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Case study: Nosocomial Infections

Nosocomial infections still remain the most frequent complications in hospitalized patients. They are the fourth most common cause of mortality in the United States after the cardiovascular system diseases, cancer and strokes. Discussing background of the necessity of this question observation Schaffer et al stated that “Nosocomial infections are widespread. They are important contributors to morbidity and mortality. They will become even more important as a public health problem with increasing economic and human impact because of: Increasing numbers and crowding of people. More frequent impaired immunity (age, illness and treatments). New microorganisms. Increasing bacterial resistance to antibiotics.” (Schaffer et al, 1996). Despite advances in infection control, the emergence and introduction into clinical practice of new antimicrobial drugs, improved diagnostic methods, improving the overall level of care, the issue of prevention and control of nosocomial infections is still valid. Thus, we are going to talk about nosocomial infections and their prevention with more details in the body of this paper. First of all it is necessary to define the term a “nosocomial infection”, and analyzing medical literature it was found that the most commonly used definition was given by the World Health Organization. According to the World Health Organization “A nosocomial infection – also called ‘hospital-acquired infection’ can be defined as: ‘an infection acquired in hospital by a patient who was admitted for a reason other than that infection.’ An infection occurring in a patient in a hospital or other health care facility in whom the infection was not present or incubating at the time of admission. This includes infections acquired in the hospital but appearing after discharge, and also occupational infections among staff of the facility.” (Ducel, Fabry, and Nicolle, 2002) Analyzing a general timeline of infections, it is necessary to mention that infections occurring more than 48 or 72 hours after hospitalization are often considered nosocomial. It is generally accepted position that there must be clinical signs of infection in the first place of diagnosing nosocomial infections, which are identified either by direct observations of the patient, or when analyzing the primary documentation about the patient (for example, diagram of body temperature). In addition to the clinical signs of infection may be used the results of paraclinical methods of investigation (e.g., radiological examination for nosocomial pneumonia), as well as laboratory data (microbiological, serological, and rapid diagnostic methods). In complex analysis of these data physicians should take into account the fact that some out-of-hospital infections have an incubation period of more than 48 hours, such as typhoid fever, and intrauterine infections, for example, the symptoms and signs of which appear shortly after birth. Thus, the above numerated infections did not relate to nosocomial infections according to their different nature. Observing division of nosocomial infections we could mark out several classes: endemic and epidemic. Observing sources of infection appearance we see that the most important are still endogenous sources. First of all, it is obligatory flora of the patient (skin, gastrointestinal tract, etc.), and not only that flora which already existed in the patient’s admission to the hospital but also acquired in a second time in a hospital, and foci of chronic infection. Describing exogenous sources we see among them hands of medical personnel, medical equipment, tools, household articles, unsterile catheters, syringes, etc., aerogenic contamination, water and foodstuffs. It is frequently observed the combination of exogenous and endogenous factors in their interaction. In addition to previously stated information, Pinner et al added that “most are endemic, meaning that they are at the level of usual occurrence within the setting. Epidemic infections occur when there is an unusual increase in infection above baseline for a specific infection or organism.” (Pinner, 1982) Research on the epidemiology of nosocomial infections provides essential information for making decisions in the event of outbreaks of communicable diseases in those or other departments, analyze the structure of pathogens, the level of phenotypes and their antimicrobial resistance, the prevalence of “rare” pathogens. Structure of nosocomial infections depends on the profile of hospital, its policy in antibacterial drugs using, and patient contingent. Decisive for the choice of therapy in a particular health facility are the results of microbiological monitoring of antibiotic resistance in pathogens. As it was stated in the beginning of this paper it is necessary to concern our attention not only on the nature of nosocomial infections, but also on preventive methods in the struggle against this kind of infections. Wenzel troubled about the prevention of nosocomial infections and due to this described specific infection control measures in his work; and according to them we see that “Besides the committees and other leaders in infection control, much of infection control lies in the hands of the personnel in direct contact with the sick patient. These healthcare employees must understand specific guidelines in prevention of infection transmission through isolation and other good healthcare habits. Much of this information in disseminated through training and educational programs given by the infection control departments. An example of guidelines that are essential for the healthcare worker are specified as: Hand washing; Hygiene and uniform; Barriers: caps, masks, gloves; Injection practices; Equipment safety; Isolation.” (Wenzel, 1997). Statistical data demonstrated that approximately 90% of all nosocomial infections caused by bacteria, a distinctive feature of which is resistance to many groups of antibacterial drugs (polyresistance) (Berntsen, 2004) In such a way exactly this its property causes problems in the treatment of nosocomial infections, predetermining a low efficiency and high cost of treatment. Resistant strains are formed in the hospitals under the influence of commonly used antibiotics out there. They can go to the hospital from an organism of patients-carriers. Health care personnel is involved in the transfer of bacteria from patient to patient in caring for the sick person, during the process of diagnostic procedures realization, etc. The problem connected with the treatment of nosocomial infections is widely discussed all over the world and medical facilities in conjunction with pharmaceutical companies are looking for ways to combat this kind of infection nowadays. Lynch as one of the researchers who is interested in nosocomial infections prevention and treatment declared that “Most of these infections can be prevented with readily available, relatively inexpensive strategies by: adhering to recommended infection prevention practices, especially hand hygiene and wearing gloves; paying attention to well-established processes for decontamination and cleaning of soiled instruments and other items, followed by either sterilization or high-level disinfection; and improving safety in operating rooms and other high-risk areas where the most serious and frequent injuries and exposures to infectious agents occur.” (Lynch, 1997). Thus, summarizing the above presented information we could say that solutions of the problem of nosocomial infectious complications greatly depends on effective control and prevention measures, among which an important place occupies the use of modern aseptic and antiseptic remedies. Microorganisms circulating in the hospital and attending the various environmental objects can interact with the patient in two ways. Under appropriate conditions, they are either the direct cause of infectious complications, causing the so-called exogenous infection or hospital strains replace patient’s microflora with impaired colonization resistance (mostly due to antibiotic therapy), forming part of its auto microscopic flora and become the cause of endogenous infection. In this case as it was previously explained patient nosocomial infection with strains of microorganisms and colonization of them can be prevented through the use of modern sterilization, disinfecting and antiseptic agents by disinfection and sterilization. These activities are not only important from a medical point of view but also considered economically viable steps in medical treatment. We should remember that medical housekeeping of environment, sterilization of medical instruments, which are in contact with skin or mucous membranes of patient adherence to aseptic technique during any invasive manipulation, and currently remain the cornerstone in the prevention of nosocomial infections. The most important and maybe the most simple of these measures is to wash own hands before and after patient contact (even when wearing medical gloves). Discussing this side of the problem it becomes understandable that in terms of effectiveness of prevention of nosocomial infections is most advisable to use disposable instruments, gloves, catheters, equipment, factory-sterilized. However, this is not always possible. Thus, the question of decontamination of reuse medical devices consists of the following steps: disinfection, cleaning and sterilization. Under the pre-sterilized cleansing understand the mechanical removal of foreign, mainly organic material with disinfected surfaces. Disinfection – is a physical or chemical process, which destroyed virtually all microorganisms, except bacterial spores. Under the sterilization process physicians imply the complete destruction of all microorganisms including bacterial spores. And connecting disinfection with antibiotic treatment we should say that prophylactic use of antibiotics – is one of the methods of control of nosocomial infections, the theoretical basis of which is the need for surgical intervention during a certain concentration of antibiotic for the maintenance of microbial numbers in the field of surgical wound below the level at which infection may occur. Thus, basing on the information presented in this paper we see that timely identification of infection sources, the detection mechanisms of microbial resistance are the key measure to combat nosocomial infections, which are required to take medical facilities. In such a way qualitative diagnosis, allowing in proper time to identify the carrier, plays a crucial role in preventing of nosocomial infections spread and favour the decrease of treatment costs. In conclusion, nosocomial infections continue to be the great problem for the entire healthcare system throughout the whole world due to increased risks to patients and medical personnel. Nowadays there were developed a big quantity of effective infection control programs directed on the control and prevention of nosocomial infections. But for the best results it is necessary to continue educate medical personnel about the elementary hygiene rules and norms that are the first step of nosocomial infections prevention.
HIS 200 Southern New Hampshire University Supporting a Thesis Statement Discussion.

I’m working on a history writing question and need a sample draft to help me study.

Based on your reading in the webtext, select and respond to one of the following thesis statements. Your response should be two to three paragraphs long and should include your position on the issue. Cite at least three specific pieces of historical evidence.In the long run, busing helped Boston because it desegregated the school system, provided equal educational opportunity for minority students, and set the stage for racial healing and an improved racial climate in the twenty-first century.ORIn the long run, busing hurt Boston because it led to violent racial strife, contributed to white flight, and damaged the quality of the public school system.
HIS 200 Southern New Hampshire University Supporting a Thesis Statement Discussion

Moraine Valley College Procter & Gamble Human Resource Management Essay

Moraine Valley College Procter & Gamble Human Resource Management Essay.

Choose a global firm and write a 2,500 Word APA formatted document with at least 10 peer-reviewed references. Assume you are the senior leader and write your paper on the following:Based on the organization’s global human resources strategic plan:What is the the role of the organization in the current global economy? Why?What is professional cultural competence among personnel? Why?Plan and develop processes for global human resources functioning:Explain, contrast and compare the utilization of practices within the organization’s domestic and global HR markets.Based on what we have studied in this course, apply HR solutions to the global market for improved functioning and outcomes to ensure mission and vision are achieved.Discuss world issues, laws, trends, and international business that may impact the effective human resources global strategy you have developed and plan to implement.Optional: Submit your paper to the SafeAssign Draft link in the box below to check your “originality” score. Make corrections as desired.When you are prepared to submit your assignment for grading, please submit to the “View/Complete” link below that is located in this box. Due Saturday before midnight. Additionally, international HRM/GHRM courses are every evolving and changing due to the global landscape, please use materials from 2009 – present as peer review, books, journals. You may use Google Scholar but NO;; HTML, or websites with advertising.
Moraine Valley College Procter & Gamble Human Resource Management Essay

Sudden Oak Death: Causes and Treatments

order essay cheap Sudden Oak Death is a plant pathogen that kills oak and other species of trees. It has mostly affected trees located in California and Oregon as well as being somewhat present in Europe. According to information provided by,” Sudden Oak Death is a forest disease caused by Phytophthora Ramorum…These trees are infected through the trunk of the tree” (“What Is Sudden Oak Death?”. 2019.) Phytophthora Ramorum is a plant pathogen. It’s located in areas that are cool, moist, and foggy. The pathogen was first discovered in the early 1990’s, being observed on container-growth plants located in nurseries. It was first isolated in 2000 from cankers on dying trees. Symptoms of the pathogen include bleeding cankers on the tree’s trunk and dieback of the foliage. Phytophthora Ramorum doesn’t produce spores or spread in dry conditions nor is it common in urban areas or suburban areas where native vegetation has been largely removed. If there is a tree that’s been infected with the pathogen then it would have already affected the surrounding area. If it’s a small infected area, then removal of the trees is recommended. To prevent the spread of the pathogen then it’s also recommended to stay out of wet areas that may be contaminated with it. Phytophthora ramorum is the plant pathogen known to cause the disease called Sudden Oak Death, which currently doesn’t have a cure. This disease causes oak trees and other species of trees to die as the pathogen kills the tree from the inside of its trunk. P. ramorum was first recorded in 1995, and the pathogen’s origins are still uncertain, but most proof indicates that it was introduced as an exotic species on several occasions. The disease has very few control mechanisms, and they depend on early identification and adequate disposal of infected plant material. In the 1900’s when the disease was discovered, it was recognizable by a common trait that was being observed on a species of tree called Tanoaks. The disease can be acknowledged by wilting fresh roots, old leaves becoming pale green, and after two to three weeks, leaves turning brown as they cling to their branches. Dark brown sap can stain the bark of the reduced trunk. With noticeable discoloration, the bark can divide and exude the gum. Suckers attempt to sprout the next year after the tree comes back, but their tips quickly bend and die. P. Ramorum is still a new disease and the direct source of it is still uncertain. However, according to an article written by Matteo Garblotto and associates, “Our data shows that almost all of the main tree species in mixed-evergreen and redwood-tanoak forests of the state-including the coniferous timber species on the coast of redwood and Douglas fir- may be hosts of P. Ramorum.”. This claim is provided by data that the researchers received when examining the sampled leaves and stems of tree and shrubs species located within sites with oak mortality in California. Tests were also conducted on DNA of the plants. The DNA-diagnosis was made up of a process which included: 1) sample freezing, 2) grinding of infected plant tissue and extraction of DNA, and 3) amplification of P. ramorum DNA using the polymerase chain reaction. Overall the diagnosis was able to detect the pathogen within. 10 out of 13 of the sampled plants. There is currently no cure for the Sudden Oak Death disease but there was an effective treatment that was able to put a stop to the disease for up to 2 years. Phosphonate treatments were effective in slowing infection and development rates for at least 18 months. By contrast, an alternative technique composed of azomite soil modification and bark lime wash was always ineffective and did not decrease growth rates or rates of infection. Matteo Garbelotto states, in an article about the many treatments of Sudden Oak Death,” these simple derivatives of phosphorous acid enhance the production of secondary metabolites that act as antibiotics” (Garbelotto et al. 2008). In order to protect the trees against this devastating pathogen, checking the trees for the noticeable symptoms is necessary. There are two main sections of the tree that pathogen can use as a host. Those two main sections are the trunk and the foliar. The trunk infection is used to kill the tree more quickly. The foliage infection can range from leaf spots to twig dieback. These hosts,however, rarely die from the infection. Examining plants from these symptoms and administering any treatments is the only to prevent the spread of this pathogen to new plants. If one were to use insecticides as a form of treatment then it wouldn’t have any result when in comparison to phosphonate treatments. The only effect the insecticide can have is prolonging th tree’s lifespan for a minimum time but only if it’s applied when the disease is not an advanced stage. Sudden Oak Disease may be a new plant pathogen but at least there are temporary treatments to keep it at bay instead of there being no help at all. There are also many ways to prevent the spread of the pathogen and what to do to contain it. References Garbelotto, Matteo, and Douglas Schmidt. “Phosphonate Controls Sudden Oak Death Pathogen for up to 2 Years.” California Agriculture, University of California, Agriculture and Natural Resources, 1 Jan. 2009, v063n01p10. Garbelotto, Matteo, et al. “Non-Oak Native Plants Are Main Hosts for Sudden Oak Death Pathogen in California.” California Agriculture, University of California, Agriculture and Natural Resources, 1 Jan. 2003, v057n01p18. “What Is Sudden Oak Death?” Sudden Oak Death, 2 Sept. 2017,

Chronic Obstructive Pulmonary Disease

Share this: Facebook Twitter Reddit LinkedIn WhatsApp Introduction It is not easy to explain to someone of what COPD is. COPD stands for Chronic Obstructive Pulmonary Disease. (Brown and Edwards, 2012) COPD, as stated by Brown and Edwards (2012), is a general term which involves both chronic bronchitis and emphysema. COPD can be defined as a respiratory condition that is progressive and unable to be cured. It is characterised by airflow limitation and irreversible obstruction (Brooke, 2013). Current statistics provided by Brown and Edwards (2012) indicate that approximately 2.1 million Australian have some form of COPD, however, the figure will rise up to about 4.5 million in 2050. This essay will provide a thorough explanation on how COPD develops, what risk factors that contribute to the exacerbation of COPD and the interventions, both pharmacological and non-pharmacological that help addressing its exacerbation. Pathophysiology of COPD Chronic bronchitis, as explained by McCance, Huether, Brashers

Savannah Tech College Importance of Ethics & Morals in Society Case Study

Savannah Tech College Importance of Ethics & Morals in Society Case Study.

Part 1Pg 140: Case 5. Is it morally wrong to read literature or listen to speeches sponsored by groups that promote hatred of racial, ethnic, or religious groups? Are there any special circumstances in which you would modify your view? Explain.Part 2you are required to complete a Written Case Analysis of approximately 200 words. Please read Thinking Critically About Ethical Issues, Case 5, pp. 167-168. Identify the moral issue(s) and the parties involved, and infer their interests; discuss the case in terms of finding common ground in the diversity of interests you identify. A number of groups have urged restrictions on child labor. For example, they believe that no one under age 16 should be permitted to work in the manufacturing, mining, agricultural, and construction industries; that hours of work should be limited in all jobs for workers under the age of 18; and that no one under 21 should be allowed to have any contact with pesticides. Discuss the moral considerations attending this proposal.
Savannah Tech College Importance of Ethics & Morals in Society Case Study