Human Papillomavirus (HPV) and the Fight to Protect Men�s and Women�s Health JUST READ THIS TO GET AN IDEA ABOUT THIS PAPER AND WHAT IT IS ABOUT. READ CAREFULLY Human Papillomavirus (HPV) and the Fight to Protect Men�s and Women�s Health Human Papillomavirus (HPV) and the Fight to Protect Men�s and Women�s Health The Human Papillomavirus (HPV) is a virus passed from one person to another through skin-to-skin contact. According to Henderson, Clements, & Damery (2013), HPV is the most common sexually transmitted infection (STI) among men and women. Most sexually active men and women will contract HPV at least once in their lifetime, but there are over forty types of HPV. This virus can be transmitted through vaginal, oral, or anal sex, but can also be caused by any exposure that allows skin-to-skin contact with a person who carries the virus (Jemal, Bray, Center, Ferlay, Ward, & Forman, 2011). Most types of HPV go away on its own, but there are four types out of over forty types of HPV that do not go away. These four types of HPV are very dangerous to one�s health and these four types can cause cancer or genital warts. Seventy nine million people are currently affected by HPV, and fourteen million new cases of HPV are recorded each year. This topic is of high interest to me because so many people are affected by HPV, and also because the controversy about the new vaccination and its affect against HPV. Human papilloma virus (HPV) affects millions of men and women, and specific types of HPV can cause genital warts or cancer of the cervix, vulva, penis, vagina, oropharynx, or anus. Three hundred and sixty thousand women and men are affected by genital warts each year (Henderson, Clements, & Damery, 2013). Eleven thousand women are affected by cervical cancer each year (Henderson, Clements, & Damery, 2013). Men and women are both affected by HPV, but more women than men are affected and HPV cause severe health concerns in women. Women are more negatively affected by HPV, so more education is needed for better outcomes in women�s health. Women need to be educated on the importance of safe sex, HPV vaccinations, and the affects contracting HPV would have on one�s health. Women need to get their routine Pap smear test done because this is how HPV is diagnosed. The cells that are scraped from the cervix during a Pap smear are examined under a microscope, and if there are abnormal cells found these cells can possible change into genital warts or cancer. Cancer that is caught early has a better prognosis, so understanding risk factors, preventive measures, and early diagnosing can save lives. There is no cure for HPV but there are three vaccinations that are readily available to prevent the disease. FDA and CDC have approved Cervarix, Gardasil, and Gardasil 9 as safe and effective HPV vaccinations, but there is controversy on the ages the vaccinations are given and the idea that it is protecting against a sexually transmitted disease (Knox, 2011). For example, some mothers do not want to protect there eleven year old daughter or son from a STI because it seems as if she is expecting her child to have sex, but if the vaccination is done after the child is sexually active it may be to late for protection against HPV. Two questions related to the human papilloma virus (HPV) infection that I would like to explore and explained are: 1. What are the four types of HPV that do not go away and are very dangerous to one�s health? 2. What are the advantages and disadvantages of the HPV vaccines, and how the vaccines work to prevent most types of HPV? The four types out of forty types of HPV that do not go away and are dangerous to one�s health include HPV types 16 and 18, which are high risk types of HPV. On the other hand, HPV types 6 and 11 are low-risk types and pose insignificant effects on the health conditions of the affected patient population. These HPV types can be prevented by use of HPV vaccines. The advantage of most HPV vaccines is that they prevent cervical cancer as well as preventing HPV types 16 and 18 infections (Riethmuller et al., 2015). However, HPV vaccines are only effective in people who have yet to be exposed to these types of HPV. According to Smith and Canfell (2014), the vaccines rarely prevent HPV in those already exposed to these HPV types. The vaccines only protect one from being infected with particular HPV types. There is likelihood that the HPV vaccines could prevent HPV-related cancers, such as those cancers affecting the penis, head and neck areas though studies are yet to prove this. The vaccines work to prevent most types of HPV through stimulation of the immune system of the body (Szarewski et al., 2013). In response, as if the person actually had the HPV virus, antibodies to the specific HPV types are produced by the body. Nevertheless, the vaccines do not protect the vaccinated person from being infected by other STIs or other HPV types. In most cases, HPV vaccines only prevent infections by some of the most common HPV types and may minimize the risks of being infected with cervical, vulvar, vaginal, anal cancers, pre-cancers and genital warts. However, since a vaccinated person can still be infected by HPV and STIs, it is advisable to practice safe sex. Research Review AlObaid, A., Al-Badawi, I. A., Al-Kadri, H., Gopala, K., Kandeil, W., Quint, W., & … DeAntonio, R. (2014). Human Papillomavirus Prevalence And Type Distribution Among Women Attending Routine Gynecological Examinations In Saudi Arabia. BMC Infectious Diseases, 14(1), 132-149. doi:10.1186/s12879-014-0643-8 In this article, the authors sought to establish the level of awareness and the different types of HPVs among Saudi women. In particular, the authors hypothesized that the epidemiology of HPV was poorly understood among Saudi women. In order to verify the hypothesis, the researchers conducted an observational cross-sectional study, where cervical samples were taken for examination and a questionnaire on HPV infection were given to patients receiving routine gynecological services. Results from this study indicated that the most prevalent high risk HPV to be HPV-68/73, HPV-18 and HPV-16. On the other hand, low risk HPV types identified in this study included HPV-6, HPV-42, HPV-53 and HPV-54. Of more significance, the study established that only 32.2% of total sample population was aware of HPV infection and that 89.9% were interested in vaccination. Smith, M. A., & Canfell, K. (2014). Incremental Benefits of Male HPV Vaccination: Accounting for Inequality in Population Uptake. Plos ONE, 9(8), 1-10. doi:10.1371/journal.pone.0101048. Szarewski, A., Skinner, S. R., Garland, S. M., Romanowski, B., Schwarz, T. F., Apter, D., & … Martens, M. (2013). Efficacy of the HPV-16/18 AS04-Adjuvanted Vaccine Against Low-Risk HPV Types (PATRICIA Randomized Trial): An Unexpected Observation. Journal Of Infectious Diseases, 208(9), 1391-1396. Retrieved from http://eds.a.ebscohost.com/eds/detail/detail?vid=2&sid=77c3cef7-5dcc-4552-9ddd-9f69b82d647b%40sessionmgr4004&hid=4203&bdata=JnNpdGU9ZWRzLWxpdmU%3d#db=aph&AN=90612495 In this study, the hypothesis by Szarewski et al. (2013) is that it is apparent to protect individuals from low-risk HPV types through vaccination whereas that of Smith and Canfell (2014) is that men should be added to HPV vaccination programs if choice of a partner is influenced by factors that influence the uptake of vaccine. Szarewski et al. (2013) used case control studies for a period of four years in which a group vaccinated for over 6-months was observed against those not yet vaccinated. On the other hand, Smith and Canfell (2014) simulated a model whose data was obtained from observations made in Australia and USA. In addition, Szarewski et al. (2013) findings were that among the population that was not vaccinated, the HPV-16/18 AS04-adjuvanted vaccine had moderate efficacy against the infections that were persistent with some low-risk HPV types that are significantly responsible for external genital warts. Smith and Canfell (2014) found that the impact of more male vaccination was less likely to affect the levels of heterogeneity in vaccine uptake. The findings by Smith and Canfell emphasize the continual importance of having high vaccine coverage especially amongst groups infected with HPV to achieve equality of outcomes. References AlObaid, A., Al-Badawi, I. A., Al-Kadri, H., Gopala, K., Kandeil, W., Quint, W., & … DeAntonio, R. (2014). Human papillomavirus prevalence and type distribution among women attending routine gynecological examinations in Saudi Arabia. BMC Infectious Diseases, 14(1), 132-149. doi:10.1186/s12879-014-0643-8 Henderson, L., Clements, A., & Damery, S. (2013). A false sense of security�? Understanding the role of the HPV vaccine on future cervical screening behaviour: A qualitative study of UK parents and girls of vaccination age. Journal of Medical Screening, 18(1), 41-45. doi:10.1258/jms.2011.010148 Jemal, A., Bray, F., Center, M. M., Ferlay, J., Ward, E., & Forman, D. (2011). Global cancer statistics. CA: a cancer journal for clinicians, 61(2), 69-90. Knox, R. (2011). HPV Vaccine: The Science Behind The Controversy. Retrieved from http://www.npr.org/2011/09/19/140543977/hpv-vaccine-the-science-behind-the-controversy Riethmuller, D., Jacquard, A., St Guily, J.L., Aubin, F., Carcopino, A., Pradat, P., Dahlab, A & Pr�tet, J. (2015). Potential impact of a nonavalent HPV vaccine on the occurrence of HPV-related diseases in France. BMC Public Health, 15:453. Retrieved from DOI 10.1186/s12889-015-1779-1 Smith, M. A., & Canfell, K. (2014). Incremental Benefits of Male HPV Vaccination: Accounting for Inequality in Population Uptake. Plos ONE, 9(8), 1-10. Retrieved from http://eds.a.ebscohost.com/eds/detail/detail?vid=5&sid=77c3cef7-5dcc-4552-9ddd-9f69b82d647b%40sessionmgr4004&hid=4203&bdata=JnNpdGU9ZWRzLWxpdmU%3d#db=aph&AN=97800780 Szarewski, A., Skinner, S. R., Garland, S. M., Romanowski, B., Schwarz, T. F., Apter, D., & … Martens, M. (2013). Efficacy of the HPV-16/18 AS04-Adjuvanted Vaccine Against Low-Risk HPV Types (PATRICIA Randomized Trial): An Unexpected Observation. Journal Of Infectious Diseases, 208(9), 1391-1396. Retrieved from http://eds.a.ebscohost.com/eds/detail/detail?vid=2&sid=77c3cef7-5dcc-4552-9ddd-9f69b82d647b%40sessionmgr4004&hid=4203&bdata=JnNpdGU9ZWRzLWxpdmU%3d#db=aph&AN=90612495 ********************PLEASE READ CAREFULLY BECAUSE THESE ARE THE DIRECTIONS FOR THIS PAPER For Part 3 of the research review paper, you will do a synthesis of the literature and create a research proposal. Before you begin, review the overall assignment instructions from Weeks 1 and 2. Revise Parts 1 and 2 of your paper, as needed, on the basis of instructor feedback, new knowledge acquired in class, or discussion questions and/or additional readings. Part 3 will probably be the most challenging part of the assignment, so allow yourself plenty of time to think about what you’ve read and develop an argument for further research. Using the knowledge gained from work on Parts 1 and 2, identify one research question that has not been investigated previously or that you would address in a different way than you’ve read about so far. This is sometimes known as gap analysis, in that you are looking for a gap in the existing body of knowledge where new research would contribute to an understanding of the issue in a way that could improve clinical practice for the nurse practitioner and improve patient outcomes. Your research question must be clearly related to Parts 1 and 2. Be sure to state this clearly as a research question. Explain why you think this is a gap in existing research (relate directly to published research), its clinical relevance (why you think your specific research question is an important area to explore), and your ideas about research design (how you would conduct research to investigate it). Include a discussion of whether your question would lend itself to a quantitative, qualitative, or mixed design; why; and how you might be able to acquire participants for the study. Submission Details: � Submit your answers in a 2- to 3-page Microsoft Word document. Assignment 2 Grading Criteria Maximum Points Identified and clearly stated a research question that represents a gap in current research. 5 Described the clinical relevance of the proposed research question. 5 Presented a possible research design for investigating the proposed question. 5 Maintained the originality of the research question. 3 Used correct spelling, grammar, and professional vocabulary and cited all sources using APA style. 2

Human Papillomavirus (HPV) and the Fight to Protect Men�s and Women�s Health JUST READ THIS TO GET AN IDEA ABOUT THIS PAPER AND WHAT IT IS ABOUT. READ CAREFULLY Human Papillomavirus (HPV) and the Fight to Protect Men�s and Women�s Health Human Papillomavirus (HPV) and the Fight to Protect Men�s and Women�s Health The Human Papillomavirus (HPV) is a virus passed from one person to another through skin-to-skin contact. According to Henderson, Clements, & Damery (2013), HPV is the most common sexually transmitted infection (STI) among men and women. Most sexually active men and women will contract HPV at least once in their lifetime, but there are over forty types of HPV. This virus can be transmitted through vaginal, oral, or anal sex, but can also be caused by any exposure that allows skin-to-skin contact with a person who carries the virus (Jemal, Bray, Center, Ferlay, Ward, & Forman, 2011). Most types of HPV go away on its own, but there are four types out of over forty types of HPV that do not go away. These four types of HPV are very dangerous to one�s health and these four types can cause cancer or genital warts. Seventy nine million people are currently affected by HPV, and fourteen million new cases of HPV are recorded each year. This topic is of high interest to me because so many people are affected by HPV, and also because the controversy about the new vaccination and its affect against HPV. Human papilloma virus (HPV) affects millions of men and women, and specific types of HPV can cause genital warts or cancer of the cervix, vulva, penis, vagina, oropharynx, or anus. Three hundred and sixty thousand women and men are affected by genital warts each year (Henderson, Clements, & Damery, 2013). Eleven thousand women are affected by cervical cancer each year (Henderson, Clements, & Damery, 2013). Men and women are both affected by HPV, but more women than men are affected and HPV cause severe health concerns in women. Women are more negatively affected by HPV, so more education is needed for better outcomes in women�s health. Women need to be educated on the importance of safe sex, HPV vaccinations, and the affects contracting HPV would have on one�s health. Women need to get their routine Pap smear test done because this is how HPV is diagnosed. The cells that are scraped from the cervix during a Pap smear are examined under a microscope, and if there are abnormal cells found these cells can possible change into genital warts or cancer. Cancer that is caught early has a better prognosis, so understanding risk factors, preventive measures, and early diagnosing can save lives. There is no cure for HPV but there are three vaccinations that are readily available to prevent the disease. FDA and CDC have approved Cervarix, Gardasil, and Gardasil 9 as safe and effective HPV vaccinations, but there is controversy on the ages the vaccinations are given and the idea that it is protecting against a sexually transmitted disease (Knox, 2011). For example, some mothers do not want to protect there eleven year old daughter or son from a STI because it seems as if she is expecting her child to have sex, but if the vaccination is done after the child is sexually active it may be to late for protection against HPV. Two questions related to the human papilloma virus (HPV) infection that I would like to explore and explained are: 1. What are the four types of HPV that do not go away and are very dangerous to one�s health? 2. What are the advantages and disadvantages of the HPV vaccines, and how the vaccines work to prevent most types of HPV? The four types out of forty types of HPV that do not go away and are dangerous to one�s health include HPV types 16 and 18, which are high risk types of HPV. On the other hand, HPV types 6 and 11 are low-risk types and pose insignificant effects on the health conditions of the affected patient population. These HPV types can be prevented by use of HPV vaccines. The advantage of most HPV vaccines is that they prevent cervical cancer as well as preventing HPV types 16 and 18 infections (Riethmuller et al., 2015). However, HPV vaccines are only effective in people who have yet to be exposed to these types of HPV. According to Smith and Canfell (2014), the vaccines rarely prevent HPV in those already exposed to these HPV types. The vaccines only protect one from being infected with particular HPV types. There is likelihood that the HPV vaccines could prevent HPV-related cancers, such as those cancers affecting the penis, head and neck areas though studies are yet to prove this. The vaccines work to prevent most types of HPV through stimulation of the immune system of the body (Szarewski et al., 2013). In response, as if the person actually had the HPV virus, antibodies to the specific HPV types are produced by the body. Nevertheless, the vaccines do not protect the vaccinated person from being infected by other STIs or other HPV types. In most cases, HPV vaccines only prevent infections by some of the most common HPV types and may minimize the risks of being infected with cervical, vulvar, vaginal, anal cancers, pre-cancers and genital warts. However, since a vaccinated person can still be infected by HPV and STIs, it is advisable to practice safe sex. Research Review AlObaid, A., Al-Badawi, I. A., Al-Kadri, H., Gopala, K., Kandeil, W., Quint, W., & … DeAntonio, R. (2014). Human Papillomavirus Prevalence And Type Distribution Among Women Attending Routine Gynecological Examinations In Saudi Arabia. BMC Infectious Diseases, 14(1), 132-149. doi:10.1186/s12879-014-0643-8 In this article, the authors sought to establish the level of awareness and the different types of HPVs among Saudi women. In particular, the authors hypothesized that the epidemiology of HPV was poorly understood among Saudi women. In order to verify the hypothesis, the researchers conducted an observational cross-sectional study, where cervical samples were taken for examination and a questionnaire on HPV infection were given to patients receiving routine gynecological services. Results from this study indicated that the most prevalent high risk HPV to be HPV-68/73, HPV-18 and HPV-16. On the other hand, low risk HPV types identified in this study included HPV-6, HPV-42, HPV-53 and HPV-54. Of more significance, the study established that only 32.2% of total sample population was aware of HPV infection and that 89.9% were interested in vaccination. Smith, M. A., & Canfell, K. (2014). Incremental Benefits of Male HPV Vaccination: Accounting for Inequality in Population Uptake. Plos ONE, 9(8), 1-10. doi:10.1371/journal.pone.0101048. Szarewski, A., Skinner, S. R., Garland, S. M., Romanowski, B., Schwarz, T. F., Apter, D., & … Martens, M. (2013). Efficacy of the HPV-16/18 AS04-Adjuvanted Vaccine Against Low-Risk HPV Types (PATRICIA Randomized Trial): An Unexpected Observation. Journal Of Infectious Diseases, 208(9), 1391-1396. Retrieved from http://eds.a.ebscohost.com/eds/detail/detail?vid=2&sid=77c3cef7-5dcc-4552-9ddd-9f69b82d647b%40sessionmgr4004&hid=4203&bdata=JnNpdGU9ZWRzLWxpdmU%3d#db=aph&AN=90612495 In this study, the hypothesis by Szarewski et al. (2013) is that it is apparent to protect individuals from low-risk HPV types through vaccination whereas that of Smith and Canfell (2014) is that men should be added to HPV vaccination programs if choice of a partner is influenced by factors that influence the uptake of vaccine. Szarewski et al. (2013) used case control studies for a period of four years in which a group vaccinated for over 6-months was observed against those not yet vaccinated. On the other hand, Smith and Canfell (2014) simulated a model whose data was obtained from observations made in Australia and USA. In addition, Szarewski et al. (2013) findings were that among the population that was not vaccinated, the HPV-16/18 AS04-adjuvanted vaccine had moderate efficacy against the infections that were persistent with some low-risk HPV types that are significantly responsible for external genital warts. Smith and Canfell (2014) found that the impact of more male vaccination was less likely to affect the levels of heterogeneity in vaccine uptake. The findings by Smith and Canfell emphasize the continual importance of having high vaccine coverage especially amongst groups infected with HPV to achieve equality of outcomes. References AlObaid, A., Al-Badawi, I. A., Al-Kadri, H., Gopala, K., Kandeil, W., Quint, W., & … DeAntonio, R. (2014). Human papillomavirus prevalence and type distribution among women attending routine gynecological examinations in Saudi Arabia. BMC Infectious Diseases, 14(1), 132-149. doi:10.1186/s12879-014-0643-8 Henderson, L., Clements, A., & Damery, S. (2013). A false sense of security�? Understanding the role of the HPV vaccine on future cervical screening behaviour: A qualitative study of UK parents and girls of vaccination age. Journal of Medical Screening, 18(1), 41-45. doi:10.1258/jms.2011.010148 Jemal, A., Bray, F., Center, M. M., Ferlay, J., Ward, E., & Forman, D. (2011). Global cancer statistics. CA: a cancer journal for clinicians, 61(2), 69-90. Knox, R. (2011). HPV Vaccine: The Science Behind The Controversy. Retrieved from http://www.npr.org/2011/09/19/140543977/hpv-vaccine-the-science-behind-the-controversy Riethmuller, D., Jacquard, A., St Guily, J.L., Aubin, F., Carcopino, A., Pradat, P., Dahlab, A & Pr�tet, J. (2015). Potential impact of a nonavalent HPV vaccine on the occurrence of HPV-related diseases in France. BMC Public Health, 15:453. Retrieved from DOI 10.1186/s12889-015-1779-1 Smith, M. A., & Canfell, K. (2014). Incremental Benefits of Male HPV Vaccination: Accounting for Inequality in Population Uptake. Plos ONE, 9(8), 1-10. Retrieved from http://eds.a.ebscohost.com/eds/detail/detail?vid=5&sid=77c3cef7-5dcc-4552-9ddd-9f69b82d647b%40sessionmgr4004&hid=4203&bdata=JnNpdGU9ZWRzLWxpdmU%3d#db=aph&AN=97800780 Szarewski, A., Skinner, S. R., Garland, S. M., Romanowski, B., Schwarz, T. F., Apter, D., & … Martens, M. (2013). Efficacy of the HPV-16/18 AS04-Adjuvanted Vaccine Against Low-Risk HPV Types (PATRICIA Randomized Trial): An Unexpected Observation. Journal Of Infectious Diseases, 208(9), 1391-1396. Retrieved from http://eds.a.ebscohost.com/eds/detail/detail?vid=2&sid=77c3cef7-5dcc-4552-9ddd-9f69b82d647b%40sessionmgr4004&hid=4203&bdata=JnNpdGU9ZWRzLWxpdmU%3d#db=aph&AN=90612495 ********************PLEASE READ CAREFULLY BECAUSE THESE ARE THE DIRECTIONS FOR THIS PAPER For Part 3 of the research review paper, you will do a synthesis of the literature and create a research proposal. Before you begin, review the overall assignment instructions from Weeks 1 and 2. Revise Parts 1 and 2 of your paper, as needed, on the basis of instructor feedback, new knowledge acquired in class, or discussion questions and/or additional readings. Part 3 will probably be the most challenging part of the assignment, so allow yourself plenty of time to think about what you’ve read and develop an argument for further research. Using the knowledge gained from work on Parts 1 and 2, identify one research question that has not been investigated previously or that you would address in a different way than you’ve read about so far. This is sometimes known as gap analysis, in that you are looking for a gap in the existing body of knowledge where new research would contribute to an understanding of the issue in a way that could improve clinical practice for the nurse practitioner and improve patient outcomes. Your research question must be clearly related to Parts 1 and 2. Be sure to state this clearly as a research question. Explain why you think this is a gap in existing research (relate directly to published research), its clinical relevance (why you think your specific research question is an important area to explore), and your ideas about research design (how you would conduct research to investigate it). Include a discussion of whether your question would lend itself to a quantitative, qualitative, or mixed design; why; and how you might be able to acquire participants for the study. Submission Details: � Submit your answers in a 2- to 3-page Microsoft Word document. Assignment 2 Grading Criteria Maximum Points Identified and clearly stated a research question that represents a gap in current research. 5 Described the clinical relevance of the proposed research question. 5 Presented a possible research design for investigating the proposed question. 5 Maintained the originality of the research question. 3 Used correct spelling, grammar, and professional vocabulary and cited all sources using APA style. 2
JUST READ THIS TO GET AN IDEA ABOUT THIS PAPER AND WHAT IT IS ABOUT. READ CAREFULLY
Human Papillomavirus (HPV) and the Fight to Protect Men�s and Women�s Health
Human Papillomavirus (HPV) and the Fight to Protect Men�s and Women�s Health
The Human Papillomavirus (HPV) is a virus passed from one person to another through skin-to-skin contact. According to Henderson, Clements, & Damery (2013), HPV is the most common sexually transmitted infection (STI) among men and women. Most sexually active men and women will contract HPV at least once in their lifetime, but there are over forty types of HPV. This virus can be transmitted through vaginal, oral, or anal sex, but can also be caused by any exposure that allows skin-to-skin contact with a person who carries the virus (Jemal, Bray, Center, Ferlay, Ward, & Forman, 2011). Most types of HPV go away on its own, but there are four types out of over forty types of HPV that do not go away. These four types of HPV are very dangerous to one�s health and these four types can cause cancer or genital warts.
Seventy nine million people are currently affected by HPV, and fourteen million new cases of HPV are recorded each year. This topic is of high interest to me because so many people are affected by HPV, and also because the controversy about the new vaccination and its affect against HPV. Human papilloma virus (HPV) affects millions of men and women, and specific types of HPV can cause genital warts or cancer of the cervix, vulva, penis, vagina, oropharynx, or anus. Three hundred and sixty thousand women and men are affected by genital warts each year (Henderson, Clements, & Damery, 2013). Eleven thousand women are affected by cervical cancer each year (Henderson, Clements, & Damery, 2013). Men and women are both affected by HPV, but more women than men are affected and HPV cause severe health concerns in women. Women are more negatively affected by HPV, so more education is needed for better outcomes in women�s health. Women need to be educated on the importance of safe sex, HPV vaccinations, and the affects contracting HPV would have on one�s health. Women need to get their routine Pap smear test done because this is how HPV is diagnosed. The cells that are scraped from the cervix during a Pap smear are examined under a microscope, and if there are abnormal cells found these cells can possible change into genital warts or cancer. Cancer that is caught early has a better prognosis, so understanding risk factors, preventive measures, and early diagnosing can save lives.
There is no cure for HPV but there are three vaccinations that are readily available to prevent the disease. FDA and CDC have approved Cervarix, Gardasil, and Gardasil 9 as safe and effective HPV vaccinations, but there is controversy on the ages the vaccinations are given and the idea that it is protecting against a sexually transmitted disease (Knox, 2011). For example, some mothers do not want to protect there eleven year old daughter or son from a STI because it seems as if she is expecting her child to have sex, but if the vaccination is done after the child is sexually active it may be to late for protection against HPV.
Two questions related to the human papilloma virus (HPV) infection that I would like to explore and explained are:
1. What are the four types of HPV that do not go away and are very dangerous to one�s health?
2. What are the advantages and disadvantages of the HPV vaccines, and how the vaccines work to prevent most types of HPV?
The four types out of forty types of HPV that do not go away and are dangerous to one�s health include HPV types 16 and 18, which are high risk types of HPV. On the other hand, HPV types 6 and 11 are low-risk types and pose insignificant effects on the health conditions of the affected patient population. These HPV types can be prevented by use of HPV vaccines. The advantage of most HPV vaccines is that they prevent cervical cancer as well as preventing HPV types 16 and 18 infections (Riethmuller et al., 2015).
However, HPV vaccines are only effective in people who have yet to be exposed to these types of HPV. According to Smith and Canfell (2014), the vaccines rarely prevent HPV in those already exposed to these HPV types. The vaccines only protect one from being infected with particular HPV types. There is likelihood that the HPV vaccines could prevent HPV-related cancers, such as those cancers affecting the penis, head and neck areas though studies are yet to prove this.
The vaccines work to prevent most types of HPV through stimulation of the immune system of the body (Szarewski et al., 2013). In response, as if the person actually had the HPV virus, antibodies to the specific HPV types are produced by the body. Nevertheless, the vaccines do not protect the vaccinated person from being infected by other STIs or other HPV types. In most cases, HPV vaccines only prevent infections by some of the most common HPV types and may minimize the risks of being infected with cervical, vulvar, vaginal, anal cancers, pre-cancers and genital warts. However, since a vaccinated person can still be infected by HPV and STIs, it is advisable to practice safe sex.
Research Review
AlObaid, A., Al-Badawi, I. A., Al-Kadri, H., Gopala, K., Kandeil, W., Quint, W., & … DeAntonio, R. (2014). Human Papillomavirus Prevalence And Type Distribution Among Women Attending Routine Gynecological Examinations In Saudi Arabia. BMC Infectious Diseases, 14(1), 132-149. doi:10.1186/s12879-014-0643-8
In this article, the authors sought to establish the level of awareness and the different types of HPVs among Saudi women. In particular, the authors hypothesized that the epidemiology of HPV was poorly understood among Saudi women. In order to verify the hypothesis, the researchers conducted an observational cross-sectional study, where cervical samples were taken for examination and a questionnaire on HPV infection were given to patients receiving routine gynecological services. Results from this study indicated that the most prevalent high risk HPV to be HPV-68/73, HPV-18 and HPV-16. On the other hand, low risk HPV types identified in this study included HPV-6, HPV-42, HPV-53 and HPV-54. Of more significance, the study established that only 32.2% of total sample population was aware of HPV infection and that 89.9% were interested in vaccination.
Smith, M. A., & Canfell, K. (2014). Incremental Benefits of Male HPV Vaccination: Accounting for Inequality in Population Uptake. Plos ONE, 9(8), 1-10. doi:10.1371/journal.pone.0101048.
Szarewski, A., Skinner, S. R., Garland, S. M., Romanowski, B., Schwarz, T. F., Apter, D., & … Martens, M. (2013). Efficacy of the HPV-16/18 AS04-Adjuvanted Vaccine Against Low-Risk HPV Types (PATRICIA Randomized Trial): An Unexpected Observation. Journal Of Infectious Diseases, 208(9), 1391-1396. Retrieved from http://eds.a.ebscohost.com/eds/detail/detail?vid=2&sid=77c3cef7-5dcc-4552-9ddd-9f69b82d647b%40sessionmgr4004&hid=4203&bdata=JnNpdGU9ZWRzLWxpdmU%3d#db=aph&AN=90612495
In this study, the hypothesis by Szarewski et al. (2013) is that it is apparent to protect individuals from low-risk HPV types through vaccination whereas that of Smith and Canfell (2014) is that men should be added to HPV vaccination programs if choice of a partner is influenced by factors that influence the uptake of vaccine. Szarewski et al. (2013) used case control studies for a period of four years in which a group vaccinated for over 6-months was observed against those not yet vaccinated. On the other hand, Smith and Canfell (2014) simulated a model whose data was obtained from observations made in Australia and USA.
In addition, Szarewski et al. (2013) findings were that among the population that was not vaccinated, the HPV-16/18 AS04-adjuvanted vaccine had moderate efficacy against the infections that were persistent with some low-risk HPV types that are significantly responsible for external genital warts. Smith and Canfell (2014) found that the impact of more male vaccination was less likely to affect the levels of heterogeneity in vaccine uptake. The findings by Smith and Canfell emphasize the continual importance of having high vaccine coverage especially amongst groups infected with HPV to achieve equality of outcomes.
References
AlObaid, A., Al-Badawi, I. A., Al-Kadri, H., Gopala, K., Kandeil, W., Quint, W., & … DeAntonio, R. (2014). Human papillomavirus prevalence and type distribution among women attending routine gynecological examinations in Saudi Arabia. BMC Infectious Diseases, 14(1), 132-149. doi:10.1186/s12879-014-0643-8
Henderson, L., Clements, A., & Damery, S. (2013). A false sense of security�? Understanding the role of the HPV vaccine on future cervical screening behaviour: A qualitative study of UK parents and girls of vaccination age. Journal of Medical Screening, 18(1), 41-45. doi:10.1258/jms.2011.010148
Jemal, A., Bray, F., Center, M. M., Ferlay, J., Ward, E., & Forman, D. (2011). Global cancer statistics. CA: a cancer journal for clinicians, 61(2), 69-90.
Knox, R. (2011). HPV Vaccine: The Science Behind The Controversy. Retrieved from http://www.npr.org/2011/09/19/140543977/hpv-vaccine-the-science-behind-the-controversy
Riethmuller, D., Jacquard, A., St Guily, J.L., Aubin, F., Carcopino, A., Pradat, P., Dahlab, A & Pr�tet, J. (2015). Potential impact of a nonavalent HPV vaccine on the occurrence of HPV-related diseases in France. BMC Public Health, 15:453. Retrieved from DOI 10.1186/s12889-015-1779-1
Smith, M. A., & Canfell, K. (2014). Incremental Benefits of Male HPV Vaccination: Accounting for Inequality in Population Uptake. Plos ONE, 9(8), 1-10. Retrieved from http://eds.a.ebscohost.com/eds/detail/detail?vid=5&sid=77c3cef7-5dcc-4552-9ddd-9f69b82d647b%40sessionmgr4004&hid=4203&bdata=JnNpdGU9ZWRzLWxpdmU%3d#db=aph&AN=97800780
Szarewski, A., Skinner, S. R., Garland, S. M., Romanowski, B., Schwarz, T. F., Apter, D., & … Martens, M. (2013). Efficacy of the HPV-16/18 AS04-Adjuvanted Vaccine Against Low-Risk HPV Types (PATRICIA Randomized Trial): An Unexpected Observation. Journal Of Infectious Diseases, 208(9), 1391-1396. Retrieved from http://eds.a.ebscohost.com/eds/detail/detail?vid=2&sid=77c3cef7-5dcc-4552-9ddd-9f69b82d647b%40sessionmgr4004&hid=4203&bdata=JnNpdGU9ZWRzLWxpdmU%3d#db=aph&AN=90612495
********************PLEASE READ CAREFULLY BECAUSE THESE ARE THE DIRECTIONS FOR THIS PAPER
For Part 3 of the research review paper, you will do a synthesis of the literature and create a research proposal.
Before you begin, review the overall assignment instructions from Weeks 1 and 2. Revise Parts 1 and 2 of your paper, as needed, on the basis of instructor feedback, new knowledge acquired in class, or discussion questions and/or additional readings.
Part 3 will probably be the most challenging part of the assignment, so allow yourself plenty of time to think about what you’ve read and develop an argument for further research. Using the knowledge gained from work on Parts 1 and 2, identify one research question that has not been investigated previously or that you would address in a different way than you’ve read about so far. This is sometimes known as gap analysis, in that you are looking for a gap in the existing body of knowledge where new research would contribute to an understanding of the issue in a way that could improve clinical practice for the nurse practitioner and improve patient outcomes.
Your research question must be clearly related to Parts 1 and 2. Be sure to state this clearly as a research question. Explain why you think this is a gap in existing research (relate directly to published research), its clinical relevance (why you think your specific research question is an important area to explore), and your ideas about research design (how you would conduct research to investigate it). Include a discussion of whether your question would lend itself to a quantitative, qualitative, or mixed design; why; and how you might be able to acquire participants for the study.
Submission Details:
� Submit your answers in a 2- to 3-page Microsoft Word document.
Assignment 2 Grading Criteria Maximum Points
Identified and clearly stated a research question that represents a gap in current research. 5
Described the clinical relevance of the proposed research question. 5
Presented a possible research design for investigating the proposed question. 5
Maintained the originality of the research question. 3
Used correct spelling, grammar, and professional vocabulary and cited all sources using APA style. 2

The post Human Papillomavirus (HPV) and the Fight to Protect Men�s and Women�s Health JUST READ THIS TO GET AN IDEA ABOUT THIS PAPER AND WHAT IT IS ABOUT. READ CAREFULLY Human Papillomavirus (HPV) and the Fight to Protect Men�s and Women�s Health Human Papillomavirus (HPV) and the Fight to Protect Men�s and Women�s Health The Human Papillomavirus (HPV) is a virus passed from one person to another through skin-to-skin contact. According to Henderson, Clements, & Damery (2013), HPV is the most common sexually transmitted infection (STI) among men and women. Most sexually active men and women will contract HPV at least once in their lifetime, but there are over forty types of HPV. This virus can be transmitted through vaginal, oral, or anal sex, but can also be caused by any exposure that allows skin-to-skin contact with a person who carries the virus (Jemal, Bray, Center, Ferlay, Ward, & Forman, 2011). Most types of HPV go away on its own, but there are four types out of over forty types of HPV that do not go away. These four types of HPV are very dangerous to one�s health and these four types can cause cancer or genital warts. Seventy nine million people are currently affected by HPV, and fourteen million new cases of HPV are recorded each year. This topic is of high interest to me because so many people are affected by HPV, and also because the controversy about the new vaccination and its affect against HPV. Human papilloma virus (HPV) affects millions of men and women, and specific types of HPV can cause genital warts or cancer of the cervix, vulva, penis, vagina, oropharynx, or anus. Three hundred and sixty thousand women and men are affected by genital warts each year (Henderson, Clements, & Damery, 2013). Eleven thousand women are affected by cervical cancer each year (Henderson, Clements, & Damery, 2013). Men and women are both affected by HPV, but more women than men are affected and HPV cause severe health concerns in women. Women are more negatively affected by HPV, so more education is needed for better outcomes in women�s health. Women need to be educated on the importance of safe sex, HPV vaccinations, and the affects contracting HPV would have on one�s health. Women need to get their routine Pap smear test done because this is how HPV is diagnosed. The cells that are scraped from the cervix during a Pap smear are examined under a microscope, and if there are abnormal cells found these cells can possible change into genital warts or cancer. Cancer that is caught early has a better prognosis, so understanding risk factors, preventive measures, and early diagnosing can save lives. There is no cure for HPV but there are three vaccinations that are readily available to prevent the disease. FDA and CDC have approved Cervarix, Gardasil, and Gardasil 9 as safe and effective HPV vaccinations, but there is controversy on the ages the vaccinations are given and the idea that it is protecting against a sexually transmitted disease (Knox, 2011). For example, some mothers do not want to protect there eleven year old daughter or son from a STI because it seems as if she is expecting her child to have sex, but if the vaccination is done after the child is sexually active it may be to late for protection against HPV. Two questions related to the human papilloma virus (HPV) infection that I would like to explore and explained are: 1. What are the four types of HPV that do not go away and are very dangerous to one�s health? 2. What are the advantages and disadvantages of the HPV vaccines, and how the vaccines work to prevent most types of HPV? The four types out of forty types of HPV that do not go away and are dangerous to one�s health include HPV types 16 and 18, which are high risk types of HPV. On the other hand, HPV types 6 and 11 are low-risk types and pose insignificant effects on the health conditions of the affected patient population. These HPV types can be prevented by use of HPV vaccines. The advantage of most HPV vaccines is that they prevent cervical cancer as well as preventing HPV types 16 and 18 infections (Riethmuller et al., 2015). However, HPV vaccines are only effective in people who have yet to be exposed to these types of HPV. According to Smith and Canfell (2014), the vaccines rarely prevent HPV in those already exposed to these HPV types. The vaccines only protect one from being infected with particular HPV types. There is likelihood that the HPV vaccines could prevent HPV-related cancers, such as those cancers affecting the penis, head and neck areas though studies are yet to prove this. The vaccines work to prevent most types of HPV through stimulation of the immune system of the body (Szarewski et al., 2013). In response, as if the person actually had the HPV virus, antibodies to the specific HPV types are produced by the body. Nevertheless, the vaccines do not protect the vaccinated person from being infected by other STIs or other HPV types. In most cases, HPV vaccines only prevent infections by some of the most common HPV types and may minimize the risks of being infected with cervical, vulvar, vaginal, anal cancers, pre-cancers and genital warts. However, since a vaccinated person can still be infected by HPV and STIs, it is advisable to practice safe sex. Research Review AlObaid, A., Al-Badawi, I. A., Al-Kadri, H., Gopala, K., Kandeil, W., Quint, W., & … DeAntonio, R. (2014). Human Papillomavirus Prevalence And Type Distribution Among Women Attending Routine Gynecological Examinations In Saudi Arabia. BMC Infectious Diseases, 14(1), 132-149. doi:10.1186/s12879-014-0643-8 In this article, the authors sought to establish the level of awareness and the different types of HPVs among Saudi women. In particular, the authors hypothesized that the epidemiology of HPV was poorly understood among Saudi women. In order to verify the hypothesis, the researchers conducted an observational cross-sectional study, where cervical samples were taken for examination and a questionnaire on HPV infection were given to patients receiving routine gynecological services. Results from this study indicated that the most prevalent high risk HPV to be HPV-68/73, HPV-18 and HPV-16. On the other hand, low risk HPV types identified in this study included HPV-6, HPV-42, HPV-53 and HPV-54. Of more significance, the study established that only 32.2% of total sample population was aware of HPV infection and that 89.9% were interested in vaccination. Smith, M. A., & Canfell, K. (2014). Incremental Benefits of Male HPV Vaccination: Accounting for Inequality in Population Uptake. Plos ONE, 9(8), 1-10. doi:10.1371/journal.pone.0101048. Szarewski, A., Skinner, S. R., Garland, S. M., Romanowski, B., Schwarz, T. F., Apter, D., & … Martens, M. (2013). Efficacy of the HPV-16/18 AS04-Adjuvanted Vaccine Against Low-Risk HPV Types (PATRICIA Randomized Trial): An Unexpected Observation. Journal Of Infectious Diseases, 208(9), 1391-1396. Retrieved from http://eds.a.ebscohost.com/eds/detail/detail?vid=2&sid=77c3cef7-5dcc-4552-9ddd-9f69b82d647b%40sessionmgr4004&hid=4203&bdata=JnNpdGU9ZWRzLWxpdmU%3d#db=aph&AN=90612495 In this study, the hypothesis by Szarewski et al. (2013) is that it is apparent to protect individuals from low-risk HPV types through vaccination whereas that of Smith and Canfell (2014) is that men should be added to HPV vaccination programs if choice of a partner is influenced by factors that influence the uptake of vaccine. Szarewski et al. (2013) used case control studies for a period of four years in which a group vaccinated for over 6-months was observed against those not yet vaccinated. On the other hand, Smith and Canfell (2014) simulated a model whose data was obtained from observations made in Australia and USA. In addition, Szarewski et al. (2013) findings were that among the population that was not vaccinated, the HPV-16/18 AS04-adjuvanted vaccine had moderate efficacy against the infections that were persistent with some low-risk HPV types that are significantly responsible for external genital warts. Smith and Canfell (2014) found that the impact of more male vaccination was less likely to affect the levels of heterogeneity in vaccine uptake. The findings by Smith and Canfell emphasize the continual importance of having high vaccine coverage especially amongst groups infected with HPV to achieve equality of outcomes. References AlObaid, A., Al-Badawi, I. A., Al-Kadri, H., Gopala, K., Kandeil, W., Quint, W., & … DeAntonio, R. (2014). Human papillomavirus prevalence and type distribution among women attending routine gynecological examinations in Saudi Arabia. BMC Infectious Diseases, 14(1), 132-149. doi:10.1186/s12879-014-0643-8 Henderson, L., Clements, A., & Damery, S. (2013). A false sense of security�? Understanding the role of the HPV vaccine on future cervical screening behaviour: A qualitative study of UK parents and girls of vaccination age. Journal of Medical Screening, 18(1), 41-45. doi:10.1258/jms.2011.010148 Jemal, A., Bray, F., Center, M. M., Ferlay, J., Ward, E., & Forman, D. (2011). Global cancer statistics. CA: a cancer journal for clinicians, 61(2), 69-90. Knox, R. (2011). HPV Vaccine: The Science Behind The Controversy. Retrieved from http://www.npr.org/2011/09/19/140543977/hpv-vaccine-the-science-behind-the-controversy Riethmuller, D., Jacquard, A., St Guily, J.L., Aubin, F., Carcopino, A., Pradat, P., Dahlab, A & Pr�tet, J. (2015). Potential impact of a nonavalent HPV vaccine on the occurrence of HPV-related diseases in France. BMC Public Health, 15:453. Retrieved from DOI 10.1186/s12889-015-1779-1 Smith, M. A., & Canfell, K. (2014). Incremental Benefits of Male HPV Vaccination: Accounting for Inequality in Population Uptake. Plos ONE, 9(8), 1-10. Retrieved from http://eds.a.ebscohost.com/eds/detail/detail?vid=5&sid=77c3cef7-5dcc-4552-9ddd-9f69b82d647b%40sessionmgr4004&hid=4203&bdata=JnNpdGU9ZWRzLWxpdmU%3d#db=aph&AN=97800780 Szarewski, A., Skinner, S. R., Garland, S. M., Romanowski, B., Schwarz, T. F., Apter, D., & … Martens, M. (2013). Efficacy of the HPV-16/18 AS04-Adjuvanted Vaccine Against Low-Risk HPV Types (PATRICIA Randomized Trial): An Unexpected Observation. Journal Of Infectious Diseases, 208(9), 1391-1396. Retrieved from http://eds.a.ebscohost.com/eds/detail/detail?vid=2&sid=77c3cef7-5dcc-4552-9ddd-9f69b82d647b%40sessionmgr4004&hid=4203&bdata=JnNpdGU9ZWRzLWxpdmU%3d#db=aph&AN=90612495 ********************PLEASE READ CAREFULLY BECAUSE THESE ARE THE DIRECTIONS FOR THIS PAPER For Part 3 of the research review paper, you will do a synthesis of the literature and create a research proposal. Before you begin, review the overall assignment instructions from Weeks 1 and 2. Revise Parts 1 and 2 of your paper, as needed, on the basis of instructor feedback, new knowledge acquired in class, or discussion questions and/or additional readings. Part 3 will probably be the most challenging part of the assignment, so allow yourself plenty of time to think about what you’ve read and develop an argument for further research. Using the knowledge gained from work on Parts 1 and 2, identify one research question that has not been investigated previously or that you would address in a different way than you’ve read about so far. This is sometimes known as gap analysis, in that you are looking for a gap in the existing body of knowledge where new research would contribute to an understanding of the issue in a way that could improve clinical practice for the nurse practitioner and improve patient outcomes. Your research question must be clearly related to Parts 1 and 2. Be sure to state this clearly as a research question. Explain why you think this is a gap in existing research (relate directly to published research), its clinical relevance (why you think your specific research question is an important area to explore), and your ideas about research design (how you would conduct research to investigate it). Include a discussion of whether your question would lend itself to a quantitative, qualitative, or mixed design; why; and how you might be able to acquire participants for the study. Submission Details: � Submit your answers in a 2- to 3-page Microsoft Word document. Assignment 2 Grading Criteria Maximum Points Identified and clearly stated a research question that represents a gap in current research. 5 Described the clinical relevance of the proposed research question. 5 Presented a possible research design for investigating the proposed question. 5 Maintained the originality of the research question. 3 Used correct spelling, grammar, and professional vocabulary and cited all sources using APA style. 2 appeared first on homework handlers.

Food Safety Management.

Food Safety Management.
Food safety in hospitals is an important issue in preventing food poisoning which can result in negative impacts on the economy, individuals and the hospital sector in Saudi Arabia (Griffith et al. 2010). Consequently, the Saudi government through its MOH, is committed to ensuring public health and there are continuous food or premise inspections and various regulations that have been put in place to reduce the risk of consuming unsafe food. Food contamination due to mishandling remains to have a critical role in the spread of food-borne illnesses hence the Saudi hospitals are constantly alert to minimize any chances of food contamination through complying with food safety regulations and HACCP systems (Tomohide, 2010).
In this literature review, a number of indications have been provided and existing literature discussed in order to understand the management of food safety as well as the role of HACCP implementation in hospitals. In essence, the main sections in the chapter include the review of Ministry of Health and Saudi Arabia, discussion of food safety practices in the hospitals, Saudi Legislations on food safety and the HACCP. The chapter ends with indications of the objectives, research questions, purpose and the study assumptions/limitations. The first section concerns the overview of Ministry of Health and Saudi Arabia.
1.1.1 Saudi Arabia and Ministry of Health
Saudi Arabia
Reports by Mousa (2015) notes that in the GCC, Saudi Arabia plays a critical role and is regarded as most influential country with US$ 20,327 in per capita GDP. There are over 27m people in Saudi Arabia and the government provides free health services. Generally, its economy is considered as oil-based and one of the fastest growing in the region over the past decade with GDP growth of over 4.15% yearly. According to MOH (2015) the Saudi government regards health as an important factor in overall development of the country and spends over US$ 19.3bn on health annually. Hence health expenditure per capita amounts to over US$ 714 and total expenditure translates to about 3.6 percent of the country’s GDP. Moreover, the increase in Saudi population directly relates to the increase in health service demand by citizens and increase in expenditure by government given that most health services are provided by MOH (MOH 2015).
The health expenditure annually by the Saudi government accounts for 6.5% of government budget. In essence, 6% of total Saudi population is covered mainly by public health insurance, public health service or the social insurance (Mousa 2015). However, the remaining 31% are accounted for by the private insurance thus private sector also plays a major role in health service to the Saudis. Public health is critical to reducing disease incidences and disease prevalence (Kassa 2010). Therefore, the MOH regards disease prevention to be vital in attaining its strategies towards achieving health for all population in Saudi Arabia.
Ministry of Health
The MOH in KSA is committed to attaining to disease control and public health is among the top priorities of the Saudi government. Moreover, the projects, policies and objectives of the MOH are aligned towards attaining its vision of delivering comprehensive, integrated and best quality healthcare services to the citizens (MOH 2015). Consequently, the strategy of MOH in KSA is to consider various elements that are vital in attaining its vision which conforms to other health services globally. Since WHO requires that food organizations should implement HACCP, the MOH also complied with this requirement in major food organizations and has also introduced the HACCP system to be implemented in the Saudi healthcare sector and the hospitals in particular since they are under its supervision (Prianka 2012).
In essence, healthcare services in KSA are provided by both government and private sector (MOH 2015). There are 249 hospitals in KSA which are directly operated and owned by MOH and this represents 60 percent of all the hospitals. Nonetheless, the remaining 40% are operated and owned by the private sector under the regulations and supervision of MOH. In total, the MOH has 20 directorates to help in the enforcement of health regulations. Knowledge on HACCP implementation among staff in both private and public hospitals is vital for the hospitals to successfully implement the system. In particular, the food handlers in the Saudi hospitals require proper training on food hygiene to support the disease prevention efforts.
1.1.2 Food Safety in Saudi’s Hospitals
Indications of Getachew (2010) were that food-borne illnesses are a public health challenge globally especially in the developing countries compared to the developed countries due to the poor measures of food safety and low personal hygiene. In particular, Giritlioglu et al. (2011) notes that outbreaks of food-borne illnesses in hospitals cause more negative effects on the patients who consume the food given their weakened immunity and disease status. Despite the fact that provision of safe food is the obligation of the hospital’s top management, the practices of food handlers during food preparation and processing have the major link to the cause of the unsafe food.
In this regards, Grintzali and Babatsikou (2010) adds that the prevention of food-borne illnesses in hospitals thus require the involvement of all the individuals involved in handling food including the individual patients. According to MMRA (2009) in Saudi Arabia, a number of efforts have been made in the hospitals towards improving the food hygiene and food safety conditions such as amending the conditions and terms of the nutrition contracts to hospitals. Generally, the hospitals in KSA contract food service providers or catering service companies to supply and prepare food hence they operate under the tendering system. However, such services are usually supervised by the nutrition departments in the hospitals which have about 20 nutritionists to 1 nutritionist employed by the MOH for large and small hospitals respectively (Kassa et al. 2010). Consequently, it was required that in the MOH hospitals, all the contracted food suppliers must comply with the requirements of HACCP principles. Nonetheless, such directives are yet to be fully implemented in the various MOH hospitals which could be linked to various challenges.
Specifically, it was required that the contracted food suppliers should have a HACCP coordinator to help in maintaining hygienic practices and ensure they implement the HACCP system in the hospitals operated by MOH (Kokkinakis et al. 2011). Other initiatives that contracted food suppliers were required to undertake to promote food safety included providing sufficient training and health education to their staff and particularly food handlers. In addition, the food handlers must possess health license which indicate that they are medically fit to handle food in order to avoid cross-contamination. Such health licenses for the food handlers are valid for 6 months (Martins et al. 2012). The supervisors and managers of the contracted food suppliers were also required to pursue courses in HACCP system and management of food hygiene. According to Oinee and Sani (2011), the requirement for further training implied that there are few individuals who are knowledgeable in HACCP system and its implementation which could be attributable to the few training institutions which provide course in management of food hygiene and food safety.
Study by Griffith et al. (2010) reported that having the education and training on promotion of food safety ensure that employees have the necessary knowledge and awareness on prevention of food-borne disease in the Saudi hospitals. Furthermore, food handler training is vital element of HACCP which is recognized by WHO and EU legislations. In addition, Tomohide (2010) confirmed that it is also vital for hospital staff to attain the necessary knowledge on HACCP in order for the hospitals in KSA to be effective in food safety like other hospital in developed countries which implement HACCP.
1.1.3 Codex Alimentarius and Saudi Arabia Legislation
Kassa et al. (2010) maintained that food standards are mainly guidelines which indicate the various requirements of microbial regulation, food products, the accepted contaminants levels, labeling and packaging requirements as well as the requirements for hygiene maintenance for the products that are manufactured. Consequently, Codex Alimentarius develops the food standards which serve as the main reference standards for trading food internationally. Generally, Prianka et al. (2012) posited that Codex Alimentarius aims at protecting the health of the consumers, ensuring the food trade practices internationally are fair, and coordinating the work by international organizations on the food standards. In this regards, a number of countries including Saudi Arabia have complied with the food standards set by Codex Alimentarius. In essence, Saudi Arabia developed its standards and requirements for agricultural and food products in line with the indications of Codex Alimentarius.
Reports by Getachew (2010) pointed that one of the major actions of Codex Alimentarius was the development of the regulations on HACCP system and recommendation for its implementation worldwide. However, indications of Giritlioglu et al. (2010) was that complying with food standards such as HACCP and other Codex Alimentarius standards involve high implementation costs which has been mentioned to be a challenge. Consequently, many food establishment and large organizations in Saudi Arabia have often embraced the standards of Codex Alimentarius such as HACCP in order to comply with the directives of the government and remain competitive in Saudi Arabia as well as globally. However, Grintzali and Babatsikou (2010)believe that the available financial resources and technical resources have not been adequate to successfully implement the requirements of Codex Alimentarius.
Kassa et al. (2010) affirmed that in any country, the action plan for food safety indicates the minimum standards expected or the approaches employed and outlines the objectives or targets which the food safety systems must achieve. The legislations in Saudi Arabia on food safety require certain food items to satisfy all the consumer, legal and customer requirements so as to attain the minimum safety and quality standards (SFDA 2015). Although food quality standards involves all the product characteristics that affect the value of food in the viewpoint of consumers, the food safety standards encompasses all measures to protect public health. These standards in Saudi Arabia are in line with ISO and Codex Alimentarius.
In Saudi Arabia, the nationwide safety and food quality systems are controlled legally by different government agencies or departments of various ministries (SASO 2015). For example, regulatory agencies include SFDA and SASO which rely on Codex Alimentarius. In addition, health certificate must be obtained for certain food products such as poultry or meat. There also various standards such as SSA 630/1990, SA9019, GS9/1995, SSA 457/2005, GS654/1996, and GS707/1997 among others which are followed in Saudi Arabia for food products (EPD 2015). In particular, such standards concern, for example, Halal slaughter license, product registration, import documentation, labeling, general requirements, nutrition, colours, biotech and preservatives. The main objective of these specific and general hygiene legislations are to ensure consumer protection specifically protection against issues arising from lack of food safety. Moreover, compliance with HACCP is also a requirement to enhance hygiene and food safety in Saudi Arabia.
1.1.4 Hazard Analysis and Critical Control Points (HACCP)
Kokkinakis et al. (2011) emphasized that public health involves mainly disease prevention and it has been found that prevention of disease is vital for populations than curing diseases. Hence, there are various international agencies and national agencies which encourage better measures towards the protection of people against the occurrence of food-borne illnesses. Consequently, understanding of Martins et al. (2012) was that one of the main achievements has been HACCP development and enacting of regulations on HACCP by UN Codex Alimentarius. HACCP refers to a rational and structured approach towards the prevention of hazards and analysis of potential points for occurrence of hazards at each food preparation stage. In essence, HACCP requires that the operators must identify and also enumerate the various steps involved in their operations which are deemed critical to attaining food safety, besides; the operators must also evaluate and identify the various safety measures. In the hospitals, Oinee and Sani (2011) claimed that ensuring food hygiene involves thoroughness when it comes to the implementation of the preventive measures aimed at minimizing hazards and food poisoning. Thoroughness in hospitals is essential given that the consumers (patients in hospitals) tend to be more vulnerable if they consume unsafe food compared to people who are healthy.
Study by Giritlioglu et al. (2011) noted that the HACCP system helps to attain food safety thus it is a program which is proactive and an ideal approach in the hospitals. This approach can identify the likely hazards before the occurrence of the problems which is the ideal aim of illness prevention. Getachew (2010) affirmed that HACCP ensures the nutrition products and the food are safe and also helps in the development of strategies for corrective measures and improvement overtime instead of depending on impromptu checks on the food preparation processes and checking finished products at random to attain food safety. In essence, Prianka et al. (2012) revealed that HACCP concentrates mainly on the strategies of preventing the known hazards and places great focus on the control during preparation process and the various steps involved, instead of the layout and the structure of the premises.
HACCP develops the necessary procedures which are vital in eliminating and minimizing the hazards and it also requires these control approaches are verified and documented. Tomohide (2010) noted that the CCP determined by the HACCP systems have been found to enhance food safety by analyzing the different sources of hazards including the physical hazards, biological hazards and chemical hazards which affect the safety and ensure they are controlled in the food chain right from the beginning to the final consumption of the food product.
Consequently, Oinee and Sani (2011) view was that HACCP is recognized internationally as a system for assurance of food safety in both large organizations and small organizations. In this regards, food businesses a part from the food produces, have been implementing the management procedures to ensure food safety based on the principles of HACCP. Complying with every indication of the HACCP principles is vital for high consumer protection when it comes to consumption of safe food.
1.1.5 Principles of HACCP
Reports by Martins et al. (2012) considered that the successful implementation of HACCP in organizations involves producing food for consumption which is completely free from any biological hazard, chemical hazard or physical hazard. Hence, this is the main objective of implementing HACCP in organization; however, there are seven principles which must be ensured during the HACCP implementation. These include: 1) identifying the various hazards which may be present during preparation of food and assess the potential risk of these hazards and their level of severity; 2) identify the CCP during the preparation of food; 3) determine the critical limits required for the preventive measures required for each of CCP identified; 4) develop the required procedures for monitoring of the CCP identified; 5) establish the necessary corrective action which must be taken when monitoring outcomes reveals that CCP is exceeded; 6) develop an effective system for keeping records and documenting HACCP; and 7) establish appropriate procedures for verifying that HACCP approach is actually working. Refer to table 1 for HACCP principles
Table 1: HACCP principles
Source: CAC (2013)
Revelation by Kokkinakis et al. (2011) was that HACCP principles are used widely as the main reference standards with regards to safe practices in food preparation and handling. Due to the fact that the HACCP principles require the enforcement of rigorous documentation and procedural governance practices in the organizations implementing the HACCP regulations, it serves both as the model for risk assessment and the model for effective communication of risk control measures. Although there have been controversies on the use of HACCP in the hazard identification and their prevention in food establishments, explanation by Kassa et al. (2010) was that the HACCP guidelines have been recognized in hospitals as having the advantage of enabling patients to receive or consume safe food.
Several countries globally embrace the implementation of HACCP principles given that it is also recommended by WHO (Griffith et al. 2010). For instance, in Europe, all the countries since 2006 have been obligated to implement HACCP with the exception of the primary producers. Similarly, Prianka et al. (2012) provided that a number of countries in Asia are also implementing HACCP. A major reason for the increasing implementation of HACCP principles in various countries can also be attributed to globalization and increased trade in food items between countries. Consequently, some countries impose regulations on HACCP for importers requiring them to comply with HACCP system. Getachew (2010) wrote that such requirements have also been extended to the local suppliers of food services to major organizations such as those supplying food services in hospitals. In addition, it was found that in countries that implement HACCP principles, there were reduced cases associated with food-borne illnesses.
1.1.6 Benefits and Limitations of HACCP
Benefits
There are a number of benefits to organizations such as hospitals that can be associated with HACCP besides the fact that it helps to reduce cases of food-borne illness among the public (Giritlioglu et al. 2011). Implementing HACCP and all its stages results in having a comprehensive understanding of issues concerning food safety which may affect an organization and hence the organizations develop confidence in their food products or service. Such confidence enables the management to address demands from external auditors, law enforcers and other stakeholders. Studyby Grintzali and Babatsikou (2010) notes that it also enables the organization to use their experience and knowledge in refining and reviewing their systems. Consequently, HACCP implementation empowers firms. Reduction of costs is also associated with HACCP in that it enhances better manpower use, reduces wastage and less record keeping when focus has been achieved. Kokkinakis et al. (2011) established that focus is also enhanced by HACCP since attention is given on the food preparation aspects which can affect the food safety. Moreover, filtering out controls which are less essential enables management to give full attention on CCP of production processes.
Oinee and Sani (2011)’s viewpoints was that team building is also associated with HACCP in organizations since all the individuals in the organization work together to attain HACCP systems. In this regards, organizational development is enhanced which enables it to deal with changing demands. Furthermore, indication of Martins et al. (2012) was that achieving HACCP system successfully necessitates certain changes in approaches towards using knowledge and skills of employees, solving problems by managing employees and developing the organization culture which is focused more on safety instead of purely costs and output.
Besides, Kokkinaki et al. (2011) felt that legal protection is also a benefit of HACCP as many countries sue firms which do not comply with HACCP guidelines yet their operations involve food business. Moreover, Grintzali and Babatsikou (2010) confirmed that during food-borne illness outbreak, complying with HACCP can act as legal defense against prosecution. Trading opportunities is also enhanced when a firm that implements HACCP seeks to expand their operations to international markets. In addition, food businesses that implement HACCP cab supply other organizations which contract only firms implementing HACCP in their operations.
Limitations
Despite the various benefits that have been reported in organizations that implement HACCP, there are also limitations that have been linked to HACCP system. In the first place, Getachew (2010) believed that HACCP requires that the process must be understood comprehensively, consequently, this implies that it tends not to be suited ideally for processes and hazards which are little known. Another limitation which has been reported by Priankaet al. (2012) was that HACCP does not actually prioritize or quantify the risks involved and the impact of having additional controls for eliminating the said risks are also not quantified. Since implementing HACCP is complex, it requires additional material, human and technical resources which may not always be adequate in an organization. Other limitations which have been mentioned by Kassa et al. (2010) include the constant updating of technical data as well as involvement and sincere effort of all individuals handling the food which may not be the case. Nonetheless, it was argued by Tomohide (2010) that limitations are often overshadowed by the benefits.
1.1.7 Challenges of Implementing HACCP
Although the food manufacturing sector and large firms in catering and hospital sector in many countries have adopted HACCP and implemented its various guidelines, revelations by Griffith et al. (2010) was that there are concerns when it comes to HACCP implementation in smaller organizations such as hospitals. Consequently, a number of scholars have doubted its efficiency and reported various potential reasons for the reduction in HACCP efficiency and failures. The analysis of challenges faced in HACCP implementation revealed that elements such as management commitment, competence and knowledge, planning, training, resources, human resources and documentation were the main challenges identified. Each of these elements was ranked based on their effect on the efficiency of HACCP (Kassa et al. 2010).
There have also been reports by Prianka et al. (2012)that lack of regulations or inadequate legal requirements, attitude, financial constraints and lack of competence were major challenges in the HACCP implementation in organizations. The practical experience has also demonstrated that to successfully install, verify, develop and monitor HACCP system effectively requires individuals and organizations to overcome the complex combination of technical, managerial and organizational hurdles which impede HACCP implementation. Getachew (2010) indicated that even the well equipped and largest food manufacturing companies that have significant resources, management skills and technical expertise also face the challenge of implementing HACCP, on the other hand, the small organization often consider the HACCP implementation challenges as potentially insurmountable.
In particular, Giritlioglu et al. (2011) noted that HACCP implementation in hospitals also faces the same challenges faced by other operators of food businesses. In essence, lack of training, inadequate finances and inadequate tools and equipments were reported as hurdles in hurdle implementation in hospitals. Besides, various food product range also limit efficiency of HACCP since there are many CCP which must be considered. Moreover, the systems involved in hospital food service is very complicated than other production processes. Grintzali and Babatsikou (2010) noted that in their study, only 4 hospitals out of 99 hospitals established a system for HACCP implementation. In addition, survey by Kassa et al. (2010) involving 27 hospitals reported HACCP implementation in half of sampled hospitals.
Food consumption changes, emergence of microbes, modern lifestyles, increase in travel and global trade as well as the frequent changes in food production technologies have been found by Kokkinakis et al. (2011)to be challenges of HACCP implementation. In the small businesses, the challenges to HACCP implementation were mentioned to include financial constraints and poor resources. In addition, some managers or owners do not believe that HACCP are practical or effective for businesses. Sentiments of Martins et al. (2012) were that this could be because such managers may have insufficient knowledge about safety requirements for businesses involved in food product manufacturing and thus they do not educate their staff as well. It is important for organizations to consider their need for HACCP training and involve competent educators who can change the employee attitudes and their performance in terms of implementing HACCP. An increase in food handler knowledge may not necessarily reflect in their behavior of handling food which depends on individual attitude. Hence, poor attitude towards HACCP implementation among food handlers is also a significant challenge in implementation of the HACCP guidelines.
1.4 Research Questions
The following were research questions assessed in the study:
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M3.4 Reflect and Ask Questions

M3.4 Reflect and Ask Questions
Reflect & Ask Questions

Evolve

In Module 3 you grappled with the concepts of critical thinking and argumentative reasoning for today and tomorrow. You examined the standard-bearer for scholarly thoughtthe peer-reviewed journal articleand considered what it can tell us and how it differs from other kinds of sources. In Module 4, you will continue questioning and examining information to understand that not all information is created equal, and in fact, some of it isnt the truth at all.

As you reflect on what you learned in this module, ask yourself:

Do I understand the components of a peer-reviewed journal article and how to use it in an academic argument?
Can I spot a logical fallacy when I see or hear it?
How does an academic debate differ from the debates I see on social media or in personal conversations?
Do I have any questions about the feedback I’ve been receiving from my instructor on my assignments?
This is an ungraded, optional activity.

Patient care plan

Patient care plan
Case study
Patient Profile:
Hana is 72 years old
Previous Medical History:
Hana had gastroscopy before twice. The first time was when she complained of pain in her stomach. Tofind out what the cause was she was given sedation so that the surgeon can have a look in to her stomachand duodenum if there is any bacterial infection. Gastroscopy is performed to see if there is any abnormalities in the upper gut.
Presenting Complaint:
Hana is having hysteroscopy to diagnose abnormal bleeding, due to heavy length menstrual flow.
Anaesthetic Management:
Hana had three previous anaesthetics, which did not have ill effect, Hana induction was achieved by using.Hana had general anaesthetic, blood pressure cuffs was put on her to monitor her blood pressure. She first had iv access in to her arm a cannula was inserted for fluid. The type of drugs she was give whereondansetron, fentanyl , and propol. Once she moved into theatre she was given sevoflurane According trust policy and also with the national guideline an accurate contemporaneous record of anaesthesia is documented for every patient the record is kept which should document.
Surgical Management:
Hana was put in lithotomy position her body in supine position. betadine antiseptic
was used to prep. Warming blanket was to keep Hana temperature from falling from safe levels due to
anaesthesia. Sterile instruments where prepared on trolleys. Warm saline was used for irrigation. The
saline was pressureized using pressure bags 300mmHg
Discussion:
The sending slip was sent to the ward with her details. The sending slip was delivered by the porter. The nurse brought Hana to the anaesthetic room with her medical note. The Operative Theatre Practitioner (ODP) opened the medical records and proceeded checklist and showed Hana the consent form to confirm the right patient was in theatre and asked if the signature was hers, and she replayed “that is correct”. Also the name corresponded to Hana name tag. There was little spoken by the nurse who was handing over the patient.
Health professionals must have obtained valid consent from the patient for any examinations/surgery/treatment or care in accordance with Department of Health policy and guidance for England (DH 2009).
When Hana came to the theatre, it was a different setting for her from the ward. When Hana was met on the ward in her room, she was with her husband. They were both very welcoming. Hana was forthcoming for the type of information I was looking for to be able to complete the study case. If she was worried about the procedure, she was not showing it. Being accompanied by her member of family may have put her at ease. Although position of Hana’s hands clasped may have been sings of anxiety about her procedure from my experience.
This was Hana’s second time to have this type of surgery and in the same operating place. She was familiar with the hospital The fact that the day of the operation was in the afternoon and the weather was warm, She felt less anxious about the surgery. She felt on her first visit to this hospital; the lights were not on. she felt confused as why was no one here to meet her. Patients need to know who is expecting them. She was the happy easy going character she explained about her previous experience how she felt the first time she came to the hospital. It was winter time everything was dark in the reception where patient usual wait. The reason they remain in the reception area in the morning was so they can be escorted to the floor when they have been allocated a room.
This procedure was a standard general anaesthesia which was done on the table using the pat-slide. The doctor supported the head end and two people one each side of the table, and one was at foot ready to transfer Hana. The transfer to the table was completed.
The surgeon and scrub staff went through the WHO checklist (WHO 2009) and documented by circulating the correct book, this was done before Hana was put in lithotomy position.
As she had a red band this meant, she was allergic to Elastoplast, to confirm with the patient the ODP showed Hana the type of plaster and she confirmed it correctly. It is good practice to involve the patient in their care, after all, it the patient who will have direct information.
Identifying allergies on a patient is vital as it has serious conscious to patient health.
During the hysteroscopy procedure, Hana lied supine with legs raised onto lithotomy boots. These can support the calf to the ankle, or just the ankles are secured. The patient’s arms are secured across their chest while the end of the table was removed. The legs were elevated and positioned simultaneously to prevent lower back injury, sacroiliac ligament damage and pelvic asymmetry (Adedeji, R., Oragui, E., Khan, W. & Maruthainar, N. 2010,).
Nerve damage can occur from pressure applied directly from lithotomy strips that are inadequately padded to the medial or lateral side of the leg. A lumbar support should prevent.
Hana was physically well supported at all times during transfer and positioning while she was anesthetized. Injury to the radial nerve can occur if the arms are left dropping down over the edge of the operation table. In families that support the patients should be given information to care for the patient needs referred to as patient-centred care (NICE 2003).
The patient journey could be enhanced when they make their way from the ward to the theatre. The corridor can in some occasion be full of medical equipment such as x-ray machine that is used in the operating room by the radiographers. In this situation, medical equipment can be moved where patients cannot see them or until they required for surgical procedures.
The day Hana had her surgery the theatre area which lead to the operating room was neatly kept. The only thing was the layout of the corridor to the theatre it happens have coffee room. Patients coming to have their operation done would walk past the coffee room. When door to the coffee room is opened patient can see staff eating, and they could also smell the food. The patients have been fasting for 12 hours prior to their procedure do not need to be a reminder of food. The hospital recently improved patients experience in the hospital by relocating/ closing the coffee room because patients complained. As a result patients are not put in this position again. The hospital has given thought and consideration to patients need and appropriate methods have been put in place to encourage giving feedback and responded to it.
Environmental factors contribute to patient anxiety that’s why the theatre doors are locked so that patients like Hana do not see the inside of the operating room itself which increase worry about her operation. Hana was having this procedure for the second time, although she may be familiar with the staff, hospital and with some procedure, like with any operation involving instrumentation of the uterus, hysteroscopy can be associated with pain, anxiety and embarrassment. Anxious patients need reassurance (Nursing Times 2011). Patients should be well informed about their procedure and any changes that might occurred. Encourage patients to express their concern, worries and personal needs. The staff in return should listen and acknowledge their concern. This would alleviate patient’s anxiety and make them at ease. This can be done by establishing effective communication (NICE 2012). Easy simple language that patient can understand can be used when explaining medical terms. The practitioner has to be sensitive to different culture values. Where there is language barrier or in place of family member, an interpreter, or a patient advocate can be used respectively to meet patient individual needs. Clinical guidelines state Healthcare professional must show competency in relevant communication skills (NICE 2012). Although with Hana her first spoken language was English she did not find communicating with the health care staff too difficult.
All hospital has a duty to comply with the national guideline. Elderly patients should have well-structured care plan for their individual needs. A particular patient who may not have family member accompanying them to the hospital and the care they need after leaving the hospital can be addressed. This provides reassurance and alleviates patient’s anxiety.
There is not adequate time to prepare the service user, like Hana to make them feel comfortable before they are sent to the theatre. It is good practice for theatre staff to visit wards before a patient is brought down to the theatre. They have enough worries of unfamiliar surroundings, and about their operation.
Health care practitioners are accountable for their action. Once the patient arrives there is a lot to do before they can be sent to the theatre. The patient should not be sent for until every document has been completed. This reduces delays and alleviates patient’s anxiety.
The reason Hana was having this procedure is to diagnose the cause of abnormal bleeding in the uterus ( Liberis, V., Tsikouras, P., Christos, Z., Ammari, A., Dislian, V., Koutlaki, N., Liberis, A. & Maroulis, G. 2010). The ODP was well-experienced staff member he made the patient feel at ease was already introduced to Hana before, on the wards. The ODP introduced the student on placement again to Hana, but she replied to the ODP she had met the student beforehand on the ward. The handover was remarkably quick. The ward nurse and the ODP checked the patient medical notes.
The team briefing was done correctly before the start of the operation; the case was hysteroscopy which she had previously had the same operation. The team briefing allows surgeon, anaesthetist; ODPS and scrub staff in the theatre to be informed about Hana’s condition and what type of procedure she was having.
Different members of the healthcare team work in coordination to care for patients. Their roles and responsibility should be informed and communicated. In this case the porter, nurse, anaesthetist and the ODP work together to deliver safe and smooth procedure thereby putting patient at the centre and minimise the impact on the patient.
Reference
Department of Health (DH 2009) Reference guide to consent for examination or treatment. [online]. Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/138296/dh_103653__1_.pdf [Accessed 9 May 2015]
Nursing Times (2011) Reducing anxiety in elective surgical patients. [online] Available from:
http://www.nursingtimes.net/nursing-practice/specialisms/perioperative-care/reducing-anxiety-in-elective-surgical-patients/5024376.article [Accessed 10 May 2015]
National Institute for Health and Care Excellence (2012) Patient experience in adult NHS Service: Improving the experience of care for people using adult NHS services. [online]. Available from: https://www.nice.org.uk/guidance/QS15 [Accessed 10 May 2015]
Adedeji, R., Oragui, E., Khan, W. & Maruthainar, N. 2010, “The importance of correct patient positioning in theatres and implications of mal-positioning”, Journal of perioperative practice, vol. 20, no. 4, pp. 143.
Touqmatchi, D., Boret, T. & Nicopoullous, J. 2010, “The quality of
operative consenting against RCOG advice as standard”, Journal of Obstetrics & Gynaecology, vol. 30, no. 2, pp. 159-165.
Liberis, V., Tsikouras, P., Christos, Z., Ammari, A., Dislian, V., Koutlaki, N., Liberis, A. & Maroulis, G. 2010, “The contribution of hysteroscopy to the detection malignancy in symptomatic postmenopausal women”, Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy, vol. 19, no. 2, pp. 83-93.
Siddiqui, J. & Tuffnell, D. 2005, “Minimising risk in gynaecological surgery”, Reviews in Gynaecological Practice, vol. 5, no. 3, pp. 152-158.
reflection
When a patient like Hana was admitted to hospital she already had received preoperative instruction with regards to how she needed to prepare for the day of her surgery (i.e., fasting), including arrangements she had to organise with someone to accompany her to the hospital. Also after surgery, before she was discharged who was going to take her home. In this instant it was the husband who has come to the hospital who will be looking after her needs.
Hana has had this surgery previously, so she was more educated about the process that she will go through. From talking to her, she was calm about the surgical procedure she was having. The care plan questions will pick up the experience she had before whether it was negative or positive experience so improvement can be made. The fact practitioner gathers information from patient helps them to create individuals care.
Ted stocking worn by patients have to be the correct size if the stocking is bigger it will not be effective against DVT. The speed of admitting the patient to the ward should not compromise patients safety health care worker must methodically go through the care plan. Following the care plan is a team effort to support patient their journey through pre and postoperative care.
The care plan should be revised as necessary of the patient needs so that the steps that the ward nurses take when going through the care plan correct to get the patient ready. It is vital that theatre department give enough time to the wards staff to prepare patients for surgery.
Once I became a practitioner, I would encourage ward round that would improve the patient care plan. A Patient who has been well informed beforehand about their surgery have improved outcome and need reduce analgesia during the postoperative recovery phase.
Although the patient I was involved with was brought on time on occasions, there has been a long wait after the surgeon and anaesthetist have come to the theatre, after consenting patient on the ward. To improve delays to patients coming to theatre can be alleviated by having a dedicated lift to allow patients to be transported to the theatre area efficiently.
The staff had good communication with each other considering the patients age and followed the correct procedure when transferring to the operating; patient like Hana age have to be treated with care. As we get older, our skin becomes thinner, reduced elasticity occurs that leads to damage to the skin due to age. The area that the skin came in contact with must be well cushioned.
The case study has improved my understanding why the elderly patient is prone to pressure area ulcer.
It is essential to plan patient care in a multi-professional environment to ensure highest care is provided. The care given by practitioners in theatre has to be communicating with the ward nurse to create a uniform standard of care. Hana stay in hospital will be enhanced by following good practices.
It is well-known fact, as we age, we are prone to hypothermia so it is vital to keep patient warm especially during anaesthesia phase. Hana procedure took 15 minutes in total and throughout the procedure warming blanket was used to keep her body temperature at safe levels.
In major case, the patient might have spent a while longer in the anaesthetic room before they are
transferred onto the operating table. From what I have learnt I will have knowledge and reason behind why patients particularly elderly patient needed to be kept warm during surgery procedures.
When transferring the patient to the operating table, sufficient numbers of staff are recommended and no transferring of a patient should take place without the supervision of the anaesthetist.
Having experienced being a patient once myself, I have some understanding the emotional side that the patients go through. I feel I am in the ideal position to support patients who have different types of surgical procedures. Hana was very appreciative about the care she was given. I shared my experience of being in the hospital with her and I talked to her how I felt during and after the procedure. I have understood what emotion she is going through.
It is one thing to advocate personal care plan, but where the individual is unable to say who they are, through disability, and then there is a danger of care falling short of the ideal. Hana can speak for she she has no disability she had mature understanding about the procedure she was having.
Patients are very attached to items they bring from home. It is extremely important for theatre staff to look after patients belonging. Therefore when patient come down to the theatre before they go to sleep, their glasses are removed and explain beforehand that their belongs will be kept safe until they wake up in the recovery room.
Hana’s experience was positive she was smiling and happy when she was leaving recovery to go back to the ward. I believe it was down to communication between healthcare staff centre to having a good team interaction. If everybody knows their role within a team, the theatre activities go smoothly.
Having close working relations improves safety aspect within the theatre environment. Patient pick up on around them whether it good or bad. Recently we had feedback from the head of the hospital telling us to smile. I already smile when I meet patients as I have learned from the different roles I have done during my employment.
My view is patients need to feel welcomed and listen too. When I was speaking with Hana, she was so willing to explain to me how she felt. From asking her questions, I would find out about what she would be doing if she were not here at the surgery. This kind of conversation to patients takes their mind off from the procedure they have to feel less stressed about it. From the case study I have learned valuable experience, communication with the patient in correct manner.
the case study is 2000 words and the reflection on the case study is 1000.
i want you to improve the writhing some are not relevant . more on patient anxiety. the reflection should mirror the case study. research why people of this age need to be scope .
COMMENT TO IMPROVE THE ESSAY
The standard of English in this assignment is not good enough to meet the requirements at this level. In many cases the sentences make no sense at all, the tenses are mixed, and plurals are inserted inappropriately.
Aside from the standard of written English, you have failed to meet the requirements for this piece of work at all. You do not discuss this patient’s individualised care in any detail, instead you have written a lot about the step by step process of the patient being taken to theatre.
You have included some references – often for no apparent reason, and you do not indicate how those references should be applied to your particular case. You also have got the technique of referencing wrong in both the list, and the citations in the text. This at least could be sorted by using the Helpsheet from the library about how to use references correctly.
You need to plan your work more effectively so you do not have so much repetition of information. (for example you say that this lady has had this surgery before, and you say that several times). You need to think about the issues for this patient which may have contributed to her anxiety, how this was managed, and whether anything more could be done to make her experience less of an ordeal. You need to read more about patient anxiety and apply those things to the example you are discussing, in order to demonstrate sound understanding of the issues.
Aside from all of this, the patient you are describing is 72 years old and you say she is being investigated for heavy menstrual flow. A woman of this age would be long past the menopause, and any bleeding at that stage of her life would be investigated because there would be a worry about a serious illness. This would make her particularly anxious because it would be likely that she had cancer – yet you do not even consider any of this – in fact you do not even indicate that you think this is unusual, which shows a worrying lack of understanding.
Another issue which demonstrates unsafe level of understanding is your comment about red wrist bands telling us that the patient is allergic to Elastoplast. Red wrist bands tell us the patient is allergic to “SOMETHING”. It is merely an alert mechanism to make us look further to see what the allergy is – it does not automatically mean an allergy to Elastoplast.
There are many, many, comments on your work – these should help you with the poor English and the referencing, as well as the things you have included which are not relevant.
 
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