The concept of reflection in nursing, Qualitative findings on student and teacher perspectives Critique

The concept of reflection in nursing, Qualitative findings on student and teacher perspectives Critique

Nurse Education in Practice: The concept of reflection in nursing: Qualitative findings on student and teacher perspectives Critique

Name

Institution

Course

Date

Limitations of the studies reviewed require that caution be used in the application of the findings to educational programs. As indicated above, occupational health nursing practice involves the synthesis of principles form nursing, public health, and other disciplines. However, several researchers used a task-oriented approach to identify practice elements rather than a clearly identified conceptual approach to curriculum derivation. This is not surprising given the relative newness of research in occupational health nursing.

All studies reviewed involved some form of descriptive research, with survey designs employed most frequently. One study was national in scope, one regional, two statewide, and all other locals. Excepting where total populations were used, sample selection was mostly purposive or by convenience, and sample size often were small. In all but one study, instruments were developed by the authors. Contents validity either was explicitly or implied; however, no other types of validity or reliability were reported. Lack of instrument testing may have been due to the general lack of research conducted in occupational health nursing prior. Data were analysis mostly using descriptive and nonparametric statistical techniques, which is consistent with the type and state of the research.

A significant role of a research that is well demonstrated in this research is the incorporation of ethical approval and ensuring the wellbeing of participants. This based on the research was achieved by going through a process of formal ethical approval. However, the non-predictive nature of action research means that it is also important to mutually agree an ethical code of practice at the start of the study. Winter (2001) highlights various ethical code issues and principles of procedure. First they emphasize the importance of maintaining a professional relationship, guided by a duty of care and respect for the individual; regardless of gender, age, and ethnicity along with a respect for cultural diversity and individual dignity, as well as protection from harm. This last principle is part of any special researcher’s role, in addition to the need for informed consent and honesty. However, Winter (2001) suggest that there are other principles of procedure that should be followed in action research.

Having an ethical code of practice does not negate the additional need for research governance and formal ethical approval for action research. However, these quality processes are made all the more complex by the action researcher not being able to say in advance what the research will do. Action research proposals need to be written in collaboration with participants, often as co-applicants, with an inbuilt degree of flexibility. The action researcher should indicate the likely course of the study, specify the need for flexibility and enter into open and ongoing dialogue with ethical committees to seek approval for emergent changes in design.

Credibility of the finding

The study takes both qualitative and quantitative approaches to achieve the desired objectives. The qualitative approach will help in the examination of the current demographic factors exploring the various factors that act as drivers to the effectiveness and satisfaction level of the social workers (Jeon, 2004). This method is appropriate because initially the research aims to examine the satisfaction or dissatisfaction of the beneficiaries bearing in mind the diverse nature of the contemporary social workers but using a qualitative approach exploring the perceptions that drive the formulation and adoption of the management strategies.

The literature examines original investigations, other literature reviews, peer reviewed academic literature, research databases, reviews, journals in various academic fields and original manuscripts that relate to beneficiary satisfaction (Charmaz, 2006). One of the most recent studies, which directly involved investigation of customer satisfaction of user is the study carried out by SSP (2006). Since a search in the research databases produces a big number of results, the reviewed literature sources are picked on a random- sample strategy (Camilla, 2003).

Reliability and validityThe performance of any research tool is usually measured in terms of reliability, validity and sensitivity as well as specificity. These concepts will also be applied in this study by the researcher to ascertain the reliability of the study. According to Waliman (2005), reliability is the ability by which a study is able to produce results that are consistent and stable over a given period of time and given similar circumstances (Waliman, 2005). Various types of validities exist that include internal validity and external validity. Internal validity relates to the correlation between items when measured on a scale. Whenever a study provides the same results after the application of two different measures, the outcome is said to be equivalent.

Validity is the extent to which a given instrument is designed to measure. The validity of a study can vary in different samples used. In one situation, a study can be valid while in other scenarios, it may not. The validity of a study is measured by what the study claims to and the availability of logical errors in the conclusions drawn from the study. According to Crotty (2003), internal validity is the extent to which it is possible to make independent reference from the findings of a study especially if the independent variable influences the dependent variable. On the other hand, external validity is the general application of the findings of a study to other settings.

The measurement of the theoretical construct of a study is measured using construct validity while convergent validity makes comparison between the scores that are obtained from different instruments that are used in the study. Unlike convergent validity, divergent validity compares the instruments used in the study that measure concepts that are opposite. Given the above validity and reliability, the study is valid ad reliable for use by any person or strategic department (Waliman, 2005)

Internal validity of the research is low as with most field research. A number of factors are likely to impact on the amount and type of collected data. Some of the factors that have been identified to cause an impact on the internal validity of a study include the following. The variety of information collected from various people and sources might contradict. For instance, in one study, the researchers found out that the management had created different environments for the social workers (Jeon, 2004).

Another notable threat to the research validity is the method of selection that might be (though the probability cannot be determined) biased. Since participation in the study by respondents is voluntary, selection bias is likely to affect the internal validity. Instrumentation is also identified by the scholars as another factor that affects internal validity. In this threat, any change or alterations made in the measurement of variables or changes in the techniques of observation may justify changes in the measurement that is ultimately obtained. This is evident from various researches (Camilla, 2003). A good way of dealing with this threat is to ensure consistency of the data analysis method used and techniques applied by the authors.

Research approach

This research will take a deductive approach that will entail the researcher working from a known hypothesis that teamwork affects positively the employee performance in the strategic management department in ADP. Thus, the study takes a top down approach as compared to the inductive approach that takes an up down strategy.

A study that is quantitative usually makes an emphasis on transforming the data quantities and the models of statistics for purposes of measuring and analyzing data. The research topics in which researchers use this method have clear idea of what they look or search for and tools like questionnaires are used to collect data. Quantitative approach has its focus on the preciseness of data that is seen in terms of measuring data. Quantitative approach to a research involves using statistical data analyses to obtain information about the study simply because the approach is based on measuring the quantity or amount.

To realize the use deductive approach, quantitative tools of collective and analyzing data like questionnaires and interviews were used. Quantitative tools were preferred as compared to qualitative tools because they enable the researcher to come up with facts like a hypothesis that teamwork can improve the performance of employees in the strategic department of ADP and thereafter testing and confirming the hypothesis. This is unlike qualitative tools that first come up with an abstract idea that is followed by creation of theories and concepts about the idea. Lastly, data in quantitative research is hard and reliable as compared with qualitative research where data that is just rich and deep (Quinn, 2002).

In addition to the above, this study takes a positivism kind of philosophy towards the impact of teamwork o employee performance in strategic management department in ADP. A positivism approach will make us understand more the impact of teamwork on not only employees but also overall organization. On the contrary, a qualitative approach to research makes the researcher to switch his focus to gaining a better understanding of the problem of the research by giving detailed information about the main theme of the study topic. The major goal of a qualitative study is to have a complete and detailed description of the study phenomenon by applying reasoning. Qualitative research involves the use of interviews and observations to collect data and there are no formal measurements involved. Qualitative approach makes the researcher understand the phenomenon under study and be in a position to describe the whole situation as it is. The approach consists of descriptions, quotes, observations, and excerpts from books and other documents (Quinn, p. 2002, p. 308).

Bibliography

Caldwell, E., 2003, Research Designs and their applications: Connecticut, USA: Engage

Publishers.

Camilla, M., 2003, Textbook of basic Research Methods. New York, USA: Lippincott

Williams & Wilkins. Pp. 45-56.

Charmaz, K., 2006, Constructing Grounded Theory: A Practical Guide Through Qualitative Analysis. Thousand Oaks, CA: Sage Publications.

Clarke, A., 2005, Situational Analysis: Grounded Theory After the Postmodern Turn. Thousand Oaks, CA: Sage Publications.

Jeon, Y., 2004, The application of grounded theory and symbolic interactionism: Sydney, Australia. University of technology.

Kabala, M., 2005, Modern Research Methods and Techniques. New York, USA: Lippincott

Learning.

Mandan, S., 2005, Branding and Marketing: Modern salons. New York, USA: Lippincott

Williams & Wilkins.

Munhall, L., 2007, Nursing research: a qualitative perspective. Jones & Bartlett Publishers.

Posted in Uncategorized

Nsecurity,Firewalls and VPN solutions

Nsecurity,Firewalls and VPN solutions

Nsecurity, firewalls, and VPN solutions

Name:

Number:

Course:

Lecturer:

Date:

Introduction

Data security is very important in safeguarding private, personal or business information. Personal data like credit card information should be well protected from access by unauthorized individuals or hackers. Any company that deals with credit card transactions via computer network should therefore employ reliable security measures if they are to maintain trust by their customers. This paper gives an overview of network security fundamentals, threats and issues with a detailed network security recommendations followed by summary with reference to one medium-sized start-up company that processes credit card transactions on a daily basis (Tipton & Krause, 2012; Gajrani et al., 2013).

Overview of network security fundamentals, security threats, and issues

The entire network security implementation will depend on the size of the company or organization and hence the number of computers to be linked. In case just a dozen of computers with inclusion of Wi-Fi devices are to be connected, then a simple business wireless router is considered. These routers can offer sufficient Wi-Fi coverage and to provide Ethernet ports for wiring computers into the network or for addition of extra components like printers, wireless access points and others(Tipton & Krause, 2012; Gajrani et al., 2013).

If more than a dozen computers are to be connected like the case of this medium sized company, then security devices such as VPN router/firewall and unified threat management gateway or firewall will be needed. All these devices are step up from the basic wireless router. The virtual private network (VPN), server and at times other enhanced feature like VLAN support and multiple SSIDs are all integrated in these routers. Unified threat management (UTM) routers are normally for Ethernet only with limited number of ports and hence need separate access points for network links. Apart from offering functions of router and internet gateway with VPN server and firewall, these devices also include protection against threats of malware and viruses, anti-spam, content filtering and issues of intrusion detection and prevention as well as any form of unauthorized access to sensitive information(Tipton & Krause, 2012; Gajrani et al., 2013).

3.0 Detailed network security recommendations

3.1 Fundamentals of firewalls and VPNs

Since this middle sized company requires remote access to the network services, this can be implemented by employing a router, gateway or firewall having VPN server that supports remote connections. In this way, users will be capable of accessing the network away from their offices. In addition, two or more offices can easily be linked together in a site to site configuration (Tipton & Krause, 2012; Gajrani et al., 2013).

There are a number of VPN types that can be used. First is the Point-to-Point Tunneling Protocol (PPTP) with built in VPN. However, PPTP has low level of security with other issues arising from users remotely connecting from networks that do not permit VPN services. Second is Layer 2Tunneling protocol (L2TP/IPSec which has better security as compared to PPTP. L2TP is also supported by many operating systems and popular mobile devices. Nevertheless, L2TP is hard to configure and can lead to connectivity issues from remote network connections that don’t permit VPN services. Third is the Secure Sockets layer (SSL) protocol which permits remote access by users who connect through web browser there by removing the VPN service issue. Next is the OpenVPN which is not supported by most built in clients on computers or mobile devices. Due to this, a third party VPN client software has to be installed on the computers or devices to support connections for remote users. However, OpenVPN provides high security and extra reliable connections from other networks that do not permit VPN pass-through (Tipton & Krause, 2012; Gajrani et al., 2013).

3.2 Recommendations for firewall and VPN solutions for the new company

First of all, this is a medium sized company where security is crucial to credit card transactions. Due to this size of the company, I recommend VPN/firewall which is able to support more than a dozen computers. These routers configured as firewalls also has integrated VPN server with virtual local area network support together with many SSIDs in case of wireless connections (Tipton & Krause, 2012; Gajrani et al., 2013).

As far as the discussion in 3.2 above is concerned, I also recommend the company to employ the use of Secure Sockets Layer (SSL) protocol since it eliminates the VPN pass-through problems. In addition, this protocol of VPN does not need full client software .With SSL, it is also possible to install a small plug-in through the browser in order to smooth the progress of tunneling of email traffic along with web browsing for users. A number of SSL VPN approaches also provide web portal whereby users can get the right of entry to applications in addition to emails without any VPN client. This kind of setup will also be suitable when the connection from home is needed or on different non corporate computer instead of a work laptop (Tipton & Krause, 2012; Gajrani et al., 2013).

3.3 Recommendations for implementing my proposed solutions

I would like to recommend the following for the implementation of the proposed solution. First is that the credit card information for every client should be encrypted for safety across the network in order to compliment on the security offered by the provision of Firewalls and VPN routers as mentioned above. Next is that both the company management team together with the anticipated company users of the expected system should participate fully during the implementation part of it. This kind of participation is important in ensuring that everyone’s opinions is taken in to an account for purposes of avoiding future complaints of network security system inefficiency(Tipton & Krause, 2012; Paul et al., 2012).

If the success of implementation is to last for longer time, then I also recommend that the company should have some staff assigned specifically to data security. The assigned staff should also be trained on regular basis to make them aware of all technical and legal issues of security. Safety guidelines should also be created for both laptops and other portable computing devices when they are used off-site. All employees should also adhere to the use of strict passwords and virus protection procedures. The company should also consider using payment card industry (PCI) standards to enforce encryption procedures for the protection of personal sensitive information like those of credit card transactions especially when it comes to their transmission across the network. In addition, the company should also carry out system penetration tests to find out if their system is hacker proof. Lastly, extra precautions ought to be taken to safeguard against information leakage just in case the company is vulnerable for industrial espionage (Tipton & Krause, 2012; Paul et al., 2012).

3.4 Practices that I will use to ensure security within the enterprise

Some of the security practices I intend to use within the enterprise include the following. First is to use sufficient access restrictions such as audit trails as well as strict penalties for violations on the company employees in order to safeguard against unauthorized access. The use of authentication procedures such as log in passwords will be enforced for every user. Secondly is to instruct the company employees during their initial orientation and on the ongoing training programs so that data for customers are confidential. Third is to ensure that the company security list is secure and that the company also has the sufficient security to prevent remote computer access to the company list. The forth practice is to make sure that the list recipients use adequate safeguards by ensuring that security measures are in place during the transfer of the list. Next is to ensure secure and timely return or description of lists used by other entities. I also intend to employ checking system to track usage list like the use of decoy names. Last but not least, I will ensure that there is always someone in the company who is responsible for the list security in such a way that he/she keeps up to date laws and regulations concerning fair information practices (Tipton & Krause, 2012; Gajrani et al., 2013).

Summary

From the discussion above, it is clear that the type of Routers/firewalls for VPN is determined by the size of the organization or company. This is because; company size also translates to the number of computers to be linked within the network. In our case of medium sized company, it is apparent that the number of computers required exceeds the dozen sizes. Therefore VPN router configured as firewalls which are a step up from the simple wireless Wi-Fi router is used for network security. Authentication and encryption measures are also needed for data security of unauthorized access.

The VPN and firewall protocols available for our case include PPT, L2TP/IPSec, SSL and Open VPN. This report has recommended the use of SSL because it is more reliable as compared to the rest in terms of remote access, that is, free from problems of VPN pass-through problems and other strengths as explained above. The recommendation also goes with the fact that daily credit card transactions calls for extra high security in terms of network and data itself if the issues of hacking and virus threats are to be eliminated. However, the success of this implementation will require full participation of all stakeholders involved in order to get maximum support.

References

Tipton, H. F., & Krause, M. (2012). Information security management handbook. CRC Press.

Paul, S., Gupta, S. D., Islam, K. A., Saha, K., & Majumder, S. (2012). Challenges of Securing the Smart Grid and Their Probable Security Solutions. International Proceedings of Chemical, Biological & Environmental Engineering, 44.

Gajrani, K., Bhargava, A., Sharma, K. G., & Bansal, R. (2013, November). Cyber security solution for wide area measurement systems in wind connected electric grid. In Innovative Smart Grid Technologies-Asia (ISGT Asia), 2013 IEEE (pp. 1-5). IEEE.

Posted in Uncategorized

Nursing Staffing challenges in Maryland

Nursing Staffing challenges in Maryland

Nurse Staffing challenges in Maryland.

The medical profession has been witnessing rapid growth mostly in the demand for the primary care services. Although this growth was somehow expected, it has not been accompanied by an increase in the number of doctors. This has led to the health care industry in Maryland calling upon the nurses into action.

Unfortunately, the nursing field is also facing its own shortages in staff numbers and who operate under very demanding schedules. Previous studies like the one by the University of Maryland Nursing School (Nursing research 2011 quoted in Rajaraman 2013)Bottom of Form.One of the issues that were associated with low numbers of staff was the long hour shifts. These long hours at work and reduced off job hours contributed to poor patient handling and even deaths from avoidable errors.

The cadres that have been targeted mostly to replace the physicians are the nurse practitioners who have the skills to perform the tasks of a physician. This is only a stop gap measure since as indicated above; this has a domino effect on the lower job cadres.

Currently, Maryland’s population of nurses stands at 49,600, registered nurses who are active. Of these, 3,500 are nurse practitioners which mean they hold master’s degrees and a board of nursing license. The Government of Governor Martin O’Malley has committed to increase the population of nurses by 25% by 2020 partly via improving educational access as well as address the burden the medical staff faces (Gantz 2012).

In the words of Phyllis Snyder the vice president of the council for adult learning, it is not business as usual and we have to develop a variety of new pathways. One of these ways has been the concerted effort by health advocacy groups and nursing training institutions towards increase their drives towards having more students in the college level to choose nursing as a career. The groups are also encouraging nurses who are already in practice to pursue higher qualifications (Hoffman & Kaplan, 1998).

Schools have also embarked on missions to make nursing studies more accessible and affordable through inter schools partnerships, credit earned against prior experience and offering support towards tuition. The state on its part is designing ways in which it enhances access to nursing training as well as attracts more nurses into the state’s workforce.

An earlier report from the CGME (Council for Graduate Medical education) had established that only fewer than 20% of med school grandaunts pursue primary care as careers instead going for specialties with higher pay (Goldfarb, Goldfarb & Long 2008).Under the prevailing circumstances, nurses have been more than willing to take up the challenge of filling the gap but are forced to grapple with regulation and bureaucracy issues. For example, an assistant dean at the school of nursing University of Maryland Jane Kapustin bemoans the fact that she can legally diagnose diabetes at the university of Maryland Medical Center diabetes clinic, issue a prescription for insulin and commission tests but if she were to recommend special shoes, a physician would have to sign against the order.

It is encouraging to note that nurses in collaboration with advocacy organizations are exerting pressure to have the barriers reduced and it is hoped that these efforts combined with the pressure from increased need for additional primary care providers will eventually break the barriers.

References.Gantz S (2012). Maryland Nurses Come to fore as care landscape shifts, Baltimore Business Journal. Retrieved from http://www.bizjournals.com/baltimore/print-edition/2012/07/20/nurses-come-to-fore-as-care-landscape.html?page=all.Top of Form

Goldfarb, M., Goldfarb, R., & Long, M. (January 01, 2008). Making Sense of Competing Nursing Shortage Concepts. Policy, Politics, and Nursing Practice, 9, 3, 192-202.Top of Form

Hoffman, S., & Kaplan, M. (January 01, 1998). Problems encountered in the implementation of dementia care programs. American Journal of Alzheimer’s Disease and Other Dementias, 13, 4, 197-202.

Rajaraman M (2013) Study suggests link between lengthy Nurse shifts and patient deaths. Southern Maryland online. Accessed from http://somd.com/news/headlines/2011/13155.shtml.Bottom of Form

Null Hypothesis Significance Testing

Null Hypothesis Significance Testing

Null Hypothesis Significance Testing

Please analyze the data according to the NHST steps. Show your work and respond to as much of the following as you can.

STUDY 1

STEP 1 Design a study (Make a choice for the items that have a choice/choice below)

a) observation/correlation/experiment?

b) Model variable is IV/predictor/QIV/none?

c) Outcome variable is nominal/ordinal/interval/ratio?

d) Model variable is continuous/discrete?

e) What parametric assumptions still need checking?

Assume representativeness = yes and linearity = yes.

f) RQ: What is the effect/association of the number of hours worked on/to the number of publications?

STEP 2 State mutually exclusive hypotheses

a) H0: There is no association between the number of hours worked and the number of publications by a faculty member

b) H1: There is an association between the number of hours worked and the number of publications by a faculty member

STEP 3 Calculate test statistic(s), df, and effect size(s). Indicate whether the effect size(s) are small, medium, large.

Pearson correlation0.604

Df = 20 – 1 = 19

P-value0.005

STEP 4 Compare to alpha level

A p-value of 0.005 is statistically significant for an alpha level of 0.05

STEP 5 Invoke a decision rule and draw a conclusion(s)

The null hypothesis is rejected if we have a statistically significant p-value. We therefore conclude that there is an association between the number of hours worked and the number of publications by a faculty member

STEP 6 Interpret and report Write up the results in APA style, include appropriate descriptive statistics, inferential statistics, and effect size. Interpret the results in terms of the research question(s).

Results

Correlation: hours, num_pubsCorrelations

Pearson correlation 0.604

P-value 0.005

Descriptive Statistics: num_pubs, hours

Statistics

Variable N N* Mean SE Mean StDevMinimum Q1 Median Q3 Maximum

num_pubs20 0 7.45 2.98 13.31 0.00 0.25 1.00 9.25 49.00

hours 20 0 24.85 3.28 14.65 5.00 13.00 21.50 40.25 50.00

STUDY 2

STEP 1 Design a study (Make a choice for the items that have a choice/choice below)

a) observation/correlation/experiment?

b) Model variable is IV/predictor/QIV/none?

c) Outcome variable is nominal/ordinal/interval/ratio?

d) Model variable is continuous/discrete?

e) What parametric assumptions still need checking?

Assume representativeness = yes and linearity = yes.

f) RQ: What is the effect/association of _____________ on/to ___________?

STEP 2 State mutually exclusive hypotheses

a) H0:

b) H1:

STEP 3 Calculate test statistic(s), df, and effect size(s). Indicate whether the effect size(s) are small, medium, large.

STEP 4 Compare to alpha level

STEP 5 Invoke a decision rule and draw a conclusion(s)

STEP 6 Interpret and report Write up the results in APA style, include appropriate descriptive statistics, inferential statistics, and effect size. Interpret the results in terms of the research question(s).

Results

Posted in Uncategorized

NSG124 Pharmacology Study Test Plan Exam 3

NSG124 Pharmacology Study Test Plan Exam 3

NSG124 Pharmacology Study Test Plan Exam 3

Unit 3 Module 9 & 10 Location Student Notes

Therapeutic uses

Adverse effects

Patient education

NSG124.09.01.02

RAA Drugs Patient education

Nursing interventions

Nursing considerations

NSG124.09.01.03 (x2)

Nursing Care for RAA Drugs Adverse effects

Patient education

Nursing Interventions

Nursing Considerations

NSG124.09.02.02 (x3)

Nursing Care for Calcium Channel Blockers Therapeutic uses

Adverse effects

Examples

Drug to drug interactions

NSG124.09.03.01 (x2)

Vasodilator Agents Therapeutic uses

Adverse effects

Examples

Nursing considerations

Drug to drug interactions

NSG124.09.04.03

Hypertensives in Emergencies & Pregnancy Nursing interventions

Nursing considerations

Adverse effects

Patient education NSG124.09.04.04 (x3)

Nursing Care for Antihypertensive Agents

Nursing considerations

Adverse effects

Patient education

Therapeutic effects NSG124.09.05.04 (x3)

Nursing Care for Antihypertensive Agents

Nursing considerations

Nursing interventions

Patient education

Therapeutic effects

NSG124.10.01.03 (x4)

Nursing Care for Antidysrhythmic Agents Nursing considerations

Nursing interventions

Patient education

Therapeutic effects

NSG124.10.02.02

Atherosclerotic drugs Nursing considerations

Adverse effects

Patient education NSG124.10.02.03 (x3)

Nursing Care for Atherosclerotic Agents Nursing considerations

Adverse effects

Patient education

Therapeutic effects

NSG124.10.03.03 (x3)

Nursing Care for Antianginal Agents Nursing considerations

Nursing interventions

Patient education

Adverse effects

NSG124.10.04.02

Anticoagulant Drugs Nursing considerations

Nursing interventions

Patient education

Adverse effects

NSG124.10.04.03 (x5)

Anticoagulant Nursing Considerations Nursing considerations

Adverse effects

Patient education

NSG124.10.04.07

Thrombolytic Nursing Considerations Treatments

Patient education

Examples

NSG124.10.05.02

Myocardial Infarction Agents Nursing considerations

Treatment

Patient education

Adverse effects

NSG124.10.06.03 (x3)

Nursing Care for Deficiency Anemia Agents Unit 3 Module 11 &12 Location Student Notes

Examples

Patient education

Nursing considerations

Adverse effects

NSG124.11.01.02

SSRI & SNRI Depression Agents Patient education

Nursing considerations NSG124.11.01.05

Atypical Antidepressant Agents Patient education

Nursing considerations

Adverse effects

NSG124.11.01.06 (x2)

Antidepressant Agent Nursing Consideration Examples

Patient education

Nursing considerations

Nursing interventions

Adverse effects

NSG124.11.02.02 (x2)

Antianxiety Agents Patient education

Nursing considerations

Nursing interventions

Adverse effects

NSG124.11.03.02

Bipolar Disorders & Nondrug Therapy Patient education

Nursing considerations

Nursing interventions

Adverse effects

NSG124.12.01.03 (x2)

First-Generation Antipsychotic Nursing Considerations Patient education

Nursing considerations

Nursing interventions

Adverse effects

NSG124.12.01.05

Second-Generation Antipsychotic Agents Patient education

Nursing considerations

Nursing interventions

Adverse effects

NSG124.12.02.03

Barbiturates Patient education

Nursing considerations

Nursing interventions

Adverse effects

NSG124.12.03.02

Controlled Substance Act & Healthcare Impact Patient education

Nursing considerations

Nursing interventions

Adverse effects

NSG124.12.03.03

Alcohol Pharmacology & Alcohol Use Disorder Patient education

Nursing considerations

Nursing interventions

Adverse effects

NSG124.12.03.04

Nicotine & Smoking Cessation

Posted in Uncategorized

NUTRITION RESEARCH ASSIGNMENT

NUTRITION RESEARCH ASSIGNMENT

NTR 198

NUTRITION RESEARCH ASSIGNMENT

You will be required to research a nutrition topic of your choice based on the subjects we are discussing. You must find one article of original research on your topic, from an accredited journal (i.e. The Journal of Clinical Nutrition, The Journal of the Academy of Nutrition and Dietetics (JADA, JAMA. The Journal of the American Medical Association or any other medical journal available the library or on the library’s database. You will submit the first page of the article with your paper and include a bibliography of the article read and proper citations when necessary. The final assignment will consist of the following components: Minimum of 500 words

A summary of your topic, including issues of concern or what research is being done and why.

Include a copy of the first page of the article, bibliography and citations.

Write a summary of the research article including who the subjects were, how many subjects were involved, what exactly was being studied, the methodology, the results and conclusion. – IN YOUR OWN WORDS

Then write your own conclusion on the topic relating to the research your just read what you learned. Was it good science? Why? What did you come to believe about the topic?

*Topics must be specific, i.e. not simply “Vitamin A” but “Vitamin A and Cancer Prevention” or not just “Pediatric Nutrition” but “Parental Influence of Food Choices of Children.

*** Research articles must have subjects, methods, experiments and conclusions. It must be the original research NOT an arable about research. Not all articles in journals are original research, choose carefully.

**** All citations must be written in APA format (see directions). Help is available at the Library and the Writing Center

Posted in Uncategorized

Nuclear Weapons and Global Peace

Nuclear Weapons and Global Peace

Nuclear Weapons and Global Peace

Name

Course

Tutor’s Name

Date

Nuclear Weapons and Global Peace

When the United States dropped two atomic bombs over the two Japanese towns of Hiroshima and Nagasaki, World War II gradually came to an end. But shortly afterwards, the world entered into a cold war, a period of great tensions as two sides (NATO and Warsaw Pact) engaged in an arms race. The situation was so tense that analysts came with a term Mutually Assured Destruction (MAD), to refer to a situation whereby the two protagonists (Soviet Union led by Russia and the United States) will simultaneous strike each other with nuclear weapons and wipe themselves out of the planet (Gaddis, 1982). Eventually the two sides had to step away from the brink of a major catastrophe.

As to whether the presence of more nuclear weapons can guaranteed continued world peace and stability is a matter of conjecture. On one side it has been argued that more nuclear weapons has a deterrent effect on nations (Oupblog, 2009), so that in case of a conflict, countries will always pull back from the brink by the mere thought that war will escalate to nuclear war. The consequences of nuclear war are too grave that anybody will not dare use them.

It can also be argued that, nuclear weapons cannot sustain the peace we have all along known. Countries such as Iran look at such weapons as leveling the ground against states that are out to bully them, casting doubts as to whether sobriety can prevail when it faced with obvious threat of an attack. It should also not be forgotten that terrorist elements such as Al Qaeda, have proved that they derived great delight from mass killings of innocent civilians (Oupblog, 2009, and Greenpeace, n.d.). The September 11 attacks in the United States are clear example of their thinking. One wonders what the world will look like should they access either the technology or the nuclear war heads.

In the current dispensations, and with the reality of terrorism, more nuclear weapons simply mean less control and easy access to terrorists, turning them into killing devices.

References

Gaddis, J. L.(1982). Strategies of Containment: A Critical Appraisal of Post-war American

National Security. New York: Oxford University Press.

Greenpeace,(n. d). Moving to a nuclear weapons-free world. Retrieved October 4, 2013, from

http://www.greenpeace.org.uk/peace/moving-nuclear-weapons-free-world

Oupblog, (2009, March, 26). Do nuclear weapons make the world a safer place?

Message posted to http://blog.oup.com/2009/03/nuclear-weapons/

.

Posted in Uncategorized

deliverables of an early warning system

deliverables of an early warning system

Output/ deliverables of an early warning system

Student name:

Instructor:

Institution

Introduction

As a labour intensive industry, hospitality employs large numbers of wage earners, whose taxes and disposable income add to gross domestic output and help to create further employment opportunities. Given that each hotel room typically requires one member of staff, every hotel room built has the potential to create an additional job [1].

Furthermore, for every dollar spent by a guest in a hotel, one additional revenue dollar is generated for the community. Referred to as the ‘multiplier effect’, this concept is used by economists to explain how money spent by a hotel guest travels through a community to purchase the goods and services required to meet the guest’s needs. In the United States, for example, the multiplier effect is approximately two; that is, for every dollar spent by a guest in a hotel, one additional revenue dollar is generated across a wide range of businesses [2].

`Captive’ customers and database marketing, combined with modern information technology, provide the means for achieving these goals and measuring company achievement in unlocking the potential expenditure from customers. Information systems provide early warning of resorts and/or product types that are losing customer appeal while identifying others that are growing in popularity [3].

Eco-tourism system, good or bad, is shown by the state of health index. The comprehensive index is decided by the pressure index, state index and response index. “Pressure index” shows reasons that tourism ecosystem health took place deterioration, which is indicated with its abundant tourism resources, socio-economic development pressure and intensity of human activity. Status Index refers to the situation of the quality of the eco-tourism system under the current period, shown by the quality of eco-tourism environment, the level of tourism development, and environmental awareness of the tourists. Status is the result that we continually put pressure on our natural environment, which decides anti-interference ability and buffering capacity or ability to the pressures. In the face of the state of the tourism ecosystem under the pressure, we have to take some of the policies and measures, which is response index which is characterized by preferential policies and environmental protection efforts.

The issue of multi-objective decision-making, as well as specific analysis of the levels is established by the index system, using layer-analysis and expert investigation methods to determine weight of the indicators. After identifying tourism ecosystem health evaluation index system, actual development of regional tourism is combined through a great deal of statistical analysis of survey data, regional tourism of the ecosystem health index is calculated, is analyzed and ecosystem health status is predicted through appropriate antitheses of the tourism indicators and the health diagnosis of tourism ecosystem is carried out, and finally countermeasures are proposed[4].

Airspace industry: The aerospace division of Diamler-Benz (acronym DASA) was a company most would recognize as a member of the Airbus consortium. It was also involved in manufacturing military aircraft, as well as related fields. Today it is no longer a division of Diamler, which in July 2000 merged it into the new European Aeronautic Defense and Space Agency (EADS) with the French Aerospatiale Matra and the Spanish CASA.

While still at Diamler, DASA had an elaborate strategic early warning system with some classic German characteristics (highly analytical and systematic process of identifying risk, an attempt to put the world into a clearly defined, fully mapped, orderly system, and measure as much as possible. As expected, this engineering company’s strategic early warning system (SEWS) was extremely analytical. At the heart of its methodology for identification of risks was a unique “driver driven analysis”, an analysis of the main factors influencing the future along the lines of system dynamics[5]. Once the scanners reported remarkable changes on the most critical descriptors, the issue which was pertinent to a particular business unit, the notice went to a special evaluation committee in this business unit. On issues pertaining to corporate decisions, the reporting and monitoring were initiated within the corporate staff and the early warning team did the analysis[6].

As increasing urbanization is taking place worldwide, earthquake hazards post strong threats to lives and properties for urban areas near major active faults on land or subduction zones offshore. Earthquake early warning systems can be useful. At least three countries have earthquake early warning systems in operation: (1) Japan, (2) Mexico, and (3) Taiwan. These systems can provide a few seconds to several tens of seconds of warning for large earthquakes. More significantly, a properly upgraded seismic network can provide a shake map within minutes after a disastrous earthquake, so that loss estimation can be quickly assessed to aid disaster response and recovery[7].

References

[1] Olsen, M. D., 1995: Into the New Millennium: A White Paper on the Global Hospitality Industry. International  Hotels &Restaurants Associations. France.

[2] Ibid

[3] Marketing in Travel and Tourism by Victor T. C. Middleton, Jackie Clarke; pg. 441

[4] FAN Qiumei, SUN Tieheng/Management Science and Engineering Vol.2 No.4 2008 59-65

[5] Early warning: Using competitive intelligence to anticipate..,Vol.2003 by Benjamin Gilad; Case study of CEW in Action; 184,185,186

[6] Early warning: Using competitive intelligence to anticipate..,Vol.2003 by Benjamin Gilad; Case study of CEW in Action; 188,189

[7] Earhquake Early Warning Systems: Current Status and Perspectives by Willy H. K. Lee, Juan Manuel Espinosa-Aranda./ Early Warning Systems for natural disaster reduction by Jochen Zschau, Andreas N. Kuppers.

Posted in Uncategorized

Deliberate exclusion

Deliberate exclusion

Name:

Institution:

Course:

Tutor:

Date:

Discussion Questions

Question 1:

The court put in consideration various factors before reaching a decision. To begin with, it determined whether Kodak had monopoly power and after establishing this, it delved into determining whether the decision that was undertaken by Kodak was informed by the need to protect its patented parts as well as copyrighted works. The court then evaluated various competing interests of the public policy and found out that Kodak’s decision to protect the others form its patented and copyrighted work had devastating effects on the consumer base. In this regard, Kodak’s decision to exclude some consumers such as independent service organizations can be considered to be unethical and needs to be shunned. From a business point of view, all consumers are major stakeholders in a given business entity and therefore their needs need to be addressed accordingly. Deliberate exclusion form benefiting from the services and products of this company undermined the degree of happiness of the respective consumers. From a utilitarian standpoint, this is immoral because it reduces the level of happiness of the consumers.

Question 2:

In this case, the agreement between Northeast and Wellington was not bound by any fiduciary like obligations. For this reason, Northeast was not obligated to provide any adverse information about the clients to Wellington. The court ruled in favor of Wellington because in light of the contract agreement, Northeast was solely required to find and present suitable candidates as opposed to performing the services provided by an investment consultant or banker which are bound by fiduciary like obligations. Ruling otherwise would have accorded Northeast other obligates that were not initially presented in the contract. The court also ruled in favor of Northeast because this organization fulfilled its role as required by the contract. Put differently, it found and presented Wellington with a willing buyer of its investment.

There are various risk factors that the management needed to have reviewed prior to finalizing and implementing the acquisition agreement. To begin with, the management of Wellington needed to have reviewed the credibility of Sternau’s companies as well as their reputation. Prior analysis in this regard would have been useful in enabling Wellington to make informed financial decisions either before or after entering the acquisition agreement. Besides understanding the history of Sternau’s companies Wellington organization also needs to have evaluated the investment options that it had at its disposal. Likewise, this would have been useful in enabling it to make credible financial decisions and to define its position in the acquisition contract.

Question 3:

The United States has 94 different federal district courts that also represent the federal trial courts under general jurisdiction. Every district court covers a geographic region that is called a judicial district. The respective locations covered by the each district differ considerably. The District of Columbia, three territories and Puerto Rico have one judicial district each. The remaining states have either two or more judicial districts. The inherent geographic disparity has diverse implications on the quality of service that the citizens are accorded. Arguably, the services provided by judicial districts covering bigger geographical areas as comparatively of lower quality than those covering a smaller geographical area. This is further compounded by the rising population and increasing diversity as well as complexity of social problems.

Question 4:

The constitutional right that the government would be infringing upon under these facts pertains to the student’s right to free speech. Under the US constitution, very individual has a right to communicate his or her ideas, expressions and opinions freely. This is inclusive of the freedom to hold individual opinions without any form of interference. It also involves the right to receive, seek, or impart ideas or information using any form of media irrespective of the frontiers. Expelling the student from the school would certainly infringe upon the rights of the student to free speech.

In addressing this concern, the court would review the school regulations regarding the dress code. Arguably, an education institution that would tae such a step would certainly have strict rules regarding the dress code and the relative expectations of the students. The school would in this regard refer to cases of controversial articles or information on student clothing to shield it self. Also, reference to the right to freedom would be made and the action of the education institution analyzed in light of the respective provisions.

Indeed, there are competing interests that are presented in this case. These need to be balanced in order to foster harmonic co existence between the school principal and the students. Allowing the child to wear the t-shirt would have profound implications on the authority of the learning institution. In particular, this would imply that the student is more powerful than the school authority and might culminate in the occurrence of other detrimental discipline cases. Considering the fact that the information on the t-shirt is a little bit sensitive, allowing the student to wear it would also imply that the respective information is indeed true. This has adverse impacts on the smooth running of the school. Preventing the student form wearing the t-shirt on the other hand would raise various concerns related to the free speech right.

There are various other factors outside the constitution that the court might consider during its decision making. To begin with, it would analyze whether there have been occurrences in the school in the recent past that might have compelled the student to print the writings on the t-shirt. Then, I would also evaluate the past behavior of the student in a bid to determine whether s/he has been involved in discipline matters previously. This would enable the court to ascertain the action and decision of the student in this respect. Further, it would be useful for the court to determine whether the student has had relationship problems with the principal before.

If the t-shirt contained vulgarity or profanity according to community standards, the analysis of the case would not change. This is because the issue lies under the freedom of speech issue and the community is not directly involved in the matter. Finally, it is not a must that the student takes the case to court. There are other viable mechanisms through which the dispute can be resolved. To a great extent, these would be based on the relationship that the student has with the school administration. For instance, negotiation approach to problem resolution can be pursued. In this regard, a third party such as parents of the student or school board would be employed in helping the principal and the student to resolve the problem.

Posted in Uncategorized

Delegation Example in a Health Care Setting

Delegation Example in a Health Care Setting

Delegation Example in a Health Care Setting

Student’s Name

Institution

Delegation Example in a Health Care Setting

Introduction

In a health care context, delegation is always necessary to allow a nurse manager to delegate some responsibilities to his or her junior nurses. Nurse case managers are the registered nurses (RN) who by virtue of their stature and complex responsibilities must develop the ability and skills of delegating some work to the assistant nurses (Weiss & Tappen, 2014). However, delegation is a complex nursing skill that demands final accountability and sophisticated clinical judgment. Therefore, its effectiveness depends on individual’s nursing experience, and understanding of the fundamental concepts of accountability, authority, and responsibility. Notably, RNs use Work Complexity Assessment (WCA) tool to analyze the skills and knowledge of the delegates before assigning them the responsibilities (Persily, 2013). Objectively, delegation in nursing aims at improving quality patient care and enhancing the coordination between the senior and ancillary personnel.

Undoubtedly, effective delegation is one of the most intricate and complicated responsibilities of RNs. It is imperative for RNs to understand what the patients and their families need, after which, they have the task of appropriately engaging the caregivers (Persily, 2013). As such, it is obligatory for them to develop a plan that would result to the desired patient outcomes and maximizing the use of available resources. Also, the senior nurses assign some responsibilities to nursing assistants, unlicensed assistive personnel (UAP), or licensed vocational personnel (LVP) by providing relevant directions, guidelines, and regulations (Weiss & Tappen, 2014). In order to categorically understand the whole concepts of delegation in a health care context, this paper organizes all the sections entailed. In particular, the rudiments include the delegation process, issues, stakeholders and how to choose them. In addition, it highlights the plan of action during delegation, which entails communication, conflict resolution, feedback provision, evaluation, and recommendations (Persily, 2013).

Delegation Model or Process

National Council of State Boards of Nursing (NCSBN) defines delegation as a process which involves transferring of responsibilities, directions, or guidelines of patient care to competent individuals (In Cherry & In Jacob, 2014). The RNs act as the delegators, who assign their co-workers the authority to care for the patients. The process entails selecting particular subordinate nurses to perform specific tasks, which they are well acquainted with. As a result, prior to the actual delegation, the RN must understand what the patients need and then match the needs with competent health care assistants (HCAs). However, the delegator remains accountable and responsible for the rationale of the delegation if in case something goes wrong. For example, if the UAP, HCA, or LVP administers a wrong medication to a patient, RN will also be held liable for assigning an incompetent nurse (Persily, 2013). Similarly, the nurse shall also be accountable for his or her ineptness in performing the task.

Objectively, delegation gears towards achieving quality patient care outcomes, where liable persons are held responsible and accountable. The concept is about sharing of activities with individuals who possess the appropriate authority. The sharing and collaboration herald efficiency and effectiveness in care and facilitate synergistic positive outcomes (Weiss & Tappen, 2014). Evidently, delegation has four main components namely; quality care outcomes, responsibility and accountability, sharing activities, and selection of the appropriate authority.The general procedure of delegation is summarized in the figure below

Figure 1: Shows the general procedure of delegation

Source: (Hansten, & Jackson, 2009)

Example: Delegation process

At St. Mary Hospital, Mr. Robert, a RN, had many TB Patients that he had to attend to. He, therefore, decided to call Miss Effie, a nurse assistant, who was free at that time. So, in order to follow the whole procedure, Robert first assessed the needs of the patient and the scope of the task to delegate. He then ensured that Effie was competent and well versed with the needs; thus he communicated to her about the assignment by explain all the guidelines, directions, and responsibilities. After which, Effie left to execute her task, and the RN clarified that he shall be conducting surveillance and supervision to ensure that all was well. In addition, Effie was to evaluate her patient care results and report the feedback to Robert.

Delegation Issue in the Workplace

Principally, delegation has some issues that it must comply to since the whole process is complex and involves multiple stakeholders. Therefore, it is very critical for the RN to model on what, where, how, to who to delegate a task (In Cherry & In Jacob, 2014). RNs may delegate the tasks or some elements of patient care, but the overall nursing process cannot be delegated. In addition, the delegation should not be beyond the scope or competence of HCA. Also, the process of delegation must be done in order to benefit the patient, but not merely performing it to save money or time (Persily, 2013).

When nursing assistant performs the task, he or she must keep records concerning the state of the patient. The records should be regularly submitted to the RN to monitor and supervise the conditions of the patients. In essence, as the HCAs do their assignments, they should ensure that the task is within their capacity to handle (Hansten & Jackson, 2009). If in case a complication arises, they should not assume by continuing to care for the patient, but should immediately report to the RN. The RN shall then take over the case and address the care intricacy. The point is each, and every HCA should understand his/her scope or boundary of work, anything outside that must be reported to the senior nurse (Weiss & Tappen, 2014). If so, then patient care seems to be given the priority, which ought to be the primary goal of the nurses.

Example: Knowing the Boundaries

Miss Effie, the HCA goes to care for the patient as directed by Robert. Before then, Robert assigned her to go and note all the symptoms that the patient was showing, which she actually well understood and had the knowledge. In the process of caring and noting, she realizes that the patient has some form of cardiac complications. Although Effie is competent and experienced in the basic aspects of TB, she is aware and prospects that the cardiac complication seems lethal and to treat it would mean she is working outside her competence sphere. She also knows that the complication has not been assessed by Robert, the RN.

As a result, Effie reports the case to Robert, who then takes over to care for the complication. As such, Effie is said to have acted in accordance with the guiding protocols of delegation in the workplace and is able to justify her actions. From the case, Effie has demonstrated her awareness and understanding of responsibilities and accountability towards the patient (Persily, 2013). Robert examines the patient and realizes that the complication is worsening and should transfer the patient immediately to the Intensive Care Unit. He contacts the hospital supervisor, who informed Robert to engage other health stakeholders to successfully transfer and treat the patient.

The Stakeholders and Different Health Care Roles

Because of the complexity of the health status of the patient, there was an urgent need for collaborative function of various nurse practitioners. According to the case study, the patient had to be transferred to the ICU, where nurses from Cardiac/Coronary Unit (CCU) were required. In addition, other nurse practitioners, patient’s family, and hospital administrators cooperated to ensure the safety, quality, value, and flow of the healthcare provision to the patient (In Cherry & In Jacob, 2014). The inter-professional care shall ultimately drive and result in the highest quality of patient care. Notably, every stakeholder has his or her area of competence; thus, there integrated efforts will save the patient (Hansten & Jackson, 2009). The patient’s family also has the role of receiving information and supporting the patient. Below is a list of relevant stakeholders and the roles they play.

The Stakeholders

Robert, CCU RN – As the RN, he coordinates the transfer to the CCU and collaborate with the CCU Nurses for reception and commencement of treatment by coordinating to the relevant doctors.

CCU Nurses – Ensure that the patient is received, and all the conditions are recorded. They also coordinate with Robert and doctors before, during and after the treatment.

Medical Surgery Nurses – Prepares the patient for surgery if in case the doctor recommends

Medical Laboratory Technician – Collects samples like blood, saliva, and phlegm from the patient for testing and reports the results to nurses and physicians concerned.

Respiratory therapist – Does the chest therapy to monitor that status of the TB and the reason for cardiac complication

Hospital ICU Coordinator/Supervisor – Coordinates with the other practitioners in passing information, transferring and receiving the patient and ensuring proper housekeeping

Physician/Doctors – Work with the nurses to treat the TB and the cardiac problem. They also inform nurses to communicate unfolding to the patient’s family.

Friends and Families of the Patient – Provide relational support to the patient and receive information from the nurses and doctors.

How to choose the right Stakeholders

When choosing the stakeholders, it is important to consider a number of factors and issues. For example, the patient’s case should demand the contribution of each and every stakeholder (Weiss & Tappen, 2014). In addition, their presence should increase the probability of saving the patient or offering the best quality care. Also, each and every person’s role should be integral to cumulative well-being of the patient and build a broad-based support and synergy in patient care (Persily, 2013). In sum, the choice of the stakeholders is a function of the mentioned parameters and the following considerations.

•The number of stakeholders must be kept manageable to avoid overemphasis in one patient at the expense of others. However, there should not be a loophole in competence or role in order to care adequately for the patients.

•All the stakeholders should be competent and relevant to the patient’s condition. This ensures completeness and lack of ineptness in the healthcare provision.

•The balance of interest or roles ought to be maintained so as to facilitate coordination and collaboration in the process of caring.

The contributive roles of the stakeholders should ensure improved acuity of the patient and encourage the use of UAPS and Licensed Practical Nurses (LPN). Again, RN responsibilities of management need to increase in the units of care in order to accelerate the pace of patient’s recovery.

Action plan

Healthcare plan outlines all the partners, credentials, and the procedure to follow during the delegation process. First, the overall RN must notify and inform all the stakeholders of the healthcare plan. Through coordinated information, all the relevant practitioners receive prior notification about the condition of the patient and what is expected of them (Hansten & Jackson, 2009). As such, the notification gives the stakeholders ample time to prepare and refine their tools, instruments, and skills.

Then transportation logistics is done, where the patient is transferred to the surgery department and received by the nurse in charge. Thereafter, nurses in the medical surgery prepare the samples for further test then the patient is seen by the relevant doctor for surgery and further treatments

Proper housekeeping must be maintained in the patient’s room in order to ensure sanity and proper care of the patient and the family. Notably, clean environment is mandatory when caring for patients because they are vulnerable to subsequent infections.

After the diagnostic results, the patient is immediately taken to CCU for the cardiac checkups. At this stage, all the stakeholders with relevant competence should strive and work in collaboration, with the priority of saving the patient.

After, the family of the patient has to be informed of all that unfolded. However, the mechanism of communication ought to be encouraging and respectful of humanity. The aim of communication is to give hope to the family.

Lastly, proper evaluation of the whole treatment process or record has to be evaluated and then the overall feedback is provided.

In sum, the action plan involves proper communication with the healthcare stakeholders. In the process, the practitioners resolve conflicting aspects of their operations then provide appropriate evaluation and feedback at the right time.

Components of the Action Plan

How to Communicate With the Stakeholders

The communication should be concise and clear when the RN is notifying the delegatees. The communication must clearly highlight all that is expected of the subordinate nurses. Also, all the information concerning the patient’s conditions should be given to the HCAs (Weiss & Tappen, 2014). In addition, Proper directions, authority, guidelines, and expected outcomes need to be communicated to the HCA.

How to Resolve Conflicts

By default, conflicts always occur among the health care stakeholders; therefore, there if the need to arrive at positive resolutions for the betterment of the patient. In order to resolve the conflict and possibly avert it, proper and respectful communication has to be imperative. This builds mutualism amongst the co-workers and enhances cooperation (Persily, 2013). Also, acceptable behaviors and conducts must be outlined in prior to provide the framework for decisions and roles. The conflict should also be viewed as an opportunity for improving and strengthening relationships and future cooperation (Hansten & Jackson, 2009). Thus, in case of the conflict, it should be approached head-on without postponement so as to resolve it once for all. Other measures include promoting teamwork and limiting blame games.

When to Provide Feedback

The feedback should only be provided if the information has been proved as valid and pertinent. Therefore, all the stakeholders need to append to the information to confirm its reliability and validity before the feedback is given to others or the patient families (Weiss & Tappen, 2014). Reliability of the feedback is a function of properly followed standards and protocols in accordance to the healthcare accreditation system. Also, the feedback needs to be given in time in case of inquiries and complaints from other healthcare providers, the patient, or families (Hansten & Jackson, 2009).

How to evaluate the problem solved

In order to evaluate whether the problem has been solved, the RN has to once again assess and analyze if all the procedures of delegation and stakeholder participation were followed (In Cherry & In Jacob, 2014). For example, the RN should assess and monitor the health status of the patient by considering if the principles of delegations that were followed. That is, what was the initial health status of the patients? Did the HCAs have all it required to care for the patients in relation to their care context and scope? Lastly, did the HCA execute their responsibilities using all the skills, knowledge, and competence they hold? If all the questions were positively addressed, and the patient’s outcome is positive coupled with good relationship amongst the stakeholders involved, then it is right to conclude that the proper solution was found.

Recommendations

In order to ensure proper communication, leadership, conflict resolution, feedback, and evaluation, five main rights must be followed. Effective delegation ensures that the rights are adhered to when guiding and planning for the overall process of patient care (Hansten & Jackson, 2009). Thus, the rights should act as the reference point for the entire decision-making, concept, and as a checklist for the model of assigning responsibilities and authority to HCAs and other stakeholders. The rights include:

Right Activity or Task

The RN’s professional judgment concerning the task to be delegated should be appropriate and within the scope or boundaries of the HCAs. Also, the RN ought to assess the exact health of the patient so as to delegate the right task.

Right Circumstances

The context of delegation should be appropriate in relation to the available resources, and nature of the health setting. All the situational factors should be considered in order to delegate with the available provisions.

Right Person

The RN should be the right person with skills, experience, and competence for delegation. In addition, the tasks should be assigned to the right HCAs, who understand their responsibilities and accountabilities.

Right Communication

Concise and clear illustrations of the tasks are mandatory to ensure that objectives, expectations, limits, and persons to give feedback are clearly described.

Right Direction/Supervision

The RN must accomplish his or her role in monitoring, intervention, and evaluation according to the need and time required. That will ultimately result in the best positive patient care and feedback.

Conclusion

Delegation is an important and powerful tool in a hospital setting to assign responsibilities and authority from the delegator (RN) to the delegatees (HCAs). The primary rationale for delegation is to distribute roles in relation to workers’ experience, skills, and knowledge in order to achieve efficient and effective health care provision. From the case study of St. Mary hospital, it is important to define the scope of delegation and because of the complexity; various stakeholders may be required to ensure that synergistic positive outcomes are achieved. Critical factors must also be considered when choosing the delegates and stakeholders so as to avoid inefficiencies and ineffectiveness in patient care. In sum, through the application of appropriate rights, the delegation process becomes effective in terms of communication, conflict resolution, provision of feedback and evaluations. In health care setting, delegation is complicated but mandatory.

References

Hansten, R. I., & Jackson, M. (2009). Clinical Delegation Skills: A Handbook for Professional Practice. Sudbury, MA: Jones and Bartlett.

In Cherry, B., & In Jacob, S. R. (2014). Contemporary Nursing: Issues, Trends, & Management.

Persily, C. A. (2013). Team Leadership and Partnering in Nursing and Health Care. New York, NY: Springer Pub. Co.

Weiss, S., & Tappen, R. (2014). Essentials of Nursing Leadership & Management: Concepts, Connections & Skills. Philadelphia: F. A. Davis Company.

Posted in Uncategorized