Professional Autonomy as an Advanced Clinical Practitioner Free Essay Example, 2500 words

Professional Autonomy as an Advanced Clinical Practitioner Introduction The role an advanced clinical practitioner plays in the society today is everpresent and ever felt as the needs and demands of the community grow and vary. Service and professionalism are principal values that must be upheld constantly. It thus becomes imperative to advance the knowledge and medical skills of the clinical practitioner to cater to the specific needs of the patient and different situations that will be confronted. It is thus the aim of this paper to show the importance of advancing the education of clinical practitioners. This paper shall also demonstrate how the health promotion will be further pursued and advanced through education of the patients by the competent and capable health care professionals. Health Promotion / Education in Clinical Setting The trend to be advocated today is to promote health through the proper education of the primary health care providers and the patients as well. To respond to the need of the patients, it is best to improve first the skills, competence and independence of the nurse practitioners caring for them. This is the professional autonomy of the advanced clinical practitioners that pertain to their capability to work and serve the patients without depending on the instructions or supervisions of the physician (Dueker et al. , 2005). We will write a custom essay sample on Professional Autonomy as an Advanced Clinical Practitioner or any topic specifically for you Only $17.96 $11.86/pageorder now The degree of this professional autonomy may vary depending on what policies a given locality may have. There could be certain areas in the clinical setting where substantial regulations are imposed on the authority of the nurse practitioners. For example in United States, some states have granted nurse practitioners the authority to prescribe medications of certain controlled substances (Pearson, 1998). Such responsibilities and tasks show how dynamic and comprehensive a nurse practitioner must be. Evolution of the Culture of Nursing The culture of nursing has evolved through the years. Nursing people probably existed from the time that people started getting sick. However, traditionally, people think of nurses as the ones who help and follow the instructions of the doctor to implement the treatment of the patient. They also are the ones who do the actual caring and assistance to the patients. Such are very noble acts and they still hold true today. However, there is a more dynamic point to things now (Dueker et al. 2005). Today, the nurturing provided by advanced clinical practitioners goes beyond the usual or traditional notion of their roles in health care.

Building effective technical skills Free Essays

Chief operating officer The organization is headed by the COO. All the department heads will be reporting to him. The activities of all departments will be assessed and approved by him. We will write a custom essay sample on Building effective technical skills or any similar topic only for you Order Now 1. Legal Statutory department: This department is represented by the Manager – Regulatory affairs. He will take care of all regulatory registrations, their renewals, their compliances, disputes arising due to non compliances, etc. He will be a line employee reporting to the COO. 2. Human Resources Department: Manager – HRD is the head of this department. He is a line employee who takes care of recruitment, training, remunerations, discipline, appraisals, outsourced services, etc. An Officer- HR, a staff employee reports to the Manager – HR. He takes care of time office, salaries and wages, documentation, coordination with other departments, etc. 3. Finance Department: Manager – Finance is the head of the department. He is a line employee taking care of budgeting, fund planning, taxations, accounting, auditing, etc. He is assisted by an accountant, a staff employee, who takes care of documentation, cash flow, ledger maintenance, day book maintenance, etc. Cashier, a staff employee takes care of billings, cash transactions, cash deposition, etc. He reports to the Manager – Finance. 4. Sales Marketing Department: Manager – Sales Marketing heads the department. He is a line employee taking care of market research, planning, promotions, advertisements, store design set up, sales, customer feedbacks and complaints, etc Building effective technical skills 04 Executive – Market Research, a line employee having a sound knowledge about the type of books reports to Manager – Sales Marketing. He utilizes his skills to forecast customer requirements and identify an adapted product mix from time to time. Executive – Media is a line employee, reporting to the Manager – Sales marketing, taking care of media and magazine advertisements, promotional programs, etc. Executive – Stores Operations, a line employee, reports to the manager – Sales Marketing. He is responsible for the store design, displays, maintenance, etc. He co ordinates with the Inventory department to organize stocks. Retail sales persons are staffs reporting to the Executive – Stores Operations. They take care of sales at various sales counters or sales zones. They are responsible for the packing and forwarding of the purchased books to the delivery department. 5. Inventory Department: Manager – Inventory heads the department. His span management includes procurement, warehouse management, inventory control, etc. He co ordinates with the Manager – Sales marketing to ensure that the stock levels are maintained properly. Purchase assistant, a staff employee reports to the Manager – Inventory. He takes care of purchase order preparations, stock receipts, inward stocks verification, return of damaged stocks, etc. Stores assistant reports to the Manager – Inventory and he is a staff. He takes care of warehouse management, inventory control, documentation, etc. 6. Systems Department – Executive – Systems, is a line employee taking care of computer hardware, billing software, etc used by the organization. He reports to the COO. Co ordination Mechanism: The co ordination mechanism in such a book store is as follows. The Executive – Market research makes a thorough study of the market and prepares an adapted product mix. This is sent to the Manager – Inventory. The Stores assistant assesses the stock situation in the book store and the warehouse. He sends a stock report to the Manager – Inventory. Based on the market requirements and the stock situation, the Manager – Inventory prepares the Procurement plan. He directs the Purchase assistant to conduct purchases based on the procurement plan. This cycle repeats on a regular frequency. Comparison of a traditional book store and an online book store This is a traditional bookstore, operated by a traditional Hierarchical structure. The quantum of work involved is more and hence a relatively higher number of employees are employed. The information flows from the top level to the bottom level through paper correspondences or mail communications. These shops are slow in adapting to the market changes. The stocks are usually built and maintained based on the market forecasts. Hence, this type of stores usually carries a large inventory and hence requires a lot of space. This has a direct impact on the financial overheads. The book stores like â€Å"Barnes Noble†, â€Å"Amazon† or â€Å"Border† are online bookstores since 90’s. They are E enabled business concerns. They make use of the web and the Information and communication Technology (ICT). Hierarchical flow of information is less. The flow of information is through digital mode and fast. They usually maintain low inventories. They take the order from the customers, procure the requirements from the suppliers and deliver them to the customers directly. Their inventory carrying costs are much lower. The quantum of work involved is less and the flow of information is more. The savings due to the reduction in the inventory levels are passed on to the customers. References 1. Electronic Commerce: Opportunities and Challenges by Syed Mahbubur Rahman, Mahesh Raisinghani 2. The E-Commerce Book by Steffano Korper and Juanita Ellis. 3. Electronic Commerce: The New Business Platform for the Internet by Debra Cameron How to cite Building effective technical skills, Papers

Law of Management Competition Policies and Strategies

Question: Describe about the Law of Management for Competition Policies and Strategies. Answer: In the current document discussed below various questions would be answered relating to the competition policies and strategies followed by an organization for the benefit of the people at large; it also give a brief about the cases of negligence done on the part of any organization and reliefs which could be awarded to the plaintiff; at last the standards which prevails in an organization for its employees have been talked about. 1: Kmart is a discount department store retailer in Australia and New Zealand and Kmart Tyre and Auto Service is a provider of retail automotive services, repairs and tyres in Australia. Kmarts vision is to ensure it is where families come first for the lowest prices on everyday items. It was established in1969 with the opening of its first store in Burwood, Victoria. It was the very first discount department store in Australia. It offers the people of Australia the lowest price on everyday items and focus on growing the business through operational excellence, creating adaptable stores, driving a high performance culture and investing in the store network. The corporation aims to deliver profitable growth through increased volumes, enhanced product ranges, expansion of its digital strategy and operational efficiency throughout the business. There has been various strategies of which the three main strategies are as follows: Kmarts strategy remains constant to provide with everyday products at the lowest price; Deliver development and improvement in productivity and efficiencies for further investment; It focuses on creating a stimulating and encouraging work environment so everyone can thrive. These strategies have been adopted in order to promote competition and also to levy the competition and consumer act which has been applicable on all the Australian corporations for leading a corporation in a healthy way. The market is highly concentrated and competition has been anticipated to increase as international retailers to enter the market and existing competitors expand store networks. The market players would want or desire to adopt such policies which the organization has adopted in order to attract more customers. This would automatically promote competition in the market and then they would focus on fulfilling the customer satisfaction in order to be in the market. The organization will remain focused on maintaining its lowest price position and ensure the product pricing architecture continues to deliver value. It also would continue to lead price and value despite increased competition from new entrants, online and existing competition. Australian competition and Consumer Commission has been an organization which promote competition under which it was prescribed under the competition and consumer Act. The main objective of the act was to eliminate any kind of act which restricts the flow of competition in the market. The corporation has been recommended that as it complies with the competition act and laws which have been regarded and imposed on all the organ izations of Australia. So, it should comply with it and also at the same time it should not indulge in any of the acts which would effect the competition for the prevailing market players in the market. As the market should not create such situations that effect the work of others. It has been recognized by the organization that as the organization operates in a complex and dynamic environment with sophisticated and diverse wants and desires if people, both in Australia and through regional and global trades. The organization does not work individually but it has been its employees who put in their efforts as they just keep producing and releasing the products for the customers. They also work from home or any place where they go so that the work would not hamper and the consumers get benefit. At the same time, the inquiry conducting and resourcing authorities of competition and regulatory bodies have strengthened in order to detect any anticompetitive behavior. It focuses on the prosecution and penalties both with more streamlined cooperation among the jurisdictions in enforcement matters of the organization. So the organization should comply with the competition regulations and rules which can help and grant aid to the consumers against any unfair agreement t erms; protecting them against any unconscionable behavior of the corporation and nay misconduct. The organization therefore should make such regulations which protect the society and consumers at large as a satisfied consumer makes the goodwill of the organization to develop in a positive and good way. Competition has also been regarded as the procedure by which the rival business strives to maximize their earnings by developing and offering desirable goods and services to customers. It can also lead to lower cost of resources; better services; better information etc. All the new startup businesses believe that they should discover the needs and wants of the consumer in order to be in the market. Because, it was the consumer only who have the power either to make a company stay or blown away. If the customer would not be happy than the work of the corporation would not prevail in a market. Also, if the strategies made by the organization would properly work and fulfilled than the ot her market players would also do the same and would be boosted up by what has been done by the other organization. 2: Memorandum stating grounds for negligence action against BW To: The Board of Directors, BW From: Manager, Safety Operations, BW Subject: Regarding grounds for a successful case of negligence Date:22ndSeptember2016 cc: In this memorandum the civil liability with the duty in regard to negligence and duty of care would be discussed keeping in mind the incident which occurred. Also some recommendation would be discussed at the end. Negligence can be defined as the act of failing to do what a prudent individual would have done in the situations (Bugg, 2006). In order to institute an obligation, a plaintiff must first establish that the defendant owe a duty of concern towards the plaintiff (Supreme Court of Tasmania, 2016). So, before a plaintiff could recover reimbursement from a defendant for the act of negligence, he must prove three things in regard to the defendant that: He owed a duty of concern; He violated that duty of concern; and Private harm or land damage suffered by the plaintiff was as a result of that violation. In order to determine whether there was a duty of concern or not various factors have to be taken into account by the Court (Hobart Community Legal Service, 2013). The factors include: The type of injury suffered by the plaintiff; The defendants control over the circumstance that gave rise to the injury, and the plaintiffs vulnerability to that injury; The character of the relationship of the plaintiff and defendant, as compared to other duty relationships; Ethical and moral price, including human rights considerations; and Consistency and coherency of lawful morals and relationships. The concept of a duty of concern functions as a control device which allows the court to determine, as a case of policy, the situations in which there should be liability for negligent act (Australasian Legal Information Institute, 2016). Courts have experimented with various approaches to the new cases, developing obligations incrementally, emplaning with due regard to policy considerations (Handford, 1982). In the matter of Donoghue v Stevenson (1932) it was discussed that the modern doctrine of tort law was born out from this case as it concern a right of a customer to claim damages from a manufacturer of bottled ginger beer for nervous shock induced by the discovery of a fermenting snail in the bottle, after its contents had been drunk. It was the case in which extension has been made of the concept of duty of care (The Personal Injury Lawyers, 2016). In the matter of Baltic Shipping v Dillon High Court of Australia (1993) 176 CLR 344 it was held that reimbursement were available where the suffering or disappointment arises from a violation of an express or implied term or the suffering was consequent upon the suffering of a physical harm (Australian Contract Law, 2013). In another matter of Caparo Industries Plc v Dickman [1990] a threefold test was established. It stated that the injury must be reasonably foreseeable; there must be an association of proximity among the plaintiff and defendant; and it must be just, immediate, and rational to oblige a liability. Though, emotional suffering has been recognized as an actionable tort (Australian Law Reform Commission, 2016). It means that the plaintiff could recover reimbursement for emotional suffering caused by injury but only if was escorted by a physical or financial harm (Holme, 2004) (Rajendran, 2004). In the case of Rodrigues v state it was held that the plaintiffs could recover damages for a negligent infliction of emotional suffering as a result of carelessly caused flood reimbursement to their house. In the case of Giller v Procopets it was held by the court that the claimant could recover reimbursement for disturbing suffering in her fair claim for infringement of confidence. Similarly in the matter of Doe v. Australian Broadcasting Corporation it was held that a fair reimbursement can be awarded for contravention of self-assurance for harm and suffering as a part if a larger award for other wrings. As per Division 4 of the civil liability act 2002 section 26H certain limits have been mentioned which were being forced on injuries which occur for any non- economic loss. It states that a court would not be in a place to award injuries for non- financial loss except as allowed by this Division (Australasian Legal Information Institute, 2016). Also, according to Section 26I it has been clearly describes the non-financial loss injuries limited to the employees return amount. Under it a court may award reimbursement for the non- monetary failure up to a maximum of the total amount to which a worker would be allowed as reward under this division of part 3 of the Workers Reimbursement Act 1987. As per it if the worker had received a injury that entitled the worker to reward under that act and that resulted in a degree of enduring harm that was same as the offenders degree of lasting injury (Australasian Legal Information Institute, 2016). When formatting the total amount to which a worker would be allowed for reimbursement under the provision of Workers Reimbursement Act 1987, the sum was to be resoluted under the section as it was in force when the destruction to the lawbreaker was acknowledged (Australasian Legal Information Institute, 2016). According to Division 5 of the act authority has been given to make subtractions from reimbursement under section 26J. As per section 5L of the civil liability act the defendant has no liability for harm suffered from an obvious risk of dangerous recreational activities. Also as per section 5M of the act the defendant have no duty of care for recreational activity where risk warning. Section 5R describes in brief about the standard of contributory negligence as therefore by referring to these sections it can be stated that BW was not liable for the act which was done not by the negligence of the organization and so no damage would be paid off. In the case Action Paintball Games Pty Ltd (in liquidation) v Barker [2013] NSWCA 128 it has been held that a general warning about the risks involved was sufficient, without the need to describe each separate or specific risk or hazard and also on the basis that Action Paintball had given a risk warning to the plaintiff within the meaning of section 5M(1) of the CLA and therefore no duty of care was owed to her. So, it has been highly recommended that the organization should made pertinent reward to the plaintiff for the loss incurred by him due to the steel which broke down due to corrosion. Organization should also purchase new tools for restricting any future danger or harm which could be caused if new machinery would not be adopted. The organization for making the services better can make a disaster organization team in prior for dealing with such mishappening for the future if occur by any means (Bernstein, 2016). 3: The National Employment Standards (NES) are the 10 minimum stipulations and state of affairs of an employment which were mentioned in Part 2-2 of the Fair Work Act, 2009. It applies to the system of the national workplace relations of the workers. NES are the minimum required standards which cannot be overridden by the terms of the organization agreements or awards (Fair Work Commission, 2016). The ten minimum standards which every employment has to follow include the following matters: The employees should work for maximum of 38 weekly hours in addition to rational additional hours; Workers in some situations can make a request for making a change in their arrangements of work (Australian Government, 2016); Parental leaves and connected entitlements should be given up to 12 months for unpaid leave for each employee plus they have the privilege to make a request for an additional 12 months unpaid leave; Annual leaves should be provided which includes 4 weeks paid leave pr year plus an additional week for some shift workers (Fair Work Ombudsman, 2016); Private/ carers leave and compassionate leaves should also be provided which includes 10 days paid private leave; 2 days unpaid carers leave when required; and 2 days compassionate leave unpaid as required; Unpaid leave should be offered for chosen crisis activities and up to 10 days of paid leave for service of Jury; An agent right for the workers as mentioned in a relevant pre-modernized reward, awaiting the growth of a consistent national long service leave standard; On every public holiday a paid off would be given except where logically requested to work; Up to 4 weeks notice of execution plus an additional week for the staff over 45 years of age who have been in the job for at least 2 years and up to 16 weeks division pay on being jobless both based on the span of service (The Australian Workers Union, 2016); and The Fair Work data statement was available from the Fair work Ombudsman (Australasian Legal Information Institute, 2016). As per section 26(4) of the Fair Work Act 2009 applies to the service generally but if it applies subject to the constitutional limitations then it would relate to: All the manager and workers in the state or territory; or All manager and workers in the state or territory except those recognized by an act of the state or territory. Being a HR manager a person should ensure that the corporations comply with the 10 national standards and should not contravene them as per section 44 of the act; ensure terminations dont contravene; and maintain fully complaint time and wages records. HR manager should follow all the national standards but at the same time he should and can ask the workers to work more and can cut off their leaves depending upon the work load for any particular month. But the HR manager should also make such changes as when required as it was not necessary that in the organization all the standards would apply. He should include them while dealing with the employees but also should include those standards which would help the organization and can make some changes and ask the workers to work accordingly For this reason, it does not matter whether or not the regulation also was applicable to other individuals, or if or not an exercise of a power under the regulation affects all the individuals to whom the rule was applicable. Similarly, if any of these points would be violated then he must be punished under section 550 of the act. The HR Manager should understand the problems of the workers and should see that the corporation in which it has been working complies with all the standards which have been made and drafted for the benefit of the working staff. If all the staff would be granted such compliance with the standards then it would make them feel that they work in a safe environment. So the HR should not dispense with such polices which have been specially made fir the employees. References: Australasian Legal Information Institute. (2016) CIVIL LIABILITY ACT 2002. [Online] Commonwealth Numbered Acts. Available from: https://www.austlii.edu.au/au/legis/nsw/consol_act/cla2002161/ [Accessed on 22/09/16] Australasian Legal Information Institute. (2016) COMPETITION AND CONSUMER ACT 2010 - SCHEDULE 2. [Online] Commonwealth Numbered Acts. Available from: https://www.austlii.edu.au/au/legis/cth/consol_act/caca2010265/sch2.html [Accessed on 22/09/16] Australasian Legal Information Institute. (2016) FAIR WORK ACT 2009 (NO. 28, 2009). [Online] Commonwealth Numbered Acts. Available from: https://www.austlii.edu.au/au/legis/cth/num_act/fwa2009114/ [Accessed on 22/09/16] Australian Contract Law. (2013) Baltic Shipping v Dillon High Court of Australia (1993) 176 CLR 344. [Online] Australian Contract Law. Available from: https://www.australiancontractlaw.com/cases/baltic.html [Accessed on 22/09/16] Australian Government. (2016) The National Employment Standards. [Online] Australian Government. Available from: https://www.ieuvictas.org.au/files/8613/4214/4413/nes.pdf [Accessed on 22/09/16] Australian Law Reform Commission. (2016)Breach of Confidence Actions for Misuse of Private Information. [Online] Australian Government. Available from: https://www.alrc.gov.au/publications/13-breach-confidence-actions-misuse-private-information/reimbursement -emotional-suffering [Accessed on 22/09/16] Bernstein, J. (2016) The 10 Steps of Crisis Communications. [Online] Bernterin Crisi Management. Available from: https://www.bernsteincrisismanagement.com/the-10-steps-of-crisis-communications/ [Accessed on 22/09/16] Bugg, T. (2006) Negligence and damages personal injury, property damage and pure economic loss. [Online] Law Council of Australia. Available from: https://www.lawcouncil.asn.au/lawcouncil/images/LCAPDF/speeches/20060526Negligenceanddamages.pdf [Accessed on 22/09/16] Fair Work Commission. (2016) National employment standards. [Online] Fair Work Commission. Available from: https://www.fwc.gov.au/awards-and-agreements/minimum-wages-conditions/national-employment-standards [Accessed on 22/09/16] Fair Work Ombudsman. (2016) National Employment Standards. [Online] Fair Work Ombudsman. Available from: https://www.fairwork.gov.au/employee-entitlements/national-employment-standards [Accessed on 22/09/16] Handford, P.R. (1982) Damages for Injured Feelings in Australia. University of New South Wales Journal. [Online] Australasian Legal Information Institute. Available from: https://www.austlii.edu.au/au/journals/UNSWLawJl/1982/16.pdf [Accessed on 22/09/16] Hobart Community Legal Service. (2013) Negligence and the Duty of Care. [Online] Hobart Community Legal Service. Available from: https://www.hobartlegal.org.au/tasmanian-law-handbook/accidents-and-insurance/negligence/negligence-and-duty-care [Accessed on 22/09/16] Holme,R. ( 2004) MENTAL SUFFERING DAMAGES FOR BREACH OF CONTRACT. Victoria University of Wellington Law Review. 35. [Online] Available from: https://www.victoria.ac.nz/law/research/publications/vuwlr/prev-issues/pdf/vol-35-2004/issue-3/holmes.pdf [Accessed on 22/09/16] Rajendran, R. (2004) "Told Nervous Shock: Has the Pendulum Swung in Favour of Recovery by Television Viewers?". Deakin Law Review 7319(2). [Online] Australasian Legal Information Institute. Available from: https://www.austlii.edu.au/au/journals/DeakinLawRw/2004/31.html [Accessed on 22/09/16] Supreme Court of Tasmania. (2016) NEGLIGENCE FORESEEABILITY: Doctrine Of Law Or Public Policy. [Online] Supreme Court of Tasmania. Available from: https://www.supremecourt.tas.gov.au/publications/speeches/underwood/negligence[Accessed on 22/09/16] The Australian Workers Union. (2016) What are the 10 National Employment Standards (NES)?. [Online] The Australian Workers Union. Available from: https://www.awu.net.au/national-employment-standards [Accessed on 22/09/16] The Personal Injury Lawyers. (2016) What are Emotional Suffering Damages in Personal Injury Cases?. [Online] Available from: https://www.thepersonalinjurylawyers.com.au/What-are-Emotional-Suffering-Damages-in-Personal-Injury-Cases [Accessed on 22/09/16]

Nursing Sensitive Indicators free essay sample

Nursing-sensitive indicators can be an important tool in identifying patient care issues that could potentially arise during a hospital stay. By analyzing the data on specific nursing-sensitive indicators, the quality of patient care can be optimized and patient satisfaction can be improved. The American Nurses Association (ANA) and the National Database of Nursing Quality Indicators (NDNQI) are two sources of information and guidelines for nurses and nurse managers to use in planning patient care and workloads for each nursing unit. The use of available resources, staffing by acuity and patient needs, appropriate referral indicators, and cooperation among colleagues are all necessary components in providing ethical, safe, and patient-centered care in the hospital setting. Care of the patient should always center on the individual needs, wishes and cultural practices, within the framework of evidence-based patient care interventions. Nursing Sensitive indicators â€Å"Nurses use theoretical and evidence-based knowledge of human experiences and responses to collaborate with healthcare consumers to assess, diagnose, identify outcomes, plan, implement, and evaluate care. We will write a custom essay sample on Nursing Sensitive Indicators or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Nursing interventions are intended to produce beneficial effects, contribute to quality outcomes, and above all, do no harm. † (American Nurses Association, 2010) There are several nursing sensitive indicators that were either ignored or overruled in the case of Mr. J. Falls risk, dementia diagnosis, pain medications, immobility and cultural or religious values are all indicators that special steps must be taken in the care of this patient to avoid further harm and achieve quality patient care. Mild dementia can create problems in some patients with their ability to reason, make sound judgment, and respond appropriately to requests and interventions. The simple fact that he fell, has mild dementia, and is drowsy does not, according to ANA standards and the Joint Commission, make him a candidate for use of restraints. Falls risk indicators should be assessed on admission and at least every 24 hours post admission. Optimally, the falls risk should be addressed each shift, as in some patients with dementia there can be marked differences in cognitive levels of function at different times of day, making them more susceptible to falls at night. Unless a patient is in immediate danger of harming self or others, such as pulling out IV lines, trying to remove breathing or feeding tubes, or striking out at staff without being able to be redirected, there is no indication that restraints should be used. There are many restraint alternatives that can be employed in the care of patients who are at risk for falls, have cognitive issues, or are combative. Use of bed alarms, personal alarms, active listening, direct observation, one-to-one sitters, family visits, and redirection should all be attempted prior to obtaining a physician order for restraints. Restraints should never be applied without the knowledge of the attending physician, and there are very strict guidelines in place for frequent skin checks, restraint-removal trials, and frequent vitals and welfare checks. All staff, whether licensed care professionals or unlicensed assistive personnel should be aware of the institutional policies regarding use of restraints. Likewise, the development of pressure ulcers while hospitalized is greatly increased by immobility. It takes only two hours of lying in one position for skin to begin breakdown, especially over bony prominences such as the buttock/coccyx area. This can also be exacerbated by incontinence, whether the incontinence is due to lack of control or simply lack of staff to assist in toileting needs. Quality patient care in the case of Mr. J would have to include restraint alternatives, falls prevention care plans, frequent skin checks, and frequent (every two hours) turning or repositioning to avoid skin breakdown. A toileting schedule would also be helpful in this case, to assure the patient and his family that basic needs will be met. My recommendation for the care plan of Mr. J would include restraint alternatives consisting of bed alarm, active listening, rounding at least hourly by nurse or CNA, toileting assistance and repositioning every two hours, and reassurance or redirection as needed if confused. I would encourage family visits if possible, and even suggest that if a family member felt comfortable rooming in with patient for reassurance all effort would be made to accomplish that scenario. It is common for patients with dementia to become more confused and distressed in the later evening hours, so having family or a one-to-one sitter would be a very effective way to reduce the chance of fall and to reassure and redirect as needed. Also, the CNA should not have ignored the growing sign of skin breakdown on Mr. J’s lower spine. The depressed, reddened area is a precursor to a stage one pressure ulcer. Due to his age, injury, and lack of mobility, a pressure ulcer prevention care plan should have been initiated on admission. When the evidence was brought to the attention of the CNA , she should have immediately informed the primary care nurse of her findings. Following the evidence-based practice of frequent repositioning, padding bony prominences, and the use of products designed specifically for prevention and healing of compromised skin areas will dramatically reduced the incidence of hospital-acquired pressure ulcers. Research and use of data on prevention and avoidance of falls and pressure ulcers can make a remarkable difference in the cost of patient care. Reimbursement to hospitals by Medicare often depends on the use of proper care planning and documented use of nursing sensitive outcome indicators. A second very important rule of quality patient care was violated with the incident of Mr. J receiving the wrong type of meal on his tray. When it was discovered by the nurse that the pork had been given to and eaten by the patient, the nurse did the right thing by notifying her supervisor. However after that, the cascade of events was a dismal failure as far as transparency, customer service, and patient satisfaction are concerned. The supervisor was negligent in telling the staff to â€Å"keep it quiet†. Although she did the right thing by notifying the kitchen supervisor, she should have immediately apologized to the patient himself, and then informed the patient’s daughter of the incident. An apology to the family, along with an outlined plan of how such a mistake would be avoided in the future would have most likely helped to avoid the hard feelings and complaints that followed. What the nurse later said to the patient’s daughter was not therapeutic, in fact it was belittling of the religious and cultural beliefs held by this family. Culturally sensitive care dictates that even if healthcare workers do not agree with or fully understand the religious and cultural beliefs of the patient, they must still honor and accommodate whenever possible within the confines of sound medical practice. Failure to provide meals that are culturally appropriate was apparently an ongoing problem at that hospital. Resources, Referrals and Colleagues â€Å"Nursing practice respects diversity and is individualized to meet the needs of the healthcare consumer or situation. Healthcare consumer is defined to be the patient, client, family, group, community, or population who is the focus of attention and to whom the registered nurse is providing services† (American Nurses Association, 2010) As a nursing shift supervisor, there are many resources available to assist in achieving quality, culturally appropriate care for patients. In the case of Mr. J, there are many online resources that could have been used to familiarize staff with the dietary requirements of Jewish who keep kosher. Also, the dietician should have been consulted to set up kosher menus, and kitchen staff should be educated on kosher dietary requirements. The entire facility could benefit from education regarding dietary differences of different cultures and religions, and about cultural practices that may affect care interventions at all levels of care. Perhaps the nursing supervisor could facilitate training and education for all staff, with the help of the Jewish physician that would improve the level of satisfaction for the Jewish patients and their families. Other resources that the nursing supervisor could employ would be to coordinate with the attending physician to obtain consultation and/or treatment for physical therapy, occupational therapy, wound care nurse, dietician, palliative care nurse, chaplain, and social worker. For immediate resolution of the issues with Mr. J, a personal apology from hospital administration, along with assurance that the complaints are being taken seriously and plans are being made to avoid such problems in the future would be a good start. As for future patients, creating and following policies, care plans, and evidence-based guidelines for patients with dementia, patients at risk for pressure ulcers, patients at risk for falls, and patients with special dietary needs are a necessary step to insuring quality patient care. All staff, at every level of care, needs to be held accountable for following policies and guidelines, with clear expectations and consequences for deviation from policy. It seems that there were many opportunities to provide quality patient care that were either overlooked or ignored in the case of Mr. J. Identifying risk for falls, risk for pressure ulcers, and risk for culturally inappropriate care at time of admission and addressing in advance possible issues that could arise could have resulted in a much safer and acceptable patient stay. Early use of assessment tools, referrals, and ancillary resources is essential to ensuring the safety and quality care of all patients. Communication between colleagues and communication with patients and families is paramount and transparency when errors do occur is necessary to create the trust that is so essential between patient and all care providers. According to the ANA, â€Å"nurses must be as proficient in communication skills as they are in clinical skills†, and â€Å"must be relentless in pursuing and fostering a sense of team and partnership across all disciplines†. (American Nurses Association, 2010). It is only by becoming true collaborators that nurses can be seen as effective, valued, and committed partners in healthcare.

History of Nursing Research Essay Example

History of Nursing Research Essay Example History of Nursing Research Essay History of Nursing Research Essay University of Phoenix Material History of Nursing Research Worksheet There have been many influential publications, agencies, and people in the field of nursing research. Write 1–3 sentences in each cell of the table below to describe the importance, goal, or influence of each item. Publications |First publication date and importance: | |Nursing Research |First published: 1952 | | |Importance: | | |The increase in research activity during the 1940s prompted the | | |publication of the first research journal (Burns Grove, 2007, pp | | |9-10-11-12). | |Sigma Theta Tau Journal published by this organization is |First published: 1967 | |now called Image- The Journal of Nursing Scholarship |Importance: | | |Sponsored many local conferences to communicate research findings. It| | |provided research articles and summaries of research conducted on | | |selected topics (Burns Grove, 2007, pp 9-10-11-12). |Research in Nursing and Health |First published: 1978 | | |Importance: | | |Pro vides research articles and summaries of research conducted on | | |selected topics (Burns Grove, 2007, pp 9-10-11-12). | |Western Journal of Nursing Research |First published: 1979 | | |Importance: | | |Provides research articles and summaries of research conducted on | | |selected topics (Burns Grove, 2007, pp 9-10-11-12). | | | |Scholarly Inquiry for Nursing Practice |First published: 1987 | | |Importance: | | |The conduct of clinical research (Burns Grove, 2007, pp | | |9-10-11-12). | |Applied Nursing Research |First published: 1988 | | |Importance: | | |The conduct of clinical research (Burns Grove, 2007, pp | | |9-10-11-12). |Nursing Science Quarterly | First published: 1988 | | |Importance: | | |The conduct of clinical research (Burns Grove, 2007, pp | | |9-10-11-12). | |Conduct and Utilization of Research in Nursing |First published: 1982-1983 | | |Importance: | |To facilitate the use of research to improve nursing practice (Burns | | | Grove, 2007, pp 9-10-11-12). | |Annual Review of Nursing Research |First published: 1983 | | |Importance: | | |Experts ‘reviews of research organized into four areas: nursing | | |practice, nursing care delivery, nursing education, and the nursing | | |profession (Burns Grove, 2007, pp 9-10-11-12). |Agencies |Establishment date and goal or function: | |American Nurses’ Association (ANA) Council of Nurse |Established: 1972 | |Researchers |Goal: | | |To advance research activities, provide an exchange of ideas, and | | |recognize excellence in research. | | |The commission also influenced the development of federal guidelines | | |concerning research with human subjects and sponsored r esearch | | |programs nationally and internationally (Burns Grove, 2007, pp | | |9-10-11-12). |National Institute for Nursing Research (NINR) |Established: 1993 | | |Goal: | | |Focused its support on five research priorities; | | |Community-based nursing models. | | |Effectiveness of nursing interventions in human immunodeficiency | | |virus and acquired immunodeficiency syndrome (HIV/AIDS). | | |Cognitive impairment. | |Living with chronic illness. | | |Bio-behavioral factors related to immuno-competence (Burns Grove, | | |2007, pp 9-10-11-12). | |Agency for Health Care Policy and Research (AHCPR) |Established: 1989 | | |Goal: | | |To facilitate the conduct of outcomes research. It also had an | | |active role in communicating research findings to health care | | |practitioners and was responsible for publishing the first clinical | | |practice guidelines in 1989. These guidelines included a synthesis of| | |the latest research findings with directives for practice developed | | |by health care experts in a variety of areas (Burns Grove, 2007, pp| | |9-10-11-12). |Agency for Healthcare Research and Quality (AHRQ) |Established: 1999 | | |Goal: | | |Evidence-based guidelines and provided standards for practice in | | |nursing and medicine. Became a scientific partner with the public and| | |private sectors to improve the quality and safety of patient care | | |(Burns Grove, 2007, pp 9-10-11-12). |Department of Health and Human Services (DHHS) Health People|Established: 1992 | |2010 |Goal: | | |To focus of health care research and funding is expanding from the | | |treatment of illness to include health promotion and illness | | |prevention interventions (Bur ns Grove, 2007, pp 9-10-11-12). | |Sigma Theta Tau |Established:1967 | | |Goal: | | |Sponsored many local conferences to communicate research findings. It| | |provided research articles and summaries of research conducted on | | |selected topics (Burns Grove, 2007, pp 9-10-11-12). |People |Contribution to the field of nursing research: | |Florence Nightingale |Contribution: | | |Her initial research focused on a healthy environment promoting | | |patients’ physical and mental well being that included environmental | | |aspects such as ventilation, cleanliness, water, and diet. | |Collection and analysis of soldier morbidity and mortality during | | |Crimean war which gave soldiers the right to adequate food, housing | | |and proper medical treatment. | | |Changes within society with testing public water, improving | | |sanitation, preventing starvation, and decreasing morbidity and | | |mortality (Burns Grove, 2007, pp 9-10-11-12). |William Roper |Contribution: | | |Promot ed outcomes research during the 1980s to determine quality and | | |cost-effectiveness of patient care (Burns Grove, 2007, pp | | |9-10-11-12). | References: Burns, N. , Grove, S. (2007). Understanding nursing research-building and evidence-based practice (4th ed. ). St. Louis, MO: Saunders Elsevier. CERTIFICATE OF ORIGINALITY: I  certify that  the attached  paper is my original work and has not previously been submitted by me or anyone else for any class. I further declare I have cited all sources from which I used  language, ideas, and information,  whether quoted  verbatim or paraphrased, and that any assistance of any kind, which I received while producing this paper, has been acknowledged in the References section. I have obtained written permission from the copyright holder for any trademarked material, logos, or images from the Internet or other sources. I further agree that my name typed  on the line below is intended to have, and shall have, the same validity as my handwritten signature. Students  signature (name typed here is equivalent to a signature): Diana Wisocki___________________ ___

English paper Essay Example | Topics and Well Written Essays - 500 words - 5

English paper - Essay Example That is the function of an art, its relationship to nature and life, distinction of its beauty from the truth, its use, and moral goodness. According to Sartwell, â€Å"It is systematic attempt to pit aesthetics against rationality since it views beauty as a teeming opposite of simplicity. In this case spiritual orientation entails an aesthetic and vice versa† (Sartwell 59). Therefore, in depicting spirituality, different objects are in use by different cultures and religions. For instance, the Christians crucifixion really moves one to see the brutality received by Christ on the Calvary. Mathias crucifixion exaggerates the suffering a depiction that goes beyond realism. The body is covered with big sores of wounds to show the beatings and it is discoloured all over with blood. The legs intertwined with a nail at the place of intersection to hold the body on the cross. Sartwell asserts, â€Å"The legs have begun to putrefy and were turning green beneath the rivers of blood. He hands wide open, fingers contorted in a wild gesture in which were supplication and reproach† (Sartwell 71). This kind of work can move even the non-Christians to belief as they experience beauty in different emotions of this sight. Another example of objects that depict beauty are furniture and other work designs. For instance, the work of Shakers disjoins the physical object from its meaning. Just as the shakers believed that work is a form of worship, looking at their work one can view the devotion. Beauty revolves around some values that depict morality. The simplicity of art works, austerity, and integrity made the Shakers work outstanding, which made them make a lot of money as they marketed genuine items with honesty and quality. This is beauty (Sundara) as one looks at it in all dimensions such as moral aspect, physically, and spiritually. As one admires a good craft and the skilful work that goes into the craft, the mind can

TEMPERAMENT Essay Example | Topics and Well Written Essays - 500 words

TEMPERAMENT - Essay Example In this period, children develop a sense of freedom and exploration (Feldman p. 187, 2010). Children have been observed to have many different types of temperaments, which have been broadly classified as easy babies, difficult babies and slow-to-warm babies. Easy babies have a consistent behavior, which can be adapted easily to patterns of eating, sleeping and other routines. Difficult babies are very irregular and irritable in their patterns making it harder for them to adapt to changes. Slow-to-warm babies tend not to be very irritable, though their behavior is negative and they recede from public (Feldman p. 188, 2010). Common sense dictates that temperament should effect the development of a baby into a good or bad individual, or a healthy or unhealthy individual. But researches have shown that this is not the case, although temperament does have an indirect effect. The overall effect combines temperament and the societal nature and the general atmosphere around a person also. Temperament directly affects the attachment of babies with their parents. A recent research has shown that the parental attachment can also govern the development of a child’s temperament. Easy to handle babies are generally highly attached to parents (Smith, 2009). Behavior of a mother post-partum is a very important factor in determining a child’s temperament. Women with a higher level of maternal education are able to cope with babies better, having a lesser negative post-partum impact on their children (Smith, 2009). It has been observed that the mode of delivery has a very direct impact on the mother’s emotional stability. Natural and planned cesarean births fare far better than emergency cesareans and epidurals. These can also affect the temperament of children indirectly (Smith, 2009). Scientists are still unsure whether temperament is a completely psychological aspect of a human, or is there some biological effect too as