Is early recognition of deterioration in vital observation effective Dissertation

Is early recognition of deterioration in vital observation effective in identifying critically ill patients in hospital - Dissertation Example y evaluate research that describes or appraises the nursing practice of taking and recording physiological observations (Vital signs) in the detection of deteriorating hospital patients. Background. Nurses are required to recognise early clinical deterioration in patients and call emergency support. However, there is increasing recognition that indicators of deterioration in acutely unwell patients are being missed and referral delayed. The reasons for this are unclear and require exploration. Failure to recognize or act on deterioration of hospital ward patients has resulted in the implementation of early warning scoring system and critical care outreach teams. Design. A comprehensive review of the literature. Methods. Critical review as the research methodology was used as the dissertation topic required a comprehensive collection of research evidence. The literature was searched using different sources: such as electronic databases, reference lists, key reports and experts in the field. Medline, CINAHL, Embase and Cochrane databases were searched from January 2001–2011. Ten papers were selected that most clearly reflected the research aim. Each paper was critically appraised and systematically assessed. Major themes and findings were identified for each of the studies. Result. Early warning systems and physiological monitoring processes help ensure the early detection of critical illnesses among patients. Conclusions. Early warning systems with appropriate applications of vital signs and other physiological monitoring processes are crucial tools in the early assessment of critical care patients. Relevance to clinical practice. The studies establish the importance of using early warning systems and physiological monitoring processes to detect symptoms which... The paper tells that vital signs are significant components in monitoring the patient’s progress during hospitalisation as they allow for the timely detection of delayed recovery or adverse events. These vital signs, or patient observations, usually consist of blood pressure, temperature, pulse rate and respiratory rate. While the measurement of vital signs has become an accepted component of any hospitalisation, the optimal practice is yet to be determined. A preliminary search of the literature indicated that there were a vast number of published articles relating to this topic; however there had been few previous attempts to review critically this literature. This review was initiated to identify and summarise the best existing evidence relating to the use of vital signs by nurses to monitor hospital patients. The dissertation starts by highlighting and discussing the particular issues surrounding early recognition of deterioration using vital observation by other studies. This has assisted the writer to clarify the dissertation aims, objectives and methods further. The methodology section has provided details of a robust strategy deployed in collecting, organising and analysing secondary qualitative data. This has been followed by the result section where collection of data and discussion of results was carried out in the light of the writer review objectives. Finally in the conclusion section, a summary of the overall findings of the review and implications for NHS policy and future research will be provided.

Writing a report about 4 presentations and discuss them each Coursework

Writing a report about 4 presentations and discuss them each presentation 2 pages - Coursework Example n time we may become addicted to the internet and this presentation allowed us to judge our usage of internet and whether we need to take steps to curtail our growing addiction. This topic is very important and should be taken up by every class. In terms of the presentation, I very acutely felt that at this level, groups should not be reading material from their notes or slides. They should come well-prepared. Even though the group was well dressed and presentable, they did not focus on delivering a strong presentation. The group was not very professional in my opinion and one member was too quiet. The final speaker did not seem well-rehearsed. Since the final speaker was not very convincing, at the conclusion, the presentation seemed to fall apart. Since the last part remains in the minds of the viewers the most, the presentation became weak due to this. The beginning and end should always be strong to retain interest of the viewers. The good point of the presentation was the fact that the group was able to properly define the scope of their topic. In this way, they were able to exclude irrelevant information which made the presentation crisp and easy to understand. This also made the conclusion clearer and easier to grasp. However, the presentation lacked a little due to the fact that it was not very interest grabbing. If the group had included case studies in the presentation, the topic would have become more interesting and the students would have taken the concept home. They could have taken people from their own surroundings and researched on them. A profile of these addicts could have been developed which would have made the presentation more appealing to us- the viewers. Apart from that, the research depended on scholarly research which made the research more credible. Additionally, the content was up-to-date and taken from 2011 studies which was another good point. This aspect of the research made it convincing and created a professional look of the

Management case study Example | Topics and Well Written Essays - 500 words

Management - Case Study Example There is a feeling of job insecurity. Shank’s social needs have not been met too by her previous employer. She did not feel a sense of belonging because the owners just did not seem to care about their employees. Shank’s esteem needs were not satisfied too. The company did not show any appreciation for their employees. She did not feel that she is being valued as an employee and she felt that she was taken for granted; thus, her self-esteem and personal worth was at a low. Her ideas were not important to management. Even her self-actualizing needs were not met because they were not concerned with her personal growth. There are several things that can be done to meet these missing needs such as recognizing achievements of employees through promotions, bonuses and salary increases, so they will feel appreciated and valued. Job security should also be provided for including the giving of retirement benefits. Management should also provide employees opportunities to reach t heir full career potential. Use the Expectancy Theory and/or the Equity Theory of motivation to explain how feeling underpaid might affect the work of a Flight 001 associate and what a manager can do to increase the employee's motivation.

Same sex marriage shoul not be allowed Essay Example | Topics and Well Written Essays - 500 words

Same sex marriage shoul not be allowed - Essay Example ive demographic change, it is quite twisted and bizarre to claim that it is the role of married couples to procreate just to keep the stability of the western civilization. Plus, its much exaggerated. The main area in the article that is quite vague is that which speaks about the role of married heterosexual couples in driving and maintaining the western stability by procreating and having more children. The author refers to it as a role for them to carry out and fulfill, and this perception seems quite distorted and untrue. Moreover, it is stated that an acceptance of homosexuality will bring about the decline of western civilization, as the denouncement of it enabled the creation and continuance of this civilization. Although having a wrong perception of the situation, the source does seem credible. It does not only present facts meant to convince and persuade readers to agree with it, but also presents some opposite opinions and fact, such as the one about the MCCs acceptance of gay marriages. The main fallacy presented by the author once again has to do with the role of the heterosexual and married couples in maintaining the stability of the western civilization by their procreating and delivering more children. The author claims that that is what has kept the western civilization throughout the centuries, and this is clearly false and exaggerated. One argument the author makes is that men and women are uniquely biologically compatible, and explains his claim by saying that the human body can identify the intrusion of any unknown or alien matter into it and destroys it. However, the mans semen contains something that enables it not to be destroyed by the womans body, hence bringing forth the possibility of creating a baby. The conclusion of the author in the article is that marriage is a tool which leads to having children, and since the bond of "two become one" exists biologically and historically only between men and women, marriage of homosexual couples

How the content of this web page relates to the materials presented in Assignment

How the content of this web page relates to the materials presented in Chapters 11, 12 and 13 - Assignment Example Wal-Mart’s service delivery and commitment to satisfying their customers is expressed on this web page by saying that their energy, passion and respect for individuals are some of their core values in service delivery. This web page also shows Wal-Mart’s commitment to the community sense of belonging whereby they have sites that show their commitment to protecting the environment, helping others especially the less fortunate, community investment and supporting people. This web page basically advertises careers for people looking for employment, also how Walmart as a whole has different sections all under one roof. This is covered under job enrichment. This explains how variety, identity and significance contribute to motivating a worker through the job itself. This self-motivation is evidently brought out on Walmart’s web page when they say that their entrepreneurial spirits drive them to grow and innovate daily. This is covered under recruitment strategy and policy. This involves recruiting skilled, semi-skilled and unskilled employees. Walmart’s page shows this recruitment policy by advertising jobs online and the jobs are offered in different locations for different people and it can be easily accessed online. This is covered under a collective bargaining power of unions. Since Walmart has different employees from different places all over the country, they always try to give them a collective voice to help them air their views and complaints to the management, and this is clearly seen under Walmart’s core values which include treating employees equally and respecting them too. This is well covered under open communication. Walmart web page offers an open kind of communication in that job application can be done through online and when they also say that they walk the talk to mean that whatever they say they act on it or put it into action. This can be discussed

Aviation Organization in Nigeria Research Paper

Aviation Organization in Nigeria - Research Paper Example Women workforce in Nigeria would aid the development of its economy as women have started taking tertiary education. Third, it is also important to understand the difference in the managers’ attitudes to work, in both Nigeria and the United States. This is important as many MNCs have expanded their operations in developing countries and employ both local and expatriate managers. The managers need to have an in-depth understanding of how to manage diversity because decisions on issues such as recruitment and training, promotions and retentions, could vary. Managing diversity could mean utilizing the differences to gain competitive advantage. It not only helps in recruitment and employee retention, it also leads to reduced turnover and absence costs, enhanced customer service and greater flexibility and creativity in the organizations (Maxwell, 2004). Nigeria is the most populous African country having about 130 million inhabitants. It consists of more than 250 ethnic groups and is besieged with ethnic and religious tensions. Nigeria has an abundance of labor and scarce talent. The average Nigerian could find employment based on the culture, religion, language, gender and educational qualifications. Attracting, developing, deploying and retaining talent has become a major concern in Nigeria. Nigeria has been facing the challenge of managing religious and political diversity ever since its independence in 1960 (Anaba, 2011). In the aviation sector diversity matters to customers; hence, in the airline company proposed to be set up in Nigeria, diversity should be kept as a part of the hiring policy. The commercial airline is a highly competitive, safety-sensitive, high technology service industry (Applebaum & Fewster, 2002). The core competency can come from people and employees. Hence, the focus should be in managing people. The whole aviation sector functions as a traditional, top-down, highly divisionalized, industrial model of operations and governance. T o have a customer-centric, learning-oriented workforce capable of adapting to the strategic goals and the change-imperative facing the industry, diversity and equal opportunity are required. Southwest Airlines believes that its dedication to ensure employee diversity also ensures the right fit. They give preference to women and minorities in interviewing them ahead of other candidates. Diversity and Equal Employment Opportunity at Continental Airlines experienced continued profits and double-digit growth. It has an aggressive attitude towards hiring, training and retaining minority employees as a result of which 23% of its employees and 37% of its employers are minorities. America West also has a corporate statement of commitment regarding equal employment opportunity that is updated annually. United is committed to provide opportunity for career advancement for women and minorities. Diversity matters to customers and this has been incorporated as the organization’s hiring po licy. Delta Airlines also promotes the development of women and black pilots in an industry where only 5% of all pilots are women and less than 1% is non-Caucasian. Applebaum and Fewster find that a high correlation exists between customer satisfaction and that of employees. A high correlation also exists between satisfied employees and world-class human resource practices. Women in Nigeria have

Pride and Prejudice Plot Essay Example for Free

Pride and Prejudice Plot Essay Elizabeth Bennet receives two proposals; one from Mr Collins and one from Mr Darcy. Mr Collins was a tall and heavy looking man of twenty-five years. Although he was polite and well mannered he was also pompous and had a self-inflated ego. He always made never ending speeches about nothing and bored everyone to death. Mr Collins flattered everyone constantly but sometimes inappropriately. He begged to know which of his fair cousins the excellence of its cooking was owed. -By this, Mrs Bennet was offended and assured him they were in fact able to keep a good cook. This showed his lack of judgement in when to compliment. He was also quite absurd and Mr Bennets sarcasm often went completely unnoticed. For example, on page 54, Mr Bennet asked if his flatteries were prepared and Mr Collins admitted that sometimes he would think of them for his amusement! Lady Catherine de Bourgh who was his patroness employed him. He grovelled to her constantly as she paid his way; because of her, he was middle/upper class. He was a clergyman at Hunsford near Rosings, Lady Catherine de Bourghs home. When Mr Bennet dies, Mr Collins will inherit Longburn, as Mr Bennet cannot leave the house to his wife; women couldnt inherit. In Mr Collins letter, he proposes to make peace with the family. Mr Darcy on the other hand was very good looking. He soon drew the attention of the room by his fine tall person, handsome features, noble mien He is also described as a fine figure of a man. But he was soon to be discovered to be proud above his company. He was clever, but at the same time he was haughty, reserved and fastidious. He owned Pemberly Estate and got one thousand a year. -He was upper class and he knew it; He had seen a collection of people in whom there was little beauty and no fashion for none of whom he had felt the smallest interest. Darcy and Bingley had a good friendship despite many differences. Bingley was sure of being liked wherever he appeared; Darcy was continually giving offence. Darcy had no sense of humour and admitted it. He couldnt see the funny side of life whereas Bingley was light hearted and liked to enjoy everything he did. In the past Wickam and Darcy had a disagreement. Mr Darcys father had promised Wickam a place in the church but when he died Darcy refused to help him. Mr Collins first hints on his future plans in his letter to the Bennets when he writes; I cannot be otherwise than concerned at the means of injuring your amiable daughters, and beg leave to apologise for it, as well as to assure you of my readiness to make them every possible amends. On the first day of staying at Longburn, he, in a conversation to Mrs Bennet said; I can assure the young ladies that I come prepared to admire them. -Here he gave Mrs Bennet a small glimpse of his intentions. Jane Austin then gave it away saying that now having a good house and income; Mr Collins was in want of a wife. He was also pleasing Catherine de Bourgh who thought he should marry. So for the first evening Jane was the settled choice being not only the eldest, but the prettiest -this was, until he was informed by Mrs Bennet that she was soon to be engaged to Bingley (exaggeration). Then at the Netherfield Ball he asked Lizzy to dance several times and she realised she was the chosen one out of the five sisters. Mr Darcy on the other hand was far from admiring Lizzy at first and when Mr Bingley suggested he dance with her at the Meryton Ball he replied that he had not the least intention of dancing. -Bingley was dancing with the only good looking girl in the room. Here he was referring to Jane. He said Lizzy was tolerable, but not handsome enough to tempt me. Then at Sir William Lucass party, William tried to pair up the two of them and Darcy did not resist, but Lizzy brushed him off with; I have not the least intention of dancing. -this was pay back. It was at this party that Darcy realised his true feelings for her. At Netherfield when Jane went to stay, she fell ill and Lizzy being worried came to visit. Here, she noticed that Darcy was constantly watching her. Miss Bingley who secretly liked Darcy, in seeing that he was drawn to Lizzy tried to turn him against her. But all in vain, for whatever she said, he just stuck up for Elizabeth. Miss Bingley, in Mr Darcys defending her said; I am afraid Mr Darcy that this adventure has rather affected your admiration for her fine eyes. I think when she says this shes half-teasing and half jealous of him liking her. Before proposing, Mr Collins said to Mrs Bennet, May I hope madam, for your interest with your fair daughter Elizabeth, when I solicit for the honour of a private audience with her in the course of this morning? -Here, he was basically asking Mrs Bennets permission to propose. He then launched straight into his speech. Mr Darcy came to visit Lizzy and at first made light conversation, asking about her health. Then there was an awkward silence where he must have been trying to think of how to start before proceeding. -Differences are already showing through. Mr Collins first said hed chosen Lizzy almost as soon as hed met her (which was a lie) and went on to specify his reasons for marrying her. He, as a clergyman wanted to set an example to the rest of the parish, he thought it would make his happy and he was following Lady Catherine de Bourghs advice. Hed obviously planed out his speech carefully but in his reasons, he had not mentioned that he was in love with her! Darcy on the other hand offered his hand in marriage because he did love her and his opening sentence expressed this clearly; In vain I have struggled. It will not do. My feelings will not be repressed. You must allow me to tell you how I admire and love you. Mr Collins also made several insults to Lizzy when proposing to her without even realising it! For instance, he said that if she refuses, she my never get another offer. He also reminds her that if she stays single, all she may ever be entitled to is twenty-five pounds when her mother dies. Darcy put his foot in it too. After saying how much he loved her, he went on to say that it was not his wish to do so with her connections and status; His sense of inferiority -of the family obstacles which judgement had always opposed to inclination. When he was turned down he thought she was just offended; Could you expect me to rejoice in the inferiority of your connections? -To congratulate myself on the hope of relations, your connections? He also admitted to trying to split up Jane and Darcy and even rejoiced in his success of doing so. In response to rejection, Mr Collins thinks Lizzy is playing hard to get and says this is to be expected of a lady. He goes on to say all the good materialistic reasons to marry him forgetting to mention things like love. He acts as if marrying would be a good investment for Lizzy or something. He then assured her that both of her parents approved of the marriage. Mr Darcy in response to rejection is shocked and angry but manages to control himself. He asked why he had been refused and thought she must be offended by what he had said earlier; Could you expect me to rejoice in the inferiority of your connections? But after saying these words he accepted her answer. Both proposals were made for very different reasons; Mr Collins obviously proposed for convenience, whereas Mr Darcy was in love. Both men also reacted in different ways when turned down; although Mr Collins couldnt take the rejection, he was not actually bothered about anything other than having his male pride hurt. -Darcy must have been extremely upset, to him Lizzy was the woman he wanted to spend the rest of his life with but he tried not to show his emotions. They both involved a lot of snobbery in their proposal speeches. They thought that Lizzy would not reject someone of the higher class and she should be grateful that she was chosen out of all the other girls; both reminded her constantly about her status. Mr Collins was more personal mentioning both what would happen when her mother and father died but Lizzy got more angry at Darcy because of things he has said and done in the past. Mr Collins and Mr Darcy both said in much detail all the pros and cons of the marriage. In conclusion, both proposals have some similarities but they differ in the essential requirement of love.