A PATIENT WITH MUSCULOSKELETAL LIMITATIONS COMPLICATED BY A MEDICAL ILLNESS

1 1 1 1 1 1 1 1 1 1 Rating 5.00 (1 Vote)

1. Utilizing evidence, explain one of the SCIP core measures, and how it has impacted the prevention of surgical complications.

Surgical care improvement is an organizational partnership within the nation that seeks to reduce episodes of complications before during and after surgery by following a checklist of measures. To achieve this aim evidence based practice that utilizes available proven evidence is used with the goal of improving the patients’ outcome. Surgical care improvement seeks to utilize the best information to guide clinical practice with an overall aim of reducing surgical complications and thus healthcare costs. It utilizes several core measures that are prophylactic in nature.In this question I’ll be discussing prophylactic antibiotic received within one hour prior to surgical incision (SCIP Inf-1) and how it impacts patients’ outcome positively or otherwise. The chief goal of this measure is to reduce incidence of surgical site infections.

Antibiotic prophylaxis is recommended for invasive orthopedic procedures like arthroplasty. The reason for this is that such an invasive procedure has an infectious risk that ranges from 5% to 15% without antibiotics. This high rate of infection can greatly increase morbidity and mortality among these patients. Conversely if antibiotic prophylaxis is provided there is a marked reduction in the risk for infection to around 3%. Staphylococcus epidermidis and Staphylococcus aureus which are members of the normal flora are the leading causes of joint infections. The antibiotic of choice for prophylaxis against these organisms is cefazolin (ancef) since it’s the most effective choice against the aforementioned organisms. There is no evidence to support extension of prophylaxis post-surgery or addition of an aminoglycoside. Antibiotic prophylaxis was adopted as a core measure of ensuring better surgical outcomes since there is evidence to support its use. In the above case the patient receives cefazolin which is the antibiotic of choicefor prophylaxis against Staphylococcus aureus and Staphylococcus epidermidis. On the first post-operative day the administration of antibiotic ceases. This is also in agreement with the best practice that has demonstrated little benefit if any in extending the prophylaxis period.There is also no extra antibiotic given since additional antibiotics are of no proven value(Page, Bohnen, Fletcher, McManus, Solomkin and Wittmann, 1993).

The efficacy of antibiotic prophylaxis is not only influenced by the organisms to be targeted but also the timing of administration. The general recommendation is that the antibiotic should be administered within 30 minutes before the procedure. In the above case the patients receives the first dose 30 minutes before surgery which is in line with the best practice recommendations. To further confirm that this is the best practice the patients has uneventful post-operative period (Classen, Evans, Pestotnik, Horn, Menlove, and Burke, 1992).

Other authorities recommend the administration of prophylactic antibiotic to be within 60 minutes prior to surgery. The longer the time period between the antibiotic administration and the incision time the higher the risk of surgical site infectionthe right drug should be administered at the right dose the right route and right timing for optimal protective effects (Bratzler, Dellinger, Olsen, Perl, Auwaerter, Bolon, Fish, Napolitano, Sawyer, Slain, Steinberg and Weinstein, 2013).

In the above case the patient received the right drug at the right timing. The result of which was uneventful recovery period. Prophylactic antibiotics for surgical operations have greatly reduced incidences of infections during the perioperative period. As mentioned above the drop is from the ranges of 5%-15% to 3%. Failure by providers of healthcare to adhere to this best practice is what is resulting in increasing case of post-surgical wound sepsis, increased mortality and increased healthcare costs.

In conclusion the impact of this drop in infections is reduced morbidity and mortality, reduced hospital stay and reduced health care costs. It is therefore the right practice for healthcare providers to employ this measure since it has been proven to effective and beneficial for patients and the healthcare system as a whole. The administration of the right antibiotic within the stipulated time is the reason this measure will be effective or not.

2. Explain why, no hair removal was required for the surgical procedure. If it had been ordered, would a razor have been appropriate to use? Explain your rationale with evidence.

Previously the general recommendation prior to surgery was that hair at the site that is to be incised ought to be removed. The primary method of choice for hair removal was shaving using a razor blade. Following years of research this is no longer the case anymore. New information has been brought to light in relation to some of the down sides to hair removal as dictated by the method used. Hair removal is not therefore bad in itself. Whether it’s a bad thing or a good thing is depended on the hair removal method used and the timing.

Hair removal was not required since unequivocal evidence is still lacking to support the use of pre surgical hair removal to reduce surgical site infections. Most studies have not yielded significant differences between patients who had hair removal prior to surgery and those who did not although some of the researches done were considered to be of low quality to be generalizable (Tanner, Woodings and Moncaster, 2007). The Centre for Disease Control (CDC) recommendation pertaining to pre-operative hair removal is that it should only be done if it will interfere with the surgical procedure to be done. This recommendation serves to discourage routine hair removal that had been the standard practice (CDC, 2008).

In addition to this other studies have indicated that hair removal of any kind can result in increased incidences of surgical site infections serve to discourage routine pre-surgical hair removal. Another authority that argues against hair removal is the Association of perioperative Registered Nurses’ (AORN). It recommends that hair should be left at the surgical site as much as it is possible. This too serves to dissuade healthcare providers from practicing routine hair removal on patients prior to surgery since in certain instances it can increase the risk of surgical site infections (AORN, 2008). With this information in mind a decision was made based on the existing evidence that hair removal wasn’t necessarily beneficial and if anything it can be detrimental to the patient as it can increase the risk of surgical site infections given the evidence above.

If hair removal had been ordered a razor blade would not have been the most appropriate instrument to use for the procedure. The key aim of pre surgical hair removal is to reduce infections at the surgical site and also ensure that hairs don’t interfere with the procedure in any way. The most readily available method for pre surgical hair removal is shaving with a razor. Shaving with a razor has been proven to result in micro cuts that can increase the incidence of surgical site infections defeating its very purpose.

Suvera and colleagues compared the use of depilatories against the use of a razor blade for pre surgical hair removal. From their findings they concluded that unlike depilatories use of razor increased the incidence of surgical site infections due to the skin injuries it produced. This research based information serves to discourage hair removal by the use of a razor as it proves it to be the worse option of the two (Suvera, Vyas, Patel, Varghese, Ahmed, Kashyap and Nair, 2013). From the above research conclusions the use of a razor won’t result in the best patient outcomes in fact it might result in increased of surgical site infection. Apart from that depilatories have in certain instances resulted in sensitivities that have even resulted in the cancellation of some surgical procedures. For this reason the CDC recommends the use of hair clippers if hair removal is really necessary and that this should be done just before the surgical procedure (CDC, 2008). The use of clippers will be the method of choice if pre-surgical hair removal had been ordered for and not the razor blade.

Other researchers recommend that depilatories and clippers are superior methods of pre surgical hair removal when compared to shaving using a razor. From their findings shaving should not be done under any circumstancesas they increase the chances of surgical site infections (Tanner et al 2007). In addition to that, a study conducted by Celik and Kara concluded that shaving with a razor just before a surgical procedure increases the rate of post-surgical operation infections. Although their research focused on patients undergoing spinal surgery this information can be generalized to the knee surgery. Rather than risk increasing the chances that the patient could get a surgical site infection not using a razor for hair removal will be the better option as this researchers found out (Celik and Kara, 2007).

And lastly a systematic literature review found increased surgical site infections from shaving using a razor in the pre-operative period (Orsi, Ferraro and Franchi, 2005).It is therefore self – evident from this finding that shaving using a razor does not confer the benefit it was once thought to confer. If anything, its use serves only to harm the patient.

In summary routine pre-surgical hair removal is not the practice of choice for reducing surgical site infections. And if hair removal has to be done the using clippers is preferable to shaving using a razor or even using depilatories. And if clipping is to be used it should be done immediately before surgery. The general recommendation is that razor blades should be removed from wards to help stop this practice of pre-surgical shaving that has been proven to result in increased surgical site infections.

3. What methods were used to ensure that the recommended VTE/DVT prophylaxis was implemented, and why is the timing important? Explain your rationale with evidence.

One of the core measures of surgical care improvement is surgery patients who received appropriate venous thromboembolism prophylaxis within 24 hrs prior to surgery to 24 hours after surgery (SCIP VTE- 2). The patient had a hose TED and sequential compression stockings. In addition to this measure the patient received levonox 30mg subcutaneously starting on the first post-operative day.

The risk for pulmonary embolism that ends in death for patients undergoing orthopedic surgery under general anesthesia is estimated at 0.8% to 1.0%. The chances of a patient developing deep venous thrombosis reduce if prophylaxis with heparin (low molecular weight) is instituted early.The generally accepted time frame that ensures best results for drug prophylaxis is within 8 hours of surgery. Mechanical methods also serve together with pharmacological methods to produce better results for thromboembolism prophylaxis. Mechanical options available function by preventing the pooling of blood mainly in the lower extremities. They achieve this role by promoting blood flow and the amount of fibrinolysins in circulation.

According to a graduated compression stockings in the preventions of postoperative venous thromboembolism a meta-analysis this stockings result in significant reduction in the risk of thromboembolism. The stocking works by preventing the pooling of blood in the lower extremities thus preventing formation of blood clots. These stockings promote linear flow of blood hence no pooling of blood occurs. Furthermore these stockings stimulate fibrinolysis on the endothelium preventing formation of clots. Graduated stockings alone reduced the incidence of deep venous thrombosis by approximately14%.Case in point is that elastic stockings are effective as a method of prophylaxis against deep venous thromboembolism(Ross-Adjie, McAllister, & Bradshaw, 2012).

Together with pharmacological intervention they achieve synergistic effect that is more beneficial unlike if each method was employed singly. A combination if intermittent compression device and heparin for thromboembolism prophylaxis was found to be more effective than aspirin or warfarin alone.

In respect to this evidence the patient received two prong approach for prophylaxis against development of deep venous thrombosis and the resultant embolism. Both the pharmacological and mechanical methods for DVT prophylaxis were employed. The use of mechanical devices served as adjuncts to drug therapy helped to guarantee better results for the intervention(Ross-Adjie et al., 2012).

The timing for the prophylactic intervention is also important. Time is allowed to let the hemostasis at the surgical wound settle before the pharmacological prophylaxis is instituted. Without this window period allowance the pharmacological intervention can result in the hemorrhage of the surgical site negating its benefits altogether. In addition to this one of the risk factor for formation of thrombi is prolonged immobility. Intervention is instituted earlier before the effects of immobility set in. In case of prolonged immobility there is resultant pooling of blood that serves to encourage clot formation.

The recovery period of this patient was uneventful. No deep venous thrombosis resulted lending credence that the prophylactic measures against it were effective. The combination of thromboembolic stockings and anticoagulants is now part of routine post-operative management for patients at risk of deep venous thrombosis. The impact of instituting this measure is reduction in the incidence of thromboembolism with their associated complications.

In conclusion choosing the right prophylactic method against deep venous thrombosis and instituting it in a timely manner can greatly reduce the incidence of thromboembolism and its related complications. Rather than sticking to old ways healthcare providers should be able to stay abreast with the latest findings that have a direct bearing to the patients’ health. This evidenced based approach will go a long way in improving the quality of care patients receive.

REFERENCE

AORN,(2008).Recommended practices for preoperative patient skin antisepsis. Perioperative Standards and Recommended Practices.Denver. p. 537-555.

Bratzler D., Dellinger E., Olsen K., Pearl T., et al. (2013). Clinical practice guidelines for Antimicrobial prophylaxis in surgery.Am J Health Syst Pharm. 70(3):195-283.

CDC (2015). Surgical site infections (SSI): Data and statistics. Retrieved on 21st September 2015 from http://www.cdc.gov/ncidod/dhqp/dpac_ssi_data.html

Celik S., Kara A.(2007). Does shaving the incision site increase the infection rate after spinal surgery? Spine;32(15): 1575-1577.

Mukesh S., Patrick V., Mansukh P., et al. (2013). Two methods of pre-operative hair removal and their effect on post-operative period. Int J Med Sci Public Health; 2(4): 885-888

Orsi G., Ferraro F. &Franchi C. (2005).Preoperative hair removal review.Ann Ig. 17(5):401-12.

Phillip S., Anthonie W. & Hirsh J. (1994).Graduated Compression Stockings in the Prevention of Postoperative Venous ThromboembolismA Meta-analysis.Arch Intern Med. 154(1):67-72.

Ross-Adjie, G., McAllister, H., & Bradshaw, S. (2012). Graduated compression stockings for the prevention of postoperative venous thromboembolism in obstetric patients: A best practice implementation project.International Journal of Evidence-Based Healthcare, 10(1), 77–81.

Tanner J., Moncaster K., Woodings D.,(2007). Preoperative hair removal: a systematic review. J Perioper Pract.17:118-21, 124-32.

Pin It

Why choose us

Unlike most companies that offer all manner of writing services, NursingWritingServices.com specialize in only one industry. Medical and Nursing field. All our writers, editors and top management is comprised of individuals with strong medical background.It doesn't matter what you want. Whether it's a PhD thesis/dissertation or a Masters level or university essay, we have what it takes. All our services come with 100% money-back guarantee.

NursingWritingServices.com was founded not by just other ordinally folks looking to make money out of medical and nursing writing business, but real medical and nursing trained individuals. The entire team of custom nursing writers have medical training backgrounds, a fact that makes us stand out from the others. Our nursing writers can handle any assignment from college to university to PhD.

  • Custom Written Papers Free from plagiarism
  • 100% Privacy guarantee. Details of client never shared
  • 100% refund guarantee for poorly written work
  • Timely delivery of all Essays, research papers etc
  • Qualified and experienced medical and nursing writers

Nurses spend a lot of time with their patients as it is part of their healthcare system. It is part of their job as they get lots of opportunities in observing and monitoring patients to see how they are faring and spot problems early. Understanding how to asses a patient’s wellbeing i.e. checking his or her pressure and temperature is part of her daily routine. Undertaking this career often leaves nurses with lots of questions. Many are not always content with their selves as it is a process which requires deep preparations and the right attitude for the job. Nurses are in demand for their services in many healthcare centers. It is also evident because many schools require admission letters of purpose before joining. Nursing skills are vital in preparing yourself for a future of serving and caring for others by learning and acquiring upon the skills and characteristics needed to succeed on the job. Many clinical skills are important that will help you achieve greater strides in your career.

1. Good communication skills

Nurses are always on the frontline of care. Many will have to pass critical information that is coming from a physician to a patient. He or she must create an open dialogue with patients and their families so they fully comprehend medication, diagnosis or any other medical concerns that may be in need. Clear concise information amongst fellow colleagues is key as it involves sharing of responsibilities and caring for your patients. Many nurses find themselves sharing information with critically ill patients or their doctors. Strong communication is critical for achieving this.

2. Possess critical thinking skills

For one to be admitted to the nursing field, critical skills are vital to employing in your everyday life situations. Crucial decisions need to be met and solved on the spot as it always a matter of life and death. Showing confidence and quickly mitigating the issue is necessary to the nursing profession field.

3. Flexibility

Nurses often meet surprises in their daily operations. Emergency situations are constant in their day to day operations. Many nurses should be able to juggle the strenuous schedules that they have. Showing the capability to adapt to the evolving schedules is imperative to them succeeding. Apart from acquiring skills, nursing must constantly attend remedial classes or go back to books to improve their nursing skills. as the world continues to evolve so is the emergence of new medications and diseases that should have them prepared for the rest of their careers.

There are multiple sources for improving nursing skills. resources help improve a nurse’s competency in the profession and provides an overview of procedures or the desired outcomes that need communication with the patient’s family. Nurses can also improve their skillsets by acquiring additional resources that include resources covering a wide range of topics that relate to their communication skills, critical thinking skills and about drug information.

Enhancement of your clinical skills also includes accessing drug information and also knowing those that contain precautions, side effects before administering them to patients. Another way of enhancing your skillset is by continuing to work on education modules that will help expand their knowledge capacity and thinning areas. Having a broad scope of knowledge is beneficial to one’s career. Many diseases are emerging in this fast-paced moving healthcare environment. One can increase their skills with additional resources that includes going through research information’s found in clinical libraries and textbooks covering a wide range of topics. Nurses can greatly improve their skills through resources which focus on many areas of clinical nursing that include patient care, technical, nursing, communication, and critical thinking skills as stated above.

Health and Human Ecology Research Paper

Human ecology is a sub-discipline in ecology which focuses on humans. It is the study of the relationships of humans with natural, social and other environments.A Health and human ecology research paper is written by a students in the field of medicine, and it involves researching on the topic, then crafting a quality research paper on the same. No student graduates without writing a quality research paper. Since quality research paper writing is always important, students should ensure they research reliably well on the research paper topics in question. Tutors will never give grades for shoddy work, therefore, students must ensure they research comprehensively on their papers.




HOW IT WORKS

1. You place an order and provide any necessary instructions

2. We assign your work to a writer with a relevant degrees

3. The assigned writer starts working on your paper right away

4. We send the completed paper to your email and accounts





GET Health and human ecology research paper help.

Research and writing are very demanding tasks, and getting the time to effect these processes is a challenge to a good number of students. This is why it is important for any student who is busy, or who simply lacks the writing experience called for to get help from online writing help providers. There are competent writing help providers which will craft any student an authentic Health and human ecology research paper. Students should however understand that it is only a full fledged writing company which will give them the best papers.




Choose NursingWritingServices.com.

Nursing Writing Servicesis a competent writing company which will craft you the best Health and human ecology research paper. We have been writing for long to understand the writing standards we must match all through. Every client gets a competent paper done according to instructions given. We also have a competent client support staff which can be reached at by any client regardless of the time of the day. Our unique 24 hour free chat service will be open to all clients.




OUR EXCLUSIVE FEATURES

Are you wondering who will write your Nursing paper? Look no further. With the help of our experienced writers and exclusive features, nursingwritingservices.com is an Online Nursing Paper writing company that takes up responsibility to give you a quality and original Nursing paper. Some of the exclusive features are as shown below:

Integrated plagiarism checker

Guaranteed 100% original Nursing papers every day

Live chat with your writer

Guide writers on your expectations and suggestions while they work

Choose your favorite writer

Select from hundreds of writers and pick your favorite one for your Nursing papers

Free preview of your order

Get a free preview of your Nursing papers and request for any revisions




We Guarantee Quality.

We are a writing company of excellence which understands that it is only top quality research papers which get positive grades. We have therefore invested well in outstanding research facilities to ensure clients get authentic papers. We also have a competent proofreading panel which will reread your original Health and human ecology research paper to ensure it is competent.




Choose NursingWritingServices.com to get;

  • A top quality Health research paper.
  • A timely submission of your paper.
  • We guarantee privacy.
  • No hidden charges on writing health and human ecology research papers.
  • Get the best cited Health and human ecology research papers.
  • Top quality Health and human ecology research papers by competent and professional writers.
  • Most reliable client support staff.
  • 100% original Health and human ecology research paper.
  • 24/7 free chat service .
  • Free health and human ecology research paper revisions if clients are dissatisfied.



BEST HEALTH AND HUMAN ECOLOGY RESEARCH PAPER ONLINE





WHY CHOOSE US?

We have able writers.

  • Our health and human ecology research paper writers have been writing for long to understand the writing standards every single research paper written should match.
  • We have excellent writers who are not intimidated by any health and human ecology research paper topic .
  • Health and human ecology research paper writers have been through top ranking Universities all over the world, and are natives of English speaking countries.
  • We guarantee clients an authentic Health and human ecology research paper done by a writer holding Masters or PhD degrees in different academic fields.
  • Our health and human ecology research paper writers can be reached at by any client through our 24/7 free chat service, in-case clients have a question they want answers or specifications to give.
  • The writers draft you a custom Health and human ecology research paper according to instructions given.



Best Nursing Paper writers

Our Professional writers comprises of medical doctors, nurses and pharmacist with passion for writing and research

Read More

Custom & Non-Plagiarised Papers

Our nursing papers are crafted from scratch and we offer money-back guarantee on originality of our custom papers.

Read More

Affordable Prices. Great Quality.

Our prices are formulated in a way that ensure good quality papers and cost effective services for our clients

Read More




Recent Orders By Our Writers




FAQs

The writers we select must be professionals who have built an admirable reputation in the medical field. And who have enough background on nursing management.

We offer our clients free unlimited research paper revisions to their satisfaction

Yes it is possible to monitor the progress of your research paper order. Our website has a 24/7 live chat support that guarantees that you continually communicate with your writer about everything.

Yes you can! You can place your order on our website. Our research writing services are global.

In case you are not satisfied with the health and human ecology that we write kindly notify us. You are entitled to unlimited revisions until you are fully satisfied.

Yes. You can contact our support team and request for the draft. Make sure you request for the draft early enough.

We normally follow the client’s instructions. The client is allowed to select the topics they want us to include in the research paper or they can allow us to include the relevant topics ourselves.

Not at all. All our writers are professional and always write unbiased research papers.




What Clients Say



Related Services

developmental disability nursing research paper

Developmental disability refers to a certain cognitive and, or physical impairment occurring to humans in the early stages of life. It is a permanent impairment which can also occur to anyone below 18 years of age.A developmental disability nursing research paper is an academic paper written by student doing nursing as a course. The student will simply be required to craft a competent paper on this topic.




HOW IT WORKS

1. You place an order and provide any necessary instructions

2. We assign your work to a writer with a relevant degrees

3. The assigned writer starts working on your paper right away

4. We send the completed paper to your email and accounts





Write From Research.

The best crafted research paper will get a student positive grades. This is because tutors will want a strong demonstration through competent writing that the student in question has grasped what they learn in class. As a student, you should understand that crafting an authentic developmental disability nursing research paper will require you to conduct research earnestly. Outstanding essays will get positive grades, because tutors are knowledgeable intellectuals. Information should also be gotten from reliable sources.




Developmental Disability Nursing Research Paper help

If you are a student who can not get ample time to craft a research paper, or if writing experience escapes you, get help. There are multiple online writing companies with the capability of crafting you a quality developmental disability nursing research paper, provided you choose the best. Top quality writing companies will provide you with papers of high standard, and before you trust any company with your paper, check its authenticity. Nursing Writing Servicesis a quality writing service provider. We guarantee clients authentic research papers because we are well exposed in writing to understand the writing standards we must match all through. We have a competent client support staff, and a unique 24 hour free chat service, which is open to any client. Your custom developmental disability nursing research paper will be done according to instructions given and submitted to beat any submission deadlines.




OUR EXCLUSIVE FEATURES

Are you wondering who will write your Nursing paper? Look no further. With the help of our experienced writers and exclusive features, nursingwritingservices.com is an Online Nursing Paper writing company that takes up responsibility to give you a quality and original Nursing paper. Some of the exclusive features are as shown below:

Integrated plagiarism checker

Guaranteed 100% original Nursing papers every day

Live chat with your writer

Guide writers on your expectations and suggestions while they work

Choose your favorite writer

Select from hundreds of writers and pick your favorite one for your Nursing papers

Free preview of your order

Get a free preview of your Nursing papers and request for any revisions




Why choose NursingWritingServices.com?

  • They are graduates from the best universities all over the world and natives of English speaking countries.
  • Our writers are competent intellectuals who have been writing for long.
  • We guarantee an excellent developmental disability nursing research paper because our writers have been lecturers before hence understand the writing standards your research paper must match.
  • They have Masters and PhD degrees in numerous academic fields, and will craft you an authentic developmental disability nursing research paper.
  • Ours are friendly intellectuals who can be reached at by any client at any time of the day, through our unique 24 hour free chat service.
  • They follow instructions fully, and this is why you will get a top quality essay.



BEST DEVELOPMENTAL DISABILITY NURSING RESEARCH PAPER ONLINE





Quality Research Papers.

It is through quality writing alone that a student will get positive grades. This means that students should get help from a writing company that is capable of delivering. Nursing Writing Serviceswill not let you down, and this is because we have outstanding research facilities which we use fully to guarantee authentic papers. We also have a competent proofreading panel to guarantee you authentic research papers.
With us;

  • You get the best cited developmental disability nursing research paper.
  • We are 0ffer Developmental Disability Nursing Research Paper help wiyh low prices
  • We guarantee privacy and Confidentiality.
  • Get a top quality developmental disability nursing research paper.
  • We guarantee timely submission of Developmental Disability Nursing Research Paper
  • No hidden charges.
  • We are available round the clock.
  • Get a 100% original developmental disability nursing research paper.
  • 24/7 Free chat service for Developmental Disability Nursing Research Paper help.
  • Free Developmental Disability Nursing Research Paper revisions if your custom paper is substandard.
  • Competent Developmental Disability Nursing Research Paper writers.






Best Nursing Paper writers

Our Professional writers comprises of medical doctors, nurses and pharmacist with passion for writing and research

Read More

Custom & Non-Plagiarised Papers

Our nursing papers are crafted from scratch and we offer money-back guarantee on originality of our custom papers.

Read More

Affordable Prices. Great Quality.

Our prices are formulated in a way that ensure good quality papers and cost effective services for our clients

Read More




Recent Orders By Our Writers




FAQs

A good number of our developmental disability nursing research paper writers are registered members of the developmental disabilities nursing association.

Our writers are very hardworking so it is possible as long as you include your deadline when you make your research paper order.

Yes you can, however, your essay will be assigned to one of our writers once you have made full payment for it.

You can always use a plagiarism checker to ensure that the work you have received is original. In case the work is plagiarized the writer will revise the essay at no fee.

In case you are not satisfied with the developmental disability research paper that we write kindly notify us. You are entitled to unlimited revisions until you are fully satisfied.

We don’t put a limit on the number of pages a research paper should have. We allow our clients to decide on the number of pages they want their research papers to have.

Yes it is possible. You can communicate with the writer working on your essay and inform them of any further instructions or changes




What Clients Say



Related Services