Missed Nursing Care free essay sample

Patient safety is a concern in the hospital setting. Missed nursing care due to high nurse patient ratios, or staffing issues leads to patient falls. Patient falls tend to be a big issue and expensive matter for hospitals nationwide. This paper will focus on a qualitative research article regarding missed nursing care, staffing, and patient falls. Included will be a summary of the research, methods and research used in the study, significance of the research findings, ethical considerations, and a conclusion. Summary of Research Problem Falls pose problems for many patients, such as death, fractures, functional need, and afraid of reoccurrence. Although, hospitals have set forth evidence based guideline strategies for de creasing the number of falls. Consistency and implementation of the strategies are limited. Data was gathered from 188 medical surgical units in 48 separate hospitals nationwide. Data revealed there was not consistent use of interventions to address specific risks. The findings go hand in hand with nursing care being regularly missed. We will write a custom essay sample on Missed Nursing Care or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Nursing care often gets missed due to staffing issues. Missing any nursing care or not fully completing tasks leads to patient falls (Kalisch, Tschannen Lee, 2012). Methods and Research Used in the Study A qualitative approach was used in the design of this research. The research project was conducted in smaller scale hospitals of 60 beds to larger scaled hospitals with 913 beds. The total number of units was 124, this was broken down to as little as 2 units in the smaller hospitals to as many as 22 units  in the bigger hospitals. Unit inclusion criteria were, an average patient length of stay of 2 days or more and, a patient population greater than 18 years. Exclusion criteria were short stay units and pediatric, womens health, perioperative, and psychiatric units. All patient care units in the hospitals that met the inclusion criteria agreed to participate in the study (Kalisch, Tschannen Lee, 2012). 3432 nurses were included in this study. In addition to nurses 980 nursing assistants were participants of this study. The surveys return rate was 57. 3%, some units was as high as 99.6% and as low as 34. 4%. (Kalisch, Tschannen Lee, 2012). Missed nursing care data was collected from the MISSCARE survey. This survey focuses on identifying the rate of missed care. (Kalisch, Tschannen Lee, 2012). The article states that the National Database of Nursing Quality Indicator standards was used as a guideline to describe Hour Per Patient Day (HPPD). The number of working hours by all nursing staff was to calculate these HPPD values (Kalisch, Tschannen Lee, 2012). Any witnessed or unwitnessed event that leads to a patient found on a floor is used as a definition for patient falls. A ratio of falls per 1000 patient days was used as the calculation of fall rates for this research. (Kalisch, Tschannen Lee, 2012). Significance of Research Findings Statistical analysis showed that there is a high correlation between patient falls and the factors of nurse staffing that were addressed in this study. This shows that nurse staffing is significant in preventing patient falls and safety concerns in the hospital. The findings in data collected reinforce previous findings that greater staffing leads to fewer patient falls in the hospital. There were several correlations between the data collected and patient falls. The correlation and data collected also support that the types of missed care can be predicted at different staffing levels(Kalisch, Tschannen Lee, 2012). Ethical Considerations After institutional review board approval from each of the contributing hospitals, study data was collected from November 2008 to August 2009. During the research process patient privacy remained protected. No ethical issues were listed to being an issue. Conclusion The findings from this research study emphasizes the significance of guaranteeing that required care is accomplished daily, to decrease the number of patient falls. Although, staffing may affect the rates of patient falls, the level of influence is lowered when care is finished entirely. Additional work must be done to help nurses in completing essential tasks such as ambulating patients, assisting patients with toileting, patient assessments, and answering call lights, which may mean more staff members. Techniques for helping staff members complete all portions of nursing care include lists, reminders, and engagement of the patient. Until it is completely understood that the process of nursing care and its relationships to patient outcomes are related, we will not be able to develop positive strategies to stop unfavorable proceedings such as falls. Staffing and nurse to patient ratios should be considered to help aid in nursing care completion.

Visit to the planetarium essays

Visit to the planetarium essays Second Paper 11-27-00 I attended the Wagner College Planetarium(located in Spiro Hall)on November 15, 2000 at 11:00 for research and to observe the stars, planets and our entire solar system more closely. There was a clear dome on the ceiling for us to see the sky. The director of the show was Dennis Anderson. He put the latitude to forty degrees, and dimmed the lights. Up in the sky the stars are beautiful and bright. They seem, by the naked eye to be moving but the earth is what is actually moving. Everyone knows that the sky doesn't move. The earth rotates around the sun. The earth being in a different spot in its' orbit all the time gives us different stars to see at different times out of the year. A star is a huge ball of glowing gas in the sky. The Sun is a star. It is the only star close enough to the earth to look like a ball. The other billions of stars are so far away that they are no more than a pinpoint of light. A constellation is a bunch of stars in the sky that form a picture. Each Constellation has a definite time of the year when it reaches its highest point. At latitudes to far north or to far south of the equator, many constellations do not reach there culminates high enough to be seen. The constellations appear to move westward as the earth rotates around the Sun. For this reason, certain constellations can only be seen during one season of the year. There is Pegasus which is extremely large. If you connect the stars of Pegasus it is supposed to look like a horses body. However it is upside down. The instructor put a line going across the middle of the dome. It separated the sky from north to south. He said this line is called the Meridian. When a star is at the Meridian it is at its highest point. It is nine degrees elliptical on each side. The second brightest star is Mercury it has a very thick atmosphere. However the brightest star neares ...

Thomas Green and His Dynamic Display Essay Example | Topics and Well Written Essays - 1500 words

Thomas Green and His Dynamic Display - Essay Example According to the discussion, Thomas had reached his position based on a recommendation from Frank’s boss. The case describes the work performance of Thomas based on different incidents based on the perspective of Frank who is building up a case to fire newly appointed marketing executive. Dynamic Display Corporation is dedicated to providing self service options to banks via Automated Teller Machines. The company has been in business since 1990. In 1994 the managerial staff of the firm noticed an opportunity for growth in the travel and hospitality industry. A new division was founded to serve this market by offering self-service check-in kiosks. By 2007 the travel and hospitality division had become the market leader with 60% market share and over 1500 kiosks across a network of 75 airports. The attractiveness of the company products was that it reduced the costs of checking in a passenger to about $0.30 per passenger which represents a 90% cost reduction in comparison with a gent check-in. A new trend in the industry was the utilization of web-check in. Web checks were taking business away from the company. Dynamic Display was looking for new managerial talent with fresh ideas to keep its travel and hospitality industry competitive. Thomas Green was young professional with an outgoing personality that started working at Dynamic Display in March 2007 as an account executive. Ever since he was recruited by this company Thomas had high hopes for his chances to succeed at his new job. A common key success factor of successful business people is the ability to set and achieve goals1. Thomas showed initiative and voluntarily attended training at corporate headquarters. His communication skills, energy, and insight into the ATM market caught the attention of a key executive, Shannon McDonald. McDonald took Green under his wings and mentored the kid and in a short period of time McDonalds promoted Thomas to senior market specialist.

Learning about legal aspects of contract practice and procedure Assignment

Learning about legal aspects of contract practice and procedure - Assignment Example In some countries, a valid substitute can satisfy the element attention. The law can also terminate contracts. The law tends to provide remedies in case of breaching of the promise. The law also recognizes the commitment’s performance as a duty. Existence of duty gives rise to contracts due to the promise that one of the parties makes. For a contract to be legally bound, the promise has to be exchanged so that it may be adequately considered. Mainly, the governance of contracts lies on the hands of common law, state statutory and the private law. Private law primarily concentrates on agreement terms made between the parties involved exchange (Chen-Wishart, 2007). The case of Barry is tricky since there are no written documents to show that they had entered into a contract with Iva. It is clear and evident that the offer is a key element which provides a definition of the contract’s relevant issues. For an offer to be legally valid, it must be first communicated efficiently. This gives the receiving party the ability to either accept or reject because a contract is only entered into voluntarily. It does not of importance on whether the receiving party reads the contract or not, but he or she has no bearing when it comes to determination of the offer’s clarity. The offer should only provide a clear opportunity to the recipient of rejecting or accepting the contract. However, in case of someone enters into a contract without reading or understanding it, it is for his or her risk (Chen 2007, p 130). In addition, particular and definite terms must be in place for an offer to be considered valid. The contract’s terms are considered definite when a reasonable person has a capability understanding readily the terms. In the case of Barry, he was given an offer by Iva and clearly understood the terms in that contract. However, review by the courts on whether the terms are definite is usually done with the help of primary elements agreement.

Animal Farm Summative Essay Example for Free

Animal Farm Summative Essay Animal Farm is an allegorical novel by George Orwell. It is considered to be an allegory because the farm and the various controversies within it are representing Russia’s condition before and after its overthrow of the tyrannical tsar. The novel explores more than just political conflicts – it shows the lengths human nature and gluttony can go, how surplus of power can destroy the truest of morality, how greed is present in every governing system, and no book, rule, or law can obliterate avarice. It also cleverly observes how humans alter their relationships and mask their true feelings towards others for their own security, and this course of action is evident in the relationship between Napoleon and Mr. Pilkington. Napoleon plays a greater role in the aftermath of the rebellion, rather than evoking the rebellion itself, and Mr. Pilkington does not play a great role in the novel until after the rebellion. Napoleon, from the very beginning, is made out to be an antagonist as he indulges in all sorts of suspicious activity, and constantly engages in arguments with Snowball, his partner in looking after the new â€Å"liberal† Animal Farm. The Seven Commandments are against everything man stands for, including Pilkington of Foxwood, and even if they do not have a direct relationship with each other in the beginning, Mr. Pilkington and Napoleon are enemies, because, as Old Major had once said, â€Å"Man is the only real enemy we have. Remove Man from the scene and the root cause of hunger and overwork is abolished forever† (4). Napoleon and Snowball have a very idealistic view of Animal Farm, but Napoleon’s attitude towards everything is noticed to be changed after the overthrow of Snowball. His hatred towards the other farmers had already started to falter when their rations fell short, but it is perceived that Napoleon started favoring Mr. Pilkington as he was against Frederick of Pinchfield, where Snowball was rumored to have resided. But their relationship is much like a seesaw as Napoleon goes through a phase of indecisiveness as to whether or not trust Mr. Pilkington as he had declined him any help during the Battle of the Windmill. For instance, when he had sent the pigeons to ask for help, Mr. Pilkington only replied with, â€Å"Serves you right†. As the novel progresses, the commandments are slowly altered, and this shows that Napoleon’s mind is slowly changing, his attitude towards the commandments are changing, and his attitude towards the humans are changing as well. For instance, the commandment â€Å"No animal shall sleep in a bed,† is altered to â€Å"No animal shall sleep in a bed with sheets,† for Napoleon’s own luxury, and this not only shows that Napoleon has a new outlook on life, but also a new outlook on humans – not only that, but he alters all commandments, showing he is becoming more and more like a human every day, until finally, the day comes when he stands on his hind legs, indulges himself in alcohol, and is seen to be playing poker with Mr. Pilkington. The most important chapter concerning Napoleon’s relationship with Mr. Pilkington would be the last chapter of the novel when the pair are chatting and laughing, when they both draw aces in a game of poker. This sig nifies the looming power struggle between the two. Both Napoleon and Pilkington are striving to be the stronger party and will stoop to any level to emerge the winner. At the beginning of the novel Napoleon treats Pilkington with heavy disdain, and tries to form an isolated community of self-sufficient animals. As the novel progresses Napoleon engages in trade with Pilkingtons farm, and conspires with him to frame Snowball and make him appear a traitor. His relationship with Pilkington is purely selfish and both of them after the same end, to be the stronger of the two farms. To conclude, in Napoleon’s pursuit of creating his idealistic socialist utopia, he ended up turning into the evil he set out to banish, and turning into what all the animals dreaded – turning into a human, just like Pilkington, which is why â€Å"it was impossible to tell which was which†(89).

othello :: essays research papers

  Ã‚  Ã‚  Ã‚  Ã‚  Women in Othello are very profound. They are very dependent on their men. During the 16th Century, women were traditional and accustomed to being submissive to their men/husband. Desdemona secretly married Othello a â€Å"Moor† (a black man). She is devoted to her husband, and respects and obeys his wishes. Even though Othello can be cruel to Desdemona, his wife Desdemona responds to her husband in a way that she gets her point across, and still respects Othello. Women during the 16th century were not highly honored by men. During that time women in Othello were very dependent on men.   Ã‚  Ã‚  Ã‚  Ã‚  Desdemona father has learned that she has married Othello. Her father Senator Brabinto is very furious. Desdemona has come to confront her father: â€Å"How to respect you. You are the Lord of duty; I am hitherto your daughter. But he’s my husband, and you, preferring you before her father, So much I challenge that I may profess. Due to the Moor my Lord†(lit.act1sceneIII v186-91) Desdemona is saying she loves and respects her father the same as her mother did, but she also respects her husband, and will stand by Othello.   Ã‚  Ã‚  Ã‚  Ã‚  Emilia’s is the wife of Iago. Emilia is cynical, and a worldly woman. She speaks as though she understands and knows men very well. To Emilia men are callous and betraying. They want whatever they can not have, and what they have they do not want. Her relationship with her husband is unworthy. Iago lies and will do anything to get what he wants. Emilia is asked by her husband to steal a handkerchief of her mistress (a maid), Desdemona. Emilia refuses to do such a thing. She love Desdemona and would never hurt her. Coincidently Emilia found the handkerchief lying on the floor. She surprised Iago with the handkerchief, and he is well pleased. Emilia’s regard for Othello is unpleasant. She realizes that Othello is very jealous towards Desdemona, his wife, and she does not like how he speaks to Desdemona.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   â€Å"Is he not jealous† (lit act III scene1 v 22) â€Å"‘Tis not a year or two show us a man. They are but stomach, and we all but food; they eat us hungerly; and when they are full they belch us† (act III scene4 v 99-102) Emilia is stating that when men bellies are full and they had enough to eat they move on to the next meal.   Ã‚  Ã‚  Ã‚  Ã‚  Bianca, a very fair looking woman, and is only mentioned in small detail.

Federal Reserve Eco 372

Economic strategy can overwhelm some, but one who understands the idea of how money can stimulate or dissolve the economic market obtains an understanding of the Federal Reserve. The Federal Reserve is a bank in which other banks loan and call upon when in need. The Federal Reserve Bank ensures all funds in Community and other federally accredited banks, also known as FDIC. Even though the Federal Reserve is a bank it is impacts the economic growth or decline in ways of monetary policy and stimulation or dissolve. The Federal Reserve Bank uses a tactic known as discount rate, which is the term used for the interest charged for loans by banks.When the discount rate is low, banks can increase the amount of loans offered, as well as lower the interest rate in their location. When the discount rate is high, banks will decrease the number of loans and raise the interest rates they charge. The Federal Reserve can use the power of the discount rate to increase or decrease the amount of mone y in circulation. Banks may even need to â€Å"share† the excess or surplus of funds in their reserves with another bank; this is known as Fed Funds. These funds carry an interest rate as well.The interest rate may be higher or lower depending on the Federal Reserve. The higher the interest rate the more likely a bank is wanting to loan to another bank. If it is lower the desire will be undesirable. The Discount and Fed Funds rate correspond, the Discount rate is normally set slightly below the Fed Funds rate in effort to increase the money in circulation. When the discount rate is above the Fed Fund rates then the money in circulation is decreased. The Federal Reserve Bank is located in each region to allow for an even distribution among the United States.Each of the Reserve Banks are governed by the Federal Reserve System’s Board of Governors who have been nominated by the President and confirmed by the Senate. The Chairman and Vice Chairman of the Board are then app ointed by the President from the confirmed members. The members’ term are each 14 years in length, with new members being nominated and confirmed every two years on even-numbered years. The Chairman and Vice Chairman will serve for four years in the respective title without affecting their member status on the Board.The Federal Reserve Board of Governors will assist in recommending stimulus programs when needed. These programs assist in building the economy without relying on the banking or finance industry heavily. Expansionary and Contractionary Fiscal Policy may also be needed when programs seem to be ineffective. After one has been able to learn the basics of how the Federal Reserve works then the process of understanding the measures needed to affect the economic outcome may become easier to understand. This process is done by the way of government involvement with the budget, fiscal and monetary policy.Each of the procedures are meant to assist in building the economic stability, and to help ensure the soundness of the United States currency. Every congressional budget planning session affects the need for the monetary policies for the Federal Reserve. After the Board of Governors is nominated and confirmed they are ready to get in and work on stabilizing the economy along with the monetary policies needed to build for the future. The Board of Governors will sit in position for 14 years, this will allow them to see and gain a better understanding of the true economic cycle.This will allow for a better gage on the flow of the economic path. After obtaining an understanding of the Federal Reserve, one will be able to identify and understand the measures taken to assist in maintaining the proper stabilization in which employment increases and the economic market is sustained by the open market. The open market is maintaining by the buyers and sellers in the economy. These are the businesses people work and shop at daily. The major focus on the econom ic model is the open market and this is apparent with the Federal Reserve and the tools for the monetary policy.