Tuesday, December 24, 2019

Debriefing Simulation As A Reflective Tool - 1034 Words

Debriefing in the simulation as a reflective tool Simulation is one kind of reflective tool that widely use in nursing education. National League for Nursing (NLN) described that simulation was a teaching technique that encouraged students to use and apply their theoretical knowledge in clinical scenarios (2015). NLN (2015) also mentioned that â€Å"simulation engages learners with diverse perspectives to reflect and reframe the understanding of practice, bringing thinking and doing together† (p. 4). Jones (2009) showed the similar view that reflective simulation was a critical learning process via practiced-based scenario activity that enhanced students to learn and to practice skills before they faced real situations. However, not all processes of simulation use reflection, it is just debriefing process. According to Pivec (2012), â€Å"Reflection is often a part of debriefing† (p. 9), debriefing in the simulation was a method that students reflected their experiences and knowledge after simulation (Pivec, 2012). Likewise, Shinnick et al. (2011) explained that debriefing, a guided reflection after simulation produced by educators, was a crucial process of simulation that was the time for students to reflect and explore their learning. The appropriate time for debriefing was immediately after finishing their action in case scenario (Pivec, 2012; Shinnick et al, 2011). The length of debriefing time should be two or three times of simulation’s times that scheduled by educatorsShow MoreRelatedSimulation Of Nursing Education : A Literature Review1712 Words   |  7 PagesSimulation in Nursing Education: A Literature Review Teachers are champions of learning. They work endlessly to push students to succeed and grow. They teach them to be better readers, writers, mathematicians, scientist, historians and artists. Teachers are constantly evaluating what they can do to help their students learn and to achieve personal goals, life goals, and become productive members of society. However, not all learners have the same learning style and not all teachers have the sameRead MoreCase Study Of PEPTALC Needs1085 Words   |  5 Pages Sends email requesting instructors- 2 per session (1 simulation, 1 Newborn Sim Instructor) ii. Space in Sim Center (Theater and debriefing room) e. Simulation Center AC to confirm date/time with PepTalc instructors, NICU/PCU TC, and caregivers by an outlook meeting course request in Simulation Center calendar i. Outlook invitation will include: PEPTALC Instructors assigned for that session, Simulation Technology Specialist (TS), Simulation Center Room, and NICU/PCU TC f. NICU/PCU TC will confirmRead MoreSimulation And Virtual Applications For Learning1271 Words   |  6 PagesAccording to McGonigle Mastrian, (2012), educational games, simulation and virtual technologies each have features that can assist an individual in learning and assist educators to choose appropriate tools for learners. The features include, goal orientation, competition, exploratory learning and social interaction. Learning is a skill acquired and uses thought processes that individuals need to respond, such as in gaming. Interactive experiences motivate and engage individuals in the learningRead MoreThe International Nursing Association For Clinical Simulation Based Learning1344 Words   |  6 PagesStrategies Given the rapidly changing patient population and the increased complexity in health care, it is important to recognize the value of IPE and simulation, and aim to integrate the two strategies as we train future health professionals. This has been referred to in the literature as interprofessional simulation-based education or simulation-enhanced interprofessional education (sim-IPE), and is getting increased attention from accrediting bodies, health professional schools and educators.Read MoreThe Quality Of Standardized Patient1809 Words   |  8 Pageswho also posses proper bedside ettiquite. Simulation has taken a bold role in training students of not just procedures and medical competencies, but also clinical skills. Standardized patients have provided a unique human touch in this process of simulation. Specifically those that are trained to provide feedback have become an invaluable tool to medicine. In this paper, the focus will be on the quality of standardized patient debriefing. Debriefing in medicine has recently become a popular formRead MoreEmergencies In A Home Environment Case Study1269 Words   |  6 Pagesrelated emergencies in a home environment. The evaluation tools and survey were purposely developed to eliminate certain factors that could affect internal validity. Selection bias is eliminated by ensuring that participant characteristics incorporated all families/caregivers who care for children with tracheostomies can participate voluntarily in this curriculum. Therefore, the volunteer aspect can minimize bias results and reflect unbiased data of the educational intervention for this curriculumRead MoreThe Importance Of A Thoughtful Pre Briefing, Introduction, And Orientation Occurring Before A Simulation1793 Words   |  8 Pagespre-briefing, introduction, and orientation occurring before a simulation has been mentioned in literature for long time (Dismukes RK, McDonnell LK, Jobe KK. 2000; Howard S, et al. 1992). A good pre brief is also very important to increase the fidelity and to ensure learner’s feeling of security and well being (Bion WR. 1962 2005; Modell AH. 1976. Winnicott DW. 1955). Participants should not feel exposed by the simulation and debriefing in a way that threatens their professional and social identityRead More Nursing Practicum Proposal Essay2699 Words   |  11 Pagesserve as a guide for faculty to follow in order to provide high quality education for nursing students (NLN, 2007). This paper is aimed at proposing a student teaching practicum at North Central Michigan College (NCMC) in the nursing high fidelity simulation/skills lab for the winter 2014 semester. Scholarly Practicum Proposal The NLN has developed eight core competencies for nurse educators. The NLN proficiencies serve as a guide for faculty to follow in order to provide high qualityRead MoreThe Effects Of Simulation On The Nursing Education System1714 Words   |  7 PagesSimulation is has been adopted in the nursing education system, as a technique to curb common and dangerous occurrences that ensues in the health care system. After graduation and upon gaining employment in a hospital, nurses ought to be familiar with the fast paced and intense hospital setting, while executing various nursing practices, which includes clinical competence, timely decision making, critical thinking, efficient and professional human interaction. They are various form of simulationRead MorePolicies And Procedures For Student And Faculty Performance1611 Words   |  7 Pagescourse and annually (including teaching assignments/approaches, advising). Students will be evaluated with formative and summative evaluat ions including coursework (exam grades), clinical (performance, concept map, and reflective clinical evaluation tool or CET), and simulation. Curriculum will be evaluated at end of course (including clinical requirement/location, clinical site surveys, course sequencing, remediation, admission requirements). Program will be evaluated by retention, progression

Monday, December 16, 2019

Clinical Decision Support Free Essays

A state of irritability, exhaustion, or bewilderment triggered in clinicians who have been exposed to too many alerts which cause the user to ignore some or all the alerts. American National Standards Institute (ANSI) ; coordinates for the development of Health bevel Seven’s Arden Syntax Standard. Bar Code Medication Administration (ABACA) ; An inpatient CADS to assist nurses with the five rights of medication administration. We will write a custom essay sample on Clinical Decision Support or any similar topic only for you Order Now ; Provides warnings if any of the five rights are violated. ; It also requires the nurses to enter an override reason if he/she chooses to proceed. Bar Code Medication Administration Health Level Seven (HAL) ; A standards development organization for health information technology (HIT) Look-Alike, Sound-Alike (ALAS) ; Drugs with similar spelling or pronunciation. ; Refers to providing clinicians or patients with clinical knowledge and patient-related information, intelligently filtered or presented to appropriate times, to enhance patient care. ; Integrate patient-specific data with an available knowledge base in order to assist the clinician in selecting and delivering the safest and most effective therapies. Clinical Decision Support System A system intended to provide CDC to clinicians, caregivers and health care consumers. ; An Automated CADS includes: 1. A Knowledge base 2. An Event monitor 3. A Communication system Take Note: ; CADS may be a stand alone system ; CADS may be integrated into other technology solutions (ex. Bar code scanning technology and e-Prescribing) General Attributes of CADS 1. Designed for three purposes: Improve the quality of clinical decisions Notify of potential change in patient status ;. Prevent errant action at the point of care a. Error of commission b. Error of omission 2. Patient specificity 3. Context sensitive- relates directly to the work at hand 4. Integrated into workflow- convenient to use. 5. Timely- executes in real time 6. Pushes information to the clinician, care-giver or health care consumer 7. Intelligently filtered clinical information ; Information, advice or warning is relevant and meaningful ; CADS uses patient data to infer that the message is actually needed. ; CADS is customizable to clinical preferences. Types of Clinical Decision Support A. Patient-specific CADS B. Non-patient specific CADS ; This type of CADS consist of three types f alerts 1 . Commercial drug-interaction alerting system 2. Commercial dose and dose-range checking alerts 3. Commercial clinical rules engine Commercial drug-interaction alerting system ; Most common in COPE and Pharmacy Information systems. ; Provides alerts for drug-allergy, drug-drug, drug-pregnancy and other interactions. ; Limitation is that severity levels Of drug interaction is pre-assigned by the vendor based on the anticipated adverse reaction and cannot be customized. Four Possible Results from deterioration alerting system Alert Result Produces alert? Relevant? Clinician deeds to see? True Positive Yes True Negative NO No Positive False Yes but never gets the chance Commercial dose and dose-range checking alerts ; Currently, this is rudimentary using few patient data, usually only age. Therefore this systems only loosely fit paternalistic category. Commercial clinical rules engine ; These allow local development or customization of clinical content and programming logic. 2. 3. 4. Data mining Informational notice Order sets Knowledge retrieval systems ; Provides population specific relationships and information. ; Encompasses numerous methods used to identify patterns and relationships in data. ; Usually just-in-time, product specific information. ; Examples: 1 . Provides alert for possible ALAS 2. In COPE, it might be order specific information such as the cost off lab test, or formula status of a drug. ; An organized set of patient care orders that are usually population, procedure or disease specific. It may be evidence-based such as clinical guideline. ; The KIRKS ; It could be: 1. Primary KIRKS ex. Google and 2. Secondary KIRKS (Harridan’s online) 3. Tertiary KIRKS (ASAP, Thomson Health care and How to maximize the benefits Of CADS? Maximizing the benefits 1. Ensure that the data available for decision-making is as comprehensive as possible. Data should be current and urge Larry updated. 2. Optimize the method by which the decision support informat ion is delivered to the health care provider values of CADS ; Application of CADS in different current medical technologies available: 1. COPE 2. OMAR(Getronics Medication Administration 3. Smart Pumps 4. Automated distribution cabinets CADS in COPE CADS integrated in COPE can: ; Reduce medication errors (any preventable event that may lead to inappropriate medication use or cause harm to he patient while the medication is in the control of a health care professional, patient or consumer) ; Improve compliance with recommended monitoring or adjunctive therapies. ; Improve efficiency by reducing the time spent clarifying incomplete orders. Screen for a variety or risks on the point of entry (ex. Duplicate therapy, drug-drug, allergic cross sensitivities) ; can reduced mathematical errors by automating weight-based and similar dosing calculations. ; can identify possible ALAS medications. Computerized Provider Order Entry CADS in Omar ; OMAR (Electronic Medication Administration Record) CADS integrated in Omar can: ; Can provide real time confirmation of the 5 rights of medication administration: 1. Right medication 2. Ri ght dose 3. Right route 4. Right patient 5. Right time ; Can screen for recent changes in laboratory parameters, vital signs, or allergy status which may interact with a scheduled medication and alert the nurse prior to administration. ; Ex: laboratory shows critical level of potassium thereby alerting the nurse before administering dioxin to patient. CADS in Smart Pumps ; Smart pump- a computerized infusion device that can be programmed to include specific set of data. CADS integrated in Smart Pumps can: ; Provide real time confirmation of the volume, rate and concentration of the solution being administered. Smart Pumps CADS in Automated Dispensing Cabinets ; ADS- secure storage cabinets typically located decennially on patient care units capable of handling most unit-dose and multiple dose medications. ; CADS integrated in ADS can: ; Notify nurses of potential hypersensitivity or ADAIR when certain trigger medications are withdrawn for a patient. ; In pharmacy, can provide alerts when medication is withdrawn too early or too ate based on scheduled administration time. Automated Dispensing Cabinets Unintended consequences in CADS ; A. Alert fatigue ; 8. Delay in care ; C. System performance A. Alert fatigue ; Tendency users to become overwhelmed and begin to ignore CDC messages due to a high quantity of alerts or a perception that the alerts have little perceived value. B. Delay in care ; The risk that interruptions in the workflow caused by clinical decision support alerts or system limitations may lead to a delay in delivery of patient care. C. System Performance ; The risk that the processor resources seed by the CADS will cause the hospital information system software to perform slowly. Arden syntax standard ; A programming language designed for clinicians to build clinical rules. Streamlined computer language based on Pascal. ; Developed in Columbia University Arden Homestead in 1989. ; This standard provides a method to construct clinical rules, such as alerts, reminders and recommendations, known as Ml. ; Provides a flexible and clinically way to develop Ml. What is Ml? Ml ; Means Medical Logical Modules ; Offers a suggestion or warning (alert, recommendation or rem inder) regarding a alnico decision or action, or an informational notice to report a change in a patient’s clinical status. How to cite Clinical Decision Support, Papers

Sunday, December 8, 2019

Adolf Hitler Essay Example For Students

Adolf Hitler Essay Adolfs father was Alois, an illegitimate child, his mother was Marie Schickulgruber. Alois took his fathers name Hitler before Adolf was born. Alois was already a successful border guard when he was 18, and later became an Austrian customs official. He retired in 1849 after 40 years of service. He was 58 and retired early because of bad health. After he retired he bought a nine acre farm near the small town of Hafeld. His dream was to live a country life, but the farm took much more work than he expected. Since his health was poor, he had a very hard time making a living on the farm. He had always found that spending time with his children was irritating, but on the farm they were forced to work side by side. This was difficult for Alois, who was very hard on the children. He often beat them when they didnt mind. Adolfs fathers main hobby was bee keeping, often the mother had to remove 30 or more bee stingers at the end of a day. TheWeimar Republic began at the end of 1918, two days before the First World War ended. It was not strong from the start because it had signed the dreaded Versailles Treaty. People felt Germany had been stabbed in the back by the government, so there was a lot of political unrest. Then the Great Depression set in and there was economic turmoil as well. No one believed in the Weimar Republic anymore. This boosted the Nazi Party’s membership(Toland 349). In 1921, Hitler gained control of the National Socialist German Workers’ Party and changed the name to the Nazi Party. From 1921 to 1923, the membership grew from a mere 6,000 people to 50,000. Hitler worked to win the support of the peasants, workers, middle class, and some of the wealthy business leaders by promising order, unity, strength and a better life for all. Hitler became the Chancellor of Germany in 1933 and later earned a dictatorship, which allowed him to establish a fascist state known as the Third Reich. Opposers of the Nazi Party were rounded up by the Gestapo, the secret police, and many of them were murdered. Nazis extended their control over every aspect of people’s lives and through propaganda, they kept people happier. Thus was the beginning of the campaign against the Jews and others, known as the â€Å"Inferior Beings.† The previous conditions of life in Germany had successfully opened the door for the Nazi Party to take over and exhibit their power as they did. Nationalism in Germany played a major part in setting the stage for someone to take over. Germany had been a country made through nationalistic tactics, led by Bismarck, and was a very proud country. When Germany lost W.W.I, they were humbled. The Versailles Treaty forced them to accept blame. They lost their over seas colonies and were only allowed a limited army. This left a lot of hatred towards the rest of Europe with the German people. The Nazi party came into the political scene soon after W.W.I h ad ended. German support for the Weimar had decreased because of the inflation and other side affects of the Versailles Treaty. Many people turned towards the Nazi party because it attacked both the Weimar Republic and the Versailles Treaty. The Nazi’s ideas were already formed, Hitler just came at the right time to be their spokesperson, giving people what they wanted, someone to blame and someone to look for help(Rathbone 78). Hitler began his rise to power during a difficult time for the German people. The failing economy and government required a strong and charismatic leader to take control. Hitler had both of these qualities, along with promises for a fixed economy and successful government. When Hitler joined the Nazi party in 1921 there was only 6,000 members, but within two years his powerful speeches and influential ideas caused the number of party members to explode to 50,000(Heck 45). Hitler creatively started his speeches soft and slow. He gradually grew louder and spoke with great emotion that carried the people right off into his world. Hitler’s powerful speeches not only gained the Nazi party thousands of members, but also the positions of chancellor and then dictator. These positions would not have been reached if Hitler had been a quiet self-contained person. His booming voice and great hand gestures added to the great impact of his speeches, as well as his powerful charisma(Toland 221). Hitler’s influential ideas reached past the adult members of the Nazi party, to the German children. Hitler felt that by teaching the future generation about fascism, then all of his plans and ideas would succeed with the help of the children. Hitler then acted as the father of the German children. He gained their respect and support at a young age, which was a new tactic that had never been used before. Hitler nurtured the children’s respect and support by teaching them strict manners and disciplinary orders while they were stil l in school. He also enforced the teaching of fascism and severe nationalism in the schools(Heck 122). Throughout Hitler’s career he retained these very powerful characteristics, helping him remain a powerful leader in Germany and the rest of the war throughout W.W.II until the German defeat in 1945. Now, with Germany on his side, he commenced his plan of totalitarian control. Hitler believed that in order for Germany to obtain full prosperity, it must ‘cleanse’ itself of the ‘impure’ people. Hitler expressed his views in the book Mein Kampf in which he also talked of his right to maintain ‘living space.’ He increased his forces from a measly 100,000 men to 500,000 men and withdrew from the League of Nations(Rathbone 70). Planning a major invasion of Europe, Hitler decided to test out his new weapons in the Spanish Civil War, and while he was there he became acquainted with Italian methods and political ideas. This was the basis for the Rome Berlin Axis, and an alliance was made in October 1936. Only six months later, German troops occupied the Rhineland. Hitler then turned to Sudetenland, Czechoslovakia. He convinced the 3,000 Germans living there to demand self-government. After the Czech crisis was resolved, Hitler called a conference of the major European powers but conveniently forgot to invite Czechoslovakia and the Soviet Union, its major alliance. Germany, Britain, France, and Italy determined the fate of Czechoslovakia. Hitler gained the right to send troops into the Rhineland and promised to control his actions involving world affairs from then on. But only six months later, Hitler gained control of the rest of Czechoslovakia in March of 1939. The world was shocked at his inability to keep a promise, and before they could react, Hitler was demanding Danzig and the Polish Corridor. These were both taken from Germany during the Versailles Treaty. Because of this, Neville Chamberlain (the Prime Minister of Great Britain) and France both agreed to help Poland if Hitler invaded. Hitler was not shocked by this, but he also knew that they could not help Poland to any great extent because he had territorially cut off both countries from Poland. Hitler then realized that Russia might pose a problem to an invasion because of its long border with Poland. To resolve this, Hitler secretly signed a treaty with Stalin, planning to divide up Poland, the Soviet Union with one-third, Germany with two. So on September 1, 1939, Germany crossed over the Polish border. Two days later, the world was at war. Using his unique tactic of the blitzkrieg, or lightning war, Hitler took control of Poland in almost four weeks. There were five effective steps of the blitzkrieg: 1: Hitler sent spies and saboteurs into the area to map out and mark major intersections and storehouses. 2: Airplanes were sent into the area and bombed bridges and key points to create chaos. 3: Tanks going 40 miles per hour with cannons roll into back yards and across cities. 4: Then come the troops in fast moving trucks with machine guns to wipe out any protesters or soldiers getting in the way. 5: Then finally came the occupation with either special officers or just regular German police to capture and kill, if necessary, anyone who objected(Toland 823). This method was very effective because of its speed and efficiency. He took the enemy by surprise, not giving them time to react to the situation. By catching them off their guard, Hitler easily crushed Poland and occupied the country without a problem. Hitler took a slight seven month break from his invasions in order to make Europe think he was done seizing other â€Å"weaker† countries. However, Hitler took Denmark, Norway, Luxembourg, the Netherlands, and Belgium. Using the same tactics, Hitler went around the Maginot line and took France. While some countries were falling victim to Hitler’s attacks, some decided it would be easier to side with him. Hungary and Romania joined with Germany in 1940, Bulgaria joined in 1942 and Spain let Hitler use its ports. Hitler, remembering that the Soviet Union had killed most of its army generals in the Great Purges, decided it would be worth the risk of a two front war to obtain the Soviet’s rich farm lands and oil deposits. And masked by Mussolini’s attacks, Germany crossed the border and marched into the Soviet Union in June of 1941. Adolf Hitler was very anti-Semitic and wrote Mein Kampf while he was in jail. It detailed his beliefs that the â€Å"Aryan† race was far superior to the â€Å"inferior races,† such as Jews, Slavs, Gypsies, the physically and mentally disabled, and the Aryans were destined to rule them. He blamed the Jews for all the economic troubles and started persecuting them. It became practiced so much that concentration camps were set up for the inferior races to be sent to. At the concentration camps, people suffered terrible deaths. I f they were lucky enough to live through the mass executions in gas chambers, being buried in mass graves, and being executed; then they were forced to work for the Germans(Deichmann 54). When working for the Germans the prisoners were fed very little and many died of sickness or starvation. If the dead bodies were not thrown into a community burial grave, then they were burned in furnaces. These camps were found all over Europe, in Germany, the Netherlands, and Poland, as well as other countries. There were about 12 million deaths with 6 million being political prisoners, the physically and mentally disabled, Gypsies, and Slavs. The other 6 million were Jewish deaths. Hitlers purification process was obviously against all Anglo Saxon morals and ethics, but was part of his master plan for control. Until his death in 1945, a suicide, which he chose as his fate, Hitler, proved to be an Influential character of charm, charisma and power. He worked himself into power, led a nation into war and executed his plans for a supreme race, no matter how unethical his ideas were. Like a tragic hero, however, he held his own flaw and in the end his own downfall and collapse of power. Hitler found a time where he could easily slide into power, giving a torn apart nation a purpose, goal and a union to build upon. Bibliography: