There are many reasons for concern about the number of preterm and low birth weight infants in Canada. In the article, The Cost of Prematurity, the author indicates that the cost of hospital care in the United States for newborns was more than $ 10 billion dollars in 2003 . They note that over half that budget was spent on preterm infants born less than 37 weeks gestation.(Cuevas et al, 2005). Cuevas notes the total number premature babies born was only 12.3%, this demonstrates the high cost of caring for preterm infants and the importance of prevention rather than treatment.
Cuevas mentions that the number of preterm births probably has not changed much in the past 25 years. The main difference between then and now is improved technology and prenatal care. Many of the low birth weight and premature babies born now are surviving, whereas they probably would have died years earlier. Often the outcome of preterm infants is still grave. Many of the affected babies have long term developmental delays, respiratory problems, vision and hearing impairment. (Lowdermilk & Perry, 2004).
Crowther suggests that there are many reasons for low birth weight and preterm infants. Some of the possibilities might be: low socio-economic status, smoking, maternal infections and multiple pregnancy. It is thought that 30 Ė50% of preterm births are caused by maternal infections (Crowther et al,2005). The importance of prenatal care and early diagnosis of potential infections is crucial.
In recent years, there has been a great deal of research on the effects of poor dental care in relation to pregnancy. Research shows that there is a strong relationship between Oral Hygiene 3 periodontal infections and preterm birth. (Lowdermilk & Perry, 2004).
It is known that gums may become inflamed and bleed during pregnancy, thus increasing the risk of infection. Reducing the inflammation of the gums and cleaning the teeth is one of the most important preventions for reducing preterm birth in relation to periodontal disease (Crowther et al, 2005). Bacteria from infected dental pockets can spread into the motherís bloodstream and can cause bacteremia putting both mother and baby at risk (Crowther et al, 2005).
automated external defibrillator It is estimated that over 50,000 Canadians per year die of coronary artery disease (Canadian Red Cross, 2004). Patient outcome is directly linked to the amount of time it takes for the heart to be defibrillated. The American Heart Association reports a survival rate of 90% when defibrillation is achieved within the first minute of collapse. For every minute of delay after the event has occurred, there is a seven to ten percent increase in mortality rate (Canadian Red Cross, 2004). In a majority of cases, the initial heart rhythm of a patient having a cardiac arrest is ventricular fibrillation or pulseless ventricular tachycardia (Canadian Red Cross, 2004). The benefit of the AED (automated external defibrillator) in public places is that it can detect the patientís heart rhythm and analyze it without the rescuer having had any cardiac training. The AED would audibly indicate to the rescuer if a shock is needed and defibrillation could occur with the simple push of a button. The AED is so simple to use that one mock cardiac arrest study showed the mean time to defibrillation from arrival on scene was that of 90 seconds for a group of grade six students to that of 67 seconds for trained EMTís and paramedics (Marenco et al 2001). With some guidance, most initial rescuers could perform this function with minimal training and as a result save lives. Implementation of AED 9 References Mattei,L., Mckay,U., Lepper,M., & Soar,J. (2002, June) . Do nurses and physiotherapists require training to use an automated external defibrillator? Retrieved March 8, 2005 from http://sciencedigest.com.login.ezprozy.library.ualberta.ca/science?_ob=ArticleUR American Heart Association. (2004). Sudden deaths from cardiac arrest statistics. Retrieved March 8, 2005 from www.americanheart.org/downloadable/heart/1103835297279FS27SDCA5.pdf Marenco,J., Wang,P., Link,M., Homoud,M. (2001, February). Improving survival from sudden cardiac arrest: the role of the automated external defibrillator. Retrieved March 8, 2005 from http://www.skyaid.org/Skyaid%20Org/Medical/AED_Jama_301.htm Canadian Red Cross. (2004, November). Saving a life can be as easy as an afternoon. Retrieved March 8, 2005 from http://www.redcross.ca/article.asp?id=011063&tid=001 Schein, E.,(2004) Kurt Lewinís change theory in the field and the classroom: notes toward a model of managed learning. Retrieved March 8, 2005 from http://www.a2zpsychology.com/articles/kurt_lewinís_change_theory.htm Maurer, R., (2004) Results of effective change survey. Retrieved March 8, 2005 from http://www.beyondresistance.com/htm/2articles/survey.html Implementation of AED 9 Mind Tools, (2002) Force field analysis-understanding the pressures for and against change. Retrieved March 8, 2005 from http://www.mindtools.com/forcefld.html Sugden, L., (2001, November) Building for tomorrow: in a changing world, constant motion toward a defined vision is the key to organizational success. Retrieved March 8, 2005 from Ö/webacc?action=Item.Read&User.context=dphwQjruemDm&Item.drn=291Z0&merge=msg09/11/02 Vollman, A., Anderson, E., McFarlane, J. (2004). Canadian Community as Partner. Philedelphia: Lippincott Williams & Wilkins Buonocore,D. (2004). Leadership in action:creating a change in practice. AACN Clinical Issues, 15(2). Retrieved February 10, 2005 from HYPERLINK "http://gateway.ut.ovid.com.login.ezproxy.library.ualberta.ca/gw2/ovidweb.cgi" http://gateway.ut.ovid.com.login.ezproxy.library.ualberta.ca/gw2/ovidweb.cgi Appendix A
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