Health Care

Dually-diagnosed individuals refer to a “group of patients with severe and persistent mental illness and co-existing drug and alcohol problems” (Burns-Lynch, 1997). Patients are more likely to go through physical, psychological, social, and spiritual problems, not only affecting their families and loved ones, but the community as a whole.

Some of these include family or intimate relationship, isolation and social withdrawal, financial problems, employment/ school problems, risky behavior while driving, multiple admission for chemical dependency services and for psychiatric care, increased need for health care services, legal problems, and homelessness (Hamilton, n. d. ).

More importantly, the condition of the patients could get worse with psychiatric symptoms being masked by alcohol or drug use, alcohol or drug use or withdrawal that can mimic or give the appearance of some psychiatric illness, untreated chemical dependency that can contribute to a reoccurrence of psychiatric symptoms, and untreated psychiatric illness that can contribute to an alcohol or drug relapse (“Dual Diagnosis or Co-Occurring Disorders”, n. d. ).

Certain treatments can be done, such as the care/ confrontation methods (choosing between managers who will care for the patients, or allow the client to care for himself), the abstinence-oriented/ abstinence-mandated programs (which depends on the willingness on the patient to remain abstinent, or abstinence will be made a goal), and the recovery and rehabilitation method/ deinstitutionalization (which focuses on restricting the patient in an intensive setting or allowing him to recover in the community) (Burns-Lynch, 1997).

The law requires the safety of every member of the community. Dangers can be posed by dually diagnosed individuals. But it also has to be kept in mind that they too are people who need extra care and understanding. Man has a duty to help other men in times of need. Caring for dually-diagnosed individuals will not only bring safety to the patients, but to all members of the community as well.

The article of Debi Gerger (2008), RDH, MPH, entitled ‘Xylitol several times a day… may help keep caries away! ’ states that xylitol which is commercially available as a noncariogenic sugar substitute has the potential to reduce caries rates by preventing Mutans Streptococci growth. Gerger also mentions that to perform a caries risk assessment, pathological, risk factors and protective factors of caries must be first determined. After determining such factors, the next procedure would be determining the patient’s caries risk level.

There are two approaches to determine risk levels including the American Academy of Pediatric Dentistry’s Carries-Risk Assessment Tool (CAT) and the Caries Management by Risk Assessment (CAMBRA). According to Gerger’s article, managing dental carries include at-home and in-office recommendations. The at-home recommendations include daily oral hygiene with fluoride-containing toothpaste, mouth rinsing, drinking water, antibacterials and Xylitol-containing products.

The in-office recommendations include dental procedures done by dental hygienists and dentist. In addition, Gerger’s article also mentioned that 25% of American children aged 2 to 5, and half of 12% of the ages 12 to 15 have tooth decay. He also mentions that tooth decay is highly infectious at any age bracket. Gerger states that Caries management with the use of xylitol decreases the amount of MS and raises the salivary pH level because MS is unable to metabolize xylitol and xylitol inhibits the attachment of MS to teeth.

It is also said that xylitol is effective in preventing the transmission of the Mutans Streptococci frome parent to child (2008). Xylitol has been used since the early 1960s through infusion therapy and diabetic foods. It is a five-carbon sugar alcohol derived from forest and agricultural materials. Finnish researches are the first one to recognize its dental health benefits. Xylitol is commercially available in many forms which have different xylitol doses.

For this reason, the patient is advised to check the xylitol content of a product to determine the needed dose to be taken (Gerger, 2008). Gerger argues that xylitol is a major addition to the treatment of caries. She proposes that considering the caries balance concept is vital to determine the appropriate recommendations. She also asserts that the prevention of the caries will be obtained by providing proper education by clinicians to their patients and producing xylitol-containing products.

From Data, Information and Knowledge to Wisdom The data-information-knowledge-wisdom (DIKW) continuum is a concept of the transformation of data into wisdom through cognitive processes. DIKW was initially used to illustrate principles of information management for the designing of information systems (Davenport & Pursak, 1989)(Saltworks, 2009).

DIKW models utilized by nursing such as the model by Englebart & Nelson (2002), incorporate principles of increasing complexity due to increasing interactions What is important and unique to nursing is the DIKW concepts and models also help describe the critical thinking processes that nurses use to transform knowledge into the delivery of patient care, into education and learning and also into nursing research (ANA-American Nurses Association, 2008).

The purpose of this paper is to demonstrate the progression through the four steps of the data, information, knowledge, wisdom continuum that occurs research information to answer a clinical question pertinent to nurse practitioner practice. Standardized N nursing Language in Nurse Practitioner Practice The use of electronic information and decision support systems in nursing practice has brought about the introduction of several standardized nursing languages to document and communicate patient care. (McGonigle & Mastria, 2012 ).

The identity of the Nurse Practitioner is grounded in nursing practice but has also expanded to include the functions of a physician (O’Connor, Hameister, & Kershaw, 2000). Given the merged identity of the Nurse Practitioner the clinical question is :Would a standardized nursing language adequately document the patient care delivered by a nurse practitioner? The Search for Clinical Data Data are discreet entities that in of themselves have no meaning. The search for data related to the clinical question was conducted through the Walden Library Health Science and Nursing Databases.

3 Using the search words Nurse Practitioner and Standardized Nursing Language, both the CINHAL/Medline and the OVID data bases were queried. The search identified 6 articles. According to Bernstein (2009), The Data-Information-Knowledge-Wisdom hierarchy is based on filtration and reduction, so to select the most relevant articles, the titles and the keywords of the articles were reviewed first. This resulted in one article that did not contain the search words to be elimiated from further review. Translating Clinical Data to Information

To further evaluate the usefulness of the 5 remaining articles, their abstracts were read to identify any relevant information. Information is data that has some meaning to it. Davenport and Prusak (1989) describes information as data that makes a difference to the receiver of the data. The data which is now aggregated into informational sentences and paragraphs (complete thoughts) reveal that the NANDA Nursing Diagnoses, the Iowa Nursing Interventions, and Iowa Nursing Outcomes Classification SNLs have been explored for use in Nurse Practitioner practice.

This is information as it has context to the reason the literature search is being performed. Linking Information to Knowledge In the , Knowledge is transformed from Information At the knowledge stage in Englebart’s & Nelson’s (2002) DIKW model, an increased level of complexity in thinking must occur as a result of the increasing occurrences of interrelationships between information and knowledge (McGonigle & Mastrian, 2012 ).

Davenport and Pursak also describe the knowledge stage of the continuum as a level of higher order of thinking and go on to describe some of the higher level thinking actions that turn information into knowledge. DATA TO WISDOM 4 One such action is Comparison i. e. How does this information compare to other known facts ? In this case the information found was about one type of SNL, but it known that there are about 13 different SNLs in existence. Another action is making Connections i. e. How does this information relate to other pertinent topics? In this situation another pertinent topic in NP practice is e-Prescribing.

How does the use of an SNL relate to e-prescribing? Thus far the knowledge gleaned is not enough information has been found to answer the clinical question as written. Wisdom—Knowledge Applied in Meaningful Ways. Can informatics be used to gain wisdom? Interestingly the concept of wisdom has been eliminated from many DIKW models (DIK models) because according to Davenport and Prusak(1989) there is “enough difficulty distinguishing among the three related concepts of data, information and knowledge” and so “higher-order concepts such as wisdom and insight have been lumped into the category of knowledge”.

There are differences in defining what wisdom is. According to Bernstien (2009) “wisdom means an ability to see the long-term consequences of any act”. Or wisdom is knowing when and how to apply knowledge to complex problems or needs (Englebart & Nelson, 2012). In this case Wisdom is knowing that more research needs to be done on the topic of SNL’s and NP practice in order to determine if standardized nursing language adequately applies to NP practice. It is what nurses do with the information available or lack of information available in informatic systems that creates wise decision making.

Summary In nursing, Data- Information- Knowledge-Wisdom continuum models help depict the critical thinking nurses use to provide patient care. In information science DIKW models depict information management systems. DATA TO WISDOM 5 Data and Information can be stored in the databases of information systems in the forms of numbers, symbols and words that in of themselves have no meaning. It is only when data and information have context and meaning and are correctly applied to a problem that they are transformed into Knowledge and Wisdom in the minds of the users of these information systems. DATA TO WISDOM 6 References American Nurses Association. (2008). Nursing informatics: Scope & standards of practice. Silver Springs, MD Bernstein, J. H. ( 2009) The Data-Information-Knowledge-Wisdom Hierarchy and its Antithesis.

Retrieved from http://arizona. openrepository. com/arizona/handle/10150/105414 Davenport, T. , Prusak, L. (1998) Excerpt of Working Knowledge: How Organizations Manage What They Know. Retrieved from http://wang. ist. psu. edu/course/05/IST597/papers/ Davenport_know. pdf McGonigle, D. & Mastrian, K. G. (2012). Nursing informatics and the foundation of knowledge (2nd ed. ). Burlington, MA: Jones & Bartlett Learning. O’Connor, N. A. , Hameister, A. D. , Kershaw, T. (2000). Application of Standardized Nursing Language to Describe Adult Nurse Practitioner Practice. Nursing Diagnosis Magazine. Copyright 1999 Nursecom, Inc. Retrieved from www. highbeam. com The Data-Information-Knowledge Continuum. The Saltworks Blog Archive. Retrieved from http://www. datamobilitygroup. com/saltworks/archives/76

HIV and AIDS medically known as Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) are spreading within the United States among women and young girls at an astounding rate. It is imperative that women and girls comprehend the issues, data, and trends associated with living with these diagnoses. December 2010, one in four individuals living with a medical diagnosis of the HIV infection within the United States was women (CDC, 2013).

The percentage of HIV cases in 1985 was at 8%, and rose to 25% by the end of 2010 (CDC, 2013) HIV/AIDS diagnosis in women represent over half of all adults living in the United States with one of these medical conditions (Kaiser Family Foundation, 2007). Transmission of HIV/AIDS in Women The epidemic and rate of transmission of HIV/AIDS is continually growing within the United States and the impact it has on women is profound. The main source of transmission of HIV/AIDS in women is through heterosexual intercourse.

According to the statistics from the Kaiser Family Foundation HIV/AIDS transmission has increased to 31% in 2005 from 3% in 1985 (Kaiser Family Foundation, 2007). Women between the ages of 13 to 19 are 50% more likely to acquire the diagnosis of HIV/AIDS. The increased number of young women diagnosed with HIV has resulted in more women with the diagnosis of AIDS between the ages of 24 and 44. This means most women received her HIV diagnosis at a very young age (Kaiser Family Foundation, 2007).

African American women with HIV/AIDS The numbers have increased at a very high rate in African American women diagnosed with HIV/AIDS. The diagnosis of HIV/AIDS elevated in women of African American decent dwelling in the United States (Kaiser Family Foundation, 2007). However, the Centers for Disease Control and Prevention (CDC) estimated the year ending in 2010, that women of color diagnosed with HIV/AIDS decreased (CDC, 2013). There was a time that HIV infection was one of the prominent causes of demise among African American omen between the ages of 25 to 34 and third with African American woman aged 34 to 44 residing in the United States. . The African American women diagnosed in 2005 were 20 times more than White women (Rose, Sharpe, Raleigh, Reid, Foley, and Cleveland, 2008). The health care industry is attempting to obtain a solution to the increased incidents of HIV/AIDS in women of color as well as the lack of medical care. Policy Recommendations by the CDC to revamp guidelines associated with HIV testing to promote this as a product of routine health care prevention (CDC, 2013).

The CDC recommends that every woman receive routine HIV screenings no matter the age, and every pregnant woman within her third trimester (Kaiser Family Foundation, 2007). Signing the Affordable Care Act by President Obama affords HIV/AIDS patients to obtain early treatment and preventative care. Another positive attribute of the Affordable Care Act is that health insurance companies cannot deny care to patients for any pre-existing condition, so women will obtain treatment even though the condition is pre-existing (Sharp, Khaylis, Kamen, Lee & Gore-Felton, 2010). Conclusion

The women and young girls who live with HIV and AIDS (AIDS) spread at an astounding rate within the United States. It is imperative that women and girls understood the issues, data, and trends associated with living with those diagnoses. By December 2010, one in four individuals was living with a medical diagnosis of the HIV within the United States was women (CDC, 2013). The percentage of HIV cases in 1985 was at 8%, and rose to 25% by the end of 2010 (CDC, 2013) HIV/AIDS diagnosis in women represented over half of all adults living in the United States with one of these medical conditions (Kaiser Family Foundation, 2007).

References

1. CDC. (2013). Centers of Disease Control and Prevention. HIV Among Women http://www. cdc. gov/hiv/topics/women/
2. Kaiser Family Foundation. (2007). Women and HIV/AIDS in the United States. Retrieved from http://www. kaiseredu. org/Tutorials-and-Presentations/Women-and-HIV-in-the-US. aspx Rose, M. , Sharpe, T. , Raliegh, K. , Reid, L. , Foley, M. , & Cleveland, J. (2008).
3. An HIV/AIDS crisis among African American women: a summary for prevention and care in the 21st century.
4. Journal of Women’s Health (15409996), 17(3), 321-324. Retrieved from EBSCOhost. Sharp, S. , Khaylis, A. , Kamen, C. , Lee, S. , ; Gore-Felton, C. (2010).
5. A Review of Psychosocial Factors that Facilitate HIV Infection among Women Living in Canada ; the United States: Implications for Public Health Policy. Women’s Health & Urban Life, 9(2), 63-79. Retrieved from EBSCOhost.

Introduction
Now more than ever, the advances in technology have accompanied the health care delivery system in providing efficient and effective treatment and management for a wide range of patients. According to an article on “Medical Technology”, “from gene therapy to tissue engineering to telepresence medicine, the proliferation of new technology promises even greater improvements in patient care, health status, and quality of life” (ct.gov, n. d., p. 89). Nevertheless, the advent of these developments considerably affects the health system, in general. Thus, this paper aims to describe the uses of technology for patient management
and its impact on health care and health status.

Findings
The uses of technology for patient management comprise an array of services that would include new medical and surgical procedures, drugs, medical devices, and new support systems. Indeed, these services had undergone innovative changes during the past years to cater the needs of the patients. These facts are exemplified in the following sections of this paper, as quoted from reliable references. “Surgery is another area of medicine that has been virtually transformed by innovative new techniques and technologies.

The acceptance and refinement of minimally-invasive surgical procedures, improvements in anesthesia, patient demands and the push towards greater cost savings have facilitated the shift of surgical procedures from the traditional hospital setting to free-standing ambulatory surgical centers, outpatient clinics, and physicians’ offices” (Medical Technology, ct.gov, n. d., p.92).

On the other hand, another study called “AstraZeneca Submission” (n. d.) typified the progress in medicines, as we quote, “many examples describe the impact of new medicines on patient symptoms and quality of life:
Advanced cancer is incurable. Many medicines for this devastating disease have provided value to patients and their families by improving their quality of life.

Drugs to prevent nausea, a common side-effect of cancer chemotherapy, can help make the treatment easier to bear both for patients and their families.
In patients with moderate to severe migraine, subcutaneous sumatriptan improved quality of life by more than 20% compared to placebo (61.6% versus 20.6%). Patients on rizatriptan show significantly better responses to three domains of the 24-hourMigraine Quality of Life Questionnaire (social functioning, migraine symptoms and feelings/concerns) compared to patients treated with placebo. (This entry has been quoted from Santanello N C, Polis A B, Hartmaier S L, Kramer M S, Block G A, Silberstein S D, Improvement in migraine-specific quality of life in a clinical trial of rizatriptan. Cephalalgia 17(8):867-872 1997)

A systematic review of a new schizophrenia medicine – an atypical antipsychotic – found that, compared with typical antipsychotics, it was more effective in improving global state, general mental state and the negative symptoms of schizophrenia, and was as effective as typical antipsychotics with regard to positive symptoms. (This entry has been quoted from Mota N E, Lima M S, Soares B G, Amisulpride for schizophrenia. Cochrane Database of Systematic Reviews 2:CD001357, 2002)”.

With regards to medical devices, “one specific example of the dynamic changes in the use of medical technology in the state (CT) is PET scanning. PET scanners are among the most expensive units of major medical equipment available today. PET scans are non-invasive procedures used to detect metabolic rates of organs and tissues using radioactive agents that emit positively charged electrons (positrons).

While useful in a number of specialties, PET is increasingly valuable in the fields of neurology, cardiology, and particularly cancer imaging including monitoring the effectiveness of chemotherapy and radiation therapy” (Medical Technology, ct.gov, n. d., p.92). In addition, new support systems have also been employed in the health care system. An example is the so-called telemedicine of which according to the Centers for Medicare & Medicaid Services, “it is the use of medical information exchanged from one site to another via electronic communications to improve a patient’s health.

Electronic communication means the use of interactive telecommunications equipment that includes, at a minimum, audio and video equipment permitting two-way, real time interactive communication between the patient, and the physician or practitioner at the distant site. Telemedicine is viewed as a cost-effective alternative to the more traditional face-to-face way of providing medical care (e.g., face-to-face consultations or examinations between provider and patient) that states may choose to cover.

This definition is modeled on Medicare’s definition of telehealth services located at 42 CFR 410.78” (Overview Telemedicine, n. d.). Hence, “the institution and utilization of new technologies in the hospital setting has dramatically influenced the way in which hospitals function as health care providers. Minimally invasive surgical procedures, highly advanced medical equipment, and breakthrough prescription medications are particularly significant in the evolving role of hospitals as they have all contributed to shorter and oftentimes costlier hospital stays” (Medical Technology, n. d., p.89).

Conclusion
Consequently, we have learned how the health care system utilized the use of the new technology in the treatment of patients, as reflected in the abovementioned findings. We realized that technology has an impact on the costs of health care services: cost effective, when it comes to medications, but costly, when it comes to acquisition of new medical devices. Nonetheless, we discovered that the impact of technology in health care is basically characterized by the provision of optimum patient management, thus leading to the attainment of a better quality of life and improvement in the health status of individuals.

References
AstraZeneca Submission – The impact of advances in medical technology on healthcare in Australia – The Value of Medicines. (n.d.). Retrieved November 27, 2008, from http://72.14.235.132/search?q=cache:Z7LXq-jne1MJ:www.pc.gov.au/__data/assets/pdf_file/0014/17501/sub023.pdf+Impacts+of+Advances+in+Medicine+to+Patients&hl=tl&ct=clnk&cd=1&gl=ph
Centers for Medicare & Medicaid Services. (n.d.). Overview Telemedicine. HHS.gov. Retrieved November 27, 2008, from http://www.cms.hhs.gov/Telemedicine/
CT.gov. (n.d.). Medical Technology. Retrieved November 27, 2008 from http://www.ct.gov/ohca/lib/ohca/hospitalstudy/Medical_Technology.pdf

The tropical climate of the Philippines has made it possible for thousands of plants and vegetation to thrive more in lush forests. Many herbal plants have been tapped because of its efficacy against common ailments and the practice of the use of herbal plants as medicines have stretched as far as during the pre-Spanish era, and are still being practiced until these modern times. The Department of Health (DOH) advocated the use of herbal plants as what is considered a form of primary health care and as an answer to the increasing cost of synthetic drugs in the market.

These 10 DOH-approved herbal plants are found within the country and have been proven to treat common ailments, according to the thorough research done by National Science Development Board, and other government and private agencies and persons. Its importance in providing better health care was not overlooked. In 1992, The DOH, through former Health Secretary and Senator Juan M. Flavier made a health program by virtue of Administrative Order No. 12. This program was known as the Traditional Medicine Program, with its main function of promoting and advocating the use of traditional medicine across the country.

In 1994, the drafting of a traditional medicine law was initiated in order to institutionalize the program. Then by 1997, President Fidel V. Ramos saw the promising potential of traditional medicines both in the health of Filipinos and the economy and timely approved the Republic Act 8423, also known as the Traditional and Alternative Medicine Act (TAMA) of 1997. This law then gave rise to the government-owned and controlled corporation known as the Philippine Institute of Traditional and Alternative Health Care (PITAHC).

It is attached to the DOH in delivering safe, effective, and affordable proper traditional and alternative (TAHC) health care products and services to the people.

The 10 DOH-approved herbal plants are listed below, along with their uses, preparations, and names in different places/dialects within the country.

1.

• Lagundi (Vitex negundo)
• Kamalan (Tag. )
• Limo-limo (Ilk. )
• Tugas (Ceb. )
• Dabtan (If. )
• Molave aso (Sul. )
• 5 leaves chaste tree (English)

Lagundi is a shrub type of plant growing wild in vacant lots and wasteland. Matured branches are planted. The flowers are blue and bell-shaped. The small fruits turn black when ripe. It is better to collect the leaves when are in bloom.

Uses:

For asthma, cough, and fever – boil raw fruits or leaves in 2 glasses of water for15 minutes until the water left in only 1 glass (decoction). Strain. Leaves should be chopped and the following dosages of the decoction are given according to age group: Dried leaves/Fresh leaves Adult4 tbsp. 6tbsp. 7-12 yrs. 2 tbsp. 3 tbsp. 2-6 yrs. 1 tbsp. 1 ½ tbsp.

For dysentery, colds, and pain in any part of the body as in influenza – boil a handful of leaves and flowers in water to produce a glass full of decoction and drink it three times a day. For skin diseases (dermatitis, scabies ulcer, eczema) and wounds – prepare a decoction from a handful of leaves. Wash and clean the skin/wound with the decoction.

For headache – crush leaves and may be applied on the forehead.

For rheumatism, sprain and contusions, insect bites – pound the leaves and apply on the affected part.

For aromatic bath for sick patients – prepare leaf decoction for use in sick and newly delivered patients.

2.

• Yerba (Hierba)
• Buena (Mentha cordifelia)
• Herba Buena (most dialects)
• Hierba/Yerba Buena (Spanish)
• Hilbas (Dav. , Ley. )
• Opiz Ablebana (If. )
• Malipuen (Als. )
• Peppermint, mint (English)

Buena is a small multi-branching aromatic herb. The leaves are small, elliptical, and with a toothed margin. The stem creeps to the ground and develops roots. It may be also propagated through cuttings.

Uses:

For pain in different parts of the body as headache, stomach ache – boil chopped leaves in 2 glasses of water for 15 minutes. Cool and strain. Dried leavesFresh leves Adult6 tbsp. 4 tbsp. 7-12 yrs.? tbsp. of adult dose Divide decoction into two parts and drink one part every three hours.

For rheumatism, arthritis and headache – crush the fresh leaves and squeeze sap. Massage sap on painful parts with eucalyptus.

For cough and cold (serves as an expectorant) – get about 10 fresh leaves and soak in a glass of hot water. Drink as tea.

For swollen gums – steep 6 g. of fresh plant in a glass of boiling water for 30 minutes. Use the solution as a gargle.

For toothache – cut fresh plant and squeeze sap. Soak a piece to cotton in the sap and insert this in aching tooth cavity. Mouth should be rinsed by gargling salt solution before inserting the cotton dipped with plant sap.

To prepare a salt solution: add 5 g. of table salt to one glass of water. For menstrual and gas pain – soak a handful of leaves in a glass of boiling water. Drink infusion. It induces menstrual flow and sweating.

For nausea and fainting – crush leaves and apply at nostrils of patients.

For insect bites – may be prepared in two ways:

1. Crush leaves and apply the juice on the affected part.
2. Pound leaves until paste-like. Rub this on the affected part.

For pruritis – boil the plant alone or with eucalyptus in water. Uses decoction as a wash on the affected area.

3.

• Sambong (Blumea balsamifera)
• Alibhon Alimon (Vis. )
• Kambihon, Lakdanbulan (Vis. )
• Ayohan, Bulaklak, Ga buen, Kaliban (Tag.)
• Gintin-gintin, Haliban/Camphor (English)

Sambong is a plant that reaches 1 to 3 meters in height with rough hairy leaves. Young plants around the mother plant may be separated when they have three or more leaves.

Uses:

For anti-edema, diuretic, and anti-urolithiasis – boil chopped leaves in a glass of water for 15 minutes until one glassful remains. Cool and strain. Dried leaves/Fresh leaves Adult 4 tbsp. 6 tbsp. 7-12 yrs. ½ tbsp. of adult does Divide decoction into 3 parts. Drink one part 3 times a day.

Note: Sambong is not a medicine for kidney infection.

4.

• Tsaang Gubat (Carmona retusa)
• Alibungog (Vis. )
• Kalabonog, Maragued (Ilk. )
• Kalimunog, Taglokot, Talibunog, Tsa (Tag. )
• Malatadian (Gad. )

Tsaang- Gubat is a shrub with small, shiny nice-looking leaves that grows in wild uncultivated areas and forests. Mature stems are used for planting.

Uses:

For diarrhea – boil the following amount of chopped leaves in 2 glasses of water for 15 minutes or until the amount of water goes down to 1 glass. Cool and strain. Dried leaves/Fresh leaves Adult10 tbsp. 12 tbsp. 7-12 yrs. 5 tbsp. 6 tbsp. 2-6 yrs. 2 ½ tbsp. 3 tbsp. Divide decoction into 4 parts. Let the patient drink 1 part every 3 hours. For stomach ache – wash leaves and chop. Boil chopped leaves in 1 glass of water for 15 minutes. Cool and filter/strain. Dried leaves/Fresh leaves Adult2 tbsp. 3 tbsp. 7-12 yrs. 1 tbsp. 1 ½ tbsp.

5.

• Niyug-Niyogan (Quisqualis indica L. )
• Balitadham, Pnones, Pinio, Bono (Bis. )
• Bawe-bawe (Pamp. )
• Kasumbal, Talolong (Bik. )
• Tartarau (Ilk. )

Burma creeper, Chinese honeysuckle (English) Niyug-Niyogan is a vine which bears tiny fruits and grows wild in backyards. The seed must come from mature, dried but newly opened fruits. It is propagated through stem cuttings about 20 cm. in height.

Uses:

For anti-helmintic purposes – used to expel roundworms which cause ascariasis. The seeds are taken 2 hours after supper. If no worms are expelled, the doses may be repeated after one week.

• Adults 8-10 seeds
• 7-12 yrs. 6-7 seeds
• 6-8 yrs. 5-6 seeds
• 4-5 yrs. 4-5 seeds

Caution: Not to be given to children below four years old.

6.

• Bayabas (Psidium guajava L. )
• Guyabas, Kalimbahin, Tayabas (Tag. )
• Bagabas (Ig. )
• Bayabo (Ibm. )
• Bayawas (Bik. , Pang. )
• Biabas (Sul. )
• Guyabas (Ilk. )
• Guava (English)

Bayabas is a tree about 4-5 meters high with tiny white flowers with round or oval fruits that are eaten raw.

It is propagated through seeds.

Uses:

For washing wounds – may be used twice a day

For diarrhea – may be taken 3-4 days twice a day

For relief of toothache and as a gargle – a warm decoction is used for gargle. Freshly pounded leaves are used for toothache. Guava leaves are to be washed well and chopped. Boil for 15 minutes at low fire. Do not cover the pot. Cool and strain before use.

7.

• Akapulco (Cassia alata L. )
• Bayabas-bayabasan, Kapurko, Kantada, Katandang Aso, Pakagonkon, Sonting (Tag. )
• Andadasi, Andadasi-a dakdakol, Andadasi-bugbugtong (Ilk. )
• Adadasi (Ting. )
• Ancharasi (Ig.)
• Andalan (Sul. )
• Bayabasin, Bikas-bikas (Bik. , Tag. , Bis. )
• Kasitas (bik. , Bis. )
• Snting, Palo china (Bis. )
• Pakayomkom Kastila (Pamp. )
• Ringworm bush or shrub (English)

Uses:

For anti-fungal purposes (Tinea flava, ringworm, athlete’s foot, and scabies) – fresh, mature leaves are pounded. Apply to the affected part 1-2 times a day.

8.

• Ulasimang Bato (Peperonia pellucida)
• Pansit-pansitan (Tag. )

Ulasimang Bato is a weed with heart-shaped leaves that grow in shady parts of the garden and yard.

Uses:

For lower uric acid (rheumatism and gout)

Preparation: Wash the leaves well.

One and a half cup leaves are boiled in two glassfuls of water over a low fire. Do not cover the pot. Cool and strain. Divide into three parts and drink each part three times a day after meals. It may also be eaten as a salad. Wash the leaves well. Prepare one and a half cups of leaves (not closely packed). Divide into three parts and take as salad three times a day.

9.

• Bawang (Allium sativum)
• Ajos (Spanish, Bis. )
• Garlic (English)

Uses:

For lowering of cholesterol levels in the blood; for hypertension and toothache Preparation: maybe fried, roasted, soaked in vinegar for 30 minutes, or blanched in boiled water for 5 minutes. Take two pieces three times a day after meals.

Caution: Take on a full stomach to prevent stomach and intestinal ulcers.

For toothache – pound a small piece and apply it to the affected part.

10.

• Ampalaya (Mamordica charantia)
• Amargoso (Spanish, Ilonggo)
• Margoso, Ampalaya (Tag. )
• Apalia (Pamp. )
• Agape (Ibn. )
• Apapet (Itn. )
• Palia (Bis. , Ban. , If. , Ilk. )
• Pubia (Sub. )
• Suligum (Sul. )
• Balsam Apple, Balsam Pear, Bitter Gourd (English) Uses:
• For those with Diabetes Mellitus (Mild non-insulin-dependent)

Preparation: Gather and wash young leaves very well. Chop. Boil 6 tablespoons of chopped leaves in two glassesful of water for 15 minutes under slow fire. Do not cover the pot. Cool and strain. Take one-third cup 3 times a day after meals.

Note: Young leaves may be blanched or steamed and eaten 1/2 glassful 2 times a day.

Reminders on the use of herbal medicine:

1. Avoid the use of insecticides as these may leave poison on plants. This may be hazardous to consume and may cause poisoning that may lead to death.
2. In the preparation of herbal medicine, use a clay pot and remove the cover while boiling at low heat.
3. Use only the part of the plant being advocated. The use of the parts not indicated may affect the potency of the herbal medicine, making it less effective or not effective at all when consumed.
4. Follow an accurate dose of suggested preparation. The proper amount and timing of dosage are critical in achieving the expected results. Not following those can be detrimental to one’s health and recovery.
5. Use only one kind of herbal plant for each type of symptoms or sickness.
6. Stop giving the herbal medication in case an untoward reaction such as allergy occurs.
7. If signs and symptoms are not relieved after 2 or 3 doses of herbal medication, consult a doctor.

Professional Roles Running head: Professional Roles and Values 1 Professional Roles and Values Jennifer Kelso, RN Western Governor’s University Professional Roles 2 Professional Roles and Values The nurse supervisor has the responsibility of coaching all of her staff members in the importance of utilizing her team members to provide the most holistic care for patients. As a nurse supervisor it is important to recognize when a team member is struggling with this concept and to provide the proper leadership and mentoring so that the most best possible patient outcomes can be consistently realized.

The nurse supervisor must provider leadership and confidence to try to guide her staff in utilizing available resources to achieve the goal of optimal patient care and outcomes. Promoting Interdisciplinary Care To promote interdisciplinary care the nurse supervisor must find a way to engage her staff in the concepts of team building and how to utilize each member of the healthcare team and the unique contributions that they bring to patient care. One effective way that I have experienced this personally is with team building exercises. In the clinic where I work as a registered nurse we have weekly team building exercises.

These exercises provide a regular opportunity to further get to know one’s co-workers outside of the daily rigors of patient care. At my current job I have participated in races, games and scavenger hunts, among other activities. These activities bring an element of fun and stress relief to what might otherwise be another mundane meeting, while at the same time promoting team cohesiveness and friendship. I would recommend that the nurse supervisor provide time in the weekly or monthly schedule for her healthcare teams to meet together to discuss and participate in team building exercises.

Setting aside time for all of the staff in the clinic to meet come together and engage in team building activities will help improve cohesion of the staff, improve communication and help to build comradery. Professional Roles Another technique that the nurse supervisor can use to promote the advantages of interdisciplinary care is to discuss with and demonstrate to her staff how team based healthcare achieves better patient outcomes. The nurse supervisor can present case studies during team meetings and ask staff to problem solve how different members of the team can be utilized to address the patients’ needs.

These types of exercises can be used to remind staff of the resources that are available to them in the clinic. All the members of the team, from the nutritionist to the 3 social worker, bring their talents and strengths to the table. Being able to help staff recognize the value in utilizing their fellow team members and to appreciate what those team members offer in the way of enhancing patient care is vitally important. Another approach to try in engaging Ms. W in interdislipnary care is to spend some time mentoring her. The nurse supervisor can set aside time dedicated to coaching Ms.

W regarding the benefits of a team-based approach to patient care and how to implement this concept in her own practice. Some of the benefits of interdisciplinary care include improved patient health outcomes and overall patient satisfaction in the quality of the healthcare received (Mitchell, Hall & Gaines, 2012). One way she could mentor Ms. W is to shadow her in some of her appointments and provide support and guidance to her as she learns how to utilize the resources available at the clinic. The nurse supervisor could also involve Ms.

W’s colleagues by having her shadow another provider and observe a few appointments where the provider utilizes the other team members and to provide concrete examples of how this practice benefits the patient. It is important that the nurse supervisor address these issues with Ms. W in a caring and supportive fashion with the intention of improving the quality of healthcare and continuity of care that each patient receives. Professional Roles Delegation and Teamwork To promote delegation and teamwork within the clinic, the nurse supervisor must ensure 4 hat her staff recognizes how vitally important these are to the patient care that they provide. The nurse supervisor needs to promote these practices in the functioning of the clinic every day. Weekly staff meetings are a place where everyone can come together and discuss what did and did not work well in the clinic for that particular week. This is one way to increase communication between staff members. Fostering open communication and providing an environment where everyone’s voice can be heard is very important during these meetings and could be considered one of the major responsibilities of the nurse supervisor.

When employees can begin to appreciate the benefits of an interdisciplinary approach and can recognize the potential of such an approach for improving patient outcomes then it will be natural that they would want to continue using this approach. A nurse supervisor must be present to answer staff questions and to help guide them in this process while taking advantage of opportunities to help staff recognize that the interdisciplinary approach is improving patient care. When the nurse supervisor approaches Ms. W regarding delegation and team work, it is important that she utilizes the concepts mentioned above.

The nurse supervisor can begin the conversation by recognizing and affirming the difficulties that Ms. W must be having with trying to provide healthcare for Ms. R, who presents with many barriers to care. Inquire of Ms. W what she sees as the barriers that Ms. R has to being compliant with her plan of care. Problem solve with Ms. W in a supportive and open-minded manner regarding various resources the clinic has available to help this patient. Arrange to have a clinic meeting with the other members of the staff and discuss Ms. R’s circumstances and have each team member discuss what they bring to the table to help this patient.

It is important that the nurse supervisor try to help Ms. W Professional Roles understand that there is support available to help her care for Ms. R and that acknowledging and utilizing the other team members in the clinic will not only help lessen the load on Ms. W, but will also provide more comprehensive care to Ms. R. Responsibility Ms. W has a responsibility to understand that when she delegates tasks to other staff in the clinic that she is doing so appropriately and safely. When Ms. W delegates any form of the patient’s care it is important that Ms.

W recognize that she is legally responsible to ensure that the person that she delegated the task to is competent. Ms. W must make sure that she is delegating the right task, under the right circumstances, to the right person under the right directions with the right supervision (Anthony & Vidal, 2010). It is important that Ms. W consider the financial implications of delegation and whether she is being a good steward of clinic resources (Weydt, 2010). A nurse needs to be aware of the cost of services and supplies and to always strive to not be wasteful with healthcare resources.

One way a nurse does this is through delegating work to a qualified staff member who can safely do the task and still achieve desired patient outcomes (Weydt, 2010). It is very important to recognize that there are limited healthcare resources and the nurse must be able to efficiently coordinate patient care in an effective and responsible way that maximizes patient outcomes (Weydt, 2010). Trust and open communication are the landmarks of all good relationships and it is no different in a professional relationship. Open communication and trust are vitally important for Ms. W and the staff to have to be able to work effectively as a team.

The nurse and the 5 supporting staff must work together and have respect for and trust in each other and what unique contributions that they bring to the patient’s care. Professional Roles To properly delegate the right task to the appropriate supportive staff, Ms. W must consider if the person that she is delegating to is qualified and has the appropriate skill set to perform the task. It is important that Ms. W consider whether the task requires any nursing judgment, assessment, or licensure to be safely carried out, as these kinds of tasks cannot be 6 delegated to supportive staff (Weydt, 2010). Ms.

W must be able to trust and have confidence in the skills of the supportive staff (Weydt, 2010). Different resources that Ms. W can use in the clinic to help with the delegation process is to ask to see the job descriptions of supportive staff to see if the task she is asking the staff member to perform fits in the job description. She can also accompany the support staff when they are helping patients to ensure that she is comfortable with their skills. She can also look up her nurse practice act of her state and review the legal and ethical implications of delegation to ensure she is upholding the standards.

Ms. W must ensure that the care she is delegating to another team member is under the right circumstances. It is imperative that Ms. W consider the current circumstances that the patient is in. Ms. W must assess the patient’s current health situation and then decide if it is safe, appropriate, a good use of clinic resources and in the patient’s best interest to delegate a task to a supportive staff (Weydt, 2010). To delegate to the right person Mrs. W must consider the qualifications of the supportive staff that she is delegating to. Points that Ms.

W must consider include the job description, experience, years of practice and competency of supportive staff (Weydt, 2010). If the supportive staff is inexperienced or has not proven that he or she can safely perform the assigned task then Ms. W should not delegate as it would not be safe. When Ms. W does deem that the task that she would like the supportive staff to do is safe she must also provide adequate supervision. Ms. W must be available and accessible to support staff that she delegates to in case there are any issues that may come up (Weydt, 2010). Ms. W must continue

Professional Roles to assess the patient’s response to care provided by supportive staff and be prepared to intervene appropriately if needed. Ms. W must consider and implement the principles mentioned above if she is to delegate patient care to supportive staff in a safe, effective and appropriate manner. Referrals. Ms. W needs to also take into account the above principles when making referrals to other health care providers. When making referrals, Ms. W must ensure that she is referring to a provider that has the skills and appropriate experience to care for Ms.

R’s needs (Maji, 2009). Ms. W will need to consider what care that the patient needs from the referral to another health care provider and then monitor Ms. W’s response to the treatment. It is Ms. W’s responsibility to ensure that she is following Ms. R closely and to ensure that she is benefiting 7 medically from being referred outside of clinic (Maji, 2009). It is Ms. W’s ultimate responsibility to provide safe and competent care to the patient and delegating or making referrals is never something to be taken lightly; it must be done in a safe and effective manner. Resources.

As a nursing supervisor it is imperative to support providers and staff with learning resources that are available to find out more information that will aid them in their jobs. Ms. W would benefit from going to her state board of nursing to find out more information regarding delegation. Another readily-available resource is the American Nursing Association’s website, which contains articles regarding delegation and how to implement it into her practice. Every state also has a Nurse Practice Act and Ms. W should be very familiar with and quite capable of following the standards put forth by this act.

Delegation opportunities. In the assigned case study there were many support staff that Ms. W could utilize to provide optimal patient care. Ms. R has many barriers to care that make it more difficult for her to be compliant with her plan of care. Ms. R is a Latina and would benefit greatly from having someone communicate with her who is familiar with her culture. It would Professional Roles 8 benefit Ms. R to work with the Latina social worker on staff at the clinic to help this patient with transportation issues and also to help find additional resources in the community that could help this patient once the baby is born.

As the patient is not responding when Ms. W is speaking with her, it must be considered that this patient does not understand English very well and possibly cannot read English. As the patient is developmentally delayed it may be more difficult for this patient to have a full understanding of her plan of care and be able to follow her provider’s recommendations. Again, Ms. W would be wise in utilizing the Latina social worker who can speak Spanish and also write detailed instructions in Spanish.

In order to help this patient prepare for labor, delivery and postpartum care, Ms. W can have the LVN on staff with training in labor and delivery, prenatal care, parenting and infant care to aid this patient in preparing for the birth and infant care of her baby. In providing continued care and support for this patient, the nurse who specializes in community health nursing would be ideal to work with this patient in ensuring that she is taking advantage of any community resources that are available to help this patient and her newborn infant.

It would be important to ensure this patient has an understanding of how to properly care for herself and her baby since she is developmentally delayed. Utilizing all support staff and the different services that they offer can ensure that this patient is receiving culturally appropriate, comprehensive, and excellent interdisciplinary care. Professional Roles References Anthony, M. , & Vidal, K. (2010). Mindful communication: a novel approach to improving delegation and improve patient care. The Online Journal of Issues in Nursing, 20(2), Retrieved from 9 http://www. ursingworld. org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJI N/TableofContents/Vol152010/No2May2010/Mindful-Communication-andDelegation. html Maji, A. (2009, June 30). Referrals, consultations & collaboration in nursing care. Retrieved from http://voices. yahoo. com/referrals-consultations-collaboration-nursing-care3665053. html? cat=4 Mitchell, P. , Hall, L. , & Gaines, M. (2012). A social compact for advancing team based highvalue healthcare. Health Affairs Blog, Retrieved from http://healthaffairs. org/blog/2012/05/04/a-social-compact-for-advancing-team-