The Healthcare Quality Strategy Nursing Essay

The Healthcare Quality Strategy Nursing Essay This essay will discuss a significant event in relation to the peoples priorities identified within the Healthcare Quality Strategy. It will also discuss my role as a student nurse in relation to a patient who is receiving palliative care. The essay will demonstrate my understanding and views on reflection and the issues surrounding my practice. I have chosen Gibbs (1988) reflective framework as it has a structured format and six steps which follow in order starting with a description of the event and ending with an action plan for future practice. The steps are Description, Feelings, Evaluation, Analysis, Conclusion and Action Plan (Gray, 2007). Reid, (1993) describes reflection as a process of reviewing an experience of practice in order to describe, analyse, evaluate and so inform learning about practice. In May 2010, the Scottish Government introduced the Healthcare Quality Strategy for NHS Scotland, their aim is to deliver the peoples priorities which are: firstly caring and compassionate staff and services, good communication and a clear explanation about conditions and treatments, effective teamwork between clinicians, patients and others, a clean and safe care environment, continuity of care and clinical excellence. Secondly, to bring together the patients priorities as well as the values of everyone working within the NHS Scotland. Thirdly, by applying these three interventions and putting them into practice improvements within priority areas of the Healthcare Quality Strategy will be met (Scottish Government, 2010, p.6). This reflective account will focus on the importance of communication and how it can affect individuals. It will identify if the priority was met in relation to my significant event and it will further clarify its importance (Scottish Government, 2010, p.6). Description Whilst on my Management Placement I met Janet, she is 65 years old and has been admitted to my ward for palliative care. She has end stage bowel cancer and is awaiting a bed at the local hospice. All names have been changed to protect her identity and maintain confidentiality (NMC, 2008). Janets GP has requested that she be admitted onto the ward as she is now confined to bed because of increased pain and a general deterioration of her condition (Dougan and Colquhoun, 2006). Feelings Whilst carrying out my training as a student nurse, I have met a number of palliative patients and I feel that I lack confidence when communicating with these patients and their families at this difficult time. However, whilst on this placement I was able to build up a good rapport with Janet and her family and this allowed me to provide good patient centred care (NMC, 2008). Therefore when dealing with Janet and her family at this difficult time I must treat Janet as an individual (NMC, 2008) and I must provide the best care for my patient and be caring and compassionate always (Scottish Government, 2010, p.6). I was privileged to have the opportunity to be involved in Janets care as well as working within a ward of clinical excellence (Scottish Government, 2010, p.6). Evaluation When caring for palliative patients a holistic approach with continuity of care is extremely important and all nurses have a central role in providing information, care and support (Kennedy and Lockhart, 2007). Excellent communication and good interpersonal skills are paramount when caring for Janet, it is important not only to establish Janets wants and needs but also her families. It is imperative when relaying any information to Janet or her family make sure they understand it, if not explain the information to them again (NMC, 2008). Also when dealing with members of the multi-disciplinary team, effective teamwork is imperative again providing Janet and her family with continuity of care and the clinical excellence they require from all staff. I feel the Quality Strategy aim was achieved, as all staff when looking after Janet dealt with her in a caring and reassuring manner at all times, in turn providing Janet with the best care, whilst she was on the ward (Scottish Government, 2010). Analysis Palliative care helps to improve the quality of life for patients and their families who have to come to terms with the difficulties associated with life threatening illness. It is about identifying the patients needs through accurate assessment, good symptom control and sensitive nursing care (Scottish Partnership for Palliative Care, 2012). When planning Janets care I must take a holistic approach and look at her physical, psychological, social, emotional and environmental needs. This included not only the patient, the hospital and any multi-disciplinary team members but also her husband and any other family members she would like involved (Dougherty and Lister, 2011). As Janets condition could change from day to day her care plan was reviewed on a daily basis and updated accordingly (Dougan and Colquhoun, 2006). Good communication is paramount when dealing with my patient, it is important to listen and support them and make sure any information they have been given, do they understand it, if not explain it to them again (NMC, 2008). It is also important to document any care given to the patient in accordance with the NMC guidance on record keeping (NMC, 2009). In addition to caring for Janet on the ward I was given the opportunity to go to the Hospice and meet with Janets palliative care nurse and also be included in her multi-disciplinary team meeting. This again highlighted the importance of good communication and good record keeping as all team members are aware of Janets circumstances and can pick up her file and know exactly what is happening with Janet at any given moment (Nice, 2004). This meant that when I was communicating with Janet and her family I was more confident and I was able to communicate in a language that they understood (Dunne, 2005). As well as building a trusting relationship between nurse and patient, good communication skills again helps to reduce fear and anxiety at this stressful time (Dunne, 2005). When dealing with patients who are receiving palliative care the peoples priorities are relevant. All nurses must be able to make the patient as comfortable as possible, be aware of their wants and needs and provide a safe and clean environment (Scottish Government, 2010, p.6). On reflection this event has brought further awareness of the level of involvement of staff members from nursing auxiliaries, nurses and consultants. This was shown by the number of multi-disciplinary meetings, assessments, re-assessments, written correspondence and working hours placed into looking after this patient (NMC, 2009). All staff members were committed to providing the correct input and treatment for this patient and to make her last few days as comfortable as possible (Scottish Government, 2008). Conclusion This reflection has demonstrated the difficultly in caring for palliative care patients. It requires a holistic approach to ensure that the patient and their family receive the best possible attention. Nurses have a duty to ensure that the care they deliver is of an acceptable standard (NMC, 2008). While participating in ward rounds I took on board the doctors instructions and carried out and prioritised the care of my patient, therefore making Janets stay in hospital as comfortable as possible. The code provides values, which can be adapted to any setting and as long as these are followed, nurses will be able to carry out their legal and professional duty of care (NMC, 2008). Action Plan Palliative care is a sensitive subject to deal with but I feel that as long as you treat the patient as an individual, listen to their wants and needs, then a positive outcome can be accomplished. Communication and good interpersonal skills are once again highlighted as an essential part of good nursing practice. I must be an effective communicator and be able to provide a high standard of care at all times and this is imperative when dealing with palliative care patients. I must keep my knowledge and skills up to date (NMC, 2008). Identify Steps Through experience of this placement and in relation to my transition from student nurse to staff nurse; the steps to facilitate an improvement and development would be to ensure effective communication with all staff and all members of the multidisciplinary team. This includes accurate record keeping and collection of all relevant information from the patient and their family in order to deliver safe effective patient care. It also promotes a positive nurse patient relationship and offers reassurance at this difficult time (Dunne, 2005). In addition palliative care does not only deal with cancer patients but with patients who have long term chronic illnesses such as multiple sclerosis, heart disease and respiratory problems, therefore palliative care is relevant today and also in the future because we will be caring for an ageing population (Scottish Partnership for Palliative Care, 2012) In conclusion and in relation to The Healthcare Quality Strategy I feel that Janet was looked after in a caring and compassionate manner at all times and the nursing auxiliaries and nurses looking after Janet worked well together putting her first and treating her with respect at all times (Scottish Government, 2010). Conclusion In conclusion and in relation to The Health Quality Strategy and my transition from student to nurse, Bowie (2010) states that positive practice should be highlighted as it allows others to learn from it and provides opportunities to improve the safety of patient care. Reflecting on these events has helped me to identify areas where practice needs improvement and given me a greater insight into my own role as a registered nurse.

Honey :: essays research papers

A Tasting Tour of U.S. Honey Varieties   Ã‚  Ã‚  Ã‚  Ã‚  There are many choices when it comes to sweeteners. However, no other sweetener has as many varieties as honey. Honey is pure, all natural, and was first sweetener known to man. Honey is made when a bee changes the composition of nectar by adding moisture and enzymes. The product is then stored in bee combs and covered with bees wax.   Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  Honey comes in many shapes, colors, and has a variety of flavors. Different types of honey come from different types of flowers. If there is an area with a large amount of one type of flower, a bee will produce honey with a flavor and color of the   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   plant. In areas with various types of flowers, bees will produce natural blends of honey. Flavors of honey stretch from bland tastes to sweet pleasant ones. Honey colors can range from a light golden color to dark brown depending on the flower. Darker honey means it is a different taste, not that it is low quality.   Ã‚  Ã‚  Ã‚  Ã‚  Different forms of honey are produced and sold in stores. Comb honey is a filled beeswax comb and is stored directly by the bees. Liquid honey is produced by clipping the wax off of the comb and extracting the honey from the cells. Creamy granulated honey is made by mixing granulated honey with liquid honey. Chunk honey is comb honey in a jar, covered with liquid honey.   Ã‚  Ã‚  Ã‚  Ã‚  There are many common types of honey in the United States. Alfalfa honey is a light colored honey that comes from purple blossoms and has a mild taste. Honey from a dark avocado blossom is avocado honey. Blueberry honey is taken from the blueberry bush which has tiny flowers. Blueberry is sweet and has somewhat of a tart taste. Fireweed is a honey light in color. This comes from a perennial herb found in Northern and Pacific states. Honey with a distinctive taste, golden color, and green cast is tupelo honey. Tupelo honey has a high fructose content, so it takes longer to granulate than other honeys. Wildflower honey is honey that is undefined at could have come from several different flowers. Sourwood honey comes from the sourwood tree which can grow up to 60 feet tall. Sourwood trees mostly grow and the mountains and can be found in Northeast Georgia. This honey has a sour taste. Maple honey is very sweet and tastes

Swan Lake Response

For my additional performance viewing, I attended a dance concert at The Ohio State University. Gene's Goings was choreographed by Rodney A. Brown. Performed by a group of Ohio State dancers, Gene's Goings was brought to life at Emerson Auditorium. The piece was choreographed to Ritual Union by Little Dragon and Suite for Ma Dukes by Miguel Atwood Ferguson and Carols Ion. Overall, Gene's Goings was a Journey that used the blending of images such as planting seeds, growing, and traveling to create a story for the audience.As the story unfolded, more intricate parts were noticed. For example, there was a leader on the Journey, which was the featured soloist throughout the piece of art. She had a distinct costume on and the other dancers seemed to follow her and mimic her movements. There seemed to be female dominance on this Journey that was clearly present with only 4 males on the stage throughout the entire piece. The tribal music gave it an African feel, later emphasized by the gran d hip rotations and grounded feel to the dancing. All of this was possible due to the use of a constant flip.Along with this, the entire piece had a funky and original feel to it. The costumes worn were normal, pedestrian clothing tit lots of neon colors. The girls had a constant blue and purple pattern, which pulled everyone together and gave the piece a feeling of unity. This also brought about a very vibrant and colorful vibe. Big movements using every part of the body portrayed the group of dancers changing along the Journey and growing into new people. Once they reached their destination, they were completely new individuals.Some of the movements remained throughout the piece, but as the Journey continued, new repetitive movements were also introduced. The group of 4 men in the beginning of the piece was acting as the starting force that began the Journey. The part where they were making sounds and building off of each other's movements was the chain reaction that started the v oyage. I also noticed that they were reappearing throughout the piece. After I noticed this, I realized that they came into the choreography once a new, signature movement was introduced.This represented the next step on their Journey. In the end, once the Journey was completed, the group of travelers exited the stage with their signature hip rotations and therefore ended their Journey in a similar fashion that they started it with. Commonplace was also performed in Emerson Auditorium. This piece was choreographed by Susan Hadley in 1996. The music being danced to was Forgotten Peoples by Evolve Tourism, but performed by the Estonian Chamber Choir. The music was in a foreign language and therefore required the audience to develop their own storyline for the performance.This piece was definitely a narrative, symbolizing a ritual of women in all places and times. The costumes worn were simple, black dresses, which gave the piece a very dim and dark setting. Each dress was unique with slightly different designs, showing the individual personalities of the women in this so-called community. The designs ere extremely modest, which gave the dance somewhat of a religious feel to it. At the same time, I got the vibe of some sort of witchcraft happening, symbolic of struggle and pain occurring among the women.The group of women almost resembled a sisterhood, Journeying through struggles and supporting each other along the way. The choreography had the group of all women moving together and in complete unison at the beginning of the piece. As the dance processed, there were many more levels and formations, including a circle where a single woman would be in the center while the remaining women stood around her as support. Partnering was a big aspect of this piece as the women carried and suspended one another as an act of creating.While in this circle, movements including shaking, convulsing, and seizing were happening to represent death, sickness, abuse, and any type o f struggle that women go through. This was a very emotional part of the piece because the women carried each other and supported one another. This showed courage and belonging as no one was left out or neglected because of their problems and struggles. The movement displayed was very intricate and detailed as the women moved together on their Journey of support and love.

Taking a Look at Amytrophic Lateral Sclerosis (ALS)

Amyotrophic lateral sclerosis (ALS) presents as progressive weakening of all the voluntary muscles in the body due to the degradation of motor neurons. It is a severe motor neuron disease (MND) that is usually fatal within 5 years due to arrest of the respiratory muscles [Rowland, 2000]. It is only relatively recently that studies have defined specific gene mutations affecting protein function, giving some hope for finding an effective therapy for ALS. Currently there is no cure or treatment for the disease. Over the last five years discovery of mutations in two genes, transactive response (TAR) DNA-binding protein (TDP-43), so called because of its 43-kDa mass, and fused in sarcoma/transloacted in liposarcoma (FUS/TLS) have shifted research into trying to understand the roles of RNA metabolism in neurodegeneration. This micro-review will try to summarise what is known so far about TDP-43 and FUS/TLS and how they relate to pathogensis of ALS. TDP-43 was first identified in 2006 [Neumann, Sampathu and Kwong, et al., 2006] where it was shown there was a link between the protein and both ALS and frontotemperal lobar degeneration (FTLD). This study used double-labelling immunofluorescence to show that TDP-43 antibodies (antiTDP-43) immunolabelled ubiquitinated cytoplasmic, nuclear, and neuritic inclusions in sALS. However, it remained unclear how and what gene mutations were the underlying cause. This study observed that patients with ALS and FTLD had pathologic TDP-43. It