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/

The Nature of Hamlets Ghost free essay sample

Hamlet tries to decide whether his father’s ghost is from Heaven or Hell. â€Å"O all you host o heaven! O earth! What else? And shall I couple hell? † (1. 5. 91-92). Fig. 1. Thompkins, Hamlet, The Shakespeare Art Museum, Toledo, OH. Hamlet seems very perplexed by the nature of his father’s ghost. His decision on the nature of the ghost’s intention is prolonged further by his melancholy. To help himself come to a conclusion Hamlet seems to turn to Lavater’s Of Ghosts and Spirits Walking by Night in which Lavater provides explanations on how to verify the intentions of a spirit. Whether the ghost’s purpose for visiting the realm of the living is evil or good is determined by a great number of things. â€Å"Good spirits do appear under the shape of a dove, a man, a lamb, or in the [light] of the sun† (Lavater 115). King Hamlet appears in the shape of a man, but does exhibit traits of an evil ghost by â€Å"teach[ing lessons] that doth vary from the doctrine of the apostles, and other doctors approved by the church’s censure† (Lavater 115). We will write a custom essay sample on The Nature of Hamlets Ghost or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Because of this ambiguity, Hamlet further delays his proceedings by validating the story King Hamlet’s ghost told him about Claudius’s vile crime. He does this by putting on a play in which â€Å"one scene of it comes near the circumstances of†¦ [his] father’s death† (3. 2. 67-68). Based on Claudius’s reaction Hamlet believes the ghost was truthful in his story, but still Hamlet delays due to his melancholy. Hamlet, due to the fact that the ghost was telling the truth and he was ordered to kill a villain, Hamlet eventually comes to the conclusion that Hamlet’s spirit is one of good nature shown by his reaction to King Hamlet’s appearance in his mother’s chambers, â€Å"Save me and hover o’er me with your wings, you heavenly guards† (3. . 105-106). In the Wood Cut Hamlet (Fig. 1), Hamlet displays his greatest act of melancholy. â€Å"Hamlets visage is grim. He clutches a sword with three impaled bodies† (Thompkins) but demonstrates an expression of indecision. â€Å"The idea of murder was alien to [Hamlet’s] disposition† (Thompkins), but now even a fter he has killed Claudius, Polonius, and indirectly, Ophelia, he still is unsure of his course of action. And standing ominous over Hamlet’s shoulder is King Hamlet, the catalyst of this tragedy. His visit to Hamlet caused this carnage. Hamlet struggles throughout the play to obey his father’s words and â€Å"taint not the mind† (1. 5. 85). Although Hamlet may believe his is doing as directed he destroys any relationships he had with his mother and Ophelia and he destroys the lives of Laerates and Polonius. In the wake of Hamlet’s dark and simmering rage he does not only taint his mind but also his very soul.

Finding Good Microeconomic Essay Topics

Finding Good Microeconomic Essay TopicsMicroeconomic essay topics to help you generate and process information quickly while comprehending new concepts. Topics that can be used in this kind of writing include business, economics, psychology, life, gender, society, and the environment.Nowadays, an increasing number of high school students are writing papers, and students have become quite adept at writing essays. However, it is not easy to write long academic papers as compared to short papers. A single paragraph essay containing many sentences and paragraphs, no matter how good it is, cannot compete with a more complex work.The internet provides ample space for students to post their ideas and choices for topics that can form the basis of their essay. As long as you can write an engaging and interesting topic and make use of a novel theme, then the chances of getting a favorable reading from the teacher are likely to be high.The importance of using good essay topics for students to w rite their papers is well known. But most students cannot take the time to think about what they want to write. Essay topics are very important because these determine the kind of paper you will submit to college, and whether you will pass or fail.A student who really wants to get good grades will find it hard to answer that question. However, you must be careful not to rely too much on your subject knowledge. Students should be encouraged to diversify their writing by making use of what they know about their class.For microeconomic essay topics, students should provide the name of their favorite author or perhaps just an idea. The choice of writing theme, theme in general and your writing style should be fully integrated. If possible, try to combine these elements so that there is a balance between theme and style. The topic should give the student a lot of ideas that hecan discuss in the papers.Essays can not only be published as the standard types of essays but also written as a part of reports, business courses, and thesis. When students make use of these topics in their papers, they will surely come up with engaging papers that will stand out among others.

How to Treat Gummosis, or Bleeding in Tree Bark

How to Treat Gummosis, or Bleeding in Tree Bark Bleeding bark on  trees and other woody plants  often leads to concern when its discovered by tree growers and yard tree owners. Gum or sap draining from a tree trunk or limbs is common in trees in the genus Prunus, which includes peaches and cherries, but it can happen in many species. This sap flow can be caused by biotic diseases, which are triggered by living organisms such as fungi, and abiotic injury, caused by non-living factors such as sunlight and temperature change. One textbook definition gummosis is the copious production and exudation of gum by a diseased or damaged tree, especially as a symptom of a disease of fruit trees. But it also can be an early symptom of other problems, not only in orchards but in prized landscape trees in yards, parks, and forests.   Gummosis can weaken a tree, but it isnt the end of the world. Bleeding or oozing of sap from a tree, although not normal, wont necessarily permanently harm a tree or woody plant; most of them will survive. Its also important to remember that there are many causes for free-running sap from trees, including insect borers, cankers, bark injury, and a variety of diseases. Controlling these sources of damage will control gum deposits and sap flow, but there usually is no cure. Causes Gum exuding from cherry, peach, and sweetgum trees is common, so keep an eye on these species. Gummosis isnt a pathogen in itself but the response to environmental stress from pathogenic, insect, or mechanical injury. Pathogenic infectious diseases and cankers that result in bleeding sap can become problematic in fruit orchards. Particularly, the  cytospora canker, or perennial canker, commonly causes fungal bleeding in stone fruited trees such as apricot, cherry, peach, and plum. This infection can be distinguished from insect damage and mechanical injuries because sawdust or pieces of bark arent mixed in the sap, as would be the case with insect or mechanical damage. It isnt vital for you to identify the specific cause or causes involved, but its very important to differentiate between insect infestation, mechanical injury, and infectious disease for diagnosis. Prevention and Treatment There are management practices you can follow to lower the risk of gummosis: Be careful when using lawn and garden equipment to avoid tree tissue injury, which can harbor fungal spores.Prevent winter cold injury to your tree by planting cold-hardy species within their hardiness zones and outside isolated wind  avenues.Maintain a trees health to discourage boring insects.Prune and dispose of limbs during late winter.Try to identify whether the tree has been injured mechanically, been attacked by insects, or infected by a disease. Typically, mechanical injury and insects will leave exposed sapwood or sawdust. Treat the  causes as best you can while increasing the most comfortable tree conditions for optimal health. Increasing tree vigor is important and will yield great results. One helpful treatment is applying several pints of garden lime under the tree drip line if your site has a low to moderate PH. Raising soil Ph to 6.5 can do wonders for tree health.

Lab Report #2 Example | Topics and Well Written Essays - 1750 words

#2 - Lab Report Example Measurement is an essential aspect mainly utilized in the scientific field to quantify diverse forms of matter. This entails determining the objects’, quantity of matter, volume and their densities (Wilson & Cecilia 242). However, an object’s exact measurement despite one being an expert, accuracy mainly relies on the equipments a person utilizes to take diverse measurements. This is due to the imperfections, which result from the equipments’ errors while a researcher is taking measurements of different types of matter or their parts. Therefore, it is essential for the researcher to have adequate knowledge regarding how to minimize errors via being able to manipulate the readings one attains while measuring. Since this varies across the equipments, where some are complex especially if one lacks proper knowhow regarding particular equipment (Wilson & Cecilia 39). The study’s focus encompasses measurements of diverse objects coupled with determining their l engths, mass, volume and densities. 1. The initial step was to take the readings of a copper wire with the help of a metric ruler. This is by placing the wire on the metric rule, reading the positions of the two sides and estimating the readings to approximately tenth of a millimeter. Then developing four sets of independent measurements to approximately 0.01cm in centimeters by estimating using diverse parts of the meter rule 3. The diameter of the copper wire was measured with the aid of a micrometer caliper where the measurements’ approximation was 0.0001cm. To increase the accuracy of the study, it entailed obtaining six independent recordings in a table. Despite the experiment carried out with high level of keenness to shun any possible errors that may emanate from carelessness or readings’ improper taking, they were inevitable. Mainly, the source of errors in this study that have prompted the results to deviate from the ordinary expected

Communication and practice within the early years environment Essay - 1

Communication and practice within the early years environment - Essay Example It will be a way for the practitioner to assess whether or not she is on the right track in terms of communicating effectively with children, parents, colleagues and other professionals and make the necessary amendments to be a better communicator. Interpersonal communication is the process of sending and receiving information between two or more people. Almost anything that takes place in work and personal life involves communication (Dubrin, 1996). It consists of verbal and nonverbal interactions which play a part in the effective exchange of ideas. Lefebvre (2008) advises that when speaking, one must also be aware of body language and tone and inflection of voice. She notes that different ideas may be conveyed by simply emphasising different parts of the statement. Being an active listener helps one understand the message being relayed to him. As the listener, one should hold his response until the speaker is done, and keenly observe nonverbal cues expressed. It must always be rem embered that communication is a give and take process. One must learn to wait his turn to be the speaker and the listener (Lefebvre, 2008). This is one important key in effective communication. Although currently, there are many available forms of communication, this essay will be limited to the discussion of face to face interpersonal communication, most especially in the context of the early years environment. It will draw specific, practical examples from the practitioner’s experiences in placement. Verbal communication or speaking out to another person is often accompanied by non-verbal language which includes facial expressions, gestures, posture, body language and tone of voice. Sometimes, such non-verbal expressions say more than the verbalizations of a person. Whereas verbal language must be delivered clearly for it to be understood, it is much more difficult with non-verbal language (Lee, 2008). With verbal language, most of the time, the verbalization is thought out first, before a person releases it. However, with non-verbal language, it naturally comes out, even without thinking. Hence, the non-verbal communication can sometimes betray what a person says when his actions are not compatible with his words. Usually, this is where miscommunication occurs (LeFebvre, 2008). An individual’s communication skills reflects his emotional intelligence. Goleman (1998) defines emotional intelligence as one’s capacity for recognising one’s own feelings and those others, to be able to motivate oneself and manage emotions well for one’s sake as well as for his relationship with others. This means that if one knows how he will react to a certain situation, he will be able to manage his communication style better and be able to send his message across effectively. Thus, it is essential that a practitioner becomes emotionally intelligent in dealing with various situations in placement in order to establish and maintain harmonious in terpersonal communication (Goleman, 2006). From the placement period with young children, the practitioner learned how important interpersonal communication is. Through daily interactions with children, they develop relationships that help them about themselves and the world that is why adults in the early years setting should be able to create and maintain positive and healthy relationships

Marketing case Essay Example | Topics and Well Written Essays - 1250 words

Marketing case - Essay Example ions were manifested regarding the introduction and marketing of casual runners and walkers in 11 new designs, instead of focusing on the 5 designs that the company has produced for the last 15 years. There are different symptoms that were identified in the case such as: (1) an eroding regional share; (2) eminent failure to increase the share in the broader market; (3) inability to cope with production of more designs using the present workforce; and (4) ineffective advertisements that confused old customers more than attracting new ones. From these symptoms, one could deduce that using the 5 Why Analysis: why was there an erosion in regional share? (could be due to increasing competition where more product options were available); why did they fail to increase the share in a broader market base despite increasing the number of designs? (could be due to their inability to cope with the required high quality expected of the products they produce); why were they unable to cope with the production of new designs (maybe their present staff of 35 production workers could not comply with the increased product designs or there were failure to detect the quality of work outsourced from t wo plants in South Korea); and, why was there ineffective advertisements (maybe due to the increase product designs, management could not focus on the product and marketing strategies that they want to project to the consumers). In this regard, after closer evaluation, the root problem actually stemmed from the overexpansion in product lines and designs that have not been supported by appropriate marketing strategies to enhance public awareness and to establish core competence and competitive advantage for a particularly strong product brand or line. 1. What had Henry done right? Actually, Henry was right in identifying that Pacer must respond to the changing and increasing demands of the athletic shoe market. The industry’s largest players begun to go after their established market