Pressure Ulcer Care Essay Example for Free

Pressure Ulcer Care Essay The aetiology of pressure ulcers is in some parts insubstantial due to the numerous influences that apply to the formation of a pressure ulcer. There are, none the less, a diverse array of contributing factors that have been proven to impair the structure of the skin and disrupt the healing processes, for example heart complications, lack of mobility, nutrition, sensory loss, temperature and age effecting the skins texture and strength. The most significant rationale behind the choice of clinical skill is to assist in the advancement of knowledge base, as Ali amp; Atkin (2004, p. 03) accurately specify, ‘we need to use our increasing knowledge base to transform service provision and provide better primary care’. As health professionals it needs to be realised that we are a vital link between patients and other specialised health care services, Morison (2001, p. 4) points out the importance of, ‘health care professionals as patient advocates in relation to tissue viability services’, if we do not make it our duty to be knowledgeable of what options our patients have it is impossible to administer care holistically as if our duty as a health care professional. In recent studies it has shown that pressure ulcers are most prominent with surgical patients, research has also shown that the surgical patient develops a pressure ulcer 8 times more than the non surgical patient (Pulskamp, 2007). Interestingly it shows that not only are pressure ulcers observed in older patients but just as often in the younger ago groups, with an increase in occurrence in those who receive neck and head surgeries (Bader et al, 2005), In a study is it is shown that adaptation to the operating table diminished sharply the incidence of pressure ulcer development. Bader et al found that often Pressure ulcers are observed after 2 weeks of being admitted, this then contradicts the theory that ‘pressure ulcers are caused by inadequate nursing care’, this then can only suggest that pressure ulcers develop during an operation, during periods of treatment or during investigations, for example X-ray departments where the mattresses are not adapted to the variety of different patients with a different variety of problems. To reduce occurrence and risk there must be put in place preventative measures in terms of risk assessments but as Pulskamp (2007) points out, ‘There is no validated tool to predict risk of pressure ulcers in the surgical patient’. There are numerous pressure ulcer risk assessment tools in use, yet none being significantly more preferred than others and each with particular strengths and weaknesses. In 2003 the National Institution for Clinical Excellence produced the guidelines, ‘pressure ulcer risk assessment and prevention, including the use of pressure relieving devices (beds, mattresses and overlays) for the prevention of pressure ulcers in primary and secondary care’. They suggest that in order to maximise the effectiveness of the guidelines, they should be enhanced by implementing them in working partnerships such as tissue viability teams. The aim of the guidelines, as LittleJohns amp; Rawlins (2005, p. 9) highlight, are to ‘inform clinical practice and to direct clinical decision making in order to improve patient outcomes with regard to pressure ulcer prevention and management’. To encourage the use of this guideline the National Institution of Clinical Excellence suggest, ‘incorporating guidance into continuing professional development programmes (in order to) further encourage its use in clinical practice’ (LittleJohns amp; Rawl ins, 2005, p. 100). After initial implementation an audit was arried out which highlighted significant pitfalls in implementation of the guidelines in clinical practice, for example being unable to record timings or risk assessments, repositioning charts not being used and seating assessments n out being carried out, this highlights the need for flexibility in future risk assessments as clinical issues often arise and cannot be avoided in the busy schedules of health care professionals and can often become barriers to the effective implementation there for making the correct use of the guidelines impossible risks unattended concerning the patients. They also voice the fear that the guidelines are simplifying clinical decision making and urge professionals to adopt any particular recommendations in light of such issues as available resources, local policies, patient circumstance and updates research findings. The European Pressure Ulcer Advisory Panel quick reference guidelines on prevention for developing pressure ulcers (2009) have a in depth and diverse approach on the assessment of pressure sores and contributing factors, their guidelines investigate not only the treatment of pressure ulcers but use of pressure ulcer prevention devices and wound management with a grading system to reflect the severity of the sore. The advisory panel suggests that, ‘pressure ulcers need to be assessed in the context of the patients overall condition’, they also identify ‘nutrition, pain and psychosocial factors as potential areas of complication, looking into the localization, grade, size, wound bed, exudates, pain and status of the surrounding skin’ (Dealey, 2005, p. 138). One of the pitfalls of this particular assessment strategies is the actual analysis of the pressure ulcer itself, one must have gained adequate back ground knowledge and experience on the analysis of a sore and the most suitable wound management product (for example dressings or antibiotics if the wound appears infected) to truly be able to grade it, Dealey (2005, p. 142) herself discusses, ‘accurate assessment is necessary in order to select a suitable wound management product’.

Labelling People Essay example -- essays research papers

Labelling A label defines an individual as a certain kind of person. Defining an act as deviant or criminal is not a simple straight forward process. A label is not neutral, it contains an evaluation of the person to whom it is applied. It is a ‘Master Status’ in the sense that it overshadows all the other statuses possessed by the individual. If an individual is labelled as criminal, mentally ill or gay, such labels tend to override the individuals status as father, husband, worker, friend or neighbour. Whether or not the label is applied will depend on how the act is interpreted by the audience. This in turn will depend on who commits the act and where and when it was committed. Deviance is amongst other things a consequence of the response of others to a persons act. Students of deviance can not assume that they are dealing with a homogenous category. When they study people who have been labelled deviant (Howard Becker) If the agents of social control define youngsters as delinquents for breaking the law, those youngsters become deviant. They have been labelled as such by those who have the power to make labels stick. However Becker argued ‘deviance is not a quality that lies in behaviour itself but in the interaction between the person who commits an act and those who respond to it’. From this point of view, deviance is produced by a process of interaction between the potential deviant and the agents of control. Becker then examined the possible effects on an individual being labelled as deviant and that a deviant label can lead to further deviance. However, Becker argued that this process is by no means inevitable, ex-convicts do get jobs and go straight, drug addicts do sometimes give up their habit ... ...e due to lack of empirical support and a conservative political climate (www.mpcc.cc.ne.us). Becker (1963) believes the future of labelling lies in the widespread empirical study of deviance and the various kinds of deviance. In conclusion, once an individual is labelled deviant, the pressure within society to conform to the ‘said norm’ is an ever demanding and increasing pressure. Whilst the intention of the said individual may well be to follow the path of ‘ normal individuals’, once labelled, for whit ever reason it is ever increasingly difficult to return to the ‘normal way of life’ without this shadow overwhelming most. References Becker H.S. 1963 Outsiders The Free Press New York (Pg 9) Becker H.S. 1963 Outsiders The Free Press New York (Holstein 1993, www.sscf.ucsb.edu) (www.mpcc.cc.ne.us)

A Peoples History Essay

ZINN QUESTIONS – A People’s History of the United States by Howard Zinn Chapter 1 – Columbus, the Indians and Human Progress http://www.historyisaweapon.com/zinnapeopleshistory.html 1. According to Zinn, what is his main purpose for writing A People’s History of the United States? 2. What is Zinn’s thesis for pages 1-11? 3. According to Zinn, how is Columbus portrayed in traditional history books? 4. Why does Zinn dispute Henry Kissinger’s statement: â€Å"History is the memory of states?† 5. What is Zinn’s basic criticism of historian Samuel Eliot Morison’s book, Christopher Columbus, Mariner? 6. What major issues does Bartolome de las Casas bring up regarding Spanish expeditions in the Caribbean? 7. Identify one early and one subsequent motive that drove Columbus to oppress indigenous peoples. 8. What was the ultimate fate of the Arawak Indians? 9. What was the significance of Quetzalcoatl? 10. Compare the strategies and motives underlying the conquest of the Aztecs by Cortez and the conquest of the Incas by Pizzaro. 11. What were the major causes of war between the Powhatans and the English settlers? 12. Discuss the significance of Powhatan’s statement, â€Å"Why will you take by force what you may have quietly by love?† 13. Explain Governor John Winthrop’s legal and biblical justification for seizing Indian land. 14. Explain the main tactic of warfare used by the English against the Indians. 15. According to Roger Williams, how did the English usually justify their attacks on the Indians? 16. What ultimately happened to the estimated 10 million Indians living in North America at the time of Columbus’ arrival? 17. Evaluate the statement: â€Å"If there are sacrifices to be made for human progress, is it not essential to hold to the principle that those to be sacrificed must make the decision themselves?† 18. How does Zinn attempt to prove that the Indians were not inferior? Provide examples.

Submartingale in Economics

A submartingale is a kind of stochastic process; one in which the expected value of next periods value, as projected on the basis of the current periods information, is greater than or equal to the current periods value. This kind of process could be assumed for securities prices.