Data Collection Plan Essay Example for Free

Data Collection Plan Essay Abstract Postoperative Pulmonary complications (PPC) such as atelectasis, impaired gas exchange, pneumonia and acute respiratory failure (ARF) are not uncommon in patients undergoing major surgery and are a leading cause of increased patient morbidity, mortality and increased length of hospital stay (Yoder, Sharma, Hollingsworth, Talavera, Rice, 2013). Healthcare professionals are now expected to give patients verifiably effective treatments by implementing current evidence based practice (EBP). In order to do so, interventions to prevent PPCs must be investigated. The aim of this study was to evaluate the effectiveness of adding incentive spirometry (IS) to traditional postoperative chest physiotherapy (CPT) and respiratory care. Eighty patients between 30 and 50 year old who had undergone surgery participated in the study. Patients were divided into two groups: the intervention group where IS was used in addition to the traditional CPT, and the control group which included only traditional CPT. The results obtained in the investigation indicated that there were significant differences between both groups at the end of the study in terms of PPCs and hospital length of stay (LOS). Conclusion: Addition of IS to postoperative care helped in controlling PPCs. Keywords: postoperative pulmonary complication, incentive spirometer, chest physiotherapy, length of Stay Research Question In postsurgical patients, how does using incentive spirometer, compared to not using incentive spirometer, affect incidence of PPCs and hospital LOS? Hypothesis Because the risk for developing PPCs is not well studied specific numbers of occurrences are difficult to predict. However, it was hypothesized that patients who incorporated IS as part of their postoperative care would have a clinically significant decrease in the occurrence of PPCs and hospital LOS compared to those who did not incorporate IS into their postoperative care. Data Collection A quasi-experimental control trial was conducted from February 1, 2014 to May 31, 2014. The lead researcher, Adrienne Hinson, collected the data personally. During the four month study, eighty patients ranging in age from 30 to 50 years old who were undergoing surgery where the abdomen or chest was opened were selected randomly from the General Surgery Department at McLeod Regional Medical Center in Florence, SC. On sampling days, patients meeting the criteria were numbered chronologically based on their surgery time. For eighty consecutive business days, one of the patients was chosen randomly using a random numbers table created on Microsoft Excel. Patients who had recently been diagnosed with or treated for acute pulmonary complications, those who could not be instructed or supervised to assure appropriate use of the IS, and patients whose cooperation or comprehension was lacking were excluded from the study. All appropriate procedures were used to safeguard the rights of study participants. The study was externally reviewed by the hospital’s institutional review board before data collection began. Patients received verbal and written explanations of the study purpose and data collection procedures and after indicating willingness to participate in the study, voluntary informed consent was obtained (See Appendix A). Information included within the informed consent included participant status; participants were told which postoperative activities were routine, and which activities were being evaluated. Participants were informed that the data collected about them would be used for research purposes. The overall goals of the research, to evaluate to addition of IS to postoperative care, was described to patients. Participants were informed about which types of data would be collected, what procedures they would undergo, and how they were selected. The time frame of the commitment was defined as beginning on post-op day one and lasting until their follow up  visit after discharge. Information regarding funding was available to participants. All participants were educated on potential risks and benefits of participation. Finally, patients were assured that their privacy would be protected at all times and that they would be allowed to withdraw from the study at any point during their hospital stay (Polit Beck, 2012). The patients were deliberately placed into one of two experimental groups. Deliberate placement reduces confounding by ensuring the two groups were comparable when age, sex, smoking history, type of surgery and post-operative analgesia were compared. The control group consisted of 40 patients who underwent routine chest physiotherapy (CPT) postoperatively, as recommended by the Clinical Practice Guidelines set forth by The Agency for Healthcare Research Quality (2011). A physiotherapist supervised and assisted the treatment twice a day in the first two postoperative days and once a day from the third to the tenth days. During any session, the patients performed three to five deep breaths interspersed with periods of quiet breathing followed by two or three coughs or huffs with support from a pillow at least 10 times over a 15 minutes period. Additional techniques such as positioning and chest wall percussion were applied if breathing and coughing exercises alone were not effective in clearing excessive or retained pulmonary secretions. Patients were instructed to perform coughing and deep breathing exercises independently every hour while awake. The treatment group consisted of the remaining 40 patients who also followed the same Clinical Practice Guidelines but also received breathing exercise training with IS (Voldyne Volumetric manufactured by Sherwood Medical Company U.S.A.) In addition to the routine chest physiotherapy up to the tenth postoperative day. Application of breathing training with incentive spirometry was applied for five minutes, five times a day (El-Marakby et al., 2013). Monitoring began immediately postoperatively and continued until discharge. Hospital LOS was documented for each patient, along with whether or not the patient developed a PPC within 10 days of surgery. The researcher rounded on each hospitalized patient daily to ensure compliance and to update discharges and PPC diagnoses. In order to determine LOS, participant observation was used as a tool to collect data. LOS was calculated by subtracting day of admission from day of discharge. Date of admission was the date of surgery for all participants. Date of discharge was determined  by the surgical teams, who were blinded to the study and therefore measures are not likely to be influenced by reactivity (Polit Beck, 2012). PPCs were defined as any pulmonary abnormality that produced identifiable disease or dysfunction, was clinically significant, and adversely affected the postoperative clinical course (Hayden, Mayer, Stoller, 1995). Patients were monitored daily for 10 days for the diagnosis of a PPC. Given this definition, PPCs documented included atelectasis, pneumonia, acute respiratory failure, and exacerbation of COPD. Along with physical assessment and past history, biophysiological measures were used as data collection tools to aid in the diagnosis of PPCs (See Appendix C). Equipment and lab analysis were readily available and tests for biophysiological measures were completed by the appropriate staff at McLeod Regional Medical Center. Ordering tests and the interpretation of results was fulfilled solely by the healthcare providers as deemed necessary. The researchers were not responsible for diagnosing PPCs, but rather the observation and recording of data. Biophysiological measures for diagnosing acute respiratory failure include a low level of oxygen; a pulse oximetry falling below 80% saturation on room air or when arterial blood gas shows PaO2.

Should Trade Sanctions Be Stopped Essays -- essays research papers fc

  Ã‚  Ã‚  Ã‚  Ã‚   SHOULD ALL TRADE SANCTIONS BE STOPPED? To most of the world, sanctions are a mixed blessing. On the one hand, they reinforce trade rules and promote respect for them. On the other hand, they tend to undermine the principles of free trade and provoke a kind of ‘trade envy’(Charnovitz) in other international organizations.   Ã‚  Ã‚  Ã‚  Ã‚  Trade retaliation goes back quite a ways; we see examples of it in much of US law: -Antidumping Act of 1916, which has seen little use.(Charnovitz) -International Labor Organization, from the Treaty of Versailles 1919, which served as an international dispute system, but no economic measures were ever recommended until 2000, against Burma.(Charnovitz) -UN Security Council, which handles breaches of peace, only used sanctions 3 times between 1920-1990, but now uses them much more frequently.(Charnovitz)   Ã‚  Ã‚  Ã‚  Ã‚  To understand the difficulty I have agreeing with the suggestion that all trade sanctions must be stopped, I feel it is important to discuss some of the good, the bad, and the ugly involved with imposing sanctions. I’ll start my discussion with some of the good that comes from restricting trade, move into some of the negative affects, and summarize with improvements I feel could be made to this defunct system.   Ã‚  Ã‚  Ã‚  Ã‚  The first advantage that comes to mind about imposing trade sanctions would have to be the ability of the sanctioning government to let everyone know how pissed they are, make their own people relatively happy, and then move on. Although this may only be temporary.(Charnovitz)   Ã‚  Ã‚  Ã‚  Ã‚  Individual countries, especially major world powers, like to impose trade sanctions even when the probability of forcing a change in the target country’s policy is small. In addition to indicating a resolution and suggesting their disapproval to the direct wrong doer and to other countries, politicians may also want to pose for their own people.(Library of Economics) If you look at the example of the US, European, and British sanctions against South Africa as well as US, European, and Japanese sanctions against China in the wake of the Tiananmen Square massacre, you can see that these were specifically designed to put their own citizens at ease, to make a moral and historical statement, and to send a warning to f... ...t be a common ground. There are different circumstances for every case brought forth, some where sanctions seem to be the only course of action, and some where they seem to be the worst course of action. We need to learn how to take this effective bargaining tool, and use it to better our global trading community.   Ã‚  Ã‚  Ã‚  Ã‚   BIBLIOGRAPHY Chanovitz, Steve Rethinking WTO Trade Sanctions Social Science Research Network http://papers.ssrn.com/sol3/papers.cfm?abstract_id=256952 Elliott, Kimberly Evidence on the Costs and Benefits of Economic Sanctions Institute for International Economics http://www.iie.com/publications/papers/elliott1097.htm Library of Economics Lookup = Sanctions http://www.econlib.org/library/Enc/Sanctions.html Schooland, Ken International Trade and Finance HPU Economics 3400, Lecture/Video on Panama. Weiss, Stanley A. Trade Sanctions are a Misused Tool International Herald Tribune Saturday, June 26, 1999 Yang, Jaiwan; Teegan, Hildy Both are Associate Professors for the Department of International Business at George Washington University US Economic Sanctions and Globalization: Economic Impact and Policy Implications http://www.gwu.edu

Compare the use of motivation theories at Center Parcs Essay

I will be researching different job types in Center Parks so I can see the different management styles of each sector and I shall be looking at the motivational factors within the organisation. Three different job roles at Center Parcs and what theorist is involved. The first job I will be looking at is a Water sports Instructor, they’re looking for somebody who can windsurf, use a dinghy, a powerboat, a kayak and is confident in abseiling, rock climbing and playing football. You will be asked to instruct people in all of the above, first-aid is a must as you will be working with activities which could all pose a significant risk to health including activities including deep, cold water. They also expect that you maintain a professional attitude at all times, despite the customers getting on your nerves. Staff will be given free day passes to the park, I think this is typical of Mayo as people like to feel like the part of the team, this also meets their social needs at work. If they’re working in a team then you have a good chance to get your ideas across to other team members for them to take action on your ideas, suggestions and opinions. The second job I will be looking at is a food and beverage assistant, they require that you maintain a professional attitude at all times, they state that your duties are table services, preparing the restaurant to a set standard, taking orders, bar duties and you must serve drinks from the bar, serving meals, cleaning and tidying up at the end of your shift. You will be handling a lot of cash through your shifts, they expect you to be honest about it and full training will be given to work with cash in hand. You must ensure that all the guests are happy with their stay and their meals. The theorist behind this would in fact be Taylor, this is driven by money as you’re handling quite a lot of money. As with this you’re typically paid by every table you clean, take orders from and hours behind the bar (as one of my friends mention, she got paid by every table she cleaned and took orders from). Taylor also comes into play as you get a bonus at the end of the month and a t ypical bonus at the end of the year (around Christmas time) and  this makes employees strive to do as much as they can as it is a performance related bonus. The last job I will be looking at is a Lifeguard, they’re looking for somebody to assist in the â€Å"smooth running of the subtropical swimming paradise† by guarding the inside and outside of the pool areas, the lifeguard must maintain a high standard of hygiene in order to offer the best services to holiday guests. They also request that you maintain a professional and a reliable attitude at all times and to put the safety of their swimmers first. The motivational theory behind this job would be Herzberg as being a lifeguard can bring some sense of achievement, this proves that you are qualified to take care of people, watch them and possibly save their lives when the time comes. A high hygiene standard is required for this and this can be an achievement in itself as if you get through this shows you have nearly impeccable hygiene. Conclusion I think Center Parcs has chosen different rewards, for example different bonuses and different objectives to obtain these bonuses and different material bonuses such as free day passes and unlimited use of services and stations around the park, because it scales with the difficulty of the job. For example, anybody can be a beverage assistant but it takes a lot of qualifications and knowhow to become a life guard and since lifeguards are scarce and they’re offering really competitive pay and bonuses to compete with other companies that want life guards. It’s the same with Water sports instructors as they have to be highly skilled in all forms of water sports, it takes a lot of time to get that much knowledge of water sports so it’s a difficult job to do as you need to remember everything. I agree that this is one of the best policies to have as the bonuses and rewards scale with the harder jobs. The harder the job, the better the rewards.

The Great Gatsby By F. Scott Fitzgerald Essay - 1546 Words

Consumption and materialism were both taken to new and extreme heights on the eastern coast of America in the Roaring Twenties. Consumption, and especially materialism were always hallmarks of the elite upper class aristocracy of any culture in any time period, but with the new technology, urbanization, the consolidation of funds via the world stock market, and a brand new breed of elite, called millionaires, evolved the upper class culture beyond anything any human had seen before. In The Great Gatsby, F. Scott Fitzgerald imbues a story with many themes and qualities from his own life, reflected in the parallels between his own history and that of Gatsby and Nick Carraway. With new, unbridled, booming economic growth, what started as the Great American Dream became a vulgar, empty, greedy pursuit of material goods. On top of this rise in national wealth, the addition of disillusioned World War I veterans looking to grab the American Dream and use it to hoist themselves up in the wor ld, and the 18th Amendment’s creation of a thriving and powerful organized criminal underworld gave birth to a new America, with unprecedented levels of consumption and wealth. East and West Egg is aptly named, as they symbolize the old aristocracy and the new, fresh millionaires which are two sides of the same solid gold coin- the absurdly wealthy. The difference between the two is based in the social ties and moral values held by the old aristocracy that contrast the materialismShow MoreRelatedThe Great Gatsby by F. Scott Fitzgerald1393 Words   |  6 PagesF. Scott Fitzgerald was the model of the American image in the nineteen twenties. He had wealth, fame, a beautiful wife, and an adorable daughter; all seemed perfect. Beneath the gilded faà §ade, however, was an author who struggled with domestic and physical difficulties that plagued his personal life and career throughout its short span. This author helped to launch the theme that is so prevalent in his work; the hu man instinct to yearn for more, into the forefront of American literature, where itRead MoreThe Great Gatsby By F. Scott Fitzgerald1343 Words   |  6 PagesHonors English 10 Shugart 18 Decemeber 2014 The Great Gatsby F. Scott Fitzgerald s 1925 novel The Great Gatsby is a tragic love story, a mystery, and a social commentary on American life. The Great Gatsby is about the lives of four wealthy characters observed by the narrator, Nick Carroway. Throughout the novel a mysterious man named Jay Gatsby throws immaculate parties every Saturday night in hope to impress his lost lover, Daisy Buchanan. Gatsby lives in a mansion on West Egg across from DaisyRead MoreThe Great Gatsby By F. 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Scott Fitzgerald1607 Words   |  7 Pages The Great Gatsby is an American novel written in 1925 by F. Scott Fitzgerald. One of the themes of the book is the American Dream. The American Dream is an idea in which Americans believe through hard work they can achieve success and prosperity in the free world. In F. Scott Fitzgerald s novel, The Great Gatsby, the American Dream leads to popularity, extreme jealousy and false happiness. Jay Gatsby’s recent fortune and wealthiness helped him earn a high social position and become one of the mostRead MoreThe Great Gatsby By F. Scott Fitzgerald1592 Words   |  7 PagesMcGowan English 11A, Period 4 9 January 2014 The Great Gatsby Individuals who approach life with an optimistic mindset generally have their goals established as their main priority. Driven by ambition, they are determined to fulfill their desires; without reluctance. These strong-minded individuals refuse to be influenced by negative reinforcements, and rely on hope in order to achieve their dreams. As a man of persistence, the wealthy Jay Gatsby continuously strives to reclaim the love of hisRead MoreThe Great Gatsby By F. Scott Fitzgerald1646 Words   |  7 PagesThe 1920s witnessed the death of the American Dream, a message immortalized in F. Scott Fitzgerald’s The Great Gatsby. Initially, the American Dream represented the outcome of American ideals, that everyone has the freedom and opportunity to achieve their dreams provided they perform honest hard work. During the 1920s, the United States experienced massive economic prosperity making the American Dream seem alive and strong. However, in Fitzgerald’s eyes, the new Am erican culture build around that