Patient Advocate At A Federally Qualified Health Center (...

Over the past two years, I have been working as an ACA Patient Advocate at a Federally Qualified Health Center (FQHC). Throughout the course of the week, I interact with patients who are affected by age associated illnesses. At this community health center which serves a large, and indigenous uninsured population, my specific role as a patient advocate is to intervene, assist, manage and fight for my clients. I also provide assistance in interpreting and clarifying healthcare coverage. Lastly, I encourage my patients to engage in frenetic participation in the overall health insurance enrollment process. In so doing, I am ensuring that the health care needs of the public are met. Aging is a fact of life. As I grow older, I become†¦show more content†¦This ambitious agenda, aims to reduce federal spending and balance the budget within 10 years. Republicans and economist want to privatize Medicare turning it into a voucher-like program that subsidizes purchases of privat e health insurance. House Republicans have proposed this bill in order to fulfill the GOP goal of balancing the budget in 10 years. Having said that, I can only hypothesize that the amount of capital available to the â€Å"new† Medicare population will dwindle and the needs of elderly patients may not be met. Life expectancy has increased over the last century. With this greater survival rate, there needs to be an increase in the rate of spending for Medicare. Despite what one does to improve their health behavior, the need for medical care cultivates as one ages. This need will continue to increase significantly as medicine continues to modernize. Moreover, Medicare has improved quality of life and covers the essential health benefits one needs to stay healthy. Further, Medicare covers short-term home health care and covers the cost of paid companions who assist ‘seniors’ with activities of daily living at an affordable price. The National Government and Protecting the Public’s Health Article I Section Eight of the U.S. Constitution provides that the Congress shall have the power to lay and collect taxes, duties, imposts and excises, to pay the Debts and provide

Negotiable Instruments Under State and international Law - Free Essay Example

Sample details Pages: 4 Words: 1289 Downloads: 7 Date added: 2017/06/26 Category Law Essay Type Review Did you like this example? Negotiable Instruments 1 Part 1 Negotiable instruments are governed by both state and international law. Universally, the instruments are governed by the Universal Commercial Code (UCC) which defines negotiable instruments as unconditioned writing that promises payment of a fixed amount of money. Under the UCC checks are chiefly covered in article 3 and 4. The articles generally address check fraud litigation that emanate from check alterations, forging of the makerà ¢Ã¢â€š ¬Ã¢â€ž ¢s signature, payeeà ¢Ã¢â€š ¬Ã¢â€ž ¢s check endorsement or either counterfeited checks created by dishonest third parties (Ames, 1972). In a bid to help protect and recover losses made by victims of fraud, the UCC by implication endorses a policy that the loss resulting from fraud is best placed on the party that is best placed to prevent the occasioning of the loss. This implicit policy gives light in Nicholsonà ¢Ã¢â€š ¬Ã¢â€ž ¢s scenario that he has a chance of recovering hi s money back from either bank. In a real case scenario, a drawerà ¢Ã¢â€š ¬Ã¢â€ž ¢s check moves downstream from the drawer to the checkà ¢Ã¢â€š ¬Ã¢â€ž ¢s payee. The check then moves from the payee to the drawee bank that in turn pays out the amount shown. The offender may at any time in the sequence enter the stream. In most case scenarios, since the offending party who commits the fraud often disappears into thin air without a trace, the claim involves the injured party against the drawee bank that processed unendorsed or forged check. The drawee bank is generally liable in cases of processed checks with forged drawerà ¢Ã¢â€š ¬Ã¢â€ž ¢s signature while the depository bank is liable for claims that involve the payeeà ¢Ã¢â€š ¬Ã¢â€ž ¢s endorsement of the check (Ames, 1972). In Nicholsonà ¢Ã¢â€š ¬Ã¢â€ž ¢s scenario, the depository bank is liable for processing a check that did not bear the payeeà ¢Ã¢â€š ¬Ã¢â€ž ¢s endorsement. The bank depository bank had direct contact with Micha el Kittinger who presented the fraudulent check. Thu,s the depository bank was in the best position to verify the checkà ¢Ã¢â€š ¬Ã¢â€ž ¢s endorsement. The bank ought to have taken reasonable caution to establish that the check was not endorsed by the payee and was fraudulent thus making it liable in recovering Nicholsonà ¢Ã¢â€š ¬Ã¢â€ž ¢s money. In cases of double forgery where the drawerà ¢Ã¢â€š ¬Ã¢â€ž ¢s signature and endorsement are forged or unauthorized, the drawee bank is generally liable as it is held responsible for verifying the drawerà ¢Ã¢â€š ¬Ã¢â€ž ¢s signature. Subsequently, Nicholson may recover his money by suing the depository bank for conversion. The law permits an instrument to be converted if other than negotiation, it is taken by transfer, from an entity that is not permitted to implement the instrument or a bank that makes payment to a person who is not at liberty to implement the instrument or obtain any payment. According to the law, in a conversion claim , the measure of damages is presumed to be instrumentà ¢Ã¢â€š ¬Ã¢â€ž ¢s face value (Ames, 1972). To improve Nicholsonà ¢Ã¢â€š ¬Ã¢â€ž ¢s chances of recovering his money back, the law ought to be revised in fraud litigation actions to give rise to a new cause of action for contributing to the recovery of the losses solely based on shared culpability. Most state laws permit a bank to only charge customerà ¢Ã¢â€š ¬Ã¢â€ž ¢s accounts for checks that are deemed to be à ¢Ã¢â€š ¬Ã‹Å"properly made.à ¢Ã¢â€š ¬Ã¢â€ž ¢ The provision in turn creates room for claims against banks that impose charges its customers for checks à ¢Ã¢â€š ¬Ã‹Å"not properly payable.à ¢Ã¢â€š ¬Ã¢â€ž ¢ The claim may constitute an action for a breach of contract claim against the bank by a customer for paying an item that is not à ¢Ã¢â€š ¬Ã‹Å"properly payable.à ¢Ã¢â€š ¬Ã¢â€ž ¢ However, the parties in the contract may decide by agreement the standards b which the bankà ¢Ã¢â€š ¬Ã¢â€ž ¢s responsibility maybe measure d if the standards are not manifestly unreasonable (Ames, 1972). Additionally, to improve Nicholsonà ¢Ã¢â€š ¬Ã¢â€ž ¢s chances of recovering his money courts ought to embrace the use of conversion in check fraud claims and that depository bank ought to be allowed to recover from upstream banks for errors that may result in shifting liability. Nicholson may also sue the bank for indemnification and negligence to recover his money back (Ames, 1972). Part 2 Under the auspices of the UCC Joey can indeed recover his money from the 24 Hour check cashing company. The drawee bank, in this case, the 24 Hour check cashing company that paid out money after the check was presented is generally liable for claims that involve drawerà ¢Ã¢â€š ¬Ã¢â€ž ¢s signature. The bankà ¢Ã¢â€š ¬Ã¢â€ž ¢s liability arises as the bank is liable for claims that involving the drawerà ¢Ã¢â€š ¬Ã¢â€ž ¢s signature. The bank is held responsible for verifying the signature and anything that may arouse suspicion on the drawerà ¢Ã¢â€š ¬Ã¢â€ž ¢s check (McKeehan, 2001). In Joeyà ¢Ã¢â€š ¬Ã¢â€ž ¢s scenario, he was mugged by his assailant Stan leading to his bleeding on the check. Stan then took the check with blood stains on it and cashed it on the 24 Hour check cashing company where he withdraws all the money. The teller ignoring the blood stains on the check after verifying the checkà ¢Ã¢â€š ¬Ã¢â€ž ¢s proper endorsement handed over the money to Stan. The availability of blood on the check ought to have raised reasonable suspicion about the check. The bank via its employee had a duty to verify the authenticity of the check which was glaringly brought into issue by the availability of blood stains on the check. However, the bank failed to act on its duty of exercising ordinary care and negligently issued the money to Stan even after presenting a check that was doused in blood. On a reasonable point of view, the issuance of the money was as a result of a negligent act that ought to have be en prevented and led to the loss of Joeyà ¢Ã¢â€š ¬Ã¢â€ž ¢s money. Because the negligent act was perpetrated by the bankà ¢Ã¢â€š ¬Ã¢â€ž ¢s employee, the doctrine of vicarious liability makes the bank liable for any wrongs done by its employees in the scope of their work. In recovering his money, Joey can bring a claim of negligence against the bank based on the bankà ¢Ã¢â€š ¬Ã¢â€ž ¢s negligent act (Whaley, 1974). Subsequently, Joey can also plead legal duress as his defense against the bankà ¢Ã¢â€š ¬Ã¢â€ž ¢s refusal to repay his money back. Scholars articulate that an individual can plead duress in a claim brought against a bank for recovery of money if the individual can prove that he or she was the subject of immense pressure caused by another person at the time of the deedà ¢Ã¢â€š ¬Ã¢â€ž ¢ execution. Joey signed the instrument under threat and subject to physical violence that was evidenced by his bleeding on the check presented to the 24 Hour check cashing company by Stan . If an entity is forced to sign an instrument without his or her will, the entity is not legally bound to honor the terms of the instrument. Joey, in this case, was not bound by the transaction as his endorsement was obtained under duress (Palmer, G. E. (2001). Under the auspices of the UCC which protects negotiable instruments, duress invalidates delivery. Delivery of the instrument as well as the transfer of ownership from one person to another is solely based on mutual consent and duress invalidates that consent, thus constituting an illegality. There must be an intention on the part of the holder, in this case Joey to relinquish ownership of his possession to Stan. However, this intention was absent in the instrument (Palmer, G. E. (2001). Stanà ¢Ã¢â€š ¬Ã¢â€ž ¢s endorsement of the check was forcefully sought which constituted an illegality. An illegality renders a contract void and thus the bank is under no duty to enforce an illegal contract and ought to refund Joey his money back (Palmer, G. E. (2001). References Ames, J. B. (1972). The Negotiable Instruments Law. Harvard Law Review, 241-257. McKeehan, C. L. (2001). Negotiable Instruments Law. Am. L. Reg., 50, 437. Palmer, G. E. (2001). Negotiable Instruments Under the Uniform Commercial Code. Michigan Law Review, 255-310. Whaley, D. J. (1974). Negligence Negotiable Instruments. NCL Rev., 53, 1. Don’t waste time! Our writers will create an original "Negotiable Instruments Under State and international Law" essay for you Create order

Essay on Analysis of Mending Wall by Robert Frost

Analysis of Mending Wall by Robert Frost Robert Frost was inspired to write Mending Wall after talking with one of his farming friend Napoleon Guay. He learned from talking with his neighbor that writing in the tones of real life is an important factor in his poetic form (Liu,Tam). Henry David Thoreau once stated that, â€Å"A true account of the actual is the purest poetry.† Another factor that might have played a role in inspiring Frost to write this poem was his experience of living on a farm as a small boy. Mending Wall was published in 1915 along with a collection of Frost’s poems in North of Boston. Theme Statements Nature dissolves the barriers that humanity erects. The purpose of the wall in this poem was to isolate one’s†¦show more content†¦Apples come and go with the seasons, but pines are forever and never out of season. Change instinctively challenges and questions the ideals of tradition. In order to change, one must first break tradition. But, in the poem the old man does not wan t to change and break tradition. The person who is willing to question tradition and confront the problem is the young man. He uses those â€Å"w† words to ask the question, â€Å"There where it is we do not need the wall,† and â€Å"Why do they make good neighbors...Where are the cows?† The youth is asking logical questions, but is rebutted with the answer that, â€Å"Good fences make good neighbors†. The youth challenges the old man to say what is on his mind, but the old man is an, â€Å"old-stone savage armed,† who, has no ideas of his own and, â€Å"moves in the darkness,† of the traditions he follows. Tone Narrative and explanations (lines 1-22) In these lines, Frost is introducing the setting, characters, and the conflicts to the reader. We also get an explanation about how, â€Å"Something there is that doesn’t love a wall,† and how the wall has been damaged to the point where, â€Å"gaps even two can pass abreast.â₠¬  The reader is also introduced to the attitudes of the characters, and how they feel towards the wall. The youth is curious and jolly in the beginning, thinking it as a game. But, the old man is a complete opposite, he doesn’t say much and gets right to workShow MoreRelatedAnalysis of Mending Wall by Robert Frost Essay670 Words   |  3 PagesAnalysis of Mending Wall by Robert Frost Robert Frost is describing a process in Mending Wall, which is repairing a wall that separates his territory and his neighbors. The wall was deteriorated during the winter, when the cold frost created cracks and gaps in the wall. He uses a nearly infantile imagination to unravel the mystery of the damage that appeared suddenly in spring. 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Leonardo Da Vinci Artist Of The High Renaissance Essay

Leonardo da Vinci was considered one of the most influential artist of the High Renaissance, also known for his intellect. He was an illegitimate child, born to Ser Piero and a peasant women, Caterina in 1452 (Adams 292). His young life, not well known, could have been the subject of turmoil since his father had been married to more than one woman. At a young age Leonardo was apprenticed to Verrocchio, who was known for his artistic achievements and an owner of a bottega in Florence (Adams 292). During his apprentice to Verrocchio he would have been in charge of preparing, paints and surface areas for Verrocchio. Leonardo’s young life would be swayed by his education in humanities and a range of technical skills he would learn whilst Verrocchio. Leonardo had a string of talents that rendered his artistic abilities limitless. His talents included sketching, proportionality and spatial mechanics, linear perspective and a master of paintings. 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Blacks In Baseball Essay Research Paper Jackie free essay sample

Blacks In Baseball Essay, Research Paper Jackie Robinson Jackie Robinson was one of the best participants that proffesional baseball has of all time seen and greatly helped major conference baseball accept African American participants that otherwise would non hold palyed. Jack Roosevelt Robinson was born January 31, 1919 in Cairo, Georgia ( Hill 1 ) . Jackie # 8217 ; s gramps was a slave and his male parent a sharecrop farmer ( 1 ) . His ma and pa got a divorce when Jackie was merely a babe ( 1 ) . He, his female parent and four siblings moved after his parents got a divorce ( 1 ) . His female parent took all the kids and moved to Pasedena, California ( 1 ) . Not long after the household moved to Pasedena, Jackie # 8217 ; s female parent enrolled him into Pasedena Junior College ( # 8221 ; Robinson, Jackie # 8221 ; ) . He went on to University of California at Los Angeles ( UCLA ) ( 1 ) . Jackie was a standout in school athleticss at UCLA, he played football, baseball, hoops, and path ( 1 ) . He subsequently left college in the center of his junior twelvemonth to fall in the Army in 1941 ( 1 ) . Four old ages after come ining the Army Jackie was discharged because of a confrentation with another officer when he would non give up his place on a military coach ( 1 ) . He was discharged as a first Lieutenant ( 1 ) . After go forthing the Army Jackie wanted to play baseball, his favourite athletics. He tried out for many squads and was drafted by the Kansas City Monarchs Negro League Team ( Hill 1 ) . The Negro League agenda was really tuff. The squad was ever on the route playing games. Jackie did non like the life manner of being on the Monarchs ( # 8221 ; Robinson, Jackie # 8221 ; ) . He and his teammates would hold to defy the racial tensenesss everyplace they went ( Ward, Burns 285 ) . While Jackie was playing in the Negro Leagues, Branch Rickey, the Los Angeles Dodgers director was in secret directing out lookouts to look at Jackie and other participants in the Negro leagues that stood out above the remainder fo their baseball endowment ( Hill 1 ) . Rickey made the alibi to the lookouts that he wanted to set together an all black baseball squad called the # 8220 ; Brown Dodgers # 8221 ; ( 2 ) . He was truly looking for the right black participant that would interrupt the colour barrier in professional baseball ( 1 ) . Rickey looked at all his options and he chose Jackie Robinson of the Kansas City Monarchs ( 1 ) . He chose Jackie because of his accomplishments in baseball and his bravery ( 1 ) . Branch and Jackie met on August 28, 1945 to discourse his sign language to the LA Dodgers ( 1 ) . The meeting was really of import because rickey wanted to do certain Robinson would non revenge against the racialist remarks that he will be confronting if he was moved up to the LA Dodgers ( 2 ) . Rickey sent Robinson to the semi-professional squad the Dodgers had, the Montreal Royals ( # 8221 ; Robinson, Jackie # 8221 ; ) . While Robinson was with the Royals, he was he was an athletic standout with a batch of endowment for playing professional baseball ( Hill 1 ) . He enjoyed playing on the Montreal Royals because race was non truly an issue in Canada and he was really popular all over the state ( # 8221 ; Robinson, Jackie # 8221 ; ) . He led the Royals to the minor conference title ( Rydell 86 ) . The following season Robinson got moved up to the Los Angeles Dodgers professional squad tardily in spring preparation, merely five yearss before the Dodgers first game ( 86 ) . This gave the critics non much clip to respond to the new participant in the conference ( 86 ) . On April 15, 1947 Jackie became the first black participant to play major conference baseball in the United States ( 87 ) . Robinson # 8217 ; s traveling to the squad caused national indignation between managers, squads, and fans ( 87 ) . His new teammates signed a request to acquire him off the squad merely because he was black ( Ward, Burns 283 ) . The general directors and caput managers of the Dodgers including Branch Rickey and Pee Wee Reese kept him on the squad and encouraged him to remain and disregard the racial slurs and name naming ( Ward, Burns 283 ) . Other squads tried to boycott, but it did non work ( Rydell 86 ) . Robinsons first games were the hardest ( 86 ) . He had many decease menaces made against him ( # 8221 ; Robinson, Jackie # 8221 ; ) . The hotels that Robinson went to with the squad would non function him because inkinesss were non allowed ( # 8221 ; Robinson, Jackie # 8221 ; ) . Even though he would non acquire served at eating houses and hotels, he ever kept his composier and neer lost his pique ( Ward, Burns 283 ) . Robinson was ever called names but he merely ignored them and took a non-violent attack to the state of affairs ( # 8221 ; Robinson, Jackie ) . After many games Robinson started winning the regard of his fellow teammates, other squads, and fans by non contending back ( Rydell 86 ) . Not merely was Robinson the lone black participant in the major conferences, but he was besides one of the best. Stadiums filled with record Numberss of fans came to watch him play baseball ( Hill 2 ) . By the terminal of his first twelvemonth, he was a major conference ace ( 1 ) . Robinson led T he majors in stolen bases and was 2nd in scored tallies ( 1 ) . He was voted Rookie of the Year for the 1948 season ( 2 ) . Robinson had a really successful baseball calling. He proved all of his critics incorrect, they said Rickey merely wanted him because he was black and non how good he could play baseball ( Rydell 87 ) . He proved his critics wrong the really first game he played with the LA Dodgers ( 87 ) . He had four hits, including one homerun and two stolen bases ( 87 ) . After his dramatic first game Robinson started acquiring decease menaces, but ignored them and he kept on playing ( Hill 1 ) . After taking a successful calling in baseball Robinson retired from the game in 1957 ( Ward, Burns 289 ) . The LA Dodgers besides retired his figure ( Ward, Burns 289 ) . He opened a concatenation of eating houses in New York and moved on to persue another dream, to assist other black people become successful like he did ( Hill 2 ) . He foremost joined the National Association for the Advancement of Colored People ( NAACP ) and was on the board of managers ( Ward, Burns 289 ) . In 1963 he started acquiring involved with the civil rights motion ( Enders 1 ) . Robinson teamed up with Martin Luther King Jr. and went to Birmingham, Alabama to talk out against racism. King and Robinson went to many assemblages around the Birmingham country to talk out against racism ( Enders 1 ) . The two had a really difficult clip acquiring people together to talk to them because of all the force that was go oning as a consequence of the racialist South and the black motion ( Enders 2 ) . In 1963, while Robinson and King were traveling from church to church talking they learned that an NAACP officer Medgar Evers was murdered ( 2 ) . Shortly after the slaying Robinson sent a missive to President John F. Kennedy inquiring him to give Martin Luther King secret service protection ( 3 ) . Kennedy gave them the protection and subsequently on August 28, 1963 Robinson took his household to see Martin Luther Kings celebrated # 8220 ; I have a dream # 8221 ; address ( 3 ) . Subsequently in 1964, the Governor of New York and Republican presidential campaigner Nelson Rockefeller asked Robinson if he wanted to be one of his run managers ( 3 ) . He worked on the run for a short piece until Rockefeller lost Barry Goldwater ( 3 ) . In 1967 while Robinson was acquiring angry with the NAACP and he resigned because he thought they were non extremist plenty to take charge of the motion ( 3 ) . While Robinson was still really defeated and non satisfied with the manner things were traveling, he got a call from Hubert Humphery. He was a presidential campaigner from Minnesota. Humphery asked Robinson to run along side him and give addresss about the black rights motion. But Humphery lost to Richard Nixon ( 3 ) . One ground why the two campaigners that Robinson went with ended up losing was because America still did non like politicians that helped black people and that went along with their positions ( 4 ) . After the elections clip was have oning down Robinson and he went back place to populate with his household ( 4 ) . At his old age Robinson had endured a batch of hurting. Many of the close friends he had and household members had died including, John F. Kennedy, Martin Luther King and Malcom X who were all assassinated. Besides his female parent Mallie, Branch Rickey, and his boy Jackie Junior who died in a auto accident at the age of 24 ( Hill 2 ) . Near the terminal his life, Robinson was invited to throw the first pitch of the 1972 World Series. He died of a bosom onslaught ten yearss subsequently at the age of 53 ( 2 ) . Jackie Robinson was a great baseball participant and an every bit great civil rights leader. Although he neer got to see the integrating of black people in the United States, his attempts helped a batch of people. He was one of the great American heroes and is an American fable. His bravery gave the strength to other black jocks to persue their dreams. # 8212 ; # 8212 ; # 8212 ; # 8212 ; # 8212 ; # 8212 ; # 8212 ; # 8212 ; # 8212 ; # 8212 ; # 8212 ; # 8212 ; # 8212 ; # 8212 ; # 8212 ; # 8212 ; # 8211 ; Outline Thesis Statement Jackie Robinson was one of the best participants that professional baseball has of all time seen and greatly helped major conference baseball accept African American participants that otherwise would non hold played. I. Early Years A. History 1. School 2. Background B.Family 1.Five Siblings 2. Son of a Share Sharecropper II.School A.College 1. Pasadena Junior College 2. UCLA B.School Sports 1. Baseball favourite 2. Excelled in four athleticss III. Baseball A.Semi Pros 1. Monarchs 2. Royals B. Pros 1. LA Dodgers 2. Retirement IV.Civil Rights A. Civil Movement 1. Martin Luther King 2. Birmingham, Alabama B. NAACP 1. On board of managers 2. Resigned V. Later Years A. Diseases 1. Diabetes 2. Heart Problems B.Deaths of loved 1s 1. three friends assassinated 2. Family members # 8212 ; # 8212 ; # 8212 ; # 8212 ; # 8212 ; # 8212 ; # 8212 ; # 8212 ; # 8212 ; # 8212 ; # 8212 ; # 8212 ; # 8212 ; # 8212 ; # 8212 ; # 8212 ; # 8211 ; 382 # 8220 ; Robinson, Jackie # 8221 ; Computer Software. Encarta. Microsoft Corporation, 1996. IBM

Nurses Role in prevention of HAIs Free-Samples for Students

Question: Why do Nurses Practice hand Hygiene and use protective gear? Is there emerging evidence that could inform changes to practice? Answer: Hospital-acquired infections, are those that one acquires within a healthcare unit and present themselves in the first 48 hours following a hospital admission; or infections that occur after 30 days following discharge from a hospital after a time of admission (Revelas, 2012). HAIs are not related to the original infections or illnesses that first bring a patient to a hospital and neither are they present in the incubation stage at the time that a patient is admitted (WHO, 2015) Several reasons have made the prevalence of HAIs in the 21st century to reach alarming rates. Some of these reasons include hospitals that have large populations within their premises who on average, are sicker and with weak immune systems; increased cases of treatment in the outpatient departments which implies that persons who are in the hospitals are on average more sick; many medical procedures which navigate around the natural protective body barriers; movement of medical staff from one patient to another which offers pathogens a vehicle for spreading; inadequate adherence to sanitation protocols with reference to equipment and uniform sterilization, washing as well as other measures for prevention which may be ignored by personnel which insufficiently isolate the patients from being infected by the disease agents; and the anti-microbial agents' routine use within hospital settings which creates pressure for emergence selection for the resistant microorganism strains (Revelas, 2 012). Occurrence of Healthcare-Associated Infections is common in both paediatric and adult patients. The most common infections among children include blood stream infections, UTIs and pneumonia while the commonly occurring infections in adults are UTIs. Among children, those that are below 1 year, babies born with very low birth weight of less than 1000 grams, and children admitted at the NICU or PICU, have the highest rates of Healthcare Associated Infections (Reed Kemmerly, 2009). This paper discusses the role that nurses can play in the prevention of HAIs and will look into four literature pieces to further expound on the topic. The research articles were searched from Google Scholar (See Appendix 1 for detailed breakdown). HAIs are spread via several routes such as surfaces (more so, hands), water, air, and oral passageways. However, there are also several interventions that are non-pharmacological and which can be used to reduce prevalence of HAIs which are often ignored by personnel. The best and most adequate intervention is the use of hand washing practice as it prevents the spread of most HAIs. However, the number of healthcare providers that actually engage in this simple exercise is surprisingly low and ranges from 20-50percent for every hospital patient that they get in contact with although some researchers have reported rates of close to 81percent. The hands of healthcare providers often carry viable pathogens and these include Clostridium dif?cile (59percent), Acinetobacter spp. (15percent), and Klebsiella spp. (17percent), Pseudomonas spp. (1.3-25percent), MRSA (16.9percent), rotavirus (19.5-78.6percent), yeasts (including Candida) (23-81percent), and VRE (1percent). Several studies have shown that frequent washing of hands can reduce HAIs rates including those of MRSA although there are those studies that have shown a negative relation. and washing solutions that are alcohol-based are considered to be generally better compared to washing hands with soap and water, Comparisons of hand washing with soap and water have shown that there are lower rates of HAIs when the soaps used are either triclosan, chlorhexidine, or alcohol based. Besides washing hands, nurses and other personnel can reduce prevalence of HAIs by wearing gloves to protect themselves and the patients from infection. There are a number of studies that have demonstrated that latex gloves have shown to be more effective in the prevention of viruses and water penetration when compared to vinyl gloves as cited by the authors. However, approximately 3-16 percent of nurses and healthcare personnel are sensitive to latex and will sometimes report severe reactions of the respiratory system. The powder free gloves are highly recommended for use in hospitals as they release latex levels that are much lower. Nurses and healthcare workers should ensure that they wear sterilized gowns when attending to patients who have infectious diseases. There is sparse data linking gown use and prevention of HAIs. However, one study as cited by the authors, showed that the use of gowns in ICU was linked to a reduction of VRE by approximately 54 percent P 0.01). The study also showed that using gowns also had an economic benefit by reducing the ICU net costs by close to $420,000 and averted 58 cases of VRE. Another study also showed that gown use was linked to insignificant and modest drop in rates of MRSA cases. The rates at which gowns are used by staff when attending to patients that have contact precautions has been reported to be 76percent among the hospital staff and only 65percent for persons visiting the patients. Besides gowns, head and shoe covers need to be used in areas that contain patients that are immunocompromised or those being prepared or undergoing surgery. Although there have been studies that the shoe covers used by healthcare staff in such scenarios do indeed collect pathogens, the spread of the same is very minimal. The authors cite one study showed that wearing shoe covers and gowns during a bone marrow surgery of a patient did not reduce the risk of the patient in a significant way as was measured by the antibiotic therapy used. Another study showed that wearing headgear during a sham surgery did not significantly reduce the probability of airborne bacteria when compared to not wearing a headgear. The four common types of HAIs as stated by the authors were surgical site, urinary tract, Pneumonia, and blood stream infections BSI (Horan, Andrus, Dudes, 2008). SSIs are linked to approximately 1/3 of all nosocomial infections, while UTIs and BSIs that are catheter associated, and VAPs account for the remaining 2/3. There are many protocols that nurses and other hospital personnel can follow besides those mentioned earlier. One such protocol discussed in the research by Tsai et al., (2014) is decolonizing personnel prior to a patient surgical procedure. In decolonizing personnel, the authors cite one study assessed its effects specifically on a surgical team (Portigliatti, Mognetti, Pecoraro et al., 2010). The study identified carriers among the surgical team which comprised of nurses, doctors, and anaesthesiologists who were subsequently treated using mupirocin administered intranasally. In retrospect, 1000 consecutive patients that had SSI were recorded as being 6%. 300 consecutive patients examined post intervention, had yielded 0% of SSI rate. Though there needs to be further studies done, the preliminary findings are indicative that healthcare personnel including nurses are responsible for the spread of microorganism during operation procedures. This therefore, calls for institution-wide decolonization and screening of personnel as it promises to be a successful and feasible preventive measure. There are currently very few hospitals that carry out personnel screening procedure which is in contract t the mandatory screening tha t hospitals are expected to adhere to with regard to TB screening of employees. Ventilator associated pneumonia occurs frequently among patient using mechanical ventilators and is the second most frequently occurring HAI (Sedwick, et al. 2012). The VAP mortality rates are at 29-70percent which far exceed those of other (Mietto et al., 2013). That said, nurses are tasked with ensuring that VAP is controlled within the hospital settings and this requires collaboration among all nursing staff to ensure best practice implementation is achieved through knowledge dissemination. Educational interventions are an effective way of increasing knowledge among nurses. Along with educating nurses, assessment and on-going support is necessary for the evaluation of compliance as well as in determining the patient outcome impact of the education. At the entire institute level, APRNs can develop and implement modified VAP bundle that is evidence based to initiate in the Emergency Room. Evidence shows that goal-directed early therapy is useful in improvement of patient outcomes as well as in reducing hospital costs. For the APRN to accomplish these, he/she would need to take up a temporary leadership role within a team of interdisciplinary professionals for further development, implementation, and evaluation of the modified VAP bundle. By developing the said interdisciplinary team within the ER, the institutional support will be assured with regard to initiating, piloting, and evaluating the intervention within the ER. If the VAP rates decrease, then the nurse wil have succeeded in implementing a practice change to reduce HAIs. Hand washing has been shown to be effective in reducing HAIs however; other potential means of transmission need to be focused on including, common vehicles, environment, bodily fluid, air, and droplets. By gaining an understanding of the different modes of transmission, nurses can better grasp the importance of implementing several other interventions for the control of HAIs besides just hand hygiene. It is recommended that nurses should be educated on pathogen target interventions to minimize disease outbreaks. In addition to this, the nurses need to be educated on the importance of carrying out HAIs routine surveillance as well as identifying vulnerable patients to HAIs in order to highlight problematic HAIs while reducing their transmission and outbreaks. Conclusion HAIs are preventable and it is the duty of nurses as well as other personnel, to ensure that patients are protected from nosocomial infections. Deliberate acts of prevention of HAIs such as simple hand hygiene, wearing of sterilized gowns; head gear, shoe cover, and un-powdered latex gloves should be enforced in hospital settings. In addition, other prevention and control strategies such as decolonization of personnel prior to surgical procedures ought to be adopted. Lastly, continuous education for nurses with regard to criticality of control and prevention of HAIs should be implemented in all hospital settings References Curtis, L. T. (2008). Prevention of hospital-acquired infections: review of non-pharmacological interventions.Journal of Hospital Infection,69(3), 204-219. Ferrazzano, D. M. (2014). Preventing Ventilator-Associated Pneumonia: Educating Emergency Room Nurses. (Retrieved on 28th April, 2017) https://digitalcommons.ric.edu/cgi/viewcontent.cgi?article=1039context=school_of_nursing Horan TC, Andrus M, Dudeck MA: (2008). CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control, 36: 309-332. Mietto, C., Pinciroli, R., Patel, N., Berra, L. (2013, June 1). Ventilator associated pneumonia: evolving definitions and preventative strategies. Respiratory Care Journal, 58, 990-1007. https://dx.doi.org/10.4187/respcare.02380 Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., Prisma Group. (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.PLoS med,6(7), e1000097. Portigliatti Barbos M, Mognetti B, Pecoraro S, Picco W, Veglio V(2010). Decolonization of orthopedic surgical team S. aureus carriers: impact on surgical-site infections. J Orthop Traumatol, 11: 47-49. Rashleigh-Rolls, R. M. (2016).Hospital acquired infections: outbreaks and infection control interventions, a national descriptive survey(Doctoral dissertation, Queensland University of Technology Reed, D., Kemmerly, S. A. (2009). Infection Control and Prevention: A Review of Hospital-Acquired Infections and the Economic Implications.The Ochsner Journal,9(1), 2731. Revelas, A. (2012). Healthcare associated infections: A public health problem.Nigerian Medical Journal?: Journal of the Nigeria Medical Association,53(2), 5964. https://doi.org/10.4103/0300-1652.103543 Sedwick, M., Lance-Smith, M., Reeder, S., Nardi, J. (2012, August, 2012). Using evidence-based practice to prevent ventilator-associated pneumonia. Critical Care Nurse 32(4), 41-51. Tsai, D. M., Caterson, E. J. (2014). Current preventive measures for health-care associated surgical site infections: a review.Patient safety in surgery,8(1), 42. WHO (2015). Clean Care is Safer Care: The burden of healthcare associated infections worldwide. (Retrieved on 30th April, 2017). https://www.who.int/gpsc/country_work/burden_hcai/en/