UC The Global Interest in Technology Acceptance Model Research Paper

Critical Analysis Nursing Care for the Older Adult

Share this: Facebook Twitter Reddit LinkedIn WhatsApp Dementia is an umbrella term to describe a collection of symptoms that develop in association with a progressive disorder of the brain of which dementia of the Alzheimer’s type is the most common. Other forms of dementia include Lewy body dementia, Pick’s disease and (MID) multi-infarct dementia (Ramsay et al, 2005). The main features of dementia are a decline in memory, ability to learn and understand in a continuing progression. There are often changes in social behaviour, general motivation and the client’s ability to control their own emotions (Burgess, 2005). These changes vary from a gradual to more sudden onset that varies from individual to individual. In the early stages of dementia memory problems are often the most obvious sign (DH, 2009). Mental health practitioners find that memory problems and other needs are only the beginning of the process in making a diagnosis. The doctor is required to check in what ways an individual is not functioning as they would expect. Assessments may be carried out at home in order to gain a clearer image of how the client is managing (Ramsay et al, 2005). The doctor will also need to know the client’s medical history including any physical illness and current medication. The doctor will also want to rule out depression as a cause of the memory problems. If the memory problems are attributed to depression, then treatment using an antidepressant could help substantially (Ramsay et al, 2005). Diagnosis is a scientific tool. Beyond that the carer requires an understanding of the client’s experience of having a problem or disorder, health and social care needs to be values based as well as evidence based. To translate this philosophy into practice requires that the assessment process be driven by the principles of partnership, holism and personalisation (Atkins et al, 2004). Assessment is a valid and integral part of any nursing intervention and must be performed in partnership with the client (RCN, 2004). Following this, the next step is to consider involvement of various investigations, often carried out in hospital or in a clinic, including the use of blood testing, X-ray and if necessary, brain scanning to discover the cause of the symptoms (Ramsay et al, 2005). To carry out a full assessment of the client’s problems, other practitioners are likely to play a part in the assessment as part of a multi-disciplinary team (MDT). Members of the team may include nurses, occupational therapists, psychologists, physiotherapists, social workers and doctors. Making a diagnosis is important as diagnosis affects the type of treatment used (Ramsay et al, 2005) Difficulties that can occur in practice when attempting to engage with clients in an effective manner include; making all of the information that is being exchanged comprehensible to the client, finding methods to reduce frequency of forgetting that can occur, finding methods to encourage clients to feedback information – positive or negative to overcome any difficulties that many people can feel in clinical settings (Ley, 1997). The reflective account outlines the importance of communication skills in practice where the nurse can be delivering care to individuals with very specific needs that must be attended to with privacy, comfort and dignity for the health and wellbeing of the patient. In the account it is clear that clients with dementia can find communication, mobility, and physical health problems difficult and in managing the care of clients with dementia although challenging, may be overcome through empathic understanding and best practice including evidence based care delivery. In relation to communication, the most suitable approach is the use of selective questioning, providing information, respecting personal dignity and being clear so that the client understands (Zimmermann, 1998). Patient centred methods of care place demands on nurses because such a method involves responding to the cues from clients in which feelings and emotions are expressed. Nurses are required to develop the expertise to respond in an appropriate manner to the client’s feelings and emotions (Stewart et al, 1989). In order to provide high quality person centred care, the needs of each patient must be assessed individually to ascertain additional requirements that the client may have. Conversely, some clients will require less assistance than initially considered by the team. It is equally important to understand these needs in order to respect each client’s need for independence (Stewart et al, 1989). Best care can be defined by the underlying principles that communication should always be person centred (Oberg, 2003). Therefore the client should be provided with a quality standard of care that allows a sense of control over the treatment that is being provided. It is vital that the client is involved in their own care and treatment, not only does this maintain the comfort and dignity of the person, but prevents errors and miscommunication leading to an effective client/nurse relationship. In one study findings concluded that actively involving the patient in aspects of care and treatment often leads to earlier recovery and an improved quality of life (Stewart et al, 1989). Overview of Care Practice – Reflection in Action In practice, a male client was confused as a result of his dementia. The client was an older adult who used a wheelchair and required assistance with mobility because of a leg amputation. Sometimes the client would try to leave his wheelchair which resulted in him falling to the floor. The client was unable to find the lavatory and was becoming increasingly frustrated by his inability to identify specific places. In addition the client became agitated and at times had difficulty with speaking. On one occasion the client called a nurse who responded to the patient, approaching him slowly from the front and greeted him, and asked “How can I help? Is everything ok?” The patient responded to the question with an answer “I need… I need to go to the…” The client repeated this statement several times with increasing sense of urgency but was unable to find the correct word to finish the sentence due to his level of confusion. The client experienced memory problems and episodes of agitation. Managing the client’s ability to be continent was another important consideration in the care of the individual as he used an attachment (catheter) and was occasionally incontinent of faeces (Johns, 2000; Schön, 1983; 1987). The assessment phase of the nursing process is fundamental at this stage of the interaction so that the nurse was able to ascertain if the client required the use of the toilet (Kozier, 2004). The nurse asked the client if he needed to use the toilet. The client responded by nodding his head and saying “yes”. The planning phase of the nursing process is equally important at this stage. The nurse informed the client that he would show him the way and escorted the client to the toilet. When speaking to the client the nurse was careful to maintain eye-contact and speak slowly and calmly to ensure that the client would understand. Whilst being escorted the client explained that he had been incontinent of faeces. The client began apologising but the nurse reassured him and explained that he would get him some fresh clothes (Johns, 2000; Schön, 1983; 1987). The nurse was able to provide comfort and maintain the dignity of the client as well as the client’s confidence in the nurse’s abilities. The client was reassured and an explanation of the procedure was provided to the person in a step-by-step process, asked if he understood and if he was agreeable. The client confirmed he was agreeable and began to converse with the nurse and appeared much more relaxed. The client responded with additional banter and appeared more content. The client was able to carry out more intimate aspects of his personal cleansing so that further consideration to preserving his dignity and independence was maximised. The nurse recommended that the client’s catheter bag was emptied on a more regular basis to aid comfort and reduce distress (Johns, 2000; Schön, 1983; 1987). The NMC (2008) guidelines stipulate that nurses maintain the respect, dignity and comfort of clients. After being washed the client was assisted with putting on clothing, explaining each step slowly, the client responded y following each step and no longer appeared agitated and was returned to the lounge in a wheelchair. The student reported the information to the rest of the team and discussed regular catheter care for the client. Reflection on Action During the reflection in action (Johns, 2000; Schön, 1983; 1987) the nurse was able to quickly and effectively clean and change the client with comfort and dignity through implementation of the nursing process and incorporating the ideas of assessment, diagnosis and planning phases of care. The reflection on action (Schön, 1983; 1987) highlights what the nurse was trying to achieve and provides opportunity to consider alternatives for future practice. Care was delivered to the client using the Care Programme Approach (CPA) and the procedure implemented to offer a framework to complement policy documents and therefore allow the process to be followed. The approach allows mental health practitioners to provide a structured pattern of care throughout the process, assess client’s need, plan ways to meet the needs and check that the needs are being met (DH, 2007). Those who experience dementia may find some tasks increasingly difficult such as everyday tasks of living, including washing and dressing without assistance or with finding the right words when talking. Interaction for the person can become increasingly difficult and distressing for the client in their relationship with others (Ramsay et al, 2005). Dementia care practice provides opportunities to mental health nurses on how to engage effectively with clients. During the initial contact stages of any nurse and client interaction it is important that the nurse keeps the environment simplified and to eliminate noise that can distract the client (Zimmermann, 1998). It is useful if the nursing team minimises activity occurring in a shift change because a confused client may misunderstand nurses saying goodbye to each another and may wish to leave. Approaching the client slowly and making eye contact can reduce any risk of alarming the client (Zimmermann, 1998). Also the nurse should speak slowly and calmly with pauses so that the client responds to the content of the communication and not the mannerisms of the nurse (Zimmermann, 1998). These skills may help to reduce the client’s anxiety and confusion. The National Service Framework (NSF) for older people sets out national standards and service models of health/social care that older people using mental health services can expect to receive, whether they are living at home, in care or are in hospital (DH, 2001; WAG, 2006). Older people are generally referred to as anyone aged sixty and over and the national ten year initiative is to ensure better health and social care services for people meeting the criteria. It includes older people with dementia, carers and ethnic minority groups. In addition, age discrimination and patient-centred care have been identified as two key areas. Including the NSF, there have been a number of campaigns to promote dignity in the care of older people, recognising that standards of care in some cases are poor and inadequate (DH, 2006a). Unfortunately, there has been a lack of clarity associated with the notion of dignity and the appropriate minimum standards and/or recommendations that should be applied. For example, in an attempt to address the concerns of dignity the Department of Health published an online public survey around the views of dignity and care provision (DH, 2006a). Results of the survey reported that a many aspects of care were identified by older people as vital in maintaining dignity, such as respecting the person and communicating effectively. The Lets Make It Happen NSF (2002) outlines eight standards of care that address issues such as age discrimination, person centred care, mental health and the promotion of health and active life in old age. The success of the NSF for Older People depends on how well it is being implemented. Lets Make It Happen follows the NSF for Older People in 2001 and focuses on examples of research and good practice through evidence based care provision, which demonstrates how implementing good practice can improve people’s quality of life and should also help to develop ideas for how the NSF might be implemented (Alzheimer’s Society, 2002). In 2006, the Department of Health released a report: ‘A New Ambition for Old Age’, in an attempt to move the requirements outlined in the National Service Framework forward, and offers details of the next stage of healthcare reforms for older people. This documentation places older peoples’ needs as integral to care planning and delivery, with ‘respect’ and the maintenance of ‘dignity’ by recognising the existing issues around health related age discrimination (Department of Health 2006b). Furthermore, the Department of Health have established a set of benchmarking tools to ‘root out age discrimination’ and to ‘advance person-centred care’ (Department of Health 2007a). This is to be achieved, in the first place, by actively ‘listening to the views of users and carers about the services they need and want’ (Department of Health 2007a). Within Wales the Care Programme Approach (CPA) is highly regarded as the cornerstone of the Government’s mental health policy and procedures. The framework was introduced in 2004 for the care of people with mental health issues who are accepted as clients by mental health services in an inpatient or community setting. All NHS Trusts in Wales participated in a review and all had processes in place to deliver CPA to clients (Elias

CLP 4143 USF Abnormal Psychology On Being Sane in Insane Places Article Discussion

custom writing service CLP 4143 USF Abnormal Psychology On Being Sane in Insane Places Article Discussion.

Read the article On being sane in insane places.1) Write a 200 to 250 word summary of this article in your own words. Follow these instructions from the Purdue Online Writing Lab (Links to an external site.) to write an APA style abstract : “write a concise summary of the key points of [the] research. Your abstract should contain at least [the] research topic, research questions, participants, methods, results, data analysis, and conclusions. You may also include possible implications of [the] research and future work you see connected with [the] findings.”2) Write a 150 to 250 word response to the article that includes 1) your personal reaction to this article, 2) what are the implications of the article regarding diagnosis and treatment of mental health disorders, and 3) do you think the findings would be the same if this study were conducted today? (explain why)
CLP 4143 USF Abnormal Psychology On Being Sane in Insane Places Article Discussion

University of Cumberlands International Monetary System and The Role of The International Monetary Fund Discussion

University of Cumberlands International Monetary System and The Role of The International Monetary Fund Discussion.

All original threads should be at least 250 words. This parameter helps to promote writing that is thorough, yet concise enough to permit other students to read all the postings. The thoughts and opinions expressed in your thread need to be substantiated by research and literature (from the textbook or outside sources). All references should be in correct APA style. While this is a formal discussion environment, you are allowed to use the first person perspective in all your posts since you will be expressing your personal opinions. All original threads should: Bring clarity to the issues being discussed. Raise new and novel (yet relevant) points. Relate issues to personal experience. Rationally defend your stated position.Egypt and the IMFThis activity is important because, as a manager, you must be able to understand the international monetary system and its implications for business. Understanding the exchange rate system and policy adopted by a government is essential to understanding the economic outlook for a country and the costs and benefits of doing business in that country.The goal of this exercise is to demonstrate your understanding of the international monetary system and the role of the International Monetary Fund (IMF).Read the case and answer the questions that follow.When President Abdel Fatah al-Sissi came to power in a 2013 military coup, he promised to fix Egypt’s mounting economic problems. Three years later, those problems had only intensified. The country was struggling with low economic growth; 13 percent unemployment; a 12 percent inflation rate; a large trade deficit, amounting to 7 percent of GDP; a persistent budget deficit of around 12 percent of GDP; and public debt, which by 2016 stood at 92 percent of GDP. The tourism trade, a major source of foreign currency, had collapsed in the wake of concerns about terrorism, which included an Islamic State-linked insurgency in the Sinai Peninsula that claimed the bombing of a Russian passenger jet in 2016. Foreign direct investment, another source of foreign currency, had also slumped in the wake of Egypt’s economic and political problems.One major issue was a lack of foreign currency in the country, which made it difficult to pay for imports and resulted in shortages of key commodities. For example, Egypt imports one-third of its sugar. By mid-2016, this commodity was in short supply due to the inability of Egyptian traders to get the foreign currency required to pay for imported sugar. Historically, in times of trouble, the oil-rich Arab states of the Persian Gulf had loaned foreign currency to Egypt at low interest rates, but a collapse in oil prices had left those states financially strained, and loans were not forthcoming. In an indication of the depth of Egypt’s problems, while the official exchange rate of the Egyptian pound was pegged at 9 pounds to the U.S. dollar, the black market rate had soared to 18 pounds to the dollar.In mid-2016, with its foreign exchange reserves being rapidly depleted, the Egyptian government applied to the IMF for a loan. The IMF agreed to loan Egypt up to $12 billion, but only if the government undertook a number of economic reforms. These included liberalizing the exchange rate, letting the Egyptian pound float against other currencies. The thinking was that the pound would immediately depreciate against major currencies such as the U.S. dollar and the euro, making Egyptian exports cheaper and its imports more expensive. This should help the country to improve its trade deficit and earn more foreign currency. At the same time, the IMF required the Egyptian government to implement an austerity program that included an immediate end to energy subsidies, which had kept energy prices artificially low; reforms to public enterprises to make them more efficient; tighter monetary policy to rein in inflation; and the imposition of a value-added tax to raise government revenues.In November 2016, Egypt let the pound float freely. It immediately lost 50 percent of its value against the U.S. dollar, trading at around 13 pounds to the dollar. The depreciation continued into the new year, with the pound falling to 19 pounds to the dollar by mid-January 2017, bringing the official exchange rate and the black market rate into equality. Egypt also moved rapidly to impose the value-added tax. In return, the IMF released the first $2.75 billion of its loan to Egypt. Further tranches of the loan will be released as Egypt makes progress on the economic reforms advocated by the IMF.Only time will tell if these policies will work. In addition to a fall in the value of the pound, the immediate impact included a surge in the annual inflation rate to around 20 percent. The IMF envisages the inflation rate falling to 7 percent within three years, while there should be sharp improvements in both the trade deficit and the budget deficit. However, the planned austerity measures carry significant political risks for the Egyptian government. If protests materialize over short-term hardships, the government might cave in to political pressure and pull back from the IMF-mandated reforms. If that happens, the IMF might withhold further installments under the loan program, and the Egyptian economy could continue to deteriorate.Sources: Heba Mahfouz and Paul Schemm, “Struggling Egypt Devalues Currency by Almost 50% Ahead of IMF Loan,” The Washington Post, November 3, 2016; Lin Noueihed and Ahmed Aboulenein, “Egypt on Track to Receive IMF Loan’s Second Tranche,” Reuters, January 18, 2017; “State of Denial,” The Economist, August 6, 2016; and CIA World Fact Book, Egypt, accessed February 2017.Do you think that the policy measures required by the IMF are appropriate? What are these policy measures designed to do? What might be the unintended consequences of these measures?
University of Cumberlands International Monetary System and The Role of The International Monetary Fund Discussion

Dq’s I need help with thIis

Dq’s I need help with thIis.

Discuss how a chart is
to be organized, include data elements, source oriented versus problem
oriented, active, inactive or closed status.  Describe protocols for
retrieving, routing, purging, storing, transferring, retaining and
destruction of medical records.  What filing systems are available, i.e.
numbering, alphabetical and alphanumeric and which one would you
choose? Include what order would you organize medical encounters into
one chronological file.  What type of information
(labs, x-rays, progress notes, etc.) would you gather? What supplies do
you need to build that record? Answer in detail if the record belongs to
the patient since he/she pays for the services?
Discussion Rubric

Dq’s I need help with thIis