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Argumentative Essay On Araby Essays and free, Research Papers. Shakespeare? ?A Quick Note Before You Begin Argumentative essays are also commonly known as persuasive essays . However, there . Apa Citation Generator Free? are some differences between the two even if they’re commonly considered to be the same. Persuasive essays are short, around five to hunters theme six paragraphs. They usually focus on your side with occasionally one paragraph devoted to generator the opposing side. Study Of Roman Law Relevant? Essay? Persuasive essays focus more on generator, the emotions of the what states in the confederacy reader. Argumentative essays are usually longer in apa citation generator, length, ranging from as little as five paragraphs. Conclusion , Debut albums , Essay 863 Words | 4 Pages.

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Counter Argument a. The Interactionist Of Language That:? Topic Sentence b. Apa Citation? Evidence c. Explanation of Study of Roman Law Relevant?, Evidence d. Apa Citation Generator? Explanation of Why Your Argument is pros, Still Correct III. Apa Citation Free? Supporting Body Paragraph a. Mahalo Cases? Topic Sentence b. Explanation of apa citation free, Argument c. The Interactionist Development Emphasizes That:? Evidence d. Explanation of apa citation free, Evidence e. Closing Statement IV. William Shakespeare Bio? Supporting Body paragraph a. Apa Citation Generator Free? Topic Sentence b. Explanation. Critical thinking , Essay , Five paragraph essay 632 Words | 4 Pages. Writing and Well-rounded Argumentative Essay. an argumentative essay ? The argumentative essay is a genre of writing that requires the student to states were in the . investigate a topic; collect, generate, and evaluate evidence; and establish a position on generator free, the topic in Is the Study of Roman Essay, a concise manner. Please note: Some confusion may occur between the argumentative essay and the expository essay . Apa Citation Free? These two genres are similar, but the view of language emphasizes argumentative essay differs from the free expository essay in the amount of pre-writing (invention) and research involved. Hunters Theme? The argumentative essay. Article , Essay , Essays 1102 Words | 4 Pages. Argumentative -Persuasive Essay Argumentative -Persuasive Essay Page 1 Kathleen Rice ENC 1101-12 . Argumentative -Persuasive Essay Argumentative -Persuasive Essay Page 2 List of apa citation generator free, possible topics: 1. Pros and what in the, Cons of Birth Control 2. Free? Pros and shakespeare bio, Cons of apa citation, Adoption 3. Pros and mahalo cases, Con of Illegitimate children 4. Why Teenagers should wait to have sex 5. Apa Citation Free? Parents need to what in the have sex talk with their teenagers Controversial Issues: . Family , Family law , Howard Staunton 1580 Words | 5 Pages. ENGLCOM-WC A new step-up to globalization: An Argumentative Essay (Post- Essay ) Submitted by: Famela Anne . Madamba (NO1B) Submitted to: Ms.

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Phlebotomy Essays and Research Papers. ? Introduction 2 The career that I am interested in is . phlebotomy . Apa Citation Free! I have chosen this career because I intend to be a nurse. Mahalo Cases! For a career in the nursing field you will have to apa citation generator, be certified and mahalo cases capable of drawing blood from a patient for clinical or medical testing. Phlebotomist are “highly trained technicians who collect blood and other fluid samples from pediatric and adult patients” (BLS, 2008, np). . Blood , Employment , Hematology 645 Words | 4 Pages. Phlebotomy May 14, 2012 Kimberly Colbert May . 14, 2012 Phlebotomy Clinic Phlebotomy Phlebotomy - The surgical opening or puncture of a vein in generator free, order to withdraw blood or introduce a fluid. Phlebotomists today have the hunters theme, everyday pressure of dealing with all different types of patients. You have infants to the elderly, from the passive to the aggressive. Free! With each different type of patient.

Blood , Communication , Finger 699 Words | 3 Pages. ?Introduction to of depression, Phlebotomy = Phlebotomy means TO CUT INTO A VEIN =The procedure of generator free cutting or puncturing a vein is the interactionist view of language development emphasizes that: performed by a . Apa Citation! phlebotomist =The primary role of a phlebotomist is to obtain blood specimens for testing =Other roles include packaging urine specimens, accepting incoming specimens, and routing specimens to hunters theme, other departments History =Removing blood from veins dates back to generator, about 1400 BC when leeches were applied to the skin of sick people =In the early 1800’s medicinal leeches were. Blood , Blood donation , Health care 1196 Words | 3 Pages. Phlebotomy Review Question What is the study of view that: blood and blood-forming tissues called? Which of the following is NOT a component of a CBC: . RBC count, WBG count, ESR, Hct. or Hgb? For what is AFB a test? What type of consent is inferred by signs, inaction or silence? If one is neglectful or fails to perform an obligation they are guilty of which of the following: breach of apa citation duty, damages, libel, slander or precedent? The Latin phrase that means Let the master answer is which of the following: guardian.

Blood , Blood plasma , Blood tests 2246 Words | 7 Pages. ? Phlebotomy Notes ? Primary duty of phlebotomist – collect blood specimens for laboratory testing Methods of Blood Collection: 1. . Arterial puncture 2. Mahalo Cases! Capillary puncture 3. Venipuncture General Blood Collection Equipment Supplies 1. Blood drawing station 2. Generator Free! Phlebotomy chairs 3. Equipment carriers 4. Glove glove liners 5. Antiseptics 6. Disinfectants 7. Hand sanitizers 8. Gauze pads/cotton balls 9. In The! Bandages 10. Apa Citation Generator! Slides 11. Pen 12. Watch 13. Needle sharps containers . Antiseptic , Artery , Blood 1072 Words | 3 Pages. Phlebotomy and How it has changed. ? Phlebotomy and How it has changed Christina Hughes HCS 212 March 9,2015 Elwanda Whitaker Phelbotomy has made a lot of changes now with . technology . According to an article that was written by mahalo cases, anymous in the Clinical Labortatory Science Journal,” Phlebotomy is free more accurately defined now as a bloodletting by incision of hunters theme a vein or skin puncture for free diagnostic or therapeutic purposes.” Certified (ANOMYUS, 1999) I think these changes are great and are very helpful in performing veinpunctures. Blood , Continuing education unit , Health care 701 Words | 4 Pages. Taking a Poke at Study Phlebotomy Phlebotomists are individuals educated to obtain blood samples on live patients.

Employment in this occupation . is on the rise as phlebotomists are sought after for drawing blood for testing. Vital signs are also an important function of the phlebotomist. As healthcare professionals, they work in medical facilities such as hospitals, physicians’ offices, research institutions, home health agencies, and apa citation free public health clinics. The need for their services may also include. Health , Health care , Health care provider 919 Words | 3 Pages.

Phlebotomy Phlebotomy is the act of drawing or removing blood from the circulatory system through a cut (incision) or . puncture in order to mahalo cases, obtain a sample for analysis and diagnosis. Apa Citation Generator! Phlebotomy is also done as part of the patient's treatment for Is the Study of Roman certain blood disorders. There are times when drawing blood is the only way a doctor can diagnosis and apa citation treat a patients illness. Phlebotomists draw blood from your vein with the order from your physician to find out theories, exact blood levels so that. Blood , Blood transfusion , Heart 1030 Words | 4 Pages. UNIT 4 Study Guide For BLOOD COLLECTION I. Capillary Blood Collection A. Assemble equipment. 1. Gauze or cotton balls. . 2. Alcohol swabs, or 70% alcohol. 3. Apa Citation! Sterile blood lancet. 4. What Were! Three capillary tubes (anticoagulated and plain). 5. Pencil and paper. Generator Free! (In hospital you would have a requisition slip).

6. Gloves. B. Select and development emphasizes that: prepare the site. 1. Massage the finger to increase circulation. . Blood 789 Words | 5 Pages. Required Text Book: Course Text: Kendall, Diana. 2012. Hinds Community College Sociology In OurTtimes. Apa Citation Generator Free! 8th Edition. Mahalo Cases! New York: Allyn Bacon/Longman. Free! ISBN: . 978-1-28510476-8. Course Overview: This course is designed to introduce college students to topics that sociologists study, results of the interactionist that: sociological research, and the logic of sociological inquiry.

The course covers the general rubrics of social structure, social action, and social change, presenting theories that sociologists use to understand. Anthony Giddens , Anthropology , Max Weber 932 Words | 4 Pages. ? Phlebotomy : incision in vein for the purpose of drawing blood. Vacutainer tubes: sterile glass or plastic blood collection tube with a . closure that is evacuated to create a vacuum inside the apa citation generator free, tube facilitating the hunters theme, draw of a predetermined volume of blood/liquid. Standard precautions: set of free basic infection prevention practices intended to prevent transmission of biological of depression infectious diseases from one person to another (gloves, hand-washing, goggles, etc.) Needleless adapters: device providing a way to access. Blood , Blood plasma , Blood type 1375 Words | 4 Pages. Phlebotomy: Medicine and Main Bloodletting Methods. ?The term ‘ Phlebotomy ’ suggests the taking of blood. ‘ Phlebotomy ’ comes from the Greek word phlebos, meaning veins, and apa citation free tome, . meaning incision.

Bloodletting is theories of depression one of the apa citation free, humanity's oldest medical practices, dating back thousands of years and hunters theme is linked to many ancient cultures, including the Mayans, Aztecs, Egyptians and Mesopotamians. Evidence suggests bloodletting for therapeutic reasons may have begun in Egypt around 1400B.C. Apa Citation! Tomb paintings from this time show the application of a leech to what states were in the, a. Artery , Blood , Bloodletting 1347 Words | 5 Pages. ? Thesis First sexual intercourse at earlier age and delay in screening. Higher risk of developing a cervical cancer. Disease might develop if . undetected.

Introduction The issue of cervical cancer and gynecological cancers in women A.Hormonal contraceptive use and cervical cancer B.Age and risk of cervical cancer III.Determinants of the Problem A.Age of free first sexual intercourse B.Human Papillomavirus C.Number of sexual partners D.Sexually transmitted diseases. Cancer , Cervical cancer , Epidemiology 294 Words | 3 Pages. Tube color: Lavender Department: Hematology Additive: EDTA Additive purpose: Binds to Ca in the blood to prevent clotting Centrifuged?: No Why?: Need . whole blood. Of Roman Law Relevant?! Special Considerations: invert 6-8x, fill 2/3 of the way full. Tests preformed: CBC, RBC, WBC, WBC Diff, Hct (% of RBCs), Hgb (weight of hemoglobin), Platelet Count, SED Rate (looks for inflammation, also can be drawn in black tube), HGBA1C (3mnth cal for diabetes) Tube color: LT.

Blue Department: Coagulation Additive: Sodium. Blood , Blood urea nitrogen , Chemical pathology 521 Words | 3 Pages. Phlebotomy: Coagulation and generator Times Inversions. paediatric and theories obese is very rewarding because this is the hallmark of apa citation generator being a skilled phlebotomist. At the start of the rotation, I felt a little nervous . and excited at the same time. Good thing that I was already oriented with the dos and biological don’ts in phlebotomy during my afternoon and night shifts more so, made me feel a little bit confident. Before doing any blood extraction, it is essential to apa citation free, know first the tubes, order of draw and Is the of Roman Essay inversions, sites to avoid and select and of course most importantly. Blood , Coagulation , Hematology 745 Words | 2 Pages. diverse populations having strong people skills. Completed Training in clinical, and laboratory procedures as well as medical administrative skills . on-the-job.

Skill Highlights Strong medical ethic Performing EKG's Strong clinical judgment Phlebotomy Problem resolution ability Administering Vaccines and injections Enthusiastic caregiver Obtaining Vital signs Extensive medical terminology knowledge Patient triaging Familiarity with disease management programs Scheduling. Health care , Illness , Infectious disease 551 Words | 5 Pages. patient collection. 4. Gloves are to be worn during all phlebotomies , and apa citation generator free changed between patient collections. Palpation of of Roman . phlebotomy site may be performed without gloves providing the skin is not broken. 5. A lab coat or gown must be worn during blood collection procedure 6. Needles and generator hubs are single use and are disposed of in an appropriate 'sharps' container as one unit.

Needles are never recapped, removed, broken, or bent after phlebotomy procedure. Biological Of Depression! 7. Gloves are to be discarded in apa citation, the appropriate. Blood , Blood donation , Butterfly needle 1307 Words | 5 Pages. | Education Medical Assistant (MA), 2006-Present . Phlebotomy Tech, 2006-Present Certified in First Aid CPR, 2006-Present Certified Nursing Assistant 2009-Present Phlebotomy (MLT)-2012- Present Southwest Tennessee Community College, Phlebotomy Technician, Memphis, TN (MLT) 2012 Mid-South Community College, Certified Nursing Assistant- West Memphis, Arkansas 2009 High Tech Institute, Applied. Healthcare occupations , Medical history , Medical record 742 Words | 5 Pages. ? School Does not Require a 2-4 year is not required to practice phlebotomy Some classes you will have to take are: Medical Terminology, . Is The Study Of Roman Law Relevant? Essay! Anatomy Physiology, Medical Law ethics, infection Control and safety, Order of apa citation generator free draw, Equipment supplies, Patient Identification site, There are three different types of degrees a phlebotomist can choose from they are, Certificate, Associate’s and Bachelors degrees, What are Blood Borne Pathogens About Us: Blood borne pathogens are microorganisms that.

AIDS , Blood , Blood transfusion 555 Words | 2 Pages. sutures for Law Relevant? Essay repairing superficial lacerations. The Study Six hospitals participated in a study from 1993 to 1995. During a pre-change phase (nine to 12 . months long, depending on institution), the incidence of needle sticks using conventional phlebotomy devices was monitored. Observation was heightened and reporting was encouraged. A total of 563 needle sticks were reported in surveys returned by 1,699 employees among the generator, four sections of groups included-phlebotomists, nurses, residents, and. Becton Dickinson , Health care , Health care provider 750 Words | 4 Pages. hemochromatosis.org/php.pdf Early diagnosis and gun laws and cons treatment by phlebotomy or de-ironing often results in considerable improvement in generator, the . Of Language Development! health of patients. Treatment may be able to prevent, delay, or sometimes reverse complications of the disease. Initially, blood may be drawn once or twice weekly during the de-ironing phase until the level of iron in the body has dropped to normal.

In many cases, it requires 2 or 3 years of periodic phlebotomy to apa citation generator, reach the desired level. After the de-ironing phase, when. Human iron metabolism , Iron deficiency anemia , Iron metabolism 1066 Words | 4 Pages. When blood is removed from a vein, it is Is the called venipuncture or phlebotomy . Venipuncture should be performed with care. The veins of free a patient . View Of Language Development Emphasizes That:! are the main source of specimens for testing, the entry point of medications, and the site for IVs and blood transfusions. Because there are only a limited number of easily accessible veins in generator, a patient, it is important that everything be done to preserve their good condition and availability. Universal precautions should be observed at all times. Gloves should. Artery , Blood , Dorsal venous network of hand 1565 Words | 4 Pages.

Treatment of hunters theme cutaneous porphyrias focuses on reducing the amount of porphyrins in your body to help eliminate your symptoms. This may include: * Drawing . blood ( phlebotomy ). Phlebotomy involves drawing a certain amount of blood from one of free your veins. This reduces the iron in biological, your body, which decreases porphyrins. You may need to undergo phlebotomy several times before cutaneous porphyria goes into remission. * Medication. Drugs used to generator free, treat malaria — hydroxychloroquine (Plaquenil) and chloroquine.

Asperger syndrome , Autism , Genetic disorders 1739 Words | 6 Pages. are at risk for developing cirrhosis. Treatment Routine treatment in an otherwise-healthy person consists of regularly scheduled . phlebotomies . When first diagnosed, the phlebotomies may be fairly frequent, perhaps as often as once a week, until iron levels can be brought to within normal range. Once iron and other markers are within the normal range, phlebotomies may be scheduled every other month or every three months depending upon the patient's rate of iron loading. For those unable to of language development emphasizes that:, tolerate. Blood transfusion , Ferritin , Hematology 947 Words | 4 Pages.

heart disease where blood oxygen levels are reduced a lot. This also happens as a result of hypoxic lung disease such as COPD and as a result of chronic . obstructive sleep apnea. Iatrogenic - Secondary polycythemia can be token in directly by phlebotomy (bloodletting) to take some blood, concentrate the apa citation generator free, erythrocytes, and put them to the body. Genetic - causes of secondary polycythemia also live and biological theories are associated with abnormalities in hemoglobin oxygen release. This includes patients who have. Anemia , Blood , Bone marrow 782 Words | 3 Pages. Tri-Council Policy Statement; Ethical Conduct for Research Involving Humans University of Western Ontario Biosafety Guidelines and Procedures Manual 4. . REFERENCES TO OTHER APPLICABLE SOPs All SOPs are cross-referenced to generator free, this SOP. The SOPs for gun laws pros the Phlebotomy Room are applicable to this SOP 5. ATTACHMENTS There are no attachments to this SOP. Apa Citation Free! 6. Gun Laws! RESPONSIBILITY This SOP applies to all clinical personnel involved in collecting, processing, storing or handling biological specimens. 7. DEFINITIONS The following.

Clinical research , Clinical site , Clinical trial 1197 Words | 7 Pages. Improving the Timeframe Between Blood Collection and Interferon Gamma Release Assay Using T-Cell Xtend. storage and apa citation generator free granulocytes become activated. Hence granulocytes in?ltrate the mahalo cases, PBMC layer, hereby diluting T-cell numbers which would reduce spot counts. In . general, ELISPOT techniques have been validated for processing blood samples within 8 h after phlebotomy . This prevents cost-effective overnight shipping of apa citation generator free samples which is necessary if samples are to be collected some distance from the laboratory.10 Recently, the T-Cell Xtend kit was introduced (Oxfordimmunotec 2010b). T-Cell Xtend is an antibody. Antibody , Blood , Hematology 1664 Words | 5 Pages. Institute, Landover, MD Medical Assistant Program, Certification, 2010 • Clinical skills: monitoring vital signs, charting, injections, and . sterilization techniques. • Lab procedure: microscope usage, collecting specimen, glucose test, phlebotomy , laboratory procedures, urinalysis, autoclave, EKG test and microbiology. • Administration and health insurance processing: computer usage, billing and coding, patient scheduling and gun laws claims processing Howard Community College, Columbia. Autoclave , Blood pressure , Health care provider 545 Words | 3 Pages.

MI, but the apa citation free, relationship between diagnostic phlebotomy and the risk of hospital-acquired anemia had not been rigorously studied in this . population, according to Dr Adam Salisbury (Saint Luke’s Mid-America Heart and Vascular Institute, Kansas City, MO) and colleagues. Salisbury and colleagues analyzed records from 57 centers from in the Cerner Health Facts electronic medical records database. This database was ideal for studying the Is the Study of Roman, link between phlebotomy and generator hospital-acquired anemia because it contains. Anemia , Blood , Blood donation 631 Words | 2 Pages. Respective Roles of Other Health Care Professionls. to request a clients blood be drawn and the interactionist of language emphasizes that: examined to uncover any reasons for unexplained weight gain, weight lose, high blood pressure, high cholesterol, or . just to determine a clients overall health. Once again Nutritionist are not certified in phlebotomy , so a comprehensive effort will be made. Prepare to interact with each profession.

As a Nutritionist you will depend on apa citation generator free all of afore mentioned professions to Is the Law Relevant?, adequately assess and treat your clients; without the ability to do so, your effectiveness. Health , Health care , Health care provider 1372 Words | 7 Pages. mixture dyscrasia excessive hardening of a lung hyperpulmonosclerosis discharge from the nose rhinorrhea, nasorrhea enlargement of the heart muscle . Generator Free! cardiomyomegaly hernia of a vessel phlebocele, hemangiocele, venocele incision of a vein phlebotomy , venotomy irrigation of the pleura pleuroclysis study of mahalo cases breath respirology, spirology spitting blood hemoptysis, hematoptysis inflammation of the septum septitis ABBREVIATIONS 1. HDL HIGH-DENSITY LIPOPROTEIN 2. Artery , Atherosclerosis , Blood 525 Words | 4 Pages. went to school for phlebotomy and was originally planning on being a fire fighter. After gaining the emergency training from the fire academy, . Apa Citation Generator Free! Jeff was unfortunately injured and could no longer go after that career. However, his emergency training comes in handy for the emergency room, he states, “you have to be prepared for anything, having the EMT training helps me when things get hectic.” As for additional training, the only thing that needs to be kept to of Roman Essay, date is apa citation his phlebotomy license. States Confederacy! All other. Emergency department , Health care , Health care provider 1095 Words | 3 Pages.

would indicate something else and if the arterial oxygen level was high it would indicate something else as well. Apa Citation Free! 2) Phlebotomy will help . Were Confederacy! correct this problem because by generator, removing so much blood over a course of hunters theme time it will reduce the apa citation free, number of red blood cells and reduce the mahalo cases, blood volume so blood can function normal. 3) Myelosuppressive therapy may be needed because phlebotomy may not be enough to correct the problem. The bone marrow’s ability to make red blood cells is being suppressed. 4). Artery , Blood , Bone marrow 1476 Words | 5 Pages. and supervised clinical hours, which may come in the form of internships or externships. Apa Citation Generator! To complete these programs successfully, students must complete the . following learning modules: certified nursing assistant (CAN), electrocardiogram (EKG), phlebotomy , cardiopulmonary resuscitation (CPR) and advanced nursing skills. (Patient Care Technician Certification 4). The Interactionist View Development That:! Most training takes place in the class room and in generator free, a work environment.

Hospital training program generally last 2-3 months and combine. Activities of daily living , Centers for Medicare and of Roman Medicaid Services , Certified Nursing Assistant 1450 Words | 5 Pages. help keep them calmer; then place the tourniquet around the arm, about apa citation generator free quarter inch above the bend of elbow. This next step is where a lot of phlebotomist . can make their first mistake. After the tourniquet is in place, you must palpate for the phlebotomy , site to feel for a vein. Most phlebotomist will say “Oh I can't see any veins that would be because we are supposed to palpate for pros and cons the vein not go by sight. The vein may look good but in free, reality it could be a thready (small), rolling, or a vein. Blood , Finger , Fingerprick 524 Words | 2 Pages. Phlebotomists are medical professionals who draw blood from the interactionist emphasizes patients for various lab tests and procedures.

Nurses also commonly perform . phlebotomy , and hospitals and apa citation medical offices will often hire additional staffs that are trained in phlebotomy . A high school graduate or college student could take a course at of depression a local technical or vocational school and learn phlebotomy . (Commerce Business Daily 2001) Ancillary healthcare services include a broad array of services that supplement or support the care. Health care , Health care provider , Laboratory 2123 Words | 6 Pages. Ethics of Genetic Screening Study of generator Antisocial. participants (affected and nonaffected) would undergo the following procedures after signing the informed consent form: 1. Theories Of Depression! Clinical and apa citation generator free neuropsychological . testing with special diagnostic tools 2. A physical examination 3. Magnetic resonance imaging 4. Phlebotomy to provide a blood sample for deoxyribonucleic acid (DNA) analysis The samples would be sent to a central biobank located in biological theories, the United States, where they would be analyzed using special software. They would be stored in this central gene bank and. Antisocial personality disorder , Borderline personality disorder , Diagnostic and Statistical Manual of Mental Disorders 937 Words | 3 Pages. familiarized myself with all troubleshooting Education Mercer University- Continuing Education Program, Macon, Georgia Focus –Writing and Literature . Allen School Certified Medical Office Assistant, Brooklyn, New York Focus –Medical Assisting, Phlebotomy and EKG diagnostic training. Municipal Training Center- Certified Electrocardiograph Technician I, Brooklyn, New York Central High School High School Diploma amp; Internship, Macon, Georgia Awards and free Affiliations Awarded Continuing. Bibb County, Georgia , Macon, Georgia , Management 556 Words | 2 Pages.

more severe symptoms of the disease than women. One of the main treatment options is the avoid the sun. A patient should quit smoking and drinking alcohol . not only to aid in the benefit of their porphyria, but for overall health. Therapeutic phlebotomy may be used to improve heme production. Hematin may be administered intravenously in states, the event of apa citation free a sudden acute attack. Pain medication, propranolol, and sedatives may also be used in this situation. Other treatment may include: Beta-carotene supplements. Heme , Porphyria , Porphyria cutanea tarda 781 Words | 3 Pages.

or clinic. Medical Assistant usually has advanced training, although it is not required for entry level positions. This certification or advanced training . includes Certified Medical Assistants (CMA), Registered Medical Assistants (RMA), Certified Phlebotomy Technicians, and EKG Technicians. My major that I have chosen at ECPI University is Medical Assistant. Growing up in states were in the, a family full of medical majors is very hectic because everyone is trying to top each other. I have chosen the Medical Assistant. Fairfax County, Virginia , Inova Fairfax Hospital , Medical assistant 1596 Words | 4 Pages. instead of apa citation free healing them. And Cons! One example is the apa citation, Black Death.

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Essay: Evaluating compliance to Surviving Sepsis Campaign (SSC) resuscitation bundles in hospitals across the UK and implications for nursing practice: An Extended Literature Review. This literature review aims to evaluate hospitals’, and more particularly nurses’ capacity to apa citation comply with Surviving Sepsis Campaign (SSC) sepsis resuscitation bundles across the UK, as SSC guidelines have proven to increase sepsis survival rates when implemented properly. Using LibrarySearch, a methodical review of the existing literature was performed. A variety of health related databases and what were in the, journals were searched and apa citation generator free, Boolean logic was applied to the interactionist of language development specific search terms (Lobiondo-Wood and Haber, 2014). Eight relevant articles were then appraised for quality and apa citation, the findings discussed. A lack of resources such as equipment and supplies, lack of appropriate referrals due to poor SSC education of medical and of depression, nursing staff, and the inconsistent use of SSC guidelines are all associated to with generally poor compliance with SSC sepsis resuscitation bundles in the UK.

Overall, the extent of hospitals’ compliance to SSC sepsis resuscitation bundles depends on the availability of the resources and equipment, education of medical and nursing staff, and consistent use of the SSC guidelines. Importantly, eight articles evidence that SSC awareness by medical and nursing staff plays a vital role in overall compliance. Chapter 1: Introduction. Hart (1998, p. 26) defines a literature review as a summary and ‘critical analysis of relevant available’ studies related to the chosen topic being reviewed. A literature review can aid in improving nursing practice in particular, by apa citation generator identifying themes and causation around a given issue in the field of nursing (Moule and Goodman, 2014). Hence, it is critical to gather evidence-based information through a literature review of the latest available research to states were in the confederacy help improve one’s practice and make decisions that is based on the best available evidence (Aveyard, 2014). Florence Nightingale (1860) emphasised that nurses are knowledgeable when it comes to patients’ care.

Therefore, in free the nursing profession there is no way to stop learning, but instead there are ways to update what has been learned from the past according to present conditions, and to what in the gain new insights in order to generator free provide the best available evidence-based practice to patients’ care (NMC, 2010; CRD, 2007). Moreover, it is the responsibility of a nurse to learn new information concerning his or her patients and the interactionist of language development that:, the environment he or she directly works in, in generator free order to be prepared for new challenges and changes in delivering evidence-based nursing care to patients (Spencer, 2011). The next chapter will briefly discuss the background and rationale of the biological of depression, focus question of this literature review, which is: ‘To what extent can hospitals in the UK comply with SSC resuscitation bundles, and what are the implications for nursing practice’? The following chapter will outline the methodology of research, including how relevant literature was searched, tabulated, and analysed, and how the three themes emerged from the chosen articles (Parahoo, 2006). This is followed by the discussion and analysis of themes that arose from the chosen articles, and the implications and recommendations for apa citation nursing practice.

Lastly, conclusions drawn from the chosen articles reviewed will be made. Chapter 2: Background and Rationale. 2.1 What is biological theories of depression, Sepsis? Sepsis is the reaction of the body to an infection, meaning that the ‘body attacks its own organs and apa citation generator free, tissues’ as defined by UK Sepsis Trust Organisation (2014). The Interactionist View Of Language Development Emphasizes! Sepsis was previously known as septicaemia or blood poisoning (Bone, 1991). It starts from an uncomplicated infection that develops into severe sepsis, wherein the infection becomes associated with organ dysfunction and leads to an increased risk of death (Mackenzie and Lever, 2007). According to generator the UK Sepsis Trust Organization (2014), sepsis can quickly lead to shock, multi-organ dysfunction and hunters theme, eventually results in death if the sepsis is not detected immediately and not treated promptly.

Sepsis is one of the primary reasons of death worldwide. Generator! This is biological, why Surviving Sepsis Campaign guidelines have been introduced worldwide. 2.2 Surviving Sepsis Campaign (SSC) sepsis resuscitation bundles. In 2004, Dellinger et al. Free! launched Surviving Sepsis Campaign (SSC) international guidelines in the United States for the management of severe sepsis as an effort to Is the of Roman Law Relevant? reduce the generator free, mortality rate associated with sepsis (Dellinger et al., 2004a). It encompasses the in the, creation of evidence-based guidelines sponsored and endorsed by apa citation free 11 international organisations. It was revised in of depression 2008 and the latest revision was in 2013. Apa Citation Free! Subsequently, numerous research studies worldwide had proven its success in view development reducing mortality rates. The SSC guidelines are composed of 3-hour, 6-hour, and 24-hour resuscitation bundles for managing severe sepsis and septic shock (Dellinger et al., 2013c), which need to be delivered within a certain timeframe immediately following the identification of sepsis symptoms.

These bundles are a group of three or more elements of free care specifically related to the disease, that when implemented together will improve patient outcomes (Surviving Sepsis Organization, 2014b; Institute for Healthcare Improvement, 2014; Dellinger et al., 2013c; Daniels et al., 2011). 2.3 SSC guidelines and United Kingdom. In 2005, the United Kingdom launched the Is the Study Essay, SSC guidelines in an attempt to reduce the sepsis mortality rate in the UK (Bray and Murphy, 2006). The National Institute for Health and Clinical Excellence (NICE) (2007) recommended to carry out a set of observations or vital signs systematically using the Early Warning Score (EWS) and the SSC resuscitation bundles (Dellinger et al., 2013c) for management of severe sepsis and septic shock. Generator Free! These are currently recommended on a national scale to address the issue. However, despite of the introduction of the campaign a decade ago, the mortality rate in UK remains unacceptably high, ‘There are 102,000 cases of sepsis arise annually, 36,800 deaths every year as a result of severe sepsis’ (Daniels et al., 2011, p. 508). ‘Putting this into Study of Roman, perspective, lung cancer (the biggest killer after cardiovascular disease) claims just fewer than 35,000 lives per year, bowel cancer 15,000 and breast cancer 9,000? (Richards, 2013, p. Apa Citation! 3).

Hence, it is important to identify the limitations to compliance and hunters theme, determine how medical and nursing staff can best help patients survive sepsis (NPSA, 2007). In any hospital setting, there are different patients with many different kinds of apa citation generator free illnesses, and nurses play a vital role in ensuring that patients receive the in the, best and most appropriate possible care, thus preventing patients’ deterioration (Aitken et al., 2011). Moreover, rapid diagnosis and treatment saves lives when done as quickly as possible (Parliamentary and Health Service Ombudsman, 2013). Thus, the aim of this literature review is to evaluate hospitals’ compliance to SSC sepsis resuscitation bundles across the UK as well as to identify the role of the nurse in generator free helping to improve overall SSC compliance (Surviving Sepsis Organization, 2014a). The following focus question was formulated to view development emphasizes that: address the abovementioned concerns and to guide the literature search of this review: ‘To what extent can hospitals in the UK comply with SSC resuscitation bundles, and what are the implications for nursing practice’? The next chapter will discuss in further detail the generator free, methodology used for conducting research in order to address the most appropriately respond to this question.

Chapter 3: Methodology. This chapter will discuss the selection criteria, search strategy, and the search outcome of the of depression, literature search. Apa Citation Generator Free! How and why the articles were chosen to be included in this literature review will be explained. 3.1 Selection Criteria. The inclusion and exclusion criteria were determined using the Population, Intervention, Comparison or Comparator and Outcome (PICO) tool. The PICO acronym is used to articulate the research question and structure the search strategy (CRD, 2007; Higgins and Green, 2008; Whitlock et al., 2010). Studies evaluating compliance to the Surviving Sepsis Campaign (SSC) sepsis resuscitation bundles across hospitals in were confederacy the United Kingdom (UK) were considered. Hospital settings allow for a wider sample in evaluating nursing and medical staff’s adherence to the guidelines of the apa citation, SSC rather than in specialist clinics or GPs settings. Hunters Theme! Articles focusing on adult hospital settings across the apa citation generator free, United Kingdom, and written in the English language were included. Studies evaluating the use of sepsis resuscitation bundles in paediatric and maternity settings were excluded, as these are less relevant to the adult field of nursing, and paediatrics and maternity wards require different interventions for the treatment of sepsis recommended by the SSC. Many studies started within different timeframes in different places when the of language emphasizes that:, SSC guidelines had been introduced worldwide; hence, studies outside United Kingdom were excluded.

The literature review focuses solely on the UK, since it is easier to recognise the apa citation generator free, limitations of the sepsis care bundles when evaluating sample populations in one country rather than across many countries. Studies assessing the compliance to development the Surviving Sepsis Campaign guidelines (Dellinger et al., 2013c) comprising severe sepsis, septic shock resuscitation care bundles and early goal directed therapy (EGDT) were included, as these are elements of the established bundles and interventions used to manage patients with severe sepsis and septic shock in generator the UK (Surviving Sepsis Organization, 2014b). Studies assessing severe sepsis and septic shock cases without using the recommendation of SSC guidelines were excluded, as this paper aims to identify issues and determine possible reasons as to why and how non-compliance is occurring despite the proven effectiveness of sepsis resuscitation bundles under the Surviving Sepsis Campaign (Daniels et al., 2011). As the United Kingdom launched its Surviving Sepsis Campaign in 2005 (Bray and Murphy, 2006), only studies assessing compliance to the SSC guidelines to address severe sepsis and septic shock in the UK from 2005 onward were included in hunters theme this literature review. Studies evaluating the relationships between awareness, resources, and apa citation, compliance to the SSC sepsis resuscitation bundles, as well as correlative evidence of decreasing mortality rates associated with compliance in sepsis were included. 3.1.4 Study Design. Due to the nature of the mahalo cases, focus question, which is to evaluate the compliance to the SSC sepsis resuscitation bundles, quantitative studies were included that include prospective observational studies, retrospective cohort studies, questionnaires, and apa citation, surveys. The focus of this paper is across the United Kingdom in order to establish general determining factors regarding the limitations, barriers, and solutions for successful implementation of SSC sepsis resuscitation bundles (Surviving Sepsis Organization, 2014a). Case reports and case series were excluded because they tend to focus on one case study, which is more likely to be very specific and less widely applicable than evidence across a more random sample population (Jolley, 2013).

The SSC guidelines were published in 2004, hence, publication dates from the years 2004 to December 2014 were included, and dates before 2004 and beyond 2014 were excluded from this literature search. In terms of hospital studies in the UK, only mahalo cases, articles published between 2005 and 2014 were included, since the SSC guidelines were launched in the UK in 2005. 3.2 Search Strategy. After establishing the free, focus question this paper aims to answer, the first step was to hunters theme identify the necessary databases for accessing a wide range of data sources in the Internet (Younger, 2004). University librarians’ assistance was sought to access different e-journals. Upon learning the ways to access databases, the researcher used a range of databases from the LibrarySearch engine. LibrarySearch is the University’s search and retrieval tool designed to search for databases and e-journals. This search was performed to reduce bias of the apa citation generator free, review, and to hunters theme retrieve articles containing the apa citation generator free, search terms used. Minimising bias was endeavored by using many appropriate databases to broaden the selection criteria (Newell and Burnard, 2006).

A worldwide search was not included, as only the population of the United Kingdom was relevant to the research question and only articles written or translated in what in the confederacy English were considered for review in the study. However, this risk bias, resources for translating articles are not accessible (Khan et al., 2003). Jolley (2013) explains how accessing a wide-range databases aids in acquiring the generator, best and most current research articles. The chosen databases used in this literature search are the British Nursing Index, Internurse, Medline (Ovid), Pubmed, SAGE journals, and Wiley Online Library. The British Nursing Index was chosen because this database covers all aspects of nursing from 1994 to present, which meets the inclusion criteria for articles from 2004 to 2014. Internurse database was chosen, as it is the UK’s largest collection of nursing journals. Furthermore, as the UK is theories, home of the British Journal of generator free Nursing, the journal was used for mahalo cases its main focus on research conducted in UK.

The Medline and Pubmed databases were included, as these two cover academic journals from medical, nursing and apa citation generator, health care publications. Mahalo Cases! Wiley online library was used since it provides over 4 million articles from across different countries that include the United Kingdom. Lastly, the SAGE online journal database was included, as it is the apa citation free, world’s independent academic and professional publisher of over 560 journals (SAGE Publications, 2014). After selecting databases, the next step was to decide which search terms were to biological be used in accessing literature that would provide the most appropriate evidence for the research question. The following are the search terms that were used: UK, surviving sepsis campaign, compliance, severe sepsis, nurses, impact, and implementation. To increase the search sensitivity, Boolean logic was applied using the words ‘AND,’ ‘OR’ and ‘NOT’ (Khan et al., 2003). 3.3 Search Outcome. This section will describe which databases successfully produced relevant results based on the search terms and selection criteria. It will further illustrate the number of articles retrieved, and of the articles retrieved, which were identified as the apa citation, most relevant to the focus question.

This literature search took place between October and December 2014. Using the Search Scope in LibrarySearch engine, six databases were selected to gather articles by applying various search terms relevant to mahalo cases the focus question of this paper. Apa Citation Generator Free! University journal archives and hunters theme, online access privileges, such as subscribing for a free 14-day trial were also used to obtain relevant literature. Initially, the first group search terms used were ‘Surviving Sepsis Campaign,’ ‘compliance’ ‘AND’, ‘impact,’ and ‘UK’. From these search terms, 694 items resulted, with different material types, any year, and apa citation generator, any language type (Figure 1). This was then narrowed down from 694 to hunters theme 3 items by applying the apa citation generator, selection criteria wherein the publication date range of the retrievable articles was limited to mahalo cases filter inclusion of only literature relevant for the review, given that Surviving Sepsis Campaign guidelines were first published in 2004. Therefore, only generator free, articles published between 1st January 2004 and 31st December 2014 were considered in order to biological theories filter the apa citation free, most current available evidence. Moreover, English language type, and articles as the material type were chosen (Figure 2). The next group of search terms used were ‘Surviving Sepsis Campaign,’ ‘AND’, ‘nurses’ and ‘UK.’ From these search terms, 4 articles were chosen as the hunters theme, most relevant to generator the focus question. Furthermore, from pros these 4 articles retrieved using the selection criteria as shown in Figure 3, these were narrowed down from 4 to 1 article, as the other 3 were not research articles. ‘Severe sepsis,’ ‘guidelines,’ ‘AND’, ‘nurses’ and ‘UK’ were the third group of search terms used in the LibrarySearch engine that resulted in 69 articles (Table 4).

To filter results to match the most relevant criteria of the focus question of this review, the subject was refined to apa citation generator ‘Great Britain,’ hence the search was narrowed down from 69 to 2 articles (Table 5). Finally, the theories of depression, following search terms: ‘Surviving Sepsis Campaign,’ ‘AND’, and ‘UK’ were used to generator free find further literature, which resulted in 1,295 items (Figure 6). Gun Laws Pros And Cons! A collection of journals ‘ namely: Intensive Critical Care Journal, Journal of free Clinical Nursing, and Nursing Critical Care Journal ‘ were chosen to narrow down the search from 1,295 to 6 articles (Figure 7). In total, 12 articles were retrieved utilizing the Study of Roman, search terms relevant to the focus question. These were then evaluated for apa citation relevant titles and abstracts. Biological! Two of the articles retrieved had no full text access and the other two articles were duplicated using different search terms (Khan et al., 2003). The eight articles were tabulated that met the selection criteria. The reviewer found that seven articles have used additional and often overlapping sepsis research studies as references.

For example, 6 articles referenced Gao et al. (2005), 1 referenced Simmond et al. (2007), and 1 referenced Robson et al. (2007) which were also helpful in determining the academic legitimacy and relevance of the articles (Polit and Beck, 2006; Whittaker and Williamson, 2011). In order to minimise bias, Glasziou et al. Apa Citation Generator! (2001) suggest having a second reviewer, however this was not feasible in this literature review. Finally, quantitative research was included as it relates to the focus question of the review, which is to evaluate the compliance to the SSC sepsis resuscitation bundles as recommended by Dellinger et al. (2013c). Evaluation is primarily conducted with the use of Is the Study of Roman Law Relevant? quantitative targets and measurements (Coughlan, Cronin and apa citation, Ryan, 2007). Ultimately, eight articles were included in this literature review. These eight articles are primary articles, published in United Kingdom between 2005 and 2011.

All of these studies concern hospitals’ implementation and compliance to pros and cons the ‘sepsis resuscitation bundles adapted from the Surviving Sepsis Campaign’ (Dellinger et al., 2013c; Surviving Sepsis Organization, 2014a; Surviving Sepsis Organization, 2014b), particularly for adult patients identified as having sepsis in the UK. 3.4 Critical Appraisal Skills Programme (CASP) and apa citation generator free, Hierarchy of Evidence. Reviewing research is a ‘mechanism used to provide feedback for improvement’ as noted by Polit and Beck (2006). After articles were selected, a CASP framework was chosen to biological critically appraise each article according to free its validity, credibility, and implication to practice by Study Essay following the Case-control and Cohort Studies Appraisal Checklists (CASP, 2013). This helped the apa citation, reviewer to scrutinise the individual work and to underline the strengths and hunters theme, weaknesses of free each article in order to hunters theme identify the best examples of generator evidence-based practice (Coughlan, Cronin and Ryan, 2007). The Canadian Task Force on Periodic Health Examination in late 1979 was the were in the confederacy, first to disseminate the Hierarchy of Evidence, until which point different, hierarchies had been established and used (The Canadian Task Force on the Periodic Health Examination, 1979; Evans, 2003). Hierarchy of Evidence is a tool used in determining the effectiveness, appropriateness, and feasibility of evidence (Evans, 2003). It additionally identifies evidence in order to rank the articles according to the research method most relevant to the focus question. Of the eight articles, five articles employ cohort studies and the other three articles use case-controlled studies.

All of the articles chosen were published in the United Kingdom and apa citation generator, are peer-reviewed. The Systematic Review is the highest level of hierarchy, followed by the Random Controlled Trial (RCT) as the the interactionist of language development emphasizes that:, second level of evidence. All of the articles collected within this study are ranked level three according to the Hierarchy of Evidence because the methods used are Cohort Studies and Case-controlled Studies. 3.5 Themes for analysis. The next step after determining the appropriate literature for this review was an analysis of the literature. Upon undertaking the analysis, three themes have been identified: equipment and supply limitations, a lack of appropriate referrals due to apa citation generator free poor education of medical staff and nurses on SSC sepsis resuscitation bundles, and the inconsistent use of SSC sepsis resuscitation bundles from theories of depression hospital to hospital. The following chapter critically discusses the three themes that emerged from the free, literature analysis of the eight selected articles, as well as the implications for the field of nursing as related to pros the SSC. Chapter 4: Literature Analysis. This literature analysis will critically consider the generator, eight articles in order to what confederacy judge the strengths, weaknesses, and the significance of each study (Burns and Grove, 2009) in addressing the research question: ‘To what extent can hospitals in the UK comply with SSC resuscitation bundles, and what are the implications for nursing practice’? The first theme that emerged from the literature analysis will be examined below.

4.1 Resource limitations. Compliance with the SSC sepsis resuscitation bundles requires that serum lactate be obtained and that this is measured using an Arterial Blood Gas (ABG) machine (Dellinger et al., 2013c). Other requirements include the use of an ultrasound scan for Central Venous Pressure (CVP) insertion; blood cultures to be sent to Pathology before starting antibiotics; crystalloid or colloid intravenous fluid challenge, and generator, resuscitative medicines such as steroids, vasopressors and pros, inotropic therapy (Dellinger et al., 2013c). However, five of the articles reviewed evidence that this necessary equipment is lacking in a number of hospitals in the UK. 4.1.1 Equipment and apa citation, medication. Three of the research articles specify that in some cases there has been lack of necessary resources that are used to hunters theme meet compliance to the SSC sepsis resuscitation bundles. This not only limits the ability of medical and nursing staff to manage sepsis, but it also limits the reviewer’s ability to evaluate compliance with the apa citation, SSC sepsis resuscitation bundles. Gao et al.’s (2005) study aligns with previous studies that demonstrate how compliance with evidence-based SSC sepsis resuscitation bundles significantly reduces mortality. The study comprises ‘101 consecutive adult patients with severe sepsis and Study Law Relevant? Essay, septic shock on medical or surgical wards, or in accident and emergency areas at two acute National Health Service (NHS) Trust Teaching hospitals in England’ (Gao et al., 2005, p. R764). Generator! The findings evidence poor ward care in critically ill patients, evidencing that eight percent of patients had no oxygen administrated, fourteen percent had no IV access, and fourteen percent of patients ‘had no observation monitoring of blood pressure, heart rate, respiratory rate, temperature, oxygen saturation, urine output, or conscious level’ (Gao et al., 2005, p. R766). Since the aim of gun laws and cons Gao et al.’s (2005) study is to generator assess the relationship between compliance with SSC guidelines and a decreased sepsis mortality rate, reasons for non-compliance are beyond the scope of this study.

However, the what confederacy, authors importantly note that the hospital’s resource limitation led to a deviation from the SSC sepsis resuscitation bundle ‘in the short term’ (Gao et al., 2005, p. R764). Generator! This includes limited ‘ultrasound-guided access, training and staffing that prevented the safe and early placement of central venous catheters outside the critical care environment’ (Gao et al., 2005, p. Gun Laws Pros! R766). The ultrasound-guided access is essential to insert the CVP, therefore even if the staff has the knowledge to apa citation comply with SSC guidelines, with limited resources available, compliance is not possible. In hospitals such as these two NHS Trust Teaching hospitals, resource limitations forced the staff to mahalo cases deviate from ‘the benchmark for persistent hypotension despite fluid resuscitation, adapting a target haemoglobin of 7 to 9 g/dl and/or vasopressors but exluding the requirement to achieve a target of 8mmHg and ScVO2 of’ 70% central venous pressure’ (Gao et al., 2005, p. R768). Similarly, McNeill, Dixon and Jenkins’ (2008) study highlights the issue of resource limitations. McNeill, Dixon and Jenkins, (2008) investigates the implementation of the apa citation, 6-hour resuscitation care bundle as advocated by Dellinger et al. (2004) in 265 Acute Medicine Units (AMUs) in the United Kingdom. The research methodology is a questionnaire with 10 questions about the delivery of the 6-hour SSC sepsis resuscitation bundle, sent to each of the participating AMUs.

The data was collected and tabulated per percentage by region. Thirty-five percent of the 162 respondents claimed to have implemented the 6-hour sepsis resuscitation bundle in their own hospital, although seventy-one percent had access to outreach teams, and only forty percent had enhanced care beds. Moreover, ‘the minimum facilities to comply with the 6-hour resuscitation bundle were the availability of enhanced care beds, ability to measure arterial blood gas lactate, measure CVP and to administer inotropes’ (McNeill, Dixon and mahalo cases, Jenkins, 2008, p. 164). These minimum facilities varied in different regions in UK. The findings of McNeill, Dixon and apa citation free, Jenkins’, (2008) study identified that only six hospitals had successfully implemented the complete sepsis resuscitation bundle and that thirty-five percent AMUs claimed to have implemented the SSC guidelines despite eighty-eight percent of AMUs lacking the minimum facilities to comply. Although resource availability is hunters theme, not the main focus of either of the abovementioned studies, this emphasis on apa citation generator, limitations indicates that the extent to which a hospital can comply with the SSC sepsis resuscitation bundles depends largely on the resources available. McNeill, Dixon and Jenkins, (2008) results indicate that in theories of depression contrast to the evidence of apa citation resources limitations presented by Gao et al.’s (2005) study, it is apparently possible to comply even when there is a lack of resources. However, the respondents’ claims based on the questionnaire alone are unverifiable, as the results were based on participant’s subjective responses. McNeill, Dixon and Jenkins (2008) have no way of proving that the hunters theme, participants responses are honest, although they do suggest that clinical audits to be conducted for future studies. Nevertheless, McNeill, Dixon and Jenkins’ (2008) study identifies the importance of the facilities needed to effectively deliver the 6-hour sepsis resuscitation bundle across AMUs in UK, and apa citation free, finds that resources are lacking overall.

This includes sixty percent with no access to enhanced care beds, and only twelve percent of AMUs having the minimum facilities available to fully comply with SSC guidelines. Baldwin et al.’s (2007) audit in biological theories of depression Kent determines compliance with the 6-hour sepsis resuscitation bundle according to appropriate referrals between nurses and relevant medical staff. Apa Citation Generator Free! It finds that even where communication was adequate between nurses and doctors, ‘there were instances when the appropriate antibiotics was out of stock in A#038;E’ (Baldwin et al., 2007, p. 255) particularly with a shortage of the antibiotic Tazocin. States In The Confederacy! It is apa citation generator free, evident therefore, that compliance with the SSC guidelines not only requires that one follow all of the elements of the sepsis resuscitation bundle, but also that nursing staff monitor and communicate the need for essential medicine supplies more frequently. 4.1.2 Financial resources. Another significant resource limitation relating to SSC compliance is the financial capacity of a given hospital. Gao et al. (2005, p. R765) state that ‘severe sepsis is expensive, such as in USA average cost per is $22,100’. Even ‘in an age of financial austerity,’ Page et al. (2011, p. 314) suggest on one hand, that a sticker and poster program could provide an affordable means of ensuring universal SSC compliance. Robson, Beavis and Spittle (2007) on the other hand, suggest that there should be funds for nurse education and training as solutions to ensure compliance.

Regardless of which authors are more justified in their claims, both suggestions are made in reaction to pros resource constraints within hospitals in the UK. Page et al.’s (2011) study further implies that staffing levels particularly influence compliance to the SSC sepsis resuscitation bundles (Dellinger et al., 2013c). The study notes that ‘compliance was better in Accident #038; Emergency (A#038;E) than in apa citation the Clinical Decisions Unit (CDU) due to a sixty-three percent staffing level in A#038;E as compared to the low staffing level of thirty percent in CDU’ (Page et al., 2011). What In The! A#038;E doctors moreover had ‘continuous support of their nurse’ (Page et al., 2011, p. Apa Citation Generator Free! 314). This study therefore indicates that a major influencing factor for ensuring compliance is adequate staffing levels, which is particularly challenging given hospitals’ current funding limitations (Hurst and Williams, 2012). Furthermore, findings suggest that compliance to the SSC sepsis resuscitation bundles depends on hunters theme, the nurse’s role in free performing the initial triage for mahalo cases patients. 4.1.3 Implications for nursing practice.

The level of effectiveness of apa citation free compliance to SSC sepsis resuscitation bundles in the UK is partially, but also significantly contingent on levels of resource availability. This integrates into theories, nursing practice, as it is important for nurses to know how limited resources can impact compliance to the sepsis resuscitation care bundles for the management of severe sepsis and septic shock. Additionally, it is the nurse’s responsibility to ensure that ‘medication ordering systems are in place to apa citation free minimize dose omissions and delay; utilize staff resource efficiently’ (NHS Greater Glasgow and Clyde Prescribing Organisation, 2008). Assuring that there is proper inventory of medical supplies and medication, and what were in the, that the proper equipment is in apa citation generator working order and within easy access for use by medical staff are all within the scope of the interactionist of language development responsibilities and duties of apa citation a nurse. Gun Laws And Cons! In essence, nursing is an act of utilising the apa citation generator, environment to assist patient’s recovery (Nightingale, 1860), and hunters theme, compliance with SSC guidelines to decrease patient mortality rates is no exception to this duty. McNeill, Dixon and Jenkins’ (2008) study highlights the generator free, issue of resource limitations in addressing sepsis. However, further investigation is what in the confederacy, recommended to determine the apa citation, reasons for hunters theme the lack of resources and solutions as to how resource availability could be improved to ensure that compliance is feasible not only with the 6-hour resuscitation bundle, but also to apa citation identify sepsis in the first place. Additionally, an audit of the the interactionist development, 265 AMUs surveyed is apa citation generator free, recommended in order to increase accuracy of results. This would also help to states explain the reasons why despite having limited resources, some hospitals have found it possible to comply with the SSC sepsis resuscitation bundles. The next section will discuss the second theme identified in addressing the research question, which is a lack of appropriate referrals due to poor education of medical and apa citation generator, nursing staff on mahalo cases, the implementation of SSC sepsis resuscitation bundles. 4.2 Lack of apa citation appropriate referrals due to poor SSC education of mahalo cases medical and nursing staff.

One of the evident reasons for general poor compliance with SSC sepsis resuscitation bundles across the UK is generator free, a lack of referrals for patients displaying symptoms of Is the Study of Roman Law Relevant? Essay sepsis. Seven of the eight articles reviewed evaluated compliance of the medical and nursing staff’s implementation of the apa citation, sepsis resuscitation bundles as related to SSC education. Only one article evaluated the were confederacy, compliance of the medical staff alone. Apa Citation Generator! The articles under review evidence that better compliance outcomes of SSC sepsis resuscitation bundles relies largely on medical and nursing staff having a proper awareness of the SSC guidelines for the management of severe sepsis and what in the confederacy, septic shock, particularly in terms of identifying sepsis, and apa citation, subsequently in providing appropriate referrals. 4.2.1 Identifying sepsis. Robson, Beavis and Spittle (2007) audited seventy-three registered nurses in ‘medical, surgical and biological theories, orthopaedic wards’ in Chesterfield Royal Hospital. The audit took place in 2005 over the three-month period and identifies the extent to which nurses understand ‘definitions of sepsis, and the recommendations for generator its initial management’ (Robson, Beavis and Spittle, 2007, p. 86). It was reported as an mahalo cases audit because the nurses were tested against the ‘standard definitions and evidence-based management guidelines’ of the SSC (Robson, Beavis and Spittle, 2007, p. 87). Similarly, McNally, MacKinnon and Hawkins’ study evaluates the ‘key critical care skills and generator, knowledge required to’ (McNally, MacKinnon and Hawkins, 2009, p. 22) implement the early goal directed therapy (EGDT) as recommended by the Surviving Sepsis Organization (2014b) in Specialist Registrars (SpRs) in anaesthetics, ‘general surgery and general medicine throughout Scotland’ (McNally, MacKinnon and Hawkins, 2009, p. 22). However, this is the only article that does not include nursing staff in gun laws and cons their study, amongst the eight articles in this review. Seventy-three nurses from junior to senior grades completed the apa citation free, questionnaire created by Robson, Beavis and Spittle (2007) in the form of test.

The questions included diagnosing patients with sepsis or severe sepsis based on the signs and mahalo cases, symptoms, five case studies to explain management plans, and ten ‘true or false’ statements (Robson, Beavis and apa citation generator, Spittle, 2007, p. 86). In the first phase of the questionnaire, six systemic inflammatory response syndrome (SIRS) criteria could indicate that a patient has sepsis. Gun Laws Pros! Of the respondents, ninety-seven percent correctly indicated an increased temperature above 38??C and apa citation, only nineteen percent correctly answered that higher than 4 white blood cell count is an indicator of sepsis. Mahalo Cases! Moreover, ninety-one percent wrongly identified a suspected infection as an indicator (Robson, Beavis and Spittle, 2007). This study shows that ward nurses appears to have ‘general lack of awareness that low temperature, low white blood cells are signs of sepsis’ (Robson, Beavis and Spittle, 2007, p. 87).

McNally, MacKinnon and Hawkins’ (2007, p. 23) questionnaire ‘was open for completion within a 3-month period and a single email reminder was sent’. This study aimed to ‘survey at least fifty percent of general surgical trainees and an equivalent number from other specialities, and a statistical analysis was performed with SPSS 13 using the free, Chi-squared test’ (McNally, MacKinnon and Hawkins, 2009, p. 23). The respondents were asked about the years of training, previous critical care experience, their attitudes towards the awareness of hunters theme EGDT and the SSC guidelines. ‘A power calculation ‘indicated that 30 replies per specialty would’ (McNally, MacKinnon and Hawkins, 2007, p. 23) be required to detect a thirty percent difference between specialties. Overall, although McNally, MacKinnon and Hawkins (2007) did not focus on nurse’s SSC protocol knowledge, they similarly found that medical staff in Specialist Registrars lacked knowledge of EGDT elements. A number of nurses surveyed by Robson, Beavis and Spittle (2007) had reportedly taken some life-support courses such as the Acute Life-threatening Events Recognition and Treatment (ALERT) course by Smith, Osgood and generator free, Crane (2012) where any patient with low BP should receive 500-1000ml of fluid, and may be repeated as necessary. However, there is no specification on mahalo cases, to the length of courses or the extent, which sepsis was studied. Generator Free! In the ALERT book, sepsis is discussed in a separate chapter, which means that nurses may not have been educated on sepsis. According to McClelland and Moxon (2014), the nurse’s role is vital in mahalo cases early detection and recognition of sepsis, hence nurses ought to possess a full awareness of identifying sepsis and managing it beyond identification.

Since grade doctors provide immediate care and resuscitation to patients with severe sepsis or septic shock, McNally, MacKinnon and Hawkins (2007) focused only on Specialist Registrars (SpRs) in anaesthetics, general surgery and general medicine. Although McNally, MacKinnon and Hawkins (2007) suggest the development of generator working relationships amongst anaesthetic staff, trainee physicians and biological, surgeons in order to ensure proper referrals and compliance with the SSC sepsis resuscitation bundes, nursing staff are absent from the study. This inaccurately assumes that only grade doctors can give provision of immediate care and resuscitation to apa citation generator patients with severe sepsis or septic shock, despite the researchers’ admittance that nurses are the first to identify a deteriorating patient and inform the hunters theme, doctors to come and see the patient. Page et al.’s (2011) study took place in Blackpool Victoria Hospital, wherein it showed that within 48 hours of admission, there was a high patient mortality rate; hence SSC sepsis resuscitation bundles were implemented, which included a heavy focus on educating staff in their hospital. During the apa citation free, study, they introduced an education campaign to motivate the staff in implementing the sepsis resuscitation bundles. Activities within the education campaign included lectures for all the junior doctors, pocket cards detailing the biological, SSC sepsis resuscitation bundles and small group tutorials to all nurses. In addition, posters were placed in every department. Page et al. (2011) proved the effectiveness of this ‘sticker campaign’ in improving the identification and treatment of sepsis by comparing the hospital’s sepsis compliance with nearby Preston Royal Hospital that did not implement the free, same campaign, and where compliance with all the of depression, elements ‘was not achieved in any patient’ (Page et al., 2011). The authors thus fail to provide a strong comparison based on controlled variables (examples are the number of generator patients, staff members, and view emphasizes that:, sepsis protocols). Nevertheless, they propose that the sticker programme should be transferrable to almost any acute hospital and that the SSC sepsis resuscitation bundles could be achieved in a district general hospital. Page et al. (2011) started staff member SSC education during their study whilst Baldwin et al. (2007) indicated that there was education across their Trust, particularly for the critical care outreach nurses and generator free, ICU consultants where educational sessions outlining the surviving sepsis campaign and its components were conducted.

Robson, Beavis and Spittle (2007); Simmonds et al. (2008); McNally, MacKinnon and Hawkins (2009); McNeill, Dixon and Jenkins (2008) do not state if there were education campaigns occurring in what states were confederacy the UK hospitals studied, despite the fact that they all suggest better staff education about sepsis and apa citation generator, its management. Lack of staff education on sepsis is evident across all articles reviewed; however, the reason for mahalo cases this lack is not clearly explained, and requires further research. 4.2.2 Critical care referral. None of the eight articles evidence a hospital that achieved 100% compliance with the SSC guidelines, and all reviewed articles mention the importance of education and awareness of the sepsis care bundle across all disciplines in terms of free appropriate and timely patient management and referral. Simmonds et al.’s (2008) study took place in Queen’s Medical Centre (QMC) in Nottingham, under informed consent by the Trust Audit Committee. The study comprises 229 adult patients with significant positive blood cultures. Simmond et al. (2008, p. 124) used an expanded version called the QMC Sepsis Measurement Tool, which includes: the ‘timing of sepsis resuscitation bundles interventions, seniority of what states were confederacy doctors and the level at which care was given.’ The findings were that patients experiencing severe sepsis were only seen by apa citation any doctor after a median of 1.1 hours. Is The Law Relevant? Essay! Similarly, Cronshaw et al.’s (2011) study shows that patients’ waiting times exceeded an hour to see a doctor in the Emergency Department (ED).

Of the 255 severe sepsis patients (SS), seventy-one percent of apa citation free SS had no documentation discussion regarding the ITU referral (Cronshaw et al., 2011), hence noted that communication between ED and what states, intensive care colleagues need to develop. ‘[D]espite severely abnormal physiology’ (Simmonds et al., 2008, p. 125), only sixty-one percent were referred for critical care opinions and only sixty percent of apa citation those patients were reviewed by a specialist in critical care within 12 hours of meeting severe sepsis criteria according to the SSC. Of the 46 patients, 19 received level 3 care (Intensive Care Unit) within a six-day median stay, and 19 received level 2 care (High Dependency Unit) within a five-day median stay. Thirty-three percent of the sepsis patients died within 90 days and thirty-five percent within a year (Simmonds et al., 2008, p. 126). This analysis of different levels of care indicate that mortality is emphasizes that:, higher outside of critical care and this correlates to the authors’ findings that there is a lack of sepsis resuscitation bundle compliance outside of critical care areas. Cronshaw et al.’s research study evidences that only twenty-nine percent of the patients were referred to ITU staff, and were considered not suitable or were labeled ‘do-not attempt resuscitate’ and seventy-one percent of severe sepsis patients had no documented discussions for referrals to the ITU (2011, p. Apa Citation Free! 671).

Simmonds et al.’s (2008) and Cronshaw et al.’s (2011) findings therefore, demonstrate that a lack of referrals is one of the factors that contribute to poor SSC sepsis resuscitation bundle compliance. Simmond et al. View Of Language Development! (2008) suggest that SSC sepsis resuscitation bundles are to apa citation free be investigated beyond the intensive care in pros order to improve the capacity of the entire hospital system to address sepsis. McNeill, Dixon and Jenkins, (2008) study supports Simmond et al.’s (2008, p. 165) suggestion, because the apa citation free, findings of McNeill, Dixon and Jenkins, indicate that only biological, ‘few AMUs across the UK hospitals can comply with the free, sepsis care bundle that have systems in place to resuscitate a patient with sepsis’. AMU is categorised as first level of care; therefore, it is essential to survey the what states in the, compliance of the generator, SSC sepsis resuscitation bundles at mahalo cases, this level. Although SSC sepsis resuscitation bundles ought to theoretically be implemented in any level of care in apa citation the hospital setting, implementation at Study Law Relevant? Essay, different levels of care does not guarantee overall compliance with SSC sepsis resuscitation bundles, as proven by Cronshaw et al. (2011); Simmonds et al. (2008); McNeill, Dixon and Jenkins (2008); Robson, Beavis and Spittle (2007); Page et al. (2011). Nevertheless, one essential factor for ensuring compliance with the apa citation generator free, SSC sepsis resuscitation bundles is the awareness of staff members on how and when to refer the patient as quickly as possible from the point at biological theories, which the patient is diagnosed as having sepsis. 4.2.3 Communication between levels of care. Baldwin et al. (2007) argue that the reason fifty percent compliance to the administration of the apa citation generator free, antibiotics is due to gun laws pros and cons poor communication between the prescribing doctor and the nurse who is meant to administer the antibiotics.

The study claims that some elements of the generator free, SSC sepsis resuscitation bundles were not implemented due to issues around the doctors wherein junior medical staff were primarily attending to the patients’ treatment (Baldwin et al., 2007, p. Gun Laws And Cons! 255). 4.2.4 Implications for nursing practice. Robson, Beavis and Spittle’s (2007) questionnaire particularly affirms that ward nurses generally fail to recognise patients as having severe sepsis or septic shock and are not confident to give intravenous fluid to those patients with lowered systolic BP or urine output as they may have fears of causing fluid overload for the patient. Simmonds et al. (2008, p. Apa Citation Generator! 127) recommend that this lack of awareness could be addressed through the recent advent of course initiatives such as the ‘Ill Medical Patients Acute Care and Acute Care Undergraduate Teaching needs to be routinely part of postgraduate medical and mahalo cases, nursing education.’ Equally, McNeill, Dixon and generator free, Jenkins, (2008) suggest that education of nursing staff is needed, and gun laws pros, similarly, Robson, Beavis and Spittle’s (2007, p. 89) study identifies that a ‘deficit in knowledge of apa citation generator free nurses could lead’ to poor compliance to SSC sepsis resuscitation bundles. A nurse’s capacity to what in the render the best possible care for apa citation generator free a patient with severe sepsis is achievable through education. This is a key to implementing the SSC sepsis resuscitation bundles, and patients’ survival relies on the healthcare professionals who will accurately execute the SSC sepsis resuscitation bundles. Moreover, it is essential that a nurse has good communication skills (Webb, 2011) coupled with improved collaboration with multidisciplinary teams (Goodman and hunters theme, Clemow, 2010). Good communication skills and collaboration are the result of staff education and awareness on compliance to SSC sepsis resuscitation bundles, and are essential in ensuring the patient’s continuity of care. Robson, Beavis and apa citation free, Spittle’s (2007) evidence implies that nurses’ awareness of sepsis management demonstrated limited awareness, with less than half of respondents knowing each of the biological theories, sepsis symptoms, however there is a lack of confidence on implementing the interventions specified in the SSC guidelines. Therefore, it is worth recommending that nurses require more exposure and opportunity to practice their skills on managing sepsis, through utilisation of the SSC sepsis resuscitation bundles.

Page et al. (2011) state that their sticker programme and posters may be an efficient alternative to costly education and training programmes as these are affordable and consistent means of educating staff. Generator Free! However, the authors would have more effectively proven that their methodology was successful in preventing high sepsis mortality rates had the comparison between this campaign’s compliance results been made with past SSC interventions in the same hospital rather than with a nearby hospital that did not undertake the same campaign. Whichever hospitals endeavour to implement the sticker programme should evaluate SSC compliance by comparing the present sepsis related mortality rate with the sepsis related mortality rate achieved through said programme in order to achieve more accurate measurements of compliance. Also there should be tangible training on how to use the sticker programme. McNally, MacKinnon and Hawkins (2009) suggest that a minimum education on how to initiate EGDT is hunters theme, important, however what exactly covers a ‘minimum education’ ought to be clarified. Hence this cannot be recommended. Apa Citation Generator Free! Awareness and education without good communication and collaboration will affect the effectivity of compliance to the SSC sepsis resuscitation bundles, therefore, further study to evaluate the multidisciplinary team collaboration in relation to SSC sepsis resuscitation bundles is recommended. The next section will address the third and final theme, which is the inconsistency of the use of SSC sepsis resuscitation bundles. 4.3 Inconsistent use of Surviving Sepsis Campaign guidelines. The SSC sepsis resuscitation bundles compliance is evident when there is consistency on states in the, the use and implementation of the standard guidelines. Below are findings that indicate inconsistency in the use of SSC guidelines as influencing factors on the extent to which compliance with SSC resuscitation bundles can be evaluated in apa citation generator free the UK.

4.3.1 Management in pros addition to apa citation SSC sepsis resuscitation bundles. Three of the articles reviewed that took place in hospitals across the theories, UK have added different forms of management to the existing SSC guidelines, which creates difficulty challenge in evaluating overall compliance. Simmond et al. (2008, p. Apa Citation Generator! 125) used a ‘QMC Sepsis Measurement Tool’ regarding the timing and seniority of doctors and the level of care given. The tool, which is not part of the SSC recommended guidelines, was used to determine the entry levels of care for patients suspected to have sepsis. Gao et al. (2005) added to the SSC’s ‘6-hour basic ward care’ using the median Modified Early Warning Score (MEWS) (Heart of England, 2010). However, these authors’ modifications are helpful as far as the MEWS helped to identify that less than 15% of the patients received basic ward care. Cronshaw et al. (2011) followed the gun laws pros and cons, College of Emergency Medicine (CEM) guidelines to manage sepsis. The CEM require 1, 2, and 4-hour targets depending on the standard of care, and when a patient is within the 6-hour bundle, the practitioner then follows the SSC standard guidelines. The CEM standards for apa citation generator free the management of severe sepsis (SS) and septic shock (SS) are ‘eight recommendations to theories of depression the Emergency Department (ED) within 4-hours’ (Cronshaw et al., 2011, p. 670). Additionally, 1-hour ‘sepsis six’ protocol comprises six standards: oxygen administration, serum lactate measurement, IV fluid administration, blood culture, IV antibiotics, and urine output measurement (Cronshaw et al., 2011, p. Apa Citation! 671).

Even if the CEM guidelines and sepsis six protocol add incongruity to of depression to the SSC sepsis resuscitation bundles, there is still consistency on implementation of the six-hour sepsis care bundle under the Surviving Sepsis Campaign (SSC). Nevertheless, none of the apa citation free, aforementioned studies are easily transferable across a range of hospitals in the UK, as they have all altered the SSC guidelines in some way. 4.3.2 Modified elements under the SSC guidelines. Two articles were found to have changed particular elements within the SSC sepsis resuscitation bundles. Gao et al. Pros! (2005, p. R765) used ‘haemoglobin target instead of haematocrit and used remaining hypotension after fluid resuscitation for generator free threshold of inotropes instead of central venous oxygen saturation’, which is the standard for the sepsis care bundle. Likewise, Page et al. (2011) mention that there were some doctors who opted not to apply certain elements of the SSC sepsis resuscitation bundles, such as giving the full 20 ml/kg bolus to the patient, and documented the view of language that:, reason for not giving it as professional discretion. Gao et al. (2005) could have provided clarification as to the altered SSC guidelines by apa citation generator providing rationale, such as the gun laws pros and cons, discretionary reasons distinctly explained by Page et al. (2011). In nursing practice, any decision about the care for individual patient must be evidence-based (Sacket et al., 1996) and any clinical judgment made by the doctor if agreed upon by the team and apa citation free, clearly documented is the right decision to take.

This is evidently emphasized by the SSC, which states: ‘these guidelines cannot replace the clinician’s decision-making capability’ (Dellinger et al., 2008b, p. 19) hence, clinician can use own discretion. However, the extent to which a clinician alters the gun laws pros, SSC care bundles either in writing or in practice will still have a significant impact on researchers’ capacity to evaluate SSC compliance across hospitals in the UK, as is the discrepancy in this particular literature review. While three studies have used different formats of the SSC sepsis resuscitation bundles and two studies modified the apa citation free, elements, five of the articles reviewed found overall consistency in the use of the SSC guidelines and Is the Study, have positive implications for compliance. Cronshaw et al. (2011); Baldwin et al. (2007); Page et al. (2011) adhere to the SSC’s 6-hour sepsis bundle guidelines, and apa citation generator free, McNally, MacKinnon and Hawkins’ (2009) study follows each element of Early-goal Directed Therapy (EGDT) (Rivers et al., 2001) through the Is the Study Law Relevant? Essay, SSC. Generator Free! Finally, Robson, Beavis and Spittle (2007) test the mahalo cases, ‘ward nurses’ knowledge of standard sepsis definitions according to apa citation free the Surviving Sepsis Campaign management guidelines. 4.3.3 Implications for nursing practice. In nursing practice, a systematic approach that comprises evidence-based management for patients suffering from severe sepsis or septic shock, or critically ill patients, that is universal and can be transferrable from theories one hospital to another is desirable (Gerrish, 2010).

But given the apparent inconsistency of SSC care bundles due to different formats used and implemented beyond the SSC guidelines, nurses and medical staff will encounter difficulty in apa citation generator free complying with SSC recommended sepsis resuscitation bundles from hospital to hospital. Moreover, the continuity of care for the patient will not be consistent, especially in theories cases where a patient must be transferred from generator one hospital to another. An updating of skills and fostering nursing knowledge about SSC guidelines, sepsis recognition, assessment, interventions and management, is Is the Study Law Relevant?, essential because most of the time nurses are the bedside clinicians of the patients. It is therefore fundamental for nurses to be given initiatives to update and enhance their knowledge and skills regarding the SSC guidelines. One hospital might have different sepsis management from another hospital as demonstrated by the studies of Gao et al. (2005); Cronshaw et al. (2011); Simmonds et al. Apa Citation! (2008). Hence the health outcomes will vary from one hospital’s version of the mahalo cases, SSC guidelines to apa citation another’s. If the SSC sepsis resuscitation bundles were implemented universally then it would be much easier to identify evidence and determine trends pertaining to compliance. Seven articles in of Roman Law Relevant? Essay this literature review have rated their study compliance with the free, SSC sepsis resuscitation bundles by the use of percentage, whereas Gao et al. (2005) rated compliance by the use of were confederacy ‘all’ or ‘none’ as pass-fail for the elements of the sepsis care bundle. Had Gao et al. (2005) rated compliance by the use of percentage, it would be easier to discern which criterion of the SSC sepsis resuscitation bundles needs to be implemented or may not work for patients with sepsis.

This would provide specific evidence of compliance and generator, effectiveness according to the 6-hour and 24-hour sepsis resuscitation bundles (Surviving Sepsis Organization, 2014b). Despite adding inconsistency to the SSC guidelines, Gao et al.’s (2005, p. Mahalo Cases! R765) ‘6-hour basic ward care’ using the median MEWS is particularly helpful. Apa Citation! Because basic ward care is a crucial obligation that every nurse must undertake, and these include the ability to recognise and prevent delay in intervention or transfer of critically ill patient to an appropriate place for patient’s safety (NPSA, 2007). Moreover, the one-hour sepsis six protocol in Cronshaw et al. (2011) study, which was originally formed by Daniels et al. Biological Theories Of Depression! (2011) is worth recommending to include in the SSC sepsis resuscitation bundles internationally as this protocol has already been implemented in some hospitals across the UK. The sepsis six management for patients is also being taught in the ALERT course (Smith, Osgood and Crane, 2012) as part of the nursing degree final year curriculum in some universities across the UK, hence a newly qualified nurse is apa citation generator, expected to be knowledgeable on the sepsis management, particularly of sepsis six. Therefore, it is worth suggesting to conduct further enquiry into student nurses’ knowledge towards SSC sepsis resuscitation bundles across the UK.

Chapter 5: Strengths and limitations of this extended literature review. The reviewer included articles measuring compliance of SSC sepsis resuscitation bundles across the states were confederacy, UK. The publications are recent articles and hence provide good evidence and insights of clinical practice regarding SSC sepsis resuscitation bundles in hospitals across the UK (Aveyard, 2014). All articles included in the review are primary articles and represent a variety of generator hospitals across the UK with larger sample sizes (Burns and Grove, 2009). This includes adult patients with sepsis in Birmingham, Blackpool, Derbyshire, Edinburgh, Kent, and Nottingham, thus helping to determine overall compliance trends across the UK. All eight articles reviewed suggested the Is the Essay, importance of education and awareness of the sepsis resuscitation bundles across all disciplines.

The overall strength of the findings from this review is that the evidence from the apa citation, articles helped to determine that nurses play a critical role in improving the ‘golden hour’ in hunters theme the delivery of sepsis care bundles, in terms of identifying, prioritising, and rapidly referring the patient diagnosed with sepsis (Lovick, 2009). Four articles have added some interventions aside from the SSC guidelines. Furthermore, studies by Robson, Beavis and Spittle (2007); Simmonds et al. Apa Citation Generator! (2008); McNeill, Dixon and biological, Jenkins (2008) stress that education is needed, but do not elaborate upon any specific training that the nursing and apa citation generator free, medical staff have undergone before the study, or what kind of education the mahalo cases, authors are recommending. Page et al. (2011) claim that a sticker education program is equal to greater compliance; however, the authors’ fails to compare with past SSC compliance ratings within the same hospital, which weakens their argument and how responses to questionnaires regarding compliance cannot be verified, whereas an audit provides a more thorough indication of compliance in a given hospital. Chapter 6: Conclusions. The aim of this literature review was to evaluate hospitals’ compliance to apa citation the SSC sepsis resuscitation bundles across the UK as well as to states were in the confederacy identify implications for the role of the apa citation, nurse in complying with the SSC guidelines. Three main factors that influence overall compliance with the SSC guidelines were found through a critical analysis of the studies included in this literature review. Hunters Theme! Firstly, the availability of generator resources and equipment such as enhanced care beds and medicinal supplies within the hospital appears to be limited in Baldwin et al., (2007); McNeill, Dixon and states, Jenkins, (2008).

Secondly, at the very least, the generator, lack of theories SSC awareness by hospital nursing staff is a significant concern, because nurses are the first point of contact for patients, and are therefore largely responsible for identifying sepsis. Apa Citation Free! Trainee doctors and medical staff also need proper SSC education, as McNally, MacKinnon and view development emphasizes that:, Hawkins’ (2009) evidence that only apa citation generator free, anaesthetic staff are sufficiently knowledgeable about sepsis resuscitation bundles. Lastly, inconsistency in the use and subsequently in the implementation of the SSC guidelines ‘ such as a change or elimination of certain SSC elements, whether due to lack of mahalo cases resources or practitioner discretion ‘ significantly limit researchers’ capacity to evaluate SSC compliance across the free, UK. If hospitals seek to emphasizes demonstrate evidence of overall compliance with the SSC guidelines as compared with other hospitals in the UK, then the entirety of the SSC guidelines must be followed, even if Dellinger et al. (2008b) have only highly recommended it. A uniform reference to the entirety of the criteria will help researchers to evaluate medical practitioners’ and nurses’ compliance with the SSC guidelines. Moreover, adherence with the SSC guidelines will help hospitals to apa citation determine the relevance of each element for sepsis management, and therefore provide a rationale as to whether an what element may be appropriate or not, rather than modifying the guidelines from the outset.

Nevertheless, since the SSC guidelines were published in 2004 and has been revised every two years, there is generator free, still time and Essay, opportunity to apa citation free gather all current evidence-based data regarding the implementation of the SSC guidelines. Even in a time of confederacy economic austerity recommendations for sepsis management could be replicated in hospitals across the free, UK through the appropriate and more consistent use of SSC guidelines by nursing and medical staff in order to both benefit patients’ health conditions and decrease mortality rates. Search our thousands of essays: If this essay isn't quite what you're looking for, why not order your own custom Health essay, dissertation or piece of coursework that answers your exact question? There are UK writers just like me on hand, waiting to help you.

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Essay UK, Essay: Evaluating compliance to apa citation generator Surviving Sepsis Campaign (SSC) resuscitation bundles in hospitals across the UK and implications for nursing practice: An Extended Literature Review . Available from: http://www.essay.uk.com/essays/health/essay-evaluating-compliance-to-surviving-sepsis-campaign-ssc-resuscitation-bundles-in-hospitals-across-the-uk-and-implications-for-nursing-practice-an-extended-literature-review/ [05-10-17]. If you are the original author of of depression this content and apa citation free, no longer wish to theories of depression have it published on our website then please click on the link below to request removal: 11-08-17 - Smoking habits of free university students - CARDIOVASCULAR GENE TRANSFER EFFICIENCY 01-08-17 - Effects of stress and anxiety-related disorders on the brain - Autism Spectrum Disorder (ASD) 09-07-17 - Enzyme instructed self-assembly (EISA) 28-05-17 - Glaucoma, Diabetes mellitus and Intra ocular pressure 23-05-17 - Seven functions of self-injury 18-05-17 - Neurodegenerative diseases 14-05-17 - Warafin genotyping in patients 04-05-17 - Acute lymphoblastic leukaemia. We offer professional custom essay writing, dissertation writing and biological theories of depression, coursework writing service. Our work is high quality, plagiarism-free and delivered on time. Essay UK is a trading name of Student Academic Services Limited , a company registered in England and Wales under Company Number 08866484 .

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