nursing-interventions

Steps of Nursing Process

NURSING PROCESS

The nursing process is the application of critical thinking to client care activities.

STEPS OF NURSING PROCESS

Nursing process involves 5 steps which include Assessment, Nursing Diagnosis, Planning , Implementation and Evaluation.

ASSESSMENT

Assessment is the first phase in nursing process. It has 2 sub-phases  , Data Collection and Data Analysis. Assessment consist of systematic and orderly collections and analysis of data about the health status of the client for the purpose of making the Nursing Diagnosis.

Such data are obtained via History taking, Observation, physical examination, laboratory data, X-rays and other diagnostic studies.

Any assessment guidelines includes the following:

  • Biographical data.
  • A health history including family members.
  • Subjective and objective data about current health status including physical examination, medical diagnosis and results of diagnostic studies.
  • social, cultural and environmental data.
  • Behaviors that may place a person at risk for potential disease problems.

NURSING DIAGNOSIS

Nursing Diagnosis is the second phase of nursing process. A Nursing Diagnosis is a clinical judgement about individual, family or community responses to actual or potential health problems.

Models for these diagnostic statements have been provided by many authors based on the taxonomy developed by NANDA. For most clients, there will be more than one nursing diagnosis.

Nursing diagnostic statements are derived from the nurse’s inferences which are based on the assessed and validated data coupled with nursing, scientific and humanistic concepts and theories.

PLANNING

Planning is the third phase of the nursing process. Planning involves the mutual setting of goals and objectives judging priorities and designing methods to resolve actual or potential problems. Two things are accomplished in the planning phase of nursing process, which includes

  • Establishing goals and objectives
  • Selection of nursing intervention.


Goals and Objectives

Goals and Objectives which are derived from the nursing diagnosis evolve from and are predicted by the problem portion of the nursing diagnoses. Goals are stated in broad terms to identify effective criteria for evaluating nursing action. Objectives are short statement of desired or expected outcomes of the client.

NURSING INTERVENTIONS

This is the phase of identification of nursing actions. Nursing interventions evolve from the etiology position of nursing diagnosis. Each nursing action is based on carefully thought out scientific rationale and specifies what kind of nursing care is to be done to meet the clients problems effectively. The nursing care plan deals with actual and potential problems.

IMPLEMENTATION

Implementation is the fourth phase of the nursing process.Implementation refers to the actions initiated to accomplish the defined goals and objectives. This is the actual giving of nursing care.  It is putting plan into action.

The implementation phase begins when the nurse begins to consider various alternative actions and selects those most suitable to achieve the planned goals and objectives. Nursing actions may be carried out by the nurse who developed the nursing care plan or by other nurses or nursing assistants.

EVALUATION

Evaluation is the fifth and final phase of the nursing process. It is the appraisal of the client’s appraisal of the client’s behavioral changes that are result of the  action of the nurse.

Evaluation consists of the following 5 steps.

  1. Review the goals or predicted outcomes.
  2. Collect data about the client’s responses to nursing action.
  3. Compare actual outcomes to predicted outcomes and decide if goals have been met.
  4. Record the conclusion.
  5. Relate nursing plans to client outcomes.
I'm so glad to be a murse.

Last night as I was watching my brother play some indoor soccer my 19 months nephew had a febrile seizure. The place was packed and I just ran toward my sister in law and grabbed him. He was cyanotic and non responsive. As soon as I got him in my arms all the nursing knowledge that I’ve learned just kicked in. His lips where purple so I immediately thought he was choking. I checked his mouth and gave him 4 breaths. The seizure finally stopped. I lay him on a bench and made sure that his airway was clear. My sister in law was in the verge of a mental breakdown and my brother was trying to calm her down. Then the EMT’s arrived and I gave them a complete SBAR report of what had happened. They just stared and me and asked me if I had any medical experience. I just told them “I’m a nursing student”. This could be the proudest moment of nursing school. The image of seeing my nephew pale, cyanotic and breathless will stick with me all my life. As I waited in the ER I came to the realization that my calling in nursing is to be an ER nurse. I came to this conclusion because as all these mayhem was happening around me I focused on my task and I was confident of my knowledge. Also I really enjoyed the adrenaline rush I got from it.

At the end it doesn’t really matter “the rush” that I got from this experience. What matters is that my patient (aka nephew) had a positive outcome. Nursing is not about you its about making sure that the patient will get the most positive outcome.

Tobacco use and the developing world

It is estimated that over 1 billion people will die of tobacco related illnesses within the 21st century. It is estimated that over 80% of tobacco related deaths will occur in low and middle income countries. Although tobacco usage in many developed nations has steadily decreased over the past decades, tobacco usage in the developing world has continued to exponentially increase.

One of the most startling examples of this has occurred in the western pacific region of the world. This area extends from China to The Philippines to Australia. Smoking in this region has increased to point to where over 45% of all cigarettes consumed in the world are consumed by this region.

Within the area, China is the largest consumer of tobacco products. They consumed over 35% of the world’s cigarettes in 2009. Further, over 60% of all Chinese men are estimated to be current smokers. Accordingly, lung cancer rates have more than doubled within the past ten years within China.

 Of particular concern for the World Health Organization and the World Bank are the related human and economic costs that are associated with increases in smoking rates. Current international objectives are to reduce smoking rates by over 40% by 2025. The intended methods include: encouraging nations to enact stronger tobacco tax laws, stronger tobacco labeling laws, and other control related laws. Regulations of this type have been directly linked to significant reductions in national smoking rates.

For the individual nurse, smoking cessation interventions should be initiated whenever possible. Nursing interventions related to smoking cessation have been linked to increases in smoking cessation and positive lifestyle changes among patients.

Assistive Devices for Ambulation

Assistive Devices for Ambulation

Definition: used to provide an extension of the upper extremities to help transmit body weight and provide support for the clients (canes, crutches, walkers)

A. Collaborative Care

  1. Nursing Interventions
  • Determine client’s mobility status and ability to bear weight per provider’s order
  • Monitor the client for the need of a safety belt
  • Instruct the client to wear shoes with non-slip soles
  • Monitor the client for risk orthostatic hypotension
  • Provide safe environment free of clutter

B. Client Education and Refferal

  1. Avoid rapid position changes to prevent orthostatic hypotension
  2. Inspect rubber tips on the device for wear and replace as needed
  3. Physical Therapy consult

C. Crutches

  1. Monitor client for correct fit of crutches: 2 - 3 finger widths between the axilla and top of the crutch
  2. Position hands on crutch pads with elbows flexed ( do not bear weight on axilla)

D. Non-weight bearing

  1. Begin in the tripod position, maintain weight on the “unaffected” (weight-bearing) extremity
  2. Advance both crutches and the affected extremity
  3. Move the “unaffected” weight-bearing foot/leg forward (beyond the crutches)
  4. Advance both crutches, and then the affected extremity
  5. Continue sequence making steps of equal length

E. Weight bearing

  1. Move crutches forward about one step’s length
  2. Move “affected” leg forward; level with the crutch tips
  3. Move the “unaffected” leg forward
  4. Continue sequence making steps of equal length

F. Walking up stairs

  1. Hold to rail with one hand and crutches with the other hand.
  2. Push down on the stair rail and the crutches and step up with the “unaffected” leg.
  3. If not allowed to place weight in the affected leg, hold up with the unaffected leg.
  4. Bring the affected leg and the crutches up beside the unaffected leg.
  5. Remember the unaffected leg goes up first and the crutches move with the affected leg.

G. Walking down stairs

  1. Place the affected leg and the crutches down on the step below; support weight by leaning on the crutches and the stair rail.
  2. Bring the unaffected leg down.
  3. Remember the affected leg goes down first and the crutches move with the affected leg.

H. Cane

  1. For correct size have the client wear shoes. The correct length is measured from the wrist to the floor.
  2. Cane is used on the unaffected side to provide support to the opposite affected lower limb.
  3. Advance the cane simultaneously with the opposite affected lower limb.
  4. The unaffected limb should assume the first full weight-bearing step on level surfaces.

I. Walker

  1. For correct size have the client wear shoes. The client’s wrists are even with the handgrips on the walker when arms are dangling downward
  2. Advance the walker approximately 12 inches
  3. Advance with the affected lower limb
  4. Move unaffected limb forward
Nursing Interventions for Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease that causes inflammation, or swelling, in many joints throughout the body, which rheumatoid arthritis nursing interventions can help. This condition can lead to pain, redness, stiffness, deformity of the joints and other severe effects like disability and premature death.

While rheumatoid arthritis does not currently have a cure, a number of treatment options can relieve symptoms of it and prevent it from worsening. A nurse can help those with rheumatoid arthritis through the following rheumatoid arthritis nursing interventions:

Medication

Medication is one of the main treatment methods for rheumatoid arthritis. While a doctor needs to prescribe the medication, a nurse can educate the patient on the medication and help them continue with it………….Rheumatoid arthritis

Lifting and Transfer of Clients

Lifting and Transfer of Clients

Implement safe care using proper body mechanics when lifting, positioning, transporting, or assisting a client to reduce the risk of injury.

A. NURSING INTERVENTIONS

  1. Assess client’s mobility and strength.
  2. Instruct client to assist when possible.
  3. Use mechanical lift and assistive devices.
  4. Avoid twisting the thoracic spine or bending at the waist.
  5. Use major muscle groups and tighten abdominal muscles.
Teens (who follow me)

If you guys EVER need to talk about anything at all I’m here. I’m mid-20’s and I’ve been through it all. Plus I have taken counseling classes and am currently doing counseling course work. So no matter what it is I won’t judge I won’t blame. I’ll just listen and offer both empathy and life experience. Sometimes it’s nice to talk to a stranger who you know can never know who you are. Just wanted to throw that out there.

I still angst quite a bit but, that is just my way of venting. If I acted on everything I thought and felt I would never have been able to get through high school college now nursing school and hold down steady management jobs since 15. I’m not as nuts as a seem just a bit sad. But, aren’t we all?

Point being you need to talk. Talk to me. I’ll listen.

Disclaimer: I might recommend certain treatments so you are warned. Thinking from a nursing perspective means trying to get you better as fast as possible.

Nursing Diagnosis: missing you
Nursing intervention: study all day and go to bed early
Goal: get to talk to you tonight
Goal outcome: goal not met. :/

What is the difference between statistical and clinical significance?

Statistical significance is a test of no effect whereas clinical significance is a test of some minimum (worthwhile) effect. Let’s take the example of an intervention—nursing rehab—on ADL performance. Compared to the controls, the intervention group scored two points better on the ADL scale. If the p-value is less than 0.05, that means that the two-point difference is real and not due to chance. The p-value does not say whether the effect is clinically worthwhile. Generally, clinical significance is assessed by experts: is it worth spending resources to achieve a two-point difference, or is a 10-point difference needed? 

Finally, the two types of significance can but do not have to overlap. An effect can be statistically significant but not be clinically significant, or vice versa.

Source: Froehlich, G. W. (1999). What is the chance that this study is clinically significant? A proposal for Q values. Effective Clinical Practice, 2(5), 234-239.

CLASS HISTORY: BSN, 2015

Four years. Four wonderful years of a roller coaster ride in our college life was filled with continuous interchangeably means and extremes, odds and evens, negative and positive inclusion of which impelled us to strive for greatness. Within those years, we’ve learned and gained insight of the theories and foundations of nursing, health assessments, principles of vital signs taking and monitoring, 10 rights of patients, different diseases – its signs and symptoms, diagnosis, treatments  and nursing interventions, nursing jurisprudence, and total quality nursing care to individuals, families, groups, and communities.

Looking into the window of memory, we see innocent and young minds freshmen class of future nurses who are somewhat apprehensive of their ever becoming globally competitive nurses. June 2011, 46 future nurses started taking their first steps at Divine Word College of Laoag, who took courage to stand, in order to fulfil their dreams. They say that first day of school was exciting, but in reality it is as scary as if you’re having doubts if it is a wonderful dream, or a nightmare. But, we are really in college.

After several days of adjustment and familiarization, we soon became comfortable in our college life. The following events was been an exciting event for us nursing students, it is when, November 2011, we finally started wearing our clinical uniforms, as well as being oriented to different affiliating hospitals, soon we’re going to have our experience and duties being nursing students, and also by that time, we begin ourselves in taking vital signs, as our first Related Learning Experience (RLE) duty. By the month of January, we were excited to have an opportunity going to Manila, as part of our Biochem class, to have an in depth understanding. We’ve come to see the Myth of the Human Body in Taguig, and visited as well as the Biology Department of University of the Philippines, Diliman Campus.

With determination and perseverance, we became sophomores in which we have our first duty as nursing students in a real, huge hospitals. It is still memorable for us in our first days of duties as we were still anxious in holding the syringes in administering medications, looking through our patient’s charts, and rendering total nursing care to our patients. To lead the BSN 2, we elected Marisa Valiente to be our Class President, and Heidi Wina Lee Gaor as our Class Representative. In our 2nd year, we remained participative in every event. On the 12th day of November 2012, gives extra excitement to us, as we were about to receive our caps and pins during the 9th Capping, Pinning, and Candle Lighting Ceremony in front of our parents, benefactors, and friends, as we were successfully accomplished 1st year in nursing school. 35 females received their Caps as a sign of willingness to serve our countrymen, and 3 males received their Pins, symbolizes the God of healing. Right from that moment, we realized that we are truly nursing students. During the summer class, we had our culminating in our subject, nutrition, which we presented different nationalities’ finest dishes, such as American, Italian, Japanese, and Filipino dishes.

“Patience is bitter, but its fruit is sweet”, as Aristotle once said. And through all the patience, we come to be in our third year, which has said to be the most crucial part of being in college. Yes. Indeed, 3rd year was rude, but it does make sense. Marisa Valiente remained as the Class President, as well as Heidi Wina Lee Gaor remained as the Class Representative. During the first weeks, we we’re already exposed in Operating Room duties. Early in the December of the same year, we had several meetings regarding our summer affiliation. Time flies so fast, as Summer Affiliation to Manila finallys was scheduled for us. Summer affiliation is one of the most exciting parts of being a student nurse, where in we were exposed to national hospitals and to different cases such as in San Lazaro Hospital, Philippine Orthopedic Center, and National Center for Mental Health, and before that we were taught in the classroom by Ma’am Carol Domingcil, Ma’am Aida Balucay, and Sir Jeff Arquillo.

And at last, here comes our senior year. At first it might be pleasing to the ears when one says “graduating students”, but what they don’t know is that, we spent sleepless nights meeting the demands of requirements and deadlines. Our first days where literally hard, due to the concepts we’ve taken, stress because of competency appraisal classes, and hectic duty schedules. Also in our senior year, a lot of things have changed; one example of this is the fusion of the School of Nursing to other courses such as the School of Information Technology, School of Engineering and Architecture, and others. We also had our Red Cross Training wherein we are trained to be a life saver in time of emergency situation, such as Basic Life Support, Adult CPR training, and Lay rescuers. After being rescuers, we also had our seminar as a requirement in nursing leadership. In which we conducted a seminar and invited speakers to talk about certain topics to widen our knowledge. After the sembreak has gone, we go for last semester. After all of these activities, we finally settled ourselves to go and practice of the graduation ceremony.

Until to this very moment, we could really say that “The long wait, is now over”, we are now about to receive our diplomas and all we have to do is to reminisce the wonderful years we’ve spent together, and later on we must be focused to make our dreams fulfilled.

So seniors, as we step up to the new chapters of our lives, let us keep hold of the knowledge and values that we learned from our much-loved Alma Mater. Despite the victories and applauses that we achieved, we must at all times bear in mind that Divine Word College of Laoag moulded us to become what we are now. To my classmates, who walk in when the rest of the world walks out, you are the bacon bits in the salad bowl of my life.

To you juniors, may you carry on our legacy and become better than us. Give your best in everything you do even if failure pulls you. Accept the challenges so that you may feel the exhilaration of victory. Enjoy your last year to the fullest!

On behalf of the graduating class of 2015, this is Ma. Althea Isabella Estabaya, saying thank you for being with me as I evoke memories. Have a great day everyone!

A Targeted Infection Prevention Intervention in Nursing Home Residents With Indwelling Devices: A Randomized Clinical Trial

According to Medicare & Medicaid approximately 1.4 million Americans reside in 15k nursing homes #tech #blogs

By stayinpharmd

Justin Kyei-Frimpong, PharmD candidate 2015, Mercer University College of Pharmacy

According to the Centers of Medicare and Medicaid approximately 1.4 million Americans reside in 15 600 US nursing homes (NHs), and in 2010 there were 2.5 million short-stay admissions.1 Studies conducted by Kauffman et al. showed that multidrug-resistant organisms are 35% more prevalent in nursing…

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Spotlight: My Elder Advocate Puts Seniors First


When Jack Halpern started working in a nursing home at age 24, he quickly formed friendships with many of the residents.


And although the nursing home where he worked was great by industry standards, many of the residents weren’t cared for in the way they really wanted. It was then that he realized that his calling was to improve the lives of elderly people. And My Elder Advocate was formed.


Read more about Halpern’s journey and the way My Elder Advocate helps elders and their families in this week’s Small Business Spotlight.


What the Business Does


Helps families make decisions about elder care and fights for their rights.


The company’s service areas include nursing home eviction prevention, nursing home and crisis intervention, nursing home and assisted living placement, planning for long-term care, home care advisory, long-distance care and monitoring.


Business Niche


Working directly for families.


All of My Elder Advocate’s revenue comes from its clients, so the company doesn’t have any conflicts of interest and always has its clients’ best interests at heart. Because of this, it offers a variety of services to fit the needs of families trying to do what’s best for their family members. Halpern says:



“There are competitors that separately offer individual services we offer, such as nursing home placement programs and lawyers, but none that offer the overarching support of helping elders and their families navigate the complex health care industry, solving health-related crises and advocating for their rights.”



About My Elder Advocate from Claudine Halpern on Vimeo.


How the Business Got Started


Thanks to some unlikely friendships.


When Halpern started working at a nursing home, he made friends with many of the residents. One particular resident, Sam, helped him understand what people were looking for in their own care.


As he rose through the ranks, Halpern became disillusioned with the whole elder care system, seeing how many in the industry were more concerned with profits than families. So he left to pursue a career in finance. But he never forgot about Sam or the other residents. Then one day it all came together. Halpern explains:



“My passion for helping elders never faded, and some 30 years after meeting Sam, the paraplegic veteran, I teamed up with my wife Claudine to launch My Elder Advocate. Claudine was the perfect partner because she had an incredibly successful career as a management consultant, earning the reputation as the go-to person to solve complex problems for financial technology companies. At the time, Claudine had been getting more involved with entrepreneurism, so she was ready to take the leap.”



Biggest Win


Successfully helping an early client.


One of My Elder Advocate’s first clients was a man who had been a political leader and prominent attorney in his earlier years. But he was being taken advantage of by a senior home care company. So My Elder Advocate helped the man and his family find an assisted living home. And later on they even protected him during his hospital stays and helped him move into an apartment and find a trusted home care aide.


By helping him in all those different ways, the company helped make the man’s last few years as comfortable as possible. And it helped Halpern and his team realize that they could really help people with their offerings. He says:



“We knew we were onto something because we could make a living providing different services that made a huge impact on the lives of others. The services we provided this client included needs assessment, home crisis intervention, home care management, monitoring, and long-distance caregiving.”



Lesson Learned


Franchising can lead to the fastest business growth.


The company started its franchise program this year, about seven years after its initial launch. Looking back, Halpern says he should have launched the program earlier to facilitate more growth.



Business Philosophy


Use proven approaches, but provide individualized care.


Those two philosophies might sound contradictory, but My Elder Advocate has found a way to balance the two methods. Halpern explains:



“On one hand, we have managed to systemize our approach to solving crises with a patent-pending workflow called “The MEA Method,” which standardizes our service delivery. For example, we have outlined a specific protocol for franchisees to follow to prevent nursing home evictions. However, within that model, we have figured out how to treat each and every client as an individual who deserves a unique result. We are able, then, to use both of these together to accomplish the best possible outcome for our clients.”



If the Business Were a Song


“Old Man” by Neil Young.


Halpern explains:



The line “I’m a lot like you,” really speaks to our motto that “our elders are us. If you don’t start caring for them now, you can expect the same treatment as you age.”



Favorite Quote


“Life’s most persistent and urgent question is, ‘What are you doing for others?’” – Martin Luther King, Jr.


* * * * *


Find out more about the Small Biz Spotlight program.


Image: My Elder Advocate


This article, “Spotlight: My Elder Advocate Puts Seniors First" was first published on Small Business Trends






from Blogger http://evangelinagius.blogspot.com/2015/03/spotlight-my-elder-advocate-puts_20.html
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Nursing Intervention Research

Nursing Intervention Research

Describe the three phases of nursing intervention research: Phase 1: Intervention Development Phase 2: Pilot Testing an Intervention Phase 3: Controlled Trial of the Intervention
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Spotlight: My Elder Advocate Puts Seniors First


When Jack Halpern started working in a nursing home at age 24, he quickly formed friendships with many of the residents.


And although the nursing home where he worked was great by industry standards, many of the residents weren’t cared for in the way they really wanted. It was then that he realized that his calling was to improve the lives of elderly people. And My Elder Advocate was formed.


Read more about Halpern’s journey and the way My Elder Advocate helps elders and their families in this week’s Small Business Spotlight.


What the Business Does


Helps families make decisions about elder care and fights for their rights.


The company’s service areas include nursing home eviction prevention, nursing home and crisis intervention, nursing home and assisted living placement, planning for long-term care, home care advisory, long-distance care and monitoring.


Business Niche


Working directly for families.


All of My Elder Advocate’s revenue comes from its clients, so the company doesn’t have any conflicts of interest and always has its clients’ best interests at heart. Because of this, it offers a variety of services to fit the needs of families trying to do what’s best for their family members. Halpern says:



“There are competitors that separately offer individual services we offer, such as nursing home placement programs and lawyers, but none that offer the overarching support of helping elders and their families navigate the complex health care industry, solving health-related crises and advocating for their rights.”



About My Elder Advocate from Claudine Halpern on Vimeo.


How the Business Got Started


Thanks to some unlikely friendships.


When Halpern started working at a nursing home, he made friends with many of the residents. One particular resident, Sam, helped him understand what people were looking for in their own care.


As he rose through the ranks, Halpern became disillusioned with the whole elder care system, seeing how many in the industry were more concerned with profits than families. So he left to pursue a career in finance. But he never forgot about Sam or the other residents. Then one day it all came together. Halpern explains:



“My passion for helping elders never faded, and some 30 years after meeting Sam, the paraplegic veteran, I teamed up with my wife Claudine to launch My Elder Advocate. Claudine was the perfect partner because she had an incredibly successful career as a management consultant, earning the reputation as the go-to person to solve complex problems for financial technology companies. At the time, Claudine had been getting more involved with entrepreneurism, so she was ready to take the leap.”



Biggest Win


Successfully helping an early client.


One of My Elder Advocate’s first clients was a man who had been a political leader and prominent attorney in his earlier years. But he was being taken advantage of by a senior home care company. So My Elder Advocate helped the man and his family find an assisted living home. And later on they even protected him during his hospital stays and helped him move into an apartment and find a trusted home care aide.


By helping him in all those different ways, the company helped make the man’s last few years as comfortable as possible. And it helped Halpern and his team realize that they could really help people with their offerings. He says:



“We knew we were onto something because we could make a living providing different services that made a huge impact on the lives of others. The services we provided this client included needs assessment, home crisis intervention, home care management, monitoring, and long-distance caregiving.”



Lesson Learned


Franchising can lead to the fastest business growth.


The company started its franchise program this year, about seven years after its initial launch. Looking back, Halpern says he should have launched the program earlier to facilitate more growth.



Business Philosophy


Use proven approaches, but provide individualized care.


Those two philosophies might sound contradictory, but My Elder Advocate has found a way to balance the two methods. Halpern explains:



“On one hand, we have managed to systemize our approach to solving crises with a patent-pending workflow called “The MEA Method,” which standardizes our service delivery. For example, we have outlined a specific protocol for franchisees to follow to prevent nursing home evictions. However, within that model, we have figured out how to treat each and every client as an individual who deserves a unique result. We are able, then, to use both of these together to accomplish the best possible outcome for our clients.”



If the Business Were a Song


“Old Man” by Neil Young.


Halpern explains:



The line “I’m a lot like you,” really speaks to our motto that “our elders are us. If you don’t start caring for them now, you can expect the same treatment as you age.”



Favorite Quote


“Life’s most persistent and urgent question is, ‘What are you doing for others?’” – Martin Luther King, Jr.


* * * * *


Find out more about the Small Biz Spotlight program.


Image: My Elder Advocate


This article, “Spotlight: My Elder Advocate Puts Seniors First" was first published on Small Business Trends






from Blogger http://evangelinagius.blogspot.com/2015/03/spotlight-my-elder-advocate-puts.html