Comparison of Normal Saline and Heparin Flush

Comparison of Normal Saline and Heparin Flush Review of literature is an essential component of the research process. It aids the researcher in the formulation of the research plan or proposal and condition of the study. It aids in relating the outcomes of the study to the findings of other investigations Review of literature is defined as a critical summary of research on a topic of interest, often prepared to put a research problem in contest (Polit and Beck, 2006). The current study and review of various associated literature and review study, topics can divide as follows; Section A: Literature related to comparison of normal saline and heparin flush  to maintain the patency of intravenous line. Section B: Literature related to cost effectiveness of normal saline flush in  maintenance of peripheral intravenous catheter. Section C: Literature related to complications of using heparin solution for  maintaining patency. Section A: Literature Related to Comparison of Normal Saline and Heparin Flush to Maintain the Patency of Intravenous Line. Elsevier (2009) did a randomized double blind controlled trial to investigate the efficacy of normal saline versus heparin saline in maintaining the patency of intravenous catheter among 150 children of pediatric unit at United States. In that, Group I received normal saline flush (n=77) whereas Group II received heparin saline flush (n=73). The result showed that 72% of children were recovered from blockage during normal saline flush. Thus researcher concluded that the normal saline flush was effective in maintaining the patency of intravenous catheter. Klieiber (2008) conducted prospective, randomized double blind study to determine the efficacy of saline versus heparin flush to maintain the peripheral intravenous lock in pediatric populations among 140 children. The sample was selected randomly into two groups. Group I received normal saline flush whereas Group II children flushed with heparinized saline. The findings revealed that there was no significant difference between the groups in maintaining the patency of catheter and reduces incidence of complications. A randomized controlled double-blind trial was conducted by Esther Mok, Tany KWong (2007) for maintaining peripheral intravenous lock among 123 children of age from one to ten years. The objective of this study was to evaluate the effectiveness and safety of three flush solutions: normal saline, one unit/ml of heparin saline and ten units/ml of heparin saline for maintaining peripheral intravenous locks in children, and to establish a research-based practice in the study hospital. Group I received one unit/ml of heparin saline, Group II received ten units/ml of heparin saline and Group III received normal saline. The group that received one ml of normal saline demonstrated the highest rate of survival and the mean length of catheter showed (49.8 hours) was seventeen hours longer than the group that received one unit/ml of heparin saline (32.5 hours). The result showed that there was no significant difference among the three types of flushing solution in terms of the catheter longevi ty and incidence of intravenous complications. A study was conducted by Visanu Thamlikitkul Artit Indranoi (2006) on switching from heparinized saline flush to normal saline flush for maintaining peripheral venous catheter patency in the patients hospitalized to medical ward at Sir raj Hospital, Thailand. The study sites were ten medical wards containing two hundred and forty beds. Group I received heparinized saline as a flushing agent whereas Group II received normal saline as a flushing agent. The information on using flush fluids was collected from the physicians order sheets in the medical records at baseline, every two to four weeks during the intervention periods, and at six months after launching intervention. The results showed that the children received heparinized saline flush in February 2005, switched on to a practice with normal saline flush in June and November 2005. Hence the researcher concluded that normal saline was effective and implemented as evidence based clinical practice. Janet Pettit (2003) performed a randomized double blind study to identify the efficacy of saline versus heparin flush to maintain the peripheral intravenous lock in pediatric populations among 124 infants over twenty eight days of age in pediatric ICU at Doctors Medical Centre, Modeto. The findings revealed that saline flush had longer period of patency. Thus the researcher concluded that saline was efficacious and safest flush in maintaining the peripheral intravenous catheter. Nelson (2002) conducted a randomized double blind study to assess the use of 0.9% normal saline flush with or without heparin for maintaining peripheral indwelling intermittent infusion devices among fifty eight children up to one year with twenty four gauge needle. Group I received ten units per ml of heparin solution (n=26) and Group II received 0.9% normal saline flush (n=32). The result showed that there was no significance between 0.9% normal saline flush with or without heparin solutions in maintaining patency of twenty four gauge peripheral intermittent intravenous devices in children younger than one year. Schultz, Drew Hewitt (2002) investigated a randomized double blind study on comparison of normal saline and heparinized saline flushes for patency of intravenous locks among forty nine neonates at Maine Medical Center, Portland. The objective of the study was to determine the efficacy of patency of intravenous locks maintained with normal saline solution compared with heparinized saline solution. Group I received 0.5 ml of heparinized saline flush containing two units/ml of heparin (n=20) whereas Group II received 0.5 ml of normal saline flush (n=29). There were no significant difference (p =0.841) between mean scores for heparin flushed catheters (M = 41.5 hours, SD = 44.0) and saline-flushed catheters (M = 30.4 hours, SD = 20.8). The researcher concluded that catheter failure was significantly longer for catheters flushed with heparinized saline compared with those flushed with normal saline. A study was conducted by Harahan Berends (2000) to evaluate the efficacy of saline versus ten units/ml heparin for peripheral intravenous flushes among 240 neonates of Special Care Nurseries at a Level III Large Mid Western University Teaching Hospital. Here an experimental group design was used to compare the longevity of heparin and saline intravenous locks. Data were collected from a convenient sampling technique. Group I received ten units per ml of heparin (n=123) whereas Group II received preservative-free normal saline solution (n=117). The result showed that there was no significant statistical difference in intravenous catheter longevity between intravenous locks flushed with ten units/ml heparin and those flushed with normal saline. Krista Brown, Tay-Uyboco Douglas McMillan (1999) did a randomized controlled trial to determine the relative efficacy and safety of peripheral intravenous locks maintained with heparin saline solutions compared with those maintained with normal saline among 186 neonates at Foot Hills Hospital, Calgary, Alberta. Group I received normal saline (n=93) whereas Group II received heparin saline (n=93). Patients were chosen to receive either heparinized saline with five units/ml or 0.3 ml of normal saline, in the intravenous catheter every six hourly, administered by nursing staff in a blinded manner. The result showed that there was no difference in catheter lifespan (39 ±24 hour for the heparinized saline group; 34 ±22 hour for the normal saline group) and no difference in the number of intravenous catheters per patient (1.9 heparinized group, 1.6 normal saline group). The researcher concluded that there was no difference between heparinized normal saline and normal saline flush in neonates in maintaining the patency of twenty four gauge peripheral intravenous locks. Heilskov, Kleiber Johnson (1998) did a randomized double blind controlled 3-arm trial of heparin and saline for maintaining intravenous locks among ninety neonates at University of Iowa Hospitals and Clinics, USA. The purpose of this study was to determine the effects of saline, heparin two units (U) per ml saline, and heparin ten units per ml saline flush solutions on the duration of intravenous locks and the incidence of intravenous infiltration in neonates. Group I received heparin two units/ml saline (n=27), Group II received heparin ten units/ml saline flush (n=28) and Group III received normal saline (n=25). Catheter flushed at least every six hourly. The outcome measures total hours from the time the intravenous was inserted to the time the intravenous was removed; hours from the time the intravenous was first flushed to the time the intravenous was removed; number of intravenous removed because of infiltration. The result showed that there was no statistical or clinical dif ference between the three groups for duration of intravenous therapy or for incidence of complications. Bridget Mudge, Dion Forcsier Mary Jo Slattery (1998) conducted a comparative study on heparin and saline flush solutions regarding patency of 24-gauge peripheral intermittent infusion devices. A prospective, non-randomized, sequential, blinded study design was conducted on a pediatric and a neonatal were similar for age, peripheral intermittent intravenous devices (PIID) placement site, irritating substances infused, and initial IV function. The median duration of catheters flushed with normal saline was 42 hours and with heparin was 35.3 hours. Kaplan-Meier Survival Analysis indicated that the duration of catheters flushed with saline was significantly longer than those flushed with heparin (p = .02). More catheters flushed with heparin were removed because of problems (p = .027). Results of this study suggested that normal saline was more effective than heparin in maintaining the patency of small, 24-gauge catheter. Kotter (1996) conducted a randomized double blind study on heparin versus saline to maintain the patency of intermittent intravenous device maintenance among fifty one neonates including premature neonates, less than one month of age admitted to a Level II Neonatal Intensive Care Unit. Group I received ten units/ml heparin (n=27), whereas Group II received normal saline flush (n=24). Catheter was flushed every fourth hourly with heparin or normal saline solutions. The researcher concluded that there was no statistically significant difference in average duration of patency between normal saline-flushed catheters and heparinized saline-flushed catheters. Phlebitis, occlusion, infiltration, and leaking occurred with equal frequency for both solutions. Kulkarni, Elsner, Ouellet Zeldin (1994) investigated a randomized double blind study on heparinized saline versus normal saline in maintaining patency of the radial artery catheter among seventy eight adults in the surgical intensive care unit of Toronto East General Orthopedic Hospital. The objective of the study was to compare the ability of normal saline versus heparinized saline infusion to maintain patency of the radial artery catheter used for monitoring blood pressure or multiple blood sampling. Group I (n=40) patients those who were admitted on odd numbered dates received heparinized saline two units per ml and Group II (n=38) admitted on even dates received normal saline, both as continuous flush solutions. At 96 hours of cannulation, 92% of the catheters in the heparinized saline group were patent compared with 74% in the normal saline group. The result showed that there was no significant difference between flushing with normal saline and heparinized saline in the mainte nance of radial arterial line patency. A comparative randomized controlled trial was conducted by Robertson (1994) on the intermittent intravenous therapy to determine whether heparinized saline solution was a superior flushing agent to normal saline among152 children between the ages of two months to eighteen years. Group I were allocated with heparinized saline as a flushing agent, and Group II were allocated with normal saline as a flushing agent. Each day intravenous sites were examined for signs of phlebitis and on removal of each cannula was flushed to check for fibrin. On Chi-square testing, highly significant associations emerged between the incidence of phlebitis and the use of the intravenous antibiotics such as Tobramycin (p=0.05) andor Timentin (p=0.008). Young children were found to have a significantly higher incidence of blocked cannulae regardless of the flushing solution used. The researcher concluded that there was no significant difference detected in either the duration of intravenous therapy, the pate ncy of the intravenous line or the incidence of phlebitis when normal saline was used to flush the intravenous cannula. Kleiber, Harahan, Fagan Zittergruen (1993) conducted a double-blind study to determine the efficacy of saline versus heparin flush solution to maintain peripheral intravenous locks in a pediatric population among 124 infants over twenty eight days of age. Group I received normal saline as a flushing agent, whereas Group II received normal saline with heparin as a flushing agent. The result revealed that the heparin and saline groups were comparable for total hour duration of the intravenous and for incidence of complications. Hence the researcher concluded that saline was efficacious in maintaining patency of intermittent intravenous peripheral intravenous locks in children. A comparative study was conducted by Rob, Kelly Trish (1992) on normal saline or heparinized saline flushing on function of arterial lines among sixty-five patients in most New Zealand intensive care units. Group I received normal saline (n=35) where as Group II received three ml/hour as a continuous flush. The scores for the intravascular line for each patient were summed, and the percentage of the total possible score was calculated. Mean study duration was 5.8 and 6.6 days for the normal saline and heparinized saline groups, respectively. Mean percentage scores were 83% with normal saline group and 82% with heparinized saline group. The statistical findings showed that there was no difference between the groups at 95% confidence interval. Thus researcher concluded that heparin as a continuous flush at three units/hour does not improve the function of arterial lines compared with a continuous normal-saline flush. A quasi-experimental study was conducted by Tuten Gueldner (1991) on the efficacy of normal saline versus diluted heparin for maintaining the patency of peripheral intermittent intravenous devices in hospitalized medical-surgical patients among seventy seven children. Group I received normal saline solution, whereas Group II received diluted heparin. The statistical findings revealed that there were no incidence of site loss due to coagulation in either group, moreover no significant difference in the incidence of site loss associated with phlebitis (p=0.708) or infiltration (p=0.910). The researcher concluded that normal saline may be an effective alternative to heparin, for maintaining the patency of peripheral intermittent intravenous devices. Ashton, Gibson Summers (1990) conducted a randomized double-blind study on the effects of heparin versus saline solution on intermittent infusion device irrigation at Shawnee Mission Medical Center among thirty two patients. The purpose of this study was to compare the effectiveness of one ml of 0.9% normal saline with ten units of heparin in one ml normal saline solution, in maintaining patency and reducing the incidence of phlebitis in patients with intermittent infusion devices. The statistical findings revealed that there was no significant difference between the groups in phlebitis or patency variables. The researcher suggested that 0.9% normal saline was as effective as ten units per ml of heparin in normal saline solution in maintaining intermittent infusion device patency and preventing phlebitis. Hamilton, Plis, Clay Sylvan (1988) conducted a randomized double-blind study on heparin saline versus 0.9% normal saline injection for maintaining patency of indwelling intermittent infusion devices in the Department of Pharmacy practice, Albany College among 307 adult patients. Group I received one ml of heparin saline as a flushing solution (n=170), whereas Group II received 0.9% normal saline flush solution (n=137). The result revealed that heparin offers no advantage over 0.9% normal saline injection in maintaining the patency of intermittent intravenous devices. The researcher concluded that there was no significant difference in the duration of catheter patency or incidence of phlebitis was observed between the groups. Epperson (1984) did a randomized study on the efficacy of 0.9% normal saline with and without heparin for maintaining indwelling intermittent injection sites in the medical and surgical units of an acute-care hospital among 412 patients. Three different solutions were used to flush intravenous catheters. Group I were flushed with 0.9% normal saline alone, Group II were flushed with heparin 10 units/ml in 0.9% normal saline and group III were flushed with heparin 100 units/ml in 0.9% normal saline. Heparin locks were flushed after each medication administration and every eight hours when medications were not being given. Using a standardized evaluation form, one of five intravenous therapists evaluated each site daily for the presence of phlebitis and loss of patency. Length of catheter placement and the percentage of patient days during which patients received cephalosporin and penicillin antibiotics were examined for each group. Rates of site loss caused by phlebitis or loss of pate ncy were compared in each group. The result showed that there was no significant differences were found among the three groups in the mean duration of heparin-lock placement, the percentage of patient days during which antibiotics were prescribed, or the rate of site loss caused by phlebitis or loss of patency. Section B: Literature Related to Cost Effectiveness of Normal Saline in Maintenance of Peripheral Intravenous Catheter. Hephzibah Alexander (International Journal for the Advancement of Science Arts, 2010) conducted a systematic review of the study on heparin versus normal saline as a flush solution. The electronic database of Ovid, Pub-Med, the Cochrane Library and the Cochrane Database of Systematic Reviews (CDSR) was searched for heparin or normal saline (either singly or in combinations). Relevant studies were critically appraised and evidence obtained was graded according to the modified Catalan Agency for Health Technology Assessment scale (CAHTA). In terms of safety, the findings indicate that it might be safer to use normal saline as it does not have the risks associated with heparin. Cost analysis studies proved that without any doubt the use of normal saline flush results in a significant amount of cost savings. For arterial catheters, majority of the available data suggest that heparin saline given as a continuous flush at low doses improved catheter patency. The result of the study reveal ed that normal saline should be used as an alternative to heparin in intravenous catheters. Low-dose heparin with 0.25 units per ml normal saline should be added to the infuscate to maintain patency of arterial catheters. The researcher concluded that heparin as an intermittent flush was ineffective and normal saline was just as effective as and more efficacious than heparin. Karen Le Duce (1997) investigated a prospective, randomized, double blind controlled trial on the efficacy of normal saline solution versus heparin solution for maintaining patency of peripheral intravenous catheters in children at the emergency department of childrens hospital, USA among 150 children. The purpose of this study was to establish the effects of heparin flush and saline solution flush solutions in maintaining patency of infusion devices in the pediatric population, and to establish cost-saving implications related to normal saline solution versus heparin flush for PIIDs in terms of pharmacy costs and costs related to nursing time to both procedures. Group I (n = 77) received 3 ml of a ten units heparin/ml normal saline solution intravenous flush whereas Group II (n = 73) received three ml of normal saline solution for the intravenous flush. Descriptive and correlation statistics were used to analyze the data. The result showed that there were no significant differences between the two groups for demographics or complications. Annual cost savings were computed with an estimated annual savings of nursing time and unit cost of solutions equaling $27,594. The researcher concluded that the normal saline solution should be used as an alternative to heparin solutions for the maintenance of peripheral intravenous devices. Jerri Shoaf Sandra Oliver (1997) did a study on the efficacy of normal saline with and without heparin for maintaining intermittent intravenous site in the coronary care unit of Scott and White Memorial Hospital among two hundred and sixty surgical patients. Group I received normal saline with heparin as a flushing agent, whereas Group II received normal saline without heparin as a flushing agent. The researcher concluded that heparinized saline was not needed to maintain the patency of an intermittent intravenous site, and the use of saline solution alone was less irritating, causes less occurrence of phlebitis, less expensive to patients, and saves nursing time. A randomized comparative study conducted by Paisley et al (1997) on the use of heparin and normal saline flushes in neonatal intravenous catheters among eighty seven preterm and term infants ranging from 33 weeks to 44 weeks of gestation in the University of Missouri-Columbia Childrens Hospital. Data were collected between February 1994 and March 1995. The majority of infants were thirty eight to forty weeks gestation (M = 38.46 weeks, S.D. = 2.48). Group I (n=33) infants received 0.6 ml of heparin solution containing 10 units/ml of heparin and Group II (n=54) received 0.6 ml of normal saline as flushing agent. The frequency of flush was 0.6 ml flush every fourth hourly. The researcher concluded that the normal saline was much cheaper than heparin. Nursing time was saved using a single solution and physician spends time in writing order was saved by standing orders. If only normal saline was used, the chance for error, over dosage, heparin-associated drug incompatibilities and hepari n induced thrombocytopenia would be eliminated. Section C: Literature Related To Complications Of Using Heparin Solution For Maintaining Patency. Mitchell et al (2009) conducted a study on a systematic review of heparin flushing and other interventions to maintain patency of central venous catheters. The objective of this study was to assess clinical studies comparing the effectiveness of different means of maintaining central venous catheter patency. A search was conducted using the MEDLINE, CINAHL, EMBASE, Cochrane, National Guideline Clearinghouse and University Health System Consortium databases. The method was a systematic review of effectiveness using grade criteria to assess the strength of evidence for each intervention. Flushing with heparin was a routine part of central venous catheter maintenance, but it presents risk, including heparin-induced thrombocytopenia. Other techniques used to prevent occlusion of catheters include saline flushes, heparin-bonded catheters and pressure caps. The result showed that flushing catheters with saline solution was more effective than flushing with heparin. A study was conducted by Stephens et al (1997) on normal saline versus heparin flush for maintaining central venous catheter patency during aphaeresis collection of peripheral blood stem cells (PBSCS) among seventy eight cancer patients. The purpose of this study was to examine the incidence of thrombotic occlusions in central venous catheters using heparin compared to saline flushing. Group I (n=29) received saline flushes and Group II (n=49) received heparin with 100 units per ml of saline flushes. Numerous studies comparing heparin to saline flushing in peripheral devices suggested equal rates of thrombotic occlusions. The outcome of the study suggested that serious complications including drug interactions and heparin induced thrombocytopenia and thrombosis syndrome in association with heparin flushing. The researcher concluded that saline was as effective as heparin for maintaining patency of central venous catheters. Triolo, Pamela Goode (1991) conducted a study on meta-analysis to estimate the effects of heparin flush and saline flush solutions on maintaining patency, preventing phlebitis, and increasing duration in peripheral heparin locks. The researcher concluded that saline was as effective as heparin in maintaining patency, preventing phlebitis, and increasing duration in peripheral intravenous locks. Quality of care can be enhanced by using saline as the flush solution, thereby eliminating problems associated with anticoagulant effects and drug incompatibilities. In addition, an estimated yearly savings of $109,100,000 to $218,200,000 U.S. health care dollars could be attained. Barrett Lester (1990) did a double-blinded, cross-over study on heparin versus saline flushing solutions for a period of two months in a small community hospital at Aroostook Medical Centre, Presque Isle. Floor nurses were used as observers and observe catheter failures, as either loss of patency or phlebitis. Data revealed a statistically significant advantage to using saline flushes when both loss of patency and phlebitis were combined (p

Telling the Partial Truth: Ethical or Unethical?

Telling the Partial Truth: Ethical or Unethical? Guan Huang 250547949 D. Proessel Philosophy 2074G March 27th, 2013 The article Advertising: The Whole or Only Some of the Truth by Tibor R. Machan states that only telling the partial truth is ethical in advertising. I completely agree with the author’s standpoint and am trying to defend his viewpoints by supporting in four aspects. Firstly, I am going to prove Machan’s position that sales associates are selling a combination of product, environment and service.Although there will be various prices for the same product at different stores essay writer australia, sales associates are not obligated to provide all of the locations that sell the product, and the price of said product at each location. Second, I am going to defend Machan’s position towards consumer beware. Thirdly, I will argue against potential criticism by strongly supporting Machan’s position— commercial advertising should be forgiven f or putting one’s best foot forward.Finally, I will highlight the definition of essential truth versus the whole truth to support Machan’s point that failing to tell the whole truth is ethical with some boundaries. In Leiser’s argument, suppression veri is unethical because the salesperson may use the technique of price deception, which is concealing the fact that their product can be purchased at a far lower price elsewhere. As Machan says, â€Å"it is legitimate for customers to seek satisfaction from the market, we must keep in mind that customers often seek various combinations of satisfaction, not simply product or price satisfaction† (Machan 586).Machan claims that when a customer is buying a product, he or she is not just looking for the product itself and the price. He or she also adds many other factors such as certain location of the store, customer service during the purchase, and store environment into consideration. These various combinations of satisfactions cannot be ignored. Buying a cup of Starbucks coffee in the Starbucks coffee shop compared to purchasing a bottle of Starbucks coffee in the grocery store can be a good example.The Starbucks shops don't just sell coffee; they sell an atmosphere (Daniel R. ). People go to Starbucks usually not for just a cup of coffee, but the combination of product including relaxing atmosphere in Starbucks store, the friendly service they provide, other Starbucks products that could be also bought etc. But purchasing at a supermarket also can be seen as a combination that includes self-service, a package of Starbucks in bulk, and convenience. The combinations are simply valued differently, and thus are priced differently.As a result, this proves Machan’s position that sales person is selling the combination of the product and that price deception proposed by Leiser is inconsistent. After proving a classical form of egoism as the most appropriate method to morally guide busine ss conduct, Machan holds the position that to promote one’s rational self-interest, â€Å"a merchant could be acting with perfect moral propriety in not offering help to a customer with the task of information gathering† (Machan 588). Thus, it is morally correct to answer only part of a question, or even deflect a question from a customer to avoid lying to them.As long as the merchant does not lie, it is perfectly ethical to communicate to the customers with a sole goal of selling the product (not caring for the customers’ personal interest). Buyers should take the responsibility to gather information. For example, McDonald’s posts all of the nutritional information of their foods on the company’s website. It is the customers’ personal responsibility to go on the website to find the information, and not the servers’ responsibility to inform the customers of the caloric or sodium content while placing the order.Machan’s position here is that information is available (through various forms communication) and the customer must not rely on the merchant to receive this, but take a proactive role while deciding on their purchases. Machan holds the position that commercial advertising should be forgiven for putting one’s best foot forward. To prove this, he demonstrated that even apart from advertising, people often enough advance a biased perspective on themselves, their skills, looks, and so on (Machan 585) first by using the example of CV and dating to show how people give others an overstated first mpression. Then by claiming commercial relationships usually take place between strangers (Mahan 589), he finally reaches his position. In his example, people will highlight his/her advantages and try to diminish his/her disadvantage as much as possible when going to a date or sending a resume to a potential company he/she may work for. At this point, the potential criticism may claim that it’s a fal se analogy by comparing commercial advertising as going on date or sending a CV. People show their best image on a date or people listing all their asset in a resume is their private business.It is their own interest to do so. But in terms of commercial advertising, advertiser is in his or her public life. There is no difference between an advertiser and a doctor or journalist in some ways. Advertisers should take some responsibility to play as a public role, thus to give some probable benefits for people on the other side. With this false analogy (Exhibit 1) the potential criticism may claim that Machan’s position that commercial advertising should be forgiven for putting one’s best foot forward is less convincing. I will argue against this potential criticism in support of Machan’s position.To begin with, the potential criticism commits a classic problem of causal oversimplification. The line of reasoning here is that because advertiser should take some respon sibility to play as a public role, so he or she has the obligation to give some benefit for people on the other side. This argument is solely based the altruism school of thought. However, the potential criticism has not indicated any other schools of thought in which the argument could be plausible, but only with basis of altruism can this line of reasoning (where helping each other is key) be applied (Exhibit 2).However, as Machan argued in his paper, only the most robust form of altruism, a form where â€Å"none is left to be the beneficiary of human action, can be a candidate for the morality to guild merchant† (Machan 588). In reality, the robust form of altruism is too extreme to be possible in society which proves that the possible opposing view is incorrect. The potential criticism also argues that the example of a date and CV is a false analogy to commercial advertising since private issues are different from public issue. Let’s consider what would happen if a rather lazy person pplied for a company with a well-written resume or if a very sloppy man was given a makeover and then goes on a date. With these enhancements, the rather lazy person has a possibility of being hired by the company, and the rather sloppy man could get a second date. Thus, the company and the girl may be harmed from people’s putting best foot forward in private issue situation. The company could have a bad employee (laziness) and the girl may realize that what seemed like a well-groomed man is actually not and that she has wasted her time.As customers can also suffer from sellers putting their best foot forward, we find that in terms of result, there is no difference between private issues and public issues. So we do not need to focus on whether or not the issue is personal or public. The answer seems to be straightforward: the example of date and CV can be seen as a good analogy to commercial advertising and those examples can be used to reach Machanâ€℠¢s position— commercial advertising should be forgiven for putting one’s best foot forward.Machan also holds the position that from a robust or classical ethical egoist standpoint, â€Å"the [essential truths] about an item or service being traded should be told† (Machan 591). Essential truths can be further thought of as information regarding the function of product when utilized under normal circumstances. So when a customer buys an air conditioner, it is expected that it will keep a room cool in the summer. This is different from the whole truth, since failing to tell the essential truth will violate the principle of an honest transaction, which is more important to oneself than competitive advantage (Machan 589).For a merchant, the truth should not be concealed just to obtain the competitive advantage. On the other hand, the whole truth also includes the information regarding what is incidental or merely closely associated with the essential truths about a p roduct. This information is not important and it’s truly not possible to tell all. Machan holds the position that essential truth should be told, but not the whole truth. Many examples can be found in the real world can be used to support Machan’s position. In the pharmaceutical industry, companies must list all the functions as well as side effects of the drug on the package.This information is essential because when we buy medicine, we must know what the function of the medicine is, and whether or not it is safe to take in our situation. Many drugs are not safe for pregnant women to take, and they must be informed of it. This would be essential information that must be given, whereas other locations where the same drug is available is not essential information about the product and can be kept to the seller. As I proved above, only telling the partial truth is ethical in commercial advertising.Merchants sell metaphorical package of goods when selling a single product , because they are also selling the store’s environment, and their service in addition to the product. Customers are all different, and some may place higher value in location of the store or attitude of the salesperson than price, so when the sales associate fails to speak of other locations selling at a lower price, this is not price deception. Different stores may have different combinations of satisfaction, and thus it is completely ethical to avoid presenting information about other stores.It is important for merchants to always put their best foot forward and present only the most valuable aspects of their product. There is no need to provide the customers with more information than they need, as buyer beware is a very realistic aspect of our world. We cannot provide all the information for everything we are telling others about, so customers should have the initiative to do adequate research before deciding on a purchase. Merchants are only obligated to provide the mos t essential information needed about the product.Thus, when advertising, it is completely unnecessary for merchants to tell the customers everything about the product. As long as the merchants are not lying to the customers, telling partial truths about products is a very ethical form of advertisement. Exhibit 1 Public Life Public Life Private Life Private Life Doctor or journalist Doctor or journalist Commercial advertising Commercial advertising Not a good reason to prove Not a good reason to prove Sending a CV Sending a CV Going on a date Going on a date Exhibit 2 Altruism AltruismHe/she should give some benefit for people on the other side He/she should give some benefit for people on the other side Advertiser should take some responsibility to play as a public role Advertiser should take some responsibility to play as a public role Work cited Tibor R. Machan. â€Å"Advertising: The Whole Truth or Only Some of the Truth?. † Allooff and Vaidya 584-592. Fritz Allooff and An and J. Vaidya. Ed. Business in Ethical Focus an Anthology. Canada: Broadview, 2008. Print. â€Å"The Starbucks Culture† Daniel Rein. Web Feb, 10, 2007

Communication And How It Affects Nursing As A Profession

Communication is central to human interaction and occurs planned or unplanned on a daily basis. Using verbal, nonverbal, written, or unwritten communication are methods in which information, a person’s thoughts, and feelings are shared. To become an ultimate professional in a field, such as nursing, it is vital to be able to communicate well with peers and clients. The purpose of this paper is to analyze the pros and cons, societal issues, promotion of change, and other pertinent issues that relates to communication and how it affects nursing as a profession. Communication is the foundation of how humans are able to interact amongst each other with the goal of conveying a message. Goals of communication include: informing, educating, influencing, and building relationships. To communicate efficiently there is a process to be followed. When communicating there needs to be a sender, this is the person wanting to transmit a message. 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This essay begins with an explanation of terminology that defines social media, followed by a discussion which will identify and explainRead MoreNursing Career : A Family Member With A Chronic Disease And Incapable Of Helping Them1747 Words   |  7 PagesAlina Muà ±oz Erwin AP English 12 13 April 2016 Nursing Career Imagine seeing a family member with a chronic disease and incapable of helping them because of lack of medical knowledge. Becoming a nurse can be the best option to be able to not have to deal with not knowing how to help someone who is sick. Nursing is defined as a profession that assumes responsibility for the continuous care of the sick, injured, the disabled, and the dying. Nursing is also responsible for encouraging the health ofRead MoreImage Of Nursing : A Look At An Historical Image987 Words   |  4 PagesThe field of nursing encompasses a vast array of knowledge, skills, and professionalism. However, often times the image of nursing does not mirror these things. What is image? Many individuals may answer this question differently depending on their age, personal experiences, and exposure to media. The image of nursing is the overall idea, perception, or belief of what nursing is. Image is an important factor in nursing, as a false image may discredit the true heart o f nursing, leading to misconceptionsRead MoreCommunication Is Important For A Health Care Professionals1502 Words   |  7 PagesSchwartz, Lowe Sinclair (2010) have stated that effective communication is very important for a health care professional and service user to interaction with each other successful and also between the health care professionals. according to Weiss Tappen (2014),P98 Communication is considered to be a core competency in promoting inter-professional collaborative practice. 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Name: Carmela Alitin Student Number: n9713271 Unit: PYB007 Communication for Health Professionals Tutor: Aleana Green Tutorial: Thursdays 11am-1pm, Z-607 Word Count: 1,380 A Reflective Essay on Effective Communication Skills in the Nursing Profession â€Å"Effective communication is integral in every profession, but in nursing, it could mean the difference between life and death,† (E.S Alitin, personal communication, 31 March, 2016)Read MoreJean Watsons Theory of Caring: The Importance of Interaction and Relationship between Nurse and Patient973 Words   |  4 PagesCaring: Jean Watsons model or theory of caring was developed initially in the 1970s and modified several times to the post-modern transpersonal paradigm of healing or caring that is applicable to the nursing practice and other disciplines. The caring model incorporates the conventional concepts of nursing since Watson believes that the traditional concepts are relevant to modern clinicians. 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Pain Management As An Essential Part Of Nursing - 1583 Words

Pain management is an essential part of nursing, but it can be challenging when the patients can no longer express their needs. I became aware of this challenge throughout my experience in both clinical and work. During my first clinical rotation, I was assigned to a patient who had severe dementia and could no longer communicate. While providing care to this patient, it was evident that the patient was irritated because she would grimace and sometimes cry out, but it was difficult to determine if the patient was in pain or where the pain was located. While working as a CNA in a nursing home, there were multiple instances when the residents would grimace and pull away when touched, especially during their morning care. The behavior changes were reported to the nurses, but it was never certain if the nurses intervened and properly managed the distress. After witnessing the challenges of dementia care, I chose to do my literature review on pain management in patients with dementia in order to relieve their suffering and improve their quality of life. Introduction As the geriatric population continues to increase, there is a greater need for management of conditions commonly found in the population. One challenging health problem in the geriatric population is dementia. Dementia is a debilitating condition that affects many people worldwide, and the number of people suffering from dementia is expected to increase in coming years. According to Alzheimer’s DiseaseShow MoreRelatedThe Middle Range Theory Of Acute Pain Management1249 Words   |  5 Pagesrange theory of Acute Pain Management by Good and Moore established in1996 used in the management of acute and chronic pain. Marion Good is working as an Associate Professor of Nursing at, Case Western Reserve University, Cleveland, Ohio. She conducted many researches in nursing. She is very much involved in Nursing theories and Nursing Research. She conducted research on patient teaching for different therapies for pain management. The first research she did about pain management and formulated theRead MoreThe Strategic Plan For A Company Essay1416 Words   |  6 Pagesimproving the HCAHPS score for three of the eight quality measures involving provider communication, pain management, and patient understanding of post discharge care and treatment information. Stakeholders connected to these measures include: 1) Organizational leaders – Board of Trustees, Executive Director, and Finance Officer; 2) Providers – physicians and physician extenders; 3) Nursing leadership; 4) Nursing Associates; 5) Ancillary support staff – pharmacy and physical therapy; and 6) Patients/Families/Caregiv ersRead MoreAsthma Case Study1675 Words   |  7 Pagesby a nursing staff on the floor next to her bed. She was conscious and lucid and her right leg was generally swollen and extremely rotated to the left which could indicate hip fracture. She had an operation to fix the fracture. The past medical history revealed that she had taken an anti-inflammatory and analgesic tablets for osteoarthritis which affect her joint causing a lot of pain. This paper is going to discuss assessment tools, Mrs. Harriss main problems, nursing goals of management, nursingRead More Caring for An Angina Patient Essays1699 Words   |  7 PagesNurses play a very important role in managing a patient from the moment of his admission up to making a discharge plan. Each part of the nursing process is vital to the wellbeing of the person he is taking care of. Clinical reasoning is always essential in each part of the nursing process from assessment, setting up goals and intervention. Effective nursing manag ement is done when a nurse looks for the early and right cues at the right patient and implementing it at the right time. This essayRead MorePalliative Care : A Form Of End Of Life Care1309 Words   |  6 PagesIntroduction According to Allen et al. (2012), â€Å"millions of people with chronic illnesses endure unrelieved pain, uncontrolled physical symptoms and unresolved psychosocial or spiritual problems.† This issue occurs because palliative care is often considered a form of end-of-life care. Palliative care is a treatment that can be used for patients who suffer from chronic illnesses and diseases while receiving curative treatment. (Horowitz, Grambling Quill, 2014) purposely states the misconceptionsRead MoreCase Analysis For Pancreatitis And Pancreatitis1086 Words   |  5 Pagesthis process of pancreatitis destroys pancreatic tissue and leads to hemorrhage , edema , steatorrhea , and severe pain . pancreatic enzymes are being secreted directly into the pancreas rather than into the duodenum , also cause pancreatitis . Another cause is gallstone that travelled backward in the duct. Pancreatitis sign and symptoms include intractable pain in the epigastric area that may radiate to the back or upper left side ,fever , anorexia , nausea , and vomiting a Read MoreNursing Practice And The Ethics Of Care871 Words   |  4 Pages Nursing Practice and the Ethics of Care Kelli O’Dea Chamberlain College of Nursing Nursing 103 Spring, 2017 Nursing Practice and the Ethics of Care The ability of a nurse to combine the principles of caring and ethics, is perhaps the best medicine. â€Å"I’ve learned that people will forget what you said, forget what you did, but people will never forget how you made them feel.† Maya Angelou (n.d.) This article helps nurses to understand the importance of caring and ethics in patient careRead MoreEssay on Cultural Competence and Intercultural Communication1673 Words   |  7 Pagesin nursing is the ability to gather relevant cultural data on the presenting problem of the patient. This cultural assessment is defined as a systematic appraisal or examination of individuals, groups, and communities as to their cultural beliefs, values and practices to determine explicit needs and intervention practices within the context of the people being served (Miller, et al, 2008, p 7). Identifying the nursing problems and the skills to be developed in a culturally competent nursing practiceRead MoreThe Clinical Situation And Plan Nursing Interventions1468 Words   |  6 PagesHospital for a scheduled cholecystectomy. The intended procedure will be performed by a laparoscopy however there is a chance that a laparotomy may be required. The patient has no previous known medical condition. It will discuss and analysis the nursing interventions, therapeutic communication and person-centred approach to perioperative care. Surgery is a unique experience and no two people respond the same to similar operations. No matter how minor or major the surgery it can still be a stressRead MoreThe Impact Of Nursing Staff On The Quality Of Life Essay901 Words   |  4 PagesThe Impact of the Nursing Staff on the Quality of Life in Nursing Homes Fady Estany Tennessee State University The Impact of the Nursing Staff on the Quality of Life in Nursing Homes: Article Critique This article is about the connection between the nursing staffing and the quality of life in nursing homes. The author discusses details about long-term care settings in particular nursing homes, the quality of care that is being provided, and the quality of caregivers