Title and Year Published
Effectiveness of a Multi-Component Educational Intervention on Knowledge and Compliance with Hand Hygiene among Nurses in Neonatal Intensive Care Units. 2015Use of a Patient Hand Hygiene Protocol to Reduce Hospital-Acquired Infections and Improve Nurses' Hand Washing
Published May 2015
The Use of Instructional Technology to Increase Independent Patient Hand Hygiene Practice of Hospitalized Adults in an Acute Care Setting. Open Forum Infectious Diseases.
Published in 2017
Hand hygiene: nurses’ adherence after training.
2018
Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study
The study was aimed to assess the effectiveness of a multi-component educational intervention on the knowledge and compliance with handhygiene guidelines among nurses working in Neonatal Intensive Care Units.
The research investigated the reduction of infections in the hospital through observation of hand hygiene.
What handwashing procedures were performed by the medical personnel before patient contact part 1.
What is the level of effectiveness of training (I) in improving nurses’(P) adherence to hand hygiene(O)?”.
Design (Type of Quantitative, or Type of Qualitative)
A pre-experimental pre-test post-test design was adopted for the study. QUANT
Pre-experimental study design
. QUANT
A quantitative study was done using quasi observational data
Qualitative/ quantitative studies
This is a review
Setting/Sample
This study was conducted in 3 level III NICUs of selected private hospitals in Kerala
Total sample compri ...
CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS2CENTRAL LINE-ASS.docxsleeperharwell
CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS2
CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS2
Central Line-Associated Bloodstream Infections Literature Review
Kerry S. Murphy
Grand Canyon University
Translational Research and Evidence-Based Practice
DNP-820-O501
Dr. Kari Lane
September 26, 2018
Running head: CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS2
Central Line-Associated Bloodstream Infections Literature ReviewComment by Microsoft Office User: The heading of introduction is inferred in APA format
I. Introduction
Central Line-Associated Bloodstream Infection (CLABSIs) in a fatal infection that results from bacteria or viruses entering the bloodstream through the central line. A central line, also known as a central venous catheter, refers to a tube used by doctors to administer medication, fluids or to collect blood from the body of a patient (Deason & Gray, 2018). Central Line-Associated Bloodstream Infection is one of the leading causes of deaths each year in different countries across the globe. Central Line-Associated Bloodstream Infection has been an area of interest for many healthcare researchers representing a diverse body of knowledge about the infection while still expanding on what is already known. The paper is an analysis of articles related to CLABSIs with the major themes of concern to the authors including risk factors, interventions, CLABSIs and Hospital Acquired Infections (HAIs), benefits of the preventive measures and the common symptoms of CLABSIs. Comment by Microsoft Office User: Add a description of how the literature search was completed. Tell the reader how you did your literature search, which databases you searched, how many articles were found, and how you eliminated articles to come to the ones you included here.
II. Questions Posed in the Studies
a. Afonso, Blot, & Blot (2016) seeks to establish how hospital-acquired bloodstream infections can be prevented through the use of chlorhexidine gluconate-impregnated washcloth bathing in intensive care units. In the study by Chidambaram (2015), the question raised is, what associations dental procedure and CVCs have.
b. Kadium, M. (2015) inquired into how the education program for 1 month, based on the
evidence-based guidelines recommended by CDC, will improve registered dialysis nurses’ knowledge regarding CVC maintenance care?
c. CDC and NCBI (2011) raise the research question, how many people have been affected in the USA from 2001-2009?
d. Srinivasan, Wise, Bell, Cardo,Edwards, Fridkin, Jernigan, Kallen, McDonald, & Patel (2011) considers questioning the perception of central line-associated bloodstream infection.
e. Dougherty (2012) questions the potential solutions in reducing incidences of central-line associated bloodstream infections have to be created in line with the clinical setting and careful consideration of the patients and the organizational culture.
f. Lin, Apisarnthanarak, Jaggi, Harrington, Morikane, Thu, Ching, Villanueva.
Running head INFECTION PREVENTION1INFECTION PREVENTION.docxjeanettehully
Running head: INFECTION PREVENTION 1
INFECTION PREVENTION 15
Phase # 2 Infection Prevention
Literature Review
Healthcare acquired infections constitute a major public health issue and it is affecting millions of people on a yearly basis. The approximation from the recent studies is showing more than 5 percent of the hospitalized patients are exposed to nosocomial infections. Many studies further show that the surgical site infections are the common infections associated with nosocomial infections and it is contributing to about 30 percent of all healthcare acquired infections cases.
Study by Ayed et al (2015) shows that healthcare providers are continuously exposed to pathogens which are sometimes severe and lethal. Nurses specifically are more exposed to different infections during the course of providing healthcare services to the patients. This study indicates that it is therefore crucial for nurses to possess sound knowledge as well as strict adherence to the infection control practices. Updating the acquaintance and the practices of nurses through involvement in ongoing in-service educational programs and putting more focus on the role of the current evidence-based practices of infection prevention in the continuous training is important. Provision of the training to the newly recruited nurses regarding the infection control frequently as well as replicating the study through observation checklist is necessary in assessing the level of practice (Imad, Ayed, Faeda, & Lubna, 2015).
Study by Desta et al (2018) reveals that working experience is a stronger predictor of the knowledge in relation to the prevention of the infection. In this study, the goal was to the relationship between the acquaintance, practice and connected aspects of infection prevention among healthcare employees. Education level is a key determinant to the level of experience when it comes to the control or the prevention of infections. According to this study, it is clear that healthcare providers with advanced experience as well as advanced age are significantly linked with the knowledge. This is basically based on the fact that as healthcare providers are getting older, they are more likely to have advance knowledge due to their experiences as well as having worked with their seniors (Desta, Ayenew, Sitotaw, Tegegne, Dires, & Getie, 2018).
Teshager et al (2015) also studies the knowledge, practices, and the related aspects towards the reduction or prevention of the surgical site infections among nurses who were employed in Amhara Regional State Referral healthcare facilities, in the Northwest Ethiopia. This study looked at some of the factors linked with the knowledge of the nurses regarding the preventi ...
Research Appraisal of a Clinical Practice Guidelineemilyparker01
With the advent of new technologies in the health sector, the needs of health care have kept pace with the new technology. A growing patient numbers, growing dimensions of disease and emerging disease, no doubt forcing the health care professionals to run after the development of new drugs and technologies for combat. At the same time, patient safety and quality health care delivery are buzzing priority for every country and every health care organization.
Running head QI ESSAY BLOODSTREAM INFECTION ELIMINATION OR REDUCT.docxtodd581
Running head: QI ESSAY BLOODSTREAM INFECTION ELIMINATION OR REDUCTION 1
QI ESSAY BLOODSTREAM INFECTION ELIMINATION OR REDUCTION 20
QI Essay Bloodstream Infection Elimination or Reduction
Name
College of Affiliation
Date
Contents
Abstract 4
Introduction 4
Literature Review 6
Definition of the Terms 9
Bloodstream infections 9
The evidence-based intervention being implemented: adherence to the CDC recommended practices and infection prevention principles 9
The plan for the implementation 11
The creation of bloodstream infection prevention and control programs 11
The development of the evidence-based guidelines to be implemented for the reduction of the bloodstream infections in hemodialysis patients 11
The introduction of the bloodstream infection control or reduction education to the healthcare workers through using a team and the task-based approaches 12
The surveillance of the bloodstream infections in the hemodialysis process 12
The implementation of the multimodal strategies to help in the improvement of the practices aimed at reducing the bloodstream infections in hemodialysis patients 13
The development of the program to help in the coordination and facilitation of the implementation process of the bloodstream infection prevention activities for the patients on hemodialysis 13
A continuous process of monitoring and auditing of the bloodstream infection elimination approaches and feedback as well as the control activities 14
Workload, bed occupancy, and staffing in the facility 14
The building of the materials, environment, and the equipment needed for the implementation process 15
Ethical Considerations 15
Required Resources 17
Leadership Theory as a guide to the implementation and substance of the proposed change or practice 18
Shared Leadership Theory 19
The change theory to facilitate the implementation process 20
Behavioral change theory 20
Evaluation Procedures 21
Alternative Processes, the plan for sustainability 22
The expected outcome from the implementation of the practice 23
Conclusions 23
References 25
Abstract
Bloodstream infections refer to the infections that occur in the healthcare facilities and they are the new infections that are acquired within the facility. These infections lead to hospitalization, morbidity, and mortality in hemodialysis patients. There are about 30,100 reported incidences of infections in the United States. The bloodstream infections are caused by the equipment being used by the healthcare providers for example the surgical equipment, the environment of the facility, and the healthcare workers or patients who transmit such infection to the other. The paper aimed at discussing the adherence or the practices recommended by the CDC to help in the prevention and reduction of the bloodstream infection in hemodialysis patients. The CDC proposed some interventions to be followed in the reduction of these infections. These included the provision of the feedback, surveillance, audit of the hygi.
Running head QI ESSAY BLOODSTREAM INFECTION ELIMINATION OR REDUCT.docxcheryllwashburn
Running head: QI ESSAY BLOODSTREAM INFECTION ELIMINATION OR REDUCTION 1
QI ESSAY BLOODSTREAM INFECTION ELIMINATION OR REDUCTION 20
QI Essay Bloodstream Infection Elimination or Reduction
Name
College of Affiliation
Date
Contents
Abstract 4
Introduction 4
Literature Review 6
Definition of the Terms 9
Bloodstream infections 9
The evidence-based intervention being implemented: adherence to the CDC recommended practices and infection prevention principles 9
The plan for the implementation 11
The creation of bloodstream infection prevention and control programs 11
The development of the evidence-based guidelines to be implemented for the reduction of the bloodstream infections in hemodialysis patients 11
The introduction of the bloodstream infection control or reduction education to the healthcare workers through using a team and the task-based approaches 12
The surveillance of the bloodstream infections in the hemodialysis process 12
The implementation of the multimodal strategies to help in the improvement of the practices aimed at reducing the bloodstream infections in hemodialysis patients 13
The development of the program to help in the coordination and facilitation of the implementation process of the bloodstream infection prevention activities for the patients on hemodialysis 13
A continuous process of monitoring and auditing of the bloodstream infection elimination approaches and feedback as well as the control activities 14
Workload, bed occupancy, and staffing in the facility 14
The building of the materials, environment, and the equipment needed for the implementation process 15
Ethical Considerations 15
Required Resources 17
Leadership Theory as a guide to the implementation and substance of the proposed change or practice 18
Shared Leadership Theory 19
The change theory to facilitate the implementation process 20
Behavioral change theory 20
Evaluation Procedures 21
Alternative Processes, the plan for sustainability 22
The expected outcome from the implementation of the practice 23
Conclusions 23
References 25
Abstract
Bloodstream infections refer to the infections that occur in the healthcare facilities and they are the new infections that are acquired within the facility. These infections lead to hospitalization, morbidity, and mortality in hemodialysis patients. There are about 30,100 reported incidences of infections in the United States. The bloodstream infections are caused by the equipment being used by the healthcare providers for example the surgical equipment, the environment of the facility, and the healthcare workers or patients who transmit such infection to the other. The paper aimed at discussing the adherence or the practices recommended by the CDC to help in the prevention and reduction of the bloodstream infection in hemodialysis patients. The CDC proposed some interventions to be followed in the reduction of these infections. These included the provision of the feedback, surveillance, audit of the hygi.
SYSTEMS-LEVEL QUALITY IMPROVEMENTFrom Cues to Nudge A Knolisandrai1k
SYSTEMS-LEVEL QUALITY IMPROVEMENT
From Cues to Nudge: A Knowledge-Based Framework
for Surveillance of Healthcare-Associated Infections
Arash Shaban-Nejad1,2 & Hiroshi Mamiya2 & Alexandre Riazanov3 & Alan J. Forster4 &
Christopher J. O. Baker2,5 & Robyn Tamblyn2 & David L. Buckeridge2
Received: 3 June 2015 /Accepted: 30 September 2015 /Published online: 4 November 2015
# Springer Science+Business Media New York 2015
Abstract We propose an integrated semantic web framework
consisting of formal ontologies, web services, a reasoner and a
rule engine that together recommend appropriate level of
patient-care based on the defined semantic rules and guide-
lines. The classification of healthcare-associated infections
within the HAIKU (Hospital Acquired Infections – Knowl-
edge in Use) framework enables hospitals to consistently fol-
low the standards along with their routine clinical practice and
diagnosis coding to improve quality of care and patient safety.
The HAI ontology (HAIO) groups over thousands of codes
into a consistent hierarchy of concepts, along with relation-
ships and axioms to capture knowledge on hospital-associated
infections and complications with focus on the big four types,
surgical site infections (SSIs), catheter-associated urinary tract
infection (CAUTI); hospital-acquired pneumonia, and blood
stream infection. By employing statistical inferencing in our
study we use a set of heuristics to define the rule axioms to
improve the SSI case detection. We also demonstrate how the
occurrence of an SSI is identified using semantic e-triggers.
The e-triggers will be used to improve our risk assessment of
post-operative surgical site infections (SSIs) for patients un-
dergoing certain type of surgeries (e.g., coronary artery bypass
graft surgery (CABG)).
Keywords Ontologies . Knowledge modeling .
Healthcare-associated infections . Surveillance . Semantic
framework . Surgical site infections
Introduction
Healthcare-associated Infections (HAIs) affect millions of
patients around the world, killing hundreds of thousands
and imposing, directly or indirectly, a significant socio-
economic burden on healthcare systems [1]. According
to the Centers for Disease Control (CDC) [2], hospital-
acquired infections in the U.S., where the point preva-
lence of HAIs among hospitalized patients is 4 %, result
in an estimated 1.7 million infections, which lead to as
many as 99,000 deaths and cost up to $45 billion annually
[3, 4]. Similar or higher rates of HAI occur in other coun-
tries as well with an estimated 10.5 % of patients in Ca-
nadian hospitals having an HAI [5]. Clinical assessment
and laboratory testing are generally used to detect and
confirm an infection, identify its origin, and determine
appropriate infection control methods to stop the infection
from spreading within a healthcare institution. Failure to
monitor, and detect HAI in timely manner can delay di-
agnosis, leading to complications (e.g., sepsis), and
allowing an epid ...
Exploring Knowledge, Attitudes and Practices of ICU Health Workers Regarding ...QUESTJOURNAL
Background: Nosocomial Infection is a localized or systemic infection acquired at any health care facility including hospitals by a patient admitted for any reason other than the pathology present during admission. Including an infection acquired in a healthcare facility that manifest 48 hours after the patient's admission or discharge. Objective: Themain aim of this study is toassess the level of knowledge, attitudes and practice of ICU health personnel with regards to the spread of nosocomial infections. Methodology: A cross-sectional and facility based study was conducted from March to November 2016 at King Khalid hospital in Najran, Saudi Arabia. By adopting convenience technique, 50 subjects had been recruited to participate in this study. Results: 62% of respondentswere female. The mean age was 29 years. Concerning educational status, 54% of the participants have Bsc. professionally most of them (48%) were nurses. 60% of the participants have less than three year working experience in ICU.86% of them highlighted that hands must be washed with soap and water or even rubbed with alcohol before contacting with patients. Additionally, the result reveals that employees who had master degree or above displayed higher mean knowledge scores as compared to the other two groups (diploma or less & bachelor) (0.7147 & 4.6656) respectively. High significant statistical differences were found between the three academic groups in relation to sharp devices, personal protective equipment (gloves, gowns &masks), care of intravenous infusion therapy, central line care and urinary catheter care (F=4.594, F=7.982, F=5.539, F=4.471, F=15.310, F=4.345) respectively at p < 0.05. Recommendation & conclusion: Health workers in ICU (King Khalid hospital) showed adequate knowledge and faire attitude regarding universal precautions
REVIEW CENTRAL LINE-ASSOCIATED BLOODSTREAM2REVIEW CENTRAL .docxzmark3
REVIEW: CENTRAL LINE-ASSOCIATED BLOODSTREAM2
REVIEW
CENTRAL LINE-ASSOCIATED BLOODSTREAM2
Central Line-Associated Bloodstream Infections
Grand Canyon University
Translational Research and Evidence-Based Practice
DNP-820-O501
Running head: CENTRAL LINE-ASSOCIATED BLOODSTREAM 2
October 9, 2018
CLABSI Supporting Literature
Central Line-Associated Bloodstream Infection (CLABSIs) in a fatal infection that results from bacteria or viruses entering the bloodstream through the central line. A central line, also known as a central venous catheter (CVC), refers to a tube used by doctors to administer medication, fluids or to collect blood from the body of a patient (Deason & Gray, 2018). Central Line-Associated Bloodstream Infection is one of the leading causes of deaths each year in different countries across the globe. Central Line-Associated Bloodstream Infection has been an area of interest for many healthcare researchers representing a diverse body of knowledge about the infection while still expanding on what is already known. The paper is an analysis of articles related to CLABSIs with the major themes of concern to the authors including risk factors, interventions, CLABSIs and Hospital Acquired Infections (HAIs), benefits of the preventive measures and the common symptoms of CLABSIs. There were 200 articles that were established to talk about the CVCs, CLABSIs, risk factors, intervention, and benefits of preventive measures. Through inclusion and exclusion criteria many journal articles were left out because of being written in other languages rather than English. Therefore, the use of the English language index the Cumulative Index of Nursing and Allied Health Literature (CINAHL) was used to search related journal articles. Other search tools includeThe National Center for Biotechnology Information (NCBI) – PubMed. Studies older than five years were excluded to ensure that the research remained current and up to date. Using real-time cases or conditions helps to improve the quality and validity of the resulted research.
Questions Posed in the Studies
Afonso, Blot, & Blot (2016) seeks to establish how hospital-acquired bloodstream infections can be prevented through the use of chlorhexidine gluconate-impregnated washcloth bathing in intensive care units. In the study by Chidambaram (2015), the question raised is, what associations dental procedure and CVCs have.
Education, Simulated Training, Experience, and Knowledge
Kadium (2015) inquired into how the education program for one month, based on the evidence-based guidelines recommended by CDC, will improve registered dialysis nurses’ knowledge regarding CVC maintenance care? Other researchers that focus on how education, experience, and workshops enhance prevention or reduction of CVC infections include; El-Sol & Badawy, (2017), Leistner, Thürnagel, Schwab, Gastmeier, & Geffers (2013), and Soffle, Hayes, & Smith (2018). Dougherty (2014) questions the potential solutions in reducin.
INTERGRATIVE REVIEW 14
Equipment and Product Safety
Introduction
Equipment, drugs, and medical supplies have significant impact on quality of patient care and they account for high proportion of health care costs. Hospitals should make informed choices about what to procure in order to meet priority health needs and avoid wasting the limited resources (Chu, Maine, & Trelles, 2015). Procurement is an important part of managing equipment and products, and stock control, effective storage, and maintenance are also significant factors in health services. Many firms have produced information about important drugs, however, there is less information available about essential equipment and medical supplies (Weinshel, et al., 2015). This results in procurement of items which are inappropriate because they are incompatible with existing equipment, technically unsuitable, and spare parts are unavailable. Despite this, there is little information available about these aspects of management of equipment and medical supplies.
According to “American Association of Critical-Care Nurses (AACN), there is convincing evidence that unhealthy surgery environment contributes significantly to ineffective care delivery, medical errors, and stress among nurses (Magill, O’Leary, Janelle, & Thompson, 2018). This integrative literature review was executed to find evidence between surgery operation environment and products on patient safety. This paper is intended to be resourceful in management and procurement of equipment and medical products at primary health care level. It includes guiding concepts for care and maintenance, selecting products and equipment, and safe disposal of medical waste.
Purpose of research
The integrative literature review aim at analyzing pieces of research which have been conducted on surgical environment and product and their effect on patient safety and outcome.
Background
Although there are various improvement ongoing, the prevalence of healthcare-associated infections (HAIs) remain a risk and cost within hospitals. Unsafe, inappropriate, and negligent surgical products and equipment affect one in ten patients, on average in the US. Despite the advancement in use of surgical techniques and ergonomic improvements in operating rooms, cases of surgical site infections (SSIs) are high and they cause patient mortality and morbidity. Necessarily, there is increased emphasis on prevention of these infections. The risk of error in operating environment is greater. Some of the environmental and products risks include risk of patient falling and risks of infections. In this light, nurses should promote use of evidence-based care to promote patient safety and improve the quality of care.
Patient safety is an important element in health care. Within the principles of WHO, patient safety is the reduction of risk of harm or injury associated with health care. Hospitals are focused in creating healthy and safe ...
SYSTEMS-LEVEL QUALITY IMPROVEMENTFrom Cues to Nudge A Kno.docxdeanmtaylor1545
SYSTEMS-LEVEL QUALITY IMPROVEMENT
From Cues to Nudge: A Knowledge-Based Framework
for Surveillance of Healthcare-Associated Infections
Arash Shaban-Nejad1,2 & Hiroshi Mamiya2 & Alexandre Riazanov3 & Alan J. Forster4 &
Christopher J. O. Baker2,5 & Robyn Tamblyn2 & David L. Buckeridge2
Received: 3 June 2015 /Accepted: 30 September 2015 /Published online: 4 November 2015
# Springer Science+Business Media New York 2015
Abstract We propose an integrated semantic web framework
consisting of formal ontologies, web services, a reasoner and a
rule engine that together recommend appropriate level of
patient-care based on the defined semantic rules and guide-
lines. The classification of healthcare-associated infections
within the HAIKU (Hospital Acquired Infections – Knowl-
edge in Use) framework enables hospitals to consistently fol-
low the standards along with their routine clinical practice and
diagnosis coding to improve quality of care and patient safety.
The HAI ontology (HAIO) groups over thousands of codes
into a consistent hierarchy of concepts, along with relation-
ships and axioms to capture knowledge on hospital-associated
infections and complications with focus on the big four types,
surgical site infections (SSIs), catheter-associated urinary tract
infection (CAUTI); hospital-acquired pneumonia, and blood
stream infection. By employing statistical inferencing in our
study we use a set of heuristics to define the rule axioms to
improve the SSI case detection. We also demonstrate how the
occurrence of an SSI is identified using semantic e-triggers.
The e-triggers will be used to improve our risk assessment of
post-operative surgical site infections (SSIs) for patients un-
dergoing certain type of surgeries (e.g., coronary artery bypass
graft surgery (CABG)).
Keywords Ontologies . Knowledge modeling .
Healthcare-associated infections . Surveillance . Semantic
framework . Surgical site infections
Introduction
Healthcare-associated Infections (HAIs) affect millions of
patients around the world, killing hundreds of thousands
and imposing, directly or indirectly, a significant socio-
economic burden on healthcare systems [1]. According
to the Centers for Disease Control (CDC) [2], hospital-
acquired infections in the U.S., where the point preva-
lence of HAIs among hospitalized patients is 4 %, result
in an estimated 1.7 million infections, which lead to as
many as 99,000 deaths and cost up to $45 billion annually
[3, 4]. Similar or higher rates of HAI occur in other coun-
tries as well with an estimated 10.5 % of patients in Ca-
nadian hospitals having an HAI [5]. Clinical assessment
and laboratory testing are generally used to detect and
confirm an infection, identify its origin, and determine
appropriate infection control methods to stop the infection
from spreading within a healthcare institution. Failure to
monitor, and detect HAI in timely manner can delay di-
agnosis, leading to complications (e.g., sepsis), and
allowing an epid.
Running head ANALYSIS OF LITERATURE REVIEW 1ANALYSIS OF LITERA.docxhealdkathaleen
Running head: ANALYSIS OF LITERATURE REVIEW 1
ANALYSIS OF LITERATURE REVIEW 7
Literature Review
Atsede Iyasu
NRS-490- 0500- Professional Capstone and Practicum
Grand Canyon University
08/11/2019
Analysis of Literature Review
Introduction
Catheter-associated urinary tract infection (CAUTI) more so in the ICU seems to be an issue that is challenging hospitals and health care centers. Nurses are the healthcare staffs who are responsible for ensuring that patients do not acquire CAUTI in their stay in the ICU (Mody et al., 2015). There are proven techniques and methods identified to be effective at preventing the catheter associated urinary tract infection. One technique that is highly mentioned in the prevention of CAUTI is strict aseptic technique and hand hygiene. The technique can significantly help nurses reduce CAUTI in intensive care units and lessen the health burden of patients in the intensive care unit (Bradley et al., 2018).
In order to confirm whether the above-mentioned technique is effective at preventing CAUTI, a literature review was carried out. The review touched on these method as well as other known methods or techniques for preventing CAUTI. A total of eight studies were reviewed. All the reviewed studies were on publications made between 2014 and 2018. It is important that the studies reviewed are not over five years old. The above was important as it ensured only relevant and up-to-date information established from the review. Comment by Shanna Foley: Great introduction. Be sure your thesis discusses the purpose of the current paper, not the purpose of your change proposal.
A comparison of the research questions
There were three main research questions that were identified in the studies reviewed. The first main research question identified was whether there was an effective scientific method of preventing CAUTI (Purvis et al., 2014). Five of the studies reviewed were interested in answering whether there is a well-known and established medical interventions or scientific interventions that can effectively prevent CAUTI. All the five studies are driven by the hypothesis that CAUTI can be prevented and treated by given medication and it is for the above reason that all the five studies were seeking to confirm whether medical interventions can effectively prevent the infection.
The second main research question was what is the role of hospitals or health centers in the acquiring of CAUTI? According to a publication done in 2017 by Theobald and his colleagues, Hospital conditions are the primary reasons that patients acquire CAUTI. The conditions being mentioned above include; general hospital cleanliness practices and the handling of patients. The third main research question identified was whether the method of administering and removing the catheter was the main reason that patients were acquiring CAUTI. Three of the studies reviewed seemed to run on the hypothesis that the main reason that CAUTIs are acquir ...
Similar to Running head LITERATURE REVIEWLITERATURE REVIEWLiteratu.docx (20)
Case Study 1 Applying Theory to PracticeSocial scientists hav.docxcowinhelen
Case Study 1: Applying Theory to Practice
Social scientists have proposed a number of theories to explain juvenile delinquency. Each has its own strengths and weaknesses. For this assignment, go to the following Website, located at http://listverse.com/2011/05/14/top-10-young-killers/ and select one of the juvenile case studies.
After reading the case, select one (1) of the psychological theories discussed in Chapter 4 of the text.
Write a two to three (2-3) page paper in which you:
1. Summarize three (3) key aspects of the juvenile case study that you selected.
2. Highlight at least three (3) factors that you believe are important for one to understand the origins of the juvenile’s delinquent behavior.
3. Apply at least two (2) concepts from the theory that you chose from the text that would help explain the juvenile’s behavior.
4. Identify one (1) appropriate strategy geared toward preventing delinquency that is consistent with the theory you chose.
5. Use at least three (3) quality references. Note: Wikipedia and other Websites do not qualify as academic resources.
Discussion-
"The Changing Family System"
Using what you’ve learned this week, respond to the following prompts in your post:
· Explain at least two (2) roles that different parenting styles play in shaping the overall behavior of children. Next, indicate the significant impacts that each role has in contributing to delinquent behavior among juveniles.
· Think about the following question: Should juvenile delinquents be removed from their home and parent(s) and placed in a foster home or group home if the child continues to commit criminal acts after repeated attempts at treatment and confinement? Based on this question, discuss your thoughts on this subject. Provide support for your response.
Discussion-
"Exploring Monopolies and Oligopolies"
Watch this video, Oligopolies and Monopolistic Competition, to help you prepare for this week’s discussion.
Reply to these prompts by using the company for which you currently work, a business with which your familiar, or a dream business you want to start:
· With your selected business in mind, determine if it is competitive, monopolistic competitive, an oligopoly, or pure monopoly. Explain how you drew your conclusion about its market structure.
· How does the business/firm in this industry determine the price it will charge for the products or services it sells?
Discussion-
"Considering Tradeoffs You Make Every Day"
Let's talk about two tradeoffs we face every day: how we spend our time and money.
We can only do two things with income: spend it or save it. Time is the ultimate resource. We can choose to spend time working to earn an income or we can do other things, broadly classified as leisure. Reply to these prompts to start your discussion:
· How does a change in interest rate affect your decision to spend or save? How would a change in the interest rate affect a firm's decision to invest or save?
· How might an increas.
Case Study - Option 3 BarbaraBarbara is a 22 year old woman who h.docxcowinhelen
Case Study - Option 3: Barbara
Barbara is a 22 year old woman who has recently graduated from college with a psychology degree. She is currently working as a waitress at a popular restaurant near campus, and says she has always planned to attend law school. Barbara was born in a New Orleans, Louisiana. Her mother is an African American who is an assistant manager at a grocery store. Her father is Caucasian and works at a department store. Barbara reports that she was a shy, unattractive child, but that in general her early childhood was "pretty happy." Barbara says that during elementary school, she was constantly harassed by classmates about being of mixed race. Still, she says that she felt very close to her family during this period. She now insists that "I am not black or white, I am me."
Barbara is sexually active and engages in sexual activity with different men at least 1 time a week. Barbara indicates that she does not need protection because she is on the pill. She says she is simply too young to settle down. During her junior year of high school, Barbara had her first serious boyfriend, Morris, who was a high school classmate. She describes the relationship as warm and supportive and they became sexually active during her senior year of high school. They broke up soon after the first sexual interaction. In college, Barbara has dated and she acknowledges some bisexual experimentation. Barbara says that she prefers heterosexual relationships, however.
Although Barbara appears to be a natural athlete, she leads a relatively sedentary lifestyle. She does not exercise regularly and indicates that it is just not enjoyable.
Barbara does not like her job at the restaurant, but seems unwilling to look for other employment. She says that she feels "very jittery" whenever she gets ready for work, and she uses any excuse to take days off. She also refuses to associate with fellow employees, and reports getting very anxious when she was given a surprise birthday party. Recently, she has lost interest in cleaning her house and seldom cooks for herself. She also attends less to her personal grooming.
Diagnosis – Social Anxiety Disorder/Minor Depression
DSM-5 – Diagnostic Criteria for Social Anxiety Disorder
1. Fear or anxiety specific to social settings, in which a person feels noticed, observed, or scrutinized.
2. Typically the individual will fear that they will display their anxiety and experience social rejection,
3. Social interaction will consistently provoke distress,
4. Social interactions are either avoided, or painfully and reluctantly endured,
5. The fear and anxiety will be grossly disproportionate to the actual situation,
6. The fear, anxiety or other distress around social situations will persist for six months or longer and
7. Cause personal distress and impairment of functioning in one or more domains, such as interpersonal or occupational functioning,
8. The fear or anxiety cannot be attributed to a medical disorder, s.
Case Study - Cyberterrorism—A New RealityWhen hackers claiming .docxcowinhelen
Case Study - Cyberterrorism—A New Reality:
When hackers claiming to support the Syrian regime of Bashar Al-Assad attacked and disabled the website of Al Jazeera, the Qatar-based satellite news channel, in September 2012, the act was another act of hacktivism, purporting to promote a specific political agenda over another. Hacktivism has become a very visible form of expressing dissent. Even though there have been numerous incidents reported by the media, the first case of hacktivism was documented in 1989 when a member of the Cult of the Dead Cow hacker collective named Omega coined the term in 1996. However, hacktivism is not the only form of cyber protest and conflict that has everyone from ICT professionals to governments scrambling for solutions. Individuals, enterprises, and governments alike rely in many instances almost completely on network computing technologies, including cloud computing. The international and ever-evolving nature of the Internet along with inadequate law enforcement and the anonymity the global architecture offers creates opportunities for hackers to attack vulnerable nodes for personal, financial, or political gain.
The Internet is also rapidly becoming the political and advocacy platform of choice, bringing with it both positive and negative consequences. Increasingly sophisticated off-the-shelf technologies and easy access to the Internet are significantly increasing incidents of cyberterrorism, netwars, and cyberwarfare. The following are a few examples.
• According to The Israel Electric Company, Israel is attacked 1,000 times a minute by cyberterrorists targeting the country’s infrastructure—water, electricity, communications, and other services.• The New York Times, quoting military officials, said there was a seventeen-fold increase in cyberattacks targeting the US critical infrastructure between 2009 and 2011.• The 2010 Data Breach Investigations Report has data recording more than 900 instances of computer hacking and other data breaches in the past seven years, resulting in some 900 million compromised records. In 2012, the same study listed 855 breaches, resulting in 174 million compromised records in 2011 alone, up from 4 million in 2010.• Another study of 49 breaches in 2011 reported that the average organizational cost of a data breach (including detection, internal response, notification, post notification cost) was $5.5 million. This number was down from $7.2 million in 2010.14 The Telegraph (London) reported that “India blamed a new ‘cyber-jihad’ by Pakistani militant groups for the exodus of thousands of people from India’s north-eastern minorities from its main southern cities in August after text messages warning them to flee went viral.”
There have been recorded instances of nations allegedly engaging in cyberwarfare. The Center for the Study of Technology and Society has identified five methods by which cyberwarfare can be used as a means of military action. These include defacing or di.
Case Study - APA paper with min 4 page content Review the Blai.docxcowinhelen
Case Study - APA paper with min 4 page content
Review the
Blaine
case on the capital structure by understanding the case well enough to help the CEO make informed analysis and decisions on the issues listed in the second paragraph.
I want you to, of course, show me that you understand the situation but then to add the
.
Case Study - Global Mobile Corporation Damn it, .docxcowinhelen
Case Study - Global Mobile Corporation
“Damn it, he's done it again!”
Charlie Newburg had to get up and walk around his office, he was so frustrated. He had been
reviewing the most recent design, parts, and assembly specifications for Global Mobile's latest
smart phone (code named: Nonphixhun) that had been released for production the previous
Thursday. The files had just come back to Charlie's engineering services department with a
caustic note that began, “This one can't be produced, either…” It was the fourth time production
had returned the design.
Newburg, director of engineering for the Global Mobile Corporation, was normally a quiet
person. But the Nonphixhun project was stretching his patience; it was beginning to appear like
several other new products that had hit delays and problems in the transition from design to
production during the eight months Charlie had worked for Global Mobile. These problems were
nothing new at Global Mobile's Asian factory; Charlie's predecessor in the engineering job had
run afoul of them, too, and had finally been fired for protesting too vehemently about the other
departments. But the Nonphixhun phone should have been different. Charlie and the firm's
president, Hannah Hoover, had video-conferenced two months earlier (on July 3, 2006) with the
factory superintendent, Tyson Wang, to smooth the way for the new phone's design. He thought
back to the meeting …
• “Now, we all know there's a tight deadline on the Nonphixhun,” Hannah Hoover said, “and
Charlie's done well to ask us to talk about its introduction. I'm counting on both of you to find
any snags in the system, and to work together to get that first production run out by October
2. Can you do it?” “We can do it in production if we get a clean design two weeks from
now, as scheduled,” answered Tyson Wang, the factory manager. “Charlie and I have already
talked about that, of course. I've spoken with our circuit board and other parts suppliers and
scheduled assembly capacity, and we'll be ready. If the design goes over schedule, though, I'll
have to fill in with other runs, and it will cost us a bundle to break in for the Nonphixhun.
How does it look in engineering, Charlie?” “I've just reviewed the design for the second
time,” Charlie replied. “If Marianne Price can keep the salespeople out of our hair, and avoid
any more last minute changes, we've got a shot. I've pulled my technical support people off of
three other overdue jobs to get this one out. But, Tyson, that means we can't spring engineers
loose to confer with your production people on other manufacturing problems.” “Well
Charlie, most of those problems are caused by the engineers, and we need them to resolve the
difficulties. We've all agreed that production problems come from both of us bowing to sales
pressure, and putting equipment into production before the designs are really ready. That's
just wh.
Case Study #3Apple Suppliers & Labor PracticesWith its h.docxcowinhelen
Case Study #3
Apple Suppliers & Labor Practices
With its highly coveted line of consumer electronics, Apple has a cult following among loyal consumers. During the 2014 holiday season, 74.5 million iPhones were sold. Demand like this meant that Apple was in line to make over $52 billion in profits in 2015, the largest annual profit ever generated from a company’s operations. Despite its consistent financial performance year over year, Apple’s robust profit margin hides a more complicated set of business ethics. Similar to many products sold in the U.S., Apple does not manufacture most its goods domestically. Most of the component sourcing and factory production is done overseas in conditions that critics have argued are dangerous to workers and harmful to the environment.
For example, tin is a major component in Apple’s products and much of it is sourced in Indonesia. Although there are mines that source tin ethically, there are also many that do not. One study found workers—many of them children—working in unsafe conditions, digging tin out by hand in mines prone to landslides that could bury workers alive. About 70% of the tin used in electronic devices such as smartphones and tablets comes from these more dangerous, small-scale mines. An investigation by the BBC revealed how perilous these working conditions can be. In interviews with miners, a 12-yearold working at the bottom of a 70-foot cliff of sand said: “I worry about landslides. The earth slipping from up there to the bottom. It could happen.”
Apple defends its practices by saying it only has so much control over monitoring and regulating its component sources. The company justifies its sourcing practices by saying that it is a complex process, with tens of thousands of miners selling tin, many of them through middle-men. In a statement to the BBC, Apple said “the simplest course of action would be for Apple to unilaterally refuse any tin from Indonesian mines. That would be easy for us to do and would certainly shield us from criticism. But that would also be the lazy and cowardly path, since it would do nothing to improve the situation. We have chosen to stay engaged and attempt to drive changes on the ground.”
In an effort for greater transparency, Apple has released annual reports detailing their work with suppliers and labor practices. While more recent investigations have shown some improvements to suppliers’ working conditions, Apple continues to face criticism as consumer demand for iPhones and other products continues to grow.
Essay directions –
Students will have to identify and analyze the above ethical dilemma. Write a 750 – 1000 word, double-spaced paper, and APA style.
Students are expected to identify the key stakeholders, discussion of the implications of the ethical dilemma, and answer the case study questions. Each paper should have the following sections: • Introduction of the case• The ethical dilemma • Stakeholders • Questions • Conclusions • References .
CASE STUDY (Individual) Scotland In terms of its physical l.docxcowinhelen
CASE STUDY (Individual): Scotland
* In terms of its physical landscape, where is the region that is experiencing a devolutionary process located and what type of climate is prevalent? (use Figure 2.5 and 2.4 of the textbook).
* According to the sources you have consulted, do these physical/natural characteristics have played any role in the historical background for this devolutionary process? How?
* How do the people that inhabit the region you are studying speak about their relationship to the land and the environment? Do they express any ideas on biodiversity conservation?
* Do they say anything about their homeland? If the region you are studying has a website (official or not), what role do maps play on their web site/s?
* Is this region located close to or far from the center of power of the country (the national capital city)?
* Does this condition have any impact on the reasons why they would like to gain at-least more autonomy to make their own decisions?
* According to the source/s you have consulted, what are the main reason/s why this population would like to break-up from the country in which they live in?
Do this/these source/s mention any explanation/s based on cultural or ethnic characteristics? For example, speaking a different language? Which one? Professing a different religion? Which one? Economic disparities
.
Case Study #2 T.D. enjoys caring for the children and young peop.docxcowinhelen
Case Study #2
T.D. enjoys caring for the children and young people in the schools where she works, but sometimes she is faced with tough situations such as suspected child abuse and neglect, teen pregnancy, and alcohol and drug use among teenagers. She works hard to ensure that the children in her schools receive the best care possible.
Question:
Several third graders reports having received no breakfast at home for more than a week. T.D. is exercising Advocacy for the students under her care. What type of actions she might be doing to exercise advocacy for the students?
Discuss this:
Moral distress is a frequent situation where health care providers should face. Please define and discuss a personal experience where you have faced Moral distress in your practice.
Discuss how health promotion relates to morality.
Discuss your insights about your own communication strengths and weaknesses. Identify situations in which it may be difficult for you to establish or terminate a therapeutic relationship.
*
formatted and cited in current APA style with support from at least 2 academic sources.
.
CASE STUDY #2 Chief Complaint I have pain in my belly”.docxcowinhelen
CASE STUDY #2
Chief Complaint:
“I have pain in my belly”
History of Present Illness (HPI):
A 25-year-old female presents to the emergency room (ER) with complaints of severe abdominal pain for 2 weeks . The pain is sharp and crampy It hurts if I run, sit down hard, or if I have sex
PMH:
Patient denies
Drug Hx:
Birth control
Allergies:
NKA
Subjective:
Nausea and vomiting, Last menstrual period 5 days ago, New sexual partner about 2 months ago, No condoms, he hates them No pain, blood or difficulty with urination
Objective Data:
PE:
B/P 138/90; temperature 99°F; (RR) 20; (HR) 110, regular; oxygen saturation (PO2) 96%; pain 5/10
General:
acute distress and severe pain
HEENT:
Atraumatic, normocephalic, PERRLA, EOMI, conjunctiva and sclera clear; nares patent, nasopharynx clear, good dentition. Piercing in her right nostril and lower lip.
Lungs:
CTA AP&L
Card:
S1S2 without rub or gallop
Abd:
INSPECTION: no masses or thrills noted; no discoloration and skin is warm to; no tattoos or piercings; abdomen is nondistended and round
• AUSCULTATION: bowel sounds (BS) are normal in all four quadrants, no bruits noted
• PALPATION: on palpation, abdomen is tender to touch in four quadrants; tenderness noted on light palpation, deep palpation reveals no masses, spleen and liver unremarkable
• PERCUSSION: tympany heard in all quadrants, no dullness noted in abdominal area
GU:
• EXTERNAL: mature hair distribution; no external lesions on labia
• INTROITUS: slight green-gray discharge, no lesions
• VAGINAL: normal rugae; moderate amount of green discharge on vaginal walls
• CERVIX: nulliparous os with small amount of purulent discharge from os with positive cervical motion tenderness (CMT)
• UTERUS: ante-flexed, normal size, shape, and position
• ADNEXA: bilateral tenderness with fullness; both ovaries without masses
• RECTAL: deferred
• VAGINAL DISCHARGE: green in color
Ext:
no cyanosis, clubbing or edema
Integument:
intact without lesions masses or rashes
Neuro:
No obvious deficits and CN grossly intact II-XII
Then answer the following questions:
What other subjective data would you obtain?
What other objective findings would you look for?
What diagnostic exams do you want to order?
Name 3 differential diagnoses based on this patient presenting symptoms?
Give rationales for your each differential diagnosis.
-
Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.
.
Case Study #1Jennifer is a 29-year-old administrative assistan.docxcowinhelen
Case Study #1
Jennifer is a 29-year-old administrative assistant married to Antonio, an Italian engineer, whom Jennifer met four years earlier while on a business trip for her marketing company. The couple now lives in Nebraska, where Antonio works for the county's transportation department and Jennifer commutes an hour each way to her marketing office. They have been trying to start a family for over a year. Eight months ago, Jennifer miscarried in her second month of pregnancy. Antonio's parents love Jennifer and often ask her if she is expecting again, hoping to encourage her to focus on her next baby. Jennifer's mother passed away two years ago and her father's health is rapidly deteriorating. Jennifer faces the probability of placing her father in a skilled nursing care facility within the next few months, against his wishes.
At work, Jennifer runs a tight ship. She is organized and prepares lists to assure that everything is done according to schedule. Everyone counts on Jennifer and she takes pride in never letting people down.
Jennifer has visited her physician numerous times in the last six months, complaining of headaches, backaches, and indigestion. Jennifer insists that she is happy and is not feeling stressed, yet she finds herself making more mistakes at work, unable to keep up with housework, and feeling tired and overwhelmed; she has begun to question her effectiveness as an employee, wife, daughter, and potential mother. Her pains seem to be increasing, but her doctor cannot find a physical cause for her discomfort.
Case Study #2
Michael is a 40-year-old airline pilot who has recently begun to experience chest pains. The chest pains began when Michael signed his final divorce papers, ending his 15-year marriage. He fought for joint custody of his two children, ages 12 and 10, but although he wants to be with them more frequently, he only sees them every two weeks. This schedule is, in great part, a result of his employer's announcement that budget constraints would result in layoffs. Michael worries that without his job he will be unable to support his children and lose the new townhouse that he purchased. Michael's chest pains are becoming more frequent and he fears that he may be dying.
Review case studies 1 and 2.
Choose one case study.
Complete the following questions in 150 to 200 words each. Be as detailed as possible and use the information you have learned throughout this course.
• What are the causes of stress in Michael’s or Jennifer’s life? How is stress affecting Michael’s or Jennifer’s health?
• How are these stressors affecting Michael’s or Jennifer’s self-concept and self-esteem?
• How might Michael’s or Jennifer’s situation illustrate adjustment? How might this situation become an opportunity for personal growth?
• What defensive coping methods is Michael or Jennifer using? What active coping methods might be healthier for Michael or Jennifer to use? Explain why you would recom.
Case Study # 2 –Danny’s Unhappy DutyEmployee ProfilesCaro.docxcowinhelen
Case Study # 2 –Danny’s Unhappy Duty
Employee Profiles
:
Carol Brown, Danny Winthrop, Thomas Fletcher
Carol, the Department Secretary for Purchasing and General Stores, has been
working at St. Louis Memorial Hospital for sixteen years, four of which have
been for the present Manager, Dan Winthrop. Carol likes her Boss, who gives
his employees more leeway than most. Carol’s main interests are her work and
her home—traits also typical of the other people who work in the Department.
Carol feels she is part of a close, cooperative group of employees.
Dan, or Danny, as he likes to be called, arrived at St. Louis Memorial four years
ago as a replacement for a Department manager who had been at the Hospital
for a number of years. Danny’s predecessor, Bill Taylor, was very strict in
everything from insisting that employees take exactly one-half hour for lunch
breaks to not having a coffee pot in the Department. When Danny came on
board as a Department Manager, his management style was much less strict.
The result was that Danny’s employees were much happier, and began to meet
and exceed expectations in getting their work done. St. Louis Memorial’s
previous CEO was a good friend and frequently complimented Danny on his
efficient and effective staff. Now a new CEO, Thomas Fletcher, has been hired
by the Hospital’s Board of Directors. Things are about to change.
Thomas Fletcher, new CEO and a recent graduate from a superior school of
hospital management, has always believed in “doing things by the book”.
Thomas originally had wanted to become a doctor, but decided two years into
the process that it was going to take him too long, and that he would be better
off becoming an administrator. He likes the idea of being an administrator,
and wants to be a good one. He has decided to start out his career at St. Louis
Memorial, of the smaller hospitals in the St. Louis area, but hopes to progress to a
a much larger facility in about four years, once he develops a track record at
St. Louis Memorial.
The Challenge: Communication, Criticism and Discipline, Leadership, Motivation,
Rules and Policies
Danny knows his employees quite well. They are generally a happy, cohesive, and cooperative group. They joke around a lot among themselves, but get the work done more than satisfactorily. All of them seem to give a
gr.
Case Study – Multicultural ParadeRead the Case below, and answe.docxcowinhelen
Case Study – Multicultural Parade
Read the Case below, and answer the following questions:
(No references needed, 2 pages double space, label the answer without copying the question in the paper)
1. What images come to mind when you hear the term “costume”? In what ways might it be considered demeaning?
2. Often people conflate “culture,” “ethnicity,” “heritage,” “race,” and “nationality,” or use them interchangeably. How are these concepts different from one another? Is a “Multicultural Day” different than an “International Day”?
3. How is Ms. Morrison’s definition of “cultural clothing” different from her definition of “ethnic heritage”? Did her explanation clarify things for Keisha and Emily?
4. How might activities that require students to share part of their ethnic heritage alienate students or contribute to students’ and teachers’ existing stereotypes and biases?
5. Connect to 3 of the core themes:
(Equity in Education/ Theories of Learning, Culture, and Identity/ Teaching and Learning in a Multicultural Society/ Research and Educational Knowledge )
-------------------------------------------------------------------------------------------------------------------------------
Case Study:
In an effort to celebrate the growing racial and ethnic diversity at Eastern School, the school’s Diversity Committee decided to sponsor Multicultural Day. Numerous performers were hired for assemblies and presentations. During the day’s feature event, the “Culture Parade,” students were asked to showcase cultural clothing as they walked through the hallways. Teachers were encouraged by the committee to discuss clothing from countries outside the United States and to invite students who had such clothing to bring it to school for the parade.
Ms. Morrison was excited about Multicultural Day because many of her students had parents who were immigrants. She imagined the day as an opportunity for those students to teach others about their cultures.
A week before the event, Ms. Morrison brought a kilt to class and explained its significance to the students. “This represents my Scottish heritage,” she said, “and I am proud to show it to you today.” She then asked whether students had “special costumes” at home that represented their cultures. Several students raised their hands, which prompted Ms. Morrison to discuss the events planned for Multicultural Day, including the parade.
During dismissal the day before the parade Ms. Morrison announced, “Don’t forget to bring your costumes to class tomorrow!”
The next day, Ms. Morrison was pleased to see several Hmong and Liberian students came with bags of clothing. She saw that two other students, Emily and Keisha, brought clothing, so she inquired about what was in their bags. Emily, a white student excitedly pulled out her soccer uniform, and Keisha, an African American student, pulled jeans and her favorite sweatshirt out of her bag. Ms. Morrison told the two girls she appreciated the.
Case Study THE INVISIBLE SPONSOR1BackgroundSome execut.docxcowinhelen
Case Study : THE INVISIBLE SPONSOR1
Background
Some executives prefer to micromanage projects whereas other executives
are fearful of making a decision because, if they were to make the wrong
decision, it could impact their career. In this case study, the president of the company assigned one of the vice presidents to act as the project sponsor on a project designed to build tooling for a client. The sponsor, however, was reluctant to make any decisions.
Assigning the VP
Moreland Company was well-respected as a tooling design-and-build
company. Moreland was project-driven because all of its income came
from projects. Moreland was also reasonably mature in project management.
When the previous VP for engineering retired, Moreland hired an executive from a manufacturing company to replace him. The new VP for engineering, Al Zink, had excellent engineering knowledge about tooling but had worked for companies that were not project-driven. Al had very little knowledge about project management and had never functioned as a project sponsor. Because of Al’s lack of experience as a sponsor, the president decided that Al should “get his feet wet” as quickly as possible and assigned him as the project sponsor on a mediumsized project. The project manager on this project was Fred Cutler. Fred was an engineer with more than twenty years of experience in tooling design and manufacturing. Fred reported directly to Al Zink administratively.
Fred's Dilemma
Fred understood the situation; he would have to train Al Zink on how to
function as a project sponsor. This was a new experience for Fred because subordinates usually do not train senior personnel on how to do their job. Would Al Zink be receptive?
Fred explained the role of the sponsor and how there are certain project documents that require the signatures of both the project manager and the project sponsor. Everything seemed to be going well until Fred informed Al that the project sponsor is the person that the president eventually holds accountable for the success or failure of the project. Fred could tell that Al was
quite upset over this statement.
Al realized that the failure of a project where he was the sponsor could damage his reputation and career. Al was now uncomfortable about having to act as a sponsor but knew that he might eventually be assigned as a sponsor on other projects. Al also knew that this project was somewhat of a high risk. If Al could function as an invisible sponsor, he could avoid making any critical decisions.
In the first meeting between Fred and Al where Al was the sponsor, Al asked Fred for a copy of the schedule for the project. Fred responded: I’m working on the schedule right now. I cannot finish the schedule until you tell me whether you want me to lay out the schedule based upon best time, least cost, or least risk.
Al stated that he would think about it and get back to Fred as soon as possible.
During the middle of the next week, Fred and Al m.
CASE STUDY Experiential training encourages changes in work beha.docxcowinhelen
CASE STUDY: Experiential training encourages changes in work behavior and growth in one’s abilities, which is accomplished through a multitude of methods. Experiential training has proven to be cost-effective while motivating employees as well as improving self-awareness, personal accountability, teamwork skills, and communication skills (Ritchie, 2011). Additionally, the training methods provide trainees with direct experience, the opportunity to reflect on that experience, and share models to help trainees to deduce using both present and past experience, while accommodating learning styles and strengths (Ritchie, 2011). Valkanos and Fragoulis identify several reasons why experiential training provides value:
1. Ongoing advances in technology requiring changes in knowledge, skills, and abilities
2. Divergence between theory and practice
3. Mergers and acquisitions of enterprises which tend to bring new jobs, organizational culture, and work content
4. Constant environment of change, from working conditions to processes and procedures relating to organizational issues, quality, and new products or services, and requiring new competencies, duties, or work content (Valkanos & Fragoulis, 2007, p. 22).
Method
Description
On-the-job Training
Receives instructions on the functions of their job in their assigned workplace.
Simulators
Teaches employees on how to operate equipment in a given context
Role Playing
Developing interpersonal and business skills, such as decision-making, communication, conflict resolution, and solving complex problems.
Case Study
Develops critical thinking skills to include analytical, higher-level skills, and exploring and resolving complex problems.
Games
Develops general business and organizational principles addressing application in a variety of situations.
Behavior Modeling
Used when learning goals are a rule and inflexible procedures. Provides skills and practice to modify and model behavior.
In-basket Techniques
A variety of items placed in an envelope that reflects what might be found in an inbox. This activity is used to assist trainees in developing and applying their strategic and operational skills.
(Blanchard & Thacker, 2013, pp. 222-223)
References:
· Blanchard, P. N., & Thacker, J. W. (2013). Effective training: Systems, strategies, and practices (5th ed.). Upper Saddle River, NJ: Pearson Education, Inc.
· Valkanos, E., & Fragoulis, I. (2007). Experiential learning – its place in in‐house education and training. Development and Learning in Organizations: An International Journal, 21(5), 21-23. doi:10.1108/14777280710779454
Discussion Question--Choose one perspective in which to respond.
Non-HR Perspective: Your department is not meeting performance expectations. What steps do you take to resolve the issue? Is training a possible solution; if so, which of the above training methods would be the most effective in addressing the issue? Would you, at any point, involve HR--if so, at what point and why?.
Case Study Hereditary AngioedemaAll responses must be in your .docxcowinhelen
Case Study: Hereditary Angioedema
All responses must be in your own words. Answers that have been copied and pasted will not receive credit.
1. Translate “angioedema”. [Note: I am not looking for a description of the disorder. Rather, I would like you to translate the medical term itself.]
2. The complement system is described as a ‘cascade system’. How does the system fit into this description of being a cascade? [Suggestion: Google the definition of cascade, then think about the complement system in light of the definition]
3. Is complement involved in the innate, or the adaptive immune system, or both? Please explain you answer.
4. What role does C1INH play in the complement system? Why is it so important?
5. What was the physiologic cause of Richard’s abdominal pain?
6. How can one distinguish the swelling of HAE from the swelling of allergic angioedema?
7. What is bradykinin’s role in HA?
8. Do you think Richard’s infancy colic was related to his HA? No need to research this. Just use your intuition. Explain your thinking.
9. What is typically used to treat attacks of HAE?
10. Swelling in the extremities is not dangerous. What other areas of the body are subject to swelling? What is the most dangerous location for swelling to occur and why is it the most dangerous?
2018
BUS 308 Week 2 Lecture 1
Examining Differences - overview
Expected Outcomes
After reading this lecture, the student should be familiar with:
1. The importance of random sampling.
2. The meaning of statistical significance.
3. The basic approach to determining statistical significance.
4. The meaning of the null and alternate hypothesis statements.
5. The hypothesis testing process.
6. The purpose of the F-test and the T-test.
Overview
Last week we collected clues and evidence to help us answer our case question about
males and females getting equal pay for equal work. As we looked at the clues presented by the
salary and comp-ratio measures of pay, things got a bit confusing with results that did not see to
be consistent. We found, among other things, that the male and female compa-ratios were fairly
close together with the female mean being slightly larger. The salary analysis showed a different
view; here we noticed that the averages were apparently quite different with the males, on
average, earning more. Contradictory findings such as this are not all that uncommon when
examining data in the “real world.”
One issue that we could not fully address last week was how meaningful were the
differences? That is, would a different sample have results that might be completely different, or
can we be fairly sure that the observed differences are real and show up in the population as
well? This issue, often referred to as sampling error, deals with the fact that random samples
taken from a population will generally be a bit different than the actual population parameters,
but will be “close” enough to the actual.
case studieson Gentrification and Displacement in the Sa.docxcowinhelen
case studies
on Gentrification and Displacement
in the San Francisco Bay Area
Authors:
Miriam Zuk and Karen Chapple
Chapter 3: Nicole Montojo
Chapter 4: Sydney Cespedes, Mitchell Crispell, Christina Blackston, Jonathan Plowman, and
Edward Graves
Chapter 5: Logan Rockefeller Harris, Mitchell Crispell, Fern Uennatornwaranggoon, and Hannah Clark
Chapter 6: Nicole Montojo and Beki McElvain
Chapter 7: Celina Chan, Viviana Lopez, Sydney Céspedes, and Nicole Montojo
Chapter 8: Alexander Kowalski, Julia Ehrman, Mitchell Crispell and Fern Uennatornwaranggoon
Chapter 9: Mitchell Crispell
Chapter 10: Logan Rockefeller Harris and Sydney Cespedes
Chapter 11: Mitchell Crispell
Partner Organizations:
Causa Justa :: Just Cause, Chinatown Community Development Center, Marin Grassroots, Monument
Impact, People Organizing to Demand Environmental & Economic Rights (PODER), San Francisco
Organizing Project / Peninsula Interfaith Action , Working Partnerships USA
Acknowledgements:
Research support was provided by Maura Baldiga, Julian Collins, Mitchell Crispell, Julia Ehrman, Alex
Kowalski, Jenn Liu, Beki McElvain, Carlos Recarte, Maira Sanchez, Mar Velez, David Von Stroh, and
Teo Wickland. Report layout and design was done by Somaya Abdelgany.
Additional advisory support was provided by Carlos Romero. This case study was funded in part by
the Regional Prosperity Plan1 of the Metropolitan Transportation Commission as part of the “Regional
Early Warning System for Displacement” project and from the California Air Resources Board2 as part
of the project “Developing a New Methodology for Analyzing Potential Displacement.”
The Center for Community Innovation (CCI) at UC-Berkeley nurtures effective solutions that expand
economic opportunity, diversify housing options, and strengthen connection to place. The Center
builds the capacity of nonprofits and government by convening practitioner leaders, providing techni-
cal assistance and student interns, interpreting academic research, and developing new research out
of practitioner needs.
communityinnovation.berkeley.edu
July 2015
Cover Photographs: Robert Campbell, Ricardo Sanchez, David Monniaux, sanmateorealestateonline.com/Redwood-City, marinretail-
buzz.blogspot.com, trulia.com/homes/California/Oakland , bloomingrock.com, sharks.nhl.com/club/gallery, panoramio.com
1 The work that provided the basis for this publication was supported by funding under an award with the U.S. Department of Hous-
ing and Urban Development. The substance and findings of the work are dedicated to the public. The author and publisher are solely
responsible for the accuracy of the statements and interpretations contained in this publication. Such interpretations do not neces-
sarily reflect the views of the Government.
2 The statements and conclusions in this report are those of the authors and not necessarily those of the California Air Resources
Board. The mention of commercial products, their source, or their u.
Case Studt on KFC Introduction1) Identify the type of .docxcowinhelen
Case Studt on KFC
Introduction
1) Identify the type of business organization and strategies
2) Key players
Body
1. Opportunities
2. Threats
Closing/Conclusion
1. Make recommendations
2. Offer a plan for implementation
.
Case Study Crocs Revolutionizing an Industry’s Supply Chain .docxcowinhelen
Case Study Crocs: Revolutionizing an Industry’s Supply Chain Model for
Competitive Advantage
If the products sell extremely well, we will
build more in season, and will be back on the
shelves in a few weeks. And we’ll build even
more, and even more, and even more, in that
same season. We’re not going to wait with a
hot new product until next year, when hope-
fully the same trend is alive.
—Ronald Snyder, CEO of Crocs, Inc.1
On May 3, 2007, Crocs, Inc. released its results for the
first quarter of the year. The footwear company,
which had sold its first shoes in 2003, reported reve-
nues of $142 million for the quarter, more than three
times its sales for the first quarter of 2006. Net in-
come, at $0.61 per share was more than 17 percent
of sales, nearly four times higher than the previous
year.2 These results far exceeded market expecta-
tions, which had been for earnings of $0.49 per share
on $114 million of revenue.3 As part of the earnings
release, the company announced a two-for-one stock
split. Immediately after the announcement, the stock
price jumped 15 percent.
The growth and profitability of Crocs, which made
funky, brightly colored shoes using an extremely com-
fortable plastic material, had been astounding. Much
of this growth had been made possible by a highly
flexible supply chain which enabled the company to
build additional product to fulfill new orders quickly
within the selling season, allowing it to respond to un-
expectedly high demand—a capability that was previ-
ously unheard of in the footwear industry. This ability
to fulfill the needs of retailers also made the company
a very popular supplier to shoe sellers.
This success also raised questions about how
the company should grow in the future. Should it
vertically integrate or grow through product line
extension? Should it grow organically or through ac-
quisition? Would potential growth paths exploit
Crocs’ core competencies or defocus them?
CROCS, INC.
In 2002, three friends from Boulder, Colorado went
sailing in the Caribbean. One brought a pair of foam
clog shoes that he had bought from a company in
Canada. The clogs were made from a special mate-
rial that did not slip on wet boat decks, was easy
to wash, prevented odor, and was extremely com-
fortable. The three, Lyndon “Duke” Hanson, Scott
Seamans, and George Boedecker, decided to start a
business selling these Canadian shoes to sailing en-
thusiasts out of a leased warehouse in Florida, as
Hanson said, “so we could work when we went on
sailing trips there.”4 The founders wanted to name
the shoes something that captured the amphibious
nature of the product. Since “Alligator” had already
been taken, they chose to name the shoes “Crocs.”
The shoes were an immediate success, and word
of mouth expanded the customer base to a wide
range of people who spent much of their days stand-
ing, such as doctors and gardeners. In October 2003,
as the business began to grow, th.
Case Studies Student must complete 5 case studies as instructed.docxcowinhelen
Case Studies: Student must
complete 5 case studies
as instructed by course
materials. Fill out form below for 5 different people (imaginary is okay).
Master Herbalist Questionnaire
Date: _____________________
Name: _________________________________ Age: ______ Birth date:_____________
Address: ________________________________________________________________
Home Phone: _________________________ Work Phone:________________________
Height: _________ Weight: _________ 1 year ago:__________ 5 years ago:_________
Occupation: _______________________________________ Full Time Part Time
Living situation: Alone Friends Partner Spouse Parents Children Pets
What are your major health concerns and intentions for your visit today?
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Please list any other health care providers or consultants you are currently working with:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Please list any current health conditions diagnosed by a medical doctor:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Please use this form
as a source of
reference when
conducting your
Case-Studies.
Treat this part as information only as you are not to treat or prescribe treatment for any specific diseases
It is important to know if the client is receiving treatment from other practitioners and what these entail
Since legally you are not allowed to diagnose disease, it is helpful to get one from an MD
When was your last physical exam?
________________________________________________________________________
Please list all herbs, vitamins, and dietary supplements you are currently taking, includingdosage and frequency:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
List all medication.
Case Studies in Telehealth AdoptionThe mission of The Comm.docxcowinhelen
Case Studies in Telehealth Adoption
The mission of The Commonwealth
Fund is to promote a high performance
health care system. The Fund carries
out this mandate by supporting
independent research on health care
issues and making grants to improve
health care practice and policy. Support
for this research was provided by
The Commonwealth Fund. The views
presented here are those of the author
and not necessarily those of The
Commonwealth Fund or its directors,
officers, or staff.
For more information about this study,
please contact:
Andrew Broderick, M.A., M.B.A.
Codirector, Center for Innovation
and Technology in Public Health
Public Health Institute
[email protected]
The Veterans Health Administration:
Taking Home Telehealth Services to
Scale Nationally
Andrew Broderick
ABSTRACT: Since the 1990s, the Veterans Health Administration (VHA) has used infor-
mation and communications technologies to provide high-quality, coordinated, and com-
prehensive primary and specialist care services to its veteran population. Within the VHA,
the Office of Telehealth Services offers veterans a program called Care Coordination/
Home Telehealth (CCHT) to provide routine noninstitutional care and targeted care man-
agement and case management services to veterans with diabetes, congestive heart fail-
ure, hypertension, post-traumatic stress disorder, and other conditions. The program uses
remote monitoring devices in veterans’ homes to communicate health status and to cap-
ture and transmit biometric data that are monitored remotely by care coordinators. CCHT
has shown promising results: fewer bed days of care, reduced hospital admissions, and
high rates of patient satisfaction. This issue brief highlights factors critical to the VHA’s
success—like the organization’s leadership, culture, and existing information technology
infrastructure—as well as opportunities and challenges.
OVERVIEW
Since the 1990s, information and communications technologies—including tele-
health—have been at the core of the Veterans Health Administration’s (VHA’s)
successful system-level transformation toward providing continuous, coordinated,
and comprehensive primary and specialist care services. The VHA’s leadership
and culture; underlying health information technology infrastructure; and strong
commitment to standardized work processes, policies, and training have all con-
tributed to the home telehealth program’s success in meeting the chronic care
needs of a population of aging veterans and reducing their use of institutional
care and its associated costs. The home teleheath model also encourages patient
activation, self-management, and helps in the early detection of complications.
To learn more about new publications
when they become available, visit the
Fund's website and register to receive
Fund email alerts.
Commonwealth Fund pub. 1657
Vol. 4
January 2013
www.commonwealthfund.org
www.commonwealthfund.org
mailto:[email pro.
Honest Reviews of Tim Han LMA Course Program.pptxtimhan337
Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Running head LITERATURE REVIEWLITERATURE REVIEWLiteratu.docx
1. Running head: LITERATURE REVIEW
LITERATURE REVIEW
Literature Review: Hand washing and Hospital-Associated
Infections
Name
Walden University
Course Name
April 3, 2016
Literature Review: Hand washing and Hospital-Associated
Infections
Most Hospital associated infections are alleged to be
transmitted via the hands of Healthcare providers mainly
through direct contact when the medical practitioner’s hands
transfer the pathogens between individuals or between an
environmental reservoir and an individual (Al-Khawaldeh, Al-
Hussami, & Darawad, 2015). The purpose of this study is to
2. find out whether there is sufficient evidence to indicate whether
there is need for further research on hand washing with regards
to the infections that patients are susceptible to in the case of
contaminated contact. The evidence from the various studies
and nursing journals were carefully assessed to ensure that
salient information regarding the research study area were
present and were relevant to the study. The researcher took into
consideration the ethical issues that are involved in research.
The identities of the sample population were not released at any
given time and they gave consent for the use of the information
retrieved from them (Newcomb, 2010). Furthermore, most of
the information used was from journal articles that allow for
others to reference the works and findings of the research and,
thus, the researcher could include the research material in the
literature review (Fouka & Mantzorou, 2011).
Synthesis on the Current State of Knowledge
Despite the relative simplicity of hand hygiene procedure, the
adherence rates to the standard recommendations remain
unacceptably low; well below 50% (Bukhari et al., 2011). The
reasons for non-compliance with hand washing are low staff to
patient ratios, lack of appropriate hand washing equipment,
insufficient knowledge about risks and procedures, allergies to
some hand washing products, the casual attitude of healthcare
practitioners (HCPs) and time factors (Pfoh, Dy, & Engineer,
2013). Patients are likely to suffer infections that arise from
inconsistent hygiene practices especially those that are
supposed to undergo an operation and have undergone a surgical
operation.
The United Stated Department of Infectious Diseases estimated
the incidence of hospital-acquired infections by 4.5% and with a
5% fatality in 2014 translating to a huge economic impacts (Al-
Khawaldeh et al., 2015). One of the main contradictions is the
fact that; despite the numerous hand washing guidelines that
have been adopted by a majority of health facilities, the
compliance by the health care providers remains low despite the
practice being one of the simplest and most effective ways of
3. preventing hospital-acquired infections (Bukhari et al., 2011).
Some studies point of knowledge, attitude and practice as the
primary factors affecting hand hygiene practices while other
researches show that even if the healthcare workers from some
developing countries would love to adopt best practices for
hand hygiene, financial resources is a major factor (Bukhari et
al., 2011; Pfoh, Dy, & Engineer, 2013)
In the recent past, studies in Croatia indicated that when it came
to general hygiene especially hand washing when caring for
patients at the health care centers most of the nurses and other
health care providers did not meet the set of the World Health
Organization (WHO) hygiene standards (Krleza et al., 2015). In
addition, the inconsistent aseptic handling of capillary blood
sampling especially dirty and infected hands reduced the
chances of getting accurate analysis from the blood sample tests
carried out (Krleza et al., 2015). Consequently,
recommendations for promotion of hygiene are proposed by the
researchers that include washing of the hands so as to reduce
contamination of the blood samples that are collected.
Research also indicates that every year at least 290 000 surgical
site infections are caused by the health care associated
infections (Tsai & Caterson, 2014). Every year at least 1.7
million patients suffer tertiary infections that are as a result of
health care associated infections. Furthermore, the results
indicate that the health care system spends at least $45 billion
every year on the treatment of surgical site infections that are
caused due to health care associated infection (Tsai & Caterson,
2014). These statistics are staggering in terms of the amount of
money that is spent on resultant infections that can easily
prevented. Furthermore, hand washing is considered as one of
the major causes of surgical site infections especially during
post-operation health care provisions (Tsai & Caterson, 2014).
Most of the health care officials are usually overwhelmed with
the long hours of working shifts that some of the essential
aseptic procedures are overlooked during caring for the
patients’ wounds (Aiken, Karuri, Wanyoro, & Macleod, 2012).
4. According to Aiken et al (2012), most of the surgeries carried
out in Sub- Saharan Africa are usually high risk because of the
challenges that the health care providers face when it comes to
maintenance of hygiene in the course of their work.
Furthermore, the research indicated that some of the
disinfectants that are to be used pre and post operation are not
readily available given the high costs health centers incur when
purchasing them (Kargupta et al., 2015). Alternatives such as
alcohol and other aerosolized forms of disinfectants would be
more appropriate in disinfecting the hands because they are
readily available and are abundant in quantity. Therefore, it was
suggested that the hospitals resort to using some of the cheap
methods of disinfecting their instruments and well as using
alcohol runs as hand wash given that it is cheap and it is readily
available (Aiken et al., 2012). Furthermore, during post-
operation care hygiene is paramount given that it hastens the
recovery of patients and it further reduces their susceptibility to
surgical site infections that are the key cause of some of the
mortality cases witnessed in Sub Saharan Africa (Aiken et al.,
2012)
Intravenous medication delivery has also been noted to suffer
contamination especially given that some of the health care
providers practice inconsistent aseptic techniques (Moureau &
Flynn, 2015). Aseptic techniques include washing of the hands,
disinfection of the needleless connectors, and use of anti-
infective agents so as to reduce the risk of contamination;
intravenous infections that have occurred as a result of
contamination of the needleless connectors (Moureau & Flynn,
2015). The fact that the intravenous medication delivery is
directly in contact with the veins of a person it increases the
chance of infections that can be severe and in some cases fatal;
therefore, it is important for consistent aseptic techniques to be
carried out so as to ensure that the cases of contamination of
intravenous medication delivery reduced to a minimum
(Moureau & Flynn, 2015).
Preliminary Conclusions
5. This study has the primary objective of identifying and
assessing the behaviors and factors affecting the practice of a
simple intervention that is “hand hygiene” as practiced by
healthcare practitioners (Davies, 2011). The study question
is;does hand washing and appropriate staff dressing among the
surgical ward nurses reduce cross infection during patient
management? Research identifies the factors that motivate and
those that affect the hand washing practice among health care
providers (Davies, 2011). The gaps identified are meant to
assist the healthcare management team and infection control
units to develop appropriate measures for the implementation of
hand washing policies and a translated reduction in the rates of
hospital acquired infections (Davies, 2011).
summary
There is a need for strategies that emphasize or remind the
health care practitioners about hand washing; these include
pinning of charts about hand washing at strategic points,
provision of sufficient hand hygiene products, periodic classes
on hand washing and an introduction of penalties for non-
compliance.
Citation
Type of Study
Design Type
Framework/Theory
Setting
Key Concepts/Variables
Findings
Hierarchy of Evidence Level
Aiken, A. M., Karuri, D. M., Wanyoro, A. K., & Macleod, J.
(2012). Interventional studies for preventing surgical site
infections in sub-Saharan Africa. International Journal of
Surgery, 242-249. Doi: 10.1016/j.ijsu.2012.04.004
Type of Study:
Quantitative
6. Design Type:
Systematic review
Framework/Theory: Interventional studies can reduce the post
surgical site infections
Sub-Saharan Africa
Post-operative surgical site infections increase the risk of
mortality.
Use of single dose pre-operative antibiotic prophylaxis reduces
the chances or the risk of surgical site infections during post-
operation care.
Alcohol-based hand rubs served as low cost and readily
available alternatives to the traditional surgical hand wash.
Level V
Kargupta, R., Hull, G. J., Rood, K. D., Galloway, J., Matthews,
C. f., Dale, P. S., & Sengupta, S. (2015). Foaming Betadine
Spray as a potential agent for non-labor-intensive preoperative
surgical site preparation. Annals of Clinical Microbiologicaland
Antimicrobials. doi: 10.1186/s12941-015-0076-2
Type of Study: Quantitative Research
Design Type:
Experimental Research
7. Framework/Theory:
Effective Surgical Site preparations allows for faster and
uncomplicated recovery
Setting:
Clinical based experiments
Concepts:
Importance of surgical site preparation
Findings
Surgical Site preparation reduces risk of surgical site infections
pre and post surgical operation.
Aerosolized form of antisepticdelivery was more efficient that
traditional forms of the
Alcohol-based hand rubs served as low cost and readily
available alternatives to the traditional surgical hand wash.
Level II
Citation
Study
Design Type
Framework/Theory
Setting
Key Concepts/Variables
Findings
Hierarchy of Evidence Level
Krleza, J. L., Dorotic, A., Gruznov, A., & Maradin, M. (2015).
Capillary blood sampling: national recommendations on behalf
8. of the Croatian Society of Medical Biochemistry and Laboratory
Medicine. Biochemia Medica, 335-358.
doi: 10.11613/BM.2015.034
Type of Study: Qualitative Research
Design Type: Cross-sectional
Framework/Theory:
Capillary blood sampling is important in receiving the best
sample tests.
Croatian hospitals.
Concepts:
Best capillary blood handling gives better and accurate results
of the tests being undertaken
Independent Variable: Aseptic techniques
Dependent Variable: Sample test results
Controlled Variable:
Capillary blood samples
Few hospitals complied with the WHO requirements for
capillary blood sample handling.
Alcohol use in hand washing reduces sample contamination.
Aseptic techniques in blood sampling handling increases test
results accuracy
Level III
Moureau, N. L., & Flynn, J. (2015, May 14). Disinfection of
9. Needleless Connector Hubs: Clinical Evidence Systematic
Review. Nursing Research and Practice. Doi:
http://dx.doi.org/10.1155/2015/796762
Type of Study: Qualitative Research
Design Type: Systematic Research
Framework/Theory: Break in aseptic techniques increases the
chances of contracting infections resulting from the
contaminations of the catheters.
Different Nursing databases were used in the experiment that
had relevant literature concerning the area of study
Concepts:
Needleless connectors are responsible for at least 50% of
infections through because of inconsistent aseptic processes.
Controlled Variable:
Capillary blood samples
Aseptic techniques reduced the chances of contaminating
intravenous medication while treating a patient.
Passive disinfection caps reduced the risks of contaminating the
catheters used for intravenous medication delivery
Level III
Tsai, D. M., & Caterson, E. J. (2014, October 11). Current
preventive measures for health-care associated surgical site
infections: a review. Patient Safety in Surgery. Doi:
10.1186/s13037-014-0042-5
Type of Study
10. Qualitative Study
Design Type
Mixed method
Framework/Theory
Healthcare Associated infections are very costly to not only to
the hospital but to the patients.
Various nursing database were used with literature concerning
the salient issues on Healthcare associated infections.
Exemplary hygiene ensures that healthcare associated infections
are reduced if employed at every stage.
Independent variable : Maintenance of hygiene
Dependent variable :
Healthcare Associated Infections
Surgical site infections lead to at least 290 000 Healthcare
associated infections and cause about 8000 deaths every year.
$45 billion is spent annually to treat healthcare associated
infections that could have been prevented.
Level V
11. References
Aiken, A. M., Karuri, D. M., Wanyoro, A. K., & Macleod, J.
(2012). Interventional studies for preventing surgical site
infections in sub-Saharan Africa. International Journal of
Surgery, 242-249. Doi: 10.1016/j.ijsu.2012.04.004
Al-Khawaldeh, O., Al-Hussami, M., & Darawad, M. (2015).
Influence of Nursing Students Handwashing Knowledge,
Beliefs, and Attitudes on Their Handwashing Compliance.
Scientific Research Publishing. Doi:
http://dx.doi.org.ezp.waldenulibrary.org/10.4236/health.2015.75
068
Bukhari, S., Hussain, W., Banjar, A., Almaimani, W., Karima,
T., & Fatani, M. (2011). Hand hygiene compliance rate among
healthcare professionals. PubMed - NCBI. Ncbi.nlm.nih.gov.
Retrieved 1 April 2016, from
http://www.ncbi.nlm.nih.gov/pubmed/21556474
Davies, K. S. (2011). Formulating the evidence-based practice
question: A review of the frameworks. Evidence-Based library
and information Practice, 6 (2), 75–80. Retrieved from
https://ejournals.library.ualberta.ca/index.php/EBLIP/article/vie
wFile/9741/8144
Fouka, G., & Mantzorou, M. (2011). What are the major ethical
issues in conducting research? Is there a conflict between the
research ethics and the nature of nursing? Health Science
Journal, 3-14.
Kargupta, R., Hull, G. J., Rood, K. D., Galloway, J., Matthews,
12. C. f., Dale, P. S., & Sengupta, S. (2015). Foaming Betadine
Spray as a potential agent for non-labor-intensive preoperative
surgical site preparation. Annals of Clinical Microbiologicaland
Antimicrobials. doi: 10.1186/s12941-015-0076-2
Krleza, J. L., Dorotic, A., Gruznov, A., & Maradin, M. (2015).
Capillary blood sampling: national recommendations on behalf
of the Croatian Society of Medical Biochemistry and Laboratory
Medicine. Biochemia Medica, 335-358.
DOI: 10.11613/BM.2015.034
Moureau, N. L., & Flynn, J. (2015, May 14). Disinfection of
Needleless Connector Hubs: Clinical Evidence Systematic
Review. Nursing Researcj and Practice. Moureau, N. L., &
Flynn, J. (2015, May 14). Disinfection of Needleless Connector
Hubs: Clinical Evidence Systematic Review. Nursing Research
and Practice. Doi: http://dx.doi.org/10.1155/2015/796762
Newcomb, P. (2010). Evolving fairness in research on human
subjects. Journal of Child and Adolescent Psychiatric Nursing,
123-124. doi: 10.1111/j.1744-6171.2010.00233.x
Pfoh, E., Dy, S., & Engineer, C. (2013). Interventions to
improve hand hygiene compliance: Brief update review. Agency
for healthcare research and quality (US). doi: 10.1136/bmjqs-
2012-001769
Polit, D., & Beck, C. T. (2012). research: Generating and
assessing evidence for nursing practice. Philadephia, PA:
Lippincott Williams and Wilkins.
Tsai, D. M., & Caterson, E. J. (2014, October 11). Current
preventive measures for health-care associated surgical site
infections: a review. Patient Safety in Surgery. Doi:
10.1186/s13037-014-0042-5
13. Walden University M.S. in Nursing
Formative Evaluation Criteria for Applications and Formal
Papers
Categories and Criteria
Points
QUALITY OF WORK SUBMITTED - 35 Possible Points
1. The extent to which work meets the assigned criteria and
work reflects graduate level critical and analytic thinking
(0-30 Points)
Assignment exceeds expectations. All topics are addressed with
a minimum of 75% containing exceptional breadth and depth
about each of the assignment topics.
25-30
Assignment meets expectations. All topics are addressed with a
minimum of 50% containing good breadth and depth about each
of the assignment topics.
20-24
Assignment meets most of the expectations. One required topic
is either not addressed or inadequately addressed.
16-19
Assignment superficially meets some of the expectations. Two
or more required topics are either not addressed or inadequately
addressed.
0-15
2. Purpose of the paper is clear
(0-5 Points)
A clear and comprehensive purpose statement is provided which
delineates all required criteria.
5
14. Purpose of the assignment is stated, yet is brief and not
descriptive.
4
Purpose of the assignment is vague.
1-3
No purpose statement was provided.
0
ASSIMILATION AND SYNTHESIS OF IDEAS - 50 Possible
Points
The extent to which the work reflects the student’s ability to-
1. Understand and interpret the assignment’s key concepts
(0-10 Points)
Demonstrates the ability to critically appraise and intellectually
explore key concepts.
9-10
Demonstrates a clear understanding of key concepts.
8
Shows some degree of understanding of key concepts.
5-7
Shows a lack of understanding of key concepts, deviates from
topics.
0-4
2. Apply and integrate material in course resources (i.e. video,
required readings, and textbook) and credible outside resources
(0-20 Points)
Demonstrates and applies exceptional support of major points
15. and integrates 2 or more credible outside sources, in addition to
3-4 course resources to support point of view.
15-20
Integrates specific information from 1 credible outside resource
and 3 to 4 course resources to support major points and point of
view.
10-14
Minimally includes and integrates specific information from 2-3
resources to support major points and point of view.
3-9
Includes and integrates specific information from 0 to 1
resource to support major points and point of view.
0-2
3. Synthesize (combines various components or different ideas
into a new whole) material in course resources (i.e. video,
required readings, and textbook) by comparing different points
of view and highlighting similarities, differences, and
connections. (0-20 Points)
Synthesizes and justifies (defends, explains, validates,
confirms) information gleaned from sources to support major
points presented. Applies meaning to the field of advanced
nursing practice.
18-20
Summarizes information gleaned from sources to support major
points, but does not synthesize.
16-17
Identifies but does not interpret or apply concepts, and/or
strategies correctly; ideas unclear and/or underdeveloped.
14-15
16. Rarely or does not interpret, apply, and synthesize concepts,
and/or strategies.
0-13
This assignment provides an opportunity to apply psychological
theory in the exploration of a book or film. Students choose a
film or book of special interest. The book or film should have
content that can be meaningfully explored through application
of psychological theory and research. Students can look at some
of the later chapters in the text that deal with emotion,
motivation, personality, the development of the individual over
the life span, health and stress, and psychological disorders and
treatment, so that they have a more complete idea of different
concepts that might apply.
Students might pick a movie or book in which the main
character suffers from a psychological disorder or is merely
trying to cope with the everyday stress of life. Students might
17. discuss defense mechanisms or refer to developmental stages in
the person's life that might have been important, or consider the
effects of abuse, alcoholism and addiction, etc. Students can
approach the subject matter from different perspectives—
psychoanalytical, biological, behavioral, cognitive, and/or
sociocultural. They can discuss the role emotion, memory, or
motivation plays in the character's development, or the
importance of the environment, and influences such as racism
and sexism.
This is a research-based paper, and the film or book provides
only the backdrop for research on a psychological topic. You
should use at least one psychological, peer-reviewed reference
in addition to the textbook.
The paper should be 1,200 to 1,500 words and in APA format. I
was thinking of a movie on Good Will Hunting or something
similar. Let me know if this is something you are interesting in
and if 45 dollars is a reasonable price.
Running Head:IDENTIFYING A RESEARCHABLE PROBLEM
1
IDENTIFYING A RESEARCHABLE PROBLEM
9
Identifying a Researchable Problem
Name
Institution
Course Name
April 3, 2016
18. Identifying a Researchable Problem
Hundreds of millions of patients worldwide are affected by
healthcare associated infections every year. The infections lead
to severe illnesses, long-term disabilities, prolonged hospital
stays and added costs to patients, their families, and the
healthcare system. Hand hygiene is the primary action to reduce
the number of healthcare-acquired infections; a simple action
maybe, but the compliance rates among the healthcare providers
is the main problem. The purpose of this paper is to provide a
summary on the issue of handwashing non compliance amongst
healthcare workers and its relation to nosocomial infections.
This paper will also generate five questions and describe how
they are analyse for feasibility, as well as a PICOT question and
a description of its variable. Additionally, ten keywords will be
developped to help conduct the literature search.
Problem Identification
A crucial factor in selecting a problem is its significance to
nursing and evidence from the study should have potential to
contribute meaningfully to nursing practice ( Polit & Beck,
2012). Nurses comprises of 55% of the healthcare workforce
and number more than 3 million, as such represent the most
critical group in hand higiene compliance as they spent the most
time with the patients (McGonigle & Mastrian, 2012). Hand
19. hygiene is a critical practice aimed at keeping the hands clean
and free from pathogens or reduce the amounts before
performing any medical procedure or touching a patient.
Practicing hand hygiene is important in the prevention of cross
infection in clinical settings. Healthcare workers need an easy
to use, timely access to both skin protection and hand hygiene
for good hand hygiene practice.
Studies show that most nosocomial infections are transmitted
through the hands of healthcare practitioners. It is well-known
that better hand hygiene practices among healthcare workers
play a critical role in the prevention of transmission of
infectious agents (Pittet, Allegranzi & Boyce, 2009). The
practice of hand washing is one of the most effective ways of
preventing the transmission of infectious diseases, but despite
the implementation of the Centers for Disease Control and
Prevention guidelines for hand hygiene, the compliance among
health practitioners remains low (Pittet, Allegranzi & Boyce,
2009).
Hand washing is a critical element of patient safety as it
prevents healthcare associated infections as well as the spread
of antimicrobial resistance. The promotion of hand hygiene,
therefore, presents a common challenge that calls for a
multimodel strategy. Healthcare worker’s adherence to hand
washing guidelines is poor and calls for a behavior change.
Most studies have recommended multimodal strategies that
include education of healthcare workers, audit and performance
feedback practices, increased supply of water and soap,
reminders, use of automated sinks and the use of alcohol-based
hand rub (Pfoh, Dy, & Engineer, 2013).
Hospital-acquired infections carry a far-reaching and real threat
to every individual admitted to hospitals. The pathogens from
the hands of the healthcare workers are readily transmitted to
the patients hence hand hygiene practices substantially reduce
this chance. Evidence-based guidelines for hand hygiene in
clinical practice are very clear, but the compliance remains
internationally low (Bukhari et al., 2011).
20. Significance of the Problem of Nursing Practice
Hand hygiene is considered as the most simple and the most
effective way of preventing hospital-acquired infections.
Despite the milestones and achievements made in epidemiology
and infection control, the hygiene message has not been
consistently translated into medical practice, and the healthcare
workers adherence to the guidelines for hand hygiene is
unacceptably low. (Bukhari et al., 2011). The average
compliance with the hand washing guidelines varies from the
patient wards, among health care workers categories and based
on the working conditions, but also varies according to the
different definitions used in different studies (Pittet, Allegranzi,
& Boyce, 2009).
Compliance with hand-washing recommendations is a very
significant measure in the prevention of hospital-associated
infections. Studies report that transmission of pathogens from
the hands of healthcare workers is one of the primary sources of
cross-infection in clinical settings and can be prevented by
proper hand hygiene practices (Bukhari et al., 2011). There are
cases of very low or insufficient compliance rates in developing
and developed countries with the mean baseline rates of
between 5% and 89% making an overall average of 38.7%
(Bukhari et al., 2011).
Variation in hand washing behavior across healthcare workers
and hospital wards suggests the need for a strategic educational
program. Nosocomial infections are a significant cause of
complications in the ICU; and hand-washing being the single
most effective preventive measure, the compliance rates remain
low (Bukhari et al., 2011). The association between
handwashing non-compliance and surgical wards may also
suggest a fact that understaffing reduces the quality of patient
care. Hand washing has a proven benefit in the prevention of
cross-infection. Hence the compliance, especially in the surgical
and ICU wards, is paramount (Royal Pharmaceutical Society,
2014).
Studies and estimations by the World Health Organization
21. (WHO) show Healthcare-associated infections affect at least
1.4million patients on the global scale at any given time. In the
surgical units, the burden of hospital acquired infections has
significantly increased, leading to increased morbidity and
mortality. In some instances, multidrug resistant pathogens are
involved or are part of the infection, hence pose a challenge to
effective treatment (Pittet, Allegranzi & Boyce, 2009). Proper
hand hygiene is the simplest, single most important and the
least expensive means of preventing the cross infections. The
WHO and CDC (2009) guidelines on hand hygiene also propose
the use of alcohol base hand rub as a means for routine hand
disinfection.
Questions Related to the Identified Issue
1. What are the hand hygiene practices among Healthcare
workers?
Rationale
It is important to assess the types of hand hygiene practices
commonly used by healthcare workers so as to determine the
choices available and the recommended practices
2. What are the reasons for non-compliance with hand hygiene
practice?
Rationale
It has been noted that there is moderate to low rates of
compliance with standard hand hygiene practices among
healthcare workers. It is, therefore, important to get to know the
reasons behind the non-compliance.
3. What are the alternative hand hygiene practices?
Rationale
There exist more than one hand hygiene techniques from which
healthcare workers can choose preferred as well as the simplest
and most efficient method of hand hygiene practice.
4. What are the disparities in hand hygiene practices among
different healthcare workers?
Rationale
The non-compliance to hand hygiene practices vary across the
various cadres, ages and experience of health personnel. It is
22. important to know the personal factors that are attributed to the
variation between the different categories of health workers.
5. What can be done to improve hand hygiene practices in
healthcare?
Rationale
It is also important to assess the actions that can be taken to
encourage hand hygiene practices in healthcare.
The most appropriate question from the above-related questions
is; does hand washing and appropriate staff dressing among the
surgical ward nurses reduce cross infection during patient
management?
Description of the PICOT Question
The PICOT question is: Does hand washing and proper staff
dressing among the surgical ward nurses reduce cross infection
during patient management? The elements of the table are:
P- (Patient, population, or problem): nurses, hospitalized
patients
I- (Intervention): hand washing and appropriate dressing
C- (Comparison with other treatment/current practice): Nurses
forget to wash their hands when switching from one patient to
the other
O- (Desired outcome): Reduced incidences of cross infection
(Davies, 2011)
Ten Possible Keywords that Could Be Used When Conducting a
Literature Search for PICOT Question and A Rationale for Your
Selections
1. “Hand washing."
Rationale
Knowing the definition and practice of hand washing
2. “Hand hygiene."
Rationale
Alternative comprehensive description of clean hands
3. “Cross-infection”
Rationale
Assessing the effects of poor hand hygiene and its contribution
to transmission of micro-organisms from one person to the
23. other.
4. “Healthcare workers."
Rationale
The population or persons who participate in the study
5. "Healthcare-acquired infections."
Rationale
The results of transmission of micro-organisms through
unhygienic hands
6. “Hand washing guidelines."
Rationale
What are the recommended hand washing practices for
healthcare workers?
7. “Hand washing nonconformance”
Rationale
The percentage of conformity to the hand washing guidelines
8. "Hand hygiene strategies."
Rationale
The methods used to promote hand hygiene
9. "Nosocomial infections"
Rationale
The most common infection transmitted through unhygienic
hands in the ICU
10. “Hand hygiene and cross-infections."
Rationale
Determining hand hygiene and the relationship with cross
infections
Conclusion
Studies consistently show that better hand hygiene reduces the
risks of cross contamination and nosocomial infections in
Hospitals. Since most of the cross infections are thought to be
transmitted through the dirty hands of healthcare workers, an
assessment of the knowledge, attitude and practice of them is
also necessary. Hospital-acquired infections carry a serious and
real threat to all the patients admitted to hospitals, hence the
assessment of healthcare worker’s hand hygiene practices is
equally very significant.
24. References
Bukhari, S., Hussain, W., Banjar, A., Almaimani, W., Karima,
T., & Fatani, M. (2011). Hand hygiene compliance rate among
healthcare professionals.- PubMed - NCBI. Ncbi.nlm.nih.gov.
Retrieved 11 March 2016, from
http://www.ncbi.nlm.nih.gov/pubmed/21556474
Davies, K. S. (2011). Formulating the evidence-based practice
question: A review of the frameworks. Evidence-Based Library
and Information Practice, 6 (2), 75–80. Retrieved from
https://ejournals.library.ualberta.ca/index.php/EBLIP/article/vie
wFile/9741/8144
Pfoh, E., Dy, S., & Engineer, C. (2013). Interventions To
Improve Hand Hygiene Compliance: Brief Update Review.
Agency For Healthcare Research And Quality (US). Retrieved
from http://www.ncbi.nlm.nih.gov/books/NBK133371/
Pittet, D., Allegranzi, B., & Boyce, J. (2009). The World Health
Organization Guidelines on Hand Hygiene in Health Care and
Their Consensus Recommendations. Infection Control and
Hospital Epidemiology, 30 (7), 611-622.
http://dx.doi.org/10.1086/600379
McGonigle, D., & Mastrian, K. G. (2012). Nursing informatics
and the foundation of knowledge (Laureate Education, Inc.,
custom ed.). Burlington, MA: Jones & Bartlett Learning.
Royal Pharmaceutical Society. (2014). Hand washing plugged
as a way of cutting infection rates. The Pharmaceutical Journal.