Understanding Variations in Communication Related to Failure to Rescue - Free Essay Example

Sample details Pages: 4 Words: 1121 Downloads: 1 Date added: 2019/03/18 Category Analytics Essay Level High school Tags: Failure Essay Did you like this example? RESULTS We conducted 58 interviews from February through June 2017. Table 1 describes the number of interview subjects by care area and role. Direct care nursing refers to General Care, Post Anesthesia Care Unit (PACU), and Surgical Intensive Care Unit (SICU) nurses. Don’t waste time! Our writers will create an original "Understanding Variations in Communication Related to Failure to Rescue" essay for you Create order These nurses hold primary responsibility for their assigned patients care and are considered the first line at the bedside. Consultation services include Life Safety nurses and Respiratory Therapists (RT). Life Safety nurses are ACLS and PALS certified critical care RNs, who are the first tier of the hospitals Rapid Response Team (RRT). A Life Safety Consult may be initiated by a frontline nurse whereby a Life Safety nurse comes to the bedside for assessment and provides necessary critical care and referral to a higher level of care. At the physician level, house officers are comprised of interns and residents, designated by their post-graduate year (PGY). Recognition Table 2 provides representative examples of facilitators and barriers to recognition of patient deterioration or complication by clinician type. The primary concepts identified within the recognition domain include 1) use of existing technology to aid in recognition of decline, 2) importance of staff experience level, and 3) acting on clinical intuition alone without supporting physiologic data. The use of technology that aids in detection of patient deterioration was a common point of emphasis across clinicians. There was uniform agreement that these tools are helpful, but that they do not replace the importance of visual and physical assessment of patients. For example, PACU nurses commented on this socio-technical relationship, reflecting on both alarms being sensitive to alert when vital signs change and having nurses available with their eyes on the patients 24/7 to detect decline. Respondents cited the importance of staff experience level is for identifying important problems and knowing when to call for help. General care nurses specifically noted that the majority of staff on the floor are inexperienced†both nurses and house officers. An Attending Surgeon stated the barrier is that both the direct care nurse and the junior house officer are the team members with the least amount of experience, yet they are the keystone to early recognition. Some noted the importance of allowing new staff to have teachable moments, however, when issues of patient safety arise, experienced level staff have to intervene and escalate care accordingly. Clinical intuition is developed over years of experience and may not have traditional physiologic data that accompanies it. Clinicians cited difficulty in appropriately communicating development of a hunch or gut feeling of potential patient deterioration. For example, general care nurses reflected on hesitating to call when an issue first started to develop. They still felt the need to allow the issue to develop further before calling the surgeon or life safety team. Also, while junior house officers described having suspicions that their patient was not doing well, they deferred to the opinions of their senior resident, which may be delayed. Communication Process Table 3 provides representative examples of communication processes, such as handoffs and communication hierarchies that influence the rescue process. The primary concepts identified include 1) the availability of the primary and consulting services, 2) how well information was relayed and received in report, and 3) the involvement of staff during rounding. The ability of primary and consulting services to connect with the direct care nurse was consistently described as a key barrier to early detection of deterioration. For example, general care nurses reported the unavailability of consultation and specialty services to meet face to face to discuss individual patients would often leave the nurse to communicate crucial information in an unstructured, ad-hoc manner. Nuances of patient concerns across providers could be lost in these circumstances. The quality of information exchange during routine patient handoffs or discussions relied on three factors: 1) the clinician relaying the information, 2) the clarity of expectations or orders, and 3) the platform used to communicate. For example, nurses and RTs cited the need for physician to physician communication regarding escalation of care. Recommendations for escalation from nurses and RTs were taken into consideration, but not necessarily acted upon immediately. Also, more precise and clear instructions from physicians on postoperative care pathways proved invaluable to managing patients and detecting early deviation from the expected course. Finally, physicians and others cited verbal communication via telephone or in-person as key to effective communication of concerns or plans. Many respondents also noted the importance of shared rounding and the presence of frontline staff to effective communication. For example, house officers and SICU nurses described rounds as a time for discussion and interdisciplinary contributions to the care plan. In particular, they noted the tension between both the immense value and logistic difficulty in interdisciplinary rounds for complex patients. Specifically nurses felt this poorly coordinated communication process may result in potential missed opportunities for early detection. Communication Accessibility Table 4 provides representative examples of the timely accessibility of appropriate clinicians involved in a patients care. The primary concepts identified include 1) ability to contact the patients primary decision-making clinician, 2) day of week and shift related staff availability, and 3) response times based on the position of who calls. Clinicians reported barriers in the ability to contact the appropriate clinician responsible for decision making in a timely and efficient manner. General care and PACU nurses expressed that while access to urgent or emergent services like Life Safety or rapid response teams were excellent, the accessibility of the surgical provider or team often delayed care. Determination of the primary team by frontline clinicians was not always clear and resulted in frustration and delay. For example, if all interns were in the operating room, the general care nurses could not determine who the covering provider was. This seemingly routine step in communication was also highlighted by attending surgeons who found similar barriers in contacting consulting services. A distinct and important factor in accessibility of providers was the day of week and shift. Uniformly, clinicians reported barriers to accessing staff and resources on weekends and during the night shift. Even in high acuity setting such as the SICU, nurses reported ease in getting a hold of a staff member on a week day or during the day shift, but significant difficulty on nights and weekends. House officers reported needing to alter their practices and adapt to having fewer people and resources during these off hours and days. When contacting clinicians, response times varied according to the perceived positional status of the caller. Some staff reported that all concerns were not weighted equally when expressed by general care nurses versus PACU or Life Safety nurses. For example, PACU and Life Safety nurses reported receiving more respect from other staff solely based on their title. Interns and residents responded to Life Safety nurses with urgency, ensuring they were readily available by pager and responsive at the bedside.

The Healthcare Reform Occupational Therapy - 998 Words

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The Moral Principles of Premarital Sex Essay - 3043 Words

Running Head: THE MORAL PRINCIPLES OF PREMARTIAL SEX The Moral Principles of Premarital Sex English 2 Katherine Fitch Madison College Author Note This paper was prepared for English 2, taught by Mary Sarko. THE MORAL PRINCIPLES OF PREMARTIAL SEX Abstract Over many years, the views of premarital sex have been becoming increasingly more tolerant. The whole reasoning behind why sex was created is lost in the minds of society and used for pleasure and own physical satisfaction. There are negative consequences for these actions leading to guilt, depression, and numbness to intimate relationships. Having strong parental influence can also strongly affect the outcomes of adolescence and causal sex. Additionally, marriage can be†¦show more content†¦Hence, even if there may be a motivation for casual sex because of developing one’s script or fulfilling a man’s physical satisfaction and a women’s intimacy in a relationship, there are the same emotional effects and negative outcomes that result from taking part in premarital sex. An action that was morally right would not have THE MORAL PRINCIPLES OF PREMARTIAL SEX negative emotional and psychological consequences, which would conclude casual sex was not intended to be done before marriage. There is also another consequence for participating in casual sex such as disturbance in later marriage. Sexual scripts can be written prior to marriage, providing knowledge about their own abilities, leading to a stable marriage because they may be able to make more informed choices concerning marriage. 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A Communication Analysis Of The Waterview Connection...

Have the Right Actions been Taken? A Communication Analysis of the Waterview Connection Development Introduction Grunig (2013) sees public relations and communication management as fundamental to the achievement of organisational goals. A major road and tunnelling project in West Auckland, has required considerable planning and communication alongside its publics. The Waterview Connection Development (WCD) is a motorway connection between State Highways 16 and 20, which, in part, runs as tunnels. The WCD links between the central business district and the airport, and an alternative to State Highway 1. This essay critically assesses how the New Zealand Transport Authority (NZTA) has communicated with publics throughout the WCD. It analyses the communication activity, and applies public relations theory. Key Publics Major publics with a distinct interest include residents with properties affected by the noise and possible shifts of land, road-users who may experience delays during building, and businesses that may lose of revenue if customers find it difficult to access them. Mehta and Xavier (2009) note engagement relationship strategies used with various publics may be different to each other and during different parts of the project. Managers will need to negotiate with residents, road-users and business-owners to minimise disruptions. All affected sections of Auckland s multicultural population should be included in the organisation s publics. The diversityShow MoreRelatedPublic Relations And Communication Management Essay1491 Words   |  6 PagesIntroduction Grunig (2013) sees public relations and communication management as fundamental to the achievement of organisational goals. A major road and tunnelling project in West Auckland, has required considerable planning and communication with publics. The Waterview Connection Development (WCD) is a motorway link between State Highways 16 and 20, which, in part, runs through tunnels. The WCD aims to provide a direct link between the central business district and the airport, and an alternative

J.J Reddick Free Essays

What is rounding? Rounding a number means approximating it. A rounded number is often easier to use, understand, and remember than the precise number. In MyFinanceLab most of our answers are rounded decimal numbers. We will write a custom essay sample on J.J Reddick or any similar topic only for you Order Now A decimal number has three parts: The whole number part, the decimal point and the decimal part. For example: [pic] So, in order to round a decimal number we basically round the decimal part of it. These are the two basic steps for rounding decimals to a place value to the right of the decimal point Step 1: Locate the digit to the right of the given place value. Step 2: If this digit is 5 or greater, add 1 to the digit in the given place value and delete all digits to its right. If this digit is less than 5, delete all digits to the right of the given place value. For example: Round 736. 2359 to the nearest hundredth. Solution: Step 1: We locate the digit to the right of the hundredths place Step 2: Since the digit to the right is 5, we add 1 to the digit in the hundredths place and delete all digits to the right of the hundredths place. Thus, 736. 2359 rounded to the nearest hundredth is 736. 24 Rounding in MyFinanceLab In MyFinanceLab we use input instructions to indicate the place value to which you must round your final answer(s). For example: Let’s say your final answer is 736. 2359. †¢ You must enter 736. 2 if the input instruction is: Round to the nearest tenth. †¢ You must enter 736. 24 if the input instruction is: Round to the nearest hundredth. Note: Other typical input instruction in MyFinanceLab is Round to the nearest cent if the final answer is in currency units. †¢ You should enter 736. 236 if the input instruction is: Round to three decimal places. Now, let’s use a simple Time Value of Money (TVM) question you may encounter in MyFinanceLab. | | |Problem Example: Comparing Interest for Various Compounding Periods. If $1,000 is invested at 8% compounded | |annually, | |monthly, | |what is the amount after 5 year? (Round to the nearest cent. ) | To solve this problem without using a financial calculator or a spreadsheet, we need to use the compound interest, future value, formula: [pic] where, i |= |r/m | |FV |= |future value at the end of n periods | |PV |= |present value | |r |= |annual rate | |m |= |number of compounding periods per year | |i |= |rate per compounding period | |n |= |Total number of compounding periods | Solution: a. Compounding annually means that there is one interest payment period per year. So, n = 5 and i = r = 0. 08. [pic] [pic] [pic] Therefore, rounded to the nearest cent, the final answer is $1,469. 33 b. Compounding monthly means that there are twelve interest payments per year. So, n = 12(5) = 60 and i = 0. 08/12 = [pic] [pic] [pic] Therefore, rounded to the nearest cent, the final answer is $1,489. 85 | |This TVM example helps us to understand a basic roundin g principle in MyFinanceLab: â€Å"Do not round until the final answer. † As you | |can see in part a. after solving the expression [pic]we leave it unrounded and use as many digits as possible in its decimal part. | |The same happens in part b with the other exponential expression. | | | |Take another look at part b. because rounding i to a small number of decimal places, such as 0. 007 or 0. 0067, would have resulted | |in round-off errors. So, to avoid this, use as many decimal places as your calculator is capable of displaying. | Tips: If you want to calculate TVM problems, mathematical calculations are relatively straightforward. However, as you will see, TVM calculations are easier using a financial calculator or spreadsheet. But, no matter what method you use – equation, financial calculators, or spreadsheets, you get the same answer because they all use the same formula and concept. These are some tips for solving TVM questions. Calculator Tips: †¢ Set your calculator to display at least five decimal places or to floating decimal place (nine decimal places). †¢ Set your calculator to one payment per year. Adjust this setting if necessary. †¢ Set your calculator to the â€Å"end† mode. Adjust this setting if necessary. Excel Tips: †¢ Take advantage of the formula help that Excel offers. †¢ If you are lost, click on â€Å"Help†. †¢ Be careful about rounding variables. For example, suppose you’re dealing with the interest rate 6. 99% compounded monthly. This means you will need to enter the interest rate per month, which is = 6. 99%/12, and since you are performing division in the cell, you need to put an â€Å"=† sign before the division is performed. Don’t round the result of 0. 0699/12 to 0. 58 and enter 0. 58 as i. Instead, enter =6. 99%/12 or as a decimal =0. 0699/12 for i. How to cite J.J Reddick, Essay examples

CONTENTS Essay Example For Students

CONTENTS Essay INTRODUCTION1Canonicity1Authorship and Dating2INTERPRETATION4Allegorical4Literal5Wedding Cycle5Pastoral Drama6CONCLUSION6INTRODUCTIONThe Song of Songs, or Song of Solomon, is a unique book in the Old Testament canon. The book contains exquisitely beautiful lyric poetry, full of sensuous symbolism.Because of the sexual nature of Song of Songs, the message of this book has been debated for the past eighteen-hundred years. The erotic content of this book has lead it into canonicity problems and authorship problems.These issues have become central to the interpretation of the Song of Songs. CanonicityThe issue of the canonicity of Song of Songs was a major subject of debate at the 90 A.D. Council of Jamnia.Jewish Rabbis from across the spectrum of Judaism assembled in order to close in Jewish Canon. At that time, many rabbis who opposed the Song of Songs and other works toke the opportunity to argue against their inclusion in Jewish Canon. It was the Palestinian rabbinical school of Shammai that stood in the fore of the opposition for canonization of Song of Songs. They argued that nothing could be considered scripture that was being employed in lewd, barroom songs. Fortunately the cause of Song of Songs was championed by the less stringent Babylonian rabbinical school of Hillel.The entire universe is not as worthy as the day on which the Song of Songs was given to Israel, for all the Writings are holy, but the Song of Songs are the Holy of Hollies.Lead by the defense of Rabbi Aqiba, the Hillal school succeeded in maintaining the canonicity of Song of Songs!. Authorship and DatingWhile the different schools represented at the Council of Jamnia may have held opposing views of the canonicity and interpretation, both held to the belief that King Solomon was the author of the work. It was not until the advent of modern textual criticism that questions began to arise over the authorship of Song of Solomon.The view now held by the majority of biblical scholars is that Song of Solomon, in reality, may have nothing more to do with Solomon than use of his name. Instead, scholars believe that Song of Songs represents a conglomeration of smaller love poems or songs. These poems, 20 to 30 in all, were collected by an unknown editor(s) for their consistent themes, and placed in the anthology which is found today. Unfortunately, the nature of Song of Songs as an anthological work precludes precise dating of the material. However, there are several textual clues within the work which allow for citing a general range of years. The naming of the city of T irzah in 6:4 is evidence that the compilation must have occurred sometime before 876 B.C. This is because Tirzah, compared to Jerusalem in the verse, ceased to be the capital of Israel in 876 B.C. when Omri moved the Northern capital to Samaria.Further evidence used to limit the possible span of years is found in the presence of Aramaic, Persian, and Greek words in the text.The presence of these words means that the work antedates the sixth century B.C.All internal evidence considered, the best dating available places the compilation of Song of Songs between 400 and 300 B.C. INTERPRETATIONAllegoricalFirst among the four primary, modern approaches to the interpretation of Song of Songs is the Allegorical approach. This view of Song of Songs is one of the two oldest interpretations, and was forwarded by the Midrash, Targum, and Medieval Jewish commentators. This interpretation states that the intended message of Song of Songs is an allegory of God and Israel. The succession of events flows from the Sinai Covenant through subsequent events. Later, the early church fathers adapted this view to Christianity by changing the role of Israel to that of the Church. LiteralThe second of the two oldest interpretations of Song of Songs is the literal approach. At one time held by a few Jewish rabbis, this view fell out of acceptance in leu of the allegorical interpretation. Among the Christian fathers who accepted this approach were Theodore of Mopsuestia and Sebastian Castellio, both of whom were criticized for their opinion. The literal view saw Song of Songs as no thing more than a collection of love poems. Useful for exemplifying the nature of Godly love, but otherwise only poems. Wedding CycleAmong the more recent interpretations proposed by Christians is the wedding cycle. This interpretation is basically a revised,and more specific form of the literal interpretation. First presented by Herder in 1778, the view of Song of Solomon as a group of songs used in palestinian and syrian weddings has reopened the consideration of the work. Herder contends that Song of Songs represents a wedding anthology. There is a surprising amount of evidence to corroborate this conclusion. Throughout the book one can find rituals and customs followed in palestinian and syrian wedding celebrations. Pastoral DramaThe final major interpretation is the pastoral drama approach. Supported by Ewald and Delitzsch, this position claims that Song of Songs was originally intended to be a dramatic presentation. The entire book is a play with either two (Delitzsch), or thr ee (Ewald) characters. Delitzschs version held that Solomon and some rustic maiden were the two characters. Ewalds three character version assumed a third person, the maidens shepherd lover. Both of these views suggested that the work was meant to either be read aloud, or acted out. CONCLUSIONToday, the majority of Christians belief in the Allegorical interpretation of Song of Songs, with a large number holding to the literal interpretation. However,it is not because of informed scholarship that most Christians hold to their particular view, but rather they are responding to what they have been taught from their youth. This is evidenced in the fact that a large percentage of Christians still adamantly believe that Song of Solomon was in fact written by Solomon. Whether or not the general Christian populace will ever come to understand why they believe, what they believe concerning the Song of Songs is indeterminate. .ude7fa3d75d4db4af4f6efdbc0613f338 , .ude7fa3d75d4db4af4f6efdbc0613f338 .postImageUrl , .ude7fa3d75d4db4af4f6efdbc0613f338 .centered-text-area { min-height: 80px; position: relative; } .ude7fa3d75d4db4af4f6efdbc0613f338 , .ude7fa3d75d4db4af4f6efdbc0613f338:hover , .ude7fa3d75d4db4af4f6efdbc0613f338:visited , .ude7fa3d75d4db4af4f6efdbc0613f338:active { border:0!important; } .ude7fa3d75d4db4af4f6efdbc0613f338 .clearfix:after { content: ""; display: table; clear: both; } .ude7fa3d75d4db4af4f6efdbc0613f338 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .ude7fa3d75d4db4af4f6efdbc0613f338:active , .ude7fa3d75d4db4af4f6efdbc0613f338:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .ude7fa3d75d4db4af4f6efdbc0613f338 .centered-text-area { width: 100%; position: relative ; } .ude7fa3d75d4db4af4f6efdbc0613f338 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .ude7fa3d75d4db4af4f6efdbc0613f338 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .ude7fa3d75d4db4af4f6efdbc0613f338 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .ude7fa3d75d4db4af4f6efdbc0613f338:hover .ctaButton { background-color: #34495E!important; } .ude7fa3d75d4db4af4f6efdbc0613f338 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .ude7fa3d75d4db4af4f6efdbc0613f338 .ude7fa3d75d4db4af4f6efdbc0613f338-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .ude7fa3d75d4db4af4f6efdbc0613f338:after { content: ""; display: block; clear: both; } READ: Observation And Recomendation Report Of T.G.I.Frid EssayBibliographyAdeney, Walter F. The Song of Solomon and the Lamentations of Jeremiah. New York: A. C. Armstrong and Son, 1903. Bunn, John T. Song of Solomon. The Broadman Bible Commentary. Nashville: Broadman, 1969. Gordis, Robert. The Song of Songs and Lamentations: A Study, Modern Translation and Commentary. New York: KTAV Publishing House, 1974. Pope, Marvin H. Song of Songs: A New Translation with Introduction and Commentary. The Anchor Bible Series. Garden City: Doubleday, 1977. Terrien, Samuel. ed. The Interpreters Bible. Vol. 5. Nashville: Abingdon Press, 1951. S. v. The Song of Songs: Introduction, by Theophile J. Meek.