ICU Delirium

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According to the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV delirium is defined as “a disturbance of consciousness and cognition that develops over a short period of time (hours to days) and fluctuates over time.”  Delirium is an all too common problem in the ICU and according to Girard, Pandharpande, & Ely (2008),  “Delirium occur[s] in up to 80% of the sickest intensive care unit (ICU) populations.”   Patients in the ICU share some common risk factors for developing ICU Delirium which, according to Girard, Pandharpande, & Ely (2008), include  “exposure to sedative and analgesic medications.” To help reduce the risk of a patient developing delirium, factors such as sedatives and analgesia can be closely monitored and titrated. Girard, Pandharpande, & Ely (2008), also suggest “that all ICU patients be monitored using a validated delirium assessment instrumentmay be modified to reduce risk.”  It is important to decrease the risk and the occurance of delirium in ICU patients because “delirium is now recognized to be a significant contributor to morbidity and mortality in the ICU…Patients with delirium have longer hospital stays and lower 6-month survival than do patients without delirium, and preliminary research suggests that delirium may be associated with cognitive impairment that persists months to years after after discharge” (Girard, Pandharpande, & Ely, 2008).  As nurses we should be aware of the signs and symptoms of ICU delirium and attempt to implement assessment tools to monitor for this complication.

Girard, T., Pandharipande, P., Ely, E.W. (2008). Delirium in the intensive care unit. Critical Care 12(3).

 

ICU Delirium

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The article I chose is called “Delirium assessment in intensive care units: practices and perceptions of Turkish nurses” by Aysel Özsaban PhD. The aim of the article was to identify current practices of intensive care nurses regarding the delirium assessment  and to find factors that affect these perceptions. Being an ICU nurse is a very important job, it is different from any floor in the hospital. The patients are more critical and the nurse to patient ratio is more intimate. It is very important for a nurse to know how to do an appropriate delirium assessment. Data were collected from five Turkish public hospitals using a structured survey questionnaire. The study sample comprised 301 nurses who agreed to participate. Data were analysed using descriptive statistics. Results showed more than half of the nurses performed delirium assessments. However, the proportion of nurses who use delirium assessment tools was quite low. Almost all of the nurses perceived delirium as a problem and serious problem for ICU patients. The patient group least monitored for delirium was that of unconscious patients. While most nurses know the importance of doing a delirium assessment and understand this is a serious problem, the proportion of those who perform routine delirium assessments was less. It was found that delirium assessment practices of nurses were affected from their perceptions of delirium and the implementation of patient-centred care delivery.

I would say that I agree with this article because in nursing school we are taught that doing a good assessment could make a difference in the care that we provide for a patient. Just because most of the patients we do a delirium assessment on are sedated, does not mean we have to skip important steps. Steps needed to reduce this problem is to teach nurses the correct way to do this assessment and the importance of it. There should be classes that help nurses understand and comprehend what exactly they are assessing for.

Thank You, Ashleigh

http://onlinelibrary.wiley.com.summit.csuci.edu:2048/doi/10.1111/nicc.12127/full

Sugaah Overload! Group Project Guidelines!

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Group number 3: Jennifer Haldeman, Arely Rosales, Eugenie Fasulo
Group name: Sugaah Overload!

Member strengths, limitations and values:

  • Limitations – timing and scheduling
  • Strengths- Were all good teamworkers! Were all positive people!! Yayy!
  • Values- We value trust, respect, and hard work. No slackers here!

Roles and Accountability: We are not going to have a leader. We will share all roles equally.

Communication Style: We are utilizing google docs and we will be meeting before class.

Leadership Style: We will be utilizing a democratic leadership style with an emphasis on teamwork and collaboration

Strategies: Utilize good communication and if we are having problems brainstorm with the others.

candy

Group Project Rules

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State a team name, letter of your group (A-F), and describe the reason the name was chosen:
Group 11 (Nikki, Carl, Janine)
COPD – we chose this name because it is the disease we chose to highlight in our project

Group Meeting time(s) and location(s) for the duration of the semester:

 Broome Library
Jan. 28 – Broome Library – delegated first portion of project
Feb 8 – Deadline for voicethread outline and powerpoint on Googledocs
Feb 13 – Nikki’s home – recording voicethread/PPT for 1st part of project

March – TBD
April – TBD

 

 

Role of each group member (Are there roles? Or delegated tasks?):

 Nikki – Leader
Voicethread assignment – Patho/Presentation of disease
Carl – Recorder/Online coordinator
Voicethread assignment – Interventions & related complications to disease process

Janine – Researcher
Voicethread assignment – Pharmacological interventions

 

Who will lead each meeting? If you will rotate, detail how this will occur?:

 Nikki Ives

 

Who will take minutes and record action items? If you will rotate, detail how this will occur?:

 Carl Eisenthal

 

What will your process be for dealing with group members who miss meetings or who are late? How will you address first time offense and repeat offenses? Will the discussion happen one-on-one or as a group?

 

-Missing meetings or being late is understandable with proper reason.
– First time offense will be excused and we will try to work on scheduling around
everyone’s schedule
– Repeat offenses will be communicated with member of the group alongside
all the members of the group
– If it is merely difficult to meet based on differing schedules we will attempt
to meet evenings utilizing Skype

 

What will your process be for dealing with distractions (side bar conversations, cell phone conversations, etc.) during a meeting? How will you address first time offense and repeat offenses? Will the discussion happen one-on-one or as a group?

– First time: the group member will respectfully and courteously be asked to put
away distracting devices to have an efficient meeting

– Repeat offenses: will communicate to the member of the group how these
distractions affect other group members.

 

What will your process be for decision making? If you decide on a consensus vote, what will your process be for making a decision if consensus cannot be reached?:

 -We will democratically vote on an agreement.
– If consensus cannot be met, we will agree to compromise on other aspects of the
project in order to fairly reach agreement.

 

What will your process be for dealing with team member who does not fulfill his or her team assignment(s)? How will you address first time offense and repeat offenses? Will the discussion happen one-on-one or as a group?:

–       If a group member does not fulfill their assignment after expectations have been
communicated, an extension will be made so that they may be able to turn in
their portion of the assignment in time.
– If the offense continues, other group members will have to step in to complete
the assignment to receive credit by instructor. However, the group member’s
failure to cooperate and meet deadlines will be communicated to the professor.
The amount & quality of work (or lack thereof) will be evaluated by the group
alongside Dr. Jaime Hannans to designate the grade this group member merits.

 

What will your process be for resolving conflict within the group? Will the discussion happen one-on-one or as a group?:

 Conflict will be resolved using discussion and compromise by all group members.
If conflict is due to a group member underperforming, the process mentioned
above will be utilized. Discussion will occur as a group and will involve
respect of all group members and their opinions.

 

List any other applicable group norms that your group committed to:

 It was agreed by the group that constant communication and early deadlines will
be set throughout the course of the semester. Group deadlines will be prepared far
in advance of the class deadlines in order to control any unexpected
complications. All group members agreed to respect the early deadlines and
each others’ opinions.

 

 

 

First and Last Name of all group members:
Nikki Ives
Carl Eisenthal
Janine Villanueva

The Fluid Resuscitators Group Rules

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Group #7
• Group Name: Fluid Resuscitators
• Group Members: Maria Magaña, Robert (Bobby) Martinez, Emily Sentianin

• Why group name was chosen: We chose to study sepsis for our group project and fluid resuscitation is a very important concept in sepsis management.

• Meeting times and locations for duration of semester: Meeting times 1100 on Wednesdays in the Student Union as needed.

• Role of each group member: Bobby-Researcher, Emily-Editor, Maria- Making presentations, everyone: Voice Thread Contributors. The duties will be shared but the ultimate responsibility will be the assigned person for each task.

• Who will lead each meeting? We will rotate leaders each week so that everyone has a chance to run a meeting.

• Who will take minutes and record action items? Maria

• What will the process be for dealing with group members who miss meetings or who are late? How will you address first time offense and repeat offenses? Will the discussion happen one on one or as a group? If the reason for missing meetings or tardiness is valid, then it will be excused. First time offense, if reasonable, will be given a warning. If repeat offenses occur and assigned workload is not completed, then this will be reflected in the final project grade. The discussion will happen as a group because it affects the entire group.

• What will your process be for dealing with distractions during your meeting? How will you address first time offense and repeat offenses? Will the discussion happen one on one or as a group? Meeting times need to be productive so will be no cell phone use rule during meetings unless expecting an important call/message. First time offense will be and repeat offenses will result in dismissal from the meeting. The discussion will happen as a group.

• What will your process be for decision making? If you decide on a consensus vote, what will be your process for making a decision if consensus cannot be reached? The decision making will consist of discussing options and ideas from all members and coming to a consensus. If consensus cannot be reached, further options will be explored and final decisions will be decided by a 2/3 majority vote.

• What will your process be for dealing with a team member who does not fulfill team assigments? How will you address first time offense and repeat offenses? Will the discussion happen one on one or as a group? Perform a verbal root cause analysis of failure to complete duties to ensure that assignment was fully understood. If deadlines are not met then, the first time offense will have an extension of 1 day, additional failures to meet deadlines will be reflected in the final grade. This discussion will happen as a group.

• What will your process be for resolving conflict within the group? Will the discussion happen one on one or as a group? The conflict will attempt to be resolved within the group by a roundtable discussion of issues; if the issue cannot be resolved then it will be taken up with the course instructor. This discussion will occur one on one if only involving two people but will occur as a group if the conflict is amongst the entire group.

• List any other applicable group norms:
o If you can’t make it to a meeting, let the group members know in advance as soon as possible, preferably the day before.
o Respect other group members.
o Collaboration and teamwork will be utilized.
o Do not be afraid to verbalize disagreement.

The Fluid Resuscitators Group Rules

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Group #7

  • Group Name: Fluid Resuscitators
  • Group Members: Maria Magaña, Robert (Bobby) Martinez, Emily Sentianin
  • Why group name was chosen: We chose to study sepsis for our group project and fluid resuscitation is a very important concept in sepsis management.
  • Meeting times and locations for duration of semester: Meeting times 1100 on Wednesdays in the Student Union as needed.
  • Role of each group member: Bobby-Researcher, Emily-Editor, Maria- Making presentations, everyone: Voice Thread Contributors. The duties will be shared but the ultimate responsibility will be the assigned person for each task.
  • Who will lead each meeting? We will rotate leaders each week so that everyone has a chance to run a meeting.
  • Who will take minutes and record action items? Maria
  • What will the process be for dealing with group members who miss meetings or who are late? How will you address first time offense and repeat offenses? Will the discussion happen one on one or as a group? If the reason for missing meetings or tardiness is valid, then it will be excused. First time offense, if reasonable, will be given a warning. If repeat offenses occur and assigned workload is not completed, then this will be reflected in the final project grade. The discussion will happen as a group because it affects the entire group.
  • What will your process be for dealing with distractions during your meeting? How will you address first time offense and repeat offenses? Will the discussion happen one on one or as a group? Meeting times need to be productive so will be no cell phone use rule during meetings unless expecting an important call/message. First time offense will be and repeat offenses will result in dismissal from the meeting. The discussion will happen as a group.
  • What will your process be for decision making? If you decide on a consensus vote, what will be your process for making a decision if consensus cannot be reached? The decision making will consist of discussing options and ideas from all members and coming to a consensus. If consensus cannot be reached, further options will be explored and final decisions will be decided by a 2/3 majority vote.
  • What will your process be for dealing with a team member who does not fulfill team assigments? How will you address first time offense and repeat offenses? Will the discussion happen one on one or as a group? Perform a verbal root cause analysis of failure to complete duties to ensure that assignment was fully understood. If deadlines are not met then, the first time offense will have an extension of 1 day, additional failures to meet deadlines will be reflected in the final grade. This discussion will happen as a group.
  • What will your process be for resolving conflict within the group? Will the discussion happen one on one or as a group? The conflict will attempt to be resolved within the group by a roundtable discussion of issues; if the issue cannot be resolved then it will be taken up with the course instructor. This discussion will occur one on one if only involving two people but will occur as a group if the conflict is amongst the entire group.
  • List any other applicable group norms:
    • If you can’t make it to a meeting, let the group members know in advance as soon as possible, preferably the day before.
    • Respect other group members.
    • Collaboration and teamwork will be utilized.
    • Do not be afraid to verbalize disagreement.

 

 

Protected: Group #7 Group Rules

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NRS 420 Group Communication Homework

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State a team name, letter of your group (A-F), and describe the reason the name was chosen:

Group 1 consists of:  Brittany Brown, Marylou Fulton, Julia Greiner, Alissa Pang

Team Name: “The Fiery Synapses”

We chose this team name because we are the means by which the information and knowledge on the chapters for The Nervous System will be “fired off” and communicated to the rest of the class:)

Meeting time(s) and location(s) for the duration of the semester:

Presentation Date: 4/29/15

Skype meeting dates…

Feb 13, 20, 23, 27

Mar 6, 12, 27

Apr 3, 10, 24

Role of each group member (Are there roles? Or delegated tasks?):

The Nervous System section will be divided as follows:

Chapter 21: Marylou

Chapte 22: Brittany

Chapter 23 Part 1: Alissa or Julia

Chapter 23 Part 2: Julia or Alissa

Each group member will be responsible for doing their part but will also take part in looking over the entire project as a whole before project is finalized.

Who will lead each meeting each meeting? If you will rotate, detail how this will occur?:

We will rotate the leadership role. Each member will lead at least one meeting.

Who will take minutes and record action items? If you will rotate, detail how this will occur?:

The team leader will be responsible for taking the minutes and record action items. They will record what goes on during the meeting they lead.

What will your process be for dealing with group members who miss meetings or who are late? How will you address first time offense and repeat offenses? Will the discussion happen one-on-one or as a group?

This group will discuss any issues that arise one-on-one first (with the group leader) and if problems persist, we will discuss the issue as a group.

What will your process be for dealing with distractions (side bar conversations, cell phone conversations, etc.) during a meeting? How will you address first time offense and repeat offenses? Will the discussion happen one-on-one or as a group?

This group will discuss any issues that arise one-on-one first (with the group leader) and if problems persist, we will discuss the issue as a group.

What will your process be for decision making? If you decide on a consensus vote, what will your process be for making a decision if consensus cannot be reached?:

We will collaborate as a group to make decisions. If a consensus cannot be met, we will use a Randomizer/Numerator machine to come to a conclusion.

What will your process be for dealing with team member who does not fulfill his or her team assignment(s)? How will you address first time offense and repeat offenses? Will the discussion happen one-on-one or as a group?:

If a group member is not fulfilling their role, the whole group will get together to discuss the issue.

What will your process be for resolving conflict within the group? Will the discussion happen one-on-one or as a group?:

This group will discuss any issues that arise one-on-one first (with the group leader) and if problems persist, we will discuss the issue as a group.

List any other applicable group norms that your group committed to

-As a group, we will touch base at least once a week to “check in” with each other.

-We will support each other! If one or some of us fall behind, we will not blame, but pick up the slack if need be.

-We have to keep our eyes on the mission at hand.  But, we also need to be responsible for each of our parts.

-Each group member will be forthright and transparent with fellow group members about any personal struggles we may be dealing with that may be hindering the progress of the project.

-We will not have a culture of blame.

-We will assess the situation and collaborate as a group on how to move forward if issues arise.

First and Last Name of all group members:

Brittany Brown

Marylou Fulton

Julia Greiner

Alissa Pang

Signature of all group members:

All members of the Fiery Synapses have convened regarding these topics and are in accordance with the contents of this assignment.

Group Rules

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State a team name, letter of your group (A-F), and describe the reason the name was chosen:
Group 11 (Nikki, Carl, Janine)
COPD – we chose this name because it is the disease we chose to highlight in our project

Group Meeting time(s) and location(s) for the duration of the semester:

Jan. 28 – Broome Library – delegated first portion of project
Feb 8 – Deadline for voicethread outline and powerpoint on Googledocs
Feb 13 – Nikki’s home – recording voicethread/PPT for 1st part of project

March – TBD
April – TBD

Role of each group member (Are there roles? Or delegated tasks?):

Nikki – Leader
Tasks: Voicethread assignment – Patho/Presentation of disease
Carl – Recorder/Online coordinator
Tasks: Voicethread assignment – Interventions & related complications to disease process

Janine – Researcher
Tasks: Voicethread assignment – Pharmacological interventions

Who will lead each meeting? If you will rotate, detail how this will occur?:

Nikki Ives

Who will take minutes and record action items? If you will rotate, detail how this will occur?:

Carl Eisenthal

What will your process be for dealing with group members who miss meetings or who are late? How will you address first time offense and repeat offenses? Will the discussion happen one-on-one or as a group?

-Missing meetings or being late is understandable with proper reason.
– First time offense will be excused and we will try to work on scheduling around
everyone’s schedule
– Repeat offenses will be communicated with member of the group alongside
all the members of the group
– If it is merely difficult to meet based on differing schedules we will attempt
to meet evenings utilizing Skype

What will your process be for dealing with distractions (side bar conversations, cell phone conversations, etc.) during a meeting? How will you address first time offense and repeat offenses? Will the discussion happen one-on-one or as a group?

-If a group member does not fulfill their assignment after expectations have been
communicated, an extension will be made so that they may be able to turn in
their portion of the assignment in time.
– If the offense continues, other group members will have to step in to complete
the assignment to receive credit by instructor. However, the group member’s
failure to cooperate and meet deadlines will be communicated to the professor.
The amount & quality of work (or lack thereof) will be evaluated by the group
alongside Dr. Jaime Hannans to designate the grade this group member merits.

What will your process be for resolving conflict within the group? Will the discussion happen one-on-one or as a group?:

Conflict will be resolved using discussion and compromise by all group members. If conflict is due to a group member underperforming, the process mentioned above will be utilized. Discussion will occur as a group and will involve respect of all group members and their opinions.

List any other applicable group norms that your group committed to:

It was agreed by the group that constant communication and early deadlines will be set throughout the course of the semester. Group deadlines will be prepared far in advance of the class deadlines in order to control any unexpected complications. All group members agreed to respect the early deadlines and each others’ opinions.

First and Last Name of all group members: 
Nikki Ives
Carl Eisenthal
Janine Villanueva

 

Group Guidelines

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Cesar:

-Strengths: organization, time management, has significant interest in topic (renal), consistently meets deadlines

-Weaknesses: group projects, busy schedule, lack creativeness in composing computer presentations.

-Values: appreciates equal workload, timeliness, quality over quantity

-Strategies for successful team functioning: setting deadlines, appreciating each other’s unique talents and perspectives, communication (especially if things do not go well), equal distribution of workload

Rose:

-Strengths: Possesses leadership qualities, dependable, organized, and creative

-Weaknesses: Busy work schedule, different schedule than team members, not computer saavy

-Values: Honesty, hardwork, and respect

-Strategies for team success: Meeting deadlines, respecting other’s ideas, equal workload, interest in topic

-Leadership Style: Democratic leadership style: Involving others in their decisions

-Communication Style: Hopefully, everyone uses an assertive communication style. Having a passive or aggressive communication style will get the group nowhere fast.

 State a team name, letter of your group (A-F), and describe the reason the name was chosen:

Our team name is the ACE inhibitors (B). This name was chosen because we are responsible in providing information about the renal systems.

Meeting time(s) and location(s) for the duration of the semester:

Between nursing 420 and 488 on Wednesday afternoons. Whatever was not taken care of we will meet after nursing 488. We will meet at various locations on campus; classrooms, library, student union, and outside.

Role of each group member (Are there roles? Or delegated tasks?):

Roles have not indefinitely be defined. Each person will pull their weight equally and we will work as a team to get the job done.

Who will lead each meeting? If you will rotate, detail how this will occur?

Each person will contribute to the meeting with no particular leader. Everyone will be encouraged to share their ideas and have an equal input.

Who will take minutes and record action items? If you will rotate, detail how this will occur?

Rose will take minutes and keep track of what is said at each meeting.

What will your process be for dealing with group members who miss meeting or who are late? How will you address first time offense and repeat offenses? Will the discussion happen one-on-one or in a group?

We hope that everyone is responsible enough to meet, however, things do come up and there will be another mode of communication to keep the absent group member updated; email, phone, googledoc, etc. Repeat offenders will be talked to in a group setting.

What will your process be for decision making? If you decide on a consensus vote, what will your process be for making a decision if consensus cannot be reached?

There will be a democratic vote. Everyone will have the right to have an opinion or idea. We will narrow it down to two topics and vote. Two out of three gets the vote. We are not worried that we will not meet a consensus.

What will your process be for dealing with a team member who does not fulfill his or her team assignment(s)? How will you address first time offense and repeat offenses? Will the discussion happen one-on-one or as a group?

Again, we are in hopes that everyone in the group is responsible and respects each other’s times and wishes. A person that does not fulfill their assignment will be talked to in a group setting. We will find an alternative to the student getting the assignment done.

What will your process be for resolving conflict within the group? Will the discussion happen one-on-one or as a group?

Hopefully, there is no conflict. If it is a conflict between two group members than the third does not need to be present. The conflict will be discussed in a professional manner in hopes to resolve it and move on.

First and Last Name of all group members:

Autumn Moon

RoseAnn Fischer

Cesar Rivera