Evidenced Based Practice Paper Essay Example | Topics and Well Written Essays - 7500 words

Evidenced Based Practice Paper - Essay Example The patient population affected the significance of the problem, when the problem became significant, and the current practice and probable proposed change in practice will also be discussed. Spirit of Inquiry The topic of coronary artery bypass graft versus percutaneous coronary stent insertion was an interesting topic to me because I have been doing coronary artery bypass surgery for the past twelve years. During these twelve years, a decline in open coronary bypass has decreased in numbers drastically. Invasive interventional radiology, a new trend in medicine to treat coronary disease without open surgery, has sent the open-heart surgery market down to non-existence. Stent placement has increased, but is it the best treatment? The populations involved in this treatment are adults having acute myocardial infarctions (MI) needing stent placement or open-heart surgery. The adult population being between the ages of 60-70 with an occasional patient in they’re fifties. One problem using stents, instead of opting for open surgery, is that a person could keep coming back for repeat stent placements due to reoccurring angina, thrombosis, and eventually ends up with open surgery after one year anyway (Cohen et al., 2011, p. 1016). Another problem with stent placement is the incidence of stroke or death and quality of life (Kajimoto, Miyauchi, Yamamoto, Daida, & Amano, 2012, p. 155). This population is targeted because there is a higher incidence of Obesity, Diabetes Mellitus, Hypertension, Hypothyroidism, and Hyperlipidemia that are leading causes of Coronary Artery Disease. This clinical problem became a significant problem when stent placement during a cardiac catheterization is easier to do than open-hear t surgery (Arjomand, McCormick, Turi, & et al., 2003, p. 790). It has decreased open bypass drastically as mentioned above. With the stent placement, patients are on Plavix, which is expensive, and with the open procedure they are not required to be on blood thinners as a rule. I am really not sure if there is preferred current practices per say, but I think it is left up to the Interventional cardiologist. He decides who gets a stent, how many and if they should be consulted out to a heart surgeon. A good clinical example is a patient that was forty-two years old went to the catheterization lab and received four stents, two to the right coronary artery, one to the circumflex, and one to diagonal. Two months later, the guy came back with angina and back pain. Another catheterization was done and his right coronary stent had a thrombosis and closed off. He then was consulted out to the heart surgeon. If the open procedure with arterial and vein grafts were done first this second cath eterization could have been averted. On the other hand, who plays God and makes these guidelines and choices. To understand each procedure, Percutaneous Coronary Intervention (PCI) and Open Coronary Artery Bypass Graft

Leadership in context 2 Essay Example | Topics and Well Written Essays - 1000 words

Leadership in context 2 - Essay Example The general perspective of leadership focuses on the responsibilities given to both people and their performance. It is believed that moral efficacy helps to determine the reason why a leader acts upon his or her moral judgment while others fail on the same idea. Role of the Leader In Terms of Power and the Opportunity to Abuse their Role According to Hannah (2010) a highly developed moral leader is expected to perform a given task or work in his or her self-concept in order to achieve higher levels of agency in making the right decision. Modern governor’s plays an important role in leadership is concerned with the development of self concept which should be supported by ones knowledge in applying theories like cognitive and emotional. The individual on governors need to lead with a lot of power of their personal strength and charisma. Hannah (2010) argues that the governor has a primary goal of overlapping the powers of the political systems in the states. According to Albert Bandura (2004) social learning theory remains the most influential theories explaining about learning and development in relation to understanding the behaviors of leaders and their followers. The argument is more about the concept and exploration of leadership behaviors, which is perceived by observing other people behavior. Leaders have to set policy making processes in order to rule the state with the legitimacy procedures. The formal powers and the responsibilities assist in strengthening the constitutional rights. The behavioral focus separates social learning theory from the aspects of leadership hence it requires behaviors to be imparted even to leaders in future (Mayo 2007). Coalition Building Power Leaders should be in a position to have a certain character traits of the specific context, which defines an enormous success in an organization. The focus of leadership is based on the situational context by putting more effort on the individual part and CEO in believe that the individual is correct according to the new settings in the organization. The ability to succeed depends on the styles in ones self and the approach to fit in the culture and condition of the organization. State system should have the power to persuade the agreement between the governors and legislators in achieving their goals in building coalition. In order to achieve on the goals, the governor should be in a position to persuade the people towards their opposition. The governors should develop a strong support in the constitution rights to solve the problems like bureaucracy. Governors should have to offer some chances to the other members of the support on the proposed legislation in order to support the political goals. Role of Chief Legislature Context in leadership helps somebody pass through a hard life situations. Governors should have a clear goal to become the nations leading in the creation and innovation of agencies. The vision of leading in an organization determines a lot in solving the problem. A force for change helps in the sustainability leadership which is termed to be relational meaning that something extraordinary is imparted in people (Lynham 2006). Law making process needs to be monitored and evaluated in every organization in order to produce an effective work. Leadership is contextual because it needs somebody to get