Primary nursing and quality assurance Essay Example | Topics and Well Written Essays - 1250 words

Primary nursing and quality assurance - Essay Example â€Å"Do† referred to the act of executing the test trial on a small scale. Studying the results of the procedure and the reasons for it going wrong was the next step. The â€Å"act† implied that change could be accepted for future implementation or if it was not favorable, it could be abandoned. The repeated processes of this PDSA cycle were bound to lead to evolution of evidence-based practice. Demming first introduced the PDSA cycle in 1988. In essence the objective of a change could guide us in the planning of a small-scale trial. Appropriate questions and predictions needed to be derived for answering the relevant questions of ‘who’ or ‘what’ or ‘where’ or ‘when’, following the implementation of the plan. In â€Å"do† the plan was carried out and data were collected. The analysis also came under the â€Å"do† phase. â€Å"Study† included the analysis and interpretation of the data obtained (Me lnyk and Fineout-Overholt, 2010). A summary of the new information clarified the findings. Under â€Å"act†, the nurse decided which of her concepts were acceptable for bringing about a favorable change and also planned her next cycle for further information for future change. Clinical research was essential to keep checking on predictions and hypotheses as they could go wrong at any time. Reality had to be faced: we could have been mistaken. Placing the facts inferred for others to judge is part of the game. Patients for dialysis in the outpatient department were usually too tired or ill to participate in any active trial. They were end-stage renal disease patients who required dialysis. The dialysis procedure was of utmost importance for maintaining the life of these patients (Doss et al, 2009). The patients could be having multiple comorbidities which needed individual attention to produce a successful outcome. Quality assurance in nursing was possible only with repeated r esearches but in an outpatient dialysis center, the question arose as to whether it was possible to do so. Clinical research was an arduous task in the outpatient dialysis clinic where the staff was already busy and focusing on terminal patients (Doss, 2009). Research procedures were too sensitive to time protocols and the rigidity could produce problems in the dialysis setting. There was a strong doubt as to whether the staff would understand the importance of ongoing research and trials. The chances of them not accepting that research as a component of end-stage renal disease were high. â€Å"Would the data collection be expected in time?† was the question many of the staff had. The biggest worry was whether the care to the patients would be interfered with. The terminology of research was also most unfamiliar to the staff. The extra work could produce a challenging environment with a huge tight schedule (Doss, 2009). The strengths and limitations of the quality assurance p rocess of primary nursing The quality of care provided by nurses was done by evaluating the process standards (Stanhope and Lancaster, 2006). Different agencies employed specific techniques for appraisal of nursing care. The peer review committee and client satisfaction survey constituted two primary approaches. Direct observation could provide some information on the nursing care. In the outpatient dialysis clinic it would not be possible for questionnaires, interviews or written audits as the patients were terminal and could not appreciate other interferences. However

MicroL4 Essay Example | Topics and Well Written Essays - 1000 words

MicroL4 - Essay Example Higher education has proved to be beneficial in voting matters also. Education is an asset. It has provided benefits like self awareness, ability to think wisely and critically, having the ability to meet different people, which are less tangible and will help a child to grow up being a better individual. However, there are certain costs that have to be incurred for going to college. The opportunity costs of going to college include several components. First, the opportunity cost of one going to college includes the money that he or she would have earned instead of attending classes. It also includes the amount of wages that were foregone by not doing work and just attending college. In opting for going to college, one has also lost the opportunity to build up a career and the associated income that could be earned instead of not going to college. The greatest opportunity cost of going to college is the wage income that the individual has to forgone for attending classes. 2. The marg in is considered to be a very significant concept in the area of business and economics. In economics the concept of margin is related to a wide range of topics including utility, revenue, costs, profit, product, etc. We are quite familiar with the terms of marginal utility, marginal revenue, marginal costs, marginal profit, marginal product and so on. The term margin mainly stands for the difference in the value of a variable when one additional unit of some other variable is used. For example, marginal utility of a product refers to the increase or decrease in total utility of an individual due to one unit increase in the consumption of the product. The concept of margin is very essential in economic decision making. The level of p of goods, the level of production of goods, etc are always determined by considering marginal requirement. For example, a firm is a profit maximizer in the sense it will always produce a commodity in such a way that its profit is maximized. In a perfect ly competitive market, the firm will maximize its profit when marginal costs will b equal to its marginal revenue. The firm will continue to increase its production until marginal revenue becomes equal to its marginal cost. The point of equality is considered to be the equilibrium point of the firm. Thus the concept of margin is very important in economic decision making. Without the consideration of margin requirement it is not possible to conduct economic activities in optimum ways. However, it is not always necessary that all kinds of economic decisions are taken using the marginal concept only. For example, in a perfectly competitive market the break even point of a firm is not determined by any marginal concept. The break even point is relevant in short run production. This point mainly refers to the point of shutting down of production. A firm in a perfectly competitive market will shut down or stop production in short run when its average variable costs become greater than it s average revenue, i.e. its average revenue even fail to cover the firm’s average variable costs. Thus the concept of average is important in taking shut down decision. 3. There has been a huge debate over the tax cut policy by bush administration in 2001 and 2003. Bush tax cuts mainly refer to two important tax policies created and implemented during the Presidential era of George W. Bush. Through these policies, the Bush administration mainly lowered tax rates in the United States. These tax policies effectively lowered marginal tax rates for almost all

1967 Six Day War Essay Example for Free

1967 Six Day War Essay Assess the consequences of the 1967 (Six Day) War for Arab–Israeli relations On the 23rd May 1967, the Israelis declared war on the Arabs due to the blocking of the straits to Israeli shipping. The 1967 Six Day War had a major impact on Arab-Israeli relations. This is due to Israel gaining control over the occupied territories, large increases of Jewish settlement in the occupied territories, the increase of Israeli military in the Middle East. The Israeli occupation of Arab territories had a large impact on Arab-Israeli relations. Through the dominancy of the Israeli army during the Six Day War, they were able to capture the Sinai Peninsula, the Gaza Strip from Egypt, East Jerusalem, the West Bank from Jordon and the Golan Heights from Syria. In addition, Israel controlled the Sharm el-Sheik and the Gulf of Aqaba. This was significant as Israel stopped Jordanian ships from entering the Red Sea and closed the Gulf of Aqaba to Arab shipping increasing the tensions between Israel and its neighbouring Arab States. In November 1967, UN Resolution 242 called for ‘the withdrawal of Israeli armed forces from the territories occupied in the recent conflict’ and the right of all countries ‘to live in peace with secure and recognised boundaries’. Even though, UN Resolution 242 favoured both parties, the Arabs did not regain their territories as Israel debated the resolution did not specify the withdrawal from all territories and they claimed that the Occupied Territories were vital to its security. However, Israel did emphasis the second measure of the resolution claiming their right to exist, but the Arabs ignored it implying that Israel would first have to withdraw from the occupied territories. By both Arabs and Israelis not accepting UN resolution 242 and the continual Israeli control over the occupied territories, the tension between Arab-Israeli relations had increased. Also, the large increases of Jewish settlement into the Occupied Territories had a major impact on Arab-Israeli relations. Between 1975 -1977, Israel had made 75 settlements in the West Bank as they offered people cheap housing and necessities such as employment and appliances. The Gaza Strip contained approximately 300,000 Arabs and the Israelis had settled 3000 Jews in the area creating tension between Arabs and Israelis as evident through the ‘Intifada’ from 1987 to 1993 which killed thousands of people. By Israel creating large settlements in the Occupied Territories, it would be an obvious obstacle to any future peace negotiations over withdrawal from the Occupied Territories. The large group of Jewish immigrants also produced conflict in the Occupied Territories creating hardship for the Israeli Army as they continually had to stop violent raids. The Arabs argue that Jewish settlements should not occur in the Occupied Territories as it was Arab land; however the Jews argue that this land religiously belonged to them as through the biblical names of the West Bank, â€Å"Judea† and â€Å"Samaria†. By Israel increasing Jewish settlements in the Occupied Territories, the Arab-Israeli relations had deteriorated as it was now difficult to organise a Jewish withdrawal. Furthermore, the increase in the Israeli reputation and the decrease in military strength of the Arabs heavily impacted Arab-Israeli relations. On the 5th June 1967, the Israelis launched a pre-emptive strike on the Arabs as 180 Israeli warplanes attacked the airfields of Egypt, Syria and Jordon destroying 400 military planes ultimately deciding the fate of the Six Day War. There is a general agreement amongst historians â€Å"that although Israel struck first, this pre-emptive strike was defensive in nature†. As a consequence of the war, 12,000 Arabs had died with only 338 Israeli casualties. Historian Avner Cohen writes, â€Å"In the end Israel launched a pre-emptive aerial attack in which most of the Egyptian air force was destroyed, virtually deciding the Six Day War. Through Israel’s dominance they were regarded as the ‘strongest military power in the Middle East’. Also, the Arabs had become severely weakened as a result of the Six Day War, as they had lost a high amount of casualties and the relations between Syria, Jordon and Egypt declined as evident through Syria not accepting UN Resolution 242 while Egypt and Jordon did. Through Israel’s superiority, their relations with Egypt had improved as highlighted through Egypt recognising Israel as a state in 1979. Nevertheless, Israel’s dominancy also stresses its improvement in its relations with Jordan signing a peace treaty in 1994, and Iran signing a peace treaty in 1979. Even though, certain relations improved the Arabs would turn to terrorism and the Israeli army would be seen as the aggressor. By Israel dominating the Six Day War and establishing itself as the ‘strongest military power in the Middle East, its relations with other Arab countries had dramatically improved. In conclusion, the 1967 Six Day War had a major impact on Arab-Israeli relations. Due to Israel gaining control over the occupied territories and increasing its settlement, the Arab-Israeli relations had declined as the Arabs were livid that Israel would not withdraw from the Occupied Territories and further complicate the situation by increasing Jewish settlement. Also, the Israeli’s had become maddened as most Arab countries continued not to recognise Israel as a state. However, as the reputation of the Israelis became high and the military strength of the Arabs declined, Arab-Israeli relations improved as evident through the peace treaties of Jordan, Egypt and Iran.

Characteristics In Autism Children Psychology Essay

Characteristics In Autism Children Psychology Essay Approximately one in every 88 children in the United States has been diagnosed with Autism, also known as Autism Spectrum Disorder, a complex neurodevelopmental disorder of unusual social and communication behaviors that begins in early life (Peterson and Barbel, 2013). This type of disorder has been more prevalent in recent years, occurring primarily in children. Even though many researchers have not yet found the exact cause of autism, they have pointed out several possible risk factors that contribute to autistic individuals. Without a specified cause of autism and universal intervention, the challenges of diagnosing and having care for the disorder causes more difficulty. However, it is important for parents to seek early intervention for children with autism. This causes many controversies and confusions from diagnosis to treatment. Yet, it is expected that new research will assist in discovering some of these mysteries aspects of autism. Characteristics in Autism Children with autism show a wide range of signs and symptoms that vary from child to child. It is difficult to phrase all the characteristics and signs into simple words. Characteristics found in autistic children have appeared in early ages, from toddlers to infants. However, they may improve overtime as the child develops. A study has been designed to assess the parents experiences regarding with their autistic child, and the majority of the parents said that the autistic child experiences unusual verbal communications and motor behavior (Guinchat et al, 2012). Additional core symptoms are unusual interests in activities or play (usually focus on little things of the toy, get upset at little things), nonverbal/ verbal communication (unable to interpret emotions, catch meaning in a word, delay or lack of communication skills), and social interactions and relationships (unable to make eye contact, make friends, feel what other people are feeling). This research was done to help docto rs to easily diagnose patients that are at risk of autism. However, this is a spectrum disorder, meaning that this affects each individual to a certain degree, ranging from mild to severe. Each child with ASD has his or her own individual pattern of unusual behavior that some parents questioned, what is wrong with their child. As a result, it is suggested that early detection of autism is up the parents and will make a huge difference on the childs life. Risk factors Many individuals questioned the cause of autism, but the question has remained open. The biggest mystery in the study of autism appears that researchers have linked possible risk factors. Autism diagnosis suggested that a combination of environmental and genetic risk factors contribute to higher chances of autism (Deth, Muratore, Benecry, Power-Charnitsky and Waly, 2008). Exposure to toxins or pollution, such as pesticides in the environment generates an increased chance of autism during pregnancy, and those toxins surrounds a genes DNA can affects the gene activity (Shelton, Hertz-Picciotto and Pessah, 2012). In addition, another study has shown that genetics influences the risk of autism; gene mutations and sex chromosomes are linked to ASD. Medical conditions with syndromes such as Fragile X syndrome, Rett syndrome, and tuberous sclerosis have shown signs of autism characteristics, but further research is still needed to prove this point (Johnson, Giarelli, Lewis, and Rice, 2013). Although much research has been conducted to build this mysterious case, researchers have yet to come up with a definite conclusion to the cause of autism. There are also controversial claims that mirror neurons are found to be delayed or dysfunctional in autism, but there is no evidence that mirror neurons in humans illustrate that correlation. Giacomo Rizzolatii, a scientist at the University of Parma, discovered mirror neurons in macaque monkeys; when the monkey observes an action from an individual, the monkey copies the same action (2004). He believes that humans behave in much the same way. The role of mirror neurons give us the ability to imitate, have empathy, and ability to understand social cues. According to an article in the Journal of Psychiatric Neuroscience and Therapeutic (2010), most children develop strong mirror activity while autistic individuals seem to have weak mirror neurons in their youth that lead to social deficits (Bastiaansen et al). However, other studies did not find mirror neuron contribute to the autistic individuals. IIan Dinstein and his colleagues doubted the mirror neuron hypothesis. His research fou nd that when the brains were scanned, there were no differences between autistic and normal individuals while the individuals performed specific tasks (Dinstein et al, 2010). Some studies show that autistic individuals mirror neurons are slower than usual while viewing the emotions or actions of others while other studies do not (Ramachandran, 2006). Due to the opposing conclusions of different studies with regard to the mirror neuron hypothesis, the link between mirror neurons and autism remains controversial. Early Intervention Evidence suggests the importance of early intervention in autistic children. Children who enter programs at younger ages will improve autism symptoms than those who enter programs at older ages. One approach to the early invention is the Early Start Denver Model (ESDM). According to the article in Journal of the American Academy of Child Adolescent Psychiatry (2012), autistic children who received the ESDM intervention, which involves structured teaching, a relationship-based approach, showed substantial improvements in IQ, language, adaptive behavior, and autism diagnosis (Guinchat et al). Second approach to the early intervention is the Applied Behavior Analysis Programs, most notable treatment approach. This approach maximizes the encouragement of positive behaviors while discouraging negative behavior in order to improve a variety of skills (Matson et al, 2012). Another approach is the therapy-based intervention. This approach provides a specific therapy that targets specific di fficulties such as speech/language therapy, physical therapy, and occupational therapy. There are many kinds of interventions that can help to treat autism, and parents should take action as soon as possible, even if his or her child is not at risk of autism. Geraldine Dawson, Ph.D., a chief science officer of Autism Speak, suggested that even brief intervention will result in better improvements of social behavior such as imitation and small changes due to early preschool program will give some benefits to young children with autism (2012). Also, encouraging the child to play with objects and communication is important in early development. That being said, imitating others will help improve other aspects of autism. An example of how early intervention is involved is my little cousin, Conner. I did not understand the characteristics of autism before doing this research paper. Every time we had family gatherings and I tried to acknowledge him, he would run away in fear toward a nonfamily member. I stepped aside and asked his mother what his problem was. She told me he is diagnosed with autism and has some difficulties approaching other people. As I observed, he looked normal. The nonfamily member is a behavioral intervention specialist, also known as his nanny, who watches over him. He would not interact with the other little cousins, but only with his nanny. According to his mother, he was not able to be accepted into day care due to his special needs. He is the only family member that is autistic. Conclusion Overall, doing a research paper on this topic led me to determine that autism is an extremely difficult disorder to understand. This topic on autism will evolve over time and further research will be conducted with the aim of discovery of the causes and proper treatment. The biological aspect of the disorder is a mystery. Continued research on the development of the autistic child relative to a normal child will assist in diagnosing and treating. With the help of diagnosis, we can develop proper early intervention techniques to positively reduce the disorders effects. There are many research ventures that are being done concerning this disorder. The purpose of this research for future is to enhance awareness to parents about their early child that maybe at the risk of autism. Additionally, they can seek characteristics followed by early intervention that will help easily diagnosis and treat.

Mcdonaldization: Health In A Fastfood Society Essay -- essays research

McDonaldization: Health in A Fastfood Society   Ã‚  Ã‚  Ã‚  Ã‚  McDonaldization, is the term Ritzer derived from the McDonalds' fast food chain to describe the state of our society. Ritzer claims our social institutions have become completely dehumanized in the form of a bureaucracy. Health care is an example of one institution that is characterized by the four components of bureaucracy: efficiency, predictability, control and quantification.   Ã‚  Ã‚  Ã‚  Ã‚  In the past, health care was more simplistic in nature. House calls were no unheard of, and doctors knew all of their patients and their families on a personal level. The doctor who delivered your parents would deliver you as well as your future children. Follow-ups were quite normal; doctors were concerned with your progress for their own peace of mind.   Ã‚  Ã‚  Ã‚  Ã‚  Over time the modern health care system emerged into the bureaucratic organization that it is. All the characteristics depicted by Ritzer are easily seen when one examines health care. From a normal trip to the doctor for a routine check-up or even a specific ailment to rush trip in the emergency room predictability, control, efficiency, and quantification are obvious.   Ã‚  Ã‚  Ã‚  Ã‚  Quantification is easily seen when you first step into a hospital waiting room and a huge sign tells you a number before you are even able to speak to anyone. After waiting a while your number is called, you must give your health card number to the receptionist before continuing. You are then given a file number, which is your only identity for the time you spend within the hospital environment. After seeing the doctor you may come out with a few prescriptions which furthers your nameless ordeal. When you drop nameless ordeal. When you drop into a pharmacy to have a prescription filled the first thing they ask is if you know your prescription number. If you cannot remember it, your actual name is a secondary possibility as a means of identification. Before paying you may have to show your Blue Cross card number or other insurance cards as well, in all it is a very dehumanizing, impersonal process.   Ã‚  Ã‚  Ã‚  Ã‚  Efficiency is another characteristic that is prominent in the hospital situation. To make sure things more smoothly you must call ahead and make an appointment with the reception... ...ike health care workers has come in the face of a demand for efficiency and quantification. It is hard to say who is victimized most by this dehumanization; the doctors who must deny their humanity or their patients who must go to them for treatment.   Ã‚  Ã‚  Ã‚  Ã‚  In conclusion when one applies the four components of McDonaldization to our present health care system one discovers that they are aptly applicable. Quantification is seen when one thinks about how our medical identity is comprised of a series of different numbers. Efficiency is supposed to occur with phone-in prescriptions and appointments. Control is assured by a doctor's capacity to make life or death decisions. As for predictability it is common knowledge as to what routine one follows to receive treatment. The irrationality is how impersonal and inefficient the whole system can become through overworked doctors and other professionals. The iron cage is how the patients of these stressed doctors feel from these doctors' ignorance and neglect. In all it is true that the health care system is one social institution that does successfully meet all of Ritzer's requirements for a McDonaldized institution.

To His Coy Mistress :: essays research papers

Seduction has been the game most played through out the centuries, as males attempt to convince and invite females into their beds. In Marvell's "To His Coy Mistress" and Donne's "The Flea", the speakers, propose a peccadilloes offer, which is so cunningly backed up by a liberalistic argument and is presented to each female when the generous request has been declined. These arguments are designed to induce thoughts of a carnal nature. The persuasions used by each are completely different but are structured entirely for one purpose. To corner or trick the maiden into saying "Yes". Though both arguements are supurb, Marvell's has a nicer, refined style to it. In "To His Coy Mistress" and "The Flea", there is an exemplification of just how crafty men can be during the hunt. The speakers, in both poems, makes a "modest" but declinable offer for sex to their maiden of choice. And, upon rejection, each male begins a fluent yet rh etoric arguments on why the maiden should accept his simple offer of passion. For Marvell, the argument was that there wasn't enough time left in the world, and that the maiden should partake in indulgence before it is too late." But at my back I always hear/ Times winged Charriot hurrying near"(lines 21-22). He also states the unpleasuarble thought of the worms enjoying her verginity instead of him. Suggesting that if she continues to waste time she will die a virgin. "then Worms shall try/ that long preserv'd Virginity:"(lines 27-28). Whereas Donne's argument revolves around a metaphorical flea. Which as claimed by the speaker, represents his union with the maiden in matrimony, since the flea has taken blood from them both."It suck'd me first and now sucks thee/And in this flea our two bloods mingled be"(lines 3-4). And, since their bloods have already mingled together, intercourse with him wouldn't be a sin and no honor would be lost if she yields to him."Though know'st that this cannot be said/A sin nor shame nor loss of maidenhood:" (lines 5-6) Though however similar the gist of the poems might be, the art of seduction used by each speaker is quite different. The speaker in "To His Coy Mistress" seems to change his tone of persuasion rapidly from stanza to stanza. At first he is sweet, comming across as a gentleman and overstating how many ages he would spent on a single part of her anatomy "A hundred years should go to praise/Thine Eyes.

Intense Factory Farming

Eng 102 Ms. Williams March 1st, 2012 Essay # 2 Intense Farming In our world today we no longer are able to farm clean natural products for others to consume. A factory farm is where animals are bred and fattened using modern industrial methods. This method allows more farming jobs to stay in the US. If we had to do it the way a farm has been run in the past, farmers wouldn't be able to compete with prices of food from China because their labor costs are much lower.According to The Scientific Veterinary Committee of the European Commission has stated, â€Å"Since the extent of the inactivity and unresponsiveness indicates abnormal behavior, the sows may well be depressed in the clinical sense and poor welfare is indicated. † Although factory farming produces more of the product to be mass distributed among countries, animals are being treated as an object instead of a living creature. These methods are rather cruel and can be harmful to these animals. These living things are he re for humans to have domain over them but the nature that these factory farmers are pursuing it is unethical and wrong.There are many more facts to be explored and through these resources one can develop the opinion whether or not these actions are right or wrong. Factory farming is something that has evolved over time. Without the advancements in medicine there would be no way our livestock would end up like this. CAFO is known for specializing in the raising of domestic pigs to be slaughtered when they have reached the proper weight. This system of pig production, grower pigs are housed indoors in group-housing or sheds. Pregnant pigs are housed sow stalls or pens and give birth in these crates.A gestation crate is only 7 feet by 2 feet; it is enclosed so the pigs aren’t able to move around freely. Animal welfare supporters see the use of gestation crates as one of the most inhumane features of animal production. More than ninety percent of pigs in the U. S. today are rais ed on factory farms. These pigs spend their entire lives in cramped, filthy warehouses under the constant stress of intense confinement. Their natural ways are denied through this system that supposedly produces more in the cost of the happiness and welfare of an animal. When the time comes for slaughter, pigs are forced onto transport trucks that travel for many miles through all weather extremes. Many die of heat exhaustion in the summer or arrive frozen to the inside of the truck in the winter. According to industry reports, more than 1 million pigs die in transport each year, and an additional 420,000 are crippled by the time they arrive at the slaughterhouse. Because of improper stunning methods, many pigs are still conscious when they are dumped into scalding-hot water, which is intended to remove their hair and soften their skin. †