Fall Risk Prevention In Health Care University Essay Example

The fall risk prevention has always been an ongoing issue for the health care sector. There are numerous facts that evidence the appearance of a number of various complications among patients experienced falls in the acute care setting (Shorr et al., 2012). Accidental falls are one of the most frequent accidents resulting in the significant deterioration of the state of a patient. Regarding the elderly patients, the problem becomes more complex as the consequences of fall are usually more significant for them.

For these reasons, the fall risk prevention becomes one of the major concerns aimed at the promotion of the health of a patient and decrease of the number of complications resulting from the accidents of this sort. There are several preventive measures that are intended to monitor the state of a patient and provide the needed assistance. The usage of bed alarms or frequent rounding is taken as one of the possible variants to improve the situation in the given sphere. However, there are still debates related to the efficiency of the given measures.

Besides, the article Effects of an intervention to increase bed alarm use to prevent falls in hospitalized patients: a cluster randomized trial also delves into the investigation of the practical utility and viability of the implementation of bed alarms to reduce the number of falls. The paper tends to “investigate whether an intervention aimed at increasing bed alarm use decreases hospital falls and related events” (Shorr et al., 2012, 692). The necessity of the given investigation is proved by the continuous debates about the efficiency of the measure and its advantages comparing with the practice of frequent rounding. The paper introduces the credible data to analyze the issue and provides the results to prove or refute the practicability of the further usage of bed alarms in the acute care setting to reduce the number of possible complications.

Resting on the main goal of the study, the authors suggest the pair-matched, cluster randomized trial over 18 months (Shorr et al., 2012). The term will be enough to collect the needed data and fix all possible changes of the setting. Therefore, nursing units were distributed randomly on the basis of fall rates. The usage of a computer and random allocation of units promotes the increase of the credibility of the obtained information and helps to exclude numerous external factors that could distort the results of the study. Furthermore, the patients participating in the study and outcome assessors were blinded while some of the last ones may also have become unblinded (Shorr et al., 2012). The given research design guarantees the efficiency of the analysis and increases the feasibility of the results obtained in the course of the investigation.

The study implies the constant monitoring of sixteen nursing units in an urban community hospital. It introduced the possibility to involve a significant number of participants into the experiment to obtain the reliable data. The sample was collected from 27 672 patients who became the main participants of the research (Shorr et al., 2012). They were separated into two control groups. The members of the first one were trained and explained how to use the standard bed alarm system while the rest of the participants were just provided with bed alarms. The given number of participants helps to create the adequate sample size that contributes to the better investigation of the issue. Additionally, the adequacy of the given size is also proved by the existence of two control groups that help to compare the results of the intervention and make a certain conclusion.

The investigators used the statistical data about the fall rates at Methodist Healthcare University Hospital. It was recorded during the eight-month period. Sixteen medical units with 349 beds provided the information about a number of patients using the bed alarm system. The authors used the electronic medical record of the hospital to gather the primary data about the usage of the tool and the impact it had on the state of patients (Shorr et al., 2012). They also analyzed the nursing documentation in the medical records, audits of orders for alarms, and direct observations to collect the needed data (Shorr et al., 2012). The given method and tools prove the credibility of the sample and provide numerous possibilities for the further analysis of the obtained results. Furthermore, the authors of the research took part in the investigation contributing to its development.

Analyzing the study, it is possible to admit the feasibility of the main assumptions and the wide range of possibilities for cogitations introduced by the chosen methods and sample. Yet, there are still several limitations resulting from the character of the investigation. First, the given pattern complicates the determination of the most common reasons for falls as the researchers are interested in the recording of the fall rate and the effect bed alarm has on it. For this reason, the paper could not provide the essential information that could be useful while creating the plan of preventive measures.

Additionally, the authors tend to compare the efficiency of the bed alarm system with the efficiency of usual care that implies rounding, monitoring, etc. However, the given pattern makes this task more complex as it is difficult to obtain the data related to the efficiency of usual care in the same settings. Another significant limitation of the study is its inability to use a blinded manner to guarantee the greater credibility of the results. Finally, the authors themselves admit the low fall rates that prevented them from the precise assessment of the data and its analysis. (Shorr et al., 2012).

In the course of the study, the investigators come to the conclusion that the intervention aimed at the improvement of the fall rates might have the positive effect in case patients are explained the basic principles of the usage of bed alarms. In this regard, the study proves the authors hypothesis and accepts the efficiency of the tool. At the same time, the investigators conclude that alarm signals may after a patient had already fallen (Shorr et al., 2012). This fact introduces the necessity of the further investigation of the issue to determine the perspectives and applicability of bed alarms as the main remedy to decrease the fall rates.

To summarize, the given paper provides the credible information related to the usage of the bed alarm system and its impact on the question of fall risk prevention. It proves the relative efficiency of the tool and provides the rationale for its further development. However, the paper does not make the final conclusion about the necessity of the usage of bed alarms to prevent patients falls. For these reasons, it is possible to suggest the further investigation of the issue to gather more information about the peculiarities of bed alarms and frequent rounding.

Reference

Shorr, R., Chandler, M., Mion, L., Waters, T., Liu, M., Daniels, M.,…Miller, S. (2012). Effects of an intervention to increase bed alarm use to prevent falls in hospitalized patients: a cluster randomized trial. Annals of Internal Medicine, 157(10), 692-699.

Impulsive And Compulsive Buying Behaviour

The methodology chosen for this research is the case study that is associated with the focus on a particular problem (Creswell, 2012). The problem under analysis is the compulsive buying disorder in women in their late 30s, and the focus is on the way these females see their conditions, its causes and effects on their personality, career, family and so on. The philosophical assumption and philosophical framework behind this study are concerned with the analysis and interpretation of various realities. The methods of data collection and analysis are consistent with the philosophical framework of the research.

It is necessary to note that the ontological philosophical assumption serves as the basis for this study. Creswell (2012) states that the ontological philosophical assumption aims at analyzing different realities people live in to gain knowledge concerning a problem. Therefore, the researcher will focus on accounts of the participants who will share their views and attitudes. Importantly, the researcher will encourage the participants to consider different domains and explore the realities they live in.

For instance, such aspects as personality and depression have appeared in scholars’ lens. For example, Shahjehan, Qureshi, Zeb and Saifullah (2012) and Granero et al. (2016) explore the correlation between personality and compulsive buying behaviors. At the same time, Müller et al. (2014) also pay attention to such dimension as depression. Of course, apart from these elements, it is crucial to look into such realities as professional life, family life and so on. The attention to multiple aspects can enable the researcher to get the necessary data on the problem, its causes and effects.

As to the philosophical framework, social constructivism can be utilized as it also focuses on multiple realities and provides particular tools to analyze them. Creswell (2012) notes that this framework puts interpretation to the fore. People live in the realities that often get in touch with each other. They are also full of meaning that can be elicited through interpretation.

The philosophical paradigm mentioned above is associated with the use of the interview as the major data collection method. Therefore, semi-structured interviews will be carried out. This data collection tool enables the researcher to adjust questions and elicit the participants’ opinions on various aspects, thus, describing realities they live in. To obtain more diverse data, the analysis of literature available on the matter will also be implemented. This information will help in the development of interview questions and aspects to pay attention to.

Finally, the construction of realities is also associated with the digital world. To gain more insights into the realities of the participants as well as ways to interpret them, the researcher will briefly review information (textual and visual) the participants post in social networks. Since people now invest a lot of time in communication through social networks, posts made during the past six months will be viewed. These data will help the researcher to get a broader view of the participants’ opinions.

As far as data analysis is concerned, the philosophical framework, as well as the nature of the case study methodology, presupposes the identification of themes recurrent in the participants’ accounts (Creswell, 2012). The themes will be analyzed and placed in chronological order. The frequency of themes will also be estimated, which will help in detecting the most relevant themes.

On balance, it is necessary to note that this research will be based on the case study methodology. The ontological philosophical assumption and social constructivism frame the case study tools that include the analysis of the participants’ accounts obtained through interviews and the review of secondary sources as well as the participants’ posts in social networks. These tools will provide the researcher with the necessary data to analyze and interpret realities of a certain group of women.

References

Creswell, J. (2012). Qualitative inquiry & research design: Choosing among five approaches. Thousand Oaks, CA: Sage Publications.

Granero, R., Fernández-Aranda, F., Mestre-Bach, G., Steward, T., Baño, M., & Del Pino-Gutiérrez, A…Jiménez-Murcia, S. (2016). Compulsive buying behavior: Clinical comparison with other behavioral addictions. Frontiers in Psychology, 7. Web.

Müller, A., Claes, L., Georgiadou, E., Möllenkamp, M., Voth, E.M., & Faber, R.J… De Zwaan, M. (2014). Is compulsive buying related to materialism, depression or temperament? Findings from a sample of treatment-seeking patients with CB. Psychiatry Research, 216(1), 103-107.

Shahjehan, A., Qureshi, J.A., Zeb, F., & Saifullah, K. (2012). The effect of personality on impulsive and compulsive buying behaviors. African Journal of Business Management, 6(6), 2187-2194.

Personal Genomics, Its Biological Basis And Implications

Biological Basis

The concept of personal genomics can be defined as the area of genomics which addresses the issues of gene sequencing, creating a personal eTQL genomic profile, and other aspects of obtaining essential information from one’s genome (Martinez-Jimenez et al., 2015). Particularly, the concept implies that the order of four crucial elements, i.e., “adenine, guanine, cytosine and thymine” (Gupta, 2016, p. 359) should be determined in the process.

An accurate identification of the nucleotide sequence, also known as the DNA strand basis, can be viewed as the ultimate goal of the gene sequencing process. The approach referred to as the “single-nucleotide addition (SNA)” (Goodwin, McPherson, & McCombie, 2016, p. 335) method of DNA sequencing needs to be brought up as one of the most common tools for carrying out the genome sequencing process.

However, when it comes to discussing the approaches that have only recently been introduced into the context of the contemporary genetic studies, one must mention the frameworks known as Sequencing by Hybridization (SBH), Sequencing by Synthesis (SBS), Sequencing by Ligation (SBL), Pyrosequencing, Nanopore DNA Sequencing, Ion Torrent semiConductor Sequencing, Illumina (Solexa) Sequencing, Transmission Electron Microscopy for DNA Sequencing, and Nanopore Sequencing (Yadav, Shukla, Omer, Pareek, & Singh, 2014). The identified approaches imply the analysis of rather long DNA sequences, as well as the entire chromosome (Martinez-Jimenez et al., 2015).

A DNA structure includes two primary elements, i.e., a sugar phosphate backbone and base pairs containing Adenine, Thymine, Guanine, and Cytosine (Goodwin et al., 2016). Its functions are restricted to carrying essential genetic information. The resulting gene expression defines the functioning of an organism, e.g., the production of specific secretions, etc. Using the information contained in a DNA will allow managing hereditary diseases, preventing severe health outcomes, and fighting the health threats that are currently considered impossible to address.

The process of genome sequencing may vary depending on the approach chosen by a researcher. To analyze the process, one may consider Nanopore Sequencing as one of the latest innovations in the personal genomic research. The process implies that the DNA strands should be heated and that the reaction should occur in the presence of a substance known as dideoxyribonucleotide. Dideoxyribonucleotide is quite similar to DNA, yet it does not have the 3′ hydroxyl group.

The DNA strand is replicated with dideoxy-T serving as the catalyst. The entire process implies that the DNA should be threaded through a pore in a membrane. First, a protein unzips the DNA helix so that it could be represented by two strands. Afterward, the second protein creates a pore in the membrane while holding the molecule that serves as an adapter and, therefore, does not allow it to close. Ions flow through it, thus, creating a current, which is altered by two base blocks (Goodwin et al., 2016). Finally, the adapter molecule keeps the pore open for the amount of time required to identify the ions and carry out an all-embracive analysis thereof, as Figure 1 below shows.

Nanopore sequencing
Figure 1. Nanopore sequencing (Shaffer, 2012).

By adopting the technique described above, one becomes capable of decomposing and reading DNA bases successfully. As a result, the unique characteristics of a patient’s genetic makeup can be identified. Particularly, the propensity toward developing certain diseases and disorders can be determined.

Social and Ethical Implications

When considering the effects of deploying personal genomics as a standard tool for addressing hereditary diseases, one is likely to encounter a range of ethical issues, the threat of genetic discrimination being the key one. By definition, generic discrimination implies a scenario in which the attitude toward one patient is strikingly similar to another one because of the ostensible gene mutations observed in one of the patients.

Viewing the needs of the patient that seems to have gene mutations as superior to the ones of the patient that has not undergone a genomic analysis or does not have the specified mutations is viewed as a possible form of discrimination that may infringe some patients’ rights (Hallowell, Hall, Alberg, & Zimmern, 2013).

Therefore, it is possible that the use of personal genomic analysis results as the means of prioritizing patients’ needs and defining some patients’ concerns as inferior to the ones of other customers will be observed in the context of healthcare facilities once a genomic analysis becomes a common service. On the one hand, there are legitimate reasons for the identified concern. Indeed, with the promotion of personal genomics as an essential tool in determining the genetic makeup of patients, some of the latter, whose health issues will have been known to a therapist, are likely to be seen as the top priority.

In other words, the risks of applying it to manage the needs of patients in the context of a healthcare facility are moderate. On the other hand, the specified tool is likely to allow preventing the instances of serious health problems, the development of severe consequences, and, possibly, reducing the death toll significantly. Thus, its benefits are quite numerous. Therefore, the use of personal genomics seems quite sensible.

Moreover, the threat of overlooking the needs of people from underdeveloped states will become tangible with the enhancement of personal genomics tools. Indeed, because of the cost of the services, they are likely to be affordable only to people with a rather high income. The risks of failing to address the needs of the members of poor communities are very high in the specified scenario. Therefore, the strategies for reducing the costs for the procedures relate dot personal genomics will have to be deployed. For instance, searching for the ways of financing healthcare facilities providing personal genomics services in low-income areas will have to be considered (Hallowell et al., 2013).

Personal Viewpoint

It seems that the application of personal genomics tools as the methods of determining the presence of genetic disorders in patients must be deployed in the context of the modern healthcare environment. The adoption of the specified framework to locate possible issues in people’s physiological and psychological development is, therefore, completely legitimate. Despite the fact that its current affordability leaves much to be desired, as well as the fact that it may compel therapists to put the needs of certain patients in front of the needs of others, the application of personal genomics tools may provide the results that will help save people’s lives.

Consequently, the further promotion of personal genetics must be enhanced in the context of the contemporary healthcare environment. Financial resources must be provided to equip healthcare facilities with the devices that are required to carry out a personal genomics analysis. For instance, the tools for carrying out bioinformatics-related processes will have to be incorporated into the set of devices used by healthcare practitioners.

It should be noted, though, that the identified changes will also require placing a powerful emphasis on the promotion of patient and nurse education. Customers will have to be instructed about the specifics of the procedures, their effects, and the health opportunities that they provide. Nurses, in turn, will need to acquire the skills that will allow them to manage the processes related to a personal genomic analysis successfully. As a result, a gradual improvement in patient outcomes is expected.

References

Goodwin, S., Mcpherson, J. D., & Mccombie, W. R. (2016). Coming of age: Ten years of next-generation sequencing technologies. Nature Reviews Genetics, 17(6), 333-351. Web.

Gupta, P. D. (2016). Nanopore technology: A simple, inexpensive, futuristic technology for DNA sequencing. Indian Journal of Clinical Biochemistry, 31(4), 359-360. Web.

Hallowell, N., Hall, A., Alberg, C., & Zimmern, R. (2013). Revealing the results of whole-genome sequencing and whole-exome sequencing in research and clinical investigations: Some ethical issues. Journal of Medical Ethics, 41(4), 317-321. Web.

Martinez-Jimenez, M. I., Garcia-Gomez, S., Bebenek, K., Sastre-Moreno, G., Calvo, P. A., Diaz-Talavera, A.,… Blanco, L. (2015). Alternative solutions and new scenarios for translesion DNA synthesis by human PrimPol. DNA Repair, 29, 127-138. Web.

Shaffer, A. (2012). Nanopore sequencing. MIT Technology Review. Web.

Yadav, N. K., Shukla, P., Omer, A., Pareek, S., & Singh, R. K. (2014). Next generation sequencing: Potential and application in drug discovery. The Scientific World Journal, 14, 1-7. Web.