Nursing Project Essay Example | Topics and Well Written Essays - 2750 words

Nursing Project - Essay Example The evidence definitely supports the use of this program and s presented in this paper. Continuous quality problems and spiraling costs in healthcare have lead to widespread interest in solutions that are effective and well supported. Evidence based practice has taken hold as an answer to the problem that makes sense (Coleman, 2003) EBP is sometimes viewed as an ideology, however, as far as practice goes it's goal is to supplement professional decision making with the latest research. It is sometimes argued today that to treat someone with a practice that the efficacy has not been shown is not ethical (Kind,2007). That would leave many healthcare treatments today as unethical. This paper will discuss nursing transition to evidence based practice in the realm of patients and transitioning. The question would be, "What are the most effective interventions for improving care coordination" Many Medicare dollars are spent on a small percentage of beneficiaries with chronic conditions and those people are in and out of the hospital many times, many within short periods of time. The causes of this are numerable but some of them are inadequate care, poor communication among primary caregivers, specialists, and patients, weak adherence by patients, and failure to catch problems early. There are three types of intervention being looked at closely at this time to try to solve these problems. Transitional Care, self managed education intervention, and coordinated care interventions are being considered as effective but requiring further study (Coleman, 2003). Transitional care is first engaged in the hospital, followed intensely post-discharge and receives comprehensive post discharge instructions on medications, self care and symptom recognition. Reminder calls are made to assure that the patients follow up with primary care providers as required. Effective transitional care is targeted for patients with specific diseases such as CHF. This is guided by APN's and is usually a twelve week intervention that is highly structured with protocols (ncga.gov.) It requires a one year post discharge follow-up. Statistically it has shown to reduce hospitalizations by 34% and lower overall costs by 39%. APN's in this case are the transitional coaches and there are tools given for cross site communication. Self management education is a term used for collaboration with patients and families to identify patient goals, improve self management, expand sense of self efficacy, and assess mastery of skills (ncga.gov). Much of this is done in group sessions of limited duration. The targeted patients are usually forty or older and have heart disease, lung disease, stroke or arthritis. There are usually seven weekly group sessions on exercise, symptom management, techniques, nutrition, fatigue and sleep management, use of medications, dealing with emotions, communication and problem solving. Statistics show that these patients have 1/3rd fewer hospital stays. Coordinated care on the other hand is considered teaching patients about self care, medications, how to communicate with problems, monitor patients symptoms, well-being, and adherence between office visits and advise patient on when to see their physician. A full report is given to the patient's physician (ncga.gov). This would also include arranging for social support

Interwar Central Europe (Czech Literature class) Essay

Interwar Central Europe (Czech Literature class) - Essay Example There were two different views of culture in the 19th century. One field of thought used the word to distinguish human adaptive strategies from the instinctive adaptive strategies of animal while the other used it to refer to symbolic representations and expressions of human experience devoid of reference to direct adaptive value. In 1869, Arnold Matthew, belonging to the second school of thought, basically defined culture the way it is viewed today. According to him, "Culture or civilization, taken in its wide ethnographic sense, is that complex whole which includes knowledge, belief, art, morals, law, custom, and any other capabilities and habits acquired by man as a member of society"(Matthew, 1869). It was in the 20th century where anthropologists considered culture as an object of scientific analysis. In 2002, the United Nations Educational, Scientific and Cultural Organization (UNESCO) defined culture "as the set of distinctive spiritual, material, intellectual and emotional fe atures of society or a social group, and that it encompasses, in addition to art and literature, lifestyles, ways of living together, value systems, traditions and beliefs". (UNESCO, 2002) The first thing that comes to mind when talking about scientific revolution is sweeping changes and discoveries in the Natural Sciences such as Physics, Biology and Chemistry. However, the term also indicates the series of changes in thought itself such as systematic doubt, empirical and sensory verification, the abstraction of human knowledge into separate sciences, and the view that the world functions like a machine. That is, the scientific revolution also encompasses the Social Sciences such as Philosophy and Political Science. The latter part of 19th century and the early portion of the 20th saw huge scientific developments in various fields. This was the period where steel, electricity, internal combustion engine, telegraph and telephone and railroads -all major factors for modernization- came into operation. This was also the period where Wilhelm Wundt applied a physiological approach to the mind, August Comte approached social problems with statistical data, Leopold von Ranke rejected history based on tradition and placed emphasis on documentary evidence, Albert Einstein proved his Relativity theories and Sigmund Freud established Psychoanalysis. (Wikipedia.org, 2006) These developments virtually revolutionize every aspect of life in many aspects of human society and it can be argued that is within this period where our understanding not only of the environment but of ourselves grew by leaps and bounds. However, it should be noted that these developments did not necessarily had positive effects; an example would be the development of chemicals for chemical gas warfare used in WW1. 3. Compare main features of "form" and "content" of Hasek's THE GOOD SOLDIER SVEJK. The novel takes the form of a satire where the contents delve on a discussion of the hypocrisy of the church, the stupidity of the army and the police and the destructiveness of war all seen thru the comic adventure of Svejk- a soldier branded by the Army and the bureaucracy as an imbecile- and the statements of a narrator. The adventures of Svejk' is played out against a backdrop of sharp and often