Changing Hand Hygiene Behavior at the Point of Care to prevent the Dissertation

Changing Hand Hygiene Behavior at the Point of Care to prevent the spread of clostridium difficile utilizing CDC's WHO model f - Dissertation Example Nosocomial infections  are preventable through proper hand hygiene.   C. PICO question: For RN’s, LPN/LVN and NA  (nursing assistants) working on patient care  areas, will changing hand hygiene at the point  of care prevent the spread of C.difficile D. P=Population-RN’s, LPN/LVN and NA’s providing  primary patient care. E. Intervention: Scheduled educational classes  introducing CDC’s â€Å"WHO model for Hand Hygiene.   F. Comparison- Comparison: RN; LPN and NA  knowledge pre and post training. â€Å"A  comparison of pre and post-tests will be  conducted to determine the participant’s  understanding of the WHO model and the impact  of hand washing technique on the incidence of  Clostridium difficile.   G. O =Outcome-Nursing staff will demonstrate and  utilize CDC’s:†WHO Model for Hand Hygiene†Ã‚  thereby preventing the spread of Nosocomial  infections such as Clostridium difficile. III. Methods-    A. Sampling strategies (examples-search process,  databases accessed, year restrictions, types of  studies, key terms used in the search).   B. Data evaluation (criteria you considered when  deciding to utilize a piece of literature).   IV. Findings-   A. ... standards, lack of  published empirical studies on the topic,  rationale for using non-empirical studies,  lack of studies in nursing but did locate  studies in another discipline)   V. Discussion   A. What has been concluded from the findings   B. Advantages and disadvantages of findings   C. How the findings could be utilized in nursing  practice   VI. Conclusion- Hand washing (soap washing and water), contact precaution and meticulous environmental cleaning with an EPA-registered disinfectant are effective in preventing the spread of the organism. Abstract Background The World Alliance for Patient Safety launched by The WHO in 2004 advocates a â€Å"clean care is safer care† program, in which health care leaders sign a pledge to take specific steps to reduce hospital associated infections in their facilities. Hand hygiene is the first focus in this worldwide initiative. Recognizing a worldwide need to improve hand hygiene in healthcare facilities, the WH O produced Advance Draft, launched its â€Å"Guidelines on Hand Hygiene in Health Care† along with the â€Å"Implementation Toolkit† that have been available since 5 May 2009 on the occasion of the launch of the â€Å"Save Lives: Clean Your Hands† initiative. The WHO regards hand hygiene as an essential tool for the prevention of nosocomial infection, but compliance in clinical practice is often low. Methods Relevant scientific literature and international evidence-based recommendations (Meta Analysis Sources) were studied. Results Hand washing (soap washing and water), Hygienic hand disinfection, contact precaution and meticulous environmental cleaning with an EPA-registered disinfectant are effective in preventing the spread of the organism. Compliance can be improved by training, and by placing hand-rub dispensers at

Using Cohens Book Compare Churchill and Linclon Essay

Using Cohens Book Compare Churchill and Linclon - Essay Example Abraham Lincoln in his Gettysburg address was able to clearly enunciate his vision for the future as he pleaded that soldiers should not have died in vain so that â€Å"that this nation under God shall have a new birth of freedom.†2 His goal of democracy for the people through equality thus became the goal of the Civil War – the achievement of freedom for everyone including the slaves, which became the goal that was to be fought for. The abolishing of slavery was the ultimate goal of Abraham Lincoln and this formed the framework of his persistent focus upon the defeat of the South in order to establish a new dawn of freedom within the United States. In a similar manner, Winston Churchill set out the goals of the IInd world war when he stated that the mission was to â€Å"wage war against a monstrous tyranny never surpassed†¦Ã¢â‚¬ with the aim being â€Å"victory at all costs.†3 He clearly spelt out the ultimate goal, which was to defeat Germany at any costs, visualizing a future where the evil perpetrated by Adolf Hitler would cease to exist. England was hard pressed for resources, yet Churchill sought to protect his country from the rule of the German dictator by going on the offensive. In this battle, defeat was untenable because it would have meant the suppression of freedom and the imposition of German rule. He clearly conveyed to his countrymen the dangers inherent in the cause, the loss of life that would result, but also spelt the goal – which was the fight against evil and by envisaging German defeat in this manner, it was able to be brought about. In achieving their respective visions, both of these leaders were able to exercise transformational modes of leadership and inspire their countrymen. In transforming his vision of freedom from slavery into concrete action, Lincoln executed this as a strategic war offensive against the generals of the Confederate Army to move swiftly and decisively and crush

Sheila birling in an inspector calls

Sheila birling in an inspector calls An Inspector Calls is a play set in Spring 1912, just before the First World War, but written by J.B. Priestley just after the Second World War. In this time Britain had a capitalist ideal. Basically if you were well-off that was great, but the vast majority of people were poor and lived off tiny wages. Furthermore it was a sexist country, so women didnt have the same rights as men. For example they were not permitted to vote until 1918, and even then they had to be over 30 until 1928 where the age was lowered to 21, equal to men. This is showed when Sheila and Sybil leave the room, so the men can talk business. Priestly may have written it at this time because he was trying to convey his socialistic views through the mouth of the Inspector, and the inclusion of dramatic irony referring to World War I a few German officers talking nonsense and a few scaremongers here making a fuss about nothing and these silly little war scares is proof that Priestley believes socialism is the best system. The Birlings are described through very detailed stage directions. For example, the Birlings are subtly described as materialistic [their house] is substantial and heavily comfortable, but not cosy and homelike. This portrays them as people who care more about appearances than comfort. The lighting is pink and intimate; this shows that they are enjoying the night and it might also suggest that they have something to hide. In the stage directions at the beginning of the play, Priestley presents Sheila, as a pretty girl in her early twenties, very pleased with life and rather excited. Sheila doesnt really contrast from the rest of the family at this stage, which would imply she is happy in this selfish, capitalist household. It is immediately apparent that Sheila and Geralds relationship is not based on love; it is more arranged and convenient. For example, Sheilas engagement to Gerald means a step up the social ladder for the Birlings as Gerald might have done better for [himself] socially. Furthermore, it appears that Birling is hoping for a business relationship between Crofts Limited and Birling and Company, for lower costs and higher prices. It shows that Birling thinks of this relationship as a means to make money, rather than to make his daughter happy. Furthermore the ring represents materialism and class, rather than love. This is shown because Sheila kisses Gerald hastily indicating a lack of romance. While Sheila looks like she is a bit childish and naÃÆ' ¯ve Mummy, isnt it beautiful? she is later seen to be quite suspicious and intelligent. For example, when she teases Gerald over his absence all last summer, she is half serious, half playful. She doesnt seem convinced he was awfully bu sy at the works. Her suspicions arent fully explored because women at the time were expected not to question their husband, which is shown when Mrs. Birling says, men with important work to do sometimes have to spend nearly all their time and energy on their business. Youll have to get used to that, just as I had. Thus at the start of the play, Sheila seems happy to have a subordinate role. When the Inspector appears the lighting changes to a brighter and harder light which gives the impression of exposure and the revelation of truth. This is significant as it shows that the Inspector will change the mood completely and it indicates secrets coming to light. The audience is enticed to trust the Inspector over Mr. Birling because Mr. Birling says a lot of things which we know not to be true dramatic irony. For example, he says that the Titanic is, unsinkable, absolutely unsinkable. The audience knows that the Titanic, of course, crashes during its voyage but Mr. Birling doesnt know this and the repetition of the word unsinkable suggests his misplaced certainty. In addition, the audience at this point believes the Inspector to be a real inspector, so they automatically think he is a trustworthy person. Something else that makes the audience more wary of Mr. Birling is when he says, Now, Inspector, perhaps you and I had better go and talk this over quietly in a corner whic h reinforces our opinion that he places money over morality. It looks like he is trying to bribe the Inspector. We also get a clear message that the Inspector is not impressed or intimidated by the social status of Mr. Birling, as many people would in that time. It is shown when Mr. Birling says, Perhaps I ought to warn you that hes an old friend of mine, and that I see him fairly frequently. We play golf together sometimes up at West Brumley followed by the response from the Inspector, (dryly) I dont play golf. This excerpt shows that people would commonly threaten people of a lower class than them using their social status and contacts, which we find out Sheila does to Eva later in the play. The Inspectors response, I dont play golf is a metaphor for saying Im not threatened by you and ultimately Im not a capitalist. This extract also voices Priestleys views on capitalism, saying how corrupt it is. When the Inspector announces the death of Eva Smith, Eric is the first to say something (involuntarily) My God! This shows that he is genuinely surprised/caring about the incident. This contrasts with what Mr. Birling says next, (rather impatiently) Yes, yes. Horrid business. But I dont understand why you should come here, Inspector. This shows how selfish Mr. Birling actually is. He obviously doesnt care about Eva, which is apparent from his impatience he just wants to know why the Inspector has bothered him. Sheila also appears caring later on when she is shown the picture of Eva Smith, She looks at it closely, recognizes it with a little cry, gives a half-stifled sob, and then runs out. This response shows she has much more remorse and guilt than Mr. Birling, who was quick to dismiss any responsibility [Me sacking her] has nothing to do with the wretched girls suicide. Eh, Inspector? We find out that Sheila is partly responsible for Eva Smiths suicide because she complained to the shop Milwards about Evas behaviour, as she was jealous of her prettiness and was in a bad mood. We realise that Sheila can be shallow and childish at times, when she says, When I tried the thing on an looked at myself and knew that it was all wrong, I caught sight of this girl smiling at Miss Francis as if to say: Doesnt she look awful and I was absolutely furious. This extract also makes her look quite vain, because she assumed that Eva was smiling about her, as if theres nothing else she could possibly be smiling about and that the world revolves around her. The childishness is also supported by the fact that she calls her parents Mummy and Daddy on numerous occasions. Overall she probably did what she did at Milwards because she had been in a bad temper anyhow and just wanted someone to blame, so she took it out on someone she considered lower than her and used her money and status to get what she wanted. Sheilas actions (and possibly her beliefs) change throughout the Inspectors investigation. Upon discovering she is partly responsible for Evas death she manages to get a moment alone with Gerald, where she tries to find out his involvement before he is interrogated by the Inspector. Gerald gives himself away because he says, (started) What? as soon as the Inspector says the name Daisy Renton. It also looks like Sheila becomes more wary and independent after this, as she asks Gerald questions about Eva and guesses correctly Geralds involvement with her You not only knew her but you knew her very well. She also realises that the Inspector knows everything already, Why you fool he knows. Of course he knows. And I hate to think how much he knows that we dont know yet. Youll see. Youll see. The repetition of Youll see is used to emphasise the fact that before the end of the evening, everyone will be proved guilty which shows that Sheila has superior insight to the rest of the family. S heila also gets an insight into the way the Inspector works, which she displays when she uses the wall metaphor, You mustnt try to build up a kind of wall between us and that girl. If you do, then the Inspector will just break it down and itll be all the worse when he does. In effect here she is saying theres no point in trying to lie or avoid responsibility, because you will find out that you are in fact responsible. The wall also represents the barriers the Birlings exact between the rich and the poor She is saying something similar with the rope metaphor Hes giving us the rope so that well hang ourselves. This shows that the Inspector is here to make the Birlings admit to their mistakes, rather than just to arrest then because of course in reality they havent committed any legal crime towards Eva. Shelia is definitely more receptive to the Inspectors message. This is further shown by the fact that she is trying to get the rest of the family to just tell the honest truth It cra zy. Please, stop mother. When Sheila gives the engagement ring back to Gerald this is actually very symbolic. Firstly it shows that Shelia has grown less materialistic and vain and that she values the truth much more, as the ring was the only thing keeping Gerald and her together. In addition it can also be thought of as Sheilas switch from a capitalist to a socialist as she is turning her back on this symbol of materialism. This shows that she was particularly receptive to the Inspector. The fact that Mr. Birling tries to keep the two engaged, Now, Sheila, Im not defending him but you must understand that a lot of young menà ¢Ã¢â€š ¬Ã‚ ¦ shows that he is still completely oblivious to the Inspectors message and is still trying to hold on to the thing that will help him step up on the social ladder. When the Birlings find out that the Inspector isnt an actually police inspector, they all behave differently. Sheila and Eric dont believe that it makes any difference because the Inspector opened their eyes to how selfish he family is, which is shown when Sheila says sarcastically, I suppose were all nice people now. So the Inspector leaves the biggest impression on the younger generation, which interestingly is mentioned earlier when the Inspector says, We often [leave an impression] on the young ones. Theyre most impressionable. This shows that the younger people have a chance to change their beliefs and do something about it, as they are the future. On the other hand, Mr. and Mrs. Birling seem to think that the Inspectors fakeness makes all the difference. For example Mr. Birling says, If that had been a police inspector and hed heard you confessà ¢Ã¢â€š ¬Ã‚ ¦ This shows that he cares more about appearances and how scandalous the ordeal would be rather than how much of an impact it should have had on his beliefs. Priestleys message is quite complicated. Earlier on the Inspector gives a speech that covers the main themes of the whole play. He says, One Eva Smith has gone, but there are millions and millions and millions of Eva Smiths and John Smiths still left with us, with their lives, their hopes and fears, their suffering and chance of happiness, all intertwined with our lives, and what we think and what we do. The hopes and fears is to emphasise the fact that these people are actual people, not cheap labour as Mr. Birling says. This whole speech is basically to say that it is not just one person; millions of people are suffering just for the rich to prosper. Afterwards he says, We dont live alone. We are members of one body. We are responsible for each other. And I tell you that the time will come soon when, if men will no learn that lesson, then they will be taught in fire and blood and anguish. The term Fire and blood and anguish is dramatic irony as it is a reference to the World Wars. The fact that the audience knows that this will happen makes them think that socialism is the correct political system. The final part is open to interpretation, but in my opinion when the family gets the phone call to find out that a girl has actually committed suicide, the audience get the idea that the Inspector might actually be God as he appears omniscient, which tells us that God would prefer everyone to share the blame and understand their mistakes, which fits in with Socialist beliefs. The Inspectors role was to make the others admit their secrets and mistakes and make them see that what they did was wrong. Sheila has definitely changed with this, becoming less vain and materialistic. Eric has also changed, becoming more Socialist than Capitalist. The change in the younger generation shows that it is up to them to change the world and make it a better place (a Socialist place). This is because it is too late for the older, elitist more prejudiced generation and the audience knows that because of them the World Wars would be inevitable.

Medicine in the Civil War :: essays research papers fc

Medicine and Hospitals in the Civil War The Civil War had more deaths than all previous wars combined. Most people think those soldiers in the Civil War died of wounds or amputations, but the truth is that most died from common diseases that they never had been exposed to. Twice as many soldiers died from diseases than those soldiers who died in battle. Most people in the beginning of the war; thought it was only going to last a few weeks or months, so not much effort was put into recruiting doctors or surgeons. Even so, surgeons really didn’t have formal training in medicine. They did not know much about bacteriology and were ignorant of what caused diseases. Most Civil War surgeons also had never treated a gun shot wound or performed surgery, which led to the fact that they were not qualified at all. They would usually have 2 years of schooling, with only bookwork in the first year, and the second year would usually just be a repeat. However, doctors tried the best they could at treating the wounded and injured, and knowledge of medicine improved a little bit more each year. Most qualified surgeons started off as litter bearer and would carry men off the battlefield. If any of them showed interest in the medical field, they could become a Steward. A Steward's job was to take care of patients with minor wounds such as, scratches, and bumps. The other duties of a Steward were to pull teeth and take care of medicines for the surgeons. The Steward would also guard the medicinal stores, because often soldiers would try to break into the medicinal stores where the morphine, opium, and whisky were stored. If a Steward completed these duties, then he might be allowed to assist a surgeon in an operation, which could lead to becoming an assistant surgeon. He could then later on become an experienced and qualified surgeon. Soldiers faced diseases like measles, small pox, malaria, pneumonia, camp itch, mumps, typhoid and dysentery. However, diarrhea killed more soldiers than any other illness. There were many reasons that diseases were so common for the causes of death for soldiers. Reasons include the fact that there were poor physicals before entering the army, ignorance of medical information, lack of camp hygiene, insects that carried disease, lack of clothing and shoes, troops were crowded and in close quarters and inadequate food and water.

Parasympathetic vs Sympathetic

The Autonomic Nervous System regulates cardiovascular, respiratory, digestive and urinary functions. The ANS studies have changed medicine practices. Before, the thought of a myocardial infarction patient living past five years was unheard of. Now doctors have learned to manipulate the ANS system with drugs that help to control blood pressure. The Autonomic Nervous System is composed of two divisions, Sympathetic and the parasympathetic divisions. They are involved in the unconscious regulations of visceral functions.These two divisions counter balance each other’s activity. The Sympathetic divisions mobilize the body during extreme or intense situations. The sympathetic or thoracolumbar division is also known as your fight or flight system. It involves the E activities exercise, emergency, embarrassment and excitement. It prepares the body for heightened levels of somatic activities. Sympathetic division of ANS increases a number of things such as mental alertness, metabolism , respiratory rate, heart rate, Blood pressure and sweat glands.It also decreases some things like digestive and urinary systems. The role of sympathetic division is to promote adjustments during exercise so that blood flow to organs is decreased and blood flows to muscles are increased. A good example would be a person driving down a dark country road. There heart rate would increase as well as the alertness and breathing. The eye pupils will dilate also. This would be their bodies’ immediate response. The parasympathetic division or the craniosacral performs maintenance activities.Its main focus is to conserve the body’s energy. Parasympathetic division involves the D activities such as digestion, defecation, diuresis. The parasympathetic division of the ANS increases the digestive gland, urination, defecation, salivary secretions and Blood pressure. . It also decreases metabolic rate and heart rate. A good example is when a person relaxes after a meal. Their blood p ressure, respirations and heart rate levels are lowered.Gastrointestinal activity is higher and skin becomes warm as the pupils are constricted. The Autonomic nerves system and its two divisions work off or are antagonistic towards each other. They are different in many ways. While sympathetic division increases your heart rate and respiratory rate. The parasympathetic is decreasing them. Sympathetic division comes into play as an intense environment appears but parasympathetic works while your body is in a relaxed or at rest levels.

Brenda’s Flight Essay

As Gregor saw his many legs waving in the air it symbolizes the rejection of different people because as a traveling salesman he used to move constantly from one place to another and in the habit of waking up in unfamiliar surroundings and various circumstances. He must show his patience, perseverance and eagerness to induce many customers because from that he can earn his living. But as we all know not all the people that we used to mingle with can accept and entertain us positively. The weight on Gregor’s life represents the resistance to change in family tradition that he is the financial head of the household; nobody else probably works in his family; their whole present and comfortable existence relies upon Gregor’s employment. Most of his burden is the debt which his father owes to the employer for whom Gregor now works. His mere condition shows the exploitation of one by many because the reactions of his own family revealed that he is just an impending burden to them. They care for him but they are so horrified by his presence that’s why they take to shutting Gregor into his room. They tend to shrink back whenever he reveals himself and his father embedded one of the apples in his back, causing an infection. As he hides himself underneath a sheet is the metaphor for rejection of sick people because it attests that he is afraid to see and to be seen by other people because of that his family becomes the jailer, they locked Gregor in from the outside. Though bereft of human contact, he is still concern for his family and at the same time mad at them for neglecting him. We can de – humanize our enemies by letting them realize their fault and shortcomings; in short we try to touch their conscience. Just like the way Gregor did in this story, he would have left his family out of love and taken their burden away. He returns to his room and collapses, finally giving in to his wound and starvation. I think he did that for one good reason to open the mind of his family that during the days of helping them and even sacrificing for their benefits, he didn’t even murmured or ask something in return coming from them. The Nazi treatment of Jews in the hand of Germany headed by Hitler was violent and so bloody. Hitler called the Jews as his enemies. Enemy defined as opponent or hostile nation. When we called somebody as an opponent it simply meant that we must do something that would hurt them, made them miserable and finally killed them. These are the objectives of Hitler to all his enemies. He pursued boycotts for the Jewish shops and businesses in ! 933; in 1934, the law banned all the Jewish form public places; plundered the Jewish teachers, civil servants and lawyers. Some of the maltreatments were removing the privilege to the Jews to become a German citizen; restriction of inter racial marriage;working and holding property in Germany; the assassination of many Jews and yet penalizing them. The reason why all of these things happened because of selfish desire and greediness. These are not good if many would suffer and be affected by covetousness and hatred. Hostility toward or discrimination against Jews as a religious, ethnic, or racial group is considered as the meaning of anti – semitism. The anti – Semitism in Europe was almost the same predicament of that in the Nazi, Germany. The hatred to the Jews that’s inside their heart becomes deeper and deeper. One example of this was a soccer match between the Israeli and Belgian national teams in Hasselt, Belgium, when Muslim fans waved Hamas and Hezbollah banners, and chanted: â€Å"Jews to the gas chambers! † and â€Å"Strangle the Jews! â€Å"(taken from the Cancer of Anti – Semitism in Europe). We can conclude in this simple illustration that the hatred developed in the past still lingers in the present situation. The suppression of one’s freedom and stepping onto the human rights of a person developed them in two personalities: they may become weak and dependent while on the other hand a person may possess a strong will to fight and defend himself from his enemies. According to Iris Bruce and Cassill, many interpretations of Franz Kafka’s writings have accentuated their psychological, religious, existential and moral dimensions and initiated a whole genre of the kqfkaesque which summon up associations of the grotesque and absurd but is rarely associated with a sense of humour. A ‘Kafkaesque,’ or Kafka-like situation being one of a strange or nightmarish quality become a part of the language from Kafka’s name. Generally, after World War II (and fundamentally due to the prominence of New Criticism and Existentialism in the literary academies during this time), a Kafka myth has crystallized which stresses Kafka’s existential anguish: interpretations, be they religious, phenomenological, existentialist, symbolic or allegorical, center on the psychology of the author, who is presented as being overcome by the sense of absurdity and alienation so prevalent in twentieth. Where this metaphysical approach in literary translation as a discipline has been most detrimental is in its emphasis on the â€Å"universal† rather than on specific textual elements, in the fascination with Kafka’s personal neuroses, in the mingling of psychological speculation and literary criticism which frequently led to a â€Å"false confusion of empirical and literary selves† and most importantly in its overall disregard of the playful and humorous dimension in Kafka’s texts. Conclusion Kafka’s wanted to share the reality that is happening into our life or others life particularly in our society nowadays. The Metamorphosis was all about Gregor Samsa. This story emphasized the way a man entered the world of despised and how discrimination created hostility. Even his own family tired to suppressed, despised and hurt him not only physically but mentally. The same with our society, the persons who are in the authority sometimes take advantage of everything even to the point that they stepped onto the human rights and privilege of a person. Loving something or someone because you profit from them will not be a good foundation because what if the proceed is gone, are you going to hate him or still love him? Conflict is always present if the environment that we used to stay with is not that aware that justice must be offer to everyone. Hurting people or even killing them without important reason, it’s simply because of selfish desire and hatred won’t make any sense in reality. Instead of doing those things, why don’t we learn to love and forgive them? In the end, we’re going to realize that love is the answer in any changes or metamorphosis that will happen in to our life. Love conquers hatred. Works Cited Peter Kuper Kafka’s The Metamorphosis http://www. randomhouse. com/crown/metamorphosis/ Walker, Jews in Nazi Germany http://www. schoolhistory. co. uk/lessons/germany/jews. html Understanding the Treatment of Jews during World War II http://www. dummies. com/how-to/content/understanding-the-treatment-of-jews-during-world-w. html Edward B. Donnell Jr. , Anti-Semitism in Europe Today http://www. state. gov/p/eur/rls/rm/38113. htm The Cancer of Semitism in Europe http://www. aish. com/societyWork/society/The_Cancer_of_Anti-Semitism_in_Europe. asp