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Nursing in the Intensive Care Unit, 2008.
An analysis of the problems in determining patient-staff ratios in the intensive care unit (ICU) and how to address this issue.
2,768 words (approx. 11.1 pages), 10 sources, APA, £ 57.95
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Abstract
This paper addresses the problem of finding a reliable means of predicting the need for nursing care of patients in the intensive care unit (ICU). It looks at present systems devised by nurses to establish nurse-patient ratios and explores these strategies and systems, as well as alternatives. The paper concludes that the preferable course will be a system designed by nurses; without that, legislation will be the only alternative. The paper also looks at the writer's point of view and the relevance of the issue to him.
Table of Contents:
Introduction
Personal Relevance
Relevance to Nursing
The Issue: Nurse-Staff Ratios
Analysis
Alternatives: Staffing Models
Legislation
Recommendations
Conclusion
From the Paper
"Another system for determining nurse-patient ratios is of more interest to the health organization and the government. The diagnostic related groups system is primarily based on the principal diagnosis. Comorbidities and other factors such as length of hospital stay allow outcomes to be costed. The diagnostic related groups are used as a means to calculate costs as well as a system to estimate the cost of nursing care. The problem with the diagnostic related groups system is that, although it is comprised of 475 diagnostic categories, they have never been evaluated in terms of the nursing workload linked with them (Adomat & Hewison, 2004). In general, no patient classification or dependency system that currently is in use is completely effective for determining nurse-patient ratios in the ICU. The problem is found in the variable nature of the ICU so that a set of circumstances cannot be projected onto even the immediate future."
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Fiscal Management in an Intensive Care Unit, 2007.
This paper is a case study demonstrating fiscal management through variance analysis for an intensive care unit.
1,455 words (approx. 5.8 pages), 5 sources, APA, £ 33.95
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Abstract
This paper explains that, currently, major activities need to be taken into consideration so that the budget for the intensive care unit can be reconfigured or some activities can be deferred to the new fiscal year. The author relates that issues relating to safety standards and staff education increase overall productivity, which improves the quality of care within the intensive care unit. The paper points out that next fiscal year budget should have personnel divided by functionality to make budget allocations indicative of different staffing activities. The author suggests that, in an intensive care unit, it is imperative that supplies are kept in stock or there can be serious legal and financial implications; therefore, there should always be padding for this area provided in the budget. The paper includes a variance table showing the current reallocation of the budget, which addresses the important factors within the intensive care unit without increasing the budget.
Table of Contents
Expenses
Conference on High Risk Medications
High Risk Medications
"Smart Pumps"
Supplies Expenses
Personnel Budget
Table 1: Reallocation Process: Intensive Care Unit Budget Adjustment
Major Fiscal Concerns and Recommendations
Table 2: Variance Analysis
From the Paper
"The traveling or staff education budget will not allow the all three nurse to attend the seminar this fiscal year, since the budget remaining in these categories is $700 and $400 respectively. However, one of the nurses can be registered for the conference this year (and take advantage of the $200 registration fee), while the other the attendance of the other two nurses get deferred to the new fiscal year. This decision was based on the nature of the seminar, and the fact that the nurse's attendance will possibly have a 'spillover' effect and create a positive externality within other sectors of the intensive care unit via."
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Visiting Hours in the Intensive Care Unit, 2007.
This paper describes the pros and cons of open versus closed visiting hours in the intensive care unit.
2,736 words (approx. 10.9 pages), 7 sources, APA, £ 56.95
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Abstract
This paper, written from the perspective of a nursing practitioner, examines the issue of open versus closed visiting hours in the intensive care unit. The author explores these questions from the perspective of a quality care issue as well as a culturally competent care issue. The author summizes that open visiting hours in the intensive care unit can cause more strain on the patient and the staff than is good for either to experience.
From the Paper
"Confounding and complicating factors in the study include the relative selectivity of the patients, and the fact it was a single center trial, which reduces the degree of generalization of the results. What should be noted in the authors favor however is that the study was indeed a pilot and used more scientific methods than had previously been done to examine the true effect on the patient. What cannot be judged from this survey is what the effect of the rotating sequences had on the staff. It is noted that the staff were not allowed to know which sequence was being used until the new period began. It is also interesting to note that the ICU did not accept any new patients in the last week of the two month period in order to prevent overlap of patients in different visiting cycles, and that the ICU was closed for 4 days between each cycle to allow a cleaning and disinfecting. This unusual procedure may have had a confounding effect on the rate of infection as well."
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Bernard Malamud?s "Angel Levine" and Lee Smith?s "Intensive Care", 2002.
This paper compares "Intensive Care" by Lee Smith and "Angel Levine" by Bernard Malamud, which both deal with issues regarding death, and illustrates why "Intensive Care" was more moving than "Angel Levine."
1,675 words (approx. 6.7 pages), 2 sources, £ 37.95
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Abstract
This paper explains that the increased emotional impact of "Intensive Care" was a result of the better developed characters, the informal and engaging tone, the conflict with a realistic ending, and the powerful theme. The author points out that Malamud does not provide the same background to the relationship that Smith did, which prevents the story from involving one emotionally to the same degree as "Intensive Care." The paper explains that the conflicts of the two stories are interesting because they are both very similar, while having very different outcomes.
From the Paper
"Both their characters are then revealed further by describing their relationship, including their meeting back in high school and then their more recent relationship. This creates a love story between them which is effective at holding the reader's interest. One of the interesting things about the story is that Cherry is the character who creates the most interest, despite her remaining in the hospital bed the whole story. She is the least active character and yet the most interesting. Her energy for life is expressed throughout and I found myself wanting to see the world the way she did. Harold then becomes the character that the reader is journeying with. Harold is struggling with the idea of losing Cherry and the reader can understand why this would be such a loss for him."
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Discharge after Intensive Care (ICU).
This paper is a comparative critical review of the literature concerning the problems following discharge directly to a patient's home after intensive care in the hospital ICU.
2,930 words (approx. 11.7 pages), 17 sources, APA, £ 59.95
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Abstract
This paper compares two articles, both indicating problems after discharge to the home from the ICU, with each other and with an additional review of the literature, "Problems Following Discharge after Intensive Care," written by Daffurn et al (1994) and "Intensive and Critical Nursing Care," written by Scraggs et al (2001). The author points out that the condition, disease, illness, or injury of the patient is most likely one of the two most predominant factors in the experience of the recovering patient upon discharge home from the ICU. The paper stresses the importance of the proper provision of both verbal and written instructions to the patient and the patient's caregiver, since this greatly impacts the patient in terms of well-being, as well as the overall experience of discharge to home from ICU, thus reducing the need for returning to the hospital.
Table of Contents
Objectives
Review of Articles for Comparative Critical Review
Article One
Article Two
Review of Available Literature
Review Comparison and Contrast of Findings
Conclusion
From the Paper
"Results of the study found that of the 54 patients 34 of the patients experienced normal sleep patterns after discharge while 15 reported that they were unable to remain asleep due to disturbances and 5 patients were unable to fall asleep. 41 patients reported a normal appetite while 11 reported that their appetite was reduced and 2 patients reported a controlled appetite. Of the 54 patients 17 were not on medications at al while 14 of the patients were n Cardiac medications, 9 patients were taking multiple meds and four patients were taking analgesic medications. In relation to the memory of the patient in relation to the ICU stay 16 of the 54 patients had no memory of the stay whatsoever while 7 had a pleasant recall of the ICU stay and 9 patients claimed an unpleasant recall of their stay in the ICU. Reporting nightmares during the ICU stay were 7 patients while 15 of the patients had complaints of a minor nature. Home support was reported to be "none" by 4 of the 54 patients, while 40 of the patients reported "good" home support and 10 patients reported inability to sleep due to interruptions from home help support."
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"Intensive Care", 2002.
A review of the short story "Intensive Care" by Lee Smith
712 words (approx. 2.8 pages), 0 sources, £ 17.95
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Abstract
This paper analyzes the short story "Intensive Care" by Lee Smith and ,in particular, the relationship between the two main characters, Harold & Cherry. It shows how Smith uses Harold and Cherry's relationship to illustrate the several different themes prevalent in society today such as the power of love and how often we settle for our lives, rather than doing anything to make them better or taking the time to love or to enjoy those around us, we simply go through the same motions every day. It examines how Harold is a classic example of someone going through the motions, who finally has the strength to break away. Smith makes us understand that love may not always last physically, but it will last forever in Harold's heart.
From the Paper
"The only person who is not transformed by love in the story is Joan, Harold's ex-wife. Her life goes on just at it did before, perfectly. There is nothing in his old house to remind anyone he ever lived there. It is as if he is a phantom who existed once but has quickly been forgotten. "He looks back at the living room but there's not a trace of him left, not even an imprint on the soft white cushions of the sofa" (Smith 769). That is another theme in this story. While Harold has been pretty much forgotten by his family, he will never forget Cherry. She has changed him that much. In the end, he may "settle" again and go back to his family, but the reader gets the feeling his life will never be the same. He has been transformed, and he will be a different man if he goes back."
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Intensive Care and Accidental Extubation, 2002.
A look at the phenomenon of unplanned extubations in ICU's.
1,650 words (approx. 6.6 pages), 1 source, £ 42.95
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Abstract
The title of this research article, "Decreasing Unplanned Extubations In The Surgical Intensive Care Unit", concisely and clearly states the theme as it goes on to discuss the skin irritation and discomfort caused by wearing of an endocracheal tube and also clearly mentions it in the title. The readers are able to understand the overall purpose of the article, which is to conduct a prospective evaluation of all intubated patients in the surgical intensive care unit to examine the effects of three parameters on the likelihood of accidental extubation.
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Neonatal Intensive Care, 1999.
Physiological differences between pre-term & full-term newborns, in terms of nursing interventions, breast-feeding and cardiac arrest.
1,350 words (approx. 5.4 pages), 7 sources, £ 32.95
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From the Paper
"NEONATAL INTENSIVE CARE
Physiologic Differences Between Pre-Term Newborns and Full-Term Newborns
Several physiologic variations differentiate the typical pre-term newborn from the typical full-term newborn. Three such differences are described in this section (Todres & Fugate, 1996).
Poor infant weight gain is one physiologic difference between the typical pre-term newborn from the typical full-term newborn. A normal full-term newborn may lose up to 10 percent of body weight in the first few days of life, but should regain to birthweight by 10 days and follow a growth curve thereafter (Todres & Fugate, 1996). Frequently, a pre-term infant will be found to not be gaining weight adequately when checked at 10 to 14 days of age. At.."
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Primary Health Care, Primary Nursing, and Primary Care, 2005.
A comparison of primary health care physicians and primary nurses.
2,154 words (approx. 8.6 pages), 15 sources, MLA, £ 46.95
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Abstract
Nursing care was developed, in part, to provide services to patients with multiple needs and evolved with the initial goals of providing efficient and effective care. Among the delivery systems used to provide this care include primary nursing, primary care, and primary health care. Primary nursing originated in the United States and emerged because of concern about the fragmented care patients were receiving particularly in hospital settings. Primary health care follows many of the same principles and is concerned with providing comprehensive, individualized, patient care from point of contact to completion. Primary care may be defined as a service provided by primary nurses and primary health care physicians. The similarities and differences between these concepts are explored in detail.
From the Paper
"According to Sergei Vinogradov (2002) primary health care or PHC is "based on family health teams, working in family health centers" whose goals include prioritizing prevention and addressing 90% of health problems and patient concerns (p.39). In primary health care systems, doctors bear the brunt of the responsibility, sometimes at the expense of efficiency according to some critics (Vinogradov, 2002). PHC teams are comprised of many individuals including medicine doctors, nurses and other relevant health professionals, but it is the doctor (usually a family doctor) that bears the brunt of accountability and responsibility in terms of patient care (Vinogradov, 2002).
Primary health care is often provided in a managed care setting which requires that a centralized medical decision be made by a primary care physician, thus enhancing according to some the 'attractiveness' of care, suggesting it is quality oriented and scientifically based (Brekke, et. al, 2002). Primary health care usually is offered in hospitals and primary medical offices, less so in community based settings."
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Community and Managed Care in Nursing, 2005.
A review of literature on the pros and cons of case management in both community nursing and managed care nursing.
675 words (approx. 2.7 pages), 3 sources, £ 18.95
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Abstract
This paper discusses community and managed care nursing. The main thrust of the paper is the evaluation of a nursing article that discusses the pros and cons of case management in both community nursing and managed care nursing. This paper then goes on to discuss the social justice approach to nursing.
From the Paper
"Healthcare and all of the fractured issues included in it is one of the most explosive topics in our society today, both politically and consumer wise. Horror stories are continually told about, among other things, the costs of insurance, the inability to receive care, racial and ethnic disparity, and a host of other intervening variables and conditions. Sometime in the past several years America's healthcare system has managed to avoid the checks and balances of the institutional system and plunge into a state of national crises. Economic and business driven healthcare (i.e., market), wherein medical practitioners are seemingly more interested in stock options and bottom line profits than in their patients, is a blight on society as a whole as well as a failing grade for the government whose obligation it is to preserve and protect the country's citizenry."
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Self-Care Deficit Nursing Theory, 2002.
An examination of self-care deficit nursing theory and how it contributes to nursing knowledge and practice.
900 words (approx. 3.6 pages), 3 sources, £ 24.95
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Abstract
This essay provides a critique of self-care deficit nursing theory. It reveals how the theory directly contributes to nursing knowledge and practice. By focusing in on a specific concept, the theory allows an immediate application of ideas to practice. Specifically, the paper illustrates how self-care deficit theory proposes that individuals have a set of tasks that are crucial to the maintenance of their health. A self-care deficit exists when the relationship between a person's ability to perform required actions is not adequate to meet all of the therapeutic self-care demand. This is where the function of nurses becomes instrumental.
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Orem's Model of Self-Care within Nursing, 2008.
A literature analysis of Orem's model of self-care as it relates to nursing in the elderly.
1,384 words (approx. 5.5 pages), 4 sources, MLA, £ 32.95
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Abstract
This paper defines and discusses Orem's model of self-care in nursing. The paper identifies the issues related to increased autonomy for patients in respect to identifying and promoting their own health care needs, while also also ensuring that the patient receives care from health care professionals, family and friends when needed. The paper analyzes current research on this topic.
Table of Contents:
Introduction
Summarization of Literature
Positive Factors Relating to Nursing Practice
Negative Factors Relating to Nursing Practice
Personal Perspectives towards Orem's Model of Self-Care and Long-Term Nursing Care
Conclusion
From the Paper
"Orem's model of self-care promotes specific health goals that increase the autonomy and the self-care of the patient. Not all patients can benefit from all aspects of this model, but most patients are likely to achieve a greater degree of control over how and to what extent their health care needs are met. The model shows substantial positive outcomes as a component of health care, as it promotes improved diagnosis, improved communication between the health care provider and the patient, and reliance on others to supplement the patient's health care needs when specific outcomes cannot be met by the patient alone."
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Family-Centered Care Nursing, 2004.
This paper discusses the implementation of a family-centered care nursing program in a surgical nursing unit.
2,712 words (approx. 10.8 pages), 13 sources, APA, £ 66.95
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Abstract
This paper describes family-centered care nursing programs. The author points out empirical research. The paper relates the historic involvement of the family as an integral part of the nursing practice.
From the Paper
The purpose of this research report is to identify family centered care practice and principles with special emphasis upon nursing interventions in the surgical perioperative care setting in a large urban medical surgical unit. According to Wright and Leahey, a significant part of nursing history is that the involvement of families has always been integrally to nursing practice; but, in recent years, nursing has begun to focus upon identifying via empirically grounded research the basic systems that should be used in caring ..."
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Critical Care Nursing, 2007.
A case study presenting the experiences and role of the writer as a critical care nurse.
1,785 words (approx. 7.1 pages), 2 sources, MLA, £ 39.95
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Abstract
This paper discusses critical care nursing and the role of the critical care nurse. It describes the nurse's role from the point of view of the writer, who is a nurse, and presents some of her experiences in this position. The paper presents a case study of an elderly patient in a critical care setting and discusses both the patient's needs and experiences, as well as the nurse's.
Table of Contents:
Introduction
A Personal Point Of View Of My Nursing Experience
Comprehensive Discussion Of Critically Ill Patient And Their Experience Of Critical Illness
Personal Reflection About Visit To The CSICU
How This May Influence My Own Vision Of Myself As A Critical Care Nurse
From the Paper
"Knowing the patient's family and social environment would have given me a better idea about her outlook, whether she was optimistic or pessimistic about getting well, how she felt about her state of health in general, and what acts of daily life and independence were most important to her. It would also have helped me assess the family's ability to facilitate the patient's self-care, and their awareness of the seriousness of monitoring her health condition. Also, I would have liked to have known the patient's attitude, and her family's attitude regarding her other ailments, such as her diabetes, her adherence to a special diet, her ability to monitor her blood sugar and cholesterol, as well as her history in observing a medication regime with religiosity and diligence."
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