Preventing Central Line Blood Stream Infections Essays

Preventing Central Line Blood Stream Infections Essays Preventing Central Line Blood Stream Infections Essay Preventing Central Line Blood Stream Infections Essay maximal sterile barrier precautions, catheter placement and optimal timing of replacement, surveillance, education, improved hand hygiene technique and compliance, etc. ), and technological (e. g. , use of preferred skin antiseptics such as chlorhexidine gluconate, closed infusion containers, catheter dressings, etc. ) practices† (Torricone et al, 2010). Another intervention includes a closed infusion container with self-sealing injection ports that reduces the risk of air and organisms from entering the infusion. According to the American Association of Critical Care Nurses (AACN), a large proportion of nosocomial infections result from â€Å"cross-contamination from the hands of healthcare workers† (2005). It is important to Always wash your hands  before and after  putting on or removing gloves, direct patient contact, inserting a peripheral catheter or assisting with CVC nsertion, palpating a catheter insertion site, changing a catheter dressing, accessing the catheter to administer a medication or flush (Hadaway, 2006). The CDC also recommends the use of alcohol-based hand rubs between patient contacts instead of just hand washing alone (AACN, 2005). Always wash your hands  before and after  putting on or removing gloves, direct patient contact, inserting a peripheral catheter or assisting with CVC insertion, palp ating a catheter insertion site, changing a catheter dressing, accessing the catheter to administer a medication or flush (Hadaway, 2006). Also, change gloves  used for other patient-care tasks before you perform any infusion or catheter care tasks. The use of the Central Line Bundle is also beneficial. The bundle focuses on hand hygiene, maximal barrier precautions, chlorhexidine skin prep, optimal catheter site selection, and daily assessment of line necessity with prompt removal of unnecessary lines (Institute for Healthcare Improvement, 2008). An article written by Suzanne M. Brungs, RN, MSN, MBA, OCN, and Marta L. Render, MD, supports the use of bundles for Central Lines in an effort to reduce infections. The bundle is composed of hand hygiene, use of chlorhexidene as a skin prep prior to insertion, a full body-drape that covers the patient from head to toe, barriers such as sterile gloves, gown, masks and caps to be worn by the inserter and avoidance of using the femoral insertion site (2005). The article reports that since the implantation of these bundles, central line associated blood stream infections were reduced by at least 50% and â€Å"compliance with using evidenced-based practices increased from 30% to nearly 95%† (Brungs Render, 2005). Florence Nightingales Environmental Theory supports the Joint Commissions patient safety goal to reduce central-line related blood stream infections. She believed that the patient is affected by the environment and that the nurse acted on the patient. By controlling the environment you could control the patient’s health. Cleanliness, among other factors, in her theory, facilitated the patients healing process. This is essentially the same thing we are doing with the use of CVC bundles. By controlling our environment and maintaining sterility during insertion, management and care of central lines, we reduce the risk of infection and promote the patients well being. Good hand hygiene prevents bacteria from being passed from one patient to another, which therefore reduces risks of infection. Another theorist that supports the Joint Commissions patient safety goal is Dorothea Orem. Her self-care model states that when the patient cannot care for his/herself, it is the nurse who in turn meets the patient’s needs by acting and doing for the patient (Current Nursing, 2010). The nurse guides, teaches, supports and provides an environment that promotes patient care and health. This is the whole premise of advocacy. When the patient cannot speak for his/herself or when they aren’t knowledgeable about a specific procedure it is our duty to make sure we assume the role of patient advocate and do for the patient and teach the patient. It is up to us that the patient received optimum care. Ultimately, patients are at risk with any intra vascular device but there are steps that we can take to minimize risks for infection. Many national efforts today are aimed to reduce the risk of blood stream infections related to central lines. I believe that infection control programs must strive to apply universal and consistent control measures and prevention tips with all types of CVC’s. There is no doubt they are here to stay but it is essential that all healthcare providers are given the tools necessary to ensure patient safety and satisfaction. There is no excuse for an infection. We must advocate and we must strive to protect our entire patient population. References American Association of Critical Nurses. (9/2005). AACN practice alert: Preventing catheter elated blood stream infections. Retrieved from aacn. org/WD/Practice/Docs/Preventing_Catheter_Related_Bloodstream_Infections_9-2005. pdf Brungs, S. M. , Render, M. L.. (2005). Using evidenced-based practice to reduce central line infections. Clinical Journal of Oncology Nursing, 10(6), 723-25. Hadaway, L. C.. (2006). Keeping central line infectio n at bay. Nursing 2006, 36(4), 58-64. Haller, L. T. , Rush, K. L.. (1992). Central line infection: a review. Journal of Clinical Nursing, 1, 61-66. Institute for Healthcare Improvement. (2008). Prevention of central line-associated bloodstream infection. Retrieved from hi. org/NR/rdonlyres/01E7F0ED-EEDE-41BA-ABB0-982405602158/0/cli. pdf Maki, D. G. , Kluger, D. M. , Crnich, C. J.. (2006). The risk of bloodstream infection in adults with different intravascular devices: A systemic review of 200 published studies. Mayo Clinic Proceedings, 81(9), 1159-71. Nursing theorists: A companion to nursing theories and models. (2010). Retrieved from http://currentnursing. com/nursing_theory/nursing_theorists. html The Joint Commission. (2009). Accreditation program: Hospital national patient safety goals. Retrieved from http://scholar360. com/cchs/media/user/1341/Joint%20Commission%202010%20NPSGs_3. pdf

Characteristics of a Metropolitan

Characteristics of a Metropolitan ABSTRACT The purpose of this paper is to understand what Groningen appropriates as a mini-metropolis city. The first step is to find the meaning of the metropolis from a variety of sources, the second step of searching for data about Groningen and the third step is to compare between the two data. In the end is at a conclusion that the metropolis are not only associated with the factor number of population, area and economy of a city, but a related metropolis of a character which is owned by the city. So Groningen with all matters and functions and its ability to further develop its compliance is said to be a mini-metropolis city. Metropolis Characteristics Metropolitan is a term used to describe a relatively large urban area, both of the size of area, population, and the scale of economic and social activity. While the etymology, said metropolitan (noun) or metropolis (adjective) is derived from the Ancient Greek language, which the word meter means mother, and the word polis means city. (Wackerman, 2000) In general, the metropolitan can also be defined as a large residential center that consists of a large city and some in the surrounding area with one or more major cities that serve as a point of contact (hub) to the towns in the surrounding areas. A metropolitan area is an agglomeration of several settlements, settlements should not be the city, but the overall form a unity in nature activities and lead to the city center (a large city that is the core) that can be seen from the flow of labor and commercial activities. According Goheen (in Bourne, ed. 1971), City / Metropolitan District is an urban area with a population characteristic that stand out in comparison with the surrounding countryside. This term is used to give a more precise picture of the amount and concentration of the population in a large area, which in turn can show the magnitude of the centers of the main settlements in the country. In general, the metropolitan region can be defined as l arge, with economic and social unity integrated and characterize the activity of the city. The characteristics of the Metropolitan of several aspects such as the amount of population, economic activities, mobility, activities of the population, and the structure of the region. 1. The amount of the total population The magnitude of population becomes a major consideration in determining the aspects of the definition of a metropolitan. However, some urban experts set different limits for the determination of the minimum number of metropolitan area population. 2. Economic activity In the metropolitan area occurs agglomeration residential areas and jobs. That is, the metropolitan area is an urban area with a specializing in social and economic activities function. The economic specialization is the industrial and services sectors. Industrial activities and services is the dominant sector in the growing metropolitan region. Economic activities that take place in the metropolitan area is heterogeneous and has a role as a central / center of economic activities on a regional scale, both within the province or state and national scope.

International strategy Essay Example | Topics and Well Written Essays - 1500 words

International strategy - Essay Example Disadvantages of Scandinavian business culture From the case study, it is clear that IKEA has been following a Scandinavian business culture, even in most of its international assignments. Scandinavian business culture is dominated by a direct style and more open culture. Conversations are more liberal and personal, and they prefer not asking questions after meetings or presentations. It should be noted that this culture is opposite to America or Asia, where business meeting are more formal and structured (Warner and Joynt, 2002). A typical Scandinavian culture gives high importance to consensus in every decision they take. Hierarchical structure is more or less flat and decision making can be sometimes very lengthy, because agreement has to be taken from every member of the business. Ingvar Kamprad, the founder of IKEA followed a similar culture. His distinctive style and objective of making a difference in the lives of common people drove his expansions strategy. He followed a non- conformist philosophy and looked at all facets of his distribution strategy, in order to focus and innovate (Politis, 2000). During the initial days, the objective of the company was to keep the costs low, and most of the strategies were made keeping this objective in focus. Supplier relationships were made reciprocal so that the company is above to sell whatever they have produced. Managers were expected to keep caring and close relationships with their subordinates and co-workers. Interactions between the co-workers and managers were characterized by egalitarianism and informality. In the following sections, IKEA business cultural and strategies will be discussed which the company implemented in different international assignments. While the culture of IKEA was a strong factor in contributing for the success of the company in its homeland, the same culture caused many issues and roadblocks when the company went for expansion strategy (Hofstede, and Minkov, 2010). The business cult ure of the host countries was vastly different from the way IKEA was doing business and caused cultural as well as business conflict (Huettinger, 2008). In Germany managers do not call each other by their first names as it is perceived as disrespectful. Business culture in Germany is mostly authoritative where managers takes order from bosses and are not supposed to perform any activity taking their own initiatives. This is vastly opposite from IKEA’s normal way of doing business. Thus, when IKEA entered Germany, its collaborative and opted business culture did not go well with the strict authoritarian German business culture. IKEA’s preference for informal relations between managers and co-workers was misinterpreted as disrespecting the boss and undermining the traditional rule of respecting authority. Also, the business culture is more adaptable to detailed work structure and a lengthy procedure, which is opposite IKEA’s cultural of minimalist bureaucracy and making things less burdensome. Similarly, in case of France, the informal culture of IKEA was interpreted as a sign of indecision and weakness. Also, in IKEA, recognition of status was not considered important, which again was interpreted as a negative sign in Germany. Even though the company was able to reduce communication problems arising in most of its international counterparts,

Empiricism Essay Example | Topics and Well Written Essays - 2500 words

Empiricism - Essay Example We should reject knowledge claims concerning matters of fact about the nature of the world which are not supportable by the evidence of experience. This leads to a tendency among empiricists to emphasize that the limit of human knowledge and imagination is bounded by the limit of our experience. Empiricists reject the rationalist claim that it is possible to come to know by a priori reason alone the nature of an intelligible real world inaccessible to experience that stands beyond appearances. The empiricist may argue that concepts (such as substance), and the terms that express them, are meaningless or else must relate to some possible experience, since concepts and terms get their meaning by reference to some possible experience, but a world beyond experience cannot be a world that might possibly be experienced; in either case it is not possible to use meaningful concepts to talk of a world beyond possible experiences. The tendency in empiricism is also to deny the existence of natural necessity: necessity is a property only of logical relations between concepts, or of logical relations between ideas or thoughts, not between things or events in the world whose existence, nature and connections are all contingent; such natural contingent connections can be discovered not by reason, which can establish only necessary truths and necessary connections, but only by experience. Empiricism is inclined to argue that there are two exclusive and together exhaustive types of proposition. (a) Propositions whose truth, logically speaking, can be known merely by understanding them, or by deductive reasoning alone, independently of the evidence of experience: truths of reason. (b) Propositions whose truth, logically speaking, cannot be known merely by understanding them, or by deductive reasoning alone, but which depend on the evidence of experience: truths of fact. All propositions which tell us anything about the real or actual world are truths of fact. Propositions stating matters of fact cannot be known to be true merely by our understanding them, or by our deducing them from other propositions known to be true by the understanding alone; if we can know them to be true at all, they must be known through consulting experience. It should be noted that the distinction is not the genetic one of how we come to have, acquire, or understand these different sorts of proposition, but a logical question concerning on what, once acquired or understood, the truth or falsity of a proposition depends, and on what knowledge of the truth or falsity of a proposition depends. If the truth or falsity of a proposition depends only on the meaning of the terms in it, then it is an a priori proposition whose truth or falsity can be known a priori by reason alone independently of empirical evidence. If the truth or falsity of a proposition does not depend only on t he meaning of the terms in it, then it is an a posteriori proposition whose truth or falsity can only be known a posteriori by empirical evidence, not by reason alone. (Frederick Copleston, 1964, 54) The basic contrast between rationalism and empiricism is an argument about the extent and nature of what truths it is logically possible to know a priori by the understanding independently of experience, by intellectual intuition

What Exactly Can Picture Books Teach Our Children? Essay -- Learning T

What Exactly Can Picture Books Teach Our Children? I chose to read and comment on Barbara Kiefer’s â€Å"Envisioning Experience: The Potential of Picture Books.† Kiefer’s main point in writing this essay was to get the message across that children enjoy picture books that allow them to identify and make connections with the characters or the plots, and that while reading and analyzing the pictures, they gain a better sense of aesthetics and how to interpret them. I agree whole-heartedly with the conclusions that she drew from her observations. It is very hard to get the whole â€Å"picture† from a children’s storybook that has no pictures. The children find it harder to identify with the characters and often find these books boring. Being able to see the pictures helps them to make connections with either the characters or with their personal experiences. For example, all small children can identify with the little monkey, George, in Rey’s Curious George. On page 27 of the book, we see George smoking a pipe because he saw the man in the yellow hat smoking it. At some point in every child’s life, he has seen an adult doing something unfamiliar and wanted to try it, just like George did. This would be a good point at which the child could articulate one of his experiences to a class or friend, helping him to become more comfortable with speaking about and sharing his thoughts. Kiefer points out in her essay that when children vocalize what they think about a story and the pictures, it helps them to become more cognitive thinkers. She also stated that â€Å"the children I observed seemed to be intent on making meaning regarding the picture books †¦Ã¢â‚¬  (Kiefer 66). I, too, can see this when I am ... ...s and classrooms should have a wide variety of books available with varying styles of writing and art work. In addition to the books, the children should be given a variety of ways in which to express their thoughts and feelings about these books, either through discussion, writing, or their own art work. I agree because this could only allow children to enjoy reading more and lets them feel like their opinions matter and are appreciated. Having books readily available only increases a child’s desire to read and creates in him or her a love for books that, hopefully, never goes away. Works Cited Kiefer, Barbara. â€Å"Envisioning Experience: The Potential of Picture Books.† Publishing Research Quarterly 7.2 (1991): 63-75. Rey, H. A. Curious George. Twentieth Century Children’s Book Treasury. Selected by Janet Schulman. New York: Knopf, 1998. 88-95.

Fireweed is written by Skye Brannon Essay

The short story â€Å"Fireweed† is written by Skye Brannon, it is a story about a young man named Baluta. He emigrated from West Africa to US, with his brother Jato and his sitster in law Sama. The story is about how an ordinary workday can trigger memories from the past. In the beginning his memories are filled with happiness, because it is about his family back in Liberia. But as the story evolves, his memories, which he desperately ties to forget presents them selves. The main character, Baluta immigrated to US about 1980-1990’s because of the civil war in Liberia. In the short story it is written thatâ€Å" The war will be coming our way soon. It was the first time Baluta saw fear behind his father’s strong eyes†. This may be the reason why Baluta left Africa and immigrated to US. Baluta and jota is not very articulate. And their problem with the English language is portrayed by the author substituting a normal English vocabulary and choose to write sentences frenetically, for instance â€Å" Dese Americans, Joto said, if you tell demy out Mandika name, dey look like you have given dem a riddle†¦Ã¢â‚¬  Though the characters may have some problems with the language, it is not said directly that they are stupid. Furthermore is seems that Baluta is a very thoughtful young man, who pays attention to the people around him. He is keen to make the people around him feel good in his company, and he finds it sad when he is incapable of making life easier for others. He feels very sad that he need to use the car, to get to work, because then his family have to get up early to cheat the buss to work. And another example is that he makes sure that the people he works with doesn’t have any problems pronouncing his name and therefore chooses to take the name Joel. He is very kind to other people, even though he had a very hard childhood in Liberia. He was an eyewitness to the murder of his family and unfortunately the memory of this still haunts him. His bad childhood, have made him in to a very sensitive person. Even though he has immigrated to US to get a better life, he stills live in a ghetto[1] which is seen in 8th sentence in the beginning of the text â€Å"Baluta washed in the shower, cold after his brother and sister-in-law had had theirs† this quotation shows how poor they are, because they don’t have enough hot water for three people to shower in the morning. But not only the problem with the hot water shows how poor they are, the car Baluta use to go to work every day is in such bad condition that Jota refers to it as the â€Å" Swiss Chevy† like the Swiss cheese. And the attempts of the duct-tape patchwork and the whistling sound the car makes at speed, clarifies the state of it. The short story follows a chronological storyline, with some flashbacks. It all starts with Baluta thinking of his little sister Alanso. His memory of her is loving and happy like her self when she was alive. Which is mentioned in the text â€Å" It was Alanso’s laugh, flowing like doves out of her bright smiling mouth. It was Alanso’s laugh, out from between those cheeks caught the sun and held it in a warm glow the rest of the day†. After having the first flashback, his day carries on as normal. On his way to work, he passes a lot of golf resorts and drives trough a big gate, this gate can symbolize a â€Å"gate back in time†, to his time in Liberia, because on the other side of the gate he gets a another flashback. The neighborhood he drives in reminds him of his father and the monkeys he used to train. Another flashback comes to him as he sees Tiffany’s diamond ring reflects the sunlight into his face. He can hear his father telling him â€Å" they found some diamonds in their mountain†. He returns to his work, just to be reminded of his past ones again. Just by hearing the word Fireweed, he is drawn back to the time where he lost his family or some of it. He relives it all, and are ones again forced to stand face to face with death and loss. There are many themes in this short story, but some of the main themes are loss, he looses his family or some of it, which he are trying to forget, the proverb, Wherever you go, your problems will follow you, even though you try to run or somehow try to get away from your problems they will follow you until you deal with them. This seems to underline theme here. Another theme is immigration. Some people flee from their homes, go get to some kind of safety. This short story is able to twists our reality, and puts in an immigrants’ shoes. This short story makes us think about life and death, and how easy it is to loss someone you love and are force to leave everything to get to safety.

Intelligence And Personality - 1682 Words

Introduction It is commonly believed that people differ in various ways, and these individual differences play a detrimental role on their behaviour at work. To be more specific, individual differences include two kernel factors which refers to intelligence and personality. It is clear that individual differences are important in determining behaviour, however, there are other external factors which are equally important, such as working environment or culture within an organisation. Intelligence Gottfredson, (1997) stated that intelligence is ‘a very general mental capability that, among other things, involves the ability to reason, plan, solve problems, think abstractly, comprehend complex ideas, learn quickly and learn from experience.†¦show more content†¦On the contrary, those people who scored low on one kinds of ability test, were more likely to score badly on others as well. Meanwhile, Spearman also concluded that intelligence is a cognitive ability which could be measured and expressed numerically. The relationship between intelligence and work related outcomes has been found through various empirical studies. A longitudinal studies found that there is a positive moderate correlation (.51) between IQ at 12 years of age and occupational level and a slightly higher correlation (.53) between IQ at 12-year-old and income (.53) aged 40-50. (Judge, Higgins, Thoresen, Barrick, 1999) Thus, we can see that IQ level plays a significant role on work related outcomes from this empirical study. In addition, another study found that IQ level has a low correlation (.23) with performance within low complexity jobs whereas IQ has a strong correlation (.58) with performance in high complexity jobs. (Hunter Hunter, 1984; See Schmidt Hunter, 2004 for an overview) To put it another way, high intelligence is not essential for low complexity jobs, for example, waiter and cleaner does not require high IQ. On the contrary, high intelligence is crucial for complex jobs since it represents high reasoni ng and mental capabilities. Thus, it is not hard to see that individuals’ behaviour at work will be remarkably