Do Catheter Washouts Extend Patency Time in Long-term Indwelling Essay

Do Catheter Washouts Extend Patency Time in Long-term Indwelling Urethral Catheters - Essay Example Bladder washouts do not have to be carried out all the time, however they may be essential when there is a significant amount of sedimentation in the urine; and in treating urinary tract infections. In this process, about 60 mls of water is usually introduced into the catheter gently via a syringe; the syringe is then removed and the catheter end is drained into a container. The procedure is repeated until 500 mls of water is used. This topic was chosen because of the growing interest of the impact of catheterization on long-term care patients and on practices which can be used to minimize the negative impact of catheterization. It is relevant to my future practice as a nurse because it would provide me with evidence on the importance of carrying out catheter washouts on patients under long-term care. This aspect of practice personally interests me because I have often encountered long-term care patients under catheterization and I have always been interested in finding ways to impro ve the quality of their lives. Evidence based practice Evidence-based practice is defined by Sackett, et.al., (1996) as the explicit and effective use of current and most appropriate evidence in health care decisions on individual patients. It also means incorporating individual clinical skills with the most appropriate clinical proof from research. Evidence-based practice is basically about getting the patient the best care possible, as proven by evidence, and according to his needs and preferences (Manzoukas, 2006). It also helps ensure that the knowledge of the nurses are up to date, that it supports clinical judgments, and can reduce time in considering appropriate care (Drisko, 2010). There are various forms of evidence which can be utilized including systematic reviews, randomized controlled trials, cohort studies, case-control studies, case series/case reports, and editorials/expert opinion (University of Illinois, 2006). Not all evidence in this case is research base, most e specially in cases of editorials and expert opinion where the weight of the evidence is based on the skill and the authority of the practitioner. The Nursing and Midwifery Council (NMC) Code of Professional Conduct describes the specific duties of nurses. It also specifies that nurses have the responsibility of providing a high standard of care for patients at all times, and this includes providing â€Å"care based on the best available evidence or best practice† (NMC, 2009, p. 16). These provisions form the legal and practice-based support for the evidence-based care required of nurses. Evidence can therefore be used in this case in order to establish whether or not carrying out catheter washouts would extend the patency of catheters among long-term care patients. Moreover, evidence can be used to determine if these washouts would improve the care of catheterized long-term care patients. Literature review Various studies have been carried out on the current topic under study . Hagen, Sinclair, and Cross (2010) carried out their study in order to establish if some specific washout regimens are better than others in relation to effectiveness, acceptability, and quality of life. About five trials were able to meet the inclusion criteria covering 242 patients in two cross-over and three parallel-group randomised control trials. After witling down the studies based on the inclusion criteria, authors reported that there is no difference between the different washout solutions, however these results were not sufficient to support the conclusions.

Discuss the roles of cognition and emotion in moral judgment, with Essay

Discuss the roles of cognition and emotion in moral judgment, with particular reference to the research of Greene et al (2001). Approximately 1000 words - Essay Example ; in the trolley dilemma, whereby a runaway trolley will kill five people and a person is given the choice to press one switch whereby instead of five, only one person will be killed, people generally deem it appropriate to press the switch. In the footbridge dilemma, however, whereby there is a person on the bridge who needs to be pushed down in front of the trolley to save five people, though he will himself be killed, people deem it inappropriate to push that person from the bridge in front of the trolley. The question arises that though the effect of both dilemmas is the same, i.e. one person needs to die to save five from dying, however, people are more reluctant to push someone on to the tracks, though not to press a switch. The question that arises in the minds of moral philosophers is: â€Å"what makes it morally acceptable to sacrifice one life to save five in the trolley dilemma but not in the footbridge dilemma?† (Green et al, 2001). Green et al purpose that perhaps, if one is to take the approach of Immanuel Kant, it can be said that the reluctance arises out of the fact that in the first example, the person is just unfortunately in the way of the trolley, whereas in the second one would have to literally use him to achieve the required end. However, when the same example is changed slightly and the track is looped so that if the body of that one person does not stop it, it will kill the five people, people still think it appropriate to let that one person’s body be used to stop the trolley. Green et al suggest that there is no one correct solution to this problem, there is still confusion as to why in one case it is appropriate for a man’s body to be used to save five people, while inappropriate in another case. The problem also lies in the fact that there are no moral reasons on which these two situations can be distinguished and there are no set moral principles to guide people in coming up with a solution to this problem. Green et al maintain