Nursing Interventions For Critically Ill Brain Injury Patients

Nursing Interventions For Critically Ill Brain Injury Patients A key priority when caring for a patient with an altered level of consciousness is giving the patient a chance, in which interventions are focused on learning about the patient, protecting and monitoring patient status, talking to the patient and working with the family (Villanueva, 1999). Neuroscience intensive care unit nurses carry numerous interventions when caring for a critically ill traumatic brain injured patient. In this study, their specific interventions, that they routinely perform, are identified. Quantitatively and qualitatively, nurses regularly monitor hemodynamic considerations such as O2 saturation, BP and temperature and other physiological parameters, monitor intracranial pressure and cerebral perfusion, and providing emotional support. While qualitative analyses solely showed that the other nursing interventions that they do could be classified as neurophysiological interventions, psychosocial interventions, injury prevention interventions, and interventions that maintains therapeutic environment. This study would present proofs of the comprehensive role of the neuroscience intensive care unit nurses caring for Traumatic Brain Injured patients and can be used in future researchers that would like to investigate the contribution of neuroscience inte nsive care unit nurses interventions to the progression of the patients condition. After gaining an approval from the institutional review boards and nursing administration, a survey was done to 67 nurses who work in 3 different ICUs from two level-I trauma centers who regularly care for critically ill TBI patients. Those two trauma centers were chosen because they were both comparable in terms of delivery and organization of nursing care, employment ratios, and nurse characteristics so as to not have bias on the study. The respondents were registered nurses that worked for at least 3 months as a full-time or part-time clinical bedside nurse in an ICU that handles critically ill Traumatic Brain Injured patients. They were approached during their unit staff meetings and change-of-shift report times and invited to take part in the study. They were then given a questionnaire which was comprised of 3 parts: Part A was comprised of series of questions about their previously handled TBI patient, part B contained case scenarios wherein they used nursing judgments, and par t C gathered demographic information about the nurse respondents. For the quantitative data, all neuroscience intensive care unit nurses indicated that they were responsible for the monitoring of the patients blood pressure, oxygen saturation, and temperature. And approximately 50% of the nurses indicated that they were also responsible for the monitoring of the ICP and CPP. For the qualitative data, there were 4 categories where in the nurses interventions were grouped. The first one is the Neurophysiological Interventions. It is comprised of monitoring and maintaining the physiological parameters to guarantee neurological stability in TBI patients. In addition to that parameter, they also monitored pulmonary artery and central venous pressure reading, cerebral spinal fluid drainage, serial laboratory values, and carbon dioxide parameters. Keeping these values within the normal range, nurses help TBI patient to prevent secondary brain injury and to uphold neurological stability. The second one is the Psychosocial Interventions. In this category, n urses make meetings between the family member and various members of the healthcare team. Meetings between the family members are held to provide education and background of the plan of care being rendered to the patients and also to give information about the possible patient outcomes and rationales for the therapies. The third one is the Injury Prevention Interventions. This category aims to prevent additional complications to the patient and to ensure patients safety. The primary interventions for this category are maintenance of spine precautions and frequent reorientation of the patient. Other interventions like prevention of skin breakdown and ventilator-associated pneumonia, prevention of falls and evaluation for the need of restraints to prevent disruption of medical devices are considered usual care for any vitally ill patient. The fourth and the last category is Maintaining Therapeutic Milieu. In this category, nurses give suitable environment for the patient and provide t heir special needs. Limiting visitors, decreasing lighting, minimizing noise, avoiding disruption of the patients sleep-wake cycle are the interventions done in this group. All of which are carried out to provide optimal care and rest periods to the patient thus limits further increase in ICP. Neuroscience nurses indeed have an essential part in the care of the critically ill traumatic brain injured patients. Their interventions address the prevention of secondary brain injury and complications and provide significant support and guidance for the family members. Therefore, they have a big contribution to the patients positive outcomes, but there is still no research documenting their multifaceted role on the patients progression. These data are needed to recognize the exceptional contribution of neuroscience ICU nurses as part of the interdisciplinary team caring for TBI patients and as a foundation for future research investigating how ICU nurses impact patient and family recovery from TBI during the acute stage of injury.

Irish Autobiographies Adapted for Film Essay -- Film Movie Cinematogra

Irish Autobiographies Adapted for Film This image of mid-twentieth century Ireland embodied in the themes of emigration, cultural isolation, economic depression, literary censorship and religious conservatism have become a fixed concept in the collective imaginative and cultural production. At the start of the twenty-first century, far from seeking to exorcise such associations, Joe Cleary has noted that "the period is repeatedly evoked because it serves as the definitive image of the anti-modern which a modernizing Ireland needed both to define itself against and to transcend" (114). In other words, maintaining an image of "Irishness" which conforms to these themes is increasingly significant, thus the further divorced they become from the present reality. Roy Foster has observed that Sometimes it is hard to avoid the feeling that the new, modernized, liberated Irish consciousness feels a sneaking nostalgia for the verities of the old victim-culture: which was also, in its way, a culture of superiority. (xv) This "nostalgia" has proved extremely marketable and continues to be expressed in self-consciously modern artistic forms, most notably in film. In spite of the obvious fascination in Ireland's recent past shown by filmmakers, it is almost impossible to find a satisfactory definition for the term "Irish Film." In his important work Irish Filmography, Kevin Rockett notes that of over 2,000 feature films produced with an Irish theme world-wide since the beginnings of the cinema, less than 200 have been made in Ireland itself and most of these only in the last fifteen years or so (510). Yet, whether the on-screen influence of high-profile Irish actors or off-screen production input are taken as definitive, many film h... ...gton, Susan Tetlow. "Angela's Ashes." Literature/Film Quarterly. 29:1(2001): 58-62. Hill, Joan. et al eds., Border Crossing: Film in Ireland, Britain and Europe. Belfast: Institute of Irish Studies, 1994. McLoone, Martin. "Ireland in Cinema." Joan Hill and Pamela Church Gibson eds. The Oxford Guide to Film Studies. Oxford: OUP, 1998. McLoone, Martin. Irish Film: The Emergence of Contemporary Cinema. London: British Film Institute, 2000. "My Left Foot." Channel4.com. My Left Foot. Dir. Jim Sheridan. Perf. Daniel Day-Lewis, Brenda Fricker, Alison Whelen and Kristen Sheridan. Miramax Films, 1989. O'Hehir, Andrew, "Borstal Boy." Salon.Com 2002. Vankin, Jonathan and John Whalen. Based on a True Story: Fact and Fantasy in 100 Favorite Movies. Chicago: Chicago Review Press, 2005. Wagner, Geoffrey. The Novel and the Cinema. Vancouver: FDU Press, 1975. Irish Autobiographies Adapted for Film Essay -- Film Movie Cinematogra Irish Autobiographies Adapted for Film This image of mid-twentieth century Ireland embodied in the themes of emigration, cultural isolation, economic depression, literary censorship and religious conservatism have become a fixed concept in the collective imaginative and cultural production. At the start of the twenty-first century, far from seeking to exorcise such associations, Joe Cleary has noted that "the period is repeatedly evoked because it serves as the definitive image of the anti-modern which a modernizing Ireland needed both to define itself against and to transcend" (114). In other words, maintaining an image of "Irishness" which conforms to these themes is increasingly significant, thus the further divorced they become from the present reality. Roy Foster has observed that Sometimes it is hard to avoid the feeling that the new, modernized, liberated Irish consciousness feels a sneaking nostalgia for the verities of the old victim-culture: which was also, in its way, a culture of superiority. (xv) This "nostalgia" has proved extremely marketable and continues to be expressed in self-consciously modern artistic forms, most notably in film. In spite of the obvious fascination in Ireland's recent past shown by filmmakers, it is almost impossible to find a satisfactory definition for the term "Irish Film." In his important work Irish Filmography, Kevin Rockett notes that of over 2,000 feature films produced with an Irish theme world-wide since the beginnings of the cinema, less than 200 have been made in Ireland itself and most of these only in the last fifteen years or so (510). Yet, whether the on-screen influence of high-profile Irish actors or off-screen production input are taken as definitive, many film h... ...gton, Susan Tetlow. "Angela's Ashes." Literature/Film Quarterly. 29:1(2001): 58-62. Hill, Joan. et al eds., Border Crossing: Film in Ireland, Britain and Europe. Belfast: Institute of Irish Studies, 1994. McLoone, Martin. "Ireland in Cinema." Joan Hill and Pamela Church Gibson eds. The Oxford Guide to Film Studies. Oxford: OUP, 1998. McLoone, Martin. Irish Film: The Emergence of Contemporary Cinema. London: British Film Institute, 2000. "My Left Foot." Channel4.com. My Left Foot. Dir. Jim Sheridan. Perf. Daniel Day-Lewis, Brenda Fricker, Alison Whelen and Kristen Sheridan. Miramax Films, 1989. O'Hehir, Andrew, "Borstal Boy." Salon.Com 2002. Vankin, Jonathan and John Whalen. Based on a True Story: Fact and Fantasy in 100 Favorite Movies. Chicago: Chicago Review Press, 2005. Wagner, Geoffrey. The Novel and the Cinema. Vancouver: FDU Press, 1975.

Operational management Essay

1. Viking Sewing Machines ltd, a large company, was engaged in manufacturing and marketing household sewing machines including electronic models and low priced mechanical models. Sale of domestic sewing machines was declining all over the world in view of the increasing popularity of readymade garments produced by companies using industrial sewing machines. At this stage there was a change in the ownership of Viking in 1997, when the CEO resigned and a new CEO took charge. Under his leadership, Viking considered the following mission statements for the company: a. To develop, produce, market and sell sewing machines and related products which enhance the joy of creative sewing; b. To be consumer driven company ensuring growth, profitability and success by providing superior satisfaction to the consumers and our dealer partners by continuously adding value to the Viking brand; c. To be recognized as the leading premier sewing machine company in the world; and d. To expand our business by creating demand for more creative uses of sewing. Which one of the above mission statements should the company adopt and why? Answer Every business had to be managed and operated with a long term seted goal. So, they need to forecast about the upcoming future of the company and that forecasting should be done in such a way so that it can be more effective and efficient for the organization in the long run. Here, the competitors had already beat the Viking Sewing Machine ltd. So to stay in the competitive market, Viking Sewing Machine ltd should adopt such a policy so that they can be sustainable in the market. Therefore, in order to be sustainable Viking Sewing Machine ltd should follow the second mission statement â€Å"to be a consumer driven company ensuring growth, profitability and success by providing superior satisfaction to the consumers and our dealer patter and by continuously adding value to the Viking Brand.† Because, consumers are the key assets for every company. When consumers will be satisfied with the product they have purchased, they themselves will repeatedly buy the products and they will promote the product by themselves to their close persons. Thus the company would gain some valued customers which will help them to be stable in the market. Again, when Viking will  maintain a good relation to their dealers (supply chain management is very important for every organization), they will be very glad for working with such a company. They will also be loyal with the company and will do for the betterment of the company always. 2. For more than ten years till 1995, Laboni stores ltd was successfully running a a number of retail stores selling cosmetics and skin care products. From 1996, sales were stagnating and now after a year had started declining. The general manager of the company made enquiries from stores in charge at various locations of stores. All of them reported that ladies, particularly the younger generation, were found to be highly discriminating about choice of products. Demand for certain branded items widely fluctuated due to movie artists’ preferences shown on the TV. Also there is a marketed tendency to equate quality with rice. The general managed decided to have environmental analysis carried out with a focus on changes in social and cultural factors among urban ladies On that basis he even thought of recommending to the board of directors a complete change in the product lines to be decided. Do you think the GM was right in his approach regarding environmental scanning? What other factors in the environment needed analysis? If there was a clear change in tastes and preferences of buyers of certain products, is it essential for the company to switch over to a different product line? Answer Every organization in the world needs to modify their business model in some context. When the demand for their products starts to decline due to the change in tastes and preferences of their customers and their competitive pressure keep increasing, they should grab a new policy for their company just to be sustaining in the competitive market. Here, considering the above mentioned fact, I would say that yes, the general manager was right in his approach regarding environmental scanning of the product. Because by scanning the environment, the company would able to know the actual demand of their products and some other factors which are hampering their market such as the quality of their competitors product, what new demand exist in  the market, what their customer wants, which innovation should they bring . As there was a clear change in the tastes and preferences of their customers of certain products, the company should switch over to a different product line based on the result s they have found from the scanning of the environment. 3. Avik industries ltd was a family owned conglomerate with diversified business activities including consumers’ durables, switchgears, batteries and both toilate and washing soapes. For a number of years the company prospered with growth in volumes and market share. But its performance had setback in 1999, when the net margins in switchgears, the most profitable product, declined from 12 to 11%, while in consumer durables it had halved to 6%, the batteries business was under pressure, and the ailing soaps division had just started looking up. The chief executive of the switchgear unit observed that the results would have been worse but for the focus on operational efficiency. For years, Avik had been organized along four divisions as independent profit centres. Except for HR and finance, all other functions were decentralized. The advantage was that each of the businesses had a strong focus. It also facilitated customer focus. The flipside was that divisions became insular and inward looking. Each division had its own ad budget even separated ad agencies. The sales force was pushed to look at short term product promotions in the face of competitive pressure. The cost of sales was rising much faster than rate of growth in sales. It seemed divisional autonomy had been pushed too far down the line. Should the divisional set up be disbanded? Or, should the divisions be converted into SBUs and spun off into separate companies? Is there any other alternative structure possible? Answer Decentralization makes all individual more creative as their decisions get more valued from the top level of the organization. So they get more encouraged to take all the decisions of the company very carefully as they know that they will be treated well for a better decision in future. Now  considering the mentioned fact, my suggestion would be neither the divisional set up should be disbanded nor a single division should be converted in to separate companies. Rather,  Avik industries ltd should disbanded their decision of decentralizing their all other departments. I would say that the decentralization would be very better for the company. And altogether, the SBUs must be added into all their separated departments. Henceforth, the decentralization will allow all other departments to make their own decision and the SBUs will put all the information of the organization from all the separated departments together. Thus, the management board and all others can look for every decision of their organization that had taken in separated departments and would be able to make any correction if they needed in future. So, the decision would mostly come from the top level of the company which will bring the betterment for the company.

Effective Time Management Planning - 1164 Words

Effective Time Management Planning Time control creates a misconception. Therefore time can or cannot be managed; it is able to most effective be managed via each person, individuals and the way that time is directed. Scheduling is extremely critical when it comes to dealing with using time. However, it s far vital to manage time wisely. While time is controlled and prepared wisely; it may make the difference among a productive day and a totally annoying day. The usage of time management all through an everyday day life can assist, reduce stress and simplify existence. Without having a plan on a way to control time, it is able to create stress in lifestyles and also forgetting vital dates and closing dates. By no longer having a few†¦show more content†¦These same learners create time with extracurricular actions such as groups that could have been invested in doing more effective work. When you lastly consist of tasks and actions a public interaction and a chance to rest must also be involved in a personsâ €™ everyday schedule. This can be just a good example of how ones time might be invested. Generally someone that has finished the amount and learning and keeps down an all-day job, this example wouldn’t be as relevant. Specific Goals To successfully handle time I recognized the most significant projects and set a well -defined objective. It was crucial that I have an knowledge of person obligations, connections and main concerns. I would focus on my day, or a â€Å"time waster† could grab the day away from me before I noticed what had occurred. I find it useful to provide my projects for the day some concern ranking, and then stick to it during the day. I would do the toughest or the most boring projects first. I was unpleasant for a brief period of time from having created these changes, but all I had to do was think about every single time that I would restore into my day and it was value it. Now comes the good aspect from effective time control. I would get to compensate myself. I would always compensate myself for even finishing the actual process. When I finish the duties that I have set, I do something that I appreciate and have fun. This way I proceed to be inspired to doShow MoreR elatedEffective Performance At Work Requires Effective Time Management, Self Organization Planning And Self Motivation1759 Words   |  8 PagesEffective performance at work requires effective time management, self-organization planning and self-motivation (Barkley Murphy, 2010). Increased evidence indicates that ADHD is associated with various occupational problems and persistence of more inattentive symptoms in adulthood is associated with greater occupational impairment (Fredriksen et al., 2014). 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