Monday, January 27, 2020

History of and Importance of Handwashing

History of and Importance of Handwashing Introduction Hand washing is the removal of micro-organisms from hands using running water or alcohol rub or gel (Brooker and Waugh, 2007). It is the most effective way of controlling the spread of infectious diseases in hospitals and populated areas. The skin is a vital part of the body that acts as a demarcation between internal and external environment and hence should be kept clean all the time to prevent harmful micro-organisms from entering our bodies (Merchant, 2001). These micro-organisms on the skin can either be resident or transient. Resident micro-organisms also called normal flora are harmless and provide protection against colonization by transient organisms and are not transferred from one person to the other, however they may cause problems if the skin is damaged or if the immune system is weak (Carroll, 2001). Transient micro-organisms are transferred from one person to the other and therefore are capable of spreading infections (Carroll, 2001). Hands can appear as if they are cl ean yet they are contaminated with bacteria, therefore it is always good practice to wash hands regularly. Staff members can pass infectious diseases to patients and patients can also pass diseases to staff members or other patients. Since this is a major issue the author will review hand washing as a means of reducing the spread of infections. The review looks at why hand washing is still an important matter; its historical perspectives, proper hand washing techniques, and the benefits it can bring to patients if practiced properly. The historical background of hand washing explains clearly that most health professionals are found to be the most usual transporters of the bacteria to patients, even though they know that the secret of controlling infections is proper hand hygiene. The production of hand washing liquids dates back from as early as the 19th century when in 1822, Labarraque, a French pharmacist carried out experiments to demonstrate that liquid chloride solutions could successfully eradicate the smell coming from human dead bodies (Safe Care Campaign, 2007). In 1825, Labarraque then recommended the use of these chemicals in hospitals by doctors handling people with contagious diseases in order to moisten their hands but no one followed the instructions (Safe Care Campaign, 2007). In 1846, Dr Ignaz Semmelweis did research on why the ward where medical students were working had a high rate of deaths in comparison to the ward were qualified midwives were working. The results showed that medical students who were having their lectures were rushing to the ward without washing their hands. Instead of washing their hands they were going straight to the patient in the ward. As soon as the error was fixed the death rate started to decline (Advanced Scientific Health, 2010). Recently a report was published by Pfizer limited which showed an increase in MRSA infections. It is believed that 9% of patients in hospitals in England (About 100,000 people per year) have healthcare associated Infections, many of which are due to MRSA. There are between 6,000 and 7,000 MRSA bloods stream Infections each year in patients in NHS hospitals in England. In 2005 in England and Wales, 1,629 deaths Certificates mentioned MRSA as a contributory factor; and MRSA was cited as the main cause of death in 467 of these cases (Pfizer limited, 2009). With this high rate of current MRSA cases in hospitals it is imperative that patients in hospitals, their families and their carers have the correct information avail able to them so that they know the risks of not adhering to proper hand washing techniques when they are in hospitals. Hand washing Technique The NHS is encouraging all health professionals to practice proper techniques of washing hands. It is argued that the more emphasis stressed on this message, the more effective it becomes. The technique of proper hand washing is very essential in any health care setting. The routine or social hand washing technique mainly emphasizes on thorough washing of hands using liquid soap and running water for 15 to 20 seconds without missing any part. It is recommended to use liquid soap delivered from a dispenser as compared to bar soap as the latter may be contaminated by the previous user or the surrounding atmosphere (Carroll, 2001). The diagram in figure 1 in apprentices section below shows most parts of the hands that are frequently missed during hand washing (Nazarko, n.d). These areas that are missed during hand washing may harbor micro-organisms that will then spread to other patients. There is no specific time that is recommended to wash hands. Hands are washed depending on a specif ic task. Health workers are advised to wash their hands when starting or finishing their shift. Several activities such as wound dressing are prone to bringing bacteria to patients and therefore, hand washing should be practiced regularly. Nurses must make sure that they wash their hands before and after they attend another patient and also whenever there is any contact of blood and body fluids or after removal of gloves. It is also advised to wash hands before and after eating and drinking and also after visiting the toilet (Wilson, 2006). Micro-organisms are very tiny such that they cannot be seen with a naked eye. Therefore, it is encouraged to maintain have short nails as longer ones easily accommodate micro-organisms that may be difficult to remove during hand washing. The areas under the watches, rings and bracelets also harbor millions of bacteria; therefore it is also advised not to wear these in hospitals (Gould, 2009). Nurses are also encouraged to wear short- sleeved clot hes. Technological developments have also led to the introduction of next generation ultraviolet light based training kits which are being manufactured by a company called Glowtec. These kits are used to check if the hands have been properly washed before attending to a patient (Glowtec, n.d). This form of hand washing technique is used to see a microscopic dirty surface that cannot be seen by a naked eye therefore improving the control of the infections. Hygienic Hand disinfection is another technique that is used to remove or destroy transient organisms from the skin by washing hands with an antiseptic such as chlorhexidine gluconate, iodine or triclosan for 15-30 seconds and should be carried out before aseptic procedures or during a pandemic situation (Carroll, 2001). The diagram in figure 2 of the appendices section below shows how to wash all areas of the hands to remove any visible contamination of the hands and also to effectively remove transient organisms (Nazarko, n.d) Surgical hand wash is also another technique that is used during surgery which involves the scraping or brushing of the nails with a sterile nail brush, washing hands and forearms with an antiseptic for a minimum of 2 minutes and then drying with a sterile towel (Carroll, 2001). This technique therefore removes transient organisms and reduces the levels of resident organisms. Hand drying is also another vital technique that involves using paper towels, the warm air dryer or sterile towels. This procedure is very important because micro-organisms are spread from one person to the other easily in wet conditions than in dry conditions and drying also reduces the risk of developing sore dry skin (Gould, 2009). Benefits to Patients Patients are the most vulnerable people who are supposed to be taken good care of in a health setting they benefit a lot from hand washing program. It prevents them from cross infection disease among themselves and those who are in care of them (BMJ, 2010). Hand washing is a process that brings hope and assurance to a patient. The patient is likely to recover better. But if a patient is in pain he or she is likely to develop physical or mental problems. If the patient is affected mentally he or she is prone to depression therefore it means the patient would develop infection due to stress environment. Another benefit of hand washing is short stay in hospital, which will enhance the social and economic (no loss of wages) part of a patients life. Eventually this would improve the quality life of a patient. Hand Hygiene Policy (2010) According to Hillingdon Annual Public Health Report 2004 a lot of death can be avoided by hand hygiene, especially those disease caused by MRSA and again a patient is also able to escape isolation in hospitals. Since patients with serious MRSA are sometimes isolated from other patients because of fear of infecting others. Therefore hand washing scheme enhances the well being of a patient. Conclusion Finally the best way of decreasing infectious diseases to patients is hand wash hygiene. According to one of the pioneers of hand wash Dr Semmelweis death rates in hospitals can be lessened if all health professionals follow the idea of handwash. Pathogens and bacteria that are found on hands are said to be the most dangerous causes of infectious diseases unless they are decontaminated by using proper hand technique patients would still suffer the same fate of olden days. According to my opinion hand washing has been discovered long time ago as a main factor of causing infectious diseases but up to now it is still not practiced in a proper way. If each nurse as an individual and those in care underpin the scheme of hand technique in an appropriate manner, they can be a massive change that can bring safety and trust to patients, their families, and friends and even to nurses themselves. Therefore children must be educated on how and when to wash their hands starting from the toddlers so that they can get used to the principle as they grow up. More education training is needed to all health professional on regular basis. If every step of hand washing is followed according to rules and regulations there can be a drastic change in all health care settings.

Sunday, January 19, 2020

Bless Me Ultima Essay -- essays research papers

Blood becomes the river. The human race dies and only the â€Å"she-goats and the he-goats† (109) remain. The lake â€Å"cracked with laughter of madness† and the â€Å"ghosts stood and walked upon the shore†.(109) Who dares dream such gruesome images? Antonio Marez. He questions God, he communicates with the dead, the dead ask him for blessings. Just who is this Tony? Tony is only a seven year boy who lives in small town of El Puerto. But he is no ordinary boy, he is the hero of Rudolfo Anaya’s Bless Me Ultima. The novel guides you through Tony’s life. From childhood to adulthood. It tells you about the experiences Tony has in life. The difficult tasks he has to overcome. Tony being only seven years old has to go through a lot.   Ã‚  Ã‚  Ã‚  Ã‚  Tony begins his story in the beginning. He does not mean the beginning of his dreams from which he learned the story of his birth and the people whom his father and mother belong to, and the story of his three brothers. He means the beginning of Ultima. Ultima is one of the most important people in Tony’s life. She is not only a curandera (healer) she is also Tony’s teacher. She guides him through his journey. A journey in which he has to find out what his destiny is. â€Å"Ultima† means â€Å"the end† for Tony Ultima is the unification between the beginning and the end. Time almost sees her as a sort of deity. Tony learns from her the names of plants, the herbs, the flowers, bushes and his appreciation for nature grows. Tony learns about the â€Å"...

Saturday, January 11, 2020

Memo Report †Starbucks

As you previously requested I have worked out a memo report on; what Starbucks have done in the past, what they are doing now and how we can learn from them. It is very important to notice what competitors do when there are uncontrollable market conditions, so there can be an easier adapting process. Starbucks have 11. 000 stores worldwide, and they serve more than 40 million customers each week and even with these enormous numbers Starbucks continues to grow. The reason Starbucks is still growing is that; people loves the products that Starbucks provide, but there is more to it, Starbucks is also a very beloved brand. They have a wide product range and they are very innovative, constantly making new products to keep on being interesting. The clever thing about this is that you never get tired of the brand because it’s constantly developing itself, making it a very effective business strategy. In my opinion there is the possibility of following the example that Starbucks have set, it’s impossible to argue with the logics of a constantly extending product range that is both innovative and high quality. Starbucks meet the customer’s needs before they even know that they need it. They come up with ideas faster than most other coffee places, making it virtually impossible to criticize the depth of their product range as it is constantly expanding. An example of the creative side of Starbucks could be the new â€Å"Instant coffee† that Starbuck have just added in their product range. The product consists of a small packet of coffee that a customer can carry with them and make coffee almost everywhere, all they need is water. It would of course be a great idea to be more innovative at Cafe Nero, as it would satisfy a wider range of customers. However one must have in mind that Starbucks is a gigantic worldwide chain and therefore can afford to have whole departments only created to make new products. It is, therefore, not possible to be as innovative as Starbucks, but that shouldn’t stop us from trying. I suggest that we should look at what Starbucks have done, for example with the â€Å"Instant coffee† but while we do that we also have to remember that our brand name have to remain ours, eaning that we cannot try to copy what competitors do, but that we have to invent our own success. There is another very important aspect; the present consumer trends and the economic downturn that should not be forgotten when we consider how we can be more successful. When people become more afraid of their future economic situation they will be less likely to spend money, meaning that a very logic proposa l would be to lower the prices on our products. Coffee is becoming more and more like a culture, for some even an addiction, some people can’t even start their day before they have had their morning coffee. With this in mind, one could make the easy conclusion that there is a demand for coffee and that we could therefore raise our prices. However, I believe that both our current and future customers would appreciate a lowering of our prices, so in a short-term period it would probably lower our income, but I believe that on long-term it would make more customers and make our current customers happier and more loyal to our brand. When the economy eventually starts getting better, maybe even turning to an economic boom it would be a possibility to slowly raising our prices back to a more normal level because people feel more safe about the future and therefore will be more likely to spend money. When looking at the present consumer trends I think it’s safe to say that consumers love variation and creativity. There isn’t a very large market for regular coffee anymore; consumers want to see different products and experience different flavors. The point of this is that Starbucks adapt to this trend by constantly trying to innovate their brand with new products, but at the same time they stay true to their brand and they don’t compromise on quality; that is what made their success. These things that I have lined up are what I have found that we at Cafe Nero can learn from Starbucks, I personally believe that Starbucks is a good source of inspiration and admiration as they have succeeded in so many ways. But what we also have to remember is that we also have to stay true to ourselves and not become something that we are not. Let Starbucks be Starbucks, and let us be Cafe Nero.

Friday, January 3, 2020

Analysis Of The Movie Trainspotting - 1513 Words

The movie Trainspotting, released in the July of 1996, depicts a group of heroin addicts and their peers eking out an existence in 1980’s Edinburgh, Scotland. Based on a 1993 book of the same name by Irvine Welsh, the movie was a commercial success as well as critical one. It is ranked as the 10th best British movie of All Time by the British Film Institute in 1999 (Best 100 British Films). When the book was published Welsh was condemned for glamorizing heroin abuse, to which he responded that he was only depicting what was going on, what he knew, and who he knew. The book and the movie mirror the reality of the creation of an underclass in Edinburgh in the late 1970’s and 1980’s. Historically opiates have been a part of Edinburgh since the late 1600’s. After heroin was synthesized and began being used as a painkiller in 1894 Edinburgh became the capital of opiate production as discussed in an article from The Guardian in 2009. The article quotes Michael F ry as saying â€Å"’By the end of the 19th century,’ writes Fry, ‘Edinburgh produced most of the world s opiate drugs, heroin included.’(Edemariam and Scott)† In the 1980’s however the situation changed dramatically. Cheaper heroin from South Asia became readily available which was met with a growing receptive audience. The same outsourcing that created the US Rust Belt and condemned Detroit to become a shadow of former self was felt in Scotland as well. So when that influx of drugs came in the early 80’s it was met withShow MoreRelatedAnalysis Of The Movie Trainspotting Directed By Danny Boyle989 Words   |  4 Pages The 1996 film Trainspotting, directed by Danny Boyle takes the audience on a fast ride exploring the life of Mark Renton; a struggling heroin addict. The extremely energetic film shows the audience the horror of the Scottish drug scene and the reality of how these addicts live. The life-style of these characters is fa r from funny, yet Boyle and screenplay writer John Hodge are able to lighten the situation with the use of black humour. Additionally, Boyle mixes reality with fantasy in his scenesRead MoreThe Drug Of Drug And Alcohol Abuse Essay1531 Words   |  7 PagesThe movie Trainspotting is an entertaining look into the dark world of drug and alcohol abuse. Heroin is the drug of choice for the protagonist, but other substances are also consumed throughout the film: heroin, prescription medication, opium, hash, amphetamines, and alcohol are a constant presence in the story. Repeated polysubstance abuse combined with a negative social environment and a weak support structure compounds the problems of Renton, a heroin addicted young adult man living in ScotlandRead MoreThemes Of Illusion And Reality By Bret Easton Elliss Trainspotting And American Psycho 2248 Words   |  9 Pagesunique perspectives on the issues faced by everyone, even those who do not acknowledge it. Trainspotting by Irv ine Welsh portrays a drug addict who rejects any conventions of normalcy in the pursuit of an alternate reality. American Psycho by Bret Easton Ellis does the same through the depiction of a rich and greedy Wall Street tycoon. This essay will closely analyze the themes of illusion and reality in Trainspotting and American Psycho. The relationship between the fantasy world and the â€Å"real† worldRead MoreWe Are Addicted And Our Thoughts Essay929 Words   |  4 Pagesvalues and narratives of the movie Trainspotting that takes place during the 80’s in Edinburgh, UK; a city that suffered from an economic depression causing the marginalization of the society in this area during that decade. Marginalization or psychosocial dislocation, as Canadian psychologist Bruce K. Alexander defines it, is a significant factor in the development of addiction, in this particular case the addiction to heroin. During the first minutes of the movie, the main character RentonRead MoreStrategic Marketing Management337596 Words   |  1351 PagesStrategic and marketing analysis 2 Marketing auditing and the analysis of capability 2.1 2.2 2.3 2.4 2.5 2.6 2.7 Learning objectives Introduction Reviewing marketing effectiveness The role of SWOT analysis Competitive advantage and the value chain Conducting effective audits Summary 3 Segmental, productivity and ratio analysis 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 3.12 Learning objectives Introduction The clarification of cost categories Marketing cost analysis: aims and methods An illustration