An Overview Of Ambulatory Surgery Centers Nursing Essay

An Overview Of Ambulatory Surgery Centers Nursing Essay An ambulatory surgery center is indication to the surgery that conducted without the need for overnight hospital stay. This term also recognized as outpatient surgery or same day surgery. This surgery in general not type of complicated surgery, it is simpler than the one which requiring hospitalization. This kind of ambulatory surgery is widely used in present time, where the cost of such surgery is low, simple and required less resources where for the inpatient it is essential to keep the patient in the hospital; that mean reserve bed for that patient in the hospital [1]. Another definition can be used here, that ambulatory surgery is â€Å"the performance of planned surgical procedure with the patient being discharged on the same day† [2]. The ambulatory surgery first found in 1909 by James Nicoll, a scottish surgeon, it was called by â€Å"day case surgery†. In 1912 Ralph Walter in the USA adopted this surgery type in the USA. It was unpopular until the 1960s and 19 70s when the traditional surgeries became a bottleneck for most of the USA’s Hospitals, where keeping the patient on holding list and admitted them in the hospital became more expensive, in addition the availability of beds decreased. Walter Reed introduced the ambulatory surgery to USA’s hospital, since then patient manages improved significantly and rapidly with ensuring the patients’ fitness after discharge [2]. Ambulatory surgery form about 90% of all surgery performed nowadays in Canada and USA [6]. The day surgery can achieve high level of quality, cost effective and safe which lead to high level of patient satisfaction [6]. University of California at Los Angeles developed a hospital based on ambulatory surgery unit in 1962, then other units in the USA were opened in 1966 At Gorge Washington university, until big number of ambulatory surgery is opened now in the USA and Canada [7]. Several associations created to developed a strategies and plans to adopt and improve the ambulatory surgery, one of these association is the Federated Ambulatory Surgery Association (FASA), this association founded in the USA since 1974, another 12 national association formed and become member of the International Association for Ambulatory Surgery (IAAS) [8] The advantages from ambulatory surgery system are varied in type, some of these advantages related to patient and their family and some related to the hospitals and the healthcare system as whole. Those advantages for the patient that they will receive more attention from the healthcare team, because the ambulatory surgery designed to serve that patient [9]. The ambulatory patient will return home after receiving the treatment, so it is better to well manage the day surgery units and provide the patient with treatment which allowed them to continue recovering at their family home environment. Small mistakes that could happen for inpatient will not occur to the ambulatory surgery patient, like missin g drug or shot or give different medicine for patient, because in the ambulatory surgery patient is always having everything in plan and no mistakes there [10]. Day surgery is better for children than inpatient surgery where the children will not be separated from their family for long time. The children will be less stressful and feel more comfortable because they can join back their family after that surgery finish [11]. In the European Charter of Children’s Rights states that â€Å"children should be admitted to hospital only if the care they require cannot be equally well provided at home or on a day basis† [12].

How do we identify trends in physical properties Ionic Compounds Lab Report

How do we identify trends in physical properties Ionic Compounds - Lab Report Example Ideally, the alkali metal or metals will donate an electron that will be added to the electron cloud of the halogen atom. At the molecular level, brittle crystals will form because the placement of ionic charges requires a precise positive/negative juxtapositioning. Physical deformation risks associating a positive with a positive and negative with a negative, generating repellant charges that cancel the bonding tendency, thus, the salt crystal shatters, whereas covalent bonds involving a more cooperative distribution of electrons are much more likely to withstand the same level of deformation. On the other hand, the structure of an ionic lattice tends towards a far higher melting and boiling point than for covalent forms. The heightened charges allow for electrical conductive when melted, but those same charges also allow for solubility in water or other polar liquids, but not in nonpolar liquids such as most lipid-based oils. SOLUBILITY OF IONIC COMPOUNDS IN WATER BASED ON CHARGES PRESENT Ionic compounds, typically salts dissolve easily in aqueous solution. Solubility is the result of an attraction between negative, and positive charges among the ions present. In simple sodium chloride the salt's positive ions (Na+) attract the partially-negative oxygens found in water. In addition, the salt's negative ions (Cl?) attract the partially-positive hydrogens in H2O. The Solubility constant (Ksp) and the common ion effect determine how much salt can potentially be dissolved within that solution. It is simply a matter of whether the ions in the water itself have a greater affinity for the ions in the compound than those ions do for each other. In general, the following rules provide a basis for predicting solubility: Ionic compounds with group 1A metal cations. Nitrates are soluble regardless of the cation. In terms of how soluble a given compound is, based on the available data, it is reasonable to assume that size; more to the point, atomic radii is a decisive fac tor. Moving down an elemental series on the periodic table, the larger atomic numbers appear to be less soluble in water. This is due to the larger sizes of atoms involved, in which the available charge that might be available to the ions in water is more â€Å"insulated† by the larger distances involved. Thus, with less charge within reach of either ion present in a molecule of water, the largest ions are less soluble. (Clark, 2002). Otherwise, the available data with the nine ions indicates an increase in conductivity as concentration throughout the solution increases. In terms of experimental design, graphs can be computed displaying the curve of each ion made as it increases in concentration and the accompanying increase in conductance. ELECTRICAL CONDUCTIVITY BASED ON QUANTITY OF DISSOLVED IONS IN SOLUTIONS With an increase in the number of charged ions in an aqueous solution, electrical conductivity will certainly increase. When ionic compounds break down, they will dis solve into both negatively and positively charged ions, which are of course attracted to the oppositely charged electric particle or current. Covalent compounds will dissociate into neutral ions which will not conduct electricity and should therefore have no consequence for aqueous electrical conductivity. Therefore, there is an inevitable correlation between electrical conductance and the actual quantity of ions present in the water. In terms of

Ethical principles in end of life care - The liverpool care pathway Essay

Ethical principles in end of life care - The liverpool care pathway - Essay Example On the contrary, other sources including that of the Health Minister Jeremy Hunt who describes it as â€Å"a fantastic step forward† (Donnelly, 2013) still maintain their favour believing that the pathway is playing its intended role of ensuring that people are treated in dignity, compassion and comfort during their last days of life instead of enduring invasive and life prolonging treatments (Randall and Downie, 2010, p.91). As a result of these controversies, the government ordered an independent review in 2012 chaired by Baroness Neuberger. The review finding recommends the Liverpool Care Pathway to be phased out and be replaced by a personalised end of life care plan that takes good care of the life of a patient who is facing imminent death (Department of Health, 2013). The LCP has clearly set the stage for ethical and legal controversies about patients, family rights and the role of the medical professions (Glare and Christakis 2008, p. 429). Replacing the LCP to a person alised end of life care plan may not resolve the controversies if the same transgressions persist. In that context, this paper aims to objectively review the literature and explore the challenges that contributed to its failure in order to accurately consider the future development of the recently recommended personalised End of Life Care Plan. Overview The Liverpool Care Pathway for the dying patient was developed as an integrated care pathway by the specialist palliative care team at the Royal Liverpool and Broadgreen University Hospitals NHS Trust and the Marie Curie palliative care institute Liverpool in 1997 (Ellershaw and Wilkinson, 2003, p. 11). The LCP is a structured clinical record developed to transfer the hospice model of care into other care settings (Jack, Gamble, Murphy, and Ellershaw 2003, p. 371). It aims to support clinical judgements and assist multidisciplinary team in providing optimal treatment and care for patients who are dying(Boyd and Murry 2012), as well a s improve the experience of the relatives or carers during this period and into bereavement (Gambles, Roberts and Anita 2011). It focuses in providing evidence-based framework on different aspects of care required including comfort measures, discontinuation of inappropriate intervention among others (Ellershaw and Murphy 2011, p. 11). The Liverpool Care Pathway was advocated by the Department of Health (2012) as a model of good practice in End of Life care and quality makers and measures for promoting high quality care for all adults in the end of life (MCPCIL). Additionally, the General Medical Council (General Medical Council, 2010) supported it, over 20 organisations and charities as demonstrated in the consensus report for its support published by the NHS in 2012 and the National Institute for Health Care Excellence (NICE) Quality Standard for End of Life care for adults. Regardless of its high approvals and recommendations, the LCP has been blamed for delivering poor quality ca re to patient in their final days (Payne, Seymour, Ingleton 2008, p.392). The independent review findings identified a number of important issues that affected the ability to implement the LCP effectively in the provision of quality healthcare to persons who are almost dying or facing imminent death. Amongst which were lack of knowledge and