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article cited essay NOTE: Although you should use these citation formats in this and other biology courses, specific formats vary considerably for individual journals. If you are trying to publish a paper in a specific journal, you will be required to follow the format of that journal. Some journals,e.g., Science , use a number system to tunnel give the text reference. That system will not be presented here, but you should expect to genre essay man encounter it in your reading of the literature. A complete listing of citation formats for diode published materials may be found in Huth et al (1994). Citing References in the Body (Intro and Discussion) of the Paper. Throughout the body of your paper (primarily the Intro and Discussion), whenever you refer to outside sources of information, you must cite the easy sources from diode, which you drew information. The simplest way to do this is to parenthetically give the author's last name and the year of publication, e.g., (Clarke 2001). When citing information from another's publication, be sure to asthma paper report the relevant aspects of the work clearly and succinctly, IN YOUR OWN WORDS. Provide a reference to the work as soon as possible after giving the information.
Standard Text Citation Formats. There are exceptions among the various journals, but generally, in biological journals, the most frequent types of citations are shown in the following examples (in red): It has been found that male mice react to tunnel thesis estrogen treatment by a reduction in phase three of courtship behavior (Gumwad 1952:209; Bugjuice 1970) . Eric. Click and Clack (1974) demonstrated that mice treated with synthetic estrogen analogs react similarly. The reduction in phase three courtship behavior may also be linked to diode thesis nutritional status (Anon. 1996; Bruhahauser et al 1973) . Essay On Nature Destruction. Note the following: Typically, only the last name of the author(s) and the year of publication are given,e.g., Bugjuice 1970 . Diode Thesis. Your Literature Cited section will contain the complete reference, and the reader can look it up there. Notice that the reference to the book has a page number (Gumwad 1952: 209 ) . Position Essay. This is to facilitate a reader's finding the diode reference in a long publication such as a book (not done for journal articles).
The paper by Bugjuice (1970) is short, and if readers want to find the referenced information, they would not have as much trouble. For two author papers , give both authors' last names (e.g., Click and Clack 1974 ). Articles with more than two authors are cited by the first authors last name followed and others or et al., and then the year. When a book, paper, or article has no identifiable author , cite it as Anon. Year, e.g., (Anon. 1996) (Anon. is the abbreviation for anonymous). See Full Citation. If you want reference a paper found in easy essay, another article , do so as follows: ( Driblick 1923, in tunnel, Oobleck 1978 ). A string of citations should be separated by semicolons, e.g., (Gumwad 1952:209; Bugjuice 1970; Bruhahauser et al 1973) . Finally, you should note the placement of the cells research period AFTER the parenthetical citation - the citation, too, is part of a sentence,e.g., . courtship behavior (Gumwad 1952:209; Bugjuice 1970) . Thesis: Theses and tunnel dissertatons should be cited as follows: Mortimer, R. 1975. A study of hormonal regulation of body temperature and consequences for reproductive success in the common house mouse ( Mus musculus ) in Nome, Alaska. Masters Thesis, University of Alaska, Anchorage. 83 p. World Wide Web/Internet source citations : WWW citation should be done with caution since so much is posted without peer review.
When necessary, report the complete URL in the text including the site author's name: Ohio State University Library has a good webpage for citing web sources: Internet sources should be included in your Literature Cited section. For unusual reference citations such a government documents, technical reports, etc, refer to Huth et al (1994) for a complete listing of citation formats. A copy of this reference should be available in genre essay man, the Ladd Library and a copy is available in diode thesis, the Biology Department. Suppose some of the information cited above was not gained from the Gumwad and Bugjuice publications, but rather in a personal conversation with or letter from an eric, expert on the subject, Dr. Cynthia Mousse. Diode. When you have talked with, or written to someone, and gained some information or data that are not published, you should give credit to cells research that person in the following way: It has been found that male mice . phase three of courtship behavior (C. Tunnel Diode. Mousse, pers. comm.). No date is entered for a personal communication, nor will it be entered in your Literature Cited section. Asthma Paper. However, the source is usually thanked in your Acknowledgments for their contribution.
DO NOT USE FOOTNOTES : Footnoting, although commonly done in diode thesis, books and other literary writing, is world environment day 2011 only rarely done in diode, journal style papers. Cite references in the flow of the text as shown above. DO NOT USE DIRECT QUOTES From Published Material : In 99.99% of the cases, the information you want from a research article is an objective result or interpretation. How the author stated this information, i.e., their prose , is of little importance compared to the results or interpretations themselves. Take the information and put it into your own words ; avoid paraphrasing since this can potentially lead to research paper plagiarism. Formats for tunnel thesis Complete Citations used in the Literature Cited.
In the Literature Cited you must provide complete citations for each of the genre essay man published sources cited in diode thesis, your paper. The format for entries in the Literature Cited section differs for books and for journal papers because different kinds of information must be provided. The formats provided here are typical, but may vary in different publications depending on their particular needs and practices. Some basic rules applicable to all formats indexed by author name(s) : All citation entries are listed in alphabetical order based the first author's last name ; If the same author(s) are cited for more than one paper having the same order of authors' names , the papers should be listed in topics, chronological sequence by year of publication. Authors' names MUST be listed in diode, the citation in world environment essays, the same order as in the article. Bugjuice, B., Timm, T. and R. Cratchet. 1990.
The role of estrogen in mouse. xxxx courtship behavior changes as mice age. J Physiol 62(6):1130-1142. Cratchet, R., Bugjuice, B.and T. Tunnel. Timm. 1994. Estrogen, schmestrogen!: Mouse. xxxx ( Mus musculus ) as a dietary alternative for humans. J Nutrition 33(6):113 -114. If the same author(s) are cited for two or more papers published within the same year, place a small case letter after the year to eric man s denote the sequence in which you referred to them. For example: Bugjuice, B. 1970a . Physiological effects of tunnel diode thesis estrogen on mouse courtship behavior. . x. J Physiol 40(2):140-145. Bugjuice, B. 1970b . Physiological effects of biology paper estrogen analogs: Insincere courtship. Diode. xxxx behavior in female mice. J Physiol 40(8):1240-1247. Eric. If no author is listed, use the word Anonymous in place of the author name(s).
Anonymous. 1992. . give rest of citation using appropriate format. Specific Format Models. Tunnel. Each model is shown as the full citation plus the in-text citation format. Journal Article: Single author. Bugjuice (1970) OR. In the citation of eric man s resume Bugjuice's paper, note the tunnel diode following:
abbreviation of her first name; no comma (if full name is given, then use a comma); if multiple authors, use commas between; capitalization of the paper words in the title is just as though it were a sentence; abbreviation of the journal name ; usually the header on thesis, the article will list the appropriate abbreviation for the journal; no periods in man s, abbreviated form of tunnel diode journal name; 40 is the volume number (2) is the number of the issue ; if no issue is given, the colon follows the volume number; 140-145 is the inclusive page numbers of the article; placement of periods is biology research paper standard; indentation of the second line (and all subsequent lines) in the citation. This applies to tunnel diode thesis all citations. Journal: Two authors. Timm and Bugjuice (1989) OR. (Timm and Bugjuice 1989) Journal: Multiple authors. Bugjuice et al . Biology Research Paper. (1990) OR. Bugjuice and others (1990) OR. (Bugjuice and others 1990) Author(s) Unknown or Not Named. If the authorship of a paper or other document is not provided, cite the author using the word Anonymous in the place of the authors name(s).
Anonymous (1979) OR. Book: single author. Gumwad (1952:224) OR (Gumwad 1952:224) Book: multiple authors. Huth et al. (1994:625) OR. Huth and others (1994:625) OR (Huth and others 1994:625) Book: authors contributing a specific chapter. Kuret and Murad (1990:1334-60) OR. (Kuret and Murad 1990:1334-60) In the books citation, note the following:
abbreviation of thesis authors first name (one or both initials ok); capitalize title as if it was a sentence; the title is not underlined (contrary to literary format) 2nd ed. means second edition; if the asthma book is thesis a first edition; no entry is made, here, but if 2nd, 3rd, etc., then the notation is made; give city of publication, and the name of the publisher; year of publication follows authors' names; placement of world environment day 2011 essays periods is standard; indentation of all lines after the first. Department of Biology, Bates College, Lewiston, ME 04240.
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How to Write an Exceptional New-Grad Nursing Resume. Writing a new-grad nursing resume is diode a daunting task for most new-grads. The fear of resume having no experience and tunnel being unqualified leaves many wondering what details to include. Moreover, many new-grads wonder how to structure their nursing resume in essay on nature a way that best conveys their current skill-set and value to prospective employers. As former recruiters, we reviewed thousands of new-grad resumes. In this blog post, we’ll draw on that experience to provide a comprehensive guide to creating an tunnel amazing nursing resume for new-grads. How to Structure Your New-Grad Nursing Resume. How you structure your resume has an impact on its effectiveness.
Let’s first consider which headings to include on genre essay man, your resume. There are certain headings that every new-grad should include and diode other headings that will depend on easy topics, whether or not you have any applicable details to thesis include under those headings. Headings that every new-grad nursing resume should include (Required) Every new-grad resume should include the research paper, following headings (we’ll discuss why we recommend these headings and provide tips for each below): Summary Licenses and Certifications Education Clinical Rotations. Optional headings for your new-grad nursing resume. Each of the following headings should be considered and included based on diode thesis, whether or not you have relevant details to world include: Work History Affiliations Volunteer Activities Honors and tunnel Awards Skills Summary Languages.
Now let’s take a look at the ordering of the headings. Easy Position Essay! Of course, your contact information should be at the top of your resume. Thesis! As usual, you should place the Summary as first heading on your resume. Next, include your Licenses and Certifications if you have already obtained them. However, if you have not already obtained them, then you may want to push this heading farther down the list under your Clinical Rotations. Next, include your Education followed by your Clinical Rotations. You will undoubtedly find many who recommend that you place your Work History first. Moreover, placing Work History before Education is the conventional standard.
As a result, it’s difficult for some to trust advice that recommends placing Education first. Asthma Paper! So, here’s our supporting argument… As a new-grad, you may not even have work experience. If you do, it’s most likely that you don’t have applicable work experience and even if you do have applicable experience, it’s most certainly not Registered Nursing work experience. You can’t obtain RN work experience without an RN license and diode thesis you can’t get an RN license without first graduating from an accredited nursing program and resume passing the tunnel diode thesis, NCLEX. Moreover, your new-grad nursing resume should quickly convey that you are a new-grad. There is genre essay man no point in trying to hide this fact. If employers are considering new-grads for an open position, then recruiters and hiring managers are going to be receptive to your situation.
If they’re not considering new-grads for tunnel, the opening and are instead requiring experience for the position, then they’re not going to asthma research paper be receptive to your situation. Thesis! You’re not going to trick them by putting your CNA or EMT work experience ahead of your education. In fact, doing this could make your resume even less effective as reviewers receptive to new-grads may never even get to your new-grad status before passing on the resume. Perhaps more importantly, our recommendation is based on what was desired by the hiring managers we worked with. You will find corroboration for genre essay man, this recommendation from reputable sources all over tunnel diode, the internet. For example, the man s, sample new-grad resumes from California State University Chico and University of Texas San Antonio both have the headings listed in the order we recommend. Additionally, UC Davis Medical Center requires Education, Senior Preceptorship and Clinical Rotations on tunnel thesis, the resumes of all applicants to their nursing residency program. For further proof, let’s take a look at what a hiring manager had to say about new-grad resumes. As the Director of Workforce Development for Orange County Memorial Care University and a Board Member of the Association of California Nurse Leaders, Maria-Jean Caterinicchio, RN, MS said, “It (your resume) should state where you have done your clinicals and any certifications such as EKG and ACLS. You can also include any conferences you have attended beyond the classroom.” Your Clinical Rotations and eric resume Education are key components of tunnel diode your new-grad resume! That takes care of the 4 required headings.
The 6 optional headings can be ranked as you see fit. Remember, you should only include these headings if you have substantial details to convey. And you may want to rank them in order of strength as they relate to the job in question. For example, if you have experience working as a CNA in easy position essay topics a hospital setting, then your Work History should be given a higher ranking because it highly relates to the job you’re applying for. Specific Details to Include on Your New-grad Nursing Resume. You’ll undoubtedly come across many people who recommend that new-grads use an Objective instead of a Summary on their resumes. The argument is that you really have nothing to summarize as a new-grad. However, we think that Objectives are an tunnel diode thesis outdated resume heading that do nothing to advance your main objective of conveying why you’re the right person for the job. Moreover, you can include an objective within a summary if you’re intent on having one. Here are three articles from major publications that support summaries over research paper, objectives: Now, you may have heard that recruiters spend 6 seconds reviewing your resume.
While we doubt that they really spend that little time reviewing each resume, we certainly believe that the tunnel thesis, time they spend is very limited. Therefore, your goal is to make sure your resume can be easily scanned, starting with your Summary. You do not want recruiters getting stuck on your Summary by writing a big paragraph. Instead, use bullet points and world environment day 2011 try to thesis keep each point at 1 to 2 lines . As for what to include in your Summary…It’s a good idea to state that you’re a new-grad. You might summarize your clinical rotations. Environment! You may point out any special skills that you have, like second languages or computer skills. And, as mentioned previously, you may include an objective. We recommend listing each license and certification with the following information: Full name of the license or certification.
Full name of the issuing body of the license or certification. Expiration date of the license or certification if applicable. License or certification number if applicable. If your license is part of the thesis, Nursing Licensure Compact, then it should be indicated. Many nurses express privacy concerns over including their license numbers. Man S Resume! Your nursing license number is made public through the state licensing board. It can easily be obtained using the basic information you provide on your resume. Adding it simply assists those recruiters and hiring managers who need to look it up for verification as a result of hospital/employer policy. Education for Your New-Grad Nursing Resume. You should display all of tunnel diode thesis your relevant college education. So if you attended 2 colleges to biology research paper attain your degree, then you should include them both.
Please do not include your high school education. We recommend including the following information for each pertinent education institution you attended: Full official name of the education institution. City and State Dates attended. Degree achieved. GPA if it was good. There are several other details in addition to these that you may want to include regarding your education. We’ve had many new-grads inform us that in their area, employers were interested in knowing their HESI or ATI scores. We recommend checking with your Nurse Educators or your school’s Career Guide to tunnel diode thesis see what they recommend.
You may also wish to include relevant coursework and corresponding grades if you got an genre essay man A. However, keep this brief and relevant to the job you’re applying for. Finally, you may wish to include any honors and thesis awards you achieved if you would rather not place these items under their own heading. Clinical Rotations on biology cells paper, Your New-Grad Nursing Resume. Clinical Rotations are an extremely important part of your new-grad nursing resume. Diode! As illustrated above, hiring managers indicate that they want to eric resume see these details. Major teaching universities require that they be included on resumes submitted for their residency programs. We consider them the tunnel diode thesis, crux of your new-grad resume. Biology Cells Research Paper! At a minimum, you should include the following: Details to include about tunnel diode thesis your clinical rotations.
Type of paper experience (Clinical Rotation, Senior Preceptorship, other). Start and end dates. Total number of tunnel hours worked. Day 2011! Name of the hospital or institution. Diode Thesis! City and State. Name of the unit/department (examples: Intensive Care Unit (ICU), Medical Surgical Unit (MS), Labor and Delivery Unit (LD)). One common mistake to avoid when listing the name of the unit is listing the hospital specific unit name.
For example, the hospital specific unit name might be 3-West, but nobody outside the hospital knows what that means. Instead, list the type of unit it was as designated by the type of patients the unit took. In addition to day 2011 the details above, we also recommend including the following information: Optional details to include about your clinical rotations. Facility type: Every facility has a technical designation. For example, most hospitals are “Acute Care Hospitals”.
Other designations include Long Term Care Facility, Long Term Acute Care Facility, Children’s Hospital, etc. Listing the facility type lets the tunnel thesis, reader know without a doubt what the setting was. Number of beds in the facility. List the eric resume, facility’s trauma designation if applicable. If the facility was a teaching hospital, then include that information.
Number of beds on the unit you were assigned to. Trauma designation of the unit you were assigned to tunnel thesis if applicable. Age range of the genre essay man, patients the unit cared for if applicable. Nurse to patient ratio on the unit. Thesis! Type of charting system used at the facility and name of any EMR/EHR you gained experience with. The grade you received if it was an A.
As you may have noticed, many of the details we recommend are technical details pertaining to the facility and unit. These details convey so much about the setting you were in resume and the experiences you were exposed to with very few words. Tunnel Diode! So including them provides the reader with a ton of useful information. Additionally, it demonstrates that you understand how import these details are to asthma research any healthcare organization, otherwise, you wouldn’t have listed them. Additional options for highlighting your clinical rotations. Finally, you may also wish to include specific details about the experience you gained while engaged with your clinical rotations. For example, did you have any experiences that might make you a more attractive candidate to the prospective employer? Did you learn anything specific about compassion for patients, team work, the importance of learning and tunnel diode thesis growth as a new-grad RN? If you did, then try to asthma offer the specifics to illustrate exactly what happened. You may also be able to relate your clinical rotation experience to tunnel specific goals or problems of the employer you’re applying to.
For example, maybe your research on the prospective employer turns up the fact that they’re seeking Magnet Status. If one of the facilities that you worked at during your rotations was seeking to achieve the same goal, then you may be able to find some way to relate your experience to paper it. Or, perhaps the diode thesis, prospective employer is asthma trying to improve their HCAHPS score and one of the facilities you worked at diode, just achieved success with a similar endeavor. Genre Essay Man! There are limitless possibilities with this option. The main idea is to try and relate your experience during clinical rotations to a real problem or goal faced by tunnel diode thesis, the prospective employer.
At this point, we’ve covered each of our recommended required headings. As you may have noticed, we’ve offered tons of genre essay man options. So many that if you were to incorporate them all, then your resume would either be too crowded or too many pages. However, many of the details we offer are simply for your consideration. Diode! It’s not required to include them all. So pick and choose the ones that work best for you by researching the job in question and determining which details will be of most value to the prospective employer. Optional Details for Your New-grad Nursing Resume. As indicated above, each of the genre essay man, following headings are optional for your new-grad resume.
You should decide whether or not to use them based on whether or not you have applicable details to provide for them. Let’s take a brief look at each of them. If you have work history, which most college students these days do, then you should probably include some reference to diode it on your resume. Try your best to convey how the experience relates to nursing. This will be a lot easier to do if the asthma, experience was healthcare related. If all else fails, offer concrete examples of how you excelled at time management, team work, compassion, service, collaboration, or communication. One important issue to consider regarding work history is stability.
Many college students work several jobs during their college career for diode, any number of asthma research paper reasons. Too many short term stints may exhibit instability to prospective employers who are about to devote a large amount of resources to you. So you may want to explain short-term work stints or leave them off of tunnel thesis your resume. You should definitely use the Affiliations heading if you are already a member of a professional organization related to nursing. For example, if you’re a member of the American Association of Critical Care Nurses, then prospective employers will want to know. You may also include relevant college organizations such as Sigma Theta Tau, or the Student Nurses Association. Of course, if the only organizations you belong to man s are scholastic, then you may choose to include them under your Education heading to save space. When listing your affiliations, consider including the following details: Full name of the diode thesis, organization. Date joined. Position Topics! Your designation within the organization.
Any special duties. Organization conferences attended. Including Volunteer Activities is a great way to tunnel demonstrate compassion. You may have volunteered for charity or at eric man s, a healthcare facility. Thesis! Consider including the following details: Full name of the resume, organization.
Dates of engagement. Quantify the tunnel diode thesis, number of hours volunteered. Genre Essay Man! Description of duties and results you achieved if applicable. Any awards or recognition you received. If you have received many honors and awards, then giving them a special place on your resume may be warranted. Tunnel Thesis! The other option is to mix them in throughout your resume where applicable. World Environment! Consider including the following details: Name or title of the award. Date received.
Organization received from. Significance of the award, or reason it was received. For most new-grads, a Skills Summary heading may not be warranted. Skills summaries are intended to convey proficiency with specific skills. As a new-grad, you most likely haven’t achieved proficiency with any aspect of nursing.
However, if you have experience in a healthcare setting, then you may indeed be proficient with relevant skills. For example, you may be certified in phlebotomy or Crisis Prevention. In any case, if you haven’t achieved proficiency, then you may be better served by tunnel thesis, listing skills as details under the heading that pertains to world environment where the skills were practiced. Additionally, you might consider utilizing a Skills Checklist during your job search. In case you’re not familiar, Skills Checklists are documents that allow healthcare professionals to self-assess their skills pertaining to a specific profession or specialty within a profession. They are commonly used by healthcare employers of all types to gauge their employees’ skill sets. BluePipes has over 100 comprehensive skills checklists that you can complete, save and download at tunnel, your convenience. You can print them out and take them to job interviews in order to easily convey your level of expertise with hundreds of skills. Again, as a new-grad, it’s not advised to asthma research utilize a checklist for thesis, a nursing specialty like Intensive Care Unit because you most likely won’t have the required expertise. However, if you have experience as a CNA, Phlebotomist, or LPN, then you could use one of those checklists as a way to essay destruction stand out from the crowd. These checklists are free to thesis use on environment day 2011 essays, BluePipes.
So, join today to take advantage! A recent study by Wanted Analytics found that “bilingual” was the thesis, second most common skill listed on nursing job postings in essay the United States. Tunnel Thesis! If you speak multiple languages, then it’s definitely recommended that you include them under their own special heading! What Hiring Managers and Job Postings are Looking for in New-Grad RNs. It’s important to remember that experience, temperament, talents, and convictions vary from environment, person to person. While all new-grads may share certain commonalities, they are all unique in their own ways. Tunnel! Similarly, it’s fine for new-grad resumes to genre essay man share certain commonalities, but each should be unique in it’s own way.
As you’ve seen, we have strong opinions on the structure of your resume and we provide many recommendations on tunnel diode thesis, various details to asthma paper include. However, we’re not writing the tunnel thesis, resume for you. In fact, we strongly recommend against the boiler-plate phrases that have become so common as a result of online resume builders. So, when it comes to the meat of your resume, let the words of hiring managers and genre essay man job postings guide your efforts. In other words, find ways to tunnel relate your unique experiences to what hiring managers and job postings are looking for. And always strive to position essay provide concrete examples as opposed to thesis generalizations. Assuming that you’re applying for a job through a job posting (as opposed to networking for genre essay man, a job), you should do your best to optimize your resume for the Applicant Tracking System (ATS).
We’ve covered how to do this in a previous blog post, so we won’t rehash it here. The bottom line is that you want to naturally include the key buzzwords and phrases used in the job posting in your resume. This way, you’re ranked higher by the ATS. Of course, you’re probably wondering what hiring managers are looking for! We’ve provided some examples above, but below are some direct quotes we found from tunnel diode thesis, interviews posted online. These quotes validate what our own experience as recruiters taught us. “Knowing that new nurses are very green in regards to their technical skills, we look to whether a nurse is really ready to step into genre essay man, the profession. We are looking for those who are really interested in making life better for people who are suffering.” Kimberly Horton, MSN, RN, FNP, DHA, Vice President and Chief Nursing Officer at tunnel diode thesis, Mercy Hospital and topics Mercy Southwest Hospital in Bakersfield, California. “We expect our new nurse graduates to diode thesis have the basic fundamental nursing knowledge and we are also looking for cells research paper, compassion, a sense of teamwork, accountability and communication. We look for diode, an attitude of collaboration and communication.” Maria-Jean Caterinicchio, RN, MS, Director of man s resume Workforce Development for Orange County Memorial Care University and Board Member of the Association of California Nurse Leaders (ACNL) Always side on tunnel, patient safety first.
Be open to man s resume feedback. Diode Thesis! Use your resources, such as more experienced nurses, physicians and other members of your team. Environment! This will also help you build a support system. Always ask questions when you are unsure or don’t know something. Discuss your feelings and/or concerns with your unit leadership. From the tunnel, first day on the job, be a team player. Greg Kingsley, RN, New Grad Nurse Recruiter, Emory Healthcare. With all of this in mind, it’s important to remember that there is no one correct way to create your resume. Genre Essay Man! We certainly hope this guide provides an idea of best practices as well as an tunnel diode thesis idea of what you shouldn’t do. Perhaps most importantly, it’s important to remember that your resume is just one facet of your job search. And while your resume is important, the single most important thing you can do to world day 2011 land that first job, or any job for that matter, is NETWORK!
Estimates indicate 70% to diode thesis 80% of all jobs are filled through networking. And it’s always best to operate with the “80-20 rule” in mind. In other words, make sure that you’re focusing on networking as your main job-search activity because it’s most often the determining factor in success. That’s why we created BluePipes in eric man s the first place…to give healthcare professionals a professional networking platform capable of providing unique career management tools designed to help them solve their unique career challenges. Tunnel Diode! Join today, it’s free and easy!
5 Things that New Grad RNs and Experienced RNs Should Know About the position, Job Market A New Grad RN recently shared their frustration with us. How to Write an Effective Nursing Resume Summary Writing an effective nursing resume summary is easier said than. 8 Things Every Nurse Ought to Know About Online Nursing Job Applications Applying online is the norm for nursing jobs. Diode! We provide. So my situation is a little different. I’ve been a Dental Assistant most of my life and decided to change careers. I have now achieved my RN. But it took me a lot longer than a traditional ADN program is world day 2011 supposed to take.
I had an “issue” at the first school I started the tunnel thesis, nursing program at and ended up needing to find another school to complete the program. Is this something I should include in world environment day 2011 my resume (as I see it as a negative thing) or how do I incorporate it to benefit my appearance? I don’t want to tunnel thesis leave out info that can hurt me but I’m wondering if the asthma research, info can hurt me if included. I agree with Kyle. List out thesis your clinicals. Add a targeted bullet point under each one that relates to the job you are applying for. Learn about ATS. Easy Position Essay! Read the job posting.
What words are on there most? What qualifications MUST you have? What qualifications do they PREFER? All the ones you have – write them down. Yes, use their words. Also read their mission and values. Tunnel! Look through their website. Encorporate their values with yours.
A great place to do this is in your cover letter. What do you recommend to someone like me whose 19 years old. Has no work experience, this is my first career.. my resume would be completely blank pretty much. I know you said don’t include high school education.. Asthma! buts that’s pretty much the only thing I’ve “accomplished” so far, I was an honor student, GPA 3.9, Received an award for tunnel diode, academic excellence all 4 years, advanced diploma. And currently my GPA is 3.5, I haven’t graduated yet but will in OCT, 2016 with my associates degree in nursing. I’m applying to asthma research a new graduate residency program now, that will start in tunnel diode February. Please HELP! #128577; how can I make my resume better? Thanks for the inquiry Glenda. Most of the position topics, applicants to new graduate residency programs have similar circumstances. To make your resume stand out, be sure to include the tunnel, details described above regarding your various experiences including clinical rotations and education.
You’re welcome to include your high school education. Genre Essay Man! However, chances are it will not be considered. Just remember that most candidates are going to tunnel diode thesis be in easy essay topics the same boat, so making sure you provide all the details hospitals like to see (as described above) will help you stand out. I hope this helps! Great article! Finally people are talking about tunnel diode thesis New Graduate Registered Nurses and the job search!! The Struggle is VERY real for new, old, reentry, and RN’s seeking a new specialty! Especially in biology oversaturated markets like California. I invite anybody who is seeking a job to join our Facebook Group RNInterview Tools. Tunnel Thesis! https://www.facebook.com/groups/PlayingTheGame/ All are invited to share what worked for them, post questions, and essay on nature destruction seek support from others who understand.
Members are landing job offers all over and we could not be more thrilled. I definitely shared this article and tunnel diode thesis have shared others from Blue Pipes in the past. Thank you for paper, assisting all of us Nurses in our quest. Glad to hear the article is useful and diode thesis thanks for sharing, Melissa! Help! I just graduated in May 2016 and got hired as an RN in a hospital. Unfortunately, I resigned after a month as I felt so overwhelmed in on nature destruction the unit I was assigned to. Should I include that one month experience in tunnel diode my resume?
Thanks for sharing, Aleli and sorry to easy topics hear about the difficulties. This is a tough situation. I believe most career consultants would recommend leaving the job off of tunnel diode your resume. This is because you’ll most certainly be required to explain the world environment day 2011, short duration in any interview. Moreover, the duration was so short that many employers wouldn’t even require an explanation for the gap in tunnel thesis employment. That said, you may want to research consider the instructions on job applications. Some hospitals have very stringent rules for entering work history on their applications.
For example, they might require every employer for the past 7 years to be entered on the application regardless of duration and also require applicants to diode provide an explanation of any gaps in employment of greater than 1 month. There will be a signing statement in the application indicating you attest the information is accurate and complete. If they find out you left the job off the application, it could result in a rescinded job offer. Although the chances of this happening are slim. I hope this information helps!
Nursing is paper my second career. I taught elementary school before this. Should I include my education for that? Also, should I include teaching school in tunnel my work history? I taught for eight years in the same school, so it’s a good example that I can hold a job long term. World Environment! Thanks! Congratulations on your new career, Priscilla. Previous work history and tunnel diode thesis education are both optional for your new-grad nursing resume.
In your case, I highly recommend including them both as they are both excellent experiences to display. However, be sure to keep them brief in order to highlight your nursing skills. I hope this helps! Hello, I was wondering how do I include my phlebotomy certification on my resume if it doesn’t have an genre essay man expiration date? If you are formatting your own resume, you can simply add the license without expiration dates.
However, I’m wondering if you’re using BluePipes to format your resume? Please let me know if so. Thanks! Hi i’m just wondering do you have an example resume with all the information you have listed here for preview? thank you! My apologies, but we don’t have a sample. We’ll work on tunnel diode thesis, creating though. Thanks!
How about information on building a new-grad RN Cover letter? When listing previous certifications and eric man s resume licenses, should you list the initial date of obtainment or expiration/ renewal date? Also, regarding Applicant Tracking System, what is the rule regarding parenthesis ()? I ask because in my certifications I have ACLS, PALS, and a bunch of other alphabet soup acronyms. Should I use (ACLS) after Advanced Cardiac Life Support? Good questions! There are no steadfast rules, but we recommend listing the thesis, expiration dates.
On our resume builder, licenses are listed with both the acronym and name. For example: ACLS – Advanced Cardiac Life Support. That said, most resume parsers are quite advanced these days, so they should be able to contextualize what is easy position essay topics meant by “(ACLS)”. Tunnel Thesis! However, as illustrated above, it’s not necessary to use the parentheses if you don’t want to. Destruction! I hope this helps! Help! I work in a long term care nursing facility as an RN for about a year and half now. This is my first nursing job and nursing is my second career. What can you suggest in writing my resume? Are my clinical rotations still relevant?
Thanks. There isn’t a steadfast rule that applies to tunnel diode your question. I think it’s fair to say that most recruiters and position essay nursing career advisers would say that your clinical rotations shouldn’t be added to your resume after a year and a half of working in an LYC facility. Tunnel Diode! That said, you might still list it in an effort to eric resume land a job in a new-grad training program.
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Free Downloadable Resume Templates. Free resume templates designed selected by RG professionals. Simply choose your favorite and get started. Just scroll down and find a Microsoft Word template that suits your work experience and sense of tunnel diode, design. Don’t worry – using a template is easy position topics, perfectly acceptable. If you don’t feel like designing your own resume, you can instead jump to diode our free and easy to use online resume builder. Save time and effort – it does all of the writing and formatting for you. Click the biology paper button below and get started! Resume Template Library 1: Resume Genius' Original Designs - Expert's Choice. The above basic resume library was designed by our resident resume experts and tunnel thesis have been battle tested by job seekers.
As this set performed the best, we included them in our resume builder software– and now we are offering them to you for free to download in Microsoft Word format. Each professional template comes in five colors. Explore these templates, download them, personalize them, and essay destruction start getting more interviews. Resume Template Library 2: Advanced Layouts. Professional Brick Red. Timeless Dark Blue. Elegant 2.0 Dark Blue. Modern Brick Red. Due to the popularity of thesis, our professional Microsoft Word templates, we decided to spend more time adding to our database after hearing from customers about what they’d like to see.
For these new designs, we’ve created five NEW layouts and updated three of our most popular selections from our resume builder software. Each resume has its own unique aesthetic — but don’t let that fool you. Each resume is on nature, thoroughly tested for clarity and readability, meaning that you could use ANY of these resumes and land more interviews. So have fun, and tunnel thesis pick one that suits your sense of design. But remember — the biology cells research way you format your resume is extremely important depending on how much experience you have, or if you have any job gaps. So be sure to modify downloaded files to you get to tunnel diode match your experience accordingly. Template Library 3: Professional Profile Layouts.
Washington Brick Red. Murray Dark Blue. Trump Brick Red. Introducing our newest batch of Microsoft Word templates, hot off the presses. Day 2011? We created these new designs due to thesis the growing popularity of genre essay man, our explainer on thesis, how to write a professional profile. People interested in a layout featuring a PP introduction skyrocketed, so we toiled to create 8 brand new HR-approved documents for you to genre essay man download for tunnel diode free. Remember — this particular template is best for those of you with some or significant work experience only. Template Library 4: Creative Layouts. Brooklyn Bridge Black. Taj Mahal Dark Blue.
White House Brick Red. Empire State Gray. Mount Rushmore Dark Blue. Are you having trouble separating yourself from your competitors? Have you been using the same resume format since you graduated college over a decade ago? Then it might be time to add some style to eric your resume! We’ve come up with a new set of creative designs that are the perfect blend of professionalism, personality, and just the right amount of tunnel diode thesis, style. These styles are great for graphic designers, artists, or anyone who wants to add a hint of character to their job search.
Template Library 5: Career Life Situations. Job Hopper Original. Mid-Level Dark Blue. Career Changer Brick Red. Whether it’s entry-level, manager, or executive, every job seeker experiences different phases throughout their career.
Some phases, like being in the middle of a complete career change or hopping around short-term jobs, are quite difficult to transfer on a resume. Fortunately, we have created a new library of templates specifically tailored to the various stages of a career. Remember: You can download any of eric resume, these resume templates for free and add the diode thesis bullet points yourself, or you can make a resume in minutes with Resume Genius’ renowned resume builder software. Day 2011 Essays? It can save you a lot of hassle designing and filling up your resume, and diode land you more interviews faster. However, if you’d still like to make the essay on nature resume on your own, use our industry-specific resume samples to thesis give you guidance and inspiration when writing your own resume. Lastly, don’t forget to check out our professional cover letter examples. Not Sure Which Template to biology paper Choose?
The answer is yes — if you want to. Every person’s experience is unique, so you’ll need to choose a template that best reflects and promotes your skills and experiences.Our templates are built to be customizable to any industry and tunnel thesis are great for any of the 3 resume formats. Research? The fact is, the web is filled with so many fantastic and creative template designs that there is undoubtedly something for you out there. We are proud of the designs we’ve created, and have seen that they are effective at landing interviews. Tunnel Thesis? But we’re not finished yet — we’ll be adding template designs to this page extensively in the near future. If you feel like creating your own, that’s fine too. Genre Essay Man? Readability is king when creating a good template — it is the diode most important factor, followed by how the resume itself is essays, structured to showcase your best experiences and conceal your negative ones. You may have read on the Internet that it’s inappropriate to tunnel use a resume template. You’ll hear these arguments: 1. It shows you’re lazy and uncreative, and unable to design your own. Wrong, it shows you’re efficient. (Creating your own is fine, too.)
2. Since your experience is essay, unique, a resume template won’t cut it. Wrong again. Your experience is personally unique, but you still generally fall into pattern that many other people have traveled before. 3. The hiring manager will be tired of looking at that resume template design because a lot of tunnel thesis, other people use it. That hiring manager should be fired.
It’s the research paper content of your resume that matters, not the aesthetic (unless it’s not readable.) We hope that clears up any misconceptions you may have had. We invite you to scroll back to tunnel the top and choose from one of our many resume libraries, and start writing. cover letter for nursing. Should i include collegiate sports in my resume? And if so where? It depends how much professional experience you have. If you are a recent college grad, then it is acceptable to include on your resume.
Good luck on the job hunt! Good luck on the job hunt! If the jobs are relevant to the ones you are applying for, then you can go as far back as you like. With regards to genre essay man your military experience, check out our military to civilian resume guide: https://resumegenius.com/blog/go-shooting-guns-coffee-runs. Any of the templates in tunnel diode thesis library 2 would be suitable for manufacturing careers. Best of luck! I’ve worked in genre essay man the same industry for the past 13 years.
Multiple employers with jobs lasting two to three years each. The jobs have been similar, so the experience looks a bit repetitive. I need to find a template that highlights my experience without getting bogged down in the chronology, Any suggestions? It provides ample space for your professional experience, while also highlighting your top qualifications. Good luck on thesis, the job hunt! hi resume genius.. Genre Essay Man? i need template resume that suitable for trainer and coach.. can u suggest to tunnel me with template is suitable.. #128578; I had a job for 7 years and during that time I wore many hats, Executive Admin, Purchasing, Vendor Management, Project Coordination, etc. How would I write that on my resume? Perhaps the Company name and then all the related roles under that and the times I did those jobs? I was always the biology cells paper Executive Admin, but I did other jobs during that period.
Yes, your suggestion is correct. Start with the company name and diode thesis included the related jobs with their own bullet points underneath. Good luck! Consider trying the ‘Job Hopper’ or the ‘Executive.’ They should able to fit all your jobs nicely. Ive never had a job so what should I use? Most of the templates above would suit your situation, but we suggest trying the Career Changer template because it emphasizes skills over the dates of research paper, your professional experience. (https://resumegenius.com/resume-templates/career-level-life-situation-templates#career-changer-templates) Best of luck! We suggest using the ‘Gatsby’ Template.
Good luck with grad school! As far as style, we suggest our ‘Professional’ template. In terms of format, if you want to tunnel include your restaurant experience, then you might want to consider using a functional format:https://resumegenius.com/resume-formats/functional-samples-writing-guide. Hope this helps! We suggest using our ‘Entry-Level’ template. Good luck with the genre essay man internship! Good Day Resume Genius.I’m a midwife by profession an has worked in tunnel a military hospital for essay on nature destruction 16 years in KSA.
I’m trying to apply as a home based ESL educator and an email respondent . Since I’m from the medical profession, I’m having difficulty in choosing the perfect resume.The skill I know is more on diode thesis, the medical.,clerical which involes data entry for appointments and summary, interpreter and eric man s my part time informal english lessons to native speaking arabs. What template should I use? Try the tunnel ‘Murray’ template. Easy Topics? Good luck! Hello. Diode? Which is good for asthma cabin crew applicant? I have no many work experience in service.
So i want to tunnel highlight the other things. Thanks #128578; Take a look at world environment day 2011 essays, our Flight Attendant resume sample: https://resumegenius.com/resume-samples/flight-attendant-resume-example You can download it and input your own information. Which template would you recommend for a career in education? Check out tunnel diode our teacher resume samples: https://resumegenius.com/resume-samples/teacher-resume-example You can download them and input your own experience. Try using the ‘Freeman’ template. Best of luck on biology cells, the promotion! Hi! What resume template would you recommend for a college freshman trying to apply for tunnel a competitive summer program with the USDA and South Dakota State University? Sound like the ‘Entry-Level’ template would be a good fit for what you’re trying to environment do. Good luck with the summer program.
Hi! Which resume template would you recommend for someone trying to tunnel diode thesis tap into the finance and world environment day 2011 accounting market. Tunnel Thesis? Looking for environment day 2011 essays an entry-level position. You should go with the ‘Entry-Level’ template. Good luck with the job hunt. I have worked 32+ years as a nurse, the last 4 years taking care of my elderly father and online work. Diode Thesis? Now seeking to get back into essay on nature destruction the job market for tunnel thesis extra income, not necessarily in the health field, just to earn some income and socialize. What resume do you suggest? Try the paper ‘Job Hopper’ template. Thesis? Good luck with your job search!
Hi! What resume template would you recommend for a 9th grader trying to apply for a doctor (any)?? Apparently, resume making and research interviewing is diode thesis, our project for world the fourth quarter this year. I couldn’t find any clear examples on the web, and I was hoping you could help me out with what template I should use.. Try using the ‘Elegant 2.0’ template. Good luck on your project. Yes, if you click the View all Resume Designs button and click the download link for the template pack of thesis, your choice. If you’ve never written a resume before, I’d recommend checking out our “How to essay on nature Write a Resume” guide to get a clearer idea (it’s much more comprehensive than any answer I can give here). Tunnel Thesis? https://resumegenius.com/how-to-write-a-resume.
Hit us up with any follow-up questions after giving that a read we’ll see if we can help further! Good luck! Hey there Margaret, In order to best understand which template works, it’s a good idea to check out which resume format fits your particular needs; then you can take it from biology there. https://resumegenius.com/resume-formats. All of the diode thesis templates were created by professional resume writers, so it’s hard to go wrong with any of them — it just depends on your preference.
Good luck! It really depends on what job you’re applying for. Since you have substantial work experience, try quantifying that in position your resume (think: any numbers that a hiring manager can look at and better understand what you accomplished during your time working there). Check out diode this page and choose the essay topics one you find most fitting, that should be a good start: https://resumegenius.com/resume-formats. Good luck on the job hunt! Hey there hbil036, This way, you can focus on your skills qualifications critical to the job application.
As an aside, you may want to look into whether you’re qualified to get back into accounting after that many years outside of the field. I understand that some regulations and rules change over the years — it may just be a matter of taking a test or updating your certifications, but I’m not certain. If that doesn’t seem to be a problem then go with the functional resume for thesis sure. Good luck on research paper, the job hunt! If you are lacking in major experience, I’d recommend using a reverse chronological format for diode your resume. Our “Classic” template on this page should do the trick: https://resumegenius.com/resume-templates/ Good luck at the job fair! I recommend you first check out our internship resume sample page: https://resumegenius.com/resume-samples/internship-resume-example. Afterwards, feel free to choose any format – just use a comprehensive education section instead of a professional experience section, and you should be good.
Tom Brady’s resume is a couple yards short of a touchdown. There are tons of errors throughout. Environment Day 2011 Essays? See why. How to Modify and Maximize your Resume Template. Need a resume template? Feel free to download one, but be sure to make small modifications to unlock your. Would You Rather Work for tunnel thesis a Man or a Woman? Do people still care whether they work for a man or woman, or do most people simply look for a nice job.
5 Ridiculous Excuses To Calling Out Of Work That Were Surprisingly Successful. Every office is bound to easy position essay have that one person that abuses the call-out policy. These people go above and. Resume Genius' builder, resources, advice and career tips are regularly featured on thesis, some of the world's leading online and offline publications including: Our code geeks and HR experts are proud to introduce our new Free Resume Builder software to help you land more interviews in today's competitive job market.
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10 Tips for Writing the thesis College Application Essay. No subject is more fraught with anxiety for the high school senior than the essay on the college application. Whether it is as bizarre as the University of Chicago's How do you feel about Wednesday?; University of genre essay man, Pennsylvania's You have just completed your 300-page autobiography. Please submit page 217.; or Tufts University's Are We Alone?—or whether it is a more mundane question about a formative experience you've had in your life, or about some controversial social or political issue, students tremble at the very thought of writing the essay and being judged on tunnel diode thesis it. Get updates from U.S. News, including newsletters, rankings announcements, new features and special offers. Man S Resume. We wondered what tips could be offered to ease the pain. For advice, we turned to tunnel thesis, visiting blogger Jonathan Reider, director of college counseling at San Francisco University High School, who before that was the senior associate director of admissions (and humanities instructor) at Stanford University. He should know; he's been on genre essay man both sides of the high school/college door.
Here are his 10 best tips. Tunnel. 1. Be concise. Even though the Common Application main essay has only a suggested minimum of 250 words, and no upper limit, every admissions officer has a big stack to read every day; he or she expects to spend only a couple of easy essay topics, minutes on the essay. If you go over 700 words, you are straining their patience, which no one should want to diode, do. 2. Position Topics. Be honest.
Don't embellish your achievements, titles, and offices. It's just fine to be the copy editor of the newspaper or the thesis treasurer of the Green Club, instead of the president. Environment. Not everyone has to diode thesis, be the star at everything. You will feel better if you don't strain to inflate yourself. 3. Be an individual. In writing the essay, ask yourself, How can I distinguish myself from those thousands of others applying to College X whom I don't know—and even the world environment day 2011 essays ones I do know? It's not in your activities or interests. If you're going straight from high school to college, you're just a teenager, doing teenage things. It is your mind and tunnel diode how it works that are distinctive.
How do you think? Sure, that's hard to explain, but that's the key to the whole exercise. Research Paper. 4. Be coherent. Obviously, you don't want to babble, but I mean write about diode, just one subject at a time. Don't try to cover everything in an essay. Doing so can make you sound busy, but at the same time, scattered and superficial.
The whole application is a series of snapshots of what you do. It is inevitably incomplete. The colleges expect this. Go along with them. Man S. 5. Be accurate. I don't mean just use spell check (that goes without saying). Attend to the other mechanics of good writing, including conventional punctuation in the use of commas, semi-colons, etc. If you are writing about Dickens, don't say he wrote Wuthering Heights. If you write about Nietzsche, spell his name right. 6. Thesis. Be vivid.
A good essay is often compared to a story: In many cases it's an anecdote of an important moment. Provide some details to help the reader see the setting. Use the names (or invent them) for the other people in the story, including your brother, teacher, or coach. This makes it all more human and humane. It also shows the reader that you are thinking about his or her appreciation of your writing, which is something you'll surely want to do. 7. Asthma. Be likable. Colleges see themselves as communities, where people have to thesis, get along with others, in dorms, classes, etc.
Are you someone they would like to genre essay man, have dinner with, hang out with, have in a discussion section? Think, How can I communicate this without just standing up and saying it, which is corny. Subtlety is good. 8. Be cautious in your use of tunnel thesis, humor. You never know how someone you don't know is easy topics going to respond to you, especially if you offer something humorous. Humor is tunnel thesis always in the eye of the beholder. Be funny only if you think you have to.
Then think again. 9. Be controversial (if you can). Easy Position Essay. So many kids write bland essays that don't take a stand on anything. It is fine to write about politics, religion, something serious, as long as you are balanced and thoughtful. Don't pretend you have the thesis final truth. And don't just get up on your soapbox and spout off on a sensitive subject; instead, give reasons and arguments for your view and consider other perspectives (if appropriate). Colleges are places for the discussion of ideas, and admissions officers look for biology research, diversity of mind. 10.
Be smart. Colleges are intellectual places, a fact they almost always keep a secret when they talk about their dorms, climbing walls, and how many sports you can play. It is helpful to show your intellectual vitality. What turns your mind on? This is not the same thing as declaring an intended major; what matters is why that subject interests you. © Copyright 2010 Professors' Guide LLC. All rights reserved. Best States for College Readiness. The highest percentage of students meet ACT benchmarks in these states. The Hidden Reason Behind College Dropouts.
Two- and four-year colleges must come together to improve transfer student success. Universities With High Tuition, Fees. More than half of these schools have an acceptance rate that's lower than 15 percent, U.S. Thesis. News data show. Weighing Faculty Diversity for College. Professors from research paper different ethnicities and backgrounds can broaden students' undergraduate experience. Discover what it's like to attend more than 70 colleges across the country. 4 Myths About Athletic Scholarships. Despite misconceptions, athletes in sports ranging from golf to water polo can earn college scholarships. Federal Investigation Fuels Amateurism Debate.
The debate over tunnel if and easy position essay how college athletes should be paid got new legs after a federal investigation alleged fraud and diode bribery schemes at resume, marquee national programs. Maximize Study Abroad as Premed Student. Students can strengthen their medical school applications through foreign experiences. Top Universities With Rolling Admissions. Tunnel Thesis. Eighty-three ranked schools evaluate college applicants on genre essay man a first-come, first-served basis, U.S. News data show.
Master SAT Command of thesis, Evidence Items. Genre Essay Man. Students will find this question type in the reading and writing and language sections of the exam. Get updates from U.S. News, including newsletters, rankings announcements, new features and special offers. Video: Creating a College Short List. See the best National Universities, Liberal Arts Colleges and more. Already know what you are looking for?
This is tunnel thesis a good place to start. Select colleges that interest you and see a side-by-side comparison.
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Essay: Evaluating compliance to Surviving Sepsis Campaign (SSC) resuscitation bundles in hospitals across the UK and implications for nursing practice: An Extended Literature Review. This literature review aims to evaluate hospitals’, and more particularly nurses’ capacity to diode thesis, comply with Surviving Sepsis Campaign (SSC) sepsis resuscitation bundles across the UK, as SSC guidelines have proven to increase sepsis survival rates when implemented properly. Using LibrarySearch, a methodical review of the existing literature was performed. A variety of health related databases and journals were searched and easy topics, Boolean logic was applied to specific search terms (Lobiondo-Wood and Haber, 2014). Eight relevant articles were then appraised for quality and the findings discussed. A lack of resources such as equipment and supplies, lack of appropriate referrals due to poor SSC education of medical and tunnel diode thesis, nursing staff, and the inconsistent use of SSC guidelines are all associated to with generally poor compliance with SSC sepsis resuscitation bundles in the UK.
Overall, the extent of hospitals’ compliance to SSC sepsis resuscitation bundles depends on the availability of the resources and equipment, education of medical and eric man s, nursing staff, and consistent use of the SSC guidelines. Importantly, eight articles evidence that SSC awareness by medical and diode thesis, nursing staff plays a vital role in world essays overall compliance. Chapter 1: Introduction. Hart (1998, p. 26) defines a literature review as a summary and ‘critical analysis of relevant available’ studies related to the chosen topic being reviewed. A literature review can aid in improving nursing practice in particular, by diode identifying themes and causation around a given issue in the field of nursing (Moule and essay destruction, Goodman, 2014). Hence, it is critical to thesis, gather evidence-based information through a literature review of the latest available research to help improve one’s practice and genre essay man, make decisions that is based on tunnel diode, the best available evidence (Aveyard, 2014). Florence Nightingale (1860) emphasised that nurses are knowledgeable when it comes to environment, patients’ care.
Therefore, in tunnel thesis the nursing profession there is no way to stop learning, but instead there are ways to update what has been learned from the past according to present conditions, and to gain new insights in order to provide the best available evidence-based practice to patients’ care (NMC, 2010; CRD, 2007). Paper? Moreover, it is the responsibility of a nurse to learn new information concerning his or her patients and the environment he or she directly works in, in order to be prepared for new challenges and tunnel thesis, changes in delivering evidence-based nursing care to patients (Spencer, 2011). The next chapter will briefly discuss the background and rationale of the focus question of this literature review, which is: ‘To what extent can hospitals in the UK comply with SSC resuscitation bundles, and what are the implications for day 2011, nursing practice’? The following chapter will outline the methodology of research, including how relevant literature was searched, tabulated, and analysed, and how the three themes emerged from the chosen articles (Parahoo, 2006). This is tunnel diode thesis, followed by the discussion and analysis of themes that arose from the chosen articles, and the implications and world environment essays, recommendations for nursing practice.
Lastly, conclusions drawn from the chosen articles reviewed will be made. Chapter 2: Background and Rationale. 2.1 What is Sepsis? Sepsis is the reaction of the body to diode, an infection, meaning that the ‘body attacks its own organs and tissues’ as defined by UK Sepsis Trust Organisation (2014). Sepsis was previously known as septicaemia or blood poisoning (Bone, 1991). Biology Cells? It starts from an uncomplicated infection that develops into severe sepsis, wherein the infection becomes associated with organ dysfunction and leads to an increased risk of death (Mackenzie and Lever, 2007). According to the UK Sepsis Trust Organization (2014), sepsis can quickly lead to shock, multi-organ dysfunction and eventually results in death if the sepsis is not detected immediately and not treated promptly.
Sepsis is one of the diode thesis primary reasons of death worldwide. This is why Surviving Sepsis Campaign guidelines have been introduced worldwide. 2.2 Surviving Sepsis Campaign (SSC) sepsis resuscitation bundles. In 2004, Dellinger et al. launched Surviving Sepsis Campaign (SSC) international guidelines in the United States for the management of position severe sepsis as an effort to diode thesis, reduce the genre essay man mortality rate associated with sepsis (Dellinger et al., 2004a). It encompasses the creation of evidence-based guidelines sponsored and endorsed by thesis 11 international organisations. Essay? It was revised in 2008 and the latest revision was in 2013. Subsequently, numerous research studies worldwide had proven its success in reducing mortality rates. The SSC guidelines are composed of 3-hour, 6-hour, and 24-hour resuscitation bundles for managing severe sepsis and septic shock (Dellinger et al., 2013c), which need to be delivered within a certain timeframe immediately following the identification of sepsis symptoms.
These bundles are a group of three or more elements of care specifically related to the disease, that when implemented together will improve patient outcomes (Surviving Sepsis Organization, 2014b; Institute for Healthcare Improvement, 2014; Dellinger et al., 2013c; Daniels et al., 2011). 2.3 SSC guidelines and United Kingdom. In 2005, the United Kingdom launched the SSC guidelines in an attempt to reduce the sepsis mortality rate in tunnel diode the UK (Bray and Murphy, 2006). The National Institute for Health and Clinical Excellence (NICE) (2007) recommended to carry out a set of observations or vital signs systematically using the Early Warning Score (EWS) and the SSC resuscitation bundles (Dellinger et al., 2013c) for management of severe sepsis and septic shock. These are currently recommended on a national scale to address the biology cells paper issue. Tunnel Thesis? However, despite of the introduction of the world environment campaign a decade ago, the mortality rate in UK remains unacceptably high, ‘There are 102,000 cases of sepsis arise annually, 36,800 deaths every year as a result of tunnel diode severe sepsis’ (Daniels et al., 2011, p. 508). ‘Putting this into easy position perspective, lung cancer (the biggest killer after cardiovascular disease) claims just fewer than 35,000 lives per year, bowel cancer 15,000 and breast cancer 9,000? (Richards, 2013, p. 3).
Hence, it is important to identify the diode thesis limitations to compliance and determine how medical and nursing staff can best help patients survive sepsis (NPSA, 2007). Easy Topics? In any hospital setting, there are different patients with many different kinds of illnesses, and tunnel diode thesis, nurses play a vital role in ensuring that patients receive the best and most appropriate possible care, thus preventing patients’ deterioration (Aitken et al., 2011). Moreover, rapid diagnosis and treatment saves lives when done as quickly as possible (Parliamentary and Health Service Ombudsman, 2013). Thus, the aim of this literature review is to evaluate hospitals’ compliance to essay, SSC sepsis resuscitation bundles across the UK as well as to identify the role of the nurse in helping to improve overall SSC compliance (Surviving Sepsis Organization, 2014a). The following focus question was formulated to tunnel diode thesis, address the abovementioned concerns and to guide the literature search of this review: ‘To what extent can hospitals in the UK comply with SSC resuscitation bundles, and what are the implications for nursing practice’? The next chapter will discuss in world environment further detail the methodology used for conducting research in order to address the most appropriately respond to this question.
Chapter 3: Methodology. This chapter will discuss the selection criteria, search strategy, and the search outcome of the literature search. How and why the articles were chosen to be included in this literature review will be explained. 3.1 Selection Criteria. The inclusion and exclusion criteria were determined using the Population, Intervention, Comparison or Comparator and Outcome (PICO) tool. The PICO acronym is used to articulate the research question and tunnel, structure the search strategy (CRD, 2007; Higgins and day 2011, Green, 2008; Whitlock et al., 2010). Studies evaluating compliance to the Surviving Sepsis Campaign (SSC) sepsis resuscitation bundles across hospitals in the United Kingdom (UK) were considered. Hospital settings allow for a wider sample in diode thesis evaluating nursing and medical staff’s adherence to the guidelines of the SSC rather than in specialist clinics or GPs settings. Articles focusing on adult hospital settings across the man s resume United Kingdom, and written in the English language were included. Studies evaluating the use of sepsis resuscitation bundles in tunnel diode thesis paediatric and maternity settings were excluded, as these are less relevant to the adult field of nursing, and asthma research, paediatrics and maternity wards require different interventions for the treatment of sepsis recommended by diode thesis the SSC. Many studies started within different timeframes in cells research paper different places when the SSC guidelines had been introduced worldwide; hence, studies outside United Kingdom were excluded.
The literature review focuses solely on the UK, since it is easier to recognise the diode limitations of the sepsis care bundles when evaluating sample populations in one country rather than across many countries. Studies assessing the compliance to the Surviving Sepsis Campaign guidelines (Dellinger et al., 2013c) comprising severe sepsis, septic shock resuscitation care bundles and early goal directed therapy (EGDT) were included, as these are elements of the established bundles and interventions used to manage patients with severe sepsis and septic shock in destruction the UK (Surviving Sepsis Organization, 2014b). Studies assessing severe sepsis and septic shock cases without using the thesis recommendation of SSC guidelines were excluded, as this paper aims to identify issues and determine possible reasons as to why and how non-compliance is occurring despite the proven effectiveness of sepsis resuscitation bundles under the biology cells research Surviving Sepsis Campaign (Daniels et al., 2011). Tunnel Diode? As the easy position topics United Kingdom launched its Surviving Sepsis Campaign in 2005 (Bray and Murphy, 2006), only studies assessing compliance to the SSC guidelines to address severe sepsis and septic shock in the UK from 2005 onward were included in tunnel this literature review. Studies evaluating the relationships between awareness, resources, and compliance to the SSC sepsis resuscitation bundles, as well as correlative evidence of decreasing mortality rates associated with compliance in sepsis were included. 3.1.4 Study Design. Due to the nature of the focus question, which is to evaluate the compliance to the SSC sepsis resuscitation bundles, quantitative studies were included that include prospective observational studies, retrospective cohort studies, questionnaires, and surveys. The focus of this paper is essay on nature, across the United Kingdom in tunnel diode thesis order to establish general determining factors regarding the limitations, barriers, and solutions for successful implementation of SSC sepsis resuscitation bundles (Surviving Sepsis Organization, 2014a). Case reports and eric man s, case series were excluded because they tend to focus on thesis, one case study, which is more likely to be very specific and less widely applicable than evidence across a more random sample population (Jolley, 2013).
The SSC guidelines were published in genre essay man 2004, hence, publication dates from the tunnel diode thesis years 2004 to December 2014 were included, and dates before 2004 and beyond 2014 were excluded from this literature search. In terms of hospital studies in the UK, only articles published between 2005 and 2014 were included, since the SSC guidelines were launched in the UK in 2005. 3.2 Search Strategy. After establishing the focus question this paper aims to answer, the first step was to biology cells research, identify the necessary databases for accessing a wide range of data sources in the Internet (Younger, 2004). University librarians’ assistance was sought to access different e-journals. Upon learning the ways to access databases, the researcher used a range of databases from the LibrarySearch engine. LibrarySearch is the University’s search and retrieval tool designed to tunnel thesis, search for asthma paper, databases and e-journals. This search was performed to reduce bias of the tunnel diode thesis review, and to retrieve articles containing the essay on nature destruction search terms used. Minimising bias was endeavored by tunnel using many appropriate databases to broaden the eric resume selection criteria (Newell and Burnard, 2006).
A worldwide search was not included, as only the population of the United Kingdom was relevant to the research question and thesis, only articles written or translated in English were considered for review in on nature the study. However, this risk bias, resources for translating articles are not accessible (Khan et al., 2003). Jolley (2013) explains how accessing a wide-range databases aids in acquiring the best and tunnel, most current research articles. Man S? The chosen databases used in this literature search are the British Nursing Index, Internurse, Medline (Ovid), Pubmed, SAGE journals, and Wiley Online Library. The British Nursing Index was chosen because this database covers all aspects of nursing from 1994 to present, which meets the inclusion criteria for articles from 2004 to tunnel diode, 2014. Internurse database was chosen, as it is the UK’s largest collection of nursing journals. Furthermore, as the essay destruction UK is home of the British Journal of Nursing, the journal was used for its main focus on research conducted in UK.
The Medline and Pubmed databases were included, as these two cover academic journals from medical, nursing and health care publications. Wiley online library was used since it provides over 4 million articles from across different countries that include the United Kingdom. Lastly, the tunnel thesis SAGE online journal database was included, as it is the world’s independent academic and professional publisher of over 560 journals (SAGE Publications, 2014). After selecting databases, the next step was to decide which search terms were to be used in accessing literature that would provide the biology research paper most appropriate evidence for the research question. Tunnel Diode? The following are the search terms that were used: UK, surviving sepsis campaign, compliance, severe sepsis, nurses, impact, and implementation. To increase the search sensitivity, Boolean logic was applied using the words ‘AND,’ ‘OR’ and ‘NOT’ (Khan et al., 2003). 3.3 Search Outcome. This section will describe which databases successfully produced relevant results based on the search terms and selection criteria. Cells? It will further illustrate the number of articles retrieved, and of the tunnel articles retrieved, which were identified as the most relevant to the focus question.
This literature search took place between October and December 2014. Using the Search Scope in LibrarySearch engine, six databases were selected to gather articles by world applying various search terms relevant to diode, the focus question of this paper. University journal archives and online access privileges, such as subscribing for a free 14-day trial were also used to obtain relevant literature. Initially, the first group search terms used were ‘Surviving Sepsis Campaign,’ ‘compliance’ ‘AND’, ‘impact,’ and ‘UK’. From these search terms, 694 items resulted, with different material types, any year, and any language type (Figure 1). This was then narrowed down from 694 to 3 items by applying the selection criteria wherein the publication date range of the retrievable articles was limited to filter inclusion of only easy position, literature relevant for the review, given that Surviving Sepsis Campaign guidelines were first published in 2004. Therefore, only articles published between 1st January 2004 and thesis, 31st December 2014 were considered in order to filter the most current available evidence. Moreover, English language type, and environment day 2011, articles as the material type were chosen (Figure 2). The next group of search terms used were ‘Surviving Sepsis Campaign,’ ‘AND’, ‘nurses’ and ‘UK.’ From these search terms, 4 articles were chosen as the most relevant to the focus question. Furthermore, from these 4 articles retrieved using the selection criteria as shown in Figure 3, these were narrowed down from 4 to 1 article, as the other 3 were not research articles. ‘Severe sepsis,’ ‘guidelines,’ ‘AND’, ‘nurses’ and ‘UK’ were the third group of search terms used in the LibrarySearch engine that resulted in 69 articles (Table 4).
To filter results to match the diode thesis most relevant criteria of the focus question of this review, the subject was refined to ‘Great Britain,’ hence the search was narrowed down from 69 to 2 articles (Table 5). Finally, the following search terms: ‘Surviving Sepsis Campaign,’ ‘AND’, and ‘UK’ were used to find further literature, which resulted in environment day 2011 1,295 items (Figure 6). Tunnel Diode? A collection of journals ‘ namely: Intensive Critical Care Journal, Journal of Clinical Nursing, and Nursing Critical Care Journal ‘ were chosen to narrow down the search from 1,295 to 6 articles (Figure 7). In total, 12 articles were retrieved utilizing the search terms relevant to paper, the focus question. Diode Thesis? These were then evaluated for relevant titles and abstracts. Two of the articles retrieved had no full text access and topics, the other two articles were duplicated using different search terms (Khan et al., 2003). The eight articles were tabulated that met the selection criteria. The reviewer found that seven articles have used additional and often overlapping sepsis research studies as references.
For example, 6 articles referenced Gao et al. (2005), 1 referenced Simmond et al. (2007), and 1 referenced Robson et al. (2007) which were also helpful in determining the academic legitimacy and relevance of the articles (Polit and Beck, 2006; Whittaker and thesis, Williamson, 2011). In order to minimise bias, Glasziou et al. (2001) suggest having a second reviewer, however this was not feasible in this literature review. Finally, quantitative research was included as it relates to the focus question of the review, which is to evaluate the compliance to the SSC sepsis resuscitation bundles as recommended by man s resume Dellinger et al. (2013c). Tunnel? Evaluation is primarily conducted with the use of quantitative targets and cells, measurements (Coughlan, Cronin and Ryan, 2007). Ultimately, eight articles were included in this literature review. These eight articles are primary articles, published in United Kingdom between 2005 and 2011.
All of these studies concern hospitals’ implementation and compliance to diode, the ‘sepsis resuscitation bundles adapted from the Surviving Sepsis Campaign’ (Dellinger et al., 2013c; Surviving Sepsis Organization, 2014a; Surviving Sepsis Organization, 2014b), particularly for adult patients identified as having sepsis in the UK. 3.4 Critical Appraisal Skills Programme (CASP) and asthma research, Hierarchy of Evidence. Reviewing research is a ‘mechanism used to provide feedback for improvement’ as noted by Polit and tunnel thesis, Beck (2006). After articles were selected, a CASP framework was chosen to critically appraise each article according to world day 2011 essays, its validity, credibility, and tunnel thesis, implication to essay on nature destruction, practice by following the Case-control and Cohort Studies Appraisal Checklists (CASP, 2013). This helped the reviewer to scrutinise the individual work and to underline the strengths and weaknesses of each article in order to identify the best examples of tunnel evidence-based practice (Coughlan, Cronin and Ryan, 2007). The Canadian Task Force on Periodic Health Examination in late 1979 was the first to disseminate the Hierarchy of Evidence, until which point different, hierarchies had been established and used (The Canadian Task Force on the Periodic Health Examination, 1979; Evans, 2003). Hierarchy of Evidence is a tool used in determining the effectiveness, appropriateness, and genre essay man, feasibility of thesis evidence (Evans, 2003). It additionally identifies evidence in day 2011 order to rank the articles according to the research method most relevant to tunnel, the focus question. Of the eight articles, five articles employ cohort studies and the other three articles use case-controlled studies.
All of the articles chosen were published in the United Kingdom and are peer-reviewed. The Systematic Review is the highest level of hierarchy, followed by the Random Controlled Trial (RCT) as the position second level of evidence. Thesis? All of the genre essay man articles collected within this study are ranked level three according to the Hierarchy of Evidence because the methods used are Cohort Studies and Case-controlled Studies. 3.5 Themes for diode, analysis. The next step after determining the appropriate literature for this review was an analysis of the position essay topics literature. Upon undertaking the analysis, three themes have been identified: equipment and supply limitations, a lack of appropriate referrals due to poor education of medical staff and nurses on SSC sepsis resuscitation bundles, and tunnel diode, the inconsistent use of SSC sepsis resuscitation bundles from hospital to hospital. The following chapter critically discusses the three themes that emerged from the literature analysis of the eight selected articles, as well as the implications for the field of nursing as related to the SSC. Chapter 4: Literature Analysis. This literature analysis will critically consider the eight articles in environment essays order to judge the strengths, weaknesses, and the significance of diode each study (Burns and asthma research, Grove, 2009) in addressing the diode research question: ‘To what extent can hospitals in the UK comply with SSC resuscitation bundles, and asthma research, what are the implications for nursing practice’? The first theme that emerged from the literature analysis will be examined below.
4.1 Resource limitations. Compliance with the SSC sepsis resuscitation bundles requires that serum lactate be obtained and that this is measured using an Arterial Blood Gas (ABG) machine (Dellinger et al., 2013c). Tunnel? Other requirements include the use of an ultrasound scan for Central Venous Pressure (CVP) insertion; blood cultures to be sent to Pathology before starting antibiotics; crystalloid or colloid intravenous fluid challenge, and man s, resuscitative medicines such as steroids, vasopressors and inotropic therapy (Dellinger et al., 2013c). However, five of the tunnel thesis articles reviewed evidence that this necessary equipment is lacking in a number of hospitals in the UK. 4.1.1 Equipment and genre essay man, medication. Three of the research articles specify that in thesis some cases there has been lack of necessary resources that are used to meet compliance to the SSC sepsis resuscitation bundles. This not only essay, limits the ability of medical and nursing staff to manage sepsis, but it also limits the reviewer’s ability to evaluate compliance with the SSC sepsis resuscitation bundles. Gao et al.’s (2005) study aligns with previous studies that demonstrate how compliance with evidence-based SSC sepsis resuscitation bundles significantly reduces mortality. The study comprises ‘101 consecutive adult patients with severe sepsis and septic shock on medical or surgical wards, or in tunnel accident and emergency areas at two acute National Health Service (NHS) Trust Teaching hospitals in England’ (Gao et al., 2005, p. Genre Essay Man? R764). The findings evidence poor ward care in tunnel thesis critically ill patients, evidencing that eight percent of genre essay man patients had no oxygen administrated, fourteen percent had no IV access, and fourteen percent of patients ‘had no observation monitoring of blood pressure, heart rate, respiratory rate, temperature, oxygen saturation, urine output, or conscious level’ (Gao et al., 2005, p. R766). Since the diode thesis aim of Gao et al.’s (2005) study is to assess the relationship between compliance with SSC guidelines and a decreased sepsis mortality rate, reasons for non-compliance are beyond the scope of this study.
However, the authors importantly note that the hospital’s resource limitation led to a deviation from the SSC sepsis resuscitation bundle ‘in the short term’ (Gao et al., 2005, p. R764). This includes limited ‘ultrasound-guided access, training and staffing that prevented the safe and early placement of central venous catheters outside the biology cells research critical care environment’ (Gao et al., 2005, p. R766). The ultrasound-guided access is essential to insert the CVP, therefore even if the staff has the knowledge to diode thesis, comply with SSC guidelines, with limited resources available, compliance is not possible. Essay On Nature? In hospitals such as these two NHS Trust Teaching hospitals, resource limitations forced the staff to deviate from ‘the benchmark for persistent hypotension despite fluid resuscitation, adapting a target haemoglobin of diode thesis 7 to 9 g/dl and/or vasopressors but exluding the requirement to achieve a target of 8mmHg and ScVO2 of’ 70% central venous pressure’ (Gao et al., 2005, p. R768). Similarly, McNeill, Dixon and Jenkins’ (2008) study highlights the issue of resource limitations. Research Paper? McNeill, Dixon and Jenkins, (2008) investigates the implementation of the 6-hour resuscitation care bundle as advocated by Dellinger et al. (2004) in 265 Acute Medicine Units (AMUs) in the United Kingdom. The research methodology is a questionnaire with 10 questions about the delivery of the tunnel diode thesis 6-hour SSC sepsis resuscitation bundle, sent to each of the participating AMUs.
The data was collected and tabulated per genre essay man percentage by tunnel thesis region. Thirty-five percent of the 162 respondents claimed to have implemented the 6-hour sepsis resuscitation bundle in their own hospital, although seventy-one percent had access to eric, outreach teams, and only forty percent had enhanced care beds. Moreover, ‘the minimum facilities to comply with the 6-hour resuscitation bundle were the availability of enhanced care beds, ability to measure arterial blood gas lactate, measure CVP and to administer inotropes’ (McNeill, Dixon and Jenkins, 2008, p. 164). Diode Thesis? These minimum facilities varied in different regions in UK. The findings of McNeill, Dixon and Jenkins’, (2008) study identified that only six hospitals had successfully implemented the eric man s complete sepsis resuscitation bundle and tunnel, that thirty-five percent AMUs claimed to have implemented the SSC guidelines despite eighty-eight percent of AMUs lacking the minimum facilities to comply. Environment Essays? Although resource availability is not the main focus of either of the abovementioned studies, this emphasis on limitations indicates that the extent to which a hospital can comply with the SSC sepsis resuscitation bundles depends largely on the resources available. McNeill, Dixon and Jenkins, (2008) results indicate that in tunnel diode thesis contrast to essay, the evidence of resources limitations presented by Gao et al.’s (2005) study, it is apparently possible to diode thesis, comply even when there is a lack of resources. However, the respondents’ claims based on paper, the questionnaire alone are unverifiable, as the results were based on participant’s subjective responses. McNeill, Dixon and Jenkins (2008) have no way of tunnel proving that the essay topics participants responses are honest, although they do suggest that clinical audits to thesis, be conducted for future studies. Nevertheless, McNeill, Dixon and Jenkins’ (2008) study identifies the importance of the facilities needed to easy position essay topics, effectively deliver the tunnel diode 6-hour sepsis resuscitation bundle across AMUs in UK, and finds that resources are lacking overall.
This includes sixty percent with no access to enhanced care beds, and only twelve percent of eric man s resume AMUs having the minimum facilities available to tunnel diode thesis, fully comply with SSC guidelines. Baldwin et al.’s (2007) audit in Kent determines compliance with the 6-hour sepsis resuscitation bundle according to appropriate referrals between nurses and relevant medical staff. It finds that even where communication was adequate between nurses and doctors, ‘there were instances when the appropriate antibiotics was out of stock in A#038;E’ (Baldwin et al., 2007, p. 255) particularly with a shortage of the antibiotic Tazocin. It is evident therefore, that compliance with the SSC guidelines not only requires that one follow all of the elements of the sepsis resuscitation bundle, but also that nursing staff monitor and communicate the need for essential medicine supplies more frequently. 4.1.2 Financial resources. Another significant resource limitation relating to SSC compliance is the financial capacity of a given hospital. Gao et al. (2005, p. R765) state that ‘severe sepsis is expensive, such as in USA average cost per is $22,100’. Even ‘in an age of financial austerity,’ Page et al. (2011, p. 314) suggest on one hand, that a sticker and easy position essay topics, poster program could provide an affordable means of ensuring universal SSC compliance. Robson, Beavis and Spittle (2007) on tunnel, the other hand, suggest that there should be funds for nurse education and training as solutions to ensure compliance.
Regardless of which authors are more justified in their claims, both suggestions are made in reaction to topics, resource constraints within hospitals in the UK. Page et al.’s (2011) study further implies that staffing levels particularly influence compliance to the SSC sepsis resuscitation bundles (Dellinger et al., 2013c). The study notes that ‘compliance was better in Accident #038; Emergency (A#038;E) than in the Clinical Decisions Unit (CDU) due to tunnel diode, a sixty-three percent staffing level in A#038;E as compared to the low staffing level of thirty percent in CDU’ (Page et al., 2011). On Nature Destruction? A#038;E doctors moreover had ‘continuous support of their nurse’ (Page et al., 2011, p. 314). This study therefore indicates that a major influencing factor for ensuring compliance is adequate staffing levels, which is particularly challenging given hospitals’ current funding limitations (Hurst and Williams, 2012). Diode? Furthermore, findings suggest that compliance to the SSC sepsis resuscitation bundles depends on the nurse’s role in performing the initial triage for patients. 4.1.3 Implications for nursing practice.
The level of cells effectiveness of compliance to SSC sepsis resuscitation bundles in the UK is tunnel thesis, partially, but also significantly contingent on levels of resource availability. This integrates into on nature nursing practice, as it is important for diode thesis, nurses to asthma paper, know how limited resources can impact compliance to the sepsis resuscitation care bundles for the management of tunnel diode severe sepsis and septic shock. Additionally, it is the nurse’s responsibility to ensure that ‘medication ordering systems are in place to minimize dose omissions and delay; utilize staff resource efficiently’ (NHS Greater Glasgow and world, Clyde Prescribing Organisation, 2008). Diode? Assuring that there is proper inventory of medical supplies and medication, and that the proper equipment is in working order and within easy access for use by paper medical staff are all within the scope of responsibilities and duties of a nurse. In essence, nursing is an act of utilising the tunnel environment to assist patient’s recovery (Nightingale, 1860), and compliance with SSC guidelines to decrease patient mortality rates is no exception to this duty. McNeill, Dixon and asthma research, Jenkins’ (2008) study highlights the issue of resource limitations in addressing sepsis. However, further investigation is recommended to determine the reasons for the lack of resources and solutions as to how resource availability could be improved to ensure that compliance is feasible not only with the tunnel diode thesis 6-hour resuscitation bundle, but also to identify sepsis in the first place. Research Paper? Additionally, an audit of the 265 AMUs surveyed is recommended in order to increase accuracy of tunnel results. This would also help to explain the reasons why despite having limited resources, some hospitals have found it possible to comply with the biology cells SSC sepsis resuscitation bundles. The next section will discuss the second theme identified in addressing the research question, which is a lack of appropriate referrals due to poor education of tunnel diode thesis medical and nursing staff on biology cells research, the implementation of SSC sepsis resuscitation bundles. 4.2 Lack of appropriate referrals due to poor SSC education of medical and nursing staff.
One of the tunnel thesis evident reasons for general poor compliance with SSC sepsis resuscitation bundles across the UK is a lack of referrals for day 2011, patients displaying symptoms of diode thesis sepsis. Seven of the eight articles reviewed evaluated compliance of the on nature destruction medical and diode thesis, nursing staff’s implementation of the sepsis resuscitation bundles as related to genre essay man, SSC education. Only one article evaluated the thesis compliance of the medical staff alone. Cells Research? The articles under review evidence that better compliance outcomes of SSC sepsis resuscitation bundles relies largely on medical and nursing staff having a proper awareness of the SSC guidelines for the management of severe sepsis and septic shock, particularly in terms of identifying sepsis, and subsequently in providing appropriate referrals. 4.2.1 Identifying sepsis. Robson, Beavis and Spittle (2007) audited seventy-three registered nurses in ‘medical, surgical and tunnel diode thesis, orthopaedic wards’ in genre essay man Chesterfield Royal Hospital. The audit took place in 2005 over diode the three-month period and identifies the extent to which nurses understand ‘definitions of sepsis, and genre essay man, the recommendations for its initial management’ (Robson, Beavis and Spittle, 2007, p. 86). It was reported as an tunnel, audit because the nurses were tested against the ‘standard definitions and evidence-based management guidelines’ of the SSC (Robson, Beavis and Spittle, 2007, p. 87). Similarly, McNally, MacKinnon and Hawkins’ study evaluates the ‘key critical care skills and knowledge required to’ (McNally, MacKinnon and Hawkins, 2009, p. 22) implement the early goal directed therapy (EGDT) as recommended by easy position essay the Surviving Sepsis Organization (2014b) in Specialist Registrars (SpRs) in anaesthetics, ‘general surgery and general medicine throughout Scotland’ (McNally, MacKinnon and Hawkins, 2009, p. 22). However, this is the only article that does not include nursing staff in their study, amongst the eight articles in this review. Seventy-three nurses from junior to senior grades completed the questionnaire created by Robson, Beavis and Spittle (2007) in diode thesis the form of test.
The questions included diagnosing patients with sepsis or severe sepsis based on the signs and symptoms, five case studies to explain management plans, and ten ‘true or false’ statements (Robson, Beavis and Spittle, 2007, p. 86). In the destruction first phase of the questionnaire, six systemic inflammatory response syndrome (SIRS) criteria could indicate that a patient has sepsis. Of the respondents, ninety-seven percent correctly indicated an increased temperature above 38??C and thesis, only nineteen percent correctly answered that higher than 4 white blood cell count is an indicator of eric man s resume sepsis. Moreover, ninety-one percent wrongly identified a suspected infection as an indicator (Robson, Beavis and Spittle, 2007). This study shows that ward nurses appears to have ‘general lack of awareness that low temperature, low white blood cells are signs of sepsis’ (Robson, Beavis and Spittle, 2007, p. 87).
McNally, MacKinnon and Hawkins’ (2007, p. 23) questionnaire ‘was open for completion within a 3-month period and a single email reminder was sent’. This study aimed to ‘survey at least fifty percent of general surgical trainees and an equivalent number from other specialities, and a statistical analysis was performed with SPSS 13 using the Chi-squared test’ (McNally, MacKinnon and Hawkins, 2009, p. 23). The respondents were asked about the years of tunnel training, previous critical care experience, their attitudes towards the awareness of EGDT and the SSC guidelines. ‘A power calculation ‘indicated that 30 replies per specialty would’ (McNally, MacKinnon and Hawkins, 2007, p. 23) be required to detect a thirty percent difference between specialties. Overall, although McNally, MacKinnon and Hawkins (2007) did not focus on nurse’s SSC protocol knowledge, they similarly found that medical staff in asthma paper Specialist Registrars lacked knowledge of EGDT elements. A number of nurses surveyed by Robson, Beavis and tunnel thesis, Spittle (2007) had reportedly taken some life-support courses such as the easy position essay topics Acute Life-threatening Events Recognition and Treatment (ALERT) course by Smith, Osgood and Crane (2012) where any patient with low BP should receive 500-1000ml of fluid, and may be repeated as necessary. However, there is no specification on to the tunnel thesis length of courses or the extent, which sepsis was studied. In the ALERT book, sepsis is discussed in a separate chapter, which means that nurses may not have been educated on sepsis. According to McClelland and biology cells paper, Moxon (2014), the nurse’s role is vital in early detection and recognition of sepsis, hence nurses ought to tunnel diode, possess a full awareness of cells research identifying sepsis and managing it beyond identification.
Since grade doctors provide immediate care and resuscitation to patients with severe sepsis or septic shock, McNally, MacKinnon and Hawkins (2007) focused only on Specialist Registrars (SpRs) in anaesthetics, general surgery and general medicine. Although McNally, MacKinnon and Hawkins (2007) suggest the development of working relationships amongst anaesthetic staff, trainee physicians and surgeons in order to ensure proper referrals and compliance with the SSC sepsis resuscitation bundes, nursing staff are absent from the study. This inaccurately assumes that only grade doctors can give provision of immediate care and resuscitation to patients with severe sepsis or septic shock, despite the researchers’ admittance that nurses are the first to identify a deteriorating patient and diode, inform the doctors to on nature destruction, come and see the patient. Page et al.’s (2011) study took place in Blackpool Victoria Hospital, wherein it showed that within 48 hours of admission, there was a high patient mortality rate; hence SSC sepsis resuscitation bundles were implemented, which included a heavy focus on educating staff in their hospital. During the study, they introduced an education campaign to motivate the tunnel thesis staff in implementing the sepsis resuscitation bundles. Activities within the education campaign included lectures for all the junior doctors, pocket cards detailing the SSC sepsis resuscitation bundles and small group tutorials to all nurses. In addition, posters were placed in asthma research paper every department. Page et al. (2011) proved the effectiveness of this ‘sticker campaign’ in improving the identification and treatment of sepsis by comparing the thesis hospital’s sepsis compliance with nearby Preston Royal Hospital that did not implement the same campaign, and where compliance with all the position topics elements ‘was not achieved in any patient’ (Page et al., 2011). The authors thus fail to provide a strong comparison based on controlled variables (examples are the number of patients, staff members, and sepsis protocols). Nevertheless, they propose that the sticker programme should be transferrable to almost any acute hospital and that the diode SSC sepsis resuscitation bundles could be achieved in a district general hospital. Page et al. (2011) started staff member SSC education during their study whilst Baldwin et al. (2007) indicated that there was education across their Trust, particularly for the critical care outreach nurses and ICU consultants where educational sessions outlining the surviving sepsis campaign and essay on nature destruction, its components were conducted.
Robson, Beavis and Spittle (2007); Simmonds et al. (2008); McNally, MacKinnon and Hawkins (2009); McNeill, Dixon and Jenkins (2008) do not state if there were education campaigns occurring in the UK hospitals studied, despite the fact that they all suggest better staff education about sepsis and tunnel, its management. Lack of staff education on sepsis is evident across all articles reviewed; however, the reason for this lack is essay on nature destruction, not clearly explained, and requires further research. 4.2.2 Critical care referral. None of the eight articles evidence a hospital that achieved 100% compliance with the diode SSC guidelines, and all reviewed articles mention the importance of cells education and awareness of the sepsis care bundle across all disciplines in terms of appropriate and timely patient management and referral. Simmonds et al.’s (2008) study took place in Queen’s Medical Centre (QMC) in Nottingham, under informed consent by the Trust Audit Committee. The study comprises 229 adult patients with significant positive blood cultures. Diode? Simmond et al. (2008, p. 124) used an eric, expanded version called the QMC Sepsis Measurement Tool, which includes: the ‘timing of sepsis resuscitation bundles interventions, seniority of doctors and the level at which care was given.’ The findings were that patients experiencing severe sepsis were only seen by diode thesis any doctor after a median of biology cells research paper 1.1 hours. Tunnel Thesis? Similarly, Cronshaw et al.’s (2011) study shows that patients’ waiting times exceeded an genre essay man, hour to tunnel, see a doctor in the Emergency Department (ED).
Of the 255 severe sepsis patients (SS), seventy-one percent of SS had no documentation discussion regarding the ITU referral (Cronshaw et al., 2011), hence noted that communication between ED and intensive care colleagues need to develop. ‘[D]espite severely abnormal physiology’ (Simmonds et al., 2008, p. 125), only sixty-one percent were referred for critical care opinions and genre essay man, only sixty percent of those patients were reviewed by a specialist in critical care within 12 hours of meeting severe sepsis criteria according to the SSC. Thesis? Of the 46 patients, 19 received level 3 care (Intensive Care Unit) within a six-day median stay, and 19 received level 2 care (High Dependency Unit) within a five-day median stay. Thirty-three percent of the sepsis patients died within 90 days and thirty-five percent within a year (Simmonds et al., 2008, p. 126). This analysis of different levels of care indicate that mortality is higher outside of asthma research paper critical care and this correlates to tunnel diode, the authors’ findings that there is a lack of sepsis resuscitation bundle compliance outside of critical care areas. Cronshaw et al.’s research study evidences that only twenty-nine percent of the patients were referred to position, ITU staff, and were considered not suitable or were labeled ‘do-not attempt resuscitate’ and seventy-one percent of severe sepsis patients had no documented discussions for tunnel thesis, referrals to man s resume, the ITU (2011, p. 671).
Simmonds et al.’s (2008) and Cronshaw et al.’s (2011) findings therefore, demonstrate that a lack of referrals is one of the factors that contribute to poor SSC sepsis resuscitation bundle compliance. Simmond et al. (2008) suggest that SSC sepsis resuscitation bundles are to be investigated beyond the intensive care in order to improve the tunnel diode capacity of the entire hospital system to world day 2011 essays, address sepsis. McNeill, Dixon and Jenkins, (2008) study supports Simmond et al.’s (2008, p. 165) suggestion, because the findings of McNeill, Dixon and diode, Jenkins, indicate that only genre essay man, ‘few AMUs across the UK hospitals can comply with the sepsis care bundle that have systems in place to tunnel thesis, resuscitate a patient with sepsis’. AMU is asthma, categorised as first level of care; therefore, it is essential to tunnel thesis, survey the genre essay man compliance of the SSC sepsis resuscitation bundles at this level. Although SSC sepsis resuscitation bundles ought to theoretically be implemented in any level of care in the hospital setting, implementation at different levels of care does not guarantee overall compliance with SSC sepsis resuscitation bundles, as proven by diode Cronshaw et al. (2011); Simmonds et al. (2008); McNeill, Dixon and genre essay man, Jenkins (2008); Robson, Beavis and Spittle (2007); Page et al. (2011). Nevertheless, one essential factor for ensuring compliance with the tunnel thesis SSC sepsis resuscitation bundles is the awareness of staff members on how and when to refer the patient as quickly as possible from the point at which the patient is diagnosed as having sepsis. 4.2.3 Communication between levels of care. Baldwin et al. Eric Man S? (2007) argue that the reason fifty percent compliance to the administration of the antibiotics is tunnel diode thesis, due to asthma research, poor communication between the prescribing doctor and the nurse who is meant to administer the antibiotics.
The study claims that some elements of the SSC sepsis resuscitation bundles were not implemented due to issues around the tunnel diode thesis doctors wherein junior medical staff were primarily attending to the patients’ treatment (Baldwin et al., 2007, p. 255). 4.2.4 Implications for nursing practice. Robson, Beavis and Spittle’s (2007) questionnaire particularly affirms that ward nurses generally fail to recognise patients as having severe sepsis or septic shock and are not confident to give intravenous fluid to those patients with lowered systolic BP or urine output as they may have fears of causing fluid overload for the patient. Simmonds et al. (2008, p. 127) recommend that this lack of awareness could be addressed through the recent advent of course initiatives such as the ‘Ill Medical Patients Acute Care and Acute Care Undergraduate Teaching needs to be routinely part of postgraduate medical and nursing education.’ Equally, McNeill, Dixon and research, Jenkins, (2008) suggest that education of nursing staff is needed, and similarly, Robson, Beavis and Spittle’s (2007, p. 89) study identifies that a ‘deficit in knowledge of nurses could lead’ to poor compliance to SSC sepsis resuscitation bundles. A nurse’s capacity to render the thesis best possible care for a patient with severe sepsis is achievable through education. This is a key to eric, implementing the SSC sepsis resuscitation bundles, and patients’ survival relies on the healthcare professionals who will accurately execute the SSC sepsis resuscitation bundles. Moreover, it is essential that a nurse has good communication skills (Webb, 2011) coupled with improved collaboration with multidisciplinary teams (Goodman and Clemow, 2010). Good communication skills and collaboration are the result of staff education and awareness on compliance to SSC sepsis resuscitation bundles, and diode, are essential in world environment day 2011 ensuring the patient’s continuity of care. Robson, Beavis and Spittle’s (2007) evidence implies that nurses’ awareness of sepsis management demonstrated limited awareness, with less than half of respondents knowing each of the sepsis symptoms, however there is a lack of confidence on implementing the diode thesis interventions specified in the SSC guidelines. Therefore, it is worth recommending that nurses require more exposure and opportunity to practice their skills on managing sepsis, through utilisation of the SSC sepsis resuscitation bundles.
Page et al. (2011) state that their sticker programme and position essay, posters may be an efficient alternative to costly education and training programmes as these are affordable and consistent means of educating staff. However, the diode thesis authors would have more effectively proven that their methodology was successful in preventing high sepsis mortality rates had the topics comparison between this campaign’s compliance results been made with past SSC interventions in diode the same hospital rather than with a nearby hospital that did not undertake the same campaign. Whichever hospitals endeavour to implement the sticker programme should evaluate SSC compliance by comparing the present sepsis related mortality rate with the sepsis related mortality rate achieved through said programme in cells research paper order to achieve more accurate measurements of compliance. Also there should be tangible training on how to use the sticker programme. McNally, MacKinnon and Hawkins (2009) suggest that a minimum education on how to initiate EGDT is important, however what exactly covers a ‘minimum education’ ought to be clarified. Hence this cannot be recommended. Awareness and education without good communication and collaboration will affect the effectivity of compliance to the SSC sepsis resuscitation bundles, therefore, further study to evaluate the multidisciplinary team collaboration in tunnel relation to SSC sepsis resuscitation bundles is recommended. The next section will address the third and final theme, which is the inconsistency of the use of SSC sepsis resuscitation bundles. 4.3 Inconsistent use of Surviving Sepsis Campaign guidelines. The SSC sepsis resuscitation bundles compliance is evident when there is consistency on position, the use and tunnel thesis, implementation of the standard guidelines. Below are findings that indicate inconsistency in the use of SSC guidelines as influencing factors on the extent to which compliance with SSC resuscitation bundles can be evaluated in the UK.
4.3.1 Management in addition to SSC sepsis resuscitation bundles. Three of the articles reviewed that took place in hospitals across the UK have added different forms of management to essay, the existing SSC guidelines, which creates difficulty challenge in evaluating overall compliance. Simmond et al. Tunnel Diode Thesis? (2008, p. 125) used a ‘QMC Sepsis Measurement Tool’ regarding the timing and seniority of doctors and the level of care given. The tool, which is not part of the SSC recommended guidelines, was used to essay on nature destruction, determine the entry levels of tunnel diode care for patients suspected to have sepsis. Gao et al. (2005) added to the SSC’s ‘6-hour basic ward care’ using the median Modified Early Warning Score (MEWS) (Heart of England, 2010). However, these authors’ modifications are helpful as far as the MEWS helped to identify that less than 15% of the patients received basic ward care. Cronshaw et al. (2011) followed the College of eric man s resume Emergency Medicine (CEM) guidelines to manage sepsis. Diode? The CEM require 1, 2, and 4-hour targets depending on the standard of care, and research paper, when a patient is within the 6-hour bundle, the practitioner then follows the SSC standard guidelines. The CEM standards for the management of severe sepsis (SS) and tunnel thesis, septic shock (SS) are ‘eight recommendations to the Emergency Department (ED) within 4-hours’ (Cronshaw et al., 2011, p. Genre Essay Man? 670). Additionally, 1-hour ‘sepsis six’ protocol comprises six standards: oxygen administration, serum lactate measurement, IV fluid administration, blood culture, IV antibiotics, and urine output measurement (Cronshaw et al., 2011, p. Tunnel? 671).
Even if the CEM guidelines and sepsis six protocol add incongruity to research, to the SSC sepsis resuscitation bundles, there is tunnel thesis, still consistency on implementation of the six-hour sepsis care bundle under the Surviving Sepsis Campaign (SSC). Nevertheless, none of the biology paper aforementioned studies are easily transferable across a range of hospitals in the UK, as they have all altered the SSC guidelines in some way. 4.3.2 Modified elements under the SSC guidelines. Two articles were found to have changed particular elements within the SSC sepsis resuscitation bundles. Gao et al. (2005, p. Tunnel Diode? R765) used ‘haemoglobin target instead of haematocrit and used remaining hypotension after fluid resuscitation for threshold of eric man s resume inotropes instead of tunnel diode thesis central venous oxygen saturation’, which is the standard for the sepsis care bundle. Likewise, Page et al. (2011) mention that there were some doctors who opted not to biology paper, apply certain elements of the SSC sepsis resuscitation bundles, such as giving the full 20 ml/kg bolus to diode, the patient, and documented the reason for biology cells research, not giving it as professional discretion. Gao et al. (2005) could have provided clarification as to the altered SSC guidelines by providing rationale, such as the diode thesis discretionary reasons distinctly explained by Page et al. (2011). In nursing practice, any decision about the care for individual patient must be evidence-based (Sacket et al., 1996) and any clinical judgment made by the doctor if agreed upon by easy topics the team and clearly documented is the right decision to take.
This is evidently emphasized by the SSC, which states: ‘these guidelines cannot replace the clinician’s decision-making capability’ (Dellinger et al., 2008b, p. 19) hence, clinician can use own discretion. However, the extent to which a clinician alters the SSC care bundles either in writing or in tunnel diode thesis practice will still have a significant impact on researchers’ capacity to evaluate SSC compliance across hospitals in the UK, as is the discrepancy in this particular literature review. While three studies have used different formats of the SSC sepsis resuscitation bundles and two studies modified the elements, five of the articles reviewed found overall consistency in the use of the SSC guidelines and have positive implications for biology, compliance. Cronshaw et al. (2011); Baldwin et al. (2007); Page et al. Tunnel Diode Thesis? (2011) adhere to the SSC’s 6-hour sepsis bundle guidelines, and McNally, MacKinnon and Hawkins’ (2009) study follows each element of Early-goal Directed Therapy (EGDT) (Rivers et al., 2001) through the SSC. Finally, Robson, Beavis and Spittle (2007) test the ‘ward nurses’ knowledge of standard sepsis definitions according to the Surviving Sepsis Campaign management guidelines. 4.3.3 Implications for nursing practice. In nursing practice, a systematic approach that comprises evidence-based management for patients suffering from world environment day 2011 severe sepsis or septic shock, or critically ill patients, that is universal and can be transferrable from one hospital to another is desirable (Gerrish, 2010).
But given the apparent inconsistency of SSC care bundles due to different formats used and implemented beyond the SSC guidelines, nurses and medical staff will encounter difficulty in complying with SSC recommended sepsis resuscitation bundles from thesis hospital to hospital. Moreover, the continuity of paper care for the patient will not be consistent, especially in cases where a patient must be transferred from one hospital to another. An updating of tunnel diode skills and fostering nursing knowledge about SSC guidelines, sepsis recognition, assessment, interventions and research, management, is essential because most of the time nurses are the bedside clinicians of the patients. Tunnel Diode? It is therefore fundamental for nurses to biology research, be given initiatives to tunnel diode, update and position, enhance their knowledge and skills regarding the SSC guidelines. One hospital might have different sepsis management from another hospital as demonstrated by the studies of tunnel thesis Gao et al. (2005); Cronshaw et al. (2011); Simmonds et al. (2008). Hence the research paper health outcomes will vary from one hospital’s version of the tunnel thesis SSC guidelines to another’s. If the day 2011 SSC sepsis resuscitation bundles were implemented universally then it would be much easier to identify evidence and diode, determine trends pertaining to compliance. Seven articles in this literature review have rated their study compliance with the SSC sepsis resuscitation bundles by the use of percentage, whereas Gao et al. (2005) rated compliance by the use of ‘all’ or ‘none’ as pass-fail for the elements of the sepsis care bundle. Had Gao et al. (2005) rated compliance by the use of percentage, it would be easier to discern which criterion of the SSC sepsis resuscitation bundles needs to be implemented or may not work for patients with sepsis.
This would provide specific evidence of compliance and effectiveness according to the 6-hour and 24-hour sepsis resuscitation bundles (Surviving Sepsis Organization, 2014b). Despite adding inconsistency to asthma research paper, the SSC guidelines, Gao et al.’s (2005, p. R765) ‘6-hour basic ward care’ using the thesis median MEWS is particularly helpful. Because basic ward care is a crucial obligation that every nurse must undertake, and these include the ability to genre essay man, recognise and prevent delay in intervention or transfer of critically ill patient to an appropriate place for patient’s safety (NPSA, 2007). Moreover, the tunnel diode thesis one-hour sepsis six protocol in Cronshaw et al. (2011) study, which was originally formed by Daniels et al. Cells Research? (2011) is worth recommending to include in the SSC sepsis resuscitation bundles internationally as this protocol has already been implemented in some hospitals across the UK. The sepsis six management for patients is also being taught in the ALERT course (Smith, Osgood and Crane, 2012) as part of the nursing degree final year curriculum in some universities across the thesis UK, hence a newly qualified nurse is expected to genre essay man, be knowledgeable on the sepsis management, particularly of sepsis six. Diode Thesis? Therefore, it is worth suggesting to conduct further enquiry into student nurses’ knowledge towards SSC sepsis resuscitation bundles across the UK.
Chapter 5: Strengths and limitations of genre essay man this extended literature review. The reviewer included articles measuring compliance of SSC sepsis resuscitation bundles across the thesis UK. Research Paper? The publications are recent articles and diode, hence provide good evidence and insights of clinical practice regarding SSC sepsis resuscitation bundles in hospitals across the UK (Aveyard, 2014). All articles included in the review are primary articles and research paper, represent a variety of hospitals across the tunnel diode UK with larger sample sizes (Burns and Grove, 2009). This includes adult patients with sepsis in Birmingham, Blackpool, Derbyshire, Edinburgh, Kent, and Nottingham, thus helping to determine overall compliance trends across the day 2011 essays UK. All eight articles reviewed suggested the importance of education and awareness of the sepsis resuscitation bundles across all disciplines.
The overall strength of the findings from this review is that the evidence from the articles helped to determine that nurses play a critical role in improving the diode thesis ‘golden hour’ in the delivery of essay topics sepsis care bundles, in terms of identifying, prioritising, and tunnel diode thesis, rapidly referring the patient diagnosed with sepsis (Lovick, 2009). Four articles have added some interventions aside from the SSC guidelines. Furthermore, studies by eric man s resume Robson, Beavis and Spittle (2007); Simmonds et al. (2008); McNeill, Dixon and Jenkins (2008) stress that education is needed, but do not elaborate upon any specific training that the nursing and tunnel, medical staff have undergone before the study, or what kind of education the authors are recommending. Page et al. (2011) claim that a sticker education program is equal to greater compliance; however, the authors’ fails to compare with past SSC compliance ratings within the same hospital, which weakens their argument and how responses to questionnaires regarding compliance cannot be verified, whereas an audit provides a more thorough indication of compliance in a given hospital. Chapter 6: Conclusions. The aim of this literature review was to evaluate hospitals’ compliance to the SSC sepsis resuscitation bundles across the UK as well as to identify implications for the role of the essay topics nurse in complying with the SSC guidelines. Three main factors that influence overall compliance with the SSC guidelines were found through a critical analysis of the studies included in this literature review. Firstly, the availability of resources and equipment such as enhanced care beds and medicinal supplies within the hospital appears to be limited in Baldwin et al., (2007); McNeill, Dixon and tunnel diode thesis, Jenkins, (2008).
Secondly, at the very least, the lack of SSC awareness by hospital nursing staff is a significant concern, because nurses are the first point of contact for patients, and are therefore largely responsible for identifying sepsis. Trainee doctors and medical staff also need proper SSC education, as McNally, MacKinnon and eric man s resume, Hawkins’ (2009) evidence that only anaesthetic staff are sufficiently knowledgeable about sepsis resuscitation bundles. Tunnel Diode Thesis? Lastly, inconsistency in the use and subsequently in the implementation of the SSC guidelines ‘ such as a change or elimination of essay on nature certain SSC elements, whether due to lack of resources or practitioner discretion ‘ significantly limit researchers’ capacity to evaluate SSC compliance across the diode UK. If hospitals seek to demonstrate evidence of overall compliance with the SSC guidelines as compared with other hospitals in the UK, then the genre essay man entirety of the SSC guidelines must be followed, even if Dellinger et al. (2008b) have only highly recommended it. A uniform reference to the entirety of the criteria will help researchers to tunnel diode, evaluate medical practitioners’ and nurses’ compliance with the SSC guidelines. Moreover, adherence with the SSC guidelines will help hospitals to genre essay man, determine the relevance of each element for sepsis management, and therefore provide a rationale as to whether an tunnel diode thesis, element may be appropriate or not, rather than modifying the guidelines from the outset.
Nevertheless, since the SSC guidelines were published in 2004 and has been revised every two years, there is still time and opportunity to gather all current evidence-based data regarding the implementation of the SSC guidelines. Even in a time of economic austerity recommendations for sepsis management could be replicated in hospitals across the biology research UK through the appropriate and more consistent use of SSC guidelines by nursing and medical staff in order to both benefit patients’ health conditions and tunnel thesis, decrease mortality rates. Search our thousands of essays: If this essay isn't quite what you're looking for, why not order your own custom Health essay, dissertation or piece of coursework that answers your exact question? There are UK writers just like me on hand, waiting to help you.
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Essay/Term paper: Lsd (lysergic acid dyethilamide) Free essays available online are good but they will not follow the guidelines of diode thesis, your particular writing assignment. If you need a custom term paper on Science Research Papers: LSD (lysergic Acid Dyethilamide) , you can hire a professional writer here to world, write you a high quality authentic essay. While free essays can be traced by Turnitin (plagiarism detection program), our custom written essays will pass any plagiarism test. Our writing service will save you time and diode, grade. A Swiss chemist named Dr. Albert Hoffman first produced lysergic acid Diethylmide ?“or best known as LSD in 1938 (Dye, 1992, p. Research Paper. 2). Hoffman discovered the drug while trying to thesis, synthesize a new drug for the treatment of headaches. He obtained the lysergic acid from the topics parasitic fungus that grows on diode, rye plants known as ergot. Asthma Research Paper. From the lysergic acid, he synthesized the compound LSD. He used the compound to test for its pain killing properties on tunnel diode, laboratory animals.
Being that appeared totally ineffective, the bottle of LSD was placed on a shelf and remained untouched for five years. On April 16, 1943, Dr. Hoffman decided to do further research with the LSD compound (Dye, 1992 p. Genre Essay Man. 5). While handling the drug, he accidentally ingested an unknown amount. Then he experienced the worlds first LSD trip. Tunnel. About eight hours later Hoffman drifted back into normal reality and the Psychedelic Revolution was born. (Encarta 98) Three days later, in an attempt to prove that the previous episode was indeed caused by the ingestion of LSD, Dr. Hoffman ingested what he thought would be a small quantity of LSD, 250 micrograms. In actuality, this is approximately five times the dosage necessary to essay on nature, produce heavy hallucinations in the average adult male (Solomon, 1964, p. Tunnel Diode Thesis. 34). The drug produced effects that were much more intense than the first time Hoffman took the LSD. He noted that he felt unrest, dizziness, visual disturbances, a tendency to laugh at inappropriate times, and a difficulty in concentration (Dye, 1992, p.7).
Dr. Hoffmans condition improved six hours after taking the drug, although visual disturbances and distortion continued. LSD was first shipped to the United States in 1949 (Solomon, 1964 , p. 54). American scientists tested LSD on animals to learn of asthma, its effects. It produced dramatic behavior changes in all animals investigated.
During the 1950s, experimentation of LSD on tunnel thesis, humans began (Solomon, 1964, p. 56). Since there were few restrictions on using humans for experimentation at the time, scientists were free to world environment day 2011, administer the drug widely, hoping to find some useful therapeutic value for the drug. Because of Hoffmans LSD account of depersonalization produced by the drug. Early studies were done using the drug to tunnel diode thesis, treat various psychiatric disorders. It was felt that if a person could step outside themselves and view situations as others saw them, they could come to grips with their problems and day 2011, be able to solve them. One of the first areas of LSD experimentation was in treating alcoholism (Dye, 1992, p.36). After extensive research, it was concluded that LSD was not effective on treating alcoholism and the research was discontinued.
LSD was also tested on schizophrenics, drug addicts and criminals (Dye, 1992 p. 38). Research determined that LSD was ineffective in treating any behavioral problems. It was also concluded that LSD might transform a normal individual into a person with a very calm to thesis, severe personality problem. The Central Intelligence Agency and various military agencies also became interested in LSD research in the late 1950s (Dye, 1992, p.410.) Their interest in the drug was in the area of mind control. They saw the environment day 2011 essays possibility of manipulating of manipulating the beliefs of strong willed people.
They gave the drug to a group of army scientists and then attempted to change some of diode, their basic beliefs while under the influence of the drug. However, one of the scientists became psychotic and committed suicide by jumping from a hotel window. Essay. These agencies continued their research by using drug addicts and prostitutes to test their mind control theories. After extensive experimentation, it became apparent that LSD could alter LSD the tunnel mind but not control it. The United States government discontinued this sort of research. Up until today, the Food and easy position essay, Drug Administration have never approved LSD.
This strong hallucinageous drug remains only as research and medical treatment. LSD belongs to a class of psychotropic drugs called hallucinogens (Gorodetzky, 1992). Other drugs in this category are mescaline (derived from peyote cactus) and psilocybin (commonly known as hallucinogenic mushrooms). LSD is most commonly taken orally but may also be taken by injection, inhalation, or by thesis, absorption through the skin. When it is taken orally, the individual usually notices the effect of the drug within thirty minutes. It may take one hour before the user experiences the drugs maximum effects.
This state usually lasts two to four hours. The usual dose taken is fifty to one hundred micrograms, although much higher and lower doses have been ingested. The intensity of the hallucinatory experience depends on the dose taken. The psychological, perpetual, and behavioral effects of LSD persists for eight to twelve hours and gradually wears off after reaching their maximum effects (Gorodetzky, 1992). Biology Research. The effect of the drug is determined by a persons mental state, the structure of their personality, and the physical setting. The role of tunnel thesis, culture and belief systems is essay primary in the effects of hallucinogenic states. The experience following the ingestion of LSD is called a trip and can be good or bad depending on its effect on the user. Another effect of LSD is diode thesis derealization. Position Topics. Derealization is a dreamlike state in tunnel thesis which the environment individual cannot tell if they are experiencing reality or dreaming (Solomon, 1964, p.159). A person under the influence of LSD may misjudge the thesis size and distance of genre essay man, objects.
The shapes of objects are also distorted and tunnel, constantly changing. Objects that do not exist may also change in form and color. These objects can often be seen when the position topics user s eyes are closed because the image is produced within the tunnel mind. Colors also appear to be brighter and research paper, more intense than normal. Synesthesia, which refers to the mixing of the senses, is another effect of LSD (Solomon, 1964, p. 164). Diode. During synthesia, experiences normally associated with one sense are translated to another. For example, sounds may be seen and easy topics, colors may be smelled. Tunnel Diode. LSD also often distorts time.
The user may be unable to separate events from the cells paper past, present, and tunnel diode thesis, future. A lack of concentration and asthma, impairment in judgment are also common. An individual on LSD may remain completely motionless for long periods of time or hyperactive. LSD can also produce rapid mood changes. Another group of LSD induced effects are referred to as somatic symptoms (Solomon, 1964, p. 171).
These symptoms include dizziness, weakness, tremors, blurred vision, and tingling sensation of the skin. It is still not fully known how LSD works on the brain. In addition to the psychological effects of LSD, the drug produces many physiological effects as well. LSD dilates the pupils of the eyes. Diode. It can also cause blurred vision, and increases blood pressure, heart rate, and body temperature. Research Paper. The drug also increases blood sugar, can produce sweating and chills headaches, nausea, and vomiting. There are also changes in thesis the muscles, resulting in weakness, tremors, numbness, and twitching. Abnormal, rapid breathing may occur. ( Dye, 1992, p. Biology Research Paper. 122) LSD users experience some kind of flashbacks after taking the drug. A flashback is a spontaneous recurrence of certain aspects of an LSD related hallucinatory experience (Gorodetzky, 1992). Tunnel Diode. If a flashback occurs after only one exposure to LSD, the initial trip was most likely a bad one.
Flashbacks can occur at any time, but are more likely to occur while sleeping, while under the influence of other intoxicants, or while a person is in the presence of someone under the influence of LSD. Flashbacks have been known to cause psychotic and suicide reactions have been recorded as insanity. LSD was not only restricted to big cities such as the on nature destruction streets of Haight and Ashbury of San Francisco. From Ken Kesey and his Merry Pranksters to the Beatles song Lucy In The Shy With Diamonds, LSD was gaining national recognition and had reached suburbia by tunnel thesis, the mid 1960s. LSD inspires art, music, fashion, and culture for essay on nature, a generation. Psychedelic, a word invented by scientist Dr. Humphrey Osmond to indicate the tunnel diode thesis mind altering or mind expanding properties of hallucinogenic drugs, became a household term in the 1960s. Aldous Huxley (b.1894-1963), writer of the biology cells research paper critically acclaimed books Brave New World (1932) and The Doors of Perception (1954), was an advocate of the usage of hallucinogens. Huxley researched and diode, experimented with mescaline and biology paper, later related his studies on mescaline to LSD.
In his usage of mescaline, Huxley experienced a change in diode every day reality. Unlike mescaline users before him, Huxley had no fantastic visions, saw no landscapes or geometrical figures. his creation - the miracle, moment by moment, of naked. existence…flowers shining with their own inner light and. all but quivering under the pressure of the significance. with which they were charged…Words like grace and. transfiguration came to my mind…Being - Awareness- -Bliss, for the first time I understood, not on the verbal. level, not by inchoate hints…but precisely and completely.
what those prodigious syllables referred to …purely aesthetic, Cubists-eye-view gave place to what I can only describe. as the sacramental vision of reality. I was back in genre essay man a world. where everything shone with the inner Light, and was infinite. in its significance.
The legs, for example, of that chair - how. miraculous their tubularity, how supernatural their polished. smoothness! I spent several minutes - or was it several. INTERVIEW AND WORDS TAKEN FROM My problem child In 1960 LSD was still strictly confined to diode, the research laboratory. This dramatically changed in the next few years due to Dr. Timothy Leary (b.
1920-1996). Leary encouraged the American public to easy position essay, Turn on, Tune in, and diode, drop out. Leary was a very respected clinical psychologist and lecturer at Harvard University for several years. Leery experimented with psilocybin while in Mexico in the early 1960s. Leary was impressed with the drugs ability to produce dramatic behavioral and perceptual effects. He began experimenting with LSD, using inmates at paper, a Massachusetts prison as subjects. Through his own use of LSD and observation of the tunnel convicts given the drugs, he became convinced that LSD was capable of easy position essay topics, expanding consciousness. Leary began holding sessions with students, in which all participating would consume the thesis LSD and then relate their drug-induced experiences to each other. Dr.
Leary openly promoted the use of LSD for the purpose of expanding ones consciousness. He and another Harvard professor, Dr. Richard Alpert, established the International Federation for easy essay, Internal Freedom. They increased their promotional activities for LSD, insisting that the drug could `recircuit the brain to produce a more effective and creative organ (Leary, 1982, p.55). Leary and Alpert were fired from Harvard in 1963 for their involvement with LSD.
Both moved to Mexico but were soon asked to leave by the Mexican government. The activities of Dr. Leary and Dr. Alpert received attention throughout the United States. Tunnel Diode. The widespread publicity accelerated the underground movement to expand the use of LSD. By mid 1960s, a wide variety of people were experimenting with the drug (Leary, 1982, p.62). By 1966, even Dr. Leary said the use of LSD on college campuses was becoming excessive (Leary, 1982, p.102). Dr. Leary remained a strong advocate of mind expansion until his death in 1996.
At the same time Leary was promoting the use of LSD, laws were being passed making the manufacture, sale, use, or possession of LSD a crime. The maximum sentence for first time LSD offenders was a five thousand-dollar fine and one-year in research paper jail. Repeat offenders could be punished with an one hundred thousand dollar fine and ten years in jail (Leary, 1982, p.139). Sandoz Pharmaceutical Company, the tunnel diode only legal American supplier of essay topics, LSD, stopped distributing the drug in 1966 and diode thesis, transferred its total supply of the genre essay man drug to the National Institute of Health, which is diode thesis now the only legal source of LSD. The use of essay, LSD continued to increase during the diode late 1960s and 1970s, due to the publicity by Timothy Leary and the social upheaval that took place in the United States at that time. The use of LSD peaked in easy the early 1970s and then began to steadily decline (Dye, 1992, p. 120).
Dye attributes this to tunnel, three factors: the increasing number of bad trips reported, speculation of LSD related chromosomal damage, and other drugs such as mescaline and psilocybin becoming more prevalent. By the late 1970s, LSD use had declined even further as many drug users turned to marijuana, PCP, cocaine, heroin, and inhalants (Dye, 1992, p. 128). While these drugs are still in widespread use, a resurgence of LSD use has been seen in recent years (Corcoran, 1987, p.1A). The 1987 National Household Survey of Drug Abuse stated that three percent of students between the ages of twelve and seventeen had experimented with one or more hallucinogens, fourteen percent of young adults ages eighteen to twenty-five and seven percent of adults twenty-six and over had tried hallucinogens at eric man s resume, least once. (Mendelson,94) LSD enables me to open my mind, and stimulates my creativity. It helps me to think clearly and helps my writing.
LSD helps me to diode thesis, be myself, said a sixteen-year-old LSD user. Does LSD enhance the mind or deteriorate it? This is not fully known. On Nature. Since LSDs effects on the brain have not been fully determined, an accurate conclusion about the drug cannot be made. Tunnel. It has been established that LSD can cause toxic reactions and even death due to the unpredictability of the drug. Is damaging yourself justification for mind expansion?
For some it is. Will we ever know how dangerous a drug LSD is? With further scientific research still taking place, this question will soon be answered.