Fungal Disease: Vaginal Candidiasis

Introduction, Epidemiology, Clinical Presentation, Pathophysiology and Treatment.  

There must be a minimum of three references, two of which must be peer reviewed (journal articles). Websites/org home pages are NOT peer reviewed. 

References must be in APA format (see examples under Course Doc). Do not just copy and paste the URL

Pathophysiology should be addressed thoroughly

Fungal Disease: Vaginal Candidiasis

Women as well as men suffer from different types of fungal infections. Candidiasis is among the most prevalent fungal diseases among the females. The disease is caused by a type of fungus referred to as Candida. Under normal circumstances, Candida lives in the body in places such as vagina, mouth, gut, or throat without causing any infections. Nonetheless, Candida could sometimes multiply due changes in the vaginal environment, thus causing infections. Therefore, this is an epidemiology, clinical presentation, pathophysiology, and treatment of vaginal candidiasis. 

Epidemiology

Vaginal candidiasis is a common fungal infection among the women. It is estimated that the condition causes around a third of the total diseases of vulvovaginitis, especially among those who have attained reproductive ages (Abdul-Aziz et al., 2019). About 70 percent of females are reported to have suffered from vaginal candidiasis at some point in their life-times (Mbim et al., 2017). It is also estimated that around 8 percent among the infected women suffer recurrent infections of vaginal candidiasis. Besides, about 90 percent of the vaginal candidiasis are caused by C. albicans pathogen while the remaining 10 percent of the vaginal candidiasis is estimated to be caused by Candida glabrata. Nevertheless, there is a scarcity of epidemiological data regarding vaginal candidiasis since most people use over-the-counter drugs if they suspect to test positive for the disease. It could be as a result of stigmatization in society. 

Some factors increase the risk of suffering from vaginal candidiasis. They include the elevated endogenous estrogens due to pregnancies or obesity. An increased use of broad-spectrum antibiotics could heighten the chances of suffering from candidal vulvovaginitis. Besides, individuals with immunosuppression due to organ transplant, chemotherapy, or HIV infections are at greater risks of contracting vaginal candidiasis. It is also hypothesized that sexually active women could easily contract the disease as compared to those who are not sexually active.  

Clinical Presentation

The clinical presentation of vaginal candidiasis is clinically suggested through the presence of vulvar pruritus and external dysuria, redness, pain, and swelling. However, more specific signs would include thick curdy discharge, vulvar edema, excoriations, as well as fissures. The likely diagnosis that also could be made in a female includes the use of wet preparations that enhances the visualization of mycelia and yeast by disordering cellular material that could obscure the pseudohyphae or yeast. Women who exhibit the signs and symptoms of vaginal candidiasis should be tested for wet mount with KOH. Those who test positive are supposed to be treated while those who test negative are supposed to be considered, not necessarily put under long-term treatment. 

Pathophysiology

Vaginal candidiasis happens when candida species enter the mucosal lining superficially triggering inflammation as a defensive mechanism by the vagina. The main inflammatory cells are macrophages and polymorphonuclear (Roselletti, Perito, Sabbatini, Monari, & Vecchiarelli, 2019). Consequently, inflammation leads to vaginal itching or swelling, adherent and thick discharge, or vaginal burning. Specifically, there are different virulence that are associated with vaginal candidiasis that trigger various defensive mechanism against the yeast. There is both innate and adaptive mechanism. 

Adaptive Mechanism

In this mechanism, immunoglobin mediated immunity is activated. Systemic IgA, IgM, and IgG antibodies are released to respond to the infections by candida. The interleukin 4 (Th2) promotes cell mediated immunity through the inhibition of anti-Candida activity. 

Innate Mechanism

The vaginal epithelial cells defend the vagina against Candida infections through the in vitro inhibition that protects against the growth of Candida. Mannose-binding lectin also helps in protecting against vaginal candidiasis through the inhibition of Candida growth. The vaginal bacterial flora also helps in the production of bacteriocins that hinder the growth of the yeast.  

Treatment

The treatment of fungal infections like vaginal candidiasis depends on the severity of the disease and frequency of infections. For those patients with mild to moderate infections, it could be recommended to use the following treatments. 

Short-Course Vaginal Therapy

In this case, a caregiver could prescribe that the patient takes antifungal infections for three days if the infection is moderate and up to seven days if the infections are moderate. Some of the antifungal drugs available for short-course vaginal therapy are suppositories, tablets, creams, and ointments. They include terconazole and miconazole (Calvo, Svetaz, Alvarez, Quiroga, Lamas, & Leonardi, 2019). The patient could acquire the drugs through over-the-counter medications or through prescriptions only. 

Single-Dose Oral Medication

Both the mild and moderate infections could be treated using Diflucan (fluconazole). Diflucan is a single oral dose but not recommendable for pregnant patients (Shabanian, Khalili, Lorigooini, Malekpour, & Heidari-Soureshjani, 2017). If the disease is more severe, it could be recommended that they take two-single doses for about three days. Nevertheless, it is advisable that the patients return to the doctor if their signs and symptoms do not heal or reoccur with a period of two months. 

If vaginal candidiasis is severe or a patient has multiple infections, then three different treatment options could be used. They include the long-course vaginal therapy, multidose oral medication, or azole resistant therapy. 

Long-Course Vaginal Therapy 

In the long-course vaginal therapy, it is recommended that you prescribe the patient, firstly, with antifungal drugs for around two weeks. Then, it should be followed by weekly doses for around six months. That is, take one dose per week for another six months.  

Multidose Oral Medication

In the multiple oral medication, a doctor should prescribe antifungal medications that are administered through the mouth as opposed to vaginal therapy. The doses are either two or three. Nonetheless, the therapy is considered unfit for pregnant patients. 

Azole Resistant Therapy

Azole resistant therapy is also an appropriate treatment option if the infections are severe. In this case, the doctor administers boric acid through a capsule that is inserted into the vagina. However, the therapy could be fatal especially when taken orally. Therefore, the treatment should only be administered in extreme cases of vaginal candidiasis. That is, it is only used for the treatment of candida fungus that has proved to be resistant to the common antifungal medications.

Alternative Medicine

Currently, therapies using alternative medicines have not been clinically approved to treat vaginal infections. Nonetheless, some alternative and complementary therapies could be used to offer temporary relief for the disease if combined with close doctor’s attention. Therefore, patients need to discuss with their doctors about the available alternative treatment options before choosing the safest alternative medicine to manage their conditions. 

To sum up, vaginal candidiasis is among the leading fungal diseases in women. It is caused by a yeast called Candida. It is estimated that about 70 percent of sexually active women suffer from the disease at some point in their lives. However, the risk factors for the disease include immunosuppression, increased intakes of broad-spectrum antibiotics, as well as the level of sexual activeness of women. The treatment options for the disease depends on the severity and frequency of the disease. 



References

Abdul-Aziz, M., Mahdy, M. A., Abdul-Ghani, R., Alhilali, N. A., Al-Mujahed, L. K., Alabsi, S. A., ... & Almikhlafy, A. A. (2019). Bacterial vaginosis, vulvovaginal candidiasis and trichomonal vaginitis among reproductive-aged women seeking primary healthcare in Sana’a city, Yemen. BMC infectious diseases19(1), 1-10.

Calvo, N. L., Svetaz, L. A., Alvarez, V. A., Quiroga, A. D., Lamas, M. C., & Leonardi, D. (2019). Chitosan-hydroxypropyl methylcellulose tioconazole films: A promising alternative dosage form for the treatment of vaginal candidiasis. International journal of pharmaceutics556, 181-191.

Mbim, E. N., Mboto, C. I., George, U. E., Umego, C. F., Edet, U. O., & Orajiaka, N. A. (2017). Prevalence of vaginal candidiasis among female students of a hostel in the University of Calabar, Calabar. Journal of Applied Life Sciences International, 1-7.

Roselletti, E., Perito, S., Sabbatini, S., Monari, C., & Vecchiarelli, A. (2019). Vaginal epithelial cells discriminate between yeast and hyphae of Candida albicans in women who are colonized or have vaginal candidiasis. The Journal of infectious diseases220(10), 1645-1654.

Shabanian, S., Khalili, S., Lorigooini, Z., Malekpour, A., & Heidari-Soureshjani, S. (2017). The effect of vaginal cream containing ginger in users of clotrimazole vaginal cream on vaginal candidiasis. Journal of advanced pharmaceutical technology & research8(2), 80.

Criteria Grading

Ratings

Pts 

This criterion is linked to a Learning Outcome Content & Development 

Clarity of purpose Critical and original thought Use of examples. Main points well developed Synthesis of ideas


40 pts 

Full Marks

0 pts 

No Marks

40 pts

This criterion is linked to a Learning Outcome Organization & reasoning 

High degree of attention to logic and reasoning of points Leads the reader to conclusion Easily followed Paper is logically organized Effective, smooth transitions Writing is coherent


40 pts 

Full Marks

0 pts 

No Marks

40 pts

This criterion is linked to a Learning Outcome Grammar, Punctuation and Spelling 

Paper is free of distracting spelling and grammatical errors Free of fragmented statements College level style Ideas followed easily


10 pts 

Full Marks

0 pts 

No Marks

10 pts

This criterion is linked to a Learning Outcome References/APA format 

Meets assignment requirements Attention to detail Essay is correctly assembled APA format for in-text citations APA format for Bibliography


10 pts 

Full Marks

0 pts 

No Marks

10 pts

 

Nursing 440 Issues and trends in nursing

As nurses we abide by nursing code of ethics for example in provision 1 code of ethics the American Nurses association states, the nurse in all professional relationships, practices with compassion and respect for the inherent dignity, worth and uniqueness of every individual unrestricted by social or economic status (ANA, 2001, p.7). Nursing has a code of ethics because we are in this field to “help protect, promote health and prevent illness and injury, alleviate suffering through diagnosis and treatment of human response and advocate for the care of individuals, families, communities, and populations” (ANA, 2010, p.10). The case study presented a nurse confronted by the difficult decision to help protect her patient from being resuscitated against his will. The nurse was also confronted with the dilemma of trying her best to help guide the family members to understand the situation under these stressful circumstances. 

Also Read: Episodic SOAP Notes

During this case study the lack of communication between the family member (the father) who was a DNR and his children caused some confusion to arise among the CNA, registered nurse and physician during the critically ill patient’s end of life. It was the obligation of the nurse in the case study to advocate and protect her patient based on his written healthcare directive and adhere to his preference to be a DNR status. As a dignified nurse that commits oneself to the code of ethics, our duty is to advocate for him. It’s understandable the children want their father to be revived, as a compassionate nurse it’s relatable that this type of scenario can make us re-think our decision to do the right thing. DNR can be a complex, sensitive matter with all parties involved. Specific DNR measures can be indicated such as, circulatory measures to receive blood transfusions and certain medications may be okay to certain patients to help revive them. But feeding tubes, CPR or intubation may not be okay with the patient at the end of life. These types of preferences are indicated in the written healthcare directive. According to Interprofessional Journal on Healthcare Institutions, the purpose of an advance directive is to allow an individual to maintain autonomy in the end of life (EOL) medical decision-making process even when incapacitated by disease or terminal illness (Vearrier, 2016).When I compare this case study to my nursing experience, I think of a similar time when I was confronted with a similar situation, during the time I cared for a 94-year old patient who was ready to accept a DNR status after learning he had 18 percent ejection fraction and needed a feeding tube to sustain life, among other issues. Once his wife learned of his DNR decision she stayed with him the entire week and convinced him to take all necessary measures to stay alive. We ended up coding this patient twice with cardioversion and he ended up intubated in ICU.  I felt awful about this decision because I felt his wife was convincing him to do something, he was not comfortable doing but probably wanted to please her. It’s very likely he didn’t have the energy or right mind set to argue with her in his frail, elderly state.  The case study I watched presented a family member (likely his son) who was the power of attorney who wanted all measures to be taken to revive his pulseless family member. At one time his Father may have wanted to be revived but this type of situation changes over time when patients become chronically ill and learn the quality of life will decline drastically over time. Ethical barriers may be difficult to overcome at the end of life. Open communication among family members and healthcare members are important to keep everyone informed and up to date on the current progress or decisions of the patients care and end of life wishes.  

 




According to the annual review of nursing research, educators take on the responsibility to teach the foundation for professional identity, ethical decision making, and professional practices, it is up to nurses to be advocates for patients, families, and health-care teams (Gibbons, 2016, pg. 7). As nurses just as in the DNR case study, we do face challenging issues in our day to day practice, this will continue to increase overtime with an aging population. As practicing nurses, we should be confident in our ability to face such dilemmas. We also need to encourage others in the healthcare field to closely monitor situations within the workplace and act on the best interest of our patients even when it is difficult to do so (Lachman, 2007). By maintaining the open gates of communication and developing an approach of professionalism, we will continue to keep the skills necessary to face difficult end of life situations and represent nursing code of ethics. 



References

 Epstein, Beth, PhD., R.N., & Turner, Martha, PhD., R.N.-B.C. (2015). The nursing code of ethics: Its value, its history. Online Journal of Issues in Nursing, 20(2), 33-41. doi:http://dx.doi.org.westcoastuniversity.idm.oclc.org/10.3912/OJIN.Vol20No02Man04

Fowler, M., & American Nurses Association. (2015). Guide to the code of ethics for nurses with interpretive statements: Development, interpretation, and application (Second ed., Ana pub). Silver Spring, Maryland: American Nurses Association.

 Gibbons, S. W., & Shafer, M. R. (2016). Annual Review of Nursing Research, Volume 34, 2016 : Nursing Ethics: Vulnerable Populations and Changing Systems of Care. New York, NY: Springer Publishing Company.

Lachman, Vicki. (2007, May). Moral courage: A Virtue in need of development. Medsurg nursing; Official journal of the Academy of Medical Surgical Nurses. 16(2) 131:3

 Vearrier, L. (2016). Failure of the current advance care planning paradigm: Advocating for a communications-based approach. Hec Forum Healthcare Ethics Committee Forum: An Interprofessional Journal on Healthcare Institutions' Ethical and Legal Issues,28(4), 339-354. doi:10.1007/s10730-016-9305-0



Decreasing CLABSI in oncology nursing among Cancer Patients

Introduction

The following evidence based practice database feature both qualitative and quantitative peer reviewed article after selecting the best articles related to decreasing Central Line Associated Blood Stream Infection (CLABSI) in oncology nursing with a special focus on the treatment and care for cancer patients. According to the center for disease control in the United states, the most common healthcare associated infection is the CLABSI which reports about 50%  of all ICU patient that require a central line, having high cases of CLABSI infections. As a Nursing practitioner to understand the nature leading to CLABSI incidences it is important to conduct a review on strategies.  In most cases, the catheter on the central line is known to puncture the skin which allows for bacterial and function infection to enter the human body. After the infection enters the body, this can spread to the patient’s blood stream leading to hemodynamic changes that could possibly head to death of the patient. In most cases, proof of infection is found in the recovery of a pathogen from blood culture and patients that suffered from central line.  

Peer review findings

Altounji et al., (2020) in a qualitative literature review study reports that most children receiving cancer treatment will require a central venous catheter (CVC) which continue to put them at risk of CLABSI. According to the researchers, as patient are discharged home with a CVC, it is important that a follow up by nurses is done to ensure that CVC is maintained. The article is very important as it suggests the relevance of education sessions with the patient family using a step by step handbook among other materials that equip caregivers with the right skills and checklist of competency.  Base on the study, it is evident that the clinical significance in reducing  home based acquired CLABSI can produce positive  regard on the patient outcomes through  a reduction of mortality and morbidity thus reducing costs of care and length of stay in hospital. 

Inman & Torres, (2020) in a focused group qualitative study argues that blood cultures usually will be contaminated during the pre-analytic phases in regard to collection that leads to downstream ramifications. The study is important as it provides a summary of performance improvement when it comes to factors that contribute to a reduction in the blood culture rates.  The article is thus important as it meets the goal of the study to reduce their rate of BCC through analyzing, pre and post intervention data.  Based on the study, it is possible to achieve these rates with the support of multi-disciplinary team. It is thus important for nurses to benchmark as part of their practice if they are to achieve a sustainable BCC levels. 

(Chaves et al., 2018) in a quantitative study reports that CLABSI is often made of an important cause of hospital acquired infection related to mortality, morbidity and cost. The study provides a guideline with recommendations for the management and diagnosis of CLABSI in adults. Criteria for the study included use of short term peripheral venous catheter, and long term CVC among other criteria’s.  The article is important as it is formulated in regard to amount of evidence based practices. Also the recommendation is made in regard to the diagnosis of CLABSI by establishing various clinical situations where a conservative diagnosis related to CLABSI can be feasible.  Among the notable areas in the study also is the importance of pathogen specific treatment and empirical therapy during this time. 

Patel et al., (2019) in a quantities study on the National Intervention prevention of CLABSI informs that it is important to understand the impact of multimodal intervention in institutions that are common with healthcare related infection.  The study was observational involving two target hospitals one with tertile of performance for the clostridioides difficile infection while the other one looked at care related to CLABSI. According to the results of the study from 2016 to 2018 it was evident that there was still need to educated nurses on the implementation of CLABSI prevention methodologies. Also during the period of –pre invention to was realized that the rates of clabsi will reduce. This is important as it provides the need for organization to provide orientation and education for nurses on the issue of CLABSI management and prevention. 

Aloes, (2019) in a comparative study found that using the Center for Disease control in prevention of CLABSI complications is often very important   in ensuring improvement of care and prevention of complications.  It is however to verified if nursing students are provide with education regarding the guidelines.  The study is important as it provides and assessment on the knowledge of nurses in educating their patients on the importance of hygiene and do not bring bout jokes. 

Conclusion

The above evidenced pare looked the issue of CLABSI and nursing participation in the reduction of such incidences.  The article share are a strong ground for future studies on the same.  It is important to ensure I sally.

References

Aloush, S. M. (2019). Lecture-based education versus simulation in educating student nurses about central line–associated bloodstream infection–prevention guidelines. Journal of Vascular Nursing, 37(2), 125-131. https://doi.org/10.1016/j.jvn.2018.11.006

Altounji, D., McClanahan, R., O’Brien, R., & Murray, P. (2020). Decreasing central line–associated bloodstream infections acquired in the home setting among pediatric oncology patients. Journal of Pediatric Oncology Nursing, 37(3), 204-211. https://doi.org/10.1177/1043454220907551

Chaves, F., Garnacho-Montero, J., Del Pozo, J., Bouza, E., Capdevila, J., De Cueto, M., Domínguez, M., Esteban, J., Fernández-Hidalgo, N., Fernández Sampedro, M., Fortún, J., Guembe, M., Lorente, L., Paño, J., Ramírez, P., Salavert, M., Sánchez, M., & Vallés, J. (2018). Diagnosis and treatment of catheter-related bloodstream infection: Clinical guidelines of the Spanish society of infectious diseases and clinical microbiology and (SEIMC) and the Spanish society of Spanish society of intensive and critical care medicine and coronary units (SEMICYUC). Medicina Intensiva (English Edition), 42(1), 5-36. https://doi.org/10.1016/j.medine.2017.09.001

Inman, T., & Torres, E. (2020). Blood culture collection teams reduce contamination rates and reduce central line associated blood stream infections. American Journal of Infection Control, 48(8), S40. https://doi.org/10.1016/j.ajic.2020.06.038

Patel, P. K., Greene, M. T., Jones, K., Rolle, A. J., Ratz, D., Snyder, A., Saint, S., & Chopra, V. (2019). Quantitative results of a national intervention to prevent central line–associated bloodstream infection. Annals of Internal Medicine, 171(7_Supplement), S23. https://doi.org/10.7326/m18-3533

 

Introduction to Professional Nursing(Narccella)

Introduction to Professional Nursing(Narccella)


Introduction


The major objective of nursing is to give care that is rewarding to nurses, seen by patients as personal and caring and is in an environment of maximum patient safety. The nurses see every individual as a whole system of body, spirit, and mind, whose wellbeing and health is subjective by their setting. The workplace itself should be presentable since the design factors attract nurses to a hospital for employment and can also retain them over time (Naccarella, 2016).

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Therefore, the hospital project teams should focus on principles of art and design that include features like rhythm, proportion, balance, unity, and emphasis.

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Nursing Homes And Transition Of Care

Nursing Homes And Transition Of Care


Introduction


The population of older adults is rapidly increasing because of the constant increase in life expectancy. It is projected that in the next 40 years the number of older adults will be higher than that of the younger people. Therefore, the number of older adults is estimated to grow by more than the double rate from 880 million in 2012 to slightly above 2 billion in 2050. Concurrently, aging is associated with increased functional disabilities and a rise in morbidity rates. Many older adults desire to age-in-place, to remain independent, autonomous, and active. They also want to age at home where family and friends surround them. The paper comprehensively describes an article by Lecovich (2014) that describes aging in place (AIP) among older adults.

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Describe what you found
Aging in place (AIP) is the ability to experience a safe, comfortable, and independent stay in one’s homestead or community regardless of age, ability level, or income (Center for Disease Control and Prevention [CDC], 2017). Lecovich (2014) begins by exploring AIP and gives the various dimensions associated with the term such as physical, social, psychological, and cultural dimension. According to Lecovich (2014), AIP deals with the strategies of making a home more functional and less risky for the elderly population by providing numerous home aids to assist in various aspects of daily life. From the older person’s point of view, the goal of aging is to stay in their homes for an extended period since it helps in preserving their identity and well-being, and they have control of their lives (Anderson et al., 2018).
From the policymakers’ point of view, the goal of aging is to provide alternative care for older adults in their communities because institutional care is much more expensive than providing care in the community (Black et al., 2015). The author also describes some of the programs designed to facilitate AIP. These include home-based programs, age-friendly communities, and AIP in long-term-care facilities. Lecovich (2014) also describes the factors that policymakers need to consider before implementing AIP. These are community planning, housing programs, health, land use, transportation, and social services.

How it can help older adults transition back to the community
AIP is an important strategy that enhances the person-environment fit by improving personal control, living conditions, and reducing environmental pressure (Lecovich, 2014). This implies that older adults should massively embrace the idea because of its positive results. The author educates people on community care which is the care offered to the elderly population in their own homes or communities rather than in homes or long-term care facilities. By reading the article, the older adults can also get to learn of formal home-and community based supportive services and assistive technology devices that have been developed to meet the demands of the older people (Kim et al., 2017). They include home care services, home-hospice, home health care, telemedicine, and tele-homecare. Lecovich (2014) also describes age-friendly communities and AIP in long-term care facilities. All these help in acquainting older people with strategies for AIP and therefore one can choose the most effective method to help in the transition back to the community.

Whether the article is helpful or not
The article by Lecovich (2014) is useful to older adults, healthcare providers, and policymakers. It informs older adults on some of the programs that have been developed to facilitate AIP. For instance, the Global Age-Friendly Cities Project, a program launched by WHO purposely to promote the physical and psychosocial well-being of the older adults thus helping to improve the quality of life of the whole society (Szanton et al., 2016).
Other programs include home care services, home-hospice, and home health care. The article enlightens nurses and social workers in the role of caregiving such as providing help with assistive devices, operating specialized medical equipment and ensuring older people adhere to the prescribed medication regimen. Lecovich (2014) also implies that policymakers should give more attention to community planning, housing programs, health, land use, transportation, and social services due to the increasing number of baby boomers.

How healthcare providers (nurses or social workers) might be able to assist the client in getting access to these things or who they might recommend them to
The caregivers have a role to play in assisting the clients on using assistive devices, ensuring they take medications as prescribed, and assisting in activities of daily living (ADLs). The healthcare professionals help in sourcing for gerotechnologies and assistive devices from respective organizations and make them available to the older adults. These help in the person-environment interaction, hence, helping the older adults to age-in-place and alleviate caregiving burden (Lecovich, 2014).

Conclusion
AIP is the ability to experience a safe, comfortable, and independent stay in one’s homestead or community regardless of age, ability level, or income. There are various programs which have been designed to facilitate AIP. These include home-based programs like home care services, home-hospice, and home health care and community-based programs such as the Global Age-Friendly Cities Project. The social workers perform a variety of roles in caring for older adults including in assisting the clients on using assistive devices, ensuring they take medications as prescribed, and helping in ADLs.

References


1. Anderson, K., Dabelko-Schoeny, H., and Fields, N. L. (2018). Home-and community-based services for older adults: Aging in context. Columbia University Press.
2. Black, K., Dobbs, D., and Young, T. L. (2015). Aging in community: Mobilizing a new paradigm of older adults as a core social resource. Journal of Applied Gerontology, 34(2), 219-243.
3. Center for Disease Control and Prevention (CDC). (2017). Healthy places terminology. Retrieved from https://www.cdc.gov/healthyplaces/terminology.htm
4. Iecovich, E. (2014). Aging in place: From theory to practice. Anthropological notebooks, 20(1), 21-33. 5. Kim, K. I., Gollamudi, S. S., and Steinhubl, S. (2017). Digital technology to enable aging in place. Experimental gerontology, 88, 25-31.
6. Szanton, S. L., Leff, B., Wolff, J. L., Roberts, L., and Gitlin, L. N. (2016). Home-based care program reduces disability and promotes aging in place. Health Affairs, 35(9), 1558-1563.

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Pain Management For Non-verbal Patients

Pain Management For Non-verbal Patients


Introduction


Pain management in relation to non verbal patients could be one of the most challenging tasks when it comes to taking care of wounds that require debridement, wound vacs and panking (Kandel, 2010) However, it is now well established that unresolved pain is more likely to cause a negative impact on the process of wound healing or even lead to neuropathic pain (Abraham, 2008). This implies that efficient pain and management care especially for the non verbal patients is a core concept that needs to well taken care of. This assignment was aimed at analyzing ways in which care for non verbal patients with regards to pain management of chronic wounds has been handled in long term care facilities.

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This study case focused on long term facilities due to their wide exposure to chronic wound pain cases. Chronic pain care and management for non verbal patients such as those that are physical impaired or in a comma in long term care facilities has tremendously improved in most of the facilities. The findings of this study revealed that most nurses are now well equipped with both knowledge and skills to tackle challenges related to chronic wound pain. Both pharmacological and non pharmacological approaches towards managing the chronic pain cases are now employed in most long term care facilities (Moffat, 2014).

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Applying Ethical Principles In Practice

Applying Ethical Principles In Practice


Introduction


Ethical principles are guidelines that help in protecting study participants and preserving the integrity of research. These principles include social and clinical value, fair subject selection, informed consent, scientific validity, favorable risk-benefit ratio, and informed consent. The paper utilizes a study on a nosocomial infection to address the ethical principles of social and clinical value, fair subject selection, and independent review. Besides, the article will also explain how the role of nurses in research has changed over time.

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Social and Clinical value
Every research aims at answering a specific question. Providing answers to a problem is essential to society because it provides solutions to present or future diseases (Melynk & Overholt, 2015). For instance, the study on the nosocomial infections in ICU in Fiji is sufficient to provide the prevalence data on the problem. The information garnered from the incidence rate is crucial in describing the current epidemiology and improving the methods of control of nosocomial infections in adults (Naidu et al., 2014).

Fair Subject Selection
The primary objective of the study should be to enroll and recruit individuals and groups based on fair selection but not vulnerability or privilege diseases (Melynk & Overholt, 2015). The people should be chosen in a manner that eliminates risks and maximizes benefits to the individuals and society. The recruitment of study participants in our case was fair and included all the ICU patients whose nosocomial infection had been microbiologically confirmed (Naidu et al., 2014).
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