This paper is a comparative critical review of the literature concerning the problems following discharge directly to a patient's home after intensive care in the hospital ICU.
2,930 words (approx. 11.7 pages), 17 sources, APA, $ 86.95
Abstract This paper compares two articles, both indicating problems after discharge to the home from the ICU, with each other and with an additional review of the literature, "Problems Following Discharge after Intensive Care," written by Daffurn et al (1994) and "Intensive and Critical Nursing Care," written by Scraggs et al (2001). The author points out that the condition, disease, illness, or injury of the patient is most likely one of the two most predominant factors in the experience of the recovering patient upon discharge home from the ICU. The paper stresses the importance of the proper provision of both verbal and written instructions to the patient and the patient's caregiver, since this greatly impacts the patient in terms of well-being, as well as the overall experience of discharge to home from ICU, thus reducing the need for returning to the hospital.
Table of Contents
Objectives
Review of Articles for Comparative Critical Review
Article One
Article Two
Review of Available Literature
Review Comparison and Contrast of Findings
Conclusion
From the Paper "Results of the study found that of the 54 patients 34 of the patients experienced normal sleep patterns after discharge while 15 reported that they were unable to remain asleep due to disturbances and 5 patients were unable to fall asleep. 41 patients reported a normal appetite while 11 reported that their appetite was reduced and 2 patients reported a controlled appetite. Of the 54 patients 17 were not on medications at al while 14 of the patients were n Cardiac medications, 9 patients were taking multiple meds and four patients were taking analgesic medications. In relation to the memory of the patient in relation to the ICU stay 16 of the 54 patients had no memory of the stay whatsoever while 7 had a pleasant recall of the ICU stay and 9 patients claimed an unpleasant recall of their stay in the ICU. Reporting nightmares during the ICU stay were 7 patients while 15 of the patients had complaints of a minor nature. Home support was reported to be "none" by 4 of the 54 patients, while 40 of the patients reported "good" home support and 10 patients reported inability to sleep due to interruptions from home help support."
Abstract This paper describes commercial construction as "building projects exclusive of residential construction," and discusses commercial construction from both an economic point of view and from the point of view of the community. The paper discusses why commercial construction is a boon to the construction business, providing stable work even when residential construction is at a lull. The paper also discusses the complexities of managing commercial construction.
From the Paper "Commercial construction is defined as "building projects exclusive of residential [single- or two-family home] construction". It is one of the biggest segments of the entire construction industry and is believed to have strengthened the industry in recent years due to rapid and steady growth. The commercial sector has been growing steady for some time now as is evident from market research and reports. Back in 2000, Sinderman wrote: "...the state of the commercial real estate market is strong. The demand for office, industrial and retail buildings remains high, and, as Internet-based companies continue to grow, specialized facilities have become more popular than ever." In 2005, a construction report by McGraw-Hill supported that claim: "The commercial and infrastructure construction segments are providing a lift to the overall construction industry, marking a role reversal from most of the past two or three years. According to October 2004 figures for future construction contracts calculated by McGraw-Hill Construction, Lexington, Mass., overall new construction starts increased 4 percent in October versus September (on a seasonally adjusted basis), with nonresidential and infrastructure construction gaining while the residential sector fell slightly." (Late Rebound)"
Tags: commercial, construction, residential, business, office, hotel
Abstract Federal contracts for construction, while similar in many respects to other types of federal contracts, have some unique aspects that have caused the federal government to create a system of rules within the Federal Acquisition Regulation (FAR) specific to construction contracts. The federal government has been justified in creating these rules separate from those that apply specifically to supply and service contracts. This paper focuses on some of the unique rules and regulations that apply to federal construction contracts, including those related to contract types, labor laws, specifications, payments, delays, and differing site conditions.
Abstract
Overview
Contract Types
Federal Construction Contracting Laws
Contract Performance and Specifications
Payment Financing
Delays
Differing Site Conditions
References
From the Paper "The federal government is the largest owner of real property in the world (Bastianelli, et. al., 1998), so it stands to reason that they spend an enormous amount of money on construction and maintenance of that property. It is difficult to gauge exactly how much the federal government spends on construction annually, but it is noteworthy that the Department of Defense alone planned to award over $10 billion on construction contracts in 2002 (Bush, 2001). Because of this significant amount of construction outsourcing, and the intricacies that go along with construction contracting, the federal government has been justified in developing unique regulations and rules for construction contracts. The federal government, in the Federal Acquisition Regulation (FAR), defines construction as, ?"construction, alteration, or repair (including dredging, excavating, and painting) of buildings, structures, or other real property"? (FAR 2.101). Determining whether or not something is considered a building or a structure is general straightforward, although there are always exceptions. However, the line defining whether or not something is real property can, at times, be somewhat unclear. The FAR does not provide a definition for real property, but in federal contracts the common legal definition is used, that real property is, ?"land and all things that are attached to it"? (Lectric Law Library, 2003). Though many of the clauses, terms and conditions, and rules applicable to federal construction contracts are the same, or similar, to those that are used on federal contracts for supplies, there are a number of differences in the nature of contracting for construction that have caused the federal government to create separate laws that deal specifically with federal construction contracts. One of the major differences is that construction contracts are performed on Government property. Because of this, construction contractors are subject to a great deal more in the area of inspections and general surveillance on their contracts (Abernathy and Kelleher, 1976). Construction contracts typically have much more paperwork than federal supply contracts. On construction contracts, a contractor is required to file daily reports showing that they complied with all the unique construction regulations, including safety, schedules, and submittals of material samples (Arnavas, 2001, ?? 27.4.a.). Construction contracts are subject to much greater scrutiny on performance than supply contracts, as detailed analysis and explanation of any deficiencies are reported to contractors and contractors have the right to respond. Past performance information is also kept on construction contracts for six years, where the norm on supply contracts is three years (Arnavas, 2001, ?? 27.4.a). Other differences that will be the focus of this paper include contract types, labor laws, specifications, payments, delays, and differing site conditions."
Abstract This paper discusses green building construction and points out that this design saves energy as well as money. The paper explains that green building construction is vital and is a determinative of project success. The paper also explains that the individual needs to take the initiative in addressing construction design and development and associated costs as well as funding, marketing and sales. In addition, the paper tells us that green building construction holds great financial promise for the future. A graph of taxes by state is included with the paper.
Outline:
Objective
Introduction
Significance of study
Methodology
Literature Review
Findings and Conclusion
From the Paper "The work of Andrew Meyerson (2005) entitled: "The Dollars and Cents of Green Construction" states that green construction and design can not only save energy but also can result in monetary savings in the areas of: (1) Tax breaks and rebates; (2) Lower construction costs; (3) Reduction or elimination of the need for heating and air-conditioning equipment and the associated costs of purchase, maintenance and electricity; (4) Reduction in energy and water bills by as much as fifty-percent; (5) Increase in labor productivity, retail customer sales and apartment rental prices; and (6) Protection of operating budgets from increases in energy prices. (Meyerson, 2005, p. 2) Meyerson relates that practically all states offer incentives in the form of reduction of taxes for construction that is friendly to the environment. (2005, p. 4) Additionally in green construction projects where a pre-existing structure is on the construction site, cost savings may be realized through reuse of as much of the existing structure as possible. Additionally, is it necessary to be aware of the attitudes that serve as drivers of the choice of clients to use the firm and added to this is the fact "that commercial 'green buildings' outperform their conventional counterparts across a wide variety of metrics, including energy savings, occupancy rates, sale price and rental rates, another very practical and often times overlooked data for improving the cash flow of the client is the "energy efficient commercial building tax deductions.""
Tags: green, building, construction, funding, marketing, save, money, energy
Abstract This article serves as a defense of the claim that race is a social construct, rather than a biological fact. The writer discusses the view that genetic inequalities are not inborn, but rather created by society. In this paper, the writer looks at inequality in society caused by differences in race that appear to have been constructed by society.
From the Paper "The argument that race is a genetic predisposition is an old one and certainly an important one as it has been practiced among governments and other such institutions for centuries. This argument however leads to unwanted implications of genetic inequality between the races that we have learned is simply not the case. There are no inherent differences between individual races that are not arbitrarily constructed by society. In fact, it seems apparent that there are more variations in appearance and personality within a single race ... "
Abstract This paper describes the history of race as a distinctly Western idea. Through this process, the writer shows how and when the concept of "race" was invented or socially constructed. It then emphasizes the point that race has no biological reality by focusing on genetics and human variation, among other factors that repudiate the notion that race is biologically real. Finally, it looks at how the concept of race is, indeed, as Hacking states, "quite bad as it is," and puts forth a new archetype, one that does away with the concept of race altogether and focuses on the uniqueness of individual human beings.
From the Paper "What does it mean to say that race is "socially constructed"? In fact, what do we mean when we say that anything is socially constructed? Ian Hacking, after researching many books on social construction, stated that in order for something - he called it "X" - to be socially constructed, it must adhere to the following two premises: (0) In the present state of affairs, X is taken for granted; X appears to be inevitable. (1) X need not have existed, or need not be at all as it is. X, or X as it is at present, is not determined by the nature of things; it is not inevitable. Hacking goes on to state that these next two claims are also usually, though not always, implied by the use of the phrase "social construction": (2) X is quite bad as it is. (3) We would be much better off if X were done away with, or at least radically transformed."
Abstract This essay is about residential sprinklers in modern construction. It considers the effects of residential sprinklers on consumers, the government, and businesses and evaluates whether the overall effects has been positive or negative.
From the Paper "Using sprinklers to irrigate residential landscaping has become so commonplace that few people give the matter much consideration Homeowners consider sprinklers a boon since it eliminates watering ..."
Abstract This paper examines external factors that can cause problems in construction projects.
From the Paper "Construction projects are often used to describe the project management process because of the many interrelated tasks that must be accomplished in order for the project to be completed on time and within budget. Construction projects are also used to demonstrate risk management and risk aversion principles because of the many external factors that can have a detrimental effect on the project. If a task is not accomplished early in the process it can put the entire project offtrack and may cause ..."
Abstract This paper deals with the basic history of the residential construction market and the current market. It looks at several factors, current and past which lead the industry to where it is today.
From the Paper "Throughout the last century many aspects of our economy and way of life were permanently altered as a result of governmental involvement and the development of finance options, never before seen in the residential construction industry. In the beginning of the 20th century, what seemed unattainable by homebuyers became a common expectation by that century's close. These expectations dealt with a consumer not only being able to build his own home but more importantly being able to possess personal property, which represented, "comfort, convenience and quality of life unknown to previous generations" ("A Century of Progress", 2003). The catalyst of change began in 1949 when the U.S. government established the "Housing Act of 1949". At this point it became a national goal to improve living standards for all American families and provide them with the opportunity to own their own home. "
Abstract In this article, the writer looks at Florida, that has a high concentration of migrant labor in all industries involving manual labor. The writer notes that this concentration of migrant, or otherwise largely Hispanic, workforce is readily apparent in the construction industry where large numbers of Hispanic workers are regularly employed. The writer looks at the problems faced by the U.S. in order to ensure the safety and care of such employees. Further the writer discusses related U.S. welfare and social policies, in comparison to Canada.
From the Paper The United States has long resisted using government programs to reduce inequalities to the degree that Canada has, and the result is predictable in that the problems in the U.S. are much greater. At the same time, Canada has been reconsidering some aspects of its social policies. The assumption made by this statement is common, that capitalism does not cover certain types of social program, certain types of human needs, while the welfare state does cover these elements. Between Canada and the United States, this has been illustrated most starkly over the past couple of decades by the difference in terms of health care. Canada offers a comprehensive and centralized health care system, a so-called single payer system, while the United States does not and has been embroiled in controversy for years as a result.
Abstract The paper examines Section 107 of the Housing Grants Construction and Regeneration Act, passed by the United Kingdom Parliament in 1996. Specifically the paper looks at the interpretation of section 107, which deals with matters of adjudication, and how it was affected by a series of United Kingdom court cases between the years 2002 - 2007.
Outline:
Introduction
Body
Conclusion
Bibliography
From the Paper "The Court stated that the broad interpretation of the section 107 of the HGCRA 1996 was wrong and that the Section 107 was intended by Parliament to be interpreted as meaning that the whole agreement has to be in writing, not only the basic terms. This was underlined by the fact that the time in adjudication is tight, therefore the adjudicator should not have to spend time deciding what contract terms may or may not apply. As not all terms of contract were in writing, The Court found that in the case of RJT v DM there was no right to adjudicate.
"This whole issue remains a real concern within the industry particularly given the apparently restrictive interpretation of section 107 of the Act by the Court of Appeal in the RJT case, which may mean that many industry contracts, particularly those involving small and medium-sized enterprises, will fall outside of the scope of the legislation."
Examines what constitutes appropriate care when assessing a patient's need for services after being discharged from hospital, with a focus on newborns.
Abstract Discharge planning is a process of assessing a hospital patient's need for care or other services once he or she is discharged from the hospital. The paper shows that the trend toward early discharge of newborns and their mothers grew at such a rate and was accompanied by such serious consequences for some, that the American Congress took note, passing the Newborns' and Mothers' Health Protection' Act of 1996 which allows mothers the option of requesting a longer stay if she feels she and/or her child require it. Despite this act, most women elect the shorter hospital stay. The paper shows that the problem that needs to be addressed, however, is to determine, as precisely as possible, what constitutes effective early discharge planning for newborns and their mothers. The paper delineates effective practices and then applies the obtained information to midwifery concerns and practice.
From the Paper "One of the more interesting findings regarding early discharge planning is that there are some indications that certain factors allow for earlier release than others, and one of these is delivery by a midwife. In this regard, Margolis, Kotelchuck and Chang (1997) examined if mothers discharged from the hospital and one night's stay differed in any ways from mothers discharged after two or three nights stay. Specifically, it was found that mothers whose babies were delivered by midwives were more fit for early discharge than mothers whose babies were not delivered by midwives."
Abstract This paper evaluates hospital discharge procedures. The author cites a number of empirical research studies which look at caregiver and patient attitudes toward discharge practices. The author also discusses the legal, moral and procedural considerations a hospital must take in determining its discharge plan. The paper concludes that while systematization is important, flexibility is also crucial to ensure that the individual patient's needs are met.
From the Paper "There have been a number of studies concerned with the issue of patient discharge practices. Studies on decision making in discharge planning have investigated patient participation (Coulton, Dunkle, Chow, Haug, & Vielhaber, 1988; Coulton, Dunkle, Goode, & MacKintosh, 1982) and social workers' perceptions of patient participation (Abrahamson, 1988). To date, no studies have conceptualized discharge planning as a social process of small-group decision-making by elderly patients, family caregivers, and discharge planners. Participants' perceptions of the process are unknown."
Abstract The paper presents the seven step discharge policy and practice for newborns. It reviews current issues along with a historical perspective in terms of hospital discharge practices for mothers and newborns. The seven step method is expounded upon very thoroughly along with all the factors necessary for implementation.
From the Paper "America has a highly developed health care system, which is available to all the people whether through individual pay or through program affiliation. Although it can be very complex and frustrating at times it has come a long way from the health care organizations of the decades before. Previously most health care facilities were a place where the sick were housed and cared for until death. Physicians rarely practiced in hospitals and only those who were fortunate could afford proper care at home or in private clinics. Today the level of health care has excelled tremendously. Presently the goal of our health care is to have a continuum of care for the patient, one which is integrated on all levels. Many hospitals offer a referral service or discharge plan to patients who are being discharged. Plans for the patient are discussed with a discharge planner."
