GRACE Score Analysis

Sample. Using discharge diagnosis, 2 samples were collected. Sample 1, was composed of all patients discharged with diagnosis of myocardial infarction at Baptist Hospital during the period of

Often, we think of older people as being smarter, wiser, and generally more mature, but this is not always the case. Ordinary Grace by William Kent Krueger gives a number of examples that shatter this generalization, offering an alternative to age as the primary factor in one’s level of maturity. Ordinary Grace shows how maturity is a result of circumstance and does not necessarily correlate with age.

As Jane was presenting with a symptom of a life threatening event it was important that treatment was immediate. Priority was initially made from assessment of the airways, breathing and circulation, level of consciousness and pain. Jane’s respirations on admission were recorded at a rate of 28 breaths per minute, she looked cyanosed. Jane’s other clinical observations recorded a heart rate of 105 beats per minute (sinus tachycardia), blood pressure (BP) of 140/85 and oxygen saturation (SPO2) on room air 87%. It is important to establish a base line so that the nurse is altered to sudden deterioration in the patient’s clinical condition. Jane’s PEWS score (Physiological Early Warning Score) was 4 and indicated a need for urgent medical attention (BTS 2006). Breathing was the most obvious issue and was the immediate priority.

These discoveries prompted change and allowed the National Institute of Health and Clinical Excellence (NICE), to set standards to reduce unnecessary detriment to patients. Many tools were introduced to assist in the consistency and accuracy of observations of patients’ physiological conditions. ViEWS (VitalPac Early Warning Score) is a standardized and high-tech scoring system that helps recognize and respond to deteriorating patients. It is the basis of the newest warning system, appropriately named National Early Warning System or NEWS (Featherstone, Prytherch, Schmidt & Smith, 2010).

A Grace Disguised written by Jerry Sittser, is one of the most heart felt and transparent books I have ever read. The idea that our purpose and who we are is shaped through our suffering and loss, puts one in perspective to understand that our pain lies a blessing, even at times we don't understand. Jerry Sittser, a husband, son, and father of four is a true witness to what its like to experience loss and even feel hopelessness in times of despair. In the fall of 1991, him and his families lives were changed forever. Driving back home from a Native American reservation in rural Idaho, an incoming car driving extremely reckless and fast, jumped its lane and smashed head-on into their families mini-van. Rescuing his daughter Catherine and two sons David and John, Jerry Sittser had to endure seeing the lives of his wife Lynda, mother Grace, and four year old daughter Diane flash before his eyes (Sittser, 1998 pg. 26). Three generations instantly gone without any signs or warnings. Letters of comfort that was sent by mail frequently asked Jerry the question, “Why did this have to happen to your family? Y'all were the ideal family to model. If bad things can happen to good people like the Sittser’s then we’re all in trouble (Sittser, 1998 pg. 30).” In this book Jerry Sittser highlights many different aspects of how to differentiate our view of loss from both a carnal and spiritual perspective. Yes, its no debate that loss is a terrifying and dreadful event to experience, but

Patients were assessed at admission and discharge of ICU and assessed using Braden Score and APACHE II score.

“We proclaim Christ and Him Crucified.” Why is this important and why does your pastor say this ‘all the time’? [Proclaiming Christ Crucified]

EW was chosen for this study because of his diagnosis of NSTEMI and undergoing a CABG procedure, both of which are common for patients with heart attacks that require invasive interventions, and because of his unique combination of risk factors, mainly low HDL, a history of smoking, and central obesity, as other risk factors such as high LDL levels and physical inactivity were not present in

The purpose of this paper is to discuss a new best practice, the necessary steps for implementing the new practice, and support this change in practice with current literature. Heart disease is the leading cause of death in the United States. Evidence-based clinical practice guidelines regarding patients with ST-segment elevation myocardial infarction (STEMI) seek to reduce variation in practice and improve outcomes for this patient population (O 'Gara et al., 2013). Current evidence-based practice includes immediate reperfusion therapy to the involved coronary artery in this patient population. However, it is often challenging for emergency department nurses to implement the initial steps of this evidence-based practice, which includes obtaining a 12-lead electrocardiogram within ten minutes of arrival, as some patients present with symptoms other than chest pain, or atypical symptoms. For instance, atypical presentations include shortness of breath, altered mental status, upper extremity pain, upper back pain, generalized weakness, and abdominal pain (Glickman et al., 2012). Ultimately, this results in delays of reperfusion therapy.

AIMS65 is a scoring system with high accuracy for predicting inpatient mortality among patients with UGIB. Five factors associated with increased mortality are Albumin less than 3.0 g/dL, INR greater than 1.5, Altered Mental status, Systolic blood pressure of 90 mmHg or less and Age > 65 years. Increasing score predicts mortality, increased length of hospital stay and cost (29).

The Alias Grace novel takes place in the 19th century in Ontario, Canada. The setting of the novel is based on murder, gender and feminism during that time. In the novel, Margaret Atwood touches upon various gender role issues that women faced in the mid 19th century by reviving the life of the 16-year-old Grace Marks, who was convicted of murder. Using Grace’s perspective, Atwood reflects the gender stereotypes of the patriarchal society in the novel. While facing limited opportunities in defining themselves independently, women are expected by men to act and look in certain ways and are looked down upon as objects. The constructed gender-biased identity illustrated in the novel, positions women as the fragile, weaker sex and leaves men with all the power and free of any moralities.

For the hospital, there is a lower risk than the reference population. The indicator measures in-hospital deaths per every 1000 hospital discharges with a principal diagnosis of acute myocardial infarction for patients above 18 year of age. This measure excludes all obstetric discharges and any transfers to other hospitals. The numerator is the number of deaths and the denominator is the number of discharges with a ICD-9 code for AMI.

The first steps in understanding forgiveness begins by recognizing the similarity between grace and forgiveness. In the New Testament, one will find the use of the verbal form of the Greek word grace used several times, often meaning “to forgive.” In the book, What’s so Amazing about Grace, Yancey suggests that like the meaning of grace, the word forgive contains the word give meaning unmerited (Yancey, 1997). Grace though not a word often used or applied, means unmerited favor much like receiving a gift not earned.

Arrived in New York and after settling wherever he could. Peter became acquainted with the various communities and people who lived there. Peter had a vision and he shared it wherever he went… people talked up Dorothy and her quest. Peter knew he had to meet this woman and when he did. It was almost serendipitous! Again, In All is Grace, A Biography of Dorothy Day, Dorothy’s recounts her meeting Peter Muiner with affection and admiration.” “His face seen as weathered beaten as is clothing. However, the visit wasn’t down- and- out and his welcoming smile. His whole manner communicated gentleness, vitality and intellectual energy. When he spoke, his calloused hands you're as lively as his thoughts. ‘I am Peter

In the past 20 years, the percentage of AF-related hospitalizations has increased by 66%, which represents a significant impact for health care providers, with a total cost burden of approximately 13.5 billion Euros in Europe.170 This is mainly the consequence of increasing number of patients with cardiac diseases, coupled with the expanding segment of elderly patients and improved diagnostic tolls.186 Maglio et al. reported that over a 2-year period, an AF patient requires an average of 14 office visits, 12 outpatient visits, 2 admissions to hospital and one emergency department visit.196