Lighting withing religious buildings Thesis Example | Topics and Well Written Essays - 8500 words

Lighting withing religious buildings - Thesis Example By 15 BC, the Roman people made use of natural light in buildings given the unavailability of artificial light, and natural light became the domain of the architect. The need for natural lighting led to the introduction of windows that used glass panes. The invention of glass dates back to 2500 BC in Mesopotamia. Originally, the use of glass in religious buildings served a decorative role with colour being an essential attribute of glass. It is this attributes that religious people explored to create stained and art glass windows in places of worship. According to religious people, the art or stains on glass was light enough to allow light streams to pass through while projecting plays of colour and light throughout the interior spaces. Over time, art glass in religious architecture became part of religious culture. Although religious architecture is extremely complex for lack of shared basic characteristics amongst all religions, most religions embrace art glass in their architecture (Anon., 2011). For instance, Muslims and Christians’ embracing of art glass dates back to the middle ages when both introduced large scale colour art glass window. Back then, art was elevated as a symbol of the divine while adding colour, light, and beauty. For the worshippers, these windows shared the faith teachings with worshippers through secular and Christian scenes present in art glass design. For the Christians, the windows were used by the clergy to teach the gospel. One of the major roles of glass, evident in France during the 12th century, was for the provision of natural lighting. This light was equated with beauty and goodness while stained glass window was preferred for its superb connection to daylight. The value of natural lighting through the glass was defined by Philosopher Abbot Suger as â€Å"Divine light† based on his reasoning that through natural light, God could be experienced by

Methods Which Writers Use to Develop Their Style Essay Example for Free

Methods Which Writers Use to Develop Their Style Essay Explore the methods which writers use to develop the ways in which their characters see and understand their own worlds in Pride and Prejudice and The Yellow Wallpaper Austen first published ‘Pride and Prejudice’ in 1813 the novella touches on several themes such as prejudice, first impressions and pride; themes that individually define the main characters. Charlotte Perkin Gilman an American writer first published ‘The Yellow Wallpaper’ in 1892, the novella touches upon attitudes in the nineteenth century towards women’s physical and mental health. Writers tend to contrast characters hoping to intrigue the readers in the variation of characterisation. Throughout this essay I will illustrates the ways in which characters see and understand their own worlds through ‘Pride and Prejudice’ by Jane Austen and ‘The Yellow Wallpaper’ by Charlotte Perkin Gilman. Darcy is the character most often associated with pride and Elizabeth Bennett with prejudice. Ironically the novel was originally called ‘First Impressions’ an aspect Darcy seems to lack originally. Understanding the world can be perceived in many different aspects; literally or figuratively. The protagonists; Elizabeth Bennet and Fitzwilliam Darcy capture our attention from the beginning of the novel. Austen is able to contradict the patriarchal society that existed in the nineteenth century, as she builds Elizabeth to be rational, strong and independent. Women were mainly seen in this time to entertain yet Elizabeth did not carry these traits. Her perspective of the world was different to how her mother saw her future, she rejects two men of which rank highly on the social ladder proposal towards her. Ironically she ends the novel marrying the wealthiest of them all. Whereas, Darcy originally is not fond of Elizabeth ‘She is tolerable, I suppose, but not handsome enough to tempt me’ his second glance at her changes his judgement he describes her eyes to be. Darcy emits a character full of pride and arrogance qualities that seemed typical from a man of his status. The Yellow Wallpaper; the narrator sets an omniscient tone on the novella, it is written in first person narrative, for example ‘I’ this allows the readers to feel somewhat emotional attraction, towards the onset of the novella. The novella is a paradox; the narrator loses touch with the outer world, as she comes to a greater understanding of the inner reality of her life. It dwells upon a controversial issue; postnatal depression an illness that has become more common in our patriarchal society. ‘Pride and  Prejudice’; Jane Austen effectively portrays the way characters can understand and see things, in a literal as well as metaphorical aspect. Ironically the protagonist; Elizabeth Bennet believes to have the greatest understanding of people yet she falls short when she fails to understand Wickam. Initially losing some of her pride ‘I who have prided myself on my discernment†¦ how humiliating is this discovery’ she realises that she is a bad judge of character. Though Elizabeth constantly reminds us of her understanding of characters she clearly in occasions see’s things differently. In addition, the narrator in ‘The Yellow Wallpaper’ suffers from postnatal depression, however still manages to cope, because her source of relief is self-expressed through her creative and imaginative outlook on her depression. Her husband; John believes her depression to be a ‘temporary nervous depression – a slight hysterical tendency’. This quotation clearly suggests John relies more on his medical education than his wife’s feelings and opinions, he neglects her consultation on her illness, he just accepts the fact that he is not going to listen to her. Evidence of this is shown â€Å"You see he does not believe I am sick! And what can one do?†. This quotation further suggests there lack of communication in the relationship, John has trapped her in this room ‘for her health’ she describes he r room, to be ‘horrid’ however because he is a high standing doctor which is initiated in the beginning of the novella, she believes him. He trusts that the â€Å"illness† of hers is simply a nervous condition, which would easily be cured with lots of rest and very little intellectual time hence. Mr Fitzwilliam Darcy a main character in the novella arrives at Longbourn, originally the Bennets are fond of him ‘Darcy was clever. He was at the same time haughty, reserved and fastidious, and his manners, though well bred, were not inviting.. he was continually giving offence’ there thoughts of him had quickly changed. Austen builds him to be a character we become greatly fond of as we witness his beliefs towards Elizabeth’s family he is straight forward in that matter rude yet honest. However we grow knowledge of his action in the break-up of Jane and Mr Bingley, he was wrong about Jane’s feelings and in this he lacks the ability to understand what happens behind a situation. Lady Catherine, who possesses wealth and social standing, is condescending, although her manner is seen by some as entirely proper and even admirable. She is a fixed character of exaggerated  propensities, in her case representing the extremes of snobbish and pride and prejudice. Prejudice seems to be a theme that exists within all the characters, the hunger to wed into a wealthy family this touches on pride another theme that commonly exists. Austen conveys Lady Catherine to be the wicked witch, she is strong willed and values status her beliefs are traditional. The scene where Elizabeth is invited to her home she undermines her and disapproves of her family with her snide comments. Darcy ‘looked a little ashamed of his ill-breeding’ he is offended by her lack of manners, especially towards Elizabeth, and later, courts her disapproval by marrying Elizabeth in spite of her objections. Lady Catherine indicates her understanding of her own world to be fairly clear, she believes highly in the social hierarchy and isn’t the least fond of mixing beneath her class. Overall, the two major themes of Jane Austens Pride and Prejudice are summed up in the title. The first aspect can be traced in the actions and statements of the work’s entire major and many of its minor characters. Austen and Charlotte share the comparison of misunderstood characters, the narrator in ‘The Yellow Wallpaper’ and Darcy in ‘Pride and Prejudice’. Though 80% of Austens novel is dialogue this only seems to intrigues the readers more, suggesting that the characters appear to need to express themselves through writing, a reason may be because they feel they will able to justify themselves; Darcy and Elizabeth’s typical romance may have not blossomed if not for this. To conclude the themes that existed within both novellas were boldly effective.

Eindhoven Model Of Incident Causation Nursing Essay

Eindhoven Model Of Incident Causation Nursing Essay Patient safety is the foundation stone and one of the central concerns in quality improvement for the health care institution. Keeping our patients safe is a challenging issue because errors and mistakes can and do occur any time. Human error is inevitable, reducing error and minimizing the consequences of error is best achieved by learning from mistake, rather than blaming attitude. Over the years, nurses have assumed roles in various quality improvement and health care risk management activities. Learning from errors and near misses helps to provide opportunities to overcome system gaps, design solutions and modify management systems can reduce the chances of future errors and prevent disaster. According to U.S Agency report (2001) patient safety practice is a type of process or structure whose application reduces the probability of adverse events resulting from exposure to the health care system across a range of diseases and procedures. The Institute of Medicine (IOM) reported that between 44,000 and 98,000 patients die in hospitals setting in 1997 in the United State of America (USA) each year as a result of health care errors which includes, transfusion of incompatible blood products, medication errors, foreign objects left in bodies, equipment failures, mistaken identities of patients or body parts. These errors occurred at any phase of the health care delivery system, errors with serious consequences were observed in most vulnerable clinical settings. Department of health (2001) An Australian study reported adverse event rates of 16.6% of which 13.7% resulted in permanent disability (Wilson, 1995). The Institute of Medicine (IOM) released (2001) a report on To Err Is Human: Building a Safer Health System On the basis of two research studies: one conducted in Colorado and Utah found that 6.6 percent of adverse events led to death, as compared with another study conducted at New York, found that adverse events occurred in 13.6 percent in New York hospitals. In both of these studies over half of these adverse events resulted from medical errors and could have been prevented. When extrapolated to the over 33.6 million admissions to U.S. hospitals in 1997, the results of the study in Colorado and Utah imply that at least 44,000 Americans die each year as a result of medical errors. The results of the New York Study concluded that deaths due to medical errors exceed the number attributable to the 8th leading cause of death. Scenario During my clinical experience, I encountered a situation where I received call from hospital incharge and reporting one sentinel event, series of e-mail exchanged and on call administrator requested me to terminate assigned staff who did an error. I have utilized my leadership knowledge and skills to the best of my understanding. The scenario was an 11 years old boy (Patient A) presented to hospital with the complaint of fever, headache and vomiting. 40 years obstetrics (Patient B) was admitted through emergency department for induction of labour. Both Patients blood was arranged and both have different blood groups. At night physician order to transfused blood to Patient A. Assigned nursing staff went to the laboratory with correct transfusion request slip and blood releasing form but unfortunately Patient B blood pack was picked instead of Patient A from the blood refrigerator at laboratory. Blood checked by same nurse with on call assigned physician before transfusion but again fa iled to check for correct identification at the bed side. Transfusion started to Patient A at 0700 hours. Shift changed at 0800 hours, over taken from night staff with blood transfusion but again verification was not done as a result unrecognized transfusion reaction occurred and ultimately Patient A expired at 13:00 hrs. I have investigated the case and requested respective assigned team and stake holders for root cause analysis. The situation was very painful and challenging as an eleven years old child died due to error but it gave me lots of opportunity to identify the system gaps in order to prevent from re-occurrence in future. As a management position, I requested multidisciplinary team to do the root cause analysis. Root cause analysis is a process for identifying the factors that underlie variation in performance, including the occurrence or possible occurrence of a sentinel event. A root cause analysis focuses primarily on systems and processes, not on individual performance. The analysis progresses from special causes, clinical processes, organizational processes and systems, identify potential improvements in these processes or systems. After did a root cause analysis the incidence was categorized as sentinel event. A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof. Serious injury specifically includes loss of limb or function. Such events are called sentinel because they signal the need for immediate investigation and response. Sentinel events are identified under the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and emphasized those policies helps organization to develop preventative measures. (The Joint Commission, 2011). The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has placed considerable emphasis on promoting patient safety through a variety of mechanisms, including the reporting and analysis of sentinel events that can lead to modifications and improvements in policy and practice within health care settings. We must apply the same principles learnt from our experiences. When a sentinel event occurs in a health care organization, it is necessary that appropriate individuals within the organization be aware of the event, investigate, understand the causes that underlie the event, and make changes in the organizations systems and processes to reduce the probability of such an event in the future. As a key management position it is my prime responsibility to work as a team with multidisciplinary approach, take as an opportunity to improve the system and ensure the compliances of the institution policies and procedure by nursing division. An organized approach for identification, analysis and evaluation of risks and the devising a plan to decrease the occurrence of accidents, incidents and injuries (Sullivan Decker, 2000). The Institute of Medicine has designed six aims for improving the delivery of care in the United States which includes; Safe, effective, efficient, timely provision, equitable and Patient centered approach in order to provide safe and quality health care services. (Institute of Medicine, 2001). According to Pelletier and Beaudin (2004) The Institute of Medicine defines healthcare quality as the extent to which health services provided to individuals and patient populations improve desired health outcomes. The care should be based on the strongest clinical evidence and provided in a technically and culturally competent manner with good communication and shared decision making. During root cause analysis I came across lots of areas which was identified for areas of improvement that, leadership needs to provide resources in order to provide quality services as evidence by provision of resources was absent in laboratory which resulted that in night shift staff went to receive blood by herself and no check and balance of patient identification was done. However, it is not clearly defined in the policy that what will be the mechanism of check and balance at laboratory end. At secondary hospital laboratory services timing is from 0800 hours to 2300 hours, but what if need arises after wards. It was taken as a granted that services will not require in night timings. In addition, it was not clearly defined in the blood transfusion policy which defines the first steps of checking blood for correct identification at laboratory level. According to Daniel (2004) Clinical Management refers to diagnosis, treatment planning and delivery and ensuring the correct identific ation of each patient and procedure. As a nursing departmental heads the need was identified to review the policies and procedure, structured quality assurance program and Total Quality Management system (TQM) is required in order to prevent from reoccurrence. TQM is a management philosophy that emphasizes a commitment to excellence throughout the organization (Sullivan Decker, 2000). Total Quality Management (TQM) is a sub-discipline of management science which deals with the issue of standardization and enhancement of organizational performance. According to Khan (personal communication November 20, 2012) research was carried out in 2006-2009 by for critical analysis of TQM implementation in Pakistani organizations located on geographical basis. This study explores the factors influencing the success and failure of the TQM program in the organizations. It particularly explores how these programs work within the context of various organizational profiles, dynamics and culture. The study found that TQM implementation is heavily dependent on various factors related to organizational context and culture. It also identified that the end results and changes expected by organizations from TQM implementation are not only dependent on its own framework but on many other cultural related intermediate impacts. These intermediate impacts are mostly related to organizational dynamics and culture and are ignored in most of the firms, resulting in early failure of TQM. Based on the findings of this research and the practical experience of implementing TQM in different organizations, the author also proposes a new framework of TQM implementation named as MSAC cycle i.e. Mobilization (trial phase), Standardization (Short term phase), Acclimatization (mid-term phase) and Culturization (long term phase). This study and the proposed TQM implementation framework is quite valuable for the organization who are presently implementing or desirous to implement TQM more effectively and successfully. The Aga Khan University Hospital started its operation in 1985. Basic quality assurance methodologies were introduced and from 1994 onwards, the continuous quality improvement (CQI) model of AKUH fostered a positive culture of change by establishing lots of core quality activities across the clinical and managerial disciplines; which includes, quality circles, basic quality control tools, education and training in quality, monitoring of quality indicators, health care professionals credentialing, Patient complaints, Patient satisfaction, morbidity and mortality reviews, nursing quality assurance program and quality grand rounds. Finally in 2006, AKUH acquired the gold seal of international accreditation in health care by the Joint Commission International Accreditation (JCIA) with the unique distinction of being the first hospital in Pakistan and among few universities based hospitals in the world to get the quality recognition. AKUH is now on the expansion and integration phase of i ts quality journey, the central driving force towards its quality vision is improvement of processes and outcomes and achieving a strong customer orientation towards both external and internal customers. This will be achieved through concentrating on the goals and strategies of the hospital and all its departments to these three major themes that is improvement in quality of care, services and cost-effectiveness. It is widely recognized that quality indicators or performance indicators can give a valuable insight into the quality of care being provided to patients. Performance indicators are best way to learn and improve, but to instill ownership in the heart of every individual is the key to having meaningful indicators. Thus making performance indicators a part of a physicians and nursing performance evaluation not only ensure that they actively participate in improving their own performance, but also ensure that, quality of care provided to the patients is always and continuously improving. In this clinical situation I also participated in developing the policies with multidisciplinary team and tool in order to control quality system and to evaluate the compliances of practice for sustainability. Fostering a culture of safety requires more than introducing new policies and procedures. Developing a culture of safety requires critical thinking, problem solving, risk identification management and human factor training. The relevant literature and websites on patient safety program has suggested many safety related performance indicators and sy stems of check and balances which can ensure patients safety during patients stay at hospital. A systematic and multidisciplinary approach is, therefore, very imperative to pick-up medical errors and devise strategies to reduce them as it defiantly plays an important part in patient safety. Literature Review The literature review will address overall concept of patient safety and its related issues and concerns, international perspective of error occurrences, safety related performance indicators and measures to create positive safety culture. Several studies are carried out on measuring and evaluating patient safety and outcomes at several health care institutions (Baker 2003; Arah, 2004; Colla, 2005; Karsh, 2006). According to Colla (2005) Achievement of a culture conducive to patient safety may be an admirable goal in its own right, but more effort should be expended on understanding the relationship between measures of safety climate and patient outcomes. The Luxembourg Declaration on Patient Safety (2005) has observed that the health sector is a high-risk area because adverse events, arising from treatment rather than disease, can lead to death, serious damage, complications and patient suffering. Although many hospitals and healthcare settings have procedures in place to ensure patient safety, the health care sector still lags behind other industries and services that have introduced systematic safety processes. Almost fifty percent of joint commission standards are directly related to safety, addressing such issues as medication usage, infection control, surgery and anesthesia, blood transfusions reactions, staff credentialing, fire safety, medical equipment, disaster management, risk identification and management, sentinel event monitoring, safety and security structures. These standards address a number of significant patient safety issues, including the implementation of patient safety programs; the response to adverse events when they occur; the prevention of accidental harm through the prospective analysis and redesigning of vulnerable patient systems and its the organizations responsibility to transparent and take ownership and accountability. Agency for Health Research and Quality (AHRQ) reports (2001) has suggested the same that to review best practices from scientific literature, Redesign care based on best practices through collaboration of multiple departments, Evaluate technology solutions, Implement performance measurements and Monitor selected measurements and present summary reports to senior leadership. Moreover, the Advisory Board Research document supports the type of error mentioned in the AHRQ 2000 reports that the most common errors per 1,000 visits are: 65 incidents per due to adverse drug events, 60 incidents due to hospital acquired infections, 51 incidents related to procedural complications and 15 incidents related to falls. Besides analyzing the common errors in terms of patient safety, Mrayyan and Huber (2003) discussed three aspects of patient safety issues. First is the fear that is whenever any unfortunate incident happens and it is publicized; it creates fear and apprehension among team members. Second issue is errors as a system problem, which involves repetition of same type of error that requires close and immediate interventions. Third is the link between errors and inadequate resources that means inadequate number of staffs or inadequate trained staff that can jeopardize patient safety. The medical error and harm to patient safety does not only let the patient suffer but brings an impact on society at large. The Danish Society for Patient Safety (2005) discussed the effects that adverse events can have on patients; health care personnel and society at large are significant. Patients may suffer both physically and psychologically from sufferings created by the injury itself, but also by the way the incident is handled. Health care personnel on the other hand may experience shame, guilt and depression, with litigations and complaints imposing an additional burden. Society at large suffers from a lower quality of life of its members, with associated extra health care costs but also costs caused by a lower productivity of the society. After root cause analysis I also felt that it is necessary to have interaction one is to one basis to relevant health care personal who did an error in order to sensitized them and mentored through education path rather than terminating the employee, give them insight that the will be the future ambassador for patient safety because, I personally believe that quality reflect when person itself willing to do so, it should be our constant commitment towards organization that patient safety should be our top priority, which infuses the entire organization, for that it is mandatory that first we should acknowledge the error then promote blame-free environment where individuals are empowered to report errors without any fear and punishment so they can willingly address safety concerns. Daniel (2004) explains that, what can be done today to improve patient safety while we are waiting for evidence on effective interventions. First, we need leaders those at the top of organizational charts as well as leaders at all level, second, we need to focus on comprehensive systems of safety rather than attempting to address safety one problem at a time. Three elements comprise comprehensive patient safety: active case finding, methodical analysis, and system redesign. Patient safety initiatives and programs vary from institution to institution but the aim remains the same that is reducing errors and promote safety. Klazinga and Arah (2004) said it is evident that current efforts focus too narrowly on the patient with little explicit linkage to wider aspects of health system safety. Risks management entails reducing harm not just to patients but also to staff, visitors and the environment including society. Some of the patient safety alternatives and solutions proposed by Mrayyan and Hubber (2003) are emphasizing on strengthening system of error reporting and correction that is error detection and reporting system within organization to reduce medical error, patient education in all aspects of care and applying risk management skills by healthcare personnel. In addition, creating an information system and building evidence base for patient safety, analyzing the impact of various management practices like staffing, increasing of medical errors and high risk population and monitoring error rates with necessary actions can reduce medical errors and also use of information technology can work towards enhancing patient safety. Besides all this, commitment of the healthcare professional to reduce errors and promote safety in any organization enhances safety not only for patients but also for the healthcare staff and society in general. This position paper related to sentinel event also gives me insight to do a self-reflection of my job related competencies as a key management representative. I personally believe that, Knowledge can be achieve by reading literature but the art of utilizing that knowledge and skills will give confidence to fulfill job in an effective way. According to (Barker, Sullivian Emery 2006). describe three key roles organized in to three categories called interpersonal roles, informational roles and decisional roles. In interpersonal roles manager has lots of job responsibilities in order to full fill organizational goals, informational roles comprises of monitor and disseminator as that manager is the focal person and considered an as nerve center. Third category is decisional roles which consist of entrepreneur, disturbance handler, resource allocator and negotiator. The first two categories are related to day to day operation However, the third category need that how manager use his/her c ompetency in clear direction which meet the organization vision and mission. Integration of Model There are number of the clinical theories and models regarding the human error are discussed in management. Among which I have selected the Eindhoven model of incident causation. Eindhoven Model of Incident Causation: This model was originally developed to identify root causes of safety related incidents in the Netherlands and has since been tested in industrial and health care settings. The Eindhoven Model of incident causation identifies three main causes of error: human operator, organizational and technical failure. These failures, alone or in combination, are through responsible for reinitiating a chain of events that may ultimately lead to an adverse patient outcome. In performance improvement terminology, such a failure would be considered the root cause of an incident. According to this model, high risk situations will develop into incidents if inadequate system defenses are available to remediate the problem. The Eindhoven Model of Incident Causation served as the theoretical basis for developing the Eindhoven Classification Model, which has since been adapted for the health care domain (Jacob Cherry 2011). This classification model claims that errors occur either because of active failu res or latent conditions. Human Operator Error: (Active failure): Human operator errors are those made by individuals at the sharp end by health care workers. They are also referred to as active failures or active errors. Active failures fall into three major categories; skill based, rule-based or knowledge-based. Skill based error occur when an individual makes an error during the performance of a routine task that requires little conscious effort as evidence by its routine practice of nurses to bring blood from laboratory or its routine to take daily over from upcoming shift but in different intervals but nurse fails to check for correct identification with patient name and medical record number. An example of a skill based error would be a nurse forgetting to push the start button on an IV pump after priming the tubing. A rule based error occurs when an individual fails to perform a procedure or protocol correctly or chooses the wrong procedure as in this sentinel event nurse and physician fails to compliance with policies and procedure as a res ult wrong blood was transfused. An example of a fuel-based error is a phlebotomist failing to check the patients identification before obtaining a blood specimen. A knowledge based error refers to the conscious but incorrect application of existing knowledge to a new situation. An example of a knowledge-based error would be when first patient develop fever or sign of reaction she took as an granted and stop blood for time being neither nurse or physician utilized their knowledge and integrated theory in to practice or critically analyze that what would be the possible reasons for fever. Human errors have typically been the focus of traditional incident report monitoring because they are more obvious that latent conditions. Although some of the factors leading to human error are amenable such as knowledge deficit, staffing shortages, work over load etc. Technical or organizational error (Latent Condition/ Latent error): Technical and organizational errors are referred to as latent condition or latent errors. Latent conditions result from sanctions or decisions made by administrators or others in leadership positions that affect technical issues, organizational policy or the allocation of resources. These errors are called latent because of the delayed and unintended consequences that may affect patient safety at a later point. Technical error occurs when there are problems with equipment, forms, labels, etc. (e.g. a computer does not print out patient identification labels in a timely manner). Organizational error can be related to various, often complex issues involving management priorities and organizational culture. An Example of a latent error would be an organizational decision not to use a computerized provider order entry system which results in a high number of medication errors related to illegible handwriting. Other Error (Unclassified): A third category in the Einhoven Classification Model accounts for errors that cannot be classified as active or latent. In health care, such errors are generally due to patient-related factors that contribute to error, for instance, if patient gave the history of allergy and this can lead to potential medication error. An error whose cause cannot be placed in any category (i.e. latent, active, or patient-related) is termed unclassifiable. In order to continuous quality improvement and promote patient safety culture it is necessary to promote culture of reporting of errors is the first step along with a constructive process towards understanding that what factors within a system enable an error to take place. This systems approach is gaining ground and many hospital administrators are becoming well versed in its theory and practice. To promote a culture of safety the leadership of an organization promulgates an atmosphere in which the reporting of errors is welcomed, so that others may benefit from knowledge of the situation and can develop strategies based on the data. A major element of this framework is a non-punitive stance towards the individual who reports or who has involved in an incident. In a just culture an organization lets its employee know that they will not be disciplined for making mistakes and that the leaders value the importance of learning from mishaps and seek to improve the system that allowed the m to occur. Recommendation Based on sentinel event which I address in my position paper and in light of literature, I would like to recommend few suggestions/ recommendations to strengthen our quality system. First in order to promote in healthcare organization, major emphasis required in order to create non-punitive environment where health care workers can report events, errors and near misses without fear of reprisal or disciplinary action. Next, the risk management forum should be structured at organizational level where relevant multidisciplinary key stake holders should identified in order to take ownership and facilitate clinicians and organizational managers at all levels, the in order to create such an atmosphere which promotes patient safety culture in an organizations. Needs to develop and implement a reporting system that encourages and enhances reporting by all department and staff. Educate all clinicians, staff, and management personnel on the nature and importance of the event reporting process, including disclosure and discovery issue. Needs to do timely and accurate documentation of sentinel events help organizations improve their safety and quality of care and learn from other organizations unexpected outcomes, which allow other health care organizations to be aware of the possibility of certain sentinel events, thus giving staff the time and knowledge to develop strategies to avoid these events before they actually occur. Utilization of event report data to trend and analyzes organizational risks and distributes this information to appropriate staff of the organization so that risk-prevention measures can be developed and implemented. Last but not least provide clinicians and staff ongoing feedback on their risk-reduction efforts, results of event reporting should be discussed at the departmental level, and input on corrective actions/process improvements should be solicited. Conclusion: In conclusion, I must say that errors can occur at any point in the health care delivery system. Acknowledging that errors, learning from those errors, and working to prevent future errors represents a major change in the culture of health care, a paradigm shift from blame and punishment to analysis of the root causes of errors and strategies to improve systems and processes by implementing patient safety measures which provide an objective, validated measure for identifying Potential Safety Issues. Management should make an effort to break down barriers by adopting non-punitive cultures based on industry best practices. This will sheds new light on traditional methods for removing reporting barriers, develop employee commitment to recognize and report errors or incident occurrences. When the staff proactively participates in reporting, the reporting process becomes a vehicle for making practices improvements in the delivery of patient health care and management receives information that otherwise would not be available. As one manager said, if nobody reports it, you dont know. When some occurrences are not reported, management receives limited information on which to base their decision. It goes without saying that better data mean better decisions. According to Daniel (2004) the goal should be not only to increase the number and quality of reports but also to increase their usefulness as rich sources of information for the generation of strategies tactics aimed toward medical-error reduction (p. 27). According to Minesota Alliance for Patient Safety (2005) safety culture is not blame-free approach; it is an approach that balances the need to promote open reporting and the need to hold practitioners accountable for their behavioral choices. Hospitals should identify potential safety issues, having proactive approach, measure baseline performance, and set priorities for process improvement efforts. Using this methodology, hospitals can implement patient safety program with minimal investment on their part. Informational reports can be generated and disseminated to proactively identify safety issues and drive improvements for the better health care outcomes.

Transmission of Livestock Diseases to Humans Essay -- Health Science P

Transmission of Livestock Diseases to Humans For decades now, death and disease have driven the progress of technology. Through the advancements of science, many diseases have been made obsolete and many more are drawing closer and closer to being conquered. However, with all the diseases that we have defeated, more and more keep appearing. And old diseases that we thought we were protected against have made comebacks. An example of this is Foot and Mouth Disease. "Since 1930 the United States of America has prohibited the importation of livestock and fresh, chilled, or frozen meat from countries in which rinderpest or foot-and-mouth disease exist," (Publication 1343, 49). The United States is considered a Foot and Mouth Disease Free country. However, that does not mean that we have not been active in trying to get rid of FMD in other countries. There was an Argentine-United States Joint commission on FMD held in 1966. In a report on this meeting it was stated that, "The conditions under which the virus of foot-and-mou th disease (FMD) survives in animal tissues have long been matters of fundamental interest to all officials concerned with the prevention and control of the disease," (Publication 1343, 3). There was a CENTO Seminar on Viral Diseases held in Istanbul, Turkey on June 12-17, 1972. This seminar had a special emphasis on FMD and rinderpest-like diseases. A discussion of disease-free zones and the regulations for these zones was brought up (Girard 93). Some of the stated regulations included complete control of domestic livestock movement, traffic of persons to and from an area that has been quarantined should be restricted and if an outbreak would occur, no animals can be exported, all the animals in... ...ases. Vol. 7, Issue 4. Jul/Aug 2001. Petersen, Lyle R. & John T. Roehrig, Guest Editors. â€Å"West Nile Virus: A Reemerging Global Pathogen.† Emerging Infectious Diseases. Vol. 7, Issue 4. Jul/Aug 2001. Sibbald, Barbara. "Quebec Clear Way for Use of Aerial Pesticides to Combat West Nile Virus." CMAJ: Canadian Medical Association Journal. Vol. 165, Issue 4. 8/21/2001, p. 463. Tyler, Kenneth L., M.D. â€Å"West Nile Virus Encephalitis in America.† The New England Journal of Medicine. Vol. 344, No. 24. June 14, 2001. Weir, Erica. â€Å"Foot and Mouth Disease in Animals and Humans.† Canadian Medical Association Journal. Vol. 164, Issue 9. 5/1/01 Yang, Joo-Sung, et al. â€Å"Induction of Potent Th1-Type Immune Responses from a Novel DNA Vaccine for West Nile Virus New York Isolate (WNV-NY1999).† The Journal of Infectious Diseases. Vol. 184, 2001.

Workplace Incivility

Select and complete one (1) of the following assessments from your text: †¢ Box 8. 2: Workplace Incivility Scale I selected this exercise since my organization recently had a change in leadership at the highest levels. I thought to compare/contrast the Incivility Scale under the old and new regimes. I concentrated on my interactions with my superiors. | |Old Leadership |New Leadership | |Put you down or was condescending to you? |Yes. This was a frequent occurrence at staff |No. | |meetings | | |Paid little attention to your statement or |Yes. This was a frequent occurrence at staff |No. | |showed little interest in your opinion? |meetings | | |Made demeaning or derogatory remarks about you? |No. The boss always separated his professional |No. | | |feelings from personal ones. He frequently | | | |would question you professional competence, but| | | |would not cross the line into a personal | | | |attack. | | |Addressed you in unprofessional terms either |Yes. This seems to be at odds with the above |No. |publically or privately? |statement, but these did not seem to be a | | | |personal attack. | | |Ignored or excluded you from professional |No. This does not really apply in my situation|No. This does not really apply in my situation| |camaraderie? |because of the differences in ranks. |because of the differences in ranks. | |Doubted your judgment on a matter over which |Yes. Was very vocal about it during staff |Yes. This still occurs at staff meetings, but | |you have responsibility? |meetings. |with a different tone. It is not so much a | | | |doubt in judgment, but more of an â€Å"are you | | | |sure† second check. | |Made unwanted attempts to draw you into a |No. We never had this sort of relationship. |No. We never had this sort of relationship. | |discussion of personal matters? | | | | | | As can be seen above, there have been a wholesale change in the leadership style in my organization. Everyone that has been promoted to a leadership position has had to attend at least one Leadership Continuum (more likely, he has attended at least five). One of the core concepts that is taught is the theory to â€Å"Praise in Public, Shame in Private. It has constantly amazed me how many leaders never picked up on that lesson. I try to embrace that lesson with my subordinates in all of my interactions. With the new leadership in place, we seem to produce the same output as before, but with a hi gher morale level. The new boss still challenges your professional judgment to keep you on your toes, but it is accomplished in a far less confrontational manner. In conclusion, It seems as if the Incivility Scale for my organization has shifted significantly in the â€Å"civil† direction [pic]

How to Get Rid of Chiggers in Your Yard

How to Get Rid of Chiggers in Your Yard Chiggers  measure a mere 1/150th of an inch  and so are nearly impossible to see with the human eye. But there is an easy way to sample your yard for chiggers if youre concerned about a possible chigger mite infestation. Be sure, of course, to wear appropriate clothing and repellent whenever you walk through an area that may have chiggers. Theyre also called harvest mites, harvest lice, and red bugs. What Do Chiggers Look Like? The tiny arachnids are found in a range of warm colors, from straw to yellow, to orange and red. You might see them in groups or moving on your legs (or you might see the welts from their bites). The larvae are the ones that bite; they have six legs. They dont have eight legs until theyre adult. Chigger Sampling Test Your first step, of course, should be confirming that you have a chigger infestation in your yard. If youve experienced the incessant itching of  chigger bites  after spending time outdoors, youll know it. But if you arent sure whether youve got chiggers or not, you can do a  quick sampling test  to confirm the offending pests are, indeed, chiggers. Before you do the test, dress preventively; otherwise, youll find the chiggers with your legs instead of your test item. Chiggers prefer moist, shady areas with thick vegetation, so focus your sampling efforts on these places in your yard. Dont bother sampling for chiggers in areas that get full sun  or where you keep the lawn mowed short. To sample your yard for chiggers, youll need one or more squares of black cardboard, each about 6 inches by 6 inches. Stand the cardboard squares on edge in areas where you suspect chiggers may be. Leave the squares in place for several minutes. Then, look closely at the cardboard. If chiggers are present, they will climb up the cardboard and gather near the top. The chiggers will be tiny and either red or yellow in color. You can also leave a shallow bowl of water in the grass for a few minutes, which will attract them as well. Look for them around the rim. You may need a magnifying glass to see them. Get Rid of Their Habitat If you find a heavy infestation of chiggers in an area of your yard, you should take steps to eliminate them. Youll definitely want to avoid walking through those areas of your yard. The best method to control chiggers is to eliminate their habitat on your property. Widespread use of pesticides to get rid of chiggers is rarely required or recommended. Again, most chiggers prefer moist, shady areas with thick vegetation. Some species do like dry areas, so keep that in mind. Prime chigger habitat includes overgrown lawns, ground covers, leaf litter, weedy areas, and densely planted shrubs or trees. Chiggers tend to cluster in certain areas because  the small females lay their eggs in one location. You may find an abundance of chiggers in one area and a complete lack of chiggers in an equally suitable area nearby. So how do you get rid of chiggers in your yard? Maintain a neat and tidy landscape, specifically: Mow your lawn regularly and keep it short, especially around the edges where the grass meets landscape beds or woody areas.Keep landscape beds weeded, and remove accumulated leaf litter.Trim and prune landscape plants regularly to keep them from becoming overgrown.Remove brush piles from your property.Because chiggers avoid sunny areas, eliminating shade in your yard can reduce chigger populations. If you feel you must treat your property for chiggers with pesticides, please  do so responsibly and safely: Treat only areas of your yard where chiggers are confirmed to live.Dont overuse pesticides by treating your entire lawn or yard.Chigger control usually requires multiple applications of pesticides during the spring.Keep children and pets off treated areas until it has dried completely. Dont allow animals to eat treated plants.Contact your local cooperative extension office to get information about which pesticides work best for chiggers in your area  and how to safely apply them.Always follow all directions on pesticide labels. Remember, the label is the law! Get Rid of Chiggers on You You might find the little red bumps on your legs or the bugs themselves. Especially check necklines, shirt and pant cuffs, and the tops of your socks.  If bumps or chiggers are found, wash your skin with soap and water in the bath or shower, and wash your clothes in hot water. Also, throw in  the wash any towels or blankets that touched the ground. The bumps will go away with hydrocortisone cream, allergy medication, or rarely, a steroid injection given by your doctor and antibiotics if the sores become infected.   On Your Pets and in Your House For your pets, wipe off  their face with a soft cloth or vet-recommended wipe. Longer, denser  fur should keep the rest of their body protected. If they do get bit, give them a warm bath. Seek treatments for the itching from your vet, as home remedies added to bathwater that is espoused online, may not work.  Ã‚   Hot water helps rid your house of chiggers as well; clean with soapy water thats at least 120 degrees Fahrenheit. You can also use a carpet shampooer that has a heat setting.   Prevention Wear long sleeves and pants when walking in tall grass, tucking your pants into your socks, and use insect repellants. Wear thick socks and high shoes or boots. If you can stand the smell, dust your socks with sulfur powder or the inside of your shoes. Stop your hike every half hour or so and brush off the places where chiggers would congregate, at the edges of clothing. Indoors, just vacuum regularly.  For  your pets, bathe them with soaps that contain flea and tick repellants.

Health Economics Example

Health Economics Example Health Economics – Book Report/Review Example Health Economics The economic trend as discussed in the newspaper tends to favor employee expenditure. This is because of the cut cost of healthcare expenses that makes health cover affordable to employees. According to Kaiser family foundation survey, more than 75% of employees receive health cover from their employers based on a percentage deduction from the salaries. The gradual premium growth in healthcare expenditure is fit for both employees and employers though risky to the economy. The continuation of the medical economic trend is due to weak economy and this may in future turn to be a burden to both the employee and employers. At some point, weak economies tend to raise costs of service rendering costs to meet up to the economic stability (Feldstein, 56). Employee deductibles will continue to rise with the gradual increase in healthcare expenses, as employers have nothing to lose but to update employee deductible percentage in line with the increased medical expenses.Accordi ng to the health economists, the slowdown in medical expenses is a big risk to the economy and premiums are rising gradually in relation to the survey. Currently, employee deductibles are rising gradually and this is set to shoot sooner than expected. This can be proven by the unrealized increase in health insurance between a span of one year. Actually, the health cover premium increased by 3% between 2013 and 2014 hence calculating the increase in about five or tears to come, the percentage will rise to shock employees. The percent increase in healthcare premiums realized in 2013-2014 provides a standard percentage to be multiplied by the estimated years in the bid to understand the premium increase trend.Work citedFeldstein, Paul J. Health Care Economics. Clifton Park, NY: Delmar Cengage Learning, 2012. Print.