Questionaire2 xquestionaire1 xEXTENDEDPROJECTASSIGNMENTBRIEF2019NURSINGANDSOCIALWORK1 2SEVEREOBSTRUCTIVESLEEPAPNEAANDTHEUSEOFNASALMASK2 x
 

• Type of paperDissertation
• SubjectHealthcare
• Number of pages6
• Format of citationHarvard
• Number of cited resources0
• Type of serviceWriting

this is an investigation essay. primary and secondary source need to be detailed The investigation is the bulky part of the 3000 words. which is 1100 word counts

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6).What was your

Epworth Sleepiness Scale

(ESS) Score before Your

therapy commenced?

a) 0-10 Normal range b) 10-12 Borderline c) 12-24 Abnormal

7). How improved is your sleep quality with the use of your current

mask?

a) Very improve b). Slightly improved

c) No different d) Worst e) I don’t know.

8) Rate the chance that you would doze off during the following 8

routine daytime situations.

0- I would never doze

1 – slight chance of dozing

2 – moderate chance of dozing

3 – high chance of dozing

Epworth Sleepiness Scale

Sitting and reading

Watching TV

Sitting, inactive in a public place (e.g. Theatre or

meeting)

As a passenger in a car for an hour without a break

Lying down to rest in the afternoon when circumstances

permit

Sitting and talking to someone

Sitting quietly after a lunch without alcohol

In a car, while stopped for a few minutes in the traffic

Total

Questionnaire

This questionnaire is designed to find out if your OSA is being

controlled with your choice of mask. Your view is important and will

be very grateful if you would take few minutes to complete this

confidential survey.

1). What has made a biggest difference in comfort and compliance

for your OSA treatment therapy?

a) CPAP ramping features ———– Yes No

b) Better fitting Mask ———– Yes No

c) Humidifier ———————- Yes No

d) Mask cushions /headgear — Yes No

e) Others (please specify) —— ——————————————- —–

————————————————————————————–

————————————————————————————–

2). Does your current mask meet your exp ectations?

a) Yes b) No

3). What kind of Mask do you use?

a) Full-Face Mask b) Nasal Mask c) Nasal Pillow

4). Was this the mask type you were first prescribed?

a) Yes b) No

5). How long have you been using mask of your choice?

Assignment Brief and Feedback
Form (Unit with single assignment)

Name of Centre:
LSEC BEXLEY CAMPUS

Learner achievement (please circle)
NB: All learner achievement is provisional until confirmed at the AVA Awards Board.

Level Achieved:

L3

Achievement

(Level 3 units only)

P M D

Resubmission?

Y

N

Title of Access to HE Diploma: Nursing and Social Work

Unit title(s): Extended Project

Unit code(s): HC8/3/LR/003

Learner:

Tutor/Assessor: Paula Bloomfield

Description of Assignment:

· Using a title which has been agreed with and signed off by your tutor, you should investigate a subject area relevant to your current or future discipline.

· The investigation will require you to produce a report in the given style which follows academic conventions in line with your subject area (the bold type below on the checklist shows the format and heading titles required for your report, also with a guidance regarding the word count for each section).

· The project word count should be approximately 3000 words (+ / –

1

0%). Use the checklist below to ensure you follow the format and guidelines.

Task Checklist

Completed (Tick)

· Title page (To include your name, student ID and title of investigation) (1.1,4.1)

· Contents page (4.1)

· Abstract (approximately 100 words) (1.2,4.1)

· Introduction (to include aims) (approximately 300 words) (1.1,1.2,4.1)

· Methodology (to include ethical considerations, timeline and limitations) (approximately 500) (1.2,2.1,2.2,4.1)

· Investigation (approximately 1100) (1.3,2.1,

3.1

,4.1,4.2)

· Results/Findings (approximately 700) (1.3,2,2,4.1,4.2)

· Conclusion and Recommendations (approximately 300 words) (4.1,4.2)

· Reference List (4.1,4.2)

· Appendices (4.1) – remember this should only consist of relevant material that you have referred to within your project such as:

· Project proposal form – signed by tutor / specialist (recommended to be included)

· Record of action points and evidence from one to one tutorial meetings (recommended to be included)

· Charts, diagrams or pictures

· Timeline of how you managed your project

Check that you have carried out the following:

· Defined the topic, the aims and limitations of your investigation.

· Processed the most appropriate and specific sources of research

· Analysed the findings with a balanced and logical argument

· Presented the investigation in the given format and order as above (headings in bold type as above to be used)

· Used Harvard style referencing

· 1.5 line spacing and size 12 font

· Written in an academic style and objective manner (not first person)

NOTE:

The overall word count (excluding appendices) should be between 2700 – 3300. The word count for each section as above is for guidance only and is not prescriptive. There is flexibility in the word count for each section, but not for the overall total.

Note: Do not put your work in a special plastic wallet or folder; use the heavy-duty staplers in the LRC to keep your work together (alternatively use treasury tags). All projects should be submitted in the usual way; that is a copy submitted to the LRC and a copy uploaded to Turnitin via Moodle. Your assignment will not be marked and graded, unless it has been submitted through the Turnitin link. Appendices do not have to be scanned and uploaded, as long as a paper copy is submitted (and you keep a spare copy), then this is acceptable.

Date set: 1/11/18

Date for draft submission

(if applicable): N/A

Date for

submission: w/c 20/5/19

Extension date

(if agreed):

Signed by Tutor/Assessor to agree extension:

Date

submitted:

Internal Moderation: Yes/No

Date:

Signed by internal moderator:

ON TIME
/
LATE

Learner declaration:

Learner declaration:

 The explanations and evaluations in this work have been developed and written by me.

 I have not submitted material copied from the Internet, text books or other sources in place of my own thinking and writing.

 When I have referred to the work of others I have done so to discuss, comment on or argue their ideas.

 I have kept quotation and paraphrasing to an absolute minimum and only to support points I have made.

 I understand that referencing the names of authors whose ideas I have used without including my own interpretation of those ideas, does not meet the assessment criteria and cannot attract the Pass, Merit or Distinction grades.

 I have not copied the work of my peers.

Learner comments:
(please use this space to comment on any aspect of the assignment when handing in your work)

Signature:

Date:

TO THE LEARNER: Please attach this assignment brief to any written work you are handing in for assessment, or submit the brief as instructed.

YOUR WORK CANNOT BE ASSESSED UNLESS YOU HAVE SIGNED AND SUBMITTED THIS FORM

Be able to demonstrate extensive subject specific knowledge

Grade Descriptor

Grade Descriptor

Merit

(Choose one or more relevant grade components)

Distinction

(Choose one or more relevant grade components)

Grade Descriptor

Merit

(Choose one or more relevant grade components)

Distinction

(Choose one or more relevant grade components)

Grade Descriptor

Merit

(Choose one or more relevant grade components)

Distinction

(Choose one or more relevant grade components)

Level 3	Unit title: Extended Project
This assignment addresses the following Assessment Criteria from the unit (or a copy of the unit may be attached, if all AC are covered):
Learning Outcome	Level Three
1	Be able to work within the conventions of a specific subject	1.1. Define a subject specific topic of investigation. 1.2. Define the aims & limits of this investigation within the conventions of the chosen subject area. 1.3. Process subject specific sources according to the conventions of the chosen discipline.
2		Be able to demonstrate extensive subject specific knowledge	2.1 Explain the details, and analyse the nature of, the subject specific material under consideration. 2.2 Evaluate the relevance of the subject specific material to the topic
3	3.1. Sustain a logical argument in an extended piece of work in form/s and using terminology consistent with subject specific conventions.
4	Be able to present work in form/s consistent with the conventions of the specific subject, including an appropriate form of academic citation.	4.1. Present the finished project in a form/s consistent with subject specific conventions. 4.2. Use academic citation / referencing appropriate to the form of the extended project & to the specific academic discipline.
Level 3 units only: Learners achieve a Pass if they meet all Level 3 Assessment Criteria for a unit. You will achieve a Merit or Distinction by meeting the following Grade Descriptors. Your tutor will give you feedback for all three grades.
					Grade Descriptor	Merit (Choose one or more relevant grade components)	Distinction (Choose one or more relevant grade components)
	GD 2: Application of Knowledge	The student, student’s work or performance a) makes use of relevant · Facts · Perspectives · Theories with either b) breadth or depth that goes beyond the minimum required to pass c) very good levels of · Consistency · Accuracy · analysis	The student, student’s work or performance a) makes use of relevant · Facts · Perspectives · Theories with both b) breadth and depth that goes beyond the minimum required to pass c) excellent levels of · Consistency · Accuracy · analysis
			Merit (Choose one or more relevant grade components)				Distinction (Choose one or more relevant grade components)
GD 4: Use of Information	The student, student’s work or performance a) identifies new information from sources which are generally appropriate b) makes some use of new information c) generally, appraises the relevance and value of new information accurately	The student, student’s work or performance a) identifies new information from sources which are consistently appropriate b) makes extensive use of new information c) consistently appraises the relevance and value of new information accurately
GD 5: Communication and Presentation	The student, student’s work or performance shows very good command of • structure • use of images • syntax • spelling • punctuation • referencing	The student, student’s work or performance shows an excellent command of • structure • use of images • syntax • spelling • punctuation • referencing
GD 6: Autonomy and Independence	The student, student’s work or performance a) in most cases takes opportunities to initiate appropriate actions b) responds promptly and effectively to guidance c) demonstrates very good time management	The student, student’s work or performance a) nearly always takes opportunities to initiate appropriate actions b) works effectively with a high level of independence c) demonstrates excellent time management
GD 7: Quality	The student, student’s work or performance is a) structured in a way that is generally logical and fluent b) taken as a whole, demonstrates a very good response to the demands of the brief / assignment	The student, student’s work or performance is a) structured in a way that is consistently logical and fluent b) taken as a whole, demonstrates an excellent response to the brief / assignment
There is no grade descriptor for pass. Students achieve a pass by meeting the requirements of all the assessment criteria for a unit.

Grade Guidance: Learners must carefully read the guidance below which is linked to the components above

MERIT and DISTINCTION: For a merit your response will show that the information found, as a result of your primary and secondary investigations, has been presented in a way that shows you have used the information with very good levels of accuracy and analysis; this could be most evident in your discussion about the results / findings. You will be able to show that you have been able to deconstruct the information and analysed it appropriately in order to solve a problem (that is, the question created for your investigation). The different perspectives from the sources will have been interrogated. For a merit; this will apply to and require either breadth or depth of information and for a distinction this will require both breadth and depth and a higher level of consistency and accuracy. The primary and secondary sources you include within your investigations, will be graded according to their appropriateness. If sources are generally appropriate to the subject matter, then a merit could be achieved. However, for a distinction, your choice of sources would need to be consistently appropriate throughout your work. You will also be graded on your ability to appraise the information; this could be your judgement on its academic value, for example, any bias evident, or the reliability or authenticity of the information. Your ability to comment on this aspect (academic worth of information) will be graded appropriately with either a merit if carried out in a general way, or a distinction level if covered extensively within your response. You are expected to follow the guidance given on the brief with regard to the structure of your report. In addition, you are expected to write in an academic style and register; the degree to which you do this effectively will be graded appropriately. Generally logical and fluent work could achieve a merit, whereas consistently logical and fluent work could achieve a distinction. Throughout the process of completing your extended project, you should show that you are an independent learner and to an extent autonomous. You will need to manage your time effectively and manage any problems effectively too. You will, with the guidance and support of your tutor be able to work with levels of autonomy and independence. Evidence of this will be gathered from your one to one tutorial meetings, which will show how well you respond to targets and how well you demonstrate effective time management skills. Academic citation using the Harvard style of referencing should be used accurately; the levels of accuracy will contribute to the quality of the assignment.

Date:

Date:

Part A: Feedback on credit level
AC no	Credit achieved (L3)	Location of evidence	Tutor/Assessor comments on assessment criteria (you could also indicate on the work itself where each AC is met)
1.1, 1.2, 1.3
2.1, 2.2
3.1
4.1, 4.2
Level achieved	Tutor/Assessor’s signature:
Resubmission (if applicable) If any of the assessment criteria for this assignment have not been met at Level 3, a resubmission may be permitted. Resubmission must follow the QAA guidelines and be permitted only once.
Requirements for resubmission/new Task set:
Date Set:	Date due:	Date Submitted:
Feedback on resubmission:
Level achieved after resubmission:	Tutor/Assessor’s signature:

Grade Descriptor

GD 2: Application of Knowledge

Part B: Feedback on grading (Applicable only if all assessment criteria achieved at Level 3)
Tutor/Assessor comments against grade descriptors	Grade indicator (P/M/D) Please enter the final grade on page 1 based on this grade profile e.g. PMP = P
GD 4: Use of Information
GD 5: Communication &Presentation
GD 6: Autonomy / Independence
GD 7: Quality
Tutor/Assessor’s reason for final grade decision (if applicable):
Areas for development (how will the learner be able to use and improve on what they have learnt on this unit and the skills that they have used in their further studies?)

1

HOW CONTROLLED IS OBSTRUCTIVE SLEEP APNEA WITH THE USE

OF NASAL / PILLOW MASK?

INVESTIGATION

When people sleep, the neck muscles relax to the extent that the upper airway closes partially and become narrow, this causes disruption to the air way passage (ResMed, 2019). This narrowing of the airway brings about vibration in the throat when breathing, which causes the sound of snoring. The relaxation of the neck muscles can occur due to many reasons. From swollen tonsils to too much of alcohol, being overweight and most especially the shape of the nose and the jaw- to mention few of the factors that could cause the neck muscles to relax and causes snoring (ResMed, 2019). This situation leads to a condition known as Obstructive Sleep Apnea.

According to British Lung Foundation (2014), Obstructive Sleep Apnoea (OSA) is a sleep-related respiratory condition that causes repeated temporary cessations of breathing occur during sleep, as a of a narrowing or closing of the pharyngeal airway in sleep. (NHS, 2016) describes Obstructive sleep apnoea (OSA) as a condition where the walls of the throat relax and narrow during sleep, interrupting normal breathing, while the Central Apnea occurs when the body fails to make attempt to breathe during pauses If OSA is not treated, it deprives people of a healthy sleep, which can cause severe daytime sleepiness (Carlos Rejón Parrilla, et al. 2014). British Snoring & Sleep Apnoea Association (2018) explain that, these periods of ‘stopping breathing’ only become clinically significant if the stopping lasts for more than 10 seconds each time and occur more than 5 times every hour. 1.5million adult is estimated to be experiencing Obstructive Sleep Apnea in UK, and only around 330,000 are currently diagnosed and treated. (BBC NEWS UK, 2017). It is linked to increased cardiovascular, motor vehicle, and other accident risk, lower workplace productivity, and increased health care expenditure in comparison with the normal population (Rowland, et al. 2018).

Investigation shows that Obstructive Sleep apnea (OSA) patients prefer the pillow/nasal mask. Even though, some of these patients still have complain about their sleep (Rowland, et al. 2018). It has been observed that in some patients the symptoms of tiredness and sleepiness come back after a while, hence investigation of why and how commenced. Research has proved the direct health benefits that effective treatment of OSA can generate. Guest et al. (2008), estimated that CPAP usage for a given time of 14 years could save the NHS close to £1,000 per patient.

What is CPAP?

Continuous positive airway pressure (CPAP) is a type of treatment that has shown effective for sleep apnea. Even though it is effective, compliance with this therapy continues to be problematic. In fact, up to 83% of patients don’t comply with CPAP therapy (Brooks, 2017). Studies explained that for treatment to be effective the right respiration pressure and a mask that fits perfectly has to be in chosen. While the average CPAP usage is around five to six hours a night, many patients use it fewer than four hours a night. As long-term plans of CPAP usage are often proved in the first few days (Brooks, 2017). Brooks 2017 clarified further that, it is necessary to find a mask that is acceptable to the patient, seals comfortably, and is linked with minimal side effects. This will surely boost the patient adherence.

Types of Mask

The Journal of Clinical Sleep Medicine Article (Rowland, et al 2018), explain there are many types of masks for CPAP patients to choose from. The Full-Face Masks also called Oronasal mask, which covers both the mouth and nose and allows the patient to breathe through nose and mouth as seen in fig. 1 and 2.

Fig 1 Fig.2

The Full-Face Mask (from ResMed.) Patient with Full-Face mask in Bed

Another type of mask is known as Nasal mask this cover only the nose, and can be describe as small plastic with soft silicone that rest on the nose bridge for easy grip and comfort as shown in Fig. 3 and 4.

Fig. 3 Nasal Mask Fig 4 Nasal Mask in use

Last mask to mention is the Nasal pillow mask, which seat in the nose exclusively. Nasal pillow mask has been known to be in popular request by OSA patients, it is compact and lightweight option for patient with designs that allow minimal contact with their face. Nevertheless, side effects have been reported in more than 50% of patient in some studies (Rowland, et al. 2018). Example of Nasal Pillow Mask is shown in Figure 5.

Fig. 5 Nasal mask in use Fig. 6. Nasal Pillow (under nose)

Patient compliance

Size, fit, and comfort are essential considerations when choosing a CPAP mask. It’s not likely to be compliant with CPAP therapy, If the mask doesn’t fit, isn’t comfortable, or doesn’t meet breathing needs. Hence, the purpose will be jeopardised. A right choice of CPAP mask leads to successful therapy, which is quality of sleep and good health. This can always be measure by checking Epworth sleepiness score (ESS). The ESS requests the patient to rate themselves on a 4-point scale (0-3) their usual chances of having dozed off or fallen asleep while engaged in eight different activities (Johns, 1994; 2010).

Mador et al. (2005), estimated that 70% of CPAP users do experience nose and nasal dryness as well as nasal congestion, these situations contributes to non-compliance of patients. Humidifier is usually introduced to CPAP therapy for patient’s comfort to moisturise the air patient breathes and prevents nasal resistance which causes mouth breathing. Thus, humidification reduces nasal congestion and throat dryness and improve compliance of patients by adding warmness and moistness.

According to British Thorax Society Journal.

References

Brook, R. (2017) Which CPAP Mask is Best for your Patient? Pros & Cons of Various Mask Types. Available at:

https://www.aastweb.org/blog/cpap-masks-options-full-face-nasa-and-nasal-pillows (Accessed: 02

January 2019).

Carlos Rejón Parrilla – J. Garau M. and Sussex J. (2014) Obstructive Sleep Apnoea Health Economics Report [Online] Available at:

https://www.blf.org.uk/sites/default/files/OHE-OSA-health-economics-report—FINAL—v2

(Accessed 26 December 2018).

Guest, J. F., Helter, M. T., Morga, A., & Stradling, J. R. (2008). Cost-effectiveness of using continuous positive airway pressure in the treatment of severe obstructive sleep apnoea/hypopnoea syndrome in the UK. Thorax, 63(10), pp.860-865.

Mador MF, Krauza M, Pervez A, Pierce D, and Braun M (2005). Effect of heated humidification on compliance and quality of life in patients with sleep apnea using nasal continuous positive airway pressure
. Chest. 2005;128: 2151–8. pmid:16236868.

Rowland, S., Alyappan, V., Hennessy, C., Catcheside, P., Li, C., McEvoy, R., and Antic N. (2018) Comparing the Efficacy, Mask Leak, Patient Adherence, and Patient Preference of Three Different CPAP Interfaces to Treat Moderate-Severe Obstructive Sleep Apnea
. Journal of Clinical Sleep Medicine. 15 January, 14(1) (12), pp. 101-108.

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