Hospitals have noises that are buzzing day and night. Emergency Rooms, ICU’s and monitored patient floors to mention a few, have high rates of noise saturation. The most common attribution to the noise is alarms. Alarms are designed to alert staff of a change or potential change in patient status (Hebda et al., 2019). Often, the alarm going off is false or has no patient threat. This is due to parameters not being set, patches not sticking, or positioning of a sensor. This can cause alarm fatigue, “The desensitization of a clinician to an alarm stimulus that results from sensory overload causing the response of an alarm to be delayed or missed” (West et al., 2014).

The result of alarm fatigue can lead to harmful patient situations. For example, if a nurse on a busy med-surg floor has several patients on beds with alarms, patients with IV pumps infusing and on telemetry monitoring, the alarm noise from all the devices could cause the nurse to tone out some of the sounds. If one of her patient’s bed alarms continues to go off repeatedly and every time she enters the patient’s room, finds the patient in bed, she determines the sensor is set to sensitive for the patient. But if the sensor is not reset, and the alarm continues to go off, the nurse may start to ignore the alarm. The last time the alarm sounds, the patient does get out of bed and falls, injuring his hip. This can turn into a legal issue as the safety measure was in place to protect the patient from harm, but due to a failure to change the bed setting, and the nurse’s desensitization of the alarm, the patient had a poor outcome. There is an ethical responsibility for the nurse to assess the injured patient, report the fall to appropriate change according to hospital policy and discuss the incident with the patient or family members. According to Kadivar et al., (2017), that despite measures put into place in the health care setting, there are still numerous threats posed to patient safety.

Evidence suggests that alarm fatigue is a patient safety and quality concern. As health care delivery becomes more digitalized, it is increasingly important to develop a safety culture to address alarm fatigue. The research suggests establishing safe alarm management and response processes. The use of multilevel sharing practices and prevention strategies is also a way to collaborate with multidisciplinary teams on strategies for reduction in alarm fatigue (Winter et al., 2021). By decreasing the number of false alarms with use of proper management, nurses can better care for patients needs without disruptions. Thus, reduce potential missed or ignored alarms resulting in poor patient outcomes.

 

References:

Kadivar, M., ManooKian, A., Asgharican., & Zarvani, A. (2017). Ethical and legal aspects of patient's safety: A clinical case report.
Journal of Medical Ethics and History of Medicine,
10, 15.

 

Winters, B., Slota, J., & Bilimoria, K. (2021). Safety Culture as a Patient Safety Practice for Alarm Fatigue.
Journal of the American Medical Association,
326(12), 1207-1208.

https://doi.org/chamberlainuniversity.idm.oclc.org/10.1001/jama.2021.8316

Links to an external site.

 

Hebda, T., Hunter, K., & Czar, P. (2018). Handbook of Informatics for Nurses & Healthcare Professionals (6th ed.). Pearson Learning Solutions.

https://ambassadored.vitalsource.com/books/9781323903148

Links to an external site.

 

West, P., Abbott, P., & Probst, P. (2014). Alarm fatigue: A concept analysis.
Online Journal of Nursing Informatics,
18(2), 1.

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• Choose one skin condition graphic (identify by number in your Chief Complaint) to document your assignment in the SOAP (Subjective, Objective, Assessment, and Plan) note format rather than the traditional narrative style. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in this week’s Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.
• Use clinical terminologies to explain the physical characteristics featured in the graphic. Formulate a differential diagnosis of five possible conditions for the skin graphic that you chose. Determine which is most likely to be the correct diagnosis and explain your reasoning using at least three different references, one reference from current evidence-based literature from your search and two different references from this week’s Learning Resources.

Week 1 Discussion: Social Factors

I live in Lady Lake, FL. According to the U.S. Census Bureau in 2022, the city of Lady Lake’s population was 16,661, the median income was $42,088, and the percentage of people living in poverty was 14.0% (U.S. Census Bureau, 2022). The grocery store that I usually shop at and that is local is called Winn-Dixie. The Winn-Dixie I went to was located in Lady Lake FL. I did my research when I went grocery shopping yesterday and gathered the prices of the following, all were non-organic.

· 1 gallon of milk: $ 4.19 (whole milk)

· 1 loaf of bread: $4.19 (butter bread)

· 1 bag of apples (including price per pound): $5.99 (for a 3lb bag) /$2.39 per pound.

· 1 bag of carrots: $2.39 (baby-cut carrots)

· 1 large container of yogurt: $5.99 (Greek yogurt 32 ounces)

· 1 2-liter of soda: $1.49 (liter of coke)

· 1 bag of chips: $5.99 (bag of Doritos)

· 1 package of cookies: $4.19 (Chips Ahoy)

When it comes to buying groceries there are several social factors that could impact what groceries are purchased. Poverty levels can impact what groceries are purchased due to limited income. Those with limited income and are considered to be “in poverty” will rely more on cheaper and more affordable food options.  According to the US Department of Health and Human Services, “Low-income groups tend to rely on foods that are cheap and convenient to access but are often low in nutrients” (U.S. Department of Health and Human Services, n.d.).Cheaper food options may not be the most nutritious or healthy. Also, those who live in poverty might rely more on food that is processed and packaged, these foods will last longer helping them get the most out of their money.  We can look at what is gathered above, yogurt is $5.99 and will not last as long as cookies which is $4.19.

The second social factor that could impact what groceries are purchased would be availability. When grocery stores have a wide variety of fresh fruits and vegetables it can be easier for people to select those healthier options and incorporate them into their diets. If the grocery stores do not have these items readily available, then customers may be led to frozen processed fruits and vegetables. Availability and assortment are important for those who may not have the money or accessibility to other sources of fresh produce.

A community health nurse could use outreach as an intervention to address areas of food security. According to our book,
Community/Public Health Nursing, the definition of outreach is, “locates populations of interest or populations at risk and provides information about the nature of the concern, what can be done about it, and how services can be obtained” (Nies & McEwen, 2022). The community health nurse should focus on the poverty population recognizing that they are at risk for food security and reach out to them. Once information is gathered the CHN can then do further research on how we can help those in need and provide them the services they may need.

References

Nies, M., & McEwen, M. (2022).
Community/Public Health Nursing. Elsevier Health Sciences.

U.S. Census Bureau. (2022).
U.S. Census Bureau. Retrieved from https://www.census.gov/quickfacts/fact/table/ladylaketownflorida,US/PST045222?

U.S. Department of Health and Human Services. (n.d.).
U.S. Department of Health and Human Services. Retrieved from Access to Foods That Support Healthy Dietary Patterns: https://health.gov/healthypeople/priority-areas/social-determinants-health/literature-summaries/access-foods-support-healthy-dietary-patterns#:~:text=Low%2Dincome%20groups%20tend%20to,are%20often%20low%20in%20nutrients.&text=Fresh%20fruits%20and%20vegetab

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Evaluate the impact of aging on the structure and function of the pulmonary system. How do age-related changes, such as decreased lung elasticity and decreased respiratory muscle strength, affect respiratory function and increase susceptibility to respiratory disorders?