Hospital Emergency Operations Plan Essay Example | Topics and Well Written Essays - 750 words

Hospital Emergency Operations Plan - Essay Example The emergency plan for the hospital has guidelines for facility evacuation. Facility evaluation is undertaken when the present environment cannot adequately ensure patient treatment or care. The University of Toledo Medical center (UTMC) is a component of the University of Toledo Health Science campus; which has several buildings, hospitals, and health sites. All the buildings are interconnected aboveground and underground tunnel infrastructures; separated through firewalls, having different utility systems, and different emergency power sources. Hence, if one part of the building is unusable, an alternative care site can be located in a different equipped building. The UTMC has also collaborated with other community partners, to establish an alternative care site at the Collier Building; therefore, medical staff or students can continue caring for the relocated patients. During patient relocation, copies of medical records and other medical items are sent to the alternative clinic s ites. Communication and transport infrastructure and services between the hospital and the alternative clinic sites are coordinated in the Hospital command Center in liaison with the Lucas County Emergency Operation Coordinator. In addition, the Hospital Council of Northwest Ohio in collaboration with regional health providers, have initiated a plan for opening a major alternative care facility.The HICS has a flexible method to emergency management which can be utilized in various disaster responses.

How satisfactory is this view of Wolseys position as Henry VIIIs Minister Essay Example for Free

How satisfactory is this view of Wolseys position as Henry VIIIs Minister Essay Thomas Wolsey rose from being the lowly son of a butcher, through various posts in the royal service, to become Lord Chancellor in December 1515, and remained at the pinnacle of the Kings service until his fall in October 1529. To stay in power for so long, it needs to be established whether he spent his time as a servant to the King, or as a authority in his own right. Historian G.R.Elton stated that, He had lasted so long because he knew how to promote himself, and for most of the time, he knew how to keep henry satisfied. Eltons words indicate what I believe are the two main factors in studying Wolseys ministry how he served the King, and how much he did for himself. It is my opinion that Wolsey, despite his plentiful policy in areas of little interest to the King like social and governmental reform, remained so prominent in the Kings service due to his ability to serve the King, allowing Henry to live life as a young Renaissance Prince. The King also felt relatively safe giving such power to Wolsey, as he didnt pose a threat to his throne in the way that some nobles or those of royal blood may have posed. However nature of the relationship between Henry and Wolsey was unusual, as it was not like the archetypal master-servant relationship. In some of his letters to Wolsey, Henry signed off as your loving friend and master, or referred to hims as father in the spiritual sense of the word. George Cavendish, a contemporary, and Wolseys butler said The king displayed a most loving disposition towards him, especially as he was most earnest and readiest among all the council to advance the Kings mere will and pleasure. The friendship seemed to work both ways, and although it has been suggested that Henry took Hampton Court by force, I am in agreement with most historians that Wolsey gave it to Henry as a gift. To judge the extent to which Wolsey did serve his master, it is necessary to analyse Wolseys work, and discover the true aim behind each of his major areas of policy. In studying Wolseys domestic policy, one must establish Henrys role in this area, and in particular, what he wanted done and how much of it he was willing to do himself. As Henry was not the first son of his father Henry VII, he had not received the same royal training that his older brother Arthur had done, thus he had never really developed an interest in royal domestic affairs. While Henry VII chose to rule the country himself, Henry VIII saw ruling his country as delegating jobs to other people so he could live a youthful life, spending time hunting and enjoying himself with other men of his age. His lack of interest in day-to-day administrative affairs left a void to be filled, so the arrival in the his service of someone who not only excelled in the field, but was willing to serve his every need seems to have been the main reason for the King to keep Wolsey. As Lord Chancellor, Wolsey was effectively head of the legal system. However, as I established previously, Henrys interest in fields such as this was limited, so he gave Wolsey power to do what he pleased (but he did have to approve Wolseys reform before it was implemented). Wolsey became a contriver of many policies of reform in the legal system, notably with his personal service in the Court of Chancery, increasing the administering of law of equity as opposed to common law, and with his revision of the role of Star Chamber in 1516, so that it would dispense justice and oversee fairness in the legal system. The question we need to ask is how much of this was done for the King, and how much did Wolsey do of his own accord, as arguments can be established for either opinion. By sitting in on the Court of Chancery, Wolsey was taking on a lot of unnecessary extra work, and his enforcement of equity (which was seen as dangerously close to Roman Law) is evidence to suggest that Wolsey allegiance may not have only lain with Henry, but with the Pope as well. However, Wolsey himself had little or no legal training, and the work he carried out was rather early in his ministry, which suggests that is ultimate aim was to please the King by offering him exciting new plans of reform to keep him happy. Also, the work he carried out in Star Chamber was demanded of him by Henry. It is my personal opinion that Wolseys needed to maintain the Kings interest and appear as though he was working directly to serve the King, and this seems to have been his main priority, as this was the key to remaining in the Kings favour. Wolseys background lay in religion rather than in law, so it seemed that anything policy he would implement would be more likely to reflect his own personal desires, rather than as a service to the King. In 1514, he was made Archbishop of York, and in 1518, he was promoted to Papal Legate (a position which was conferred on him for life in 1524), effectively making him the most powerful man in the church. The important question is that when serving the Pope in England, would he be acting for himself (and the Pope) or his master, the King? Wolseys first major policy in the church was the defence of Benefit of Clergy. In the 1515 Parliament. This itself was a bold move for Wolsey, as he had only recently been given power, and to defend something that both King and Parliament didnt approve of meant losing popularity. Nevertheless, Wolsey knelt to Henry to assure him that his power was totally unthreatened by the church. This evidence suggests that Wolsey may not have necessarily wanted to do everything that the King wanted, and he seemed to have some power of refusal over the King himself. In the church, we also witness Wolseys collection of offices, wealth and power, which we can hardly regard as a service to the King. His offices included Bishop of Durham and Winchester, Abbot of St Albans (one of the richest abbeys in England), as well his previous offices as Archbishop of York, Papal Legate and Lord Chancellor, providing examples of pluralism. He even charged clergy to carry out duties which he could not fulfil, in a gross example of non-residence. He derived a huge income from all of the above while maintaining power, placing him in a unique position, and freeing him up to serve the King in other ways. One third of land in England belonged to the church, and this seemed to be the one of the few aspects of the church that Henry himself was displeased with, thus it can be said that the dissolution of 30 monasteries between 1524-9 would have theoretically been done for the King. In practice, Wolsey kept a great deal of the revenue from the monasteries, diverting it to his school in Ipswich and his college at Oxford. Social reform was one of the areas of domestic policy that least concerned the King, so it seems likely that most of Wolseys action in this field would not be in service to the King. His attempt to reduce the injustice of enclosures and engrossing via the Enclosure Commission of 1517-9 was clearly of little consequence to the King, and was more likely to be an area of policy where the King gave Wolsey freedom to implement his own policy. The fact that Wolsey carried out policies for which there is little evidence of any involvement on Henrys part suggests that Wolsey may have been more than just a servant to Henry. Wolseys immense activity in financial policy corresponds with Henrys desire for money to carry out foreign expeditions against the French. The Act of Resumption of 1515, the Subsidies of 1513-5 and 1523, the Forced Loan of 1523 all reduced his popularity, but managed to quench Henrys desire for money. However, Wolsey was seen to go one step too far to please his master in 1525, in asking for the Amicable Grant, while the forced loan of 1523 was still being collected. The country reached a state of near-rebellion, and more serious disturbances occurred in London, East Anglia and Kent. It was at this stage when the relationship between Henry and Wolsey faced its first major attack, and Henry blamed the whole fiasco on Wolsey to save himself. Wolsey himself had largely been opposed to his attempts to raise extra revenue for the King, yet he had been acting as the Kings servant, doing his bidding. To Henry, Wolsey was to act as a scapegoat in situations where things went wrong. The other area of domestic policy in which conflict arose between Henry and Wolsey was in the Eltham Ordinances of 1526. Wolsey had been struggling to eliminate those who may have influenced the King. In 1518, he had attempted to expel Henrys minions or young favourites, but his governmental reform as he called it, was reversed by Henry, indicating some tension, but more importantly indicating to Wolsey that he could not consider overpowering the King. It was in the Ordinances of 1526 that Wolsey again went too far. In another bout of governmental reform, he was able to reduce the number of Gentlemen of the Privy Chamber from 12 to 6, and he removed enemies such as William Compton, the groom of the stool. The resultant lack of advisors around Henry angered him, and he was well aware that Wolsey was the cause of his seclusion. Wolsey had emerged as a competent organiser during the 1512-3 French campaign, and also organised the peace with France in 1514, proving himself to Henry as effective in diplomacy as well. Clearly, Henry was a king who sought glory, and was full of dynastic ambition. He wanted England to be as influential in European affairs as it had been in the time of Henry V. His jealousy of his French rival, Francis I meant that he would be seeking alliances against his traditional opponent. Wolsey on the other hand was a man of humanist tendencies, sought glory in diplomacy through his desire to become the peacemaker of Europe. The Venetian Ambassador at the time stated that Nothing pleases him more than to be called the arbiter of the affairs of Christendom. In 1516, Henry wanted to renew his campaign against the French alongside the new leader of Spain, Charles V, but Wolsey managed to convince him to join a coalition against French action in Italy instead. Henry clearly trusted Wolsey sufficiently to trust his advice in this are, indicating that he held more importance than that of just a servant. One aspect of Henrys personal policy is also revealing at this stage as to his relationship with Wolsey. In 1518, Pope Leo X was expressing some concern as to the advance of the Ottoman Empire into Europe, and sent cardinals around Europe to organise a unification of Christendom against them. Henry used his desperation to his advantage, refusing entry to Cardinal Campeggio, the embassy, unless Wolsey was made legate a latere (papal legate), to which the Pope agreed. In this action, Henry can be seen to have depended somewhat on Wolsey, as he was essential to Henry in maintaining some degree of control over the church in England. Wolsey, seeing an opportunity to fulfil his personal aims, took diplomatic control of the Popes mission, and turned it into an international peace conference of more than 20 countries in London. The resultant Treaty Of London was signed in October 1518, and served as a great achievement for Wolsey. It not only brought together the great powers of Europe in a universal and perpetual peace, but also put England at the centre of European affairs. More importantly, Wolsey had not needed to compromise the wishes of his master to achieve his role of peacemaker, as the treaty also allowed Englands standing in Europe to improve, which was one of Henrys major priorities. Wolsey carried out more diplomacy to serve the King two days later, in an Anglo-French treaty in which a marriage between the Dauphin and Henrys daughter Princess Mary was proposed. Henry was getting his most important desires fulfilled, and foreign affairs seemed to be going exceptionally well for Henry and Wolsey, until the death of the Holy Roman Emperor Maximillian, which saw Charles V become the new emperor, and imminent conflict between the newly strengthened Charles and Francis I, would see the destruction of the glorious Treaty of London. In 1520, Wolseys service to his King in foreign policy continued, and faced with both sides of the conflict courting the support of England, he organised the splendorous meeting between Francis and Henry at the Field of the Cloth of Gold, which would have seemed like the beginning of a grand peace between the two countries. However, Wolsey had to sacrifice his role as peacemaker to appease Henrys desire to benefit from the inevitable war, and at the Treaty of Bruges in August 1521, Wolsey served the Kings cause further by providing the possibility that Charles may marry the 8 yr old Princess Mary who Henry desperately wanted to marry off. The war itself provided no real success for England, and only further marginalized England as a minor power in Europe. Against Wolseys desire, Henry wanted to fight on during 1523, and Wolsey was obliged to carry out his duty, in the way that any servant would, and England only met further wartime embarrassment. Despite Henrys hopes of campaigning in 1524, Wolsey managed to convince Henry otherwise, and in the following year, Wolsey took the bold step of instigating a peace with France, and the Treaty of the More was signed in August 1525, and now, a force to face the might of Charles had begun. Wolsey began to slip back into his comfortable role as peacemaker, orchestrating the League of Cognac between France and the Papal States (Wolsey made England abstain from joining, so that England remained peaceful). Another Wolsey-organised treaty was made in April 1527 between France and England in the Treaty of Westminster, which declared perpetual Anglo-French peace, promised Francis second son to Princess Mary and threatened Charles with war if he didnt join the peace. England was back at the forefront of English politics, thanks to Wolseys redemption from Henrys war failures. However, this grew inconsequential, and just as Wolsey done what Henry wanted in foreign affairs, Henrys desire for divo rce grew urgent. Wolsey could reasonably expect to stay in power as long as he kept carrying out the Kings wishes, and despite his unpopularity and court faction working against him, it is clear that his inability to get Henry his divorce led to his downfall. Henrys new love Anne Boleyn managed to convince Henry that Wolsey had no use any more he couldnt get a divorce and he hadnt secured the Kings succession. In general, his service was no longer required, and historian John Guy concludes that Wolsey was destroyed because he had become a liability in the eyes of the king and was expendable. This has fundamental implications for reassessing his relationship with Henry. Guy is correct is saying that this sheds new light on the nature of the relationship between the two men, and suddenly, Henrys regard for Wolsey as a loving friend became trivial. This essay has been able to establish that the majority of Wolseys policy was executed in service to the King. Wolsey may have acted for his own interest in certain areas such as the church and social reform, but this was only because of Henrys lack on interest in the fields, and the trust that he placed in Wolseys service. I am therefore able to conclude that theoretically, Wolsey was the Kings Servant. However, I say theoretically, because although Wolsey was a servant to Henry in his actions, the image created by the word seems to extreme for Wolsey. I believe that the relationship between Henry and Wolsey was strong and full of friendship when Wolsey did what was required of him. In reality, everyone in the kingdom was a servant to the King, and many people wanted to serve him more to gain more influence. In light of this, although he was a servant, it appears to me that the word servant underestimates the immense of power that he had, despite the fact that the power was given to him by the King, and many other more complimentary words can be used to describe the importance of Wolsey to the King. Nevertheless Wolsey, as a minister, remained a servant to Henry throughout his time in power, and devoted the majority of his policy to the Kings service.

Organisational Culture and Values at Nokia

Organisational Culture and Values at Nokia Organisation culture Nokia is the leading mobile company all over the world which started their operation in the early 1980s. The values of Nokia are customer satisfaction, respect for individuals, achievement and continuous learning. Customer satisfaction means how satisfaction is the customer with the effort of organisation in the marketplace. Nokia has their dedicated sales and marketing personnels with logistic and sourcing functions. Keeping in mind that, what will best suit the customers and what are their needs, Nokia randomly responding to the customers and making things according to their customers choice. Respect for individuals means to give attention to each and every individual for their opinion. Nokia gives opportunities for personal growth. Nokia encourage new strategy to change the global market. They also emphasise on constant attention to the objectives. Continuous learning means Nokia always encourage improving the perfections. Nokia encourage developing mobile with affordable cost and also which can help increasing economic growth along with quality of life. Nokia support constant innovation on human technology to improve communication and finding the new ways of interchanging information. Nokia provides opportunity to grow personally, give confidence to come with new ideas and creation, motivates high quality people to serve the best customer service. Organisational and national culture National culture related to our values held in our deep such as good vs. evil, normal vs. abnormal, rational vs. irrational and safe v. dangerous. National culture learned very early stage of life and held deep insight every human being and changed very slowly over the period of time. On the other hand, organisational culture is brought from the practical experiences from the organisation and learned from the organisational job. To change organisational culture is difficult and it takes time. It is very difficult to coup up when two or three organisations merge or shift to each other then the employees of the organisation faces the difficulties to follow the culture. Sometimes it clashes to national culture. People in an organisation can adopt organisational culture over his national cultural values but when two or three organisation merge then it becomes difficult for the employees to adopt organisational culture over their deep values of national culture. Organisational culture sometimes become inappropriate to national culture and national culture sometimes get inappropriate to organisational culture. But organisational culture never trumps national culture. There are some basic differences between organisational culture and national culture. These are: leadership style, organisational policies and procedures, organisational and operational structure, recruitment and selection procedures and measuring the performance of the employees and reward systems, global team and leadership development. Corporate culture profile Corporate culture is one of the strategic and competitive advantages of Nokia. Connecting people is the catch phrase which means the physical facilities of the company. Nokia buildings hold the strong corporate image. Nokia has four main values and principles at his heart of its corporate philosophy: customer satisfaction, respect for individuals, achievement and continuous learning. Establishing Goals It was the challenge for Nokia to develop a unique, award-wining workplace which reflects the corporate culture, values and vision of the company. Nokia house Boston property has the major RD facilities and it was important to open the new floor plan and give the credit to the engineer and creative group for their creative design. However the design of the Scandinavian headquarters was not totally mimic but include New Englands culture as well. A Corporate Culture Retrofit Nokia not only holds the Scandinavian culture itself rather than transport it to the England for both the employees and visitors. There are high-tech and traditional furniture showcase along with brilliant lighting design particularly in the lobby area, cafeteria and meeting rooms helps creating a warm and professional atmosphere. Another important design characteristics is its new office space system and flexible desks. Connecting People After coming to new Nokia house in spring 2000, the company provides full friendly sense of place and purpose for the customers. The set up and cultural elements of the building gives the employees confidence and comfortable settings. Nokia provides more productive and interactive workforce after implementing the goals and culture to its actual design. After managing all the facilities the employees are more connected to the customers indirectly. As more companies want to redesign their head office to highlight their corporate culture such as the lobby, the real estate professionals must need to ensure that the changes will made in a healthy and profitable business relationship matter. The impact of corporate culture According to the researcher a healthy organisational culture may have various kinds of benefits which include: competitive advantage deduce from customer service and innovation, constant and efficient performance of the employees, great team facilities, high valued employee, and strong company association, employees with high motivation and loyalty, control and coordination within the company and also promoting consistency, rearranging the behaviour of the employees to the benefit of the company.

Movement Education Essay example -- Health

â€Å"Movement is as natural and essential to young children’s lives as loving care, rest and nutrition. Movement provides children with an outlet for expression, creativity, and discovery. Through movement, children learn about themselves, their environment, and others. Movement is a stimulus for physical growth and development. The joy of movement is a child’s expression of an emotional need fulfilled.† (Curtis) The movement education teaching model, its historical development, its concepts and core activities will be discussed in this essay. Furthermore, the general objectives of movement education, the detailed objectives within physical education programs and the applicable teaching methods will be outlined and explained. The history of movement education goes as far back as the 1800s. Many people articulated ideas and theories about movement. Three of the most influential people are Francois Delsarte, Liselott Diem, and Rudolph von Laban. Laban is considered by most the true pioneer of movement education. (Karen Weiller Abels) In the early 1900s Laban identified the four cornerstones of movement: weight, space, time, and flow. In the late 70s and early 80s, Stanley, Logsdon and his colleagues distinguished the four major movement concepts, based on Labans discoveries. Stanley, Logsdon and his colleagues classified body, space, effort, and relationship. Parallel to the discovery of the movement concepts, new trends and new teaching models emerged in physical education programs. Movement education faded from the physical education programs because other teaching models became popular and because movement education is an extremely complex teaching model. Today, movement education has returned a nd has planted it... ...sical Education, Recreation and Dance. Movement Education for preschool children. Reston: AAHPERD, 1980. Print. Curtis, Sandra R. The joy of movement in early childhood. New York: Teachers College Press, 1982. Print. George Graham, Shirley Ann Holt/Hale, Melissa Parker. Children Moving, A Reflective Approach to Teaching Physical Education. Vol. 8th Edition. New York: McGraw-Hill Companies, Inc., 2012. Text. 28 March 2012. Jennifer Wall, Nancy Murray. Children & Movement, Physical Education in the Elementary School. Dubuque: WCB Brown & Benchmark, 1990. Print. Karen Weiller Abels, Jennifer M. Bridges. Teaching Movement Education, Foundation for Active Lifestyles. Human Kinetics, 2010. Print. 16 March 2012. Robert P. Pangrazi, Victor P. Dauer. Movement in Early Childhood and Primary Education. Minneapolis: Burgess Publishing Company, 1981. Print. 16 March 2012.

Accreditation Audit Task Essay

The Joint Commission defines the Periodic Performance Review as an assessment tool created to assist health organizations improve and monitor their performance throughout the year. This tool focuses on the processes that influence patient care and safety while providing the structure for unremitting standards fulfillment. Nightingale Community Hospital is compliant with most standards as set forth by the Joint Commission. However, upon inspection and in an effort to stay focused on compliance, our standards committee has located a few discrepancies that must be resolved to maintain our accreditation with the Joint Commission. Rather than focus on the discrepancies found within each unit, we will look at the trends that affect the hospital’s compliance with the Joint Commissions recommendations regarding patient care. Armed with the trends, we will then explore staffing patterns and how they relate to patient care in order to establish a plan that will assist our hospital to minimize patient safety issues as they relate to falls, pressure ulcers, pneumonia, and the general safety of our patients. See more:  Manifest Destiny essay NON-COMPLIANT TRENDS Although the Joint Commission standards clearly define the requirements for an organization to remain in compliance with the patient care and safety criterion for accreditation, Nightingale Community Hospital’s policies are not being routinely followed throughout each unit. The policy that states verbal orders must be authenticated within 48 hours is not being followed in several units and there seems to be little, if any consistency throughout the hospital with regards to policy observations. Generally, the compliance rate in the second quarter was steady and the best of all quarters, while the third quarter compliance results were very poor. Policy must be reviewed and standards improved in order to bring the hospital into compliance. Policy that should be implemented include a form in which the nurse who takes the order must sign and date the form and place it on outside of the patients chart to alert the physician that actions are  required of him regarding this patient. Only two abbreviations were monitored in ICU, Telemetry, 3E, and 4E because they are the most frequently used forbidden abbreviations. These forbidden abbreviations are â€Å"cc† and â€Å"qd†. The audit revealed â€Å"cc† was most often used in the months of April and September. The abbreviation â€Å"qd† was used much more sparingly but was used most often during the months of June and July. The second and third quarters proved to be the quarters when the two prohibited abbreviations were used the most. To increase awareness of prohibited abbreviations, a list will be posted in the nursing station in close proximity to where the charting takes place. Nurses and nursing staff will receive education regarding the use of approved abbreviations as set forth by the Joint Commission. Additionally, everyone who documents in the patients chart will be required to sign and date the entry at the time of documentation. The pain assessment audit was another standard that was out of compliance with the Joint Commission recommendations. The ED, 3E, and PACU were the units focused on for this portion of the audit. Clearly, the Emergency Department was the least compliant throughout the year for pain assessment. This may be due to the urgency or life threatening events in which pain assessment is not a priority. Regardless of the reason for neglecting to assess for pain, it is a requirement for accreditation. Each assessment should be documented in the patient’s record of care and all personnel responsible for patient care must receive education regarding the necessity of the pain assessment. The Nurse Managers of each department has the responsibility of implementing a corrective action plan based on the particular department standard of care. The Joint Commission’s focus is on safety. At Nightingale Community Hospital, safety is also important and the policies and procedures are reviewed to ensure the hospital is compliant with the Joint Commission’s recommendations. The hospital policy for fire drills requires one drill per shift per quarter. The audit shows that there are some compliancy concerns regarding the fire drills. During third shift, for the first and third  quarters, no fire drill occurred. Also, there was no fire drill on the second shift during the fourth quarter. Obviously, there should be further study to determine the cause for the compliancy issue vs. staffing deficiencies during third shift. Additionally, each department will have a safety monitor assigned to ensure the fire drills occur as per hospital policy. The safety monitor will complete a form documenting the staff involved in the fire drill, date, and time the drill took place and will keep a copy in the safety manual to be inspe cted monthly. Other safety concerns that were identified during the PPR rounds include clutter in the hallways, smoke wall penetrations, master alarm panel for medical gasses was not tested, and the gift shop did not have the required 18† clearance from the sprinklers. The maintenance department manager will need to implement a corrective action plan and be held accountable for the discrepancies identified. Additionally, the Moderate Sedation Monthly Audit of the Endoscopy Department shows some compliancy issues regarding pre-procedure events. Mallampati classification, ASA, Sedation plan documentation, and completion of reassessment are consistently below 90% for all four quarters. However, the actions that must occur during the procedure and post procedure rated at 90% or higher with regards to the Joint Commission recommendations for compliancy. Per the Joint Commission, compliancy should idealistically be 100%, therefore, the majority of the pre-procedure events are out of compliance and a corrective action plan to improve consistency must be implemented. Patient falls continue to be a concern throughout the healthcare industry because many times the fall results in injury. Other concerns of patient safety that are addressed by the Joint Commission are related to pressure ulcers and ventilator associated pneumonia. The Intensive Care Unit had an increase in falls but no correlation was found between the numbers of falls to nursing care hours. However, ventilator associated pneumonia increased this year. Corrective actions were put into place to improve the VAP numbers. On the Oncology Unit, 3E, both falls and pressure ulcer rates  decreased. There were no trends identified with falls and ulcers in relation to nursing care hours or overtime. On 4E, patient falls and pressure ulcers increased when nursing care hours increased. To determine the causes of non-compliance, the committee should look into the events that occurred during the fourth quarter. While there are trends during the second and third quarter, the fourth quarter appears to have been when the majority of falls, pressure ulcers, and VAP’s occurred. Otherwise, hospital-wide, the trend seems to show a decrease in compliancy during the third quarter. STAFFING PATTERNS The Joint Commission depicts staffing effectiveness as ensuring a proper mix of expertise and numbers of proficient staff necessary to effectively provide for the needs of the patient population in a hospital setting. Although costs incurred due to staffing levels consume a considerable portion of the hospitals revenue, studies have shown that sufficient staffing has a direct effect on quality and safety. (Joint Commission, 2010) Dall, Chen, Seifert, Maddox, and Hogan discovered financial benefits for increasing nursing staff levels. They determined that nosocomial infections and hospital length of stays were decreased when there was adequate nursing staff available. They also determined that mortality rates decreased as a result of increased nursing staff. (Dall, 2009) Nursing hours indicate the quantity and complexity of patients for each area in the hospital. In order to determine how many nurses and other nursing staff will be necessary to care for the patients, one must determine the nursing hours per patient day. This is calculated by comparing the amount of nursing staff providing care to the total number of patients requiring care. Nightingale Community Hospital has combined staffing effectiveness with performance improvement in order to demonstrate sustained improvements throughout selected clinical units. The units selected are based on the clinical and human resource indicators such as patient population,  historical staffing issues, and input from staff and existing data. Traditionally, the clinical indicators have been falls, falls with injury, pressure ulcer prevalence, and ventilator associated pneumonia (VAP). Additionally, the human resource indicators include overtime and nursing care hours. Although the Joint Commission has not directed specific staffing levels or ratios, hospitals and other organizations are expected to ascertain their own levels with regard to their experience and history. Based on the data from 3E – Oncology, no trends were identified with regard to falls, falls with injury, pressure ulcer prevalence, nursing hours, or overtime indicators. In fact, 3E experienced a decrease in falls and pressure ulcers. This may be the result of the nursing staff focusing on these indicators due to their patient population. Also, increasing awareness, improving education, and providing a skin care representative has improved patient safety. The Intensive Care Unit (ICU) experienced an increase in falls without regard to nursing care hours. However, the unit did show an increase in ventilator associated pneumonia events. This occurred during the month of September when nursing care hours decreased. Prior months showed an increase in overtime hours for nursing staff which caused fatigue and burnout to become noticeable later. Due to increases in both falls and VAP’s, corrective actions were implemented to reduce these statistics for the coming year. The Unit, 4E, data proved just the opposite as this unit encountered increases in both falls and pressure ulcer prevalence. According to the date obtained regarding falls, it is apparent that nursing care hours showed a relational trend with falls. In other words, when the nursing care hours decreased, falls increased. In comparison, when nursing care hours increased, the falls rate decreased. Drastic increases in falls occurred during June, September, November, December and February. Nursing hours during this time averaged 15 hours per shift. It appears the overtime hours occurred as a result of the holiday season and therefore caused nursing burnout. Due to vacations, holidays, and absenteeism, nurses are often required to work overtime. This pattern is obvious again during the summer  months when accommodations for vacations are necessary. However, the opposite is true with regards to pressure ulcers vs. nursing care hours. When the nursing care hours increased, the occurrences of pressure ulcers increased as well. This is possibly caused due to increased overtime hours resulting in the fatigue and burnout. This is a perfect environment for errors or the potential to cause harm. A more extensive study in the nursing care hours must be implemented in order to establish an aggressive corrective action plan to reduce the occurrences of pressure ulcers and falls. If the study shows the nursing staff to be working overtime, additional staff may be necessary as part of the corrective action plan. Hiring additional nurses will improve patient care, result in decreased turnover rates, and lead to increased job satisfaction which will ultimately lead to positive outcomes in patient care. STAFFING PLAN Hiring and retaining an adequate number of competent nurses is the greatest challenge facing hospitals and other healthcare organizations. Nursing has to work with the human resources department to improve hiring procedures. Human resources should implement plans to recruit competent nurses with the skills and education necessary to provide the care Nightingale is known for. Human resources will perform an analysis to determine the best qualities for nursing candidates and will recruit according to that standard. Additionally, alternative plans for additional staffing during known periods of absenteeism such as vacations and holidays will be constructed. It is imperative that nursing coverage does not become impaired due to absenteeism. In order to attract and retain the best nurses, Nightingale needs to improve the benefit package. Nurses have often stated that caring for their patients is a joy, but administrative duties, non-nursing activities, and poor staffing practices results in low job satisfaction. Increased job satisfaction in turn, results in improved patient care and increased positive outcomes. Studies have shown that unhappy nurses have unhappy patients. Other strategies that Nightingale Community Hospital can implement are to encourage nurses to cross train in multiple units in order to fill positions in other units when staffing shortages occur. Inadequate staffing levels can cause considerable harm to the patients but is also a financial burden to the organization. Adverse events are more common when staffing levels are low which are associated with increased costs due to the need for more intensive nursing care. (Stanton, 2004) The Utilization Guide for the ANA Principles for Nurse Staffing suggests the use of patient classification systems. (Utilization guide for the ANA principles for nurse staffing, 2005) Utilizing a patient classification system provides guidelines for difficult staffing issues by identifying processes and procedures for improved staffing. Organizations benefit by supporting nursing judgment regarding individual patient needs, incorporating sources that reinforce standards of nursing practice, encouraging nursing participation evaluating products that may be used in staffing decision making, and champion the use of patient classification systems. Works Cited Dall, T. C. (2009). The Economic Value of Professional Nursing. Medical Care, 97-104. Joint Commission. (2010). Management of Human Resources. CAMH: Comprehensive Accreditation Manual for Hospitals, Hr-1 – HR-10. Stanton, M. R. (2004, March). Hospital Nurse Staffing and Quality of Care. Research in Action. Rockville, MD, USA: Agency for Healthcare Research and Quality. (2005). Utilization guide for the ANA principles for nurse staffing. Washington, DC: American Nurses Association.

Mazda Case Essay

1. Analyze the role of integrated marketing communications in the marketing of automobiles such as the Mazda Protegà © and MAZDA6. How is each IMC element used to market automobiles? IMC played a very important role in the marketing of automobiles. Using the new IMC program, Mazda had a new segmentation and selected a new target market. The advertising of Protegà © and MAZDA6 made a big difference, the Protegà © advertisement focused on the target audiences’ inner mind and presented the life-related scene to strike a sympathetic chord. But MAZDA6 advertisement focused more on the performance of the car and made a â€Å"mature† image, spent more budgets in advertisement on the magazines, even cooperated with ESPN to appeal to sport fans (the target audience). The Mazda used some direct marketing like sending mails and CD-ROM to the client. Also set the website for the model to attract more people, especially the Protegà ©. Mazda gave a major push to the Protà ©gà © on the Internet including several fun activities and games, this Internet marketing made a huge success. The slogan and advertisements gave the audience a impression of the sporty, fun-to-drive Mazda. The IMC program of Mazda gave the company a second birth. 2. Evaluate Mazda’s decision to drop the â€Å"Get In. Be moved† tagline for the Protà ©gà © and adopt the â€Å"Zoom-Zoom† theme for is advertising. â€Å"Get In. Be Moved† was a powerful slogan for Mazda developed by Doner, it created a brand promise to consumers that when you get in a Mazda car, the car can get you moved. It was a success since it can stand for all the models of Mazda. But the question is this tagline could not demonstrate the spirit and the distinguishing feature of Mazda. Instead, the â€Å"Zoom-Zoom† phrase created an environment of senses for the audience. The â€Å"Zoom-Zoom† sound stand for the sound of the engine and wake the inner child of the target audience. This new phrase not only perfectly describe the sporty theme of Mazda, but also more appeal†¦