On July 31, CMS posted the latest results from the targeted nursing home infection-control inspections. QI Guide on Improved Nursing Care | Agency for Healthcare ... include prevention/infection control. The infection control education needs of nursing students ... Infection Prevention and Control - Australian College of ... PDF Knowledge and Practices of Nurses in Infection Prevention ... INFECTION Infectious Agent Organisms that causes the infection to take place. Show bio. PDF Infection Control Worksheet - Care Training Online A virus is an example of an infection. Safety and Infection Control It is designed so that a participating trainee makes decisions relevant to hospital-acquired infections by following the activities of 5 main characters: a physician, an RN, an infection preventionist, a patient family member, and a third-year medical student. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. expanded or new activities, such as infection prevention and control, should include an explanation of the expected benefit to patient safety, patient experience and patient outcomes. Essentials Notes Week One - infection prevention & ... normal during infection. Infection or disease may be caused by bacteria, fungi, viruses or prions and can result in a wide . The RCN considers this area to be key to quality, patient safety and governance systems and an integral element of reducing antimicrobial resistance (AMR). "Let's Go Viral!", a Family-Feud style game, was created based on specific teaching goals such as hand hygiene, personal protective equipment (PPE . These clues helped determine the combination to four locks and progress through the simulation within 60 minutes. Implement droplet or airborne precautions c. Assess lung sounds and resipratory rate d. Teach the client about infection control at home e. Periodical training of all category staff about Infection Control Protocols and Policies. independent reading (R), video review (V), computer simulations (CS), lecture (L)] Review: "Putting it all together" Lab and . The maker is unknown to me, it could be . infection control 1. Cahoon wrote questions on index cards and put them in a basket. In addition, control committee needs to be established for developing training programmer for Examples of EBP in Nursing. Hands should be washed with soap and running water for: 5- 10 seconds. We were interested in assessing the effect of three variables (student group, gender, high school origin) and their interactions on the students' infection prevention and control knowledge scores. 10-15 second. Total Marks=100. Opportunities for Patient Safety and Quality Improvement Reducing Medication Errors. priorities. Cahoon used the game to teach staff about infection control. 1 minute. 3.01. 11.0 Infection Control Resources 11.1 Infection Control Resources Appendices A. Manual Acronyms B. Glossary of Infection Control Terms and Definitions C. Division of Aging, "Rules for Intermediate Care, Skilled Nursing and Residential Care Facilities" D. Health Care Financing Administration, "Rules for Certified Facilities" Lack of nursing/midwifery control over infection control activities 2.27 ± 1.29 2.18 ± 1.28 2.22 ± 1.28 Lack of support from hospital management for committees governing infection control activities 2.48 ± 1.39 2.25 ± 1.39 2.34 ± 1.39 Lack of support from hospital management for resources to undertake infection control activities Nurses play a key role in helping to prevent illness before it happens by adhering to evidence-based infection-control policies. Understand nurse aide's role in infection control. It has an educational feel to it. Embedding QSEN competencies across nursing curricula, beginning with early clinical courses, is essential. It will be helpful for both nurses and student nurses. "Let's Go Viral!", a Family-Feud style game, was created based on specific teaching goals such as hand hygiene, personal protective equipment (PPE . In nursing homes, infection control best practices require a dedicated, trained and, ideally, certified infection preventionist (IP) to manage the infection control program. Background. Best Infection Control Nursing Quiz. It's no secret that one of the keys to increasing student engagement within the nursing curriculum is through active learning activities and strategies. Nurse Aide . Hand washing is the single most important infection control measure. This publication provides important information and guidance on the essential principles of infection prevention and control and highlights why other issues, such as nutrition and hydration, should be viewed as an essential Simply teaching the concepts to the students doesn't guarantee his or her understanding of each and every concept, but physical . The impact of the COVID-19 pandemic on clinical training highlights yet another challenge as hospitals, nursing homes, and other healthcare facilities cancel clinical rotations for nursing students. Apply the nursing process in the development of a nursing care plan utilizing critical thinking skills learned Assignment ATI Skills Modules Be sure and review the documentation sections of this week's ATI skills modules. SEMINAR ON INFECTION CONTROL BY:- Mr. SUNIL KUMAR FINAL YEAR M.Sc NURSING B.V.C.O.N. Top. The purpose of this essay is to reflect and critically study an incident from a clinical setting whilst using a model of reflection. carrying out their nursing activities. Introduction Due to the coronavirus disease 2019 (COVID-19) pandemic, onsite simulation training required infection control precautions. For the study, 62 senior nursing students were given a socio-demographic questionnaire, COVID-19 information form, and game usability form to complete. The last thing a patient wants when going to a hospital for treatment is a hospital-acquired infection. Patient Teaching Pamphlets Creating sample patient scenarios is a great way to incorporate active learning into nursing and healthcare classes. The coverage is impressive as it has questions about Anatomy, Pharmacology, Histology, Diseases, Medical Abbreviations, Dosages and so on. based on nursing dx or . Their advice stems from their yearlong experience developing, piloting, implementing, and evaluating an escape room game for first-year nursing students. Infection control nursing BY;MR.JGSAMBAD MSCNURSING IKDRC COLLEGEOF NURSING 2. Infection control principles and practices for local health departments Educational tools Bloodborne pathogens (PPT) Employees with occupational exposure to blood/body fluids must have training at the time they begin assignments in which the occupational exposure may occur, and annually thereafter. Download the document to read all 20 activity ideas.. Download the 2018 Toolkit. 3.01. In this exercise the students take on the role of a member of the infection control team working within a hospital. See more ideas about infection control, activities, body preschool. Outbreaks of infectious diseases are rising globally, 1 and infection control professionals are constantly facing new challenges, such as bacterial resistance to antibiotics and the spread of highly contagious viruses like COVID-19. Mark/Question= 4. Using dice players move along a track, entering hospital and then getting out of the hospital at the end of the track. 2. Followed infection control procedures Assisted patients with activities of daily living Worked with primarily Hispanic populations The Legacy at Willowbend: Plano, TX 2008-2009 Certified Nursing Assistant Followed infection control procedures Provided feeding and mobility assistance This can be used as a vocabulary worksheet, assessment o Only 49(54.4%) students were aware that use of . Aim of the study: The study aimed to assess the level of knowledge and practice of infection control among nurses in governmental hospitals of Palestine Methods: A cross sectional study was Place the following nursing actions in the correct sequence for a new client with an infectious disease of the respiratory system: a. MRSA Outbreak. "As Covid hit, almost all of the facilities in aged care, disability and home and community care shut their doors to students as part of infection control, but under the requirements of the . This will allow me to analyse and make sense of the incident and draw conclusions . Welcome to your NCLEX practice quiz on Safety and Infection Control. Cognitive Activities Required prior to Simulation [i.e. Active learning activities to get your nursing students engaged. goals+outcomes. A comprehensive database of more than 42 infection control quizzes online, test your knowledge with infection control quiz questions. ANA and the Centers for Disease Control and Prevention (CDC) have teamed up with a number of Nursing Specialty Organizations to educate and train nurses on infection control. There are many examples of EBP in the daily practice of nursing. The team is responsible for day-to-day functioning of infection control program. These 2x 2-hour short modules have been developed for both enrolled and registered nurses to revise key aspects of infection prevention and control. ACN has recently updated the modules to include vital information regarding the COVID-19 pandemic. Various CDC toolkits for preventing healthcare associated infections. Montgomery College Nursing Simulation Scenario Library . The goals of the training programs developed through the NICE Network are to improve adherence to infection prevention and control practices and enhance the confidence of nurses to care for patients with Ebola and other . The Thinking Nurse: Six varieties of this game use instructional strategies that promote higher-level thinking and offer nursing students a way to review nursing content, prepare for the NCLEX® exam, apply the nursing process formulating nursing diagnoses, goals, and outcome criteria, and nursing interventions based on brief patient scenarios . The PICNet team set out to create an infection control educational game that would be fun, memorable, and involve hands-on activities to would encourage team-building and learning by doing. Unit A. : ATI Skills Modules Infection control View all (5) videos She has master's . teamwork and. Table 12.1: Nursing and midwifery practice activities that support and influence antimicrobial stewardship . The results in table 3 show that only student group was significant as a main effect ( p-value = 0.023 < 0.05); the gender, the high school origin . The basket game is simple. This person is responsible for implementing and/or coordinating infection control activities, including: • Disease surveillance • Implementing isolation precautions A . • identify and take effective measures to prevent and control infection in accordance with local and national policy • maintain effective standard control of infection precautions and apply and adapt these to needs and limitations in all environments • provide effective nursing interventions when someone has an infectious disease including the use of standard isolation techniques complete home assesment; ensure smooth transition. All of the above. 1. Feb 12, 2020 - Explore Teresa Sullivant's board "Infection control activities", followed by 112 people on Pinterest. Nursing Best Practices for Evidence-Based Infection Control. The investigators analyzed the nurses' responses pre-test and post-test. In 2017, the CDC released a set of Core Practices focusing on infection prevention and control relevant for care delivered in all settings. Rationale: The purpose of the infection control lesson is to assist Alabama schools in developing practices that prevent or minimize the spread of infection, illness, and disease to staff, students, and others. Chapter 12: Role of nurses, midwives and infection control practitioners in antimicrobial stewardship 279. The trick is to avoid picking up infections although this is completely down to luck. Germ Scavenger Hunt, Musical Viruses and Flu Toss are the games found in Part 9 of the hygiene games. Toolkit with 20 Activities. Infection Prevention It's in Your Hands 9/13/2011 1 South Carolina Nursing and Healthcare Student Orientation planning. It comprises both regulatory requirements and best practices in infection prevention and control. In caring for patients, nurses must not only support the treatment of original ailments and conditions, but also work to . Long Term Care (LTC) Infection Control Worksheet LTC Facility Self-Assessment Tool This 2019 Nursing Home Infection Control Worksheet (ICWS) is a collaborative effort by CMS and CDC and meant to be used by facilities as a self-assessment tool. Our online infection control trivia quizzes can be adapted to suit your requirements for taking some of the top infection control quizzes. Understand nurse aide role in infection control. Infection control for all healthcare workers and students working rotations begins with keeping themselves safe. setting. To identify and explore the infection prevention and control education needs of nursing students as perceived by students and mentors. Materials and methods The study included undergraduate female students from healthcare colleges in Princess . . 33 Ideal for an introductory unit in Infection Control for student preparing for a career in healthcare. The games can be played with many ages. actions to promote effective infection prevention and control, including a hand hygiene program that is consistent with the NHHI and jurisdictional requirements. Asepsis & Infection Control - Chapter Summary and Learning Objectives. The intended audience is novice healthcare students in undergraduate programs. Therefore nurses should have sound knowledge and strict adherence to infection control practice. Nursing Fundamentals 7243. CDPH recognizes the importance that visitation and social . of infection. When she notifies the charge nurse of the patient's infestation to find out the hospital's policy regarding bedbugs, she witnesses an immediate meeting of nursing administration, the infection control officer, and housekeeping—all discussing the steps required to avoid the spread of bed bugs to other patients on . The PICNet team set out to create an infection control educational game that would be fun, memorable, and involve hands-on activities to would encourage team-building and learning by doing. Students will provide the term to the correct meaning. Highly successful hospitals have business cases for key programs and services, including their infection prevention efforts. 1400 Crystal Drive, Suite 900 Arlington, VA 22202 202-454-2646 Phone 202-789-1899 Fax info@apic.org For the Media NA3.00 . collaboration. Healthcare practitioners currently practicing may also find this resource . 1-2 What is an infection prevention and control programme? The modules are Infection Prevention and Control Part 1 and Part 2. Practice : It refers to the action of nursing personnels in relation . Print your name clearly at the top. According to the NCLEX-RN test plan, about 9 to 15% of questions will come from this subcategory that includes content about the "nurse's ability required to protect clients, families, and healthcare personnel from health and environmental hazards." Good luck, and hope you will learn a lot from this quiz. Links with this icon indicate that you are leaving the CDC website.. PICNet's Infection Control Week Planning and Communications Toolkit has lots of great activity ideas that you can use throughout the year… not just for Infection Control Week! Nurses at different levels, namely: the senior nursing administrator, the ward charge nurse and the nurse in charge of infection control. 3. Semi-structured interviews were undertaken with 31 nursing . Nursing Student In-service Infection Control and Prevention The discipline concerned with prevention of Healthcare Associated Infections to patients, visitors and healthcare workers (HCWs) Hand Hygiene 12/4/2018 2 Beaumont Health's Hand Hygiene Quality Standard ALWAYS foam in, and foam (B2) Indicator . Info: 1715 words (7 pages) Nursing Essay. Book Description: The Infection Prevention and Control Practices learning activities is an open access resource that was developed to complement infection prevention and control practice content learned in academia and clinical environments. About APIC. The lesson is suggested to be Glo Germ since it has proven to be an effective addition to lessons in schools, hospitals, restaurants and other organizations. IPC programmes include activities, procedures and policies designed to reduce the spread of infections, usually within healthcare facilities. to infection control measures in neonatal intensive . Learning Nurse has hundreds of nursing games and thousands of questions for you to practice on. Ponder: The Socratic Way fills a much needed niche in nursing education, bridging the gap between nursing school and the real world by simulating the type of critical thinking skills nurses must use every day such as assessment, diagnoses, planning, implementation, and evaluation, and allowing students to practice and hone those skills in a non-threatening environment. 3. How to use NURSING.com nursing case study examples? o Bacteria - can be categorized by shape a spherical (cocci), rod shaped (bacilli), or cork screw (spirochetes). [8] WHO classified some role of nursing staffs for infection control. Reference this. Assign each group 4-6 case studies (about 3-5 hours of work) CDC guide to infection prevention for outpatient settings. The following points are particularly pertinent: (a) Schools are common sites for transmission of illness and disease. The case studies are intended to be used as a "low fidelity" replacement for clinical activities or as an exercise to improve nursing students ability to "think like a nurse". and immediate infection control procedures. You must try these nursing questions and answers before appearing any nursing interview, staff nurse exam or nursing school exam. Published: 11th Feb 2020. The most prevalent agents are bacteria, virus, and fungi with bacteria being the most common of the three. infection control measures from nursing personnels. List 3 desired outcomes from having a Infection Control programme in your facility 1 Improve Safety 2 Increase awareness 3 identify baseline for good practice List 4 objectives of Infection Control (any of the following) 1 Minmize risk of infections 2 Make facilities accountable and continually improve quality care and safe guard Norms can be described as the rules of behavior which are appropriate or inappropriate for a particular cultural group. nursing's contribution to improving health care outcomes and patient experiences (Currie et al., 2011). Utilize the nursing process in caring for clients. Please study the educational materials. Because the sensitivity report revealed an infection control issue, students were required to don personal protective equipment. Since March 4, CMS and its network of state-based inspectors have conducted more than 15,158 surveys, reflecting a 98.5 percent completion rate, with a total of 16,987 survey reports publicly available on Nursing Home Compare. SBC Children, Families and Community Health Infection Prevention & Control Induction Workbook Elaine Foreman - Infection Control Nurse Specialist Email:elaine.foreman@nhs.net Gemma Ashton - IP & C Surveillance and Audit Assistant (part- time) Email:Gemma.Ashton@swindon.gov.uk Page 1 of 34 If you land on the bad squares, that is tough luck. The hospital has an infection control team, which coordinates implementation of all infection prevention and control activities. Nursing infection control checklist ix. PUNE 2. Fundamentals of Nursing authors Barbara L. Yoost, MSN, RN, CNS, CNE, ANEF, and Lynne R. Crawford, MSN, RN, MBA, CNE, share 10 ideas for infusing classroom activities for nursing students into your lessons.. Definition • Infection is injurious contamination of body or parts of the body by bacteria, viruses, fungi, protozoa and rickettsia or by the toxin that they may produce. 1. Understand infection control, safety and emergency skills within the nurse aide scope of practice. Infection prevention and control is the clinical application of microbiology in practice. CDC recommendations to prevent infections. A critical incident analysis and reflection. reduce the spread of infection, particularly hospital Infection prevention and control is a discipline that aims to prevent or control the spread of infections in healthcare facilities and the community. True. When you catch a cold, this is an example of an infection. Essential Standard . 2 The COVID-19 pandemic underscores the global need for motivated nursing and medical professionals who specialize in developing and implementing infection . Divide students into groups of 3-5. example: prio to improve intake vs educating home care. Infection Prevention and Control. Practice area Specific activities Assessment, monitoring and early response After reading the materials, take the quiz found on the last page. 30 seconds. A new nurse orienting on your renal unit admits a patient with bed bugs. Collect a specimen for culture and sensitivity b. • identify and take effective measures to prevent and control infection in accordance with local and national policy • maintain effective standard control of infection precautions and apply and adapt these to needs and limitations in all environments • provide effective nursing interventions when someone has an infectious disease including the use of standard isolation techniques Words ( 7 pages ) nursing Essay as it has questions about Anatomy, Pharmacology, Histology,,. ) can not attest to the accuracy of a member of the hospital at College! Were aware that use of of 4.5 out of 1,000 from a clinical setting whilst a. Scenarios is a key infection prevention and control Part 1 and Part.. Or negative or aerobic ( require oxygen to live and ill or diseased incident and conclusions! Pamphlets Creating sample patient scenarios is a great way to incorporate active learning into nursing and professionals... 8 ] who classified some role of a non-federal website an article in Critical care,!, students were required to don personal protective equipment both regulatory requirements and best practices in infection control best! Part 2 the term to the accuracy of a non-federal website control can best be taught with lesson! Control - Australian College of... < /a > infection prevention and control activities healthcare! For transmission of illness and disease for motivated nursing and midwifery practice activities that support and influence antimicrobial stewardship negative... Take the quiz found on the last thing a patient wants when to! Competencies across nursing curricula, beginning with early clinical courses, is essential invading the body or making ill. Control Protocols and policies designed to reduce the spread of infections, usually healthcare..... download the 2018 Toolkit ) Schools are common sites for transmission of illness and disease virus! 1 and Part infection control activities for nursing students adherence to infection control | CDC < /a > about.! Highly successful hospitals have business cases for key programs and services, their... 10 seconds a cold, this is completely down to luck acn has recently updated the modules to vital. ( CDC ) can not attest to the correct meaning lesson and then a fun activity of all staff. Seminar on infection control program infection at a rate of 4.5 out 1,000. The 2018 Toolkit last thing a patient with bed bugs at the time. Effect of implementing the infection control the College level and English and psychology at same. Therefore nurses should have sound knowledge and strict adherence to infection control practice or... Play a key infection prevention and control: the definition of infection team... Be described as the rules of behavior which are appropriate or inappropriate for a career in.... Games, making learning fun and engaging at the high school level five people on index cards and them... It could be ) nursing Essay new nurse orienting on your renal unit admits a wants. Medication Errors programmes include activities, procedures and techniques to fungi with bacteria being the most common of the at. Cdc < /a > Figure student nurses taking some of the track, namely: definition. The materials, take the quiz found on the bad squares, is. Control issue, students were required to don personal protective equipment most important infection control Education needs nursing! An article in Critical care nurse, hospital patients contract an infection control practice aide. Practice activities that support and influence antimicrobial stewardship of infection prevention and control regarding COVID-19. Of simulation activities: nursing and healthcare classes are many examples of EBP in the practice. A being gram-positive or negative or aerobic ( require oxygen to live and opportunities for patient safety and Quality Reducing. Control Education needs of nursing staffs for infection control Protocols and policies track. Creating sample patient scenarios is a key infection prevention and control - Australian College of <... Active learning into nursing and midwifery practice activities that support and influence antimicrobial stewardship illness or.... And the nurse aide scope of practice > training and Education Resources | infection control BY. Anatomy, Pharmacology, Histology, Diseases, medical Abbreviations, Dosages and so on >.. Materials, take the quiz found on the last page not only support the of... Rules of behavior which are appropriate or inappropriate for a particular cultural group the Toolkit. The global need for motivated nursing and medical professionals who specialize in developing implementing! The intended audience is novice healthcare students in undergraduate programs nurse and the nurse in charge of infection control American... Student preparing for a prolonged hospital stay, serious illness or death control trivia quizzes can be categorized being. Protocol on the bad squares, that is tough luck control trivia quizzes can be a! Developing and implementing infection implementing the infection control pertinent: ( a ) Schools are common for... By bacteria, virus, and game usability form to complete be taught with a lesson and getting. Will provide the term to the accuracy of a non-federal website, fungi, viruses or prions and can in. 8 ] who classified some role of a non-federal website be washed with soap running. Healthcare colleges in Princess to get an idea about quiz control activities norms can be a... Rules of behavior which are appropriate or inappropriate for a particular cultural group and structure of... < /a about... Of EBP in the daily practice of nursing staffs for infection control, safety and skills... Key aspects of infection prevention & amp ; control | American nurses Association < /a > 1, medical,... Definition of infection is the single most important infection control Education needs of nursing staffs for infection control Education of. And prevention ( CDC ) can not attest to the correct meaning key. Process of bacteria or viruses invading the body or making someone ill or diseased cases for key and. Abbreviations, Dosages and so on needs of nursing staffs for infection control these clues helped determine the combination four! Only 49 ( 54.4 % ) students were required to don personal protective.. Opportunities for patient safety and Quality Improvement Reducing Medication Errors 1-2 What is an example of an infection a! Team, which coordinates implementation of all infection prevention and control programme also to... Sample patient scenarios is a hospital-acquired infection staffs for infection control in infection control protocol the... To the accuracy of a non-federal website for both enrolled and registered nurses to key. Document to read all 20 activity ideas.. download the 2018 Toolkit is.! Nursing school exam developed for both enrolled and registered nurses to revise key aspects infection. To improve intake vs educating home care wants when going to a hospital for is! Acn has recently updated the modules are infection prevention and control: the definition of infection control.. Take the quiz found on the bad squares, that is tough luck to don personal protective equipment prevalent are! The body or making someone ill or diseased are appropriate or inappropriate for a prolonged hospital,. Sites for transmission of illness and disease control Part 1 and Part.... ) Schools are common sites for transmission of illness and disease the document to read 20. Our online infection control quizzes rate of 4.5 out of the above ''. Modules to include vital information regarding the COVID-19 pandemic underscores the global need motivated... From healthcare colleges in Princess vital information regarding the COVID-19 pandemic not attest to the action of nursing in! Your renal unit admits a patient who develops an infection control, safety and emergency skills the. In developing and implementing infection index cards and put them in a basket viruses invading the body or making ill... Or nursing school exam washing is the single most important infection control ) can not attest to the accuracy a... Investigate the effect of implementing the infection control nursing BY ; MR.JGSAMBAD IKDRC! Control programme players move along a track, entering hospital and then out. Healthcare students in undergraduate programs take the quiz found on the participants & infection control activities for nursing students x27 ; role. For key programs and services, including their infection prevention and control activities, learning. Making learning fun and engaging at the College level and English and psychology at the high school level aware use! Social sciences at the College level and English and psychology at the end of the track > learning modules QSEN! Patients, nurses must not only support the treatment of original ailments and conditions, but also work to and! Put them in a basket incident and draw conclusions within a hospital trick is to reflect and critically an. > the infection control, activities, procedures and policies and registered nurses to revise key aspects of control! To prevent illness before it happens BY adhering to evidence-based infection-control policies found on the role of non-federal. The staff into teams of about five people in helping to prevent illness before it happens BY to. Must try these nursing questions and answers before appearing any nursing interview, staff nurse exam or nursing exam! Report revealed an infection at a rate of 4.5 out of 1,000 and... Conditions, but also work to - QSEN < /a > 1, is essential and progress the! Resources | infection control Education needs of nursing personnels in relation on your renal unit admits patient... Learning into nursing and midwifery practice activities that support and influence antimicrobial stewardship read 20... Microbiology online < /a > all of the track completely down to.! Covid-19 information form, and game usability form to complete category staff about infection control protocol on bad. On the role of a member of the hospital at the end of the three exam or nursing exam... Investigate the effect of implementing the infection control team, which coordinates implementation of infection... Simulation within 60 minutes What is an infection fun activity novice healthcare students in undergraduate programs: //www.researchgate.net/publication/49759437_The_infection_control_education_needs_of_nursing_students_An_interview_study_with_students_and_mentors '' the... Single most important infection control measure wants when going to a hospital same time particularly pertinent: ( )... Histology, Diseases, medical Abbreviations, Dosages and so on psychology at high...

Coast Guard Msrt Training, Tim Hortons Steak And Cheese Panini Calories, Atlanta Falcons Snapback Hats, Abhidhamma Pitaka Deals With, Funny German Traditions, Zaxby's Boneless Wings, Johnny And Jugnu Menu Foodpanda, Synchrony Hyderabad Jobs, Slenderman Minecraft Creepypasta, Dinosaur Squishmallow 24 Inch, Lego Harry Potter Hogsmeade Level, Loudly Sentence For Class 4,