Censorship and Material Selection Policies Essay - 863 Words

A book is a door into a new world. When someone writes, they choose their words carefully so that the story flows, makes sense, and goes along with what they are writing about. Everything from the scenery, to the way a certain character talks is thought about and brought to life by a few simple scratches on a page. Some people want to suppress the writings of geniuses just because of an image, idea, or phrase on the grounds that they are morally objectionable by the standards applied by a censor. It has been like this for ages. As long as someone has something to tell, another will be there to try and prevent them. Schools have been doing this for quite a while now and there is a need to stop it. Censorship of books in schools should not†¦show more content†¦Promoting student power in the choice of high school literature can prove uncomfortable, wild, and touchy. Without the right amount of preparation, research, and reading, teachers may find language, content, and themes t o be more mature than they really wanted. Young adults’ choices in literature can make teachers cringe at the very thought. However, instead of censoring texts, the focus should shift to students ability to read beyond what society has marked as â€Å"inappropriate.†(Denzin) For multitudes of children, teens, and even some adults, Harry Potter is a hero. He fights wickedness and stands up for his friends and the entire wizarding world. However, not everyone agrees. Instead, he is perceived as a threat by quite a few groups. DeMitchell and Carney discusses how some adults on a school board reacted to this perceived threat. Over half of a school board voted to restrict access to Harry Potter books in the public school library. The resulting legal battle over the boards actions helps to define not just Harry Potters place in the public school library but the rights of students alike. (eric.ed.gov) There are States who still censor practically everything that goes through their school libraries. Long Island has remained quiet with respect to the censoring of books in public schools. The rest of the country, as the National Library Association has made all too clear. Throughout the United States, every day books fall victim to theShow MoreRelated Censorship and Selection Essay1595 Words   |  7 PagesIntroduction Censorship is a dirty word to information professionals. Attempts by individuals or groups to restrict the public from reading, hearing or viewing certain materials due to their content, is enough to send librarians and organizations such as the American Library Association, to the proverbial battle field. 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Analysis Of Producing A Six Supplied Line 180 Second Drama...

Individual Analysis For the assignment of producing a six supplied line 180-second drama short film I was tasked as the 1st Assistant director in our production ‘Hidden’. In my role analysis I shall be examining my role as 1st AD going into depth of preparation, research and contributions I made towards the short film. The main roles of the 1st AD is to creating a shooting schedule, working with the director to decide a shooting order, give directions to crew and actors and be aware of health and safety whilst on set. As the 1st AD I was the right hand person to the director, I had found out through basic research that my role required me to help decide a shooting order and how long each scene will take to film, creating a shooting†¦show more content†¦[1] The shooting schedule itself included all the necessary information needed to be organised and to hopefully keep on track, these were timings, scene number, night or day, location (Forest or House), short scene description, any props needed. The printed schedule allowed space underneath for any notes to be added if timings or schedules changed, this way I could alert the director of any required information. On day one we did fall behind by two hours but I had told the group before hand that I had schedule it so we could overrun by 2.5 hours if need be, even though we didn’t keep to schedule I still let the director and the crew know how behind on time we were, what scenes were coming up and progress reports of the day. With regards to lunch I checked with everyone on set for it to be pushed back a little to fit in the morning scenes, even though it’s annoying they were still happy that I had checked with them beforehand adding to the approachable aspects of my role. However when I found out we would be reshooting I should have created a second shooting schedule so we could keep organised on day two, doing this would allow the director to be certain on what shots needed to be re-filmed and if any audio needed to be captured. I did have notepad with some notes on shots but a shooting schedule would have been more ordered and precise so we could have been there for as little time as possible. Next time

Nursing Care Plan Essay Example For Students

Nursing Care Plan Essay Course: NUR 1210LInstructor: Dates of Care: 12, 13, 19 20 Sept 96Date Submitted: 11/15/96Student Names: Anthony Bernardi, SN/SPJCHOLISTIC NURSING CARE PLANSTUDENT Anthony BernardiGRADEDATE November 15, 1996Client’s Clinical Picture (5)(Initial Cephacaudal assessment)Textbook Description of Diagnosis (5)Summary of Client’s Progress (5)Completion of Holistic NCP Tool (30)NURSING DIAGNOSIS (15)GOALS (10)INTERVENTIONS (10)RATIONALES (5)EVALUATIONS (10)REFERENCES (5)TABLE OF CONTENTSSUBJECT PAGE #? Cover Page 1? Grading Point Scale 2? Table of Contents 3? Summary Page 4? Client’s Clinical Picture (Cephacaudal Assessment) 5? Medical Diagnosis 6? Textbook Description of Disease 6-12? Treatments and Procedures 13? Summary of Caregiver Progress Notes 14? Diagnostic Values Out Of Normal Range Clinical Implications 16? Radiology 17? Medications 18-52? Holistic Nursing Care Plan Form 53-62? List of Nursing Diagnosis 65? Five Nursing Diagnoses 66-70? References 71CLIENT CLIN ICAL PICTURE:Please see attached Cephacaudal Assessment (Pages 5)MEDICAL DIAGNOSIS: Current diagnosis:Necrotizing pneumonia, cachexia secondary to malnutrition / infection, hypothroidism, NIDDM, empyema RUI, Aspergilloma, RUI, and depression. HX: HTN, atrial fibrillation, COPD, asthma TEXTBOOK DESCRIPTION OF DIAGNOSIS:See attached Disease Process Description (pages 6-12-)SUMMARY OF CAREGIVER PROGRESS NOTES: See attached Caregiver Progress Notes (page 14-15)CLIENT CLINICAL PICTURE Mr. GB is a 78 year old white male admitted to Bay Pines VAMC on 6/18/96. for â€Å" atypical chest pain and hemoptysis†. V/S BP 114/51, P 84, R 24, T 97.4. He seems alert and oriented x 3 and cheerful. Bowel sounds present x 4. Pt. has a red area on his coccyx. Silvadene treatments have been started. Pt. Has a fungal lung infection with a pleural suction drainage tube inserted in his chest . Pt is extremely thin with poor skin turgor with a diagnosis of cachexia ( wasting) secondary to malnutrition and infection. Patient is no known allergies to drugs but is allergic to aerosol sprays disinfectants and dust.. Advanced directives on chart. Code status DNR. Primary physician Dr. R, Thoracic surgeon Dr. L. Psychology Dr.W. There is PT, OT Dietary and Infectious Disease consults when necessary. He lives with his wife who he has been married to for 56 years. His son and his daughter come to visit him. He does not smoke. He wears dentures but did not bring them. He dose not use a hearing aid but he does have a hearing deficit. Pt. is able to do all his ADL’s with limited assistance. He wants to get better and leave the HSP. Pt. Stated’ 90 days is to long to be here†. Pt. States that he is concerned about caring for his tube site when he goes home and does not feel that his wife can do this for him. Diet: Pureed Hi protein, low fat, anti-dumping with Calorie count (all meals) and drink supplements between meals. TPN @ 79cc/hr 12hr around the clock through PICC lineMEDICAL DIAGNOSIS: Empyema, Hemoptysis, Necrotizing pneumonia, Aspergillosis (Aspergillus fumigatus) cachexia secondary to malnutrition/infection, hypothyroidism, Diabetes Type II melitius , and depression. PATHOPHYSIOLOGY HEMOPTYSIS: Expectoration of blood arising from the oral cavity, larynx, trachea, bronchi or lungs (Tabor’s, 17th ed. 1989 p.879)CACHEXIA SECONDARY TO MALNUTRITION/INFECTION : The state of ill health, malnutrition, and wasting It may occur in any chronic diseases, certain malignancies and advanced pulmonary tuberculosis. (Tabor’s, 17th ed. 1989 p.287)NECROTIZING PNEUMONIA: Aspiration pneumonia. Aspiration pneumonia is frequently called necrotizing pneumonia because of the pathologic changes in the lungs. It usually follows aspiration of material in the mouth into the trachea and subsequently the lungs. The aspirated material. Either food, water, or vomitus, is the triggering mechanism for the pathology of this type of pneumonia. If the aspirated material is an inert substance (e.g. barium or nonacid stomach contents), the initial manifestation is usually caused by obstruction of airways. When the aspirated materials contain gastric acid, there is chemica l injury to the lung parenchyma with infection as a secondary event usually 48 to 72 hours later. The infecting organism is usually one of the normal oropharyngeal flora. The clinical manifestations proceed as those of a classic pneunococcal or streptococcal pneumonia. Fungi may also be a cause of pneumonia. These infections are not transmitted from person to person, and the patient does not have to be placed in isolation. The clinical manifestations are similar to those of bacterial pneumonia. Skin and serology tests are available to assist in identifying the infecting organism. However, identification of the organism In a sputum specimen or in other body fluids is the best diagnostic indicator. (Lewis, S.M. Collier, p. 643-644)ASPERGILLOSIS INFECTIONS : There are several forms of Aspergillosis infections. All are caused by one or more of the many different Aspergillus fungus species; only a few of these organisms are capable of producing disease in humans. These species are sprea d through the air and can be found almost any place in the world. Because these spores are inhaled, they usually affect the lungs or other airway passages such as the bronchial tubes, nose and sinuses. The fungi can be invasive, affecting any tissue, mucous membrane or vital organ of the body. Allergic Bronchopulmonary Aspergillosis (ABPA) is an immune disorder that occurs in people with asthma or chronic obstructive pulmonary disease (COPD) infected with Aspergillosis fungi. It causes an excess of certain white blood cells (eosinophils), an infiltration of the lungs, and impaction of the bronchial tubes with eosinophils and Aspergillus organisms. Symptoms of this disease may consist of fever, shortness of breath (dyspnea), chest pain, wheezing, a cough with sputum (with or without blood) or a generalized feeling of ill-health (malaise). This form of Aspergillosis is not usually invasive, but it can lead to a chronic dilation of the bronchial tubes (bronchiectasis). Pulmonary Mycetoma, also known as Aspergilloma or fungus ball, is a form of Aspergillosis that often occurs as a result of the Aspergillus fungus growing together (colonization) in a cavity of the lungs. These cavities are usually caused by other pulmonary diseases such as tuberculosis, sarcoidosis, histoplasmosis or coccioidomycosis. The fungus ball can be seen on x-rays. This form of Aspergillosis is characterized by a chronic cough, weight loss, a generalized feeling of ill-health (malaise) and the spitting up of blood (hemoptysis). Fulminative or Invasive Aspergillosis is another form of this disorder that can cause distribution of the Aspergillus fungus to other parts of the body. This disease can progress from a localized infection to a widespread erosion and ulceration of the bronchial system and an inflammation of the vascular system (vasculitis). Vasculitis is a narrowing of the inside of a blood vessel that can obstruct the flow of blood to the tissues. This lack of blood can cause damage to the tissues (necrosis), and a possible formation of blood clots (thrombosis). Invasive Aspergillosis is usually first confined to the lungs but it can spread through the blood to other organs especially the liver, brain, kidneys, skin, gastrointestinal tract and other sites. This can be a very serious disease which can have a slow or rapid course. It is seen in those whose immune system has been weakened by other illnesses, especially people with cancer (e.g., Leukemia, Hodgkins Disease), kidney transplant patients or those undergoing certain drug therapies. Occasionally, Aspergillosis can cause Infective Endocarditis which is an infection of the inner lining of the heart muscle (endocardium). A type of infective endocarditis, prosthetic valvular endocarditis (PVE), may develop in patients who have previously had artificial (prosthetic) heart valve replacement. This infection may occur as a result of contamination of the operating room area by the Aspergillus spores. Drug addicts are also more susceptible to this form of Aspergillosis. Mycetoma, also known as Madura Foot, is a chronic infection produced by Aspergillosis as well as several other fungi. It is a progressive fungal disease that is characterized by lesions of the foot, face, trunk, hand or leg. These lesions can cause swelling, hardening, pus formation, sinus drainage and abscesses that can lead to bone destruction and deformities. It is more commonly seen in tropical climates. Aspergillosis is a group of infectious diseases that are caused by the inhalation of the Aspergillus fungus. The spores that cause these infections can be found in decaying vegetable matter, grains, grass, leaves, soil, wet paint, air conditioning systems, on refrigerator walls and in construction and fireproofing materials. It is not known why most people resist infection from this common fungus, and why others are more susceptible to infection. A weakened immune system, or an abnormal immune response to the fungus, may cause the fungus to proliferate and become a threat to ones health. Aspergillosis is a rare disorder that affects males and females in equal numbers. It is seen more often in those people who have chronic respiratory problems or whose immune system has been weakened by other serious illnesses or drug therapy. DEPRESSION: Depression is the most common functional disorder. Signs of depression include sadness, low energy, diminished memory and concentration, sleeping disturbances, appetite disturbance, with withdrawal, irritability, alcohol abuse, expressed feelings of helplessness and hopelessness, apathy, impaired attention span, and expression of suicidal wishes. Depression is often treatable and reversible through use of antidepressant medications and counseling. (Brunner/ Suddarth, 1988)HYPERTENSION: Hypertension can be defined arbitrarily as persistent levels of blood pressure in which the systolic pressure is above 140 mm Hg and the diastolic pressure is above 90 mm Hg. In the elderly population, hypertension is defined as systolic pressure above 160 mm Hg and diastolic pressure above 90 mm Hg. Hypertension is a major cause of heart failure, stroke, and kidney failure. It is called the â€Å"silent killer† because the person who has it is often symptom free. Gerontological Cons iderations: Changes in the peripheral vascular system are responsible for the changes in blood pressure that occur with age. As the age related process of atherosclerosis evolves, the ability of the vessels to distend and recoil is reduced. Consequently, the aorta and large arteries are less able to accommodate the ejected stroke volume, and a decrease in cardiac output and increase in peripheral resistance result. Systolic blood pressure increases as a result of the increased peripheral resistance, and pulse pressure widens subsequent to the diastolic fall that accompanies reduced distensibility of the aorta. The risk factors for high blood pressure that are present in the population in general continue into old age. These are approximately the same for elderly men and women. (Brunner/ Suddarth, 1988)CHRONIC OBSTRUCTIVE PULMONARY DISEASE : Chronic obstructive pulmonary disease (COPD) is the most common cause of death and disability due to lung disease in the United States. COPD is a broad classification that includes a group of conditions associated with chronic obstruction of air flow entering or leaving the lungs. Airway obstruction is diffuse airway narrowing, causing increased resistance to air bronchiectasis, emphysema, and asthma. Basically, the person with COPD has (1) excessive secretion of mucus within the airways not due to specific causes (bronchitis or bronchiectasis), (2) an increase in the size of the air spaces distal to the terminal bronchioles with loss of alveolar walls and elastic recoil of the lungs (emphysema), and (3) narrowing of the bronchial airways that varies in severity (asthma). As a result there is a subsequent derangement of airway dynamics for example, loss of elasticity and obstruction of air flow. There is often an overlap of these conditions. (Brunner/ Suddarth, 1988 )ASTHMA : Asthma is an intermittent, reversible, obstructive airway disease characterized by increased responsiveness of the trachea and bronchi to various stim uli. This results in narrowing of the airways, causing dyspnea This narrowing of the airway changes in degree, either spontaneously or because of therapy. Asthma differs from other obstructive lung diseases in that it is a reversible process, and patients may exhibit no symptoms for a prolonged period of time. Asthma is a reversible diffuse airway obstruction. The obstruction is caused by one or more of three developments: (1) contraction of muscles surrounding the bronchi, which narrows the airway (2) swelling of membranes that line the bronchi and (3) filling of the bronchi with thick mucus. In addition, there is bronchial muscle enlargement, mucous gland enlargement, thick, tenacious sputum, and hyperinflation or air trapping in the alveoli but most of what is known involves the immunologic system and the autonomic nervous system. (Brunner/ Suddarth, 1988 ATRIAL FIBRILLATION: Atrial fibrillation (disorganized and uncoordinated twitching of atrial musculature) is usually associate d with atherosclerotic heart disease, rheumatic heart disease, CHF, thyrotoxicosis, or pulmonale, or congenital heart disease. Atrial fibrillation is characterized by the following- lowing: Rate: An atrial rate of 350 to 600 beats per minute ventricular response usually 120 to 200 beats per minute. P waves: No discernible P waves: irregular undulation, termed fibrillary or â€Å"f† waves, is seen; PR interval cannot be measured. QRS complex: Usually normal. Conduction: Usually normal through the ventricles. Characterized by an irregular ventricular response, because the AV node is incapable of responding to the rapid atrial rate. Impulses that are transmitted cause the ventricles to respond irregularly. Rhythm: Irregular and usually rapid, unless controlled. Irregularity of rhythm is due to concealed conduction within the AV node. A rapid ventricular response reduces the time for ventricular filling and hence the stroke volume. The atrial kick, which is 25 to 30% of the cardi ac output, is also lost. Congestive heart failure frequently follows. There is usually a pulse deficit, the numerical difference between apical and radial pulse rates. Treatment is directed toward eliminating the cause, decreasing the atrial irritability, and decreasing the rate of the ventricular response. In patients with chronic atrial fibrillation, anticoagulant therapy may be used to prevent thromboemboli from forming in the atria. Drugs of choice to treat atrial fibrillation are similar to those used in the treatment of paroxysmal atrial tachycardia, digitalis preparation is used to slow the heart rate, and an antidysrhythmic such as quinidine is used to correct the dysrhythmia. (Brunner, Suddarth 1988). TYPE II DIABETES MELLITUS: In diabetes, insulin is not secreted in proportion to blood glucose levels because of several possible factors: deficiency in the production of insulin by the beta cells, insensitivity of the insulin secretory mechanism of the beta cells, delayed or insufficient release of insulin, or excessive inactivation by chemical inhibitors or â€Å"binders† in the circulation. In some non-insulin dependent persons with diabetes, however, insulin secretion is increased, resulting in higher , circulating insulin levels. Although excess insulin is present, it is not utilized because of an inadequate number of insulin receptors present on cells. This mechanism has been observed in obese patients. With weight loss, the number of insulin receptors on the cells increases, thereby allowing glucose to enter the cell. This may result in return of a normal glucose tolerance. (Burner/ Suddarth, 1988 )HYPOTHYROIDISM : Hypothyroidism is a condition in which there is a slow progression of thyroid hypofunction, followed by symptoms indicating thyroid failure. More than 95% of patients with hypothyroidism have primary dysfunction of the thyroid gland itself. When the thyroid dysfunction is due to failure of the pituitary gland, it is known as sec ondary hypothyroidism; when failure of the hypothalamus is the underlying cause, the term tertiary hypothyroidism is used. When thyroid deficiency is present at birth, the condition is known as cretinism. In such instances, the mother may also suffer from thyroid deficiency. (Brunner/ Suddarth, 1988) TREATMENTS AND PROCEDURESPatients activity orders are as tolerated with wheel chair transport. Pt needs partial assist with ADLs. He is continent of B B with assistanceNeeds to be turned in bed Q 2 hr, elevate heels in bed . Pt has a special mattress. Encourage I.S. Q 1 hr w/a. IV flush q shift peripheral line. PICC line flush. Chest tube to water seal to 20cm, with cont. suction 55-60 wall green. DO NOT DISCONTINUE SUCTION. Chest tube dressing change no deviations from present form. Accurate IO’s . VS. Q shift and prn. with lung sounds assessment. Skin assessment q 2 hr with wound assessment at the same time(abrasion on the back ) and finger ulceration. FSGs q 6 hr with Sliding scale coverage. Weight every week on Monday. SUMMARY OF CARE GIVER NOTES:All times are approximate07:30 Received report on G.B. from night shift. 08:00 Spoke with G.B. before breakfast was delivered. Vital signs taken and noted. Insured patency of chest drainage tubes and amount of fluid from last shift. Noted time and initialed on collecting container. 09:00 09:00 medications given and noted09:30 Assisted G.B. with ADL’s. Pt stated that he wasn’t very hungry. Pt. Ate only 25% of solid food. Noted intake of 250ml. Urine output after breakfast 225ml. Pt. Performed own bed bath and oral care. Lotion applied to Pt. Pt. Helped into bedside commode. Curtains drawn for privacy. 10:30 Dressing change on tube insertion site as ordered. Skin assessment done and lung sounds checked. Check position of G.B. He had re-positioned himself for comfort10:45 X-Ray of G.B. performed in room. G.B. dressed and assisted into wheel chair. 11:00 Reported pt status to Team Leader. 11:00 Documented morning activities in appropriate charts, i.e. Nsg Notes, treatment book and V/S charts. 11:15 Returned to room to interview G.B. . Pt was cheerful but stated that he was feeling tired and wanted to be helped back into bed. 11:45 Noted I O 12:00 G. B. In bed resting comfortably. Reported pt status to team leader and report off floor to post-conference. DIAGNOSTIC VALUES OUT OF NORMAL RANGE CLINICAL IMPLICATIONSBUN 32H 10-26 A. Increased BUN levels (azotemia) 1. The most common cause of increased BUN level is inadequate excretion due to kidney disease or urinary obstruction, frequently- : occurring in cases of prostate enlargement. (A) An increased BUN of 50 to 150 mg / 100 ml indicates serious impairment of renal function. (Fishbach p. 312)Creatinine .5H 0.7-1.4 A disorder of kidney function reduces excretion of creatinine, resulting in increased levels of blood creatinine. The test is used to diagnose impaired renal function. It is a more specific and sensitive indicator of kidney disease than BUN, although in chronic renal disease, BUN correlates more accurately with symptoms of uremia than does the blood creatinine.( (Fishbach p. 312)WBC 10.4H 5-10 A. Leukocytosis (white blood cell count above l0000 / gl) 1. Leukocytosis is usually due to an increase of only one type of White cell and is given the name of the type of cell that shows white cell and is given the name of the type of cell that shows the main increase. .In increase in circulating leukocytes is rarely due to a proportional increase in leukocytes of all types. When it occurs it is usually to hemoconcentration. Leukocytosis occurs in acute infections in which the degree of increase of white cells depends on, 1. The severity of the infection, 2. The patient’s resistance, 3. The patient’s age.(Fishbach p. 25.)RBC 2.96L 4.2-5.6 Decreased RBC Values . Anemia, a condition in which there is a reduction in the number of circulating RBCs, in the amount of hemoglobin, and/or in the volume of packed cell(hematocrit).(Fishbach p. 41)HGB 10.L 13.1-17.2 AnemiaHCT 29.3L 39-50 decreased hematocrit values are an indicator of anemia. In hematocrit of 30 or less means the patient is moderately to severely anemic. ALBUMIN 3.1l 3.9-5 decreased albumin levels severe hypoalbuminemia is often associated with edema and decreased transport function such as hypocalcemia. Decreased albumin levels are caused by many different conditions i.e. Nephrosis (Fishbach p. 363)LY# 1.2L 1.8-2.6 AnemiaMCH 34H 26-34 An increase of the MCH is associated with macrocytic anemia. MCV 99.2H 87 -103 Note VA values differ from Fishbach. F the MCV is greater than 103 mm3, the red cell 5 are macrocy tic. PLT 433H 150-350 Abnormally increased numbers of platelets (thrombocythemial thrombocytosis) occur in iron-deficiency and posthemorrhagic anemia acute infections and many other diseases. In 50% of those patients who exhibit an unexpected increase in plate- lets, a malignancy will be found. This malignancy is usually disseminated, advanced, or inoperable. MPV 6.3L 8 -10L This test is done in the investigation of various hematologic disorders such as thrombocytopenic purpura, and study of alcoholics under treatment. Na+ 135 135-148 Hyponatremia usually reflects a relative excess of body water rather than a low total body sodium. K 4.6 2.7-4.5 Hyperphosphatemia (increased phosphorus levels) The most common causes of elevated blood phosphate levels are in association with kidney dysfunction and uremia. This is because phosphate is so closely regulated by the kidneys. Renal insufficiency and severe nephritis (accompanied by elevated- : BUN and creatine) Albumin 3.1 3.8-5.0 albumin is a protein that is formed in the liver and that helps to maintain normal distribution of water in the body (colloidal osmotic pressure). It also helps in the transport of blood constituents such as ions, pigments, bilirubin, hormones, fatty acids, enzymes, and certain drugs. Decreased albumin levelsDecreased albumin levels are caused by many different conditions- inadequate iron intake, Severe liver diseases Malabsorption, Starvation, excessive administration of IV glucose in water RADIOLOGYF/Y empyema status no change since 9/3/96. F/U bilateral sever pulmonary emphysema interstitial fibrosis. CBC shows high levels of WBC’s and bends indicative of ongoing infection. Chemistry shows elevated liver enzymes. UA and CS are negative. Blood cultures are also negative. Sputum CS and Gram Stain show WBC* 25, Eph.*10 and presence of Alpha streptococcus neisseria. NATO EssaySelf-Expression Reflection, reminiscence, self-actualizing pursuits within physical capabilities. BW p 898 Neat, clean, well groomed; articulate; Affective response consistent with norms. Articulate; expresses self well. Concerned about his future at home. â€Å"Who will help me take care of my tubes at home?† Client expresses accep-tance of stage in life but not physical limitations. Skin Tissue Integrity Skin more fragile less elastic, less SC fat, blood vessels more fragile; Increases risk of skin tears. Vascular insufficiency increases risk of decubitus ulcer BW p 974 Warm, pale, good turgor. Reddened area on coccyx Understands import. of being turned in bed, moving extremities, ingesting adequate fluids food. Good personal hygiene. Client demonstrates a little anxiety about the possibility of developing a decubitis ulcer. Client verbalizes anxiety about possibility of skin tissue breakdownNutrition Body maintenance and repair, type and quality of food, calories must be rich in nutrients. Lowered calorie requirements due to lower BMR BW p 1082 Cachexia secondary to malnutrition, poor intake. TPN q 12 hrs, supplements Client understands his need to increase the food intake for adequate nutrition healing. Client does not like hospital food but tries to eat as much as possible. He also dislikes his supplements. Client wants to gain weight stating, †I try to eat more than I want.†Fluid Balance Decreased renal concentra-tion fx. Increased loss amounts of water salt, muting of thirst response, decreased intake. BW p1558 Good skin turgor, no edema IO’s q shift Client understands the need for adequate fluid intake. No emotional relationship seen with regard to fluid balance. Understands importance of adequate fluid intake in health maintenance. Elimination Loss of muscle tone in bladder bowel changes elimination patterns, that vary with diet, lifestyle, medications. BW p 1136 Continent of bowel bladder. Uses toilet with assistance. Bowel sounds present X4. Urine clear yellow Client recognizes the need for regular bowel schedule. Non-verbalized discomfort with having to go to the bathroom while in bed. Client verbalizes no concerns. Oxygenation Some loss of lung elasticity; pO2 decreased, especially if smoked. BW p 1227 Resp. rate 18-24/min. lung sounds slightly diminished Understands the need for O2 and reason for SOB. Does not like the idea of needing O2 inhalers to control SOB. Client admits to periods of SOB, and pain with coughing. Sleep-RestPatterns/Pain Incr. Time to get to sleep, incr.# times awaken, decrease total sleep time. Daytime naps may compensate. BW p 1321 Client naps several times during day, sleep-rest poor at night. Being turned q2hrs and pain from chest tube wakes up. Verbalized that being turned q 2 hrs interrupted his sleep causes

Out-Patient Department Record Management System free essay sample

But as the years rolled by, the number of patients has grown and various medical cases arise that the manual method of managing patients’ records, prescriptions and appointment schedule, is no longer practical. In this study, we hope to develop an application that will minimize all paper works and manual records keeping, therefore allowing doctors and staff ease in keeping track of patients, reducing patients’ waiting time and increasing the number of patients served – a system that is fully automated, user-friendly, time effective and efficient. Now more than ever, people have become more health conscious and are taking necessary steps to ensure that they have a sound body and mind – that is why everyday many people come to hospitals or health facility for check-ups and treatments. A Hospital is an institution for the medical treatment and care of the sick. Basically, patients spend a substantial amount of time in hospital waiting for services to be delivered by the doctor or health professional. We will write a custom essay sample on Out-Patient Department Record Management System or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page The degree to which the patients are satisfied with the care received is relative not only to the doctors’ expertise in their field, but also to the quality of the hospital management. And we all know that as the number of patients continually increase, managing a hospital can also become increasingly difficult, especially if everything is done manually. Statement of the Problem This study intends to design and develop a Record Management System for the Out-Patient Department of Tarlac Provincial Hospital, for the benefit of both the hospital staff and the patients. The researchers of this study seek to answer the following question: 1. What is the present status of the Tarlac Provincial Hospital? 1. Accommodations of patients 1. 2 Reliability of the existing system 1. 3 Enlisting records of patient 2. What are the possible major problems or risks that can be encountered using the existing manual system when it comes to: 2. 1 Time consumption (speed) 2. 2 Efficiency of work 2. 3 Security of Data 3. Will the proposed system help solve the problems in terms of: 3. 1 Accommodations of patients 3. 2 Reliability of the existing system 3. 3 Enlisting records of patient 3 . 4 Convenience in using the proposed system Scope and Delimitation The proposed system will focus in the developing and designing the existing system of the Out-Patient Department of Tarlac Provincial Hospital. Furthermore, the hospital staff and the patients will get the benefits if ever the proposed system will be implemented. Significance of the Study If the proposed system will be implemented the workload of the medical staff will be lighten. The product of the study will help the hospital staff encounters less paper works, organized compilation of patient’s records or files once the proposed system is implemented. With this, they will have more time to accommodate the other patients who needed their services. The records of each patient are safe from an unknown user. And most of all, the finding or searching of the patients record will be easy and take a little time not like with the existing system, the searching of their records will take a lot of effort and their time. To the patients of OPD, faster result will be given to them in releasing or giving their records of diagnosis and prescription. Instead of wasting their time waiting they can do their other tasks. With just a few minutes the patients who needs medical certificate can have it in their hands without going back and forth from a building to another. The two people that will get the benefit of the proposed system are the medical staff and the patients who come in the hospital. Definition of Terms Automate To convert a process or workplace to automation, or utilize the techniques of automation. Efficiency The ability to be productive with a minimum of wasted effort. It is defined by the function of the system to produce organized results, lessen manual effort and its accessibility. Manual System A system involving data processing which does not use of stored- program computing. Refers to the process of recording data of the student without the use of a computer or any machine. Out Patient Department (OPD) – Stands for Out-Patient Department, this depart Record Management Systematic administration of records and documented information for its entire life cycle from creation, classification, use, filling, retention and to final disposition. Managing patients record by recording, updating, storing, organizing, and retrieving. Security The ability to protect and provide confidentiality to the data stored within the data system. It is expressed by the features requiring authentication, control of access keys, backup and recovery, user limits and protection from outside elements and environment. System – A set or arrangement of elements that are organized to accomplish some predefined goal by processing information. Tarlac Provincial Hospital (TPH) Institution that provides a broad range of medical services to sick, injured, or pregnant patients. Mostly the patients of this hospital are at the average class because of a lower cost of hospital bill than to private hospital. CHAPTER II REVIEW OF RELATED LITERATURE This chapter consists of Local Literature, Foreign Literature, Local Studies, Foreign Studies and Synthesis or Relevance of the Reviewed Related Literature to the Present Study. And also discusses the theoretical framework of the proposed study. Local Literature Dr. Manuel Dayrit stated that: â€Å"The provision of health care is a seamless effort which encompasses preventive and curative interventions. We must synergize efforts the spectrum of interventions, affordable and quality health care must be integrated geographically. † Providing the concept of giving the wellness of Filipinos we must eventually give important to the process on how will be manage our services to our patients with regards to the efficiency and effectiveness of hospital. And with the use of a technology the patients will be having the satisfactory they needed. Foreign Literature Mark Dominic dela Torre stated that: The concepts of a simple dream, a determination, quality nd perseverance are the forefront to any business that leads to successful outcome. Having the concept of determination and assuring quality service to patients, the proponents proposed a Record Base Management System to cater to hospital employees in making their job more efficient thus delivering quality service and determining a successful business. Kneener Lim and Antonette Goyenechea stated that: Records security is also one of t he primary objectives and all the information received from its clients are confidential. The proponents proposed a Record Base Management System for the hospital to make the system perfect where all the records should be kept, thus giving the assurance that these files are secured and accessible for the advancement of the hospital. Carl P. Zeithami Thomas S. Bateman of Management Function and Strategy cited that: In todays environment, planning has become a widespread management function, involving people throughout the organization in the analysis, identification, and selection of goals and priorities. Authors of the book state that planning is very important for every individual, work group, or organization because it helps the systematic process during which decisions are made about the goals and activities, just like companies using a manual system method to carefully plan on what would be the possible solution to make the system work faster so that there is less probability o f errors in the activities, and in considering the need for a computerized system in order to better answer the problem. Local Studies In 1954, Manila Doctors Hospital (MDH) guided by the philosophy that â€Å"all persons, principally the working class, are entitled to the best available medical services at the price they can afford† launched the Industrial Medical Services Department (IMSD) also known as Prepaid Health Services. The department provides services for pre-employment physical examinations of applicant, annual health examinations of employees and executive check-up services for client companies. IMSD also offers medical and nursing retainer services. IMSD services has since expanded and offers pre-employment and pre-deployment examinations and repatriation services for Overseas Contract Workers (OCW), HMO and Walk-in consultations, dental services, psychological examinations and blood donor screening services. Through its continuous and relentless effort to improve the services, the department recently was able to offer five (5) Out-Patient Executive Check-up packages, which includes oman care program, to various client companies and walk-in patients. Foreign Studies Hospital is a phenomenon of 20th century. Its evolution of supporting sick from normal to care of sick and now it is sophistication of providing preventive, promotive, curative and rehabilitative services is phenomenal. As the hospital has grown in stature, so has its important arm, out-patient department. The activities of out-patient departments have made the hospital a real force in the community programmed, for the prevention of diseases. Much of the investigations and diagnostic work that formerly necessitated admission to hospital wards can now be carried out in a well equipped out-patient department. The new concept extended ambulatory services is borne out of the fact that certain diseases are treated right in out-patient department, without getting patients admitted for long durations as inpatients, thus, reducing expenses for the patients, community and exchequer. Out-patient department services are corollary to inpatient services in the form of general out-patient department, day care, home-care and rehabilitative centers. It is important for planners to know about the catchment area of the hospital so that cost-effective and cost containment techniques will be employed before hospital gets commissioned. This is particularly true, when tremendous strides have been made as far as patients care through out-patient department is concerned. Relevance of the Reviewed Related Literature to the Present Study The studies that were conducted are related to the proponents study because these studies are concerned with the records system of the hospital. Both studies are related in the area of the importance in keeping all the records and files of the patients of a hospital and putting into account solid historical data of the hospitals that could be used to further improve the company’s growth in the future. It will give the assurance that these files are secured and accessible for the advancement of the hospital. It also guarantees that people’s job will be easier, faster and more efficient for the benefit of the hospital. Theoretical Framework The theoretical framework of the study is used to illustrate how the proposed system operates. It also shows how the proposed system differs from the existing system. Figure 1. 0 Theoretical Framework of the Proposed System In the existing system, the inputs are patient information which includes Patient Number, Case Number, Personal Information, PhilHealth Information and Admitting Information. And these inputs are compiled and organized to a folder to sort patients according to their Patient Information. On the other hand, the proposed system gets clearer inputs, an effective process and accurate outputs. On the proposed, the inputs include patient information which the same to the existing system. Then proposed system will store patient information and medical report with prescription to the database. The outputs of this process are printed diagnostic and prescriptions of the patient. CHAPTER III METHODOLOGY This chapter discusses the different methodologies of research that will be used by the researcher as well as the methods in developing the software system. Under the methods of research used are the data gathering instrument and analytical tools, which will be used by the in doing this particular research. Research Design There are so many ways in doing a good study. There are things that the proponents must consider to form an extensive source for the application, and then there should be an extensive analyst to produce quality or excellent software. The proponent meant to acquire relative research for the application for the proposed software or system. The researchers would be able to formulate solutions by applying these kinds of methods. Descriptive Method. It is defined as the fact finding with data subjected to the thinking process in terms of ordered reasoning. This method was used for analyzing the present status or process in order to determine its problems and limitations. It was also a tool in studying the present Out Patient Department (OPD) of Tarlac Provincial Hospital to be able to know its limitation and strength. The results of the study would help the researchers to determine what features would be included in its design and development. This method was used by the researchers in choosing the best possible alternative to improve the current or the existing system. Library Research Method. Usually this method was done by all researchers to gathered data and information. A library contains reading materials for research. It can provide the needed information regarding what the researcher would need, a library would be a great help to the researchers to develop the proposed system. Instrument/s Used in the Study The Researchers gathered data that was useful in developing this study. With this information from books, unpublished materials, programming language software, interviews (oral and written), and observations, the proponent had chosen the following data gathering materials because they know that they need this for the proposed system. Interview. An interview is act of asking or questioning orally to gather some information. The pharmacists were asked to express their view on the work regarding the current system and on any changes that will occur in the work situation if the proposed system is going to be used. The researchers conducted an interview with a number of respondents, which provided them accurate information that could not be found in other resources. The proponents used this kind of data gathering instruments to know what the problems of the present system are and why it needs to be improved. This is where semi-structured and concern work content, workload, personal control, influence and participation in decision making. Questionnaire. This is also one of the forms in data gathering instrument wherein information gathered is related to the existing/proposed system. This would concern job content, physical and psychosocial work environment. The researchers prepared questionnaires that will be given to the different respondents like the pharmacist and patients. Observation. The proponents gathered data in detailed manner. It was used by carefully observing the process of the current system. The proponents observed and interviewed the doctor during their ordinary work with the current system. This was also determine the limitation of the present system; this is also used to observe the usual transactions happening inside the pharmacy so that the proponents will gain knowledge in visualizing the different functions of the proposed system and how it will run. The goal of this method is to know the work environment problem. Procedures of Data Gathering The method used by the proponents in gathering procedure deals with the direct confrontation with the appropriate person who is responsible in giving information based on the study. These are conducted to obtain the precise and reliable information. The proponents conducted an Interview, Library Research, E-Source Research and Survey Questionnaire. These methods are enumerated below: Interview. The data gathering procedure deals with the face to face encounter or confrontation with the appropriate person who is responsible in giving information. The researchers interviewed the some patients of the hospital and doctor’s staff because the researcher believe that they are the best persons knowledgeable about the study. Library Research. Library is the most essential source of reliable data information and the most commonly used method in data gathering. The proponents used books, magazines and previous research from AMA Computer Colleges Tarlac Branch in their researchers, which are relevant for the study. E-Sourcing Research. This method involves gathering of information through the internet. It’s a tool used in order to gather data/information or search for an idea by accessing and studying the sites or pages of various groups, individual and entities around the world, or wherever digital information is available. Statistical Analysis of Data In most instances, the numerical information in its original form would be difficult to interpret. For this reason, the information is usually organized, summarized, and presented in a form that can be more really interpreted. Statistics is important not only for communicating: it is also provides a basis for decision-making. A Frequency Distribution is a tabular arrangement of data showing as classification, otherwise, grouping according to level or size. In this study, the data to be used would come from the extensive range of the Out-Patient Department of Tarlac Provincial Hospital. Ranking is the order according to some statistical characteristic. After formulating and distributing, questionnaires to the respondents, researchers have sum up the results and arrange these either from the highest to lowest or vice versa. This is a way of organizing the gathered data to determine what possible decision to end up. Figure 2. 1 ERD of Existing System for Out-Patient Department of Tarlac Provincial Hospital Context Diagram of Existing System for Out-Patient Department of TPH If you’re a new patient you will be given an ID card, but if you’re an old patient, you can use your ID card for registration. After showing your OPD ID, you will be given a form to be filled-up then you will pay the necessary fee after that, the patient will bring his/her old records to the OPD where the doctors evaluate the patient’s vital sign or symptoms, then he/she will go to the room where you’ll be checkup. After check-up has been done the doctor who have diagnosed will return the paper to the patient. If the patient wants a medical certificate she/he will be sent in the Health Office. In the Health office the personnel will ask the patient where to use the medical certificate and ask a payment for it. After receiving the certificate the patient is asked to let the doctor that who has done the check-up signs it. Then the patient will return the record to the admission office, and the transaction ends. Figure 2. 0 Context Diagram of Existing System for Out-Patient Department of Tarlac Provincial Hospital Context Diagram of Proposed System for Out-Patient Department of TPH If you’re a new patient you will be given an ID card, but if you’re an old patient, you can use your ID card for registration. After showing your OPD ID, you will pay the necessary fee, the patient will go to the department where the doctors will evaluate the patient’s vital sign or symptoms, and then you will go to the room where you’ll be check-up. After the check-up has been done the doctor who have diagnosed you will save the diagnosis into the database. If the patient wants a medical certificate she/he will be sent in the admission office. In the admission office the personnel will ask the patient where the medical certificate will be used and the payment for the certificate. After receiving the certificate the patient is asked to let the doctor/s that who has done the check-up signs it, and the transaction ends. Figure 3. 0 Context Diagram of Proposed System for Out-Patient Department of Tarlac Provincial Hospital Top Level of Existing System for Out-Patient Department of TPH After the check-up, the doctors who have done the diagnosis will return the paper to the patient. If the patient wants a medical certificate she/he will be sent in the Health Office. In the Health Office the personnel will ask the patient where the patient will use the medical certificate and ask a payment for the certificate. After receiving the certificate the patient is asked to let the doctor/s that who has done the check-up signs it. Then the patient will return the record/s to the Admission Office, and the transaction ends. Top Level of Proposed System for Out-Patient Department of TPH After the check-up has been done the doctor who have diagnosed you will save the diagnosis into the database. If the patient wants a medical certificate she/he will be sent to the Admission Office. In the Admission Office the personnel will ask the patient where the medical certificate will be used and the payment for the certificate. After receiving the certificate the patient is asked to let the doctor/s that who has done the check-up signs it, and the transaction ends.

SWOT Analysis for Panera Essay Example

SWOT Analysis for Panera Essay Example SWOT Analysis for Panera Essay SWOT Analysis for Panera Essay Strengths There is an increasing consciousness in healthy feeding. premium ingredients. and cultural nutrients. Apparently. because of the quickly lifting rate of people who are going corpulent and unhealthy. more and more people are going health-conscious diners. This means that people are going more concerned with what they eat every clip they dine out. Therefore. they are going inclined to take their nutrient based on their wellness and nutritionary concerns. Fast insouciant eating houses are known for providing keen yet healthy nutrient picks. Failing Fast insouciant eating houses provide keen bill of fare that make usage of unique and definite ingredients. As such. when nutrient rising prices happens. fast insouciant eating houses tend to be the first to increase nutrient monetary values. When this happens. people may choose for cheaper options that quick service eating houses offer. Opportunities For every bit long as fast insouciant eating houses maintain their cross-cultural market entreaty. trendsetting decors and decorations. keen bill of fare inventions. and healthful nutrient publicity. they will probably derive and keep their ain just portion of the eating house frequenters. Menaces New entrants in the industry may escalate the competition among the presently bing fast insouciant eating house houses in the nutrient industry. This makes their sector more disconnected. As a consequence. the more fragmented the nutrient industry becomes ; the more hard it would be for each house to aim their clients and increase their profitableness. Restaurant Company strategies to do up for Rising Commodity Costss Raising the bill of fare monetary values Most eating house companies capitalize on land beef. cheese. dairy merchandises. poulet and porc. Since the monetary values of these trade goods have significantly increased over the past few months. they are left with no pick but to somewhat increase their bill of fare monetary values every bit good. Switching bill of fare mix Most restaurant houses are seeking to happen ways to integrate new nutrient picks in their bill of fare so as to have nutrient trade goods with lower costs. For illustration. companies that centered on porc or beef dishes are now seeking to integrate changing nutrient options such as fish. bean curd. and poulet. Changing market mix Some companies adjust their mark market. Alternatively of merely providing to people who crave for steaks. barbeques. and chops. most companies are now spread outing their bill of fare in order to include salmon. veggies. and other culinary arts. Arguments against Healthy Lifestyle Related Bills Trans fat Legislation Harmonizing to the Trans fat statute law. eating houses and nutrient constitutions should be prohibited from utilizing ingredients that contain trans fat. This includes oleo. oil. and other shortenings. While this is deemed as a manner to advance public wellness. many restaurant associations point out that such should be complemented by runs that really address nutritionary consciousness. In add-on to that. they point out that censoring the usage of these ingredients for frying may coerce them to happen healthy replacings that are well more expensive that the former trade goods. As such. it can take to an addition in nutrient monetary value. This addition in nutrient monetary values can. in bend. contribute to the worsening popularity of eating houses and the increasing figure of people who merely opt to dine at place. Furthermore. some of them indicate out that butter and thenar oils may take the topographic point of trans fatty oils. And. while these options are non rich in trans fat. they are extremely known to increase cholesterin degrees and advance arteria clogging and other jobs with the circulatory system. Last. some restaurant associations say that this statute law may motivate eating house houses to finally extinguish some nutrient picks from their bill of fare. This limits the nutrient picks of people. Menu Labelling Bill The menu-labeling measure is applicable for all concatenation eating houses that have more than 14 mercantile establishments all over the state. Based on this measure. eating houses should expose the nutritionary content of the nutrient picks that they offer. in the same size fount as the monetary value. As such. some eating house organisations oppose this measure chiefly because compulsory bill of fare labeling restricts the freedom of eating houses in running their concerns. Harmonizing to the National Restaurant Association. aone-size-fits-all menu-labeling approach should non be applied the full eating house industry. They noted three major points on why such attack should non be promoted: Restaurant repasts are non like packaged nutrients that come in boxes and tins. The stairss in mensurating the nutritionary content of eating house repasts are far harder to cipher and show. Furthermore. nutritionary labeling can be really expensive- with an estimation of $ 850- $ 1. 000 for every bill of fare point tested. Small and family-owned nutrient ironss may happen it hard to manage the disbursal. Restaurants should supply nutritionary informations in a manner that suits their varied clients. There are many types of eating houses and each type should be given a opportunity to supply their ain alone method to supply nutritionary informations. Seventy per centum ofeating house clients opt to custom-make their repasts. As such. any ingredient that they opt to take from their nutrient pick will do a important alteration in the nutritionary content of the full nutrient bundle. This makes menu-labeling an impossible procedure. Mentions: Kennedy. D. . Way. B. . and B. Ryan. ( 2003 ) . Restaurant Industry Trends. Accessed September 15. 2008 from hypertext transfer protocol: //www. uwex. edu/ces/CCED/downtowns/ltb/lets/0803ltb. pdf Milford Prewitt Dinnerhouses employ assorted tactics to battle lifting trade good costs . Nation’s Restaurant News. . FindArticles. com. 14 Sep. 2008. hypertext transfer protocol: //findarticles. com/p/articles/mi_m3190/is_30_38/ai_n6135223 _______ . ( 2006 ) Dining Out Review: Fast Casual Restaurants.Fast Casual Dining Segment Shows Explosive Growth .Accessed September 15. 2008 from hypertext transfer protocol: //www. marketresearchworld. net/index. php? option=content A ; task=view A ; id=852 A ; Itemid= _______ . ( n. d. ) Menu Labeling. Accessed September 15. 2008 from hypertext transfer protocol: //www. eating house. org/government/issues/issue. cfm? Issue=menulabel

Essay on Coming To America

Essay on Coming To America Essay on Coming To America Dear Alessia and Little Luca, I really miss Italy; I have been in the United States for about five or six weeks, la terra libera!! But I wish you could be here with me, I always think about our child. However, my new job offers a higher salary and I will start saving some money for you to come here and live a much better life without hunger or poverty, we will always have enough food for our baby and ourselves, che meraglivia! The kind of life I am living now here in America was worth all the pain and suffering I experienced to get here. We last saw each other in Port of Augusta and after I waved goodbye from the boat, I was taken along with other passengers to the steerage, which is located under the deck and we were not allowed to go out of there during the entire journey, many of the passengers got really sick. Di notte, it was always cold and we felt miserable, however, once we arrived we were full of joy and happiness. We got off the boat at a place called Ellis Island where many doctors were waiting for us; they wanted to make sure we would not carry any disease into their precious land. After they made sure I was healthy, some officers started asking many question, I told them I was only here to work and save some money for my hungry family and they let me in. I now live in a city called New York, it is wonderful and it was easy for me to find a job, I thought my lack of experience would be a problem but that was not the case. I work in a huge factory

Hand Hygiene of Nurses Essay Example | Topics and Well Written Essays - 1000 words

Hand Hygiene of Nurses - Essay Example Action planning involves active participation in the hand washing process, for example, nurses may list when they are supposed to wash their hands. This was also supported in the study by Nicol, et.al., (2009; Curtis, et.al., 2009) where the authors emphasized the theory of planned behavior. The study revealed that the theory of planned behavior could sufficiently help improve the education and training of nurses in hand hygiene behavior (Nicol, et.al., 2009; Curtis, et.al., 2009). This study was also able to demonstrate that deep-seated habits which are incorporated well into a person’s activities have a significant potential of improving a certain activity or behavior (Nicol, et.al., 2009; Curtis, et.al., 2009). The theory of planned behavior also points out that where individuals unconsciously apply certain activities, they also learn to carry out hand washing activities where necessary (Nicol, et.al., 2009; Curtis, et.al., 2009). This study provides a more in-depth and per sonalized verbalization of how habits and planned activities can lead to better hand washing compliance. The value of planned behavior in the promotion of hand washing was also explored in the study by Curtis, et.al. (2009; Nicol, et.al., 2009). The authors were able to establish that hand washing is a habitual behavior and planning it into a person’s life can help ensure that it would always be carried out. This study explored the value of planned and habitual activities which can eventually be incorporated into a person’s life (Curtis, et.al., 2009; Nicol, et.al., 2009). It also relates the value of building habitual behavior in relation to hand washing. Through this study, a holistic and specific picture of hand washing is obtained, including the impact of planned habits and behavior on its compliance.