Nursing Research article critique Effects of nursing rounds

The article Effects of nursing rounds on patients’ call light use, satisfaction and safety as reported by Meade, Bursell, & Ketelsen (2006) examines the possible implications that implementation of regular rounds by nurses might have on patients and nurses. The purpose of the study is to determine the extent to which the frequency of responding to call lights ‘affects patient-care management’ and the possible contribution that frequent nurse presence can make. The independent variables are scheduled one-hour or two-hour rounds as they affect the dependent variables of number and frequency of patient use of call button, patient satisfaction and the safety of patients.The research functions under the hypothesis that scheduled rounds by nursing staff, involving the performance of certain mundane tasks related to patient comfort and concerns, on medical, surgical or medical-surgical wards would have the effect of reducing the rate of use of call lights by patients, of increasing overall patient satisfaction and of improving the safety of patients. The relationship between the dependent and independent variables is thus expected to be positive. This hypothesis directly aligns with the specific purpose of the study.The literature reviewed in this study is quite comprehensive covering material from both classic and modern sources. Materials cited are from primary data sources and the majority fall within five years prior to the research. The concepts examined are rounding, patient satisfaction and call light usage. Table 1 provides a list of activities involved in rounding procedures. The literature review examines prior research exploring the variables under consideration such as the correlation between rounding and patient safety and between rounding and frequency of use of call light. The authors note, however, that specific research exploring the relationship of the nursing rounds on the aforementioned variables is lacking or inadequate. This r esearch presents new knowledge on the correlation between scheduled rounds by nurses only and improved care delivery.The theoretical framework that forms the basis of the research is that ‘improved patient-care management and patient satisfaction and safety are achievable with interventions that nurses can initiate and carry out.’ The research is of a quasi-experimental design which means that the researcher had little influence over the assignment of the hospital units into either of the experimental or control group.Hospitals opted to experiment with either a one-hour or a two-hour round in a medical, surgical or medical-surgical unit plus a control group in a separate unit over a four week period. Some administrators were asked to change a particular choice, however, so as to ensure equitable distribution across groups. Nurses in the experimental groups were trained on the procedures to follow during the rounds. The control group received no intervention but was brie fed on how to record the use of call lights by patients.The sample consists of 46 units in 22 hospitals across 14 states and representing both urban and rural populations. To be eligible hospitals were required to have medical, surgical or medical-surgical units, less than 5% external agency employees and nurse managers capable of overseeing the research. There is no evidence of randomization. Informed consent was through hospital administrators. The sample size is quite small given that there were only about 16 units per subgroup or a little over one per state. The sample size is not thus reasonable or equitable.Call light logs were used to record the room and time as well as to specify which of 26 given reasons, were responsible for patient calls. Patient satisfaction data was obtained from hospital administered surveys and questionnaires. Patient safety was recorded as the number of falls. Where reliability and validity of data was questionable they were not included in the analy sis.Data collection strategies were clearly described except for the questionnaire which the researchers had no control over. Data analysis procedures which include the use of means and t-test comparisons of the times that call lights were used among the groups. Ranking and classification were used to determine the seriousness of the calls made and the most frequent reasons. Paired t tests were used to analyze number of patient falls to determine patient safety.Results reveal that frequent rounds improve patient care as supported by the data showing one-hour rounds having a more significant impact on the other variables. The researchers believe that the findings are ‘generalizable to the majority of U.S. hospitals. This view is questionable given the numerous limitations of the research. Further research into the possible correlation of these variables in different hospital settings, across different units, among diverse populations is necessary. A more longitudinal survey wou ld best reveal generalizability.The sample size of the research was quite small. There was a lack of randomization so hospitals seemed to have chosen the experimental method that was more appealing to them. Researchers had little control over some of the instruments and thus were unable to ensure their reliability or validity. There were also no adequate procedures put in place to ensure nurse compliance in performing rounds and completing logs. Additionally staff may have been rotated between groups and thus brought practices from one into the other.The findings of this research, though not completely generalizable, have significant implications for nursing practice and general health care administration. If further research into the correlation between regular rounds and improved patient safety and satisfaction corresponds to the present findings then administrators will need to consider reorganizing their nursing schedules.The benefits to be gained from having nurses perform rout ine rounds seem to be positive and therefore the implementation of this method could become a mainstay of health institutions. Of course the research suggests that nurses do not have to complete these rounds, that other personnel could be utilized in accomplishing this. However, where constraints of resources are limited, having nurses complete regular rounds could be a very economical option.Meade, Bursell, & Ketelsen (2006) suggest that the consequent impact of these rounds on overall patient satisfaction and safety could have a corresponding positive effect on the number of lawsuits filed against hospitals for negligent practices. More routine monitoring of patients implies that nurses are able to check both serious and non serious matters before they escalate. Particularly with one-hour rotations serious relapses in patients’ health while they are unsupervised would be avoided. It is in the rare case where patients experiencing difficulties are unable to get medical assis tance in a reasonable amount of time. Discomfort could therefore be estimated during these routine visits.This could be a solution administrators use to address nursing shortages, ensuring that patients are adequately monitored. Long-term scheduling of rounds could be done in little time bearing in mind staff allocations. Where necessary other staff may be utilized even alternating rounds with nurses so that the patient is visited by a nurse every two hours.Further nurses would be held more accountable for the patients in their care. Administrators contemplating this method could also consider using logs to record the time of patient visits and the state of the patient during these visits and requiring that nurses complete these logs. Though this suggests more time demands it will mean patients calling on the nurses unnecessarily out of the scheduled round times and nurses having more time in between to attend to critical matters such as patient education. Nursing schools will also have to consider including additional training on round procedures. ReferencesMeade, C. M., Bursell, A. L., & Ketelsen, L. (2006, Sept). Effects of nursing rounds on patients’ call light use, satisfaction and safety. American Journal of Nursing, 106(9), 58-70.

The Significance of Privilege

Privilege and its significance Privilege is a particular advantage or a particular right which is available for a specific group and or a peculiar individual while opposite to this ; the disadvantage means the group who can non bask those benefits or advantages which the particular group is taking as privilege. In other words, we can state that privilege is a kind of favoritism where one is basking some benefit while the other is non eligible to take that benefit ( Kimberly ; 73 ) . Bing a male, I think that we should non wait for such jurisprudence or we must non propose authorities to go through the policies against favoring but the whole community must work on it to extinguish the construct of favoring. We must hold voice for equality in the society. In article, â€Å"Michael M. vs. Superior Court of Sonoma County† , there was contention non around the instance but around the issue. I feel a review against the suspect that why he charged Michael with statutory colza although it seems a physical colza as it was portraying that Michael forced Sharon until she submitted for the sex. I felt that Michael must non be charged with physical colza because Sharon was besides responsible for the whole bad luck. They drank together ; they left group together, their arousal and their intimacy, it all made the state of affairs of bad luck. By reading this I feel two sorts of privileges were given two Sharon, the first is her gender and the second was age. They both were guilty, but as Michael was of 18 and Sharon was 17, so Sharon was privileged because of her age and Michael was punished merely. Sharon must be punished as she encouraged Michael for this onslaught. This instance is a clear illustration that the privilege is a sort of favoritism. While populating in a same community and society, we do non hold right to know apart our determinations on the footing of age or gender. Both Sharon and Michael must penalize every bit because they were every bit responsible for their Acts of the Apostless. It was right determination to bear down him against the statutory colza but the same determination must be taken for the Sharon as she motivated Michael for the sex. In the instance between Mcleskey V. Kemp, the issue was raised that on the footing of the races, black adult male are punished more often as compared to the white one ( Mcleskey ; 1 ) . We have a clear white privileged over the black disadvantaged in the society of USA. This instance can besides back up my sentiment that privilege is favoritism. While populating in a same society, why two people or group of people is been handling otherwise. White privilege is a set of benefits that white can avail in the same economic, political and societal fortunes but the inkinesss can non avail. This set of benefit includes greater societal position, cultural avowals, and freedom to purchase, drama, move, speak and work freely. White privilege is a sort of racism. I do non state that white people deliberately or accidentally do this favoritism or ache the black one, but they are unfamiliar with their white-color privilege. It is wholly at opportunity that single will be treated as a alone human being but taking into histories the race of a victim or suspect while make up one's minding that if punishment of decease should be imposed. Further, Mcleskey is right that in malice of sing race or colour, it is better to see that what quality does those single posses ( Mcleskey ; 8 ) . Two people may belong to same race but their qualities will be different so in order to convey equality in society, it is of import to detect every individual separately non with the race. By his statements we can state that handling two people otherwise with response to his or her race is besides a privilege for one who will be treated as holding good race over the 1 who is non good in the oculus of judge. In another manner, we can state that this is a racial favoritism where 1 is acquiring benefit over the other. This is why, it is my sentiment that privilege is a sort of favoritism. By taking another illustration of instance held between Rostker v. Goldberg, which was on the determination of the U.S Supreme Court keeping that the pattern of necessitating merely work forces to register for the bill of exchange was constitutional. Robert challenged the bill of exchange enrollment policy of U.S.A. and suit against the manager of Selective service system named Bernard Rostker. After the tribunal Sessionss, it announced that it was legal to register merely work forces for the bill of exchange. Then Robert L. Goldberg challenged in the tribunal that the gender differentiation is unconstitutional for this jurisprudence as it is â€Å"only men† . After 6 to 3 determinations, U.S Supreme tribunal announced that neither this is gender favoritism nor this Act violated the equal protection of Torahs. At the terminal tribunal decided that this Act would remain passed as it is. Although the tribunal does non alter its determination but it is a clear gender based determination where merely work forces will be merely at that place to register for the bill of exchange. In article â€Å"Overcoming Racism in Environmental Decision† , Bullard said that there is a large societal job that is economic and racial minorities are forced to digest the economic loads. Bullard claimed that this environmental unfairness violates societal, geographic, and procedural equity.He besides proposed five basicss of environmental justness to authorities that how to rectify the job. Bullard said that in order to extinguish the ailments of sexism and racism from the society, it is of import to take favoritism from top to down. It can be done by sing the jobs and demands of disadvantaged where necessary and with remarking and reconstituting the universe where would see that how to give benefit to the disadvantaged. Through his survey, it seems clearly that he has believed in it that there is favoritism among different races. I am besides in the same sentiment that society trades different races otherwise which is doing a major rise in the societal ailments. In order to take the societal ailments from the society, it is of import to extinguish favoritism. Bullard survey is really important because of his environmental justness model. There should be â€Å"no forfeit zones† but environmental justness for all. In my sentiment, privilege is merely critical for jurisprudence. The privilege is critical if sound lawful exhortation is to be given in every field. It has a profound centrality in practically every circumstance where lawful counsel is looked for whether it is refering corporate and concern minutess, to household connexions, or to civil prosecution condemnable accusals. Family insider facts, organisation privileged penetrations, peculiar defects and injudiciousnesss all must now and once more be uncovered to the lawyer by the client. Without this benefit clients could ne'er be existent and equip all the important informations that must be given to legal counsellors on the off opportunity that they are to lawfully cheer their clients. It is a constituent that is both indispensable and to a great grade paramount to the working of the legitimate model. It is a consequence of the basic essentiality of the benefit that the burden lawfully rests upon those looking to put aside the benefit to legalize doing such a notable pace. Customer lawful privilege ( CLP ) , often alluded to as â€Å" legitimate proficient benefit † , is a typical jurisprudence right that exists to procure the organisation of equity and the right of people and different elements/associations to get secret counsel about their legitimate fortunes. It secures legitimate advocate given by an lawyer to his or her client ( exhortation benefit ) and interchanges associating to genuine or mulled over suit or tribunal minutess ( prosecution benefit ) . The best possible organisation of equity obliges that clients can talk uninhibitedly and evidently with their lawyer, without trepidation of unveiling any informations pertinent to the lawful counsel they are looking for. It is good comprehended that, without the benefit, legitimate incidents may be postponed or even lost as legal advisers will be unable to suitably talk to their client, or convey pertinent affairs to the consideration of the tribunal. Guaranting pragmatism and genuineness in such correspondences is critical, on the evidences that we live in a complex public sentiment and our Torahs and lawful model are on juncture exceptionally muddled. It is in the public oculus ‘s investing that persons ( numbering organisations ) look for legitimate exhortations about their issues and in looking for counsel don’t hesitate to unveil all important certainties. The multilateral quality of these Torahs is coupled with spread outing dependance on ego ordinance by the group, for case the self rating agreement of appraisal.

Access the internal control of Shangri-la company

Access the internal control of Shangri-la company Access the internal control of Shangri-la company Internal control is defined as Systematic measures that been used by accountant and auditor to make sure the goals is achieved, conduct the business in efficient matter, safeguard of asset, to ensure that rules and regulation is being followed, completeness and accuracy of financial record and produce reliable and timely financial and management information. There are a few matters that Shangri-la concerning about of internal control such as: a. Completeness and accurancy of financial record. Shangri-la company use a system to ensure of appropriateness of business operation of the Group consisting of the Company and its subsidiaries. Chief Executive Officer of the company which is Mr Lim Beng Chee should discovered the fact and any decision that may cause a substantial damage, or act in violation of the laws, regulations or the Articles of incorporation and other acts outside the scope of the purpose to ensure that proper operation of subsidiaries is well-managed. In addition it also help to ensure the proper operation of subsidiary companies so that the reliability of financial reports by performing the maintenance, construction of internal control system in accordance with the financial statements, together with ongoing assessment, carried out necessary corrections if there are deficiencies, management shall appropriate the Company and to ensure. b. Ensure that rules and regulation is being followed. Shangri-la company always ensure that their operating business followed the rules. Information Management will make sure that they are following regulation and security guideline about Rules on the handling of personal data, Personal information protection regulation, and Information security policy by proper managing of important document. c. Ensure that the goals of company is achieved.Promote agile decision-making by the executive officers of small and further strengthen executive power. Set up the goals and objective of company so that the employee will understand and help employee achieved the company objectivity. d. The management and operating manager should segregate duties amongst executive officers and employee.The manager should divide the duties and work among their staff to make sure that objective of company is achieved. Shangri-la set up the goals for every department and their staff know their roles and responsibility for the company. e. Safeguard of asset. Shangri-la company established Risk Management Regulation clarify the department responsible for each risk category, endeavor to establish a risk management system. Established a management meeting risk, together with the corresponding consultation on matters relating to risk management, internal control report to the Commission on a regular basis for other conditions.

System and Operation Management Assignment Example | Topics and Well Written Essays - 2750 words

System and Operation Management - Assignment Example This company started with photocopying services and then moved to printing services, which motivate its development until currently. The performance of the selling points has been up to date although with some few setback here and there. This paper highlights the setbacks and provides insights on the areas where the company has shown good performance. It also looks deeply at some of the problems the company is experiencing and provides strategy for making changes in the organization. First, the history of the organization tells much more about the company structure and how it developed from a very low status to become a reckoned organization in the entire Europe region. Introduction History of the Company Atokowa is an organization that deals within the office supply industry within the Australian region. The company sells several items that are used in offices. For instance, the organization deals with selling office furniture, printing and paper. Initially they sold printed fliers, business cards among other office equipments. The company started from a humble background when Lachlan bought his first photocopying Xerox 914 machine in Sydney and started photocopying services in his garage in the year 1964 (Gomez-Mejia, David and Robert 2008). The organization started expanding in through printing and reproducing several copies for different companies. Atokowa tremendously grew in 1970 when Lachlan bought a retail outlet thus expanding his services to include printing services. This enabled him to develop a high reputation in service delivery providing the organization a better environment for growth and development. Additionally, the company gained a good picture when the owner decided to make it as a one point for selling and buying and further coming up with decisions for identifying and setting up new shops in different areas of Europe at large. The organization got its name from the original owner as he felt that this was the right name for it (Kotter, Joh n & Dan 2002). Lachlin wanted to retire early from business activities and let eldest son Jonathan Atokowa run the business in the year 1983 (Gomez-Mejia, David and Robert 2008). It is during this period that Jonathan Atokowa became more focused on technological improvement of the company. He introduced the selling of Commodore 64 together with IBN PC 5100 that was the highest technology during that period. Jonathan has continually followed his father’s footsteps for developing the organization through involving in selling of various technological equipments in its different selling points in the Australia. Regional outlets that sell under Atokowa name are found in areas like Canberra, Adelaide, Newcastle and Brisbane regions. The picture below indicates all retail regions that enjoy services from the organization. Purpose of the report Business operations require that customers get their services to the fullest. This is quite challenging in some cases where the organization has many outlets that serve many customers. The company that applauds best services for its customers has the

Assessment of a Fictional Family Essay Example | Topics and Well Written Essays - 1000 words

Assessment of a Fictional Family - Essay Example The child, on the other hand, has his share in influencing the family as well. In the family, when a member, usually a child or adolescent, has a (psychiatric) disorder, this influence is magnified. And for diagnostic purposes, the effect of the family on the child and the child’s effect on the family must be assessed to prepare for optimal treatment, according to Allan M. Josephson, M.D. A comprehensive family assessment is the process of identifying, gathering, and weighing information to understand the significant factors affecting a child’s safety, permanency and well-being, parental protective capacity, and the family’s ability to assure the safety of their children (Johnson et al, 2006, p.1). There are several sequential functions included in family assessment, which are (1) screening and general disposition, which usually takes place during intake; (2) definition of the problem, which may include diagnostic assessments (or quantification of problem severity) that takes place during intake and investigation procedures; (3) planning, selecting, and matching services with identified problems; and (4) monitoring progress and evaluating service outcomes (Hawkins, 1979). In short, the family plays a major role in this context, and the role it will play in the treatment process should be based on a balanced case formulation which can be realized through a complete, systematic, and detailed family assessment. A good family assessment doesn’t only gather information to be able to formulate a well-made treatment plan for the patient, rather it is also relationship building. It involves everyone in the family to take part, exploring goals, values, and strengths to help build mutual trust and respect among them. This relationship can be built when problems arise -- a slice of truth in the saying that problems do create opportunities for a brighter tomorrow. In short, the family assessment identifies areas for intervention and engages the family

Combustion process, whether used for electricity generation or in Essay

Combustion process, whether used for electricity generation or in engines for transport, produce airborne emissions of environmental concern - Essay Example Acid rain is due to the presence in the atmosphere of SO2 and NOx which, after a series of reactions, are deposited as nitric and sulphuric acid in the form of rain. Particulate matter is known to cause serious respiratory diseases. Carbon sequestration is a method that allows the reduction of CO2 by capturing it at its source (e.g. a power plant) and storing it in non-atmospheric reservoirs such as geologic or oceanic reservoirs (Herzog). The Sleipner project is a working example of carbon sequestration technology. Off the coast of Norway in the North Sea, it is in fact the world's first commercial CO2 capture and storage project collecting about one million metric tons of CO2 each year since it was opened in 1996 (Sleipner CO2 project). The term "scrubber" is used to refer to a group of air pollution control devices that aid the removal of fine particles and/or gases (especially acid gases) from industrial exhaust streams. Scrubbers work by either physically removing substances from the exhaust gas stream or by chemically neutralising them so that they cannot do any harm once released into the environment. Wet scrubbing is used to clean gases from pollutants and particulates by putting in contact the exhaust gas stream with the scrubbing solution. The scrubbing solution can simply be water for the removal of dust or a chemical solution which contains reagents that can specifically target certain compounds. Removal efficiency of pollutants is improved by increasing residence time in the scrubber or by the increase of surface area of the scrubber solution. 2.2. Dry scrubbing Dry scrubbing is generally used to remove acid gases, such as SO2, primarily from combustion sources. All dry scrubbing systems consist of two main devices: 1) a device to introduce a solid sorbent material into the gas stream; and 2) a particulate control device to remove reaction products, excess sorbent material, any particulate matter already in the flue gas. 2.3. Seawater scrubbing The natural buffering capacity of seawater can be taken advantage of by using it as a sorbent in a scrubbing system. When SO2 comes into contact with seawater a reaction takes place between the SO2 and the CaCO3 present in the seawater, producing CaSO4 and CO2. This reaction is complete in a very short time, so the equipment required for seawater scrubbing can be compact. 3. NOx 3.1. Primary measures Primary measures can be applied pre-combustion. In Bowin low NOx technology, air and

Edgar Allan Poes Essay Example | Topics and Well Written Essays - 750 words

Edgar Allan Poes - Essay Example Both the stories are written using the same technique by Edgar Allan Poe. He has used the narrator as a tool to describe the events in both the stories. This essay would further revolve around the two stories and present the differences and similarities found in both the stories. Edgar Allan Poe has explicably written both the works to show the madness that is prevalent in the world. He uses the technique of a narrative to describe both the stories along with the justice that is served in the ending of both stories (Poe 375). Poe uses the first person experience to narrate both the stories so that the readers can take an insight in the scenes of the horror fiction. Poe gives a detailed explanation of the lives of the two narrators in the stories aforementioned in the beginning so that the readers can grasp the scenes of the story. Both the stories follow the genre of horror and fear as the author shows psychological trauma and fear in the characters that are being played by the narra tors. These themes can be clearly seen in the quote taken from the story ‘The Tell Tale Heart’ which says ‘I cut off the head and the arms and the legs’(Poe 7). ... â€Å"The Tell Tale Heart† and â€Å"The Black Cat† depict the extent to which a human being can go and the narrative serves to explain the reader that the narrators are not as mentally sound as they argues that they are. The mental state of both the narrators can clearly be said to be inappropriate even though they argue that they are sane enough. In both the stories the narrators are the killers and they kill for reasons that are only known to them. It can be seen that both the works have quite a lot of similarities but upon close analysis it can also be seen that the works have a difference. In the ‘The Black Cat’ the narrator kills the cat and his wife unintentionally whereas in â€Å"The Tell Tale† the narrator plans out to kill the old man as he fears his eye. Poe places the factor of anger differently in both the stories as it is seen that the narrator in â€Å"The Black Cat† takes out his anger on a living thing that can possibly not r esist. However in â€Å"The Tell Tale† it is seen that the narrator takes out anger on a person who can resist. It is also seen that the beginning in both the stories is different as in ‘The Tell Tale’ the narrator gives out the ending in the opening paragraphs whereas in ‘The Black Cat’ the narrator gives the whole account at the end of the story. The plot of the stories is shown differently to the readers by Poe to but in the end both the narrators are caught for the crime that they commit. In conclusion it can be said that Poe has written two classical works in the genre of horror to present the insanity of individuals in a different perspective. He has used the object of fear as a tool to describe the scenes in the stories so that the readers