Recent orders
Poster Presentation
Poster Presentation
Continuous Quality Improvement (CQI)
Use of Red Rules
Through this poster, I would like to discuss the importance of implementing red rules in inspiring people to participate in the CQI process. Red rules are regulations and rules that cannot be violated under any circumstances. They are guidelines that, with the exception of unusual or time-sensitive circumstances, should be followed every time a particular procedure is carried out. In the event that they are violated, severe disciplinary action may be taken. The protection of patients is an essential part of the administration of healthcare. Both those who provide healthcare and those who receive it place a high premium on developing efficient techniques to reduce medical mistakes and boost patient safety. To improve patient safety, healthcare facilities should not only set a primary emphasis on fostering a culture of safety, but they should also launch innovative programs to research, design, and put into action safe work procedures, as well as provide staff members with training in patient safety. By introducing red rules in health care facilities, I believe we can inspire those willing to participate in the continuous quality improvement process. Since employees will be afraid of the repercussions of reporting mistakes as a direct result of the implementation of Red Rules, there will be a reduction in both the frequency with which errors are reported and the total amount of errors that are reported.
The following criteria for red rules should be implemented to ensure that healthcare professionals are motivated to participate in continuous quality improvement. First, the red rules should be few, well understood, and memorable. Every person involved in a CQI process must be able and constantly encouraged to perform as directed by a red rule under all circumstances. Besides, anyone who discovers a violation of the red rule is obligated with the responsibility and authority to immediately halt all patient treatment related to the red rule to prevent additional damage to the employee or the patient.
Understanding Errors
It is essential to understand errors because it is only through reporting mistakes that nurses and perhaps other health care workers may learn which aspects of operational failures and system design lead to human fallibilities and, as a result, enhance the quality of care provided. Reporting and disclosing actual mistakes and near-misses provide possibilities to lessen the impact of errors and cut down on the probability of errors occurring in the future, thus improving the quality of health care services offered to patients. Ensuring that nurses and other healthcare employees can understand, report, and disclose errors will help improve health care quality provided to the patients.
Models that can be used to understand errors include;
The Swiss Cheese Model; this model centers its attention on the breakdown of the system and acknowledges the possibility of mistakes occurring in each step.
Generic Error Modeling system; provide more flexibility in action and, more importantly, have the potential to considerably cut down on human mistakes that occur throughout the working process.
The Disadvantages of Bottled Water and Tap Water
The Disadvantages of Bottled Water and Tap Water
Presented by
Institution
Thesis
Drinking tap water is more healthy and economical as compared to drinking bottled water.
Introduction
Water is the basis of all life because every animal and plant depends on it for survival. The human body composes of 60% water, which makes it necessary for people to drink large volume of water daily. People prefer drinking clean water because it is healthy and quenches thirst more effectively. Clean drinking water is not abundant, but people have tried many ways of providing clean water to the community. The limited availability of water in some areas has resulted into companies coming up with bottled water to serve people. Both tap water and bottled water have their advantages and disadvantages associated with them. Making a decision towards the best drinking water depends on an individual choice, but I would recommend tap water not bottled water. Most people prefer bottled water because they assume it is free from germs as compared to tapped water.
The fact that water is essential for life means drinking water from a bottle is of significant to our body however, the water could contain traces of PET and BPA that leaches from the plastic bottle making it unhealthy for drinking. In addition, plastic bottles are disposed to the environment causing a threat to the flora and fauna. Even though, tapped water has some disadvantages, people should turn from using bottled water because it poses many health threats and environmental effects (Gleick, 2010).
Main argument
Bottled water is associated with a lot of problems related to waste and transportation. In addition, landfills get filled with disposed plastic bottles making it more expensive to put other things in them. Moreover, producing plastic bottles consumes a lot of energy that could be used to fuel vehicles and other machines. Many instances of political instability are common in today’s nations, and water has been turned into a profitable business. Bottled water is marketed to those who have the capability of buying it while they have access to clean tap water in their homesteads. A lot of money is spent in the manufacture of water bottles, and processing of water as compared to the treatment of tap water. The urge for money makes many nations spend a lot of time and energy producing bottled water for selling while they neglect the essential quality of tap water. In addition, the used bottled are a nuisance to the environment when not well disposed. Out of the total number of bottles produced each year, only 23 % are recycled. The environmental problems associated with bottled water and the economic cost of producing it can be used in improving the quality of tap water (Gleick, P., & Cooley, 2009).
Disadvantages of tap water
The production of tap water follows many procedures that involve various chemical additives for water purification. Tapped water is the best for drinking, but it is associated with the following cons. First, tap water is cleaned using lead and chlorine chemicals that poses a lot of threats to people if not well mixed. Second, tap water has a higher probability of being contaminated with germs especially when a leakage occurs on an underground pipe. In addition, tapped water is liable for contamination with germs where the water fountains are used by many people. Moreover, contamination occurs because of the materials used for collecting water, for example dirty jerry cans, and tanks (New York Times, 2007).
Disadvantages of bottled water
Food and Drug administration (FDA) regulates bottled water production. The production of bottled water is well monitored, and many activities are involved. Bottled water is extremely expensive especially when used frequently, and only the rich people afford it. More cost is incurred to take a bottle of water compared to filling a glass of water from a sink. Second, bottled water is wasteful because only the bottle remains. In addition, some minerals are taken away during production of bottled water useful to the body. On the other hand, bottled water costs more than tap water because of the many processes involved. Moreover, many environmental repercussions are associated with bottled water (Gleick, 2009).
Environmental effects of water bottles
Plastics have adverse effects on individual’s physical health, and to the planet’s health at large. Water bottle production in industries requires a lot of energy generated from burning carbons. The carbon releases toxic carbon dioxide to the atmosphere resulting to global warming, a very serious environmental hazard. In addition, large volume of water is used in production of these bottles that could be treated and fed into domestic pipes for use. After drinking water, the bottles become waste, and more cost is incurred while disposing them. Most of these exposed bottles end up in landfills, about 23% of the total used bottles. Most bottles end up in incinerators, or are left outside to the natural ecosystem. Landfills are being filled up at a very fast rate, and valuable space is wasted by these water bottles. If the government could come up with policies regulating the production of bottled water, a lot of space could be saved in landfills for other biodegradable waste materials (Gleick, 2009). According to New York Times (2007), bottles spread all over the ground due to poor recycling methods. These create dwelling places for harmful insects, like mosquitoes, causing a threat to people’s lives. Most countries have realized the need for turning on the tap water and withdrawing from bottled water since it saves more cash leading to a more stable economy.
Health issues
Many people prefer bottled water in fear of health issues related to tap water. Bottled water is the most contaminated because it contains some traces of chemicals used in the manufacture of bottles, and also during its purification. Buying bottled water is unhealthy because a person ends up being exposed to chemical compounds that have serious health effects. Research done in America found out that some samples of bottled water contained toluene, a gasoline constituent used in paint thinners. This compound is associated with cancer causing agents (US Environmental Protection Agency, 2005). Water bottle health effects are felt after a long time because the toxins accumulate in the body as people continues drinking bottled water. Moreover, some bottles are recycled increasing the effects of infection because of the methods used for recycling (Standage, 2005).
Why drink tapped water
Tapped water is the safest because it is less costly, and has less health effects. All nations ensure they produce clean municipal water, and nobody should think of drinking bottled water, especially in America. On the other hand, physicians recommend that an individual should take at least 8 glasses of clean water daily. A person following this argument would end up spending almost 1400 dollars per year on bottled water compared to 49 cents spent on tapped water. In addition, tap water has no environmental effects. Some states have banned people from buying bottled water because of the impact it causes to the natural environment. Most companies producing bottled water extracts it from the ground water leading into depletion of the natural water sources. In U.S, the large water bodies are changing due to depletion of service water. Moreover, tap water leaves no remnants on landfills across the continent (New York Times, 2007).
Summary
Drinking bottled water has no advantages over tap water even though the tap water is not 100% safe. Tap water saves a nation a lot of revenue because it has low cost of production and maintenance. In addition, it is most convenient for use in the developing countries since most people are below the poverty line, and would not afford drinking bottle water daily. The health issues associated with bottle water could be minimized if the government focuses on giving citizens clean and adequate tap water (Zak, 2011).
Conclusion
Both tap water and bottled water have their own disadvantages that make a consumer choose which type to use. More reforms are necessary to produce high quality water that is environmentally conscious and cost effective. People should spare bottled water for use during emergency cases for people whose health only requires very clean water. Drinking tapped water is more economical, and has no environmental effects associated with it. Countries should ensure water treatment plants are well maintained in order for them to produce clean water and discourage production of bottled water. I prefer drinking tap water to bottled water.
ReferencesGleick, P., & Cooley, H. (2009). Energy Implications of Bottled Water. Oakland, CA: IOP
Publishing.
Gleick, P. H. (2010). Bottled and Sold: The Story Behind Our Obsession with Bottled Water.
Washington DC: Island Press.
New York Times (2007). In Praise of Tap Water. Retrieved from:
http://www.nytimes.com/2007/08/01/opinion/01wed2.html?_r=0Standage, T. (2005). Bad to Last Drop.
US Environmental Protection Agency. (2005). Safe Water. Retrieved from Water & Health
Series: Bottled Water Basics. Retrieved from:
http://www.epa.gov/safewater/faq/pdfs/fs_healthseries_bottlewater.pdf.
Zak, M. (2011). Defying the Nelgene. Retrieved from:
http://aseoanebsu.blogspot.com/2011/09/defying-nalgene-by-zak-moore-reflection.html
Type-1 Interferon Alpha Receptor and Bipolar Disorder Proposal
Student’s Name
Professor’s Name
Course
Date
Type-1 Interferon Alpha Receptor and Bipolar Disorder Proposal
Specific Aims
The primary objective of this proposal is finding whether blocking type-1 interferon alpha receptor is a potential way of inhibiting bipolar disorder development.
Bipolar disorder institutes a significant public health delinquent which affects almost 1.5 percent of the adult populace. It can result in severe long-term impacts, and thus it is usually connected with substantial psychological damage. According to Qurashi and Frangou [210-213], a contemporary analysis which was sponsored by the National Institute of Mental Health, as well as the Agency of Health Care Policy and Research, discovered that 1.3 million patients who had temperament disorders found out that the financial rate of bipolar malady is 3.5 times that of primary depression. Thus, bipolar disorder is furthermore a significant jeopardy element for suicide. The demises characterized with by suicide are like thirty-five times of that which was found in the overall population. Apart from lithium treatment, the long-term treatment, as well as reintegration of bipolar disorder, has been comparatively disused compared to handlings for unipolar mood maladies and also schizophrenia. Therefore there is a better focus on the growth plus the use of advanced, long-term therapeutic intrusions including natural as well as psychosocial treatments.
The long-term goal is reviewing the theoretical as well as clinical features of mood disorders related to interferon treatment and also evaluate their administration. Also, another objective is analyzing and examining proper clinical methods of inhibiting bipolar disorder in this paper is dissected and scrutinized.
Significance
Bipolar disorder is an austere as well as a persistent psychiatric condition which in numerous instances starts during primary adulthood and follows a reverting besides a dispatching progression throughout life. The disease seems to pursue an advanced trail with short-term stages of inter-episode recapture, sub-inception signs, and treatment resistance as well as increasing functional damage in the biopsychosocial areas. It is discernible by regular temperament exacerbations which can be of reverse schism, stretching from main depressive occurrences to manic occurrences.
Type I interferon is a cytokine which affords one of the first streaks of host resistance against virus infection by all FMDV serotypes. It triggers intercellular antimicrobial programs and also effects the growth of innate and adaptive immune reactions [217-220]. Type 1 interferon has been associated with suppression of tumorigenesis together in hematological as well as substantial development. The type 1 interferon’s which came into existence about more than an era ago, is part of the helical cytokines superfamily. They comprise secreted proteins which are vital for antiviral invulnerability, ant proliferation as well as immune-modulatory actions in vertebrates, acting in almost every nucleated cell. Therefore due to their extensive range of undertakings, type 1 interferons are applied as a method of treatment of numerous human diseases, for example, hepatitis C, multiple sclerosis plus cancer.
Approach
In the contemporary years, various recombinant interferon proteins have been accepted and hence are commercially available for the treatment of several diseases. However, the therapeutic advantages of the causes of the disease are occasionally hindered by their harsh as well as upsetting adversative effects, for example, depression which is a bipolar disease, cognitive impairment and also mania.
Rationale
The work of Iancu [834-835], suggests that Interferon alpha treated patients have been reported to grow depression during the entire therapy period regularly. Though most Interferon induced depressive disorders attain remission after the therapy, there have been no studies which have achieved to test the long-term mood special effects of Interferon treatment. The central depressive disorder is a greatly intermittent illness, and hence its recurrence is a significant goal for its problem. Several population studies have established a 40 to 75 percent lifetime recurrence of the central depressive syndrome amid the patients who have recuperated from their initial depressive episode. The patients have been studied for some several years, and thus the understanding of the mechanisms underlying its relapse remains to be inadequate because most studies typically explore major depressive disorder in the acute phase.
Preliminary Data
The works by Lichtman and Judith [1770-1771] discoursed that Majority of the illnesses in which interferon are recommended have been characterized to have severe complications. For instance, it has been assessed that 3.9 million Americans were affected and also infected with the hepatitis C virus between 1988 and 1994. As a result of some of the infected patients ultimately develop liver cirrhosis plus hepatocellular carcinoma. Therefore this shows that there is a need for blocking the type-1 interferon alpha receptor as a prospective technique to inhibit bipolar disorder progression. The type-1 interferon therapy is linked with depression which is an example of bipolar disorders as well as some neuropsychiatric adversarial effects. In a specific literature review, Dusheiko classified these adverse effects of interferon-alpha into four major groups as follows:
Trivial to moderate adversarial impacts which do not need dose alteration
Trivial to mild adversarial effects which may require some dose change
Severe adversative effects and lastly
Irretrievable adversarial consequences
Amongst the adversely special effects are some neuropsychiatric symptoms which include seizure, ataxia, fever, blindness, akathisia, and paresthesia and some mood-linked symptoms.
Over the years it has been broadly stated that the interferon alpha treatment may be associated with mood variations. A meta-analysis which was conducted in which the occurrence of depression was indicated to be seven percent for a treatment duration of six months with three million units (MU) of interferon alpha and ten percent for six months of treatment with doses which were higher than five million units (MU). Moreover, a group of researchers who came from Finland during the early 1980s described psychomotor obstruction as a neurotoxic adversative impact of high dosages of interferon which was given to the individuals with amyotrophic lateral sclerosis [1773-1774]. Some behavior changes were also reported in ten patients who had been indicated to have metastatic renal cell carcinoma. In this case, the alterations were experienced in the first week of therapy with humanoid leukocyte interferon. Also, psychomotor retardation was regarded to be the most substantial sign in their small sample. In another non-blind precise study which was conducted, it monitored psychopathology in a cluster of twenty-seven individuals who were all men infected with chronic hepatitis B, treated with interferon alpha-A.
From the experiment, the most recurrent symptoms experienced symptoms were tiredness, anxiety, lack of attentiveness and depression. Most of these symptoms were associated with bipolar disorder, and that is the reason I suggest in this paper that the type-1 interferon alpha receptor should not be used as an exceptional way to inhibit bipolar disorders since it is projected to result to more problems. Additionally, a group of fifty-eight chronic hepatitis patients which comprised of forty-nine patients with hepatitis C and nine patients who had other types of hepatitis were treated with interferon alpha. It was reported that three patients who were on high dose psychoanalysis and had depressing symptoms, attributed to therapy. All these studies reported the frequency of interferon-induced mood disorders varied.
From the above analysis, it is evident that the depression symptoms in interferon-treated individuals can be austere and disabling. There has been reported thirty-nine to forty-two suicide attempts as well as the completed suicides. Moreover, depression in interferon-induced treated patients cannot be easily projected. However, decreasing the dosage of interferon or the delay of interferon psychoanalysis may lessen the symptoms. The application of antidepressant agents, mainly the discerning serotonin reuptake inhibitors has as well been encouraged [1774-1775]. Depression resolves in about one month in some patients after the suspension of interferon treatment. Therefore it is depicted that the recommencement of interferon psychotherapy in patients alleviated on antidepressant agents is suitable, and hence a clinical decision is suggested. Thus, in patients treated with interferon alpha, cognitive debits as well as delirium ought to be distinguished from depressive symptoms. Moreover, the therapeutic use of interferon has as well been linked with manic indications.
Research Plan
This research will comprise of undertaking an experiment in a group of about six patients who exhibits some diseases like Hepatitis which is considered to connect well with interferon. One group of three patients will be subjected under the treatment of interferon for about two weeks. Consequently, the other group will involve the other three patients, however, this group will not be subjected under interferon therapy and will also take two weeks. During this period the reaction of the patients will be examined to observe whether there will be any adverse changes in the two groups of patients. Data analysis will also be collected and reviewed to explore whether there will be experienced any adversative effect between the patients and the interferon. This will entail studying and analyzing whether interferon therapy inhibits bipolar disorders for example whether it might lead to some distresses like depression or not.
Discussion
Depression typically ranges from short-lived depression to an austere as well as a disabling disorder. It is evident that uncontrolled studies as well as anecdotal reports ought to be interpreted with caution plus skepticism, and therefore this study follows the same course. According to Miller and Charles [736-738], clinical opinions propose that, in some patients, substantial mood-related clinical symptoms are linked with interferon therapy. Therefore in this study, it is expected that the patients treated who were with the interferons, development or exacerbation of their major ailment, for example, chronic hepatitis could mimic or contribute to the interferons depressing symptoms. Thus this study will help in distinguishing disease-related depressing features from interferon-prompted depression.
In this study, it must be noted that the proper assessment of patients considered for interferon therapy is necessary. If there is an absence of severe concurrent affective symptoms which are associated with bipolar disorders, a history of mood disorders does not continually institute a contraindication to the use of interferons. Therefore such kind of patients’ needs to be carefully observed at the progress of therapy for good results at the end of the study.
Works Cited
Quraishi, Seema, and Sophia Frangou. “Neuropsychology of bipolar disorder: a review.” Journal of affective disorders 72.3 (2002): 209-226.
Iancu, I. et al. “Bipolar Disorder Associated With Interferon-Alpha Treatment.”. Postgraduate Medical Journal, vol 73, no. 866, 1997, pp. 834-835. BMJ, doi:10.1136/pgmj.73.866.834.
Lichtman, Judith H., et al. “Depression and coronary heart disease: recommendations for screening, referral, and treatment: a science advisory from the American Heart Association Prevention Committee of the Council on Cardiovascular Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, and Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Psychiatric Association.” Circulation 118.17 (2008): 1768-1775.
Torrey, E. Fuller, et al. “Seasonality of births in schizophrenia and bipolar disorder: a review of the literature.” Schizophrenia research 28.1 (1997): 1-38.
Miller, Andrew H., Vladimir Maletic, and Charles L. Raison. “Inflammation and its discontents: the role of cytokines in the pathophysiology of major depression.” Biological psychiatry65.9 (2009): 732-741.