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Selasa, 12 Julai 2016

Happy nurses day 2016

Nurses week is a great week to reflect on the value nurses bring to the delivery of care and also a time to forecast into the future. What can each of us do to advance the profession of nursing to a higher level? What can each of us do to achieve greater success?
Sometimes we all just need a little inspiration to figure it out. Quotes are a great place to begin. #50 is my favorite 
We will start with Florence and end with a few of mine.

1.     “It may seem a strange principle to enunciate as the very first requirement in a Hospital that it should do the sick no harm.” ~Florence Nightingale
2.     “Let us never consider ourselves finished nurses….we must be learning all of our lives.” ~Florence Nightingale
3.     “I attribute my success to this – I never gave or took any excuse.” ~Florence Nightingale
4.     “How very little can be done under the spirit of fear.” ~Florence Nightingale
5.     “Let whoever is in charge keep this simple question in her heard – Not, how can I always do this right thing myself, but how can I provide for the right thing to be always done?” ~Florence Nightingale
6.     “Kind hearts are the gardens, Kind thoughts are the roots, Kind words are the flowers, Kind deeds are the fruits, Take care of your garden And keep out the weeds, Fill it with sunshine, Kind words, and Kind deeds.” ~Henry Wadsworth Longfellow
7.     “Be kind, for everyone you meet is fighting a hard battle.”~Plato
8.     “Do what makes you happy, be with who makes you smile, laugh as much as you breathe, and love as long as you live.” ~Rachel Ann Nunes
9.     “If you’ll not settle for anything less than your best, you will be amazed at what you can accomplish in your lives.” ~Vince Lombardi
10.  “Cooperation is the thorough conviction that nobody can get there unless everybody gets there.” ~Virginia Burden Tower, American writer
11.  “When you’re a nurse you know that every day you will touch a life or a life will touch yours.”  ~Author Unknown
12.  “The only way to do great work is to love the work you do.” ~Steve Jobs
13.  “Never lose sight of the fact that the most important yardstick of your success will be how you treat other people.” ~Barbara Bush
14.  “The time is always right to do what is right.”~Martin Luther King, Jr.
15.  “Faith is taking the first step even when you don’t see the whole staircase.”~Martin Luther King, Jr.
16.  “An optimist is someone who goes after Moby Dick in a rowboat and takes the tartar sauce with him.”~Zig Ziglar
17.  “Honesty and integrity are absolutely essential for success in life – all areas of life. The really good news is that anyone can develop both honesty and integrity.” ~Zig Ziglar
18.  “The most important persuasion tool you have in your entire arsenal is integrity.” ~Zig Ziglar
19.  “The sole purpose of human existence is to kindle a light in the darkness of mere being.” ~Carl Jung
20.  “If you get the inside right, the outside will fall into place.” ~Eckhart Tolle
21.  “The mighty oak is just a nut that held its ground.” ~Unknown
22.  “Let no one ever come to you without leaving better and happier.” ~Mother Teresa
23.  “Expect problems and eat them for breakfast.”~Alfred A. Montapert
24.  What makes the dawn come up like thunder? Courage!”~Cowardly Lion
25.  “It’s not about being better than everyone else, it’s about being better than you used to be.” ~Dr. Wayne Dyer
26.  “People often say that motivation doesn’t last. Well, neither does bathing – that’s why we recommend it daily.” ~Zig Ziglar
27.  “If you woke up breathing, congratulations! You have another chance.” ~Andrea Boydston
28.  “It’s not what you know or who you know. It’s what you are that finally counts.” ~Zig Ziglar
29.  “Keep your thoughts positive because your thoughts become your words. Keep your words positive because your words become your behavior. Keep your behavior positive because your behavior becomes your habits. Keep your habits positive because your habits become your values. Keep your values positive because your values become your destiny.” ~Mahatma Gandhi
30.  “What do we live for; if it is not to make life less difficult for each other.”~Mary Ann Evans
31.  Life is not easy for any of us. But what of that? We must have perseverance and, above all, confidence in ourselves. We must believe that we are gifted for something, and that this something, at whatever cost, must be attained.’’ ~MARIE CURIE
32.  “If you want others to be happy, practice compassion.  If you want to be happy, practice compassion.” ~Dalai Lama
33.  “You don’t get to choose how you are going to die.  Or when.  You only decide how you are going to live.”~Joan Baez
34.  “Our prime purpose in this life is to help others.  And if you can’t help them, at least don’t hurt them.” ~Dalai Lama
35.  “Let no one ever come to you without leaving better and happier.  Be the living expression of God’s kindness: kindness in your face, kindness in your eyes, kindness in your smile.” ~Mother Teresa
36.  “Carry out a random act of kindness, with no expectation of reward, safe in the knowledge that one day someone might do the same for you.”~Princess Diana
37.  “We can’t help everyone, but everyone can help someone.”~Ronald Reagan
38.  “My religion is very simple.  My religion is kindness.”~Dalai Lama
39.  “Whether you think you can or think you can’t, either way you are right.”~Henry Ford
40.  “Happiness is not something you postpone for the future; it is something you design for the present.”~Jim Rohn
41.  “Human capacity is equal to human cruelty, and it’s up to each of us to tip the balance” ~Alice Walker.
42.  “Individually, we are one drop. Together, we are an ocean.” ~Ryunosuke Satoro
43.  “Believe and act as if it were impossible to fail.”~Charles F. Kettering
44.  “To accomplish great things, we must not only act, but also dream; not only plan, but also believe.”~Anatole France  
45.  “Change your thoughts and you change your world.” ~Norman Vincent Peale
46.  “Any fool can criticize, condemn and complain-and most fools do.  But it takes character and self-control to be understanding and forgiving.” ~Benjamin Franklin
47.  “You can make more friends in two weeks by becoming a good listener than you can in two years trying to get other people interested in you.” ~Dale Carnegie
48.  “You deserve to believe you make a difference; because you do!” ~Renee Thompson
49.  “Patients deserve to be cared for competent, compassionate nurses.” ~Renee Thompson
50.  “Nurses are humans by birth and heroes by choice.” ~Renee Thompson

Thanks so much for choosing to become a nurse!
Happy Nurses Week!

Kempen pentingnya vaksin

Kanak – kanak, terutama bayi, tidak mempunyai sistem imun yang kuat seperti mana orang dewasa. Beberapa imunisasi (vaksinasi) diperlukan dalam beberapa tahun pertama kehidupan kanak-kanak bagi melindungi anak anda daripada jangkitan penyakit serius

Apakah vaksin?

Prof Dr Zulkifli Ismail, seorang pediatrik konsultant, berpandangan bahawa vaksinasi adalah cara yang paling efektif untuk melindungi anak-anak daripada jangkitan penyakit yang boleh  membawa  kematian. Vaksinasi merupakan satu proses pembentukan imuniti. Ia dapat melindungi bayi dan kanak-kanak daripada beberapa penyakit tertentu dengan mudah, selamat dan berkesan. Ini dilakukan melalui pemberian vaksin bagi pembentukan antibodi untuk membina daya ketahanan badan. Pemberian vaksin boleh dilakukan secara suntikan atau melalui mulut.
Vaksin adalah virus/bakteria yang mati atau dilemahkan dan diberikan secara suntikan atau melalui mulut. Imuniti (daya tahan) boleh diperolehi melalui 2 cara:
Aktif – Antibodi diperolehi hasil daripada jangkitan penyakit berkenaan.
Pasif – Antibodi diperolehi melalui imunisasi

Penyakit – penyakit yang boleh dicegah melalui vaksinasi ini:
 Tibi (Tuberculosis) – akibatkan radang paru – paru, radang selaput otak, jangkitan pada organ lain seperti usus, tulang, sendi serta buah pinggang dan boleh membawa maut.
– Hepatitis B – boleh menyebabkan penyakit hati kronik (chronic liver disease) dan kanser hati.
– Polio – lumpuh dan mengakibatkan ketidakupayaan fizikal atau kematian.
– Difteria– akibatkan kesukaran bernafas,masalah jantung dan saraf.
– Pertussis (batuk kokol) – boleh menyebabkan radang paru-paru, epilepsi dan boleh membawa maut.
– Measles (campak) – akibatkan radang paru-paru, radang selaput otak (meningitis), radang otak (encephalitis), pekak, buta, cirit-birit dan kematian.
– Mumps (beguk atau bengkak di belakang telinga hingga dagu) – radang otak (encephalitis), radang buah zakar (orchitis) yang boleh membawa kemandulan.
– Rubella pada ibu yang mengandung boleh mengakibatkan bayi dilahirkan cacat seperti katarak (buta), pekak, jantung berlubang, terencat tumbesaran dan terencat akal. Kecacatan ini dikenali sebagai Congenital Rubella Syndrome.
– Penyakit Hib (Haemophilus influenza type B) akan menyebabkan radang paru-paru, radang selaput otak, pekak, buta, epilepsi dan terencat akal serta radang epiglotis yang menyebabkan saluran pernafasan tersumbat.
Kepentingan vaksin
Vaksin membantu menyelamatkan nyawa kanak-kanak. Meskipun begitu, kedengaran kini spekulasi yang membimbangkan kita berhubung imunisasi boleh membawa kepada penyakit autisme dan masalah-masalah lain. Ramai ibu bapa tertanya-tanya akan potensi vaksin ini dalam melambatkan atau mengelakkan penyakit. Ini boleh meletakkan semua anak-anak kita pada risiko – itulah sebabnya ia begitu penting untuk memisahkan fakta daripada fiksyen. Walaupun begitu,kepentingan dan kebaikan vaksin mengatasi kesan sampingannya. Antara kepentingan vaksin kepada bayi anda:
  • Imunisasi memberi faedah kesihatan kepada kanak-kanak kerana dapat mengelakkan daripada dijangkiti pelbagai penyakit berjangkit yang serius yang boleh mengakibatkan kecacatan dan kematian.
  • Kebanyakan penyakit berjangkit ini tidak mempunyai rawatan khusus dan boleh mengakibatkan kesan sampingan dan komplikasi yang teruk dan kekal.
  • Mencegah adalah lebih baik daripada merawat. Imunisasi juga dapat mengelakkan kesengsaraan yang dialami oleh kanak-kanak itu dan juga ahli keluarga.
  • Imunisasi dapat mengelak daripada berlakunya kejadian epidemik dan wabak penyakit berjangkit.
  • Imunisasi juga dapat mengurangkan atau membasmi sesetengah penyakit seperti polio, neonatal tetanus dan difteria.
  • Imunisasi merupakan satu-satunya intervensi kesihatan dengan kos-efektif
Bagi memastikan kesihatan bayi dan kanak – kanak terjamin, kerajaan telah memberikan vaksinasi secara percuma mengikut jadual imunisasi yang telah ditetapkan oleh Kementerian Kesihatan Malaysia. Vaksin yang diperlukan oleh bayi dan kanak – kanak adalah seperti berikut :
    • *Tiada Parut – BCG hanya akan diberi kepada kanak-kanak yang tiada parut ketika Tahun 1 persekolahan.
    • B – Dos booster (Tambahan)
    • DT – Diptheria dan Tetanus
    • # Dos ini diberi kepada kepada kanak-kanak di Sabah sahaja.
    • ♀ Imunisasi Rubella diberi kepada kanak-kanak perempuan semasa Tahun 6 persekolahan.
    • Rubella akan diberhentikan setelah kanak-kanak yang mendapat imunisasi MMR dos pertama dan tambahan mencapai Tahun 6.

Air terjun kemensah

Pernah dengar air terjun Kemensah? Memula ingatkan kat area luar Lembah Klang, rupanya dalam bandar aje lokasinya. Jalan nak masuk tempat ni adalah berdekatan dengan Zoo Negara Ulu Kelang tu je. Saya memang dah lama plan.
Kitaorang pilih lokasi yang dekat dengan rumah dan mudah untuk ke sana. Malas nak pergi tempat yang jauh sebab habis masa dalam perjalanan je nanti, lainlah kalau ada perancangan untuk bermalam, 

Khamis, 2 Mei 2013

Tracheostomy cuff inflation and deflation: Results What information should you include when documenting tracheostomy care?
  Family member present during the procedure
  Stoma and skin condition
  Number of staff members on duty
  Number of tracheostomy sets used
Rationale: You should include the patient's stoma and skin condition in your documentation.

Which complication may result from removing a blocked tracheostomy tube?
  Increased infection
  Airway closure
  Decreased carbon dioxide levels
Rationale: If a patient's tracheostomy becomes blocked for any reason (such as secretions that can't be suctioned), don't remove the tracheostomy tube entirely because doing so may allow the airway to completely close.

How should you position a patient to inflate a tracheostomy cuff?
  Semi-Fowler's position
Rationale: Position a patient in semi-Fowler's or supine position with the head of the bed elevated as tolerated when inflating a tracheostomy cuff.

When can you begin to perform clean tracheostomy care?
  When the patient has a stable complete blood count
  When the stoma has healed
  When the doctor approves it
  When the patient is discharged from the hospital
Rationale: Whichever tube is used, tracheostomy care should be performed using sterile technique until the patient's stoma has healed to prevent infection.

The purpose of an uncuffed, fenestrated tube is to:
  permit better suctioning.
  cause a more aesthetic appearance.
  permit mechanical ventilation.
  allow speech.
Rationale: A plastic fenestrated tube permits speech through the upper airway when the external opening is capped and the cuff is deflated.

Which complication may occur from replacing an expelled tracheostomy tube?
  Trauma to the airway
  Patient discomfort
Rationale: Use extreme caution when attempting to reinsert an expelled tracheostomy tube because of the risk of tracheal trauma, perforation, compression, and asphyxiation. Reassure the patient until the doctor arrives.

For which complication should you monitor a patient with a tracheostomy?
  Poor patient compliance
  Improved oxygenation
  Decreased secretions in the airway
  Tracheal necrosis
Rationale: The presence of the tube or excessive cuff pressure can produce tracheal erosion and necrosis.

The primary benefit of using an uncuffed tracheostomy tube is that it:
  blocks air completely from moving through the trachea.
  reduces the risk of tracheal tube damage.
  works well in patients who are unconscious.
  can be used for patients receiving mechanical ventilation.
Rationale: An uncuffed tracheostomy tube, which may be plastic or metal, allows air to flow freely around the tracheostomy tube and through the larynx, reducing the risk of tracheal damage.

In which situation should you suspect a tracheal cuff leak?
  If respiratory pressures are adequate
  If the patient can't speak while the cuff is inflated
  If the cuff pressure exceeds previously documented pressures
  If the cuff won't deflate
Rationale: Suspect a leak if the injection of air fails to inflate the cuff or increase cuff pressure, if you can't inject the amount of air you withdrew, if the patient can speak, if ventilation fails to maintain adequate respiratory movement with pressures or volumes previously considered adequate, or if air escapes during the ventilator's inspiratory cycle.