Posts Tagged ‘Healthcare Online Education Consultant’

Forensic Nursing

April 12, 2013

Forensic nursing should be included in the BSN programs today. A friend of mine and I were discussing why it should be included in the programs. There are many different fields of nursing. If for some reason you are not happy with one you may try another field. The reasons to include forensic nursing are because one never knows what they may encounter. An OR or ER nurse is guaranteed to see forms of child abuse, sexual abuse, gunshot wounds, and many more serious conditions that forensic nursing would improve the patients care. The nurse would be able to respond and understand the situation better, which may be a matter of life or death. TUESDAY, MAY 06, 2008 Assessment Course As a 1970 graduate of a diploma program, this assessment course seemed far more defined. My assessments were taught in chapters in my medsurg, peds and maternity nursing texts. Forensic nursing was never mentioned. I love doing and teaching assessments because I love a good challenge and every patient is one. My skills became more fine tuned after my forensics nursing class over 10 yrs ago. I love stories by Patrica Cornwell, Tess Geristen and some by Kathy Reichs although I find her writing less sophisticated and more predictable than the others. “Bones” a TV drama based on her works and experiences is far more interesting to me. If Forensic Nursing is not a required course in BSN programs today, in my opinion it should be. It would fine tune basic assessment, observation and interviewing skills which all benefit the care of the patient.

Links
This is an excellent work from your home opportunity. Start work for today and get paid daily. You can easily work from home.

Click on this picture for more information or to begin work today.

Healthcare Online Education Consultant
Forensic Nursing Online College Professor Teacher Instructor Available
Forensic Nursing Online Tutor
Nursing Nurse Online Tutor

For Helpful Links and more information, click here

Advertisements

Informed Consent Post

April 10, 2013

Specifically in Psychiatry informed consent is a major concern for patient safety and care. Before each patient is given a psychotropic medication, the doctor must first explain what medication the patient will be taking for their specific disorder and what symptom they are targeting. For example the doctors must explain to the patient all psychotropic medications that the patient will be taking; Risperdal for psychosis and delusional thought content, Ativan for anxiety or agitation. The patient is also informed of side effects, and that they may or may not get better from the medication. Both patients and doctor sign the consent form which then becomes part of the medical record. Before a nurse can give a psychotropic medication, the consent form must be signed. When emergent medications are needed secondary to patient agitation, direct threats, bodily harm to self or others then the consent is waived for the safety of both staff and patients. However, IM medications are only given for emergent medication needs and the safety of the unit. Patients do have the right to refuse any and all medications in the psychiatric unit including medical medications and procedures. When patients refuse to sign the Psychotropic Medication Consent Form or agrees to take the medication but may refuse to sign the form, then a witness must also sign the form along with the doctor’s signature. If the patient refuses any or all of their psychotropic medications as is their right, a Riese hearing can be applied for by the doctor to force a patient to take medications against their will. This is a court hearing with the doctor, judge, patient and patient advocate (attorney for patient). Each side states why the patient should or should not be forced to take medication against their will. If the finding is that the patient will benefit from the medications more than be hurt from the medications, then the psychotropic medication can be given against the patients will usually with IM medication. Patients are always offered PO medications first, however, if they refuse then the medication will be given IM against their will. As is the law in California, all medications that could possibly be given to the patient must appear on the Riese form. Patients have the right to refuse medication if they are voluntary or involuntary (placed on a legal hold for observation). The only time patients do not have a legal right to refuse psychotropic medications is if they have lost their Riese or if they are on a Permanent Conservatorship and that person’s Conservator then has the right on behalf of the patient to make psychiatric decisions for the patient. I believe that California law covers informed consent and the right for least restrictive treatment and environment for psychiatric patients.

Links
Healthcare Online Education Consultant
Forensic Nursing Online College Professor Teacher Instructor Available
Forensic Nursing Online Tutor
Nursing Nurse Online Tutor
Power of Attorney for Health Care

For Helpful Links and more information, click here

Is it Necessary to Document Your Efforts in Providing Culturally Competent Care?

April 5, 2013

Cultural competence has been a responsibility addressed in nursing programs since before I became a student and I have noticed a steadily increasing amount of focus placed on the topic throughout the years. As with all aspects of nursing (including forensic nursing), there will always be room for improvement in how we conduct our profession in a culturally sensitive manner. It seems to be a basic understanding that any nurse be acutely aware of his or her own cultural beliefs, practices and biases. I also notice universal agreement that health care professionals need to attempt to learn about all clients’ cultural attitudes towards healthcare and allow for specific integration of these attitudes when at all possible. As this is a responsibility of the health care professional, is documentation of the practice necessary as well? Cultural competence can be applied in forensic nursing and all aspects of nursing care; so documenting the practice is very complicated. Much discussion will be needed to determine how it can be applied to daily documentation without taking excessive time from other nursing responsibilities. A basic need of clients is to have their healthcare options given to them in their first language to maximize the potential for full understanding. Hospitals have addressed this need in a variety of ways including written translation of informed consent and having native speaking interpreters present during any medical explanation before “informed consent” is given. The practice of providing culturally sensitive care is then “documented” by the presence of the signed translated copy of the consent or the presence of the interpreter’s signature on the English version of the consent. The cost to health care providers in both the areas of finance and time is great to accommodate these needs. Therefore, the value of our current practice should be continuously evaluated in order to assure we meet the needs of the client without excessive cost. Value is the key word in this sentence. In the case of the written translated consent form, I have seen consents get signed without being read and this has forced me to think about the various reasons this might occur. Could the client read the consent? Although the consent was in the language self-identified by the client, was the terminology not familiar to the client? Were the opinion and “desires” of the healthcare professional deemed sufficient and therefore explanation not required? The signed consent, however, is placed in the client’s chart and acts as documentation that the client was explained the procedure in a manner facilitating understanding. Healthcare facilities are also managing costs by trying to minimize the amount of paper used in documenting. I have seen consents presented to clients in the form of laptop computers with electronic writing devices. Does this technology intimidate the patient and further compromise their comfort during their healthcare experience? I am sure the answers to the questions posed above are as varied as are the cultures and people of those cultures seeking healthcare in this country. Is it really of value, then, to “document” all of our efforts in providing culturally competent care? Or rather, should we seek to create an environment in healthcare settings where continued education and discussion enhances the healthcare professional’s awareness of the need for culturally competent care? This in turn might increase our accountability to this responsibility without further straining the healthcare system with the financial and emotional stress of balancing the application of good care with the documentation of the process.

Links
Healthcare Online Education Consultant
Forensic Nursing Online College Professor Teacher Instructor Available
Forensic Nursing Online Tutor
Nursing Nurse Online Tutor

For Helpful Links and more information, click here

Female Genital Mutilation

March 27, 2013

Female genital mutilation (FGM) is recognized internationally as a violation of the human rights of girls and women. It reflects deep-rooted inequality between the sexes, and constitutes an extreme form of discrimination against women. It is nearly always carried out on minors and is a violation of the rights of children. The practice also violates a person’s rights to health, security and physical integrity, the right to be free from torture and cruel, inhuman or degrading treatment, and the right to life when the procedure results in death. Procedures are mostly carried out on young girls sometime between infancy and age 15, and occasionally on adult women. In Africa, about three million girls are at risk for FGM annually. Between 100 to 140 million girls and women worldwide are living with the consequences of FGM. In Africa, about 92 million girls age 10 years and above are estimated to have undergone FGM. The practice is most common in the western, eastern and north-eastern regions of Africa, in some countries of Asia and the Middle East, and among certain immigrant communities in North America and Europe. Since 1997, great efforts on the part of the World Health Organization (WHO) have been made to counteract FGM, through research, work within communities, and changes in public policy. Progress at both international and local levels includes wider international involvement to stop FGM, development of international monitoring bodies and resolutions that condemn the practice, revised legal frameworks and growing political support to end FGM, and in some countries, decreasing practice of FGM, and an increasing number of women and men in practicing communities who declare their support to end it. Research shows that, if practicing communities themselves decide to abandon FGM, the practice can be eliminated very rapidly. WHO efforts to eliminate female genital mutilation focus on developing publications and advocacy tools for international, regional and local efforts to end FGM within a generation; generating knowledge about the causes and consequences of the practice, how to eliminate it and how to care for those who have experienced FGM; and developing training materials and guidelines for health professionals to help them treat and counsel women who have undergone procedures. WHO is particularly concerned about the increasing trend for medically trained personnel to perform FGM. WHO strongly urges health professionals not to perform such procedures. (2008). Female genital mutilation. World Health Organization Fact Sheets, (no. 241).

Links
Healthcare Online Education Consultant
Forensic Nursing Online College Professor Teacher Instructor Available
Forensic Nursing Online Tutor
Nursing Nurse Online Tutor
HUman Rights Attorney Lawyer

Save Up to 75% off your prescription medications with this Free National Rx Prescription Card. A medication discount is available for almost everyone, regardless of insurance or no insurance coverage.

Click on this prescription discount card for immediate activation or more information.

For Helpful Links and more information, click here

Musculoskeletal System

March 21, 2013

I have found that the most consistent complaint, and yet the most difficult to evaluate, is chronic low back pain. Although most complaints are valid, I have had experiences where they were not. In one situation, a 56-year-old man presented for evaluation for long term disability- I was seeing him as a follow up. All appropriate scans had been ordered and were negative. He had several office exams that were inconsistent. When I examined him, he complained loudly with LE range of motion, but had no complaints when I did a leg raise. After speaking with the physician, we went with our instincts and refused to fill out his disability paperwork. He was very angry and sought a second opinion. He never returned to our office. Imagine my surprise when I was playing in a local golf tournament for charity and there was our patient who had absolutely no difficulty swinging his golf clubs! He saw me at the dinner following and refused to make eye contact. I told the physician I was working with and we both felt good about following our instincts.

Links
This is an excellent work from your home opportunity. Start work for today and get paid daily. You can easily work from home.

Click on this picture for more information or to begin work today.

Healthcare Online Education Consultant
Forensic Nursing Online College Professor Teacher Instructor Available
Forensic Nursing Online Tutor
Nursing Nurse Online Tutor
Disability Attorney Lawyer

Save Up to 75% off your prescription medications with this Free National Rx Prescription Card. A medication discount is available for almost everyone, regardless of insurance or no insurance coverage.

Click on this prescription discount card for immediate activation or more information.

For Helpful Links and more information, click here

Sexual Abuse

March 19, 2013

A program that is in place to help sexual assault victims is SANE: Sexual Assault Nurse Examiner.  The nurses employed by this program are trained forensic nurses who help rape survivors on a first-response medical care basis.  They are concerned with psychological healing, emergency contraception, STD prophylaxis, documenting evidence, presenting evidence in court, organizing community resources for case management.  Prophylactic treatment of sexually transmitted diseases varies by health center, but generally includes a first dose Hepatitis B vaccine with follow up dose instructions.  Female patients are offered pregnancy prophylaxis medications after current pregnancy status has been established. HIV prophylaxis is also administered in these situations. The article “The Effectiveness of SANE Programs: A review of psychological, medical, legal, and community outcomes” by Campbell et al, from the journal Trauma, Violence, and Abuse, October 2005 reviews the effectiveness of SANE programs in all of its domains.

Links
Healthcare Online Education Consultant
Forensic Nursing Online College Professor Teacher Instructor Available
Forensic Nursing Online Tutor
Nursing Nurse Online Tutor
Sexual Abuse Assault Lawyer Attorney

Save Up to 75% off your prescription medications with this Free National Rx Prescription Card. A medication discount is available for almost everyone, regardless of insurance or no insurance coverage.

Click on this prescription discount card for immediate activation or more information.

For Helpful Links and more information, click here

Cancer screening among jail inmates

March 18, 2013

Many cancer victims can significantly improve the prognosis of the diagnosis with early detection and treatment. Two cancer types that have had improvement in survival rates due to disease screening are breast cancer and cervical cancer. Screening test for breast cancer include breast self-examination (BSE), clinical breast examination (CBE) and mammography. The screening test for cervical cancer is the Papanicolaou (Pap) test. The National Cancer Institute (NCI) released a series of statements of benefit and harm for the above screening tests based on research. In the case of BSE, the NCI asserts that it does not reduce breast cancer mortality and formal instruction and encouragement to perform leads to more breast biopsies and to the diagnosis of more benign breast lesions. In the case of CBE, screening reduces breast cancer mortality. For Mammography performed in women aged 40 to 70 years, breast cancer mortality decreases. The benefit is higher for older women, in part because their breast cancer risk is higher. With the Pap test, regular screening of appropriate women reduces mortality from cervical cancer. In any screening examination, false-positives result in further testing which can carry inherent risks and false negatives may provide false reassurances resulting in a delay in cancer diagnosis. A study conducted at the University of San Francisco reviewed cancer screening of these conditions among jail inmates. The study reviewed the sociodemographic profile of incarcerated persons and suggested they might be at higher risk for the development of certain cancers and for poor outcomes from those cancers. One item the study sought to examine was whether these inmates had received age-appropriate screening. Findings revealed no significant difference in cervical cancer screening between these inmates and other non-incarcerated individuals, however, the women who reported having a Pap test while in jail or prison were significantly more likely to be up to date on cervical cancer screening than women who had never had a Pap test while incarcerated. This suggests that correctional systems may be a principal provider of this preventive test for many female inmates. The researchers report that study results in regards to breast cancer screening was limited by a small number of women in older age groups. Their limited findings suggest, however, that women in the study group were less likely to be up to date on mammography than California women. They also reported that knowledge about breast cancer screening could be improved as most women eligible for screening identified breast examinations rather than mammography as a mean of screening, despite the fact that the CBE and BSE are of less certain benefit than mammography. There is no national registry for tracking disease prevalence and risk factors among incarcerated persons and they are excluded from national health surveys. The results of the cited study were from data obtained by self-report, which are likely to overestimate frequency. A cancer screening registry or statewide computerized medical records in jails would give more significance to this data and may show or confirm that the jail may be an appropriate setting for this type of cancer screening.

Links
Healthcare Online Education Consultant
Forensic Nursing Online College Professor Teacher Instructor Available
Forensic Nursing Online Tutor
Nursing Nurse Online Tutor
Forensic Lawyer Attorney

Save Up to 75% off your prescription medications with this Free National Rx Prescription Card. A medication discount is available for almost everyone, regardless of insurance or no insurance coverage.

Click on this prescription discount card for immediate activation or more information.

For Helpful Links and more information, click here

Managing the Incidence of Syphilis

March 12, 2013

The U.S. syphilis rate increased for the seventh consecutive year in 2007 according to the CDC. This is a concerning finding given the potentially serious consequences of the disease if it goes untreated. Effective screening is essential and is a big focus for the CDC as well as many advocacy groups for at risk individuals. The disease is mostly spread through sexual contact, but can also be passed from the mother to child in utero. This can have devastating effects including stillbirth, death shortly after birth or death after a period of illness in infancy. In the adult, the disease can go undetected for many years if the lesions in the primary and secondary stages go unrecognized. They can then be in a latent stage for many years before progressing to the late stage where the disease can cause serious and extensive damage to the body. Syphilis has also been called “the great imitator” since it’s symptoms often resemble those of other diseases. Since the disease is highly treatable in the early stages, screening efforts have the potential for significantly decreasing these divesting occurrences. By treating the infected individual you have high probability of cure thus reducing the effects in the individual as well as preventing spread of the disease to others. Widening screening efforts can facilitate earlier identification of the disease. This is important since the secondary stage of the disease is the most contagious when the infectious lesions are more numerous on the body. The CDC put together a report in 2003 with recommendations for surveillance of the disease in an effort to advance a national plan to eliminate syphilis from the United States. In this report is a list of “priority populations” for routine screening efforts. This list includes arrestees, pregnant women, STD clinic patients and patients diagnosed with STDs in other settings, clients at drug treatment facilities, HIV counseling and testing clients, clients in certain specialty clinics (i.e., HIV, family planning, community based), homeless populations and emergency room patients. The next step in facilitating effective control measures is reporting. With adequate reporting epidemic patterns can be assessed and adequate treatment can be assumed to prevent sequelae of infection. It can also be used to identify cases in a timely fashion in order to interrupt the chain of infection by management of sexual contacts and behavioral risk reduction counseling.

Links
Healthcare Online Education Consultant
Forensic Nursing Online College Professor Teacher Instructor Available
Forensic Nursing Online Tutor
Nursing Nurse Online Tutor
Forensic Lawyer Attorney

Save Up to 75% off your prescription medications with this Free National Rx Prescription Card. A medication discount is available for almost everyone, regardless of insurance or no insurance coverage.

Click on this prescription discount card for immediate activation or more information.

For Helpful Links and more information, click here

Elder Abuse

February 27, 2013

Elder abuse is an umbrella term referring to any knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to an older adult. Elder abuse includes physical abuse, neglect, sexual abuse, emotional or psychological abuse, financial or material exploitation or abandonment. Elder abuse can happen within the family. It can also happen in settings such as hospitals or nursing homes or in the community. Elder abuse is a serious problem in this country, affecting as many as 2 million elderly persons. Elder abuse occurs among all racial, ethnic and economic groups. Healthy, as well as frail, aging adults may be victimized. Although elderly men may be victims, the profile of the older adult at greatest risk for abuse is a disabled woman, older than 75 years of age, who is physically, socially or financially dependent on others. Perpetrators may be acquaintances, sons, daughters, grandchildren or others. Most often, physical and emotional abuse stems from stressful caregiving situations. Abuse is also associated with a family history of violence, alcohol or substance problems and emotional or cognitive dysfunction of the abused and/or perpetrator. All elderly patients should be screened for abuse in privacy. An abuser may be reluctant to leave the patient’s side or become angry, overprotective or defensive. Questions about abuse are less threatening when asked, matter-of-factly, in the context of a social history. To ease into a more in-depth screening for abuse, you might say, “Just to make sure you’re okay, we ask all patients questions related to their safety.” A full inspection of the elder’s body should be performed. After assessing and screening the patient, the elder’s response, as well as any suspicious assessment findings should be documented in detail. Being alert for patterns of abuse, as well as paying attention to the patient and caregiver’s interactions, are essential when caring for elderly patients. Additionally, reporting suspected elder abuse is the law in all 50 states. Healthcare providers must know the system for reporting suspected abuse in their state. Although elder abuse occurs to a lesser extent in healthcare facilities, maltreatment in institutions also needs to be policed and violators reported. Dunlap, MAEd, RN, M. (2008). Assessment of elderly abuse. Grown Up, volume 13 (3).

Links
Healthcare Online Education Consultant
Forensic Nursing Online College Professor Teacher Instructor Available
Forensic Nursing Online Tutor
Nursing Nurse Online Tutor
Elder Abuse Neglect Lawyer Attorney

Save Up to 75% off your prescription medications with this Free National Rx Prescription Card. A medication discount is available for almost everyone, regardless of insurance or no insurance coverage.

Click on this prescription discount card for immediate activation or more information.

For Helpful Links and more information, click here

Diabetes and Police Force Article

February 19, 2013

Recently it has come to the attention of the police force and diabetic specialists that greater attention is needed in the area of caring for diabetic patients who are being held in police custody. There have incidences where a detainee has suffered the affects of a diabetic attack while the condition went unnoticed or misinterpreted by the law officers. It is easy to mistake the symptoms of a hypo or hyperglycemic state as the side effects of drug or alcohol use. For the safety of both parties (derangement and violence are not uncommon in metabolic crisis and death can even occur in the patient) some police forces have decided to take the precaution of providing diabetic training and medical supplies for their stations. (Management of Diabetes in Police Custody: a liaison initiative between diabetic specialist service and the police force. Wright, et al. Practical Diabetes International, March 2008, vol. 25.)

Links
Healthcare Online Education Consultant
Forensic Nursing Online College Professor Teacher Instructor Available
Forensic Nursing Online Tutor
Nursing Nurse Online Tutor

For Helpful Links and more information, click here


%d bloggers like this: