Knowledge And Skill Among Nurses Health And Social Care Essay

Knowledge And Skill Among Nurses Health And Social Care Essay Review of literature is a systematic search of a published work to gain information about a research topic (Polit and Hungler). This chapter deals with the related literature review which aids to generate a picture of what is known and not known about a particular situation. The literature review was based on extensive survey of books, journals and international nursing studies. A review of literature relevant to the study was undertaken which helped the investigator to develop insight into the problem and gain information on what has been done in the past. An extensive review of literature was done by the investigator to lay a broad foundation for the study and a conceptual framework framed based on Hildegard peplus interpersonal theory to proceed with the study under the following headings. The logical sequence of the chapter is organized in the following section: 2.1 Part I Reviews related to effectiveness of essential newborn care module on knowledge and skill among nurses. 2.2 Part II : Reviews related to knowledge and skill of newborn resuscitation among nurses. 2.1 Part 1: Reviews related to effectiveness of essential newborn care module on knowledge and skill among nurses. Joshi, P. (2012) conducted a randomized controlled trail, to evaluate the knowledge and skills of essential newborn care among student nurses. After the training on essential newborn care the student nurses knowledge and skills score were gained than before training. The study concluded thus using essential newborn care as new technology in class room teaching may be an effective method. Garclrs, A., et al. (2012) conducted population based, prospective, interventional pre post design study on essential newborn care course among traditional birth attendants. This study analyzed the effect of training and implementation of the essential newborn care. The study concluded that the essential newborn care training reduced still births. Scale-up of this intervention in other settings help to assess reproducibility. Elliott-Carter N., Harper J (2012) stated that, keeping mother and newborn together during the time immediately after delivery has several benefits, which is the components of essential newborn care. A new care delivery model was instituted so the women who delivered by cesarean were able to recover with their infants and the outcome has been very positive with increased satisfaction as well as the promotion of breast feeding and maternal infant bonding. Sodani PR, Sharma K (2011) conducted a case study on essential newborn care at Baratpur. Data were collected through structured questionnaire and evaluated. The result showed that in the communities the infrastructure of newborn care unit should have adequate facility and community health centre birth attenders should have knowledge and practice in newborn care. Pradhan Y V., et al. (2011) stated an over view of implementation of essential newborn care program. Effective implementation of community based intervention program are an essential step to avert newborn death, in settings where the health facilities are unable to effectively deliver the intervention. Saravanan S., et al (2011) conducted a study to assess the effectiveness of essential newborn care program during delivery and in community care in developing countries. The aim of the study to assess the post training program and in disseminating evidence based knowledge on essential newborn care program. The finding suggested that the training program improve the knowledge and practice among birth attendants. Goudar, SS., et al. (2011) conducted a community based cluster randomized controlled trial to evaluate the effect of WHO essential newborn care course on perinatal mortality among birth attendants, Karnataka, India. Using a pre post design WHO essential newborn care community birth attendant training resulted in a significant reduction in perinatal mortality. In low resource settings, the newborn care training package appears to be an effective intervention to decrease perinatal mortality. Matendo R., et al (2011) conducted a secondary analysis on the effect of training of essential newborn care program among traditional birth attendants and midwives in Democratic Republic of Congo. The study revealed that training midwives and birth attendants reduces perinatal mortality after the training. There was a gradual but significant decline in neonatal mortality during the year following essential newborn care training which was independently associated with following training. Manasyan A., et al (2011) conducted the study to evaluate the WHO essential newborn care training in Zambia. Data were extracted the effectiveness of essential newborn care was evaluated. Training of essential newborn care was given to clinical midwives in their first level facilities. Before and after study of the effect of essential newborn care was evaluated. The result showed that, after the training neonatal mortality decreased from 11.5 per 1000 to 6.8 per 1000 live births. Samson LF (2011) stated that, the training on essential newborn care among midwives in low cost intervention reduces the neonatal mortality. Newborn infants need some form of assistance after birth. Only 1% will require more advanced form of care. Because the rare events cannot be always anticipated, pediatricians and neonatologist may not be readily available and the care should be performed but the nurses. Provision of essential newborn care training may improve the knowledge among midwives. Grady K., et al., (2011) conducted an observational study to assess the effectiveness of essential newborn care are key strategies for reducing newborn mortality and morbidity globally. Lack of adequately trained competent staff is a key barrier to achieving this. Assessed the effectiveness of a new package of Life Saving Skills Essential Newborn Care Training designed specifically around the UN signal functions in seven countries in sub-Saharan Africa. Among 600 healthcare providers (nurse-midwives, doctors, clinical officers and specialists), knowledge about the child birth as well as newborn care significantly increased. There was measurable improvement in skills, and participants expressed a high level of satisfaction with the training. The training package was found to meet the needs of healthcare providers, increased awareness of the need for evidence-based care and encouraged teamwork. Adhisivam B., et al., (2010) in Indian pediatric articles stated that the effectiveness of essential newborn care a need to reorient nursing staff. Improvement of knowledge and skills reduces the mortality and morbidity of newborn and maternal morbidity level. Newborn needs some kinds of assistance in the external environment. The reorientation of essential newborn care increases the newborn care among nurses. Kirkwood BR., et al., (2009) conducted a Newhints cluster randomized trial to evaluate the impact on package on essential newborn care intervention. The study aims in Ghana, to develop a feasible and sustainable community-based approach to improve newborn care practices and improved neonatal survival. The result stated that the package intervention should significant improvement in knowledge and skills among birth attendants. Darmstadt GL., et al (2009) conducted the study cluster-randomized controlled trial among birth attendants in Mirzapur, Bangladesh. The level and cause-structure of neonatal mortality in the local population must be considered in developing interventions.The study emphasis the programs must ensure skilled care during childbirth. The findings shows the programe reduced the primary causes of the death. Primary outcome measures were immediate newborn care behaviors, knowledge of danger signs, care seeking for neonatal complications, and neonatal mortality. Carlo, WA.,et al.(2010) conducted a pre experimental study to evaluate the effectiveness of essential newborn care program in improving knowledge, skills and self-efficacy among nurses working in low risk delivery clinics in USA. After training, written scores improved from 57% to 80%, performance scores improved from 74% to 90%. The study revealed that essential newborn care training program has the potential to substantially improve the knowledge and skills of essential newborn care. Opiyo, N., English, M. (2010) conducted a study to investigate the effectiveness in-service training on essential newborn care among health workers in Kenya. Independently selected the study and abstracted data using a standardized form to assess the study quality. The study results shows there were significant improvement in performance reduction in the potentially harmful practice and improvement in the delivery room following implementation of essential newborn care training. Ariff, S. Soofi, S.B. (2010) conducted a need assessment analysis on knowledge and practice of neonatal care among health care providers in the public sector of Pakistan. The nurses knowledge was good with 30% scoring more than 70% and 50% were able to demonstrate steps of immediate newborn care. The study revealed that training of health worker is very vital to address the gaps and to develop continuing education modules. Monebenimp, F., et al. (2009) conducted an observational study to evaluate the competence of health care providers towards newborn care at birth in Cameroon. The results showed that there is a need to reinforce the ability of health care providers by training in WHO essential newborn care with emphasis on providing skills on essential newborn care in order to reduce the burden neonatal related deaths. Kesterton, AJ., Cleland J. (2009) conducted a prospective survey among birth attendants in Karnataka. An interview schedule was done individually and found that many potentially harmful newborn practices are being carried out in that area. A package of essential newborn care practices exists, which has a proven impact on reducing newborn mortality. Successful implementation of essential newborn care package increased the knowledge. Vittner, D. (2009) in his articles on essential newborn care states that, the newborn intensive care unit is technology focused and crisis driven. Working in that area demands technical competence as well as the emotional aptitude to ensure that infant should care in the environment of basic humanness. Essential newborn skills that enhances the nursing profession. In an effort to make change in newborn intensive care unit have to incorporate reflective process to prepare the nurses to improve their knowledge in implementing essential newborn care. Vidal SA., et al. (2009) conducted a study to compare the effectiveness of two training strategies for improving essential newborn care in the state of Pernambuco, Brazil. . Doctors and nurses working at hospitals in Group 1 were given a conventional 5-day training course. Those in Group 2 were given the same manual used by Group 1 but the training course was organized as self-directed learning, with the participants having 5 weeks to complete the course. Participants knowledge was tested at baseline, immediately after the course. Participants practices were observed before training and knowledge were tested by interview method. The result showed that improved knowledge and skills. Agrawal PK., et al.(2009) conducted study and explored the knowledge of essential newborn health care practices among community health workers, Anganwadi workers and auxiliary nurse midwives in rural India. Using principle component analysis, knowledge scores for preventive care and danger signs were computed separately. A multivariate logistic regression model was used to estimate the adjusted effect of knowledge level. A generalized estimating equation (GEE) was used to account for clustering there were significantly higher improvement in knowledge and skills compared with those with control group. Knowledge is one of the crucial aspects of health systems to improve the coverage of community-based newborn health care programe as well as adherence to essential newborn care practices at the care level. Chomba E., et al. (2008) conducted controlled study to test the effect of WHO essential newborn care training on neonatal mortality by education among nurses in first level urban community health centers Zambia. Protocols and essential newborn care certified course were given. The data were collected after one week. The study showed that essential newborn care training is associated with decreased in early neonatal mortality, rates from 11.2% to 6.2% after the training. Osrin D., et al. (2008) conducted the study to implementing a community based participatory intervention to improve the effectiveness of essential newborn care with women and other key members in community in rural Nepal. Each group moved through a participatory assessment, sharing experiences, planning, action and reassessment, with the aim of improving essential newborn care. Outcomes assessed are neonatal mortality rates, health care seeking and referral. The result showed that implementing essential newborn care programe reduced mortality among newborn. Senarath U., et al. (2007) conducted the study to evaluate the effectiveness of a training program for care providers in improving practice of essential newborn care in obstetric units in Puttalam, Sri Lanka. The design used was before-and-after study with an intervention and a control group. A 4-day training program given on essential newborn care for doctors, nurses, and midwives of the obstetric units in two hospitals. The data collected by direct observation, practices of essential newborn care at delivery in the labor room. The evaluation was done by direct observation, practices of essential newborn care at delivery in the labor room. The result showed that the comprehensive 4-day training program showed significant improvement in essential newborn care practices in obstetric units. Uxa, F., et al.(2006) in his articles stated that training of health care professionals and health policy makers in the field of essential newborn care is one of the corner stones of the WHO initiatives making pregnancy safer and promoting effective perinatal care. After the training the positive changes in planning for and delivering neonatal care taking place, even in challenging contexts. Elizabeth, M., Mcclure., et al. (2005) conducted a pre-experimental study to evaluate the educational impact of newborn care among 115 nurses in Global network for women and children health research, Zambia. The post test score for knowledge was increased to 89% from 68% and practices were increased to 81% from 65%. The study concluded that there is improvement of knowledge and practice after essential newborn care training. 2.2 Part II: Reviews related to knowledge and skill of newborn resuscitation among nurses Matendo.,et al.(2011) conducted a secondary analysis on the effect of training of newborn resuscitation program among traditional birth attendants and midwives in Democratic Republic of Congo. The study showed that training midwives and birth attendants reduces newborn mortality. There was a significant decline in newborn mortality during the following newborn resuscitation program training. Kalmbach, K. (2011) stated that, successful resuscitation of newborn infants depends on adequate preparation, exact evaluation and prompt initiation of support by trained personnels, especially by the health care professionals. Adequate ventilation is the most important step in newborn resuscitation. Nelson, C.A., et al. (2011) conducted a pre-experimental study to quantify newborn resuscitation capacity at birthing sites in urban and rural Nepal among health care workers. Assessment included standardized interviews and evaluation of newborn resuscitation areas. The tool was recorded. The study result revealed that , there was a improvement in skill and knowledge, when caregivers have proper training of essential newborn care. Anne., et al. (2011) conducted a systemic review and Delphi estimation of mortality effect of neonatal resuscitaion among 136 million babies born annualy, the study revealed that around 10 million require assistance to breathe and each year 814,000 neonatal deaths due to complication of prematurity. The study concluded that newborn resuscitation training reduces neonatal deaths by 30%. Topyian, A.A., et al. (2010) stated resuscitation training in developing countries, increaesd child survival after resuscitation training, with an absolute risk reduction that ranges from 0% 34%. Further stated that training in developing countries has significantly improved the knowledge and practice of health professionals by reducing the mortality rate. Jukkala, A.M., Henly, S.J (2009) conducted a correlational study on provider readiness for newborn resuscitation among nurses and physician working in rural hospital, USA. The samples were 165 nurses and 59 physicians. Correlation between frequency of skill performance and comfort was higher for nurses than physicians. The study revealed that nurses had significant higher average level of comfort, knowledge and experience. Zaeem-ul-Haq., et al. (2009) conducted a postal survey on evidence for improvement in the quality of care among nurses and doctors from public sector hospitals Islamabad. 90% of the samples reported the use of acquired skills and the structured airway, breathing and circulation approach in handling emergencies. The study concluded that introducction of training program in a resource constrained health care system had improved the emergency management of newborn. Berger, T.M., Pilgrims. (2009) stated almost 10% of all newborn need some form of respiratory assistance after birth, only 1% will need more advanced form of resuscitation. Because these rare events cannot be always anticipated. Pediatricians and neonatologists may not be readily available and resuscitation has to be performed by nurses. Surg. Cdr S Narayanan., et al. (2009) conducted one group pre test and post test design to evaluate the effectiveness of teaching of newborn resuscitation for medical personnel including nursing officers and probationers nurses. The mean pre test score was 9.03 which improved to a mean of 15.53 in post test. Bream, K.D. (2005) conducted a study to assess barriers to and facilitators for newborn resuscitation among nurses in a central hospital in Malawi. The study concluded that solution to barriers included small resources additions as well as term policy changes. With standard protocols, experienced confident nurse could overcome the barriers in providing newborn resuscitation so that it can reduce infant mortality and improve the quality of life of women receiving care in Malawi. Mc.Namara, P.J. (2002) conducted a comparative study on resuscitation and stabilization of premature infants when specialized neonatal retrieval team is in attendance at delivery with immediate resuscitation performed by the referral hospital team. Results showed that the presence of highly skilled transport team at a high risk preterm delivery improves the quality of newborn resuscitation.

Statement of Facts

This case in Fenton, Missouri involves 17 yrs. old Christopher Simmons born in 1993. Charles Benjamin and John Tessmer were Christopher Simmons friends and accomplices. Christopher Simmons planned and committed a capital murder along with Charles Benjamin. The plan was to commit burglary and murder by breaking and entering, tying up Shirley Crook, and tossing her off a bridge. The three boys met at 2am in the morning however, Tessmer then dropped out of the plan. Simmons and Benjamin broke into Mrs. Crook's home, bound her hands and covered her eyes. They put Mrs. Crook in a minivan drove her to a state park and threw her off a bridge. Once the case was brought to trial court, the evidence was solid and overwhelming. Simmons had confessed to the murder, performed a videotaped reenactment at the crime scene, and there was testimony from John Tessmer against him that showed premeditation. After the crime Christopher discussed the plot in advance and later bragged about the crime. After 2 hours of investigation Christopher broke down and confessed. At trial the State introduced Simmons confession and the videotaped reenactment of the crime, along with testimony that Simmons discussed the crime in advance and him bragging to fellow classmates about it later. The defense called no witnesses due to the evidence and confession. The jury having returned a verdict of murder, the trial proceeded to the penalty phase. The jury returned a guilty verdict. The jury recommended a death sentence in which the trial court imposed despite Christopher not having a criminal background. The State charged Simmons with burglary, kidnaping, stealing, and murder in the first degree. Simmons was 17 at the time of the crime. He was outside the criminal jurisdiction of Missouri’s juvenile court system. Charles Benjamin and was 15 years old and John Tessmer was 16 years old. The State later charged Tessmer with conspiracy, but dropped the charge in exchange for his testimony against Simmons. The jury recommended the death penalty after finding the State had proved each of the three aggravating factors submitted to it. Accepting the jury’s recommendation, the trial judge imposed the death penalty. Defense counsel reminded the jurors that juveniles of Simmons age couldn’t drink, serve on juries, or even see certain movies, because â€Å"the legislatures have wisely decided that individuals of a certain age aren’t responsible enough. Defense counsel argued that Simmons age should make a huge difference to the jurors in deciding just exactly what sort of punishment to make. Procedural History At eh age of 17, Christopher Simmons along with partner Charles Benjamin planed and killed Shirley Crook. After, he turned 18 he was sentenced to death. Christopher processed a direct appeal and subsequent petitions for state and federal post convictions relief but was rejected. Simmons filed a new petition for state post convection relief arguing that Atkins v. Virginia reasoning established that the constitution prohibits the execution of a juvenile who was under the 18 when he committed the crime. The Supreme Court agreed in favor of Simmons and abandons the death sentence in agreement of life imprisonment without the possibility of parole. Issues Does the Eighth Amendment prohibit the execution of juveniles who commit capital crimes prior to turning 18 years of age? Arguments For Roper * Currently, juries are very careful when they decide whether a 16 or 17 year old should be given the death penalty. When sentences are made, the jury considers the defendant’s age and other relevant information. Since only one juvenile has been executed in Missouri, this shows that juries only use the death penalty for the worst offenders. * Since 1989, only Indiana, Montana, South Dakota, and Wyoming have changed their laws to make it impossible for 16 and 17 year olds to get the death penalty. The previous amount of states was not enough show the nation agrees on this issue. * The Supreme Court case that ruled against using the death penalty for the mentally retarded Atkins v. Virginia should not be compared to this case. Sixteen and seventeen year old offenders should not be placed in the same category with the mentally retarded. Juries should decide in each individual case whether a juvenile was mature enough to take responsibility for a crime. * Some crimes are so horrible that the death penalty is the only appropriate sentence. It is better for society to remove the worst criminals with the death penalty. Using the death penalty will also discourage other youth from committing crimes. Arguments For Simmons * In many cases, juries are overwhelmed by how horrible the crimes are that some juveniles commit. It is a problem, then, for juries to consider the maturity of a juvenile in each individual case, because the crime itself may make it difficult for the juries to be fair. The juries may get distracted by the crime and not consider the offender’s age as an explanation for the crime. * A national consensus has developed in which the majority of states do not support the use of the death penalty for juveniles. Currently, 30 states prohibit the juvenile death penalty, and 12 of those states have banned the death penalty completely. In addition, since 1989, five states that previously allowed the juvenile death penalty have banned its use. Most other countries in the world disapprove of using the death penalty on juvenile offenders. The United States is one of the only countries in the world that still allows the execution of juveniles. There is a clear global opinion that the death penalty is too strong a punishment for offenders under the age of 18. * There is research that shows that adolescents do not have the maturity and judgment necessary to fully weigh decisions and control their impulses. Brain research shows that the brain is not fully developed until adulthood. Our society has decided that age 18 is an important turning point. The majority of states do not allow people under the age of 18 to vote, serve on juries, or marry without their parents’ permission. It makes sense then that 18 should also be the age when a person can be held fully responsible for committing a crime. Judgment The United States Supreme Court judgment in the Roper v. Simmons cases ruled in favor of Simmons. The United States Supreme Court said, â€Å"that sentencing a minor to death was indeed cruel and unusual punishment and voided against the 8th amendment†. The United States Supreme Court overturned the ruling that was established in Sanford v. Kentucky case that took place in 1989, in which the court decided that minors could be subject to the death sentence only if the charges warrant execution. Christopher was sentenced to life in prison with out the possibility of parole. Holding The Eighth and Fourteenth Amendments forbid obligation of the death penalty on offenders who were under the age of 18 when their crimes were committed. Supreme Court of Missouri affirmed and the United States overruled the Atkins v. Virginia case and Simmons original sentence. Rule Of Law Or Legal Principles Applied The 8th amendment is prohibits cruel and unusual punishment. Any amendment is an unchanging statue. Therefore the case itself or whatever the ruling is has to change if proven justified. Reasoning The Missouri Court voted 6 to 3 that he should receive the death penalty. They believed if he was older and committed murder it would just get worse f rom there. The lawyers argued that this was unfair punishment for a boy who couldn’t see an R rated movie. The Supreme Court voted 5 to 4 that executing a minor is cruel and unusual punishment. Society didn’t like the view of executing children. What he did was wrong but at the same time he is still a child and should be treated like one. If they had executed him society would have a negative aspect on the criminal justice system. Additional Comments I think Christopher Simmons deserve the death penalty. Despite he background and rough up bringing that doesn’t give you the right to kill an innocent lady for no reason. Due to the planning and precision behind the murder he deserves to die. His intentions from the beginning were for her to die and die painfully. Tying her up and throwing her off the bridge requires a lot of hatred and regards for humanity. Despite his confessing to the murder Chris didn’t feel remorseful for the family or his actions. My opinions would be different if he had a mental disorder, suffered more serious child neglect or maybe Shirley harmed his family in retaliation he killed her. Other wise Chris actions are similar to the James Holmes massacre and the Newtown shooting. All three deserve to die slow in my opinion.

Network Hardware Essay

Choice of good network hardware will depend on a number of factors. First it has to be planned properly to allow growth without adversely affecting future business. The design of the network should ensure sufficient performance, availability and security. All this aims at providing enough information and processing of transactions for all its users. A list of users who will access the net has to be generated so as t determines the capacity the hardware will be able to support. A list of severs that need network connection should also be developed. Mid and high end servers should be selected. Server consolidation should be prioritized as a means of minimizing costs. The company will save much on power and floor space. It will also reduce administrative and maintenance costs. The various host machines that need to be supported by the network should also be determined and assigned specific names and IP addresses. The type of host will determine the design of the network. The network media has to be compatible with the available servers and host machines to be supported by the network. In this case I would recommend Ethernet cables because they are of its lower cost and easy manageability. There is also need to plan for bridges, hubs, routers, or switches. These devices come into use during connection of various subnets on a network. Routers for instance when connecting different domains within a network, offer better administrative control over network traffic. A good network topology should also be created so as to provide sufficient network resources for all applications. A hierarchical network is preferred with the trunk at the top and the hosts at the bottom.

Outlaw Motorcycle Gangs Essays - 845 Words

Identify a range of legal and non-legal responses to OMCGs Outlaw Motorcycle Gangs (OMCGs) is a contemporary issue that engulfs Australian society. What makes prosecution of such gangs so complex is the strong foothold that gangs have in organised crime and the faà §ade that is worn in order to evade the eyes of the law. Various responses have been implemented in order to cease all violence and more importantly disenfranchise organised crime and prosecute those within the illegal syndicates. Legal responses put into act are: task forces and intelligence and lastly, targeting the organisation and membership. The non-legal responses on the other hand are, the media and the formation of political parties. OMCGs in Australia are seen to†¦show more content†¦The problem with achieving justice with this legal response is that the police of government officials can make the determination of criminalising clubs without court oversight thus may be used to target individuals or individual associations rather than being equally applied to all . What is deemed to be more of an issue is that this legal approach virtually affects a person’s fundamental freedom to associate with whomever one pleases. This is seen throw the introduction of â€Å"guilty by association† – under which a person may be found criminally liable simply for associating with another person who commits a crime, even though that person has committed no crime his or her self. An act, which illustrates this legal response, is the Serious and Organised Crime (Control) Act 2008 (SA). The primary goal was to disrupt OMCG activities and protect the public from their violence. An example of a non-legal response to OMCGs is the media. 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