Pressure Ulcer Prevention Using Skin Bundle Research Paper

Pressure Ulcer Prevention Using Skin Bundle - Research Paper Example Once the skin succumbs to bacteria or sustains injuries from friction and shear, healing takes longer because reduced flow of blood brings nutrients and removes wastes more slowly. Ischemia due to unrelieved pressure is usually observed in the elderly, malnourished patients, patients reduced to immobility because of their medical condition, fecal incontinence, and patients under less than conscious condition (Mauk 2009, p. 501). Pressure Ulcers: Incidence, Prevalence and Prevention In 2004, the National Home Survey reported that for every 10 residents in nursing homes all over the United States, 11% have succumbed to pressure ulcers with stage 2 pressure ulcer as the most common (see Fig. 2). Both whites and non-whites had equal percentage with the males edging the females at 13% and 10%, respectively (Park-Lee & Caffrey 2009). In 2007, the Centers for Medicare and Medicaid Services reported some 257,412 preventable pressure ulcers as secondary diagnoses at cost averaging at $43,180 for every stay in the hospital. This compelled Medicare to give up shouldering pressure ulcer costs so as to encourage its prevention (Mauk 2009, p. 501). The Institute for Healthcare Improvement has recommended a set of simple interventions collectively known as ‘bundle’ for pressure ulcers prevention in 2003. Hospitals are encouraged to develop their own â€Å"bundle† in approaching pressure ulcer prevention (Paciella 2009, p. 43). The SKIN bundle, which is an acronym for Surface, Keep Moving, Incontinence and Nutrition, was developed by the Ascension Health facilities in 2004. In the succeeding pages a sample of change in practice program is outlined for a fictitious hospital ward called HTMC for the prevention of pressure ulcer using the SKIN bundle. Change in Practice for Pressure Ulcer Prevention Name of Ward (fictitious): East Wing 13 Holy Trinity Medical Center (HTMC) Demographics: 24-bed unit, 10 private and 14 semi-private; Staff is composed of ARNP, RN s, patient care technicians, nutritionists, therapists, and others Scope of Service: Patients in the ward are admitted for the following conditions: strokes and seizures, multiple sclerosis and other diseases that make them prone to develop pressure ulcers. A. ASSESSMENT In the first quarter of 2010, the East Wing 13 of the HTMC had reported 27% incidence of pressure ulcer cases compared to the National Database of Nursing Quality Indicators or NDNQI’s report of 3.8%, for Stage I-IV and 2.7%, for Stage II-IV for the year 2010. This is not a good development, not only because the ward’s statistic paled in comparison with the NDNQI’s but also because the CMS has stopped shouldering costs for pressure ulcers that are acquired in the ACFs. B. LINK The US DHHS recommended several measures in the prevention and care of pressure ulcers. These recommendations can be used by the East Wing 13 to reduce the percentage of pressure ulcer incidence. They include the following : skin inspection of patients at least once daily; skin cleansing in accordance to the needs of each patient; skin care such as moisturizers for dry skin and less exposure to humidity and cold; moisture due to incontinence, perspiration, or wound

Geisha Girls In Japan Essay Example | Topics and Well Written Essays - 2500 words

Geisha Girls In Japan - Essay Example The concept of geisha and geisha girls believed to be started from the 17 the century onwards in Japanese community even though the history of Japan shows that even in the 9 Th and 11th centuries some girls performed dances for warriors and other upper classes of the society. Young girls were forcefully sold into the geisha life by their families until the mid-20th century and their virginity was sold to the highest bidder. Prostitution was strongly associated with the geisha girls. Even the dance forms geisha girls perform were erotic and sex provoking. By tradition, Japanese society is not giving much importance to the one girl for one man concept. For them, sex was not a sin, but a much needed psychological need. It was quite possible for a person to have sex with the wife of another person if both of them were in love with each other. Japanese males had the habit of selecting their wives just for producing healthy children. They gave least considerations to the aspects of love an d sexual relationships when they selected their partners for marriage. The duty of the wives was childbearing and looking after of the children. Japanese males looked for geisha girls for their true sexual needs and love relationships. Thus geisha girls had more roles in Japanese male life than their wives. Moreover, they had more importance in Japanese social life also compared to the other normal females. The profession of geisha girls was considered as a glorified profession similar to the professions of current film celebrities.

Exam Assignment Example | Topics and Well Written Essays - 1500 words

Exam - Assignment Example You will NOT be able to save the exam and return to it at another time; you must complete it in one attempt. Be sure to submit it when you are finished! If you have any questions about aspects of the exam, please take note of these and you are welcome to e-mail me after you have completed the exam. Further, if there are any exam questions that are unclear, please take note of these as well and I will ask about this in the class. Often when a hazard event occurs, other hazards are triggered by the initial event. These are known as secondary hazards. Which of the following is an example of a hazard that can potentially follow wildfires? A wildfire that caused over $4.4 billion (unadjusted) damage and burned a significant amount of tropical rain forest for which loss calculations were attempted in terms of impacts on global carbon contributions occurred in which place? c. Create an emergency plan for you and your family, which particularly includes arrangements for contacting one another in the face of a disaster, but does not necessarily address school and work situations. Wildfires are a relatively common hazard throughout the U.S., occurring every year and in various regions. There is a distinct seasonality to this threat, although it is possible to have an event outside of the season. Which best describes wildfire season in Colorado? We have talked about how important risk communication can be in saving lives and reducing injuries. Which of the following statements BEST describes the role of risk communication in reducing the hazard threat to people? d. The urban-wildland interface is not of particular concern when considering wildfires because so many places are now creating and enforcing building codes that reduce the threat of fire to buildings. While the focus of this class is on hazards geography and geography is one of the main disciplines contributing to hazards research, many disciplines actually contribute directly to

Scenario planning for the future of Energy Essay

Scenario planning for the future of Energy - Essay Example After decades of thought and consideration, countries have mutually consented to get rid of cars altogether. Now, in 2030, roads are crowded with bicycles. People are generally happy to use bicycles because they have not only obviated the need to use oil, but has also rapidly decreased the number of road accidents. The bicycle-bicycle collision is far less as deadly and dangerous as a car-car collision used to be few years ago. Besides, regular peddling has been a good source of exercise and has helped people burn their calories. In the midst of Shanghai lives Chen with his family in a condominium. Today is Chen’s final exam, and he needs to get into the school within fifteen minutes. He lives one and a half miles away from the school. He catches his bicycle, but the tire is punctured. He can not wave to a taxi because there are no taxies, no bus, no car whatsoever! Mum and dad have gone to work over their respective bicycles. Chen has only two options to reach the school, eit her walk his way up to the school, or else, seek lift from somebody else. But most bicycles are overloaded because that is the only thing people have as a means of travel. Normally, if a person does not have a bicycle of his own, he/she has to suffer, though Chen is lucky enough to find a cyclist, Koto, with no one sitting on the back seat. Chen asks Koto the favor to drop him to school. Koto agrees to do the job provided that Chen purchases him a tin of cooking oil since he comes from a very poor family and can not afford to buy the cooking oil. Chen agrees and the two set off. Second Story: Saudi Arabia is suffering from a financial crisis as a result of her inability to meet the global demands of oil. Saudi Arabia’s predictions of her oil reserves have turned out to be overstatements which had no concern with reality. In reality, Saudi oil reserves had been depleting at a dangerous rate and much of the oil has been drawn out of the known reserves till 2025. For the last fi ve years, Saudi Arabia has reduced the supply of oil and is now suffering from a financial crisis. Ted, a teenager, turns the TV on to hear the news. Newscaster: Saudi Arabia’s attitude is being criticized for the turmoil in oil supply. For the past twenty years, Saudi Ministers have been making unnecessarily optimistic statements about their ability to make uninterrupted and sustained supply of oil to the world for a long period of time. Saudi Ministers have always been reluctant to get their oil reserves audited nor have they ever revealed accurate information about the volume of oil reserves. Much of the disparity in the demand and supply of oil in the contemporary age is attributed to the non-serious and inconsiderate attitude and short-term vision of the oil producing companies in Saudi Arabia. Experts are of the view that had Saudi Arabia allowed the auditing of her oil reserves and generate correct information about the oil reserves, it would have been possible for the world to take precautionary measures in time. The economy of Saudi Arabia has declined as a result of the reduced oil supply. Third Story: The New York City in 2030 looks totally different from the way it looked in 2010. On the roof of every house, there is a solar panel that faces the sun and revolves according to it in order to keep its surface exposed to the sunlight throughout the day. On every garage, there is a car that is driven by biofuel or electricity. Every individual

Simulated Chinese restaurant summarize Essay Example | Topics and Well Written Essays - 2000 words

Simulated Chinese restaurant summarize - Essay Example It was observed that the mode of advertising was modeled on the common usage of both posters and flyers in both restaurants. In addition, Red Lantern has adopted A La Carte Menu arrangement (Campbell & Campbell 2006). Decorations at the hotel, and store layout were very incorporative of the Chinese decorations and culture. There are a number of issues we could address to draw differences in the hotels. For instance, in considering the modes of making payments, we found that Red Lantern made offered three meals at a price of $12.50 (Roberts 2002). On the other hand, Hotel Hunan had the same offer of three meals at a price of $14.00. The difference in prices between the two hotels is a margin of $1.50. From this, we could conclude that Red Lantern is much cheaper and more economical given all its other services are top notch and excellent. In addition, the two hotels were similar in the aspect of service delivery. They have adopted use of banquet style serves. Another important similarity that is key to both restaurants is that they have both adopted use of Chinese music (Campbell & Campbell 2006). Red Lantern and Chopsticks restaurants also have their differences. To start with, Chopsticks offers both Japanese and Chinese foods in its menu. Red Lantern, on the other side offers only Chinese food in its menu. Another notable contrast is that Chopsticks has tried to set different prices for its adult and children customers. This is to ensure that the needs of each customer are taken into consideration and no one will fell oppressed. Red Lantern has no special prices for children and adult customers. Its prices are fixed for all customers. If we look at the promotion items on offers in each of the restaurants, Red Lantern promotes bubble tea and Tsingtao beer (Campbell & Campbell 2006). In hotel Chopsticks, there are no promotional items

King Lear by William Shakespeare and Brave New World by Aldous Huxley Essay

King Lear by William Shakespeare and Brave New World by Aldous Huxley - Essay Example   Some citizens have made the choice not to live this way; others are considered â€Å"savages†. Both groups are made to live separately from society, either on islands or on far-off, restricted â€Å"reservations† (Huxley 101). In contrast, the story of  King Lear, set in England in the 17th century, gives the story of King Lear, a king whose thoughts of dividing his kingdom and then living out his days with one of his loving daughters are rudely interrupted, as he begins a long, slow slide into a world of madness, while plots against him swirl as others attempt to gain power through their own devices and interests.  King Lear and his family are not the only victims in this story, as bitterness and greed cause characters around him to vie for power. Both  A Brave New World  and  King Lear, while being on the whole very different stories,  share many tragedies, including parental abandonment, madness, and exile of characters, while the tragedy and sufferin g of characters ultimately leads readers to catharsis, as those tragedies play out to their respective conclusions.   Both  A Brave New World  and  King Lear  share parental abandonment, as both stories have parents that abandon their children willingly, but for different reasons. Linda, a woman who became pregnant in the â€Å"civilized world† and eventually gave birth to John the Savage, is forced to live on the â€Å"savage reservation† due to having committed what is known in this world as an atrocity, as babies are not born, they are â€Å"decanted† (Huxley 18). She has thus become the mother of the John the Savage, but cannot deal with this reality and abandons him for drugs, wishing nothing more than the "mescal" that a man named Pope brings to her (Huxley 125).   When she is returned to what she calls the â€Å"Other Place†, she only wants the drug â€Å"soma† that is freely dispensed to the people, ravishing herself in the wond ers of taking â€Å"holiday after holiday† (Huxley 154). John the Savage, her only child, is left to make his own way, both on the reservation and after. On the reservation, he suffers as a little boy from the remarks that the other children make about his mother, and from witnessing her being beaten by women whose husbands have slept with Linda (Huxley 165). He grows up in a solitary, lonely and bewildered existence, wondering why Linda does not love him (Huxley 167). King Lear also contains parental abandonment. Cordelia, the youngest daughter of King Lear, is asked by her father to tell him how much she loves him. Cordelia, who has been contemplating whether to tell him the truth or not, refuses to lie, telling him â€Å"That lord whose hand must take my plight shall carry, half my love with him, half my care and duty; sure I shall never marry like my sisters, to love my father all† (I.i.103-107). King Lear is at first shocked, but then tells everyone present: †Å"Here I disclaim all my paternal care, Propinquity and property of blood.† (I.i 115-118). Like Linda, King Lear has abandoned his child, though Lear does so not for drugs but because he does not believe that Cordelia loves him. Lear comes to regret his mistakes later, but is completely hard-hearted towards his daughter, as Linda was towards John. Fortunately, Lear finds forgiveness from Cordelia before things are

Moral Problem Research Paper Example | Topics and Well Written Essays - 2000 words

Moral Problem - Research Paper Example Gaddafi has no official government function, and prefers to be called â€Å"Brotherly Leader and Guide of the Revolution† (Elgood, 2011). Furthermore, he has unflinchingly ordered the violent repression of dissident citizens, prompting the UN General Assembly to pass a resolution allowing member states to intervene on behalf of the Libyan people. In this paper I shall examine the decision Gaddafi has so far pursued but may still revise, regarding his response to his people’s clamor for democracy. I shall examine the moral dilemma, and arrive at a moral solution pursuant to the decision procedures of Utilitarianism and Kantianism. However, I shall first relate the background of Gaddafi, the type of leader he is, his decisions and actions, so that these may be made the basis for discerning his motivations. Factual details In 1969, 27-year-old Col. Muammar Gaddafi successfully led a bloodless coup against King Idris to take over the reins of power in oil-rich Libya. Gaddaf i was born to nomadic parents, the son of a Bedouin herdsman, and dropped out of college to join the army; despite his humble beginnings, he had been able to maintain absolute dictatorship over his country for the past four decades (Al Jazeera, 2011; Elgood of Reuters, 2011). Gaddafi’s rule was and continues to be oppressive towards the Libyan people, having imprisoned countless dissidents and putting thousands to death, as reported by Human Rights Watch. During the 1970s, he publicly hung student demonstrators who marched and demonstrated for the restoration of their human rights. In another incident, Gaddafi ordered the execution of 1,200 unarmed prisoners in the span of three hours (Al Jazeera, 2011). The media remains under tight government control, as does all large businesses. Gaddafi has been openly anti-US and anti-Israel, and he is strongly associated with terrorism due to his role in the 1988 bombing of the Pan Am flight over Lockerbie, Scotland which was perpetrate d by Libyan intelligence agents. However, in 2003, in a seeming act of reconciliation he accepted responsibility for this act and indemnified the families of those who died, although his admission remained guarded. He also relinquished his complete inventory of weapons of mass destruction (MacLeod & Radwan of Time, 2005). Due to these acts, Libya assumed normalized relations with the West, allowing the oil industry to flourish and the economy to grow. In 2009, however, Gaddafi spoke at the UN General Assembly, at which he tore a copy of the UN Charter in protest, accused the United Nations and the US of being a terrorist group like the Al Qaeda, and demanded $7.7 trillion in compensation from past colonial rulers. Nor was his contempt directed solely at the US. In a two-day visit to Italy in 2010 to strengthen Rome-Italy ties, Gaddafi unabashedly invited thousands of women to convert to Islam as he was accompanied by a dozen female bodyguards (Al Jazeera, 2011; Elgood, 2011). In the recent spate of civil unrest that has spread throughout the Arab states, Gaddafi showed he has not changed his militaristic dictatorship. Human rights protesters have been gunned down in the hundreds within the span of a few days, and even those attending funerals were not spared the carnage (Elgood, 2011). Libya has never held free elections under Gaddafi, and his sentiments on the matter became clear during a Time interview in 2005: â€Å"Elections? What for? We have surpassed that stage you are presently in. All the people are in