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

Garvey vs. Du Bois - 1980 Words

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The Television On The Broadcast - 1129 Words

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Pathophysiology of Asthma

Question: Discuss about thePathophysiology of Asthma. Answer: Introduction Asthma is a chronic inflammatory disorder of the airways. It involves airway inflammation, airflow obstruction and bronchial hyper responsiveness. It affects the patterns of breathing that is characterized by wheezing and coughing (Zone and Guide 2017). In this case study, Jessica White, a five year old girl is diagnosed with asthma. The past medical history showed mild eczema and asthma triggered by a viral infection after the common cold. This study shows the pathophysiology, signs and symptoms and pharmacology of asthma on Jessica. Pathophysiology, Signs and Symptoms, Pharmacology In this case, Jessica White, a five year old girl was diagnosed with asthma. She was at a high risk of having asthma as she was born premature at the thirty three weeks. She had high risk for wheezing during the first years of her life. Moreover, the past medical history reported eczema and viral infection during the winters and after the common cold. The diagnosis and management of asthma is difficult for the children below the age of five. The wheezing and coughing are the main primary symptoms in the children that might be manifested by other symptoms. The pathophysiology of asthma primarily consists of inflammation that plays a central role (Olin and Wechsler 2014). The airway inflammation of the various cell types and multiple mediators results in the manifestation of asthma like airflow limitation and bronchial inflammation. This results in recurrent coughs, wheezing and shortness of breath (Heijink, Nawijn and Hackett 2014). The cellular response and profile of the structural cells are quite consistent in asthma. Jessicas asthma can be linked to her premature birth. She was born premature at the thirty three weeks of the gestation period. According to Trnnes et al. (2013) the babies who are born before the thirty three weeks of gestation are likely to have asthma in their childhood as compared to full term babies. The preterm birth of Jessica is the main cause of her breathing problems as her lungs were immature. The asthma like symptoms occurs in the children under the age of there. The asthma like symptoms in Jessica occurred before the age of three that is associated with symptoms of asthma. The root cause of asthma is not clear yet it results from the respiratory infections. The asthma in children is different from the asthma in adults. They have smaller airways and small amounts of swellings caused due to the viral infections can make the airways tightened or blocking of the air flow due to increased mucus amount (Szefler et al. 2014). This results in difficulty in breathing for the young child. The viral respiratory infection is the triggering event for asthma in the young children. As they are not able to tell their parents, it results in trouble breathing. The immature lungs pose a way to the breathing problems in the premature babies. The airway tubes are swelled up and produce excess mucus (Harju et al. 2014). Gradually, the muscles surrounding the airways tightened up and the breathing tubes become narrowed. This makes the breathing rapid with a wheezing or whistling sound as the breath is forced through the airways that are narrow. Jessica continuously experienced shortness of breath and hear breath was noisy. Asthma affects 14% of the premature babies and has 50% of chances of developing asthma (Priante etal. 2016). Jessica also suffered from mild allergic skin infection like eczema that was triggered during the winters after she suffered from common cold. More than 60 % of the asthma in babies occurs due to allergy like eczema. When the airways are exposed to irritants that triggers an allergic response in the respiratory pathways causes them to spasm, swell and produces mucus in excess amount. This causes constriction of the airways resulting in wheezing making a high-pitched whistling sound when a person exhales. Likewise, in Jessica, the eczema might have caused the airways to swell making it difficult for her to breathe. This leads to inflammation and respiratory problems being the early sign of asthma in Jessica. The primary effects of asthma are the narrowing down of the breathing airways due to inflammation of the airways in the lungs. The airways are swollen in the asthmatic patients and there is difficulty in breathing. There is also constricting of the airways due to allergens that irritate the airways. This also causes excess of mucus production that triggers the symptoms of asthma. The bronchioles contract as the wall lining expands constricting the airway (Ionescu 2013). According to the National Heart, Lung and Blood Institute, asthma is characterized by wheezing, coughing, shortness and tightness in the chest (Kang et al. 2016). She had shortness of breath at night and a noisy sound while breathing. She also coughed during the night and the salbutamol puffer relieves her of the breathing problems and she went back to sleep. However, after that she had persistent coughs and shortness of breath and it did not improve even after the second dose of salbutamol puffer. After she was taken to the emergency department, a respiratory assessment was done and she was prescribed to take salbutamol and ipratropium with prednisolone dose. She was also given high flow of oxygen as her saturated oxygen levels were below 93%. Jessica showed the main symptoms of asthma with coughing, wheezing and shortness of breath. She also had a history of common cold, viral infection and eczema which are some of the non-specific symptoms that triggered asthma. She coughed especially at night and a noisy or wheezing sound when breathing out. She also experienced fast or troubled breathing with tightness in her chest as the skin surrounding the neck or ribs are pulled tightly. She also had common cold during the winters that settled in her chest. After that when the symptoms recurred that gave a clue of asthma in Jessica. The high-pitched, whistling sound while exhaling that worsened during the night gave an indication of asthma in Jessica. Moreover, the certain events like the mild skin disorder that caused eczema worsened the asthma symptoms. The case study revealed that Jessica has family pets and she helped her grandmother with the pets. She has two long haired dogs and one short haired cat that might be a source of allergy that has triggered the asthma symptoms. The children below the age of five feel uncomfortable as they experience shortness of breath. Jessica also had short periods of wheezing and coughing between periods showing no symptoms. There were also events of frequent symptoms with worsened wheezing and coughing episodes where she was taken to the emergency department. Her breathing was so hard that her abdomen was sucked under the ribs and trouble while speaking because of the restricted breathing. Moreover, Jessicas mother Anne informed the emergency department consultant and the registered nurse that she often wakes up during the night if she is well. She also said that she even coughs at times when she plays in the playground. This also shows the symptoms of asthma that gets worsened during any physical activity and day-to-day activities (Depner et al. 2014). These symptoms manifested as a part of asthma in Jessica. She showed the major symptoms of asthma having coughing, wheezing, shortness of breath and significant troubled breathing. She was diagnosed with moderately severe asthma by the emergency department consultant. Moreover, she leaned forward in a sitting position in order to breathe and there was no relief by the use of salbutamol puffer at home that triggered the asthma emergency. Salbutamol is a bronchodilator that helps in the widening of the airways. Its application opens the air passage so that air passes freely into the lungs. This helps to relieve the symptoms of asthma such as coughing, wheezing and shortness of breath. It starts its action in few minutes and lasts between three to five hours. It also helps to relieve the breathlessness but do not prevent it from happening. Jessica was prescribed with salbutamol puffer that relieved her of the symptoms of asthma. When she had a wheezing attack, the passage in the airways gets narrowed making it difficult for her to breathe causing the asthma symptoms to occur. Salbutamol helps in the opening of these narrowed airways and relieved her of the attack. She uses it through an inhaler and spacer that goes through her airways and lungs. In the case study, Jessica was advised to use the salbutamol puffer via a spacer every two hours. Gradually, her respiratory status improved and she could enjoy eating along with her mother. At around eight oclock in the hospital, Jessica said that her breathing is normal and the spacing was increased between her salbutamol doses. She was also administered with a steroid, prednisolone that prevents the release of the inflammatory substances in the body. The breathing disorder and allergic disorders are treated by prednisolone that is used to prevent the asthma attacks in Jessica and control the asthmatic symptoms like wheezing (Page and Barnes 2013). After its administration orally, it is absorbed into the body that goes directly into the lungs and treat the asthma attacks. Moreover, it is also helpful for her to gain better control over asthma while at home or at school. The asthma plan with medical follow up is helpful for her to prevent the acute asthmatic attacks. The above case study of Jessica White shows the pathophysiology of asthma and significant signs and symptoms. She showed the asthmatic symptoms like coughing, wheezing ad shortness of breath. The use of salbutamol puffer relieved her of the asthmatic attacks followed by asthma action plan and medical follow up helped her and her mother to manage the periods of asthma. References Austen, K.F. and Lichtenstein, L.M. eds., 2013.Asthma: physiology, immunopharmacology, and treatment. Elsevier. Depner, M., Fuchs, O., Genuneit, J., Karvonen, A.M., Hyvrinen, A., Kaulek, V., Roduit, C., Weber, J., Schaub, B., Lauener, R. and Kabesch, M., 2014. Clinical and epidemiologic phenotypes of childhood asthma.American journal of respiratory and critical care medicine,189(2), pp.129-138. Harju, M., Keski-Nisula, L., Georgiadis, L., Risnen, S., Gissler, M. and Heinonen, S., 2014. 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