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Preventing Musculoskeletal Disorders in Nurses

Appendices APPENDIX C SECTION 1: ERGONOMIC FOR PREVENTION OF MUSCULOSKELETAL DISORDER Introduction Nurses provide care to physically demanding patient and assist them in mobilization and other activities like bath, feeding etc. Patient handling tasks such as lifting, transferring or repositioning are contributing factors for MSP among nurses particularly the back being most prevalent. These tasks can entail high physical strains due to different body size involved, leaning over a bed or working in cramped postures, supporting patient during gait activities, and many other factors. The risk factors that health care workers face include: Force: the amount of physical effort required to lift or to maintain control of heavy equipment or tools; Repetition: performing same task over and over continually or frequently; and Awkward postures assuming positions that put strain on the body, such as working above shoulder height, kneeling, squatting, leaning over a bed, or twisting the back while lifting. Identifying Problems and Implementing Solutions for patient Lifting and Repositioning Manual handling tasks such as lifting and repositioning can be variable, dynamic, and unpredictable in nature. In addition, factors such as patient self-esteem, safety, and medical contraindications should be taken into consideration. The analysis of any handling task involves an assessment of the requirements and capacities of the patient. The patient assessment should include an analysis of the following factors: The level of cooperation from the patient; The body size and weight of the patient; Any health anomalies that may influence the choice of lifting or repositioning techniques. Repositioning in Chair Description: Variable position Geri chairs When to Use: Repositioning partial- or non-weight-bearing patients who are cooperative. Points to Remember: One caregiver can assist if patient has strength in both upper extremities of arms. If patient cannot assist in self-repositioning on chair, help from at least 2 caregivers and friction reducing device may be required. Ensure that chair is easily adjustable; wheels are freely movable flexible and steer. Lock wheels on chair before repositioning. Remove trays, footrests, and seat belts where appropriate. Ensure device correspond with patient weight. Various Activities of Daily Living and Bedside Assistance Description: Work practices for feeding, dressing and grooming. When to Use: During feeding, dressing, personal hygiene tasks, vital sign assessment, and other bedside assistance. Bedside Assistance: Lower side rails, position patient as close as possible to edge for safety purposes. Sit or stand in front and near to side of patient. Adjust height of tables and electric beds to waist level and place supplies close by to prevent back flexion and bending. Collect supplies in advance and place them on a table that is located perpendicular to the patient. Avoid leaning across patient; rather, move to other side. Carry items close to the body. Provide adaptive equipment that offer independence to patients and reduce assistance from caregiver. Feeding: Chop food into pieces before placing it in front of patient. Dressing and grooming: Ensure that patient’s feet lie flat on the ground or a stool for stability when sitting. Place feebler limb in pant or sleeve first. Use suitable adaptive equipment for dressing, grooming and oral hygiene. Activities of Daily Living Activity: Administrating medications Description: Low profile medication cart and cartridge pill dispenser When to Use: Dispensing medications. The cart increases precision and lessens time required to perform task. Medications cart: Classify medications according to day and time. Low profile carts with easy side opening drawer are recommended to accommodate hand height of shorter nurses. Cartridge dispenser: Use cartridges with a “flip top” for drug storage until administered rather than wrapping the doses individually in foil of paper or small container that require more finger forces and a sharp object to break the seal. Bathtub, Shower, and Toileting activities Description: Long-handled extension tools on hand-held showerheads wash or scrub brushes. When to Use: When bathing or showering patients. Points to Remember: These equipments limit the extent of bending, reaching, and twisting required when cleaning feet, legs, and trunk of patients. Patients who are autonomous can also use these devices to facilitate personal hygiene care. Guiding and Slowing Falls Description: Method for guiding and slowing falls. When to Use: When patient is falling. Points to Remember: Utilization of transfer or gait belts may aid nurses in guiding the fall. Grip onto the belt/handles and slowly lower the patient to the floor using proper body mechanics. Reviewing patient assessments and monitoring for signs of weakness are effective strategies of preventing falls. Stand with back straight, tighten stomach muscles, bend legs, and stay adjacent to patient if it practical to do so. Don’t try to stop the fall abruptly as this may increase the risk of injury among nurses. Lifting from the Floor Description: Methods to lift patients from floor When to Use: After a patient fall. Points to Remember: Assess patient for injury prior to lifting and use a powered portable or ceiling-mounted lift device to move patient with minimal assistance. If patient can maintain standing position with minimal assistance, use gait or transfer belt with handles to support patient. If manual assistance is required ensure a team lift are s are available to provide assistance as needed. Use 2 or more caregivers when assisting heavy patients. Stand with back straight, bend legs, and stay near to patient as possible. Ambulation Description: Ambulation assist device When to Use: For patients, who are able to support their body weight, cooperative, need extra security and assistance when ambulating. Increases patient safety and reduces risk of falls during ambulation Points to Remember: Typically needs one caregiver. The device provides assistance to patients as they walk and pushes it along during ambulation. Ensure device is in good working condition with height adjusted correctly before use and rated for the load weight to be lifted. Apply brakes before positioning patient in or releasing patient from device. Implementing solutions for patient lifting and repositioning Ergonomics is the science of designing equipment and work tasks to conform to the capability of the worker and provides a means of adaptation to work environment and work practices to prevent injuries. Ergonomic solutions are proposed to reduce musculoskeletal disorders among the staff nurses. The recommended solutions brought forward are not intended to be an exhaustive list, nor do all of them will be used in any given set up. The material signifies a variety of options available that a facility can consider using. Many of the solutions are simple to implement and do not require substantial time or resources such as modification in procedures or equipment. Others may require more significant efforts. The integration of various solutions into hospital management, can lead to beneficial outcome in the long run. Patient and Equipment handling solutions Lateral Transfer Description: Ceiling-mounted device with horizontal frame system or litter When to Use: Moving patients who are totally helpless, non-weight bearing, has other physical impairment, or are very big in size and cannot be safely shifted by staff between 2 horizontal surfaces, such as from bed to stretcher or gurney in supine position. Points to Remember: Motors can be fixed or portable (lightweight). Device can be functioned by hand-held control attached to unit or by infrared remote control. Always ensure lifting device is in good working condition before use and is assessed for the load weight to be lifted. Lateral Transfer Description: Gurneys with transfer devices When to Use: Transferring a partial- or non-weight-bearing patient between 2 horizontal sides, such as from bed to stretcher or gurney in supine position. Points to Remember: Two nurses are required to achieve this type of transfer. Additional assistance may be required depending on patient status, e.g., for heavier or uncooperative patients. Motorized height-adjustable gurneys with built-in slide boards are preferred to those adjusted by crank mechanism to lessen physical effort required by caregiver. Always ensure that lifting device is in good working condition before use and is evaluated for the load weight to be shifted. Ensure wheels on equipment are locked and transfer surfaces are same level to at waist level of caregivers in order to avoid over reached and back flexion Lateral Transfer; Repositioning Description: Air-assist lateral sliding aid; flexible mattress inflated by portable air supply When to Use: Transporting a partial- or non-weight bearing resident between two horizontal sides such as from bed to stretcher or gurney in supine position. It can also be used for repositioning a patient in bed, increase patient well-being and reduces risk of tissue injury during transfer. Points to Remember: Two caregivers are needed to achieve this type of transfer. Additional assistance may be required depending on patient ability, e.g., for heavier or uncooperative patients. Ensure wheels on equipment are locked and transfer surfaces are at level and height that permits nurses to work at waist level to avoid over reach and back flexion. Count down and coordinate the transfer motion between caregivers. Patient Lifting Description: Ceiling-mounted lift device When to Use: Lifting patients who are totally helpless, are partial- or non-weight bearing, very heavy, or have other physical impairment. Transfers from bed to chair (wheel chair, Geri or cardiac chair), chair or floor to bed, or for bathing and toileting. Points to Remember: May need 2 or more nurses. Some patients can use the device quicker than portable device without assistance. Motors can be fixed or portable (lightweight). Device can be activated by hand-held control attached to unit or by infrared remote control. Ensure lifting device is in good working condition before use and is assessed for the load weight to be lifted. Transfer from Sitting to Standing Position Description: Stand-assist devices; can be fixed to bed or chair or be free-standing When to Use: Transferring patients who are able to support their weight and cooperative and can pull themselves up from sitting to standing position. It can be used for independent patients who need extra lift to stand and aid patient independence. Points to Remember: Check that device is constant before use and is evaluated for patient weight to be held. Ensure frame is firmly attached to bed, or if depend on mattress support that mattress is big enough to support the frame. 1
SU Criminology Justice Arson Charges Committing Crimes & Criminal Act Discussion.

I’m working on a criminal justice project and need support to help me understand better.

Here is the information Jordan has found about several different arson charges.Arson in the first degree: Intentional fire damage to a building which results in serious injury or was done with an expectation of a benefit from the fire and a disregard for potential injury. (Class A felony, 20 years to life sentence)Arson in the second degree: Intentional fire damage to a building when someone else is present in the building. (Class B felony, 5–25 year sentence)Arson in the third degree: Intentional fire damage with no reason to believe the fire would endanger others. (Class C felony, 3.5–15 year sentence)Arson in the fourth degree: Reckless fire damage to a building. (Class E felony, 1.5–4 years)Jordan now believes whoever set the fire will be found guilty at trial and sent to jail for at least 20 years.Although you hate to dash Jordan’s hopes, explain to Jordan why that outcome is unlikely.Question Text:Read the journalist’s notes about the series of crimes in the other town. Then, in your notes, organize the information by listing all the crimes committed and noting whether each one is a property crime or a violent crime. You can use the table provided as a guide.Journalist’s Notes:Within the span of three months, several homes on one side of town have been broken into during the day. No one is ever home at the time, and numerous high value items have been stolen. Additionally, three local businesses have been broken into at night after closing. Cash was stolen from the safes in two of the businesses. The third business is a hardware store and several expensive tools were stolen. During this time period, two bicycles and one all-terrain vehicle were also stolen while left outside unattended; it is unclear if these thefts were committed by the same offender(s) breaking into homes and businesses.Finally, two disturbing incidents occurred in the midst of these crimes.First, a man with a gun forcefully pushed a man who was stopped at a red light off of his motorcycle. The gunman then hopped on the motorcycle and sped off.Second, two women got into an altercation in the mall parking lot when one woman accused the other of stealing her parking spot. The angry woman parked her truck behind the other woman’s car, blocking it in. She then proceeded to kick and hit the other woman for several minutes before grabbing a baseball bat from her truck and hitting the other woman in the back with it. She then smashed the windshield and drove off.Description of Criminal ActType of CrimeProperty Crime or Violent CrimeExample: Two bicycles were stolen outside when no one was around.LarcenyProperty
SU Criminology Justice Arson Charges Committing Crimes & Criminal Act Discussion

West Coast University Nursing Quality Care and Patient Safety Discussion

West Coast University Nursing Quality Care and Patient Safety Discussion.

Discussion 2 – Read and Review Nursing Essential II: Basic Organizational and Systems Leadership for Quality Care and Patient Safety.Post one paragraph addressing the following: Why are knowledge and skills in leadership, quality improvement, and patient safety necessary to provide high–quality health care?Write a second paragraph describing how you met Essential II during the BSN program. Provide specific examples.Be sure to use in-text citations and cite scholarly reference(s) in APA format.Discussion 3 – Read and Review Nursing Essential III: Scholarship for Evidence-Based Practice.Post one paragraph addressing the following: Why is professional nursing practice grounded in the translation of current evidence into practice?Write a second paragraph describing how you met Essential III during the BSN program. Provide specific examples.Be sure to use in-text citations and cite scholarly reference(s) in APA format.Discussion 4 – Read and Review Essential IV: Information Management and Application of Patient Care Technology.Post one paragraph addressing the following: Why are knowledge and skills in information management and patient care technology critical in the delivery of quality patient care?Write a second paragraph describing how you met Essential IV during the BSN program. Provide specific examples.Be sure to use in-text citations and cite scholarly reference(s) in APA format.Discussion 5 – Read and Review Essential V: Healthcare Policy, Finance, and Regulatory Environments.Post one paragraph addressing the following: Why are healthcare policies—including financial and regulatory—that directly and indirectly influence the nature and function of the healthcare system important considerations in professional nursing practice?Write a second paragraph describing how you met Essential V during the BSN program. Provide specific examples.Be sure to use in-text citations and cite scholarly reference(s) in APA format.
West Coast University Nursing Quality Care and Patient Safety Discussion

Write a discussion post and two replies

online dissertation writing Write a discussion post and two replies.

The discussion should be 100-150 words and the prompt is: Some Central and Eastern European countries have taken conservative policy stances when it comes to issues of LGBT rights and abortion. In Poland, for example, abortion is illegal in almost all circumstances. Despite opposition from Western governments, the policies have been implemented by democratically elected governments and have mass public support. Policymakers in these countries often express resentment for Western leaders condemning these policies as “undemocratic.” Are these conservative social policies implemented in Eastern Europe undemocratic? Why or why not?Each reply should be around 50 words.Reply 1: Democracy includes a fundamental right to choose. This, in my opinion, includes the right for a woman to choose what happens to her body and get an aborition. Although Eastern Europe is strictly conservative at its core and their policies reflect the popular opinion of their constituents, I think that taking this fundamental right away from a woman is undemocratic. If Eastern European women do not want to have an abortion because of their conservative beliefs, then that is their choice. However that should not influence ALL women’s rights to choose. If other women want to have an abortion, then they should also be allowed to select that alternative.Reply 2: I do not think a woman’s reproductive rights should be politicalized at all first and foremost. A main aspect, as a part of democratic regimes, is individual rights, such as freedom of speech, etc. Women in society have historically and continuously been oppressed and democracy tries it best to get minority voices as part of the government. Women should be protected under democracy and have the right to choose what they do. Anti-abortion laws just put women at risk and stigmatize women’s healthcare for when they do seek help for reproductive concerns. I do not think it is fair for Eastern European countries to restrict these women’s rights.
Write a discussion post and two replies

USC PF Strawson RM Hare & JL Austen Analytic Philosophy Questions

USC PF Strawson RM Hare & JL Austen Analytic Philosophy Questions.

Please answer three questions, no two of which are on the same philosopher. Each answer should be between 300 and 400 words.-Links to texts are embedded in title names-An answer to only one question is needed for sections with more than one questionSection II: Strawson’s on Truth and Moral Responsibility (P.F. Strawson, Truth; Analysis, 9, 1949) 3. What is determinism and how is it thought by some to threaten moral responsibility? How does Strawson use “reactive attitudes” to counter that threat, while continuing to recognize genuine circumstances in which moral responsibility is diminished or suspended?Section III: Hare’s Theory of Goodness (R.M. Hare, Language of Morals ch 5-8)4. Explain Hare’s analysis of the “primary meaning” of sentences of the form x is a good N. What is the main problem with it?5. Sketch the reasoning behind Hare’s claim that the “primary meaning” of sentences of the form x is a good N can’t be descriptivist. How might a descriptivist respond?Section V: Austin’s Sense and Sensibilia (J.L. Austin, Sense & Sensibilia; A.J. Ayer, Has Austin Refuted the Sense-Datum Theory in Metaphysics and Common Sense)9. Explain Austin’s argument that some claims about the external world can be known without evidence. Why does the argument fail?10. Austin rejects theories of perception according to which what we directly see are images private to ourselves. Explain how the theory arises and Austin’s most important criticisms of it.
USC PF Strawson RM Hare & JL Austen Analytic Philosophy Questions

Academy of Art University Python Code Text File

Academy of Art University Python Code Text File.

Edit the gamers database program (Main.py) so that it prints the following menu when executed (notice there are two new items):What would you like to do?
V – View a specific gamer
E – Edit a gamer’s name
D – Delete a gamer
Q – QuitPart 2Implement the second menu item so that entering E should ask the user to enter a gamer’s name. If the user enters a name that does not exist, the message Gamer not found! should be printed. If the gamer’s exists, the user should ask the user to enter a new name and the gamer’s name should be changed. The message Name changed should be printed confirming that the name has been changed.Part 3Implement the third menu item so that entering D should ask the user to enter a gamer’s name. If the user enters a name that does not exist, the message Gamer not found! should be printed. If the gamer exists they should be deleted and the confirmation message Gamer deleted should be printed.NOTE: Don’t forget that the menu items and gamer names should be case insensitive.
Academy of Art University Python Code Text File

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