Nursing Accountability in Relationship Essay Example for Free

Nursing Accountability in Relationship Essay In this paper, I will review and implement recommendations based on the findings of the Agency for Health Care Research and Quality (AHRQ) regarding the training of hospital staff to respond to a mass casualty incident (MCI). I will give examples and situations that can affect the effectiveness of proper training and responses to a traumatic event in our city, county, state, or country. For years, hospitals have contemplated the possibility of a mass casualty incident (MCI). Federal agencies planning and responding to these events have determined that it would be overwhelming and catastrophic to any community. The resources would not be sufficient to absorb the needs and requirements for help. These events can be naturally occurring or manmade, for example, hurricane season and tornado season in Texas can be predicted with accuracy. In the West coast, we have constant planning and preparation for the next big earthquake even though we do not know with accuracy when it would be. During hurricane Katrina, we had an excellent opportunity to witness how prepared a city is, and how hospitals can easily be overwhelmed by a massive influx of patients. Examples can be given worldwide, but for the purpose of simplicity we will not elaborate further. Never before have we experienced more threats than in the past few years starting from the Oklahoma City bombing and the 911 attacks as the most horrific examples to site. More and more we have seen our fears become our realities and our vulnerabilities, and this is what has made us rethink our strategies and training for proper response to chemical, radiological, or biological threats. Findings The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requires that hospitals implement and test proper hospital response training twice a year. My hospital, BAMC, a military hospital, has complied with the training and has made significant contributions to the evolution and preparedness in response to a potential or actual event. The military has always been an integral part in training and preparation in regards to logistics and coordination of available resources, but even the best trained or better equipped hospitals cannot compensate for the impact it has on its employees, particularly nurses. Nurses take part and are an important aspect of training and preparation, and they are essential in the response to a crisis or trauma. Working in the emergency department, I often question myself as to how is it that we can train and prepare every year for a mass casualty incident (MCI) when I can see how easily we get overrun and in total disarray. Our hospital is currently capable of taking up to four major traumas all at the same time, but the reality is that even under the best staffed days we get overwhelmed, resourcing quickly to diversion of Emergency Medical Service (EMS) to other hospitals when we have reached maximum capacity. If training then is to prepare us and allow us to be well equipped with the necessary knowledge to perform, why is it that we struggle under small real life case scenarios? The response has to be once again in the level of preparation that each individual nurse takes to be ready to be able to function under very stressful environment. The nurse can be well prepared for future events by performing after action reviews (AAR), which is primordial in determining the stressors and the potential solutions to the problems encountered after each event. Disaster drills are beneficial in the effectiveness of command and control, communication, triage, patient flow, security response, and the roles each practitioner must perform. Recommendations Hospital drills and disaster planning are key and instrumental to make the nurse familiar with his/ her role, as well as the role of all the providers of care and first responders. Proper coordination and adequate allocation of resources are essential. The nurse can be instrumental in his/her flexibility and ability to adapt to different roles under extremely chaotic circumstances. Also, nurses are important for the delegation of tasks and coordination of duties to be taken to stabilize the emergency department for the proper movement of patients arriving and departing. The nurse plays an integral role in the transporting of patient, triage, and treatment of the injured. Properly identifying those who are very critical (expectant, life threatening), and those who are stable and can still function (broken bones, laceration, psychological issues) allows the provider to render the proper and efficient care. The nurse needs to have clear communication with the rest of the staff at every level of the disaster event in order to function and coordinate efficiently. Good documentation needs to be implemented. Nurses need to remain creative in finding ways to document what has been done to a patient with regards of his or her care. In a war zone, we can document key components of patient treatment on the uniforms of soldiers, and the same can be done with civilian population in the absence of computers or charting for short periods of time. Another important aspect is the transport of first aid equipment and supplies as soon as the disaster is identified, including body bags, stretchers, wheelchairs, crutches, splints, IV solutions, blood products, antibiotics, and plenty of analgesics and narcotics. Keeping an adequate number of chaplains, counselors, and security is imperative for the emergency department to maintain order under the chaos and stress. Summary In conclusion, the registered nurse needs to be ever vigilant of the realities of our current situations of the world. Today, more than ever with ongoing climate changes and unpredictable massive storms, tornados, earthquakes, and the impending threats created by man, we are always at risk for an (MCI). Keeping a good understanding of the preparation and the steps to take, and knowing his or her role the nurse can be reassured that he/she will be ready for the unpredictable and often unthinkable. References Training of Hospital Staff to Respond to a Mass Casualty Incident Evidence Reports/Technology Assessments, No. 95 Rockville (MD): Agency for Healthcare Research and Quality (US); July 2004 http://angel03. gcu. edu/section/default. asp? id=705202 Mass Casualty Incident (MCI) St. John West Shore Hospital, MCI Overview http://www. emsconedonline. com/pdfs/EMT-Mass%20Casualty%20Incident-an%20overview-Trauma. pdf

How pH Affects the Break Down of Starch by the Enzyme Amylase Essay

How pH Affects the Break Down of Starch by the Enzyme Amylase Hypothesis: The optimum pH for the reaction of starch with amylase is pH 7. PH values lower or higher than this value will result in a slower rate of reaction. Amylase works in the range pH 3 to pH 11. Biological Knowledge ==================== PH changes affect the structure of an enzyme molecule and therefore affect its ability to bind with its substrate molecules. Changes in pH affect the ionic bonds and hydrogen bonds that hold the enzyme together, which naturally affects the rate of reaction of the enzyme with the substrate. On top if this, the hydrogen ions neutralise the negative charges of the R groups in the active site so that the substrate and the active site do not attract and therefore do not react. The optimum pH for most enzymes is pH7. In the body, amylase works mainly in the small intestines, where the acidity from the stomach has been neutralised by the hydrogencarbonate ions in the pancreatic juices secreted by the pancreas. Therefore, it follows that if amylase were adapted well to the surroundings which it is found most commonly at, it would work best in neutral conditions, which is pH 7. To allow for fluctuations in pH, amylase would need to work from around pH 3 to pH 11. Apparatus Apparatus Reason/Reference to pilot study Colorimeter Values can be obtained measuring the breakdown of starch, instead of just the colour when the iodine solution is added. If not much starch is broken down, iodine will colour it blue/black so a low % Transmission will be obtained. If a large volume of starch broken down, iodi... ...ially used 3 cm ³ of distilled water with 3 drops of iodine. It then occurred to me that this was inaccurate, as amylase solution is cloudy. Therefore, I blanked it with 2 cm ³ water, 1 cm ³ amylase and 3 drops of iodine. I decided to experiment with pHs within the range pH 2 to pH7, as I discovered that pH 4 is the optimum pH, instead of my predicted pH7. Risk Assessment  · Wear goggles to protect eyes from iodine solution  · If spilt on clothes or skin, wash with water to prevent harm to the body  · Keep iodine bottle away from edge of table to prevent injury from broken glassware Ethical Implications The amylase solution is taken from an animal. The owner of the animal must permit this act. The animal's body must be paid respect when the enzymes are removed so must therefore be treated carefully.

Ptlls Written Rationale

Preparing to Teach in the Lifelong Learning Sector (PTLLS) Written Rationale My micro-teach is about Accessibility Options, an IT related topic. I choose this subject because I am interested in IT. We are all aware that IT covers a wide range of topics. I have deliberately concentrated on the topic, Accessibility Options in the Control Panel in Windows XP, simply because I want to make my learners aware of the feature available for disabled users and how those types of users could apply it to their daily lives.I also intend to explain the methods in which a normal user can support disabled users. The Accessibility Options will cover 4 categories, which are Sticky Keys, Filter Keys, Toggle Keys and Magnifier. I have re-looked at my previous comments related to the one to one micro-teach, such as practicing before hand and being better prepared, which I currently doing so. I have designed individual handout booklets for the learners to use during the session and refer to after the less on.I want the learners to demonstrate what they have learned. The ideal way would be to get the learners to practice on their own individual computers, to do this I will need a few extra computers which unfortunately do not have. I shall therefore ask my learners to answer a few questions related to the session instead. My teaching delivery is based on lecturing whilst demonstrating my topic by using the computer and smart board to help my learners understand.

The Customers Revenge - 1138 Words

‘The Customer’s Revenge’ We have all been somewhere in a store or dealership when there was an irate and unhappy customer looming in our presence. They were obviously upset about something and generally draw a lot of negative attention to themselves and to the company. Luckily for companies, just a few short years ago only a few customers out of hundreds, thousands, or millions would have seen the negative effects of the incident, but in current times almost everyone has a camera phone that records videos and it only takes a matter of seconds for videos like that to go viral on some social-media network. Because of today’s technology, everyone has free access to various social-media channels such as YouTube, Twitter, or Facebook that†¦show more content†¦When a company treats its customers with respect the products and brands tend to sell themselves because customer satisfaction and trust in the brand rises. When customers shop where they can trust they will be taken care of they tend to be r epeat customers and give positive word-of-mouth. To accompany new policy changes, the company needs to have workshops or employee meetings on the changes for everyone involved in every aspect of customer service. These employees must know how to handle individual customer’s problems and learn that each case is different and that there can never be one generalized way to solve someone’s problem. Customer service representatives must learn to handle each case individually and treat the customer as fairly as possible. The three main focuses of a changed policy is to, first, make sure that the implemented policy was just and fair to both customers and the company, secondly, notify customers of the changes and provide them with a way to have any questions answered, and lastly, set a deadline to re-evaluate the policy and make changes as needed. 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