Write a brief review of Rebecca’s Skloot’s book, “The Immortal Life of Henrietta Lacks” as if it were going to appear in a newsletter dedicated to graduate students in health psychology.

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Write a brief review of Rebecca’s Skloot’s book, “The Immortal Life of Henrietta Lacks” as if it were going to appear in a newsletter dedicated to graduate students in health psychology.

 

The Immortal Life of Henrietta Lacks
Write a brief review of Rebecca’s Skloot’s book, “The Immortal Life of Henrietta Lacks” as if it were going to appear in a newsletter dedicated to graduate students in health psychology. Identify at least two concepts we have discussed at any point in the semester that appear in or are relevant to the book, and give an opinion (pro or con) on the book’s usefulness in graduate psychology education.

Patient Safety in the ICU

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PATIENT SAFETY


Patient Safety in the ICU

Safety in patient care has been of concern since the release of the Institute of Medicine Report in 1997 attributing human error to between 4 percent and 16 percent of sentinel events. However, the report did little to inspire medical professions to develop concerted actions to improve patient safety and reduce the frequency of deaths in hospitals resulting from human error. More recently, Rodziewicz and Hipskind (2019) cited medical errors as the leading cause of death in the United States. The authors contend that it remains challenging to “uncover a consistent cause of the errors and, even if found, to provide a consistent, viable solution that minimizes the chance of a recurrent event.” Medical errors remain a public health concern whose resolution requires identifying the root causes from that include the working environment, equipment distribution, working conditions and skills among personnel, and lack of effective communication amongst staff.


Human factors or ergonomics are individual components in the treatment of patients in hospitals. Thus, systems governing treatment processes in hospitals should be based on the nature of the task and the understanding of human behavior, thereby requiring a multi-disciplinary approach (Rodziewicz and Hipskind, 2019). This approach involves the input of multiple stakeholders in and without the hospital, and the collaboration of teams rooted in specialized knowledge, equipment delivery, communication, and a functional environment. These attributes result in reduced medical errors in the ICU setting. The fishbone diagram below is a summary of the causes and effects of factors resulting in an increase of mortality in ICUs. As earlier indicated, the environment, equipment, people, and communication are the primary cause of deaths in the ICU.

PATIENT SAFETY

Source: Eleanor Wilkinson, 2019.


Communication

Communication among caregivers is critical for any functional team (Despins, 2009).

Citing a report by The Joint Commission National Patient Safety, Despins contends that ineffective communication is among the leading causes of sentinel events. The multinational

Sentinel Events Evaluation study indicates that over 20 percent of ICU patients experience critical incidents following the lack of adequate communication between staff (Ellison, 2015). According to Ellison, reporting systems are among the non-technical skills that lead to increased frequency in critical incidents. The author contends that among the common forms of errors in the ICU included inability by clinicians to “communicate order changes to nursing staff, incorrect patient information passed between different teams, and inadequate information dissemination on severely ill patients transferred to ICU” (Elisson, 2015). In their resolve, the authors poised that communication between teams working in the ICU was critical following the multitude of activities requiring effective communication.


PATIENT SAFETY

Another aspect of communication in the ICU found inhibiting effective communication is the mode of transmission of data. The consensus among medical professionals is that digital data transmission is more effective than verbal or paper-based communication (De Georgia et al., 2015). The authors contend that critical care “involves highly complex decision making often involving intense data; however, the approach of data collection and management remains unchanged.” It remains of concern the large volumes of data are collected from multiple sources and reviewed retrospectively. In this regard, De Georgia et al. raise concerns over the inability of medical personnel working in the ICU to convert data from the numerous types of equipment present to a digital format that can be stored or sent offsite. The limited device interoperability and integration, and the challenges in analytical approaches “provide little insight into the patient’s actual pathophysiologic state.” Unfortunately, even with modern clinical information systems present in hospitals, limitations remain on the acquisition, synchronizing, integrating, analyzing, and transmitting data. However, these challenges are surmountable if medical personnel can effectively communicate with each other and send available data digitally as the world awaits the development of integrated critical care informatics capable of supporting clinical decisions making and with data transmissions capabilities.


Equipment

For years, medical professionals have grappled with the shortage of medical equipment, low-quality equipment, or poor maintenance of equipment. Moyimane et al. (2017) contend that the lack of medical equipment adversely influences patients, particularly those in the ICU. The challenge of lack of medical supplies resulting from supply chain inefficiencies has been ongoing in the United States. Guillot (2018) asserts that inventory management fails to meet the demand for medical equipment. In instances when suppliers can meet demand, Guillot postulates that many facilities order, replenish a supply their hospitals in an inefficient and costly manner. In this regard, medical distribution should be automated. According to Guillot, “automating hospital supply chains can improve visibility and enable more accurate forecasting as well as reduce costs throughout the healthcare continuum.”


Environment

The location of the medical room can influence the morbidity and mortality rates among ICU patients. A study by Okech (2014) found critically ill patients, particularly in countries in the global south, did not have access to ICUs or the ICU setups lacked in essential equipment and inconsistent or had poorly maintained equipment and had faulty

layout. In the United States, similar challenges exist regarding the defective plan of the ICU, which, according to Reiling and Murphy (2008), affects patient safety. The authors contend that the hospital layout, with its technology and equipment, has not been a concern of many scholars, yet, billions of dollars are spent in these facilities. Cognitive psychologists share similar sentiments. They argue that the physical environment significantly influences the safety and human performance (Leape, 1994). As such, it is critical to understand the interrelationship between the context in which humans work and the tools they use particularly in healthcare, whereby, the performance of the medical personnel is dependent on the environment.

Indeed, conditions for errors are exacerbated by organizational factors. Reiling and Murphy (2008) argue that faulty layouts in hospitals are “latent conditions that may lie dormant within the system for a long time, only becoming evident when they combine with other factors to breach the system’s defenses.” Nonetheless, such latent conditions can be identified and remedied, thereby preventing adverse events from occurring. As such, the location of the medical room can be attributed to specific medical errors and not others.

According to Reiling and Murphy (2008), such faulty layout occur following the “blunt end, where administrators, the work environment, and resources determine the processes of care delivery.” Though unintentionally created, these underlying conditions can be reduced by researching before designing a hospital layout, or designing facilities, particularly the medical room, that is movable. Furthermore, by targeting human factors in the design of hospital and ICU layouts, Reiling and Murphy (2008) contend that underlying conditions and cognitive failures can be kept at a minimum and consequently, improve patient safety.


People

Trends in hospital use and staffing patterns resulting in nurses and other personnel overworking remains potentially hazardous for patient safety. Nurses, in a study conducted by Rodgers et al. (2004), reported deficiencies in working conditions that have been reported for decades citing long and unpredictable working shifts and poor working condition as the leading contributor to error. Glette, Aase, and Wiig (2017) cited reasons for irregular working shifts as resulting from understaffing. The authors contend that patient safety and the occurrence of sentinel events results from understaffing, sentiments shared by many scholars, including Kiekkas et al. (2019). Although the authors did not find an increase in ICU mortality among nurses with an increased workload, it remains possible that overworking nurses and understaffing has an influence on the prevalence of sentinel events. ICU patients require individual care by adequately matching personnel the number of patients. Hospitals should also keep patient nurse’s workload if they are to reduce the severity of sentinel events.


Conclusion

Scholarly evidence point sentinel event in ICUs as resulting from the environment, communication challenges, staffing issues, and logistics and challenges with the medical supply chain. Nonetheless, multiple scholars have found ways to address these challenges that include ensuring adequate staffing of nurses, developing communication strategies that circumvent the current lack of technology in data transmission, implementing new supply chain strategies to overcome inventory management challenges, and placing emphasis on the design and layout of hospital plans. These initiatives improve service delivery, ensure adequate care is provided to ICU patients, and reduce morbidity and mortality rates in the ICU.


References

De Georgia, M., Kaffashi, F., Jacono, F., & Loparo, K. (2015). Information Technology in Critical Care: Review of Monitoring and Data Acquisition Systems for Patient Care

and Research. The Scientific World Journal 1–9.

Despins, L. A. (2009). Patient safety and collaboration of the intensive care unit

team. Critical Care Nurse, 29(2), 85-91.

Ellison, D. (2015). Communication skills. Nursing Clinics, 50(1), 45-57.

Glette, M. K., Aase, K., & Wiig, S. (2017). The relationship between understaffing of nurses

and patient safety in hospitals-A literature review with thematic analysis. Open

Journal of Nursing, 7, 1387 – 1429.

Guillot, C. (2018). Facing inventory problems, hospitals automate their supply chains.

Supplychaindive. Retrieved from supplychaindive.com/news/hospital-inventory-

automation-case-study-Cardinal-White-Memorial/520004/

Kiekkas, P., Tsekoura, V., Aretha, D., Samios, A., Konstantinou, E., Igoumenidis, M., … &

Fligou, F. (2019). Nurse understaffing is associated with adverse events in

postanaesthesia care unit patients. Journal of clinical nursing, 28(11-12), 2245-

2252.

Leape, L. L. (1994). Error in medicine. Jama, 272(23), 1851-1857.

Moyimane, M. B., Matlala, S. F., & Kekana, M. P. (2017). Experiences of nurses on the

critical shortage of medical equipment at a rural district hospital in South Africa: a

qualitative study. Pan African Medical Journal, 28(1), 157.

Okech, D. (2014). A Survey Of Icu Setups In The Republic Of Kenya. Dissertation. Retrieved

from repository.uonbi.ac.ke/bitstream/handle/11295/74857/Umani.%20%20%20A

%20SURVEY%20OF%20ICU%20SETUPS%20IN%20THE%20REPUBLIC

%20OF%20KENYApdf?sequence=2&isAllowed=y

Reiling, J., Hughes, R. G., & Murphy, M. R. (2008). The impact of facility design on patient safety. In-

Patient safety and quality: An evidence-based handbook for nurses

.

Agency for Healthcare Research and Quality (US). Retrieved from ncbi.nlm.nih.gov/books/NBK2633/

Rodziewicz, T. L., & Hipskind, J. E. (2019). Medical error prevention. In

StatPearls


[Internet]
. StatPearls Publishing. Retrieved from ncbi.nlm.nih.gov/books/NBK499956/

Rogers, A. et al. (2004). The Working Hours Of Hospital Staff Nurses And Patient Safety.


Health Affairs 23,

202–212.

Ex utero mouse embryogenesis from pre-gastrulation to late

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Read the attached research paper and answer the following questions.

1. What are some of the conditions that had to be maintained for the growth of ex utero embryos.

2. What day were these embryos grown to (mice are on embryonic day 20 (E20)), were they normal to this point / how many development marks were analyzed to determine this?

3. What is a factor that would have to be overcome to continue ex utero development?

4. Summarize what the authors are showing in Figure 4 of the paper.

5. The last sentence of the article notes that this work sets the stage for expanding ex utero embryo research to different mammalian species and from stem cell aggregated synthetic embryos. Should we study human embryos with this technique if they can be developed in culture from stem cells. Why or why not?

Applied Psychology Admissions Essay

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Applied Psychology Admissions Essay

Instructions: What does “service to others” mean to you?
This is for an admissions essay to declare my major (applied psychology).
Topic – As members of the university community we are asked to become aware of the world in which we live and to seek to improve it through service to others.  What does “service to others” mean to you?
Essay needs to be 5 paragraphs – 300-500 words.
Just a few thoughts- to me sevice to others means giving back to the community – working to help others benefit in their lives, mentoring children and teens, leadership development,.
I have spent many hours mentoring teens with everyday life situations and working as an elementary classroom volounteer for 5 years.

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What are the importance of using simulation for learning in Nursing education.

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What are the importance of using simulation for learning in Nursing education.

 

 

Debriefing after the observation or participation in a simulation has been shown to improve patient safety and care by increasing participants’ knowledge and understanding, identifying best practices, and fostering clinical reasoning (Dreifuerst, 2009). Remember to use proper APA format for the sources that you use. Please use credible sources and put page numbers in your in-test citation. Please do not reuse the reference on your assignment.
1. What are the importance of using simulation for learning in Nursing education. Why?
2. Is there anything that you would have done differently? Why?
3. How can simulation learning help you in your future practice?
Reference
Dreifuerst, K. T. (2009). The essential of debriefing in simulation learning: A concept analysis. Nursing Education Perspectives, 30(2), 109-114. Retrieved from https://tulane.edu/som/sim/faculty/upload/debriefing-article.pdf

Traumatic Brain Injury Assessment- Diagnosis and Management

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Abstract


Traumatic brain injuries are caused by external forces that affect many areas of cognition. These types of brain injuries lead to impairments in many different areas within the brain. Such areas include attention, reasoning, judgment, language, memory, problem-solving, psychosocial and perceptual and motor abilities. In this paper we will discuss the different assessment techniques and methods needed to treat individuals with


traumatic brain

injuries. We will investigate a pre-morbid measure of functioning using the Weschler test (WTAR) to determine the pre-morbid level of intellectual functioning. Other assessments we will cover include the WAIS-IV Assessment, Trails A & B, Digit Symbol and the PASAT test. The level of the TBI will be discussed while recognizing the cognitive deficits the intellectual has been experiencing. Assessment deficits will also be observed when studying both pre-injury and post-injury performance. The diagnosis, assessment and management of a traumatic brain injury is critical in achieving a successful outcome.

Mary is a 17-year-old girl. She had recently jumped off of a balcony that was over two stories high in an attempt to land in a swimming pool. Mary had lost her footing and slipped causing her to hit her head before falling into the pool. After being pulled out of the pool she was already unconscious and there was blood present on the side of her head where she had hit it. After a trip to the emergency room and a PET scan, Mary was found to have bruising and hemorrhaging within the tissues of her frontal lobe.

When looking at the Diagnostic and Statistical Manual (DSM) to medically diagnosis Mary’s injuries and acute symptoms I found that her lack of concentration, tiredness and trouble keeping up are all relevant and coincide with her traumatic brain injury. I would diagnosis Mary with a moderate

traumatic brain injury

. When determining the level of a TBI for a patient you must look at the symptoms. Mary has a moderate traumatic brain injury because she is showing many of the symptoms that come along with a moderate brain injury. Mary is showing signs of persistent headaches, mental fatigue, lack of concentration and she’s emotional

.

I chose this level of a TBI for Mary based on several factors. Mary had a loss of consciousness for over three hours and was in a coma. When first waking up she had trouble speaking but as time passed, she gradually improved. Mary was awake and able to respond to doctor’s verbally. Although doctor’s thought other problems may be present, a week later she was cleared by the neurologist to return to school when she felt ready. When trying to determine the level of a TBI, professionals may run a battery of tests to assess an individual’s brain, nerve functioning, and level of consciousness. A mild traumatic brain injury would consist of a patient being unconscious for less than 30 minutes and experiencing memory loss in less than a 24-hour period. They would score anywhere from a 13-15 on the Glasgow coma scale.

Symptoms of a

mild

traumatic brain injury

include headaches, fatigue, depression, confusion, blurry vision and temporary memory loss. A moderate traumatic brain injury happens when patients are unconscious anywhere from 30 minutes to 24 hours and will score between a 9-12 on the GCS.  Patients with a moderate traumatic brain injury can suffer from an inability to communicate, diminished cognitive skills, and even partial paralysis. Serious effects can accompany this type of injury. A traumatic brain injury is considered severe if the patient is unconscious for more than 24 hours, has memory loss for over seven days and scores an 8 or lower on the GCS. Symptoms of a severe brain injury include possibly death, permanent vegetative condition and/or state, and locked-in syndrome.

The Glasgow coma scale can be used immediately following a trauma by emergency medical professionals. It can also be used continuously throughout a patient’s treatment in the hospital and in rehabilitation to track progress. The Glasgow Coma Scale is however a great predictor for individuals who have more severe brain injuries. When assessing the presence and initial severity of a traumatic brain injury, the Glasgow Coma Scale is the most commonly used. The Glasgow Coma Scale is a neurological evaluation tool that was designed to assess and evaluate the level of consciousness in people who have brain damage. There are three different parameters that that can be observed, and they include motor response, eye response, and verbal response (Lezak, Howieson, Bigler & Tranel, 2012). Using the Glasgow coma scale to measure Mary’s initial level of unconsciousness will include medical professionals using this tool to initial determine the severity of her TBI. The Glasgow Coma Scale will determine Mary’s current level of consciousness (LOC) based on her responses to various stimuli that include motor, verbal and eye-opening responses. Mary’s score will give doctor’s an idea on how bad her injury is. When Mary awoke three hours later in the ICU, medical professionals can retest her using the GCS. Mary will be rescored using a criterion based on her eye-opening responses, verbal responses, and her motor responses. If Mary’s score went up, that means there are signs of significant improvement. A decreased GCS score is associated with worsening level of consciousness (Ramazani & Hosseini, 2019).

To determine Mary’s pre-morbid level of intellectual functioning using the National Adult Reading Test (NART) we can estimate Mary’s level of intellectual functioning and her levels of cognitive competence. The NART test is pretty reliable when estimating the comparison standard such as the premorbid ability level of a patient. NART is correlated with episodic and working memory and can estimate premorbid memory functioning. If Mary is cognitively impaired, then her current cognitive functions would need to be compared with her premorbid function. Reading tests such as the NART, have been found to provide more accurate estimations. This test depends on cognitive function at time of acquiring correct pronunciation. As stated in the journal article by Frick, Wahlin, Pachana, & Byrne (2011), This makes reading ability relatively resistant to brain injury and other disorders affecting cognitive function, and a good estimator of premorbid cognitive function (Franzen et al., 1997).  Mary’s performance on the NART will correlate to an elevated degree with both cognitive ability and premorbid intelligence. The NART will also give medical professionals an indication of Mary’s previous cognitive functions regarding her visual perception, speed/attention, memory, learning, phonemic fluency, and executive functions when looking at her existing school records and comparing them to how she processes information after the accident.

Assessing Mary’s post-injury intellectual ability using the Wechsler Adult Intelligence Scale/assessment –Fourth Edition will allow us to examine cognitive functioning following a TBI. This test is composed of 10 core subtests and five supplemental subtests, with the 10 core subtests comprising the Full-Scale IQ. I.Q. scores have been the subject of validity because the declines in verbal I. Q. scores, indicate the suppression of good performance. After testing Mary’s perceptual reasoning, working memory, processing speed, general intellectual ability, and verbal comprehension, post-injury, we would then see what abilities are better developed and her overall cognitive ability. As far as any deficits when comparing her pre-injury and post-injury performance TBI patients with mild to severe injuries showed a greater magnitude of discrepancies.

The Paced auditory serial addition test (PASAT) is a sensitive auditory test that requires a patient to add 60 pairs of digits that are randomized together by adding each digit to the digit that immediately precedes it (Lezak, et al., 2012). The digits are presented using four different rates of speed. Performance will then be scored based on the number of correct responses. This test is known to be hard even for individuals who are normal (i.e. no brain damage). This can be quite stressful for people such as Mary who may be cognitively impaired or intact. Attentional deficits can be elicited by the use of others tests so the PASAT test might not be necessary for Mary to take. This test could help determine why Mary has trouble focusing in class.

The Trails A & B Digit Symbol test will provide professionals with a wide variety of information in regard to the cognitive skills of the patient. This test will also measure processing speed, visual screening ability, and attention. Because Mary is having trouble focusing, this test could help in finding why she is struggling to keep up. This test will assess Mary’s cognition along with her ability to think, reason, and remember. The professional will administer different cognitive tasks that are related to the speed of processing and executive functioning. If Mary shows signs of cognitive impairment during this test that means she could have suffered some type of brain damage from her accident.

Some recommendations for her rehabilitation is to start with an effective treatment plan. Rehabilitation specialists will provide Mary with support in the functional management of her brain injury. Mental healthcare professionals may also be necessary in helping Mary in terms of dealing with her mood swings and learning how to function normally at school again. Mary’s neuro-functional strengths and weaknesses should also be taken into consideration when designing a program of brain rehabilitation.

After assessing, diagnosing, and managing Mary’s traumatic brain injury, we can see that she has faced intellectual incapacitation, lack of concentration and emotional distress. Managing and treating traumatic brain injuries comes with a variety of requirements. Such requirements include the assessment factors that accompany a TBI. Language, speech production and cognition. When effective treatment procedures are followed, Mary can learn how to continue and manage the symptoms of her injury. Assistive strategies can also be implemented with symptoms such as amnesia and some memory loss.


References

Theoretical Foundations of Nursing Practice

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Theoretical Foundations of Nursing Practice

Write a 5-6 page paper that is based upon the Grand Nursing Theorist, Martha E. Rogers.
Select a grand nursing theory by Martha E. Rogers.
After studying and analyzing the assigned theory, each student will write a paper on this theory, which includes an overview of the theory and specific examples of how it could be applied in your specific clinical setting.
Include in your paper:
An introduction including an overview on the selected Grand Nursing Theorist.
Background of the Theorist
Philosophical underpinnings of the theory
Major Assumptions, Concepts, and Relationships
Clinical Applications/usefulness/value to extending nursing science Testability
Parsimony
Conclusion/Summary
References – use the course text and 3 additional sources; all to be listed in APA format, 6th ed.

smilesmilePLACE THIS ORDER OR A SIMILAR ORDER WITH NURSING TERM PAPERS TODAY AND GET AN AMAZING DISCOUNT

Criminal justice 3 | Criminal homework help

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Throughout the course, you will be learning about the steps, people, and activities involved in the criminal justice system. Each week, you will be reading about a high profile case and adding real case information from the case to your reflective journal for the module. Additionally, you will reflect on your understanding of the course content and applying it to the case, answering guiding questions each week.

For your third journal entry, you will be asked to select your high profile case, discuss burden of proof and how it was carried out in the case.

Applying information and ideas from Module 3 readings, discussions and activities, address the following questions about your high profile case:

The classification of the crime in your ‘high profile case’.

Outline the burden of proof (the criminal act, the mental state, and concurrence) used by the prosecutor to pursue the person in your high profile case.  What proof did the prosecutor have?

Were there any ‘attendant circumstances’ in your case?

In a short paragraph, discuss your opinion if the high profile person should have accepted a ‘plea bargain’ if it were offered.

What role did the media play during due process?  Do you feel it had any impact on the prosecutor pursuing the case?

You will need to research your own background information on your High Profile case as it applies to content from Module 3 by using an online search engine.  You can use a variety of resources and websites to collect your information on due process and officers of the court.

Discussing impact of dementia on patient and carer

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Introduction

Dementia is a serious disease of the brain. When someone has dementia, the brain cells are damaged and they die more frequently than normal. When an individual looses brain cells, this means that he will gradually start to loose all of his abilities. Often the first thing you loose is memory, sometimes people just cannot remember their husbands’ and wives’ names. When the disease worsens, the patient may become disorientated and does not know what date or day it is. Moreover when the disease has the patient firmly in its grip, the effected person can change in many aspects and can even change their behaviour. Patients with dementia loose most of their abilities and therefore find it difficult to live alone. For this reason many people end up in elderly homes because they find it impossible to cope. This assignment will be discussing the impact of dementia on the patient and carer. Also how the patient and the carer will be empowered to live with the consequences and outcomes of dementia. (Gilliard, J. (2001)

Impact on the Patient

Patients diagnosed with moderate and severe dementia typically need a lot of care, ideally round the clock care. This is because when you take care of these types of patients one must make sure that neither the patient nor the carers come to any harm. These persons usually require a lot of assistance in almost all activities of daily living such as nutrition and hygiene. These patients tend to forget important things like how to shower or how to eat with a fork and knife.

A previous safe home environment can become one full of obstacles and danger for a patient with dementia. There are many hazards around the house like sharp knives, tools and chemicals. They should be removed so as to make the home as safe as possible. Since people suffering from dementia can become disorientated, it is very important that locks in the home are more secure than usual and even stairs are guarded by the gate. Furthermore the carer of patients with dementia should put some sort of identification on the individual, in case he wanders around alone and is lost.

Since persons with dementia are prone to change in their behaviour, they get frustrated and certain situations irritate them a lot. Comprehending, adapting or avoiding the conditions that set off these actions may assist to make life more pleasant for the person with dementia as well as his or her caregivers. For example the person may be confused or irritated by the intensity of movement or sound in the nearby environment. Reducing pointless movement and sound, such as limiting the amount of visitors and turning off the television when it’s not in use may make it easier for the person to be aware of needs and carry out simple tasks. Reducing clutter in the home may be help the person feel less confused in his surroundings. It is also essential to maintain familiar objects close, and encourage the person to follow an expected routine throughout the day. Calendars and clocks may also assist patients in familiarizing themselves.

Persons with dementia should be encouraged to go on with their ordinary leisure time activities as long as they are secure and do not effect disturbance. Activities such as skills, games, and music can offer significant mental stimulation and improve mood. Some studies have proposed that participating in exercise and intellectually stimulating activities may lower the decline of cognitive function in some people. (Current Alzheimer Research ISSN: 1567-2050 – Volume 8, 8 Issues, 2011)

A lot of studies have found that driving is insecure for people with dementia. They frequently get lost and they may have problems recalling or following policies of the road. They in addition may have difficult handing out information rapidly and dealing with unpredicted conditions. Even a second of uncertainty while driving can lead to an accident. Driving with impaired cognitive functions can also put others in danger. Some experts have proposed that normal screening for changing in intellectual functioning might help out to decrease the number of driving accidents among elderly people, and some states now demand that doctors report people with dementia to their state motor vehicle department. However, in many cases, it is up to the individual’s family and friends to make sure that the human being does not drive. (Current Alzheimer Research ISSN: 1567-2050 – Volume 8, 8 Issues, 2011)

The emotional and physical load of caring for somebody with dementia can be devastating. Support groups can frequently assist caregivers in dealing with these difficulties and they can also suggest supportive information about the disease and its treatment. It is significant that caregivers rarely have time off from endless nursing demands. Some communities supply respite facilities or adult day care centres that will take care for dementia patients for a period of time, giving the primary caregivers a break.

Early on in the illness, loads of individuals may require aid such as reminders and memory assistance, and help with controlling money or making decisions. Later, they will need increasing amounts of help with their daily activities. In the later stages of the illness, people with dementia are likely to require a lot of assistance with usual daily activities such as eating, washing, dressing and going to the toilet.

Numerous people are concerned about memory failure and may become concerned that it is the beginning of dementia. However, in many cases, there may be another cause. Illnesses and infections, as well as depression, nervousness, bereavement, tiredness and the side effects of some prescribed medications can all cause memory problems which can be taken care of.

Generally dementia is a progressive and degenerative disease and patients will need more care as the disease worsens. When the disease is in the initial stages, more commonly referred to as mild, the patient will find it hard to manage in their employment, might find it hard to make certain decisions or might forget to pay bills or attend appointments. As the disease progresses, and is at the moderate stage, the affected person may find it hard to recognize his own family members and may also need guidance in their everyday activities like dressing and toileting. In the final stages, the disease will take hold of brain function and hence problems with memory, co-ordination and communication will certainly increase. Physical abilities are also likely to be affected.

There is no cure for dementia; however there is a lot to be done to ease the impact of the disease on the patient and his carers. It is most important that the person has the best quality of life possible and people with dementia should try to keep up with their daily activities and interests. They should also be given choices as much as possible so as to maintain their grip on normal life as much as possible. Carers should also make sure that the patient’s eyesight, hearing and general well being are taken care of.

Dementia can have an effect on the performance of a lot of the body system and, therefore, the capability to carry out day-to-day tasks. Dementia may increase problems. One of the main problems is inappropriate nutrition. Almost everybody who has dementia will at some point lessen or discontinue eating and drinking. Frequently, advanced dementia causes people to have less control of the muscle that is used to masticate and swallow, placing them in

danger of obstructing or aspirating food into their lungs. If this occurs, it can obstruct breathing and cause pneumonia. People with advanced dementia also lose the sense of hunger and, with it, the wish to eat. Depression, side effects of medications, constipation and other conditions such as infections also can reduce a person’s significance in food. Another important factor which can be affected in dementia is reduced hygiene. In the moderate to severe stages of dementia, the patient looses the capability to autonomously complete everyday living everyday jobs. The patient may not be able to cleanse, put on clothes, brush your teeth and go to the toilet on your own. The patient suffering from dementia will have trouble in taking medications. This is because a person’s memory is affected; keeping in mind to take the correct amount of medications at the exact time can be tough. Worsening of emotional health is one of the main concerns. Dementia alters performances and personality. A number of the changes may be caused by the definite weakening occurrence in a person’s brain, while other deeds and personality changes may be responded to the emotional confronts of coping with the worsening changes. Dementia may lead to despair, violence, misunderstanding, irritation, anxiety, a lack of embarrassment and uncertainty. Having difficult in communicating is also a problem. As dementia advances, the skill to keep in mind the names of people and belongings may be lost. This makes communication hard at all stages, whether to let a caregiver be acquainted with what need and how patients experience or only to communicate within society. Trouble communicating can guide to feelings of disturbance loneliness and hopelessness. Delirium is the state in which it is distinguished by a turn down in attention, understanding and mental clarity. Delirium is regular in people with dementia, particularly when admitted to the hospital. It emerges that the unexpected transformation in surroundings, activity level and other routines may be the cause. Dementia patients have problems in sleeping. Disturbance of the normal sleep-wake cycle waking up at night and sleeping during the day is very frequent. Insomnia is another ordinary difficulty, as are agitated legs syndrome and sleep apnea, which also can interfere with sleep. Another concern is personal safety challenges. This is because of a reduced ability for decision making and problem-solving, some everyday circumstances can present protection subjects for people with dementia. These include driving, cooking, falling and discuss impediments. (Ritchie K, et al (2010)

Impact on the Carer.

The caregiver of the patient with dementia often has as many needs as the patient with dementia. Through the process of the disease the ability to control and maintain ones self stability is somewhat overwhelming and can lead to depression of the nurse caring for the patient in most cases. Depression and frustration usually comes from the fact that the dementia’s patient’s mental and physical health is gradually dwindling away, and the caregiver or nurse feels helpless. This helplessness comes from the fact that the nurse or caregiver is showing care, compassion, and using all the knowledge he or she has, yet the nurse sees little to no progress in the person because the disease process is taking over. “One caregiver described the disease as being a long journey in which the undeniable end is death, no fixed route, and no estimated time of departure” (Morton, 2003 p.262). Philosophy Nursing is the art of caring. Nursing is the concept of adaptation, self actualization, knowledge, and the ability to use and demonstrate these ideals in every situation. Holistic nursing is the idea that you understand and perceive the patient’s state of health. Dementia puts the nurse in a situation that in reality he or she has no idea what it is like to actually understand what the patient is going through. Through the process of this disease the nurse must overcome their own emotions and realize that they are there for one reason. This one reason is simply to care for the patient. The patient over time will change mentally, emotionally, and physically which will not only challenge the nurse and their ability to understand and care for the patient, but these factors will also affect the family of the patient.

Caring for an elderly person with dementia is a major life challenge and it entails emotional, physical, social and financial burden (Morris 1998).It also has been described as one of the most difficult situation met by caregivers. (Teusing JP, Mahler S., 1984).

Caregivers of dementia patients can experience various emotional problems during the course of the illness (Rabins PV.,1984).One such disorder, that is frequently overlooked and not treated, is carers depression (Harwood,et al,1998).It is well documented that family caregivers of persons with dementia have significantly more depressive symptoms than age and gender-matched non caregivers(Gallagher,et al,1990).Caregivers of persons with dementia report more emotional strain and depressive symptoms than caregivers of persons who are not demented (Hooker,et al,1998).

Empowerment of the Patient and the Carer

Empowerment is seen as a mainly important approach in allowing more marginalized groups of society, those who may be ‘powerless’ in many other aspects of their lives as well as in regards to control over their health (Bergsma, 2004).

The confront of linking people with dementia is in essence the challenge of dealing with the social exclusion by which people with dementia: “… are disempowered in a variety of ways. They have limited choice and control over their lives, they may have difficulty participating in the decisions that affect their lives and ultimately their fundamental rights as citizens and human beings may be infringed.” (Cantley and Bowes, 2004,)

The common-sense model (CSM) of self-regulation of health and illness was developed in the 1980s by Howard Leventhal and his colleagues (Diefenbach & Leventhal, 1996). It was supported on Leventhal’s research from the earlier decade that studied the effect of fear in relation to health related behaviours. It’s main goal and purpose is to give details how a person processes an illness risk. The CSM is centered on the human being and his or her idea of health and illness. It works underneath the idea that the individual is “an active problem solver.” CSM also theories an individual’s demonstration of the illness will be the primary cause of their accomplishments and manners and the method of illness representation will lead the individual to make common sense health behaviours. (Diefenbach & Leventhal, 1996) Self-regulation is the giving out of information by a patient concerning their health and the actions that an individual takes to go back to a normal position of wellbeing.

The participation of people with dementia should be established on values of personhood, relationship and citizenship, and on the principles of ethical practice. Participation activities with people with dementia can get position at a diversity of organisational levels with purposes or plans ranging from influencing the operation of individual services to influencing social approach all over the country and globally. Contribution can have individual advantages for people with dementia who regularly tale increased self-esteem and assurance happens from being incorporated in taking part in activities and feeling that they have somewhat to donate. Approaches to connecting people with dementia comprise individual discussion, group consultation, contribution and group act. With every of these advances a numeral of activities or means can be used. It is vital to be familiar with that some participation activities are further empowering of people with dementia than others. Loads of existing dementia contribution proposals has been service started with people with dementia being engaged more as “passive suppliers of opinion” as contrasted to “active negotiators of change”. There are good quality reasons for ‘starting small’ and building on accomplishment, above all when the contribution of people with dementia is still a fairly fresh and developing part of work. On the other hand, the processes by how interest expands and power relationships alter are compound and need vigorous thought and management by all concerned. (Cantley et al 2005)

Coroner’s Report: discuss the importance of documentation in health care

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Coroner’s Report: discuss the importance of documentation in health care

Portfolio
activity 2 Coroner’s Report (2,500 words)
As part of your portfolio you are required to review one coroner’s report from the examples provided on the MyUni site and provide a discussion with regards to the criteria detailed below. The discussion must be supported by contemporary literature.
This assessment must include the following criteria:
•A brief summary of the coroner’s findings (one or two paragraphs only).
•Discussion of medical and nursing practice in regards to the following areas:
•documentation and communication
•ethical decision-making
•advocacy
•leadership and management
•cultural competence or organizational culture.

It is important that you use the report to highlight these areas of practice, but the discussion should provide a more general overview with regards to each criterion. For example, it may be evident in the coroner’s report that documentation was not recorded well and may have contributed to the outcome. You should use this as an example to discuss the importance of documentation in health care, such as outlining what is good documentation, how it contributes to effective care or how poor documentation may result in poor care.

Support your discussion with relevant literature. Please include a minimum of ten (10) contemporary references relevant to
•A concise critique on the how the deceased person’s death may have been prevented.
•A brief discussion on the coroner’s findings with regards to the practicability of implementing any recommendations.