...This Case study is an example of what happens when life gets in the way. Mr. Rogers originally called a meeting with Jeff Dean and Celeste Brown to go over any questions the Mr. Dean had in regards to the survey findings. Mr. Rogers had to excuse himself from the meeting for personal reasons and instructed Ms. Brown to find out what questions Mr. Dean had. He then instructed her to run the analysis and they would go over the results the following day. Ms. Brown ended up with six questions that Mr. Dean was especially interested in. (Burns, A., Bush, R. (2006) p518) The problem with this case study is even though Ms. Brown may be a competent employee she isn’t Mr. Rogers. Mr. Rogers called the meeting and has his own agenda in regards to the survey findings. Unless Mr. Brown and Mr. Rogers are on the exact same page she may not be able to determine the right questions that Mr. Dean may ask: furthermore, her analysis may be in complete depending on what information she has taken form Mr. Dean. Mr. Rogers should have rescheduled the meeting so that he could ensure all pertinent areas regarding the results of the survey and questions were adequately addressed. The strengths of this case are apparent in that it is assumed that Ms. Brown has a good understanding of what Mr. Rogers wants. If she is able to accurately gather the information from Mr. Dean in regards to his concerns about the survey, then her analysis should be accurate: however this will not be known...
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...American Economic Association Auctions Versus Negotiations Author(s): Jeremy Bulow and Paul Klemperer Source: The American Economic Review, Vol. 86, No. 1 (Mar., 1996), pp. 180-194 Published by: American Economic Association Stable URL: http://www.jstor.org/stable/2118262 Accessed: 14/10/2008 10:06 Your use of the JSTOR archive indicates your acceptance of JSTOR's Terms and Conditions of Use, available at http://www.jstor.org/page/info/about/policies/terms.jsp. JSTOR's Terms and Conditions of Use provides, in part, that unless you have obtained prior permission, you may not download an entire issue of a journal or multiple copies of articles, and you may use content in the JSTOR archive only for your personal, non-commercial use. Please contact the publisher regarding any further use of this work. Publisher contact information may be obtained at http://www.jstor.org/action/showPublisher?publisherCode=aea. Each copy of any part of a JSTOR transmission must contain the same copyright notice that appears on the screen or printed page of such transmission. JSTOR is a not-for-profit organization founded in 1995 to build trusted digital archives for scholarship. We work with the scholarly community to preserve their work and the materials they rely upon, and to build a common research platform that promotes the discovery and use of these resources. For more information about JSTOR, please contact support@jstor.org. American Economic Association is collaborating with JSTOR to...
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...often preventable. When such events transpire, it is necessary to fully assess the situation so that these errors can be prevented in the future. Root cause analysis (RCA) is a tool employed by healthcare facilities to analyze adverse events and the systems that lead to them. A. Root Cause Analysis “A central tenet of RCA is to identify underlying problems that increase the likelihood of errors while avoiding the trap of focusing on mistakes by individuals” (AHRQ, 2012). The emphasis of RCA is on error prevention. It is a structured process of gathering data regarding the event, analyzing the information, and finding solutions to the problems to prevent reoccurrences. A team consisting of the charge nurse, a physician, a respiratory therapist, a pharmacist, hospital administrators, and patients not involved in the case is assembled to work through the process. The team begins by interviewing patients and staff involved to gather as much vital information as possible. Once all necessary information is compiled, the team works together to get to the root(s) of the problem. In the case of Mr. B, there were multiple issues that led to the adverse event as opposed to one root problem. In the process of defining the problem, several causal factors were identified. The error was a result of both facility and human error. Mr. B, a 67-year-old patient, presented to the small, six-room, rural hospital ED due to severe pain in his left hip following a fall. In his quest for care...
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...QUESTION TWO: ADULT CASE STUDY, AN ETHICAL ISSUE OF CONSENT. This essay presents a critical incident analysis of a 70 years old man refusing to give consent to a life saving treatment. The essay will discuss its impact by discussing the conflict between professional and the patient’s issues. It will go on to explain the main professional issues in the scenario, breach of any NMC code of conduct and show how they relate to the guidelines set by Nursing and Midwifery Council (NMC). It will also highlight on the relevant underlying legal or ethical principles that applies to the case study and its implications. For instance, ethical principles, such as beneficence, non-maleficence, autonomy, justice, human rights and the best interests of the patient will be explored, in the light of relevant laws, in order to show some of the legal and ethical complexities within this case study, and finally draw a conclusion. For confidentiality purposes, have been changed in accordance to the NMC guidelines. The main professional issue reflected in this case study is the issue of consent. Consent, means to give permission for something to take place or to agree to do something (oxford dictionary 1998). This does not necessitate that, the actions approved have been developed or permission given in the knowledge of possible consequences known as informed consent has been achieved. This goes to show that, for medical purposes, although the patient has the right to refuse treatment, he has to also...
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...Self-Management in Chronic Illnesses: A Concept Analysis Dianne Rinehardt Chamberlain College of Nursing NR501: Theoretical Basis for Advanced Nursing Practice November 2015 Self-management in Chronic Illness: A Concept Analysis Globally, the human species is experiencing longer life-spans. As the number of persons with extended lifespans increases, so does the prevalence of those living with chronic illnesses. With the inception of the Patient Protection and Affordable Care Act (ACA) in 2010, there has been a paradigm shift in the focus of healthcare from treatment to prevention. The origin of this paradigm shift occurred when traditional provider-directed/patient compliant approach failed to produce the outcomes that were expected (Udlis, 2011). Transforming healthcare from a treatment modality to one of prevention assumes that each person will be actively engaged in the prevention of chronic illnesses. Dorothea Orem’s self-care and self-care deficit nursing theory is based on the premise that people are naturally inclined towards self-care and that nursing should be focused on identifying and correcting any self-care deficits. Orem defined self-care as, “care that is performed by oneself for oneself when one has reached a state of maturity that is enabling for consistent, controlled, effective, and purposeful action” (Orem, Taylor & Renpenning, 2001, p 149). Orem’s self-care and self-care deficit theory is directly applicable to the concept of self-management...
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...Analysis of Nursing Indicators Related to Lapses in Nursing Care name name Western Governors University Nursing-sensitive indicators are areas of data collection which have been empirically shown to correspond to patient outcomes; “NSI reflect the structure, process and outcomes of nursing care.” (Nursing World, 2015). These data are collected in many types and locations of medical and nursing facilities and nursing units, which report their data to The National Database of Nursing Quality Indicators (Nursing World, 2015). Units and facilities which submit to and participate with the NDNQI have a means to compare their Nursing Sensitive Indicator data to national data standards. Nurses who have an understanding of NSI in this case may be more attuned to NSI that relate to the care of their patients; ie, the rate of use of restraints, patient fall rate, and pressure ulcer rate at their facility versus national standards and goals (Nursing World, 2015). Nurses and CNAs who understand that nursing indicators are reflective of good nursing care and good patient outcomes can more effectively focus their efforts in the care of patients. In the case of Mr J, issues in the narrative describe a CNA who does not recognize signs of a pressure ulcer, does not implement repositioning, and a RN/CNA team who do not advocate for the discontinuation of restraints in an oriented patient. Further, the concerns of Mr J’s daughter for the condition of his skin as well as a dietary mistake...
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...Organizational Systems and Quality Leadership Task 2 Jill Riccobono Western Governors University Organizational Systems and Quality Leadership Task 2 A. Root Cause Analysis A root cause analysis (RCA) looks at an event and considers what happened, why it happened what will be done to prevent it from happening again and how will we know that the changes made will improve the safety of the system. It takes into consideration causative factors, errors and hazards that led to a sentinel event. In this case it was a patient’s death. RCA should not look to place blame on people, but rather processes that need to be improved. The first step in a RCA is to identify what happened. In the scenario, presented in this task, the patient was over sedated and subsequently died. Step two is to identify why this happened. There were preventable causative factors, or errors, that led to this sentinel event. The hospital’s conscious sedation policy requires that the patient remains on continuous BP, ECG, and pulse oximeter throughout the procedure and there was no mention that this was performed at all throughout the procedure. It was not until after the procedure that Mr. B was placed on continuous BP and pulse oximeter, and at that time, the patient was left in the room, with only a family member while Nurse J attended to another patient. When the alarm is heard that the patient has low O2 sats, the LPN, enters the room and resets the alarm and repeats the B/P reading. His oxygen level...
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...The Unfortunate Hospital Experience for Mr. B Identification of Events * Mr. B presents to the Emergency Room with complaints of Left hip and leg pain * His son is at the bedside * Dr. T assesses Mr. B determining that he needs to set Mr. B’s hip at the bedside. * Dr. T orders moderate sedation * Mr. B takes oxycodone for chronic pain * Nurse J is assigned to care for Mr. B * Nurse J administers medications per Dr.T’s orders * 5 mg of Diazepam * Dr. T assesses Mr. B’s sedation level. Mr. B needs more sedation * Dr. T orders additional sedation medication * 2mg of Hydromorphone * Nurse J administers additional sedation medication per Dr. T orders * Mr. B is not fully sedated and Dr. T orders a 3rd dose of sedation medication * 5 mg of Diazepam and 2 mg of Hydromorphone * Dr. T assesses Mr. B. * Mr. B is fully sedated for the procedure * Dr. T reduces and sets Mr. B’s left hip * Mr. B’s procedure is completed. He appears comfortable and remains sedated * The Emergency Room receives an emergency dispatch call * Pt. in respiratory distress * Nurse J needs to respond to the call. * Nurse J puts a blood pressure cuff on Mr. B with 5 minute cycles and places the pulse oximeter on Mr. B * Son remains at bedside * Nurse J leaves the room to care for the patient in respiratory distress * Mr. B’s pulse oximeter alarm goes off “ low...
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...into the city of a large retailer, a sudden explosion of workers resulting in a substantial increase in the cost of labor. All things had a negative effect on Guillermo’s bottom line. Discussion: The essence of any business operation is to maximize profits. This is only achieved when the business is able to meet its recurring costs and have a surplus available for reinvestment or payment as dividends to the owners. Guillermo’s case requires a critical investigation into the business operations to determine available to him. Given the current situation, Guillermo has three very viable options to consider. He could either maintain the present business model and continue operations as currently constituted, or adopt a new business model by embracing high technology and thus investing in highly automated machines similar to what the competitor is using or change his operations and instead become a broker to one of the big competitors who is looking for an entry point into the North American market. In business, a sensitivity analysis is a business interrogative technique that allows one to change certain variables affecting a business in order to determine how the business will be in the...
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...of conduct: Mr. Lyons suggested to a client during his initial meeting with her regarding a dissolution of marriage, that she should work as an escort. He then proceeded to harass her with requests to have an affair with him or engage in various sexual conduct with him over the next several months she was his client. This behavior culminated in the client assisting law enforcement by accepting money from Mr. Lyons for sex in a police sting. Furthermore, Mr. Lyons coerced a client into a sexual relationship whom he was representing pro bono through a women’s shelter resulting in her relapsing and losing custody of her children. He also coerced another client into a sexual relationship which including offering payment for sex and committed an assault and battery upon her. In an incident unrelated...
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...Critical reflection of a nursing incidence Name Institution Introduction This report focuses on a critical analysis of scenario related to management in nursing and how it can impact on knowledge skills and experience. The incidence which is analysed in this report is one of my encounters during my placement. Confidentiality and privacy have significantly been emphasised in the area of nursing. The Nursing and Midwifery council outlines a strict code of ethics which should be adhered to by all the nurses in their daily practices and interaction with both colleagues and patients(NMC, 2008). Within the code, it is emphasised that nurse should respect the privacy and confidentiality of the patients. Based on this, the report shall adopt a pseudonym; Mr. Jason, in place of the real name of the patient. Additionally, this report shall adopt the Gibbs (1998) reflective cycle model. The model allows nurses to think systematically over the faces of a given experience. The model involves six components which include description, feelings, evaluation, analysis, conclusion and action plan in that order. This model allows nurses to assess their behaviour, emotions and thoughts when they encounter challenging situation. Gibbs (1998) insists that while using the model to reflect on an event, the components should be used as subtitles for particular phases. As such, this report outlines the reflection in the stages below. Description In my second placement when I was in third...
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...Critical reflection of a nursing incidence Name Institution Introduction This report focuses on a critical analysis of scenario related to management in nursing and how it can impact on knowledge skills and experience. The incidence which is analysed in this report is one of my encounters during my placement. Confidentiality and privacy have significantly been emphasised in the area of nursing. The Nursing and Midwifery council outlines a strict code of ethics which should be adhered to by all the nurses in their daily practices and interaction with both colleagues and patients(NMC, 2008). Within the code, it is emphasised that nurse should respect the privacy and confidentiality of the patients. Based on this, the report shall adopt a pseudonym; Mr. Jason, in place of the real name of the patient. Additionally, this report shall adopt the Gibbs (1998) reflective cycle model. The model allows nurses to think systematically over the faces of a given experience. The model involves six components which include description, feelings, evaluation, analysis, conclusion and action plan in that order. This model allows nurses to assess their behaviour, emotions and thoughts when they encounter challenging situation. Gibbs (1998) insists that while using the model to reflect on an event, the components should be used as subtitles for particular phases. As such, this report outlines the reflection in the stages below. Description In my second placement when I was in third...
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...has created implications for employers who must review the terms of their employment contracts and reconsider their pre-termination processes, and doubt relating to the scope and operation of the term. Facts: Mr Barker was employed as an executive manager at Commonwealth Bank of Australia (CBA); he had a considerable period of service with the bank. In 2009, the CBA undertook a nationwide restructure of its corporate financial services unit, causing Mr Barker’s position made redundant. Its redeployment policy was to reallocate employees to a suitable position where possible, however the banks HR manual provided that the policy did not ‘form any part of an employee’s contract of employment’. Mr Barker was informed that his position had become redundant and he was told that his employment would be dismissed in one month if another position was not found within CBA. On his notification of redundancy, Mr Barker was told to clear his desk, return his keys and phone and told that he was not to return to work, his access to CBA's email and intranet was also revoked. The staff members accountable for assisting Mr Barker with redeployment tried to make contact with him via his work email and phone number, which he did not have access to. It was only shortly before Mr Barker's employment was due for termination that the staff...
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...Vargus Western Governor’s University Organizational Systems RTT Task 2 Questions A The main goal of Root Because Analysis is to identify the policies and procedures in an agency that can be changed for the better. These changes are identified within an organization and a plan is put into place to prevent any reoccurrences of negative outcomes. RCA is defined as a “process for identifying the basic or casual factors that underlie variation in performance, including the occurrence of a sentinel event; it focuses primarily on systems and processes, not individual performance” (Cherry and Jacon, 2011, p. 442). A multidisciplinary team must assemble and pinpoint the exact causation of the problems. After the issues have been identified the next step is to determine refinements to prevent them from occurring again. Mr. B arrived at the Emergency Room after he had a fall in his home. The sixty-seven-year-old man arrived to the 6 bed, small town ER with his son and neighbor in a severe amount of pain in his left hip and leg area. There are several unfortunate reasons that lead to Mr. B’s demise. The information gathered to complete the RCA will determine the causation of this ill-fated situation. I will discuss these factors in further detail ahead. The first factor in this case I will discuss is the lack of education on hospital policies and procedures. Mr. B was placed under conscious sedation and therefore he should have received increased assessments and observations...
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...Brochure More information from http://www.researchandmarkets.com/reports/680564/ The Top Five Global Pharma Companies; Where they are Now and Where they heading? Description: A mini report identifying drivers and barriers to sustaining financial performance over the next 5 years for the top five global pharmaceutical companies -Johnson & Johnson, Pfizer, GSK, Novartis and Sanofi-Aventis This report presents the cases of the top five global pharma companies: J&J, Pfizer, GSK, Novartis and SanofiAventis and identifies their key growth areas. Pooling data from 6 major investment institutions, it delivers a 360o analysis on these big five global pharma with further value add and refinement coming from 8 leading key opinion leaders, to produce an easy to read 25 page PowerPoint deck. Johnson & Johnson has reached a critical point in its product portfolio which should see the company convert from “cash cow” (high market share; low market growth) to “star” (high market share; high market growth) status by 2010. This is reflected in J&J having not less than 6 late stage drugs that will either unveil phase III data or be filed with the FDA within 2008 culminating in strong impact on its P&L account by 2010. Likewise the other cash cow Pfizer, boasts of at least 17 disclosed products under late phase development, with launches in the post-2010 period, thus are likely to buoy double digit sales growth beyond Lipitor patent expiry. GlaxoSmithKline on the other hand, has a product portfolio...
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