Nursing Sensitive Indicators free essay sample

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

Hormones have a central role to play in regulating body function The WritePass Journal

Hormones have a central role to play in regulating body function Introduction Hormones have a central role to play in regulating body function IntroductionHyperthyroidismBlood glucoseHypoglycaemiaKidneysOsmoregulationHomeostasisBibliography Related Introduction All hormones in the body play a central role in the body, and quite a few of them regulate body function and help keep homeostasis. One gland that makes and stores important hormones is the Thyroid gland, which is located at the lower part of the neck, below the Adams apple and is wrapped around the trachea. The hormones it produces and stores help regulate heart rate, blood pressure, body temperature and the rate at which food is converted to energy. The two most important thyroid hormones are thyroxine and triiodothyronine. The thyroid gland also makes the hormone calcitonin, which is involved in calcium metabolism and stimulating bone cells to add calcium to bone. The production of thyroid hormones is controlled by another hormone called thyroid stimulating hormone (TSH). This is made by an endocrine gland in the brain called the pituitary gland. The thyroid gland can become overactive (hyperthyroidism) or underactive (hypothyroidism). Hypothyroidism usually develops gradually. The symptoms are mild some of the symptoms are, tiredness, dry skin, thinning hair, sore muscles, weakness, depression, weight gain and a slow heart rate. The most common cause of hypothyroidism is autoimmune thyroiditis, this is an autoimmune disease, which is caused by antibodies attacking the body, rather than attacking foreign bodies like bacteria. The Antibodies destroy the thyroid gland cells and this prevents the thyroid gland from working properly. Hypothyroidism can be treated with a thyroxine replacement medicine, called levothyroxine. Hyperthyroidism The thyroid gland is overactive and produces excess thyroid hormones; Graves disease is the most common cause of hyperthyroidism. Its is another autoimmune disease. In Graves disease, the antibodies mimic the activity of TSH, causing the thyroid gland to produce too much thyroid hormone, leading to the symptoms of hyperthyroidism some of the symptoms are, shaking, being hot and sweating more than usual, losing weight, having increased appetite, tiredness, muscle weakness, palpitations and shortness of breath. Medical treatment of hyperthyroidism can be anti-thyroid medicines such as carbimazole and propylthiouracil, to reduce the production of thyroid hormones. However, over time anti-thyroid medicines can lead to hypothyroidism. Blood glucose Controlled by hormones; these hormones are controlled by the pancreas. The pancreas has glucose receptor cells, which monitor the concentration of glucose in the blood, and it also has endocrine cells (called the islets of Langerhans), which secrete hormones. The alpha cells in the islets secrete the hormone glucagon, while the beta cells in the islets secrete the hormone insulin. In a healthy person blood glucose levels should be 80-120mg.100cm- ³. Insulin is secreted when blood glucose levels are high to make it fall and glucagon is secreted when blood glucose is low to make it rise. As shown in the diagram: The most common disorders involving blood glucose and the hormones are diabetes type 1 and type 2; Type 1 insulin dependent diabetes mellitus (IDDM) is caused by a lack of insulin either by a faulty insulin gene so there is no functioning insulin or by an autoimmune attack on the beta islets cells that produce the insulin so there are no cells left to produce it. This type of diabetes mainly occurs in children and young adults, onset is usually sudden. The main Symptoms of this are fatigue and copias quantities of urine which contains glucose. If this goes undiagnosed and treated then a coma may result from hyperglycaemic or hypoglycaemic, hyperglycaemia is where too much blood glucose is in the body, there is no insulin so no removal of the glucose from blood, the kidney then cant reabsorb all the glucose and the glucose in the urine takes water with it by osmosis, cells also can’t take the glucose in the blood up quick enough so start using fats and proteins in respiration, all this causes Dehydration, loss of vital salts and low blood pH which results in a coma. Hypoglycaemia Where there is not enough blood glucose, and no glycogen stores in liver because of the lack of insulin, glucagon has nothing to act on and blood glucose is too low to supply respiring cells which results in a coma. The treatment for type 1 is diet and insulin injections. Type 2 none insulin dependent diabetes mellitus (NIDDM) is caused by a resistance to insulin and usually comes later on in life, a contributing factor to type 2 is also obesity, treatment is diet and exercise, tablet that increase cell sensitivity to insulin and in extreme cases insulin injections. Additional glands that make hormones are the adrenal glands (also called suprarenal glands), these are small glands located on top of both kidneys. The adrenal glands work with the hypothalamus and pituitary gland. Both adrenal glands are composed of two parts that have different functions and structures. The outer part is the cortex and is essential to life, where as the inner part is the medulla and is not essential to life. The adrenal cortex makes three groups of steroid hormones from cholesterol, collectively called adrenocorticocoids these are, glucocorticoids, minerslocorticoids and sex hormones (androgens). The medulla is completely surrounded by the cortex, and it is part of the sympathetic division of the autonomic nervous system. It is stimulated by its extensive sympathetic nerve supply to produce the hormones adrenaline (epinephrine) and noradrenaline (norepinephrine). One of the main disorders of the adrenal cortex is hypersecretion of glucocorticoids or Cushing’s syndrome, symptoms of this syndrome include; weight gain and fatty deposits, skin changes, depression, brittle bones, muscle weakness, headaches and high blood pressure. Cushing’s syndrome can be caused by an over use of a steroid medication or by a tumour that causes your body to produce more cortisol. Treatments for these causes could be reducing the dose of steroid medication or for tumours surgery, radiotherapy or chemotherapy. With the adrenal medulla the main disorder is hormone secreting tumours, which cause excess adrenaline and noradrenaline, the symptoms of which are; hypertension, weight loss, nervousness, headaches excessive sweating, hyperglycaemia and glycosuria. Kidneys Important functions to do within the body, there functions are; the formation of urine, filtration and selective reabsorption. Each kidney is associated with a different group of structures, the right kidney is associated with; the right adrenal gland, the right lobe of the liver, the duodenum, the hepatic flexure of the colon, the diaphragm and the muscles of the posterior abdominal wall. The left kidney is associated with; the left adrenal gland, the spleen, stomach, pancreas, jejunum, the splenic flexure of the colon, the diaphragm and the muscles of the posterior abdominal wall. The kidney is extremely flexible in its working. It excretes large amount of hypotonic urine when water intake is very high, while it excretes small amount of hypertonic urine when water is deficient and needs to be conserved. This is very useful in Osmoregulation. Osmoregulation control of the levels of water and mineral salts in the blood.   The water potential of the blood must be regulated to prevent loss or gain of water from cells. Blood water homeostasis is controlled by the hypothalamus. It contains osmosreceptor cells, which can detect changes in the water potential of the blood passing through the brain. In response, the hypothalamus controls the sensation of thirst, and it also secretes the hormone ADH (antidiuretic hormone). ADH is stored in the pituitary gland, and its target cells are the endothelial cells of the collecting ducts of the kidney nephrons. These cells are unusual in that water molecules can only cross their membranes via water channels called aquaporins, rather than through the lipid bilayer. ADH causes these water channels to open. It works as the diagram below shows. All these hormones that have been mentioned are working to help keep homeostasis. Homeostasis is the maintenance of a constant internal environment and is important because it results in our cells being bathed in tissue fluid which has the correct amount of water, mineral salts, glucose and temperature, a great deal of the hormone system is dedicated to homeostasis. Temperature homeostasis is controlled by the thermoregulatory centre in the hypothalamus. It receives input from two sets of thermoreceptors: receptors in the hypothalamus itself monitor the temperature of the blood as it passes through the brain (the core temperature), and receptors in the skin monitor the external temperature. Both pieces of information are needed so that the body can make appropriate adjustments. As stated previously Blood glucose concentration is controlled by the pancreas. The pancreas has glucose receptor cells, which monitor the concentration of glucose in the blood, and it also has endocrine cells (called the islets of Langerhans), which secrete hormones. Homeostasis Controlled by our nervous and endocrine systems. The endocrine system is all the glands that secrete hormones (proteins or steroids) some glands that have been mentioned and a lot more that haven’t, the main glands are; Thyroid, Pituitary, Pancreas,   Adrenal, Hypothalamus, Testes and Ovaries. The endocrine system relies on negative feedback to maintain control. This works as shown in the diagram, Negative feedback means that whenever a change occurs in a system, the change automatically causes a corrective mechanism to start, which reverses the original change and brings the system back to normal. It also means that the bigger then change the bigger the corrective mechanism. Bibliography Bupa (2011) [Online] Available at: www.bupa.co.uk (02/04/2011) MedicineNet (2011) [Online] Available at www.medterms.com (01/04/2011) Scott, D. (2004) [Online] Available at www.biologymad.com (02/04/2011) Tutorvista (2010) [Online] Available at www.tutorvista.co.uk (02/04/2011) University of Maryland Medical Centre (2010) [Online] Available at www.umm.edu/endocrin/adrengl.htm (02/04/2011) Waugh, A. And Grant, A. (2006) Anatomy and Physiology in Health and Illness. 10th edn: Elsevier Limited.

Cash Flow Statement of JB HI-FI Limited

In this report an adamantine study has been prepared on the cash flow statement of JB HI-FI limited. It is Australian company engaged in providing goods and services specialized in video games and other home appliance. Richard Murry is the CEO of the company who makes all the strategic decision. It is evaluated that annual report of company has been showing computation of cash inflow and outflow from all its activities by using direct method. A complete analysis has been made on operating, investment and financial activities of JB Hi-FI limited to evaluate liquidity position of company in effective manner. Evaluation of cash flow statement of JB HI-FI Ltd Cash flow statement of JB HI-FI provides liquidity position of company and determines how much cash inflows and outflow of company for a particular time period (Roth, 2017). Analysis of cash flow from operating activities It is evaluated that JB HI-FI since last five years has reduced its cash inflow from its operating activities.   In 2012, JB HI- FI was having 215.01 cash inflow from its operating activities which decreased to 185.14. This has shown company has reduced its cash flow from is operating activities. However, more deep analysis could be made by computing operating cash flow ratio (Google Finance, 2017). It is evaluated that in 2012, JB HI- FI was having .48 operating cash flow which has been reduced to .41 in 2016. It reflects that company has been inefficient to draw good amount of cash inflow from its current liabilities engaged in its value chain activities (Brigham, and Ehrhardt, 2016). This ratio measures the capital available for internal reinvestment and for payment on its existing debts. However, by evaluating this ratio it could be inferred that JB HI-FI do not have adequate cash flow CAPEX requirement. Nonetheless, cash inflow from capital expenditure would be found lower in growing company. Therefore, JB HI- FI could justify its lowers amount of cash inflow to its stakeholders (Nizam & Hoshino, 2016). Computation of cash flow statement from indirect method (ASX, 2016) Adjustment to Cash flow Statement of JB HI FI for fives years Fiscal year is July- June and all values in AUD Million Depreciation, Depletion, and amortization Deferred Taxes & Investment Tax Credit It is observed that company has positive cash inflow from its operating activities. In addition to this, financial and investing activities have been providing negative cash outflow. JB HI- FI need to increase its liquidity position otherwise it will result into jeopardize situation for the business functioning of company. Moreover, since 2012 to 2016 company has reduced its cash inflow from its operating activities from 215.01 to 185.14.   Nonetheless, cash outflow from its operating activities has increased by 16% in 2016 as compare to its 2012 cash outflow from its investing activities. Now in the end it would be inferred that company need to main its cash flow more than 1 for the smooth running of business (Thomson Reuters, 2016). Brigham, E.F. and Ehrhardt, M.C. 2016. Account Finance. Cengage Learning, PP 1-549. Google Finance, (2017).  ALL ORDINARIES: INDEXASX:XAO historical prices - Google Finance. [online] Google.com. Available at: https://www.google.com/finance/historical?cid=10584617&startdate=Jun%201%2C%202015&enddate=Jun%2030%2C%202016&num=30&ei=sTWoV9jrGNaAsgGMsouQDg&start=0 [Accessed 22 March 2017]. Nizam, N. Z., & Hoshino, Y. 2016. Corporate Characteristics of Retail Industry among 11 Asian and American Countries.  Journal of Management Research,  8(1), 224-247. Roth, M., 2017.  Top Stocks 2017: A Sharebuyer's Guide to Leading Australian Companies. John Wiley & Sons. ASX, (2016). ASX, [Online], Accessed on: 23 march 2017, Available at:  https://search.asx.com.au/s/search.html?query=jb+hi+fi+ltd&collection=asx-meta&profile=web Thomson Reuters, (2016).  JB HI FI Limited,JBHIFI:ASX historical prices - FT.com. [online]  Markets.ft.com. Available

Marketing outline of a selected organisation Assignment

Marketing outline of a selected organisation - Assignment Example Marketing strategy takes into consideration a thorough analysis of external and internal environments. Marketing mix modelling is a key factor during scanning of internal environment. This aspect even includes analysis of strategic constraints and its overall performance. The external environmental factors mainly comprises of target market analysis, customer analysis, competitor analysis along with evaluation of external environmental factors such as political, economic, legal, social and technological. Marketing strategies designed by an organization usually differs from another organization. These strategies are highly dependent on particular business scenario. Real life marketing needs to focus on external environmental conditions, market opportunity, uncertainties, and optimum utilization of available resources. In this study wide array of marketing concepts shall be applied on a UK based organization called Tesco. Tesco is a renowned multinational general merchandise and grocery retailer based in United Kingdom. The company has its retail stores located across 12 countries and is regarded as UK’s grocery market leader. Across the globe Tesco is considered to be second largest retailer in terms of revenue margins. The organization was founded in 1919 and since then it has implemented best marketing strategies. There are widespread aspects which are followed while designing its marketing strategy. Firstly different products or services of Tesco possesses specific target market segment. Their overall positioning strategy states that the firm is focused towards offering quality products at reasonable price. This marketing concept has enabled the company to remain competitive in the market place. In recent scenario the company has diversified into many areas like books, petrol, furniture, clothing, toys, electronics, financial services, internet, telecom, etc. This kind of diversification has supported the company to acquire greater percentage of

Business Financing and the Capital Structure Essay - 6

Business Financing and the Capital Structure - Essay Example Raising finance through friends and family members is the least expensive way to access funds since it avoids high interest loans. Friends and family members are more patient than lenders, such as banks. The major disadvantage is that the owners must give out approximately 50% of their business to the outsiders. This puts the venture in danger of losing their business fully. Some of them may over expect the amount of profits. This brings misunderstandings because they expect more than can be afforded. Investments from family and friends require a good explanation about the impact of the venture. The financial arrangements should all be business-like. Formal business processes should be followed regardless of the relationship between the lender and the borrower. The details of the borrowed money should be outlined. This involves the means of payment, and what would happen in case the business does not prosper (Wolff, 2000). The borrower should not accept more money than the investor could afford to lose. It may render the company bankrupt. Finally, a written contract should be availed for the business owner, friends, and family. The business should treat the money as bridge financing to the next financing level (Boa and Edmans, 2007). Any payment schedule developed should suit the entrepreneur and the lender. An exit plan should be available describing how the investors will cash out the investments. Debt capital is loan obtained that must be returned with interest. Debt capital form of financing has higher interest rate than loans given to small companies since they have higher risks of return trade off than bigger corporate consumers do. The entrepreneurs maintain complete ownership of the business. Borrowed capital is a liability on the balance sheet. The major advantage of debt financing is that the lender cannot own the business. Those who lend capital only require interest on the loan given. Debt financing cost

East Asian Art Essay Example for Free

East Asian Art Essay One mark of how developed a culture is its art forms. The arts are a large aspect or subdivision of a culture. So much of a culture’s beliefs and traditions are reflected of expressed in various art forms. Art is made by an artist, an artist’s way of seeing and interpreting things are dictated by the culture of the society of which he is a part of; this is the relationship of the arts and culture. They have a link that cannot be severed. Ancient art forms that are reflective of a societal culture can include architecture, calligraphy, culinary arts, dance, drawing/ painting, fashion, music, language, literature, sculpture, crafts, and theatre; all these are represent the rich culture of a society. Some new and modern art forms that have been brought upon by technology include film and photography. As for East Asia, in geographical context, it is the region of Asia covering 12, 000, 000 square kilometers, which is 28% of the whole Asian continent. Countries in the East Asian territory currently include Mainland China, Hong Kong, Japan, Macau, Mongolia, North Korea, South Korea, and Taiwan. East Asia being the home of some of the first great and influential cultures and civilizations, their ancient works of art would be a good area of study to understand how their culture developed. During the ancient times, the major societies that served as the cultural roots of the region are China, Japan and Korea. Understanding how their culture began through the events that transpired in the first 500 years of the Common Era that contributed to the development of their art can give us an insight on what their culture was and how the present culture of the region came to be.

Education Essay -- essays research papers fc

  Ã‚  Ã‚  Ã‚  Ã‚  Most controversies over education are centered around the question of how strictly standards should be upheld. The concern over whether or not flunking students is appropriate or even in the best interest of the student is a widely discussed topic. The argument often begins with students just starting school where the question of standardized testing for kindergartners arises. The majority of people are actually against such testing because they feel that a child who is labeled as a failure at such an early age may be permanently damaged (Bowen 86). The worry over the failure issue is further traced to educators who feel children just entering school are not fully prepared. Teachers are faced with kindergarten students who do not know their addresses, colors, and sometimes even first and last names (An ‘F’ 59).   Ã‚  Ã‚  Ã‚  Ã‚  Another reason why the assignment of failing grades has decreased is the influence of the self-esteem movement, which promotes the assumption that children who do not have a positive self-image cannot learn or develop properly. Although this theory is widely accepted, it has been discredited by several studies. Recent research shows that, although American students felt more confident about themselves and their work, they were outperformed by several Asian countries on tests of elementary skills. American schools and teachers tend to worry more about the student’s self-esteem than the actual academic performance (Leo, â€Å"Damn† 21). Mary Sherry, a teacher of adult literacy programs, does not believe such theories. Her view is that students become motivated by the threat of failure, and that not failing a student not only shows lack of confidence on the teacher’s behalf, but also hurts the society as a whole. Employees are becoming highly dis appointed with so-called â€Å"graduate† students (8).   Ã‚  Ã‚  Ã‚  Ã‚  In a letter to columnist Ann Landers, a college professor wrote about his views of the education system. He feels that universities have turned into businesses where teachers are just looking for money and students are just looking for a piece of paper with a title on it. He says that the students of today think they are automatically entitled to a degree because they pay tuition (Depressed Old Prof. 3-B). Adding to the profit motive for schools is the government which, for the p... ...ressed Old Prof. â€Å"Ann Landers.† Times-Picayune [New Orleans] 4 Sep. 1995: 3-B. â€Å"An ‘F’ for the Nation’s Kindergartners (Education).† Newsweek 16 Dec. 1991: 59. Goldstein, Andrew and Ann Blackman. â€Å"No SAT Scores Required (Education).† Time 11 Sep. 2000: 52-53. Hendren, John. â€Å"Ex-English Professor Creates Corporate Prose Police.† Courier [Houma LA] 25 Aug. 1996: 4D. Leo, John. â€Å"The Answer Is 45 Cents (On Society).† U.S. News & World Report 21 Apr. 1997: 14. ---. â€Å"Damn, I’m Good! (On Society).† U.S. News & World Report 18 May 1998: 21. Morse, Jodie et al. â€Å"Does Texas Make the Grade? (Education).† Time 11 Sep. 2000: 50-54. Mulcahy, Fred. â€Å"No Free Rides for Dumb Students (My Turn).† Newsweek 15 Aug. 1994: 12. Pedersen, Daniel. â€Å"When an A Is Average (Education).† Newsweek 3 Mar. 1997. Ravith, Diane. â€Å"In Defense of Testing (Education).† Time 11 Sep. 2000: 52-53. Roberts, Paul. Modern Grammar. New York: Harcourt, Brace & World, 1968. Sherry, Mary. â€Å"In Praise of the F Word (My Turn).† Newsweek 28 Aug. 1990: 8. Wilkes, Paul. â€Å"The First Test of Childhood (My Turn).† Newsweek 14 Aug. 1989: 8. Winters, Rebecca. â€Å"From Home to Harvard (Education).† Time 11 Sep. 2000: 55.

Article Review On “Evidence Based Management(EBM), The Very Idea” Essay

Introduction There has been a recent trend in commending evidence-based approaches for management and policy making decision in the public sector. Evidence based management(EBM) is an aspect that has been heavily developed and relied on in certain practices such as evidence-based policy and evidence-based medicine.   These forms of approaches utilize recent best evidence in decision making and management. Evidence based management(EBM) involves   managerial based decisions and organizational practices that are informed by the best and available scientific evidence with the best evidence in this case being the norms of natural sciences. Evidence based approaches have gained fame over the years. The same has not been without its ups and down. This has seen evidence based management generate debate with writers such as Learmouth & Harding (2007) opposing the very idea of utilizing the widely acclaimed evidence based approach in fields such as health care. The document reviews the(Learmouth & Harding (2007) article with a look at the evidence provided by the two in support of their opposition to the use of evidence based management (EBM) in health care. The positives and negatives of their arguments will be reviewed. Evidence of the same will be based on the Learmouth & Harding (2007) article as well as literature from related articles. Discussion The evidence based management as analyzed by Learmouth & Harding (2007) article presents a strong case that shows that there is reason to believe and support the research bothwriters   have accomplished to discredit the use of this approach especially in health care. Both Learmouth & Harding (2007) raise a good debate on the development of evidence based approaches to management and organization. The researchers clearly raise the issues they feel plague the use of evidence based management(EBM) in health care and in any other setting. To Learmouth & Harding (2007), this is an approach that is a misguided aspect with the unpredictable nature of evidence in the management discipline. Also, Learmouth & Hardin (2007) have the take that evidence based management is not there to help the public service and will not at the end contribute anything meaningful to the effectiveness in organizations (Axelsson, 1998).   This is in spite of other systems such as evidence based medicine beinghailed as the best method of reducing uncertainty in clinical practice. Learmouth & Harding (2007) opposition to the use of evidence based management(EBM) in organizational setting raises and opens the reader’s eyes to a major issue in their debate-arriving at an agreement on evidence. One is made to agree with Learmouth & Harding (2007) debate that it is one thing to reach a consensus in medicine and other fields and another in reaching the same in social sciences so as to flag the appropriateness of the use of evidence based management(EBM) in health care. Such techniques as the use of the evidence based medicine has worked well but this should not be the assumption in all the cases as highlighted by Learmouth & Harding (2007). The fact that the two researchers also disapprove of generalizations in the different approaches is a positive aspect in the research. The reasons the two give is valid in that the cause and effect connections that are there in organizational research are not in any way readily subject to controlled experiments such as those in medicine. However, there is an oversight and thus a disadvantage in Learmouth & Harding (2007) debate. One can counter their opposition to the generalization point on the use of evidence based management(EBM)in that where the presence of clear necessitates the establishment of decision making rules which the scientific community is able to endorse. Learmouth & Harding (2007) would want their readers to believe that a solution to finding a cause and effect connection in organizational settings does not exist but this is not the case (Parker, 2001).This is a side that is missing in their debate in that over the years, there has been the establishment of consensus around the use of constructive reviews and meta-analysis in order to identify the convergent findings in the organizational research and the boundary conditions. Learmouth & Harding (2007) do not leave any option to the reader to see a chance in the establishment of a movement towards evidence based management which would even be capable of fostering great attention to the convergent findings and their implications to practice and science. One feels that Learmouth & Harding (2007) are advocating and supporting the continued fragmentation and novelty in the current organizational research. By focusing on the high consensus areas, there will be a chance for EBM (evidence based management) to have efforts directed towards accounting for divergence and inconsistency in the areas of limited convergence in organizational research(Linstead & Grafton-Small, 1992). Managerialism is also another major issue that Learmouth & Harding (2007) raise with the use of Evidence Based Management (EBM).   The researchers support the opposition to the use of the same in such systems as organizations. According to Learmouth & Harding (2007), the use of EBM supports and reinforces Managerialism. The evidence based approaches are used to reinforce the managerial power with some forms of legitimized forms of evidence while they obscure non-managerial ways of understanding organizational life. One can associate with such an argument in that the evidence given by Learmouth & Harding (2007) is that there have been long standing workplace ethnographies which have stood to benefit organizations by such acts as exposing power, inequality and conflicts in the organizations (Kovner et al., 2000).   Thus elements such as Managerialism have no chance of prospering in such an environment. This greatly benefits the organization. However, there is a downside to the evaluation of only one side of the effect of EBM as far as Managerialism is concerned. The evidence by Learmouth & Harding (2007) is hinged on bias on whether there has been enough inquiry to the effective ways of organizing and managing based on less non-traditional and hierarchical view of workers, governance and employment (Ferlie et al., 2001). It is not justifiable to brush off EBM on managerialism basis since the same would serve as a counterforce to the self- serving and arbitrariness bias observed in the form firms are managed and organized nowadays (Parker, 2001). Any innovation can be affected in that it can be misused. Evidence of such is the presence of a regulation in the use of evidence based medicine in the UK National Health Service. However, the use of EBM can act as the basis to develop effective organizational and professional competencies (Harris, 1998). Learmouth & Harding (2007) are wary of the role that EBM may come to acquire in terms of power. The two are skeptic of the fact that EBM may become an avenue that serves interests. This shows how Learmouth & Harding (2007) have put a great deal of effort into all the aspects that may hinder the smooth operation of such programs as EBM in health care. As researchers, they have succeeded in evaluating all the angles of a research issue. Learmouth & Harding (2007) show that it would be naà ¯ve to not think of politics as the same are pervasive and real. Such an aspect as the development and implementation of EBM to organization and management can affect such issues as how legitimacy, funding   and influence is allocated to such groups as practitioners, teachers and scholars. Management is free of such aspects such as social and political interests as well as moral considerations.   However, true as this may be and a correct inference by Learmouth & Harding (2007), power and politics cannot be avoided. The real problem that Learmouth & Harding (2007) seem to be wary of is that qualitative research may not be able to meet the evidentiary standards that EBM may incorporate and employ (Linstead & Grafton-Small, 1992).  Ã‚   Also, Learmouth & Harding (2007) seem to be wary that qualitative research may be devalued which will result in the decline of legitimacy as well as its funding. Evidence cannot be said to be of particular measure or method social science uses. As opposed to Learmouth & Harding (2007) hesitation with unobstructed power in the use of EBM, this may not be the case as qualitative research is a sure way of identifying the areas in science that are not clear. Qualitative research is capable of being put into practice to identify the meanings underlying the observed patterns and also in helping to translate the evidence into practice through exploration of the politics, subjectivity and the conflicts that are involved in the changes to organizational practice (Carter, 2000). Conclusion The implementation and the design of the EBM is not an aspect that should be generalized and opposed without full evaluation. The implementation as well as the design of EBM should be subject to critical inquiry. The critique by Learmouth & Harding (2007) evades some aspects and in doing so mislead the audience. There is no denying that EBM may affect all the management aspects but the same should not be a reason to abandon the approach. There should and will be movements towards EBM which involve many of the community that are interested in the design of the same. There will be development, implementation, learning and redesign over time. Fear of loss should not hinder the focus for the opportunity on constructive change. References Axelsson , R . 1998 . ‘ Towards an Evidence-based Health Care Management ’ , International    Journal of Health Planning and Management , 13 , 307 – 17 . Ferlie , E . , J . Gabbay , L . Fitzgerald , et al . 2001 . ‘ Evidence-based Medicine and   Ã‚  Ã‚   Organisational Change: an Overview of Some Recent Qualitative Research ’ , in L .   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Ashburner ( ed .), Organisational Behaviour and Organisational Studies in Health Care:   Ã‚  Ã‚  Ã‚  Ã‚   Refl ections on the Future . Basingstoke : Palgrave Macmillan, pp . 18 – 42 . Carter , J . 2000 . ‘ New Public Management and Equal Opportunities in the NHS ’ , Critical   Ã‚  Ã‚   Social Policy , 20 , 61 – 83 . Harrison , S . 1998 . ‘ The Politics of Evidence-based Medicine ’ , Policy and Politics , 26 , 15 –   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   31 . Kovner , A . R . , J . J . Elton and J . Billings . 2000 . ‘ Evidence-based Management ’ , Frontiers   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   of Health Services Management , 16 , 3 – 24 . Linstead , S . and R . Grafton-Small . 1992 . ‘ On Reading Organizational Culture ’ ,   Ã‚  Ã‚  Ã‚   Organization Studies , 13 , 331 – 55 . Parker , M . 2002 . Against Management: Organization in the Age of Managerialism .   Ã‚  Ã‚   Cambridge : Polity Press Learmouth, M., & Harding, N. (April 01, 2007). Evidence-based management: The very   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   idea.  Sage Public Administration Abstracts,  34,  1.)

American Films and Backhoe Operators

Case Analysis Jim worked as a laborer for a gas utility in Winnipeg, Manitoba. When the opportunity came to apply for a backhoe/front-end-loader operator job, he was excited. Three people applied. To select the one who would get the job, the company asked each of them to go out and actually work on the backhoe for a day. Jim felt his chance for the job disappear because he had never even driven a tractor, let alone used a backhoe. When he went out, he did not know how to start the tractor.One of the other backhoe operators had to show him. He managed through the day, and to his surprise, did better than the others. He was given the job. On his first day at the new job, one of the other backhoe operators showed him where to check the hydraulic fluid and said, â€Å"These old Masseys are foolproof. You will be okay. † Jim taught himself how to dig a hole by trial and error. He initially believed that the best way was to fill the bucket as much as possible before lifting it out o f the hole and emptying it.He would wiggle the bucket back and forth until it was submerged and then curl it. When it came out of the hole, the earth would be falling off the sides. This job was not so difficult after all, he thought. He cut through his first water line about two weeks after starting his new job. Going into a deep, muddy hole did not make the crew happy. After Jim cut through his third water line, the crew chief pulled him aside and said, â€Å"You are taking too much earth out with each bucket, so you don’t feel the bucket hitting the water line; ease up a bit. Water lines were usually six to eight feet down, so Jim would dig until about four feet and then try to be more careful. It was then that he pulled up some telephone lines that were only about three feet deep. Realizing that more was involved in operating a backhoe than he first had thought, he sought out Bill Granger, who was known to have broken a water line only twice in his 15 years. It was said that he was so good that he could dig underneath the gas lines—a claim that Jim doubted. Bill said, â€Å"You need to be able to feel any restriction.The way to do that is to have more than one of your levers open at the same time. Operating the bucket lever and the boom lever at the same time reduces the power and causes the machine to stop rather than cut through a line of any type. † Jim began to use this method but still broke water lines. The difference now was that he knew immediately when he broke a line. He could feel the extra pull, whereas in the past, he found out either by seeing water gushing up or by hearing the crew chief swearing at him. He was getting better. Jim never did become as good as Bill Granger.In fact, two years later, he applied for another job as gas repairperson and was promoted, but the training as a gas repairperson was not much better. Case Questions 1. What are the potential costs to this lack of training? Why do you think the company operated in this manner? 2. What type of training would you recommend: OJT, classroom, or a combination? Describe what the training might entail. 3. What type of training environment would you provide? 4. Who would you get to do the training, and why? 5. Would you consider purchasing a training program for backhoe operators? Provide your rationale.

Free Essays on Inequality In The Workplace

Time for Change Today’s society’s concept of gender related to the division of labor in the workplace, and related to issues of power and control is a stereotype. The division of workplace labor by gender is based on the false ideology of innate sex differences in traits and abilities, which operates through various control mechanisms. These control mechanisms are primarily exercised by men over women and exaggerate differences between the sexes, especially surrounding women’s presumed inability for doing â€Å"male† work. Most forms of workplace control take the form of harassment, sexual bribery, gender based jokes and comments, which passively but briefly makes gender differences stand out conspicuously in the aspect of work relations. This reinforces such notions that men in Western societies have traditionally acquired and maintained the majority of wealth and power in society, and so in the workplace. In a sense, women’s traditional roles and identities have been formed and maintained by the workplace. The concepts of male and female are not independent relationships of the workplace; since they indeed have been strongly influenced and determined by the relationships of male and female in our society at large. The gendered division of labor has its origins in the home, and maintains its structure in the workplace. This can be seen inside families through the distinctions between paid work and non-paid work, and the separation of the private and public spheres where women are viewed as attached to the private and men to the public domains. This is an important issue because while home and work may physically be separated for working men and women, home is often not a haven for women but just another place of work. The gendered division of labor then, is not limited to the paid work force; it also applies to the unpaid work at home. The issues surrounding power inequalities in the workforce may be explained historica... Free Essays on Inequality In The Workplace Free Essays on Inequality In The Workplace Time for Change Today’s society’s concept of gender related to the division of labor in the workplace, and related to issues of power and control is a stereotype. The division of workplace labor by gender is based on the false ideology of innate sex differences in traits and abilities, which operates through various control mechanisms. These control mechanisms are primarily exercised by men over women and exaggerate differences between the sexes, especially surrounding women’s presumed inability for doing â€Å"male† work. Most forms of workplace control take the form of harassment, sexual bribery, gender based jokes and comments, which passively but briefly makes gender differences stand out conspicuously in the aspect of work relations. This reinforces such notions that men in Western societies have traditionally acquired and maintained the majority of wealth and power in society, and so in the workplace. In a sense, women’s traditional roles and identities have been formed and maintained by the workplace. The concepts of male and female are not independent relationships of the workplace; since they indeed have been strongly influenced and determined by the relationships of male and female in our society at large. The gendered division of labor has its origins in the home, and maintains its structure in the workplace. This can be seen inside families through the distinctions between paid work and non-paid work, and the separation of the private and public spheres where women are viewed as attached to the private and men to the public domains. This is an important issue because while home and work may physically be separated for working men and women, home is often not a haven for women but just another place of work. The gendered division of labor then, is not limited to the paid work force; it also applies to the unpaid work at home. The issues surrounding power inequalities in the workforce may be explained historica... Free Essays on Inequality In The Workplace Gender equality in the workplace has been an obvious problem since women first left their â€Å"jobs† as housewives to work at a real job. Ethnic equality has also been an apparent problem that has been gratuitously ignored. But what about those who belong to both of these categories? Many women of a minority race have been getting the short end of the stick for years, yet no one seems to be doing anything about it. It is a common trend worldwide for women to earn less than men. Although females’ wages have increased 140 percent since 1960, there’s still a long haul ahead (Gray, p.1). On average, women earn 73 cents for every dollar earned by men (Gardner, p.1). Why is there this difference? Is it because men are more qualified than women? Studies show that the gap between the wages of men and women is narrower in fields of work where the number of males and females are closer to equal. Yet in higher-ranking jobs, where males greatly outnumber females, the gap grows wider (Gray, p.1). As for the gap in the earnings of various races, the figures aren’t much more promising. In the early 1990’s, African Americans earned 20 percent less than Caucasians. Many employers believe that minority groups are â€Å"less dependable† than whites are. Some employers seek minorities as workers solely to improve their image as a â€Å"diversified and cultured† business. Although numerous companies claim to be indifferent to ethnicity, most still ask job seekers to identify their race on employment applications (â€Å"Earnings Inequality Between Black and White Men†, p.1). While women make less than men, it has been shown that black women make 63 cents for every dollar a man makes. Hispanic women make 53 cents for every dollar a man makes. Believe it or not, the gap for black and Hispanic women has actually widened in past years (Gardner, p.1). These minority women are also said to be shown less respect by their colleagues and th...

Teaching across cultures Essay Example | Topics and Well Written Essays - 500 words

Teaching across cultures - Essay Example Religion plays an important role in the lives of African Americans and this set out a sense of mutuality among the members. The common language helps in eradicating the communication barriers. Other secondary cultural characteristics like sense of thinking, moral values, food preferences etc. help in upholding a comfortable environment to the male and female members as they share common cultural values. Gender and learning abilities play an important role within the chosen group. The female members of the group have more stress of keeping a balance between their family and career life. They face an additional stress of raising children and nurturing them keeping their educational and learning needs in view. All three members have children; however, females have more responsibilities to attend the children’s need than men. Moreover, the learning skills are important as all the members have limited time to understand and learn the lessons. The male member has to allocate time be tween job and education while females have families to be taken care of as well. The emphasis of African American culture on respect and moral values requires careful consideration when referring to elderly population, females etc.

Contract law Essay Example | Topics and Well Written Essays - 1500 words

Contract law - Essay Example Since a breach of contract implies that one of the parties to a contract has suffered a loss or injuries, the law requires that the other party pay for damages to the injured party. Award of damages to the injured party is the major remedy which is available at common law for breach of contract. In general terms, damages refer to the monetary sum that is determined by the court in order to compensate the injured party. Damages intend to restore the injured party to his previous financial position (Beatson and Burrows and Cartwright, 2010, p. 39). In the scenario presented, Megatractors plc has suffered loss as a result of the crashing of the vehicle which was carrying its equipment. Megatractors plc had contracted the services of the Ace Transport Ltd to transport an expensive harvester to a customer, Home Farms (Flempton) Ltd. Since Ace Transport Ltd had provided similar services to Megatractors for a number of years, the latter was convinced that the former will perform its duty as per the contract. However, this did not happen as the driver’s error caused the vehicle carrying the equipment to crush and badly damaging the equipment thereby causing loss to Megatractors. After the incident, Ace Transport Ltd advised Megatractors that it intends to rely on the following clause: â€Å"Ace Transport Ltd will not accept any liability for loss or damage caused to customers’ property during transportation, no matter how the loss or damage was caused. Customers are advised to take out their own insurance.† Ace Transport further points out that the clause had been prominently displayed outside the entrance to their main offices, and is also reproduced on the back of all i9nvoices, confirmation of order notices and the receipts of the company as required under the Unfair Contract Terms Act 1977 (Stone, 2009, p. 71). In the light of the facts relating to Megatractors scenario and the laws regarding the contract, the Managing Director of Megatractors plc should first be aware of the situation’s legal position. Megatractors plc has indeed suffered a substantial loss considering that the equipment which was damaged was described as expensive. As such, the company is ideally supposed to sue in order to recover substantial damages. Inherently, Megatractors plc can sue for special damages because it has suffered a quantifiable monetary loss; in this case damaged equipment. In addition, the company has suffered direct losses in the form of economic or consequential losses as a result of lost profits. Since it has been identified that; the crushing of the vehicle carrying the equipment was due to driver’s error, Megatractors has a right to sue for both punitive and compensatory damages for the tort that was committed resulting to the loss it has suffered (Fafinski and Finch, 2009, p. 20). The damages sought will intend to restore Megatractors plc to the position that it was at before the crushing had taken place. It is pa ramount for Megatractors plc’s Managing Director to know that in order to recover the substantial damages that it has suffered; it has to show that it had actually suffered the loss it is claiming. In this case it has suffered two types of losses: incidental loss due to the damaged equipment caused by driver’